Background: Unnecessary ambulance use has become a socioeconomic problem in Japan. We investigated the possible relations between socioeconomic factors and medically unnecessary ambulance calls, and we estimated the incremental demand for unnecessary ambulance use produced by socioeconomic factors.

Studying the relation between incidence of stroke and weather is difficult because it requires large-scale community-based data collection. Despite the lack of strong evidence that weather conditions influence stroke incidence, many clinicians feel that meteorological conditions influence the onset of stroke. This study examined whether emergency events related to stroke are influenced by meteorological factors and was based on computerized records of emergency medical transport services in a Japanese city during the period January 1992-December 2003. A total of 53,585 patients transported for an event coded as stroke were analyzed in relation to meteorological factors such as temperature, humidity, and barometric pressure. Poisson regression analysis was applied to clarify the influence of daily meteorological conditions on the daily incidence of emergency transport due to events coded as stroke. Ordinary least squares regression analysis was used to evaluate the influence of weather, defined as the combination of meteorological parameters, on the occurrence of emergency transport due to events coded as stroke. Daily mean ambient temperature and daily mean relative humidity showed a statistically significant negative effect on the incidence of the emergency transport events for both men and women (P<0.001). Daily mean barometric pressure was not significantly related to these events. The occurrence of a holiday was negatively related to the incidence (P<0.001). Dry weather and cool weather were likely to shift the circadian curve of the incidence upward. Thus, occurrence of emergency transport due to events coded as stroke is likely to be associated with weather conditions.

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Objective. This study aimed to determine whether mental stress influences the plasma total homocysteine level or blood pressure in young men. Method. Twenty-seven male university students were assigned to a normal blood pressure group (24-h systolic blood pressure <125 mmHg and diastolic blood pressure <75 mmHg; 13 subjects) or a high blood pressure group (24-h systolic blood pressure > or =125 mmHg, or 24-h diastolic blood pressure > or =75 mmHg; 14 subjects). Wearing an ambulatory blood pressure monitoring device, subjects rested for 30 minutes, underwent an arithmetic test for 15 minutes, and rested again for 15 minutes. Blood samples were taken before and after the test. Plasma total homocysteine levels were measured. Heart rate, blood pressure, and sympathovagal balance were determined during the test. Results. The mean total homocysteine level at rest in the high blood pressure group was slightly, but not significantly, higher than that in the normal blood pressure group. The resting total homocysteine level was significantly higher in subjects with parental history of hypertension than in those without (p < 0.01). Blood pressure, heart rate, and the plasma total homocysteine level were increased significantly by mental stress (p < 0.05). The change in total homocysteine correlated significantly with the changes in systolic blood pressure and sympathovagal balance (p < 0.05). Conclusion. Resting total homocysteine level was significantly higher in male students with a parental history of hypertension than in those without. It was shown that mental stress elevates heart rate, blood pressure, sympathovagal activity, and the plasma total homocysteine level in young men.

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