Kazue Nakajima

Coffee consumption and decreased serum γ-glutamyltransferase: a study of middle-aged Japanese men

The potential inverse association between coffee intake and serum γ-glutamyltransferase (GGT) was examined in a cross-sectional study involving 1353 Japanese male office workers aged 35–59 years in Osaka, Japan. Those who had serum aminotransferases exceeding the normal range and/or who had been administered medical care for, or had a past history of, liver disease were excluded. Multiple linear regression analysis and analysis of covariance were used to control for confounding variables (age, body mass index, alcohol use, and cigarette smoking) and to examine possible interactions. From the linear regression analysis, coffee intake was inversely related to serum GGT levels independently of age, body mass index, alcohol intake, and cigarette smoking. All of the latter variables were also independently and positively associated with serum GGT levels. When the interactions between coffee and each of four covariates on serum GGT were evaluated by adding each interaction term to the above regression model, significant negative interactions were observed for age and cigarette smoking. From the analysis of covariance, lower levels of serum GGT associated with coffee consumption were more evident in the older age group and at the higher levels of cigarette smoking. These findings suggest that coffee consumption is inversely related to serum GGT and that coffee may inhibit the inducing effects of aging and possibly of smoking on serum GGT in the liver.

Health care quality management by means of an incident report system and an electronic patient record system

BACKGROUND Quality management in health care services has not been as successful as in other industries. OBJECTIVE To assess the potential contribution of an on-line incident reporting system (OIRS) and of an electronic patient record (EPR) system to quality management in hospitals. METHODS The two approaches are being implemented in Osaka University Hospital. RESULTS Analysis of the early use of the on-line reporting system indicates that this qualitative approach has been effective to avoid adverse medical events. The quantitative methodology with the EPR is still in the phase of developing. CONCLUSION Direct data entry by medical staff and an EPR based on dynamic templates and a dynamic problem oriented approach could be useful for building clinical data repositories that can support clinical quality management.

Public health services in Bangladesh with special reference to systems and trends of vital statistics

Health is one of the basic requirements for improvement in the quality of life. Since Bangladesh became independent, a policy for providing essential minimum health care to all has been actively pursued.An overview of Public Health Services in Bangladesh is presented in terms of: (1) a profile of the country, (2) an overview of public health, (3) medical care, and (4) environmental health. Under each of these headings observations are included on recent trends based upon relevant data and information.Finally the authors describe the importance of (1) promotion of health care and planning at the national, divisional, local, and community levels, (2) promotion of medical services at all levels, and (3) effective decentralization of health services to enhance the services of health facilities.

Does Prompt Treatment of Hypertension after Blood Pressure Check-ups Reduce Morbidity of Cerebrovascular Diseases?

In Japan, more than 20 million people utilize blood pressure check-up services in their work places or communities every year. To examine the relationship between prompt treatment of hypertension after these blood pressure check-ups and the severity, age at onset, and type of cerebrovascular diseases in these patients, a study was performed with the cooperation of all 174 independent physicians, 17 hospitals, and 4 welfare homes in the city of N.. All patients aged 50 years or more who visited a physician during the study period in this city were included in the study (n=978). Information on hypertensive control before the onset of cerebrovascular diseases was obtained from 668 patients. The results suggests that for those who had received prompt treatment after early detection of hypertension, the disease was less severe and the onset of the disease was delayed. Among our subjects, 47% of the patients claimed to have received prompt treatment after detection of hypertension. As N. is an ordinary Japanese city in terms of the promotion of health check-up programs, this percentage suggests that blood pressure check-up programs for the early detection of hypertension throughout Japan may have contributed to an overall reduction in severity for almost half of the patients with cerebrovascular diseases.

Assessment of the zinc turbidity test and the use of risk factors in detecting asymptomatic hepatitis C virus carriers: population based study

Early detection of carriers of hepatitis C virus, who are at risk of the long term sequelae of the infection, is necessary to provide comprehensive medical benefits such as education, follow up, and treatment.1 However, alanine aminotransferase concentration, even when measured several times, is a poor serum marker for detecting carriers because concentrations are often normal.2 Screening a healthy population by determining antibodies or hepatitis C virus RNA is not feasible. To target a population suspected of harbouring hepatitis C virus infection for further examination, we evaluated other biochemical tests as well as the use of risk factors for hepatitis C infection. Our 281 subjects, aged 30-82 (mean 55) years, (124 men) represented 43% of …