Publications by authors named "Norihiro Nishioka"
Background: Bystander cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) has increased in Singapore, Japan, and South Korea following the implementation of several public health, bystander-focused interventions, such as dispatcher-assisted CPR and community CPR training. It is unclear whether bystander CPR prevalence will continue on this trajectory over time. This study aimed to investigate the temporal trends of bystander CPR prevalence over a ten-year period in these three Asian countries.
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- The article aims to update evidence on the effectiveness and safety of DMARDs for rheumatoid arthritis (RA) to inform the 2024 guidelines by the Japan College of Rheumatology.
- A thorough search included randomized controlled trials published until June 2022, with independent reviews and meta-analyses conducted on 15 clinical questions related to RA treatment.
- Key findings indicate that subcutaneous methotrexate is as effective as oral, ozoralizumab with methotrexate is more effective than a placebo, and biosimilars are equally effective as their original counterparts in treating RA.
Epidemiology, microbiology, and diagnosis of infection in diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: A multicenter retrospective observational study.
Diabetes Res Clin Pract
June 2024
Article Synopsis
- The study analyzed infection characteristics and the usefulness of inflammatory markers in patients with diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) across 21 hospitals in Japan.
- It included 771 adult patients, finding that 70 had positive blood cultures, with higher mortality rates in those with bacteremia (14% vs. 3.3%).
- C-reactive protein (CRP) was identified as a more reliable diagnostic marker for bacteremia than procalcitonin (PCT) in hyperglycemic emergencies.
Background: Few prediction models for individuals with early-stage out-of-hospital cardiac arrest (OHCA) have undergone external validation. This study aimed to externally validate updated prediction models for OHCA outcomes using a large nationwide dataset.
Methods And Results: We performed a secondary analysis of the JAAM-OHCA (Comprehensive Registry of In-Hospital Intensive Care for Out-of-Hospital Cardiac Arrest Survival and the Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest) registry.
Non-linear association between the time required to reaching temperature targets and the neurological outcome in patients undergoing targeted temperature management after out-of-hospital cardiac arrest: Observational multicentre cohort study.
Resusc Plus
June 2024
Article Synopsis
- The study aimed to investigate how long it takes to reach temperature targets during targeted temperature management for patients who experienced out-of-hospital cardiac arrest and how this affects their neurological outcomes one month later.
- Researchers analyzed data from 473 patients transported to hospitals in Osaka, Japan, focusing on their neurological status assessed by the Cerebral Performance Category scale one month after the incident.
- Results showed that achieving target temperatures faster was linked to better neurological outcomes, with the fourth quintile (175.2-352.1 minutes) having the highest percentage of favorable outcomes compared to the other time frames.
Aim/introduction: This historical cohort study sought to research the relationship between eating behaviors and the incidence of type 2 diabetes in a large, long-term cohort of Japanese subjects.
Materials And Methods: Panasonic Corporation employees who had no history of diabetes and attended yearly health surveys between 2008 and 2018 were included in this study. The main outcome measure was diabetes onset.
Article Synopsis
- - A study was conducted in Japan to investigate the effects of chloride loading on hospitalized patients with diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) who experienced acute kidney injury (AKI).
- - The researchers grouped patients based on the amount of chloride they received in the first 48 hours and looked at two main outcomes: recovery from AKI and major adverse kidney events (like mortality and prolonged renal failure) within 30 days.
- - Results showed no significant difference in recovery rates or adverse kidney events between those receiving high or low chloride, suggesting that chloride loading does not affect recovery from AKI in these hyperglycemic emergency cases. !
Objective: The study objective was to investigate whether changes in metabolic phenotype affect the risk of cardiovascular events.
Methods: All 117,589 participants were included in this retrospective cohort study. The metabolic phenotypes of the participants were assessed at two points (the second evaluation was set 2 years after the first evaluation), and the incidence rate of cardiovascular events was observed for 11 years.
Article Synopsis
- Out-of-hospital cardiac arrest (OHCA) is critical, and implementing effective "chain of survival" strategies is crucial for improving patient survival rates; monitoring these processes is essential for quality assurance.
- In Japan, various OHCA registries such as the All-Japan Utstein registry and regional projects like the Osaka-CRITICAL study have been established to collect and analyze extensive data on OHCA cases, enhancing emergency medical services.
- Each registry has unique strengths and challenges but collectively contributes to improving emergency response systems and advancing resuscitation science in Japan.
Article Synopsis
- - The study explored how well fibrinogen/fibrin degradation product (FDP) and D-dimer levels predict the need for massive fresh frozen plasma (FFP) transfusion in blunt trauma patients compared to fibrinogen (Fib) levels.
- - It analyzed data from 2160 patients, finding that FDP and D-dimer levels at specific cutoff values had high sensitivity and negative predictive values for indicating the need for FFP transfusion, while Fib levels showed low sensitivity.
- - The conclusion indicates that FDP and D-dimer are more reliable than Fib in predicting the requirement for massive FFP transfusions shortly after hospital arrival.
Article Synopsis
- The study investigated survival outcomes of adults who experienced out-of-hospital cardiac arrest due to drowning, comparing two airway management techniques: endotracheal intubation (ETI) and supraglottic airway (SGA).
- Using data from a Japanese nationwide registry, researchers matched patients treated with ETI and SGA based on similar characteristics to assess return of spontaneous circulation (ROSC), one-month survival, and neurological outcomes.
- Results showed that ETI led to a higher ROSC rate than SGA but did not result in significant differences in one-month survival or favorable neurological outcomes between the two methods.
Background: Previous research indicated outcomes among refractory out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm were different in Singapore and Osaka, Japan, possibly due to the differences in access to extracorporeal cardiopulmonary resuscitation. However, this previous study had a risk of selection bias. To address this concern, this study aimed to evaluate the outcomes between Singapore and Osaka for OHCA patients with initial shockable rhythm using only population-based databases.
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- ECPR is being explored as a potential life-saving treatment for patients who experience out-of-hospital cardiac arrest (OHCA), focusing on how it impacts survival and brain function outcomes.
- The study analyzed data from a large registry, comparing ECPR-treated patients with a control group and considering factors like initial heart rhythm (shockable vs. non-shockable) to evaluate the effectiveness of ECPR.
- Results indicated that ECPR significantly improved survival rates after 30 days, particularly for patients with non-shockable rhythms, suggesting further research is needed to explore its full potential and identify the best candidates for this treatment.
Article Synopsis
- * The research used data from a Japanese registry and found 2738 applicable patients from a larger group of 57,754 who had non-traumatic shockable OHCA.
- * Results indicated that while IABP appeared less effective in the original analysis, using a different statistical approach showed no significant difference in favorable outcomes between patients with and without IABP.
Article Synopsis
- Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS) are serious diabetes complications that need more research on their clinical profiles.
- A study analyzed the medical records of 771 hospitalized adults in Japan from 2012 to 2016 to compare outcomes among different severity levels of DKA and HHS.
- Findings revealed that common triggers included poor medication adherence and infections, with ICU admission rates at 44.4% and mortality rates of 2.8% for DKA and 7.1% for HHS, indicating no significant difference in mortality among DKA severity levels.
Background: Singapore and Osaka in Japan have comparable population sizes and prehospital management; however, the frequency of ECPR differs greatly for out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm. Given this disparity, we hypothesized that the outcomes among the OHCA patients with initial shockable rhythm in Singapore were different from those in Osaka. The aim of this study was to evaluate the outcomes of OHCA patients with initial shockable rhythm in Singapore compared to the expected outcomes derived from Osaka data using machine learning-based prediction models.
View Article and Find Full Text PDFObjectives: In anticancer clinical trials, particularly open-label trials, central reviewers are recommended to evaluate progression-free survival (PFS) and objective response rate (ORR) to avoid detection bias of local investigators. However, it is not clear whether the bias has been adequately identified, or to what extent it consistently distorts the results. Therefore, the objective of this study was to evaluate the detection bias in oncological open-label trials by confirming whether local investigators overestimate the PFS and ORR compared with the findings of central reviewers.
View Article and Find Full Text PDFBackground: Japan has the second highest prevalence of dialysis use in the world. Approximately 40% of patients who begin dialysis have diabetic kidney disease (DKD). Local governments and medical facilities are required to provide preventive measures against worsening diabetes mellitus (DM).
View Article and Find Full Text PDFEvidence on common eating behaviors to support the prevention of cardiovascular disease (CVD) in Japanese people is insufficient. This retrospective cohort study aimed to investigate the association of diet behaviors (eg, skipping breakfast, eating speed, snack after dinner, and alcohol consumption) with incident CVD in Japanese individuals. Employees of Panasonic Corporation who underwent the annual health checkups and without a history of CVD at baseline were enrolled.
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- This study evaluated how effective ECG findings, specifically STEMI equivalents, are in diagnosing acute coronary syndrome in patients who experienced out-of-hospital cardiac arrest (OHCA).
- Researchers analyzed data from a registry between 2012 and 2017, focusing on patients who had specific ECG patterns upon achieving return of spontaneous circulation (ROSC).
- The results indicated that while certain ECG signs like isolated T-wave inversion and Wellens' signs had high specificity for ACS, their overall diagnostic accuracy was low, suggesting that more research is needed to understand the timing of ECG assessments after ROSC.
Carnitine supplements for people with chronic kidney disease requiring dialysis.
Cochrane Database Syst Rev
December 2022
Background: Carnitine deficiency is common in patients with chronic kidney disease (CKD) who require dialysis. Several clinical studies have suggested that carnitine supplementation is beneficial for dialysis-related symptoms. However, the clinical effectiveness and potential adverse effects of carnitine supplementation in dialysis patients have not been determined.
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- The study aimed to validate the TiPS65 score, which predicts neurological outcomes for patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR).
- Data were analyzed from a nationwide registry of OHCA cases, focusing on adult patients with shockable rhythms treated with ECPR, using factors like age and initial cardiac rhythm as predictors.
- Results showed that while the TiPS65 score had reasonable predictive ability, only 10.8% of patients had favorable neurological outcomes, indicating that the score can assist in selecting appropriate candidates for ECPR.
Background: An association between post-arrest hyperoxaemia and worse outcomes has been reported for out-of-hospital cardiac arrest (OHCA) patients, but little is known about the relationship between intra-arrest hyperoxaemia and clinically relevant outcomes. This study aimed to investigate the association between intra-arrest hyperoxaemia and outcomes for OHCA patients.
Methods: This was an observational study using a registry database of OHCA cases that occurred between 2014 and 2017 in Japan.
Background: We aimed to investigate the association between blood urea nitrogen to creatinine ratio (BCR) and survival with favourable neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA).
Methods: This prospective, multicentre, observational study conducted in Osaka, Japan enrolled consecutive OHCA patients transported to 16 participating institutions from 2012 through 2019. We included adult patients with non-traumatic OHCA who achieved a return of spontaneous circulation and whose blood urea nitrogen and creatinine levels on hospital arrival were available.