| JaLCDOI | 10.18926/AMO/60365 |
|---|---|
| フルテキストURL | 74_4_285.pdf |
| 著者 | Tsukahara, Kohei| Naitou, Hiromichi| Yorifuji, Takashi| Nosaka, Nobuyuki| Yamamoto, Hirotsugu| Osako, Takaaki| Nakao, Atsunori| the JaRPAC Study Group| |
| 抄録 | The importance of centralizing treatment services for severely ill children has been well established, but such entralization remains difficult in Japan. We aimed to compare the trauma and illness severity and mortality of children admitted to two common types of ICUs for children. According to the type of management and disposition of the medical provider, we classified ICUs as pediatric ICUs [PICUs] or general ICUs, and analyzed differences in endogenous and exogenous illness settings between them. Overall, 1,333 pediatric patients were included, with 1,143 patients admitted to PICUs and 190 patients to general ICUs. The Pediatric Cerebral Performance Category score (PCPC) at discharge was significantly lower in the PICU group (adjusted OR: 0.45; 95%CI: 0.23-0.88). Death and unfavorable neurological outcomes occurred less often in the PICU group (adjusted OR: 0.29; 95%CI: 0.14-0.60). However, when limited to exogenous illness, PCPC scores (adjusted OR: 0.38; 95%CI: 0.07-1.99) or death/unfavorable outcomes (adjusted OR: 0.72; 95%CI: 0.08-6.34) did not differ between the groups. PCPC deterioration and overall sequelae/death rates were lower in PICUs for children with endogenous illnesses, although the outcomes of exogenous illness were similar between the 2 unit types. Further studies on the necessity of centralization are warranted. |
| キーワード | kids critical care mortality morbidity centralization |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2020-08 |
| 巻 | 74巻 |
| 号 | 4号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 285 |
| 終了ページ | 291 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2020 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 32843759 |
| Web of Science KeyUT | 000562508700003 |
| NAID | 120006880204 |
| フルテキストURL | fulltext.pdf fulltext2.pdf |
|---|---|
| 著者 | Fujii, Yosuke| Yashiro, Masato| Yamada, Mutsuko| Kikkawa, Tomonobu| Nosaka, Nobuyuki| Saito, Yukie| Tsukahara, Kohei| Ikeda, Masanori| Morishima, Tsuneo| Tsukahara, Hirokazu| |
| 発行日 | 2018-03-14 |
| 出版物タイトル | Disease Markers |
| 出版者 | Hindawi |
| 開始ページ | 2380179 |
| ISSN | 0278-0240 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © 2018 Yosuke Fujii et al. |
| 論文のバージョン | publisher |
| PubMed ID | 29725488 |
| DOI | 10.1155/2018/2380179 |
| Web of Science KeyUT | 000428395400001 |
| 関連URL | isVersionOf https://doi.org/10.1155/2018/2380179 |
| フルテキストURL | fulltext.pdf |
|---|---|
| 著者 | Knaup, Emily| Nosaka, Nobuyuki| Yorifuji, Takashi| Tsukahara, Kohei| Naitou, Hiromichi| Tsukahara, Hirokazu| Nakao, Atsunori| the JaRPAC Study Group| |
| キーワード | Decision support Intensive care Length of stay Mortality Outcome Pediatric Risk Prediction rules Scoring system |
| 発行日 | 2019-07-29 |
| 出版物タイトル | Journal of Intensive Care |
| 巻 | 7巻 |
| 出版者 | BMC |
| 開始ページ | 38 |
| ISSN | 2052-0492 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © The Author(s). |
| 論文のバージョン | publisher |
| PubMed ID | 31384469 |
| DOI | 10.1186/s40560-019-0392-2 |
| Web of Science KeyUT | 000477892900001 |
| 関連URL | isVersionOf https://doi.org/10.1186/s40560-019-0392-2 |
| フルテキストURL | fulltext.pdf |
|---|---|
| 著者 | Aokage, Toshiyuki| Tsukahara, Kohei| Fukuda, Yasushi| Tokioka, Fumiaki| Taniguchi, Akihiko| Naito, Hiromichi| Nakao, Atsunori| |
| キーワード | Tobacco Cigarettes Heat-not-burn cigarettes Acute eosinophilic pneumonia Extracorporeal membrane oxygenation ECMO |
| 発行日 | 2019-12-04 |
| 出版物タイトル | Respiratory Medicine Case Reports |
| 巻 | 26巻 |
| 出版者 | Elsevier |
| 開始ページ | 87 |
| 終了ページ | 90 |
| ISSN | 2213-0071 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | © 2018 The Authors. |
| 論文のバージョン | publisher |
| PubMed ID | 30560050 |
| DOI | 10.1016/j.rmcr.2018.12.002 |
| Web of Science KeyUT | 000461453000023 |
| 関連URL | isVersionOf https://doi.org/10.1016/j.rmcr.2018.12.002 |
| JaLCDOI | 10.18926/AMO/55433 |
|---|---|
| フルテキストURL | 71_5_363.pdf |
| 著者 | Yumoto, Tetsuya| Kosaki, Yoshinori| Yamakawa, Yasuaki| Iida, Atsuyoshi| Yamamoto, Hirotsugu| Yamada, Taihei| Tsukahara, Kohei| Naito, Hiromichi| Osako, Takaaki| Nakao, Atsunori| |
| 抄録 | Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture. Massive soft tissue injury, regardless of whether isolated or associated with multiple injuries, occasionally causes extensive hemorrhage and acute traumatic coagulopathy. Specific types of injuries, including soft tissue injury or retroperitoneal hemorrhage unrelated to pelvic fracture, can potentially be overlooked or be considered “occult” causes of bleeding because classical diagnostic imaging often cannot exclude such injuries. The purpose of this narrative review article is to describe “occult” or unusual sources of bleeding associated with blunt trauma. |
| キーワード | soft tissue injury subcutaneous hematoma non-cavitary hemorrhage retroperitoneal hemorrhage hemorrhagic shock |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2017-10 |
| 巻 | 71巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 363 |
| 終了ページ | 368 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2017 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 29042693 |
| JaLCDOI | 10.18926/AMO/54987 |
|---|---|
| フルテキストURL | 71_2_179.pdf |
| 著者 | Nosaka, Nobuyuki| Tsukahara, Kohei| Knaup, Emily| Yabuuchi, Toshihiko| Kikkawa, Tomonobu| Fujii, Yosuke| Yashiro, Masato| Yasuhara, Takao| Okada, Ayumi| Ugawa, Toyomu| Nakao, Atsunori| Tsukahara, Hirokazu| Date, Isao| |
| 抄録 | Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management. |
| キーワード | cerebral perfusion encephalopathy child intracranial pressure neurological intensive care |
| Amo Type | Short Communication |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2017-04 |
| 巻 | 71巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 179 |
| 終了ページ | 180 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2017 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 28420900 |
| JaLCDOI | 10.18926/AMO/54590 |
|---|---|
| フルテキストURL | 70_5_331.pdf |
| 著者 | Iida, Atsuyoshi| Nosaka, Nobuyuki| Yumoto, Tetsuya| Knaup, Emily| Naito, Hiromichi| Nishiyama, Chihiro| Yamakawa, Yasuaki| Tsukahara, Kohei| Terado, Michihisa| Sato, Keiji| Ugawa, Toyomu| Nakao, Atsunori| |
| 抄録 | In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogenʼs effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated. |
| キーワード | hydrogen antioxidant effect medical gas gaseous signaling molecule clinical tests |
| Amo Type | Review |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-10 |
| 巻 | 70巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 331 |
| 終了ページ | 337 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27777424 |
| Web of Science KeyUT | 000388098700001 |
| JaLCDOI | 10.18926/AMO/53673 |
|---|---|
| フルテキストURL | 69_5_275.pdf |
| 著者 | Nosaka, Nobuyuki| Goda, Yu| Knaup, Emily| Tsukahara, Kohei| Yumoto, Tetsuya| Ugawa, Toyomu| Ujike, Yoshihito| |
| 抄録 | We sought to identify the incidence, injury patterns, and financial burden of ladder fall injuries to provide a reference for reinforcing guidelines on the prevention of such injuries. We enrolled the patients who were injured in a ladder-related fall and required intensive care between April 2012 and March 2014 at Okayama University Hospital, a tertiary care hospital in Okayama City:9 patients injured in 7 stepladder falls and 2 straight ladder falls. The median patient age was 69 years, and 8 were males. Six falls occurred in non-occupational settings. Head injuries predominated, and the injury severity score ranged from 2 to 35 (mean＝21±12). At the time of discharge from the intensive care unit, one patient had died and 5 patients had some neurological disabilities. The case fatality rate was 11%. The total cost of care during the review period was ￥16,705,794, with a mean cost of ￥1,856,199 per patient. Ladder fall injuries are associated with a high rate of neurological sequelae and pose a financial burden on the health insurance system. A prevention education campaign targeting at older-aged males in non-occupational settings may be a worthwhile health service investment in this community. |
| キーワード | accidental falls accident prevention hospital costs injuries ladder |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2015-10 |
| 巻 | 69巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 275 |
| 終了ページ | 278 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2015 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 26490024 |
| Web of Science KeyUT | 000365519600003 |
| JaLCDOI | 10.18926/AMO/49040 |
|---|---|
| フルテキストURL | 66_6_443.pdf |
| 著者 | Ugawa, Toyomu| Sakurama, Kazufumi| Yorifuji, Takashi| Takaoka, Munenori| Fujiwara, Yasuhiro| Kabashima, Narutoshi| Azuma, Daisuke| Hirayama, Takahiro| Tsukahara, Kohei| Morisada, Sunao| Iida, Atsuyoshi| Tada, Keitaro| Shiba, Naoki| Sato, Nobuo| Ichiba, Shingo| Kino, Koichi| Fukushima, Masaki| Ujike, Yoshihito| |
| 抄録 | The functioning of an arteriovenous fistula (AVF) used for vascular access during hemodialysis has been assessed mainly by dilution methods. Although these techniques indicate the immediate recirculation rate, the results obtained may not correlate with Kt/V. In contrast, the clearance gap (CL-Gap) method provides the total recirculation rate per dialysis session and correlates well with Kt/V. We assessed the correlation between Kt/V and CL-Gap as well as the change in radial artery (RA) blood flow speed in the fistula before percutaneous transluminal angioplasty (PTA) in 45 patients undergoing continuous hemodialysis. The dialysis dose during the determination of CL-Gap was 1.2 to 1.4 Kt/V. Patients with a 10% elevation or more than a 10% relative increase in CL-Gap underwent PTA (n＝45), and the values obtained for Kt/V and CL-Gap before PTA were compared with those obtained immediately afterward. The mean RA blood flow speed improved significantly (from 52.9 to 97.5cm/sec) after PTA, as did Kt/V (1.07 to 1.30) and CL-Gap (14.1% to －0.2%). A significant correlation between these differences was apparent (r＝－0.436 and p＝0.003). These findings suggest that calculating CL-Gap may be useful for determining when PTA is required and for assessing the effectiveness of PTA, toward obtaining better dialysis. |
| キーワード | hemodialysis recirculation clearance gap vascular access percutaneous transluminal angioplasty |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2012-12 |
| 巻 | 66巻 |
| 号 | 6号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 443 |
| 終了ページ | 447 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2012 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23254578 |
| Web of Science KeyUT | 000312966100003 |