We visited the University of Newcastle to take clinical clerkships from April to June 1989. We tried to experience what we had not had in our medical educational system; for example, geriatrics or medical ethics. We also compared the difference of medical educational program between Japan and Australia, especially, the way of examining students.

A 43-year-old man with rheumatic arthritis was admitted to our hospital for symptoms of cough, left chest pain, and left elbow pain, and further examination revealed an elevated level of C-reactive protein. On day 2 after admission, he underwent esophagogastroduodenoscopy. On the morning of day 7, he developed a high fever of 39.7°C, several hours after bronchoscopy. On day 13, he underwent colonoscopy. Five minutes after the colonoscopy, he developed a high fever of 39.9°C, accompanied by stridor, indicating a decrease in arterial oxygen saturation level. An intradermal test for peracetic acid which was used for cleaning flexible endoscopy was positive. We suspect that he suffered from an allergic reaction to peracetic acid following the flexible endoscopy. This is the first case reported on suspicious allergic reaction to peracetic acid following a flexible endoscopy procedure.

BACKGROUND: The association between meat, fish, or fatty acid intake and acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) has been investigated in a few studies, and the results were inconsistent. In addition, most studies are mainly based on the United States and European countries, in which the dietary patterns differ from that in Asia. Therefore, the risk of AML/MDS from meat, fish, or fatty acid intake in Asia requires further exploration. The aim of this study was to investigate the association between AML/MDS incidence and meat, fish, or fatty acid intake using the Japan Public Health Center-based prospective study. METHODS: The present study included 93,366 participants who were eligible for analysis and followed up from the 5-year survey date until December 2012. We estimated the impact of their intake on AML/MDS incidence using a Cox proportional hazards model. RESULTS: The study participants were followed up for 1,345,002 person-years. During the follow-up period, we identified 67 AML and 49 MDS cases. An increased intake of processed red meat was significantly associated with the incidence of AML/MDS, with a hazard ratio of 1.63 (95% confidence interval, 1.03-2.57) for the highest versus lowest tertile and a P_trend of 0.04. Meanwhile, the intake of other foods and fatty acids was not associated with AML/MDS. CONCLUSION In this Japanese population, processed red meat was associated with an increased incidence of AML/MDS.
Animals ; Japan/epidemiology* ; Prospective Studies ; Incidence ; Public Health ; Meat/adverse effects* ; Fatty Acids/adverse effects* ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes/epidemiology*

The establishment of enhanced surveillance systems for mass gatherings to detect infectious diseases that may be imported during an event is recommended. The World Health Organization Regional Office for the Western Pacific contributed to enhanced event-based surveillance for the Tokyo 2020 Olympic and Paralympic Games (the Games) by using Epidemic Intelligence from Open Sources (EIOS) to detect potential imported diseases and report them to the National Institute of Infectious Diseases (NIID), Japan. Daily screening of media articles on global infectious diseases was conducted using EIOS, which were systematically assessed to determine the likelihood of disease importation, spread and significant impact to Japan during the Games. Over 81 days of surveillance, 103 830 articles were screened by EIOS, of which 5441 (5.2%) met the selection criteria for initial assessment, with 587 (0.6%) assessed as signals and reported to NIID. None of the signals were considered to pose a significant risk to the Games based on three risk assessment criteria. While EIOS successfully captured media articles on infectious diseases with a likelihood of importation to and spread in Japan, a significant manual effort was required to assess the articles for duplicates and against the risk assessment criteria. Continued improvement of artificial intelligence is recommended to reduce this effort.

In 2021, the National Institute of Infectious Diseases, Japan, undertook enhanced event-based surveillance (EBS) for infectious diseases occurring overseas that have potential for importation (excluding coronavirus disease 2019 [COVID-19]) for the Tokyo 2020 Olympic and Paralympic Summer Games (the Games). The pre-existing EBS system was enhanced using the World Health Organization Epidemic Intelligence from Open Sources system and the BlueDot Epidemic Intelligence platform. The enhanced EBS before and during the Games did not detect any major public health event that would warrant action for the Games. However, information from multiple sources helped us identify events, characterize risk and improve confidence in risk assessment. The collaboration also reduced the surveillance workload of the host country, while ensuring the quality of surveillance, even during the COVID-19 pandemic.