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Original Article, Introduction: Myocardial damage is reported in about 20% to 60% of sepsis cases. The circulatory system in early sepsis is hyperdynamic in state, but with time, cardiac function decreases and shifts toward cardiogenic shock. This study aimed to determine whether an intra-aortic balloon pump (IABP) could be an effective cardiac support for septic cardiomyopathy. Methods: Twelve patients with septic cardiomyopathy who were screened between April 2010 and March 2016 in the Saiseikai Yokohamashi Tobu Hospital Emergency and Critical Care Center were enrolled retrospectively for this observational study. Hemodynamics was evaluated using the following parameters: mean blood pressure; heart rate; catecholamine index; and serum lactate level. These parameters were compared before IABP insertion and at 24 and 72 hours after insertion. Cardiac function was assessed by evaluating the N-terminal pro b-type natriuretic peptide (NT-pro BNP) and left ventricular ejection fraction (LVEF) at days 0, 3, and 7 after intensive care unit admission. Results: The mean blood pressure tended to increase, the heart rate significantly decreased, and the catecholamine index and serum lactate levels decreased significantly after IABP insertion. Nine of the 12 patients survived and showed improved LVEF, which returned to the normal range during the follow-up period. Conclusions: From our experience of 12 cases, we suggest that IABP may be used for septic cardiomyopathy.

Original Article, Introduction: On the basis of the self-similarity of the human body, fractal dimensions can be calculated mathematically. Fractal analysis can also quantitatively express the density and complexity of a structure as a fractal dimension. We hypothesize that the fractal dimensions of ultrasonographic findings would change in thyroid disease. In this study, we explore the possibility of applying fractal analysis to the quantitative evaluation of ultrasonographic findings in thyroid tissue. Methods: This retrospective study used data on 1205 patients who newly received thyroid ultrasonography between April 2004 and March 2016. Patients who were included had one or more of the following: normal thyroid, Graves' disease, Hashimoto's thyroiditis, subacute thyroiditis, adenomatous goiter, or papillary carcinoma. Furthermore, the fractal dimension of thyroid ultrasonography was calculated in sagittal pictures. The region of interest was set along the contour of the thyroid gland, excluding a film. Fractal analysis was performed using box-counting methods. Results: For the normal thyroid gland, there was a significant decrease in the fractal dimensions of both contour and concentration structures, with significant differences compared with the disease groups. Among the thyroid disease groups, papillary carcinoma had the highest fractal dimension. The fractal dimension of the thyroid gland increased with age in the normal group. There were no differences in fractal dimensions by gender. Conclusion: Fractal analysis makes it possible to objectively determine the presence of chronic inflammation in thyroid tissue, but it is difficult to distinguish papillary carcinoma from benign goiter.

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Original Article, Introduction: Low-grade inflammation is associated with important chronic diseases, such as diabetes, cardiovascular disease, and cancer. The neutrophil-lymphocyte ratio (NLR) has been widely used as a biomarker for systemic inflammation. Helicobacter pylori (H. pylori) eradication is widely recommended because H. pylori causes chronic inflammation and increases the risk of developing peptic ulcers and gastric cancer. The aim of this study was to determine the association between H. pylori infection and NLR. Methods: Forty-four patients undergoing upper endoscopy, rapid urease test, and routine blood examination were recruited, and 23 of them were evaluated after eradication therapy. Results: NLR significantly decreased after eradication (p < 0.01). The NLR values were 2.16±0.97 and 1.72±0.65 at baseline and 2 months after eradication, respectively. There was no significant difference in the grade of atrophic gastritis, presence of peptic ulcers, hyperplastic polyps, sex, and age between the patient groups. NLR significantly reduced after H. pylori eradication, and an increase in NLR might depend on systemic inflammation induced by H. pylori infection to a certain degree. Conclusions: Changes in NLR might provide additional information to confirm H. pylori eradication.

Original Article, Introduction: The prognosis of diverticular bleeding is subject to patient comorbidity and medication although colonic diverticular bleeding stopped spontaneously in 70-90% of cases. The aim of the study is to elucidate the risk factors of diverticular rebleeding and to determine a clinical approach that will achieve better outcomes. Methods: We evaluated 140 patients admitted with colonic diverticular bleeding, diagnosed by colonoscopy, from 2004 to 2017. We collected clinical information on age, gender, past history of colonic diverticulitis, comorbidities, ongoing medication, diverticula locations, length of hospital stay, whether the patient required red blood cell transfusions, and the presence of stigmata of recent hemorrhage (SRH) observed by colonoscopy. Results: Frequency analysis revealed that there were no risk factors for recurrent diverticular bleeding both during hospitalization and during outpatient visits after leaving the hospital. There was no significant independent risk factor for transfusion requirements. The odds ratio for prolonged length of hospital stay was 2:1 for use of antithrombotic drugs and 1:7 for alcohol habits. Conclusions: Using antithrombotic agents did not affect rebleeding during hospitalization or transfusion requirements in diverticular bleeding, but prolonged the length of hospital stay. This should induce a delay in restarting antithrombotic agents, possibly resulting in poor prognosis of underlying diseases.

Additional file 1. Suppl. 1 Event-related differences in anthropometry and body composition in male athletes.