• 제목/요약/키워드: Hospital Evaluation

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The Combination of Gefitinib and Acetaminophen Exacerbates Hepatotoxicity via ROS-Mediated Apoptosis

  • Jiangxin Xu;Xiangliang Huang;Yourong Zhou;Zhifei Xu;Xinjun Cai;Bo Yang;Qiaojun He;Peihua Luo;Hao Yan;Jie Jin
    • Biomolecules & Therapeutics
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    • 제32권5호
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    • pp.647-657
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    • 2024
  • Gefitinib is the well-tolerated first-line treatment of non-small cell lung cancer. As it needs analgesics during oncology treatment, particularly in the context of the coronavirus disease, where patients are more susceptible to contract high fever and sore throat. This has increased the likelihood of taking both gefitinib and antipyretic analgesic acetaminophen (APAP). Given that gefitinib and APAP overdose can predispose patients to liver injury or even acute liver failure, there is a risk of severe hepatotoxicity when these two drugs are used concomitantly. However, little is known regarding their safety at therapeutic doses. This study simulated the administration of gefitinib and APAP at clinically relevant doses in an animal model and confirmed that gefitinib in combination with APAP exhibited additional hepatotoxicity. We found that gefitinib plus APAP significantly exacerbated cell death, whereas each drug by itself had little or minor effect on hepatocyte survival. Mechanistically, combination of gefitinib and APAP induces hepatocyte death via the apoptotic pathway obviously. Reactive oxygen species (ROS) generation and DNA damage accumulation are involved in hepatocyte apoptosis. Gefitinib plus APAP also promotes the expression of Kelch-like ECH-associated protein 1 (Keap1) and downregulated the antioxidant factor, Nuclear factor erythroid 2-related factor 2 (Nrf2), by inhibiting p62 expression. Taken together, this study revealed the potential ROS-mediated apoptosis-dependent hepatotoxicity effect of the combination of gefitinib and APAP, in which the p62/Keap1/Nrf2 signaling pathway participates and plays an important regulatory role.

목표관리를 적용한 간호사 성과평가 핵심 지표개발과 가중치 산정 (Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives)

  • 이은화;안성희
    • 대한간호학회지
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    • 제40권1호
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    • pp.69-77
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    • 2010
  • This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Pre-anesthetic clinic internship: new teaching method of pre-anesthesia evaluation for undergraduates

  • Zheng, Shao-Hua;Mei, Xiao-Peng
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권3호
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    • pp.207-217
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    • 2021
  • Background: This study aimed to observe the effect of internship in a pre-anesthetic clinic on the teaching quality of pre-anesthesia evaluation for undergraduates. Methods: A total of 120 undergraduates from July 2017 to July 2018 in the anesthesia department of our hospital were randomly divided into two groups: pre-anesthetic clinic internship teaching group (n = 60) and traditional teaching group (n = 60). The knowledge in the pre-anesthesia evaluation teaching chapters was evaluated between the two groups of undergraduates. Results: There were no significant differences in the demographic information between the two groups. The scores in the case analysis and theoretical knowledge test in the pre-anesthetic clinic internship teaching group were significantly higher than those in the traditional teaching group. In addition, the students' satisfaction with the curriculum design was significantly higher in the pre-anesthetic clinic internship teaching group than in the traditional teaching group. Conclusion: Pre-anesthetic clinic internships can improve the quality of pre-anesthesia assessment teaching for undergraduates.

병원급식 종사자의 급식서비스 질 평가 (Evaluation of Foodservice Quality on the Viewpoint of Personnel in Hospital Foodservice)

  • 이해영;장승희;양일선
    • 대한영양사협회학술지
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    • 제10권4호
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    • pp.401-406
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    • 2004
  • The purposes of this study was to evaluate the foodservice quality on the viewpoint of personnel in hospital foodservice. In result, S hospital's foodservice quality, that was evaluated by personnel, was comparatively high on the every variables and factors, especially on 'Q13. Meals delivery to the bed'(4.70 out of 5.0), 'Q14. Removal service of tray by foodservice personnel'(4.63), 'Q15. Kind foodservice personnel'(4.63), 'Q16. Foodservice personnel's clean and neat uniforms'(4.56) and 'factor 4. personnel attitude'(4.63). Foodservice quality factors weren't significant by general characteristics of personnel, thus all personnel were considered to hold similarly the level of foodservice quality. On the basis of these results, the gap between foodservice providers and customers need to be analyzed in the further study.

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Quantitative Evaluation of Hepatic Steatosis Using Advanced Imaging Techniques: Focusing on New Quantitative Ultrasound Techniques

  • Junghoan Park;Jeong Min Lee;Gunwoo Lee;Sun Kyung Jeon;Ijin Joo
    • Korean Journal of Radiology
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    • 제23권1호
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    • pp.13-29
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    • 2022
  • Nonalcoholic fatty liver disease, characterized by excessive accumulation of fat in the liver, is the most common chronic liver disease worldwide. The current standard for the detection of hepatic steatosis is liver biopsy; however, it is limited by invasiveness and sampling errors. Accordingly, MR spectroscopy and proton density fat fraction obtained with MRI have been accepted as non-invasive modalities for quantifying hepatic steatosis. Recently, various quantitative ultrasonography techniques have been developed and validated for the quantification of hepatic steatosis. These techniques measure various acoustic parameters, including attenuation coefficient, backscatter coefficient and speckle statistics, speed of sound, and shear wave elastography metrics. In this article, we introduce several representative quantitative ultrasonography techniques and their diagnostic value for the detection of hepatic steatosis.

허혈성 뇌혈관질환에서 자기공명혈관조영술의 가치에 대한 임상연구 (Intracranial Magnetic Resonance Angiography-Its Role in the Approach to Ischemic Stroke)

  • 임동준;조태형;정용구;김백현;김근회;김세훈;권택현;정흥섭;박정율;박윤관;이훈갑;이기찬;서중근
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1063-1068
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    • 2000
  • Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

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병원약국학(病院藥局學) 대학원전공개설(大學院專攻開設)을 위(爲)한 교육내용(敎育內容)에 관(關)한 연구(硏究) (Establishment of Graduate Education in Hospital Pharmacy)

  • 김종국;이민화
    • Journal of Pharmaceutical Investigation
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    • 제13권1호
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    • pp.23-35
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    • 1983
  • Since the national health insurance was introduced in 1978, the increased utilization of hospitals and the growing importance of pharmaceutical services to hospital patients have made the administration of these services a very complex and specialized responsibility. The pharmaceutical services has always been an essential component of comtemporary hospital care. In the hospital, the pharmaceutical services is the professional department which concerns itself with the evaluation, selection, control and utilization of drugs. The director of this service must be a versatile professional person who can work effectively in a heterogenous society of educated persons. However, graduate education in hospital pharmacy has not been introduced yet in Korea. The necessity of graduate education hospital pharmacy has been discussed in this research. Graduate education in hospital pharmacy emphasizes preparation for assumption of responsibility as the senior hospital pharmacist or the director of pharmaceutical services. Graduates should also be prepared as administrators of a department that must operate with great efficiency. They should be prepared serve as a consultant on drugs for the medical and allied health professional staff, organizing and disseminating a large and dynamic body of information in their interest and to establish professional roles that emphasize procurement, storage, manufacturing, packaging, distribution, control and evaluation of drugs. Senior hospital pharmacist is a teacher charged with responsibility fer formal and informal instruction of other hospital personnel in pharmaceutical sciences. In addition, the graduates have the opportunity to be a researcher dealing with aspect of hospital care and are intensively educated in the professional aspects of hospital pharmacy practices. The curriculum of graduate education in hospital pharmacy should be established detailly and carefully to fit the educational objective.

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