The use of propylthiouracil (PTU) for the treatment of Graves' disease is associated with few adverse effects such as skin eruptions, liver dysfunction, and agranulocytosis. Furthermore, recent studies described the development of antineutrophil cytoplasmic antibody (ANCA)-related glomerulonephritis and vasculitis in patients treated with PTU. Here we investigated whether PTU therapy per se is associated with the appearance of ANCA in patients with Graves' disease. We analyzed 119 serum samples from 117 patients with Graves' disease treated with either PTU (n = 56), or methimazole (MMI) (n = 21), as well as untreated patients (n = 42). Myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA were tested by enzyme-linked immunosorbent assay (ELISA) kits. MPO-ANCA was negative in all patients treated with MMI therapy and untreated patients. However, MPO-ANCA was detected in 21 (37.5%) of 56 patients treated with PTU therapy. Furthermore, two patients who were negative for MPO-ANCA became positive after PTU therapy. The proportion of patients positive for MPO-ANCA increased with the prolongation of PTU therapy, but did not correlate with age, gender, and positive antithyroperoxidase (TPO) antibody. Among 21 MPO-ANCA positive patients, 12 had no symptoms, but 9 patients complained of myalgia, arthralgia, or common cold like symptoms after the appearance of MPO-ANCA. Three patients developed agranulocytosis or granulocytopenia, but none showed abnormal urinary findings. Our results suggest that PTU per se is associated with the production of MPO-ANCA in patients with Graves' disease.

To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03–2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29–4.64), and pain (OR, 1.82; 95%CI, 1.03–3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13–2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04–1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54–4.34), and pain (OR, 1.65; 95%CI, 1.06–2.55) in women as being independently associated with fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

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Visual display terminals (VDT) are standard equipment for many office workers. Their use, however, may increase the risk of developing adverse conditions related to vision, the musculoskeletal system, and mental health. We carried out a survey among 3070 workers aged 18 to 67 years (mean, 39.9 years) at a prefectural administrative office, in which 76% of subjects were visual display terminal (VDT) users. We examined the relationship between duration of daily VDT use and eyestrain, neck or upper extremity pain, back pain, and mental health, and estimated the effect of breaks and rest during VDT work on these symptoms. The 12-item General Health Questionnaire (GHQ-12: total scores ranged from 0 to 12) was used to identify potential poor mental health status, and subjects with 4 or more were considered to have symptoms of psychological distress. Seventeen percent of subjects reported eyestrain, 19.1% reported upper extremity pain, 11.6% reported back pain, and 17% of subjects had GHQ-12 scores of 4 or higher. Logistic regression analysis showed that duration of daily VDT use and lack of breaks and rest during VDT work were significantly associated with eyestrain, neck or upper extremity pain, back pain, and psychological distress. In order to protect users from the adverse effects associated with VDT work, reducing daily VDT exposure, taking breaks, and rest during VDT work are important.

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Our findings indicate that poor lower extremity function, especially walking ability, is an important risk factor for falls in elderly Japanese community-dwelling women.

Background Coronavirus infections are spreading rapidly worldwide, and primary and middle schools are closed in many countries. After the state of emergency was lifted in Japan, schools have reopened, and teachers are conducting face-to-face classes while maintaining safety precautions. This study aimed to assess the factors contributing to infection-related anxiety and educational anxiety among teachers conducting face-to-face classes during the COVID-19 pandemic after schools reopened. Methods This questionnaire-based cross-sectional study was conducted with 263 primary and middle school teachers in the Shinagawa area of Tokyo (October 10–30, 2020). The questionnaire assessed the type of school (primary or middle school), sex, age, and factors contributing to infection-related anxiety and educational anxiety that arose from the pandemic. The levels of anxiety and the factors contributing to anxiety were assessed using a 5-point Likert scale ranging from 1 (not at all) to 5 (very anxious). Results In an analysis of the data of 237 participants excluding the missing data, many teachers reported feeling infection- and education-related anxiety. A majority of the participants were women (n = 152, 64.1%), and the mean age of the participants was 39.8 ± 11.3 years. A stepwise multiple regression analysis identified six factors for infection-related anxiety as significant (R2 = 0.61, p < 0.001). Among these variables, the largest partial regression coefficient value was reported for the following reason: “I feel anxious because we cannot ensure the safety of teachers themselves or of their families” (β = 0.37, p < 0.001). For educational anxiety, four of six reasons were identified as significant (R2 = 0.64, p < 0.001). Among these, “anxiety about the students’ home situations” (β = 0.41, p < 0.001) and “delay in education (students’ side)” (β = 0.27, p < 0.001) had stronger associations with anxiety compared to the others. Conclusion In-person education during the COVID-19 pandemic has caused teachers to experience anxiety. This report provides useful information by highlighting the reasons for infection-related anxiety and educational anxiety that teachers experience in face-to-face classes during a pandemic. Even if the coverage of a COVID-19 vaccine becomes widespread worldwide, we will still be combating COVID-19 infections for at least a few years. Given concerns regarding such infections, to ensure students’ right to education, it is essential to understand why teachers feel anxious and to determine appropriate measures to decrease such anxiety.