Masui. The Japanese journal of anesthesiology
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The annual surveys of critical incidents in Japanese Society of Anesthesiologists (JSA)-certified hospitals in 1999-2002 demonstrated that massive and critical bleeding was the major cause of intraoperative cardiac arrest leading to poor prognosis including death and permanent brain damage. The surveys also suggested that type-specific blood transfusion and emergent O-type blood transfusions were underutilized. ⋯ Five academic societies publicized the guidelines for management of critical bleeding in obstetrics in 2010. Each hospital is expected to make institutional emergency blood transfusion guidelines on the basis of the above guidelines in order to decrease the incidence of critical bleeding and to improve the prognosis of the patients with critical bleeding.
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To prevent peripheral nerve injury and neuropathic pain resulting from venipuncture, medical students and medical workers should be educated about the following points in clinical practice. First, the medial aspect of the antecubital fossa should not be punctured, to prevent injury to the median and medial anterobrachial cutaneous nerves. Second, the symptoms and signs of neuropathic pain resulting from venipuncture should be taught, to recognize the onset of neuropathic pain. Third, pharmacotherapy for the management of neuropathic pain should be taught to treat neuropathic pain resulting from venipuncture.
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Varicella-zoster virus (VZV) causes two clinically distinct diseases: varicella and herpes zoster. Herpes zoster, recurrent infection of VZV occurs when the cell-mediated immunity to VZV declines. Since the cell-medicated immunity to VZV declines with aging, herpes zoster occurs more frequently in the elderly. ⋯ They rather aggravate PHN with time. Recent research with a live attenuated varicella vaccine to prevent herpes zoster indicated that the vaccine decreased the occurrence of herpes zoster and postherpetic neuralgia by almost half as compared with placebo. Vaccination of high risk subjects with the varicella vaccine seems to be the most effective measure for the prevention of postherpetic neuralgia.