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Acute Medicine & Surgery

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https://www.readbyqxmd.com/read/29657737/flunitrazepam-overdose-induces-brilliant-blue-gastric-fluid
#1
Toshinobu Yamagishi, Akiko Akashi, Hiroshi Shimizu, Takuto Ishida, Takahiro Tanabe, Kazuhiro Sugiyama, Yuichi Hamabe
No abstract text is available yet for this article.
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657736/a-new-mutation-of-congenital-methemoglobinemia-exacerbated-after-methylene-blue-treatment
#2
Fuminori Yamaji, Akio Soeda, Hiroki Shibata, Takuya Morikawa, Kodai Suzuki, Shozo Yoshida, Shinji Ogura
Case: Methylene blue is useful for the treatment of methemoglobinemia. However, even after the patient's methemoglobin (metHb) rate has improved, careful observation is important because they could have undiagnosed congenital methemoglobinemia. In this case, a 67-year-old man underwent gastrointestinal endoscopy with the use of lidocaine for local anesthesia. During the examination, he complained of dyspnea and had low SpO2 despite normal PaO2 and SaO2 . He was transferred to our department as a suspected case of acquired methemoglobinemia...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657735/necrotizing-enterocolitis-associated-with-clostridium-butyricum-in-a-japanese-man
#3
Yukio Sato, Dai Kujirai, Katsura Emoto, Toshiaki Yagami, Taketo Yamada, Manabu Izumi, Masaki Ano, Kenichi Kase, Kenji Kobayashi
Case: Necrotizing enterocolitis (NEC) caused by Clostridium butyricum is common in neonates; however, a case of NEC in adults has not been previously reported. An 84-year-old Japanese man developed C. butyricum -related NEC during hospitalization for treatment of stab wounds to the left side of the neck and lower abdomen, without organ damage, and concomitant pneumonia. Outcome: The patient developed acute onset of emesis accompanied by shock during his admission; partial resection of the small intestine was carried out due to necrosis...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657734/treatment-of-a-patient-with-acute-aortic-dissection-using-extracorporeal-cardiopulmonary-resuscitation-after-an-out-of-hospital-cardiac-arrest-a-case-report
#4
Takahiro Yukawa, Kazuhiro Sugiyama, Kazuki Miyazaki, Takahiro Tanabe, Susumu Ishikawa, Yuichi Hamabe
Case: Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657733/contrast-medium-induced-transient-severe-leukopenia
#5
Takashi Hongo, Satoshi Nozaki, Midori Tsuchiya, Mototaka Inaba, Kenji Takahashi, Toshifumi Fujiwara
Case: Contrast medium-induced transient leukopenia is very rare. Here, we report a case of a 73-year-old man diagnosed with contrast media-induced transient leukopenia. The patient underwent abdominal contrast-enhanced computed tomography, where he was given non-ionic iodinated contrast medium i.v. His medical history included an allergic reaction to a different contrast medium. One hour later, the patient was admitted to the emergency department complaining of chest discomfort. He had leukopenia and a fever (temperature of 38...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657732/two-cases-of-spontaneous-cervical-epidural-hematoma-without-back-or-neck-pain-in-elderly-japanese-men
#6
Takashi Hongo, Kenichi Iseda, Midori Tsuchiya, Mototaka Inaba, Satoshi Nozaki, Kenji Takahashi, Masaaki Nakajima, Toshifumi Fujiwara
Cases: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain. Outcomes: This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657731/coin-pica-induced-gastric-perforation-resulting-from-ingestion-of-1-894-coins-8-kg-in-total-case-report-and-review-of-published-works
#7
Kosuke Sekiya, Shusuke Mori, Yasuhiro Otomo
Case: Pica is common among patients with psychiatric disorders, but only a few cases regarding coin pica have been reported. A 51-year-old man with depression complaining of fatigue was found to have numerous coins in the esophagus and the stomach on X-rays. He had a peritoneal sign and underwent an emergency laparotomy. Outcome: The surgical findings showed perforation on the anterior wall of the gastric body and coins in the stomach, which were removed manually, followed by an omental patch...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657730/lemierre-s-syndrome-presented-with-acute-pancreatitis
#8
Laura Garcia, Kaori Ito
Case: Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is Fusobacterium necrophorum . A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea. She was admitted to the general practice unit with a diagnosis of acute pancreatitis then was subsequently transferred to the intensive care unit due to shock. Physical examination revealed tenderness on right side of the neck...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657729/risk-factors-for-prolonged-mechanical-ventilation-in-patients-with-severe-multiple-injuries-and-blunt-chest-trauma-a-single-center-retrospective-case-control-study
#9
Yasuyuki Okabe
Aim: Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). Methods: Consecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657728/can-we-predict-delayed-undesirable-events-after-blunt-injury-to-the-torso-visceral-organs
#10
Kenichiro Uchida, Yasumitsu Mizobata, Naohiro Hagawa, Tomonori Yamamoto, Shinichiro Kaga, Tomohiro Noda, Naoki Shinyama, Tetsuro Nishimura, Hiromasa Yamamoto
Aim: Blunt injuries to visceral organs have the potential to lead to delayed pseudoaneurysm formation or organ rupture, but current trauma and surgical guidelines do not recommend repetitive imaging. This study examined the incidence and timing of delayed undesirable events and established advisable timing for follow-up imaging and appropriate observational admission. Methods: Patients with blunt splenic (S), liver (L), or kidney (K) injury treated with non-operative management (NOM) in our institution were included and retrospectively reviewed...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657727/preoperative-fluid-restriction-for-trauma-patients-with-hemorrhagic-shock-decreases-ventilator-days
#11
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657726/high-dose-steroid-therapy-for-acute-respiratory-distress-syndrome-lacking-common-risk-factors-predictors-of-outcome
#12
Yoshiaki Kinoshita, Hiroshi Ishii, Hisako Kushima, Kentaro Watanabe, Masaki Fujita
Aim: Acute respiratory distress syndrome (ARDS) is a life-threatening lung disease that usually occurs in patients with the underling risk factors that triggers lung inflammation. We sometimes encounter patients with ARDS lacking common risk factors. Recent studies have indicated the effectiveness of corticosteroids for this cohort. However, the characteristics of survivors with ARDS who lack common risk factors, and who received high-dose methylprednisolone pulse therapy (MPPT), are not known...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657725/adherence-rate-of-quality-of-care-indicators-for-staphylococcus-aureus-bacteremia-is-extremely-low-in-japanese-emergency-and-critical-care-departments-a-multicenter-retrospective-observational-study
#13
Kyohei Miyamoto, Seiya Kato, Junichi Kitayama, Junpei Okawa, Ayana Okamoto, Jun Kamei, Kazuhisa Yoshiya, Hideki Asai, Shingo Adachi, Hidekazu Yukioka, Hiroshi Akimoto, Kazuo Okuchi
Aim: Staphylococcus aureus bacteremia causes significant morbidity and mortality and requires specific management to prevent complications. Most studies evaluating quality of care have been carried out in Europe and North America, and accurate epidemiological data are lacking in Asia. We aimed to describe the epidemiology and evaluate the quality of care for S. aureus bacteremia in Japan. Methods: From February 2011 to January 2014, we undertook a multicenter retrospective observational study in 10 departments of emergency and critical care in Japan...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657724/quality-of-dispatch-assisted-cardiopulmonary-resuscitation-by-lay-rescuers-following-a-standard-protocol-in-japan-an-observational-simulation-study
#14
Hideki Asai, Hidetada Fukushima, Francesco Bolstad, Kazuo Okuchi
Aim: Bystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch-assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study. Methods: We recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657723/accuracy-of-the-smaller-superior-mesenteric-vein-sign-for-the-detection-of-acute-superior-mesenteric-artery-occlusion
#15
Takaaki Nakano, Toshitaka Ito, Tetsuhiro Takei, Masaaki Takemoto
Aims: The smaller superior mesenteric vein (SMV) sign is a well-known computed tomography (CT) parameter for acute superior mesenteric artery (SMA) occlusion. This CT sign is potentially beneficial for the early diagnosis of acute SMA occlusion; however, few reports have documented this sign. The present study aimed to determine the accuracy of the smaller SMV sign for the detection of acute SMA occlusion. Methods: We retrospectively reviewed CT images from 20 patients with acute SMA occlusion and 1,216 controls...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657722/a-summary-of-the-japan-septic-disseminated-intravascular-coagulation-study
#16
REVIEW
Mineji Hayakawa, Kota Ono
Over the past few decades, the large, international, randomized controlled trials of anticoagulant therapies for patients with sepsis have not yielded any improvement in mortality rates. However, in Japan, anticoagulant therapies are administered for sepsis patients with disseminated intravascular coagulation (DIC), but not for sepsis patients without DIC. Furthermore, epidemiological data regarding sepsis in Japan are scarce. Therefore, a nationwide multicenter retrospective observational study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study, was undertaken...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657721/past-present-and-future-of-emergency-general-surgery-in-the-usa
#17
REVIEW
Heather G Lyu, Peter Najjar, Joaquim M Havens
Emergency General Surgery (EGS) patients represent a unique group of acutely ill surgical patients at high risk for death and complications. Since the inception of EGS as a surgical subspecialty in the early 2000s, there have been significant developments to further define the scope of EGS as well as to advance data collection, performance measurement, and quality improvement. This includes defining the EGS cohort by diagnosis and procedure and by overall burden, benchmarking of EGS outcomes, and creation of quality improvement programs aimed at reducing the excess morbidity and mortality associated with EGS...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657720/promising-novel-therapy-with-hydrogen-gas-for-emergency-and-critical-care-medicine
#18
REVIEW
Motoaki Sano, Masaru Suzuki, Koichiro Homma, Kei Hayashida, Tomoyoshi Tamura, Tadashi Matsuoka, Yoshinori Katsumata, Shuko Onuki, Junichi Sasaki
It has been reported that hydrogen gas exerts a therapeutic effect in a wide range of disease conditions, from acute illness such as ischemia-reperfusion injury, shock, and damage healing to chronic illness such as metabolic syndrome, rheumatoid arthritis, and neurodegenerative diseases. Antioxidant and anti-inflammatory properties of hydrogen gas have been proposed, but the molecular target of hydrogen gas has not been identified. We established the Center for Molecular Hydrogen Medicine to promote non-clinical and clinical research on the medical use of hydrogen gas through industry-university collaboration and to obtain regulatory approval of hydrogen gas and hydrogen medical devices (http://www...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29445509/a-case-of-paraplegia-that-developed-6-years-after-thoracic-endovascular-aortic-repair-for-blunt-traumatic-aortic-injury
#19
Hiroyuki Takahashi, Tomohisa Shoko, Fumino Taketazu, Keiichi Kuriyama, Kazuhide Yoshikawa, Yoshizumi Deguchi
Case: Thoracic endovascular aortic repair (TEVAR) is becoming the standard therapy for blunt thoracic aortic injury (BTAI). However, the long-term outcomes of TEVAR for BTAI remain unclear. A 36-year-old man was admitted to our emergency department with dyspnea. He had been involved in a serious traffic accident 6 years earlier, requiring TEVAR for BTAI. Outcome: Acute heart failure and pneumonia were diagnosed on this admission. His respiratory condition improved, but paraplegia developed 10 h after hospitalization...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29445508/development-of-the-japanese-version-of-the-preschool-confusion-assessment-method-for-the-icu
#20
Yujiro Matsuishi, Haruhiko Hoshino, Nobutake Shimojo, Yuki Enomoto, Takahiro Kido, Subrina Jesmin, Masahiko Sumitani, Yoshiaki Inoue
Aim: Delirium is associated with various negative clinical outcomes, such as decline in cognitive ability, increased length of hospital stay, and higher mortality. For these reasons, early diagnosis of delirium is critical. Unfortunately, there are no reliable diagnostic criteria or tool of delirium for infants and preschool-aged children in Japan. The aim of the present study was to translate a new delirium assessment tool, the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU), for accurately diagnosing clinically ill infants and preschool-aged children, from English to Japanese...
January 2018: Acute Medicine & Surgery
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