Publications by authors named "Yuichiro Shimoyama"

Article Synopsis
  • The study investigates the effectiveness of presepsin as a predictor for serious conditions (AKI, ARDS, DIC, and shock) in elderly patients (75 years and older) diagnosed with sepsis in ICU settings.
  • A total of 83 adult patients were examined, divided into two groups based on age: over 75 and under 75; presepsin levels and inflammatory scores were measured and analyzed.
  • The results revealed that presepsin is a better predictor for septic AKI and ARDS in patients over 75, with its predictive accuracy significantly outperforming that of younger patients.
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Objective Mortality analyses of patients with coronavirus disease 2019 (COVID-19) requiring invasive mechanical ventilation in Japan are limited. The present study therefore determined the risk factors for mortality in patients with COVID-19 requiring invasive mechanical ventilation. Methods This retrospective cohort study used the dataset from the Japanese multicenter research of COVID-19 by assembling real-word data (J-RECOVER) study that was conducted between January 1 and September 31, 2020.

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Objective: This study aimed to determine whether presepsin and inflammation-based prognostic scores can predict the progression of septic subclinical acute kidney injury (AKI) to septic AKI among intensive care unit (ICU) patients.

Results: Presepsin values were measured immediately after ICU admission (baseline) and on Days 2, 3, and 5 after ICU admission. Glasgow Prognostic Score, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio (PLR), Prognostic Index, and Prognostic Nutritional Index were measured at baseline.

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Objective: Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis.

Results: Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients.

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Background: Sepsis is the most common cause of acute kidney injury (AKI) among critically ill patients. This study aimed to determine whether presepsin is a predictor of septic acute kidney injury, renal replacement therapy initiation (RRTi) in sepsis patients, and prognosis in septic AKI patients.

Methods: Presepsin values were measured immediately after ICU admission (baseline) and on Days 2, 3, and 5 after ICU admission.

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Background And Aims: Sepsis is the main cause of death from infection. This study aimed to determine whether neutrophil gelatinase-associated lipocalin (NGAL) values better predict mortality in septic patients when combined with inflammation-based prognostic scores.

Material And Methods: Forty-four adult patients diagnosed according to the Sepsis-3 definition and who were admitted to the ICU were prospectively examined from June 2018 to November 2018.

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Background: Sepsis remains a major cause of mortality in critically ill patients. This study aimed to determine whether presepsin is a predictor of septic acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), and shock.

Methods: A total of 83 adult patients diagnosed with sepsis were prospectively examined.

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Article Synopsis
  • The study focuses on predicting severe complications in sepsis, like acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), and shock, by using a combination of urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels and inflammation-based prognostic scores rather than uNGAL alone.
  • ROC curve analyses determined specific cut-off values for uNGAL across several days, indicating its predictive usefulness for AKI, DIC, and shock with varying effectiveness (AUC values ranging from 0.71 to 0.86).
  • Multivariate logistic regression identified inflammation-based scores, specifically iNS NGAL-PI, as a strong independent predictor
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A previously healthy 40-year-old Japanese male was urgently admitted with a 2-month history of dysphagia, 30-kg weight loss, and fever. Human immunodeficiency virus (HIV) antibodies and cytomegalovirus antigenemia were positive. Pneumocystis pneumonia and cytomegalovirus pneumonia were suspected.

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A neutrophil-to-lymphocyte ratio (NLR) > 7 is reportedly an independent marker of mortality in patients with bacteremia. However, no studies have shown an association between inflammation-based prognostic scores (including the Glasgow Prognostic Score, the NLR, the platelet-to-lymphocyte ratio, the Prognostic Nutritional Index, and the Prognostic Index) and mortality in patients with pneumonia. We retrospectively examined the cases of 33 patients diagnosed with pneumonia who were treated in the ICU of Osaka Medical College Hospital between January 2014 and June 2016.

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Background: The neutrophil to lymphocyte ratio (NLR) is gaining interest as an independent predictor of survival in patients with various clinical conditions. No study to date has reported an association between inflammation-based prognostic scores, including the Glasgow Prognostic Score (GPS), NLR, platelet to lymphocyte ratio (PLR), Prognostic Nutritional Index (PNI), and Prognostic Index (PI), and mortality in patients with gastrointestinal perforation (GIP). We compared the prognostic value of these measures.

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Background: Patients with vascular Ehlers-Danlos syndrome (EDS) are susceptible to significant vascular complications, such as aortic and visceral arterial ruptures, aneurysms, and dissection. We describe a case of repeated bleeding in a 57-year-old woman and a case of sudden onset of artery dissection in her daughter, both of whom were previously diagnosed with vascular EDS and managed at our institution.

Case Presentation: A 57-year-old woman was admitted to our emergency department due to sudden onset of left low back pain.

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Background: () rarely causes lower respiratory tract infections, although most reported cases of pneumonia are fatal despite intensive antibiotic therapy. We present a case of pneumonia in an immunocompetent patient.

Case Presentation: An 81-year-old woman was transferred from a district general hospital to our hospital for treatment of congestive heart failure.

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Article Synopsis
  • Central venous catheters (CVCs) are critical in managing critically ill patients, and this study evaluated whether a targeted educational program could lower the rate of catheter-related bloodstream infections (CRBSIs) in intensive care units (ICUs).
  • A multidisciplinary task force developed a mandatory educational program featuring video introductions, lectures, hands-on training, and safety check sheets to teach best practices for preventing CRBSIs.
  • Following the program’s implementation, CRBSIs dropped from 3.4 per 1000 patient ICU-days to 0 in the next year, leading to significant estimated cost savings of between $185,000 and $270,000.
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Study Objective: To examine postoperative sore throat resulting from tracheal intubation stylet removal.

Design: Prospective cohort study.

Setting: Operating rooms and hospital ward.

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Mitral valve stenosis (MS) associated with rheumatic disease no longer represents a major heart problem during the perinatal period in Japan. Here we present a case of acute heart failure due to MS after emergency cesarean section (CS). The patient was transferred due to the development of fetal distress at 36 weeks gestation and underwent an emergency CS under general anesthesia.

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Background: In 2005, "anti--methyl-d-aspartate (NMDA) receptor encephalitis," a syndrome with prominent psychiatric symptoms, memory loss, decrease in level of consciousness, and central hypoventilation, was described in young women with ovarian teratomas and antibodies against an antigen highly expressed in the hippocampus. This report highlights the growing need for increased awareness among psychiatrists and other relevant medical professionals about this under-diagnosed disorder, which should be considered in differential diagnoses.

Case Presentation: A 19-year-old female with no psychiatric history presented to a district general hospital with acute psychosis, emotional lability, memory deficit, fluctuating behavioral changes such as wandering and babbling, and seizure.

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Study Objective: To determine the perioperative frequency of deep vein thrombosis (DVT) after lower limb joint prosthesis surgery using Doppler ultrasonography (US).

Design: Prospective cohort study.

Setting: Operating room and hospital ward.

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Background: Deep vein thrombosis (DVT) is the main cause of pulmonary thrombolism (PE). Thus by preventing DVT, the risk of PE can be greatly reduced.

Methods: Patients were divided into two groups: a group of patients who were affected with DVT after total hip arthroplasty (THA) and a group of patients who were not affected.

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We experienced a patient with respiratory insufficiency after resection of the aortic aneurysm and replacement with a synthetic conduit which recovered by airway pressure release ventilation (APRV) dramatically. A 44-year-old man diagnosed as aortic aneurysm of the descending thoracic aorta was admitted to our hospital and an operation was scheduled. The operation lasted for 19 hours and the time of general anesthesia was 23 hours.

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We encountered a patient with atrial septal defect (ASD) of sinus venous type which had not been diagnosed preoperatively. A 70-year-old-man with angina pectoris was admitted to our hospital and coronary artery bypass grafting was scheduled. After induction of general anesthesia with fentanyl, propofol, midazolam, and vecuronium, operation was going smoothly.

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