Japan’s Peacekeeping at a Crossroads

This open access book examines why Japan discontinued its quarter-century history of troop contribution to UN Peacekeeping Operations (1992–2017). Japan had deployed its troops as UN peacekeepers since 1992, albeit under a constitutional limit on weapons use. Japan’s peacekeepers began to focus on engineering work as its strength, while also trying to relax the constraints on weapons use, although to a minimal extent. In 2017, however, Japan suddenly withdrew its engineering corps from South Sudan, and has contributed no troops since then. Why? The book argues that Japan could not match the increasing “robustness” of recent peacekeeping operations and has begun to seek a new direction, such as capacity-building support

Japan’s Peacekeeping at a Crossroads

This open access book examines why Japan discontinued its quarter-century history of troop contribution to UN Peacekeeping Operations (1992–2017). Japan had deployed its troops as UN peacekeepers since 1992, albeit under a constitutional limit on weapons use. Japan’s peacekeepers began to focus on engineering work as its strength, while also trying to relax the constraints on weapons use, although to a minimal extent. In 2017, however, Japan suddenly withdrew its engineering corps from South Sudan, and has contributed no troops since then. Why? The book argues that Japan could not match the increasing “robustness” of recent peacekeeping operations and has begun to seek a new direction, such as capacity-building support

Preventive Effect of Nutrition Support on Peroneal Neuropathy in Cancer Patients

Background: The occurrence of peroneal neuropathy was reported to be higher in cancer patients than in non-cancer patients. Cancer patients should have their nutritional intake carefully managed in order to minimize weight loss and avoid the occurrence of peroneal neuropathy. However, the effect of nutrition support on the prevention of peroneal neuropathy is not understood.Aims: The present study aimed to assess epidemiologically the effect of nutrition support on the occurrence of peroneal neuropathy in cancer patients.Methods: We performed a retrospective case-control study in 178,597 cancer patients admitted to Shizuoka Cancer Center Hospital from 2002 to 2017. The rates of peroneal neuropathy were assessed between the 8-year period before nutrition support started and the 7-year period during which nutrition support performed.Results: Twenty-nine and 14 cases of peroneal neuropathy occurred in the periods without and with nutrition support, respectively. Compared with the period without nutrition support, the risk of peroneal neuropathy decreased by 62% during the period with nutrition support (odds ratio, 0.38; 95% confidence interval, 0.18–0.74; P < 0.05).Conclusion: Our study suggests the preventive effects of nutrition support on peroneal neuropathy in cancer patients

Role of the Transplant Pharmacist

At the National Cerebral and Cardiovascular Center, Japan, pharmacists have been involved in drug treatment management and patient care as members of multidisciplinary heart transplant teams that include surgeons, physicians, recipient transplant coordinators, and nurses during the waiting period for heart transplantation (HTx), HTx surgery, and post-HTx. During the waiting period, pharmacists play an important role in adjusting the use of antibiotics, anticoagulants, and antiarrhythmics by patients receiving a ventricular assist device (VAD). During HTx surgery and post-HTx, pharmacists advise physicians regarding the individualized medication protocol for immunosuppression and infection prevention to be used for each patient based on the patient’s pre-HTx characteristics as well as gene polymorphisms. They thus contribute to reducing the burden on the physician through the sharing of tasks. Throughout all three phases of HTx, pharmacists repeatedly provide medication and adherence education to the patients and caregivers. It is hoped that an academic society-led training protocol as well as transplant pharmacists will be established in Japan and other developed countries, and that these specialized transplant pharmacists would then provide individualized pharmacotherapy for the use of various antibiotics, anticoagulants, and immunosuppressive agents that have a narrow range of treatment in VAD and HTx patients

Bortezomib-cyclophosphamide-dexamethasone induction/consolidation and bortezomib maintenance for transplant-eligible newly diagnosed multiple myeloma: phase 2 multicenter trial

[Objectives:] We conducted a phase II trial to prospectively evaluate the efficacy and safety of bortezomib-cyclophosphamide-dexamethasone (VCD) induction, autologous stem cell transplantation (ASCT), VCD consolidation, and bortezomib maintenance in transplant-eligible newly diagnosed multiple myeloma (NDMM) patients in Japan (UMIN000010542). [Methods:] From 2013 to 2016, 42 patients with a median age of 58 (range 42–65) years with NDMM were enrolled in 15 centers. The primary endpoint was the complete response (CR) /stringent CR (sCR) rate after transplantation, and overall/progression-free survival rates were also evaluated. [Results:] Following induction therapy, the overall response rate was obtained in 71% of patients, including a CR/sCR of 10% and a very good partial response (VGPR) of 26%. Twenty-six of the 42 patients completed ASCT following the protocol and CR/sCR and VGPR rate 100 days after ASCT was 26% and 17%, respectively. During consolidation therapy, 3 of the 24 patients achieved deeper responses. Eight of the 18 patients completed 2-year bortezomib maintenance without disease progression and grade 3/4 toxicities. Five patients were VGPR or partial response after ASCT but maintained response with 2-year bortezomib maintenance. Two-year overall and progression-free survival rates were 92.5% (95% confidence interval [CI]: 78.5%−97.5%) and 62.6% (95% CI: 45.8%−75.5%), respectively. Grade 3/4 toxicities (≥ 10%) included neutropenia (19%) and anemia (17%) in induction, and thrombocytopenia (29%) in consolidation. [Conclusion:] VCD induction/consolidation and bortezomib maintenance with ASCT for NDMM resulted in a high CR/sCR rate and provided good overall/progression-free survival in Japan