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Usefulness of Palliative Prognostic Index, Objective Prognostic Score, and Neutrophil–Lymphocyte Ratio/Albumin Ratio As Prognostic Indicators for Patients Without Cancer Receiving Home-Visit Palliative Care : A Pilot Study at a Community General Hospital
Get PDFBackground: Although the palliative prognostic index (PPI), objective prognostic score (OPS), and neutrophil–lymphocyte ratio/albumin ratio (NLR/Alb) are well-known prognostic indicators for cancer patients, they do not provide clarity when it comes to predicting prognosis in patients without cancer who receive home-visit palliative care.
Objective: The aim of this study was to determine whether PPI, OPS, and NLR/Alb can predict prognosis for patients without cancer who received home-visit palliative care.
Design: This is a retrospective study.
Setting/Subjects: We recruited 58 patients without cancer who received home-visit palliative care from Tokushima Prefectural Kaifu Hospital, Japan, and died at home or at the hospital within seven days of admission between January 2009 and March 2023.
Measurements: The PPI, OPS, and NLR/Alb of the study patients were evaluated at regular intervals, and statistical analysis was performed on the relationship between these indices and the time to death.
Results: Simple regression analysis showed that PPI, OPS, and NLR/Alb were negatively correlated with the period until death (p < 0.001). The survival curves of the groups classified according to PPI, OPS, and NLR/Alb were significantly stratified. The predictive capacities of PPI, OPS, and NLR/Alb for death within 21 days were as follows: PPI (area under the curve [AUC]: 0.71; sensitivity: 59%; specificity: 68%), OPS (AUC: 0.73; sensitivity: 88%; specificity: 47%), and NLR/Alb (AUC: 0.72; sensitivity: 72%; specificity: 73%).
Conclusions: PPI, OPS, and NLR/Alb were useful in predicting the survival period and short-term prognosis within 21 days for patients without cancer who received home-visit palliative care.journal articl
Development of New Red Phosphors and Effects of Coordination Environment around Activator on Luminescence Properties
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Research on Early Detection of Depression Based on Neuro-Symbolic AI Approach via Social Media Analysis
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シリンダー法の内部圧力計測による表層透気性評価手法の検討
No full textコンクリートの表層透気試験としてシリンダー法についての検討を進めている。今回，測定時の内部の負圧を測定するために，無線接続にてパソコンと連携できる電池駆動式の圧力計を適用し，シリンダー内部の圧力を簡易に記録できる試験装置を構築した。その装置を用いて，W/Cおよび養生条件を変更した供試体ならびに建設後15～17年経過した実構造物での測定を実施した。その結果，内部圧力の時間変化を示す透気速度と，空気流入量には高い相関があることが明らかとなった。また，透気速度の指標を用いることにより，現在60秒の測定時間であるシリンダー法による試験をさらに短縮できる可能性を示した。journal articl
Five percent weight loss is a significant 1-year predictor and an optimal 5-year cut-off for reducing the number of obesity-related cardiovascular disease risk components : the Japan Obesity and Metabolic Syndrome Study
Get PDFObjective: This study aimed to identify the amount of weight loss needed in patients with obesity to improve metabolic syndrome (MetS), a risk factor for cardiovascular disease (CVD), over a long period of time.
Methods: A total of 576 patients with obesity were enrolled in this study. Effects of continuous physician-supervised weight loss on the cumulative MetS components excluding abdominal circumference (defined as obesity-related CVD risk score) were investigated during a 5-year follow-up period. The extent of weight loss required to reduce the obesity-related CVD risk components was assessed using receiver operating characteristic (ROC) curve analyses.
Results: Of the 576 participants, 266 completed 5-year follow-up, with 39.1% and 24.1% of them achieving ≥5.0% and ≥7.5% weight loss at the 5-year follow-up, respectively. The area under the ROC curve for reducing the obesity-related CVD risk components was 0.719 [0.662–0.777] at 1 year and 0.694 [0.613–0.775] at 5 years. The optimal cut-off value for weight loss was 5.0% (0.66 sensitivity and 0.69 specificity) and the value with 0.80 specificity was 7.5% (0.45 sensitivity) at 5 years. Greater reductions in weight were associated with greater improvements in the obesity-related CVD risk score at all follow-up periods (P-trend <0.001). Obesity-related CVD risk score was significantly improved by 5.0–7.5% and ≥7.5% weight loss at 1 year (P = 0.029 and P < 0.001, respectively) and ≥7.5% weight loss at 5 years (P = 0.034).
Conclusions: A weight loss of ≥5.0% at 1 year and ≥7.5% at 5 years could reduce the number of obesity-related CVD risk components in patients with obesity.journal articl
訪問看護師が捉える終末期高齢がん患者の未告知がもたらす様相
Get PDFPurpose : To clarify the aspects brought about when withholding the truth about the prognosis from elderly patients with terminal cancer from the perspective of visiting nurses. Methods : Semi-structured interviews were conducted with 15 visiting nurses of home visit nursing offices in the Kansai area from May to September 2021, and the obtained data were qualitatively and descriptively analyzed.
Results : Six categories of the aspects brought about when withholding the truth about the prognosis from elderly patients with terminal cancer were identified from the perspective of visiting nurses :［preventing patients from what they want to do］ etc.
Discussion : These categories clarified 2 characteristics of the aspects brought about when withholding the truth about the prognosis from elderly patients with terminal cancer : preventing patients from being convinced that they are living their last period, even though they are in their own homes ; and making it impossible for all parties involved, including families and visiting nurses, to devote themselves to parting. Based on this, the choice to withhold the truth from patients may unintentionally deprive them of the chance for a good end of life, and let home end-of-life care, which further deepens interpersonal relationships in most cases, end before its benefits are fully realized.
Conclusion : Visiting nurses should support patients and their families for a good end of life that is possible only at home, while understanding these aspects brought about when withholding the truth about the by prognosis from the former.journal articl
