The great East Japan earthquake and out-of-hospital cardiac arrest

From N Engl J Med, Kitamura, T., Kiyohara, K., Sakai, and Iwami, T., The Great East Japan Earthquake and Out-of-Hospital Cardiac Arrest., 369, 22 Copyright ? 2013 Massachusetts Medical Society. Reprinted with permission.Correspondenc

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Taha Toros Arşivi, Dosya Adı: Nazım Hikmetİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

The association between low pH value and unfavorable neurological outcome among the out-of-hospital cardiac arrest patient treated by extra-corporeal CPR: Sensitivity analysis

This is the response to the comment from Dr. Romain Jouffroy and his colleague, on the manuscript "Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan". We performed sensitivity analysis based on the comment from them. It indicated that the results of primary analysis were robust even in considering their criticism.Okada, Y., Kiguchi, T., Kitamura, T. et al. The association between low pH value and unfavorable neurological outcome among the out-of-hospital cardiac arrest patient treated by extra-corporeal CPR: sensitivity analysis. j intensive care 8, 53 (2020). https://doi.org/10.1186/s40560-020-00470-

Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan

Sado, J., Kitamura, T., Noma, N. et al. Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan. Environ Health Prev Med 21, 460–469 (2016). https://doi.org/10.1007/s12199-016-0550-

A nationwide randomized, double-blind, placebo-controlled physicians’ trial of loxoprofen for the treatment of fatigue, headache, and nausea after hangovers

Hangovers are associated with negative economic consequences due to decreased job performance or frequent visits to physicians. Thus, a new strategy for the alleviation of hangover-related symptoms is needed to avoid this detriment to society. The purpose of this nationwide randomized, double-blind, placebo-controlled physicians’ trial was to evaluate the efficacy of loxoprofen sodium for the alleviation of fatigue, headache, and nausea after hangover. A total of 229 participants were randomized to receive loxoprofen sodium (60 mg once orally) or placebo. The study was closed when the first 150 participants (n = 74 in the loxoprofen vs. n = 76 in the placebo groups) experienced hangovers. The primary endpoint was set as the difference in severity of general fatigue before and 3 h after taking the test drugs and was evaluated using a visual analogue scale. Secondary endpoints included difference in severity of headache, nausea, and incidence of adverse events. The study participants were 34 (interquartile range; 30-39) years old, 92.0% were men, and both groups were comparable for baseline characteristics. The alleviation of general fatigue did not differ statistically between the loxoprofen and placebo groups (24 [14-49] vs. 19 [9-35], p = 0.07). However, the alleviation of headache was statistically greater in the loxoprofen group (25 [10-50] vs. 10 [2-30], adjusted difference 14, 95% confidence interval 8-21, p < 0.001), whereas, there was no difference in nausea (7 [0-27] vs. 10 [0-24], p = 0.68). The incidence of adverse symptoms such as epigastric discomfort was also comparable between groups (2.7% vs. 3.9%, p = 0.25). Loxoprofen sodium was effective for relieving headaches after hangovers but did not alleviate general fatigue or nausea.Masahiko Hara, Kenichi Hayashi, Tetsuhisa Kitamura, Michitaka Honda, Masatake Tamaki, A nationwide randomized, double-blind, placebo-controlled physicians’ trial of loxoprofen for the treatment of fatigue, headache, and nausea after hangovers, Alcohol, Volume 84, 2020, Pages 21-25, ISSN 0741-8329, https://doi.org/10.1016/j.alcohol.2019.10.006

Nationwide public-access defibrillation in Japan

BACKGROUND: It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest. METHODS: From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest. The primary outcome measure was the 1-month rate of survival with minimal neurologic impairment. A multivariate logistic-regression analysis was performed to assess factors associated with a good neurologic outcome. RESULTS: A total of 312,319 adults who had an out-of-hospital cardiac arrest were included in the study; 12,631 of these patients had ventricular fibrillation and had an arrest that was of cardiac origin and that was witnessed by bystanders. In 462 of these patients (3.7%), shocks were administered by laypersons with the use of public-access AEDs, and the proportion increased, from 1.2% to 6.2%, as the number of public-access AEDs increased (P<0.001 for trend). Among all patients who had a bystander-witnessed arrest of cardiac origin and who had ventricular fibrillation, 14.4% were alive at 1 month with minimal neurologic impairment; among patients who received shocks from public-access AEDs, 31.6% were alive at 1 month with minimal neurologic impairment. Early defibrillation, regardless of the type of provider (bystander or emergency-medical-services personnel), was associated with a good neurologic outcome after a cardiac arrest with ventricular fibrillation (adjusted odds ratio per 1-minute increase in the time to administration of shock, 0.91; 95% confidence interval, 0.89 to 0.92; P<0.001). The mean time to shock was reduced from 3.7 to 2.2 minutes, and the annual number of patients per 10 million population who survived with minimal neurologic impairment increased from 2.4 to 8.9 as the number of public-access AEDs increased from fewer than 1 per square kilometer of inhabited area to 4 or more. CONCLUSIONS: Nationwide dissemination of public-access AEDs in Japan resulted in earlier administration of shocks by laypersons and in an increase in the 1-month rate of survival with minimal neurologic impairment after an out-of-hospital cardiac arrest.From N Engl J Med,Kitamura, T., Iwami, T., Kawamura, T., Nagao, K., Tanaka, H., & Hiraide, A., Nationwide public-access defibrillation in japan., 362, 11 Copyright © 2010 Massachusetts Medical Society. Reprinted with permission.Original Articl

Association of body temperature with in-hospital mortality among paediatric trauma patients: An analysis of a nationwide observational trauma database in Japan

Okada A, Okada Y, Narumiya H, et alAssociation of body temperature with in-hospital mortality among paediatric trauma patients: an analysis of a nationwide observational trauma database in JapanBMJ Open 2020;10:e033822. doi: 10.1136/bmjopen-2019-033822

Hemodynamic Effects of Intravenous Calcium Administration on Septic Shock Patients:A Retrospective Study

We evaluated the hemodynamics and outcomes of septic shock (SS) patients who did not respond to fluid resuscitation, after treatment with or without intravenous calcium. We retrospectively collected information on 154 eligible SS patients who were admitted to Fukuyama City Hospital Emergency Medical Center and did not respond to fluid resuscitation. To compare their degree of hemodynamic impairment, we compared the changes in the vasoactive-inotropic score (VIS) in the calcium-treated group (n＝112) and the noncalcium-treated group (n＝42). We compared the length of stay in the intensive care unit (ICU) and hospital, in-hospital deaths, 28-day deaths, and changes in the Sequential Organ Failure Assessment score within 72h of ICU admission between the 2 groups. Changes in the VIS at 1h after the baseline time were significantly greater in the calcium-treated group than in the noncalcium-treated group (1.41 vs. －1.25, respectively;p＜0.001). However, the changes in the VIS at 3, 6, 24, 48, and 72h did not differ between the 2 groups. The secondary outcomes also did not differ between the groups. Our findings indicate that calcium administered to SS patients might reduce their hemodynamic stabilization, but only for a short time after its administration

Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan: A nationwide case-control study

Ikeda, S, Ueda, Y, Hara, M, et al. Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan: A nationwide case‐control study. Cancer Sci. 2020; 00: 1– 8. https://doi.org/10.1111/cas.14682