1.Awareness Survey on Handling and Exposure of Anti-Cancer Drugs among the Hospital Pharmacists
Emi KABASAWA ; Hiroyuki SHIMIZU ; Takako NAKAMURA ; Takaaki SUZUKI ; Itsuko ISHII
Japanese Journal of Drug Informatics 2019;20(4):213-219
Objective: Anticancer drugs have carcinogenic potential and are associated with occupational exposure risks among healthcareprofessionals who handle them. To minimize occupational exposure, healthcare workers must be adequately aware of the risks ofanticancer drugs and the appropriate techniques for their preparation. However, there is little information on the awareness ofpharmacists who prepare anticancer drugs in medical settings. The aim of this study was to investigate awareness of hazardous drugs(HD) and appropriate preparation techniques among pharmacists, and identify problems that pharmacists experience in managing theirexposure to anticancer drugs.Design: Questionnaire.Method: The questionnaire was sent by e-mail or mail to pharmacists employed at 270 institutions who belonged to the Chiba Societyof Hospital Pharmacists. From September 2015 to March 2016, respondents completed the questionnaires voluntarily and returnedthem by mail. Returning the questionnaire was regarded as informed consent to participate in this survey. Based on the completedquestionnaires, we examined the awareness of pharmacists in their daily work.Results: In total, 218 questionnaires were returned (collection rate: 10%). Awareness of the risks of anticancer drugs was high, and ahigh percentage of respondents use personal protective equipment during drug preparation, but the use of closed system drug transferdevices was low. Overall, however, it was found that many pharmacists had insufficient understanding of safe handling techniques.Discussion: Despite some recognition of the risks associated with exposure to HD, the measures taken to prevent exposure toHDs―including anticancer drugs―were inadequate and this issue must be urgently addressed by medical institutions and pharmacists.Countermeasures such as training sessions in the handling of HDs and the development of manuals are needed for each facility.
2.Microscopic diseases remain in initial disseminated sites after neoadjuvant chemotherapy for stage III/IV ovarian, tubal, and primary peritoneal cancer
Shinichi TATE ; Kyoko NISHIKIMI ; Kazuyoshi KATO ; Ayumu MATSUOKA ; Michiyo KAMBE ; Takako KIYOKAWA ; Makio SHOZU
Journal of Gynecologic Oncology 2020;31(3):e34-
Objective:
This study aimed to evaluate the presence of pathological residual tumor (pRT) in each initial disseminated site after neoadjuvant chemotherapy (NACT) to assess the appropriate surgical margins during interval debulking surgery (IDS) for a favorable prognosis.
Methods:
This prospective descriptive study included patients with stage IIIC–IV epithelial ovarian, fallopian tubal, and peritoneal cancer. One hundred eleven patients underwent diagnostic exploratory laparotomy, and their initial intra-abdominal dissemination statuses were recorded. Any tumor >1 cm in diameter found during the exploratory laparotomy was resected during IDS even if it was macroscopically invisible after NACT. The pRT rate after NACT and negative predictive value (NPV; probability that sites with macroscopically invisible tumors have no pRT) during IDS were assessed in each disseminated site.
Results:
A median of 5 NACT cycles were performed. Sites with a high incidence of pRT and low NPV included the rectosigmoid colon (71.4%, 38.6%), transverse mesentery (70.3%, 50.0%), greater omentum (68.3%, 51.7%), right diaphragm (61.9%, 48.1%), paracolic gutters (61.1%, 50.0%), and vesicouterine pouch (56.6%, 50.0%). Organs/tissues with a high incidence of pRT featured a low NPV. The median progression-free survival and overall survival in this cohort were 27.7 and 71.9 months, respectively.
Conclusion
Even if a disseminated site >1 cm in diameter before NACT is invisible during IDS, microscopic disease remains present within it. The appropriate surgical margins for IDS with a favorable prognosis could be secured by resecting a lesion of >1 cm before NACT even if it is invisible during IDS.
3.Microdeletions in the Y chromosome of patients with idiopathic azoospermia.
Akiyuki SHIMIZU ; Tomohiko ICHIKAWA ; Noriyuki SUZUKI ; Takako YAMAZAKI ; Takashi IMAMOTO ; Satoko KOJIMA ; Yukio NAYA ; Akira KOMIYA ; Hiroyoshi SUZUKI ; Koichi NAGAO ; Kazukiyo MIURA ; Haruo ITO
Asian Journal of Andrology 2002;4(2):111-115
AIMTo evaluate the occurrence and prevalence of microdeletions in the gamma chromosome of patients with azoospermia.
METHODSDNA from 29 men with idiopathic azoospermia was screened by polymerase chain reaction (PCR) analysis with a set of gamma chromosome specific sequence-tagged sites (STSs) to determine microdeletions in the gamma chromosome.
RESULTSDeletions in the DAZ (deleted in azoospermia) loci sgamma254 and sgamma255 were found in three patients with idiopathic azoospermia, resulting in an estimated frequency of deletions of 10.7% in idiopathic azoospermia men.
CONCLUSIONWe conclude that PCR analysis is useful for the diagnosis of microdeletions in the Y chromosome, which is important when deciding the suitability of a patient for assisted reproductive technology such as testicular sperm extracion-intracytoplasmic sperm injection (TESE-ICSI).
Adult ; Base Sequence ; Chromosomes, Human, Y ; DNA Primers ; Euchromatin ; genetics ; Follicle Stimulating Hormone ; blood ; Heterochromatin ; genetics ; Humans ; Luteinizing Hormone ; blood ; Male ; Oligospermia ; blood ; etiology ; genetics ; Polymerase Chain Reaction ; Prolactin ; blood ; Sequence Deletion ; genetics ; Sequence Tagged Sites ; Testosterone ; blood
4.10. Policy on Reasonable Accommodations for Medical Students with Disabilities in Common Achievement Tests
Hirokazu FUJITA ; Yasuko NODA ; Kayano ARASEKI ; Shin ISHIHARA ; Takao OKADA ; Ikuo SHIMIZU ; Takako SHIMIZU ; Yoshimi HARADA ; Kaduyo YAMAUCHI ; Yoko SETOYAMA
Medical Education 2024;55(2):169-175
The Common Achievement Tests for medical students consists of Computer Based Testing (CBT) conducted before clinical training, and Objective Structured Clinical Examination (OSCE) conducted before and after clinical training. Since the publicization of the Common Achievement Tests for medical students before clinical training in 2023, the Committee for Reasonable Accommodation has been established within the Common Achievement Tests Organization (CATO), where reasonable accommodations for each exam are being considered. Reasonable accommodations begin with an assessment based on requests from candidates and proceed through constructive dialogue between candidates and universities. Additionally, recordings of practical training sessions are provided to facilitate objective assessments, enabling the provision of reasonable accommodations tailored to candidates’ participation in clinical training and internships, thereby ensuring smooth examination processes.
5.Differences in gestational weight gain in accordance with Japanese and Institute of Medicine guidelines between Japanese and non-Japanese Asian pregnant women at a perinatal medical center in Japan
Chie KOH ; Takako CHIBA ; Ryoko YOSHIDA ; Misato KATO ; Maho MORI ; Akiko MORIMOTO ; Yukari NAKAJIMA ; Kanako YAMADA ; Miho FURUYAMA ; Minako SAHO ; Kaori WATANABE
Journal of International Health 2022;37(4):179-188
Objectives High gestational weight gain (GWG) is associated with perinatal risks to mother and child. Research shows that non-Japanese Asian women have higher GWG than Japanese women. However, no studies have compared GWG in these two populations using GWG recommendations in accordance with Japanese and Institute of Medicine (IOM) guidelines. The study aim was to compare GWG in non-Japanese Asian and Japanese pregnant women.Methods This was a retrospective observational study. All participants were aged ≥20 years and gave birth between September 2019 and the end of October 2020 at one perinatal medical center in Japan. Medical record data were analyzed for 170 non-Japanese Asian and 316 Japanese pregnant women. We used t-tests and chi-square tests to examine differences in age, parity, smoking status, antenatal checkups, pre-pregnancy body mass index, and GWG. Logistic regression analysis was used to estimate odds ratios (95% confidence intervals) for above- and below-recommended GWG by non-Japanese Asian and Japanese status. We also analyzed differences in delivery type, abnormal blood loss, and birth size according to GWG.Results After adjustment for confounding factors, the multivariable-adjusted OR and 95% CI for GWG above the Japanese guidelines recommendations was 1.86 (1.23-2.81) and that for GWG above IOM guidelines recommendations was 2.46 (1.45-4.16) for non-Japanese Asian women, as compared with Japanese women. Conversely, the multivariable-adjusted OR and 95% CI for GWG below Japanese guidelines recommendations was 1.55 (1.03-2.32) and that for GWG below IOM guidelines recommendations was 1.87 (1.26-2.76) for Japanese women, compared with non-Japanese Asian women. Conclusion Because Japanese women tend to be below recommended GWG and non-Japanese Asian women tend to be above recommended GWG, midwives need to provide careful guidance to reduce perinatal risks.