Gan to kagaku ryoho. Cancer & chemotherapy
-
Gan To Kagaku Ryoho · Dec 2004
Case Reports[Home palliative care--2 case reports: a long-term cancer pain management with transdermal fentanyl].
Transdermal Fentanyl was released in March 2002 in Japan after the acceptance of the insurance under the office of public health. Transdermal therapy is especially effective for patients having difficulty of oral intakes, and for home care cancer patients who suffer from chronic pain only if the therapy is feasible on the long-term basis. We report our cases for long-term cancer pain management with transdermal fentanyl. ⋯ Only a little rescue powder morphine was needed as an adjuvant during the duration of transdermal therapy. In these 2 cases of long-term cancer pain management, transdermal therapy has resulted in good pain reduction and the side effects with transdermal therapy were not noted. Transdermal fentanyl can be recommended for treatment of palliative cancer pain at home.
-
In home hospice care, we must try to control steady pain, to give guidance about medication, and to calm anxiety once out of the hospital. We think that it may be important to consult on the issues related to rescue-dose drugs, selection of the drug from the stand point of QOL, and to counsel on behalf of the patient and family.
-
Gan To Kagaku Ryoho · Dec 2004
[Current situation and problems inherent to discharge planning in practice].
Discharge planning is defined as "an interdisciplinary hospital-wide process that should be available to aid patients and their families in developing a feasible post-hospital plan of care". Although the recognition about the importance of discharge planning is increasing, many problems in its practice still remain. In this paper, we focused on the following major considerations as to the implementation of discharge planning: (1) identification of the targets for discharge planning (i.e. screening for high-risk patients), (2) specific methods of discharge planning (i.e. standardization and evaluation of discharge planning), and (3) construction of the system for discharge planning (i.e. identification of the discharge planner).
-
Gan To Kagaku Ryoho · Nov 2004
Randomized Controlled Trial Comparative Study Clinical Trial[Evaluation of ten intravenous catheters for operability and safety in the infusion room].
We have a randomized trial to compare the operability and safety of ten 24-gauge intravenous catheters in the infusion room. In the present study, we used 3 intravenous catheters without safety covers (Jelco plus, Surflo flash, Intima) and 7 intravenous catheters with safety covers (Supercath, Introcan safety, Surshield surflo II, Insyte autoguard, Safetouch cath, Protective plus, Acuvance plus). ⋯ There was no difference in the incidence of these two events in all groups (ANOVA; p > 0.05). On the other hand, all intravenous catheters with safety covers revealed that 1) an in situ needle has a resistance to the catheter (i.e., a resistance during catheter release), and/or 2) blood exposure can not be sufficiently avoided.
-
Gan To Kagaku Ryoho · Nov 2004
Review[In regard to gastric cancer treatment guidelines--a revised edition].
The Japanese Gastric Cancer Association issued a revised edition of gastric cancer treatment guidelines in April 2004. Distinctive features of this revision are adopting newly published literatures after the first edition of the guidelines, laparoscopy-assisted gastrectomy and perioperative management, and illustrating evidence levels in the clinical study of chemotherapy. The treatment protocol of the phase III study is an actual example of this. ⋯ Furthermore, a revised edition of chemotherapy was the only one that could be able to show a high evidence level. According to a questionnaire investigation of the revised guidelines, more than 90% of the respondents (the members of Japanese Gastric Cancer Association) have used the guidelines. Hence, the role of the guidelines is important.