Impact of menopausal symptoms on presenteeism in Japanese women.

BACKGROUND: Menopausal symptoms are common among middle-aged women. Working women with severe menopausal symptoms are more likely to experience presenteeism-a condition where employees continue to work despite feeling unwell. However, it remains unclear as to which specific symptoms women experience during the menopausal transition and postmenopausal periods that primarily contribute to presenteeism. AIMS: To evaluate the associations between types of menopausal symptoms and presenteeism among Japanese women. METHODS: A cross-sectional study of 4000 women aged 40-59 years who were currently working was conducted in Japan in September 2022. We used an online self-administered questionnaire that included items on demographic characteristics, the Menopause Rating Scale for measuring menopausal symptoms and the Work Functioning Impairment Scale for measuring presenteeism. Logistic regression analysis was performed. RESULTS: Women with severe overall menopausal symptoms had 12.18-fold (95% confidence interval [CI] 9.09-16.33, P < 0.001) increased odds of presenteeism compared with those without symptoms. Participants with psychological symptoms also had significantly higher presenteeism (severe: odds ratio: 9.18, 95% CI 6.60-12.78, P < 0.001). However, after controlling for psychological symptoms, there were no significant associations between somatic and urogenital symptoms and presenteeism. CONCLUSIONS: The results indicate that menopausal symptoms, especially psychological symptoms, have a significant impact on presenteeism among Japanese women. Organizations need to address menopausal symptoms in the workplace, with an emphasis on reducing work-related stress for women with menopausal symptoms.

Two definitions of presenteeism: sickness presenteeism and impaired work function.

BACKGROUND: Two major definitions exist for presenteeism: sickness presenteeism and impaired work function. The evidence for comparing previous studies on presenteeism is insufficient because of the different definitions of presenteeism used. AIMS: To assess the relationship between the two major definitions of presenteeism. METHODS: This cross-sectional study analysed secondary data on 5334 respondents to an employee survey administered in a construction company in Japan. Impaired work function was measured using the Work Functioning Impairment Scale (WFun). Multiple logistic regression was performed. RESULTS: A strong linear association was observed between the number of days of sickness presenteeism and impaired work function (all P < 0.001). In contrast, the number of days of sickness absence was only partially positively associated with impaired work function. All choices for most frequent health problem were positively associated with impaired work function, beginning with mental problems (adjusted odds ratio [OR] = 20.45, 95% confidence interval [CI]: 14.94-28.01), followed by malaise (adjusted OR = 11.91, 95% CI: 9.08-15.62) and sleeping problems (adjusted OR = 8.62, 95% CI: 6.57-11.33). CONCLUSIONS: A strong relationship was observed between the two major definitions of presenteeism, even after adjusting for a variety of chronic health conditions. Although a consensus on the definition of presenteeism is yet to be reached, this study provides insight on comparing existing studies on presenteeism.

Near misses and presenteeism among paramedics.

BACKGROUND: Paramedics need to be in good physical health to be able to respond to emergencies. We hypothesized that near misses by paramedics and unanticipated incidents that cause no harm may be associated with presenteeism during emergency rescues. AIMS: To examine the association between presenteeism and near misses among paramedics. METHODS: A cross-sectional study was conducted among 254 paramedics using a self-administered questionnaire. Presenteeism was measured using the work functioning impairment scale (WFun). RESULTS: Twelve per cent of respondents experienced high work function impairment indicating presenteeism. The rate of near-miss experiences steadily increased with increasing work function impairment among paramedics (WFun score category: middle, odds ratio (OR) 3.62, 95% confidence interval (CI) 1.62-8.11; high, OR 4.36, 95% CI 1.37-13.84; very high, OR 8.62, 95% CI 2.09-35.48). CONCLUSIONS: This study demonstrated a positive relationship between impaired work function indicating presenteeism and near misses among paramedics. This suggests that presenteeism may be associated with errors that have the potential to cause serious accidents. Improved access to treatment for frequent health problems may reduce the number of incidents among paramedics.

Willingness to care for blood-borne virus-infected patients in Thailand.

Background: Although stigma and discrimination by nurses against patients infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) have been reported, potential determinants of nurses' willingness to care for these patients have not been well studied in Thailand. Aims: To identify factors associated with Thai nurses' willingness to care for patients infected with HIV or HCV. Methods: Multivariable logistic regression analysis of data from a questionnaire completed by nurses at a large hospital in Bangkok, Thailand. Results: Of 626 nurses, 546 (87%) nurses participated. Eleven per cent (59) and 6% (34) had previously experienced HIV- or HCV-infected blood contamination incidents, respectively. Forty-four per cent (240) and 38% (208) reported unwillingness to care for HIV- or HCV-infected patients, respectively. Willingness to care was less common [adjusted odds ratios 0.51 (0.34-0.74) for HIV and 0.62 (0.42-0.89) for HCV] in nurses aged ≥ 40 years and in those who feared HCV [0.63 (0.37-0.99)], but not HIV [0.84 (0.5-1.26)] transmission. Nurses who had confidence in protecting themselves against infection with HIV [1.84 (1.52-2.04)] and HCV [1.87 (1.45-2.18)], and accepting attitudes towards HIV-infected co-workers [1.39 (1.08-1.66)] but not HCV-infected co-workers [1.16 (0.83-1.5)], were more willing to care for HIV- and HCV-infected patients. Conclusions: Around 4 in 10 Thai nurses in our sample were unwilling to care for HIV- or HCV-infected patients. Minimizing the risk of nosocomial transmission and improving the public perception of infected individuals may help improve nurses' willingness to care for such patients, in Thailand or elsewhere.

Heparan sulfate levels in mucopolysaccharidoses and mucolipidoses.

Glycosaminoglycans are accumulated in both mucopolysaccharidoses (MPS) and mucolipidoses (ML). MPS I, II, III and VII and ML II and ML III patients cannot properly degrade heparan sulphate (HS). In spite of the importance of HS storage in the metabolic pathway in these diseases, blood and urine HS levels have not been determined systematically using a simple and economical method. Using a new ELISA method using anti-HS antibodies, HS concentrations in blood and urine were determined in MPS and ML II and ML III patients. HS concentrations were determined in 156 plasma samples from MPS I (n = 23), MPS II (n = 26), MPS III (n = 24), MPS IV (n = 62), MPS VI (n = 5), MPS VII (n = 5), ML II (n = 8) and ML III (n = 3), and 205 urine samples from MPS I (n = 33), MPS II (n = 33), MPS III (n = 30), MPS IV (n = 82), MPS VI (n = 7), MPS VII (n = 9), ML II (n = 8) and ML III (n = 3). The ELISA method used monoclonal antibodies against HS. MPS I, II, III and VII and ML II and III patients had significant elevation in plasma HS, compared to the age-matched controls (p < 0.0001). Eighty-three out of 89 (93.3%) of individual values in the above MPS types and ML were above the mean +2SD of the controls. In urine samples, 75% of individual values in patients with those types were above the mean +2SD of the controls. In contrast to the previous understanding of the HS metabolic pathway, plasma HS levels in all five MPS VI and 15% of MPS IV patients were elevated above the mean +2SD of the controls. These findings suggest that HS concentration determined by ELISA, especially in plasma, could be a helpful marker for detection of the most severe MPS I, II, III, VI and VII and ML II, distinguishing them from normal populations.

Nuclear localisation of glutathione S-transferase pi is an evaluation factor for drug resistance in gynaecological cancers.

AIMS: Nuclear glutathione S-transferase pi (GST7pi) has been reported to protect cancer cells against anticancer drugs. The aim of the present study was to evaluate the clinical significance of nuclear GSTpi in gynaecological cancer. MATERIALS AND METHODS: We carried out an immunohistochemical analysis of GSTpi, and examined the correlation between nuclear GSTpi: expression and prognosis in 43 epithelial ovarian cancers. We compared expression levels before and after chemotherapy in uterine cervical cancers and endometrial cancers. RESULTS: The 5-year progression-free survival rate of the nuclear GSTpi-positive group was lower than that of the cytoplasmic GSTpi-positive group, and was significantly lower than that of the negative group (14.3% vs 34.8% vs 66.7%; P = 0.041). The expression of nuclear GSTpi was compared before and after chemotherapy in uterine cervical and endometrial cancers. In eight out of 12 cases (66.7%), the expression turned positive after the chemotherapy. CONCLUSIONS: We suggest that nuclear localisation of GSTpi is associated with drug resistance. The nuclear localisation of GSTpi in tumour cells is a useful prognosticator, and may contribute to the selection of anticancer drugs for gynaecological cancers.

Familial risk among Japanese patients with endometriosis.

OBJECTIVES: This study was designed to examine the prevalence of endometriosis among female siblings of patients with endometriosis in Japan. METHODS: A total of 339 patients with endometriosis were questioned about endometriosis in their sisters. The control group consisted of 284 Japanese healthy fertile women with no history of endometriosis. Similarly, the controls were interviewed about their sisters. RESULTS: We detected sisters with endometriosis in 8.8% of cases and 1.5% of the control population. The relative risk of endometriosis in female siblings was 5.7. However, a significant difference was not seen in age at diagnosis and clinical stage between patients with or without a family history of endometriosis. CONCLUSIONS: These data demonstrate a familial tendency for endometriosis and suggest that endometriosis has a genetic factor in the pathogenesis.

Neurons but not glial cells show reciprocal imprinting of sense and antisense transcripts of Ube3a.

The human UBE3A gene shows brain-specific partial imprinting, and lack of a maternally inherited allele causes Angelman syndrome (AS), which is characterized by neurobehavioral anomalies. In several AS model mice, imprinted Ube3a expression is detected predominantly in the hippocampus, cerebellar Purkinje cells and the olfactory bulb. Therefore, imprinting of mouse Ube3a is thought to be region-specific with different levels of silencing of the paternal Ube3a allele in different brain regions. To determine cell types of imprinted Ube3a expression, we analyzed its imprinting status in embryonic brain cells by using primary cortical cell cultures. RT-PCR and immunofluorescence were performed to determine the allelic expression of the gene. The Ube3a gene encodes two RNA transcripts in the brain, sense and antisense. The sense transcript was expressed maternally in neurons but biallelically in glial cells in the embryonic brain, whereas the antisense transcript was expressed only in neurons and only from the paternal allele. Our data present evidence of brain cell type-specific imprinting, i.e. neuron-specific imprinting of Ube3a in primary brain cell cultures. Reciprocal imprinting of sense and antisense transcripts present only in neurons suggests that the neuron-specific imprinting mechanism is related to the lineage determination of neural stem cells.

Interleukin-6 and interleukin-1 receptor antagonist in amniotic fluid and cord blood in patients with pre-term, premature rupture of the membranes.

OBJECTIVE: We investigated the role of interleukin (IL)-6 and IL-1 receptor antagonist (IL-1ra) in pre-term premature rupture of the membranes (PROM). METHOD: Amniotic fluid samples were collected from 10 patients with pre-term PROM (group 1a), 13 patients undergoing genetic amniocentesis (group 2), seven patients with normal vaginal delivery (group 3a), and 11 patients with elective cesarean section (group 4a). Umbilical venous blood was collected from nine cases of pre-term PROM (group 1b), 19 cases of normal delivery (group 3b) and nine cases of elective cesarean section (group 4b). RESULTS: The concentration of IL-6 in the amniotic fluid in group 1a was significantly higher than in group 2 (P<0.001), and that in group 3a was significantly higher than in group 4a (P<0.001). The concentration of IL-1ra in amniotic fluid in group 1a was significantly higher than in group 2 (P<0.001). The concentrations of IL-6 in umbilical venous blood were not significant among the groups. The concentration of IL-1ra in umbilical venous blood in group 1b was significantly higher than in group 3b (P<0.05) and group 4b (P<0.05). CONCLUSIONS: High concentrations of amniotic fluid IL-6 present in pre-term PROM, are indicative of intrauterine inflammation, probably due to sub-clinical infection. The high concentrations of IL-1ra in amniotic fluid and umbilical venous blood suggest the possibility that the presence of this anti-inflammatory cytokine serves to prevent the development of overt inflammation.

Maternal serum triglyceride at 24--32 weeks' gestation and newborn weight in nondiabetic women with positive diabetic screens.

OBJECTIVE: To determine whether elevated midpregnancy maternal serum lipid levels predict newborn weight at term and the risk of large for gestational age (LGA) infants in women with positive diabetic screen but normal glucose tolerance test. METHODS: Japanese gravidas who had positive diabetic screens and normal 75-g oral glucose tolerance tests (GTT) at 24--32 weeks were enrolled. Subjects with complications, including diabetes, hypertension, or fetal anomalies were excluded, as were women with multifetal gestations. Fasting serum triglyceride, free fatty acids, and total cholesterol levels were measured at the time of GTT. We tested the association between maternal variables and birth weight by univariable analysis. We used multivariable analysis to test whether the association between fasting lipids and birth weight was independent of prepregnant maternal body mass index (BMI), maternal weight gain during pregnancy, and plasma glucose levels at GTT. We also used multiple logistic regression analysis to determine whether maternal hyperlipidemia, defined as more than the 75th percentile of each lipid, is a risk factor for having an LGA infant. RESULTS: We enrolled 146 subjects. Among measured maternal lipids, only triglyceride levels correlated with birth weight in univariable analysis (r = 0.22, P =.009). Birth weight also was correlated with prepregnant maternal BMI (r = 0.18, P =.04) and fasting plasma glucose levels (r = 0.17, P =.04). The association between maternal fasting triglyceride level and birth weight remained significant after adjusting for prepregnant BMI, maternal weight gain, fasting plasma glucose levels, fetal gender, and gestational age at birth (P =.01). Logistic regression analysis showed that fasting maternal hypertriglyceridemia (over 259 mg/dL) was the significant predictor of LGA infants, independent of prepregnant BMI, maternal weight gain, and maternal plasma glucose levels (odds ratio 11.6; 95% confidence interval 1.1, 122; P =.04). CONCLUSION: In women with positive diabetic screens but normal GTTs, fasting triglyceride levels at 24-32 weeks correlated positively with newborn weight at term, independent of maternal plasma glucose levels and obesity. Maternal fasting serum triglyceride levels in midpregnancy might be an independent predictor of fetal macrosomia in those women.

[The occurrence of Churg-Strauss syndrome in two patients with remitted asthma].

We report two patients with Churg-Strauss syndrome (CSS) which occurred on the remission stage of bronchial asthma. Case 1 of a 64-year-old woman suffered from asthma in June, 1997, and got relief with treatment. In February, 1998, dysesthesia, pain and severe muscle weakness occurred in the extremities and erythematous rashes appeared on the extremities and back. She was transferred to our hospital on March 3. Peripheral blood eosinophilia was observed and a diagnosis of CSS was made. Eosinophilic tissue infiltration and vasculitis was found in the skin biopsy specimen. She was treated with prednisolone (60 mg/day) with moderate improvement. But the dysesthesia in the extremities, bilateral foot drop and the weakness of the left hand grasping power continued. Case 2 of a 62-year-old woman suffered from asthma in 1995, which improved by treatment. In March 1998, dysesthesia and pain in the lower extremities occurred and progressed. Erythematous rashes appeared on the feet and she was admitted to our hospital in May. Peripheral blood eosinophilia and eosinophilic tissue infiltration in the skin biopsy specimen were observed and a diagnosis of CSS was made. The treatment with prednisolone (60 mg/day) improved the pain but the dysesthesia continued. It is important to know the occurrence of CSS on the remission stage of bronchial asthma.

Clinical bitterness masking test for phantogeusia.

It is difficult to determine the reason why a patient complains of a bitter taste when their mouth is empty. We examined a new diagnostic test using a bitterness masking substance. The bitterness masking substance, 'Benecoat BMI-60' (hereafter BMI-60), is a masking substance specific to the taste cells' bitterness receptors. After patients gargled with BMI-60 solutions, the phantom sensation of bitterness was masked in some patients, but was not masked in others. Bitter substances in saliva seemed to be masked by BMI-60, but bitterness did not seem to be masked when the locus of the phantom sensation was within the peripheral nerve and/or the brain. The bitterness masking test is useful for diagnosis of the phantom sensation of bitter taste.

Cluster analysis on multiple drugs susceptibility supplements genotyping of methicillin-resistant Staphylococcus aureus.

OBJECTIVE: To evaluate the typing power of cluster analysis of antimicrobial susceptibility. METHODS: Results of pulsed-field gel electrophoresis in 71 strains of methicillin-resistant Staphylococcus aureus were compared with cluster analysis of the diameter of growth inhibition in 11 drugs. Subjects were a consecutive series of patients (n = 71) from the wards and outpatient units of a community teaching hospital. RESULTS: The cluster analysis took 2 to 3 seconds once the data were entered into a computer. The sensitivity, specificity, and accuracy of the cluster analysis were 76.3%, 58.3%, and 73.2%, respectively, using genotyping as the reference. CONCLUSIONS: The cluster analysis offered real-time epidemiologic data at minimal cost and labor, warranting its cost-effective role.

High concentrations of serum inhibin in pre-eclampsia.

OBJECTIVE: To evaluate maternal serum immunoreactive inhibin (ir-inhibin) concentrations in women with pre-eclampsia, and assess the correlation between serum ir-inhibin and HCG. METHODS: The subjects comprised 28 pregnant women with suspected intrauterine growth retardation (IUGR) during the third trimester. Serum concentrations of ir-inhibin and HCG were measured in 13 women with pre-eclampsia and 15 pregnant women as control subjects. Serum ir-inhibin was determined by a double antibody radioimmunoassay, and HCG by a solid-phase immunoradiometric assay. RESULTS: There were no significant differences in maternal characteristics between the pre-eclamptic group and control group. The pre-eclamptic group had significantly higher concentrations of serum ir-inhibin and HCG compared with the control group. The serum concentrations of ir-inhibin correlated positively with those of HCG. CONCLUSION: The pre-eclamptic patients displayed high serum levels of ir-inhibin and HCG, and this might reflect hyperplasia of trophoblastic cells.

The novel gene, gamma2-COP (COPG2), in the 7q32 imprinted domain escapes genomic imprinting.

The gene MEST (or PEG1) on chromosome 7q32 is paternally expressed in human fetal tissues as a result of genomic imprinting. Since some imprinted genes are clustered, we speculated that an imprinted gene cluster might exist at 7q32. We have sought to isolate additional human genes close to MEST and to characterize their allelic expression patterns. Here, we report the biallelic expression of the gene, gamma2-COP (coatomer protein complex, subunit gamma 2, HUGO-approved symbol COPG2), and monoallelic expression of the transcript, CIT1, which is located in intron 20 of gamma2-COP. Recently, gamma2-COP was reported to be a novel imprinted gene that overlaps the 3'-untranslated region (3'-UTR) of MEST in a tail-to-tail orientation. However, our results revealed biallelic expression in all fetal tissues and adult blood lymphocytes. On the other hand, CIT1 was an antisense transcript of gamma2-COP intron 20 and was expressed from the paternal allele in all fetal tissues examined. Adult blood lymphocytes showed biallelic expression. We identified additional MEST 3'-UTR sequence, which overlaps the last four exons and introns of gamma2-COP. This additional MEST 3'-UTR may complicate analysis of gamma2-COP imprinting. Our data indicate that the region containing MEST at 7q32 is an imprinted domain, but gamma2-COP adjacent to MEST escapes genomic imprinting.