Objective To address the presence of post-Q fever fatigue syndrome (post-QFS) in Japan, and to evaluate the efficacy of minocycline for this condition.Patients and Methods In 20 Coxiella burnetii (C. burnetii) seropositive patients with persistent nonspecific symptoms including general fatigue, low-grade fever, myalgia and arthralgia, changes in subjective symptoms, C. burnetii antibody titers and C. burnetii DNA were evaluated after antibiotic treatment.Results After treatment mainly with minocycline (100 mg/day for 3 months), the clinical picture improved in all 20 patients as evidenced by decreases in body temperature (

Background/Aims: Seasonal variations in laboratory test results have been pointed out in dialysis patients. Although the mechanism for this phenomenon is not clear, this could result in changes in dialysis and medication prescriptions. We investigated the effect of the circannual rhythm on laboratory test parameters in chronic haemodialysis patients. Methods: Data of 38 laboratory test parameters were collected every month and analyzed for 150 stable haemodialysis patients, with non-linear sine wave regression and paired t test between data of peak and trough months. Results: Serum urea nitrogen, unsaturated iron binding capacity, lactate dehydrogenase, alkaline phosphatase, amylase, and neutrophil count showed significant circannual rhythms with high amplitudes. Additionally, serum creatinine, uric acid, chloride, calcium, phosphate, magnesium, total cholesterol, total protein, leucocyte count, mean corpuscular haemoglobin level, mean corpuscular haemoglobin concentration, and platelet count showed significant circannual rhythms with little amplitudes. Conclusions: The circannual rhythm of laboratory test parameters could be attributed to seasonal variations in food intake. Awareness of these variations should be taken into account in the interpretation of laboratory results.

OBJECTIVE: To determine the reference value of BMI for Japanese subjects and to estimate the prevalence of overweight based on this reference value. DESIGN: Epidemiological analysis with the LMS method, which provides a way of obtaining normalized BMI distributions. SUBJECTS: 7508 Japanese subjects aged 18±69 y in 1993. MEASUREMENTS: Height, age and body weight. CALCULATION: BMI was calculated and tables for percentiles of BMI were plotted against age and sex. Furthermore, the prevalence of overweight was estimated based on 85th percentile of BMI in the men and women 20±29 y of age, who were considered the reference group. RESULTS: The geometric mean BMI and the prevalence of overweight in men was highest in the 30±39 y age group. For women the maximum BMI and prevalence of overweight occurred in the decade 50±59 y. The cut-off points for overweight in this sample were 24.7 kg/m 2 for men and 22.6 kg/m 2 for women. These are considerably lower than the ®gures of 27.8 kg/m 2 and 27.3 kg/m 2 estimated for Americans. CONCLUSIONS: The prevalence of obesity in Japanese populations should be estimated using ethnic speci®c values of BMI, rather than those drawn from Caucasians who tend to have higher BMI in each age group. The prevalence of overweight is increased as age increased in both sexes, especially in women.

We assessed the usefulness of reporting direct blood Gram stain results compared with the results of positive blood cultures in 482 episodes and monitored impact on selection of antimicrobial treatment. We found that the reporting groups "Staphylococcus spp," "Pseudomonas spp and related organisms," and "yeasts" identified in this way matched perfectly with later culture identification. When the report indicated Staphylococcus spp or Pseudomonas spp and related organisms, physicians started or changed antimicrobials suitable for these bacteria more frequently than when "other streptococci" and "family Enterobacteriaceae" were reported (P < .05). Incorrect recognition of Acinetobacter spp as Enterobacteriaceae family is still the most challenging problem in this context. Gram stain results that definitively identify Staphylococcus spp, Pseudomonas spp and related organisms, and yeasts reliably can be rapidly provided by clinical laboratories; this information has a significant impact on early selection of effective antimicrobials. Further investigation is needed to assess the clinical impact of reporting Gram stain results in bacteremia.