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Aims/Introduction: To investigate the association between cardiovascular autonomic neuropathy (CAN) assessed by the coefficient of variation of the R‐R interval and the reduction in the estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes. Materials and methods: This retrospective observational cohort study enrolled type 2 diabetes patients who had their coefficient of variation of the R‐R interval measured on an electrocardiogram from January 2005 to December 2018. CAN was defined using the reference coefficient of variation of the R‐R interval value based on age and sex. The primary outcome was set as a 40% eGFR decline from baseline. Regression analyses using the Cox proportional hazards model were carried out to evaluate the association. Results: Of the 831 patients, 118 (14.2%) were diagnosed with CAN. In the analysis of the primary outcome, the median follow‐up period was 5.3 years, and 25 (21.2%) patients with CAN and 78 (10.9%) patients without CAN developed a 40% eGFR decline. In the univariate regression analysis, CAN was significantly associated with a 40% eGFR decline (hazard ratio 2.42, 95% confidence interval 1.54–3.80). In the multivariate analysis, CAN remained almost significant after adjusting for the prognostic risk factors for CAN and the decline in the renal function, and an interaction with proteinuria was found. In analyses for the interaction effect between CAN and proteinuria, the presence of CAN synergistically increased the risk of an eGFR decline in patients with macroproteinuria. Conclusions: CAN strongly increased the risk of a 40% eGFR decline from baseline, especially in type 2 diabetes patients with macroproteinuria. [ABSTRACT FROM AUTHOR]

Background: Cancer pain management in children is challenging owing to their unique patient characteristics. We present the case of a 10-year-old girl whose cancer pain was successfully managed using an intrathecal neurolytic block. Case presentation: The patient experienced severe cancer pain due to recurrent right ilium osteosarcoma. The tumor progressed rapidly despite chemoradiotherapy and gradually invaded the right lumbar plexus, which resulted in severe neuropathic pain in the right lower extremity. Systemic analgesics failed to attenuate the pain. We performed an intrathecal neurolytic block using 10% phenol-glycerol. The neurolytic block completely relieved her right lower extremity pain. After the block, the patient's quality of life improved, and she spent her time with family. Conclusions: The intrathecal neurolytic block successfully relieved the patient's cancer pain. Successful intrathecal neurolytic blocks require meticulous pain assessment of individual patients, to avoid possible serious complications such as paresis/paralysis and bladder/bowel dysfunction. [ABSTRACT FROM AUTHOR]

Background: The proportion of non-regularly employed persons has increased in Japan, but few studies have examined the relationship between employment status and lung cancer screening (LCS) participation. Methods: Authors analyzed data from the 2010 Comprehensive Survey of Living Conditions in Japan. The anonymous responses of 28,951 people aged 40–69 years old were analyzed. Authors defined nine employment status categories: unemployed, regularly employed in a large-, middle-, and small-scale company, non-regularly employed in a large-, middle-, and small-scale company, self-employed, and other. LCS participation in the past year was surveyed through a self-reported questionnaire. Sex-specific prevalence ratios (PRs) and 95% confidence intervals (CIs) for LCS participation for all employment status categories, using the regularly employed in a middle-scale company category as the reference, were calculated using multivariable Poisson regression analysis, after adjusting for potentially confounding factors. Results: Multivariable-adjusted PRs (95% CI) for LCS participation for the regularly employed in a large-scale company were 1.33 (1.25–1.41) in men and 1.53 (1.38–1.71) in women. Multivariable-adjusted PRs (95% CI) for LCS participation for the non-regularly employed in a middle- and small-scale company compared with the regularly employed in a middle-scale company were 0.81 (0.72–0.92) and 0.62 (0.50–0.76) in men, and 0.89 (0.80–0.99) and 0.80 (0.71–0.91) in women, respectively. Conclusion: Regularly employed in a large-scale company had significantly higher LCS participation, and non-regularly employed in a middle- or small-scale company showed significantly lower LCS participation than those who were regularly employed in a middle-scale company. [ABSTRACT FROM AUTHOR]

Background Marital status is one of the socio-economic factors associated with health. Several studies have indicated a significant association between marital status and insomnia. The increases in the percentages of unmarried people in Japan are expected to produce a significant impact on insomnia. The purpose of this study was to examine the association between marital status and insomnia. Methods The participants were 35 288 people aged 30–59 years selected from the 2010 comprehensive survey of living conditions. We categorized marital status into five groups: single, married couples living with other family members, married couples living without other family members, widowed and divorced. Insomnia-related symptoms (IRS) were based on the participants who chose the answer, 'I couldn't sleep'. Sex-specific multivariable odds ratios (ORs) and 95% confidence intervals (CI) of IRS according to marital status were calculated using the logistic regression model, which was adjusted for potential confounding factors. Results The proportions of people with IRS were 2.5% in men and 2.8% in women. The multivariable ORs (95% CI) were 1.15 (0.89–1.49) for single, 1.69 (1.11–2.58) for divorced and 1.01 (0.73–1.39) for married couples living without other family members in men, and 1.56 (1.20–2.03) for single, 2.43 (1.83–3.22) for divorced and 1.31 (1.01–1.71) for married couples living without other family members in women. Conclusions We found divorced men and single, divorced and married women living without other family members had higher IRS than those who were married couples living with other family members in Japanese. This association was more evident in unemployed men. [ABSTRACT FROM AUTHOR]

Background: Short sleep duration (SSD) is reported to be highly associated with socio-economic status. There are few studies on the relationship between employment status and SSD in Japan. Method: The authors used the 2006 Survey on Time Use and Leisure Activities conducted by the Ministry of Internal Affairs and Communications Japan, which provides representative samples of Japanese people. The anonymous data of 120,783 people aged 30–59 years were analyzed. Authors defined five categories of employment status: "unemployed," "regularly employed," "non-regularly employed," "self-employed," and "other." Authors also defined a sleep duration shorter than 5 h per night as SSD. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of SSD using regular employment as the reference group were calculated using the logistic regression model, adjusting for potential confounding factors, i.e., age, marital status, education level, communication device use, and the amount of time spent on various daily activities. Results: The prevalence of SSD was 2.8% (1639/58,308) in men and 3.2% (1976/62,475) in women. The multivariable-adjusted OR (95% CI) of SSD for the self-employed was 0.78 (0.65–0.92) in men and 1.78 (1.43–2.21) in women after adjustment for potential confounding factors, i.e., age, marital status, education level, and communication device use. Further adjustment for the time spent on daily activities revealed that the OR (95% CI) of SSD for the self-employed was 0.78 (0.65–0.92) in men and 1.89 (1.52–2.36) in women. Conclusion: Self-employed women had a higher prevalence of SSD. By contrast, self-employed men had a lower prevalence of SSD. [ABSTRACT FROM AUTHOR]

The neurosteroid allopregnanolone (3α, 5α-tetra-hydroprogesterone: ALLO) elicits anxiolytic, anticonvulsant, and hypnotic anesthetic effects in vivo similar to those induced by other positive allosteric modulators of the GABAA receptor. Endogenous ALLO has been shown to be rapidly elevated in the brain by acute stress paradigms, such as immobilization, in animal models. The present study was designed to ascertain the role of neurosteroid biosynthesis in the anxiety-like behavior induced by immobilization stress. Mice were exposed to an immobilization stressor for 2 h. After 24 h, the mice that had been immobilized did not behave significantly differently in the elevated plus maze (EPM) test and in the elevated open platform (EOP) test than the mice that had not been immobilized. In contrast, finasteride-pretreated immobilization stressed mice did behave significantly differently in the EPM and EOP tests. These findings suggest that ALLO biosynthesis contributes to stress resistance. Furthermore, the ALLO mimetic drug alfaxalone appeared to antagonize the effects of finasteride by significantly changing the behavior in the EPM test or in the EOP test in finasteride (10 mg kg−1)-pretreated immobilized mice. In addition, alfaxalone, unlike diazepam, did not affect the muscle tone of the mice, as measured by the grip strength test. These results suggest that alfaxalone is a promising anxiolytic candidate lacking benzodiazepine-like muscle-relaxant effects. [ABSTRACT FROM AUTHOR]

Objectives: The first aim of this study was to evaluate the association between time spent living near a contaminated area and concentration of arsenic (As) compounds in the urine among study subjects. The second aim is to assess the association between consumption of various foods or beverages and As concentration in urine among them. Methods: Urine sampling was performed on 177 persons who voluntarily participated in the survey in May 2014. The median value of the sum of inorganic As (iAs) and total As (tAs) compounds was used for us to divide into two groups, such as the high and low iAs and high and low tAs groups. We analyzed data separately in two-age strata of age group A (the subjects <18 years old), and age group B (the subjects ≥18 years old). A multivariate analysis was performed with the logistic regression model to adjust for potential confounding variables. Results: No link between time spent living near a contaminated area and urinary As concentration was observed in our study. For age group B, frequently drinking beer was significantly associated with risk of being in the high tAs group ( p = 0.008). Compared to not drinking beer, odds ratios (95 % confidence intervals) of drinking beer <1 or 2 times per week, and drinking beer ≥3 or 4 times per week were 3.09 (1.32-7.24) and 3.00 (1.02-8.80), respectively, after adjusting for age, sex, and smoking index. Conclusion: Frequent consumption of beer may be associated with high tAs in age group B [ABSTRACT FROM AUTHOR]