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Background/Aims@#Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. @*Methods@#A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. @*Results@#No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. @*Conclusions@#EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.
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Objective: Recently, special features on “dangerous” prescription drugs have been frequently published in few mass media platforms, such as weekly magazines. However, to our knowledge, there have been no prior studies, systematically organizing and evaluating the contents of these articles (e.g., drugs and their side effects that are reported). In this study, we aimed to evaluate the relevance of the information on “dangerous drugs” that was published in weekly magazines using the modified “Media Doctor” instrument.Methods: We extracted articles on “dangerous” prescription drugs from 10 weekly magazines for which the table of contents of previous issues are available on their official websites. Information regarding the target drugs and their classifications was compiled and organized. The relevance of the extracted news articles was assessed by two independent evaluators. The evaluation index was based on the modified “Media Doctor” instrument, and 9 evaluation criteria were used to assign the following categories: satisfactory, unsatisfactory, or not applicable.Results: A total of 1,064 articles were screened, and 19 articles were selected for further evaluation. A total of 179 drugs (belonging to 34 drug classes) were listed. The most frequently mentioned class of drugs included hypnotics and sedatives, and the most frequently listed was triazolam. Of the 19 articles, 11 had zero items that were judged satisfactory by both the evaluators. The number of unsatisfactory items was widely distributed, but in 11 of the 19 articles, five and more items were judged unsatisfactory by both the evaluators.Conclusion: We revealed that a wide variety of drugs have been termed as “dangerous” by weekly magazines. Additionally, we found that these articles were inadequate and incomplete with respect to scientific validity, and that there are many aspects that require further improvement.
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Abstract: We report a case of intractable pain in a patient with amyotrophic lateral sclerosis (ALS) that was successfully managed by administering a fentanyl transdermal patch. Case: A 75-year-old man was diagnosed with ALS in 2013 after he became aware of difficulty in walking and systemic pain since 2010. In 2019, he underwent gastrostomy and tracheostomy, and intractable generalized pain necessitated the administration of morphine hydrochloride six times a day; however, it could not provide adequate pain relief. Later, morphine was replaced with a fentanyl patch under a very strict safe-monitored setting and the pain became bearable. Discussion: Although high-level evidence is lacking, pain experts have reported the effectiveness of morphine for intractable pain in patients with ALS. Frequent short-acting morphine dosing is often burdensome due to the complexity of its administration and it also causes end-of-dose pain. A fentanyl patch may possibly improve these drawbacks.
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<p><b>OBJECTIVE</b>To examine the effectiveness of a drug abuse prevention program focusing on social influences for drug education classes in high school.</p><p><b>METHODS</b>The social influence program in the experimental group used role-playing led by a pharmacist, a police officer and a teacher. The intervention evaluation used a quasi-experimental design. The subjects were first-year students from 10 high schools assigned to the experimental group (6 schools, 828 students) and the control group (4 schools, 408 students). In the control group, a pharmacist used a conventional information program in a lecture format.</p><p><b>RESULTS</b>Regarding knowledge about drug abuse, in both the experimental and control groups, and for both males and females, a long-term effect was observed immediately after the program and lasted up to 15 months. For three other measures, attitudes toward drug abuse problem, self-efficacy regarding drug abuse prevention, and perception of social support for preventing drug abuse, a short-term effect was generally observed in the experimental group beginning immediately after the program and lasting for 3 months. A long-term effect was evident in high-risk students with positive opinions regarding drugs. In the control group and for both males and females, although an effect was generally evident immediately after the program, neither a short-nor a long-term effect was observed in males, suggesting the difficulty in achieving lasting effects.</p><p><b>CONCLUSIONS</b>The social influence program in the experimental group showed remarkable effectiveness. Thus, the program may be useful for preventing drug abuse among high school students in Japan.</p>
ABSTRACT
Objective: To examine the effectiveness of a drug abuse prevention program focusing on social influences for drug education classes in high school. Methods: The social influence program in the experimental group used role-playing led by a pharmacist, a police officer and a teacher. The intervention evaluation used a quasi-experimental design. The subjects were first-year students from 10 high schools assigned to the experimental group (6 schools, 828 students) and the control group (4 schools, 408 students). In the control group, a pharmacist used a conventional information program in a lecture format. Results: Regarding knowledge about drug abuse, in both the experimental and control groups, and for both males and females, a long-term effect was observed immediately after the program and lasted up to 15 months. For three other measures, attitudes toward drug abuse problem, self-efficacy regarding drug abuse prevention, and perception of social support for preventing drug abuse, a short-term effect was generally observed in the experimental group beginning immediately after the program and lasting for 3 months. A long-term effect was evident in high-risk students with positive opinions regarding drugs. In the control group and for both males and females, although an effect was generally evident immediately after the program, neither a short- nor a long-term effect was observed in males, suggesting the difficulty in achieving lasting effects. Conclusions: The social influence program in the experimental group showed remarkable effectiveness. Thus, the program may be useful for preventing drug abuse among high school students in Japan.