Following the Great East Japan Earthquake, the role of pharmacists in disaster areas has grown in importance and responsibilities have become increasingly diverse. During the 2024 Noto Peninsula Earthquake, we participated in disaster relief activities as a pharmacist team. In these efforts, we worked alongside the Kansai Intensive Area Care Unit for SARS-CoV-2 "KISA2-tai". We encountered a situation that highlights the critical role of pharmacist teams in disaster relief efforts at an intensive care home for the elderly. Herein, we report the results and problems encountered during these activities.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

Background and objectives: The number of workers taking temporary leave due to clinical depression is increasing, and the probability that these workers will take such leave again after returning to work is high. In response to this dilemma, institutions involved in psychiatric care across Japan now implement “rework programmes,” aiming to help employees resume work without relapsing to depression. Methods: This programme has several forms. Between May 2017 and June 2019, 32 patients on temporary leave due to a depressed mood participated in group psychotherapy at our clinic. Of these patients, 21 patients who were able to return to work without a recurrence of symptoms, evaluated upon reinstatement, and followed up for 1 year were analysed in this study. The participants were divided into two groups: a continued employment group (n=16) consisting of patients who were still working one year after reinstatement and a repeat leave group (n=5) consisting of those who took temporary leave again within the first year. Differences in psychiatric symptoms, social function, cognitive function, readiness to return to work, and other factors were compared between the two groups. Results: The continued employment group was likely to have better social function, cognitive flexibility, and executive function when returning to work. Conclusion These preliminary results indicate that social functions and cognitive functions might be associated with continued employment.

A 6-year-old boy was admitted with infective endocarditis and aortic regurgitation. Clinical signs of infection were severe. The leukocyte count was 13, 100/μl and the C-reactive protein (CRP) was elevated to 17.2mg/dl. Blood culture was positive for Staphylococcus aureus. Echocardiography showed a vegetation 3mm in diameter on the aortic valve, and a perforation of the right coronary cusp with moderate aortic regurgitation. With antibiotic therapy, clinical signs and laboratory data of infection improved at an early stage. We decided to operate after his complete recovery from infection. Laboratory data normalized completely in 6 weeks, but echocardiography demonstrated aneurysmal change of the right coronary sinus and severe aortic regurgitation. The Ross operation was performed on the 44th day. At operation, it was noted that the non-coronary cusp was destroyed completely leaving only strings of fibrous tissue. A perforation of 3mm in diameter was also found on the right coronary cusp. There was a mural aneurysm near the right coronary orifice without abscess formation in the surrounding structure. A pulmonary autograft was transplanted to the aortic root after resection of the destroyed aortic cusps, aortic root and the mural aneurysm. The right ventricular outflow tract was reconstructed using an autologous pericardium as a posterior wall and the Monocusp ventricular outflow patch (MVOP) #22 as an anterior transannular patch. The postoperative course was uneventful. Postoperative echocardiography revealed no aortic regurgitation.