Impact of epinephrine on neurological outcomes in out-of-hospital cardiac arrest after automated external defibrillator use in Japan.

OHCA (out-of-hospital cardiac arrest) patients have improved neurological outcomes with public-access automated external defibrillator (PAD) use. However, the benefit of epinephrine administration after PAD use remains controversial. The purpose of the study was to investigate the impact of epinephrine administration on neurological outcomes in OHCA patients after PAD use.

Annual improvement trends in resuscitation outcome of patients defibrillated by laypersons after out-of-hospital cardiac arrests and compression-only resuscitation of laypersons.

Aim: We aimed to investigate the effect of compression-only cardiopulmonary resuscitation (CPR) with conventional CPR in patients who were defibrillated by laypersons.

Methods: This is a population-based, nationwide observational study. Adult and children who sustained a witnessed out-of-hospital cardiac arrest and defibrillated by laypersons between 2005 to 2019 were identified on the national database.

Liver Abscess due to Bacteremia and Its Association with Colonic Carcinoma: Is Bacteremia with an Alert for Colonic Carcinoma?

Liver abscess caused by some kinds of group such as group has been recognized to associate with colorectal cancer. group with liver abscess has not been received much attention in this point of view. Here, we report the case of a 63-year-old man who developed liver abscess with , which belongs to the group.

Medical students' perceptions of emergency medical care before and during the coronavirus disease 2019 pandemic.

Aim: Understanding how medical students perceive emergency medical care is important in promoting education and recruitment in the field of emergency medicine. This study aimed to clarify the perceptions of undergraduate medical students on emergency medical care with a focus on comparing their perceptions before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Fourth-year undergraduate medical students were invited to complete a self-administered questionnaire in 2017 and 2020.

Heuristic bias in perception of medical students relating to out-of-hospital cardiac arrests.

Aim: The aim of this study was to assess the perceptions of medical students with respect to out-of-hospital cardiac arrests focusing on the frequency and survival and to identify potential problems in resuscitation education.

Methods: Fourth-year medical students in a six-year undergraduate educational system were asked to guess the number of out-of-hospital cardiac arrests with cardiac etiology per year in Japan, related data such as the one-month survival rate from out-of-hospital cardiac arrests with cardiac etiology and the number of deaths from traffic accidents for comparison. The guesses of students were compared with actual statistical data.

A case of black esophagus with duodenal involvement.

Black esophagus is a rare condition referred from acute necrosis of the esophagus, with characteristic endoscopic finings of circumferential black appearance of the mucosa. Black esophagus is associated with systemic dysfunction, such as massive bleeding, or severe dehydration. Although the duodenal mucosa is also susceptible to ischemia, reports of black esophagus with duodenal involvement, such as bleeding or perforation, are limited.

Outcomes after out-of-hospital cardiac arrests by anaphylaxis: A nationwide population-based observational study.

Aim: The objective of this study was to focus on outcomes of anaphylaxis-associated out-of hospital cardiac arrest (OHCA) in non-cardiac cases.

Methods: All residents with OHCA due to non-cardiac cause in Japan from 2013 to 2015 were included for analysis. Propensity score matching and logistic regression analyses were used to assess outcome-related factors in anaphylaxis cases and non-anaphylaxis cases.

Relationship between evaluation of the teaching environment using DREEM scores and students' school learning scores.

This article was migrated. The article was marked as recommended. The results from a comprehensive survey of students' perceptions of their educational environment using the Dundee Ready Educational Environment Measure (DREEM) in our Medical School were compared with students' school learning scores.

Intracellular fate of Ureaplasma parvum entrapped by host cellular autophagy.

Genital mycoplasmas, including Ureaplasma spp., are among the smallest human pathogenic bacteria and are associated with preterm birth. Electron microscopic observation of U.

The Current Status of Development and Implementation of Medical Emergency Response Plan in Schools.

Background: Automated external defibrillators (AEDs) have been widely distributed at schools in Japan. We have demonstrated that ventricular fibrillation accounted for 68% of nontraumatic sudden cardiac arrest (SCA) in schools, suggesting that a well-prepared medical emergency response plan (MERP) for schools would improve the outcomes of SCA patients. However, it is uncertain if the MERP has been well developed or implemented in Japanese schools.

Regional health expenditure and health outcomes after out-of-hospital cardiac arrest in Japan: an observational study.

Objectives: Japan is considering policies to set the target health expenditure level for each region, a policy approach that has been considered in many other countries. The objective of this study was to examine the relationship between regional health expenditure and health outcomes after out-of-hospital cardiac arrest (OHCA), which incorporates the qualities of prehospital, in-hospital and posthospital care systems.

Design: We examined the association between prefecture-level per capita health expenditure and patients' health outcomes after OHCA.

Characteristics and trends of emergency patients with drug overdose in Osaka.

Aim: Drug overdose is an important issue in emergency medicine. However, studies covering overdose patients transported by ambulance have not been sufficiently carried out. We attempted to clarify problems of suspected drug overdose patients transported by ambulance.

Social regulations predispose people to complete vaccination for vaccine-preventable diseases.

Japan experienced measles outbreaks in both 2006 and 2007 mainly among university students. Improvement of vaccine coverage against vaccine-preventable viral infections is the prime task for preventing outbreaks of viral infections. To elucidate the promoting factors for complete vaccination against measles, rubella, mumps, and varicella-zoster viruses, we conducted a case-control study among single university students in Japan.

Effectiveness of prehospital Magill forceps use for out-of-hospital cardiac arrest due to foreign body airway obstruction in Osaka City.

Background: Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO.

Methods: We retrospectively reviewed ambulance records of all patients who suffered FBAO, and were treated by EMS in Osaka City from 2000 through 2007, and assessed the characteristics of those patients.

Epidemiological characteristics of sudden cardiac arrest in schools.

Aims: The present study aimed to clarify the incidence and outcomes of sudden cardiac arrests in schools and the clinically relevant characteristics of individuals who experienced sudden cardiac arrests.

Methods And Results: We obtained data on sudden cardiac arrests that occurred in schools between January 1, 2005 and December 31, 2009 from the database of the Utstein Osaka Project, a population-based observational study on out-of-hospital cardiac arrests in Osaka, Japan. The data were analyzed to show the epidemiological features of sudden cardiac arrests in schools in conjunction with prehospital documentation.

Ambulance calls and prehospital transportation time of emergency patients with cardiovascular events in Osaka City.

Aim: This study investigated the association between the number of phone calls made to hospitals from ambulances requesting if they can accept prehospital emergency patients with cardiovascular events, and the prehospital transportation time.

Methods: Using ambulance records, we retrospectively enrolled adult patients suffering acute myocardial infarction from 1998 to 2007, and out-of-hospital cardiac arrest of cardiac origin from 2000 to 2007, transported to medical institutions by the emergency medical service in Osaka City.

Results: During the study period, 8,596 patients with acute myocardial infarction without arrest and 9,283 out-of-hospital cardiac arrests of cardiac origin were registered.

Serological assessment of measles-rubella vaccination catch-up campaign among university students.

Background: In Japan, 5000-300,000 persons contracted measles every year until 2001. The measles/rubella-combined (MR) vaccination at age 17-18 years (phase 4 MR vaccination: MR-IV) was launched in 2008 in Japan as a measles-rubella catch-up campaign. A serological assessment of this campaign has not been thoroughly performed.

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings.

Background: Stroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaired consciousness patients.

Influence of Vaccination dose and clinico-demographical factors on antibody titers against measles, rubella, mumps, and varicella-zoster viruses among university students in Japan.

To evaluate the influence of vaccination dose and clinico-demographical factors on immune status against measles, rubella, mumps, and varicella viruses among university students, we conducted a case-control study by analyzing serum antibody titers according to past immunization and infection, and perinatal histories, using a multivariate regression model. A total of 1370 medical, paramedical, and pharmaceutical students were included in the analysis. Two or more doses of measles and rubella vaccination yielded notably greater odds ratios for immuno-positivity (9.

Impact of the number of on-scene emergency life-saving technicians and outcomes from out-of-hospital cardiac arrest in Osaka City.

Backgrounds: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome.

Regional variation in survival following pediatric out-of-hospital cardiac arrest.

Background: Although regional variation in outcome after adult out-of-hospital cardiac arrest (OHCA) is known, no clinical studies have assessed this in pediatric OHCA.

Methods And Results: This nationwide, prospective, population-based observation of the whole of Japan included consecutive OHCA patients with resuscitation attempt from January 2005 through December 2009. Primary outcome was 1-month survival with neurologically favorable outcome.

Regional variability in survival outcomes of out-of-hospital cardiac arrest: the All-Japan Utstein Registry.

Objective: There is a paucity of studies on the degree of regional variability in out-of-hospital cardiac arrest (OHCA) outcomes, particularly in neurological outcome. This study aimed to determine whether there is a significant regional variation in survival outcomes of OHCA across Japan.

Methods: We analyzed a prospective, nation-wide, population-based database (All-Japan Utstein Registry) involving all Japanese individuals who had non-traumatic OHCA resuscitated by emergency responders from January 2005 through December 2010.

Association of prehospital advanced airway management with neurologic outcome and survival in patients with out-of-hospital cardiac arrest.

Importance: It is unclear whether advanced airway management such as endotracheal intubation or use of supraglottic airway devices in the prehospital setting improves outcomes following out-of-hospital cardiac arrest (OHCA) compared with conventional bag-valve-mask ventilation.

Objective: To test the hypothesis that prehospital advanced airway management is associated with favorable outcome after adult OHCA.

Design, Setting, And Participants: Prospective, nationwide, population-based study (All-Japan Utstein Registry) involving 649,654 consecutive adult patients in Japan who had an OHCA and in whom resuscitation was attempted by emergency responders with subsequent transport to medical institutions from January 2005 through December 2010.