Disease pattern and seasonal variation among Japanese expatriate children in Thailand.

BACKGROUND: Due to recent globalization, the number of Japanese expatriates including children has increased. The aim of the present study was to clarify the disease patterns and seasonal variation among Japanese children living in Thailand. METHODS: Records of Japanese children seen at the outpatient clinic at Bangkok Hospital in 2005 (n = 1668) were analyzed and records of Thai children (n = 23 339) were also analyzed for comparison. RESULTS: 'Diseases of the respiratory system' was the most frequent category in both groups (Japanese, 42.1%; Thai, 45.0 %,) followed by 'factors influencing health status and contact with health services' (Japanese, 12.7%; Thai, 14.9%), and 'certain infectious and parasitic diseases' (Japanese, 10.3%; Thai, 8.5%). The number of hospital visits by Japanese patients decreased in January, April, August and December and those by Thai patients in April and September. Identical drops in the number of visits for diseases of the respiratory system were also seen. A large number of patients visited the hospital for viral infections characterized by skin and mucous membrane lesions during the rainy season. The number of hospital visits for intestinal infection fluctuated during the rainy season. CONCLUSION: There were no marked differences between disease patterns of Japanese patients and Thai patients. Temporary visits back to Japan could account for sharp drops in total hospital visits and hospital visits for diseases of the respiratory system in January, April, August and December because these times of the year corresponded to extended school vacations. Preventive measures for viral infections characterized by skin and mucous membrane lesions should be promoted during the rainy season.

Patterns of outpatient visits by Japanese male expatriates in Thailand.

Objective of this study is to clarify the health-related conditions of Japanese male expatriates in Thailand. Records of Japanese male expatriates in their 30s to 50s who consulted outpatient clinics at Bangkok Hospital in 2005 were analyzed for number and type of outpatient visits then compared with data from the "Patient Survey" 2005 for age-matched males in Japan. "Diseases of the respiratory system" and "Certain infectious and parasitic diseases" had a higher rate of diagnosis among Japanese men living in Thailand than those living in Japan. "Endocrine, nutritional and metabolic diseases," and "Mental and behavioral disorders" had a lower rate of diagnosis among Japanese men living in Thailand than those in Japan. "Acute upper respiratory infections" accounted for 87.4% of "Diseases of the respiratory system" and "intestinal infections" accounted for 59.9% of "Certain infectious and parasitic diseases" among expatriates. Japanese male expatriates have a tendency of not visiting hospital when they have no subjective or objective symptoms. To support a healthy expatriate life, health information should be propagated widely and available support services, such as counseling via e-mail or fax, should be actively promoted. Expatriates should be informed of the availability of these services before they go abroad and during their stay.

The nature, time course and severity of methamphetamine withdrawal.

AIMS: To characterize the natural history of methamphetamine withdrawal during the first 3 weeks of abstinence. DESIGN: Cross-sectional study with comparison group. Setting A substance use treatment facility in Chiang Mai Province, Thailand. PARTICIPANTS: The sample comprised 21 in-patients undergoing treatment for methamphetamine dependence. Nine age- and sex-matched non-dependent individuals provided comparison data. MEASUREMENTS: Instruments including: the Amphetamine Withdrawal Questionnaire, a modified version of the Cocaine Selective Severity Assessment, Clinical Global Impression scale and the St Mary's Hospital Sleep Questionnaire were completed daily for the first 3 weeks of abstinence. FINDINGS: Methamphetamine withdrawal severity declined from a high initial peak within 24 hours of the last use of amphetamines reducing to near control levels by the end of the first week of abstinence (the acute phase). The acute phase of amphetamine withdrawal was characterized by increased sleeping and eating, a cluster of depression-related symptoms and less severely, anxiety and craving-related symptoms. Following the acute withdrawal phase most withdrawal symptoms remained stable and at low levels for the remaining 2 weeks of abstinence. CONCLUSIONS: This study has provided evidence of a methamphetamine withdrawal syndrome that can be categorized into two phases, the acute phase lasting 7-10 days during which overall symptom severity declined in a linear pattern from a high initial peak, and a subacute phase lasting at least a further 2 weeks.