Lifestyles Associated with Prognosis After Eradication of Hepatitis C Virus: A Prospective Cohort Study in Japan

Digestive Diseases and Sciences - Hepatocellular carcinoma develops in some patients with hepatitis C virus (HCV), even after achieving sustained virological response (SVR). We examined factors...     

Incidence of Mumps Deafness in Japan, 2005–2017: Analysis of Japanese Insurance Claims Database

BackgroundMumps deafness causes serious problems, and incidence data are needed to identify its disease burden. However, such data are limited, and the reported incidence is highly variable. Nationwide studies in Japan with a large age range are lacking.MethodsThis was a retrospective observational investigation of the 2005–2017 mumps burden using employment-based health insurance claims data. Data were analyzed for 5,190,326 people aged 0–64 years to estimate the incidence of mumps deafness.ResultsOf 68,112 patients with mumps (36,423 males; 31,689 females), 102 (48 males; 54 females) developed mumps deafness—an incidence of 15.0 per 10,000 patients (1 in 668 patients). Fifty-four (52.9%) patients had mumps deafness in childhood (0–15 years), and 48 (47.1%) had mumps deafness in adolescence and adulthood (16–64 years); most cases occurred in childhood, the peak period for mumps onset. The incidence of mumps deafness per 10,000 patients was 73.6 in adolescence and adulthood, 8.4 times higher than the incidence of 8.8 in childhood (P < 0.001). In childhood, the incidence of mumps deafness was 7.2 times higher among 6–15-year-olds (13.8; 95% CI, 10.2–18.2) than among 0–5-year-olds (1.9; 95% CI, 0.6–4.5), and this difference was statistically significant (P < 0.001). No sex difference was observed.ConclusionsThe incidence of mumps deafness per 10,000 patients aged 0–64 years was 15.0 (1 in 668 patients). A secondary risk of deafness following mumps virus infection was identified not only for children, but also for adolescents and adults.Key words: mumps deafness, congenital deafness, unilateral neurosensory deafness, mumps vaccine     

Sibship size and prevalence of allergic disorders in Japan: The Ryukyus Child Health Study

A number of epidemiological studies have reported an inverse association between increasing sibship size and allergic disorders. The present cross-sectional study assessed the association between the number of siblings and the prevalence of allergic disorders during the past 12 months in Japanese schoolchildren. Study subjects were 22,750 children aged 6–15 yr in Okinawa. The outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, gender, maternal age at childbirth, duration of breastfeeding, region of residence, smoking in the household, paternal and maternal history of asthma, atopic eczema, and allergic rhinitis, and paternal and maternal educational level. Significant exposure–response associations were observed between increasing total sibship size and all outcomes under investigation. Having two or more older siblings was significantly inversely related to the prevalence of atopic eczema and allergic rhinoconjunctivitis, but not wheeze or asthma. Having two or more younger siblings was independently associated with a decreased prevalence of atopic eczema, but not wheeze, asthma, or allergic rhinoconjunctivitis. The inverse relationships between sibship size and the prevalence of allergic disorders under study were weakened with advancing age, although the interactions between age groups were not statistically significant. No significant interactions were found in the association of having three or more siblings with allergic disorders between children with a positive or negative parental allergic history. These results are likely to support the in utero programming hypothesis because it is probable that the in utero environment would change with parity, although our observations could not refute the hygiene hypothesis.     

Mumps-Related Disease Burden in Japan: Analysis of JMDC Health Insurance Reimbursement Data for 2005–2017

BackgroundMumps vaccination coverage is low in Japan, partly because of its voluntary nature. Although pediatric cases of mumps virus infection are captured by the National Epidemiological Surveillance of Infectious Diseases program under the Infectious Disease Law, there are currently no data regarding the occurrence of mumps and its complications in adults.MethodsWe investigated the annual incidence rates of mumps and its complications based on health insurance reimbursement data for 5,209,660 individuals aged 0–64 years for 2005–2017, obtained from JMDC Inc., to estimate the mumps-related disease burden during this period.ResultsThere were three mumps outbreaks (2006, 2010, and 2016) during 2005–2017. The annual incidence of mumps was highest in individuals aged 0–5 years (808–3,792 per 100,000 persons), followed by those aged 6–15 years (658–2,141 per 100,000 persons). The incidence of mumps was higher in females than in males (male/female ratio, 0.90). Among mumps-related complications, the overall incidence (per 1,000 mumps cases) was highest for orchitis (6.6), followed by meningitis (5.8), deafness (1.3), pancreatitis (0.5), and encephalitis (0.3). No cases of oophoritis were noted. The overall incidence of mumps-related complications was 2.5 times higher in males than in females.ConclusionsThis study revealed the disease burden due to mumps and its complications in Japan during 2005–2017. These data suggest the need for mumps-prevention measures in adolescents and adults, as well as in children.Key words: disease burden, mumps, mumps complication     

Determinants of participation in prostate cancer screening: A simple analytical framework to account for healthy‐user bias

In Japan at present, fecal occult blood testing (FOBT) is recommended for cancer screening while routine population‐based prostate‐specific antigen (PSA) screening is not. In future it may be necessary to increase participation in the former and decrease it in the latter. Our objectives were to explore determinants of PSA‐screening participation while simultaneously taking into account factors associated with FOBT. Data were gathered from a cross‐sectional study conducted with random sampling of 6191 adults in Osaka city in 2011. Of 3244 subjects (return rate 52.4%), 936 men aged 40–64 years were analyzed using log‐binomial regression to explore factors related to PSA‐screening participation within 1 year. Only responders for cancer screening, defined as men who participated in either FOBT or PSA‐testing, were used as main study subjects. Men who were older (prevalence ratio [PR] [95% confidence interval (CI)] = 2.17 [1.43, 3.28] for 60–64 years compared with 40–49 years), had technical or junior college education (PR [95% CI] = 1.76 [1.19, 2.59] compared with men with high school or less) and followed doctors' recommendations (PR [95% CI] = 1.50 [1.00, 2.26]) were significantly more likely to have PSA‐screening after multiple variable adjustment among cancer‐screening responders. Attenuation in PR of hypothesized common factors was observed among cancer‐screening responders compared with the usual approach (among total subjects). Using the analytical framework to account for healthy‐user bias, we found three factors related to participation in PSA‐screening with attenuated association of common factors. This approach may provide a more sophisticated interpretation of participation in various screenings with different levels of recommendation.     

Blastogenic response and immunoglobulin production by inflamed gingival lymphocytes from dogs

The present study evaluated blastogenic responses and immunoglobulin production (IgG, IgM) by inflamed gingival lymphocytes from dogs. The excised tissues were cut finely, digested in collagenase for 60 min, then passed through a mesh, teased with a 24 G needle several times and centrifuged over a ficoll gradient. Responses to PHA, Con-A and PWM were assessed using peripheral blood lymphocytes (PBLs) and submandibular lymph node cells (SNLs) as controls. Blastogenesis was evaluated from the uptake of ³H-thymidine and the presence of IgG and IgM in culture supernatants was quantified using ELISA. The extraction procedure resulted in a mean 2.09 ± 0.44 × 10⁵ lymphocytes per 100 mg tissue (wet weight). These cells had a mean viability of 84.4 ± 3.0%. The responses of PBLs and SNLs to PHA, Con-A and PWM were substantial, as expected, while the responses of gingival lymphocytes to any mitogen remained at the level of unstimulated lymphocytes. However, gingival lymphocytes produced and secreted IgG and IgM. IgG production by gingival lymphocytes was elevated when compared with those of PBLs and SNLs, while IgM production by gingival lymphocytes was less than PBLs and SNLs. The responses of PBLs and SNLs are not parallel to the response of gingival lymphocytes.