[The smaller number of influenza patients with neuropsychiatric events had taken oseltamivir beforehand].

UNLABELLED: Oseltamivir is a neuraminidase inhibitor preventing the release of the infectious influenza virus particles from the infected respiratory tract cells of the patients. It is known that the medicine reduces the duration and the severity of this infectious disease and the incidence of pneumonia as its complication. Recently some reports emerged mainly from Japan that neuropsyciatric events are provoked by oseltamivir. However, the neuraminidase inhibitor might be expected to prevent the events, as it reduces the viral burden. Therefore it was investigated whether oseltamivir reduces the incidence of the events. PATIENTS AND METHODS: The study was conducted at the Yokohama Rosai Hospital, Kanagawa, Japan since December 2006 to March 2007. Patients with fever who had got the positive result of the influenza viral antigen test but no neuropsyciatric events, older than one year old, were enrolled in this study. The cases were the patients who visited the outpatient department of the hospital for their neuropsychiatric events (Case Group). The controls were the patients more than one year old with no neuropsychiatric events (Control Group). Nasopharyngeal aspirate fluid was used for detecting influenza virus by using a rapid diagnosis test, the ESPLINE Influenza A&B-N (Fujirebio Corp., Japan). The proportion of gender, age, and the use of oseltamivir were compared in the two groups with t-test and chi-squared test. RESULTS: Twelve cases and 335 control patients were enrolled in this study. The mean age and its standard deviation of the Case Group was 8.25 +/- 3.22 years old, which was significantly higher than that of the Control Group (6.09 +/- 3.74 years old, p = 0.049). The Case Group consisted with 9 boys (75.0%) and 3 girls (25.0%), as the Control Group had 183 boys (54.6%) and 152 girls (45.4%). The frequency of the type A virus was not significantly higher in the Case Group (7 patients, 58.3%) than in the Control Group (168 patients, 50.1%) (p = 0.162). Six cases (50.0%) in the Case Group had taken oseltamivir prior to the neuropsychiatric events on the contrast that 261 patients (77.9%) in the Control Group were prescribed the same medicine; the difference was statistically significant (p = 0.024). CONCLUSION: It is concluded that oseltamivir, an influenza virus neuraminidase inhibitor, significantly reduces the incidence of the neuropsychiatric events of the patients with influenza virus infection.

HLA-DRB1*15021 is the predominant allele in Japanese patients with juvenile dermatomyositis.

OBJECTIVE: To investigate HLA molecules and genes in Japanese patients with juvenile dermatomyositis (JDM). METHODS: Twelve patients (8 girls and 4 boys) with ages of onset between 3 and 15 years were included. HLA class I antigen phenotypes were serologically typed by the Terasaki-NIH standard method. DNA was extracted from peripheral blood leukocytes using the phenol-chloroform extraction procedure, and stored at -70 degrees C until use. Genomic DNA for HLA-DRB1, HLA-DQA1, and HLA-DQB1 alleles in JDM patients and controls was determined by the direct sequence method. RESULTS: HLA-A24 and B52 were each detected in 7 cases (OR = 0.86, 5.02, p = 0.930, 0.006, respectively). HLA-DRB1*15021 was observed in 7 patients. This was significantly more frequent than occurred in the controls (OR = 5.72, p = 0.002). Seven patients out of 12 (58%) had the combination HLA-B52, DRB1*15021, DQA1*0103, and DQB1*0601. CONCLUSION: Our results suggest that the susceptibility gene for JDM either is HLA-DRB1*15021 or is present near the HLA-DRB1 locus. This differs from previous reports that describe the association with HLA-DQA1*0501 in Caucasian patients with JDM. The combination HLA-B52, DRB1*15021, DQA1*0103, and DQB1*0601 may contribute to the pathogenesis of JDM in Japanese patients.

Risk factors of helminthiases among schoolchildren in southern Thailand.

School-age children are particularly at risk of soil-transmitted helminthiasis (STH), which affects their growth and development. Hence, school-based helminthiasis control has been discussed and conducted as one of cost-effective ways in developing countries. A parasite control program is to be planned and conducted in an evidence based way as one of practical medical fields. However, a prevalence is likely to be influenced by various factors such as local environment and residents' behavior and so on. As few reports mentioning the relation of the prevalence and children's behavior and practice have been published, we conducted a survey to investigate such relation by asking children directly. Two hundred and eighty pupils in grade 3 to grade 5 were enrolled, who were in the two schools in Nakhon Si Thammarat Province, southern Thailand. A cross-sectional study was conducted in February and in November 2001, on the relationship between helminthiasis and children's knowledge and practice by using Kato-Katz method and a questionnaire, respectively. Hookworm (Hw) was the most predominant helminth followed by Trichuris. Boys had more intensive Hw infection than girls (p = 0.022), and wore shoes less frequently than girls (p < 0.001). The pupils who nearly acquired Hw infection after the first stool examination had lower levels of the knowledge of STH comparing to those who did not (p = 0.011). This study suggests that a prior survey can identify unique local factors as a part of diagnostic process, the results of which are useful for teachers to understand some points of health education at schools and can be applied as indicators for monitoring and evaluation.