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The article presents a case study of a woman aged in her 70s who was diagnosed with COVID-19 and transferred to the hospital (Oita University Hospital, Oita, Japan) because of persistent dyspnea for 3 days. She had several pre-existing cardiovascular diseases, including patent foramen ovale and ventricular septal defect. It notes that she was successfully treated for acetaminophen induced non-anaphylactic shock.

Abstract: Background: Patient‐reported outcomes of implantable cardioverter defibrillator (ICD), such as those with shock anxiety, have emerged as important endpoints that are related to quality of life (QOL), but they have not been well studied in a sample of the Japanese population. Therefore, we prospectively examined changes in shock anxiety in a large sample of Japanese patients with an ICD. Methods: We recruited 214 consecutive patients with an ICD who visited the outpatient clinic. At registration and 12 months later, all patients completed the Florida Shock Anxiety Scale (FSAS) questionnaire to allow us to examine changes in shock anxiety over the course of the first year after registration. Results: During the 12‐month follow‐up period, 10.5% of the patients received ICD shock therapy. Female sex, secondary prevention, and experience of ICD shock therapy were associated with high FSAS scores at registration. The FSAS scores in both patients with appropriate and inappropriate shock were significantly higher at the 12‐month follow‐up interval than at registration, and there was no significant difference in the extent of changes in FSAS scores (Δ = 5.2 ± 5.1 and Δ = 6.3 ± 9.9, respectively, P = 0.62). Conclusions: Female sex, secondary prevention, and experience of ICD shock therapy are important risk factors affecting shock anxiety in Japanese patients. Attention should be paid to the after‐effects of ICD shock in these patients, regardless of the shock type, with particular attention to women and patients who require secondary prevention. [ABSTRACT FROM AUTHOR]

The admission shock index (SI) enables prediction of short-term prognosis. This study investigated the prognostic implications of admission SI for predicting long-term prognoses for acute myocardial infarction (AMI). The participants were 680 patients with AMI who received percutaneous coronary intervention. Shock index is the ratio of heart rate and systolic blood pressure. Patients were classified as admission SI <0.66 (normal) and ≥0.66 (elevated; 75th percentile). The end point was 5-year major adverse cardiac events (MACEs). Elevated admission SI was seen in 176 patients. Peak creatine kinase levels were significantly higher and left ventricular ejection fraction was lower in the elevated SI group, which had a worse MACEs. In multivariate Cox regression analysis, SI ≥0.66 was a risk factor for MACE. Elevated admission SI was associated with poorer long-term prognosis. [ABSTRACT FROM AUTHOR]

Late-onset circulatory collapse ( LCC) is a refractory hypotension occurring after the early neonatal period (>day 7), in very low-birthweight infants. Typically, infants stabilized within the early neonatal period develop sudden onset of circulatory collapse after the early neonatal period. The underlying pathophysiology of LCC is considered to be relative adrenal insufficiency, which is well known in Japan, but is not widely accepted in North America or Europe. The current increase in LCC in Japan suggests that the principal trigger is related to recent trends in neonatal medicine and/or newly introduced treatments for preterm infants, but the pathophysiology has not been fully elucidated. In this review, based on current knowledge regarding LCC, the pathophysiology is discussed. [ABSTRACT FROM AUTHOR]

Background The lack of an accurate scoring system for pediatric acute pancreatitis could cause delays in appropriate clinical management and increase the risk of progressive life-threatening complications. We investigated a modified Ministry of Health, Labour and Welfare of Japan ( JPN) scoring system that uses pediatric systemic inflammatory response syndrome ( SIRS) score, age, and weight to establish a more useful scoring system for children. Methods A retrospective chart review was conducted of pediatric patients with acute pancreatitis who were admitted to Juntendo University Hospital between 1985 and 2011. The sensitivity, specificity, and positive and negative predictive values of the pediatric JPN scoring system were calculated and then compared with those of previously developed scoring systems. Results The patient group consisted of 145 patients (88 girls, 57 boys). The pediatric JPN score had greater sensitivity (80%) than the Ranson (60%), modified Glasgow (50%), and De Banto (60%) scores. The specificity was 96% for the pediatric JPN score, 94% for the Ranson score, 99% for the modified Glasgow score, and 86% for the De Banto score. Conclusion The pediatric JPN score can be used to predict severe acute pancreatitis during the initial medical assessment. [ABSTRACT FROM AUTHOR]

Background Several drugs, when used chronically in very preterm infants, are considered to be associated with the development of late-onset circulatory collapse ( LCC), which can lead to neurodevelopmental impairment. Despite its clinical importance, conclusive risk factors for LCC have yet to be identified. The aim of the present study was to investigate the relationship between LCC and diuretics, methylxanthines, levothyroxine, and sodium chloride. Methods Infants born at <28 weeks gestational age were enrolled and divided into two groups: the LCC group and the non- LCC group. Use of diuretics, methylxanthines, or levothyroxine, and the sodium intake in each infant were recorded. We then determined if these represented primary risk factors associated with the development of LCC, using multivariate analysis to exclude confounding factors. Results Thirty-seven preterm infants were eligible for this study. LCC developed in 10 infants; 27 infants did not develop the disease. Only methylxanthine was significantly associated with a decrease in the incidence of LCC (odds ratio, 0.04; P < 0.05). We also observed a significant positive correlation between sodium intake and the period from diuretic treatment to LCC onset. Conclusions Methylxanthine use was significantly associated with LCC onset. Diuretics may have the ability to provoke LCC through sodium wasting, resulting in a negative balance of the electrolyte. The incidence of LCC could be lowered by paying particular attention to infants' sodium balance, and by aggressive methylxanthine treatment. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluates the effects of Histophilus somni vaccination among Japanese Black Calves. The study is undertaken througn an analysis of the changes in rectal temperature, the levels of tumor necrosis factor-alpha and othet clinical signs of the calves. The results of the study suggest that the sex and age of the calves are associated with the sex and age of the calves.

Objective:To characterize the risk factors for late-onset circulatory collapse (LCC) in preterm infants responsive to corticosteroid therapy and evaluate the long-term neurological prognosis.Study Design:A retrospective case-control study for preterm infants (32 weeks' gestation) admitted to our neonatal intensive care unit from 1994 through 2002.Result:Sixty-five infants (11%) were diagnosed with LCC. Infants with a shorter gestation and lower birth weight had a higher incidence of LCC. LCC infants had a significantly lower 1-min Apgar score, significantly higher incidence of severe intraventricular hemorrhage, chronic lung disease, and postnatal periventricular leukomalacia, and significantly longer duration of ventilation use, oxygen use, and hospital stay. Somatic growth at 36 weeks' postmenstrual age was poorer in infants with LCC than without LCC (controls). LCC infants were significantly more likely than controls to have cerebral palsy at 3 years.Conclusion:LCC is associated with poor neurodevelopmental outcomes. Prevention of LCC can lead to improved neurological prognoses. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest. Methods: From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest. The primary outcome measure was the 1-month rate of survival with minimal neurologic impairment. A multivariate logistic-regression analysis was performed to assess factors associated with a good neurologic outcome. Results: A total of 312,319 adults who had an out-of-hospital cardiac arrest were included in the study; 12,631 of these patients had ventricular fibrillation and had an arrest that was of cardiac origin and that was witnessed by bystanders. In 462 of these patients (3.7%), shocks were administered by laypersons with the use of public-access AEDs, and the proportion increased, from 1.2% to 6.2%, as the number of public-access AEDs increased (P<0.001 for trend). Among all patients who had a bystander-witnessed arrest of cardiac origin and who had ventricular fibrillation, 14.4% were alive at 1 month with minimal neurologic impairment; among patients who received shocks from public-access AEDs, 31.6% were alive at 1 month with minimal neurologic impairment. Early defibrillation, regardless of the type of provider (bystander or emergency-medical-services personnel), was associated with a good neurologic outcome after a cardiac arrest with ventricular fibrillation (adjusted odds ratio per 1-minute increase in the time to administration of shock, 0.91; 95% confidence interval, 0.89 to 0.92; P<0.001). The mean time to shock was reduced from 3.7 to 2.2 minutes, and the annual number of patients per 10 million population who survived with minimal neurologic impairment increased from 2.4 to 8.9 as the number of public-access AEDs increased from fewer than 1 per square kilometer of inhabited area to 4 or more. Conclusions: Nationwide dissemination of public-access AEDs in Japan resulted in earlier administration of shocks by laypersons and in an increase in the 1-month rate of survival with minimal neurologic impairment after an out-of-hospital cardiac arrest. N Engl J Med 2010;362:994-1004. [ABSTRACT FROM AUTHOR]

This article examines historical transformations of Japanese collective memory of the atomic bombing of Hiroshima by utilizing a theoretical framework that combines a model of reiterated problem solving and a theory of cultural trauma. I illustrate how the event of the nuclear fallout in March 1954 allowed actors to consolidate previously fragmented commemorative practices into a master frame to define the postwar Japanese identity in terms of transnational commemoration of "Hiroshima." I also show that nationalization of trauma of "Hiroshima" involved a shift from pity to sympathy in structures of feeling about the event. This historical study suggests that a reiterated problem-solving approach can be efficacious in analyzing how construction of national memory of a traumatic event connects with the recurrent reworking of national identity, on the one hand, and how a theory of cultural trauma can be helpful in exploring a synthesis of psychological and sociological approaches to commemoration of a traumatic event, on the other. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods: We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results: We identified 3550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8%, and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: age ≥ 65 years (adjusted OR 3.36); pedestrian accident (adjusted OR 1.94); fall from height (adjusted OR 1.91); shock on arrival (adjusted OR 4.02); concomitant injuries to the head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90); AAST grades III–V (adjusted ORs 1.42, 2.16, and 5.55); and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: shock on arrival (adjusted OR 1.98), concomitant injuries to the thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grades III, IV, and V (adjusted ORs 18.40, 113.89, and 468.17), and emergency abdominal angiography (adjusted OR 0.28). Conclusions: We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population. [ABSTRACT FROM AUTHOR]