著者
服部 正嗣 本田 一郎 松下 英信 小林 大介 大河内 治 坪井 賢治
出版者
日本臨床外科学会
雑誌
日本臨床外科学会雑誌 (ISSN:13452843)
巻号頁・発行日
vol.69, no.9, pp.2229-2234, 2008 (Released:2009-03-05)
参考文献数
16
被引用文献数
4 7 6

症例は22歳,女性.平成18年8月過食による急性胃拡張の診断で入院し保存的治療にて軽快・退院した.10月再び過食後に腹痛・嘔気が出現して当院を受診し急性胃拡張の診断にて入院となった.経鼻胃管挿入にて減圧をはかるも腹痛軽快せず.同日深夜,ショック状態となり挿管呼吸管理,カテコラミン大量投与による循環管理を開始した.CTで腹水とfree air,腹腔穿刺で混濁腹水を認め,緊急手術を施行した.胃は広範に壊死・破裂しており,腹腔内に多量の壊死物質と食物残渣を認めた.脾臓にも壊死を認め,胃全摘術・脾摘出術・腹腔洗浄ドレナージ術を行った.術中もショック状態が続き,術後,DIC・多臓器不全の状態となった.持続血液濾過・血液製剤大量投与などの加療にもかかわらず,術後26時間で死亡した.複雑な家庭環境でのストレスが誘因とされる過食による急性胃拡張が原因で胃壊死・破裂をきたした症例を経験したので報告する.
著者
服部 正嗣 本田 一郎 松下 英信 小林 大介 大河内 治 坪井 賢治
出版者
日本臨床外科学会
雑誌
日本臨床外科学会雑誌 (ISSN:13452843)
巻号頁・発行日
vol.69, no.9, pp.2229-2234, 2008
被引用文献数
7

症例は22歳,女性.平成18年8月過食による急性胃拡張の診断で入院し保存的治療にて軽快・退院した.10月再び過食後に腹痛・嘔気が出現して当院を受診し急性胃拡張の診断にて入院となった.経鼻胃管挿入にて減圧をはかるも腹痛軽快せず.同日深夜,ショック状態となり挿管呼吸管理,カテコラミン大量投与による循環管理を開始した.CTで腹水とfree air,腹腔穿刺で混濁腹水を認め,緊急手術を施行した.胃は広範に壊死・破裂しており,腹腔内に多量の壊死物質と食物残渣を認めた.脾臓にも壊死を認め,胃全摘術・脾摘出術・腹腔洗浄ドレナージ術を行った.術中もショック状態が続き,術後,DIC・多臓器不全の状態となった.持続血液濾過・血液製剤大量投与などの加療にもかかわらず,術後26時間で死亡した.複雑な家庭環境でのストレスが誘因とされる過食による急性胃拡張が原因で胃壊死・破裂をきたした症例を経験したので報告する.
著者
大嶋 繁 山田 真理絵 根岸 彰生 大島 新司 齋木 実 小林 大介
出版者
一般社団法人 日本プライマリ・ケア連合学会
雑誌
日本プライマリ・ケア連合学会誌 (ISSN:21852928)
巻号頁・発行日
vol.39, no.3, pp.175-178, 2016 (Released:2016-09-21)
参考文献数
4

薬剤師の在宅業務の充実を目的として, 在宅患者の症例を基に作成したシナリオおよび高機能患者シミュレータを用いた『フィジカルアセスメントアドバンス講習会』を行った. その際シナリオを用いた演習を行い, 薬剤師が在宅で実施すべき項目 (在宅業務必須項目) の実施率 (実施者数/受講者数) を, 訪問薬剤管理指導料の算定要件等を基に作成したチェックシートを用いて調査したところ, 項目ごとの差が大きかった. 本調査結果から薬剤師が在宅業務を実施する上で, 患者の生活を支えることを意識した薬学的管理業務のトレーニングの必要性が示唆された.
著者
大嶋 繁 原 彩伽 阿部 卓巳 秋元 勇人 大原 厚祐 根岸 彰生 冲田 光良 大島 新司 井上 直子 沼尻 幸彦 小川 越史 齋木 実 小林 大介
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.137, no.5, pp.623-633, 2017 (Released:2017-05-01)
参考文献数
20
被引用文献数
5

Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the “Guidelines for Medical Treatment and Its Safety in the Elderly” (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76.9%). This detection rate is higher than previous PIM detection rates of 48.4% and 40.4% reported in prescriptions for home-care patients in Japan under the Beers and STOPP/START criteria. The Guidelines appeared useful as a decision support tool for deprescribing. The patients continuing the changed prescriptions showed no decrease in ADL or QOL after deprescribing, suggesting its rationality. The 10 measurement items of the Barthel Index were all suitable for evaluating the physical conditions of the patients. Meanwhile, SF-36v2 includes many items, but few indexes were directly applicable.
著者
大嶋 繁 小田 藍 根本 英一 土橋 朗 小林 大介 齋藤 侑也 白幡 晶
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.11, no.2, pp.66-75, 2009-11-30 (Released:2010-05-12)
参考文献数
9
被引用文献数
1

Objective : There are two types of studies on the relationship between adverse events and genetic background and the relationship between constitution and genetic background.  To investigate the relationship between adverse events and constitution retrospectively, we first reviewed the appearance of the constitution responsible for the adverse events in the relevant sources of information.Methods : Fifty two pharmaceutical interview sheets, 150 case reports and two manuals; “jyudaina fukusayou kaihi notameno fukuyaku sidou jyouhousyu”, “jyutoku fukusayou sikanbetu manual” were selected for review.Results : Fourteen items about the constitution were found in the pharmaceutical interview sheets.  No items about the constitution were found in the case reports and manuals.Conclusion : Rules for the preparation of pharmaceutical interview sheets and case reports to use the constitution information is necessary for retrospective analysis of this issue.
著者
小栁 香織 窪田 敏夫 小林 大介 木原 太郎 吉田 武夫 三井所 尊正 斎藤 友亮 打越 英恵 髙木 淳一 瀬尾 隆 島添 隆雄
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.133, no.11, pp.1215-1221, 2013 (Released:2013-11-01)
参考文献数
16
被引用文献数
6 17

Pharmacists, being compensated through the new dispensing fee, are required to educate patients on their adhesion to the use of prescribed drugs, and to inventory the levels of leftover drugs in outpatients. Recently, Fukuoka City Pharmaceutical Association started a campaign for regulating leftover drugs (Setsuyaku Bag Campaign). Thirty-one pharmacies joined the campaign. Pharmacists distributed convenience bags, called ‘SETSUYAKU-BAG.’ The patients put their leftover drugs in the bags and brought them to community pharmacies. The pharmacists inventoried the returned drugs and reported their results to the doctors. The doctors adjusted the prescriptions accordingly. We counted and analyzed old and new inventories. The number of leftover drugs was 252, for a total value was ¥839655. Cost of leftover drug prescriptions could be reduced by ¥702695, and the value of drugs thrown away was ¥94801. In total, we could reduce the amount of leftover drugs by 83.7%. The cost of leftover drug for one dose package (ODP) is higher than that for non-ODP. However, there were no significant differences in results per age, sex, number and kinds of drugs, prescription days and premium contribution rate. These results suggest that prescription regulation by inventory of leftover drugs in community pharmacies could significantly reduce overall medical expenses. Further studies are necessary in order to account for patients’ health, and to establish more efficient patient education to raise outpatients’ adherence to the new programs.
著者
小栁 香織 窪田 敏夫 小林 大介 木原 太郎 吉田 武雄 三井所 尊正 斎藤 友亮 打越 英恵 高木 淳一 瀬尾 隆 島添 隆雄
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.13-00181, (Released:2013-08-23)
参考文献数
16
被引用文献数
6 17

Pharmacists, being compensated through the new dispensing fee, are required to educate patients on their adhesion to the use of prescribed drugs, and to inventory the levels of leftover drugs in outpatients. Recently, Fukuoka City Pharmaceutical Association started a campaign for regulating leftover drugs (Setsuyaku Bag Campaign). Thirty-one pharmacies joined the campaign. Pharmacists distributed convenience bags, called ‘SETSUYAKU-BAG.’ The patients put their leftover drugs in the bags and brought them to community pharmacies. The pharmacists inventoried the returned drugs and reported their results to the doctors. The doctors adjusted the prescriptions accordingly. We counted and analyzed old and new inventories. The number of leftover drugs was 252, for a total value was &yen839,655. Cost of leftover drug prescriptions could be reduced by &yen702,695, and the value of drugs thrown away was &yen94,801. In total, we could reduce the amount of leftover drugs by 83.7%. The cost of leftover drug for one dose package (ODP) is higher than that for non-ODP. However, there were no significant differences in results per age, sex, number and kinds of drugs, prescription days and premium contribution rate. These results suggest that prescription regulation by inventory of leftover drugs in community pharmacies could significantly reduce overall medical expenses. Further studies are necessary in order to account for patients' health, and to establish more efficient patient education to raise outpatients' adherence to the new programs.
著者
大嶋 繁 小田 藍 根本 英一 土橋 朗 小林 大介 齋藤 侑也 白幡 晶
出版者
一般社団法人 日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.11, no.2, pp.66-75, 2009

<b>Objective </b>: There are two types of studies on the relationship between adverse events and genetic background and the relationship between constitution and genetic background.  To investigate the relationship between adverse events and constitution retrospectively, we first reviewed the appearance of the constitution responsible for the adverse events in the relevant sources of information.<br><b>Methods </b>: Fifty two pharmaceutical interview sheets, 150 case reports and two manuals; "jyudaina fukusayou kaihi notameno fukuyaku sidou jyouhousyu", "jyutoku fukusayou sikanbetu manual" were selected for review.<br><b>Results </b>: Fourteen items about the constitution were found in the pharmaceutical interview sheets.  No items about the constitution were found in the case reports and manuals.<br><b>Conclusion </b>: Rules for the preparation of pharmaceutical interview sheets and case reports to use the constitution information is necessary for retrospective analysis of this issue.

2 0 0 0 OA IV.AKIと薬剤

著者
小林 大介 成田 一衛
出版者
一般社団法人 日本内科学会
雑誌
日本内科学会雑誌 (ISSN:00215384)
巻号頁・発行日
vol.110, no.5, pp.922-927, 2021-05-10 (Released:2022-05-10)
参考文献数
10

薬剤性腎障害(drug-induced kidney injury:DKI)とは,「薬剤の投与により,新たに発症した腎障害,あるいは既存の腎障害のさらなる悪化を認める場合」と定義される.臨床現場では,治療目的で投与した薬剤がしばしば腎障害を引き起こす.薬剤により,障害のメカニズムや発症様式にある程度のパターンがあり,そのパターンを把握することは有益である.
著者
小林 大介
出版者
公益社団法人 日本心理学会
雑誌
心理学研究 (ISSN:00215236)
巻号頁・発行日
pp.91.18240, (Released:2020-01-20)
参考文献数
30

The purpose of this research was to develop a Japanese version of the Unwanted Pursuit Behavior Inventory-Revised for Victimization (UPBI-R-V-J), which is a measure of unwanted pursuit behavior, and examine the reliability and validity of the UPBI-R-V-J. Unwanted pursuit behavior is defined as unwanted actions by former relationship partners, including stalking. The questionnaire survey was given to 133 university students, junior college students, and vocational college students (24 males and 109 females). The results revealed that the UPBIR-V-J consisted of instances of mild damage and severe damage, and it had adequate reliability coefficients (α = .83 and .74, respectively). Furthermore, each subscale was positively correlated with attachment anxiety associated with the former partner and was also positively correlated with the violence from former intimate partners that occurred during the romantic relationship; thus, the criterion-related validity of the UPBI-R-V-J was confirmed. Therefore, the UPBI-R-V-J was deemed to be reliable and valid. Finally limitations of the research and future directions are discussed.
著者
堀井 徳光 井上 直子 大嶋 繁 冲田 光良 秋元 勇人 根岸 彰生 大島 新司 沼尻 幸彦 小林 大介
出版者
一般社団法人 日本老年薬学会
雑誌
日本老年薬学会雑誌 (ISSN:24334065)
巻号頁・発行日
vol.1, no.2, pp.28-33, 2018-09-30 (Released:2019-10-07)
参考文献数
19

In the Integrated Community Care System, pharmacists are expected to play a central role in addressing patients’ drug problems. Therefore, it is necessary to know the patients’ drug problems as well as the occupations of professionals in solving these problems, and to clarify the problems to be preferentially resolved. Thus, we surveyed care managers working in a district near the Josai University pharmacy about their drug problem recognition and the professionals who solved these problems. Many of the care managers identified “the patient has leftover drugs” and “the patient has declining cognitive abilities” as drug problems. Many of the care managers expected pharmacists to solve the problems of “the patient has leftover drugs” and “the patient does not understand the dosage regimen.” “The patient has leftover drugs,” “the patient needs allotting of drugs to ensure adherence,” “the patient does not understand the significance of the meditation,” and “the patient does not understand the dosage regimen” are drug problems in which pharmacists should preferentially intervene and play a role in the Integrated Community Care System.
著者
進 健司 小林 大介 川尻 雄大 牛島 悠一 梅田 勇一 金澤 康範 神村 英利 島添 隆雄
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.139, no.2, pp.317-325, 2019-02-01 (Released:2019-02-01)
参考文献数
24
被引用文献数
1

Psychiatric treatment is shifting from hospital to ambulatory care. It is important that pharmacists positively support outpatients. Pharmacist-led interviews with outpatients have been conducted in the psychiatric department of Iizuka Hospital before examination by the doctor since 2015. Few studies in this field have reported about the effect of the pharmacist-led interviews using subjective evaluation of outpatients prior to examination by doctors. The aim of this study was to reveal this effect by the evaluation of outpatients. We conducted a questionnaire survey. More than 80% of the patients responded that it was “Good” to have an interview with the pharmacist prior to examination by the doctor. Moreover, 71.7% of the patients were “Satisfied” with the pharmacist-led interview, while 81.7% of them responded to “Agree” about continuing the interview in the future. Patients who were satisfied and wished to continue the pharmacist-led interviews were more likely to report better rapport with the doctor as well, in comparison to the patients who answered negatively. Furthermore, the patients who answered “Satisfied” were significantly less likely to forget reporting to the doctor than those who answered negatively. The pharmacist-led interviews in the psychiatric department were appreciated by the patients. In conclusion, pharmacists can facilitate communication between patients and doctors through these interviews. These results indicate that the pharmacist-led interview before the doctor examination is a useful effort from the perspective of outpatients.
著者
小林 大介 宮田 裕光
出版者
公益社団法人 日本心理学会
雑誌
日本心理学会大会発表論文集 日本心理学会第85回大会 (ISSN:24337609)
巻号頁・発行日
pp.PM-022, 2021 (Released:2022-03-30)

アーユルヴェーダはインド発祥の補完代替医療であり,体質ごとに異なる心理的特徴を呈することが伝統的に示されている。体質(プラクリティ)や体調(ヴィクリティ)の判断には,ヴァータ・ピッタ・カパの3 要素が用いられ,それらはトリドーシャ理論と総称されている。本研究では,トリドーシャ理論と,性格特性(Big Five尺度),気分状態(POMS-2 成人用短縮版),およびマインドフルネス(5因子マインドフルネス質問紙)との関連を,オンライン質問調査により検討した。大学生23名が,上記の心理学上の質問紙に加え,プラクリティとヴィクリティを判定する問診票に回答した。その結果,プラクリティにおいては,ピッタのみ情緒不安定性およびネガティブな気分状態と有意な正の相関を示し,調和性と有意な負の相関を示した。ヴィクリティにおいては,ヴァータがより多くのネガティブな気分状態と有意な正の相関を示し,カパのみマインドフルネスと有意な負の相関を示した。これらの結果は,アーユルヴェーダの体質論が,現代の心理学上の質問紙とも一定程度の関連があることを示唆しており,トリドーシャ理論に関する心理学的研究の実現可能性が示唆された。
著者
星野 由維 筒山 将之 杉本 博行 小林 大介 横山 裕之 望月 能成 谷口 健次
出版者
一般社団法人 日本消化器外科学会
雑誌
日本消化器外科学会雑誌 (ISSN:03869768)
巻号頁・発行日
vol.55, no.11, pp.692-700, 2022-11-01 (Released:2022-11-30)
参考文献数
36

症例は85歳の男性で,腹痛・嘔吐を主訴に前医を受診し,小腸閉塞の診断で保存的加療を行ったが食事摂取で再燃を繰り返したため,精査・加療目的に当院に紹介受診となった.腹部ダイナミックCTにて,空腸に造影効果を伴う壁肥厚とその口側の腸管拡張を認め,空腸腫瘍とそれに伴う腸閉塞と診断した.寛解・増悪を繰り返す腸閉塞を認めており,手術適応と判断し腹腔鏡下小腸部分切除術と所属リンパ節郭清を施行した.術後病理検査にて小腸組織内に膵腺房組織を認め異所性膵が存在し,異所性膵組織の一部と連続性を持って異型細胞を認め異所性膵癌と診断した.根治切除可能であったが,術後2か月で多発肝転移・腹腔内リンパ節再発を認め,S-1内服を継続し現在も外来通院中である.今回,術前診断が困難な小腸異所性膵癌の1例を経験したので報告する.
著者
大河内 治 丹羽 由紀子 小林 大介 坪井 賢治 加藤 伸幸 本田 一郎
出版者
日本臨床外科学会
雑誌
日本臨床外科学会雑誌 (ISSN:13452843)
巻号頁・発行日
vol.68, no.3, pp.687-691, 2007-03-25 (Released:2008-08-08)
参考文献数
20

症例は24歳, 女性. 17歳時に両側卵巣成熟奇形腫にて腫瘍摘出術を施行された. 手術時に腫瘍に被膜破綻を認めた. 今回, 右背部痛を認め腹部CT検査で肝腫瘍を指摘され入院となった. 施行された腫瘍マーカーは全て正常値であった. 腹部造影CTおよび腹部MR画像上, 右横隔膜下および肝下面に脂肪成分および石灰化を伴う嚢胞状腫瘍を認めた. 血管造影検査では圧排所見のみであった. 卵巣奇形腫の腹膜播種性転移を疑い開腹術を施行した. 手術所見では腫瘍は肝に付着して圧排性に発育しており腫瘍摘出術を施行した. 病理組織学的に成熟奇形腫と診断された. 成熟奇形腫の播種巣が三胚葉成分全てから構成されることは稀であるうえ, その組織型が成熟型を呈するという極めて興味ある症例を経験した.
著者
井上 直子 安田 和誠 森 勇人 秋元 勇人 大原 厚祐 根岸 彰生 冲田 光良 大島 新司 沼尻 幸彦 大嶋 繁 從二 和彦 小林 大介
出版者
日本社会薬学会
雑誌
社会薬学 (ISSN:09110585)
巻号頁・発行日
vol.37, no.2, pp.81-90, 2018-12-10 (Released:2019-01-19)
参考文献数
11

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.
著者
保坂 茂 山本 碧 斉藤 竜也 大島 新司 大嶋 繁 大島 公恵 久津間 信明 本間 精一 小林 大介
出版者
Japanese Society of Drug Informatics
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.15, no.2, pp.64-70, 2013 (Released:2013-09-05)
参考文献数
14

Objective: In this study, we evaluated distinctive types of physical predisposition in patients with common side effects.Method: We selected 500 and 1,200 individuals with and without a previous diagnosis of side effects, respectively, through web-based research.  Then, we conducted a decision tree analysis for investigating the status of 100 types of physical predisposition in these individuals.Results and Conclusion: The individuals who had suffered from hepatic disorder and answered “relevant” for “predisposition to swelling” (likelihood ratio of a positive result [LR+] 2.17; p=0.004) and “very relevant” for “predisposition to skin dryness” (LR+ 3.52; p<0.001) enhanced the probability of extracting individuals who developed side effects.  The individuals who had suffered from skin disorder and answered “relevant” for “predisposition to eczema and inflammation” and “not relevant” for “predisposition to higher temperature” had an LR+ of 2.22 (p<0.001).  The individuals with “predisposition to worsening of physical condition on a rainy or high-humidity day” are more likely to develop side effects with the use of antibiotics and NSAIDs, compared to those without this predisposition (antibiotics: LR+ 2.33; NSAIDs: LR+ 2.51).  The results of this study indicate that we can identify patients with a high risk of side effects through an interview on predisposition.