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Yoshida M, Sawano T, Kobashi Y, Hori A, Nishikawa Y, Ozaki A, Nonaka S, Tsuboi M, Tsubokura M. Importance of continuing health care before emergency hospital evacuation: a fatal case of a hospitalized patient in a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant: a case report. J Med Case Rep 2023; 17:37. [PMID: 36747281 PMCID: PMC9903404 DOI: 10.1186/s13256-022-03744-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/27/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND After a disaster, it is essential to maintain the health care supply levels to minimize the health impact on vulnerable populations. During the 2011 Fukushima Daiichi Nuclear Power Plant accident, hospitals within a 20 km radius were forced to make an immediate evacuation, causing a wide range of short- and long-term health problems. However, there is limited information on how the disaster disrupted the continuity of health care for hospitalized patients in the acute phase of the disaster. CASE PRESENTATION An 86-year-old Japanese man who needed central venous nutrition, oxygen administration, care to prevent pressure ulcers, skin and suctioning care of the trachea, and full assistance in the basic activities of daily living had been admitted to a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant and experienced Fukushima Daiichi Nuclear Power Plant accident. After the accident, the hospital faced a manpower shortage associated with hospital evacuation, environmental changes caused by infrastructure and medical supply disruptions, and the difficulty of evacuating seriously ill patients. As a result, antibiotics and suction care for aspiration pneumonia could not be appropriately provided to the patient due to lack of caregivers and infrastructure shortages. The patient died before his evacuation was initiated, in the process of hospital evacuation. CONCLUSIONS This case illustrates that decline in health care supply levels to hospitalized patients before evacuation during the acute phase of a radiation-released disaster may lead to patient fatalities. It is important to maintain the health care supply level even in such situations as the radiation-released disaster; otherwise, patients may experience negative health effects.
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Affiliation(s)
- Makoto Yoshida
- grid.264706.10000 0000 9239 9995Faculty of Medicine, Teikyo University, Itabashi-Ku, Tokyo, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan. .,Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan. .,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Yurie Kobashi
- grid.411582.b0000 0001 1017 9540Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan ,Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
| | - Arinobu Hori
- Department of Psychiatry, Hori Mental Clinic, Minamisoma, Fukushima Japan
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
| | - Akihiko Ozaki
- grid.507981.20000 0004 5935 0742Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima Japan
| | - Saori Nonaka
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima Japan
| | - Motohiro Tsuboi
- grid.264706.10000 0000 9239 9995Graduate School of Public Health, Teikyo University, Itabashi-Ku, Tokyo, Japan ,grid.410775.00000 0004 1762 2623Emergency and Critical Care Medicine, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima Japan ,grid.411582.b0000 0001 1017 9540Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan ,Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
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Sarkar S, Bardoloi N, Deb AK. Comparison between 0.1% Nepafenac and 1% Prednisolone Eye Drop in Postoperative Management Following Micro-incisional Cataract Surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:188-197. [PMID: 34120417 PMCID: PMC8200587 DOI: 10.3341/kjo.2020.0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the efficacy of 0.1% nepafenac and 1% prednisolone acetate eye drop in postoperative inflammation control in micro-incisional cataract surgery. Methods We conducted a prospective, randomized, comparative, single-blind study. All the patients underwent temporal 2.2-mm micro-incisional cataract surgery. They were randomized into two groups (group A and B). Group A received 0.1% nepafenac eye drops 4 times/day for 4 weeks and group B received 1% prednisolone acetate eye drops in tapering doses for 4 weeks after surgery. Both the groups received moxifloxacin 0.5% eye drops 4 times/day for 2 weeks. Patients were examined on 1st, 7th, and 30th postoperative days and parameters of postoperative inflammation were evaluated and noted at each visit. Results A total of 200 patients were enrolled in the study. However, five patients lost to follow up, group A had 97 and group B had 98 patients respectively. Results were statistically insignificant in terms of the difference in lid edema, conjunctival congestion, corneal edema, anterior chamber cells and flare between the two groups with p-values >0.05 for each parameter at each visit. However, the difference in mean central macular thickness between the groups was significant (205.713 ± 17.14 vs. 220.984 ± 32.83 in group A and B, respectively, p ≤ 0.001) at 1 month. Also, the mean pain score was significantly lower (p = 0.018) in the nepafenac group at day 7 of surgery. Conclusions Nepafenac is equally effective and non-inferior to prednisolone acetate in suppression and prevention of inflammation in postoperative period.
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Affiliation(s)
- Sandip Sarkar
- Cataract & Cornea Services, Chandraprabha Eye Hospital, Jorhat, India.,Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Narayan Bardoloi
- Cataract & Cornea Services, Chandraprabha Eye Hospital, Jorhat, India
| | - Amit Kumar Deb
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Gonzalez-De la Rosa A, Navarro-Partida J, Altamirano-Vallejo JC, Jauregui-Garcia GD, Acosta-Gonzalez R, Ibanez-Hernandez MA, Mora-Gonzalez GF, Armendáriz-Borunda J, Santos A. Novel Triamcinolone Acetonide-Loaded Liposomal Topical Formulation Improves Contrast Sensitivity Outcome After Femtosecond Laser-Assisted Cataract Surgery. J Ocul Pharmacol Ther 2019; 35:512-521. [PMID: 31486694 PMCID: PMC6839423 DOI: 10.1089/jop.2019.0032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: To assess visual results, macular modifications, and the incidence of clinically significant macular edema (CSME) in patients using a topical triamcinolone acetonide-loaded liposomal formulation (TA-LF) after femtosecond laser-assisted cataract surgery (FLACS). Methods: Fifty-six eyes after FLACS were selected. Twenty-eight eyes in the combined therapy group (P + N) were treated with prednisolone 1% and nepafenac 0.1% for 21 days postoperatively, whereas 28 eyes in the TA-LF group received a liposomal formulation containing 2 mg/mL of TA (0.2%) for the same period of time. Follow-up visits at 1 day, 6 weeks, and 12 weeks after surgery consisted of visual acuity, contrast sensitivity (CS), central foveal thickness (CFT), total macular volume (TMV) measurements, and the detection of CSME. Results: CS improved in the TA-LF group (basal value: 1.087 ± 0.339 vs. 1.276 ± 0.147 at week 12, P = 0.0346), whereas in the P + N group, CS was not different from the baseline (basal value: 1.130 ± 0.331 vs. 1.274 ± 0.133 at week 12, P = 0.1276). There were similar increases in postoperative CFT and TMV in both groups. CFT and TMV significantly correlate with CS only in the TA-LF group. The r2 for CFT and CS was 0.1963 (P = 0.0206), whereas the r2 for TMV and CS was 0.3615 (P = 0.0007) at 12 weeks. No difference was observed in the incidence of CSME between the groups. Conclusion: TA-LF is associated with better CS outcomes compared to combined therapy after FLACS.
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Affiliation(s)
- Alejandro Gonzalez-De la Rosa
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Jose Navarro-Partida
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Juan Carlos Altamirano-Vallejo
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | - Gerardo Daniel Jauregui-Garcia
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
| | | | | | | | - Juan Armendáriz-Borunda
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Instituto de Biología Molecular y Terapia Génica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Arturo Santos
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Zapopan, Mexico.,Centro de Retina Médica y Quirúrgica, S.C., Centro Médico Puerta de Hierro, Zapopan, Mexico
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Abstract
Aim. The study of free radical oxidation processes in an experiment on model systems using the anti-inflammatory drug bromfenac (nakwan) widely used in ophthalmology for the treatment of infectious and inflammatory diseases of the anterior chamber of the eye.
Methods. The antioxidant capacity of the drug was evaluated by chemiluminescence registration and analysis of model systems that generate reactive oxygen species and reproduce lipid peroxidation processes using the chemiluminomer CL-003. The following parameters of spontaneous and induced chemiluminescence were determined: light sum and maximum luminescence amplitude, duration of latent period, amplitude of fast and slow flash.
Results. When tested in vitro in two different model systems, a high antioxidant activity of the studied drug was established, up to complete suppression of chemiluminescence when 90 μg of bromfenac was added to the incubation medium, which characterizes the inhibition of the generation of reactive oxygen species. A significant increase in total antioxidant activity with bromfenac was also demonstrated, which is reflected by the integral parameter of chemiluminescence — light sum which decreased with the introduction of 10 μg of the drug by 1.2 times, and with 90 μg by 1.5 times. A comparative analysis of the antioxidant properties of various nonsteroidal anti-inflammatory drugs used in ophthalmic practice demonstrated a more pronounced efficacy of bromfenac compared to ketorolac, the use of which was not accompanied by statistically significant changes in chemiluminescence. A very important mechanism of the positive effect of bromfenac is the direct dependence of the action on its quantity in the reaction medium, which opens up prospects for the controlled correction of free radical phenomena and the excessive activation of lipid peroxidation in the imbalance of the pro- and antioxidant processes in biological systems.
Conclusion. It is suggested that the protective effects of the drug in various infectious-inflammatory lesions of the eye can be determined, along with previously known properties, its antioxidant activity, restriction of increased production of reactive oxygen species and oxidative stress phenomena.
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