The estimated incidence of HIV/AIDS has remained stable in recent years and patients with HIV/AIDS continue to increase in Japan. We investigated the trend of the patients with HIV infection in the people who receive the medical checkup as a Health Evaluation and Promotion, and we considered ideal way of action on the patients for achieving their early diagnosis. The subjects were 12 patients with HIV infection who were identified in our healthcare center from April 2005 to December 2014. We evaluated their background and abnormal findings in a complete health checkup. In addition, we evaluated the examinees with a high level of Zinc turbidity test (ZTT) among 35,189 examinees who received medical checkup from April 2013 to March 2014. All 12 cases were men (six in their 30’s, five in their 40’s, and one in his 20’s). At the time of medical checkup, seven cases were already under treatment, two had stopped visiting their hospitals, but in three people, HIV infection had not been diagnosed. One had acute HIV infection, and two had progressed to AIDS. Seven of the nine cases with HIV infection did not notify about HIV infection during interviews before the examinations. They informed us their status of HIV infection after serious recommendation for HIV screening test by a health checkup doctor. Ten of them (83.3%) showed high levels of ZTT. We identified 22 cases of the men aged under 50 who had a high level of ZTT (>20.0 Kunkel units) during our study period, at least 5 of them (22.7%) had been infected. When a male examinee aged under 50 shows a high level of ZTT, the health checkup doctor should first suspect HIV and recommend the HIV screening test to the examinee. In conclusion, we should understand the behavior of the HIV examinees and attempt to diagnose HIV/AIDS at an early stage.
BACKGROUND: Vasovagal reaction (VVR) is an adverse event such as drop in blood pressure, bradycardia, and nausea occurring during or after blood sampling. VVR is one of the well-known reactions during blood sampling, and it could lead to faintness, convulsion, and incontinence. In serious cases; however, few papers have been published regarding VVRs at medical examination. We aimed to investigate the characteristics of VVRs and propose a precaution manual during blood sampling. METHODS: We extracted 144 cases with VVRs out of 55,150 examinees seen in Osaka Central Hospital Healthcare Center from November 2012 until October 2013. We retrospectively analyzed age, sex, severity of VVRs, posture during blood sampling and recovery time. A questionnaire survey about VVR was performed among 20 nurses and their opinions were reflected in the precaution manual during blood sampling. RESULTS: Female showed the higher rate of VVRs (male:0.25% v.s. female:0.27%) among 55,150 examinees. From 144 cases with VVRs, the younger generation showed high tendency (age ≦40 yrs: 87.5% v.s. age ≧41 yrs: 12.5%). Regarding the severity of VVRs, 128 cases were mild (88.9%: Grade I); 9 cases were moderate (6.3%: Grade II), and 7 were severe (4.9%: Grade III). All 20 examinees collected in supine position remained Grade I, suggesting the usefulness of supine position. Of note, 106 examinees (73.6%) recovered within five minutes, which could be a criterion for recovery of VVRs. From the questionnaire survey, most nurses agreed that more than 15 minutes of supine posture is needed to relieve Grade II and III VVRs. A precaution manual for blood sampling to avoid VVR is proposed, which includes a questionnaire for examinees and routine checking of vitals every five minutes to alert medical staff. CONCLUSION: At medical examination, VVRs are not frequent side effects during blood sampling, but examinees, especially who are young and female, should be treated more carefully using our precaution manual.
In the present study, we aimed to investigate the longitudinal aspects of non-alcoholic fatty liver disease (NAFLD), and clarify the factors for the regression of fatty liver. We investigated changes of anthropometric parameters, blood tests and nutrient intake in subjects with regression of NAFLD in medical check-up both in 2007 and 2012. Fatty liver was diagnosed by ultrasonography. Intake of nutrients and food groups was assessed with a food frequency questionnaire (FFQ). Of the 118 subjects with NAFLD in 2007, 33 (28%) showed fatty liver regression in 2012. Body weight, body mass index (BMI) and waist circumferences were decreased significantly in subjects with fatty liver regression in 2012, compared with those parameters in 2007. Serum levels of total cholesterol, ALT and choline esterase were decreased significantly in subjects with fatty liver regression in 2012, compared with those blood tests in 2007. For nutrients, average total calorie intake decreased from 33.8±8.5 kcal/IBW kg/day in 2007 to 29.1±7.0 kcal/IBW kg/day in 2012 in subjects with fatty liver regression. Dietary intake of carbohydrates, especially, cereals and potatoes, was decreased significantly. There were no significant changes of anthropometric parameters, blood tests and nutrient intake in subjects with fatty liver in 2012. Weight reduction achieved through reduced calorie diets with lower carbohydrate intake may result in regression of liver fat deposition in subjects with NAFLD.
1. Aim and objectives: This report is about “NavBEE”, a health literacy checkup program for mind and body which has been developed for promoting primary health care effectively. It can be used in medical centers as well as by both companies and health insurance societies. 2. Method: The NavBEE checkup consists of the following components. 1) Profile: Name, Date of birth, Height, Weight, (BMI), Personality 2) Lifestyle: drinking, smoking, exercise, sleep, dietary habits behavior modification, health guidance. 3) Test results: 19 items from health check (Metabolic judgment, Abdominal circumference, blood pressure, fasting blood sugar, HbA1c, Total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, AST (GOT), ALT (GPT), γ-GTP, uric acid, Creatinine, Hemoglobin, Hematocrit, Urine sugar, Urine protein, Occult stool blood). 4). Current medical history: Illnesses or conditions which are already being treated (Stroke, Heart disease, Renal insufficiency, Anemia, High blood pressure, Hyperglycemia, Lipid abnormality). 5). Mental checkup: ① Mental health state - checking the mental state. ② Stress check- checking the variety and degree of stress. ③ Coping style - showing coping behavior. ④ Survival capacity- checking on resilience. 3. Results: The results are collated from an individual’s input data and presented visually in illustrations of bees. In this way, it is easy for users to check and recognize their psychological and physical state by themselves. Therefore, action to transform health is promoted. “Mental health state“ is assessed by a series of positive questions. The stimulative impression to a testee is low. NavBEE is suitable for a clinical survey medical examination. Mental health state is correlated with SDS (Self-rating Depression Scale). The Cronbach alpha level is 0.86. 4. Discussion: It is important that one’s psychological and physical health condition should be recognized by oneself. Health literacy is necessary for making appropriate decisions about health. It is difficult for an individual who is not sick to acquire the custom of looking back on health. It is necessary for an organization to raise personal health literacy, and the development of an organization’s interest toward health is necessary. The accumulation of a log history can become an effective tool for health guidance. NavBEE can become a tool for increasing the health literacy of an organization. The point of view of work-life balance is important, and it is necessary to assess psychological and physical health by means of a clinical survey.