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Acute Medicine & Surgery

Soichiro Kato, Takehiko Tarui, Yoshihiro Yamaguchi
Aim: To evaluate the ease of use, reliability, and duplication risks of a new identification (ID) coding method, which works for mass casualty events such as disaster scenes. Methods: The new ID code consisted of 16 alphanumeric characters: seven characters for the responder's information and nine for the casualty, which can be created in a very low-tech manner without using any electronic devices. A simulated triage was carried out for virtual causalities by students of the same grade at our university's medical school...
July 2018: Acute Medicine & Surgery
Gordon A Ewy
Aim: Mechanical assist devices are sometimes needed during resuscitation efforts of patients with prolonged cardiac arrest. Two such devices, the AutoPulse and the LUCAS, have different mechanisms of action. We propose that the effectiveness of mechanical assist devices is somewhat dependent on the configuration and compliance of the patient's chest wall. Methods: A previous study of patients with out-of-hospital cardiac arrest in Arizona reported that survivors were younger and many were observed to have narrow anterior-posterior chest diameters...
July 2018: Acute Medicine & Surgery
Mana Nishikawa, Noriaki Shimada, Motoko Kanzaki, Tetsunori Ikegami, Toshio Fukuoka, Masaki Fukushima, Kenichiro Asano
Aim: This study aimed to clarify the characteristics of patients who presented with severe hypermagnesemia and subsequently underwent emergency hemodialysis. Methods: We investigated the age, gender, complications, clinical symptoms, causal drugs, electrocardiogram findings, and laboratory data of 15 patients. Results: Magnesium oxide had been administered in all cases and 14 patients were over 65 years old. The male : female ratio was 6:9...
July 2018: Acute Medicine & Surgery
Takehiko Oami, Taku Oshima, Reiko Oku, Kazuya Nakanishi
Background: Thrombolysis for pulmonary embolism and targeted temperature management for cardiac arrest are controversial treatments in pregnancy. Case: A 37-year-old woman at 23 weeks gestation presented with persistent dyspnea. She experienced cardiac arrest soon after arrival at the emergency room. Massive right ventricular dilatation on echocardiography during the transient return of spontaneous circulation suggested pulmonary embolism. We administered recombinant tissue plasminogen activator for suspected pulmonary embolism to successfully resuscitate the patient experiencing refractory cardiac arrest despite heparin infusion...
July 2018: Acute Medicine & Surgery
Takumi Tsuji, Yuji Hattori, Koji Komori, Yuya Yoshida, Rie Banno, Takeyuki Kohno
Aim: In this study, to assess the utility of lipid emulsion (ILE) therapy as a treatment option for overdoses of lipophilic drugs, we examined the detoxification effect of ILE therapy in rats that were administered overdoses of the tricyclic antidepressant clomipramine hydrochloride (CMI). Methods: Female Wistar rats were orally administered 50 mg/kg CMI five times in 2-h intervals to examine whether intralipos accelerated the elimination of CMI in the peripheral blood...
July 2018: Acute Medicine & Surgery
Takaaki Maruhashi, Tasuku Hanajima, Kento Nakatani, Jun Hattori, Ichiro Takeuchi, Yuichi Kataoka, Yasushi Asari
Case: Alkaline ingestion frequently causes corrosive esophagitis but rarely causes lower digestive tract injury. In this case, a 79-year-old man accidentally drank kitchen detergent. After 3 h, lower abdominal pain occurred and gradually worsened. He was taking a proton pump inhibitor after proximal gastrectomy for gastric cancer. He had local tenderness in the left lower abdomen. Abdominal computed tomography showed expansion of the small intestine, thickening of the intestinal wall, and inflammatory changes...
July 2018: Acute Medicine & Surgery
Tomohiro Yoshizawa, Yoshito Kamijo, Yuji Fujita, Yoshiki Suzuki, Tomoki Hanazawa, Kiyotaka Usui, Tohru Kishino
Case: Is fomepizole necessary after massive ingestion of a mixture of methanol and ethanol? We report the case of a 37-year-old man who was transported to our Poison Center 12 h after ingesting 500 mL of fuel alcohol containing 70% methanol and 30% ethanol in a suicide attempt. On admission, he presented only with somnolence and mild metabolic acidosis. We hypothesized that most of the ethanol had been metabolized. Outcome: As the estimated serum concentration of methanol was lethal (242...
July 2018: Acute Medicine & Surgery
Yuichi Okano, Kazuaki Ishimatsu, Yoichi Kato, Junichi Yamaga, Ken Kuwahara, Katsuki Okumoto, Kuniyasu Wada
Aim: To clarify the features of stroke mimics. Methods: We retrospectively investigated stroke mimic cases among the suspected stroke cases examined at our emergency department, over the past 9 years, during the tissue-type plasminogen activator treatment time window. Results: Of 1,557 suspected acute stroke cases examined at the emergency department, 137 (8.8%) were stroke mimics. The most common causes were symptomatic epilepsy (28 cases, 20...
July 2018: Acute Medicine & Surgery
Yoshiro Kobe, Takehiko Oami, Tomoaki Hashida, Yoshihisa Tateishi
Aim: Urgent endoscopy is essential in gastrointestinal (GI) bleeding. Emergency physicians with endoscopy training treat patients with GI bleeding in our hospital. We compared the management and clinical outcomes of GI bleeding cases between those treated by an emergency physician (EP) and those treated by a non-emergency physician (NEP; e.g., gastroenterologist or general surgeon). Methods: We undertook a retrospective chart review of upper GI bleeding cases treated using endoscopy in the emergency department between 2012 and 2014...
July 2018: Acute Medicine & Surgery
Shohei Matsumoto, Michihiro Murozono, Masahiro Kanazawa, Takeshi Nara, Takuro Ozawa, Yasuo Watanabe
It is well known that acute ischemic stroke (AIS) and subsequent reperfusion produce lethal levels of reactive oxygen species (ROS) in neuronal cells, which are generated in mitochondria. Mitochondrial ROS production is a self-amplifying process, termed "ROS-induced ROS release". Furthermore, the mitochondrial permeability transition pore (MPTP) is deeply involved in this process, and its opening could cause cell death. Edaravone, a free radical scavenger, is the only neuroprotective agent for AIS used in Japan...
July 2018: Acute Medicine & Surgery
Tetsuhisa Kitamura, Taku Iwami, Takahiro Atsumi, Tomoyuki Endo, Tomoo Kanna, Yasuhiro Kuroda, Atsushi Sakurai, Osamu Tasaki, Yoshio Tahara, Ryosuke Tsuruta, Jun Tomio, Kazuyuki Nakata, Sho Nachi, Mamoru Hase, Mineji Hayakawa, Takahiro Hiruma, Kenichi Hiasa, Takashi Muguruma, Takao Yano, Takeshi Shimazu, Naoto Morimura
Aim: To describe the registry design of the Japanese Association for Acute Medicine - out-of-hospital cardiac arrest (JAAM-OHCA) Registry as well as its profile on hospital information, patient and emergency medical service characteristics, and in-hospital procedures and outcomes among patients with OHCA who were transported to the participating institutions. Methods: The special committee aiming to improve the survival after OHCA by providing evidence-based therapeutic strategies and emergency medical systems from the JAAM has launched a multicenter, prospective registry that enrolled OHCA patients who were transported to critical care medical centers or hospitals with an emergency care department...
July 2018: Acute Medicine & Surgery
Ryosuke Tsuruta, Motoki Fujita
Guideline-based management approaches for pain, agitation, and delirium (PAD) in critically ill adult patients are widely believed to result in good outcomes. However, there are some differences in the recommendations and evidence levels among the management guidelines established for PAD. To identify and compare the current management guidelines, we used the PubMed database. The PAD guidelines and Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva (FEPIMCTI) guidelines were identified from our search...
July 2018: Acute Medicine & Surgery
Takashi Hongo, Midori Tsuchiya, Mototaka Inaba, Kenji Takahashi, Satoshi Nozaki, Toshifumi Fujiwara, Makoto Hiramatsu
Aim: We aimed to examine the relationship between kidney size and contrast-induced nephropathy (CIN) in patients who underwent contrast-enhanced computed tomography (CT) in the emergency department. Methods: This single-center retrospective observational study was undertaken to evaluate risk factors for CIN at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2014 through to December 2016. Contrast-induced nephropathy was defined as an absolute increase in serum creatinine level of ≥0...
July 2018: Acute Medicine & Surgery
Shunsuke Amagasa, Hikoro Matsui, Satoshi Tsuji, Satoko Uematsu, Takashi Moriya, Kosaku Kinoshita
Aim: To identify markers for detecting abusive head trauma (AHT) and its characteristics in the Japanese population. Methods: We retrospectively reviewed the clinical records of 166 infants with traumatic intracranial hemorrhage between 2002 and 2013 in three tertiary institutions in Japan. The infants were classified into AHT (57), suspected AHT (24), and accidental (85) group based on the defined criteria. We compared clinical presentations and computed tomography findings among these three groups and also compared age distribution of infants with AHT in our study to those in the USA...
July 2018: Acute Medicine & Surgery
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
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
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
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
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
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
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