[Home-based infusion therapy by Broviac catheter after total parenteral nutrition therapy in a patient with a severe skin condition].

In collaboration between the in-hospital nutrition support team and infection control team, we attempted to standardize the management of infusion therapy. We report on a simple and effective at-home infusion therapy, after total parenteral nutrition(TPN)therapy, by using a Broviac catheter in a discharged patient with a severe skin condition. The patient was a man in his 50s who had amyloidosis.

[A regional alliance in nutritional management-ten years of collaboration with an nutrition support team network].

Ten years has passed since we began the nutrition support team(NST)to make a regional alliance between local institutions for construction of the NST network. The network was formed with the following aims: 1) regional joint conferences for learning about nutrition with family doctors, facilities, and hospitals; 2) open general meetings for information about nutrition within the suburbs of our city; 3) preparing and sending an NST manual about parenteral nutrition(PN)and enteral nutrition(EN); and 4) preparation of an NST summary of patient malnutrition to foster mutual understanding. We produced a questionnaire summarizing the completion of nutritional management in patients.

[Local communalization of clinical records between the municipal community hospital and local medical institutes by using information technology].

We introduced the electronic health record system in 2002. We produced a community medical network system to consolidate all medical treatment information from the local institute in 2010. Here, we report on the present status of this system that has been in use for the previous 2 years.

[The management for safety on Home Parenteral Nutrition(HPN)].

Nutrition support team(NST)continuously leads a safe and effective home nutritional management for a reliable operation. With regard to home parenteral nutrition(HPN), we provided some pamphlets on HPN for the patient and family and nurses. The utilization of the pamphlets was two folds: (1) a teaching instruction can be unified for the patient and family and nurses, (2) to eliminate the gap among nurses for instructional procedures.

[The follow-up study of patients with NST discharge summary for a continuous nutritional management].

The nutritional management of a patient discharged from a primary hospital will not end just there. The nutritional management information issued by the primary hospital is required when a patient moves to a next institute.We,the Nutritional Support Team(NST), make a nutrition summary report in addition to letters written by the doctor and the ward in charge.

[A case of severe obese patient complicated with type-2 diabetes--transition from Very Low Calorie Diet(VLCD) therapy to Low Calorie Diet(LCD)therapy].

A 6 0-year-old woman with severe obese and type-2 diabetes was hospitalized due to poorly controlled glycemia by worsening osteoarthritis of both knees. Although a diet therapy(1,200 kcal/day)was initially offered, but the body weight did not decrease. Thus, we changed VLCD therapy to LCD therapy sequentially.

[Two elderly case reports of renal excretion type drug poisoning caused by dehydration that was due to poor eating in home care].

The elderly patients are susceptible to acute renal failure due to dehydration or infection. Therefore, the drug should be administered with caution. We report two cases of acute renal failure from dehydration that led to a subsequent drug poisoning.

[The importance of Dysphagia management during the peri-operative period to home elderly care].

Dysphagia is usually a major problem for the elderly to go home after a surgical treatment for the bone fracture of the thigh bone cervix or trochanter part in the leg. We analyzed each clinical course with regard to a change of the oral intake and the nutritional status, the activity of daily living(ADL)and a nutritional management and the place after the patient was discharged. According to our results, about 20% of the patients among those surgical cases were pointed with dysphagia, and there were many cases that ADL was ultimately gotten worse.

[An awareness survey of home parenteral nutrition (HPN) in a local medical society].

Since we initiated home parenteral nutrition (HPN) in 1989 at our hospital, we have experienced a total of 96-patient cases. However, most of the patients were not accepted by the local medical society because of their own administration related problems. In the recent movement for the promotion of home medical care, a monthly joint study meeting between the NST and the local medical society was initiated in February 2003.