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poreal life support (ECLS), there is no standard policy regarding prophylactic antibiotics for patients on ECLS, including ECPR, because of the lack of studies on infectious complications during ECPR. 12 Therefore, we hypothesized that initiation of ECPR is a risk factor for infectious complications. To address this hypothesis, this observational study examined the association between initiation of ECPR and the incidence of infectious complications, such as pneumonia, sepsis, and bacteremia, in patients with OHCA who received TTM, and also assessed infection management during ECPR. Methods Patients This retrospective study used data from hospital medical records of patients with OHCA treated with TTM who E xtracorporeal cardiopulmonary resuscitation (ECPR) followed by targeted temperature management (TTM) has demonstrated significantly better outcome in patients with out-of-hospital cardiac arrest (OHCA). 1-4 Despite this surprising outcome, however, critical complications, such as infection, hemorrhage, and ischemia, sometimes occur during ECPR management in the intensive care unit (ICU). 5-7 Although a few observational studies did not note a significant association between infection complications and mortality in patients with OHCA or those managed with extracorporeal membrane oxygenation (ECMO), 8,9 and several observational studies examining infection have been conducted in patients with ECPR, 2,5,10,11 the details of infectious complications during ECPR have not been fully examined. According to the Extracorporeal Life Support Organization (ELSO) general guidelines for all extracor

Intake of supplemental vitamin A prior to and/or during pregnancy may worsen child behavior at 3 years of age.

Background—This study aimed to explore whether living alone or with a spouse only affects the short-term prognosis of acute ischemic stroke patients. Methods—We conducted a retrospective cohort study of patients with a diagnosis of acute ischemic stroke from April 2014 to February 2019 in Japan. The primary outcome was defined as worsening by at least one grade on the modified Rankin Scale (mRS). The secondary outcome was set as the degree of worsening on the mRS. The outcomes were compared between three groups of patients: (1) those living alone (ALONE), (2) those living with their spouse only (SPOUSE), and (3) OTHERs. Results—In total, 365 patients were included in this study: 111 (30%) ALONE, 133 (36%) SPOUSE, and 121 (33%) OTHERs. Cardiogenic embolisms were observed more frequently in ALONE than in OTHERs. The primary outcome occurred in 88 (79.3%) patients in ALONE and in 96 (72.2%) patients in SPOUSE, both of which were higher than the 72 (59.5%) in OTHERs. After adjusting with 19 variables, the risk of worsening was higher in ALONE (odds ratio (OR): 2.90, 95% confidence interval (CI): 1.50–5.58) and SPOUSE (OR: 1.83, 95% CI: 1.00–3.33) compared with OTHERs. Conclusions—In patients with acute ischemic stroke, not only living alone but also living with a spouse only may be associated with a worse short-term prognosis, independent of other cardiovascular risks.