Faculty Profiles - Obara Takafumi

Papers - Obara Takafumi

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当院高度救命救急センターにおける小児の熱傷と感染に関するまとめ

小原隆史, 塚原紘平, 野島剛, 上田浩平, 山本浩継, 内藤宏道, 中尾篤典

熱傷 48 ( 1 ) 41 - 41 2022.3

Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan. Reviewed International journal

Takafumi Obara, Hiromichi Naito, Kohei Tsukahara, Naomi Matsumoto, Hirotsugu Yamamoto, Takashi Yorifuji, Atsunori Nakao

International journal of environmental research and public health 18 ( 18 ) 2021.9

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

The aim of this study was to investigate the longitudinal relationship between shorter or irregular sleep duration (SD) in early childhood and increased risk of injury at primary school age using data from a nationwide survey in Japan. We categorized SD into seven groups: 6 h, 7 h, 8 h, 9 hrs, 10 or 11 h, >12 h, and irregular, based on questionnaire responses collected at 5.5 years old. The relationship between SD and incidence of injury at 5.5-nine years of age is shown. In addition, we completed a stratified analysis on children with or without problematic behavior at eight years old. We included 32,044 children, of which 6369 were classified as having an injury and 25,675 as not having an injury. Logistic regression model showed that shorter or irregular SD categories were associated with an increased adjusted odds ratio (aOR) for injuries (6 h: aOR 1.40, 95% confidence interval (CI) 1.19-1.66, 7 h: aOR 1.10, 95% CI, 0.98-1.23, 8 h: aOR 1.13, 95% CI, 1.02-1.26, irregular: aOR 1.26, 95% CI 1.10-1.43). The same tendency was observed with shorter or irregular SD in subgroups with or without behavioral problems. Shorter or irregular sleep habits during early childhood are associated with injury during primary school age.

DOI： 10.3390/ijerph18189512

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Carbon monoxide poisoning during pregnancy treated with hyperbaric oxygen. Reviewed International journal

Yoshinori Kosaki, Hiroki Maeyama, Tsuyoshi Nojima, Takafumi Obara, Atsunori Nakao, Hiromichi Naito

Clinical case reports 9 ( 5 ) e04138 2021.5

マムシ抗毒素投与が奏功した血小板減少型マムシ咬傷の1例

岡本彩, 向笠廣太, 小原隆史, 野島剛, 中尾篤典, 鬼塚拡平, 浦部尚吾, 井上智博, 古賀仁士, 山下寿

佐賀救急医学会雑誌 7 ( 1 ) 11 - 14 2021.3

Language：Japanese Publisher：佐賀救急医学会

74歳男性。農作業中に右示指をマムシに咬まれ意識消失し、受傷30分後に当院へ搬送となった。所見では意識清明で、右示指に滲出性出血を伴う創があった。出血持続、全身紫斑、血小板減少を認めたことから、マムシ毒による血小板減少と診断され、受傷5時間後にマムシ抗毒素を投与した。その結果、血小板数や症状は速やかに改善し、第15病日に退院となった。

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Plastic Bronchitis in a Five-Year-Old Boy Treated Using Extracorporeal Membrane Oxygenation; a Case Report. Reviewed International journal

Tsuyoshi Nojima, Hiromichi Naito, Takafumi Obara, Kohei Tsukahara, Atsunori Nakao

Archives of academic emergency medicine 9 ( 1 ) e16 2021

Language：English

Plastic bronchitis is an uncommon disorder marked by the production of bronchial casts and acute respiratory failure development. In pediatric cases, influenza infection sometimes results in the obstruction of bronchi and leads to this potentially life-threatening condition. We report the case of a five-year-old boy with plastic bronchitis related to influenza A infection, which could only be recovered by the use of extracorporeal membrane oxygenation (ECMO). ECMO could effectively provide sufficient oxygenation for patients suffering from severe reversible acute respiratory failure. If patients infected with the influenza virus present acute respiratory distress with total lung atelectasis, clinicians should consider the diagnosis of plastic bronchitis and the subsequent treatment interventions with ECMO in a severe cases.

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Unrecognized Orbital Images Cause Diagnostic Confusion: Silicone Oil and Implanted Silicone Encircling Bands. Reviewed International journal

Tsuyoshi Nojima, Takafumi Obara, Kohei Tsukahara, Atsunori Nakao, Hiromichi Naito

Case reports in emergency medicine 2021 9940395 - 9940395 2021

Language：English

INTRODUCTION: Most physicians are not familiar with postoperative changes to the orbit, so radiologists and clinicians may sometimes find it challenging to conduct a proper radiological assessment of the globe of the eye and orbital abnormalities. We present a patient with head trauma who had surgery for retinal detachment with implantation of silicone encircling bands. This case report may help clinicians recognize imaging characteristics after ophthalmic surgery to prevent misdiagnosis and unnecessary workup. Case Report. An 18-year-old man with severe head trauma was admitted to our hospital. Initial computed tomography (CT) revealed a high attenuation of intraocular silicone that could be mistaken for a hemorrhage. Ophthalmological examination and detailed ophthalmic history confirmed silicone oil in his eye for treatment of retinal detachment. Knowledge of the anatomical changes and radiological appearance of postsurgical findings following retinal detachment, including the surgical materials of silicone oil or bands, can prevent unnecessary alarm. CONCLUSION: Implanted ophthalmic devices, for example, silicone oil, appear similar to hemorrhages on CT and magnetic resonance imaging and cause diagnostic confusion. When in doubt, it is useful to assess the clinical presentation and obtain an accurate medical history.

DOI： 10.1155/2021/9940395

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Incidence and characteristics of medical emergencies related to dental treatment: a retrospective single-center study. Reviewed International journal

Kyoichi Obata, Hiromichi Naito, Hiromasa Yakushiji, Takafumi Obara, Kisho Ono, Tsuyoshi Nojima, Kohei Tsukahara, Taihei Yamada, Akira Sasaki, Atsunori Nakao

Acute medicine & surgery 8 ( 1 ) e651 2021

Language：English Publishing type：Research paper (scientific journal)

AIM: Although uncommon, medical emergencies arise in general dental practice. Inadequate data on their severity and frequency makes targeting medical education for general dental practitioners difficult. This also makes planning for unexpected events challenging for practitioners and makes collaborating with emergency physicians burdensome. We aimed to clarify the incidence and characteristics of a dental outpatient department's medical emergencies. METHODS: This single-center, retrospective, observational study was undertaken with patients who visited the dental outpatient department of Okayama University Hospital during the 8-year period. The primary outcome of the study was to identify the incidence and characteristics of medical emergencies in the dental outpatient department. Then we examined the timing of medical emergencies, administered medications, and final disposition (home/admission). RESULTS: During the period, 1,146,929 patients were enrolled. Forty-two patients (0.0037%) were consulted as medical emergencies. More than 60% of the incidents were vasovagal syncope, and dehydration and hypoglycemia were the second most prevalent at 9.5%. The most common types of dental treatments were tooth extraction (45.2%), followed by general dental treatment (28.6%), and other dental surgery such as implant placement (14.3%). Types of medical emergencies occurred equally before, during, and after dental treatment. Antihypertensive agents, sedatives, or glucose were used. For patients with emergencies, 90.5% recovered during the day and returned home, and 9.5% were hospitalized. CONCLUSION: The incidence of medical emergencies was low in our dental outpatient department. Knowledge of basic management principles, regular education for emergency care, and practicing first aid skills are mandatory for safe patient management.

DOI： 10.1002/ams2.651

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Oral Ethanol Treatment for Ethylene Glycol Intoxication. Reviewed International journal

Misa Sasanami, Taihei Yamada, Takafumi Obara, Atsunori Nakao, Hiromichi Naito

Cureus 12 ( 12 ) e12268 2020.12

Authorship：Corresponding author Language：English

Ethylene glycol is an odorless, sweet-tasting liquid found in industrial solutions such as antifreeze and windshield wiper fluid. Brake fluid, an automobile transmission liquid, contains poisonous alcohols such as glycol ethers and ethylene glycols. The toxicity of ethylene glycol is associated with toxic metabolite production by the liver enzyme alcohol dehydrogenase. Administration of either intravenous ethanol or fomepizole, both of which competitively inhibit ethylene glycol metabolism by alcohol dehydrogenase and can prevent the production and accumulation of the toxic metabolites, can be used as an antidote. A 42-year-old male car mechanic was transferred to our hospital after accidentally ingesting approximately 100 mL of brake fluid. Immediately after ingestion, he threw up most of the ingested liquid; however, he complained of nausea and throat pain and was moved to our emergency department. The patient was successfully treated with administration of oral ethanol in the form of whisky through a nasogastric tube since neither intravenous ethanol nor fomepizole was available in our hospital at the time of his presentation. Our case demonstrates that oral ethanol can be used as an alternative treatment for patients with ethylene glycol intoxication.

DOI： 10.7759/cureus.12268

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Delay in Emergency Medical Service Transportation Responsiveness during the COVID-19 Pandemic in a Minimally Affected Region. Reviewed

Kohei Ageta, Hiromichi Naito, Takashi Yorifuji, Takafumi Obara, Tsuyoshi Nojima, Taihei Yamada, Kohei Tsukahara, Hiromasa Yakushiji, Atsunori Nakao

Acta medica Okayama 74 ( 6 ) 513 - 520 2020.12

Language：English Publishing type：Research paper (scientific journal)

Few studies have investigated the influence of the Coronavirus Disease 2019 (COVID-19) pandemic on emer-gency medical service (EMS) systems, especially in areas less affected or unaffected by COVID-19. In this study, we investigated changes in prehospital EMS activity and transport times during the COVID-19 pandemic. All patients transported by EMS in the city of Okayama from March-May 2019 or March-May 2020 were included. Interfacility transports were excluded. The primary outcome was the time from a patient's first emergency call until hospital arrival (total prehospital time). Secondary outcomes included three segments of total prehospital time: the response time, on-scene time, and transportation time. Total prehospital time and the durations of each segment were compared between corresponding months in 2020 (COVID19-affected) and 2019 (control). The results showed that total prehospital times in April 2020 were significantly higher than those in 2019 (33.8 ± 11.6 vs. 32.2 ± 10.8 min, p < 0.001). Increases in total prehospital time were caused by longer response time (9.3 ± 3.8 vs. 8.7 ± 3.7 min, p < 0.001) and on-scene time (14.4 ± 7.9 vs. 13.5 ± 6.2min, p < 0.001). The COVID-19 pandemic was thus shown to affect EMS and delayed arrival/response even in a minimally affected region. A system to minimize transportation delays should be developed for emerging pandemics.

DOI： 10.18926/AMO/61210

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Burning Mouth Syndrome Induced by Angiotensin-Converting Enzyme Inhibitors. Reviewed International journal

Takafumi Obara, Hiromichi Naito, Tsuyoshi Nojima, Hitoshi Koga, Atsunori Nakao

Cureus 12 ( 11 ) e11376 2020.11

Authorship：Lead author Language：English

Burning mouth syndrome (BMS) is characterized as the sensation of burning in the tongue or any other area of the oral mucosa without a medical or dental cause. BMS's pathophysiology is poorly understood and may be caused by its association with various factors, particularly with antihypertensive or psychotropic medicines. Although BMS is a relatively common intraoral disorder in the dental field, emergency physicians rarely recognize it. We report a 53-year-old Japanese woman who presented to our ED with a three-week history of a strange taste and burning tongue. The patient had poor control of hypertension, captopril, an angiotensin-converting enzyme (ACE) inhibitor, was added three weeks before presentation. We discontinued her ACE inhibitor and changed her medication to a beta-blocker. After two weeks, her symptoms improved. Emergency physicians must be aware that ACE inhibitors play some roles in the pathogenesis of BMS. The correct diagnosis of the condition depends on recognizing the disease and improving the quality of life.

DOI： 10.7759/cureus.11376

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インフルエンザウイルス感染を契機に上気道閉塞、意識障害を呈した甲状腺クリーゼ一例

佐々並三紗, 塚原紘平, 小崎吉訓, 小原隆史, 野島剛, 上田浩平, 山本浩継, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1075 - 1075 2020.11

Pediatric airway compromise due to thyroid storm associated with influenza A infection: A case report. Reviewed International journal

Taiki Higaki, Kohei Tsukahara, Takafumi Obara, Tsuyoshi Nojima, Hirotsugu Yamamoto, Takaaki Osako, Hiromichi Naito, Atsunori Nakao

Respiratory medicine case reports 31 101182 - 101182 2020

Language：English

Thyroid storm is a potentially fatal intensification of thyrotoxicosis normally marked by tachycardia, hyperthermia, impaired mental status, and severe agitation. It can be initiated by numerous causes. Failure to promptly diagnose the condition may lead to high mortality. Early diagnosis and treatment of thyroid storm are essential to prevent further life-threatening complications. A 10-year-old girl was admitted to our emergency center for intensive care. The patient presented tachypnea with stridor, paradoxical abdominal breathing, and "barking" cough. The patient was diagnosed as upper airway obstruction complicated by thyroid storm associated with influenza infection. Following immediate airway management, the patient was administered a short-acting beta-blocker, hydrocortisone, thiamazole, and saturated solution of potassium iodide was initiated. The patient was extubated on day 8 and transferred to a local hospital on day 11 without adverse complications. When examining patients with influenza infection, emergency doctors should be more attentive not to miss other critical diagnoses. The present case was initially diagnosed as croup due to influenza infection. Sharing our experience may help emergency physicians treat similar cases of pediatric airway compromise due to thyroid storm.

DOI： 10.1016/j.rmcr.2020.101182

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Transient Global Amnesia in a Patient Presenting with Hypertensive Emergency; a Case Report. Reviewed International journal

Takafumi Obara, Tsuyosi Nojima, Hitoshi Koga, Atsunori Nakao, Hiromichi Naito

Archives of academic emergency medicine 8 ( 1 ) e66 2020

Authorship：Lead author Language：English

Transient global amnesia (TGA) is characterized by the abrupt onset of global amnesia, particularly anterograde amnesia. The pathophysiology of TGA is poorly understood and it could be caused by various factors and be associated with various diseases. We report a 58-year-old man who presented to the local emergency room with TGA lasting for several hours. The patient had complete anterograde amnesia without a past medical history of migraine or neurological findings. His systolic blood pressure on presentation was 220 mmHg, which was immediately treated with intravenous calcium ion influx inhibitor. Other than global amnesia, there was no evidence of neurological disturbance. Computed tomography and magnetic resonance imaging results were unremarkable. After treatment of his hypertension, his amnesia resolved within 12 hours. Emergency department physicians may encounter TGA. Correct diagnosis of the condition depends on recognizing the disease.

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A family intoxicated by daffodil bulbs mistaken for onions. Reviewed International journal

Kohei Ageta, Hiromasa Yakushiji, Yoshinori Kosaki, Takafumi Obara, Tsuyoshi Nojima, Akira Gochi, Hiromichi Naito, Atsunori Nakao

Acute medicine & surgery 7 ( 1 ) e595 2020

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Papers - Obara Takafumi