QUALITY OF LIFE IN PATIENTS WITH DIABETES MELLITUS

We evaluated the quality of life (QOL) in 268 patients with diabetes mellitus (NIDDM, 250 cases; IDDM, 10 cases; and other type of diabetes, 8 cases) to determine which aspects were adversely affected by the disease. Information concerning life satisfaction, social activities, ability to work, sexual problems and physical symptoms was obtained from a 30-item questionnaire. Clinical characteristics including duration of diabetes, glycemic control, current treatment, obesity, hypertension, hyperlipidemia, macro- and microvascular complications were obtained from medical records. Diminished QOL was most pronounced in patients who had had a long duration of disease, required insulin therapy, and whose health was disturbed by cerebrovascular disease, end-stage renal disease, mono- and autonomic neuropathy. A significant difference in the subdimensional QOL score was noted in life satisfaction, social activities, ability to work, sexual problems and physical symptoms under these circumstances

医師が患者から受ける暴力被害とその心理的影響

Objectives: To determine the incidence rate of work-related aggression and violence (WRAV) against doctors and investigate risk factors and psychological influences of WRAV doctors. Methods: We sent a self-administered questionnaire on WRAV committed by patients and their associates to 1,148 doctors in Nara Prefecture, Japan. We calculated the incidence rate of WRAV using the number of incidents encountered during the previous 12 mo and the doctor's average weekly working hours. Risk factors for the incidence WRAV were analyzed by Poisson regression, and the influence of WRAV on the symptoms of post-traumatic stress disorder (PTSD) was evaluated by multiple logistic regression analysis. Results: A total of 758 (66.0%) doctors returned the questionnaire. The incidence rate of WRAV was 0.20 [95% CI: 0.17-0.24]×10-3 per practice hour. Adjusted incidence rate ratios of WRAV were significantly increased among doctors 1) with a shorter career (11.0; 95% CI: 5.0-24.2), 2) working in a region with the lowest average taxable income (1.6; 1.1-2.4), and 3) whose specialties were dermatology (3.8; 2.3-6.3), psychiatry (2.7; 1.3-5.6) and ophthalmology (1.9; 1.2-3.2). Of 289 subjects who had encountered WRAV at least once during their career, 26 doctors (8.2%) had symptoms suggestive of PTSD due to the most severe incident. Conclusions: Doctors encountered WRAV at an incidence rate of 0.20×10-3 per practice hour, and some of them might develop PTSD. Countermeasures are required to maintain sound health and safe workplaces for doctors.博士（医学）・乙第1292号・平成24年5月28日Copyright © 2011 by the Japan Society for Occupational Healt

The GEOTRACES Intermediate Data Product 2014

The GEOTRACES Intermediate Data Product 2014 (IDP2014) is the first publicly available data product of the international GEOTRACES programme, and contains data measured and quality controlled before the end of 2013. It consists of two parts: (1) a compilation of digital data for more than 200 trace elements and isotopes (TEIs) as well as classical hydrographic parameters, and (2) the eGEOTRACES Electronic Atlas providing a strongly inter-linked on-line atlas including more than 300 section plots and 90 animated 3D scenes. The IDP2014 covers the Atlantic, Arctic, and Indian oceans, exhibiting highest data density in the Atlantic. The TEI data in the IDP2014 are quality controlled by careful assessment of intercalibration results and multi-laboratory data comparisons at cross-over stations. The digital data are provided in several formats, including ASCII spreadsheet, Excel spreadsheet, netCDF, and Ocean Data View collection. In addition to the actual data values the IDP2014 also contains data quality flags and 1-? data error values where available. Quality flags and error values are useful for data filtering. Metadata about data originators, analytical methods and original publications related to the data are linked to the data in an easily accessible way. The eGEOTRACES Electronic Atlas is the visual representation of the IDP2014 data providing section plots and a new kind of animated 3D scenes. The basin-wide 3D scenes allow for viewing of data from many cruises at the same time, thereby providing quick overviews of large-scale tracer distributions. In addition, the 3D scenes provide geographical and bathymetric context that is crucial for the interpretation and assessment of observed tracer plumes, as well as for making inferences about controlling processes

ASSESSMENT OF DIETARY BEHAVIORS IN PATIENTS WITH DIABETIC NEPHROPATHY

We examined 218 patients with non-insulin-dependent diabetes mellitus to determine which dietary behaviors were affected by diabetic nephropathy. Diabetic ne- phropathy was divided into three clinical stages : normoalbuminuria, microalbuminuria, and overt proteinuria. Information on dietary habits concerning energy intake, protein intake and salt consumption was observed among different levels of nephropathy. Inadequate behavioral lifestyle was most pronounced in patients with microalbuminuria, and whose health was disturbed by high protein intake and high salt consumption. These findings were obtained for the adults, but not for the elderly. Results in this study provide the basic data for dietary intervention for diabetic patients

HYPOURICEMIA IN HOSPITALIZED DIABETIC PATIENTS

To determine the incidepce and clinicopathological characteristics of hypouricemia in patients with diabetes mellitus, we studied 473 consecutive hospitalized diabetic patients. The incidence of hypouricemia, defined as a serum urate concentration below 2.0 mg/dl, was 1.9% (9 patients). In this group (2 males, 7 females), there were no patients receiving drugs known to reduce serum urate concentration. Two of the 9 patients had neoplastic disease, while the others suffered from no other disorder known to affect serum urate levels. Four patients exhibited glomerular hyperfiltration. Three of the 9 patients were studied in more detail by renal biopsy, and all had mild to moderate glomerular diffuse lesions and tubulointerstitial lesions, such as interstitial fibrosis or mononuclear cell infiltration. These findings suggest that the glomerular hyperfiltration which accompanies diabetic nephropathy and functional abnormality of tubular urate handling due to tubulointerstitial involvement contribute to hypouricemia in diabetic patients

LIFESTYLE OF PATIENTS WITH DIABETES MELLITUS

We evaluated the lifestyle of 214 patients with diabetes mellitus to deter- mine which aspects were affected by their disease and diabetic complications. Information concerning lifestyle was obtained from 15-item questionnaires, and a total lifestyle score (TLS) was calculated. Clinical characteristics including duration of diabetes, glycemic control, current treatment, obesity, hypertension, hyperlipidemia, and macro- and microvas- cular complications were evaluated. Patients in their 40s had the lowest TLS, and lifestyle factors were strongly associated with glycemic control, ischemic heart disease, and with autonomic neuropathy. Subjects were also divided into two subgroups of equal size based on the median rate of TLS : an adequate lifestyle group and an inadequate lifestyle group. Although degree of excess in caloric intake was similar in these two groups, sodium intake was significantly higher in the inadequate lifestyle group than in the adequate lifestyle group

SMOKING HABIT AND PROGRESSION OF DIABETIC NEPHROPATHY

The effect of cigarette smoking on the progression of diabetic nephropathy was evaluated cross-sectionally in 155 patients with non-insulin-dependent diabetes mel- litus of at least 5 years duration. Forty-four patients had a smoking habit. There was no difference in the duration of diabetes, mean value of HbA1c, or the prevalence of hyperten- sion between the smokers and nonsmokers. However, there was a significant difference in the distribution of a smoking habit among subgroups of diabetic patients with normoal- buminuria, microalbuminuria, and overt proteinuria. Thus, cigarette smoking in patients with diabetes is concluded to be a risk factor for the development of diabetic nephropathy