Publications by authors named "Sho Nachi"
Article Synopsis
- This study evaluated the effectiveness of restrictive versus liberal red blood cell transfusion strategies in patients with severe trauma to see which approach led to better survival rates during the acute post-injury phase.
- Conducted in Japan, the trial involved 22 hospitals and compared transfusion target hemoglobin levels of 7-9 g/dL in the restrictive group to 10-12 g/dL in the liberal group, measuring outcomes like 28-day survival, transfusion volume, and complications.
- Results showed no significant difference in 28-day survival rates (92.1% for restrictive vs. 91.3% for liberal), nor in complication rates, but the restrictive group required lower transfusion
Purpose: Little is known about whether pre-hospital advanced airway management (AAM) under the presence of a physician could improve outcome of patients with cardiac arrest, compared with pre-hospital AAM under the absence of a physician.
Methods: This retrospective multicentre-cohort study enrolled consecutive patients who were transported to participating hospitals after out-of-hospital cardiac arrest in Japan between 1 June 2014 and 31 December 2019. We included patients who underwent pre-hospital AAM and resuscitation after arrival at hospital, and who were ≥18 years of age, with medical aetiologies.
To evaluate the effect of cryoprecipitate (CRYO) transfusion in women referred for postpartum hemorrhage (PPH). This retrospective cohort study included patients with primary PPH referred to Gifu University Hospital between April 2013 and March 2020. We analyzed the effect of CRYO transfusion on fluid balance 24 h after the initial examination using a multivariable linear regression model adjusted for several confounding variables.
View Article and Find Full Text PDFBackground: Using the out-of-hospital cardiac arrest (OHCA) registry in Japan, we evaluated the effectiveness of physicians' presence in pre-hospital settings after adjusting in-hospital treatments.
Methods: This was a multicenter cohort study. We registered all consecutive OHCA patients in Japan who, from 1 June 2014 through 31 December 2017, were transported to institutions participating in the Japanese Association for Acute Medicine OHCA registry.
Background: Some emergency departments use triage scales, such as the Canadian Triage and Acuity Scale and Japan Urgent Stroke Triage Score, to detect life-threatening situations. However, these protocols have not been used for aeromedical services. Therefore, we investigated the factors predicting these life-threatening situations in aeromedical services as a pilot study for establishing the protocol.
View Article and Find Full Text PDFBackground: Stroke has been found to have a seasonally varying incidence; blood pressure, one of its risk factors, is influenced by humidity and temperature. The relationship between the incidence of stroke and meteorological parameters remains controversial.
Objective: We investigated whether meteorological conditions are significant risk factors for stroke, focusing on the fluctuation of weather elements that triggers the onset of stroke.
Aim: To describe the registry design of the Japanese Association for Acute Medicine - out-of-hospital cardiac arrest (JAAM-OHCA) Registry as well as its profile on hospital information, patient and emergency medical service characteristics, and in-hospital procedures and outcomes among patients with OHCA who were transported to the participating institutions.
Methods: The special committee aiming to improve the survival after OHCA by providing evidence-based therapeutic strategies and emergency medical systems from the JAAM has launched a multicenter, prospective registry that enrolled OHCA patients who were transported to critical care medical centers or hospitals with an emergency care department. The primary outcome was a favorable neurological status 1 month after OHCA.
Article Synopsis
- * Results showed that while patients receiving IVIgG were generally more severely ill and had higher ICU mortality, the overall in-hospital mortality rates were similar between those treated with IVIgG and those who were not.
- * The final analysis indicated that IVIgG administration did not significantly influence ICU or in-hospital mortality, suggesting it may not be an effective adjunctive treatment for sepsis in this context.
Background: Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management.
Case Presentation: A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming.
Background: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma.
Case Presentation: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking.
Article Synopsis
- Supplemental doses of antithrombin (AT) are commonly used in Japan to treat sepsis-induced disseminated intravascular coagulation (DIC), but the evidence supporting their effectiveness is limited.
- A large retrospective study analyzed data from 3,195 patients, finding a statistically significant association between AT supplementation and lower in-hospital mortality rates for patients with DIC, although further analyses questioned the strength of this link.
- The study concluded that AT supplementation may help reduce mortality in sepsis-induced DIC, but the evidence is not definitive, and while patients needing AT had more transfusions, they did not experience increased severe bleeding complications.
Article Synopsis
- * The average age of the patients was 70 years, and their health status, measured by the Acute Physiology and Chronic Health Evaluation II score, indicated a moderate level of severity.
- * Survival rates were estimated at 73.6% and 56.3% for patients at 28 days and 90 days post-ICU admission, respectively.*
Patients with simple pneumopericardium due to blunt thoracic trauma occasionally progressed to tension pneumopericardium, although pneumopericardium is believed to be benign in general. A 65-year-old man had both arms caught in a grinding machine and his face struck hard at work. He was diagnosed with bilateral degloving injuries of both arms and mediastinal emphysema on computed tomography.
View Article and Find Full Text PDFFlail chest is a rare complication in pediatric patients with blunt chest trauma. There is no general consensus on which treatment is most appropriate for flail chest in pediatric patients, although it has been reported that surgical fixation is associated with beneficial outcomes for flail chest in adults. The present report described two pediatric cases of flail chest, which was rare in pediatric blunt trauma.
View Article and Find Full Text PDFWe herein report a rare case of ectopic pancreatic acinar cell carcinoma (ACC) which presented as a submucosal tumor of the pylorus. A 73-year-old man came to our hospital presenting with epigastralgia. Esophago-gastroduodenal endoscopy showed no mucosal lesions, but a submucosal tumor was observed around the pylorus.
View Article and Find Full Text PDFA 71-year-old man presented with hemoptysis due to chronic contained rupture of the descending thoracic aorta after sepsis by Escherichia coli complicated with transrectal biopsy of the prostate, and underwent urgent graft replacement. The aorta had an almost normal caliber and ruptured into the left lung without abscess. The perforated site of the lung was filled with gelatin-resorcinol-formaldehyde glue, and the defect of the aortic wall was closed.
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