著者
葦沢 龍人
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.136, no.7, pp.939-944, 2016 (Released:2016-07-01)
参考文献数
9

For appropriate primary care practice corresponding to the various symptoms of a patient, team medicine on that combines the expertise of physicians and other medical staff has been recommended in recent years. It results in (1) higher quality of medical care, (2) lower burden on the physician, (3) better medical safety, and (4) reduced medical expenses. In order to promote team medicine through inter-professional collaboration, the responsibilities of the medical staff need to be reviewed to expand their respective roles. The Ministry of Health, Labour and Welfare designated nine specific medical acts by pharmacists in 2010. Some acts require clinical reasoning (medical interview and physical assessment) in order to manage side effects in patients undergoing drug therapy. The new curriculum introduced in 2015 includes primary care education for pharmacists who see patients before they are seen by a physician. Because such patients are usually seen by the pharmacist on a walk-in basis, medical interview and inspection education is especially important in this situation. However, there is incongruity in the physical assessment education of prospective pharmacists among schools of pharmaceutical sciences in recent years, which tends to focus primarily on vital signs. Moreover, there is currently no consensus among physicians on the optimum range of procedures performed by a pharmacist before the patient is seen by a physician. In this presentation, the practice of primary care by pharmacists is discussed from the following perspectives: (1) target symptoms and patients, (2) clinical reasoning education at pharmaceutical schools, and (3) future issues.
著者
植田 健治 望月 眞 篠原 靖 杉本 勝俊 阿部 公紀 田畑 美帆 片上 利生 宮岡 正明 寿美 哲生 葦沢 龍人
出版者
一般社団法人 日本消化器内視鏡学会
雑誌
日本消化器内視鏡学会雑誌 (ISSN:03871207)
巻号頁・発行日
vol.47, no.8, pp.1526-1532, 2005

症例は54歳,女性.右下腹部痛と血便を主訴に当科を受診した.大腸内視鏡検査で回腸終末部に10mm大の粘膜下腫瘍様隆起が認められ,生検でカルチノイド腫瘍と診断された.腹腔鏡補助下回盲部切除術を施行したところ,深達度はsmで筋層浸潤はなく,腫瘍径は小さかったが,回結腸動脈根部のリンパ節に転移が認められた.本症例は大腸内視鏡検査時に回腸終末部への挿入を実施したために発見された病変であり,可能な限り回腸終末部への観察が重要と考えられる.