掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Epidemiological Association  

DOI： 10.2188/jea.je20210117

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記述言語：英語  

DOI： 10.1007/s00431-023-04942-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This observational cohort study aimed to evaluate the association between the duration of neonatal phototherapy and sleep-and-wakefulness states at 1 month, 1.5 years, and 3 years of age. We analysed data from 77,876 infants using the Japan Environment and Children's Study, a nationwide birth cohort study. The participants were divided into three groups: no phototherapy, short phototherapy (1-24 h), and long phototherapy (>24 h). Multiple regression analysis was performed to assess the effect of phototherapy duration on infant sleep at each age after adjusting for potential risk factors. A longer duration of phototherapy was associated with a shorter sleep time over 24 h at 1 month of age (β, -0.62; SE, -0.77 to -0.47) when compared with a shorter duration of, or no, phototherapy, following the adjustment of confounding factors. Contrastingly, the short duration group, when compared with the no phototherapy group, was associated with later sleep onset (β, 0.04; SE, 0.00-0.08) and later sleep offset (β, 0.05; SE, 0.01-0.09) at 1.5 years of age. We concluded that the duration of phototherapy may be transiently associated with sleep duration in infants, as emphasised by the shortening of the total sleep time per 24 h at 1 month of age.

DOI： 10.1111/jsr.13911

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

UNLABELLED: This observational cohort study aimed to examine the association between the duration of phototherapy for neonatal jaundice and the risk of developmental delay at 3 years of age using nationwide birth cohort data. Data from 76,897 infants were analyzed. We divided participants into four groups: no phototherapy, short phototherapy (1-24 h), long phototherapy (25-48 h), and very long phototherapy (> 48 h). The Japanese version of the Ages and Stages Questionnaire-3 was used to evaluate the risk of developmental delay at 3 years of age. Logistic regression analysis was performed to assess the impact of phototherapy duration on the prevalence of developmental delay. After adjustment for potential risk factors, a dose-response relationship was identified between the duration of phototherapy and Ages and Stages Questionnaire-3, and the differences were significant in four domains; odds ratio for communication delay was associated with short, long, and very long phototherapy = 1.10 (95% confidence interval 0.97-1.26), 1.32 (1.04-2.66), and 1.48 (1.11-1.98), respectively; for gross motor delay = 1.01 (0.89-1.15), 1.28 (1.03-2.58), and 1.26 (0.96-1.67); for problem solving delay = 1.13 (1.03-1.25), 1.19 (0.99-1.43), and 1.41 (1.11-1.79); and for personal social delay = 1.15 (0.99-1.32), 1.10 (0.84-1.44), and 1.84 (1.38-2.45). CONCLUSION: Longer duration of phototherapy is a predictive factor for developmental delay, making it important to avoid extended periods of phototherapy. However, whether it increases the prevalence of developmental delay remains unclear. WHAT IS KNOWN: • Phototherapy is a common treatment for neonatal jaundice, associated with both short-term and long-term complications. • However, an association between phototherapy and the prevalence of developmental delay has not been revealed in a large cohort study. WHAT IS NEW: • We identified that a long duration of phototherapy was a predictive factor for developmental delay at 3 years of age. • However, whether a long duration of phototherapy increases the prevalence of developmental delay remains unclear.

DOI： 10.1007/s00431-022-04785-1

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記述言語：日本語   出版者・発行元：(一社)日本疫学会  

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記述言語：日本語   出版者・発行元：日本ダウン症療育研究会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIMS: Unhealthy eating behaviors, including eating fast, eating after satiety, skipping breakfast, and eating out are common among men aged 20-39 years. In this cross-sectional study, we aimed to examine the association between self-reported eating habits and the prevalence of dyslipidemia. METHODS: The participants of this study were 38,233 men aged 20-39 years, whose food consumption frequency related information was collected through a questionnaire. Dyslipidemia was defined as total cholesterol (TC) ≥190 mg/dL, fasting triglyceride (TG) ≥150 mg/dL and non-fasting TG ≥175 mg/dL, high-density lipoprotein cholesterol (HDL-C) <40 mg/dL, low-density lipoprotein cholesterol (LDL-C) ≥140 mg/dL. Odds ratios (ORs) and 95% confidence intervals were calculated relative to healthy eating habits using logistic regression, after adjustment for age, study unit, and other potential confounding factors. RESULTS: Moderate and fast speeds were associated with a higher prevalence of reduced HDL-C (by 27% and 26%, respectively) compared to slow speeds. Eating after satiety was associated with a higher prevalence of elevated TC (by 16%) and elevated TG (by 11%), elevated LDL-C (by 21%). Breakfast eating of 1-4 times/week and <1 time/week were associated with a higher prevalence of elevated TC (by 11% and 16%, respectively) and elevated LDL-C (by 21% and 38%, respectively) compared to that of ≥5 times/week. Eating out of ≥5 times/week was associated with a 13% higher prevalence of elevated TG. CONCLUSIONS: All of four unhealthy eating habits were associated with a higher prevalence of dyslipidemia in men aged 20-39 years.

DOI： 10.1265/ehpm.23-00008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Currently, the association between the duration of neonatal phototherapy and the risk of allergic disorders has not been reported. This observational cohort study aimed to examine the association between allergic disorders, including food allergies, that are present before 3 years of age and the duration of phototherapy using the nationwide birth cohort data. METHODS: The Japan Environment and Children's Study was a nationwide birth cohort study. Data of 77,064 infants aged 1 year, 1.5 years, 2 years, and 3 years were analyzed. We divided the participants into three groups: no phototherapy, short phototherapy (1-24 h), and long phototherapy (>24 h) and evaluated the cumulative incidence of allergic disorders before 3 years of age, including asthma, atopic dermatitis, and food allergies. Logistic regression analysis was performed to assess the impact of phototherapy duration on the cumulative incidence of allergic disorders. RESULTS: After adjustment for potential risk factors, long phototherapy was found to be positively associated with food allergies at age 2 years (OR: 1.16; 95% CI: 1.01-1.33) and all allergic disorders at age 3 years (OR: 1.12; 95% CI: 1.01-1.24), including food allergies (OR 1.18; 95% CI: 1.04-1.35). CONCLUSION: A long duration of neonatal phototherapy was positively associated with the risk of allergic disorders, especially food allergies.

DOI： 10.1159/000527381

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To investigate the association between stage 1 hypertension, defined as systolic blood pressure (BP) of 130-139 mmHg or diastolic BP of 80-89 mmHg, in the first and second trimesters and the risk of adverse pregnancy outcomes. STUDY DESIGN: We analyzed 79,249 singleton pregnancies from a nationwide birth cohort study. BP in the first and second trimesters was classified into normal, elevated, stage1 hypertension, and stage 2 hypertension. We examined the risk of adverse pregnancy outcomes in each group using multivariable logistic regression analysis. We also investigated the influence of BP changes between the first and second trimesters on adverse pregnancy outcomes. MAIN OUTCOME MEASURES: Overall preterm birth (PTB < 37 weeks), early PTB (<34 weeks), and small for gestational age (SGA). RESULTS: Stage 1 hypertension in the first trimester was associated with increased risks of overall PTB (aOR, 1.23; 95 %CI, 1.08-1.39), early PTB (aOR, 1.38; 95 %CI, 1.07-1.79), and SGA (aOR, 1.19; 95 %CI, 1.04-1.36) compared to normal BP. These risks were more evident in the second trimester; overall PTB (aOR, 1.87; 95 %CI, 1.64-2.14), early PTB (aOR, 2.21; 95 %CI, 1.69-2.87), and SGA (aOR, 1.38; 95 %CI, 1.18-1.62). The risk of PTB was higher among women with an upward BP trajectory between the first and second trimesters. CONCLUSIONS: Stage 1 hypertension in the first and second trimesters was associated with increased risks of overall PTB, early PTB, and SGA. Monitoring the BP trajectory for stage 1 hypertension may be useful for identifying high-risk groups.

DOI： 10.1016/j.preghy.2022.11.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: To evaluate the pregnancy outcomes of preterm premature rupture of membranes (preterm PROM; PPROM) by gestational age. METHODS: This cohort study analyzed data from the Japan Environment and Children's Study. Pregnancy outcomes were documented using descriptive statistics. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of complications. RESULTS: Data were collected for 104 062 fetuses, and 99 776 were eligible for inclusion. The incidences of early (18-23 weeks) and late (24-36 weeks) PPROM were 0.1% (n = 102) and 1.2% (n = 1205), respectively. Of the 1307 cases, 66 (5.0%) resulted in miscarriage or stillbirth. Overall, 85.6% (1119/1307) resulted in preterm births, and 9.3% (122/1307) in term births. There was a higher incidence of oligohydramnios (OR 6.82, 95% CI 4.07, 11.4; OR 2.42, 95% CI 1.72, 3.40), intrauterine infection (OR 11.9, 95% CI 7.06, 19.9; OR 4.39, 95% CI 3.01, 6.41), cesarean delivery (OR 3.31, 95% CI 2.32, 4.71; OR 1.34, 95% CI 0.97, 1.85), placental abruption (OR 5.57, 95% CI 2.30, 13.5; OR 5.40, 95% CI 3.58, 8.14), and 5-min Apgar score <7 (OR 35.3, 95% CI 21.5, 57.9; OR 2.66, 95% CI 1.75, 4.05) for early and late, compared to no, PPROM, respectively. Miscarriage or stillbirth was higher in early (OR 5.84, 95% CI 3.72, 9.15) and lower in late (OR 0.21, 95% CI 0.06, 0.68) compared to those without PPROM. CONCLUSIONS: This study described the epidemiology of pregnancy outcomes of early (occurring at the limit of viability) and late PPROM.

DOI： 10.1111/jog.15388

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: It is unclear if gestational weight gain (GWG) increases the risk of children with overweight. OBJECTIVES: We examined the association between GWG and the risk of overweight in 3-year-old children in the Japanese nationwide birth cohort study. METHODS: Among 64 336 singleton births, we calculated the risk ratios (RRs) and 95% confidence intervals (95% CIs) of the association between GWG categories and children with overweight, following an adjustment of the confounding variables. RESULTS: GWG was positively associated with the risk of overweight among 3-year-old children. The multivariable RR (95% CI) was 1.21 (1.17-1.25) per 5 kg increase of the GWG. The multivariable RR (95% CI) for excessive GWG was 1.20 (1.12-1.28) and 1.27 (1.16-1.39) based on the modified Japanese and IOM criteria, respectively, compared to adequate GWG. The multivariable RR (95% CI) of overweight with children for inadequate versus adequate GWG was 0.83 (0.78-0.88) and 0.84 (0.79-0.89) based on the modified Japanese and IOM criteria, respectively. CONCLUSIONS: GWG was positively associated with a high risk of overweight at 3 years of age. The risk of offspring overweight was 20%-27% higher and 16%-17% lower with excessive GWG and inadequate GWG, respectively, compared to adequate GWG, based on the aforementioned criteria.

DOI： 10.1111/ijpo.12978

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study aimed to evaluate the association of neonatal transfer with the risk of neurodevelopmental outcomes at 3 years of age. Data were obtained from the Japan Environment and Children's Study. A general population of 103,060 pregnancies with 104,062 fetuses was enrolled in the study in 15 Regional Centers between January 2011 and March 2014. Live-born singletons at various gestational ages, including term infants, without congenital anomalies who were followed up until 3 years were included. Neurodevelopmental impairment was assessed using the Ages and Stages Questionnaire, third edition (ASQ-3) at 3 years of age. Logistic regression was used to estimate the adjusted risk and 95% confidence interval (CI) for newborns with neonatal transfer. Socioeconomic and perinatal factors were included as potential confounders in the analysis. Among 83,855 live-born singletons without congenital anomalies, 65,710 children were studied. Among them, 2780 (4.2%) were transferred in the neonatal period. After adjustment for potential confounders, the incidence of neurodevelopmental impairment (scores below the cut-off value of all 5 domains in the ASQ-3) was higher in children with neonatal transfer compared with those without neonatal transfer (communication: 6.5% vs 3.5%, OR 1.42, 95% CI 1.19-1.70; gross motor: 7.6% vs 4.0%, OR 1.26, 95% CI 1.07-1.49; fine motor: 11.3% vs 7.1%, OR 1.19, 95% CI 1.03-1.36; problem solving: 10.8% vs 6.8%, OR 1.29, 95% CI 1.12-1.48; and personal-social: 6.2% vs 2.9%, OR 1.52, 95% CI 1.26-1.83).   Conclusion: Neonatal transfer was associated with a higher risk of neurodevelopmental impairment at 3 years of age. What is Known: • Neonatal transfer after birth in preterm infants is associated with adverse short-term outcomes. • Long-term outcomes of outborn infants with neonatal transfer in the general population remain unclear. What is New: • This study suggests that neonatal transfer at birth is associated with an increased risk of neurodevelopmental impairment. • Efforts for referring high-risk pregnant women to higher level centers may reduce the incidence of neonatal transfer, leading to improved neurological outcomes in the general population.

DOI： 10.1007/s00431-022-04450-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Menke-Hennekam syndrome-1 (MKHK1) is a congenital disorder caused by the heterozygous variants in exon 30 or 31 of CREBBP (CREB binding protein) gene mapped on 16p13.3. It is characterized by psychomotor delay, variable impairment of intellectual disability (ID), feeding difficulty, autistic behavior, hearing impairment, short stature, microcephaly, and facial dysmorphisms. The CREBBP loss-of-function variants cause Rubinstein-Taybi syndrome-1 (RSTS1). The function of CREBBP leading to MKHK1 has not been clarified so far, and the phenotype of MKHK1 significantly differs from that of RSTS1. We examined six patients with de novo pathogenic variants affecting the last exon of CREBBP, and they shared the clinical features of MKHK1. This study revealed that one frameshift and three nonsense variants of CREBBP cause MKHK1, and inferred that the nonsense variants of the last exon could further help in the elucidation of the etiology of MKHK1.

DOI： 10.1002/ajmg.a.62533

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

<title>Abstract</title>Lessel et al. reported a novel neurodevelopmental disorder with severe motor impairment and absent language (NEDMIAL) in 12 individuals and identified six different de novo heterozygous missense variants in <italic>DHX30</italic>. The other clinical features included muscular hypotonia, feeding difficulties, brain anomalies, autistic features, sleep disturbances, and joint hypermobility. We report a Japanese adult with a novel missense variant and two girls with de novo missense variants in <italic>DHX30</italic>.

DOI： 10.1038/s41439-021-00155-9

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その他リンク： http://www.nature.com/articles/s41439-021-00155-9

担当区分：筆頭著者   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers Media SA  

Inclusive early childhood intervention provides opportunities for children with disabilities to receive education with typically developing children. The present study examined the effects of the AI-AI STEP Program, which is designed to help nursery teachers learn the methods of inclusive early childhood intervention for children with disabilities. This study involved 37 managers of 37 nursery schools in Japan, 48 nursery teachers, and 48 children with disabilities. The school managers, who had previously learned about the program through a seminar we offered, provided the nursery teachers with guidance on the program. The guidance provided to the nursery teachers consisted of combined structured explanations with a manual and on-the-job training. The program was performed for 6 months, and changes in the children's development and behavior and the school nursery teachers' self-efficacy and state-trait anxiety, were examined before and after using the program. Multivariate analysis was used to assess factors that had an effect on the children's developmental gains through the program. The developmental quotient of children significantly improved. In addition, “emotional symptoms” and “peer problems” on the Strengths and Difficulties Questionnaire subscale markedly improved. The self-efficacy of nursery teachers significantly improved, and state anxiety decreased. There was a significant relationship between the improvement of the children's development quotient and a lower development quotient at baseline. The provision of inclusive early childhood intervention using the program promoted the children's development, and improved their behavior. Furthermore, it had a positive effect on the nursery teachers.

DOI： 10.3389/fresc.2021.759932

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

歌舞伎症候群の矯正歯科治療上の診療指針を得る目的で、大阪母子医療センター遺伝診療科で歌舞伎症候群と診断された43例(男性20例、女性23例)を対象とし、成長発育状況と合併症の種類ならびに保有割合について、診療録を用いて後方視的に調査した。また、本症候群の顎顔面形態の特徴を明らかにするために、当科で継続管理している7症例について、側面頭部エックス線規格写真分析を行い、顎顔面形態の特徴について対照群と比較した。対象者の63%に軽度から中等度の精神発達遅滞を認めた。合併症として頻度が高かったのは、先天性心疾患、口唇口蓋裂、腎疾患、反復性中耳炎、眼疾患、女性の思春期早発などであった。対照群と比較した顎顔面形態の特徴として、扁平な脳頭蓋底と下顎角部の開大を認め、骨格性開咬の傾向を示した。当センターを受診した歌舞伎症候群の合併症は多岐にわたり、各保有割合は従来の報告とほぼ一致していたが、口蓋裂は高い割合を示した。また、本症候群では平坦な頭蓋底ならびに骨格性開咬という顎顔面形態の特徴をもつことが示唆された。(著者抄録)

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担当区分：最終著者  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Hypotonia, ataxia and delayed development syndrome (HADDS) (MIM#617330) is a neurodevelopmental disorder caused by heterozygous pathogenic variants in EBF3 (MIM; 607,407), which is located on chromosome 10q26, and was first reported in 2017. To date, missense, nonsense and frameshift variants have been reported as causes of HADDS, and EBF3 pathogenic variants have been predicted to result in nonsense-mediated mRNA decay and haploinsufficiency. It was also reported that total deletion of EBF3 associated with a 10q26.3 microdeletion also causes HADDS symptoms, supporting the concept that HADDS results from haploinsufficiency of EBF3. Here, we report eight unrelated individuals with heterozygous pathogenic variants of EBF3 or haploinsufficiency of EBF3 due to 10q26 deletion, who exhibit clinical findings including craniofacial features of HADDS. In a detailed examination of clinical manifestations in this study, revealed that neurogenic bladder was diagnosed in infancy (the median 6.5 months), was more frequent than previously reported, and required cystostomy in all but one case. For psychomotor delay, it was also found that their motor/skills values were significantly lower than their cognition/adaptation values (p = 0.0016; paired t-test). Therefore, that HADDS is a recognizable syndrome that shares its characteristic facial features, and that neurogenic bladder diagnosed in infancy and psychomotor delay with marked delay in motor/skills are noteworthy findings in the diagnosis and management of individuals with HADDS.

DOI： 10.1002/ajmg.a.62369

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ajmg.a.62369

担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Angelman syndrome is a neurodevelopmental disorder characterized by intellectual disability (ID), a distinctive gait pattern, abnormal behaviors, severe impairment in language development, and characteristic facial features. Most cases are caused by the absence of a maternal contribution to the imprinted region on chromosome 15q11-q13. Here, we present the first reported case of a 3-year-old boy with an atypical phenotype of Angelman syndrome due to uniparental isodisomy with two recessive homozygous pathogenic variants: in HERC2 and AP3B2. Known phenotypes related to HERC2 and AP3B2 include ID and early infantile epileptic encephalopathy, respectively. The patient had severe global developmental delay and profound ID and showed a happy demeanor, stereotypic laughter, and hand-flapping movements, but also irritability. Craniofacial dysmorphic features, including brachycephaly, strabismus, wide ala nasi, short philtrum, wide open mouth, and slight hypopigmentation were seen. Progressive microcephaly was noted. Magnetic resonance imaging of the brain showed delayed myelination and cerebral atrophy. Trio whole exome sequencing and CGH-SNP array analysis revealed paternal uniparental isodisomy of chromosome 15 and two coexisting recessive diseases resulting from homozygous HERC2 and AP3B2 pathogenic variants. The pathogenic variant in HERC2 was inherited from his heterozygous-carrier father, and the variant in AP3B2 was de novo. We suppose that these unusual features were the combination of the effect of three concomitant disorders.

DOI： 10.1002/ajmg.a.62371

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ajmg.a.62371

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Both short and long interpregnancy intervals (IPIs) have been associated with risk of preterm birth, but the evidence is limited in Asians. It is also uncertain whether the association is modified by dietary folate intake or folic acid supplementation during pregnancy. Thus, we examined associations between IPI and risk of preterm birth, and effect modification of those associations by dietary intake of folate and supplementation with folic acid on the basis of a nationwide birth cohort study. METHODS: Among 103,062 pregnancies registered in the Japan Environment and Children's Study, 55,203 singleton live-birth pregnancies were included in the analysis. We calculated IPI using birth date, gestational age at birth of offspring, and birth data of the latest offspring. Odds ratios (ORs) and 95% confidence intervals (CIs) of the risk of preterm birth were estimated according to IPI categories. RESULTS: Both <6-month and ≥120-month IPIs were associated with an increased risk of preterm birth, compared with an 18-23-month IPI. The multivariable ORs were 1.63 (95% CI, 1.30-2.04) for <6-month and 1.41 (95% CI, 1.11-1.79) for ≥120-month IPIs. These associations were confined to women with inadequate intake of dietary folate and folic acid supplementation during pregnancy. Multivariable ORs were 1.76 (95% CI, 1.35-2.29) for <6-month IPI and 1.65 (95% CI, 1.24-2.19) for ≥120-month IPI. CONCLUSION: Both <6-month and ≥120-month IPIs were associated with an increased risk of preterm birth. These higher risks were confined to women with inadequate intake of dietary folate and folic acid supplementation during pregnancy.

DOI： 10.2188/jea.JE20210031

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担当区分：筆頭著者  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00394-020-02294-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

There is little evidence linking eating speed to gestational diabetes mellitus (GDM) incidence. We therefore aimed to evaluate the prospective association of eating speed with GDM incidence. Overall, 97,454 pregnant women were recruited between January 2011 and March 2014. Singleton pregnant women who did not have GDM, heart disease, stroke, cancer, type 1 diabetes, and/or type 2 diabetes at the time of study enrollment were eligible. Each woman was asked about her eating speed at that time via a questionnaire. Odds ratios of GDM in relation to eating speed were obtained using logistic regression. Among the 84,811 women eligible for analysis, 1902 cases of GDM were identified in medical records. Compared with women who reported slow eating speed, the age-adjusted odds ratios (95% confidence interval) of GDM for women who reported medium, relatively fast, or very fast eating speed were 1.03 (0.90, 1.18), 1.07 (0.94, 1.23), and 1.28 (1.05, 1.58), respectively. Adjustment for demographic, lifestyle-related, and dietary factors including dietary fat, dietary fiber, and energy intakes yielded similar results. The association was attenuated and no longer significant after further adjustment for pre-pregnancy body mass index. The mediation analysis showed that being overweight accounted for 64% of the excess risk of GDM associated with eating speed. In conclusion, women who reported very fast eating speed, compared with those reporting slow eating speed, were associated with an increased incidence of GDM, which may be largely mediated by increased body fat.

DOI： 10.3390/nu12051296

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: There is little evidence linking breakfast skipping to the incidence of gestational diabetes mellitus (GDM). OBJECTIVES: We aimed to evaluate the prospective association of breakfast consumption with the incidence of GDM. METHODS: A total of 103,099 pregnancies were registered during study enrollment (January 2011 to March 2014), involving 97,454 pregnant women from 15 areas across Japan. Singleton pregnant women free of GDM, stroke, heart disease, cancer, and type 1 or type 2 diabetes at the study enrollment were eligible for analysis. We used a self-administered questionnaire to obtain data on demographic information, socioeconomic status, self-rated health status, disease history, lifestyle, and dietary habits of each woman at study enrollment. A semiquantitative FFQ was used for dietary assessment. We used logistic regression to obtain the OR of GDM in relation to breakfast consumption. RESULTS: Among 84,669 pregnant women for analysis, 1935 cases of GDM were documented. After adjustment for potential confounding factors including prepregnancy BMI, the multivariable-adjusted ORs of GDM for women who consumed breakfast 5-6 times/wk, 3-4 times/wk, and 0-2 times/wk were 1.09 (95% CI: 0.93, 1.27), 1.14 (95% CI: 0.96, 1.34), and 1.21 (95% CI: 1.05, 1.41), respectively, compared with daily breakfast eaters. The association appeared to be dose dependent (P-trend = 0.006) and was not significantly modified by prepregnancy BMI. CONCLUSIONS: Breakfast consumption <3 times/wk before and during early pregnancy, compared with daily consumption, was associated with an increased odds of developing GDM.

DOI： 10.1093/ajcn/nqaa014

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Previous studies in Western countries have examined the association between prenatal smoking and risk for Postpartum depression (PPD). However, evidence from Japan is lacking, despite the high prevalence of smoking among pregnant women. Therefore, we examined the association between prenatal smoking and PPD among pregnant Japanese women. METHODS: We analyzed data for up to 1 month after childbirth from the Japan Environment and Children's Study (JECS), a nationwide birth cohort study. Among the 103,070 pregnant women recruited, 80,872 eligible participants were included in the analysis. PPD was defined as a score of ≥9 on the Edinburgh Postnatal Depression Scale (EPDS). Prenatal smoking and length of smoking cessation among ex-smokers were obtained using self-administered questionnaires at second/third trimester. RESULTS: Among 80,872 pregnant women, 9.0% reported PPD. Multivariable-adjusted odds ratios (OR) (95% confidence intervals) for PPD (reference: never smoked) were 1.24 (1.12-1.37) for women who quit smoking after becoming pregnant, and 1.38 (1.21-1.56) for those who smoked during pregnancy. Compared with women who had never smoked, those who quit smoking ≤5 years before childbirth had a higher occurrence of PPD, with a multivariable-adjusted OR of 1.10 (1.00-1.22). LIMITATIONS: Questionnaire data was self-reported by participants, thus smoking status might be under-reported. CONCLUSIONS: Women who smoked during pregnancy, quit smoking after becoming pregnant, and quit smoking ≤5 years before childbirth are more likely to experience PPD than those who had never smoked.

DOI： 10.1016/j.jad.2019.11.145

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The purpose of the present study was to investigate associations of dietary intake including vitamin D, folate, and n-3 and n-6 polyunsaturated fatty acids (PUFA) in pregnant women with broad autism phenotype (BAP). The Japan Environment and Children's Study is a government-funded birth cohort study. All complete data of 92,011 were analyzed. The Japanese version of the Autism Spectrum Quotient was used to assess mothers' BAP level, and a food frequency questionnaire was used to estimate their dietary intake. Mothers with BAP consumed less vegetables, fruits, and fish and shellfish, and they consumed lower folate, vitamin C, vitamin D, and n-3 PUFA than their counterparts. Dietary intervention should be considered for pregnant women with high BAP scores.

DOI： 10.1007/s10803-020-04380-z

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recently, the concept of "family-centered" practice was integrated into early intervention programs in Japan. Services provided through early intervention can result in beneficial family outcomes. We previously validated the Family Outcomes Survey-Revised (FOS-R) for use in Japan, but the impact on families was not evaluated. OBJECTIVES: To evaluate potential impacts of early intervention on family outcomes and factors associated with outcome attainment. METHOD: An anonymous, self-administered questionnaire was given to mothers of pre-school-age children with disabilities who were currently receiving early intervention at one of 12 development support centers across Japan. We evaluated scores of the Japanese version of the FOS-R using multivariable random effect models. RESULTS: Data from a total of 394 mothers were analyzed. Longer duration of early intervention was positively associated with family outcomes (<12 mo vs. 12-23 mo; coefficient = 0.19, p = .02, 95% CI: 0.02, 0.36). Perceived helpfulness of early intervention was significantly associated with family outcomes (coefficient = 0.49, p < .001, 95% CI: 0.42, 0.55). CONCLUSIONS: This study suggests that early intervention is associated with better outcomes for families, especially for families who perceive early intervention as helpful.

DOI： 10.1016/j.dhjo.2019.100832

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The association of chocolate consumption with risk of gestational diabetes has not been examined. We aimed to investigate the prospective association between chocolate consumption and risk of gestational diabetes in a large birth cohort in Japan. A total of 97 454 pregnant women with a median gestational age of 12 weeks were recruited from January 2011 to March 2014. Data on demographic information, disease history, socio-economic status, lifestyle and dietary habits were obtained at the study enrolment. Dietary intake during the past 12 months before study enrolment was assessed through a semi-quantitative FFQ. The logistic regression was used to obtain the OR of gestational diabetes in relation to chocolate consumption. Among 84 948 women eligible for the analysis, 1904 cases of gestational diabetes (2·2 %) were identified during the period of pregnancy. After controlling for potential confounding factors including age, smoking status, drinking status, education level, occupation, pre-pregnant BMI, depression, previous history of macrosomia babies, parity, physical activity and dietary factors, women in the highest quartile of chocolate consumption, compared with those in the lowest quartile, had a significantly lower risk of developing gestational diabetes (OR 0·78, 95 % CI 0·67, 0·90; P for trend = 0·002). Stratified analyses suggested that the association was not significantly modified by pre-pregnancy BMI, age, parity, smoking status or drinking status. The present prospective cohort study provided evidence that chocolate consumption was associated with a significant lower risk of gestational diabetes in Japanese women.

DOI： 10.1017/S0007114519001806

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The human GATA zinc finger domain containing 2B (GATAD2B) encodes a subunit of the MeCP1-Mi-2/nucleosome remodeling and deacetylase complex, which is involved in chromatin modification and transcription. Recently, patients with severe intellectual disabilities and characteristic features associated with GATAD2B mutations have been identified. CASE REPORT: The patient was a 4-year-old male with dysmorphic features, including frontal bossing, hypertelorism, epicanthal folds, down-slanting palpebral fissures, a flat nasal bridge, a high arched palate, and micrognathia. He spoke no meaningful words and exhibited severe intellectual disability. Hypermetropic astigmatism and mild spasticity of the lower extremities were noted. Whole-exome sequencing revealed a de novo missense mutation in GATAD2B (NM_020699:exon4:c.502C>T; p.(Glu168∗)). CONCLUSION: We report a novel GATAD2B mutation in a boy exhibiting bilateral leg spasticity and white matter abnormalities on brain magnetic resonance imaging.

DOI： 10.1016/j.braindev.2018.10.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Broader autism phenotype (BAP) refers to the expression of behavioral and cognitive dispositions similar to autism spectrum disorder. The present study investigated whether mothers' BAP was prospectively associated with maternal attachment, and if postpartum depression modified this association. METHODS: The Japan Environment and Children's Study (JECS) is a national and government-funded birth cohort study that began in January 2011. Among the 103,099 mothers enrolled, 87,369 mothers without a history of depression were included in the analysis. Self-administered questionnaires were used. These included: the Japanese version of the Autism Spectrum Quotient, the Mother to Infant Bonding Scale, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were performed. RESULTS: The BAP during the second or third trimester of pregnancy was linearly associated with an increased risk of postpartum depression and insecure maternal attachment when infants were one month old (p for trend < 0.001), after adjusting for confounding variables. When stratified by postpartum depression, among the BAP subscales, deficiencies in social skills and communication were associated with an increased risk of insecure maternal attachment in mothers without postpartum depression. The relationships between the BAP subscales and maternal attachment were attenuated among mothers with postpartum depression. LIMITATIONS: Only five items of the Mother to Infant Bonding Scale were used in the present study, and thus the results should be interpreted with caution. CONCLUSIONS: Mothers' BAP was predictive of insecure maternal attachment toward their infant. Postpartum depression partially moderated the associations between mothers' BAP and insecure maternal attachment.

DOI： 10.1016/j.jad.2018.09.060

PubMed

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一社)日本小児神経学会  

障害児は不慮の事故やけがにあうリスクが高く、事故防止対策の重要性が指摘されている。質問票調査により児童発達支援センターおよび児童発達支援事業所における事故やけが、健康状態の急変時に備えた取組の現状を明らかにした。84.8%の施設が緊急時対応マニュアルを作成していたが、それに従って訓練しているところは47.6%と少なかった。児童発達支援事業や多機能事業所での自動体外式除細動器の設置割合はそれぞれ40.3%、35.1%であった。心肺蘇生、異物除去、止血法などの実践訓練を行っている施設は40%に満たなかった。児童発達支援センター等の利用者の急増を背景に事故防止対策が追いついていない状況であった。事故防止の体制整備が急務である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01232&link_issn=&doc_id=20180706280012&doc_link_id=%2Fcl1nohat%2F2018%2F005004%2F016%2F0295-0297%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcl1nohat%2F2018%2F005004%2F016%2F0295-0297%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

当センターでは、Down症候群をもつ乳児とその家族を対象とした集団外来(すくすく外来)を2010年4月より行っている。今回、すくすく外来を利用したDown症候群をもつ子どもの母66名を対象にコース開始時と終了後に自記式質問票による調査を行うとともに、終了後には満足度調査も実施した。コース開始時調査60名、終了後調査36名、満足度調査49名の回答を解析した結果、1年間のすくすく外来により、母の育児負担感は有意に低下し、母子間愛着感情は有意に上昇したことが明らかになった。また、すくすく外来における1年間の講義内容についても満足度が高かったが、一方で開始までの待ち時間の長さや交流時間の短さに対する不満も判明し、今後の課題と考えられた。

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

RASopathies are phenotypically overlapping genetic disorders caused by dysregulation of the RAS/mitogen-activated protein kinase (MAPK) signaling pathway. RASopathies include Noonan syndrome, cardio-facio-cutaneous (CFC) syndrome, Costello syndrome, Neurofibromatosis type 1, Legius syndrome, Noonan syndrome with multiple lentigines, Noonan-like syndrome, hereditary gingival fibromatosis, and capillary malformation/arteriovenous malformation syndrome. Recently, six patients with craniosynostosis and Noonan syndrome involving KRAS mutations were described in a review, and a patient with craniosynostosis and Noonan syndrome involving a SHOC2 mutation has also been reported. Here, we describe patients with craniosynostosis and Noonan syndrome due to de novo mutations in PTPN11 and patients with craniosynostosis and CFC syndrome due to de novo mutations in BRAF or KRAS. All of these patients had cranial deformities in addition to the typical phenotypes of CFC syndrome and Noonan syndrome. In RASopathy, patients with cranial deformities, further assessments may be necessary to look for craniosynostosis. Future studies should attempt to elucidate the pathogenic mechanism responsible for craniosynostosis mediated by the RAS/MAPK signaling pathway.

DOI： 10.1002/ajmg.a.38337

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一財)厚生労働統計協会  

目的 わが国において療育サービスの子どもと家族への効果が評価されているかを把握する。方法 全国の児童発達支援センター(医療型・福祉型)444ヶ所に対して,記名式自記式質問票を用いた郵送調査法による実態調査を実施した。調査内容は,障害児通所支援の規模,療育サービスの子どもと家族への効果の評価状況(評価有無,評価内容)についてである。療育サービスの効果の評価状況をセンター種別に示し,評価内容を整理した。子どもと家族への効果を評価している児童発達支援センターの特徴を検討した。結果 調査票は197施設(回収率44.3%)から回答を得て,有効回答であった186施設を解析対象とした。37.6%の施設が療育サービスの子どもへの効果を評価していた。評価していると回答した施設の52.9%が,ポーテ-ジプログラム,津守・稲毛式乳幼児精神発達診断,新版K式発達検査などの発達検査を療育サービスによる子どもへの効果の評価であると考え,1年に1〜2回,これらの様式による発達検査を行っていた。また,個別支援計画を活用した施設もあった(24.3%)。残りの施設は,家族へのアンケート,聞き取り,関係者会議などで各施設独自の方法で療育サービスの子どもへの効果を評価していた。療育サービスの家族への効果は,19.4%の施設が評価していた。評価していると回答した施設の69.4%が,療育サービスの利用満足度のアンケートを実施していた。その他の30.6%は,アンケートなどの特定の様式を使用するのではなく,懇談や聞き取りなどで評価を行っていた。療育サービスにより家族の知識や行動が変化したかどうかを評価した施設はなかった。子どもへの効果を評価している施設の方が有意に多く,家族への効果を評価していると回答していた。家族への効果を評価していると回答したところは評価していないところに比べて,就学前乳幼児の利用契約総数が有意に多かった。結論 療育の代表的施設である児童発達支援センターにおける療育サービスの効果の評価状況を明らかにした。療育サービスの子どもと家族への効果は十分に評価されておらず,今後,療育の充実のためには,療育サービスの標準化された評価法の開発および普及と活用が望まれる。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

本研究では、障害児保育の現状や課題を整理し、障害児の育ちにおける保育所の役割を明確化することを目的とした。保育所所長等12名を対象に個別インタビュー、27名を対象にフォーカスグループインタビューを実施して内容を分析した。障害児保育の良いところは、【保育士の資質向上】、【子どもの育ちの促進】、【障害児家族の支援の促進】、【関係機関とのさらなる連携強化】と4つの特徴が抽出された。保育所の特徴を活かし、毎日の集団生活を通じて子どもが成長できるような子どもへの支援や、毎日家族と接することで理解・共感のもとで子どもの障害に配慮した家族支援が、障害児保育における保育所・保育士の役割であると考えられた。(著者抄録)

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担当区分：筆頭著者  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

Williams syndrome (WS) is a well-known genetic syndrome caused by a microdeletion on chromosome 7q11.23 encompassing the elastin gene. It is characterized by distinctive facies, congenital cardiovascular malformations, intellectual disabilities, and various other manifestations.
Some patients were reported with craniosynostosis. Here, we report 8 WS cases diagnosed with craniosynostosis using three-dimensional cranial computed tomography. These findings suggest that craniosynostosis may occur more frequently in WS patients than expected. (C) 2015 Elsevier Masson SAS. All rights reserved.

DOI： 10.1016/j.ejmg.2015.05.002

Web of Science

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担当区分：筆頭著者   記述言語：英語  

According to a revision of Japan's Basic Law for Persons with Disabilities in 2011, Article 17 stipulated the government's obligation to provide early intervention to children with disabilities. However, the concept of family outcomes in early intervention has not really been considered in Japan yet. This article describes the development and validation of the Japanese version of the Family Outcomes Survey Revised (FOS-R). Our goal was to determine whether this survey for assessing how families of children with disabilities are affected by early intervention would be appropriate for use in early intervention in Japan. Both the Japanese version of the FOS-R and an anonymous, self-administered questionnaire about background factors were given to 394 mothers of children who were either currently using or had in the past year used early intervention at an early intervention facility or medical institution. Survey responses were obtained from 335 mothers (response rate of 85.0%). The total number of subjects in the analysis was 301 mothers who answered the Japanese version of the FOS-R completely. To assess content validity, another survey was given to 115 experts involved in supporting children with disabilities and their families. The family outcomes indicator items as well as the helpfulness indicators items showed good psychometric properties. Although the components of the FOS-R worked better as individual subscales than as a single scale, we confirmed that a total score was also psychometrically valid. We also confirmed both content validity and external validity. The Japanese version of the FOS-R appears to be a valid tool for assessing the benefits experienced by families as a result of services received, but further research is needed to determine the nature of practices most likely to lead to positive family outcomes.

DOI： 10.1016/j.ridd.2015.01.003

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

障がい児家族ニーズを把握するために、情報、家族関係、経済面、他者への説明方法に関する項目からなるニーズのアセスメント指標(日本版Family Needs Survey:FNS-J)の活用方策を提示した。FNS-Jはスコア化したり、他者と比較するものではなく、家族と相談者がどのような面に配慮しながら支援を強化すべきかを検討するツールである。通常の相談支援の際にFNS-Jを活用し、その結果をもとにFNS-Jの活用可能な対象者や活用場所、活用方法、活用する際の留意点などをとりまとめた。FNS-Jを用いたことで、家族自身の要求や支援者に対する不満が整理され、子どもや家族が喫緊に必要な情報などを明確にでき、家族と相談者が共通の認識を持つ手助けになった。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一財)厚生労働統計協会  

目的 わが国では,子どもの虐待の予防,被虐待児の診断や治療,被虐待児や家族に対する継続的支援など,各分野の研究や対策は進み始めているものの,虐待における経済分析の分野は着手されていない。部分的な経済的評価として,虐待にかかる費用分析が最優先である。そこで,本研究では,2歳未満児の虐待による頭部外傷(Abusive head trauma,以下,AHT)における初回入院にかかる疾病費用を明らかにすることを目的とした。方法 A,B施設に頭部外傷による頭蓋内病変を疑い頭部CTを施行し,入院した2歳未満児(対象期間:A施設2005年4月から2011年3月,B施設2002年4月から2005年3月)を対象とした。診療録(サマリー)によりAHT児とnon-AHT児に分け,診療報酬明細書の分析により初回入院期間における医療費,入院期間等を比較した。結果 AHT児41例,non-AHT児69例を分析した。AHT児で男児の割合が多かった。初回平均入院日数は,AHT児で50.6日(A施設71.7日,B施設26.1日)とnon-AHT児の5.9日(A施設4.4日,B施設6.5日)の約10倍であった(p<0.001)。同様に,初回入院にかかる平均医療費もAHT児で230万円(A施設307万円,B施設140万円)とnon-AHT児の25万円(A施設28万円,B施設24万円)の約10倍であった(p<0.001)。医療費内訳では,AHT児はnon-AHT児と比べると,初回入院にかかる医療費のうち,手術にかかる医療費の割合が高かった(p<0.001)。結論 AHT児の初回入院医療費は,non-AHT児の約10倍であった。入院日数の差を反映するものであった。A施設のAHT児の多くが退院後に地域に戻ることから,AHT児が地域に戻るまでの初回入院にかかる医療費は,A施設の分析結果である310万が参考になると考えられる。この医療費はAHTを防ぐことができれば本来生じない医療費であり,経済的損失の観点からも虐待予防は急務である。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

背景:近年、急速に増加している先天性心疾患の胎児診断における母親への心理的影響の研究として、それら母親の心理的状況やニーズの把握が必要となっている。目的:胎児心疾患の診断を受けた母親に対するアンケート調査により胎児診断前後のニーズや心理状況を把握すること。方法:全国6施設にて胎児診断を受けて現在通院中の心疾患児をもつ母親を対象とし、日本版PSI育児ストレスインデックス(Parenting Stress Index、以下「PSI」)を中心とした自記式質問票による調査を行った。調査は各施設倫理委員会の承認を得て実施した。結果:回答のあった解析対象者は241名。PSIスコアは「子どもに問題を感じる」「退院後の気落ち」で高く(=ストレスが高い)、「夫との関係」では低かった。また、PSIスコアが高い母親は有意に「医師以外のスタッフの立ち会い」を必要とした(P=0.023)。PSIの高い母親のほうが有意に「不安になった時に相談できること」を必要とし(P=0.029)、有意に「ピアカウンセリング」を必要とした(P=0.048)。重症心疾患児の母親のPSIスコアに有意差は認めなかった。結論:胎児診断を受けた母親のストレスは子どもに対しては強かったが、夫とは育児をより協力しあう関係と推測された。ストレスの強い母親に対しては、検査中やその後に相談できるスタッフやピアカウンセラーが必要という結果であった。また心疾患が重症であるからストレスが強いわけではないことも判明した。今回の調査により胎児心疾患の診断を受けた母親に対する支援の方向性が明らかにできた。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：日本公衆衛生学会  

目的 障害が判明した時の障害児家族支援、就学前期の障害福祉サービスの紹介、および学齢期・青年期の障害児に対する地域生活支援の紹介、障害福祉サービスの情報収集について、病院小児科における実態を明らかにする。方法 全国の日本小児科学会が認定する専門医研修施設518施設に対して無記名自記式質問票による調査を実施した。調査対象者は、部長や医長など小児科の全貌を把握している医師とした。質問票は、障害が判明した時の障害児家族の心理的反応に対する対応、就学前期(障害が判明した時から就学まで)の障害児への障害福祉サービス(療育・医療費の助成・地域生活支援)等の紹介、学齢期・青年期の障害児に対する地域生活支援における医療機関の役割などである。回答結果を記述的に集計した。結果 278病院(回収率53.7%)から回答を得た。障害が判明した時、主治医は家族の心理的反応に留意して対応していた。就学前期では、障害児通園施設や児童サービス等の発達支援に関する障害福祉サービスについて、97.9%が「紹介している」とした一方で、相談支援、移動支援、日常生活用具給付、地域活動支援等の地域生活支援に関するサービスについては、13.3%で「紹介しない」と回答していた。学齢期・青年期では、障害福祉サービス等の紹介など、地域生活支援については50.0%が「役割を担っていない」と回答していた。療育や地域生活支援に関する障害福祉サービス等の最新情報の入手について、「特に何もしていない」と回答した者は39.6%であった。情報収集していると回答した者でも受動的に情報が入手できる者は少なく、医師が自ら情報収集していた。結論 病院小児科は、障害児に対して早期発見からフォローアップまで一貫した関わりができる。障害児のすべてのライフステージにおける障害福祉サービスの充実に向けては、福祉・行政からのアプローチの重要性は言うまでもないが、病院小児科においては、障害が判明した時の家族へのきめ細かな心理社会的支援の提供、障害福祉サービスを紹介できるようなシステムの構築、マンパワーの強化が必要である。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語  

DOI： 10.11236/jph.61.2_93

PubMed

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

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記述言語：英語  

Early intervention and disability services in Japan historically have focused on supporting the individual with a disability, with only secondary attention to family needs and priorities. Since the Basic Law for Persons with Disabilities was codified in 2011, the Japanese government has been responsible for supporting families with members who have disabilities. To assess the needs of these families, we evaluated the reliability and validity of the Family Needs Survey (FNS), initially developed in 1988 (Bailey & Simeonsson), to determine its usefulness for programs providing services for Japanese families who have a child with a disability. The FNS is a practical tool to assess family needs and is already used across many different cultures and populations. To evaluate the reliability and validity of the FNS, we conducted an anonymous survey with a self-administered questionnaire at 6 treatment and education institutions, 3 medical institutions mainly for children with disabilities, and 39 special needs schools in the Osaka area. We analyzed 1171 parents' survey responses: 452 fathers and 719 mothers of children with disabilities aged 0-15 years old who answered all items on the Japanese version of the FNS. Another survey was administered to 130 specialists who work with children with disabilities to assess the content validity of the Japanese version of the FNS. We verified the factor structure, content validity, and reliability of the Japanese version of the FNS as an assessment tool with 34 items among four factors that were based on the same items in the original FNS. The assessment could be used for families with school-age children as well as younger children, in contrast to the original version, which is not appropriate for school-age children. We also confirmed that it could be used without regard to type or degree of disability.

DOI： 10.1016/j.ridd.2013.07.024

PubMed

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一財)厚生労働統計協会  

目的 子どもの心の診療システムの整備を目的とした「子どもの心の診療拠点病院機構推進事業(以下,拠点病院事業)」が,平成20年度からの3年間実施された。今後,子どもの心の診療が推進されていくためには,拠点病院事業の実態を把握し,それに伴う人的費用を明らかにすることが重要である。本研究の目的は,分析の立場を事業提供者側として,拠点病院事業の実施状況と人的費用を記述し,部分的経済的評価を行うことである。方法 平成23年11月,11自治体18ヶ所の拠点病院に対して電子メールで記名式自記式質問票による調査を実施した。調査内容は,拠点病院の基本情報,子どもの心の診療従事者,拠点病院事業の基本情報および事業従事者の内訳などである。本稿では,事業の実態を明らかにし,事業最終年度の事業内容別職種別の年間人的費用を解析した。結果 10自治体14病院から回答があった。拠点病院間で,診療報酬上の病院の機能が異なっていた。この相違が診療報酬の相違として大きかった。医師数の多い病院ほど,診療支援や医師への初期研修や後期研修,コメディカルへの実施研修などの専門的かつ継続的な研修事業を実施していた。拠点病院事業のほとんどすべての事業項目で医師が関与していた。子どもの心の診療医は,小児領域での他の診療分野や大人の精神科領域に従事する医師とは異なり,診療業務に加えて,調整業務,連携業務等が要求されていた。出張医学的支援・巡回相談は,医師数の多い拠点病院のみ行っており,1人1回当たりの時間が比較的長く人的費用も高かった。診療支援にかかる人的費用は普及啓発や研修事業にかかる人的費用よりもそれぞれ5倍,2倍と極めて高く,約570万円であった。本調査により,拠点病院事業の必要経費である人的費用が総額約955万円と推計できた。結論 子どもの心の診療の需要ニーズは年々増加する一方,専門医や対応可能な医療機関の不足等のため,政策医療としての対応が望まれる。今後,子どもの心の診療が充足されるためには,拠点病院事業の後継事業である「子どもの心の診療ネットワーク事業」が全国規模で推進される必要がある。中でも出張医学的支援・巡回相談は効果的な連携強化,タイムリーな介入が期待できるものであるからこそ,費用面の対策も必要である。また,子どもの心の診療に関わる専門職の育成は,全国的に事業展開される前提条件となる重要課題である。(著者抄録)

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担当区分：筆頭著者   記述言語：英語   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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担当区分：筆頭著者   記述言語：英語   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本周産期・新生児医学会  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

告知直後からの適切な成長発達支援と健康管理を目的に、地域療育や集団保育に参加するまでの乳幼児を対象としたダウン症候群(DS)総合支援外来(すくすく外来)を開始した。告知後間もないDS患者の母親の育児ストレスインデックスとして評価できた。子どもの側面では「子どもが期待どおりにいかない」「子どもに問題を感じる」でPSI得点が高く、ストレスが高かった。「子どもの機嫌の悪さ」「子どもの気が散りやすい」のストレスが低かった。親の側面では「退院後の気落ち」のストレスが高く、「社会的孤立」のストレスが低かった。全体的な運営、プログラム内容、スタッフの対応のすべてにおいて、概ね肯定的評価を得た。ただ、その中でも評価が高くなかった項目は、「外来までの待ち時間を不満に思うであった。改善すべき点については、満足度・ニーズに関する調査結果と同様、個別診療後から集団指導開始までの時間に関する記載が多かった。

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

ダウン症候群をもつ成人の健康管理の検討に資することを目的に、重症心身障害児(者)施設の当該患者59名(男性36名、女性23名)の診療録を、肥満とメタボリックシンドロームに着目して分析した。その結果、とくに男性において、肥満である者の方がそうでない者よりも腹囲が太く、血圧が高く、メタボリックシンドロームと判断された3名(男性2名、女性1名)は、いずれも肥満であったことから、ダウン症候群をもつ成人では肥満がメタボリックシンドロームの指標となることが示唆された。

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

サブサハラ以南アフリカ地域における5歳未満児死亡率の平均値は、2008年時点で日本の約36倍である。大阪府立母子保健総合医療センターでは、ミレニアム開発目標4に寄与することを上位目標に、国際協力機構大阪センター主管の研修「アフリカ新生児・小児保健医療」を3年間プログラムで実施している。日本の高度医療施設で実施された当研修がアフリカの研修員に及ぼしたインパクトを検証し、今後の研修の改善に資することを目的に、17名の研修員を対象に質問票による調査を、8名の研修員を対象に半構造的インタビュー調査を実施した。研修プログラムに対する満足度は、研修プログラムのデザインの適切性、講義の質と分かりやすさ、疑問や困難への助言、能動的な参加の機会、直接的な体験の機会の項目において高かったが、日本の研修で得た知識・経験の有用性および職場への応用の容易さへの項目では低かった。また、グラウンデッド・セオリー・アプローチを用いてインタビュー結果を分析した結果、研修員が印象深かったと述べた事象は、「保健医療システム」、「医療従事者の働く姿勢」、「医療技術」、「医療設備・機材」の4カテゴリに大別された。そのうち、研修員が職場への応用が可能だと述べた項目は、「保健医療システム」では、連携搬送システム、地域保健活動サービスの内容、実践的な両親学級、母子健康手帳、医療保険制度、「医療従事者の働く姿勢」では、コミットメント、スムーズな運営、「医療技術」では、最新の正しい医療情報、「医療設備・機材」では、他国の研修員から学んだ光線療法装置であった。当研修の効果が期待できる部分は、最新の正しい医療情報の適用、職務態度の改善、保健医療システムの整備、他国の研修員からの学びであることが明確になった。一方、高度な医療設備を伴う最新の医療技術の実現は、社会基盤や教育など保健以外の分野と共に発展していく長期的課題として対応していく事項であることが示唆された。(著者抄録)

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

本研究の目的は、療育手帳または身体障害者手帳を有する児を障害児とし、小児外来における障害児の療育環境および家族ニーズ(7種35項目)の現状と課題を明らかにすることである。小児外来患者家族350人の無記名自記式質問紙調査結果を解析した。障害児家族は、有意に年齢が高く、子どもの受診頻度が高く、精神的健康度が低く、育児負担感が高く、主観的経済状況が苦しかった。また、子どもに異常行動があると考え、保健医療関係者や地域サポーターの協力を受けていた。家族の育児負担感は、情報提供、家族支援、育児支援のニーズに対する影響因子、家族の精神的健康度が低いことは、説明力向上の支援と専門家による支援のニーズに対する影響因子であった。(著者抄録)

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

2004年から2008年の大阪府の0〜14歳の「不慮の事故」による死亡者179人について、年齢階級別死亡率、二次医療圏別標準化死亡比、年齢階級別「不慮の事故」の種類を検討した。年齢階級別死亡率(人口10万対)は10.8(0歳)、3.9(1〜4歳)、2.2(5〜9歳)、1.5(10〜14歳)であった。二次医療圏別標準化死亡比は医療圏での差を認めた。種類別では「交通事故」、「窒息」、「溺死溺水」、「火災」、「転倒転落」の順であった。0歳では「窒息」、1〜14歳では「交通事故」が最も多く、「交通事故」の割合は年齢とともに増えた。全国の「不慮の事故」による死亡率は減少傾向にあるが、大阪府では明らかな減少は認められなかった。小児の発達段階に応じた具体的な事故防止対策により、多くの子どもの事故は予防可能であることから、母子保健活動や救急医療体制など「不慮の事故」に影響すると思われる要因に地域差がないかの検討が必要である。(著者抄録)

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担当区分：最終著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

先天性心疾患の出生前診断を受けた母親への心理的サポートによる胎児診断の有用性について検討した。胎児診断された時期が母体支援導入より以前の母親23例(支援前)、および母体支援開始の後の母親35例(支援後)を対象とした。質問紙は、全体として82.8%の回収率であった。母体支援がPSI育児ストレスインデックスに及ぼす影響として、支援後の方が得点は低く、特に親のサブカテゴリーで、母体支援の有無による得点の有意差を認めた。母親が大卒以外の「子供が期待通りに行かない」に関するストレスは、心理的ケアの有無に関わらず高いが、その中でも心理的ケアを行っていない群が有意に高かった。特に入院期間が長い場合、母体支援後の群が「退院後の気落ち」に関するストレスが有意に低かった。また、児に染色体異常や他臓器の疾患といった合併症がある場合には、母体支援後の群が「退院後の気落ち」に関するストレスが有意に低かった。

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

小児専門病院の患者家族309名を対象に、その精神健康状態を、信頼性・妥当性の確立された日本版精神健康調査票(GHQ28)を用いて把握し、精神健康状態に影響する因子について分析した。付き添いの52.4%のGHQ28が5点以下であり、健常者よりも精神健康状態が悪い集団であった。療育手帳または身体障害者手帳を保有している者が、育児負担感がある者が、配偶者または両親、近隣または友人の協力がない者が、ある者よりもGHQ28が有意に高かった。しかし、地域サポーターの協力ではある者がない者よりもGHQ28が有意に高かった。患者家族の精神健康悪化のリスクは、育児負担感と苦しい主観的経済状況であった。子供の異常行動の因子を入れた、子供が7歳以上の対象者の場合のロジスティク回帰分析では、前記2項目に加えて月1回以上の医療センター受診と配偶者または両親の協力がないことがリスク因子であった。

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

小児外来患者の療養環境に対する家族のニーズを明らかにすることを目的に、当センター(大阪府立母子保健総合医療センター)の小児外来受診患者の家族を対象にアンケート調査を行い、363名より有効回答を得た。その結果、子どもの年齢、病気や障害の程度などにより差違はあるが、情報提供や地域サービスに対するニーズが高いことがわかった。

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(公財)大阪成人病予防協会  

1975〜1997年に子宮頸がん及び体がんと診断された患者各々14055名及び3113名について、その5年生存率に対する地域社会経済因子の影響を分析した。地域社会経済因子は職業/経済・教育指標とし、地域社会経済レベルにより、子宮頸がん患者では年齢、進行度、組織型、治療の種類に、子宮体がん患者では年齢、進行度、治療の種類に有意な差が認められた。累積5年生存率は、子宮頸がん及び体がん患者ともに失業率の低い地域に住むほど、また教育レベルの高い地域に住むほど高値となり、これらの地域社会経済レベルによる生存率格差は、子宮頸がん患者については年齢、進行度、組織型、治療の種類を、子宮体がん患者については年齢、進行度、治療の種類を調整しても残った。

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担当区分：筆頭著者   記述言語：英語  

The purpose of this study was to analyze socioeconomic differences in cervical and corpus cancer survival, and to investigate if the differences are due to differences in age, cancer stage, histology and treatment. A total of 14,055 cases with cervical cancer and 3,113 cases with corpus cancer were obtained from the Osaka Cancer Registry. Municipality-based SES measurements were obtained from the System of Social and Demographic Statistics. Survival analysis was carried out with Kaplan-Meier survival curves. Three types of Cox proportional hazards regression models were tested to assess survival differences among groups and effects of SES on survival, controlling for clinical factors. SES was related to age and cancer stage for cervical and corpus cancer patients, and histology for cervical cancer patients. Differences were observed in cumulative 5-year survival for cervical cancer patients among low, middle and high unemployment municipalities (68.9%, 64.3% and 50.9%, respectively, P<0.0001). Differences in cumulative 5-year survival for cervical cancer patients were also observed among high, middle and low education municipalities (65.1%, 62.2% and 56.1%, respectively, P<0.0001). Similar patterns in 5-year survival were also found for corpus cancer patients. After adjusting for age, cancer stage, histology and treatment, survival differences between patients from high and low SES areas still remained. In conclusion, our population-based analysis of a metropolitan representative sample in Japan has demonstrated, for the first time in Japan, SES differences in survival following cervical and corpus cancer.

PubMed

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担当区分：筆頭著者   記述言語：英語  

Cancer mortality is generally high in people of low socioeconomic status compared with people of high socioeconomic status (SES). Although these differences in mortality may be caused by differences in cancer incidence and survival, analysis of these factors has rarely been conducted. The objective of our cross-sectional ecological study was to analyze socioeconomic differences in cancer incidence, mortality and survival in a metropolitan area of Japan. The age-adjusted cancer incidence rates, age-adjusted mortality rates, relative 5-year survival, and proportions of early stage cancer were calculated for 67 municipalities in Osaka, Japan. For area-based socioeconomic variables, we used the percentages of male unemployment, college or graduate school graduates, home ownership, households receiving government assistance, and households below the subsistence habitation level in each municipality. We performed linear regression taking each municipality's population as weight to examine the relationships between measurements relating cancer and socioeconomic variables. Factor analysis of socioeconomic variables was carried out to determine whether a particular socioeconomic variable tended to be associated with another. Cancer incidence, cancer mortality, 5-year cancer survival, and proportion of early stage cancer were highly correlated with each socioeconomic variable at the municipality level. Five area-based socioeconomic variables could be explained by three factors: economic status, housing characteristics and educational attainment. Despite the major limitation of a lack of individual information about socioeconomic characteristics and outcomes related to cancer, we hypothesize that a municipal area's socioeconomic status might be a predictor of individual incidence, mortality, and survival of cancer.

PubMed

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(一社)日本トラウマティック・ストレス学会  

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担当区分：筆頭著者   記述言語：英語  

DOI： 10.1016/S0140-6736(04)16970-5

Scopus

PubMed

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記述言語：日本語   出版者・発行元：(株)星和書店  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

母子保健計画の策定プロセス及び策定後の母子保健事業の変化について,全国の市区町村に対して郵送調査を行った.2362自治体から回答が得られ,平成9年度迄に策定を終えていた2202自治体について分析を行った.策定委員会は63.9%の自治体で,作業部会は54.4%の自治体で設置されていた.計画策定プロセスへの県型保健所の関わりでは,関係資料の提供が最も多く,策定委員等としての参画,計画策定研修会の開催,首長などへの趣旨説明,策定組織の運営の支援,ニーズ分析への支援の順であった.計画内容の住民への周知や策定後の進行管理を行っている自治体は半数に満たなかった.策定に伴う母子保健事業の変化や他部局や関係機関との連携の促進は,人口規模の大きな自治体ほど多かった.保健所の支援を含む策定プロセスや計画書の活用状況,進行管理,策定後の母子保健事業の変化は,都道府県によって大きな格差が認められた

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2003&ichushi_jid=J01074&link_issn=&doc_id=20031010180005&doc_link_id=10.11236%2Fjph.50.9_897&url=https%3A%2F%2Fdoi.org%2F10.11236%2Fjph.50.9_897&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The purpose of this study was to offer insight into the revisions needed for promotion of Maternal and Child Health Promotion Plans in the coming years. METHODS: The maternal and child health promotion planning process and changes in maternal and child health services were surveyed by questionnaires to all municipalities in Japan. RESULTS: Completed questionnaires were obtained from 2,362 municipalities (response rate: 72.6%) Replies from 2,202 municipalities, which had completed planning by March, 1998, were analyzed. Planning committees were established by 63.9% of municipalities, and working committees were set up in 55.4% of them. Members involved in the working committees were more limited when compared to the planning committees and only 9.3% of the committees had representatives from mothers. 37.5% of working committees held meetings more than 5 times. 56.0% of municipalities conducted hearings or questionnaire surveys of mothers and health personnel for assessment of maternal and child healthcare needs. Most prefectural public health centers provided statistical data for planning assistance. Public health center staff participated as planning members in 38.5% of municipalities, and a training program for the planning sponsored by health centers was utilized by 33.8% of municipalities. Only 18.3% of municipalities received support for explanation of the plans to the mayor and/or executive officers, only 12.1% received support for the management of the planning committees, and only 11.8% received support for needs analysis. Less than half of minicipalities conducted PR activities of the plans and progress management. A higher proportion conducted these activities in larger cities. After the planning process, 72.9% of municipalities started new projects according to the plans. However, 10.1% scrapped one or more projects. Changes in maternal and child healthcare services and promotion of coordination with other related organization were seen more in municipalities with a larger population. There were major differences found between prefectures with regards to the planning process, including the support from public health centers, and the effective use of plan reports, progress management, and changes in maternal and child healthcare services after the formulation of plans.

PubMed

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担当区分：筆頭著者   記述言語：英語  

PubMed

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)日本医事新報社  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(株)医学書院  

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担当区分：筆頭著者   記述言語：英語  

BACKGROUND: Projecting individualized probabilities of developing breast cancer is needed for counseling and chemoprevention for Japanese women, in whom breast cancer incidence has been rapidly increasing. METHODS: We calculated individualized probabilities of developing breast cancer within 10-20 years and until life expectancy for Japanese women by multiplying the relative risk for each risk factor combination by the cumulative risk for the reference group. The risk factors used were age at menarche, age at first delivery, family history of breast cancer, and body mass index (BMI) (in post-menopausal women). The relative risk by menopausal status for each risk factor combination was estimated from a case control study conducted at Osaka Medical Center for Cancer and Cardiovascular Diseases (OMCC), Japan. The cumulative risk of breast cancer for the reference group within 10-20 years and until life expectancy was estimated to divide the corresponding cumulative risk for Japanese women by the weighted average of the relative risk. The weight is an expected proportion of those who have each risk factor combination among the general population. The cumulative risk for Japanese women was estimated using a data file from the Osaka Cancer Registry (OCR). RESULTS: We obtained cumulative risks for any age women within a certain range according to various risk factor combinations by menopausal state. For example, the highest risk group had about a 5 times higher risk probability of developing breast cancer than the general population at initial age 40, within 10-20 years, and until life expectancy. CONCLUSION: The cumulative risk of breast cancer varied according to individuals' risk factors among Japanese women. The availability of concrete individualized risk estimation figures will be of use to health care providers in encouraging Japanese women to seek counseling and to adopt self-control of body weight as a primary preventive measure, as well as to have breast cancer screening.

PubMed

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BRITISH MED JOURNAL PUBL GROUP  

Objectives: To analyse brand nicotine yield including "ultra low" brands (that is, cigarettes yielding less than or equal to 0.1 mg of nicotine by Federal Trade Commission (FTC) methods) in relation to nicotine intake (urinary nicotine, cotinine and trans-3'-hydroxycotinine) among 246 Japanese male smokers.
Design: Cross sectional study.
Setting: Two companies in Osaka, Japan.
Subjects: 130 Japanese male workers selected randomly during their annual regular health check up and 116 Japanese male volunteers taking part in a smoking cessation programme.
Main outcome measurements: Subjects answered a questionnaire about smoking habits. Following the interview, each participant was asked to smoke his own cigarette and, after extinguishing it, to blow expired air into an apparatus for measuring carbon monoxide concentration. Urine was also collected for the assays of nicotine metabolites.
Results: We found wide variation in urinary nicotine metabolite concentrations at any given nicotine yield. Based on one way analysis of variance (ANOVA), the urinary nicotine metabolite concentrations,., of ultra low yield cigarette smokers were significantly lower compared to smokers of high (p = 0.002) and medium yield cigarettes (p = 0.017). On the other hand, the estimated nicotine intake per ultra low yield cigarette smoked (0.59 mg) was much higher than the 0.1 mg indicated by machine.
Conclusions: In this study of Japanese male smokers, actual levels of nicotine intake bore little relation to advertised nicotine yield levels. Our study reinforces the need to warn consumers of inappropriate advertisements of nicotine yields, especially low yield brands.

Web of Science

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LANCET LTD  

Web of Science

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：日本公衆衛生学会  

男性喫煙者277名を対象に,禁煙準備過程(ステージ)と喫煙の生化学的指標の関連性を断面調査のデータを用いて分析した.さらに追跡調査のデータを用いて,ステージの変化による喫煙の生化学的指標の変化を縦断的に検証し,併せてステージとその他の喫煙の行動特性に関して検討した.断面調査の結果では,呼気CO濃度,尿中ニコチン代謝物濃度,1日の喫煙本数は関心期と無関心期で差を認めなかったが,準備期では他のステージに比べ低かった.一方,吸うタバコのニコチン収量は,ステージが高くなるほど,低くなる傾向を認めた.1年間の追跡調査期間において,ステージの上昇に伴い,呼気CO濃度が2.3ppm減少,1日の喫煙本数が2.8本減少し,1日の喫煙本数の減少は有意であった.一方,ステージの下降に伴い,呼気CO濃度,1日の喫煙本数の増加傾向がみられた

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

便性腹膜炎術後の短腸症候群の1乳児において完全静脈栄養を行ったところ,開始後約3ヵ月目に口囲・陰部を中心とした皮膚炎を認めた.亜鉛及びビタミンの投与量増量等を試みるも皮膚炎は改善しなかった.しかしセレンを投与したところ血清セレン値の正常化と共に約2週間で臨床症状の著明な改善を示した.完全静脈栄養下のセレン欠乏症としては下肢筋肉痛,心筋炎,爪床の白色化等が知られているが,本症例ではセレン欠乏による皮膚炎が強く疑われた

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪急性期・総合医療センター  

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記述言語：日本語   出版者・発行元：日本小児腎不全学会  

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪急性期・総合医療センター  

64歳男.主訴は呼吸困難感.平成8年5月より整形外科で腰部脊柱管狭窄症に対しnonsteroidal antiinflammatory drug(NSAID)にて治療中,便潜血陽性,急激な貧血の進行を指摘され,消化管出血の疑いで同年12月に当科を紹介された.消化管精査では特に出血の要因となる所見を認めなかった.血色素6.5g/dlで,直接クームス試験が強陽性であった.近医で長期間にわたり複数の薬剤投与を受けており,リンパ球刺激試験でメフェナム酸が強陽性を示したため,本剤による自己免疫性溶血性貧血と考えた.薬剤投与を中止したところ,約2ヵ月で貧血は改善し,約6ヵ月で直接クームス試験が陰性化した

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪急性期・総合医療センター  

最近7年間に溶血性尿毒症症候群(HUS)を17例経験.HUS患者を血液透析を施行した群(透析群)6例と血液透析を施行しなかった群(非透析群)11例にわけ,臨床経過,検査値を比較検討することで,HUSの臨床症状を把握すると共に重症化推定因子についての検討を行った.透析群と非透析群との間でHUS発症時から既に有意差を認めた検査値は,Cr,BUN,尿潜血のみであった

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総ページ数：vii, 133p   記述言語：日本語  

CiNii Books

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総ページ数：280   記述言語：日本語  

CiNii Books

ASIN

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総ページ数：337   記述言語：日本語  

CiNii Books

ASIN

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総ページ数：ix, 195p   記述言語：日本語  

CiNii Books

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記述言語：日本語   出版者・発行元：(一社)日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：大阪小児科学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：日本公衆衛生協会-福島県支部  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY-BLACKWELL  

Web of Science

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：(公社)日本小児保健協会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本家族性腫瘍学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(一社)日本新生児成育医学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：日本語   出版者・発行元：日本臨床死生学会  

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記述言語：日本語   出版者・発行元：日本健康教育学会  

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記述言語：日本語   出版者・発行元：眼科臨床医報会  

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