The incidence of respiratory syncytial virus (RSV) has been reported to exhibit seasonal variation. However, the impact of diurnal temperature range (DTR) on RSV has not been investigated. After ...acquiring data related to cases of RSV and weather parameters of DTR in Fukuoka, Japan, between 2006 and 2012, we used negative binomial generalized linear models and distributed lag nonlinear models to assess the possible relationship between DTR and RSV cases, adjusting for confounding factors. Our analysis revealed that the weekly number of RSV cases increased with a relative risk of 3·30 (95% confidence interval 1·65–6·60) for every 1°C increase in DTR. Our study provides quantitative evidence that the number of RSV cases increased significantly with increasing DTR. We suggest that preventive measures for limiting the spread of RSV should be considered during extended periods of high DTR.
Although multiple combinations of weather factors may contribute to an increased incidence of Mycoplasma pneumoniae pneumonia, few studies have investigated the association between weather factors ...and cases of M pneumoniae pneumonia.
Data on cases of M pneumoniae pneumonia and weather factors in Fukuoka, Japan from 1999 to 2007 were obtained and time-series analysis was used to assess the effects of weather variables on M pneumoniae pneumonia cases, adjusting for confounding factors. A total of 13 056 M pneumoniae pneumonia cases were reported during the 9-year study period, of which 12 234 (93.7%) were under 15 years of age.
The weekly number of M pneumoniae pneumonia cases increased by 16.9% (95% CI 11.3% to 22.8%) for every 1 degrees C increase in the average temperature and by 4.1% (95% CI 2.7% to 5.5%) for every 1% increase in relative humidity.
From 1999 to 2007, cases of M pneumoniae pneumonia increased significantly with increased average temperature and relative humidity in Fukuoka, Japan.
The increasing international interest in the potential health effects of climate change has emphasized the importance of investigations into the relationship between weather variability and ...infectious diseases. However, few studies have examined the impact of weather variability on mumps in children, despite the fact that children are considered particularly vulnerable to climate change. We acquired data about cases of mumps in children aged <15 years and weather variability in Fukuoka, Japan from 2000 to 2008, and then used time-series analyses to assess how weather variability affected mumps cases, adjusting for seasonal variations, inter-annual variations, and temporal variations of two large epidemics in 2001 and 2004–2005. The weekly number of mumps cases increased by 7·5% (95% CI 4·0–11·1) for every 1°C increase in average temperature and by 1·4% (95% CI 0·5–2·4) for every 1% increase in relative humidity. The percentage increase was greatest in the 0–4 years age group and tended to decrease with increasing age. The number of mumps cases in children increased significantly with increased average temperature and relative humidity.
Although multiple combinations of weather variability may contribute to an increased incidence of infectious gastrointestinal disease, few studies have investigated the association between weather ...variability and cases of infectious gastroenteritis. We acquired data for infectious gastroenteritis cases and weather variability in Fukuoka, Japan, from 1999 to 2007 and used time-series analysis to assess the effects of weather variability on infectious gastroenteritis cases, adjusting for confounding factors. In total, 422 176 infectious gastroenteritis cases were reported during the 9-year study period. The weekly number of infectious gastroenteritis cases increased by 7·7% (95% CI 4·6–10·8) for every 1°C increase in the average temperature and by 2·3% (95% CI 1·4–3·1) for every 1% decrease in relative humidity. From 1999 to 2007, infectious gastroenteritis cases increased significantly with increased average temperature and decreased relative humidity in Fukuoka, Japan.
Investigations of the relationship between weather variability and infectious gastroenteritis (IG) are becoming increasingly important in light of international interest in the potential health ...effects of climate change. However, few studies have examined the impact on children, despite the fact that children are considered particularly vulnerable to climate change. We acquired data about cases of IG in children aged < 15 years and about weather variability in Fukuoka, Japan from 2000 to 2008 and used time-series analyses to assess how weather variability affected IG cases, adjusting for confounding factors. The temperature—IG relationship had an inverted V shape, with fewer cases at temperatures lower and higher than ∼13 °C. Every 1 °C increase in temperature below the threshold (13 °C) was associated with a 23·2% 95% confidence interval (CI) 16·6–30·2 increase, while every 1 °C increase in temperature above the threshold (13 °C) was associated with an 11·8% (95% CI 6·6–17·3) decrease in incidence. The increase in cases per 1% drop in relative humidity was 3·9% (95% CI 2·8–5·0). The percentage increase of IG cases was greatest in the 0–4 years age group and tended to decrease with increasing age. We found a progressive reduction in weather-related IG cases in children aged > 4 years. Our results suggest that public health interventions aimed at controlling weather-related IG may be most effective when focused on young children.
A 40-year follow-up study was conducted to examine mortality among 1,664 patients in Japan suffering from “Yusho,” a disease caused by ingestion of rice oil contaminated with polychlorinated ...biphenyls and polychlorinated dibenzofurans. To evaluate the effects of exposure on mortality, the authors calculated standardized mortality ratios. National mortality rates for major causes of death were used as reference points. A total of 1,596 Yusho patients (95.9%) were followed until death or the end of the study (December 31, 2007). The standardized mortality ratios for most major causes of death were not significantly elevated, with the exceptions of all types of cancer (standardized mortality ratio (SMR) = 1.37, 95% confidence interval (CI): 1.11, 1.66), liver cancer (SMR = 1.82, 95% CI: 1.06, 2.91), and lung cancer (SMR = 1.75, 95% CI: 1.14, 2.57) in males. In addition, the standardized mortality ratios for all cancers, liver cancer, and lung cancer among males tended to decrease over time. Results from this study suggest that the carcinogenicity of polychlorinated biphenyls and polychlorinated dibenzofurans must be taken into account when evaluating mortality risk.
Background and Objectives
Tobacco use and co‐prescription of sedative hypnotics are risk factors for misuse of prescribed opioids among patients with non‐cancer pain. However, the association between ...tobacco use and these co‐prescriptions has not been clarified. We aimed to assess differences in the prescription and co‐prescription rates of opioid analgesics with muscle relaxants and/or benzodiazepines between tobacco users and non‐users.
Methods
Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross‐sectional survey of visits to office‐based physicians in outpatient settings in the United States. Our sample patients were aged ≥18 years and diagnosed with non‐cancer back and neck pain. The χ2 test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co‐prescription rates and tobacco use status.
Results
We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non‐users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95% confidence interval (CI) 1.64–2.80; muscle relaxants and opioid analgesics, OR 2.57, 95%CI 1.76–3.74; benzodiazepines and opioid analgesics, OR 3.66, 95%CI 2.11–6.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95%CI 2.98–16.57.
Conclusions and Scientific Significance
Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and/or benzodiazepines than non‐users. Healthcare professionals need to limit co‐prescription of opioid analgesics with muscle relaxants and/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. (Am J Addict 2019;XX:1–8)
Abstract
Background
Recent clinical trials are testing strategies for short (1–3 months) dual antiplatelet therapy (DAPT) following newer-generation drug-eluting stent (DES) placement. However, the ...safety of short DAPT regimens is not supported by biological evidence in humans.
Purpose
We sought to evaluate early pathologic responses to newer-generation DES by comparing abluminal biodegradable polymer-coated DES (BP-DES) with circumferential durable polymer-coated DES (DP-DES) in human autopsy cases.
Methods
The study included a total of 37 coronary lesions with thin strut newer-generation DES (DP-DES=23 XIENCE=18, Resolute Integrity=5 and BP-DES=14 SYNERGY=9, Ultimaster=5) with duration of implantation <90 days in 25 autopsy cases. The process of stent healing was precisely evaluated for every single strut in association with underlying tissue characteristics. The degree of strut coverage was defined as follows: grade 0 (bare struts), grade 1 (struts covered with thrombus, fibrin, or other tissues or cells without endothelium), grade 2 (struts covered with single-layered endothelium without underlying smooth muscle cell layers), and grade 3 (struts covered with endothelium and underlying smooth muscle cell layers) (Figure 1).
Results
Duration of implantation was similar in lesions with DP-DES and those with BP-DES (median=20 vs. 17 days). A total of 1986 struts (DP-DES=1261, BP-DES=725) were pathologically analyzed. Focal grade 2 coverage was observed as early as 5 days after the implantation in both stents. Multilevel mixed-effects ordered logistic regression model demonstrated that BP-DES exhibited greater strut coverage compared with DP-DES (odds ratio; 3.50, 95% CI; 1.31–9.41, P=0.013), which remained significant after adjustment for duration of implantation and underlying tissue characteristics (odds ratio; 2.64, 95% CI; 1.04–6.68, P=0.040). The time course of vessel healing assessed as predictive probability of strut coverage (grade 0–3) stratified by duration of implantation is shown in Figure 2. Predictive probability of grade 2 and 3 coverage was comparably limited at 30 days (DP-DES=17.7% vs. BP-DES=29.0%) and increased at 90 days (DP-DES=76.1% vs. BP-DES=85.9%). Both stents showed few inflammation and similar degree of fibrin deposition.
Conclusions
The current first pathologic study on early biological responses to newer-generation DES in humans demonstrated that single-layered endothelial coverage begins in days following the stent placement, and abluminal BP-DES potentially exhibit faster strut coverage with smooth muscle cell infiltration than circumferential DP-DES. Nevertheless, vessel healing remains suboptimal at 30 days in both DP- and BP-DES, which progresses with time to become substantial at 90 days. Our results suggest that very short duration of DAPT for 1 month should be applied with caution, taking into account the trade-off between bleeding and thrombotic risks.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science
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