Objective: Pharmacotherapy for patients with breast cancer is now administered in an ambulatory setting, and we assume that patients would benefit if clinical pharmacists perform all stages of pharmacological intervention up to prescription in an ambulatory setting as well, especially for medicines requiring chronic administration and those that affect the patient’s life, such as hormonal therapy.  A thorough understanding of guidelines and the clinical reports is paramount for effective pharmacological intervention.  Since ambulatory care clinical pharmacists are involved in the treatment of a large number of patients, effective utilization of evidence outlined in guidelines and clinical reports is difficult.  Therefore, we developed a system for utilizing evidence as outlined in guidelines and clinical reports with a focus on hormonal therapy for patients with breast cancer.
Methods: A database based on the 2013 version of the clinical practice guidelines for breast cancer and clinical reports was constructed using Microsoft® Access 2010.
Result: Clicking on a guideline algorithm according to the disease stage of the patient results in a clinical question being displayed, and the ambulatory care clinical pharmacist is immediately able to determine suitable medications based on clinical reports that are run through the database.
Conclusion: With the use of this database, which includes information required for pharmacological intervention, ambulatory care clinical pharmacists could care for a large number of patients.

Liverpool Care Pathway (LCP) Japanese version was implemented to electronic medical chart (FUJITSU HOPE/EGMAIN-FX®). The processes were needed as follows; preparation of each templates (criteria for use of the LCP/initial assessment, ongoing assessment, and care after death), preparation of pathway/regimen, incorporation of the templates to the pathway and approval in our hospital clinical pathway committee. One problem we encountered was whether to choose an Excel or a template format for each assessment sheet, and the template format was selected as it presented us with a higher degree of convenience, since each field can be expanded into a table on the screen without scrolling and there is little limitation in the letters of the valiance records that can be used in the template format. The complexity of the three records, “the pathway”, “SOAP & focus” for recording opioid use, and “the progress sheet” for recording vital signs, in addition to the inability to expand enough to capture the same field and show changes in the daily pathway over time through night and day work shifts remain a challenge and need to be improved in the future.

BACKGROUND: Patients may receive negative results from a specific IgE (sIgE) test such as the ImmunoCAP (CAP) despite a documented history of systemic reaction to a Hymenoptera sting. Thus, further testing may be required using another serological method or venom skin prick tests to confirm allergy diagnosis and correct species. OBJECTIVE: To evaluate the sensitivity and the specificity of CAP and IMMULITE 3gAllergy (IMMULITE) for detecting sIgE to Paper wasp (WA) and Yellow Jacket (YJ) venoms using patient clinical history as the comparator. METHODS: Sera from 70 participants with a history of systemic reactions (SR) to WA and/or YJ stings were tested using CAP and IMMULITE. Fifty participants from this group had negative results on CAP. To assess specificity, sera from 71 participants who had never experienced either a WA or YJ sting were tested using CAP and IMMULITE. Fifty participants from this group tested positive using CAP. RESULTS: In participants with a history of systemic reaction to a Hymenoptera sting, yet who tested negative for WA and/or YJ sIgE according to CAP, the positivity rate according to IMMULITE was 20-42% using 0.10 IUA/mL as the limit of detection (LoD), per the manufacturer's specification. When the LoD for CAP (0.35 IUA/mL) was applied to the IMMULITE results, positivity according to IMMULITE was 14-26%. Overall, sensitivity, specificity, and agreement with SR were greater for IMMULITE than for CAP. For YJ: sensitivity (IMMULITE:CAP), 42.8%:28.5%; specificity, 53.5%:39.4%; agreement, 48.2%:34%. For WA, sensitivity (IMMULITE:CAP), 58.6%:28.5%; specificity, 49.3%:47.8%; agreement, 43.9%:38.3%. CONCLUSION: The IMMULITE performed well for detecting sIgE to Hymenoptera venom
Bites and Stings ; Diagnosis ; Humans ; Hymenoptera ; Hypersensitivity ; Immunoglobulin E ; Limit of Detection ; Methods ; Sensitivity and Specificity ; Skin ; Venoms ; Wasps

We would like to report the following errata in Table 4, and request that these items be revised appropriately.