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A 62-year-old man with diabetes mellitus and a two-day history of fever and dyspnea presented at our hospital. He was diagnosed with community-acquired pneumonia (CAP), septic shock, and respiratory failure. Sputum Gram staining revealed Gram-negative coccobacilli. Based on the Gram staining findings and history, Acinetobacter baumannii was considered as one of the causative organisms of his CAP. Consequently, he was successfully treated with the initial administration of meropenem. We suggest that A. baumannii should be considered as one of the possible causative organisms of CAP based on a fulminant clinical course, and the presence of Gram-negative coccobacilli.

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prognostic value over conventional measures for predicting major adverse cardiac events. 6 Moreover, layer-specific myocardial strain can be measured in the endocardial, transmural, and epicardial left ventricular (LV) layers using this technique. 7 Further, intraventricular pressure differences (IVPD) and intraventricular pressure gradients (IVPG) can be measured on color M-mode imaging to accurately and non-invasively estimate active suction. 8-10 IVPD has an excellent correlation with Tau index, which is a gold standard, although Tau index is an invasive method of evaluating diastolic function. 11 In 2010, the International Association of Diabetes and Pregnancy Study Groups recommended new criteria for the diagnosis and classification of hyperglycemia during pregnancy, 12 recognizing the increasing prevalence of undi-G estational diabetes mellitus (GDM) increases the risk of numerous complications in the neonate, including both structural and functional cardiovascular disease. Infants, with structurally normal hearts, born to mothers with GDM (IGDM) may develop transient myocardial hypertrophy and associated systolic and diastolic dysfunction. 1 When present, IGDM with hypertrophic cardiomyopathy (HCM) tends to spontaneously regress in the first few months of life, 2 but asymptomatic IGDM without cardiac hypertrophy develop subclinical decreases in systolic and diastolic myocardial function. 3 Recently, new technology has been developed to estimate cardiac systolic and diastolic function, including 2-D speckle tracking echocardiography (2DST)-derived strain imaging. 4,5 Additionally, 2DST deformation imaging has superior Background: This study compared the myocardial performance of infants born to mothers with gestational diabetes mellitus (IGDM) and without GDM (controls) under the new GDM definitions. Methods and Results:The subjects consisted of 36 IGDM and 39 control infants. GDM diagnosis was based on oral glucose tolerance test during pregnancy or the presence of diabetes prior to the current pregnancy. Between-group infant cardiac function was determined and compared using 2-D speckle tracking analysis, intraventricular pressure difference (IVPD) and IVP gradient (IVPG), using color M-mode Doppler imaging. IVPD and IVPG were higher in IGDM than in the controls, particularly the mid-apical IVPG. The global circumferential strain (GCS) and endocardial GCS were higher in IGDM than in controls. Increased maternal glycated hemoglobin was correlated with reduced transmural and epicardial GCS in the IGDM. Maternal maximum fasting blood sugar had a mild, positive correlation with IVPD and IVPG. Conclusions:Ventricular sucking force, measured as the IVPD, IVPG, and endocardial GCS, were higher in IGDM than in the controls. A hyperglycemic environment during pregnancy leads to impaired cardiac performance in IGDM, compared with control infants. IGDM might have favorable systolic and diastolic cardiac performance due to cardiac metabolic adaptations occurring before poor glucose control causes impaired cardiac per...

To protect against COVID-19, SARS-CoV-2 vaccines have been widely used. Besides anaphylaxis, some less severe adverse effects may occur at higher frequencies. It remains unclear whether present or past histories of allergic diseases exert effects on local and systemic reactions. We conducted a questionnaire survey among workers in our hospital. We analyzed the adverse effects occurring after the first and second doses of the Pfizer–BioNTech vaccine in 955 subjects. The presence or absence of local injection reactions and systemic reactions (headache, fatigability, fever, muscle pain, and joint pain) was questioned. The intensities of these reactions were graded on a scale of 0–4 (except fever) or 0–2 (fever). The allergic diseases that we focused on were bronchial asthma, atopic dermatitis, food allergy, pollinosis, and hand eczema. For the systemic reactions, fatigability after the first dose tended to be more severe in the bronchial asthma than in the non-allergic group. Headache, joint pain, and fever tended to be more severe in the food allergy than in the non-allergic group after the second dose. For the local skin reactions, atopic dermatitis subjects tended to show rather less severe local skin reactions after the second dose. The results contribute to the guidelines for the care of individuals with different allergy histories, so that they may safely receive their vaccine.