Subjective adverse events (AEs), such as pain, are often under-recognized when relying solely on structured data. Although natural language processing (NLP) enables the extraction of AEs from narrative electronic health records (EHRs), interpretation of their temporal dynamics is difficult. Visualization methods can bridge this gap by transforming text-derived symptom data into clinically interpretable data. This study aimed to demonstrate the clinical value of a framework integrating NLP-based AE extraction with time-series visualization for otherwise invisible symptoms. Narrative texts, including progress notes, nursing records, and discharge summaries, were processed using MedNERN-CR-JA, a pretrained Japanese BERT-based model for entity recognition. AEs were visualized using Kaplan–Meier curves to represent the time to first onset and heatmaps, displaying all subsequent symptom documentation alongside supportive medication use. Among the 35042 eligible patients, 3094 received paclitaxel (PTX) and were matched to 3094 controls. PTX was associated with a higher risk of musculoskeletal symptoms (hazard ratio, 1.77; 95% confidence interval: 1.57–1.99). Kaplan–Meier curves showed earlier onset in PTX recipients, while heatmaps depicted recurrent documentation and the corresponding analgesic use. Restricting the analyses to the triweekly PTX regimen reduced the heterogeneity between inpatient and outpatient documentation and revealed a clearer alignment between the treatment cycles and acute symptom onset. This framework demonstrates the clinical value of visualizing NLP-extracted AEs from narrative EHRs, improving the resolution of subjective AE data, enhancing monitoring, and supporting patient-centered care and clinical decision making through complementary time-to-event and heatmap visualizations.

To clarify the roles of Ca_v3.2 T-type Ca²⁺ channels and endogenous estrogen in pruritus, we conducted a fundamental study employing mice and clinical cross-sectional analyses of pharmacy claims data. In mice, intradermal injection of sulfide (Na₂S), a Ca_v3.2 enhancer, caused itch responses, an effect blocked by KTtp38, a T-type Ca²⁺ channel inhibitor, and deletion of Ca_v3.2 gene. KTtp38 also suppressed itch responses following intradermal histamine or chloroquine. The sulfide-induced itch responses in female mice decreased by ovariectomy and/or repeated treatment with letrozole, an aromatase inhibitor. Cross-sectional analyses of pharmacy claims data of 357972 female patients aged 18 years and older, obtained from nationwide branches of a chain pharmacy group, showed significantly lower prescription rates of topical steroids used for treatment of pruritus and/or dermatitis in women 55 years and older than in women under 55 years, and in the users than non-users of estrogen suppressants. Multivariate logistic regression analysis in the users and non-users of estrogen suppressants after propensity score matching indicated significant negative association of topical steroid prescription with the use of estrogen suppressants. Together, the present fundamental and clinical studies suggest the involvement of Ca_v3.2 and the promotive role of estrogen in pruritus in mice and/or humans.

Chemotherapy-induced oral mucositis is a frequent and debilitating adverse effect that impairs nutritional status and interrupts cancer therapy. Although 5-fluorouracil-induced animal models of oral mucositis are well established, irinotecan, widely used for colorectal, lung, and pancreatic cancers, has also been associated with oral mucosal injury; however, no standardized preclinical model exists. This study aimed to establish a reproducible hamster model of irinotecan-induced oral mucositis and evaluate the prophylactic and therapeutic efficacy of topical hangeshashinto (HST) compared with dexamethasone. Male Syrian hamsters received intraperitoneal irinotecan (100, 150, or 200 mg/kg) on Day 0, followed by localized mucosal injury induced by 50% acetic acid. Ulcer area, body weight, histopathology, peripheral blood count, and myeloperoxidase (MPO) activity were evaluated. HST (10% aqueous solution) or dexamethasone (0.01% elixir) was administered topically once daily either prophylactically (Days −3 to 0) or therapeutically (from Day 0 onward). Ulcer area increased in a dose-dependent manner, peaking on Day 4. The 200 mg/kg dose yielded consistent lesion formation with transient weight loss. Histopathological examination revealed dense neutrophilic infiltration and epithelial disruption. MPO activity was significantly elevated on Days 4 and 7. Prophylactic HST significantly reduced the peak and cumulative ulcer areas, whereas dexamethasone delayed healing. The 200 mg/kg irinotecan plus acetic acid hamster model thus provides a reliable platform for investigating oral mucositis. HST, particularly when administered prophylactically, exhibited better efficacy than dexamethasone, potentially through modulation of inflammatory responses and attenuation of oxidative stress. This model may facilitate further mechanistic studies and the development of preventive strategies for chemotherapy-induced oral mucositis.