Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Dec 2012
[Development of a cooperative system for palliative care among a hospice ward, general ward, geriatric health services facility, and home in Japan Baptist Hospital-provision of home-based care by hospice physicians].
In November 2009, a home hospice palliative care clinic(clinic)was opened in addition to a hospice ward, general ward, and geriatric health services facility at our hospital. This marked the initiation of a health care system able to provide the palliative care desired by patients and families. ⋯ Hospice physicians participated in the home care of 20 patients. Hospice physicians provide home-based care in cooperation with clinic physicians, facilitating the palliative care of patients who initially do not have a place to receive terminal care and the prompt discharge of patients who want to live at home.
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Gan To Kagaku Ryoho · Dec 2012
[Assessment of hand-foot syndrome in cancer outpatients undergoing chemotherapy].
Capecitabine, an oral prodrug of 5 -fluorouracil, is a promising treatment for colorectal, breast, and gastric cancers, but often causes hand-foot syndrome(HFS), which is the most common dose-limiting toxicity. The aim of this study was to evaluate of the efficacy of the pharmacist in providing support at ambulatory therapy centers, especially for HFS. The HFS is a higher-incidence adverse event that may develop during chemotherapy with capecitabine. ⋯ Additionally, early introduction of effective countermeasures for skin care, dose reduction, and rest periods is important for HFS management; in addition, team care support is dispensable. Our support system may be useful for management strategies for HFS. We suggest that improved quality of lif e is needed in cancer outpatients being treated with chemotherapy.
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Gan To Kagaku Ryoho · Nov 2012
Case Reports[A case of refractory deep incisional surgical site infection due to methicillin-resistant Staphylococcus aureus (MRSA) and successfully treated with oral linezolid].
We report a case of methicillin-resistant Staphylococcus aureus(MRSA) surgical site infection successfully treated with linezolid. A 66-year-old man had undergone total gastrectomy for gastric cancer after neoadjuvant chemotherapy. ⋯ We started treatment with oral linezolid and nutritional support, and the wound was fully healed 12 months after the operation. Antibiotic treatment with oral linezolid may be effective for refractory deep incisional surgical site infection due to MRSA in outpatients.
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Gan To Kagaku Ryoho · Nov 2012
Case Reports[A case of severe subcutaneous emphysema during laparoscopic right-hemicolectomy].
A 76-year-old woman, weighing 40 kg, was scheduled for laparoscopic right-hemicolectomy. Forty minutes after starting the laparoscopic procedure, PaCO2 increased to 64.3 mmHg. ⋯ In the laparoscopic procedure for the treatment of colectomy, it is important to discover abnormalities such as snowball crepitation and arrhythmia, and to monitor ETCO2 continuously in order to avoid massive subcutaneous emphysema and hypercapnia. During a laparoscopic procedure, hypercapnia might cause acidosis, arrhythmia, hypotension, myocardial ischemia, and cardiac arrest.
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Gan To Kagaku Ryoho · Nov 2012
Case Reports[Two cases of surgical resection of rectal gastrointestinal stromal tumor after neoadjuvant therapy with imatinib mesylate].
Case 1: A 58-year-old man who initially presented with diarrhea was diagnosed with rectal gastrointestinal stromal tumor (GIST). The patient initially received neoadjuvant therapy with imatinib mesylate. After imatinib therapy( 400 mg/day) for 23 weeks, the patient's abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a reduction of approximately 67% in tumor size. ⋯ Abdominal CT and MRI revealed a reduction of approximately 53% in tumor size. A radical operation was considered feasible and sphincter-preserving surgery with intersphincteric resection was performed. Currently, neoadjuvant imatinib mesylate therapy is performed in the setting of clinical trials, but the cases suggest that it can be a promising strategy for locally advanced rectal GIST, improving the complete resection rate and the safety of operations by reducing the size of the tumor.