Descriptive Characteristics of Drowning-Related Out-of-Hospital Cardiac Arrest in Marine Leisure Activities on a Japanese Island.

IntroductionDrowning is a global public health concern, with over 300,000 deaths annually. In Japan, approximately 700 drowning-related fatalities occur each year, increasingly involving older adults during marine leisure activities. However, limited data are available on the clinical characteristics of such incidents at tourist destinations.

Efficacy of abdominal thrusts and back blows for patients with foreign body airway obstruction: MOCHI registry analysis.

Aim: This study aimed to evaluate the effectiveness of abdominal thrusts and back blows as initial bystander interventions compared to the absence of bystander intervention in patients with foreign body airway obstruction (FBAO).

Methods: This was a prospective, observational study conducted at 25 hospitals in Japan (April 2020-March 2023), including patients aged ≥ 18 years presenting emergency departments with FBAO. The primary outcome was a favorable neurological outcome at 30 days, defined as a Cerebral Performance Category 1 or 2.

Dysregulated type I/III interferon system in circulation from patients with anti-MDA5-positive dermatomyositis.

Anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) is often complicated by rapidly progressive interstitial lung disease (RP-ILD), leading to early mortality. Previous studies on the pathogenesis of anti-MDA5-positive DM highlighted type I interferons (IFNs), while recent investigations reported the significance of a type III IFN, IFN-λ3. We investigated a range of cytokines, including type I/II/III IFNs, in serum samples from anti-MDA5-positive DM patients collected at diagnosis before treatment introduction.

Head Mounted Three-Dimensional High-Definition Display System for Microscopic Surgical Field Observation: An Observational Study.

Objective: Microscopic surgery poses ergonomic challenges due to the constraints of fixed eyepieces. While monitor-based exoscopes offer alternatives, they may limit immersion and assistant visibility. Head-mounted displays (HMDs) have proposed these constraints.

The time course of alpha 2-plasmin inhibitor and plasmin-alpha 2-plasmin inhibitor complex levels in patients with traumatic brain injury.

Background: In its acute phase, traumatic brain injury (TBI) is notable for disturbances in the coagulation/fibrinolysis system. Plasmin, alpha 2-plasmin inhibitor (α2-PI), and their complex (plasmin-α2-PI complex [PIC]) are important components of the coagulation-fibrinolytic system, but their time courses in the acute phase of TBI and their association with long-term prognosis are unknown.

Methods: We conducted a retrospective analysis of 84 consecutive patients with isolated TBI, during which plasma α2-PI and PIC levels were measured at the time of arrival, as well as at 3, 6, and 12 h, and on days 1, 3, and 7 post-injury.

Acute epidural hematoma extending bilaterally and infratentorially: illustrative case.

Background: An acute epidural hematoma (AEDH) is a severe complication of traumatic brain injury, occurring in 1%-3% of all head trauma cases. Herein, the authors report a rare case of AEDH in a 51-year-old male, with the AEDH extending bilaterally across the superior sagittal sinus (SSS) and into the infratentorial region following a fall.

Observations: The patient underwent an emergency craniotomy and hematoma evacuation, and favorable outcomes were achieved.

Rapidly progressive brain atrophy in ventilated patients: a retrospective descriptive study.

The relationship between mechanical ventilation-induced brain volume changes and ICU-acquired weakness (ICU-AW) is not clear. We assessed brain volume change in ventilated patients and identified associations with changes in extremity muscle strength. Patients admitted to the ICU due to the need for ventilation, and who underwent at least two head CT scans during hospitalization, were included.

Effectiveness of vacuum-assisted wound closure and mesh-mediated fascial traction in open abdomen management.

Purpose: To determine the effectiveness of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in patients undergoing open abdomen management (OAM).

Methods: Data from cases with OAM for at least five days who were admitted to our institution between January 2011 and December 2020 were included. We compared the patient's age, sex, medical history, indication for initial surgery, APACHE II scores, indication for OAM, operative time, intraoperative blood loss, intraoperative transfusion, success of primary fascial closure (rectus fascial closure and bilateral anterior rectus abdominis sheath turnover flap method), success of planned ventral hernia, duration of OAM, and in-hospital mortality between patients undergoing VAWCM (VAWCM cases, n = 27) and vacuum-assisted wound closure (VAWC) alone (VAWC cases, n = 25).

Effectiveness of the Abdominal Thrust Maneuver for Airway Obstruction Removal: Analysis of Data from the National Emergency Medical Services Information System.

Background: Foreign body airway obstruction (FBAO) is a life-threatening emergency. Abdominal thrusts are recommended as first aid, but the success rate for this technique is unclear. Using information from a large database of emergency medical services (EMS) data in the United States, we evaluated the success rate of abdominal thrusts and identified patient characteristics that were associated with the success of the technique.

Long-awaited evidence on back blows versus abdominal thrusts.

This is a commentary on the study conducted by Dunne et al. from Alberta, Canada, which retrospectively analyzed data from patients with foreign body airway obstruction (FBAO) in the region. By linking the region's prehospital data with hospital data, the authors were able to report not only the FBAO relief of each intervention, but also patient survival outcomes and complications associated with the interventions.

The effects of bystander interventions for foreign body airway obstruction on survival and neurological outcomes: Findings of the MOCHI registry.

Introduction: Foreign body airway obstruction (FBAO) is a life-threatening condition. We aimed to quantify the impact of bystander FBAO interventions on survival and neurological outcomes.

Methods: We conducted a Japan-wide prospective, multi-center, observational study including all FBAO patients who presented to the Emergency Department from April 2020 to March 2023.

Effect of prehospital advanced airway management on out-of-hospital cardiac arrest due to asphyxia: A JAAM-OHCA registry-based observational study in Japan.

Aim: To investigate the relationship between prehospital advanced airway management (AAM) and neurological outcomes in patients with asphyxia-related out-of-hospital cardiac arrest (OHCA).

Methods: We retrospectively analyzed data from the Japanese Association for Acute Medicine OHCA registry between June 2014 and December 2017. Patients with asphyxia-related cardiac arrest aged ≥18 years were included.

Ventilator management and risk of air leak syndrome in patients with SARS-CoV-2 pneumonia: a single-center, retrospective, observational study.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia is reportedly associated with air leak syndrome (ALS), including mediastinal emphysema and pneumothorax, and has a high mortality rate. In this study, we compared values obtained every minute from ventilators to clarify the relationship between ventilator management and risk of developing ALS.

Methods: This single-center, retrospective, observational study was conducted at a tertiary care hospital in Tokyo, Japan, over a 21-month period.

Cerebral edema associated with diabetic ketoacidosis: Two case reports.

Background: Diabetic ketoacidosis (DKA) is associated with a high mortality rate, especially if cerebral edema develops during the disease course. It is rarer and more severe in adults than in children. We present cases of two patients with cerebral edema-related DKA.

Rapidly progressive cerebral atrophy following a posterior cranial fossa stroke: Assessment with semiautomatic CT volumetry.

Background: The effect of posterior cranial fossa stroke on changes in cerebral volume is not known. We assessed cerebral volume changes in patients with acute posterior fossa stroke using CT scans, and looked for risk factors for cerebral atrophy.

Methods: Patients with cerebellar or brainstem hemorrhage/infarction admitted to the ICU, and who underwent at least two subsequent inpatient head CT scans during hospitalization were included (n = 60).

An unbroken ring of the chain of survival.

This is a commentary on the study conducted by Kennedy et al. from Victoria, Australia, that analyzed the cohort of all adult EMS-witnessed out-of-hospital cardiac arrest (OHCA) patients in the region and compared patients treated during the COVID-19 period to a historical comparator period. The commentary summarizes the study findings and discusses the importance of the study in the context of the chain of survival and changes in airway management for OHCA patients during the COVID-19 pandemic.

Food choking incidents in the hospital: Incidents, characteristics, effectiveness of interventions, and mortality and morbidity outcomes.

Aim: Foreign body airway obstruction (FBAO) due to food can occur wherever people eat, including in hospitals. We characterized in-hospital FBAO incidents and their outcomes.

Methods: We searched the Japan Council for Quality Health Care nationwide in-hospital adverse events database for relevant events from 1,549 institutions.

Effects of Changes in Body Fat Mass as a Result of Regular Exercise on Hemoglobin A1c in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis.

An increase in visceral fat is associated with an increase in insulin resistance, so reducing body fat mass through exercise may help alleviate type 2 diabetes mellitus (T2DM). The current meta-analysis evaluated the effect of changes in body fat via an intervention of regular exercise on hemoglobin A1c (HbA1c) in patients with T2DM. The inclusion criteria were randomized controlled trials involving adults with T2DM, intervention involving exercise alone, an overall duration of intervention ≥12 weeks, and reporting HbA1c and body fat mass.