Inconsistency in the Standard of Care-Toward Evidence-Based Management of Exertional Heat Stroke.

Tokyo 2020 Summer Olympics are projected to experience environmental heat stress that surpasses the environmental conditions observed in the Atlanta (1996), Athens (2004), Beijing (2008), and Rio (2016) Summer Olympics. This raises particular concerns for athletes who will likely to be exposed to extreme heat during the competitions. Therefore, in mass-participation event during warm season, it is vital for the hosting organization to build preparedness and resilience against heat, including appropriate treatment, and management strategies for exertional heat stroke (EHS).

Grand Sumo Tournaments and Out-of-Hospital Cardiac Arrests in Tokyo.

Background: Sumo wrestling is a demanding sport. Although watching sumo wrestling may have cardiovascular effects, no studies of this relationship have been performed. Thus, we aimed to evaluate the association between sumo wrestling tournaments and the rate of out-of-hospital cardiac arrests.

Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest.

Introduction: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs.

Interaction of defibrillation waveform with the time to defibrillation or the number of defibrillation attempts on survival from out-of-hospital cardiac arrest.

Aim: Early biphasic defibrillation is effective in out-of-hospital cardiac arrest (OHCA) cases. In the resuscitation of patients with OHCA, it is not clear how the defibrillation waveform interacts with the time to defibrillation to influence patient survival. The second, and any subsequent, shocks need to be administered by an on-line physician in Japan.

Effects of advanced life support on patients who suffered cardiac arrest outside of hospital and were defibrillated.

Background: The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood.

Methods: This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed.

Age × Gender Interaction Effect on Resuscitation Outcomes in Patients With Out-of-Hospital Cardiac Arrest.

Although an interaction between gender and age has been shown to influence resuscitation outcomes in patients with out-of-hospital cardiac arrest (OHCA), this interaction has not been investigated in Asian populations. In this prospective, observational study, data from all cases of OHCA in Japan between 2005 and 2012 were obtained from the Japanese National Registry. We determined the relative excess risk due to interaction and the ratio of odds ratios (ORs) to assess the interaction effect of gender and age on the incidence of return of spontaneous circulation (ROSC) before hospital arrival, 1-month survival, and neurologically intact survival 1 month after OHCA.

Successful Hospital Evacuation After the Kumamoto Earthquakes, Japan, 2016.

Two major earthquakes struck Kumamoto Prefecture in Japan in April 2016. Disaster response was immediately provided, including disaster medical services. Many hospitals were damaged and patients needed immediate evacuation to alternative facilities.

Factors associated with the outcome of out-of-hospital cardiopulmonary arrest among people over 80 years old in Japan.

Aim: To determine if termination of resuscitation should be considered for older individuals, we sought to identify factors associated with clinical outcome following out-of-hospital cardiac arrest (OHCA) in people ≥80 years old and over.

Methods: A prospective, population-based, observational study was conducted for ≥80-year-old individuals who experienced out-of-hospital cardiac arrest and to whom resuscitation was provided by emergency responders between January 1, 2005 and December 31, 2012 (n=377,577). The primary endpoint was 1-month survival.

Resuscitation outcomes of reproductive-age females who experienced out-of-hospital cardiac arrest.

Background: Although some studies have shown that women in their reproductive years have better resuscitation outcomes of out-of-hospital cardiac arrest (OHCA), conflicting results and methodological problems have also been noted. Thus, we evaluated the resuscitation outcomes of OHCA of females by age.

Methods: This was a prospective observational study using registry data from all OHCA cases between 2005 and 2012 in Japan.

Ambulance Dispatches From Unaffected Areas After the Great East Japan Earthquake: Impact on Emergency Care in the Unaffected Areas.

Objective: Although dispatching ambulance crews from unaffected areas to a disaster zone is inevitable when a major disaster occurs, the effect on emergency care in the unaffected areas has not been studied. We evaluated whether dispatching ambulance crews from unaffected prefectures to those damaged by the Great East Japan Earthquake was associated with reduced resuscitation outcomes in out-of-hospital cardiac arrest (OHCA) cases in the unaffected areas.

Methods: We used the Box-Jenkins transfer function model to assess the relationship between ambulance crew dispatches and return of spontaneous circulation (ROSC) before hospital arrival or 1-month survival after the cardiac event.

The number of prehospital defibrillation shocks and 1-month survival in patients with out-of-hospital cardiac arrest.

Background: The relationship between the number of pre-hospital defibrillation shocks and treatment outcome in patients with out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation (VF) is unknown currently. We examined the association between the number of pre-hospitalization defibrillation shocks and 1-month survival in OHCA patients.

Methods: We conducted a prospective observational study using national registry data obtained from patients with OHCA between January 1, 2009 and December 31, 2012 in Japan.

Favipiravir: a new medication for the Ebola virus disease pandemic.

The purpose of this report is to advocate speedy approval and less stringent regulations for the use of experimental drugs such as favipiravir in emergencies. Favipiravir is a new antiviral medication that can be used in emerging viral pandemics such as Ebola virus, 2009 pandemic influenza H1N1 virus, Lassa fever, and Argentine hemorrhagic fever. Although favipiravir is one of the choices for the treatment of patients with Ebola virus, several concerns exist.

Factors associated with the clinical outcomes of paediatric out-of-hospital cardiac arrest in Japan.

Objectives: To better understand and predict clinical outcomes of paediatric out-of-hospital cardiac arrest (OHCA).

Design: A population-based, observational study.

Setting: The National Japan Utstein Registry.

Physician presence in an ambulance car is associated with increased survival in out-of-hospital cardiac arrest: a prospective cohort analysis.

The presence of a physician seems to be beneficial for pre-hospital cardiopulmonary resuscitation (CPR) of patients with out-of-hospital cardiac arrest. However, the effectiveness of a physician's presence during CPR before hospital arrival has not been established. We conducted a prospective, non-randomized, observational study using national data from out-of-hospital cardiac arrests between 2005 and 2010 in Japan.

Rationale and study design of the Japan environment and children's study (JECS).

Background: There is global concern over significant threats from a wide variety of environmental hazards to which children face. Large-scale and long-term birth cohort studies are needed for better environmental management based on sound science. The primary objective of the Japan Environment and Children's Study (JECS), a nation-wide birth cohort study that started its recruitment in January 2011, is to elucidate environmental factors that affect children's health and development.

The aging population and future demand for emergency ambulances in Japan.

Demand for emergency ambulances has been increasing in developmentally advanced countries, and in Japan demand has been increasing due to the aging population since 2008, when the total population began to decrease. However, we do not know how acceleration of the aging population relates to the demand for emergency ambulances. Thus, we estimated future demand for emergency ambulances in Japan.

Consumption of seafood, serum liver enzymes, and blood levels of PFOS and PFOA in the Japanese population.

Objective: Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) have been shown to accumulate in the human body. The purpose of the present study was to examine the factors associated with the blood levels of PFOS and PFOA.

Methods: A cross-sectional study was performed on 307 men and 301 women (aged 16-76 years) living in 15 prefectures in Japan.

Prehospital lactated ringer's solution treatment and survival in out-of-hospital cardiac arrest: a prospective cohort analysis.

Background: No studies have evaluated whether administering intravenous lactated Ringer's (LR) solution to patients with out-of-hospital cardiac arrest (OHCA) improves their outcomes, to our knowledge. Therefore, we examined the association between prehospital use of LR solution and patients' return of spontaneous circulation (ROSC), 1-month survival, and neurological or physical outcomes at 1 month after the event.

Methods And Findings: We conducted a prospective, non-randomized, observational study using national data of all patients with OHCA from 2005 through 2009 in Japan.

Association between blood levels of PCDDs/PCDFs/dioxin-like PCBs and history of allergic and other diseases in the Japanese population.

Background: Previous studies reported that exposure to dioxins was associated with an increased risk of various diseases in general populations.

Objectives: The aim of this study was to examine the association between levels of dioxins in blood and allergic and other diseases.

Methods: We conducted a cross-sectional study on 1,063 men and 1,201 women (aged 15-76 years), who were living throughout Japan and not occupationally exposed to dioxins, during 2002-2010.

Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest.

Context: Epinephrine is widely used in cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA). However, the effectiveness of epinephrine use before hospital arrival has not been established.

Objective: To evaluate the association between epinephrine use before hospital arrival and short- and long-term mortality in patients with cardiac arrest.