Pharmacist Interventions for Adverse Drug Reactions in Palliative Care: A Multicentre Pilot Study.

This study aimed to investigate adverse reactions to medications administered during palliative care and compare the responses of Board-Certified Pharmacists in Palliative Pharmacy (BCPPP) and non-BCPPP professionals. Methods: This multicentre prospective survey included hospital and community pharmacists who are members of the Japanese Society for Pharmaceutical Palliative Care and Sciences. Study participants included patients who experienced new drug reactions during the study period and responded to the requested survey items. The follow-up period for each eligible patient began on the day the pharmacists initiated the intervention and ended at discharge, death, or after one month of intervention. The primary endpoint was the impact of pharmacist intervention on adverse drug reactions. The pharmacists included in the study evaluated the severity of adverse drug reactions to assess the effect of their intervention using an integrated palliative care outcome scale before and after the intervention. Key findings: During the survey period, 79 adverse drug reaction intervention reports from 69 patients were obtained from 54 pharmacists (28 certified and 26 non-certified). The response rate was 1.62% (54/3,343). The management of palliative pharmacotherapy side effects by BCPPP and non-BCPPP significantly improved the patients' activities of daily living (P < 0.001). The BCPPP group intervened for significantly more patients with adverse drug reactions and overall adverse drug reactions than the non-BCPPP group (P < 0.023 and P < 0.013, respectively). Conclusion: BCPPP interventions can improve symptom management.

Breast adenomyoepithelioma from a radiologic perspective.

Adenomyoepithelioma of the breast (AB) is an uncommon tumor that is characterized by the biphasic proliferation of epithelial and myoepithelial cells. The radiologic findings for AB have been scantly reported. This paper aims to analyze the characteristic findings for AB on ultrasonography (US) and mammography. This retrospective descriptive study used the Breast Imaging-Reporting and Data System (BI-RADS) to analyze the US and mammography findings for histologically confirmed AB in patients attended at our institution between 2007 and 2019. We identified a total of 13 AB in 13 women. All patients underwent US. On US, 12 lesions were seen as oval nodules, and the remaining lesion was irregular-shaped; 8 lesions had circumscribed margins, 3 had angled margins, and 2 had microlobulated margins. Regarding the echo pattern, 8 lesions were hypoechoic and 5 were complex (solid-cystic). On color Doppler, 11 lesions were vascularized nodules and 2 were avascular nodules. In conclusion, we present the imaging characteristics for a series of cases of AB. It is unlikely that this lesion can be suspected solely on the basis of the imaging findings; nevertheless, it is important for radiologists to be familiar with AB to carry out a good radiopathologic correlation.

Homodyne interferometry using a phase rotator for calibration of sine-cosine phase detection of a 70 GHz probe beam through a plasma.

Homodyne interferometry using a motorized phase rotator for calibration of sine-cosine detection of the phase shift of a 70 GHz probe beam through a plasma has been developed. Four interferometers based on this interferometry have been installed on the low aspect ratio torus experiment (LATE) device with four horizontal probe beams on the mid-plane, which has measured the line-integrated electron densities with a time resolution of 10 µs and a resolution of line-integrated density of 5 × 1015 m-2.

Breast adenomyoepithelioma from a radiologic perspective. / Adenomioepitelioma de la mama desde una perspectiva radiológica.

Adenomyoepithelioma of the breast (AB) is an uncommon tumor that is characterized by the biphasic proliferation of epithelial and myoepithelial cells. The radiologic findings for AB have been scantly reported. This paper aims to analyze the characteristic findings for AB on ultrasonography (US) and mammography. This retrospective descriptive study used the Breast Imaging-Reporting and Data System (BI-RADS) to analyze the US and mammography findings for histologically confirmed AB in patients attended at our institution between 2007 and 2019. We identified a total of 13 AB in 13 women. All patients underwent US. On US, 12 lesions were seen as oval nodules, and the remaining lesion was irregular-shaped; 8 lesions had circumscribed margins, 3 had angled margins, and 2 had microlobulated margins. Regarding the echo pattern, 8 lesions were hypoechoic and 5 were complex (solid-cystic). On color Doppler, 11 lesions were vascularized nodules and 2 were avascular nodules. In conclusion, we present the imaging characteristics for a series of cases of AB. It is unlikely that this lesion can be suspected solely on the basis of the imaging findings; nevertheless, it is important for radiologists to be familiar with AB to carry out a good radiopathologic correlation.

Prevalence of Prefrailty and Frailty in South America: A Systematic Review of Observational Studies.

OBJECTIVES: The present study aimed at investigating the prevalence of prefrailty and frailty in South American older adults according to the setting and region. DESIGN: A literature search combining the terms "frailty", "South America" or a specific country name was performed on PubMed, EMBASE, Lilacs, and Scielo to retrieve articles published in English, Portuguese or Spanish on or before August 2019. PARTICIPANTS: Older adults aged 60+ years from any setting classified as frail according to a validated scale were included in the study. MEASUREMENTS: Frailty assessment by a validated scale. RESULTS: One-hundred eighteen reports (98 performed from Brazil, seven from Chile, five from Peru, four from Colombia, two from Ecuador, one from Argentina, and one from Venezuela) were included in the study. The mean prevalence of prefrailty in South America was 46.8% (50.7% in older in-patients, 47.6% in the community, and 29.8% in nursing-home residents). The mean prevalence of frailty in South America was 21.7% (55.8% in nursing-home residents, 39.1% in hospitalized older adults, and 23.0% in the community). CONCLUSIONS: Prefrailty and frailty are highly prevalent in South American older adults, with rates higher than those reported in Europe and Asia. In the community, almost one-in-two is prefrail and one-in-five is frail, while hospitalized persons and nursing-home residents are more frequently affected. These findings indicate the need for immediate attention to avoid frailty progression toward negative health outcomes. Our findings also highlight the need for specific guidelines for the management of frailty in South America.

Perinatal rib fractures in 18 calves delivered from Holstein dams.

Cranial rib fractures during dystocia and the ensuing callus formations in calves often cause tracheal stenosis. Rib fractures may affect the lung since ribs tend to fracture above the costochondral junction during delivery. Considering that calving assistance rates for dystocia are high, calves with fractured ribs may develop respiratory disease which results in economic loss. The objective of this study was to elucidate the contribution of rib fractures to economic loss through respiratory disease in calves. Of 163 sick calves delivered from Holstein-Friesian dams included in this study, a total of 18 rib fractured calves was found, giving an incidence of rib fracture in sick calves of 11.0%. There were significant differences in incidence by the rib involved, indicating the 2nd to 7th ribs tend to break. Many of the rib fractured calves showed dyspnea and pyrexia. In this study, four of five scanned or necropsied calves had pneumonia lesions despite the fact that these four calves did not have tracheal stenosis. Rib fractured calves sold at below market value with a median difference from average sale price of minus 64,861 yen. Survival analysis indicated an overall association between rib fracture and time to death. In this study, we demonstrated that rib fractures happened most frequently in the 2nd to 7th ribs, and these cases tended to cause pneumonia, which decreased sale prices and longevity. Farmers should work to reduce risks and rates of dystocia so as to lessen economic loss and poor welfare in calves due to rib fractures.

Impact of a systematic education model for palliative care in cancer.

In clinical practice, pharmacists are continually required to improve their knowledge and expertise; however, the postgraduate education system for professional development cannot be confidently stated to be well established. The establishment of a systematic and multifaceted educational curriculum should be useful to improve home care and pharmacists' contribution; therefore, we developed a curriculum in collaboration with the university faculty of pharmaceutical sciences, department of pharmacy in hospital, and the Fukuoka Pharmaceutical Association. Class topics were extracted from the "Kanwa-Iryou-Yakugaku", edited by the Japanese Society for Pharmaceutical Palliative Care and Sciences. The items are necessary to perform palliative care as a pharmacist. A class schedule of 6 days (24 classes in total) was formulated. Questionnaires on comprehension degree before and after each class were provided to the participants. Comprehension was assessed on a scale of 1 to 10, where "I do not understand at all" was 1 and "I understand enough" was 10. The average recovery rates of questionnaires from each class were 92.6 % and 88.9 % before and after class, respectively. The average number of participants who completely answered the questionnaire before and after class was 45.6; therefore, these data were analyzed. Comprehension degree on each topic had significantly increased after attendance of all classes (p < 0.01). The comprehension degree of participants of the medical science of palliative care did greatly improve. Consequently, it is clear that the standard education model constructed was meaningful for the professional development of pharmacists in palliative care medicine.

Usefulness of medication instruction sheets for sharing information on cancer chemotherapy within the health care team.

Patients receiving cancer chemotherapy may experience a number of potentially severe adverse drug reactions. It is crucial for all members of the health care team to monitor the effect of medicines on the patient to ensure the safety and efficacy of the chemotherapy. The present study prepared medication instruction sheets (MISs) on hematological malignancy and conducted a questionnaire survey to verify their usefulness among physicians, dentists, and nurses. MISs were prepared for 103 chemotherapy and 44 pretreatment regimens for hematopoietic stem cell transplantation in the Department of Hematology at Kyushu University Hospital. Eight questions were prepared to investigate whether MISs could help physicians, dentists, and nurses manage cancer chemotherapy more safely, effectively, and efficiently, as well as in the sharing of information. A total of 35 medical staff working in inpatient wards, including 8 physicians, 3 dentists, and 24 nurses, participated in the questionnaire survey. All of the staff responded to the questionnaire survey, which showed that the MISs were favorably accepted by the participants. There was no negative opinion on the management of chemotherapy using the MISs. The MIS was a useful tool for sharing information on cancer chemotherapy between patients and medical staff and for enabling efficient management, thereby improving the safety and efficacy of treatment.

Expression of apoptosis inhibitor of macrophages in tissue macrophages, leukocytes and vascular endothelial cells of dogs.

Apoptosis inhibitor of macrophages (AIM) is a protein which plays important roles in controlling the immune response and inflammation in human and mice. In dogs, AIM is reported to be expressed in cancerated macrophages and regulate the survival of these tumor cells. In this study, to elucidate the physiological expression pattern of AIM in dogs, systemic expression and distribution of AIM of dogs were investigated. Mature healthy Beagles were used. Various tissues, peripheral blood cells, and bone marrow cells of normal dogs were collected for in situ hybridization, real-time RT-PCR, and immunohistochemistry. AIM mRNA and protein were expressed in tissue macrophages of the spleen, liver, lungs, and lymph nodes, but not in the microglia of the cerebrum. Proximal tubules in the kidney also expressed AIM protein. Monocytes and B lymphocytes in circulating blood and a part of microvasculature endothelial cells showed AIM expression at both the mRNA and protein levels. In the bone marrow, early-stage monocyte progenitor-like cells expressed AIM mRNA and protein. These results clarified that AIM is expressed in more cell types than previously reported in human and mice. These data spread the possibility of AIM physiological functions and implies the relationship of AIM to the maturation of macrophage-strain cells in dogs and other species.