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遺伝性血管浮腫(HAE)の診断後に、腹痛発作で救急搬送を繰り返していた一例

佐々並三紗, 薬師寺泰匡, 本郷貴識, 野島剛, 上田浩平, 内藤宏道, 中尾篤典

日本腹部救急医学会雑誌 43 ( 2 ) 520 - 520 2023年2月

Automatic emergency calls from smartphone/smartwatch applications in trauma. 国際誌

Takashi Hongo, Shunki Yamamoto, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao, Tetsuya Yumoto

Acute medicine & surgery 10 ( 1 ) e875 2023年

Successfully treated case of severe hypothermia secondary to myxedema coma. 国際誌

Hirotsugu Yamamoto, Takashi Hongo, Tsuyoshi Nojima, Takafumi Obara, Yoshinori Kosaki, Kohei Ageta, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao, Hiromichi Naito

Acute medicine & surgery 10 ( 1 ) e828 2023年

記述言語：英語

BACKGROUND: Myxedema coma is an extremely rare but fatal endocrine emergency that requires urgent recognition and treatment. We describe a case of severe hypothermia that rapidly deteriorated to cardiac arrest that was attributed to myxedema coma. CASE PRESENTATION: A 52-year-old man without a history of hypothyroidism was transferred to our emergency department due to coma and profound hypothermia. The patient developed cardiac arrest immediately after hospital arrival but return of spontaneous circulation was achieved shortly after resuscitation. The patient was noted to have generalized, nonpitting edema, dry skin, severe respiratory acidosis, hyponatremia, and elevated creatinine kinase, which was indicative of hypothyroidism. Myxedema coma was confirmed by a thyroid profile. The patient was successfully treated with intravenous levothyroxine and glucocorticoid. CONCLUSION: Although myxedema coma is a rare cause of severe hypothermia, emergency physicians should be familiar with its clinical features and management.

DOI： 10.1002/ams2.828

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Transcranial doppler ultrasound in a 3-month-old infant with brain death. 国際誌

Tomohiro Hiraoka, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Kohei Tsukahara, Tetsuya Yumoto, Atsunori Nakao

Pediatrics international : official journal of the Japan Pediatric Society 65 ( 1 ) e15587 2023年

Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan. 国際誌

Takeshi Nishimura, Masafumi Suga, Satoshi Ishihara, Shinichi Nakayama, Atsunori Nakao, Hiromichi Naito

Acute medicine & surgery 10 ( 1 ) e829 2023年

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: In the current era of the coronavirus disease 2019 (COVID-19) pandemic, the responsiveness of emergency medical service (EMS) transport for patients with internal illness is often delayed. However, the influence of the COVID-19 pandemic on prehospital transport for patients with trauma has not yet been fully elucidated. This study aims to examine the effect of COVID-19 case surges on EMS transport for patients with trauma during the COVID-19 states of emergency in Kobe, Japan. METHODS: EMS data during the states of emergency were compared with those in the 2019 prepandemic period. The incidence of difficulty securing hospital acceptance (four or more calls to medical institutions and ambulance staying at the scene for 30 min or more) was evaluated as a primary outcome. Secondary outcomes were the time spent at the trauma scene and the number of calls requesting hospital acceptance. The time spent at the trauma scene was stratified by trauma severity. RESULTS: The incidence of difficulty securing hospital acceptance increased (1.2% versus 3.2%, P < 0.01). Logistic regression analysis revealed that the duration of the states of emergency was associated with difficulty securing hospital acceptance (odds ratio [OR] 2.08, 95% confidence interval 1.77-2.45; P < 0.01). Although the mean time spent at the trauma scene among the less severe, moderately severe, and severe trauma groups was prolonged, the time for the life-threatening group did not change. The number of request calls increased during the states of emergency. CONCLUSION: Difficulty securing hospital acceptance increased; however, the time spent at the trauma scene did not significantly change for the life-threatening group.

DOI： 10.1002/ams2.829

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Rare case of intracerebral hemorrhage in anaphylactic shock following administration of intramuscular adrenaline: A case report. 国際誌

Shunki Yamamoto, Takashi Hongo, Tomokazu Tamura, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao

Clinical case reports 10 ( 11 ) e6534 2022年11月

臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

小原隆史, 内藤宏道, 塚原紘平, 青景聡之, 野島剛, 上田浩平, 小崎吉訓, 山田太平, 藤崎宣友, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 297 - 297 2022年11月

脳死の状態判断に補助検査として脳血流シンチグラフィを施行した1例

庵谷紘美, 内藤宏道, 小原隆史, 青景聡之, 塚原紘平, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 667 - 667 2022年11月

認知機能および(または)摂食嚥下機能の障害予防を目指すICU早期リハビリテーション人工呼吸管理後の嚥下障害におけるST介入時期の検討多施設後ろ向き観察研究(中間報告)

本郷貴識, 山本良平, 劉啓文, 内藤宏道, 中尾篤典, 水川俊一

日本集中治療医学会雑誌 29 ( Suppl.1 ) 373 - 373 2022年11月

集中治療における高齢者ケア～フレイルという観点から～フレイルが高齢者救急集中治療に与える影響とは?

稲葉基高, 内藤宏道, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 303 - 303 2022年11月

臓器移植におけるドナー管理(臓器保護の観点から) 6歳未満おける臓器移植ドナー管理の特徴

小原隆史, 内藤宏道, 塚原紘平, 青景聡之, 野島剛, 上田浩平, 小崎吉訓, 山田太平, 藤崎宣友, 中尾篤典

日本集中治療医学会雑誌 29 ( Suppl.1 ) 297 - 297 2022年11月

Bile pigments in emergency and critical care medicine. 国際誌

Mizuki Seya, Toshiyuki Aokage, Tsuyoshi Nojima, Atsunori Nakao, Hiromichi Naito

European journal of medical research 27 ( 1 ) 224 - 224 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Bile pigments, such as bilirubin and biliverdin, are end products of the heme degradation pathway in mammals and are widely known for their cytotoxic effects. However, recent studies have revealed that they exert cytoprotective effects through antioxidative, anti-inflammatory, and immunosuppressive properties. All these mechanisms are indispensable in the treatment of diseases in the field of emergency and critical care medicine, such as coronary ischemia, stroke, encephalomyelitis, acute lung injury/acute respiratory distress syndrome, mesenteric ischemia, and sepsis. While further research is required before the safe application of bile pigments in the clinical setting, their underlying mechanisms shed light on their utilization as therapeutic agents in the field of emergency and critical care medicine. This article aims to summarize the current understanding of bile pigments and re-evaluate their therapeutic potential in the diseases listed above.

DOI： 10.1186/s40001-022-00863-0

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Predictive Factors of Return Home and Return to Work for Intensive Care Unit Survivors after Traumatic Brain Injury with a Follow-up Period of 2 Years.

Satoru Yabuno, Takao Yasuhara, Satoshi Murai, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao, Isao Date

Neurologia medico-chirurgica 62 ( 10 ) 465 - 474 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Intensive care unit (ICU) survivors after traumatic brain injury (TBI) frequently have serious disabilities with subsequent difficulty in reintegration into society. We aimed to investigate outcomes for ICU survivors after moderate to severe TBI (msTBI) and to identify predictive factors of return home (RH) and return to work (RTW). This single-center retrospective cohort study was conducted on all trauma patients admitted to the emergency ICU of our hospital between 2013 and 2017. Of these patients, adult (age ≥ 18 years) msTBI patients with head Abbreviated Injury Scale ≥ 3 were extracted. We performed univariate/multivariate logistic regression analyses to explore the predictive factors of RH and RTW. Among a total of 146 ICU survivors after msTBI, 107 were included (median follow-up period: 26 months). The RH and RTW rates were 78% and 35%, respectively. Multivariate analyses revealed that the predictive factors of RH were age < 65 years (P < 0.001), HR < 76 bpm (P = 0.015), platelet count ≥ 19× 104/μL (P = 0.0037), D-dimer < 26 μg/mL (P = 0.034), and Glasgow Coma Scale (GCS) score > 8 (P = 0.0015). Similarly, the predictive factors of RTW were age < 65 years (P < 0.001) and GCS score > 8 (P = 0.0039). This study revealed that "age" and "GCS score on admission" affected RH and RTW for ICU survivors after msTBI.

DOI： 10.2176/jns-nmc.2022-0149

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Elderly woman with rapid progression of swallowing difficulty. 国際誌

Ryo Tanabe, Tsuyoshi Nojima, Tetsuya Yumoto, Atsunori Nakao

Journal of the American College of Emergency Physicians open 3 ( 5 ) e12806 2022年10月

水素含有臓器保護液は,虚血再灌流後のミトコンドリアの機能回復を早め,細胞死を軽減する

瀬谷海月, 青景聡之, 山田太平, 渡邉暁洋, 山本浩継, 平山隆浩, 野島剛, 中尾篤典, 内藤宏道

日本救急医学会雑誌 33 ( 10 ) 891 - 891 2022年10月

産科情報共有システム「iPicss」により迅速な対応ができた出産中の脳出血の搬送例

佐々並三紗, 小崎吉訓, 塚原紘平, 牧尉太, 中尾篤典, 内藤宏道, 湯本哲也, 上田浩平, 小原隆史, 本郷貴識, 平岡知浩

日本救急医学会雑誌 33 ( 10 ) 806 - 806 2022年10月

治療的医学ガス(Medical gas)を救急集中治療領域へ応用する救急医による挑戦

小原隆史, 青景聡之, 山本浩継, 野島剛, 上田浩平, 湯本哲也, 内藤宏道, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 823 - 823 2022年10月

デジタル田園健康特区における救急救命士の権限・役割の拡大による救急体制の充実への取り組み

上田浩平, 本郷貴識, 小原隆史, 野島剛, 湯本哲也, 塚原紘平, 内藤宏道, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 872 - 872 2022年10月

地域枠制度・地域医療に対する持続的発展を担う救急医療教育

野島剛, 湯本哲也, 小崎吉訓, 長谷川徹, 塚原紘平, 内藤宏道, 小川弘子, 佐藤勝, 忠田正樹, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 850 - 850 2022年10月

医学生による女性型シミュレーターを用いた蘇生実習の検討

久保卓也, 本郷貴識, 塚原紘平, 野島剛, 小崎吉訓, 内藤宏道, 中尾篤典

日本救急医学会雑誌 33 ( 10 ) 875 - 875 2022年10月

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