Signal an Russland: Pistorius eröffnet maritimes Nato-Hauptquartier in Rostock https://wp.me/paI27O-5NV

https://web.de/magazine/politik/signal-russland-pistorius-eroeffnet-maritimes-nato-hauptquartier-rostock-40256440

„Für die maritime Sicherheit und den Schutz der Nato-Ostflanke sei das Hauptquartier „von unschätzbarem Wert“, sagte der Minister in Rostock. „Es führt in Frieden, Krise und Krieg die Operation von Seestreitkräften.“

Albert Einstein sagte im Manifest von Russell und Einstein, angesichts der Atomwaffen dürfen keine Kriege mehr geführt werden, da jeder Krieg zu einem Atomkrieg und zur Selbstvernichtung eskalieren kann.  Das sehen wir jetzt. Unsere einfältigen, USA-hörigen Politiker  glauben sich, solche Verstöße herausnehmen zu können bei Gefahr des Untergangs. Biden nennt Putin einen Mörder, dabei klebt an seinen Händen mehr Blut als an dem von Putin. Putin aber bleibt diplomatisch und leistet sich keine solchen diplomatischen Frechheiten. Wir haben Gorbatschow versprochen, dass wir keine Natosoldaten in der ehemaligen DDR stationieren und es steht auch glaube ich im 2.+4 Vertrag,  jetzt gründen wir stolz eine Nato Hauptquartier in Rostock.

______________________________________________________________

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ArticlesVolume 76102809October 2024Open access

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Cardiac manifestations and outcomes of COVID-19 vaccine-associated myocarditis in the young in the USA: longitudinal results from the Myocarditis After COVID Vaccination (MACiV) multicenter study

Supriya S. Jain^a Sjain7@nymc.edu ∙ Steven A. Anderson^b ∙ Jeremy M. Steele^c ∙ Hunter C. Wilson^d ∙ Juan Carlos Muniz^e ∙ Jonathan H. Soslow^f∙ et al. Show more

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Summary

Background

We aimed to study the clinical characteristics, myocardial injury, and longitudinal outcomes of COVID-19 vaccine-associated myocarditis (C-VAM).

Methods

In this longitudinal retrospective observational cohort multicenter study across 38 hospitals in the United States, 333 patients with C-VAM were compared with 100 patients with multisystem inflammatory syndrome in children (MIS-C). We included patients ≤30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. The primary outcome was presence of myocardial injury as evidenced by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging.

Findings

Patients with C-VAM were predominantly white (67%) adolescent males (91%, 15.7 ± 2.8 years). Their initial clinical course was more likely to be mild (80% vs. 23%, p < 0.001) and cardiac dysfunction was less common (17% vs. 68%, p < 0.0001), compared to MIS-C. In contrast, LGE on CMR was more prevalent in C-VAM (82% vs. 16%, p < 0.001). The probability of LGE was higher in males (OR 3.28 [95% CI: 0.99, 10.6, p = 0.052]), in older patients (>15 years, OR 2.74 [95% CI: 1.28, 5.83, p = 0.009]) and when C-VAM occurred after the first or second dose as compared to the third dose of mRNA vaccine. Mid-term clinical outcomes of C-VAM at a median follow-up of 178 days (IQR 114–285 days) were reassuring. No cardiac deaths or heart transplantations were reported until the time of submission of this report. LGE persisted in 60% of the patients at follow up.

Interpretation

Myocardial injury at initial presentation and its persistence at follow up, despite a mild initial course and favorable mid-term clinical outcome, warrants continued clinical surveillance and long-term studies in affected patients with C-VAM.

Funding

The U.S. Food and Drug Administration.

Keywords

1. Myocarditis
2. COVID-19 vaccine-associated myocarditis
3. Cardiac MRI
4. Myocardial injury
5. LGE late gadolinium enhancement
6. MIS-C multisystem inflammatory syndrome in children

Research in context

Evidence before this study

In August 2021, we published the first report of a robust pediatric cohort with COVID-19 vaccine-associated myocarditis (C-VAM), systematically studied by cardiac magnetic resonance imaging (CMR) and demonstrating myocardial injury as evidenced by late gadolinium enhancement (LGE). A PubMed search from 03/01/2021 to 9/30/2021, using the terms “COVID-19 vaccine myocarditis” AND “late gadolinium enhancement” AND “outcome” produced only two results, including our study above. No literature existed on the sequelae of C-VAM or the prognosis of LGE in these patients. We thus embarked on a larger multicenter longitudinal study to comprehensively evaluate the cardiac manifestations and outcomes of C-VAM, especially the evolution of myocardial damage in children, adolescents, and young adults.

Added value of this study

This study not only provides a detailed phenotypic clinical characterization of C-VAM in 333 children, adolescents, and young adults, but also includes important longitudinal myocardial tissue information in vaccine-associated myocarditis and provides data on the cardiovascular outcomes of this complication in a large cohort of patients across 38 sites in the United States. This constitutes the hitherto largest longitudinal study in C-VAM that includes information on myocardial injury and scarring, along with its possible risk factors. The study contrasts C-VAM to multisystem inflammatory syndrome in children (MIS-C), a complication related to COVID-19 with cardiac manifestations.

Implications of all the available evidence

Myocardial injury as evidenced by LGE on CMR imaging is common in patients with myocarditis after mRNA COVID-19 vaccination who present to the hospital, especially in adolescent males. As the long-term significance of this myocardial damage is unclear, continued clinical surveillance of affected patients is warranted.

Introduction

Vaccination has been a public health cornerstone in the mitigation of the SARS-CoV-2 pandemic. Myocarditis is a rare complication of mRNA vaccines.^1–3 Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) imaging is increasingly used to characterize acute myocardial injury and chronic scarring in childhood myocarditis.⁴ We previously reported a high rate of myocardial injury with COVID-19 vaccine-associated myocarditis (C-VAM) in a pediatric pilot cohort.³ The natural history, implications of myocardial injury, and overall prognosis for young patients with C-VAM are insufficiently studied. In other conditions, including viral myocarditis, LGE can be a harbinger of heart failure, dilated cardiomyopathy, arrhythmias, and sudden cardiac death in the future.^5–9 The objectives of this study were to describe the initial clinical and cardiac imaging characteristics of C-VAM, explore possible risk factors for myocardial injury as evidenced by LGE on CMR imaging and evaluate cardiovascular outcomes, in a large cohort of children, adolescents and young adults diagnosed with C-VAM.

Methods

Study design and participants

This was a longitudinal multicenter retrospective observational study across 38 U.S. member institutions of the Myocarditis After COVID Vaccination (MACiV) study network of pediatric cardiologists and CMR experts. We included patients ≤30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings, as per the Centers for Disease Control and Prevention (CDC) criteria¹ (Appendix A). Patients with a plausible alternative etiology for their acute myocarditis, including a recent infectious cause, were excluded. Institutional research ethics boards approved the study at every participating site and waived informed consent requirements. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. Sex and race/ethnicity as reported by patients/parents were retrieved from the medical records. Patients were stratified into younger (5–15 years) and older (16–30 years) age groups, reflecting the sequential vaccine roll-out of the U.S Food and Drug Administration’s Emergency Use Authorizations of mRNA vaccines. To gain a better perspective of the cardiac involvement in myocarditis associated with COVID-19 vaccination, we compared these patients with those who had multisystem inflammatory syndrome in children (MIS-C), based on CDC criteria¹⁰ (Appendix B), an important complication of COVID-19 in the pediatric population with frequent cardiac manifestations that the vaccine seeks to prevent. Patients with MIS-C, who had CMR for myocarditis during the acute or subacute illness were included.

Clinical information and cardiovascular testing

Biomarkers of myocardial injury (troponin), heart failure (brain-natriuretic peptide BNP or NT-pro-BNP) and systemic inflammation (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) were collected. Troponin levels were standardized by dividing them by their respective upper limits of normal to account for assay variability across different institutions and to allow for comparison of different types of troponins (high sensitivity vs. regular). To compare clinical courses, greater than mild clinical severity was defined as ≥1 of the following: presence of ventricular arrhythmias, including ventricular tachy-arrhythmias and higher-grade atrioventricular conduction block, left ventricular (LV) systolic dysfunction on echocardiogram as defined by left ventricular ejection fraction (LVEF) <55%, need for inotropic medications, mechanical ventilation or invasive cardiac support, heart transplantation, or death.

Results from electrocardiograms (ECGs), telemetry, Holter monitoring, echocardiography, and CMR were collected. The CMR findings were verified by site co-investigators with expertise with this modality. CMR information about myocardial edema, hyperemia, myocardial injury and scarring along with ventricular volumes were recorded. Myocardial edema was identified by prolonged T2 time on mapping or high T2 signal intensity visually or by a myocardial/skeletal muscle signal intensity ratio ≥2. Hyperemia was diagnosed by early gadolinium enhancement. The presence of LGE in the myocardium or elevated native T1 times or extracellular volume fraction (ECV) were regarded as markers of myocardial injury.^11–14 T2 and native T1 times as well as ECV values were compared to local or reported pediatric normal ranges.^15,16 To assess the severity of myocardial injury, patients were stratified based on LGE severity. Greater than mild LGE severity was defined as multifocal and/or transmural LGE or ≥4 American Heart Association (AHA) myocardial segments with LGE.¹⁷

Outcomes

The primary outcome was presence of myocardial LGE at initial presentation. Secondary outcomes included the following variables during follow-up: presence of myocardial LGE; presence of cardiovascular symptoms including chest pain, palpitations, shortness of breath, syncope; ventricular or supra-ventricular tachycardias; frequent premature ventricular contractions; second- or third-degree atrioventricular conduction block; LVEF <55% on echocardiogram; listing for heart transplantation; re-hospitalization and/or death attributable to cardiac causes.

Statistical analysis

Continuous data are reported as means and standard deviations, if normally distributed; otherwise as medians and interquartile ranges (IQR). Categorical results are displayed as frequencies and percentages, as appropriate. Only complete data were included for analyses. Pearson’s correlation and Spearman’s rank correlation were used to assess the strength and direction of the relationship between parametric and non-parametric data, respectively. Fisher’s exact test was used for categorical variables; the student’s t-test or the Mann–Whitney U test was used for continuous variables. Tukey’s post-hoc testing was used to adjust for multiplicity. Candidate demographic characteristics were assessed for association with baseline LGE using simple logistic regression and tested for multicollinearity and interaction before being included in multivariable analyses using stepwise forward logistic regression. Relationships with LGE are reported as odds ratios (OR) with 95% Confidence Intervals (CI). The Likelihood ratio test, Hosmer–Lemeshow test, Link test, and receiver operating curves were used to assess model fit, linearity, and discriminatory power, respectively. p-values <0.05 were regarded as significant. All analyses were performed with Stata, v.18 statistical software (StataCorp. 2023. Stata Statistical Software: Release 18. TX: StataCorp LLC).

Role of the funding source

The funder of the study did not have any role in study design, data collection, data analysis, or writing of the report except for its interpretation, review, edit and decision to submit for publication.

Results

Four hundred and thirty-three patients were enrolled, including 333 with C-VAM and 100 with MIS-C. Baseline demographic, clinical characteristics and cardiac imaging findings are summarized in Table 1.

15.10.24   Netanjahu: Krieg ohne Ende! Moshe Zuckermann    https://wp.me/paI27O-5NL

 https://www.youtube.com/watch?v=3yvHx08VVjQ

Das Resumee ist einfach und zugleich höchst deprimierend: Die israelische Politik hat keine politische Lösung des israelisch-palästinensischen Konfliktes,

Dr. Michael Nehls

Ein wichtiger Mann für die Menschheit…

https://michael-nehls.de/

Newsletter KW 42: Das Jungbrunnen-Gen & Pharma- und Forschungsbetrügerei mit globaler Tragweite

Planetare Belastbarkeitsgrenzen  https://wp.me/paI27O-5Nw

Diese Grenzen wurden 2023 festgestellt:

https://www.bmuv.de/themen/nachhaltigkeit/integriertes-umweltprogramm-2030/planetare-belastbarkeitsgrenzen

Auch wikipedia benennt natürlich auch das Problem: Planetare Grenzen

https://de.wikipedia.org/wiki/Planetare_Grenzen

https://wp.me/paI27O-5Nq

zwei Adlige unterhalten sich im Kamingespräch… über unsere Konflikte , vor drei Tagen, am 4.10.24

“Die EU hat den Sinn für die Realität verloren“ – EU-Parlamentarier Michael v. der Schulenburg im Gespräch mit Alexander von Bismark

https://rumble.com/v5im831-die-eu-hat-den-sinn-fr-die-realitt-verloren-eu-parlamentarier-michael-v.-de.html

auch bei Youtube:

https://www.youtube.com/watch?v=eVyNt-zC-OI

drei Stichworte sind ganz, ganz wichtig:

Respekt, Zuhören und Verstehen!

„Die Brics Staaten sind heute die Garantoren für den Weltfrieden, nicht mehr die Amerikaner …“

Sehr gutes Interview mit Harari, sehr geeignet für https://leuchtturmard.de

https://www.youtube.com/watch?v=LlVL3P5aFxE Historiker Yuval Noah Harari: „Die Wahrheit erfordert Forschung

Für einen gerechten Frieden in Palästina und Israel, 18.10.24  https://wp.me/paI27O-5Ng

https://das-palaestina-portal.de   darin:  Israels Zerstörung des Gazastreifens in neuem Dokumentarfilm beleuchtet https://www.youtube.com/watch?v=eVSP_StGMCY

Hier schon zwei Links zum Geschehen von gestern, eine Demonstration vor dem Parlament:

https://www.youtube.com/watch?v=y6dS3fE3gso

Für einen gerechten Frieden in Palästina und Israel

https://www.laithmarouf.com

freepalestine.video

Die Links funktionieren nicht…

 Michael von der Schulenburg   äußert sich zum Ukrainekrieg, dass er sehr gefährlich uns unnötig ist…

https://michael-von-der-schulenburg.com/der-ukrainekrieg-hatte-bei-einhaltung-des-volkerrechts-verhindert-werden-konnen/

All Articles

War in Ukraine

Der Ukrainekrieg hätte bei Einhaltung des Völkerrechts verhindert werden können

Der Beitrag von Ted Postol    https://youtu.be/B_6Sk2eMEB4

VIDEO:  Etwa sechs Monate nach dem 7.Oktober zeigt es den massenhaften israelischen Extremismus

https://www.actvism.org/latest/israelischen-extremismus-film-greenwald/

„In diesem Video, das exklusiv in deutscher Sprache auf unserem Kanal veröffentlicht wird, untersucht der mit dem Pulitzer-Preis ausgezeichnete Journalist Glenn Greenwald die katastrophale humanitäre Lage im Gazastreifen und beleuchtet vor allem die drohende Massenhungersnot der palästinensischen Bevölkerung. In einem Interview mit dem unabhängigen Journalisten Jeremy Loffredo gehen sie auf die systematischen Blockaden durch israelische Siedler ein, die von der israelischen Regierung unterstützt werden und dadurch verhindern, dass Hilfsgüter, einschließlich Lebensmittel und Wasser, den Gazastreifen erreichen. Dieses Video wurde von System Update produziert und am 27. März 2024 auf YouTube veröffentlicht. Wir haben es ins Deutsche übersetzt und veröffentlichen es heute erneut, um zur Meinungsbildung zu diesem Thema in Deutschland und darüber hinaus beizutragen.“

BÜNDNIS FÜR GERECHTIGKEIT ZWISCHEN ISRAELIS UND PALÄSTINENSERN E.V.

eine wichtige Gruppe, die als Vertretung der Zivilgesellschaft partnerschaftlich neben der jüdischen Stimme für einen gerechten Frieden in Nahost steht…

https://bip-jetzt.de

Paul Schreyer: Pandemie-Planspiele – Vorbereitung einer neuen Ära?

Er sagt, dass Pandemiespiele schon im 20. Jahhundert begonnen hatten und systematisch die Coronaübung vorbereitet wurde!

Hochinteressant!

https://www.youtube.com/watch?v=SSnJhHOU_28&t=1010s

Im Gespräch mit Gunnar Kaiser: Dr. Nehls über Impfungen, Vitamin D und echte Immunität https://www.youtube.com/watch?v=GLCqu8kmA30

Fundstücke aus der Aktivenkonferenz des SND (https://www.sicherheitneudenken.de ) 11.-13.10.24

z.B. Hinweis auf die  Friedensklimaausstellung von pax christi Augsburg https://lifeguide-augsburg.de/de/search?search_api_fulltext=friedensklima

gewaltfreie aktion.de

https://www.infosperber.ch/politik/welt/57-arabische-staaten-garantieren-israels-sicherheit/

«57 arabische Staaten garantieren Israels Sicherheit»

Julian Assange äußert sich zum ersten Mal seit seiner Freilassung. Er ist schwer geschädigt durch seine Behandlung und spricht wesentliche Beschuldigungen gegen Obama, noch schlimmere gegen Trump und Biden aus.   https://www.youtube.com/watch?v=WZd3fWYKXvs

Julian Assange BREAKS silence slams CIA https://rumble.com/v5h39wa-julian-assange-breaks-silence-slams-cia-stooge-mike-pompeo-and-maga-wolves-.html

9.10.24:  Das TV-Duell: Sahra Wagenknecht (BSW) vs. Alice Weidel (AfD) & Analyse  https://wp.me/paI27O-5Ma

9.10.24:  Das TV-Duell: Sahra Wagenknecht (BSW) vs. Alice Weidel (AfD) & Analyse https://www.youtube.com/watch?v=JO8ezQNV8Jg wegen „Abschuss“ des Links hier eine Alternative zum Link:

Und noch eine:

https://www.youtube.com/watch?app=desktop&v=PaOwcdnM5eo

ein spannendes Duell der Protagonistinnen der Parteien! Da kann man die wichtigen Unterschiede und die Gemeinsamkeiten sehen und das wird danach von einigen Mainstreamjournalistinnen relativ überzeugend analysiert!

eine weitere Alternative ist dieser Link, in dem allerdings das Duell erst nach einer halben Stunde anfängt: https://rumble.com/v5hzhh9–live-alice-weidel-vs.-sahra-wagenknecht-das-duell-watchparty.html

Dr. Ingrid Pfanzelt beherzte Rede https://www.youtube.com/watch?v=uinXsiwLvLw

„die Wiedervereinigung wäre nicht möglich gewesen ohne die Zustimmung der Sowjets. Sie haben uns damals geglaubt, dass wir aus zwei Weltkriegen eine Lehre gezogen haben und dass wir in Zukunft ein friedliches Volk sein wollen…“ ….