PubMed | Minamisoma Municipal General Hospital, Imperial College London, Tokyo Medical University and University of Tokyo
Type: Journal Article | Journal: Health policy and planning | Year: 2016
After a radiation-release incident, intake of radionuclides in the initial stage immediately following the incident may be the major contributor to total internal radiation exposure for individuals in affected areas. However, evaluation of early internal contamination risk is greatly lacking. This study assessed the relationship between initial stage evacuation/indoor sheltering and internal radiation contamination levels 4 months after the 2011 Fukushima nuclear incident in Japan and estimated potential pathways of the contamination. The study population comprised 525 participants in the internal radiation screening program at Minamisoma Municipal General Hospital, 23km north of the Fukushima nuclear plant. The analysed dataset included the results of a screening performed in July 2011, 4 months after the incident, and of a questionnaire on early-incident response behaviours, such as sheltering indoors and evacuations, completed by participants. Association between such early countermeasures and internal contamination levels of cesium-134 were assessed using Tobit multiple regression analyses. Our study shows that individuals who evacuated to areas outside Fukushima Prefecture had similar contamination levels of cesium-134 to individuals who stayed in Fukushima (relative risk: 0.86; 95% confidence interval: 0.74-0.99). Time spent outdoors had no significant relationship with contamination levels. The effects of inhalation from radiological plumes released from the nuclear plant on total internal radiation contamination might be so low as to be undetectable by the whole-body counting unit used to examine participants. Given the apparent limited effectiveness of evacuation and indoor sheltering on internal contamination, the decision to implement such early responses to a radiation-release incident should be made by carefully balancing their potential benefits and health risks.
PubMed | Medical Governance Research Institute, Teikyo University, Foundation Medicine, Minamisoma Municipal General Hospital and Navitas
Type: Journal Article | Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America | Year: 2016
A sensational newspaper article concerning a possible adverse reaction to the human papillomavirus (HPV) vaccine was published in March 2013 in Japan. In June 2013, the Japanese government suspended their proactive recommendation for vaccination, despite the lack of proof for a causal relationship. We searched Nikkei Telecom 21, the largest newspaper database in Japan, for articles published from January 2011 to December 2015 to evaluate the characteristics of newspaper publications about human papillomavirus vaccination. We identified 1138 HPV vaccine-related articles. Compared with those published before March 2013, articles concerning human papillomavirus vaccination after March 2013 were more likely to include adverse reaction-related and authority-related keywords; articles that included efficacy-related keywords decreased significantly. Negative-negative and negative-neutral articles became more frequent, and positive-positive and positive-neutral articles were less frequent. A sensational case report shaped the tone of negative media coverage as a catalyst, regardless of scientific statements from health authorities.
PubMed | Tamana Regional Health Medical Center, Yokohama City University, Minamisoma Municipal General Hospital and Kuchi kara Taberu Shiawase wo Mamoru kai
Type: Journal Article | Journal: Journal of the American Geriatrics Society | Year: 2016
To verify the reliability and validity and develop an English version of an instrument (Kuchi-Kara Taberu Index (KT Index)) to comprehensively assess and intervene in problems with eating and swallowing.Multicenter cross-sectional study.Nursing homes.Individuals aged 65 and older (mean age 88.3 6.8; 80.0% female) who had lived in a nursing home for longer than 1 month (N = 115).The KT index consisted of 13 items: desire to eat, overall condition, respiratory condition, oral condition, cognitive function while eating, oral preparatory and propulsive phases, dysphagia severity, position and endurance while eating, eating, daily life, food intake level, food modification, and nutrition. Weighted kappa coefficients, Cronbach alpha, and Spearman rank correlation coefficients were determined.Weighted kappa values in the inter- and intrarater reliability tests ranged from 0.54 to 0.96 and 0.68 to 0.98, respectively. Cronbach alpha was 0.892. Spearman rank correlation coefficients (r) between the total KT index and external criteria were determined (Functional Oral Intake Scale, r = 0.790; Barthel Index, r = 0.830; Mini Nutritional Assessment Short Form, r = 0.582; Cognitive Performance Scale, r = -0.673; all P < .001). Similar correlations were observed when some items related to each external criterion were removed from the total KT index. Translation-retranslation procedures were conducted to develop an English version of the KT index.The study provided evidence of the reliability and validity of the KT index and developed an English version. Future studies regarding validation of health-related quality of life indices and their effect on clinical courses of eating and swallowing conditions are needed.
PubMed | Foundation Medicine and Minamisoma Municipal General Hospital
Type: Letter | Journal: Rural and remote health | Year: 2016
Key words: Fukushima nuclear accident, health care facilities, health education, Japan, manpower and services.
PubMed | Imperial College London, Soma Central Hospital, Jyoban Hospital and Minamisoma Municipal General Hospital
Type: Journal Article | Journal: BMJ open | Year: 2016
To assess the prevalence of non-communicable diseases (NCDs), and whether NCDs were treated or not, among hospitalised decontamination workers who moved to radio-contaminated areas after Japans 2011 Fukushima Daiichi Nuclear Power Plant disaster.We retrospectively extracted records of decontamination workers admitted to Minamisoma Municipal General Hospital between 1 June 2012 and 31 August 2015, from hospital records. We investigated the incidence of underlying NCDs such as hypertension, dyslipidaemia and diabetes among the decontamination workers, and their treatment status, in addition to the reasons for their hospital admission.A total of 113 decontamination workers were admitted to the hospital (112 male patients, median age of 54years (age range: 18-69years)). In terms of the demographics of underlying NCDs in this population, 57 of 72 hypertensive patients (79.2%), 37 of 45 dyslipidaemic patients (82.2%) and 18 of 27 hyperglycaemic patients (66.7%) had not been treated for their NCDs before admission to the hospital.A high burden of underlying NCDs was found in hospitalised decontamination workers in Fukushima. Managing underlying diseases such as hypertension, hyperlipidaemia and diabetes mellitus is essential among this population.
Sugimoto A.,University of Tokyo |
Gilmour S.,University of Tokyo |
Tsubokura M.,Tokyo Medical University |
Nomura S.,University of Tokyo |
And 4 more authors.
Environmental Health Perspectives | Year: 2014
Background: The Fukushima Dai-ichi nuclear disaster, the first level-7 major nuclear disaster since Chernobyl, raised concerns about the future health consequences of exposure to and intake of radionuclides. Factors determining the risk and level of internal radiation contamination after a nuclear accident, which are a key to understanding and improving current nuclear disaster management, are not well studied. Objective: We investigated both the prevalence and level of internal contamination in residents of Minamisoma, and identified factors determining the risk and levels of contamination. Methods: We implemented a program assessing internal radiation contamination using a whole body counter (WBC) measurement and a questionnaire survey in Minamisoma, between October 2011 and March 2012. Results: Approximately 20% of the city's population (8,829 individuals) participated in the WBC measurement for internal contamination, of which 94% responded to the questionnaire. The proportion of participants with detectable internal contamination was 40% in adults and 9% in children. The level of internal contamination ranged from 2.3 to 196.5 Bq/kg (median, 11.3 Bq/kg). Tobit regression analysis identified two main risk factors: more time spent outdoors, and intake of potentially contaminated foods and water. Conclusions: Our findings suggest that, with sensible and reasonable precautions, people may be able to live continuously in radiation-affected areas with limited contamination risk. To enable this, nuclear disaster response should strictly enforce food and water controls and disseminate evidencebased and up-to-date information about avoidable contamination risks.
Mori J.,Jyoban Hospital |
Tsubokura M.,Minamisoma Municipal General Hospital |
Sugimoto A.,University of Tokyo |
Tanimoto T.,Jyoban Hospital |
And 3 more authors.
Preventive Medicine | Year: 2013
Objective: The objective of this study is to assess the localized incidence of dog bites following the nuclear accident related to the Great East Japan Earthquake in March 2011. Methods: We identified the patients with dog bites in our hospital in Minamisoma City, Fukushima, during the period from 1. year prior to the earthquake to 3.5. months following it, and calculated the monthly and weekly incidence proportions by dividing the patient number by the total emergency room visits. We also analyzed the data by the characteristics of the patients. Results: We identified 27 dog-bite cases during the post-disaster period. The median monthly incidence proportion during the pre-disaster period and the highest monthly incidence proportion during the post-disaster period were 0.21 and 6.50 per 100 visits, respectively. The weekly incidence proportion peaked at 3. weeks after the earthquake and thereafter decreased to the baseline level. Conclusion: The Fukushima nuclear accident may be associated with an increased incidence of dog bites, and the prolonged evacuation in response to the radiation contamination may have prolonged the increased incidence after the disaster. Physicians and local residents should recognize this potential hazard. Countermeasures to contend with this risk should be a mandatory aspect of disaster preparedness, including for nuclear accidents. © 2013 Elsevier Inc.
Kato M.,Minamisoma Municipal General Hospital
Japanese Journal of Anesthesiology | Year: 2011
We report a late thrombosis of sirolimus-eluting stent 6 months after implantation of a drug-eluting stent. A 70-year-old man (52 kg, 148 cm) was diagnosed as acute cauda equina syndrome, and spinal surgery was scheduled. One week before the operation, the patient's aspirin and clopidogrel regimen was replaced with heparin injection, which was then discontinued 8 hours before the operation. The operation was completed uneventfully. The patient complained of severe chest pain 1 hour after the end of operation. Coronary angiography demonstrated stent thrombosis. PCI (removal of the thrombosis and plain old balloon angioplasty) was performed, and incomplete stent apposition was diagnosed with coronary angiography.
PubMed | Minamisoma Municipal General Hospital
Type: Journal Article | Journal: Journal of occupational health | Year: 2016
Patients with underlying conditions are at a higher risk of developing sepsis, a systematic response to infection, which has a high mortality rate. After the March 2011 Fukushima Daiichi nuclear power plant accident, there has been an influx of migrant decontamination workers; however, little is known about their health status.A Japanese 55-year-old male decontamination worker, who had several underlying diseases, was transferred to our hospital in cardiopulmonary arrest. He had a history of diabetes mellitus and hypertension and a past history of tuberculosis. Control of underlying conditions was poor, with HbA1c of 13.8% at presentation. He was diagnosed with pneumonia-induced bacteremia and sepsis due to Klebsiella pneumoniae. Although spontaneous circulation returned in emergency room, he died a day after admission.The poor control of underlying diseases seen in this patient could have been influenced by his recent job transfer and engagement in decontamination work and additionally related to his socioeconomic status (SES). This case highlights the need for further research to elucidate the underlying diseases, working conditions, and SES of this population.
PubMed | Minamisoma Municipal General Hospital
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2017
Intraabdominal tumors can cause umbilical hernia and may lead to serious consequences, such as incarcerated or necrotized intestine. However, little information is available concerning how the location and characteristics of tumors may affect the process of umbilical hernia development. A 46-year-old Japanese man presented at the department of surgery with abdominal pain and abdominal retention, which appeared on the day of presentation and 4 years before the presentation, respectively. Abdominal computed tomography revealed a suspected gastrointestinal stromal tumor(GIST)and an umbilical hernia close to the tumor, both of which were clinically diagnosed. Surgical tumor resection and hernia repair were conducted successfully. The patient was pathologically diagnosed with high-risk GIST. Adjuvant therapy with imatinib was administered with no recurrence as of 1 year post-surgery. This is a case of GIST complicated by umbilical hernia. Small solid tumors may cause umbilical hernia if they are in close proximity to vulnerable parts of the abdominal wall.