Hirohisa Imai

National Institute of Public Health, Саитама, Saitama, Japan

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Publications (64)138.03 Total impact

  • Y Nanaumi · M Onda · H Imai ·

    Value in Health 11/2015; 18(7):A541. DOI:10.1016/j.jval.2015.09.1712 · 3.28 Impact Factor
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    ABSTRACT: A nationwide large-scale survey was conducted to identify the prevalence and causal medications of adverse drug events (ADEs) that are caused by potentially inappropriate medications (PIMs) given to homebound elderly patients, factors associated with ADEs, and measures taken by pharmacists to manage ADEs and their effects on ADEs. A questionnaire was mailed to 3321 pharmacies nationwide. It asked about the details of PIMs and ADEs of up to 5 patients for whom home visits were provided by a pharmacist. Questionnaire forms were filled in by pharmacists who visited the patients. Between 23 January and 13 February 2013, comprehensive assessment forms were sent to 3321 pharmacies. Data collected from 1890 pharmacies including data of 4815 patients were analysed and 28 patients of unknown sex were excluded. Their average age was 82.7 years. PIMs were identified based on the 2003 Beers Criteria Japan. There were 600 patients who did not provide valid answers regarding the medications. In the remaining 4243 patients, one or more medications that were considered to be PIMs had been prescribed to 48.4% of patients. PIM-induced ADEs were found in 8% of these patients by pharmacists during home visits. The top ADE-inducing medications were strong anticholinergic antihistamines, benzodiazepines, sulpiride and digoxin. The most common ADEs associated with benzodiazepines were frequent lightheadedness, somnolence and sleepiness, which increase the risk of falls and subsequent fractures in elderly patients. The following factors associated with ADEs were identified: sex, pharmacist awareness of prescription issues, frequency of visits and time spent at patients' homes, and the frequency of detailed checks for patient adverse reactions by pharmacists. The PIM prevalence associated with home healthcare in Japan was relatively high, as reported in previous studies. The present study suggests that pharmacists could reduce the incidence of PIMs and consequent ADEs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 08/2015; 5(8):e007581. DOI:10.1136/bmjopen-2015-007581 · 2.27 Impact Factor
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    ABSTRACT: Background and methods: We conducted a community-based study to evaluate genotype-specific prevalence of high-risk HPV (HR-HPV) and potential predictors of its presence in young, asymptomatic, female college students. Self-administered surveys and vaginal swabs for self collection were distributed to students of participating schools. A sufficient cellular component in cervical samples was verified by examining for the presence of human β-globin DNA by PCR. A total of 1,118 valid cervical samples were subjected to screening for HR-HPV infection with the Digene Hybrid Capture 2 assay, followed by identification of HPV genotypes with GENOSEARCH HPV31 kit. Logistic regression was used to adjust for confounding factors associated with HR-HPV positivity and the adjusted odds ratio (AOR) was calculated. Results: The median age of recruited students was 20 years. Of the 1,118 women who provided valid cervical samples for testing, 770 had sexual intercourse in the past, of which 125 (16.2%) were positive for HR-HPV. Logistic regression analysis revealed that HR-HPV infection was associated with smoking history (AOR 2.13; 95% confidence interval [CI] 1.98 to 5.05; p < 0.01), total number of partners (AOR 4.72; 95% CI 1.97 to 11.32 if > 5 partners; p < 0.001), number of partners in the past 6 months (AOR 3.12; 95% CI 1.42 to 6.87; p < 0.01), improper use of condoms (AOR 2.21; 95% CI 1.25 to 3.90; p < 0.01), and chlamydia infection (AOR 2.61; 95% CI 1.28 to 5.34; p < 0.01). The most common HR-HPV genotype was type 52 (6.4%), followed by 16 (3.1%), 56 (3.0%), and 58 (2.6%). Conclusion: Compared with previous reports in East Asian coutries, the prevalence of HR-HPV infection among young, asymptomatic, female students before the nationwide use of vaccination in Japan was in the intermediate range. The most common HR-HPV genotypes were HPV 52, 16, 56, and 58.
    PLoS ONE 07/2015; 10(7):e0132462. DOI:10.1371/journal.pone.0132462 · 3.23 Impact Factor
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    ABSTRACT: A nationwide survey was conducted to verify relations between the workload of home-visiting service by community pharmacists and outcomes. Data were collected on 5447 patients from 1890 pharmacies. Most (61.9%) pharmacists visited patients' homes twice monthly, spending there a net average of 20.6 work minutes. At the time of the survey, 29.8% of the patients had improvement of adherence compared with at start of home visits; 65.5% had no change, and 1.4% had gotten worse. Similarly, 41.6% had decreased unused medications, 54.4% had no change, and 2.3% had increased. Home-visiting pharmacists found adverse drug events (ADEs) caused by drug administration in 14.4% of their patients. They dealt with 44.2% of these cases by discontinuing administration of the responsible drug, 24.5% by reducing the dosage, and 18.3% by changing drugs, with a total of 88.1% having been improved. Prescription changes intended to correct problems occurred in 37.1% of the patients. In patients whom the pharmacists visited more often, a higher percent had ADEs, had their prescription changed to correct problems, and had improved adherence and unused medications. The average actual work time was longer in patients whose outcomes improved than in those whose outcomes did not. A higher involvement in homecare by pharmacists was found to improve outcomes of drug treatment.
    Yakugaku zasshi journal of the Pharmaceutical Society of Japan 03/2015; 135(3):519-27. DOI:10.1248/yakushi.14-00220 · 0.26 Impact Factor
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    ABSTRACT: We investigated incidence and risk factors for postextraction bleeding in patients receiving warfarin and those not receiving anticoagulation therapy. Cross-sectional, multicentre, observational study. 26 hospitals where an oral surgeon is available. Data on 2817 teeth (from 496 patients receiving warfarin, 2321 patients not receiving warfarin; mean age (SD): 62.2 (17.6)) extracted between 1 November 2008 and 31 March 2010, were collected. Warfarin-receiving patients were eligible when prothrombin time-international normalised ratio (PT-INR) measured within 7 days prior to the extraction was less than 3.0. Simple dental extraction was performed, and incidence of postextraction bleeding and comorbidities were recorded. Postextraction bleeding not controlled by basic haemostasis procedure was clinically significant. Bleeding events were reported for 35 (7.1%) and 49 (2.1%) teeth, of which 18 (3.6%) and 9 (0.4%) teeth were considered clinically significant, in warfarin and non-warfarin groups, respectively, the difference between which was 3.24% (CI 1.58% to 4.90%). The incidence rates by patients were 2.77% and 0.39%, in warfarin and non-warfarin groups, respectively (incidence difference 2.38%, CI 0.65% to 4/10%). Univariate analyses showed that age (OR 0.197, p=0.001), PT-INR (OR 3.635, p=0.003), mandibular foramen conduction anaesthesia (OR 4.854, p=0.050) and formation of abnormal granulation tissue in extraction socket (OR 2.900, p=0.031) significantly correlate with bleeding incidence. Multivariate analysis revealed that age (OR 0.126, p=0.001), antiplatelet drugs (OR 0.100, p=0.049), PT-INR (OR 7.797, p=0.001) and history of acute inflammation at extraction site (OR 3.722, p=0.037) were significant risk factors for postextraction bleeding. Our results suggest that there is slight but significant increase in the incidences of postextraction bleeding in patients receiving warfarin. Although absolute incidence was low in both groups, the bleeding risk is not negligible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 12/2014; 4(12):e005777. DOI:10.1136/bmjopen-2014-005777 · 2.27 Impact Factor
  • M. Onda · M. Kasuga · S. Fujii · Y. Nanaumi · H. Imai ·

    Value in Health 05/2014; 17(3):A16. DOI:10.1016/j.jval.2014.03.101 · 3.28 Impact Factor
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    H. Imai · H. Nakao · Y. Nanami · M. Onda ·

    Value in Health 11/2012; 15(7):A534. DOI:10.1016/j.jval.2012.08.1861 · 3.28 Impact Factor
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    ABSTRACT: OBJECTIVES: To determine whether foreskin status is a measurable marker for evaluating the effect of the foreskin on sexually transmitted infections. METHODS: Inter-rater comparison of the responses on foreskin status and circumcision in a self-report questionnaire with the findings of a physical examination by an experienced well-trained urologist was performed for patients who visited a healthcare facility in Kanagawa, Japan. Foreskin status was defined using a five-point graphical scale based on the degree to which the foreskin covers the foreskin and the glans penis in a non-erectile condition: type 1, a fully exposed glans penis; types 2-4, the glans penis partly covered by the foreskin and type 5, phimosis. Linear weighted κ and per cent agreement were used to evaluate the reliability of responses. RESULTS: Among 188 participants who were evaluated about their foreskin status, linear weighted κ and per cent agreement were 0.74% and 68.4%, respectively. Linear weighted κ improved from 0.74 to 0.80 when the number of categories was changed to three. All the self-reported responses on circumcision were in agreement with the findings of the physical examination. Seventeen participants (9.0%) had been circumcised, and among them, three (17.6%) had approximately one-half of their glans penis covered by the foreskin. In 90 among the 171 uncircumcised participants (52.6%), the foreskin did not cover the glans penis. CONCLUSIONS: The self-reported response on foreskin status in this questionnaire has sufficient reliability to replace physical examination, and this questionnaire can facilitate further studies about the effect of foreskin on sexually transmitted infections.
    Sexually transmitted infections 05/2012; 88(7). DOI:10.1136/sextrans-2011-050294 · 3.40 Impact Factor
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    ABSTRACT: Hyposalivation may affect respiratory disease because the mouth serves as the entrance to the respiratory apparatus, as well as to the digestive tract. Patients with acute respiratory infection generally have a favorable prognosis and a short natural course. However, in cases in which the host has lowered resistance, such as in elderly patients, the infection may develop into pneumonia. A prospective study was performed to examine the relationship between hyposalivation, which is common in elderly patients, and acute respiratory infection, which tends to become severe in elderly patients. The subjects were 323 male and female patients ≥40 years old who lived in Utsunomiya City and surrounding areas and regularly visited the Department of Dentistry and Oral Surgery, Tochigi National Hospital. A 6-month follow-up survey was performed to examine development of acute respiratory infection. Age, sex, and known risk factors were also investigated. Hyposalivation was defined as a saliva production (saliva secretion rate) of ≤0.6 ml/min. Multivariate analysis adjusted for age and sex was performed to examine potential risk factors associated with the development of acute respiratory infection. Data were analyzed for 278 subjects who completed the follow-up survey. The incidence of acute respiratory infection was 60.4%, while hyposalivation was present in 96 subjects (35.5%). Multivariate analysis showed that the incidence of acute respiratory infection was higher in subjects with hyposalivation than in those without hyposalivation (adjusted odds ratio 1.761, p = 0.048). The results of this study suggest that hyposalivation may be a risk factor for acute respiratory infection. This also suggests that improvement of hyposalivation might prevent acute respiratory infection.
    Gerontology 11/2011; 58(3):205-11. DOI:10.1159/000333147 · 3.06 Impact Factor
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    H. Imai · H. Nakao · F. Sata ·

    Value in Health 11/2011; 14(7). DOI:10.1016/j.jval.2011.08.595 · 3.28 Impact Factor
  • F. Sata · H. Imai · H. Nakao · Y. Fukuda ·

    Journal of Epidemiology &amp Community Health 08/2011; 65(Suppl 1):A156-A156. DOI:10.1136/jech.2011.142976f.12 · 3.50 Impact Factor

  • Epidemiology 01/2011; 22:S123. DOI:10.1097/01.ede.0000392047.53558.a0 · 6.20 Impact Factor
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    ABSTRACT: Hypospadias is a common congenital anomaly caused by incomplete fusion of urethral folds. Development of the urethra and external genital system in the male fetus is an androgen-dependent process. In this regard, enzymes 17 β-hydroxysteroid dehydrogenase type 3 (17 β HSD3, encoded by HSD17B3) and steroid 5 α-reductase type 2 (encoded by SRD5A2) play crucial roles. To investigate the possible associations between common polymorphisms in HSD17B3 as well as well-known V89L polymorphism in SRD5A2 and risk of hypospadias. A case-control study was performed between 1999 and 2005. There were 89 Japanese boys with hypospadias and 291 newborn controls. We genotyped HSD17B3-1999T>C, +10A>G, +20A>G, +139G>A (V31I), +913G>A (G289S), and SRD5A2+336G>C (V89L) polymorphisms by allelic discrimination assay. We measured mRNA expression of the wildtype G289 allele and the mutant S289 allele of the HSD17B3 gene in the transfected human fetal kidney HEK293 cells. Assessment of hypospadias including its severity and HSD17B3 and SRD5A2 genes using DNA blood samples: allele and genotype distribution of single nucleotide polymorphisms in these two genes in cases and controls. In our study, the risk of hypospadias was significantly higher in subjects carrying homozygous HSD17B3+913A (289S) alleles (odds ratio [OR]: 3.06; 95% confidence interval [CI]: 1.38-6.76). The risk of severe hypospadias was much higher in these subjects (OR: 3.93; 95% CI: 1.34-11.49). The mRNA expression levels of HSD17B3 G289 were higher than those of HSD17B3 S289 mutant (P < 0.001). In addition, the risk of severe hypospadias increased in boys carrying the SRD5A2+336C (89L) allele (OR: 3.19; 95% CI: 1.09-9.36). These results suggest that the HSD17B3 G289S polymorphism may be a potential risk modifier for hypospadias. Our findings provide evidence that a certain genotype related to androgen production may potentiate risk of hypospadias.
    Journal of Sexual Medicine 08/2010; 7(8):2729-38. DOI:10.1111/j.1743-6109.2009.01641.x · 3.15 Impact Factor
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    ABSTRACT: We explored the relationship between bone mineral density (BMD) and lifestyle in juveniles to identify factors leading to higher peak bone mass and prevention of osteoporosis in later life. Juveniles (1,364 students: 770 boys and 594 girls, aged 6-18 years) attending school in Hokkaido prefecture, Japan, were asked to complete a brief self-administered diet history questionnaire for 10-year-olds (BDHQ10y) providing information about personal history, lifestyle, and intake of nutritional elements. In addition, BMD and grip strength were measured. We analyzed the relationship between BMD and lifestyle factors. The difference in BMD for boys was larger among the junior and senior high school groups. The difference in BMD for girls was larger among older elementary and later school children. Anthropometric variables and grip strength were strongly correlated with BMD. Having a nap-time routine was significantly correlated with BMD, but sleep time and sports club activities were not. BMD among juveniles who attained secondary sexual characteristics was significantly higher than that of juveniles of the same age who had not attained these characteristics. Calcium intake was significantly lower in senior high school students compared with other grades. Consumption of milk by senior high school boys and junior high school girls was weakly correlated with BMD. Our findings encourage educational interventions to counsel students to avoid weight loss and calcium deficiency. This effective intervention should begin before the higher elementary school, when juveniles have the greatest likelihood for preventing lower peak bone mass and osteoporosis.
    Environmental Health and Preventive Medicine 07/2010; 15(4):222-8. DOI:10.1007/s12199-009-0131-8
  • Hirohisa Imai · H Nakao · H Shinohara · Y Fujii · H Tsukino · R Hamasuna · Y Osada · K Fukushima · M Inamori · T Ikenoue · T Katoh ·
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    ABSTRACT: There are few epidemiological studies of asymptomatic chlamydial infection among students in non-medical settings with minimal bias and improved accuracy; thus, useful data from screening among students are limited. We aimed to obtain accurate epidemiological information about asymptomatic chlamydial infection among students in non-medical settings. A population-based cross-sectional survey of 10,440 >or=18-year-old asymptomatic students who volunteered for a urine screening test for chlamydia was conducted. The prevalences of asymptomatic infection were 9.5% for women and 6.7% for men. Multivariate analysis revealed the risk factors to be a lifetime history of >or=4 sexual partners for women (odds ratio [OR] 3.17) and inconsistent condom use for men (OR 4.18). For both sexes, younger age at first intercourse was associated with a higher rate of inconsistent condom use. This study produced accurate epidemiological information on asymptomatic chlamydial infection. These results may contribute to the establishment of preventive countermeasures against such infection.
    International Journal of STD & AIDS 05/2010; 21(5):362-6. DOI:10.1258/ijsa.2010.010026 · 1.05 Impact Factor
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    ABSTRACT: Background: Smoking is a leading risk factor for a wide variety of diseases ranging periodontitis to cancer. Adults rarely visit their physicians for preventive care. But a survey shows that more than half of adult smokers see a dentist each year for prevention-oriented care. This may put dentists in better position to intervene for smoking cessation. Objective: This study examined Japanese dentists' attitudes and practices regarding smoking cessation. Methods: The study used a survey mailed to dentists (n=1489) in three prefectures (Tokyo, Iwate, Yamanashi) asking about the practitioners' smoking cessation activities, demographic characteristic, barriers to counseling and attitudes towards smoking. Results: The response rate was 57% (n=847). Dentists advised 22% of patients to cease smoking. More than half of them used a pamphlet or similar. However, nicotine replacement therapy was prescribed infrequently (7%). Asked whether a dentist should apply smoking cessation activities in their office 76% replied Yes. The main barrier to cessation counseling was insufficient time, followed by a lack of knowledge and smoking cessation experts to refer to. 85% of respondents had no education or training in promoting smoking cessation. 22% of all responding dentists were smokers. Conclusion: Few dentists conduct smoking cessation activities in their office. Dental professionals should develop a willingness to play a more positive role in relevant smoking cessation activities despite numerous barriers.
    137st APHA Annual Meeting and Exposition 2009; 11/2009

  • Epidemiology 11/2009; 20. DOI:10.1097/01.ede.0000362595.13847.6b · 6.20 Impact Factor
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    H Imai · H Nakao · F Sata · Y Fukuda ·

    Value in Health 10/2009; 12(7). DOI:10.1016/S1098-3015(10)74402-8 · 3.28 Impact Factor
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    H Nakao · I Yoshimi · Y Fukuda · F Sata · H Imai ·

    Value in Health 10/2009; 12(7). DOI:10.1016/S1098-3015(10)74510-1 · 3.28 Impact Factor
  • Hirohisa Imai · Hiroyuki Nakao · Yuichiro Yahata · Fumihiro Sata ·
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    ABSTRACT: [Background] The national health project for lifestyle-related disease control with particular emphasis on metabolic syndrome (central obesity, impaired glucose tolerance, hypertension, dyslipidaemia) was inaugurated in April 2008. However, this project was introduced before its methodologies were adequately established; therefore, an evidence-based health policy is now desired. [Purpose] We carried out a pilot study in 2007 prior to the implementation of public health measures, developed a health guidance program in which community-based nutritional and exercise guidance is incorporated, carried out the program as a trial, and evaluated the program in terms of its validity and feasibility. [Methods] The participants of this program consisted of 311 local residents (135 males and 176 females; mean age, 61.4) with impaired glucose tolerance. A nutritional guidance program, including guidance on such items as suppression of total calories consumed per day, energy from fat of 25% or less, 10 g of salt or less, and 25 g of fiber per day or more, was developed considering the physique of the Japanese and was implemented by the participants. Regarding exercise guidance, they were instructed to walk more than 10,000 steps/day as determined using a pedometer. This comprehensive program was carried out for six months. [Results] After the program’s completion, the participants’ mean weight decreased from 63.8 to 62.1 kg (p<0.001), abdominal circumference from 91.6 to 89.5 cm (p<0.001), and HbA1c level from 5.42 to 5.25% (p<0.001). The percentage of participants whose satisfaction level was either “very satisfactory” or “satisfactory” reached 96.8%. [Discussion] Our comprehensive health guidance program incorporating community-based nutritional and exercise guidance had a significant impact and its feasibility was demonstrated. We obtained our results of the program’s evaluation six months after its implementation; long-term analyses of the effect of the program will be necessary in the future.
    12th World Congress on Public Health World Health Organization; 04/2009

Publication Stats

650 Citations
138.03 Total Impact Points


  • 2006-2015
    • National Institute of Public Health
      Саитама, Saitama, Japan
  • 2014
    • National Institute of Health Sciences, Japan
      Edo, Tōkyō, Japan
  • 2007
    • Shikoku Cancer Center
      Matuyama, Ehime, Japan
  • 2004-2005
    • Miyazaki University
      • Faculty of Medicine
      Миядзаки, Miyazaki, Japan
  • 2002
    • Tokyo Metropolitan Police Hospital
      Edo, Tōkyō, Japan

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