Relationship between diabetes mellitus and excessive sleepiness during driving.

OBJECTIVES: It is still unclear whether patients with diabetes feel excessive daytime sleepiness or dose/sleep during driving in patients more frequently. METHODS: A population-based cross-sectional survey was conducted in a rural town. Multivariable-adjusted logistic regression models were used to explore the association between prevalent diabetes cases and excessive daytime sleepiness or dose/sleep during driving. RESULTS: Of 4540 participants, a total of 470 diabetes cases were identified. Compared with those in the never doze/sleep category, multivariate-adjusted odds ratios of diabetes was 0.41 (95%CI, 0.12-1.35) in slight category of dozing or sleeping when stopped for a few minutes in traffic while driving and 2.97 (95%CI, 1.19-7.41) in the moderate to high categories of dozing or sleeping when stopped for a few minutes in traffic while driving. This association remained significant after adjusting for the presence of poor sleep quality defined by the global Pittsburgh Sleep Quality Index score equal or greater than 5. CONCLUSION: Compared to individuals without diabetes, patients with diabetes experienced excessive daytime sleepiness or dozing/sleeping when stopped for a few minutes in traffic while driving more often independent of poor sleep quality. From the public health perspective, all patients with diabetes should be asked about a history of excessive daytime sleepiness or dozing/sleeping while driving, which is a known risk factor for future traffic accidents.

Role of taurine supplementation to prevent exercise-induced oxidative stress in healthy young men.

To evaluate the protective effects of taurine supplementation on exercise-induced oxidative stress and exercise performance, eleven men aged 18-20 years were selected to participate in two identical bicycle ergometer exercises until exhaustion. Single cell gel assay (SCG assay) was used to study DNA damage in white blood cells (WBC). Pre-supplementation of taurine, a significant negative correlation was found between plasma taurine concentration before exercise and plasma thiobaribituric-acid reactive substance (TBARS) 6 hr after exercise (r = -0.642, p<0.05). WBC showed a significant increase in DNA strand breakage 6 hr and 24 hr after exercise. Seven-day taurine supplementation reduced serum TBARS before exercise ( p<0.05) and resulted in a significantly reduced DNA migration 24 hr after exercise ( p<0.01). Significant increases were also found in VO(2)max, exercise time to exhaustion and maximal workload in test with taurine supplementation ( p<0.05). After supplementation, the change in taurine concentration showed positive correlations with the changes in exercise time to exhaustion and maximal workload. The results suggest that taurine may attenuate exercise-induced DNA damage and enhance the capacity of exercise due to its cellular protective properties.

A meta-analysis of epidemiological studies on the relationship between occupational electromagnetic field exposure and the risk of adult leukemia.

Since the first paper by Milham et al. suggested that occupational exposure to an electromagnetic field (EMF) could increase the risk of adult leukemia, many epidemiological studies on this problem have been published. In this report the method of meta-analysis was used to summarize the results from these papers quantitatively. The combined relative risk of all leukemia (RR=1.11), as well as acute lymphocytic leukemia (RR=1.38), acute myeloid leukemia (RR=1.07) and chronic lymphocytic leukemia (RR=1.14) increased but not significantly. So far, it is difficult to make a consistent conclusion about the relationship of the occupational exposure to EMF and adult leukemia. Further carefully designed case-control and cohort studies using the more valid means of exposure assessment are required.

The relationship between lifestyle, social characteristics and obesity in 3-year-old Japanese children.

It has been observed that obese children receive genetic and environmental effects that are associated with them being overweight. With regard to the latter, lifestyles such as eating habits and physical activity have been focused on. In the present study, the social characteristics which would dominate their lifestyles were investigated as background variables. For this purpose, 9668 Japanese children aged three years who were all born in Toyama prefecture, Japan, in 1998, served as birth cohort subjects. For the comparison between obese (Kaup Index; mass in kg/(height in m)2 > or = 18) and nonobese (Kaup index < 18) children, irregular snack intake, physical inactivity and reduced sleeping hours were chosen as statistically significant obesity-related lifestyle indicators for the children. For social characteristics, family construction (expanded family with grandparents/nonexpanded family), main caregiver (mother/other), attending a nursery school (yes/no) and mother's employment (full-time worker/other) were chosen. These were significantly associated with the obesity-related lifestyles mentioned above using multiple logistic regression analysis adjusted for other variables of social characteristics as well as for gender and birth month (July-December/January-June). The two greatest population-attributable risk percentages were observed for mother as main caregiver (-36.5%) and attending a nursery school (-28.9%) for irregular snack intake. Therefore, these two social characteristics substantially reduced the number of children with irregular snack intake. On the other hand, the two social characteristics were reversed in children with reduced sleeping hours (population-attributable risk percentage of mother as main caregiver: 15.4%; attending a nursery school: 17%). In contrast with favourable effects on snack intake these social characteristics showed an adverse influence on the sleeping habits of children.

Working hours as a risk factor for acute myocardial infarction in Japan: case-control study.

OBJECTIVE: To clarify the extent to which working hours affect the risk of acute myocardial infarction, independent of established risk factors and occupational conditions. DESIGN: Case-control study. SETTING: University and general hospitals and routine medical examinations at workplaces in Japan. SUBJECTS: Cases were 195 men aged 30-69 years admitted to hospital with acute myocardial infarction during 1990-3. Controls were 331 men matched at group level for age and occupation who were judged to be free of coronary heart diseases at routine medical examinations in the workplace. MAIN OUTCOME MEASURES: Odds ratios for myocardial infarction in relation to previous mean daily working hours in a month and changes in mean working hours during previous year. RESULTS: Compared with men with mean working hours of >7-9 hours, the odds ratio of acute myocardial infarction (adjusted for age and occupation) for men with working hours of >11 hours was 2.44 (95% confidence interval 1.26 to 4.73) and for men with working hours of <=7 hours was 3.07 (1.77 to 5.32). Compared with men who experienced an increase of <=1 hour in mean working hours, the adjusted odds ratio of myocardial infarction for men who experienced an increase of >3 hours was 2.53 (1.34 to 4. 77). No appreciable change was observed when odds ratios were adjusted for established and psychosocial risk factors for myocardial infarction. CONCLUSION: There was a U shaped relation between the mean working hours and the risk of acute myocardial infarction. There also seemed to be a trend for the risk of infarction to increase with greater increases in mean working hours.

The comparative study on occupational mortality, 1980 between Japan and Great Britain.

Age-adjusted standardized mortality ratios (SMRs) and life tables in male occupational groups for all causes and major diseases such as malignant neoplasm of stomach and lung, cerebrovascular disease, ischemic heart disease, traffic accidents and suicide was compared between Japan and Great Britain. Except for traffic accidents and suicide, males in higher employment grades had lower SMRs which had also been found to be related to other social class indicators such as perinatal death rate, the frequency of work absence and current smoker's rate. Occupational differences in mortality rates for major diseases became smaller with advancing age in Great Britain but not necessarily in Japan. The present authors concluded that inequalities in socio-economical factors were more likely to be the primary factors for survival, and that selection such as occupation and occupation-related lifestyle might still be an important factor for the inequalities. These inequalities were more obvious in Japan, where a life expectancy was, however, best in the world.

Ischaemic heart disease deaths in a Japanese rural area evaluated by clinical records.

A community-based survey to examine the actual number of ischaemic heart disease (IHD) deaths was undertaken in the western area of Toyama, a rural area with a population of 209,000. IHD deaths (International Classification of Diseases [ICD], ninth revision, codes 410-414) and heart failure (HF) deaths (ICD code 428) according to the death certificate aged 15 to 74 in 1987 to 1990 were reevaluated from medical records using the criteria of the multinational monitoring of trends and determinants in cardiovascular disease (MONICA). Of 97 subjects with IHD and of 170 subjects with HF according to the death certificate, 85 cases (87.6%) and 143 cases (84.1%) could be examined, respectively. Using the MONICA criteria, of 85 subjects with IHD, 18 (21.2%) were reevaluated as "definite acute myocardial infarction (AMI)" and 30 (35.3%) as "possible AMI". On the other hand, of 143 subjects with HF, 1 (0.7%) were reevaluated as "definite AMI" and 12 (8.4%) as "possible AMI". From these results, the number of deaths as reevaluated IHD was estimated 104.5 in the study period, and it was 7.7% increase at least compared with the number of deaths judged from the death certificate.

Does an allergy skin test on school-children predict respiratory symptoms in adulthood?

BACKGROUND: It is interesting from the correct point of preventive health care whether allergy skin tests at entry have the positive relationship with common respiratory symptoms such as persistent cough, persistent phlegm and wheeze with colds at end point in longitudinal studies. OBJECTIVE: The purpose of this study is to investigate this relationship in subjects followed from when they were school-children until they were young adults. METHODS: Young adults aged 18-31 years who had participated in an allergy skin test and a health survey for common respiratory symptoms during primary and junior high school were asked about their respiratory symptoms at the end-point in the follow-up study. Three cohort groups were employed in the follow-up study. RESULTS: According to a multiple logistic analysis with adjustments made for sex, symptoms at entry in childhood, and age and smoking habits at the end-point, young adults with a positive skin test to an extract of house dust as school-children showed a higher prevalence of wheeze with colds compared with those with a negative skin test. However, this relationship was not found for persistent cough or persistent phlegm, indeed, the latter symptom was significantly associated with negative skin tests in one cohort group. CONCLUSION: The respective symptoms at entry in childhood were also predictors of their occurrence in young adults. The results show that the common respiratory symptoms such as persistent phlegm and wheeze with colds in childhood are related to those in young adults rather than is an allergy skin test to an extract of house dust in childhood.

Genetic and environmental effects on urinary kallikrein, catecholamines, sodium, potassium, urea nitrogen and inorganic sulfate sulfur levels in school-age twins.

A genetic analysis of twins at school was undertaken using as variables urinary concentrations of kallikrein, catecholamines, sodium and potassium which have been demonstrated to be associated with blood pressure levels. In addition to these variables, urinary concentrations of urea nitrogen and inorganic sulfate sulfur which are indices of protein intake were investigated. 35 pairs of monozygotic twins and 19 pairs of dizygotic twins aged from 6 to 14 years were examined. Variance and correlation tests for genetic analysis indicated that in school children, hereditary factors play a role in the control of urinary potassium, sodium and kallikrein excretion. However, with regard to the urinary excretion of catecholamines, urea nitrogen and inorganic sulfate sulfur, hereditary control is not so apparent.

Effects of taurine on depletion of erythrocyte membrane Na-K ATPase activity due to ozone exposure or cholesterol enrichment.

The objective of this study was to investigate the interrelationship between taurine and erythrocyte-membrane Na-K ATPase activity. A comparison was conducted to test whether taurine or uric acid (a water-soluble scavenger of free radicals) prevents or recovers the depletion in membrane ouabain-sensitive Na-K ATPase activity resulting from ozone exposure or cholesterol enrichment of the erythrocyte membrane. A depletion of 44% and 27% in ouabain-sensitive Na-K ATPase activity was respectively caused by ozone exposure and cholesterol enrichment. Taurine as well as uric acid partially prevented the activity loss from ozone exposure. In addition, taurine at high concentrations (from 1.5 to 4.5 mM) restored the depletion of erythrocyte-membrane Na-K ATPase activity due to ozone exposure and prevented the depletion of the enzyme activity due to cholesterol enrichment. In contrast, although the same high concentrations were used, uric acid failed to show either of the above effects. These results suggest that taurine acts (1.5-4.5 mM) polyvalently as not only an antioxidizing agent but also as a membrane stabilizer to maintain the functions of membrane Na-K ATPase, a membrane-bound protein.

[A study on personal information system using movable media for effective welfare services].

A data system which enables utilization of individual patient data by public health nurses, physicians and home helpers, is required both for the continuous and comprehensive monitoring of the various needs of the aged receiving care services at home in the local district and for facilitating welfare services. Therefore, an experimental and comprehensive system for public health, medical services and welfare was put into practice for district public health services for the aging society. The results of this trial system shows that this system is useful indeed for the welfare services, though it also has several problems.