Central blood pressure and pulse wave velocity in young and middle-aged Japanese adults with isolated systolic hypertension.

Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mmHg and diastolic BP (DBP) <90 mmHg, is a common type of hypertension among young men. This study aimed to investigate the clinical characteristics, central blood pressure, and arterial stiffness of young and middle-aged Japanese individuals with ISH. A total of 432 male participants, aged 18-49 years, were classified into six subgroups: optimal BP (SBP <120 mmHg and DBP <80 mmHg), high-normal BP (SBP 120-129 mmHg and DBP <80 mmHg), high-BP (SBP 130-139 mmHg and/or DBP 80-89 mmHg), ISH (SBP ≥140 mmHg and DBP <90 mmHg), isolated diastolic hypertension (IDH) (SBP <140 mmHg and DBP ≥90 mmHg), and systolic and diastolic hypertension (SDH) (SBP ≥140 mmHg and DBP ≥90 mmHg). Participants with ISH had a greater body mass index (BMI) and waist circumference than the optimal BP participants but were more likely to be physically active than the IDH and SDH participants. The central SBP of the ISH subgroup was higher than that of the optimal/high-normal/high-BP subgroups and lower than that of the SDH subgroup. The carotid-femoral pulse wave velocity (cfPWV) of the ISH subgroup was higher than that of the optimal and high-normal BP subgroups and lower than that of the SDH subgroup after adjusting for age, heart rate, BMI, and physical activity. These differences disappeared after further adjustment for central mean arterial pressure. In conclusion, the central SBP of Japanese men with ISH was greater than that of Japanese men with optimal/high-normal/high-BP, but the progression of arterial stiffness was unclear.

The opinions of occupational physicians about maintaining healthy workers by means of medical examinations in Japan using the Delphi method.

OBJECTIVES: In Japan, employee fitness for work is determined by annual medical examinations. It may be possible to reduce the variability in the results of work fitness determination, particularly for situation, if there is consensus among experts regarding consideration of limitation of work by means of a single parameter. METHODS: Consensus building was attempted among 104 occupational physicians by employing a 3-round Delphi method. Among the medical examination parameters for which at least 50% of participants agreed in the 3rd round of the survey that the parameter would independently merit consideration for limitation of work, the values of the parameters proposed as criterion values that trigger consideration of limitation of work were sought. Parameters, along with their most frequently proposed criterion values, were defined in the study group meeting as parameters for which consensus was reached. RESULTS: Consensus was obtained for 8 parameters: systolic blood pressure 180 mmHg (86.6%), diastolic blood pressure 110 mmHg (85.9%), postprandial plasma glucose 300 mg/dl (76.9%), fasting plasma glucose 200 mg/dl (69.1%), Cre 2.0mg/dl (67.2%), HbA1c (JDS) 10% (62.3%), ALT 200 U/l (61.6%), and Hb 8 g/l (58.5%). CONCLUSIONS: To support physicians who give advice to employers about work-related measures based on the results of general medical examinations of employees, expert consensus information was obtained that can serve as background material for making judgements. It is expected that the use of this information will facilitate the ability to take appropriate measures after medical examination of employees.

[General background and practical implementation of Fitness for Work Statement in the UK].

The Statement of Fitness for Work, so called Fit Note, was introduced in the UK in 2010. Physicians issue Fit Note to workers when requested. The Fit Note provides the physician's advice about the worker's fitness for work when he or she has health problems, writing their advice of either "may be fit for work" or "not fit for work" on the form. The Fit Note also records details of the functional effects of workers' condition. Then the Fit Note is used to consider and arrange support from employers in order for workers to return to work. This paper reports the general background and practical implementation of Fit Note based on a literature review and interviews from general practitioners, occupational physicians, and physiotherapists in the UK.

[Survival of Gram-positive spore-forming bacteria including Bacillus cereus after hand washing using alcohol-based handrub].

Hand washing is the most fundamental method for preventing infection. Currently, hand washing with an alcohol-based handrub is the international gold standard method. However, in our study we found many samples of ineffective hand washing using an alcohol-based handrub. The rates of ineffective samples were 10.4% (5/48) in 2004 and 34.3% (12/35) in 2005. We examined the morphology by Gram staining and biochemical properties of the bacteria which remained after hand washing in 2005. Their colonies were divided into 3 groups (round colonies, irregular-shaped and diffusive colonies). The round colonies were considered Staphylococcus spp., and the irregular-shaped colonies or diffusive colonies were considered Gram-positive spore-forming bacteria. In the 12 ineffective hand washing samples (more than the same number of bacteria colonies as before hand washing, or > or = 300), there were 3 samples considered to be the result of the survival of Staphylococcus spp., and 9 samples considered to be the result of the survival of Gram-positive spore-forming bacteria including Bacillus cereus. Based on these results, we should take careful measures, such as wearing sterile gloves if necessary. We should never be overconfident regarding the effect of hand washing.