Medical validity and layperson interpretation of emergency visit recommendations by the GPT model: A cross-sectional study.

Aim: In Japan, emergency ambulance dispatches involve minor cases requiring outpatient services, emphasizing the need for improved public guidance regarding emergency care. This study evaluated both the medical plausibility of the GPT model in aiding laypersons to determine the need for emergency medical care and the laypersons' interpretations of its outputs.

Methods: This cross-sectional study was conducted from December 10, 2023, to March 7, 2024.

Early rehabilitation and improved outcomes in patients with status epilepticus: Evidence from cases presenting to the emergency department.

Objective: Status epilepticus (SE) is a common neurological emergency characterized by prolonged or recurrent seizures that can cause permanent brain damage. Although these seizures can be controlled with appropriate treatment, SE is associated with poor outcomes and a high mortality rate. SE can cause physical, cognitive, and psychological complications at every stage of treatment.

The feasibility of point-of-care testing for initial urinary liver fatty acid-binding protein to estimate severity in severe heatstroke.

Rapid assessment of severity is crucial for timely intervention and improved patient outcomes in heatstroke (HS). However, existing biomarkers are limited in their accuracy and accessibility in ER settings. A prospective pilot study was conducted to assess urinary liver fatty acid-binding protein (L-FABP) levels using a point-of-care testing (POCT) upon HS.

Identification of unmet information needs among families of critically ill patients and their association with post-intensive care syndrome-family: protocol for a single-center cross-sectional study.

Background: Families of critically ill patients in the intensive care unit (ICU) need a variety of information about the patient. Meeting these information needs improves the quality of communication between the family and ICU staff, as well as reduces the risk of post-intensive care syndrome-family (PICS-F). However, information needs continue to be unmet, and information regarding which specific information needs are met or unmet is insufficient.

Association between prophylactic intermittent non-invasive positive pressure ventilation and incidence of pneumonia in patients with cervical spinal cord injury: a retrospective single-center cohort study.

Background: Patients with cervical spinal cord injuries (CSCIs) have a high incidence of respiratory complications. The effectiveness of non-invasive positive pressure ventilation (NPPV) in preventing respiratory complications such as pneumonia in acute CSCIs remains unclear. We evaluated whether intermittent NPPV (iNPPV) could prevent pneumonia in patients with acute CSCIs.

A machine learning model to predict neurological deterioration after mild traumatic brain injury in older adults.

Objective: Neurological deterioration after mild traumatic brain injury (TBI) has been recognized as a poor prognostic factor. Early detection of neurological deterioration would allow appropriate monitoring and timely therapeutic interventions to improve patient outcomes. In this study, we developed a machine learning model to predict the occurrence of neurological deterioration after mild TBI using information obtained on admission.

Intravenous branched-chain amino acid administration for the acute treatment of hepatic encephalopathy: a systematic review and meta-analysis.

Background: Hepatic encephalopathy (HE) is a severe complication of acute hepatic failure requiring urgent critical care management. Branched-chain amino acids (BCAAs) such as leucine, isoleucine, and valine have been investigated as potential treatments to improve outcomes in patients with acute HE. However, the effectiveness of BCAA administration during the acute phase remains unclear.

Development of Machine-learning Model to Predict Anticoagulant Use and Type in Geriatric Traumatic Brain Injury Using Coagulation Parameters.

This study aimed to investigate the patterns of anticoagulation therapy and coagulation parameters and to develop a prediction model to predict the type of anticoagulation therapy in geriatric patients with traumatic brain injury. A retrospective analysis was performed using the nationwide neurotrauma database of Japan. Elderly patients (≥65 years) with traumatic brain injury.

A Treatment Strategy for Severe Legionella Pneumonia Using Veno-Venous Extracorporeal Membrane Oxygenation.

can cause acute respiratory distress syndrome (ARDS), which often requires intense ventilatory management. is an aerobic bacterium that prefers a high-oxygen environment. However, existing treatment strategies, including veno-venous extracorporeal membrane oxygenation (V-V ECMO), have not considered the pathogen's preference for high-oxygen environments.

Rapidly progressive brain atrophy in ventilated patients: a retrospective descriptive study.

The relationship between mechanical ventilation-induced brain volume changes and ICU-acquired weakness (ICU-AW) is not clear. We assessed brain volume change in ventilated patients and identified associations with changes in extremity muscle strength. Patients admitted to the ICU due to the need for ventilation, and who underwent at least two head CT scans during hospitalization, were included.

The association between introduction of the micro-axial flow pump Impella in hospitals and in-hospital mortality in patients treated with extracorporeal membrane oxygenation: interrupted time-series analyses.

Background: The micro-axial flow pump Impella, a new mechanical circulatory device for cardiogenic shock, is still only available in a limited number of hospitals, due to the facility certification requirements and insufficient evidence of the benefit of introducing Impella in hospitals. This study aimed to evaluate the impact of introducing Impella in hospitals on in-hospital mortality of patients treated with extracorporeal membrane oxygenation (ECMO).

Methods: Using a nationwide Japanese inpatient database, we identified patients who received ECMO during hospitalization between 1 April 2014 and 31 March 2021.

Clinical features and risk factors for delayed rupture of traumatic cerebral aneurysm: A case series.

Background: Traumatic cerebral aneurysms (TA) are a subset of traumatic cerebrovascular injury (TCVI). Misdiagnosis of TA can be fatal. To investigate factors that predict TA formation and the optimal timing for searching, we present four suspected cases of delayed TA rupture during hospitalization.

Effectiveness of vacuum-assisted wound closure and mesh-mediated fascial traction in open abdomen management.

Purpose: To determine the effectiveness of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in patients undergoing open abdomen management (OAM).

Methods: Data from cases with OAM for at least five days who were admitted to our institution between January 2011 and December 2020 were included. We compared the patient's age, sex, medical history, indication for initial surgery, APACHE II scores, indication for OAM, operative time, intraoperative blood loss, intraoperative transfusion, success of primary fascial closure (rectus fascial closure and bilateral anterior rectus abdominis sheath turnover flap method), success of planned ventral hernia, duration of OAM, and in-hospital mortality between patients undergoing VAWCM (VAWCM cases, n = 27) and vacuum-assisted wound closure (VAWC) alone (VAWC cases, n = 25).

Effectiveness of the Abdominal Thrust Maneuver for Airway Obstruction Removal: Analysis of Data from the National Emergency Medical Services Information System.

Background: Foreign body airway obstruction (FBAO) is a life-threatening emergency. Abdominal thrusts are recommended as first aid, but the success rate for this technique is unclear. Using information from a large database of emergency medical services (EMS) data in the United States, we evaluated the success rate of abdominal thrusts and identified patient characteristics that were associated with the success of the technique.

Effects of dual antiplatelet therapy (DAPT) compared to single antiplatelet therapy (SAPT) in patients with traumatic brain injury.

Japan is one of the world's most aging societies and the number of elderly patients taking antithrombotic drugs is increasing. In recent years, dual antiplatelet therapy (DAPT), in which two antiplatelet drugs are administered, has become common in anticipation of its high therapeutic efficacy. However, there are concerns about increased bleeding complications in use of DAPT.

Anisocoria After Direct Light Stimulus is Associated with Poor Outcomes Following Acute Brain Injury.

Background: Assessing pupil size and reactivity is the standard of care in neurocritically ill patients. Anisocoria observed in critically ill patients often prompts further investigation and treatment. This study explores anisocoria at rest and after light stimulus determined using quantitative pupillometry as a predictor of discharge modified Rankin Scale (mRS) scores.

Survival benefits of interventional radiology and surgical teams collaboration during primary trauma surveys: a single-centre retrospective cohort study.

Background: A team approach is essential for effective trauma management. Close collaboration between interventional radiologists and surgeons during the initial management of trauma patients is important for prompt and accurate trauma care. This study aimed to determine whether trauma patients benefit from close collaboration between interventional radiology (IR) and surgical teams during the primary trauma survey.

Association between pupillary examinations and prognosis in patients with out-of-hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation: a retrospective multicentre cohort study.

Background: In some cases of patients with out-of-hospital cardiac arrest (OHCA) who underwent extracorporeal cardiopulmonary resuscitation (ECPR), negative pupillary light reflex (PLR) and mydriasis upon hospital arrival serve as common early indicator of poor prognosis. However, in certain patients with poor prognoses inferred by pupil findings upon hospital arrival, pupillary findings improve before and after the establishment of ECPR. The association between these changes in pupillary findings and prognosis remains unclear.

Development and validation of a novel overhead method for anteroposterior radiographs of fractured rat femurs.

We aimed to establish a new method of obtaining femur anteroposterior radiographs from live rats. We used five adult male Sprague-Dawley rats and created a femoral fracture model with an 8 mm segmental fragment. After the surgery, we obtained two femoral anteroposterior radiographs, a novel overhead method, and a traditional craniocaudal view.