Our hospital has a nutrition support team (NST) serving inpatients of all department. Two years ago, the team started activities with the motto “Apt nutritional management for inpatients”. It is an interdepartmental unit consisting of physicians, nurses, dietitians, pharmacists and speech therapists. Initially we found it difficult to make time to join forces, but now it has become possible to screen patients for undernourishment on a weekly basis while making nutritional assessment and planning, and holding consultations. The main purpose of the consultations is to improve the nutritional status of patients according to plans formulated after nutritional assessment made at the request of physicians and nurses in charge of the patients. To achieve the objective, we are expected to concentrate all our efforts and brains. This paper presents some consultation cases we have handled. In addition, the nutritional assessment and nutritional intervention activities of our hospital are described.
Nutrition Assessment ; Nutritional status ; Nutritional Support ; Hospitals ; Consultation

　　This study was conducted with a view to improving medication management service by reviewing renal excretory drug prescription practices in our hospital for patients with decreased kidney function without intervention of pharmacists. The subjects were the outpatients to whom the doctors had prescribed drugs containing digoxin, cibenzoline, bezafibrate, levofloxacin, valaciclovir or dabigatran. We retrospectively reviewed their serum creatinine levels, sex, age, height, weight and the amount of the drugs prescribed. It was found that there are cases in which medication had been prescribed without serum creatinine testing or prescribed in excess of the amount needed. Furthermore, there were cases in which the renal function had been judged in all probability by age and serum creatinine levels alone. Based on these findings, we concluded that pharmacists should intervene in pharmacotherapy using renal excretory drugs. For the realization of this, it would be necessary to build a system within the Department of Pharmacy to support the pharmacotherapy.

Although programmed cell death-ligand 1 (PD-L1) is a prognostic biomarker for nivolumab therapy, it is not very reliable due to its low accuracy. The pharmacological effect of nivolumab involves the cancer immunity cycle, a process that involves T cells, which are strongly associated with nutrition. In this study, we retrospectively investigated whether two measures of nutrition, namely, the Glasgow Prognostic Score (GPS) and the Prognostic Nutritional Index (PNI), could predict response to nivolumab as evaluated in terms of survival time. The subjects were 37 patients treated with nivolumab in the Department of Respiratory Medicine at our hospital between January 2017 and December 2018. Patients were classified into 2 PNI risk groups (low and high risk) and 3 GPS groups (0, 1, and 2), with lower GPS indicating better nutrition. Kaplan-Meier analysis was used to compare differences between the PNI groups and between each possible pairing of GPS groups. Survival time was significantly longer for the low-risk PNI group compared with the high-risk PNI group and for a GPS score of 0 versus 2 and 1 versus 2, but there was no significant difference for a GPS score of 0 versus 1. These results show that GPS and PNI may be potential predictors of response to nivolumab in non-small cell lung cancer.