Gender difference in the relationships between vision and hearing impairments and negative well-being.

OBJECTIVES: To evaluate the association of hearing impairment, vision impairment and their combination (dual sensory impairment) with negative well-being such as depression, subjective poor health and the reduced functional ability in community-dwelling older adults, and to determine whether any association varies by gender. METHODS: Between 2005 and 2006, we objectively examined vision and hearing impairment (using best-corrected visual acuity and pure-tone audiometric test) in 843 people aged 65 years and older (351 males, 492 females) in a rural Japanese town. Through a home visit interview survey using a structured questionnaire, we also collected information on depression (the five-item Geriatric Depression Scale), subjective poor health, and reduced functional activity (the Tokyo Metropolitan Institute of Gerontology's Index of Competence). RESULTS: We observed gender differences in the association between sensory impairment and depression. Multiple logistic regression analysis revealed that hearing impairment in males (adjusted odds ratio: 2.22, 95% confidence interval; 1.07-4.61) and vision impairment in females (1.91, 1.14-3.21) were related to depression. Vision impairment and dual sensory impairment were also associated with subjective poor health and reduced functional activity in both sexes. CONCLUSIONS: Sensory impairment is significantly associated with negative well-being in older persons, and its association with depression may differ between males and females

Serum levels of retinol and other antioxidants for hearing impairment among Japanese older adults.

BACKGROUND: The objective of this study was to assess the relation between serum levels of retinol and other antioxidants and hearing impairment in Japanese older adults. METHODS: This is a community-based cross-sectional study comprising 762 residents aged 65 years or older in Kurabuchi, Gumma, Japan. We measured serum retinol and other antioxidants (alpha- and gamma-tocopherols, and carotenoids including beta-cryptoxanthin, alpha- and beta-carotenes, lycopene, and lutein plus zeaxanthin) by high-performance liquid chromatography and divided each measurement into quartiles. Hearing impairment was defined as a failure to hear a 30-dB hearing level (HL) signal at 1 kHz and a 40-dB HL signal at 4 kHz in the better ear in pure-tone audiometric tests. The odds ratios (OR) for hearing impairment were calculated for each of the upper three quartiles of retinol and other antioxidant levels relative to the lowest quartile. RESULTS: Crude analysis showed that serum levels of retinol and provitamin A carotenoids (beta-cryptoxanthin, and alpha- and beta-carotenes) were inversely related to the prevalence of hearing impairment. The multiadjusted ORs (95% confidence intervals) for the highest quartile of retinol and the provitamin A family (combinations of provitamin A carotenoids) compared with the lowest were 0.51 (0.26-1.00) and 0.53 (0.27-1.02), respectively. A dose-response relationship was observed for retinol (p = .03) and provitamin A (p = .09). CONCLUSION: Increased serum levels of retinol and provitamin A carotenoids were clearly associated with a decreased prevalence of hearing impairment

Relationship between sleep duration and clustering of metabolic syndrome diagnostic components

Sayuri Katano1, Yasuyuki Nakamura1,2, Aki Nakamura1, Yoshitaka Murakami3, Taichiro Tanaka4, Toru Takebayashi5, Akira Okayama6, Katsuyuki Miura2, Tomonori Okamura7, Hirotsugu Ueshima2, for HIPOP-OHP Research Group1Cardiovascular Epidemiology, Kyoto Women's University, Kyoto, Japan; 2Department of Health Science, Shiga University of Medical Science, Otsu, Japan; 3Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan; 4Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan; 5Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan; 6The First Institute of Health Service, Japan Anti-Tuberculosis Association, Tokyo, Japan; 7Department of Preventive Cardiology, National Cardiovascular Center, Suita, JapanObjective: To examine the relation between sleep duration and metabolic syndrome (MetS).Methods: We examined the baseline data from 4356 healthy workers (3556 men and 800 women) aged 19–69 years. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined four components of MetS diagnostic components in this study as follows: 1) high blood pressure (BP) systolic BP [SBP] ≥ 130 mmHg, or diastolic BP [DBP] ≥ 85 mmHg, or on medication; 2) dyslipidemia (high-density lipoprotein-cholesterol concentration ,40 mg/dL, or triglycerides concentration ≥150 mg/dL, or on medication; 3) impaired glucose tolerance (fasting blood sugar concentration ≥ 110 mg/dL, or if less than 8 hours after meals ≥ 140 mg/dL), or on medication; and 4) overweight (body mass index [BMI] ≥ 25 kg/m2), or obesity (BMI ≥ 30 kg/m2). There were 680 participants in the group, with sleep duration <6 hours (15.6%).Results: Those who had 0–4 MetS diagnostic components, including overweight, accounted for 2159, 1222, 674, 255, and 46 participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of MetS diagnostic components were being male (regression coefficient b = 0.752, P < 0.001), age (b = 0.026, P < 0.001), IPAQ classification (b = -0.238, P = 0.034), and alcohol intake (mL/day) (b = 0.018, P < 0.001). Short sleep duration (<6 hours) was also related to the number of MetS (b = 0.162, P < 0.001). The results of analyses with obesity component showed a similar association.Conclusion: Short sleep duration was positively associated with the number of MetS diagnostic components independent of other lifestyle habits.Keyword: short sleep duration, MetS diagnostic components, obesit

Lifestyle factors and visible skin aging in a population of Japanese elders.

BACKGROUND: The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging. METHODS: The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis. RESULTS: Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women. CONCLUSIONS: Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population

Relationship between Dietary and Other Lifestyle Habits and Cardiometabolic Risk Factors in Men

<p>Abstract</p> <p>Background</p> <p>Prevalence of men with cardiometabolic risk factors (CMRF) is increasing in Japan. Few studies have comprehensively examined the relation between lifestyles and CMRF.</p> <p>Methods</p> <p>We examined the baseline data from 3,498 male workers ages 19 to 69 years who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study at 12 large-scale companies throughout Japan. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). Dietary intake was surveyed by a semi-quantitative Food Frequency Questionnaire. We defined four CMRF in this study as follows: 1) high blood pressure (BP): systolic BP ≥ 130 mmHg, or diastolic BP ≥ 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration < 40 mg/dl, or triglycerides concentration ≥ 150 mg/dl, or on medication for dyslipidemia; 3) impaired glucose tolerance: fasting blood sugar concentration ≥110 mg/dl; 4) obese: a body mass index ≥ 25 kg/m².</p> <p>Results</p> <p>Those who had 0 to 4 CMRF accounted for 1,597 (45.7%), 1,032 (29.5%), 587 (16.8%), 236 (6.7%), and 44 (1.3%) participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of CMRF were age (b = 0.020, P < 0.01), IPAQ (b = -0.091, P < 0.01), alcohol intake (ml/day) (b = 0.001, P = 0.03), percentage of protein intake (b = 0.059, P = 0.01), and total energy intake (kcal)(b = 0.0001, P < 0.01). Furthermore, alcohol intake and its frequency had differential effects.</p> <p>Conclusions</p> <p>Alcohol intake, percent protein and total energy intake were positively associated, whereas drinking frequency and IPAQ were inversely associated, with the number of CMRF.</p

Exposure to PM2.5 and Lung Function Growth in Pre- and Early-Adolescent Schoolchildren: A Longitudinal Study Involving Repeated Lung Function Measurements in Japan.

Rationale: Epidemiological evidence indicates that ambient exposure to particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5) has adverse effects on lung function growth in children, but it is not actually clear whether exposure to low-level PM2.5 results in long-term decrements in lung function growth in pre- to early-adolescent schoolchildren. Objectives: To examine long-term effects of PM2.5 within the 4-year average concentration range of 10-19 μg/m3 on lung function growth with repeated measurements of lung function tests. Methods: Longitudinal analysis of 6,233 lung function measurements in 1,466 participants aged 8-12 years from 16 school communities in 10 cities around Japan, covering a broad area of the country to represent concentration ranges of PM2.5, was done with a multilevel linear regression model. Forced expiratory volume in 1 second, forced vital capacity (FVC), and maximal expiratory flow at 50% of FVC were used as lung function indicators to examine the effects of 10-μg/m3 increases in the PM2.5 concentration on relative growth per each 10-cm increase in height. Results: The overall annual mean PM2.5 level was 13.5 μg/m3 (range, 10.4-19.0 μg/m3). We found no association between any of the lung function growth indicators and increases in PM2.5 levels in children of either sex, even after controlling for potential confounders. Analysis with two-pollutant models with O3 or NO2 did not change the null results. Conclusions: This nationwide longitudinal study suggests that concurrent, long-term exposure to PM2.5 at concentrations ranging from 10.4 to 19.0 μg/m3 has little effect on lung function growth in preadolescent boys or pre- to early-adolescent girls

Comparison of Targeted vs Random Biopsies for Surveillance of Ulcerative Colitis-Associated Colorectal Cancer

Background & AimsA random biopsy is recommended for surveillance of ulcerative colitis (UC)-associated colorectal cancer. However, a targeted biopsy might be more effective. We conducted a randomized controlled trial to compare rates of neoplasia detection by targeted vs random biopsies in patients with UC.MethodsWe performed a study of 246 patients with UC for 7 years or more, seen at 52 institutions in Japan from October 1, 2008 through December 31, 2010. Patients were randomly assigned to the random group (4 random biopsies collected every 10 cm in addition to targeted biopsies, n = 122) or the target group (biopsies collected from locations of suspected neoplasia, n = 124). The primary end point was the number of neoplastic lesions detected in a single surveillance colonoscopy. We estimated the ratio and difference in the mean number of neoplastic lesions between the groups. We also evaluated the non-inferiority between the groups as an exploratory study. A non-inferiority margin of 0.65 (0.13 of 0.20) was considered for the ratio of the mean number of neoplastic lesions between groups.ResultsThe mean number of biopsies found to contain neoplastic tissue per colonoscopy was 0.211 (24 of 114) in the target group and 0.168 (18 of 107) in the random group (ratio of 1.251; 95% confidence interval, 0.679–2.306). The lower limit was above the non-inferiority margin of 0.65. Neoplasias were detected in 11.4% of patients in the target group and 9.3% of patients in the random group (P = .617). Larger numbers of biopsy samples per colonoscopy were collected in the random group (34.8 vs 3.1 in the target group; P < .001), and the total examination time was longer (41.7 vs 26.6 minutes in the target group; P < .001). In the random group, all neoplastic tissues found in random biopsies were collected from areas of the mucosa with a history or presence of inflammation.ConclusionsIn a randomized controlled trial, we found that targeted and random biopsies detect similar proportions of neoplasias. However, a targeted biopsy appears to be a more cost-effective method. Random biopsies from areas without any signs of present or past inflammation were not found to contain neoplastic tissues. Clinical Trial Registry: UMIN000001608

Diagnostic radiological examinations and risk of intracranial tumours in adults-findings from the Interphone Study.

Background Exposure to high doses of ionizing radiation is among the few well-established brain tumour risk factors. We used data from the Interphone study to evaluate the effects of exposure to low-dose radiation from diagnostic radiological examinations on glioma, meningioma and acoustic neuroma risk. Methods Brain tumour cases (2644 gliomas, 2236 meningiomas, 1083 neuromas) diagnosed in 2000-02 were identified through hospitals in 13 countries, and 6068 controls (population-based controls in most centres) were included in the analysis. Participation across all centres was 64% for glioma cases, 78% for meningioma cases, 82% for acoustic neuroma cases and 53% for controls. Information on previous diagnostic radiological examinations was obtained by interviews, including the frequency, timing and indication for the examinations. Typical brain doses per type of examination were estimated based on the literature. Examinations within the 5 years before the index date were excluded from the dose estimation. Adjusted odds ratios were estimated using conditional logistic regression. Results No materially or consistently increased odds ratios for glioma, meningioma or acoustic neuroma were found for any specific type of examination, including computed tomography of the head and cerebral angiography. The only indication of an elevated risk was an increasing trend in risk of meningioma with the number of isotope scans, but no such trends for other examinations were observed. No gradient was found in risk with estimated brain dose. Age at exposure did not substantially modify the findings. Sensitivity analyses gave results consistent with the main analysis. Conclusions There was no consistent evidence for increased risks of brain tumours with X-ray examinations, although error from selection and recall bias cannot be completely excluded. A cautious interpretation is warranted for the observed association between isotope scans and meningioma

Gender-specific associations of vision and hearing impairments with adverse health outcomes in older Japanese: a population-based cohort study

BACKGROUND: Several epidemiological studies have shown that self-reported vision and hearing impairments are associated with adverse health outcomes (AHOs) in older populations; however, few studies have used objective sensory measurements or investigated the role of gender in this association. Therefore, we examined the association of vision and hearing impairments (as measured by objective methods) with AHOs (dependence in activities of daily living or death), and whether this association differed by gender. METHODS: From 2005 to 2006, a total of 801 residents (337 men and 464 women) aged 65 years or older of Kurabuchi Town, Gunma, Japan, participated in a baseline examination that included vision and hearing assessments; they were followed up through September 2008. Vision impairment was defined as a corrected visual acuity of worse than 0.5 (logMAR = 0.3) in the better eye, and hearing impairment was defined as a failure to hear a 30 dB hearing level signal at 1 kHz in the better ear. Information on outcomes was obtained from the town hall and through face-to-face home visit interviews. We calculated the risk ratios (RRs) of AHOs for vision and hearing impairments according to gender. RESULTS: During a mean follow-up period of 3 years, 34 men (10.1%) and 52 women (11.3%) had AHOs. In both genders, vision impairment was related to an elevated risk of AHOs (multi-adjusted RR for men and women together = 1.60, 95% CI = 1.05-2.44), with no statistically significant interaction between the genders. In contrast, a significant association between hearing impairment and AHOs (multi-adjusted RR = 3.10, 95% CI = 1.43-6.72) was found only in the men. CONCLUSION: In this older Japanese population, sensory impairments were clearly associated with AHOs, and the association appeared to vary according to gender. Gender-specific associations between sensory impairments and AHOs warrant further investigation

トウイン ニオケル セツジョ フノウ キョクショ シンコウ ショクドウガン ノ チリョウ セイセキ

【背景】遠隔転移のない切除不能局所進行食道癌に対する標準治療は根治的化学放射線療法(CRT)だが，近年Docetaxel/5-FU/ Cisplatin 療法をはじめとした導入化学療法（ICT）からの外科的切除の有用性が報告されている．今回，当院での切除不能局所進行食道癌に対する治療成績について検証した．【対象と方法】2016年から2019年の期間で，当院で治療した切除不能局所進行食道癌9例(リンパ節T4bも含む)を対象とした．【結果】男性：6例，女性：3例．年齢：中央値 64（41-78）歳．腫瘍主占居部位：Ut/Mt/Lt=1/7/1．浸潤臓器:気管/左主気管支/大動脈=2/4/3，cN0/1/2=1/3/5，初回治療: ICT/CRT=7/2であった．初回治療別に検証すると，奏効率:ICT/CRT=5(71.4%)/0(0%)であり，ICTにて奏効が得られた5例は根治切除可能と判断し，4例（80％）でR0切除が得られた．術後合併症は，縫合不全0例，肺炎1例(20%)，反回神経麻痺2例(40%)であった．術後在院日数中央値は16日(13-21)であった．R0切除4例は全例1年以上の生存が得られているが，2例で再発(リンパ節再発1例，肺・リンパ節再発1例)を認めた．R1切除例はCRTを追加し，術後2年無再発生存中である．根治切除を施行していない4例の初回治療からの1年生存率は25％と予後不良であった．【結語】切除不能局所進行食道癌であってもICTを組み入れることでconversion surgeryが安全に施行され，高いR0切除率が得られ，予後の延長に寄与する可能性がある．Background:Recently, the usefulness of surgical resection after induction chemotherapy (ICT) including Docetaxel / 5-FU / Cisplatin therapy for locally advanced esophageal cancer has been reported. Methods:Nine patients with locally advanced unresectable esophageal cancer who underwent multidisciplinary treatment in our hospital from 2016 to 2019 were eligible for this study. Results:The patients’ characteristics included a median age of 64 years; the male/female ratio of 6/3; Tumor main occupancy site Ut / Mt / Lt = 1/7/1; Invading adjacent organs: trachea / left main bronchus / aorta; 2/4/3, Lymph node metastasis (0/1/2); 1/3/5, and initial treatment ICT / CRT; 7/2. Response rate of ICT were 71.4% (5 cases) and that of CRT were 0%. Four patients (80%) of 5 patients who responded to ICT were underwent R0 resection. Postoperative complications were anastomotic leakage in 0 cases, pneumonia in 1 case (20%), and recurrent nerve paralysis in 2 cases (40%). The median length of hospital stay after surgery was 16 days. All 4 cases of R0 resection had survived for 1 year or more. The 1-year survival rate from the initial treatment of 4 patients who did not undergo radical resection was 25%. Conclusion:Conversion surgery after ICT for locally advanced unresectable esophageal cancer may contribute to a high R0 resection rate and better clinical outcomes