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1. Planned Versus On-Demand Relaparotomy Strategy in Initial Surgery for Non-occlusive Mesenteric Ischemia

Author

Hisahiro Matsubara, Akira Endo, Tomohisa Shoko, Yoshinori Murao, Daisuke Nemoto, Kentaro Yoshikawa, Toshiki Sera, Fumitaka Saida, Shigeru Yamagishi, Hiroyuki Koami, Mototaka Inaba, Kazuki Mashiko, Noriaki Takiguchi, Yuzuru Mochida, Makoto Kobayashi, Satoshi Hirano, Shiei Kim, Kiyoshi Murata, and Yasuhiro Otomo

Subjects
Reoperation, medicine.medical_specialty, Acute care surgery, Open abdominal management, Peritonitis, law.invention, Acute mesenteric ischemia, 03 medical and health sciences, 0302 clinical medicine, law, Medicine, Humans, Adverse effect, Retrospective Studies, Laparotomy, business.industry, Gastroenterology, Retrospective cohort study, Perioperative, Odds ratio, medicine.disease, Intensive care unit, Confidence interval, Surgery, Critical care, Mesenteric ischemia, 030220 oncology & carcinogenesis, Mesenteric Ischemia, Propensity score matching, 030211 gastroenterology & hepatology, Original Article, business
Abstract

Background There has been insufficient evidence regarding a treatment strategy for patients with non-occlusive mesenteric ischemia (NOMI) due to the lack of large-scale studies. We aimed to evaluate the clinical benefit of strategic planned relaparotomy in patients with NOMI using detailed perioperative information. Methods We conducted a multicenter retrospective cohort study that included NOMI patients who underwent laparotomy. In-hospital mortality, 28-day mortality, incidence of total adverse events, ventilator-free days, and intensive care unit (ICU)–free days were compared between groups experiencing the planned and on-demand relaparotomy strategies. Analyses were performed using a multivariate mixed effects model and a propensity score matching model after adjusting for pre-operative, intra-operative, and hospital-related confounders. Results A total of 181 patients from 17 hospitals were included, of whom 107 (59.1%) were treated using the planned relaparotomy strategy. The multivariate mixed effects regression model indicated no significant differences for in-hospital mortality (61 patients [57.0%] in the planned relaparotomy group vs. 28 patients [37.8%] in the on-demand relaparotomy group; adjusted odds ratio [95% confidence interval] = 1.94 [0.78–4.80]), as well as in 28-day mortality, adverse events, and ICU-free days. Significant reduction in ventilator-free days was observed in the planned relaparotomy group. Propensity score matching analysis of 61 matched pairs with comparable patient severity did not show superiority of the planned relaparotomy strategy. Conclusions The planned relaparotomy strategy, compared with on-demand relaparotomy strategy, did not show clinical benefits after the initial surgery of patients with NOMI. Further studies estimating potential subpopulations who may benefit from this strategy are required. Electronic supplementary material The online version of this article (10.1007/s11605-020-04792-3) contains supplementary material, which is available to authorized users.

Published
2020

2. Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan

Author

Akihiko, Inoue, Toru, Hifumi, Tetsuya, Sakamoto, Hiroshi, Okamoto, Jun, Kunikata, Hideto, Yokoi, Hirotaka, Sawano, Yuko, Egawa, Shunichi, Kato, Kazuhiro, Sugiyama, Naofumi, Bunya, Takehiko, Kasai, Shinichi, Ijuin, Shinichi, Nakayama, Jun, Kanda, Seiya, Kanou, Toru, Takiguchi, Shoji, Yokobori, Hiroaki, Takada, Kazushige, Inoue, Ichiro, Takeuchi, Hiroshi, Honzawa, Makoto, Kobayashi, Tomohiro, Hamagami, Wataru, Takayama, Yasuhiro, Otomo, Kunihiko, Maekawa, Takafumi, Shimizu, Satoshi, Nara, Michitaka, Nasu, Kuniko, Takahashi, Yoshihiro, Hagiwara, Shigeki, Kushimoto, Reo, Fukuda, Takayuki, Ogura, Shin-Ichiro, Shiraishi, Ryosuke, Zushi, Norio, Otani, Migaku, Kikuchi, Kazuhiro, Watanabe, Takuo, Nakagami, Tomohisa, Shoko, Nobuya, Kitamura, Takayuki, Otani, Yoshinori, Matsuoka, Makoto, Aoki, Masaaki, Sakuraya, Hideki, Arimoto, Koichiro, Homma, Hiromichi, Naito, Shunichiro, Nakao, Tomoya, Okazaki, Yoshio, Tahara, Yasuhiro, Kuroda, and Junya, Shimazaki

Subjects
Adult, Aged, 80 and over, Adolescent, Middle Aged, Critical Care and Intensive Care Medicine, Cardiopulmonary Resuscitation, Cohort Studies, Young Adult, Extracorporeal Membrane Oxygenation, Japan, Humans, Out-of-Hospital Cardiac Arrest, Aged, Retrospective Studies
Abstract

Background The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.

Published
2022
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3. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

Author

Belinda De Simone, Fikri M. Abu-Zidan, Elie Chouillard, Salomone Di Saverio, Massimo Sartelli, Mauro Podda, Carlos Augusto Gomes, Ernest E. Moore, Susan J. Moug, Luca Ansaloni, Yoram Kluger, Federico Coccolini, Aitor Landaluce-Olavarria, Begoña Estraviz-Mateos, Ana Uriguen-Etxeberria, Alessio Giordano, Alfonso Palmieri Luna, Luz Adriana Hernández Amín, Adriana María Palmieri Hernández, Amanda Shabana, Zakaria Andee Dzulkarnaen, Muhammad Asyraf Othman, Mohamad Ikhwan Sani, Andrea Balla, Rosa Scaramuzzo, Pasquale Lepiane, Andrea Bottari, Fabio Staderini, Fabio Cianchi, Andrea Cavallaro, Antonio Zanghì, Alessandro Cappellani, Roberto Campagnacci, Angela Maurizi, Mario Martinotti, Annamaria Ruggieri, Asri Che Jusoh, Karim Abdul Rahman, Anis Suraya M. Zulkifli, Barbara Petronio, Belén Matías-García, Ana Quiroga-Valcárcel, Fernando Mendoza-Moreno, Boyko Atanasov, Fabio Cesare Campanile, Ilaria Vecchioni, Luca Cardinali, Grazia Travaglini, Elisa Sebastiani, Serge Chooklin, Serhii Chuklin, Pasquale Cianci, Enrico Restini, Sabino Capuzzolo, Giuseppe Currò, Rosalinda Filippo, Michele Rispoli, Daniel Aparicio-Sánchez, Virginia Durán Muñóz-Cruzado, Sandra Dios Barbeito, Samir Delibegovic, Amar Kesetovic, Diego Sasia, Felice Borghi, Giorgio Giraudo, Diego Visconti, Emanuele Doria, Mauro Santarelli, Davide Luppi, Stefano Bonilauri, Ugo Grossi, Giacomo Zanus, Alberto Sartori, Giacomo Piatto, Maurizio De Luca, Domenico Vita, Luigi Conti, Patrizio Capelli, Gaetano Maria Cattaneo, Athanasios Marinis, Styliani-Aikaterini Vederaki, Mehmet Bayrak, Yasemin Altıntas, Mustafa Yener Uzunoglu, Iskender Eren Demirbas, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Derya Salim Uymaz, Nail Omarov, Ibrahim Azamat, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Emre Gonullu, Baris Mantoglu, Recayi Capoglu, Stefano Cappato, Elena Muzio, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Fatih Altintoprak, Zülfü Bayhan, Emrah Akin, Enrico Andolfi, Sulce Rezart, Jae Il Kim, Sung Won Jung, Yong Chan Shin, Octavian Enciu, Elena Adelina Toma, Fabio Medas, Gian Luigi Canu, Federico Cappellacci, Fabrizio D’Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Roscio, Federico Clerici, Roberta Gelmini, Francesco Serra, Elena Giulia Rossi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Francesco Ferrara, Gabriela Nita, Jlenia Sarnari, Mahir Gachabayov, Abakar Abdullaev, Gaetano Poillucci, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Micaela Piccoli, Gianmaria Casoni Pattacini, Francesca Pecchini, Giulio Argenio, Mariano Fortunato Armellino, Giuseppe Brisinda, Silvia Tedesco, Pietro Fransvea, Giuseppe Ietto, Caterina Franchi, Giulio Carcano, Gennaro Martines, Giuseppe Trigiante, Giulia Negro, Gustavo Machain Vega, Agustín Rodríguez González, Leonardo Ojeda, Gaetano Piccolo, Andrea Bondurri, Anna Maffioli, Claudio Guerci, Boo Han Sin, Zamri Zuhdi, Azlanudin Azman, Hussam Mousa, Shadi al Bahri, Goran Augustin, Ivan Romic, Trpimir Moric, Ioannis Nikolopoulos, Jacopo Andreuccetti, Giusto Pignata, Rossella D’Alessio, Jakub Kenig, Urszula Skorus, Gustavo Pereira Fraga, Elcio Shiyoiti Hirano, Jackson Vinícius de Lima Bertuol, Arda Isik, Eray Kurnaz, Mohammad Sohail Asghar, Ameer Afzal, Ali Akbar, Taxiarchis Konstantinos Nikolouzakis, Konstantinos Lasithiotakis, Emmanuel Chrysos, Koray Das, Nazmi Özer, Ahmet Seker, Mohamed Ibrahim, Hytham K. S. Hamid, Ahmed Babiker, Konstantinos Bouliaris, George Koukoulis, Chrysoula-Christina Kolla, Andrea Lucchi, Laura Agostinelli, Antonio Taddei, Laura Fortuna, Carlotta Agostini, Leo Licari, Simona Viola, Cosimo Callari, Letizia Laface, Emmanuele Abate, Massimiliano Casati, Alessandro Anastasi, Giuseppe Canonico, Linda Gabellini, Lorenzo Tosi, Anna Guariniello, Federico Zanzi, Lovenish Bains, Larysa Sydorchuk, Oksana Iftoda, Andrii Sydorchuk, Michele Malerba, Federico Costanzo, Raffaele Galleano, Michela Monteleone, Andrea Costanzi, Carlo Riva, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Piotr Major, Marcin Strzałka, Maciej Matyja, Michal Natkaniec, Maria Rosaria Valenti, Maria Domenica Pia Di Vita, Maria Sotiropoulou, Stylianos Kapiris, Damien Massalou, Massimiliano Veroux, Alessio Volpicelli, Rossella Gioco, Matteo Uccelli, Marta Bonaldi, Stefano Olmi, Matteo Nardi, Giada Livadoti, Cristian Mesina, Theodor Viorel Dumitrescu, Mihai Calin Ciorbagiu, Michele Ammendola, Giorgio Ammerata, Roberto Romano, Mihail Slavchev, Evangelos P. Misiakos, Emmanouil Pikoulis, Dimitrios Papaconstantinou, Mohamed Elbahnasawy, Sherief Abdel-elsalam, Daniel M. Felsenreich, Julia Jedamzik, Nikolaos V. Michalopoulos, Theodoros A. Sidiropoulos, Maria Papadoliopoulou, Nicola Cillara, Antonello Deserra, Alessandro Cannavera, Ionuţ Negoi, Dimitrios Schizas, Athanasios Syllaios, Ilias Vagios, Stavros Gourgiotis, Nick Dai, Rekha Gurung, Marcus Norrey, Antonio Pesce, Carlo Vittorio Feo, Nicolo’ Fabbri, Nikolaos Machairas, Panagiotis Dorovinis, Myrto D. Keramida, Francesk Mulita, Georgios Ioannis Verras, Michail Vailas, Omer Yalkin, Nidal Iflazoglu, Direnc Yigit, Oussama Baraket, Karim Ayed, Mohamed hedi Ghalloussi, Parmenion Patias, Georgios Ntokos, Razrim Rahim, Miklosh Bala, Asaf Kedar, Robert G. Sawyer, Anna Trinh, Kelsey Miller, Ruslan Sydorchuk, Ruslan Knut, Oleksandr Plehutsa, Rumeysa Kevser Liman, Zeynep Ozkan, Saleh Abdel Kader, Sanjay Gupta, Monika Gureh, Sara Saeidi, Mohsen Aliakbarian, Amin Dalili, Tomohisa Shoko, Mitsuaki Kojima, Raira Nakamoto, Semra Demirli Atici, Gizem Kilinc Tuncer, Tayfun Kaya, Spiros G. Delis, Stefano Rossi, Biagio Picardi, Simone Rossi del Monte, Tania Triantafyllou, Dimitrios Theodorou, Tadeja Pintar, Jure Salobir, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Orestis Ioannidis, Lydia Loutzidou, Savvas Symeonidis, Tiago Correia de Sá, Mónica Rocha, Tommaso Guagni, Desiré Pantalone, Gherardo Maltinti, Vladimir Khokha, Wafaa Abdel-elsalam, Basma Ghoneim, José Antonio López-Ruiz, Yasin Kara, Syaza Zainudin, Firdaus Hayati, Nornazirah Azizan, Victoria Tan Phooi Khei, Rebecca Choy Xin Yi, Harivinthan Sellappan, Zaza Demetrashvili, Nika Lekiashvili, Ana Tvaladze, Caterina Froiio, Daniele Bernardi, Luigi Bonavina, Angeles Gil-Olarte, Sebastiano Grassia, Estela Romero-Vargas, Francesco Bianco, Andrew A. Gumbs, Agron Dogjani, Ferdinando Agresta, Andrey Litvin, Zsolt J. Balogh, George Gendrikson, Costanza Martino, Dimitrios Damaskos, Nikolaos Pararas, Andrew Kirkpatrick, Mikhail Kurtenkov, Felipe Couto Gomes, Adolfo Pisanu, Oreste Nardello, Fabrizio Gambarini, Hager Aref, Nicola de’ Angelis, Vanni Agnoletti, Antonio Biondi, Marco Vacante, Giulia Griggio, Roberta Tutino, Marco Massani, Giovanni Bisetto, Savino Occhionorelli, Dario Andreotti, Domenico Lacavalla, Walter L. Biffl, Fausto Catena, De Simone, Belinda, Abu-Zidan, Fikri M, Chouillard, Elie, Di Saverio, Salomone, Sartelli, Massimo, Podda, Mauro, Gomes, Carlos Augusto, Moore, Ernest E, Moug, Susan J, Ansaloni, Luca, Kluger, Yoram, Coccolini, Federico, Landaluce-Olavarria, Aitor, Estraviz-Mateos, Begoña, Uriguen-Etxeberria, Ana, Giordano, Alessio, Luna, Alfonso Palmieri, Amín, Luz Adriana Hernández, Hernández, Adriana María Palmieri, Shabana, Amanda, Dzulkarnaen, Zakaria Andee, Othman, Muhammad Asyraf, Sani, Mohamad Ikhwan, Balla, Andrea, Scaramuzzo, Rosa, Lepiane, Pasquale, Bottari, Andrea, Staderini, Fabio, Cianchi, Fabio, Cavallaro, Andrea, Zanghì, Antonio, Cappellani, Alessandro, Campagnacci, Roberto, Maurizi, Angela, Martinotti, Mario, Ruggieri, Annamaria, Jusoh, Asri Che, Rahman, Karim Abdul, Zulkifli, Anis Suraya M, Petronio, Barbara, Matías-García, Belén, Quiroga-Valcárcel, Ana, Mendoza-Moreno, Fernando, Atanasov, Boyko, Campanile, Fabio Cesare, Vecchioni, Ilaria, Cardinali, Luca, Travaglini, Grazia, Sebastiani, Elisa, Chooklin, Serge, Chuklin, Serhii, Cianci, Pasquale, Restini, Enrico, Capuzzolo, Sabino, Currò, Giuseppe, Filippo, Rosalinda, Rispoli, Michele, Aparicio-Sánchez, Daniel, Muñóz-Cruzado, Virginia Durán, Barbeito, Sandra Dio, Delibegovic, Samir, Kesetovic, Amar, Sasia, Diego, Borghi, Felice, Giraudo, Giorgio, Visconti, Diego, Doria, Emanuele, Santarelli, Mauro, Luppi, Davide, Bonilauri, Stefano, Grossi, Ugo, Zanus, Giacomo, Sartori, Alberto, Piatto, Giacomo, De Luca, Maurizio, Vita, Domenico, Conti, Luigi, Capelli, Patrizio, Cattaneo, Gaetano Maria, Marinis, Athanasio, Vederaki, Styliani-Aikaterini, Bayrak, Mehmet, Altıntas, Yasemin, Uzunoglu, Mustafa Yener, Demirbas, Iskender Eren, Altinel, Yuksel, Meric, Serhat, Aktimur, Yunus Emre, Uymaz, Derya Salim, Omarov, Nail, Azamat, Ibrahim, Lostoridis, Eftychio, Nagorni, Eleni-Aikaterini, Pujante, Antonio, Anania, Gabriele, Bombardini, Cristina, Bagolini, Francesco, Gonullu, Emre, Mantoglu, Bari, Capoglu, Recayi, Cappato, Stefano, Muzio, Elena, Colak, Elif, Polat, Suleyman, Koylu, Zehra Alan, Altintoprak, Fatih, Bayhan, Zülfü, Akin, Emrah, Andolfi, Enrico, Rezart, Sulce, Kim, Jae Il, Jung, Sung Won, Shin, Yong Chan, Enciu, Octavian, Toma, Elena Adelina, Medas, Fabio, Canu, Gian Luigi, Cappellacci, Federico, D'Acapito, Fabrizio, Ercolani, Giorgio, Solaini, Leonardo, Roscio, Francesco, Clerici, Federico, Gelmini, Roberta, Serra, Francesco, Rossi, Elena Giulia, Fleres, Francesco, Clarizia, Guglielmo, Spolini, Alessandro, Ferrara, Francesco, Nita, Gabriela, Sarnari, Jlenia, Gachabayov, Mahir, Abdullaev, Abakar, Poillucci, Gaetano, Palini, Gian Marco, Veneroni, Simone, Garulli, Gianluca, Piccoli, Micaela, Pattacini, Gianmaria Casoni, Pecchini, Francesca, Argenio, Giulio, Armellino, Mariano Fortunato, Brisinda, Giuseppe, Tedesco, Silvia, Fransvea, Pietro, Ietto, Giuseppe, Franchi, Caterina, Carcano, Giulio, Martines, Gennaro, Trigiante, Giuseppe, Negro, Giulia, Vega, Gustavo Machain, González, Agustín Rodríguez, Ojeda, Leonardo, Piccolo, Gaetano, Bondurri, Andrea, Maffioli, Anna, Guerci, Claudio, Sin, Boo Han, Zuhdi, Zamri, Azman, Azlanudin, Mousa, Hussam, Al Bahri, Shadi, Augustin, Goran, Romic, Ivan, Moric, Trpimir, Nikolopoulos, Ioanni, Andreuccetti, Jacopo, Pignata, Giusto, D'Alessio, Rossella, Kenig, Jakub, Skorus, Urszula, Fraga, Gustavo Pereira, Hirano, Elcio Shiyoiti, de Lima Bertuol, Jackson Viníciu, Isik, Arda, Kurnaz, Eray, Asghar, Mohammad Sohail, Afzal, Ameer, Akbar, Ali, Nikolouzakis, Taxiarchis Konstantino, Lasithiotakis, Konstantino, Chrysos, Emmanuel, Das, Koray, Özer, Nazmi, Seker, Ahmet, Ibrahim, Mohamed, Hamid, Hytham K S, Babiker, Ahmed, Bouliaris, Konstantino, Koukoulis, George, Kolla, Chrysoula-Christina, Lucchi, Andrea, Agostinelli, Laura, Taddei, Antonio, Fortuna, Laura, Agostini, Carlotta, Licari, Leo, Viola, Simona, Callari, Cosimo, Laface, Letizia, Abate, Emmanuele, Casati, Massimiliano, Anastasi, Alessandro, Canonico, Giuseppe, Gabellini, Linda, Tosi, Lorenzo, Guariniello, Anna, Zanzi, Federico, Bains, Lovenish, Sydorchuk, Larysa, Iftoda, Oksana, Sydorchuk, Andrii, Malerba, Michele, Costanzo, Federico, Galleano, Raffaele, Monteleone, Michela, Costanzi, Andrea, Riva, Carlo, Walędziak, Maciej, Kwiatkowski, Andrzej, Czyżykowski, Łukasz, Major, Piotr, Strzałka, Marcin, Matyja, Maciej, Natkaniec, Michal, Valenti, Maria Rosaria, Di Vita, Maria Domenica Pia, Sotiropoulou, Maria, Kapiris, Styliano, Massalou, Damien, Veroux, Massimiliano, Volpicelli, Alessio, Gioco, Rossella, Uccelli, Matteo, Bonaldi, Marta, Olmi, Stefano, Nardi, Matteo, Livadoti, Giada, Mesina, Cristian, Dumitrescu, Theodor Viorel, Ciorbagiu, Mihai Calin, Ammendola, Michele, Ammerata, Giorgio, Romano, Roberto, Slavchev, Mihail, Misiakos, Evangelos P, Pikoulis, Emmanouil, Papaconstantinou, Dimitrio, Elbahnasawy, Mohamed, Abdel-Elsalam, Sherief, Felsenreich, Daniel M, Jedamzik, Julia, Michalopoulos, Nikolaos V, Sidiropoulos, Theodoros A, Papadoliopoulou, Maria, Cillara, Nicola, Deserra, Antonello, Cannavera, Alessandro, Negoi, Ionuţ, Schizas, Dimitrio, Syllaios, Athanasio, Vagios, Ilia, Gourgiotis, Stavro, Dai, Nick, Gurung, Rekha, Norrey, Marcu, Pesce, Antonio, Feo, Carlo Vittorio, Fabbri, Nicolo', Machairas, Nikolao, Dorovinis, Panagioti, Keramida, Myrto D, Mulita, Francesk, Verras, Georgios Ioanni, Vailas, Michail, Yalkin, Omer, Iflazoglu, Nidal, Yigit, Direnc, Baraket, Oussama, Ayed, Karim, Ghalloussi, Mohamed Hedi, Patias, Parmenion, Ntokos, Georgio, Rahim, Razrim, Bala, Miklosh, Kedar, Asaf, Sawyer, Robert G, Trinh, Anna, Miller, Kelsey, Sydorchuk, Ruslan, Knut, Ruslan, Plehutsa, Oleksandr, Liman, Rumeysa Kevser, Ozkan, Zeynep, Kader, Saleh Abdel, Gupta, Sanjay, Gureh, Monika, Saeidi, Sara, Aliakbarian, Mohsen, Dalili, Amin, Shoko, Tomohisa, Kojima, Mitsuaki, Nakamoto, Raira, Atici, Semra Demirli, Tuncer, Gizem Kilinc, Kaya, Tayfun, Delis, Spiros G, Rossi, Stefano, Picardi, Biagio, Del Monte, Simone Rossi, Triantafyllou, Tania, Theodorou, Dimitrio, Pintar, Tadeja, Salobir, Jure, Manatakis, Dimitrios K, Tasis, Nikolao, Acheimastos, Vasileio, Ioannidis, Oresti, Loutzidou, Lydia, Symeonidis, Savva, de Sá, Tiago Correia, Rocha, Mónica, Guagni, Tommaso, Pantalone, Desiré, Maltinti, Gherardo, Khokha, Vladimir, Abdel-Elsalam, Wafaa, Ghoneim, Basma, López-Ruiz, José Antonio, Kara, Yasin, Zainudin, Syaza, Hayati, Firdau, Azizan, Nornazirah, Khei, Victoria Tan Phooi, Yi, Rebecca Choy Xin, Sellappan, Harivinthan, Demetrashvili, Zaza, Lekiashvili, Nika, Tvaladze, Ana, Froiio, Caterina, Bernardi, Daniele, Bonavina, Luigi, Gil-Olarte, Angele, Grassia, Sebastiano, Romero-Vargas, Estela, Bianco, Francesco, Gumbs, Andrew A, Dogjani, Agron, Agresta, Ferdinando, Litvin, Andrey, Balogh, Zsolt J, Gendrikson, George, Martino, Costanza, Damaskos, Dimitrio, Pararas, Nikolao, Kirkpatrick, Andrew, Kurtenkov, Mikhail, Gomes, Felipe Couto, Pisanu, Adolfo, Nardello, Oreste, Gambarini, Fabrizio, Aref, Hager, Angelis, Nicola De', Agnoletti, Vanni, Biondi, Antonio, Vacante, Marco, Griggio, Giulia, Tutino, Roberta, Massani, Marco, Bisetto, Giovanni, Occhionorelli, Savino, Andreotti, Dario, Lacavalla, Domenico, Biffl, Walter L, Catena, Fausto, and Apollo - University of Cambridge Repository

Subjects
Male, Cholecystitis, Acute, Acute cholecystitis, Cholecystectomy, COVID-19, Gangrene, Gangrenous cholecystitis, Laparoscopy, Pandemic, SARS-CoV-2, Surgery, Cholecystitis, Acute / epidemiology, Acute cholecystiti, COVID-19 / epidemiology, Postoperative Complications, Sepsis, Cholecystitis, Humans, Cholecystitis, Acute / surgery, Pandemics, Cholecystitis / surgery, Gangrenous cholecystiti, Middle Aged, Postoperative Complications / epidemiology, Emergency Medicine, Female, Cholecystitis / epidemiology
Abstract

Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p p p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p p p p p p p p p Conclusions The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstract

Published
2022

4. The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

Author

Qingbo S. Wang, Ryuya Edahiro, Ho Namkoong, Takanori Hasegawa, Yuya Shirai, Kyuto Sonehara, Hiromu Tanaka, Ho Lee, Ryunosuke Saiki, Takayoshi Hyugaji, Eigo Shimizu, Kotoe Katayama, Masahiro Kanai, Tatsuhiko Naito, Noah Sasa, Kenichi Yamamoto, Yasuhiro Kato, Takayoshi Morita, Kazuhisa Takahashi, Norihiro Harada, Toshio Naito, Makoto Hiki, Yasushi Matsushita, Haruhi Takagi, Masako Ichikawa, Ai Nakamura, Sonoko Harada, Yuuki Sandhu, Hiroki Kabata, Katsunori Masaki, Hirofumi Kamata, Shinnosuke Ikemura, Shotaro Chubachi, Satoshi Okamori, Hideki Terai, Atsuho Morita, Takanori Asakura, Junichi Sasaki, Hiroshi Morisaki, Yoshifumi Uwamino, Kosaku Nanki, Sho Uchida, Shunsuke Uno, Tomoyasu Nishimura, Takashri Ishiguro, Taisuke Isono, Shun Shibata, Yuma Matsui, Chiaki Hosoda, Kenji Takano, Takashi Nishida, Yoichi Kobayashi, Yotaro Takaku, Noboru Takayanagi, Soichiro Ueda, Ai Tada, Masayoshi Miyawaki, Masaomi Yamamoto, Eriko Yoshida, Reina Hayashi, Tomoki Nagasaka, Sawako Arai, Yutaro Kaneko, Kana Sasaki, Etsuko Tagaya, Masatoshi Kawana, Ken Arimura, Kunihiko Takahashi, Tatsuhiko Anzai, Satoshi Ito, Akifumi Endo, Yuji Uchimura, Yasunari Miyazaki, Takayuki Honda, Tomoya Tateishi, Shuji Tohda, Naoya Ichimura, Kazunari Sonobe, Chihiro Tani Sassa, Jun Nakajima, Yasushi Nakano, Yukiko Nakajima, Ryusuke Anan, Ryosuke Arai, Yuko Kurihara, Yuko Harada, Kazumi Nishio, Tetsuya Ueda, Masanori Azuma, Ryuichi Saito, Toshikatsu Sado, Yoshimune Miyazaki, Ryuichi Sato, Yuki Haruta, Tadao Nagasaki, Yoshinori Yasui, Yoshinori Hasegawa, Yoshikazu Mutoh, Tomoki Kimura, Tomonori Sato, Reoto Takei, Satoshi Hagimoto, Yoichiro Noguchi, Yasuhiko Yamano, Hajime Sasano, Sho Ota, Yasushi Nakamori, Kazuhisa Yoshiya, Fukuki Saito, Tomoyuki Yoshihara, Daiki Wada, Hiromu Iwamura, Syuji Kanayama, Shuhei Maruyama, Takashi Yoshiyama, Ken Ohta, Hiroyuki Kokuto, Hideo Ogata, Yoshiaki Tanaka, Kenichi Arakawa, Masafumi Shimoda, Takeshi Osawa, Hiroki Tateno, Isano Hase, Shuichi Yoshida, Shoji Suzuki, Miki Kawada, Hirohisa Horinouchi, Fumitake Saito, Keiko Mitamura, Masao Hagihara, Junichi Ochi, Tomoyuki Uchida, Rie Baba, Daisuke Arai, Takayuki Ogura, Hidenori Takahashi, Shigehiro Hagiwara, Genta Nagao, Shunichiro Konishi, Ichiro Nakachi, Koji Murakami, Mitsuhiro Yamada, Hisatoshi Sugiura, Hirohito Sano, Shuichiro Matsumoto, Nozomu Kimura, Yoshinao Ono, Hiroaki Baba, Yusuke Suzuki, Sohei Nakayama, Keita Masuzawa, Shinichi Namba, Takayuki Shiroyama, Yoshimi Noda, Takayuki Niitsu, Yuichi Adachi, Takatoshi Enomoto, Saori Amiya, Reina Hara, Yuta Yamaguchi, Teruaki Murakami, Tomoki Kuge, Kinnosuke Matsumoto, Yuji Yamamoto, Makoto Yamamoto, Midori Yoneda, Kazunori Tomono, Kazuto Kato, Haruhiko Hirata, Yoshito Takeda, Hidefumi Koh, Tadashi Manabe, Yohei Funatsu, Fumimaro Ito, Takahiro Fukui, Keisuke Shinozuka, Sumiko Kohashi, Masatoshi Miyazaki, Tomohisa Shoko, Mitsuaki Kojima, Tomohiro Adachi, Motonao Ishikawa, Kenichiro Takahashi, Takashi Inoue, Toshiyuki Hirano, Keigo Kobayashi, Hatsuyo Takaoka, Kazuyoshi Watanabe, Naoki Miyazawa, Yasuhiro Kimura, Reiko Sado, Hideyasu Sugimoto, Akane Kamiya, Naota Kuwahara, Akiko Fujiwara, Tomohiro Matsunaga, Yoko Sato, Takenori Okada, Yoshihiro Hirai, Hidetoshi Kawashima, Atsuya Narita, Kazuki Niwa, Yoshiyuki Sekikawa, Koichi Nishi, Masaru Nishitsuji, Mayuko Tani, Junya Suzuki, Hiroki Nakatsumi, Takashi Ogura, Hideya Kitamura, Eri Hagiwara, Kota Murohashi, Hiroko Okabayashi, Takao Mochimaru, Shigenari Nukaga, Ryosuke Satomi, Yoshitaka Oyamada, Nobuaki Mori, Tomoya Baba, Yasutaka Fukui, Mitsuru Odate, Shuko Mashimo, Yasushi Makino, Kazuma Yagi, Mizuha Hashiguchi, Junko Kagyo, Tetsuya Shiomi, Satoshi Fuke, Hiroshi Saito, Tomoya Tsuchida, Shigeki Fujitani, Mumon Takita, Daiki Morikawa, Toru Yoshida, Takehiro Izumo, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Akihiro Ito, Yoshihiko Nakamura, Kota Hoshino, Junichi Maruyama, Hiroyasu Ishikura, Tohru Takata, Toshio Odani, Masaru Amishima, Takeshi Hattori, Yasuo Shichinohe, Takashi Kagaya, Toshiyuki Kita, Kazuhide Ohta, Satoru Sakagami, Kiyoshi Koshida, Kentaro Hayashi, Tetsuo Shimizu, Yutaka Kozu, Hisato Hiranuma, Yasuhiro Gon, Namiki Izumi, Kaoru Nagata, Ken Ueda, Reiko Taki, Satoko Hanada, Kodai Kawamura, Kazuya Ichikado, Kenta Nishiyama, Hiroyuki Muranaka, Kazunori Nakamura, Naozumi Hashimoto, Keiko Wakahara, Sakamoto Koji, Norihito Omote, Akira Ando, Nobuhiro Kodama, Yasunari Kaneyama, Shunsuke Maeda, Takashige Kuraki, Takemasa Matsumoto, Koutaro Yokote, Taka-Aki Nakada, Ryuzo Abe, Taku Oshima, Tadanaga Shimada, Masahiro Harada, Takeshi Takahashi, Hiroshi Ono, Toshihiro Sakurai, Takayuki Shibusawa, Yoshifumi Kimizuka, Akihiko Kawana, Tomoya Sano, Chie Watanabe, Ryohei Suematsu, Hisako Sageshima, Ayumi Yoshifuji, Kazuto Ito, Saeko Takahashi, Kota Ishioka, Morio Nakamura, Makoto Masuda, Aya Wakabayashi, Hiroki Watanabe, Suguru Ueda, Masanori Nishikawa, Yusuke Chihara, Mayumi Takeuchi, Keisuke Onoi, Jun Shinozuka, Atsushi Sueyoshi, Yoji Nagasaki, Masaki Okamoto, Sayoko Ishihara, Masatoshi Shimo, Yoshihisa Tokunaga, Yu Kusaka, Takehiko Ohba, Susumu Isogai, Aki Ogawa, Takuya Inoue, Satoru Fukuyama, Yoshihiro Eriguchi, Akiko Yonekawa, Keiko Kan-o, Koichiro Matsumoto, Kensuke Kanaoka, Shoichi Ihara, Kiyoshi Komuta, Yoshiaki Inoue, Shigeru Chiba, Kunihiro Yamagata, Yuji Hiramatsu, Hirayasu Kai, Koichiro Asano, Tsuyoshi Oguma, Yoko Ito, Satoru Hashimoto, Masaki Yamasaki, Yu Kasamatsu, Yuko Komase, Naoya Hida, Takahiro Tsuburai, Baku Oyama, Minoru Takada, Hidenori Kanda, Yuichiro Kitagawa, Tetsuya Fukuta, Takahito Miyake, Shozo Yoshida, Shinji Ogura, Shinji Abe, Yuta Kono, Yuki Togashi, Hiroyuki Takoi, Ryota Kikuchi, Shinichi Ogawa, Tomouki Ogata, Shoichiro Ishihara, Arihiko Kanehiro, Shinji Ozaki, Yasuko Fuchimoto, Sae Wada, Nobukazu Fujimoto, Kei Nishiyama, Mariko Terashima, Satoru Beppu, Kosuke Yoshida, Osamu Narumoto, Hideaki Nagai, Nobuharu Ooshima, Mitsuru Motegi, Akira Umeda, Kazuya Miyagawa, Hisato Shimada, Mayu Endo, Yoshiyuki Ohira, Masafumi Watanabe, Sumito Inoue, Akira Igarashi, Masamichi Sato, Hironori Sagara, Akihiko Tanaka, Shin Ohta, Tomoyuki Kimura, Yoko Shibata, Yoshinori Tanino, Takefumi Nikaido, Hiroyuki Minemura, Yuki Sato, Yuichiro Yamada, Takuya Hashino, Masato Shinoki, Hajime Iwagoe, Hiroshi Takahashi, Kazuhiko Fujii, Hiroto Kishi, Masayuki Kanai, Tomonori Imamura, Tatsuya Yamashita, Masakiyo Yatomi, Toshitaka Maeno, Shinichi Hayashi, Mai Takahashi, Mizuki Kuramochi, Isamu Kamimaki, Yoshiteru Tominaga, Tomoo Ishii, Mitsuyoshi Utsugi, Akihiro Ono, Toru Tanaka, Takeru Kashiwada, Kazue Fujita, Yoshinobu Saito, Masahiro Seike, Hiroko Watanabe, Hiroto Matsuse, Norio Kodaka, Chihiro Nakano, Takeshi Oshio, Takatomo Hirouchi, Shohei Makino, Moritoki Egi, Yosuke Omae, Yasuhito Nannya, Takafumi Ueno, Tomomi Takano, Kazuhiko Katayama, Masumi Ai, Atsushi Kumanogoh, Toshiro Sato, Naoki Hasegawa, Katsushi Tokunaga, Makoto Ishii, Ryuji Koike, Yuko Kitagawa, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga, and Yukinori Okada

Subjects
Multidisciplinary, Membrane Glycoproteins, Quantitative Trait Loci, General Physics and Astronomy, COVID-19, General Chemistry, Polymorphism, Single Nucleotide, General Biochemistry, Genetics and Molecular Biology, Japan, Viral infection, Humans, Lectins, C-Type, Gene expression, Receptors, Immunologic, Transcriptomics, Genome-Wide Association Study
Abstract

Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection., 「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.

Published
2021

5. Clinical investigation of the utility of a pair of coagulation-fibrinolysis markers for definite diagnosis of sepsis-induced disseminated intravascular coagulation: A single-center, diagnostic, prospective, observational study

Author

Tomohisa Shoko and Takamitsu Masuda

Subjects
medicine.medical_specialty, 030204 cardiovascular system & hematology, Single Center, Gastroenterology, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Prospective Studies, Blood Coagulation, Disseminated intravascular coagulation, Receiver operating characteristic, business.industry, Fibrinolysis, Hematology, Disseminated Intravascular Coagulation, medicine.disease, Thrombosis, Systemic inflammatory response syndrome, 030220 oncology & carcinogenesis, Hemostasis, Mann–Whitney U test, business
Abstract

Background Disseminated intravascular coagulation (DIC) often occurs with sepsis. A scoring system has been used for the diagnosis of DIC, but the system included at least 4 parameters. The purpose of this study was to propose a simple set of DIC criteria with coagulation-fibrinolysis markers (CFMs). Methods Patients with ≥2 signs of systemic inflammatory response syndrome and a quick Sequential Organ Failure Assessment score ≥ 2 points were investigated. All blood samples were collected on Days 0, 1, 3, and 7. Cutoff values of CFMs were calculated by receiver operating curve analysis. Positive predictive values (PPVs) and negative predictive values (NPVs) for the Japanese Association for Acute Medicine (JAAM) DIC criteria were evaluated by pairing the markers. Differences were analyzed by the Mann–Whitney U test, Kruskal-Wallis test, and the log-rank test. Results A total of 107 patients were enrolled. The cutoff values of soluble fibrin (SF), protein C (PC), and plasminogen activator inhibitor (PAI)-1 were 48 μg/mL, 42%, and 71 ng/mL according to the International Society of Thrombosis and Hemostasis DIC criteria. The PPV of the severe SFxPC group was 100% for the JAAM DIC criteria, excluding Day 0. Conclusion Cutoff values of SF over 48 μg/mL and PC

Published
2019

6. Pharmaceutical Approach for the Diagnosis and Treatment of Malignant Syndrome: A Case Study

Author

Kazuhiro Watarai, Kenji Takahashi, Keisuke Kameda, Tomohisa Shoko, Masayoshi Koinuma, and Goro Ikushima

Subjects
Adult, Male, Administration, Oral, Pharmaceutical Science, 010402 general chemistry, 01 natural sciences, Dantrolene, Fentanyl, law.invention, Young Adult, Pharmacotherapy, law, Humans, Neuroleptic Malignant Syndrome, Medicine, Medical prescription, Infusions, Intravenous, Bromocriptine, Patient Care Team, Pharmacology, 010405 organic chemistry, business.industry, medicine.disease, Intensive care unit, 0104 chemical sciences, Neuroleptic malignant syndrome, Treatment Outcome, Hydroxyzine, Pharmaceutical Services, Anesthesia, Haloperidol, Midazolam, Drug Therapy, Combination, Interdisciplinary Communication, business, Propofol, Antipsychotic Agents, medicine.drug
Abstract

Since 2012, Matsudo City Hospital has increased the number of pharmacists stationed in the ward on weekday mornings at the emergency care center, the intensive care unit (ICU) and the high care unit (HCU). Multidisciplinary joint meetings and joint conferences are conducted in the emergency care center, and patient and drug information is shared. A 20-year-old man was transferred to our hospital after a traffic accident. He was diagnosed with subarachnoid hemorrhage and brain contusion. He exhibited violent movement and intense restlessness. He was sedated with a continuous intravenous infusion of 5 mg/h midazolam and 20 μg/h fentanyl, with intubation. Propofol was also used intermittently. The midazolam infusion was concluded on day 5 of hospitalization. However, his restlessness recurred so an intravenous drip infusion of 150 mg/h haloperidol was administered. On the 7th day, he developed a high-grade fever, muscle rigidity, perspiration, and leukocytosis, and malignant syndrome or malignant hyperthermia was suspected. For malignant syndrome treatment, he received an intravenous drip infusion of 60 mg dantrolene, followed by the combined oral administration of 100 mg/d dantrolene and 7.5 mg/d bromocriptine. Considering various pharmacological effects, we selected an intravenous drip infusion of 25 mg hydroxyzine hydrochloride as the drug to alleviate restlessness. The patient's course continued without recurrence of malignant syndrome; his symptoms improved because of pharmaceutical care with an awareness of patient benefits through clinical and laboratory findings, consultation with the attending physician, presentation of information on causative and therapeutic drugs, and coordinated planning of a prescription design.

Published
2016
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7. [FIRST REPORTED GENERAL ANESTHESIA SURGERY IN THE FIRST JAPANESE FIELD HOSPITAL]

Author

Tomohisa, Shoko and Yasuhiro, Otomo

Subjects
Emergency Medical Services, Nepal, Earthquakes, Joint Dislocations, Humans, Female, Anesthesia, General, Foot Injuries
Abstract

On April 25th, 2015, a massive 7.8-Mw earthquake occurred 77 km northwest of Kathmandu, the capital of Nepal. Disaster relief medical teams from the Japan International Cooperation Agency (JICA) were sent to Nepal on April 28th. The primary medical team consisted of 46 people, including two trauma surgeons. A meeting was held in Kathmandu by the Nepal Government Ministry of Health and Population and the World Health Organization for the foreign medical teams. The JICA team was asked to provide hub hospital services in Barhabise in the District of Sindhupalchok where some of the greatest damage had occurred. It was not until May 4th that medical supplies for our large medical tents and surgeries arrived in Kathmandu; the supplies were then sent on to Barhabise by road that same day. Our field hospital for both surgery and patient beds was finally operational on May 5th. This was the first time that a Japanese team performed surgery using general anesthesia in a Japanese field hospital. The surgery was for a left Lisfranc joint dislocation with open fracture in a 37-year-old woman. We had patients stay in the field hospital overnight after their surgeries. As the quantity of supplies increases, response times are affected because we have no transportation means such as the armed forces. These problems need to be considered in the future.

Published
2018

8. Clinical Investigation of Coagulation Markers for Early Detection of Sepsis-Induced Disseminated Intravascular Coagulation: A Single-Center, Prospective Observational Study

Author

Yoshizumi Deguchi, Takamitsu Masuda, and Tomohisa Shoko

Subjects
Adult, Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Single Center, Gastroenterology, Sepsis, sepsis, 03 medical and health sciences, 0302 clinical medicine, disseminated intravascular coagulation (DIC), Internal medicine, hemic and lymphatic diseases, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Disseminated intravascular coagulation, Aged, 80 and over, business.industry, 030208 emergency & critical care medicine, Hematology, General Medicine, Original Articles, Disseminated Intravascular Coagulation, Middle Aged, medicine.disease, Systemic inflammatory response syndrome, Coagulation, Observational study, Female, coagulation marker, business, Plasminogen activator, circulatory and respiratory physiology
Abstract

Disseminated intravascular coagulation (DIC) often complicates sepsis, and its early treatment is crucial for improving patient outcomes. Coagulation markers may enable earlier diagnosis of DIC. The purpose of this study was to evaluate whether the risk of DIC onset can be predicted using coagulation markers. Patients who showed symptoms of systemic inflammatory response syndrome ≥2 and the quick Sequential Organ Failure Assessment score ≥2 points were investigated. All blood samples collected from the time of hospital admission to 7 days postadmission were investigated. Patients were classified according to time of DIC onset (1) no DIC group (not DIC developed), (2) pre-DIC group (DIC onset >24 hours after admission), (3) DIC group (DIC onset at time of the admission) and according to cutoff values of coagulation markers, High group and Low group. Statistical differences were analyzed by log-rank test, Kruskal-Wallis rank test, and Friedman test. A total of 107 patients were enrolled in the study. Soluble fibrin (SF), plasminogen activator inhibitor (PAI)-1, and d-dimer levels were significantly increased even under pre-DIC conditions. Japanese Association for Acute Medicine (JAAM) DIC scores increased significantly over time in the High SF group (≥31.0 µg/mL) and High PAI-1 group (≥49.0 ng/mL), while JAAM DIC scores in the Low SF group remained ≤3 until day 7. We proposed the cutoff values of SF as 31 µg/mL to detect early phase of DIC. Soluble fibrin might be useful not only to predict DIC but also to exclude a diagnosis of DIC.

Published
2018

9. Predictive ability and interobserver reliability of computed tomography findings for angioembolization in patients with pelvic fracture

Author

Mitsuhiro Kishino, Kosuke Sekiya, Nao Urushibata, Atsushi Shiraishi, Yasuhiro Otomo, Shunsuke Yoshikawa, Makiko Honda, and Tomohisa Shoko

Subjects
Adult, Male, medicine.medical_specialty, Cross-sectional study, medicine.medical_treatment, MEDLINE, Critical Care and Intensive Care Medicine, Wounds, Nonpenetrating, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Fractures, Bone, 0302 clinical medicine, Medicine, Humans, In patient, Embolization, Retroperitoneal Space, Pelvic Bones, Aged, Retrospective Studies, Hematoma, medicine.diagnostic_test, business.industry, Angiography, Reproducibility of Results, 030208 emergency & critical care medicine, Retrospective cohort study, Middle Aged, medicine.disease, Embolization, Therapeutic, body regions, Cross-Sectional Studies, ROC Curve, Pelvic fracture, Surgery, Female, Radiology, Tomography, business, Tomography, X-Ray Computed
Abstract

The purpose of this study was to identify computed tomography (CT) findings that predict the need for angioembolization in patients with pelvic fracture.This retrospective cross-sectional study was performed between April 2006 and October 2015 at two urban emergency medical centers in Japan. The study included patients who underwent CT within 3 hours of arrival and were diagnosed with a pelvic fracture. The study outcome was undergoing angioembolization within 24 hours of arrival. Four independent readers blinded to all clinical information interpreted the CT scans for blush, thickness of retroperitoneal hematoma, and diameter and laterality of muscle swelling around the pelvis. Receiver operating characteristics analyses provided area under the receiver-operating characteristic curves (AUROC) and diagnostic indicators at the estimated thresholds including sensitivity, specificity, positive and negative predictive values and diagnostic odds ratio (DOR). The interobserver reliability of all radiographic findings was also evaluated.Fifty-two of 244 eligible patients underwent angioembolization. The predictive ability in terms of DOR was relatively better with blush on CT scan (sensitivity, 0.57; specificity, 0.86; DOR, 8.05) than with laterality of muscle swelling of 12.9 mm or greater (sensitivity, 0.79; specificity, 0.55; DOR, 4.60; AUROC, 0.75) and thickness of retroperitoneal hematoma of 22.7 mm or greater (sensitivity, 0.65; specificity, 0.74; DOR, 5.39; AUROC, 0.73). The interobserver reliability of blush, laterality of muscle swelling, and thickness of retroperitoneal hematoma was 0.43, 0.54, and 0.70, respectively.All of the tested CT findings failed to show both sufficient predictive ability and sufficient interobserver agreement. Further diagnostic accuracy studies to validate these findings or establish a prediction model incorporating these findings are expected.Diagnostic, level V.

Published
2017

10. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS‐KANTO [Survey of Survivors after Out‐of‐Hospital Cardiac Arrest in Kanto Area] 2012 Study)

Author

Kei Hayashida, Takashi Tagami, Tatsuma Fukuda, Masaru Suzuki, Naohiro Yonemoto, Yutaka Kondo, Tomoko Ogasawara, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Arino Yaguchi, Naoto Morimura, Nobuya Kitamura, Tomohisa Nomura, Naoki Shimizu, Akiko Akashi, Sadaki Inokuchi, Yoshihiro Masui, Kunihisa Miura, Haruhiko Tsutsumi, Kiyotsugu Takuma, Ishihara Atsushi, null Nakano, Hiroshi Tanaka, Keiichi Ikegami, Takao Arai, Shigeto Oda, Kenji Kobayashi, Takayuki Suda, Kazuyuki Ono, Ryosuke Furuya, Yuichi Koido, Fumiaki Iwase, Shigeru Kanesaka, Yasusei Okada, Kyoko Unemoto, Tomohito Sadahiro, Masayuki Iyanaga, Asaki Muraoka, Munehiro Hayashi, Yasufumi Miyake, Hideo Yokokawa, Yasuaki Koyama, Asuka Tsuchiya, Tetsuya Kashiyama, Munetaka Hayashi, Kiyohiro Oshima, Kazuya Kiyota, Yuichi Hamabe, Hiroyuki Yokota, Shingo Hori, Shin Inaba, Tetsuya Sakamoto, Naoshige Harada, Akio Kimura, Masayuki Kanai, Yasuhiro Otomo, Manabu Sugita, Kosaku Kinoshita, Takatoshi Sakurai, Mitsuhide Kitano, Kiyoshi Matsuda, Kotaro Tanaka, Katsunori Yoshihara, Kikuo Yoh, Junichi Suzuki, Hiroshi Toyoda, Kunihiro Mashiko, Takashi Muguruma, Tadanaga Shimada, Yoshiro Kobe, Tomohisa Shoko, Kazuya Nakanishi, Takashi Shiga, Takefumi Yamamoto, Kazuhiko Sekine, and Shinichi Izuka

Subjects
Male, medicine.medical_specialty, Time Factors, emergency department, medicine.medical_treatment, 030204 cardiovascular system & hematology, Resuscitation Science, cardiopulmonary resuscitation, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, Japan, Risk Factors, Odds Ratio, medicine, Humans, Hospital Mortality, Prospective Studies, Cardiopulmonary resuscitation, Intensive care medicine, Prospective cohort study, Original Research, Aged, Cardiopulmonary Resuscitation and Emergency Cardiac Care, Aged, 80 and over, Patient discharge, Chi-Square Distribution, Adult patients, business.industry, 030208 emergency & critical care medicine, Recovery of Function, Odds ratio, Emergency department, Middle Aged, Patient Discharge, mechanical chest compression device, Treatment Outcome, Multivariate Analysis, Emergency medicine, Female, Observational study, Cardiology Service, Hospital, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest
Abstract

Background Mechanical cardiopulmonary resuscitation ( mCPR ) for patients with out‐of‐hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results In a prospective, multicenter, observational study, adult patients with out‐of‐hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within‐institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out‐of‐hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20–0.78; P =0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.94; P =0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40–0.80; P =0.001). Conclusions After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out‐of‐hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

Published
2017
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11. Preventable Trauma Deaths after Traffic Accidents in Chiba Prefecture, Japan, 2011: Problems and Solutions

Author

Nobuya Kitamura, Hirotaro Iwase, Tsutomu Koyama, Kunihiro Mashiko, Hiroyuki Yokota, Shigeto Oda, Miyuki Kasuya, Tomohisa Shoko, Yuichi Fukumoto, Tomokazu Motomura, Fumihiko Shimamura, Koji Sakaida, Hisashi Matsumoto, and Ayumi Motomura

Subjects
Emergency Medical Services, business.industry, Incidence, Trauma center, Accidents, Traffic, Vital signs, Poison control, General Medicine, medicine.disease, Severity of Illness Index, Triage, Occupational safety and health, Japan, Trauma Centers, Cause of Death, Severity of illness, Injury prevention, Humans, Medicine, Medical emergency, business, Cause of death
Abstract

INTRODUCTION: The incidence of preventable trauma death in the current Japanese emergency medical system remains high. The present study aimed to determine rates of clearly preventable and possibly preventable trauma deaths due to traffic accidents in Chiba Prefecture, Japan, and to consider associated problems and solutions. MATERIALS AND METHODS: During 2011, 175 victims died after traffic accidents in Chiba Prefecture. Of these, the deaths of 69 persons who had vital signs at the time of emergency medical service contact were classified as clearly preventable, possibly preventable, or not preventable through the peer review discussion. We also examined problems associated with deaths that were clearly preventable or possibly preventable. RESULTS: Of the 69 deaths, 9 (13%) were classified as clearly preventable, 11 (16%) as possibly preventable, and 49 (71%) as not preventable. Of the 20 clearly or possibly preventable deaths (each death potentially comprising multiple problems), 5 were related to selection of the hospital before hospital arrival, 4 to problems with regional emergency medical systems, and 15 to inappropriate hemodynamic management, including transfusion and delayed (or not attempted) hemostasis in the hospital. DISCUSSION: Problems of these 20 deaths showed that appropriate triage at the scene, centralization of patients with severe trauma, and trauma centers are necessary in Japan. Under-triage before arrival at the hospital was related to clearly and possibly preventable deaths. Upgrading the triage category for victims with torso injury must be considered. Not all emergency critical care centers in Japan are able to provide severe trauma care. Preventable trauma deaths occur even in some emergency critical care centers; therefore, we need centralization of severe trauma patients from wider area to reduce the incidence of preventable trauma death. Language: en

Published
2014
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12. A New Rule for Terminating Resuscitation of Out-of-Hospital Cardiac Arrest Patients in Japan: A Prospective Study

Author

Naoki Shimizu, Naoshige Harada, Tomohito Sadahiro, Shinichi Ishimatsu, Takashi Shiga, Takayuki Suda, Yuichi Koido, Kikuo Yoh, Kunihiro Mashiko, Tetsuya Sakamoto, Keiichi Ikegami, Junichi Suzuki, Manabu Sugita, Shin Inaba, Katsunori Yoshihara, Takao Arai, Mitsuhide Kitano, Kosaku Kinoshita, Hiroshi Toyoda, Kazuya Nakanishi, Fumiaki Iwase, Munetaka Hayashi, Ryosuke Furuya, Kiyoshi Matsuda, Takatoshi Sakurai, Kazuhiko Sekine, Haruhiko Tsutsumi, Shinichi Izuka, Kiyotsugu Takuma, Kotaro Tanaka, Tadanaga Shimada, Yoshihiro Masui, Shigeru Kanesaka, Minoru Nakano, Ishihara Atsushi, Yasuhiro Otomo, Tomohisa Shoko, Takashi Muguruma, Kenji Kobayashi, Yoshiro Kobe, Yasuaki Koyama, Shigeto Oda, Asuka Tsuchiya, Nobuya Kitamura, Hideo Yokokawa, Akio Kimura, Yasufumi Miyake, Takefumi Yamamoto, Masayuki Kanai, Shingo Hori, Hiroyuki Yokota, Masayuki Iyanaga, Sadaki Inokuchi, Yasusei Okada, Hiroshi Tanaka, Yuichi Hamabe, Ken Nagao, Kyoko Unemoto, Kiyohiro Oshima, Tetsuya Kashiyama, Asaki Muraoka, Kunihisa Miura, Arino Yaguchi, Naoto Morimura, Kazuyuki Ono, Kazuya Kiyota, and Munehiro Hayashi

Subjects
Male, medicine.medical_specialty, Resuscitation, Emergency Medical Services, medicine.medical_treatment, 030204 cardiovascular system & hematology, Return of spontaneous circulation, Sensitivity and Specificity, Out of hospital cardiac arrest, Decision Support Techniques, 03 medical and health sciences, 0302 clinical medicine, Japan, Predictive Value of Tests, medicine, Emergency medical services, Humans, Cardiopulmonary resuscitation, Prospective Studies, Asystole, Intensive care medicine, Prospective cohort study, Aged, Resuscitation Orders, business.industry, 030208 emergency & critical care medicine, Service personnel, Middle Aged, medicine.disease, Cardiopulmonary Resuscitation, Outcome and Process Assessment, Health Care, Emergency Medicine, Female, business, Out-of-Hospital Cardiac Arrest
Abstract

Background The American Heart Association and European Resuscitation Council guidelines for cardiopulmonary resuscitation present rules for termination of resuscitation (TOR) in cases of out-of-hospital cardiac arrest (OHCA). In Japan, only doctors are legally allowed TOR in OHCA cases. Objective This study aimed to develop a new TOR rule that suits the actual situations of the Japanese emergency medical services system. Methods Five different combinations of the TOR rule criteria were compared regarding specificity and positive predictive value (PPV) for 1-month survival with unfavorable neurologic outcomes. The criteria were unwitnessed by emergency medical service personnel, unwitnessed by bystanders, initial unshockable rhythm in the field, initial asystole in the field, no shock delivered, no prehospital return of spontaneous circulation, unshockable rhythm at hospital arrival, and asystole at hospital arrival. Results A total of 13,291 cases were included. The following combination provided the highest specificity and PPV for predicting 1-month unfavorable neurologic outcomes and death: unwitnessed by bystanders, initial asystole in the field, and asystole at hospital arrival. The specificity and PPV for the combination of the three criteria for predicting 1-month unfavorable neurologic outcomes were 0.992 and 0.999, and for predicting death at 1 month after OHCA were 0.986 and 0.998, respectively. Conclusions OHCA patients fulfilling the criteria unwitnessed by bystanders and asystole in the field and at hospital arrival had universally poor outcomes. Termination of resuscitation after hospital arrival for these patients may decrease unwarranted treatments.

Published
2016

13. Effect of Pre-existing Medical Conditions on In-Hospital Mortality: Analysis of 20,257 Trauma Patients in Japan

Author

Tomohisa Shoko, Yasuhiro Otomo, Atsushi Shiraishi, and Masahito Kaji

Subjects
Adult, Liver Cirrhosis, Male, Pediatrics, medicine.medical_specialty, Adolescent, Poison control, Comorbidity, Young Adult, Injury Severity Score, Japan, Intellectual Disability, Neoplasms, Injury prevention, Odds Ratio, medicine, Humans, Hospital Mortality, Aged, Retrospective Studies, Aged, 80 and over, Abbreviated Injury Scale, business.industry, Mortality rate, Incidence (epidemiology), Age Factors, Anticoagulants, Odds ratio, Middle Aged, Hematologic Diseases, Asthma, Surgery, Logistic Models, Psychotic Disorders, Acute Disease, Life expectancy, Wounds and Injuries, Dementia, Female, business
Abstract

Background The average life expectancy of Japanese individuals is the longest in the world. The mortality rate from injury is increasing among older people. There have been no detailed reports on the relationship between pre-existing medical conditions (PMCs) and mortality from trauma among elderly people in Japan. Study Design We conducted a retrospective analysis using 20,257 cases recorded in the Japan Trauma Data Bank from 2004 to 2007. The subjects were 11,590 hospital inpatients (57.2%) 16 years of age or older. A logistic regression analysis was conducted for the relation between 23 PMCs and in-hospital mortality. Results Overall in-hospital mortality was 10.8%, and for people 75 years of age and older, was 17.7%. The incidence of PMC was 4,752 (41.0%). Patients with PMCs of cirrhosis, active cancer, chronic obstructive pulmonary disease, hematologic disorders, anticoagulation drugs, dementia or mental retardation, or other conditions had higher in-hospital mortality. The existence of a single PMC did not increase mortality, but with 2 or more PMCs, mortality significantly increased. The existence of 2 or more PMCs in the 50- to 74-year-old age group and in the minor injury group strongly affected the odds ratio for mortality. Conclusions The existence of certain PMCs or of 2 or more PMCs increases in-hospital mortality from injury. This effect is particularly conspicuous in middle-aged patients and people with minor injuries, but was not found to be a problem among elderly people. The increased mortality from injury in elderly people in Japan is therefore not affected by the existence of PMCs.

Published
2010
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14. Needs for disaster medicine: lessons from the field of the Great East Japan Earthquake

Author

Yutaka Ueki, Naoki Tosaka, Steven Bice, Tamano Matsui, Hiroto Ushizawa, Yasuhiro Otomo, Junichi Aiboshi, Alice Ruth Foxwell, and Tomohisa Shoko

Subjects
education, lcsh:Medicine, Poison control, Context (language use), Disaster Planning, Phase (combat), Suicide prevention, Occupational safety and health, Disaster Medicine, Japan, Earthquakes, Medicine, Humans, health care economics and organizations, Other Topic, Health Services Needs and Demand, Primary Health Care, business.industry, lcsh:Public aspects of medicine, Communication, lcsh:R, lcsh:RA1-1270, Relief Work, General Medicine, Great East Japan Earthquake, medicine.disease, Triage, lessons from the field, Tsunamis, Medical emergency, business, Radioactive Hazard Release, Disaster medicine
Abstract

PROBLEM: The Great East Japan Earthquake, which occurred in Tohoku, Japan on 11 March 2011, was followed by a devastating tsunami and damage to nuclear power plants that resulted in radiation leakage. CONTEXT: The medical care, equipment and communication needs of four Disaster Medical Assistance Teams (DMAT) during four missions are discussed. DMATs are medically trained mobile teams used in the acute phase of disasters. ACTION: The DMATs conducted four missions in devastated areas from the day of the earthquake to day 10. The first and second missions were to triage, resuscitate and treat trauma victims in Tokyo and Miyagi, respectively. The third mission was to conduct emergency medicine and primary care in Iwate. The fourth was to assist with the evacuation and screening of inpatients with radiation exposure in Fukushima. OUTCOME: Triage, resuscitation and trauma expertise and equipment were required in Missions 1 and 2. Emergency medicine in hospitals and primary care in first-aid stations and evacuation areas were required for Mission 3. In Mission 4, the DMAT assisted with evacuation by ambulances and buses and screened people for radiation exposure. Only land phones and transceivers were available for Missions 1 to 3 although they were ineffective for urgent purposes. DISCUSSION: These DMAT missions showed that there are new needs for DMATs in primary care, radiation screening and evacuation after the acute phase of a disaster. Alternative methods for communication infrastructure post-disaster need to be investigated with telecommunication experts. Language: en

Published
2013

15. The day after the disaster: a report from a Japanese disaster medical assistance team

Author

Tomohisa Shoko, Yutaka Ueki, Atsushi Shiraishi, and Yasuhiro Otomo

Subjects
Patient Care Team, Injury control, business.industry, Accident prevention, Public Health, Environmental and Occupational Health, Human factors and ergonomics, Poison control, medicine.disease, Relief Work, Suicide prevention, Occupational safety and health, Disasters, Japan, Injury prevention, medicine, Earthquakes, Humans, Medical emergency, business
Published
2012

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