Utilization and Issues Related to Discharge Medication Summaries from Hospital Pharmacies to Community Pharmacies.

In 2020, the Japan Community Healthcare Organization (JCHO) Hoshigaoka Medical Center started providing information to community pharmacies about patients admitted to the acute care ward using discharge medication summaries (the summaries). We conducted an online self-recording survey of 149 pharmacies belonging to the Hirakata City Pharmacists Association to clarify the usability of the summaries, any related issues, and to further discuss future collaboration between hospitals and pharmacies. 46 pharmacies have received the summaries in the past, of which 44 pharmacies answered that they have utilized the summaries with patient instruction and prescription queries of doctors. However, two pharmacies responded they did not utilize the summaries, and the reasons were (a) the information was not timely and (b) patients whom the discharge medical summary was sent for did not come to the pharmacy. There were some requests regarding the summaries such as, "I would like to know what kind of information hospital pharmacists want from community pharmacists." Preference for sharing information other than the summaries (e.g., online tools) with hospital pharmacists was related to whether the pharmacy was providing home pharmaceutical visit services. The survey revealed that, in addition to the usability of the summaries, there are also events that prevent them from being utilized. Some of the challenges include the timing of sending the summaries, the accurate identification of the family pharmacy and the communication of follow-up after discharge from hospital. Collaborating with pharmacies providing home pharmaceutical visit services would be beneficial in creating new system of bidirectional information sharing.

Anti-metatype peptides, a molecular tool with high sensitivity and specificity to monitor small ligands.

To develop a new immunological detection system of gibberellins (GAs), a class of phytohormones, peptides that interact with an antibody against GA4 in a GA4-dependent manner, were screened from phage display random peptide libraries. The biopanning procedure yielded peptides designated as anti-metatype peptides (AM-peps), which showed specific binding to the complex of the antibody and its ligand GA4; that is, the antibody could not be replaced with the other anti-GA4 antibody, and GA4 could not be replaced with GA1, another ligand of the antibody. Together with computational analyses such as analysis of structural propensity of the AM-peps and docking simulation of the AM-peps and the 8/E9-GA4 complex, it was suggested that AM-peps formed a helix in their central region and interacted with a part of the 8/E9-GA4 complex located in close proximity to the GA4 molecule. Based on the property of AM-peps to make a ternary complex with antibody and its ligand, a noncompetitive enzyme-linked immunosorbent assay (ELISA) system corresponding to sandwich ELISA was developed to detect GA4. GA4 as low as 30 pg, which could not be achieved by conventional competitive ELISA, could be detected by the new system, demonstrating the feasibility of this system.

[Active systemic steroid therapy employed in a case of bilateral frosted branch angiitis with acute chorioretinal circulatory insufficiency].

BACKGROUND: Steroid treatment is believed to be effective for frosted branch angiitis, but frosted branch angiitis with retinal circulatory insufficiency does not have a good prognosis by steroid treatment alone. Here, we present a case of a patient that had a good outcome when treated with long-term active systemic betamethasone and vasodilation therapy for bilateral frosted branch angiitis with acute chorioretinal circulatory insufficiency. CASE: A 69-year-old male presented with sudden visual loss in his left eye. The visual acuity was 1.0 in the right eye and 0.1 in the left eye. In his left eye, only mild inflammation occurred in the anterior chamber, but extensive inflammation such as sheathing of retinal vessels, retinal hemorrhage, and edema of the optic disc was present. Fluorescein angiography showed a delay of the arm-retinal artery circulation time and severe dye leakage from the retinal vessels. The following day, the visual acuity worsened to 0.1 in the right eye and hand motion in the left eye. Moreover, extensive inflammation was now present in both the anterior and posterior segments, and the sheathing of the retinal vessels developed to frosted branch-like angiitis. Doppler examination showed flow in the bilateral ophthalmic artery but did not show flow in the central retinal artery or posterior ciliary artery. These findings were compatible with the diagnosis of frosted branch angiitis with chorioretinal circulatory insufficiency. We initiated active systemic steroid therapy for 7 months and vasodilation therapy for 3 months. Two years later, the visual acuity improved to 0.5 in both eyes. CONCLUSION: Long-term active systemic steroid therapy for frosted branch angiitis with severe circulatory insufficiency in the retina and choroid may improve visual function.