OBJECTIVESSleep disorders and psychological stress have become major concerns as health risks in modern Japanese society. Chronic sleep deprivation could lead to physical and mental exhaustion, which could affect the circulatory condition. In this study, we have investigated the effects of long-term sleep problems and mental health conditions on abnormal ECG findings from the standpoint of community health.

METHODSData were obtained from the records of community physical checkups conducted in a town in Okinawa from 1993 to 2001. Data regarding average sleep duration and the 12-item version of the general health questionnaire (GHQ) were also collected at the community physical checkups. In order to compute the odds ratio of electrocardiographic (ECG) findings according to mental health condition and sleep duration, we conducted multivariate analysis using logistic regression maneuvers.

RESULTSThere was a significant difference of average GHQ scores according to sleep duration, with shorter sleep duration (< or =6 h) correlating with poorer GHQ and longer sleep duration (> or =8 h) correlating with healthier GHQ (p < 0.05). In the multivariate logistic regression analysis among subjects with poorer GHQ, shorter sleep duration showed significantly high odds ratio (OR = 7.14) for abnormal ECG findings.

CONCLUSIONSThe present study suggested that the mental health condition appears to impact ECG results indirectly through its strong association with sleep duration and provided ground for suggestion that mental health items to be included in community physical checkup examination items.

OBJECTIVESChanges in B-type natriuretic peptide (BNP) and electrocardiographic (ECG) findings in an adult Japanese population were measured over a 5-year period, and the statistical relationships between these were evaluated.

METHODSThis was a longitudinal analysis in which data were collected on 353 subjects (135 men and 218 women) who had undergone general health checks in 1998 and 2003.

RESULTSData were examined by correlation coefficient and one-way analysis of covariance using repeated measurements. The correlation coefficient for BNP between 1998 and 2003 was 0.622 (P < 0.0001) for the men and 0.557 (P < 0.0001) for women. The changes in BNP over the same period were 13.71 +/- 26.06 (P < 0.0001) pg/ml in the men and 20.17 +/- 32.01 (P < 0.0001) pg/ml in the women. In 99 men and 145 women who had undergone ECG tests, with both normal and abnormal findings, visual inspections of changes in the ECG findings with respect to BNP changes were performed over the 5-year period. In men, both age and BNP significantly correlated with changes in ECG findings; however, in women, no significant correlation between BNP and changes in ECG findings was observed.

CONCLUSIONSThis regional longitudinal study revealed a gender difference in the relationship between long-term changes in BNP and ECG findings, suggesting that a 10 pg/ml or more increase in BNP in men over a 5-year period may a indicate worsening of cardiac function and the need for intervention.

BACKGROUND: Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out. OBJECTIVE: We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools. METHODS: A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan. RESULTS: The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification (p < 0.0001). A total of 43.9% of the kindergartens and schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors. CONCLUSION: Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies.
Anaphylaxis ; Certification ; Child ; Diet ; Eating ; Epinephrine ; Food Hypersensitivity ; Humans ; Japan ; Lunch ; Medical Overuse