The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Jul 2005
Case ReportsA new technique for superior hypogastric plexus block: the posteromedian transdiscal approach.
Superior hypogastric plexus block has been advocated for the treatment of cancer related pelvic pain. Neurolysis is usually established using the classical posterolateral approach in the prone position, in which correct placement of the needle is sometimes difficult due to vertebral anatomy and the patient's inability to lie prone. We describe an alternative posteromedian transdiscal approach under fluoroscopic guidance for the treatment of intractable pelvic pain in three patients, in whom the classical approach was not possible. ⋯ All patients had significant pain relief immediately after the block, lasting from 6 to 12 months, and their pain severity scores and opioid consumption were reduced by more than 50%. There were no complications such as discitis, disc rupture or nerve injury. Since this new posteromedian transdiscal approach provides easy access to the superior hypogastric plexus with a single puncture and with any patient position, it may be an alternative to the classical approach.
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Tohoku J. Exp. Med. · Jul 2005
Smoking prevalence and attitudes toward tobacco among student and staff nurses in Niigata, Japan.
The present study investigated smoking prevalence and attitudes toward smoking in student and staff nurses, and activities to promote tobacco intervention by staff nurses. A total of 743 student nurses in 2 colleges and one university and 490 staff nurses in the university hospital in Niigata, Japan participated in the study and filled in self-administered anonymous questionnaires focused on smoking habits, attitudes toward smoking, and activities to promote tobacco intervention. The smoking prevalence among student nurses was 6% and increased with the year of study, whereas that of among staff nurses was 16% and increased by employment up to 3-5 years. ⋯ Nicotine dependence, as defined by over 11 cigarettes per day and the first cigarette within 30 min after getting up, was high in smokers who started smoking before admission to college or university, but not in those who took up the habit thereafter. Thirty-six percent of student nurses and 25% of staff nurses agreed with the statement that "nurses should not smoke." Only 12% of staff nurses were involved in anti-tobacco interventions routinely, partly due to lack of broad knowledge and the necessary skills. Greater efforts are needed as a high priority to educate student and staff nurses systematically and comprehensively about the range of tobacco interventions available in Japan.