Notes

Weakness of β-Thalassemia Heterozygotes to be able to COVID-19.
Corynebacterium simulans was first reported in 2000. Its characteristics such as isolation frequency, specimen types, and antimicrobial susceptibilities are poorly understood, because identification is difficult using conventional methods. We performed a retrospective observational study of 13 and 317 strains of C. simulans and C. striatum, respectively, isolated from consecutive patients at Nagoya University Hospital from January 2017 to December 2018. We analyzed patients' backgrounds, types of specimens, and antimicrobial susceptibilities. Antimicrobial susceptibilities were compared with those of C. striatum. The frequencies of isolation of C. simulans and C. striatum were 3.9% and 96%, respectively. C. simulans was not detected in specimens associated with mucous membranes, such as sputum and secretions from the craniocervical region, which were frequent for C. striatum. C. simulans was mainly detected in the skin (61.5%). All C. simulans isolates were susceptible to anti-MRSA drugs, as well as to numerous other antibiotics, including those that are orally administered. For example, C. simulans was significantly more susceptible to penicillin G, ceftriaxone, and ciprofloxacin than C. striatum (respective susceptibilities 66.7% vs 5.4%, 50.0% vs 4.0%, 66.7% vs 5.9%). There was no significant difference between meropenem and erythromycin, although susceptibility to each was relatively high (100.0% vs 31.7%, 50.0% vs 11.9%). C. simulans was susceptible to numerous orally administered antibiotics and more susceptible to antimicrobial drugs than C. striatum. C. simulans was detected less frequently than C. striatum and was infrequently detected in specimens associated with mucous membranes. These characteristics will aid the selection of optimal antimicrobial therapies.The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with less then 3rd and 3rd - 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between less then 3rd and 3rd - 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.Glottic carcinoma is the most common laryngeal cancer. The outcomes for T1 bulky Glottic carcinoma and T2N0 Glottic carcinoma after radiation therapy alone are unsatisfactory. This study was conducted to evaluate the efficacy and safety of unique concurrent chemoradiotherapy regimen using S-1 for early glottic cancer. Concurrent chemoradiotherapy consisted of 60 Gy in 30 fractions with once-daily, orally administered S-1 exclusively within three to six hours prior to each irradiation. Twenty-one consecutive patients treated with this regimen were retrospectively reviewed. Initial complete remission was achieved in all patients without any subsequent local and/or regional recurrences to the last follow-up. The 4-year local control, overall survival, and disease-free survival rates were all 100%. No significant toxicities were observed, except for three cases with Grade 3 acute dermatitis.This regimen is highly effective and well-tolerated, and these results encourage further research to long-term efficacy and functional preservation.The purpose of this study is to clarify the survival benefit and acceptable extent of surgery for very elderly patients with pancreatic cancer. Patients (n=55) ≥80 years with resectable pancreatic cancer were studied. 29 underwent pancreatectomy, 16 underwent chemotherapy, and 10 received best supportive care. Uni and multivariate analysis were performed to explore predictive factors for overall survival (OS) with surgery and chemotherapy (n=45). Postoperative survival of PD (pancreatoduodenectomy) and DP (distal pancreatectomy) and of PD-PVR (PD with portal vein resection) and PD were compared. OS was equivalent with surgery and chemotherapy (median survival time [MST]; 685 vs. 626 days, respectively; p=0.057); 6 patients surivived ≥3 years after surgery. Pancreatectomy was not a prognostic factor. Survival was significantly worse with PD-PVR than with PD, but equivalent with PD and DP. Within 2 years after PD-PVR, 8 patients have died. Surgery was not a positive prognostic factor for very elderly patients with pancreatic cancer, but was the sole chance for survival ≥3 years. Indication for PD-PVR for very elderly patients should be determined more cautiously compared with that for non-elderly patients.Video-assisted thoracic surgery (VATS) has become widespread in the last 20 years, followed by robot-assisted thoracic surgery (RATS). Few studies compared the learning curve between RATS lobectomy and conventional VATS. This study included 79 RATS lobectomy cases performed in our hospital from November 2015 to October 2019. To estimate the required number for learning, the cumulative sum method, which is to plot a value obtained by sequentially accumulating a difference from a mean value was applied. As a result, the median total operative time and the median console time for all cases were 167 minutes and 138 minutes, respectively. Firstly, for our team, 28 cases were estimated to be required for learning curve for RATS lobectomy. For individual, each surgeon might be learned in only 5 to 6 cases. By contrast, the number of cases for learning VATS lobectomy which was underwent by a 'single' surgeon from 2009 was estimated to be 35 cases. The time to dock from start operation (median 14 minutes) reached plateau in 18 cases, but the time after rollout was median of 18 minutes and there was no significant change from the beginning. In conclusion, RATS lobectomy might be a technique that could be learned in a small number of cases compared to VATS. The results of this study might be helpful for certified surgeons who tried to get started with RATS and for establishing a learning program.This study compared vitamin D sufficiency between indoor and outdoor elite athletes. We also evaluated the association between vitamin D level, body composition, and stress fractures incidence. 27 outdoor elite male collegiate athletes (field hockey players) and 21 indoor elite male collegiate athletes (fencing players) were enrolled. Participants' demographic information including past fractures were recorded. Furthermore, all the athletes' body compositions including percentage of body fat were measured. Blood samples were collected to test serum calcium, phosphorus, and 25(OH)D. levels. Participants were classified into three groups vitamin D sufficiency (serum 25(OH)D levels of ≥30 ng/ml), vitamin D insufficiency (serum 25(OH)D levels of less then 30 ng/ml), and vitamin D deficiency (serum 25(OH)D levels of less then 20 ng/ml). The indoor athletes showed significantly higher mean percentage of body fat than outdoor athletes, 12.2 ± 3.2% and 9.7 ± 3.7%, respectively. The serum 25(OH)D levels of indoor athletes were significantly lower than those of outdoor athletes, 15.3 ± 3.3 ng/mL and 24.9 ± 4.5 ng/ml, respectively (P less then 0.001). Furthermore, the indoor athletes showed a significantly higher rate of vitamin D deficiency than the outdoor athletes, 19 of 21 (90.5%) and 5 of 27 (18.5%), respectively (P less then 0.001). The cohort of outdoor athletes with stress fractures' history had significantly lower serum 25(OH)D levels than those without history of any fractures, 21.1 ± 4.3 ng/ml and 26.4 ± 3.0 ng/ml, respectively (P less then 0.05). In conclusion, a majority of the indoor elite athletes were vitamin D-deficient. The serum 25(OH)D levels were significantly higher in outdoor elite athletes. However, lower serum 25(OH)D levels might be associated with stress fractures among outdoor athletes.Hadal trenches represent the deepest part of the ocean and are dynamic depocenters with intensified prokaryotic activity. Here, we explored the distribution and drivers of prokaryotic and viral abundance from the ocean surface and 40 cm into sediments in two hadal trench regions with contrasting surface productivity. In the water column, prokaryotic and viral abundance decreased with water depth before reaching a rather stable level at ~ 4000 m depth at both trench systems, while virus to prokaryote ratios were increasing with depth, presumably reflecting the declining availability of organic material. CK-666 cost Prokaryotic and viral abundances in sediments were lower at the adjacent abyssal sites than at the hadal sites and declined exponentially with sediment depth, closely tracking the attenuation of total organic carbon (TOC) content. In contrast, hadal sediment exhibited erratic depth profiles of prokaryotes and viruses with many subsurface peaks. The prokaryotic abundance correlated well to extensive fluctuations in TOC content at centimeter scale, which were likely caused by recurring mass wasting events. Yet while prokaryotic and viral abundances cross correlated well in the abyssal sediments, there was no clear correlation in the hadal sites. The results suggested that dynamic depositional conditions and higher substrate availability result in a high spatial heterogeneity in viral and prokaryotic abundances in hadal sediments in comparison to more stable abyssal settings. We argue that these conditions enhance the relatively importance of viruses for prokaryotic mortality and carbon recycling in hadal settings.A referendum on the Cannabis Legalisation and Control Bill was held in New Zealand. The Bill was meant to oversee government control over the production, supply and use of cannabis and reduce cannabis-related harm. Public health control was proposed over cannabis market by imposing licenses and cultivation, the quality and strength of marketed cannabis, and sale restrictions. Under this Bill, cannabis was only meant to be available to adults aged over 20 years through licenced stores. The potency of cannabis was to be limited. Cannabis use and was going to be permitted in private homes and specifically licensed premises. The Electoral Commission announced on 6 November 2020 that 50.7% of voters opposed the Bill and 48.4% supported it. Despite the outcome of the referendum, legalisation of cannabis may remain a live issue for many people, and doctors need to have an informed view about the impact of legalisation on mental health conditions. Experience from other countries shows that access to and potency of cannabis increased with legalisation.
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