Investigation of the efficacy of the change ratio of brain natriuretic peptide for predicting the cardiac effects of chemoradiotherapy on esophageal cancer.

The aim of this study was to investigate the effectiveness of brain natriuretic peptide (BNP) as a predictor of radiological effects on the heart. A total of 41 patients with esophageal cancer who underwent chemoradiotherapy (CRT) were retrospectively investigated. The BNP levels were measured on the first day of CRT (pre-CRT) and the last day of CRT (post-CRT), and the median concentration of BNP and dosimetric parameters of the heart were calculated. The change ratio of BNP was calculated as follows: [(BNP post-CRT) - (BNP pre-CRT)]/(BNP pre-CRT). The comparison of BNP pre-CRT with post-CRT was performed using a Wilcoxon signed-rank test. The relationship between dosimetric parameters and change ratio was analyzed using Spearman's correlation coefficient. The median levels of BNP of pre-CRT and post-CRT were 10 and 22 pg/ml, respectively, and the difference was statistically significant (P<0.0001). Significant correlations (all P<0.05) were observed between the change ratio and mean dose, V5, V10, V20, and V30. Of the cohort, 14 patients developed acute-to-subacute cardiac events, such as pericardial effusion, cardiomegaly, acute exacerbation of chronic heart failure, and a decreased ejection fraction. The change ratios of BNP, V5, V10, V20, and V30 were significantly higher in patients who experienced cardiac events compared with those who did not. The results of this study showed that BNP measurement, particularly the change ratio of BNP pre- and post-CRT, may be a useful cardiac event predictor in addition to dosimetric parameters.

[Evaluation of Usefulness of the Tools for Collaboration between Hospital and Community Pharmacists in the Provision of Outpatient Cancer Chemotherapy].

Outpatient cancer chemotherapy is becoming increasingly widely adopted. It is, therefore, essential to strengthen the collaboration between hospital and community pharmacists. Although there have been several reports on the collaboration between these two health care providers in the provision of outpatient cancer chemotherapy, there have been no reports on the usefulness of the tools provided by hospital pharmacists to their community counterparts. Hence, this study examined the usefulness of the Adverse Drug Reaction Information Form, which was provided to insurance pharmacies. The response rate of community pharmacists to the information provided was 80%. The most common content of the information provided was related to supportive care(55.9%). Telephone consultations between community pharmacists and patients were conducted in 20 cases(34.8%)to confirm the symptoms of adverse drug reactions. The telephone follow-up rate for each grade of adverse drug reaction was 34.8% for grade 1 and 45.5% for Grade 2, with the number of Grade 2 adverse drug reaction cases being the highest. These findings demonstrate that collaboration between hospital and community pharmacists using the Adverse Drug Reaction Information Form can help provide high-quality outpatient cancer care.

Comparison of the clinical features of invasive pneumococcal disease with those of pneumococcal pneumonia in adults.

Background: Invasive pneumococcal disease (IPD) is an infectious disease where Streptococcus pneumoniae can be detected in the cerebrospinal fluid or blood. Methods: Eight patients presented to our hospital with adult IPD. We compared with 69 cases of pneumococcal pneumonia treated in our department between 2012 and 2014. None of the patients had a history of pneumococcal vaccine administration. Results: Hematological examination showed the platelet count was significantly lower and the serum C-reactive protein level was significantly higher in the IPD group. There was a significant difference in the use of a respirator and mortality in the IPD group. About antibiotics, Carbapenem and quinolone were used for the treatment of many patients in the IPD group. In the fatal three cases of IPD, the age of all members were 65 years or younger. Two of three had no underlying disease. Conclusion: IPD develops without elderly people and in those without underlying disease. Also, the patients who took a sudden course may result in death. In line with previous studies that have reported the effectiveness of the pneumococcal vaccine, our study findings emphasize the need of administering vaccination for prevention of IPD in person who was younger than 65 years old.