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Early treatment of HIV relies on a timely detection of the infection, but many people living with HIV/AIDS are unaware of their infection. In the current study, we applied an electronic medical records (EMR)-based alert system flagging high-risk patients previously diagnosed with infections of syphilis, hepatitis A virus, hepatitis B virus, and/or hepatitis C virus, and those aged 20-50 years with a prior diagnosis of shingles. During the study period (April to October 2019), a total of 47 individuals among 22,264 patients visiting our department were identified as having high-risk of carrying HIV, and 14 of these individuals underwent HIV testing. Two males aged below 65 years with a previous diagnosis of syphilis were subsequently tested positive for HIV. This preliminary analysis of the EMR alert system facilitated the identification of high-risk people possibly carrying HIV, but the test rate remains to be improved., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Pneumococcal vaccination has been shown to reduce occurrence of invasive pneumococcal diseases in elderly patients. In this study, we investigated the real-world efficacy of pneumococcal vaccination implemented in elderly individuals in Japan. We reviewed the in-patient database of Juntendo University Hospital and selected elderly patients (≥65 years-old) who had received in-patient care in the general medicine department during 2014-2018. A total of 1355 patients were retrospectively enrolled and comprised of 1045 unvaccinated and 315 vaccinated elderly individuals. Prior vaccination was found associated with all-cause shorter hospital stays (adjusted RR = 0.66, 95% CI = 0.57 to 0.76) and less medical expenditure (adjusted RR = 0.76, 95% CI = 0.66 to 0.87) compared with no vaccination, as well as protection for all-cause in-hospital mortality (adjusted OR = 0.42, 95% CI = 0.22 to 0.83). The association of shorter hospital stays and less medical expenditure with vaccination was also observed in the context of pneumonia, although no altered risk in mortality was observed. In conclusion, this study is one of the first reporting real-world data after the initiation of pneumococcal vaccination program in 2014 in Japan. The national PPV23 vaccination program contributed to the reduction of all-cause in-patient days, mortality, and medical expenses in the elderly aged ≥65 years. Further data is warranted to evaluate the contribution from influenza vaccination and protein-conjugate based pneumococcal vaccine., Competing Interests: Declaration of Competing Interest T.N. has received honoraria for lectures from MSD K.K. A.W. has received honoraria for lectures from MSD K.K and Pfizer K.K. The authors declare that they have no known competing financial interests., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Pneumonia is the third most common cause of death in Japan. Low vaccination rates are thought to be related to low levels of public subsidy. Since 2014, the Japanese government has offered subsidies through a 5-year national routine vaccination program of the 23-valent pneumococcal polysaccharide vaccine (PPV23) for older adults at age ≥65 years with 5-year age intervals. We previously reported that, 2 years into the 5-year program, the estimated vaccination rate was 40.6% at the end of 2015, a significant increase compared with periods before the program introduced. Here, we present an update on the estimated vaccination coverage of the 5-year national routine vaccination program at the end of 2018. The PPV23 vaccination rates were calculated by dividing the cumulative amount shipped to each municipality by the population aged ≥65 years. At the end of 2018, the completion of the 5-year national immunization program, the estimated cumulative vaccination rate was 74%. Stepwise regression analysis revealed that the annual PPV23 vaccination rate significantly increased after 2014 (from 2 to 5% prior to 2014, to 10-11% after 2014), and remained steady for 2014-2018. Our findings suggest that the 5-year national routine vaccination subsidy program was successful in achieving a steady and higher vaccination rate of PPV23 in Japan., Competing Interests: Declaration of Competing Interest T.N. has received a grant from Pfizer Inc. and honoraria for lectures from MSD K.K. A.W. have received honoraria for lectures from MSD K.K., (Copyright © 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Low vaccination rates with pneumococcal vaccine in elderly persons in Japan are thought to be related to low levels of public subsidy. We previously reported that larger subsidies were significantly associated with elevated vaccination rates with the 23-valent pneumococcal vaccine (PPV23) in elderly persons. Since 2014, the Japanese government has offered subsidies through a 5-year national routine vaccination program for elderly persons at 5-year age intervals. Here, we investigated the effect of the national routine vaccination program on PPV23 vaccination rates. PPV23 vaccination rates were calculated as follows: cumulative amount shipped to each municipality divided by the population aged ≥65 years. At the end of 2015, 2 years into the 5-year national immunization program, the estimated vaccination rate was 40.6%, which was significantly increased compared with former periods (p = 0.01). Our findings show that the national routine vaccination program plays an important role in increasing the vaccination rate of PPV23 in Japan., (Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Aim: We aimed to evaluate the association between abdominal fat distribution (e.g., abdominal visceral fat area [VFA], subcutaneous fat area [SFA], and total fat area [TFA]), waist circumference (WC), or body mass index (BMI) and atherosclerotic changes in the carotid artery after adjusting for common risk factors., Methods: The present study is a hospital-based, cross-sectional study. Study participants included 223 Japanese individuals who underwent a medical health checkup at Juntendo University Hospital, Tokyo, between December 2005 and August 2011. Multivariate logistic regression analysis was used to examine the association between abdominal VFA, SFA, TFA, the VFA/SFA ratio, WC, or BMI and intima-media thickness [IMT] (mean IMT≥1.1mm or maximum IMT≥1.2mm) as atherosclerotic changes in the carotid artery., Results: Multivariate logistic regression analysis showed that VFA (OR for ≥150cm(2) versus <100cm(2), 3.88; 95% CI, 1.39-10.85), BMI (OR for ≥27.6kg/m(2) versus <25kg/m(2), 5.22; 95% CI, 1.69-16.16), and TFA (OR for 200-285cm(2) versus <200cm(2), 4.15; 95% CI, 1.34-12.86: OR for ≥285cm(2) versus <200cm(2), 5.53; 95% CI, 1.76-17.35) were significantly associated with atherosclerotic changes in men. After adjustment for BMI, only TFA (OR for ≥285cm(2) versus <200cm(2), 3.76; 95%CI, 1.03-13.79) in men was significantly associated with atherosclerotic changes in the carotid artery., Conclusions: Our results indicate that VFA, TFA, and BMI are independently associated with atherosclerotic changes in Japanese men. TFA may be considered as a valuable measure of atherosclerotic changes., (Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine success rates in controlling target blood pressures longitudinally by measuring several factors, including lifestyle characteristics associated with uncontrolled blood pressures for target treatment goals., Methods and Patients: This prospective observational cohort study (September 2008-September 2010) collected information on blood pressure control status and healthy lifestyle factors listed in Breslow's seven health practices through medical records and self-administered questionnaires from 884 of the 1264 Japanese hypertensive patients initially registered in the FRESH study. Multivariate analysis adjusted for associated factors was performed to estimate the association between lifestyle change and "uncontrolled blood pressures" at the final follow-up survey., Results: Median age and proportion of men were 73 years and 39.1%, respectively. All survey failure rates were 37.6% among non-elderly patients (<65 years of age) without diabetes mellitus or chronic kidney disease, and 35.0% among patients with these diseases or myocardial infarction. Maintaining a healthy lifestyle was a protective factor against uncontrolled blood pressures in multivariate analysis. Obesity and smoking status were associated with uncontrolled blood pressures, and exercise frequency was borderline significance. The number of participants with healthy responses for these factors remained relatively low during follow up., Conclusion: Our study revealed low rates of controlled blood pressures, especially in non-elderly patients without diabetes mellitus or chronic kidney disease, and patients with these diseases or myocardial infarction. Our data indicate the need to maintain a healthy lifestyle, in particular, ideal body weight and adequate exercise frequency, for better hypertension management according to treatment guidelines., (Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to estimate the prevalence of metabolic syndrome among Vietnamese diabetic patients and to investigate their characteristics., Methods: This cross-sectional study was conducted among 652 outpatients who were recruited from one public general hospital (People Hospital 115) and one private clinic (Medic Center) in Ho Chi Minh City, Vietnam. We obtained informed consent from participants, collected clinical information from medical files, and conducted patient interviews. We evaluated the collected information descriptively and diagnosed metabolic syndrome according to the International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome., Results: A total of 517 eligible patients (175 men and 342 women) were analyzed. Mean age was 54.6 years for men and 60.7 years for women. Metabolic syndrome was observed in 39.4% of men and 70.5% of women. Central obesity was more prevalent among women (72.5%) compared to men (39.4%). Participants with metabolic syndrome were less likely to endorse a sense of general well-being, and women with metabolic syndrome were likely to have less diabetes-related distress., Conclusions: this study revealed a high prevalence of metabolic syndrome in diabetic Vietnamese patients, especially among women, and revealed central obesity as a key feature. A prospective study should be conducted in this population in order to assess impacts of metabolic syndrome on disease outcome., (© 2010 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.)

Summary: The association between degree of obesity and cardiovascular and related metabolic risk factors were examined in 355 Japanese obese school children from 11 to 12 years old. The parameters evaluated were blood pressure, serum lipids, fasting blood glucose, and serum ALT and AST. ALT, AST and triglycerides were more commonly evaluated in obese boys than in obese girls, while HDL-cholesterol was more commonly lowered in obese girls. Hypercholesterolemia was 2-fold, and abnormal liver functions were 3-fold more common in severely obese than in moderate obese children. Thus, cardiovascular and related metabolic risk factors are present in obesity in school-aged children, particularly in boys.:, (© 2010 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.)