Objective: The present study investigated awareness and knowledge about clinical trials among pharmacists working in the Nagano Hokushin area as well as their contribution to the enlightenment of clinical trial.
Methods: A questionnaire survey of clinical trials was conducted to evaluate levels of interest, impressions, sources of information, and knowledge among hospital and community pharmacists.
Results: We received responses from 77 hospital and 67 community pharmacists.  The levels of interest in clinical trials were not significantly different between hospital and community pharmacists.  About impressions, hospital pharmacists thought that clinical trials were “a new development.”  Contrarily, community pharmacists thought that clinical trials were “a field that they were seldom concerned with.”  About sources of information, hospital pharmacists found that “study meetings” were the most informative.  More community pharmacists than hospital pharmacists chose “general reports, for example, newspapers and televisions” as a source of information, and similarly more community pharmacists indicated that they had “few opportunities for obtaining information about clinical trials.”  About knowledge, the percentage of correct answers about clinical trials between hospital and community pharmacists was not significantly different.  A higher percentage of community pharmacists than hospital pharmacists answered unknown.
Conclusion: Hospital and community pharmacists had different impressions and knowledge about clinical trials probably because of differences in sources of information and its access.  Henceforth, study meetings involving educational material about clinical trials should be held for discussing fundamental knowledge about the methods and structure of clinical trials and for discussing case studies wherein patients consult pharmacists about clinical trials.

We describe a case of meningeal carcinomatosis of the internal auditory meatus presenting as sudden deafness accompanied by dizziness. A 54-year-old woman complained of acute right-side hearing loss in October 2014. The pure tone audiometry test revealed right-side hearing loss of 47.5 dB. She was treated with oral steroids. Her hearing as well as her symptoms of dizziness worsened and she was admitted for further examination. Her right and left-side hearing had worsened to 105.0 dB and 47.5 dB, respectively. A magnetic resonance imaging scan of the head revealed bilateral enhancement of the internal auditory canal and multiple brain metastases. The chest radiograph revealed a mass in the left lung. Adenocarcinoma of the lung was diagnosed. Lumbar puncture yielded no evidence of carcinoma cells in the cerebrospinal fluid, but an increased number of lymphocytes was confirmed. A diagnosis of multiple brain metastases and leptomeningeal metastasis from the adenocarcinoma of the lung was considered. Whole-brain radiation therapy (30 Gr/10 fractions) was administered. Progressive bilateral hearing loss is a rare first manifestation of meningeal carcinomatosis. It is quite important to consider the possibility of this condition when patients present with sudden deafness.
Adenocarcinoma ; Audiometry ; Brain ; Cerebrospinal Fluid ; Diagnosis ; Dizziness ; Ear, Inner ; Female ; Head ; Hearing ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Sudden ; Humans ; Lung ; Lymphocytes ; Magnetic Resonance Imaging ; Meningeal Carcinomatosis ; Middle Aged ; Neoplasm Metastasis ; Radiography, Thoracic ; Spinal Puncture ; Steroids ; Temporal Bone

Lately, there has been a trend towards integration among cardiovascular surgery institutions. However, local institutions continue to play a crucial role in community-based medicine, given the emergent nature of cardiovascular diseases and the challenges involved in transporting patients with such conditions over long distances. We present the results of a questionnaire survey we conducted to examine the current status and issues faced by cardiovascular surgery institutions in community-based medicine.