Since 2000, rapid antigen detection kits and anti-influenza drugs have been used for the early diagnosis and treatment of influenza in Japan, respectively.　The main drugs available in clinical practice are the neuraminidase inhibitors oseltamivir, zanamivir, laninamivir, and peramivir, as well as the cap-dependent endonuclease inhibitor baloxavir marboxil.　Antiviral therapy with neuraminidase inhibitors has been practiced for many years, especially in Japan; it can shorten the febrile period and reduce complications.　Despite having similar structures, the pharmacologic background of neuraminidase inhibitors differs significantly, as reflected in their varying clinical efficacy.　Due to its inhibitory mechanism, baloxavir marboxil can rapidly reduce the viral load than neuraminidase inhibitors.　However, the duration of symptoms was similar after the administration of baloxavir marboxil and oseltamivir, and variants with reduced drug susceptibility have been detected in 20%–30% of pediatric patients treated with baloxavir marboxil.　Clinical trials of several novel anti-influenza drugs are currently underway.　When these drugs are first marketed, the characteristics of the influenza virus and the pharmacologic background of the drugs must be clarified before their administration to patients in clinical practice.

Increased fear of falling (FOF) increases the risk of falling and is an important issue for living an independent life.　Patients undergoing hemodialysis (HD) frequently fall, and this may be attributed to increased FOF due to common fall risk factors as well as severe chronic kidney disease and HD-related factors.　The purpose of this narrative review was to summarize the current knowledge on the mechanisms of increased FOF leading to falls in patients undergoing HD.　

Patients undergoing HD have enhanced FOF compared to community elderly people.　Furthermore, an increase in FOF is correlated with a decrease in physical activity and physical function.　It has been reported that FOF in patients undergoing HD may be associated with past and future falls, and the risk of falling increases sharply when FOF exceeds a certain threshold.　Increased FOF may serve as a fundamental mechanism leading to increased fall risk by interacting with physical inactivity and physical frailty, affecting lower limb muscle activity during walking.　Further research is needed to clarify the relationship between increased FOF and falls in patients undergoing HD.　Regular clinical assessment of FOF is critical for identifying fall risk in patients undergoing HD.

Introduction: We investigated the drug resistance status of Pseudomonas aeruginosa (P. aeruginosa) focusing on its isolation sites and types of diseases.　

Materials and methods: A microbiological laboratory database was searched to identify all clinical cultures positive for P. aeruginosa.　Clinicopathologic features and susceptibility of P. aeruginosa to any antibiotics were evaluated in patients admitted to the division of upper (Upper-GI group) or lower gastrointestinal surgery (Lower-GI group).　In addition, we investigated the susceptibility of P. aeruginosa to any antibiotics based on the isolation site.　

Results:P. aeruginosa was frequently detected in the sputum and urine of the Upper-GI and Lower-GI groups, respectively.　Among P. aeruginosa isolates from drain discharge, a significantly higher rate of resistance to imipenem, amikacin, and ciprofloxacin was observed; among P. aeruginosa isolates from wounds, a substantially higher proportion had resistance to imipenem and cefozopran in the Upper-GI group.　However, there was no difference between the two groups in the drug resistance of P. aeruginosa isolated from urine, sputum, blood, and ascites.　P. aeruginosa isolated from sputum showed more resistance to imipenem and ciprofloxacin than those isolated from other sites.　

Conclusion: There were significant differences in the drug resistance of P. aeruginosa based on the isolation sites and types of diseases.　

This study aimed to assess long-term changes in pregnancy and birth outcomes after the Great East Japan Earthquake and the accident at the Tokyo Electric Power Company’s Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture.　This is the final report on perinatal outcomes of the Prefectural Health Survey, which ended after a 10-year observation period.　Questionnaires based on a pregnancy and birth survey conducted by the Radiation Medical Science Center for the Fukushima Health Management Survey were sent to women who had received maternal and child health handbooks from municipal officers in Fukushima Prefecture.　Annual data from six geographic areas in Fukushima Prefecture were separately analyzed.　The number of eligible respondents, which was approximately 16,000 in 2011 when the earthquake occurred, declined temporarily the following year, recovered temporarily one year later, and has gradually declined since then.　However, the response rate remained at approximately 50% throughout the decade.　The incidence of preterm deliveries, low-birthweight infants, and congenital anomalies did not vary over the decade and showed a similar trend in national surveys and general reports.　Our analysis shows that the disaster had no significant adverse perinatal outcomes in Fukushima Prefecture and we recommend measures to ensure the safe delivery of babies in the region.

Objectives:In inflammatory bowel disease therapy, thiopurines have been essential.　However, several reports have investigated factors affecting thiopurine metabolism to date.　This study investigated factors affecting intracellular concentrations of 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP) in a real-world setting.

Methods:Between May 2013 and October 2021 in one institution, 44 patients (median age 44 years;male 35, female 9;ulcerative colitis 32, Crohn’s disease 12) receiving thiopurines were reviewed.　Intracellular 6-TGN/6-MMP concentrations were measured by high-performance liquid chromatography, and the initial measurement in each patient was used for the study.

Results:The 6-TGN level was significantly higher in females, with mild disease activity, absence of NUDT15 polymorphism, and allopurinol administration.　A higher trend was observed with high thiopurine dosage (>50 mg).　6-MMP levels were significantly lower with concomitant use of time-dependent 5-aminosalicylic acid (5-ASA) and allopurinol, and higher with high thiopurine dosage.　On multivariate analysis of variance, logarithmically transformed 6-TGN levels were significantly higher in females, with high thiopurine dosage, and allopurinol administration.　Similarly, logarithmically transformed 6-MMP levels were significantly higher with time-dependent 5-ASA administration and high thiopurine dosage.

Conclusions:Patients who received allopurinol, a high dose of thiopurine, or were female showed higher 6-TGN levels.

Acute pancreatitis in children in Japan is often caused by an anatomical abnormality of the pancreatic and bile duct, resulting in fever, abdominal pain, vomiting, diarrhea, and other symptoms.　Crohn’s disease, however, is a chronic granulomatous inflammatory bowel disease with ulcerative lesions of the intestinal tract of unknown cause that occurs mainly in young people, with symptoms similar to those of acute pancreatitis.　We report a case of acute pancreatitis diagnosed in a patient not only with incomplete fusion of the pancreatic duct but also with Crohn’s disease.　A 14-year-old girl, healthy by nature, presented to our hospital with complaints of abdominal pain and diarrhea.　She was initially diagnosed as having acute pancreatitis due to incomplete pancreas divisum.　However, a high level of fecal calprotectin led to endoscopic examination, which resulted in the diagnosis of Crohn’s disease.　Fecal calprotectin can be useful in the diagnosis of inflammatory bowel disease associated with acute pancreatitis in children.　Although the relationship between inflammatory bowel disease and acute pancreatitis has not yet been clarified, we suggest that in the present case, acute pancreatitis may have manifested as a complication of Crohn’s disease and an underlying case of incomplete pancreas divisum.

Myositis-specific autoantibodies play an important role on the disease phenotype of idiopathic inflammatory myopathies (IIMs). Anti-signal recognition particle (SRP) antibody-positive patients with IIMs may present with severe myopathy and highly elevated serum creatine kinase levels. These patients are often resistant to immunosuppressive therapy, but there is no established treatment strategy. A 51-year-old man referred to our department was diagnosed with IIM based on imaging and pathological findings. A high dose of corticosteroids followed by intravenous cyclophosphamide (IV-CY) treatment (750 mg three times) resulted in an improvement in clinical manifestations and functional outcomes, and recurrence did not occur. Our case suggests that IV-CY is an effective induction regimen for patients with anti-SRP antibody-positive IIMs.

Fukushima Medical University (FMU) organizes annual International Symposiums on the Fukushima Health Management Survey (FHMS) to share up-to-date Survey findings.　In response to radiation released from the Tokyo Electric Power Company’s Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake, the FHMS was established with the aim of providing long-term follow-up for the physical and mental health of Fukushima residents, and maintaining and improving their health into the future.　This year, the sixth annual symposium was convened in Tokyo on Saturday, March 2, 2024, with the theme, “3.11:Sharing Lessons of Fukushima with Japan and the World.”