ABSTRACT
<b>Objective:</b> The mechanism underlying the development of neuropsychiatric symptoms such as unconsciousness, abnormal behavior, delirium, hallucinations, and convulsions in influenza has not been thoroughly investigated. The relationship between drug administration and neuropsychiatric symptoms during influenza is also poorly understood. This study is the first pharmacoepidemiologic study focused on investigating the relationship between drug administration and neuropsychiatric symptoms.<br><b>Design:</b> Cohort study<br><b>Methods:</b> Study subjects were patients under 18 years old who had influenza during the 2006/07 season. We prepared two kinds of questionnaires for doctor and for patient's family, and carried out the survey between January and March, 2007. Using data from 9,389 patients, we analyzed the relationship between neuropsychiatric symptoms, such as delirium, unconsciousness and convulsion, and drug administration of acetaminophen and oseltamivir.<br><b>Results:</b> Analysis of the relationship between delirium and drug administration provided hazard ratios of 1.55(p=0.061)for acetaminophen and 1.51(p=0.084)for oseltamivir. These hazard ratios, which were adjusted for risk factors by multivariate analysis of the proportional hazard model, showed an increasing tendency of delirium after administration of each drug. In patients who received oseltamivir, a high incidence of delirium was observed between 6 and 12 hours after onset of fever. Furthermore, delirium was found to develop in a shorter time following oseltamivir use than it did after acetaminophen use. There was no relationship between unconsciousness and acetaminophen administration, as demonstrated by a hazard ratio of 1.06(p=0.839). The incidence of unconsciousness increased significantly with oseltamivir use with a hazard ratio of 1.79(p=0.0389), and unconsciousness was found to occur in a short time after oseltamivir use.<br><b>Conclusion:</b> The results obtained from this study suggest that there are increased risks of delirium and unconsciousness with drug administration. Further pharmacoepidemiologic studies for hypothesis testing are required to study the relationship between abnormal behavior and drug administration.
ABSTRACT
A six-month follow-up study of athletic injury and physical fitness was conducted on ten players in a nationally ranked boys' high school water polo team. The first medical check-up was conducted on May 28th, 1995, and the second just 4 days before the national athletic meet on September 2 nd. The final check-up was done on November 18 th. A thorough examination in addition to X-ray evaluation by an orthopedist was done on June 26th after the first medical check-up.<BR>In our check-ups, athletic injuries were defined as injuries due to water polo or disorders which prevented individuals from playing. In the thorough examination, athletic injuries included any physical conditions that required further investigations or treatment by the doctor.<BR>Six players had taken part in swimming before taking up water polo, and seven had played water polo since junior high school. Of the athletic injuries sustained, 55% occurred at the age of 13-14 yr. Injuries due to carelessness and over-enthusiasm amounted to six. Motion pain in the pes anserius, iliotibial tract, and hip joints without traumatic episodes were thought to originate from the characteristic leg action under the water.<BR>Although body weight and height varied among the players, the differences in the values of body fat percentage, body mass index, and lean body mass were slight.<BR>Since the players had few complaints, athletic injuries were difficult to find. However, with periodic medical check-ups and a thorough examination, we are able to prevent some problems such as pain in the pes anserius or iliotibialtract.
ABSTRACT
Previous studies have shown that the process of recovery after disuse muscle atrophy varies in different experimental models. We investigated the process of recovery of M, soleus atrophy after immobilization, with special reference to changes in structural and soluble proteins by means of electrophoresis and histochemical changes using myosin-ATPase staining. After rabbits had been subjected to 3 weeks of hindlimb immobilization, the changes were investigated immediately after the termination of immobilization, and at 1, 2, 3, 4 and 6 weeks of recovery. Just after the termination of immobilization, the wet weight of the M. soleus was 32.7±14.0% that of the opposite limb. The wet weight recovered rapidly and returned to the same level as that of the opposite side by 4 weeks. The amount of structural proteins decreased after immobilization, but did not return to the control level at 6 weeks after recovery. No new bands appeared in the electrophoretic patterns of the structural and soluble proteins at any of the stages of recovery. Furthermore, the special features of the bands of myosin light chains (MLCs-1, MLCs-2) also showed no change. ATPase staining showed that the area of type 2 fibers increased, and occupied 45.2±12.6% of the total area at 3 weeks after recovery, whereas that of muscle from controls occupied 17.3±5.7%. The area did not return too the control level by 6 weeks of recovery. The discrepancy between the histochemical changes and the changes in structural or soluble proteins during the recovery process appeared to be due to differences in the turnover ratio of each protein. It appears that the process of recovery of disuse muscle atrophy after immobilization is variable and compley, and differs according to the method of observation.