研究者詳細 - 塚原　紘平

論文 - 塚原　紘平

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日本外傷学会データバンクを用いた熱傷症例の検討

野島剛, 内藤宏道, 小原隆史, 小崎吉訓, 上田浩平, 塚原紘平, 中尾篤典

熱傷 48 ( 1 ) 38 - 39 2022年3月

黒澤寛史, 池山貴也, 賀来典之, 川崎達也, 小泉沢, 齊藤修, 竹内宗之, 武田充人, 田村卓也, 塚原紘平, 西村奈穂, 清水直樹, 三瓶智美, 清水一好, 辻尾有利子, 西村奈穂, 新津健裕, 平井克樹, 志馬伸朗, 日本集中治療医学会小児集中治療委員会日本小児集中治療連絡協議会COVID-19ワーキンググループ

日本集中治療医学会雑誌 29 ( 2 ) 177 - 180 2022年3月

記述言語：日本語出版者・発行元：(一社)日本集中治療医学会

日本集中治療医学会小児集中治療委員会日本小児集中治療連絡協議会COVID-19ワーキンググループは,新型コロナウイルスの国内流行のいわゆる第5波で,その初期の段階で20歳未満の患者数が増加していることを把握した。小児科学会との協力体制のもと,小児重症・中等症例発生状況をまとめた。登録症例数は46例。COVID-19肺炎は20例であり,その他の入室理由が過半数を占めた。また,重症症例の診療体制について整理した。(著者抄録)

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一酸化炭素中毒に対して高気圧酸素療法を施行した2例

浦田奈生子, 土屋弘樹, 柴田敬, 塚原紘平, 嶋泰樹, 小林勝弘

日本小児科学会雑誌 126 ( 2 ) 337 - 337 2022年2月

Reusable Medical Isolation Gowns with a Liquid Barrier: Washing Gowns in the Coronavirus Disease 2019 Pandemic Era?

Hiromichi Naito, Kohei Tsukahara, Soshi Takao, Takashi Yorifuji, Atsunori Nakao

JMA journal 5 ( 1 ) 107 - 108 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Healthcare providers are at risk of exposure to SARS-CoV-2 via droplets, respiratory secretions, and contact with contaminated surfaces. Personal protective equipment (PPE) is necessary for primary reliable prevention to treat patients with coronavirus disease 2019 (COVID-19). However, PPE shortages have had a significant impact on every medical facility, and outpatient clinics are especially vulnerable to shortages of medical supplies. During the first stage of the pandemic, efforts were made to reduce the use of medical supplies. Guidance and strategies were proposed to ration the use of PPE, including reusing it. However, reuse (wash) of isolation gowns has not been practically promoted despite these suggestions. Further, reusable products may have advantages for economic and ecologic reasons. We developed an adult universally sized, long-sleeved, 100% polyester, reusable/washable gown with liquid barrier protection. The isolation gown can be worn repeatedly through washing and subsequent disinfection, and it can withstand washing in 80°C hot water for 10 min and/or immersion in 0.05%-0.1% sodium hypochlorite for 30 min and then dried. This new gown's liquid barrier performance is at Association for the Advancement of Medical Instrumentation level 1, even after 20 repeated uses with low cost. The choice of barrier level for gowns should be made based on the risk of contamination. However, the healthcare setting for COVID-19 patients varies greatly with not fully elucidated transmissibility. The newly made reusable isolation gown can be one option for treating COVID-19 patients especially in low-risk settings with economical advantage. Further, preparedness for reuse may have critical implications in extreme shortage. Reconsideration should be focused on reusable gowns with liquid barrier performance and their appropriate use.

DOI： 10.31662/jmaj.2021-0075

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蘇生実習における性差教育が与えるインパクト

谷田貴, 折田沙穂, 塚原紘平, 中村俊介, 久保卓也, 小崎吉訓, 野島剛, 内藤宏道, 中尾篤典

日本救急医学会雑誌 32 ( 12 ) 2703 - 2703 2021年11月

Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study. 国際誌

Hiromichi Naito, Tetsuya Yumoto, Takashi Yorifuji, Tsuyoshi Nojima, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Mototaka Inaba, Takeshi Nishimura, Takenori Uehara, Atsunori Nakao

BMC emergency medicine 21 ( 1 ) 104 - 104 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Patients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. We aimed to define the association between emergency medical services transport time and survival to demonstrate the survival curve of TCA. METHODS: A retrospective review of the Japan Trauma Data Bank. Inclusion criteria were age ≥ 16, at least one trauma with Abbreviated Injury Scale score (AIS) ≥ 3, and CPR performed in a prehospital setting. Exclusion criteria were burn injury, AIS score of 6 in any region, and missing data. Estimated survival rate and risk ratio for survival were analyzed according to transport time for all patients. Analysis was also performed separately on patients with sustained TCA at arrival. RESULTS: Of 292,027 patients in the database, 5336 were included in the study with 4141 sustained TCA. Their median age was 53 years (interquartile range (IQR) 36-70), and 67.2% were male. Their median Injury Severity Score was 29 (IQR 22-41), and median transport time was 11 min (IQR 6-17). Overall survival after TCA was 4.5%; however, survival of patients with sustained TCA at arrival was only 1.2%. The estimated survival rate and risk ratio for sustained TCA rapidly decreased after 15 min of transport time, with estimated survival falling below 1%. CONCLUSION: The chances of survival for sustained TCA declined rapidly while the patient is transported with CPR support. Time should be one reasonable factor for considering termination of resuscitation in patients with sustained TCA, although clinical signs of life, and type and severity of trauma should be taken into account clinically.

DOI： 10.1186/s12873-021-00499-z

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

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年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

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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Off the Job Trainingがコロナ禍で生き残る道小児病院前救護トレーニングコース(PPMEC)のコロナ禍での取組み

問田千晶, 六車崇, 賀来典之, 塚原紘平, 安達晋吾, 光銭大裕, 新田雅彦, 野坂宜之, 林卓郎, 松浦治人, 守谷俊, 日本臨床救急医学会小児救急委員会

日本臨床救急医学会雑誌 24 ( 2 ) 207 - 207 2021年5月

Plastic Bronchitis in a Five-Year-Old Boy Treated Using Extracorporeal Membrane Oxygenation; a Case Report. 国際誌

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

Archives of academic emergency medicine 9 ( 1 ) e16 2021年

記述言語：英語

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. 国際誌

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

Case reports in emergency medicine 2021 9940395 - 9940395 2021年

記述言語：英語

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. 国際誌

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年

記述言語：英語掲載種別：研究論文（学術雑誌）

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

Acta Med. Okayama 74 ( 6 ) 513 - 520 2020年12月

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年11月

COVID-19影響下における救急・集中治療関連医療従事者の心理的健康度

久保卓也, 小崎吉訓, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1035 - 1035 2020年11月

amplitude-integrated EEGが意識障害患者の診断・早期治療に有効であった悪性症候群の1例

中村俊介, 内藤宏道, 野島剛, 小崎吉訓, 山本浩継, 藤崎宣友, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1105 - 1105 2020年11月

当院における産科救急の現状

藤崎宣友, 山本浩継, 野島剛, 小崎吉訓, 青景聡之, 塚原紘平, 山田太平, 尾迫貴章, 内藤宏道, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 1921 - 1921 2020年11月

食事に関する詳細な問診を必要とした壊血病の一例

小出恭大, 山田太平, 小崎吉訓, 野島剛, 塚原紘平, 藤崎宣友, 尾迫貴章, 内藤宏道, 城端慧, 高岡諒, 中尾篤典

日本救急医学会雑誌 31 ( 11 ) 2105 - 2105 2020年11月

mobile ECMOシステムの構築に向けての現状と問題点臨床工学技士の立場から

平山隆浩, 落葉佑昌, 堂口琢磨, 岡田真澄, 川田将弘, 青景聡之, 塚原紘平, 小崎吉訓, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 625 - 625 2020年9月

静脈-静脈体外式膜型人工肺療法(VV ECMO)ラットモデルの構築

青景聡之, 岡田真澄, 平山隆浩, 塚原紘平, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 471 - 471 2020年9月

当院の救急集中治療室における、急性腎障害の持続的腎代替療法の導入時期と予後を検討する

岡田真澄, 平山隆浩, 落葉佑昌, 塚原紘平, 青景聡之, 藤崎宣友, 山田太平, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 27 ( Suppl. ) 506 - 506 2020年9月

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