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Background: Atrial fibrillation (AF) is an established risk factor for ischemic stroke in a general population. However, its impact in patients on hemodialysis (HD), a group with a high risk for stroke, is still controversial. Here we examined this issue in a Japanese cohort. Methods: This study was designed as a multicenter cohort study. HD patients (n = 1,067) were enrolled from 22 institutes in January 2009 and followed up for 3 years. Patients with missing data (n = 196) or kidney transplantation (n = 4) were excluded, and 867 patients contributed to the analysis of the risk of new-onset of ischemic stroke. Results: At baseline, AF was observed in 123 patients (14.2%, AF group) and not in the others (n = 744: 85.8%, non-AF group). During a follow-up period of 31.3 months, the cumulative incidence rate for ischemic stroke was significantly higher in the AF group than in the non-AF group (6.5% vs. 2.9%, p < 0.05). In Cox regression analysis, AF was a significant independent risk factor for new-onset of ischemic stroke after adjustment for age, sex, prior history of ischemic stroke, use of warfarin, dialysis vintage, comorbidity of diabetic nephropathy, and interdialytic weight gain (hazard ratio 2.17–2.68). Conclusion: Present analyses using comprehensive adjustment for multiple confounders, including prior history of ischemic stroke, indicated that AF independently increases the risk of new-onset of ischemic stroke by more than twofold in Japanese HD patients. [ABSTRACT FROM AUTHOR]

Introduction: Neutralizing antibodies have been approved for coronavirus disease 2019 (COVID-19) treatment; however, no study has clarified the link among their neutralizing effect in vitro, the period of infectious virus shedding, and symptoms in the acute phase. Here, we aimed to assess the duration of virus shed and fever in patients with mild COVID-19 stratified by their characteristics and type of neutralizing antibody administered., Methods: We evaluated the efficacy of neutralizing antibodies in terms of the duration of infectious virus excretion and fever in three groups: patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta strain treated with REGEN-CoV2 (REGN-CoV2 group) and patients infected with Omicron strain treated with S309 (S309 group) or untreated (untreated group)., Results: REGN-CoV2 was significantly more effective in reducing viral load than S309; furthermore, S309 treatment did not show a significant reduction in fever duration when compared to no treatment. Mutations in the spike protein receptor-binding domain may reduce the binding ability of REGN-CoV2 and S309: the 50% inhibitory concentration (IC 50 ) of REGN-CoV2 for the conventional and Delta strains was 0.013 and 0.019 μg/mL, respectively, and that of S309 for the Omicron strain was 53.1 μg/mL., Conclusion: Laboratory evaluations are helpful for analyzing the clinical efficacy of neutralizing antibodies, and this study will help in not only considering effective treatments for COVID-19 but also addressing the threat of future unknown viral infections., Competing Interests: Declaration of Competing Interest: none., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Acute chest syndrome (ACS), characterized by fever, respiratory symptoms, and new pulmonary infiltration, is a serious complication of sickle cell disease (SCD). Regardless of the etiology, the conventional treatment options for ACS include empirical antibiotic therapy, the administration of analgesics, and red cell transfusion. The indications and methods of red cell transfusion are critical. We herein report the case of a 26-year-old African-American man with SCD who developed ACS and who was successfully treated with manual exchange transfusion. Despite increasing globalization, SCD remains extremely rare in Japan. Manual exchange transfusion can be performed easily anywhere and should be considered for treating SCD patients presenting with ACS.