A Case of Acute-phase Reaction of Denosumab which was Difficult to Exclude Aggravation of Original Cancer Pain

Introduction: We report a case of acute-phase reaction of denosumab which was difficult to exclude aggravation of original cancer pain. Case: A 65 year-old man with severe pain from right back to upper abdomen due to mid thoracic vertebral metastases of small cell lung cancer was consulted to palliative care team. Denosumab 120 mg was administered subcutaneously three times every four weeks. On the next day of first administration, pyrexia occurred. At all three administrations, pain worsened for four days after the next day of administration. The pain was worsened from numerical rating scale 2 to 6. Same phenomenon was observed each time denosumab was administered for three consecutive times. Although the area of pain overlapped with that of original vertebral metastases, the repetition of the pain exacerbation soon after the denosumab administration suggested acute-phase reaction. Conclusion: Pain aggravation caused by acute phase reaction of denosumab might be overlooked in patients with cancer pain. More investigation is needed for details of acute-phase reaction caused by denosumab.

Determining the Role of Welfare Education in Comedical Education / 医学教育

How are the educational goals stated by comedical schools such as “Education in Rich Humanity” and “Personnel who can coordinate with the various fields of Medicine, Health and Welfare” reflected in their curricula? I investigated the curricula and syllabi of 178 comedical schools around the nation and attempted to determine the position of welfare education therein. Welfare education was defined as a combination of learning through practical experience and programs in human rights and social welfare. The aim of such learning was found to be education in human understanding, the ability to solve problems, the foundation of cooperative social coexistence, and the awareness of self. However, I conclude that the content of the welfare education does not help students undergo meaningful personal development. Thus, this failing should be of immediate concern to comedical educators as they consider their role in medicine for the 21st century.