Abstract Background The severe acute respiratory syndrome coronavirus 2 Omicron variant has a low rate of serious illness, is highly contagious, and has spread rapidly since January 2022. The number of severe cases and deaths remains problematic. Here, we aimed to elucidate the coagulation pathology of Omicron‐infected patients using rotational thromboelastometry. Methods Patients with coronavirus disease 2019, hospitalized and treated from January 2021 to April 2022, were included. The Alpha–Delta and Omicron groups were defined during admission. Blood tests, clinical course, and rotational thromboelastometry measurements were compared using a propensity score‐matched cohort. Results Both groups had 21 patients each. Lactate dehydrogenase (Alpha–Delta group [interquartile range] vs. Omicron group [interquartile range]; 449 [368–518] U/L vs. 241 [196–398] U/L, p = 0.01) and ferritin (1428 [1145–3061] ng/dl vs. 481 [188–881] ng/dl, p = 0.0002) levels were significantly lower in the Omicron group. In rotational thromboelastometry, the thrombus hardness indexes FIBTEM A5 (29 [23–34] mm vs. 23 [18–28] mm, p = 0.034) and maximum clot firmness (34 [27–40] mm vs. 26 [21–33] mm, p = 0.021) were significantly lower in the Omicron group, whereas the fibrinolysis index FIBTEM LI60 (98 [92–100] % vs. 100 [100–100] %, p = 0.0082) was higher. Conclusion Severe coagulation abnormalities may be less likely in Omicron‐infected patients than in those infected with the previous Alpha and Delta variants.
Abstract Background Atrial fibrillation (AF) is a frequent arrhythmia in pacemaker patients and is associated with poor quality of life and increased risks of heart failure, dementia, stroke, and death. The MINERVA trial has shown that the combination of 3 pacing algorithms – 1) atrial antitachycardia pacing (aATP), 2) atrial preventive pacing and 3) managed ventricular pacing (MVP) - delays progression to persistent and permanent AF, compared with standard DDDR pacing mode and with MVP mode, in pacemaker patients with AF history. Purpose We performed a comparative non randomized evaluation to confirm the hypothesis that aATP is the main driver of persistent/permanent AF reduction independently on the effect of preventive atrial pacing. Methods Thirty-one Italian and Japanese Cardiology centers included consecutive dual-chamber pacemaker patients with AF history. aATP was programmed in all patients while preventive atrial pacing was not enabled. Comparison was made with all the 3 groups in MINERVA randomized trial. The main endpoint was incidence of AF longer than 7 consecutive days, as detected by device diagnostics. Results A total of 146 patients (73 years old, 54% male) were included and followed for a median observation period of 31 months. The 2-year incidence of AF>7 days was 12% in the aATP group, very similar to that found in the arm of the MINERVA trial with aATP enabled (13.8%, p=0.732) and significantly lower than AF incidence found in the MINERVA Control DDDR arm (25.8%, p=0.012) and in the MINERVA MVP arm (25.9%, p=0.025). Conclusions In a real-world population of dual-chamber pacemaker patients with AF history, use of aATP was associated with low incidence of persistent AF during follow up, highlighting that the positive results of the MINERVA trial are related to the effectiveness of aATP rather than to the effects of preventive atrial pacing. Funding Acknowledgement Type of funding source: None
Plasma concentrations of atrial natriuetic peptide (ANP), one of the key hormones involved in the regulation of body fluid and blood pressure, 1 have been shown to be correlated with the severity of acute lung injury.
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Combined detailed analysis of patient characteristics and treatment as well as bacterial virulence factors, which all play a central role in the cause of infections leading to severe illness, has not been reported. We aimed to describe the patient characteristics (Charlson comorbidity index [CCI]), treatment (3-h bundle), and outcomes in relation to bacterial virulence of Streptococcus pneumoniae and beta-hemolytic Streptococcus (BHS).This sepsis primary study is part of the larger Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) study, a multicenter, prospective cohort study. We included patients diagnosed with S. pneumoniae and BHS sepsis and examined virulence, defining the high-virulence factor as follows: S. pneumoniae serotype 3, 31, 11A, 35F, and 17F; Streptococcus pyogenes, emm 1; Streptococcus agalactiae, III; and Streptococcus dysgalactiae ssp. equisimilis, emm typing pattern stG 6792. Included patients were divided into high and normal categories based on the virulence factor.Of 1,184 sepsis patients enrolled in the Japanese Association for Acute Medicine's FORECAST study, 62 were included in the current study (29 cases with S. pneumoniae sepsis and 33 with BHS). The CCI and completion of a 3-h bundle did not differ between normal and high virulence groups. Risk of 28-day mortality was significantly higher for high-virulence compared to normal-virulence when adjusted for CCI and completion of a 3-h bundle (Cox proportional hazards regression analysis, hazard ratio 3.848; 95% confidence interval, 1.108-13.370; P = 0.034).The risk of 28-day mortality was significantly higher for patients with high-virulence compared to normal-virulence bacteria.
The person who injures his cervical vertebra in the traffic accident goes up to about as many as 500,000 people a year, and immediate clarification is requested in recent years. To clarify the cervical vertebra sprain, the present study executed living body information on electromyogram and a movable angle and questionnaires of NDI and the accident situation, etc. for the patient with the traffic accident. The tracking experiment of one testee who appealed for the pain to the monk cap muscle side after 487 days was executed three times in the experiment 155 days later 47 days after the wound of receiving. The NDI value would decrease in 487 days as a result of the experiment, and electromyogram showed the change. Moreover, a movable angle of the neck showed the increasing tendency.
