著者
Yurika Iwasawa Naoto Hosokawa Mariko Harada Satoshi Hayano Akihiko Shimizu Daisuke Suzuki Kei Nakashima Makito Yaegashi
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.0787-18, (Released:2018-09-12)
参考文献数
20
被引用文献数
8

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.
著者
Satoru Iwashima Satoshi Hayano Yusuke Murakami Aki Tanaka Yumiko Joko Shuji Morikawa Mayumi Ifuku Takeshi Iso Ken Takahashi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.9, pp.378-388, 2019-09-10 (Released:2019-09-10)
参考文献数
59
被引用文献数
5

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 performance.