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Nakanishi N, Liu K, Hatakeyama J, Kawauchi A, Yoshida M, Sumita H, Miyamoto K, Nakamura K. Post-intensive care syndrome follow-up system after hospital discharge: a narrative review. J Intensive Care 2024; 12:2. [PMID: 38217059 PMCID: PMC10785368 DOI: 10.1186/s40560-023-00716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system. MAIN TEXT The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine. The first PICS follow-up clinic was established in the U.K. in 1993 and its use spread thereafter. There are currently no consistent findings on the efficacy of PICS follow-up clinics. Under recent evidence and recommendations, attendance at a PICS follow-up clinic needs to start within three months after hospital discharge. A multidisciplinary team approach is important for the treatment of PICS from various aspects of impairments, including the nutritional status. We classified face-to-face and telephone-based assessments for a PICS follow-up from recent recommendations. Recent findings on medications, rehabilitation, and nutrition for the treatment of PICS were summarized. CONCLUSIONS This narrative review aimed to summarize the PICS follow-up system after hospital discharge and provide a comprehensive approach for the prevention and treatment of PICS.
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Affiliation(s)
- Nobuto Nakanishi
- Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki, Chuo-Ward, Kobe, 650-0017, Japan
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, QLD, 4032, Australia
- Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Rd, St Lucia, QLD, 4067, Australia
- Non-Profit Organization ICU Collaboration Network (ICON), 2-15-13 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Akira Kawauchi
- Department of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-Machi, Maebashi-Shi, Gunma, 371-0811, Japan
| | - Minoru Yoshida
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216- 8511, Japan
| | - Hidenori Sumita
- Clinic Sumita, 305-12, Minamiyamashinden, Ina-Cho, Toyokawa, Aichi, 441-0105, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan
| | - Kensuke Nakamura
- Department of Critical Care Medicine, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, 236-0004, Japan.
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2
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Iwata T, Kousa T, Nishioka Y, Ohwada K, Sumida K, Annese E, Kakoki M, Kuroda K, Iwasawa H, Arita M, Kumar S, Kimura A, Miyamoto K, Okuda T. Laser-based angle-resolved photoemission spectroscopy with micrometer spatial resolution and detection of three-dimensional spin vector. Sci Rep 2024; 14:127. [PMID: 38177136 PMCID: PMC10766951 DOI: 10.1038/s41598-023-47719-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/17/2023] [Indexed: 01/06/2024] Open
Abstract
We have developed a state-of-the-art apparatus for laser-based spin- and angle-resolved photoemission spectroscopy with micrometer spatial resolution (µ-SARPES). This equipment is realized by the combination of a high-resolution photoelectron spectrometer, a 6 eV laser with high photon flux that is focused down to a few micrometers, a high-precision sample stage control system, and a double very-low-energy-electron-diffraction spin detector. The setup achieves an energy resolution of 1.5 (5.5) meV without (with) the spin detection mode, compatible with a spatial resolution better than 10 µm. This enables us to probe both spatially-resolved electronic structures and vector information of spin polarization in three dimensions. The performance of µ-SARPES apparatus is demonstrated by presenting ARPES and SARPES results from topological insulators and Au photolithography patterns on a Si (001) substrate.
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Affiliation(s)
- Takuma Iwata
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
- International Institute for Sustainability with Knotted Chiral Meta Matter (WPI-SKCM2), Hiroshima University, Higashi-hiroshima, 739-8526, Japan
| | - T Kousa
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
| | - Y Nishioka
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
| | - K Ohwada
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
| | - K Sumida
- Materials Sciences Research Center, Japan Atomic Energy Agency, Sayo-gun, Hyogo, 679-5148, Japan
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - E Annese
- Brazilian Center for Research in Physics, Rua Dr. Xavier Sigaud 150, Rio de Janeiro, RJ, 22290-180, Brazil
| | - M Kakoki
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
| | - Kenta Kuroda
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan.
- International Institute for Sustainability with Knotted Chiral Meta Matter (WPI-SKCM2), Hiroshima University, Higashi-hiroshima, 739-8526, Japan.
| | - H Iwasawa
- Institute for Advanced Synchrotron Light Source, National Institutes for Quantum Science and Technology, Sendai, 980-8579, Japan
- Synchrotron Radiation Research Center, National Institutes for Quantum Science and Technology, Hyogo, 679-5148, Japan
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - M Arita
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - S Kumar
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - A Kimura
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, 739-8526, Japan
- International Institute for Sustainability with Knotted Chiral Meta Matter (WPI-SKCM2), Hiroshima University, Higashi-hiroshima, 739-8526, Japan
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
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3
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Shirasaki K, Hifumi T, Nakanishi N, Nosaka N, Miyamoto K, Komachi MH, Haruna J, Inoue S, Otani N. Postintensive care syndrome family: A comprehensive review. Acute Med Surg 2024; 11:e939. [PMID: 38476451 PMCID: PMC10928249 DOI: 10.1002/ams2.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Families of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20-40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F.
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Affiliation(s)
- Kasumi Shirasaki
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Toru Hifumi
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Nobuto Nakanishi
- Division of Disaster and Emergency Medicine, Department of Surgery RelatedKobe University Graduate School of MedicineKobeJapan
| | - Nobuyuki Nosaka
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Miyuki H. Komachi
- School of Clinical Medicine, Department of Psychiatry, Child and Adolescent Resilience and Mental HealthUniversity of CambridgeCambridgeUK
| | - Junpei Haruna
- Department of Intensive Care Medicine, School of MedicineSapporo Medical UniversityHokkaidoJapan
| | - Shigeaki Inoue
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Norio Otani
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
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4
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Okamura T, Murata S, Miyamoto K, Tane M, Okabe Y, Takeda S, Tabata S, Kosako H, Hori Y, Yamashita Y, Mushino T, Hosoi H, Sonoki T. [Veno-venous extracorporeal membrane oxygenation for capillary leak syndrome during induction chemotherapy in acute myeloid leukemia]. Rinsho Ketsueki 2024; 65:169-174. [PMID: 38569861 DOI: 10.11406/rinketsu.65.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
A 44-year-old woman was diagnosed with acute myeloid leukemia (RUNX1::RUNX1T1 translocation) and received induction chemotherapy with idarubicin hydrochloride and cytosine arabinoside. The pneumonia that had been present since admission worsened, and a drug-induced skin rash appeared. On day 17, she presented with respiratory failure and shock, complicated by hemoconcentration and hypoalbuminemia. This was considered capillary leak syndrome due to pneumonia and drug allergy, so she was started on pulse steroid therapy and IVIG, and was intubated on the same day. On day 18, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was started due to worsening blood gas parameters despite ventilatory management. Bronchoalveolar lavage fluid was serous, and both blood and sputum cultures yielded negative. The patient was weaned from VV-ECMO on day 26 as the pneumonia improved with recovery of hematopoiesis. She was disoriented, and a CT scan on day 28 revealed cerebral hemorrhage. Her strength recovered with rehabilitation. After induction chemotherapy, RUNX1::RUNX1T1 mRNA was not detected in bone marrow. The patient received consolidation chemotherapy, and has maintained complete remission. Severe respiratory failure during induction chemotherapy for acute leukemia can be fatal, but VV-ECMO may be lifesaving.
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Affiliation(s)
- Tadashi Okamura
- Department of Hematology/Oncology, Wakayama Medical University
| | - Shogo Murata
- Department of Hematology/Oncology, Wakayama Medical University
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University
| | - Misato Tane
- Department of Hematology/Oncology, Wakayama Medical University
| | - Yuka Okabe
- Department of Hematology/Oncology, Wakayama Medical University
| | - Satomi Takeda
- Department of Hematology/Oncology, Wakayama Medical University
| | - Shotaro Tabata
- Department of Hematology/Oncology, Wakayama Medical University
| | - Hideki Kosako
- Department of Hematology/Oncology, Wakayama Medical University
| | - Yoshikazu Hori
- Department of Hematology/Oncology, Wakayama Medical University
| | | | - Toshiki Mushino
- Department of Hematology/Oncology, Wakayama Medical University
| | - Hiroki Hosoi
- Department of Hematology/Oncology, Wakayama Medical University
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University
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5
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Teramoto K, Tamura S, Yoshida K, Inada Y, Yamashita Y, Morimoto M, Mushino T, Koreeda D, Miyamoto K, Komiya N, Nakano Y, Takagaki Y, Koizumi Y. Clinical Characteristics and Diagnostic Prediction of Severe Fever with Thrombocytopenia Syndrome and Rickettsiosis in the Co-Endemic Wakayama Prefecture, Japan. Medicina (Kaunas) 2023; 59:2024. [PMID: 38004073 PMCID: PMC10672843 DOI: 10.3390/medicina59112024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The Wakayama prefecture is endemic for two types of tick-borne rickettsioses: Japanese spotted fever (JFS) and scrub typhus (ST). Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne hemorrhagic viral disease with a high mortality rate and is often difficult to differentiate from such rickettsioses. SFTS cases have recently increased in Wakayama prefecture. For early diagnosis, this study aimed to evaluate the clinical characterization of such tick-borne infections in the co-endemic area. Materials and Methods: The study included 64 febrile patients diagnosed with tick-borne infection in Wakayama prefecture between January 2013 and May 2022. Medical records of 19 patients with SFTS and 45 with rickettsiosis (JSF, n = 26; ST, n = 19) were retrospectively examined. The receiver operating curve (ROC) and area under the curve (AUC) were calculated to evaluate potential factors for differentiating SFTS from rickettsiosis. Results: Adults aged ≥70 years were most vulnerable to tick-borne infections (median, 75.5 years; interquartile range, 68.5-84 years). SFTS and rickettsiosis occurred mostly between summer and autumn. However, no significant between-group differences were found in age, sex, and comorbidities; 17 (89%) patients with SFTS, but none of those with rickettsiosis, experienced gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea. Meanwhile, 43 (96%) patients with rickettsiosis, but none of those with SFTS, developed a skin rash. The AUCs of white blood cells (0.97) and C-reactive protein (CRP) levels (0.98) were very high. Furthermore, the differential diagnosis of SFTS was significantly associated with the presence of gastrointestinal symptoms (AUC 0.95), the absence of a skin rash (AUC 0.98), leukopenia <3.7 × 109/L (AUC 0.95), and low CRP levels < 1.66 mg/dL (AUC 0.98) (p < 0.001 for each factor). Conclusions: Clinical characteristics and standard laboratory parameters can verify the early diagnosis of SFTS in areas where tick-borne infections are endemic.
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Affiliation(s)
- Kan Teramoto
- Department of Internal Medicine, National Health Insurance Susami Hospital, Wakayama 649-2621, Japan
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shinobu Tamura
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Kikuaki Yoshida
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yukari Inada
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yusuke Yamashita
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Masaya Morimoto
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Toshiki Mushino
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Daisuke Koreeda
- Department of Emergency and Intensive Care Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Japan
| | - Kyohei Miyamoto
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Japan
| | - Yoshio Nakano
- Department of Internal Medicine, Kinan Hospital, Wakayama 646-8588, Japan
| | - Yusaku Takagaki
- Department of Internal Medicine, National Health Insurance Susami Hospital, Wakayama 649-2621, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
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6
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Nakanishi N, Liu K, Kawauchi A, Okamura M, Tanaka K, Katayama S, Mitani Y, Ota K, Taito S, Fudeyasu K, Masuka Y, Yoshihiro S, Utsumi S, Nishikimi M, Masuda M, Iida Y, Kawai Y, Hatakeyama J, Hifumi T, Unoki T, Kawakami D, Obata K, Katsukawa H, Sumita H, Morisawa T, Takahashi M, Tsuboi N, Kozu R, Takaki S, Haruna J, Fujinami Y, Nosaka N, Miyamoto K, Nakamura K, Kondo Y, Inoue S, Nishida O. Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study. Crit Care 2023; 27:430. [PMID: 37936249 PMCID: PMC10629074 DOI: 10.1186/s13054-023-04681-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/07/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The assessment of post-intensive care syndrome (PICS) is challenging due to the numerous types of instruments. We herein attempted to identify and propose recommendations for instruments to assess PICS in intensive care unit (ICU) survivors. METHODS We conducted a scoping review to identify PICS follow-up studies at and after hospital discharge between 2014 and 2022. Assessment instruments used more than two times were included in the modified Delphi consensus process. A modified Delphi meeting was conducted three times by the PICS committee of the Japanese Society of Intensive Care Medicine, and each score was rated as not important (score: 1-3), important, but not critical (4-6), and critical (7-9). We included instruments with ≥ 70% of respondents rating critical and ≤ 15% of respondents rating not important. RESULTS In total, 6972 records were identified in this scoping review, and 754 studies were included in the analysis. After data extraction, 107 PICS assessment instruments were identified. The modified Delphi meeting reached 20 PICS assessment instrument recommendations: (1) in the physical domain: the 6-min walk test, MRC score, and grip strength, (2) in cognition: MoCA, MMSE, and SMQ, (3) in mental health: HADS, IES-R, and PHQ-9, (4) in the activities of daily living: the Barthel Index, IADL, and FIM, (5) in quality of life: SF-36, SF-12, EQ-5D-5L, 3L, and VAS (6), in sleep and pain: PSQI and Brief Pain Inventory, respectively, and (7) in the PICS-family domain: SF-36, HADS, and IES-R. CONCLUSION Based on a scoping review and the modified Delphi method, 20 PICS assessment instruments are recommended to assess physical, cognitive, mental health, activities of daily living, quality of life, sleep, and pain in ICU survivors and their families.
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Affiliation(s)
- Nobuto Nakanishi
- Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, 4032, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4067, Australia
- Non-Profit Organization ICU Collaboration Network (ICON), Tokyo, 113-0033, Japan
| | - Akira Kawauchi
- Department of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-Machi, Maebashi-shi, Gunma, 371-0811, Japan
| | - Masatsugu Okamura
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Kohei Tanaka
- Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama, Tennouji, Osaka, 543-0035, Japan
| | - Sho Katayama
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikata, Kitaku, Okayama, 700-8558, Japan
| | - Yuki Mitani
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shunsuke Taito
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Kenichi Fudeyasu
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Yuki Masuka
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shodai Yoshihiro
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Shu Utsumi
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Mitsuaki Nishikimi
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Mamoru Masuda
- Department of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-Machi, Maebashi-shi, Gunma, 371-0811, Japan
| | - Yuki Iida
- Department of Physical Therapy, Toyohashi SOZO University School of Health Sciences, 20-1, Matsushita, Ushikawa, Toyohashi, 440-8511, Japan
| | - Yusuke Kawai
- Department of Nursing, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Kita 11 Nishi 13, Chuo-ku, Sapporo, 060-0011, Japan
| | - Daisuke Kawakami
- Department of Intensive Care Medicine, Iizuka Hospital, 3-83, Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan
| | - Kengo Obata
- Department of Rehabilitation, Japanese Red Cross Okayama Hospital, 2-1-1 Aoe, Kita-ward, Okayama, 700-8607, Japan
| | - Hajime Katsukawa
- Department of Scientific Research, Japanese Society for Early Mobilization, 1-2-12, Kudan-kita, Chiyoda-ku, Tokyo, 102-0073, Japan
| | - Hidenori Sumita
- Clinic Sumita, 305-12, Minamiyamashinden, Ina-cho, Toyokawa, Aichi, 441-0105, Japan
| | - Tomoyuki Morisawa
- Department of Physical Therapy, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masahiro Takahashi
- Department of Rehabilitation, Sapporo General Hospital, Kita11-Nishi13, Chuou-ku, Sapporo, Hokkaido, 060-8604, Japan
| | - Norihiko Tsuboi
- Department of Critical Care and Anesthesia, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Ryo Kozu
- Department of Rehabilitation Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Shunsuke Takaki
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Junpei Haruna
- Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, South-1, West-16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Yoshihisa Fujinami
- Department of Emergency Medicine, Kakogawa Central City Hospital, 439 Kakogawacho Honmachi, Kakogawa-city, Hyogo, 675-8611, Japan
| | - Nobuyuki Nosaka
- Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan
| | - Kensuke Nakamura
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, 279-0021, Japan
| | - Shigeaki Inoue
- Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017, Japan
| | - Osamu Nishida
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
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7
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Iqbal MA, Miyamoto K, Yumoto E, Oogai S, Mutanda I, Inafuku M, Oku H. Relationship between seasonal variation in isoprene emission and plant hormone profiles in the tropical plant Ficus septica. Plant Biol (Stuttg) 2023; 25:981-993. [PMID: 37565537 DOI: 10.1111/plb.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/19/2023] [Indexed: 08/12/2023]
Abstract
In Ficus septica, the short-term control of isoprene production and, therefore, isoprene emission has been linked to the hormone balance between auxin (IAA) and jasmonic acid (JA). However, the relationship between long-term changes in isoprene emission and that of plant hormones remains unknown. This study tracked isoprene emissions from F. septica leaves, plant hormone concentrations and signalling gene expression, MEP pathway metabolite concentrations, and related enzyme gene expression for 1 year in the field to better understand the role of plant hormones and their long-term control. Seasonality of isoprenes was mainly driven by temperature- and light-dependent variations in substrate availability through the MEP route, as well as transcriptional and post-transcriptional control of isoprene synthase (IspS). Isoprene emissions are seasonally correlated with plant hormone levels. This was especially evident in the cytokinin profiles, which decreased in summer and increased in winter. Only 4-hydroxy-3-methylbut-2-butenyl-4-diphosphate (HMBDP) exhibited a positive connection with cytokinins among the MEP metabolites examined, suggesting that HMBDP and its biosynthetic enzyme, HMBDP synthase (HDS), play a role in channelling of MEP pathway metabolites to cytokinin production. Thus, it is probable that cytokinins have potential feed-forward regulation of isoprene production. Under long-term natural conditions, the hormonal balance of IAA/JA-Ile was not associated with IspS transcripts or isoprene emissions. This study builds on prior work by revealing differences between short- and long-term hormonal modulation of isoprene emissions in the tropical tree F. septica.
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Affiliation(s)
- M A Iqbal
- The United Graduate School of Agricultural Sciences, Kagoshima University, Kagoshima, Japan
| | - K Miyamoto
- Department of Biosciences, Teikyo University, Utsunomiya, Tochigi, Japan
| | - E Yumoto
- Advanced Instrumental Analysis Center, Teikyo University, Tochigi, Japan
| | - S Oogai
- Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
| | - I Mutanda
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - M Inafuku
- Faculty of Agriculture, University of the Ryukyus, Okinawa, Japan
| | - H Oku
- The United Graduate School of Agricultural Sciences, Kagoshima University, Kagoshima, Japan
- Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
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8
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Nakamura R, Miyamoto K, Tsuji K, Ozaki K, Kunimoto H, Honda K, Nishimura Y, Kato S. The impact of a preoperative nurse-led orientation program on postoperative delirium after cardiovascular surgery: a retrospective single-center observational study. J Intensive Care 2023; 11:20. [PMID: 37198714 DOI: 10.1186/s40560-023-00666-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Postoperative delirium in intensive care is common and associated with mortality, cognitive impairment, prolonged hospital stays and high costs. We evaluate whether a nurse-led orientation program could reduce the incidence of delirium in the intensive care unit after cardiovascular surgery. METHODS In this retrospective cohort study, we enrolled patients admitted to the intensive care unit for planned cardiovascular surgery between January 2020 and December 2021. A nurse-led orientation program based on a preoperative visit was routinely introduced from January 2021. We assessed the association between these visits and postoperative delirium in the intensive care unit. We also assessed predictors of postoperative delirium with baseline and intraoperative characteristics. RESULTS Among 253 patients with planned cardiovascular surgery, 128 (50.6%) received preoperative visits. Valve surgery comprised 44.7%, coronary surgery 31.6%, and aortic surgery 20.9%. Cardiopulmonary bypass use and transcatheter surgery were 60.5% and 12.3%, respectively. Incidence of delirium was lower in patients that received preoperative visits, and median hospital stay was shorter than in those without visits (18 patients [14.1%] vs 34 patients [27.2%], P < 0.01; 14 days vs 17 days, P < 0.01). After adjusting predefined confounders, preoperative visits were independently associated with decreased incidence of delirium (adjusted odds ratio [aOR] 0.45; 95% confidence interval [95% CI] 0.22-0.84). Other predictors of delirium were higher European System for Cardiac Operative Risk Evaluation II score and lower minimum intraoperative cerebral oxygen saturation. CONCLUSIONS A preoperative nurse-led orientation program was associated with reduction of postoperative delirium and could be effective against postoperative delirium after cardiovascular surgery. Trial registration UMIN Clinical Trial Registry no. UMIN000048142. Registered 22, July, 2022, retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054862 .
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Affiliation(s)
- Ryo Nakamura
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Kaori Tsuji
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Kana Ozaki
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hideki Kunimoto
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Kentaro Honda
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Yoshiharu Nishimura
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
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9
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Fukumoto N, Miyamoto K, Nakashima T, Kato S. Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome Due to Severe Fever With Thrombocytopenia Syndrome. Cureus 2023; 15:e39138. [PMID: 37332423 PMCID: PMC10275394 DOI: 10.7759/cureus.39138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Few cases of acute respiratory distress syndrome (ARDS) in severe fever with thrombocytopenia syndrome (SFTS) have been treated with venovenous extracorporeal membrane oxygenation (VV-ECMO), and its role remains unclear. A 73-year-old Japanese woman presented with multiple organ failure (MOF) due to SFTS, including liver, neural, hematologic, renal, and ARDS. VV-ECMO for refractory hypoxemia under lung-protective ventilation with prone positioning led to gradual respiratory improvement, and she was successfully weaned on the 19th day of hospitalization. However, she died from persistent MOF on the 60th day of hospitalization. VV-ECMO contributed to recovery from ARDS but not from the ultimate cause of death, i.e., MOF. SFTS could have variable MOFs with different disease trajectories, which influence the decision for VV-ECMO.
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Affiliation(s)
- Nobu Fukumoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN
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10
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Iwabuchi S, Tsukahara T, Okayama T, Kitabatake M, Motobayashi H, Shichino S, Imafuku T, Yamaji K, Miyamoto K, Tamura S, Ueha S, Ito T, Murata SI, Kondo T, Ikeo K, Suzuki Y, Matsushima K, Kohara M, Torigoe T, Yamaue H, Hashimoto S. B cell receptor repertoire analysis from autopsy samples of COVID-19 patients. Front Immunol 2023; 14:1034978. [PMID: 36911681 PMCID: PMC9996338 DOI: 10.3389/fimmu.2023.1034978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
Neutralizing antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being developed world over. We investigated the possibility of producing artificial antibodies from the formalin fixation and paraffin-embedding (FFPE) lung lobes of a patient who died by coronavirus disease 2019 (COVID-19). The B-cell receptors repertoire in the lung tissue where SARS-CoV-2 was detected were considered to have highly sensitive virus-neutralizing activity, and artificial antibodies were produced by combining the most frequently detected heavy and light chains. Some neutralizing effects against the SARS-CoV-2 were observed, and mixing two different artificial antibodies had a higher tendency to suppress the virus. The neutralizing effects were similar to the immunoglobulin G obtained from healthy donors who had received a COVID-19 mRNA vaccine. Therefore, the use of FFPE lung tissue, which preserves the condition of direct virus sensitization, to generate artificial antibodies may be useful against future unknown infectious diseases.
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Affiliation(s)
- Sadahiro Iwabuchi
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tomohide Tsukahara
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Toshitugu Okayama
- Laboratory of DNA Data Analysis, National Institute of Genetics, Shizuoka, Japan
| | | | - Hideki Motobayashi
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shigeyuki Shichino
- Division of Molecular Regulation of Inflammatory and Immune Disease, Research Institute for Biomedical Sciences, Tokyo University of Science, Chiba, Japan
| | - Tadashi Imafuku
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kenzaburo Yamaji
- Department of Diseases and Infection, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinobu Tamura
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Satoshi Ueha
- Division of Molecular Regulation of Inflammatory and Immune Disease, Research Institute for Biomedical Sciences, Tokyo University of Science, Chiba, Japan
| | - Toshihiro Ito
- Department of Immunology, Nara Medical University, Nara, Japan
| | - Shin-Ichi Murata
- Departments of Human Pathology, Wakayama Medical University, Wakayama, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazuho Ikeo
- Laboratory of DNA Data Analysis, National Institute of Genetics, Shizuoka, Japan
| | - Yutaka Suzuki
- Department of Computational Biology, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Kouji Matsushima
- Division of Molecular Regulation of Inflammatory and Immune Disease, Research Institute for Biomedical Sciences, Tokyo University of Science, Chiba, Japan
| | - Michinori Kohara
- Department of Diseases and Infection, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Toshihiko Torigoe
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.,Departments of Cancer Immunology, Wakayama Medical University, Wakayama, Japan
| | - Shinichi Hashimoto
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
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11
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Yamabe K, Arakawa Y, Shoji M, Miyamoto K, Tsuchiya T, Minoura K, Akeda Y, Tomono K, Onda M. Enhancement ofAcinetobacterbaumanniibiofilm growth by cephem antibiotics via enrichment of protein and extracellular DNAin thebiofilm matrices. J Appl Microbiol 2022; 133:2002-2013. [PMID: 35818769 PMCID: PMC9539989 DOI: 10.1111/jam.15712] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/03/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022]
Abstract
AIMS To determine the effects of subinhibitory concentrations of eight cephem and carbapenem antibiotics on thebiofilm formation ofAcinetobacterbaumanniicells and examine itseffect on pre-established biofilms. METHODS AND RESULTS Effects of antibiotics on biofilm formation were assayed using microtiter plates with polystyrene peg-lids.Cefmetazole, ceftriaxone, ceftazidime, and cefpirome increased the biomass of pre-established biofilms on pegs in the range of their sub-minimum inhibitory concentrations, whereas none increased biofilm formation by planktonic cells. Carbapenems had a negative effect.The constituents of antibiotic-induced biofilms were analyzed. Ceftriaxoneor ceftazidimetreatment markedly increased the matrix constituent amounts in the biofilms (carbohydrate, 2.7-fold; protein, 8.9-12.7-fold; lipid, 3.3-3.6-fold; DNA, 9.1-12.2-fold; outer membrane vesicles, 2.7-3.8-fold; and viable cells,6.8-10.1-fold).The antibiotic-enhanced biofilmshad increased outer membrane protein A and were resistant to the anti-biofilm effect of azithromycin. CONCLUSIONS Some cephems increased the biomass of pre-established biofilms in the ranges of their sub-minimum inhibitory concentrations.The antibiotic-enhanced biofilmspossessed more virulent characteristics than normal biofilms. SIGNIFICANCE AND IMPACT OF THE STUDY Incomplete administration of certain cephems followingbiofilm-related Ac.baumannii infectionscould adversely cause exacerbated and chronic clinical results.
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Affiliation(s)
- K Yamabe
- Department of Social and Administrative Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Y Arakawa
- Department of Social and Administrative Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - M Shoji
- Department of Social and Administrative Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - K Miyamoto
- Department of Microbiology and Infection Control, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - T Tsuchiya
- Department of Microbiology and Infection Control, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - K Minoura
- Joint Research Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Y Akeda
- National Institute of Infectious Diseases, Tokyo, Japan
| | - K Tomono
- Osaka Institute of Public Health, Osaka, Japan
| | - M Onda
- Department of Social and Administrative Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan
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12
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Ibrahim A, Ciullo A, Li C, Garcia G, Peck K, Miyamoto K, Arumugaswami V, Marbán E. Engineered extracellular vesicles antagonize SARS-CoV-2 infection by inhibiting mTOR signaling. Biomater Biosyst 2022; 6:100042. [PMID: 35187508 PMCID: PMC8841010 DOI: 10.1016/j.bbiosy.2022.100042] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 01/19/2023] Open
Abstract
Effective treatment approaches for patients with COVID-19 remain limited and are neither curative nor widely applicable. Activated specialized tissue effector extracellular vesicles (ASTEX) derived from genetically-enhanced skin fibroblasts, exert disease-modifying bioactivity in vivo in models of heart and lung injury. Here we report that ASTEX antagonizes SARS-CoV-2 infection and its pathogenic sequelae. In human lung epithelial cells exposed to SARS-CoV-2, ASTEX is cytoprotective and antiviral. Transcriptomic analysis implicated the mammalian target of rapamycin (mTOR) pathway, as infected cells upregulated mTOR signaling and pre-exposure to ASTEX attenuated it. The implication of mTOR signaling was further confirmed using mTOR inhibition and activation, which increased and decreased viral load, respectively. Dissection of ASTEX cargo identifies miRs including miR-16 as potential inhibitors of mTOR signaling. The findings reveal a novel, dual mechanism of action for ASTEX as a therapeutic candidate for COVID-19, with synergistic antiviral and cytoprotective benefits.
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Affiliation(s)
- A.G. Ibrahim
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - A. Ciullo
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - C. Li
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - G. Garcia
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - K. Peck
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - K. Miyamoto
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - V. Arumugaswami
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - E. Marbán
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
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13
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Miyamoto K, Shibata M, Shima N, Nakashima T, Tanaka R, Nakamoto K, Imanaka Y, Kato S. Incidence and Risk Factors of Worsened Activities of Daily Living Status Three Months after Intensive Care Unit Discharge among Critically Ill Patients: A Prospective Cohort Study. J Clin Med 2022; 11:jcm11071990. [PMID: 35407598 PMCID: PMC9000035 DOI: 10.3390/jcm11071990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Background: We aimed to determine risk factors associated with worsened activity of daily living (ADL) status three months after intensive care unit (ICU) discharge. Methods: In this prospective, observational study, we enrolled critically ill adult patients that were emergently admitted to an ICU. We assessed ADL status by Barthel index score prior to ICU admission and three months after ICU discharge. The primary outcome was worsened ADL status, defined as a ≥10 decrease in Barthel index score. Results: We enrolled 102 patients (median age was 72 years old, 55% were male, and 87% received mechanical ventilation during ICU stay), and 42 patients (41%) had worsened ADL status three months after discharge from ICU. Multivariate analysis revealed that older age (>70 years old; adjusted odds ratio (aOR) 3.68; 95% confidence interval (95%CI) 1.33−10.19), high burden of chronic illness (aOR 4.11; 95%CI 1.43−11.81), and longer duration of mechanical ventilation (≥4 days; aOR 2.83; 95%CI 1.04−7.69) were independent risk factors for worsened ADL status at three months. Conclusions: Almost half of the critically ill adult patients in this cohort had worsened ADL status after ICU discharge. Older age, high burden of chronic illness, and longer duration of mechanical ventilation were risk factors for worsened ADL status.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
- Correspondence: ; Tel.: +81-73-441-0603
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
| | - Nozomu Shima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
| | - Rikako Tanaka
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
| | - Keita Nakamoto
- Department of Nursing, Wakayama Medical University Hospital, Wakayama 641-0012, Japan; (K.N.); (Y.I.)
| | - Yuriko Imanaka
- Department of Nursing, Wakayama Medical University Hospital, Wakayama 641-0012, Japan; (K.N.); (Y.I.)
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-0012, Japan; (M.S.); (N.S.); (T.N.); (R.T.); (S.K.)
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14
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Yoshimura J, Yamakawa K, Ohta Y, Nakamura K, Hashimoto H, Kawada M, Takahashi H, Yamagiwa T, Kodate A, Miyamoto K, Fujimi S, Morimoto T. Effect of Gram Stain-Guided Initial Antibiotic Therapy on Clinical Response in Patients With Ventilator-Associated Pneumonia: The GRACE-VAP Randomized Clinical Trial. JAMA Netw Open 2022; 5:e226136. [PMID: 35394515 PMCID: PMC8994124 DOI: 10.1001/jamanetworkopen.2022.6136] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Gram staining should provide immediate information for detecting causative pathogens. However, the effect of Gram staining on restricting the initial antibiotic choice has not been investigated in intensive care units (ICUs). OBJECTIVE To compare the clinical response to Gram stain-guided restrictive antibiotic therapy vs guideline-based broad-spectrum antibiotic treatment in patients with ventilator-associated pneumonia (VAP). DESIGN, SETTING, AND PARTICIPANTS This multicenter, open-label, noninferiority randomized clinical trial (Gram Stain-Guided Antibiotics Choice for VAP) was conducted in the ICUs of 12 tertiary referral hospitals in Japan from April 1, 2018, through May 31, 2020. Patients aged 15 years or older with a VAP diagnosis and a modified Clinical Pulmonary Infection Score of 5 or higher were included. The primary analysis was based on the per-protocol analysis population. INTERVENTIONS Patients were randomized to Gram stain-guided antibiotic therapy or guideline-based antibiotic therapy (based on the 2016 Infectious Disease Society of America and American Thoracic Society clinical practice guidelines for VAP). MAIN OUTCOMES AND MEASURES The primary outcome was the clinical response rate; clinical response was defined as completion of antibiotic therapy within 14 days, improvement or lack of progression of baseline radiographic findings, resolution of signs and symptoms of pneumonia, and lack of antibiotic agent readministration, with a noninferiority margin of 20%. Secondary outcomes were the proportions of antipseudomonal agents and anti-methicillin-resistant Staphylococcus aureus (MRSA) agents as initial antibiotic therapies; 28-day mortality, ICU-free days, ventilator-free days; and adverse events. RESULTS In total, 206 patients (median [IQR] age, 69 [54-78] years; 141 men [68.4%]) were randomized to the Gram stain-guided group (n = 103) or guideline-based group (n = 103). Clinical response occurred in 79 patients (76.7%) in the Gram stain-guided group and 74 patients (71.8%) in the guideline-based group (risk difference, 0.05; 95% CI, -0.07 to 0.17; P < .001 for noninferiority). Reduced use of antipseudomonal agents (30.1%; 95% CI, 21.5%-39.9%; P < .001) and anti-MRSA agents (38.8%; 95% CI, 29.4%-48.9%; P < .001) was observed in the Gram stain-guided group vs guideline-based group. The 28-day cumulative incidence of mortality was 13.6% (n = 14) in the Gram stain-guided group vs 17.5% (n = 18) in the guideline-based group (P = .39). Escalation of antibiotics according to culture results was performed in 7 patients (6.8%) in the Gram stain-guided group and 1 patient (1.0%) in the guideline-based group (P = .03). There were no significant differences between the groups in ICU-free days, ventilator-free days, and adverse events. CONCLUSIONS AND RELEVANCE Results of this trial showed that Gram stain-guided treatment was noninferior to guideline-based treatment and significantly reduced the use of broad-spectrum antibiotics in patients with VAP. Gram staining can potentially ameliorate the multidrug-resistant organisms in the critical care setting. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03506113.
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Affiliation(s)
- Jumpei Yoshimura
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Sumiyoshi, Osaka, Japan
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazuma Yamakawa
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Sumiyoshi, Osaka, Japan
- Department of Emergency Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Yoshinori Ohta
- Education and Training Center for Students and Professionals in Healthcare, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Kensuke Nakamura
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Hideki Hashimoto
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Masahiro Kawada
- Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, Moriguchi, Osaka, Japan
| | - Hiroki Takahashi
- Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - Takeshi Yamagiwa
- Department of Emergency Medicine, Ebina General Hospital, Ebina, Kanagawa, Japan
| | - Akira Kodate
- Department of Emergency and Critical Care Medicine, Sapporo City General Hospital, Chuoh, Sapporo, Hokkaido, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Satoshi Fujimi
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Sumiyoshi, Osaka, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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15
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Iqbal MA, Miyamoto K, Yumoto E, Parveen S, Mutanda I, Inafuku M, Oku H. Plant hormone profile and control over isoprene biosynthesis in a tropical tree Ficus septica. Plant Biol (Stuttg) 2022; 24:492-501. [PMID: 35050526 DOI: 10.1111/plb.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Plant hormone signalling and the circadian clock have been implicated in the transcriptional control of isoprene biosynthesis. To gain more insight into the hormonal control of isoprene biosynthesis, the present study measured plant hormone concentrations in jasmonic acid (JA)-treated leaves of our previous model study, examined their relationship with gene expression of isoprene synthase (IspS) and hormone signalling transcription factors. Of the plant hormones, IAA and JA-Ile and their related transcription factors (MYC2 and SAUR21) were significantly correlated with IspS gene expression. Concentrations of cytokinins, isopentenyladenine (iP), trans-zeatin riboside (tZR) and cis-zeatin riboside (cZR), were similarly significantly correlated with IspS expression. However, there was no significant correlation between their related transcription factor (ARR-B) and IspS expression. The circadian clock-related gene PRR7, but not the transcription factor LHY, was highly correlated with IspS expression. These results suggest that the hormonal balance between JA-Ile and IAA plays a central role in transcriptional regulation of IspS through the transcription factors MYC2 and SAUR21, the early auxin responsive genes. The putative cis-acting elements for SAUR on the IspS promoter (TGTCNN and CATATG), in addition to the G-box for MYC2, support the above proposal. These results provide insightful information on the core components of plant hormone-related regulation of IspS under coordination with the circadian clock genes.
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Affiliation(s)
- Md A Iqbal
- The United Graduate School of Agricultural Sciences, Kagoshima University, Kagoshima, Japan
| | - K Miyamoto
- Department of Biosciences, Teikyo University, Utsunomiya, Tochigi, Japan
| | - E Yumoto
- Advanced Instrumental Analysis Center, Teikyo University, Tochigi, Japan
| | - S Parveen
- Faculty of Agriculture, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
| | - I Mutanda
- School of the Environment and Safety Engineering, Biofuels Institute, Jiangsu University, Zhenjiang, Jiangsu, China
| | - M Inafuku
- Faculty of Agriculture, University of the Ryukyus, Okinawa, Japan
| | - H Oku
- Tropical Biosphere Research Center, University of the Ryukyus, Okinawa, Japan
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16
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Iwabuchi S, Miyamoto K, Hatai M, Mikasa Y, Katsuda M, Murata SI, Kondo T, Yamaue H, Hashimoto S. Immune Cells Profiles in the Different Sites of COVID-19-Affected Lung Lobes in a Single Patient. Front Med (Lausanne) 2022; 9:841170. [PMID: 35252273 PMCID: PMC8888686 DOI: 10.3389/fmed.2022.841170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Whereas the COVID-19 disease pathophysiology is under investigation, it is important to identify the pathways of viral transmission and inflammation from the pre-illness to the disease-onset stages. We analyzed five lung lobes from a patient with COVID-19 who finally died after prolonged lung protective ventilation. Pathological examination revealed moderate inflammation in upper lung lobes and uneven yet severe inflammation and diffuse alveolar damage in lower lung lobes. SARS-CoV-2 was detected at higher levels not in severely, but rather moderately inflamed middle lung lobes, and immunohistochemistry and bulk RNA-sequencing results showed that immune cells were detected at higher levels in lower lung lobes. The mRNA expression of cytokine families varied. We found an increase in keratin 5- or aquaporin 3-expressing basal cells in the severely inflamed lower lung lobes, and the alveolar stromal tissues were filled with them. Thus, this analysis of lung samples from a patient helps to determine the COVID-19 pathophysiology at a specific time point, and the virus localization and inflammatory responses at each site of the lungs provide various important indications.
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Affiliation(s)
- Sadahiro Iwabuchi
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Mayuko Hatai
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yurina Mikasa
- Departments of Human Pathology, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Katsuda
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shin-Ichi Murata
- Departments of Human Pathology, Wakayama Medical University, Wakayama, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shinichi Hashimoto
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
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17
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Nemoto S, Miyamoto K, Nakashima T, Shibata M, Nakamura R, Honda K, Nishimura Y, Kato S. A case of infective endocarditis in which vegetation was detected by contrast‐enhanced CT. Acute Med Surg 2022; 9:e762. [PMID: 35685431 PMCID: PMC9170946 DOI: 10.1002/ams2.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shigeki Nemoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Ryo Nakamura
- Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama Japan
| | - Kentaro Honda
- Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama Japan
| | - Yoshiharu Nishimura
- Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
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18
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Miyagawa N, Kawazoe Y, Sato T, Kushimoto S, Miyamoto K, Ohta Y, Morimoto T, Yamamura H. Comparison between midazolam and propofol in acute phase for ventilated patients with sepsis: a
post‐hoc
analysis of the
DESIRE
trial. Acute Med Surg 2022; 9:e746. [PMID: 35414941 PMCID: PMC8982504 DOI: 10.1002/ams2.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Noriko Miyagawa
- Department of Emergency and Critical Care Medicine Sendai City Hospital Sendai Japan
| | - Yu Kawazoe
- Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Tetsuya Sato
- Department of Emergency and Critical Care Medicine Tohoku University Hospital Sendai Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
- Department of Emergency and Critical Care Medicine Tohoku University Hospital Sendai Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Yoshinori Ohta
- Department of Community Emergency Medicine Hyogo College of Medicine Nishinomiya Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology Hyogo College of Medicine Nishinomiya Japan
| | - Hitoshi Yamamura
- Osaka Prefectural Nakakawachi Emergency and Critical Care Center Higashiosaka Japan
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19
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Shibata M, Miyamoto K, Shima N, Nakashima T, Kunitatsu K, Yonemitsu T, Kawabata A, Kishi Y, Kato S. Activities of daily living and psychiatric symptoms after intensive care unit discharge among critically ill patients with or without tracheostomy: a single center longitudinal study. Acute Med Surg 2022; 9:e753. [PMID: 35592703 PMCID: PMC9092286 DOI: 10.1002/ams2.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
Aim Tracheostomy is widely performed in critically ill patients who require prolonged mechanical ventilation. Long-term morbidity (post-intensive care syndrome) in tracheostomized patients is not widely reported, however, so we evaluate it here. Methods This is a sub-analysis of a single center prospective longitudinal study, which assessed activities of daily living (ADL) and psychiatric symptoms in adult patients emergently admitted to the intensive care unit (ICU). We evaluated association between these symptoms and tracheostomy by posting questionnaires at 3 and 12 months after ICU discharge. Results We analyzed 107 patients (15 patients with tracheostomy) at 3 months and 74 patients (13 patients with tracheostomy) at 12 months after ICU discharge. ADL tended to be lower in patients with tracheostomy than in those without tracheostomy at 3 months after ICU discharge (65 [10-100] versus 95 [59-100]; P = 0.28, 7/15 [47%] versus 30/102 [30%] Barthel Index scored ≤ 60; P = 0.23), however there were no significant differences. Psychiatric symptoms were not different between the groups at 3 months and again at 12 months. Conclusion Activities of daily living disability and psychiatric symptoms were not significantly worse in patients with tracheostomy at 3 and 12 months from ICU discharge compared with patients without tracheostomy. Despite the limited number in our cohort, our study may inform shared decision making concerning tracheostomy for critically ill patients and their families.
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Affiliation(s)
- Mami Shibata
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Nozomu Shima
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Kosei Kunitatsu
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Takafumi Yonemitsu
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Atsumi Kawabata
- Department of NursingWakayama Medical University HospitalWakayamaJapan
| | - Yutsuki Kishi
- Department of NursingWakayama Medical University HospitalWakayamaJapan
| | - Seiya Kato
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
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20
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Sezaki A, Imai T, Miyamoto K, Kawase F, Shirai Y, Abe C, Sanada M, Inden A, Kato T, Sugihara N, Shimokata H. Association between the Mediterranean Diet Score and Healthy Life Expectancy: A Global Comparative Study. J Nutr Health Aging 2022; 26:621-627. [PMID: 35718872 DOI: 10.1007/s12603-022-1811-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Extending healthy life expectancy (HALE), defined as the average number of years that a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury, is a common topic worldwide. This study aims to clarify the relationships between the Mediterranean diet score (MDS) and life expectancy (LE) and HALE globally using publicly available international data. SETTING Analyses were conducted on 130 countries with populations of 1 million or more for which all data were available. Individual countries were scored from 0 to 9 to indicate adherence to the Mediterranean diet according to the MDS scoring method. The supply of vegetables, legumes, fruits and nuts, cereals, fish, and olive oil per 1,000 kcal per country was calculated based on the Food and Agriculture Organization Corporate Statistical Database, with a score of 1 for above the median and 0 for below. The same method was used to calculate scores of presumed detrimental components (meat and dairy), with consumption below the median given a value of 1, and consumption above the median given a value of 0. For ethanol, a score of 1 was given for 10g to 50 g of consumption. We investigated the cross-sectional associations between the MDS and LE and HALE at birth in 2009, and the longitudinal associations between the MDS in 2009 and LE and HALE between 2009 and 2019, controlling for covariates at baseline using linear mixed models. RESULTS In the cross-sectional analysis, the MDS was significantly positively associated with LE (β=0.906 [95% confidence interval, 0.065-1.747], p=0.037) and HALE (β=0.875 [0.207-1.544], p=0.011) after controlling for all covariates. The longitudinal analysis also revealed significantly positive associations between the MDS and LE (0.621 [0.063-1.178], p=0.030) and HALE (0.694 [0.227-1.161], p=0.004) after controlling for all covariates. CONCLUSION The present study, based on an analysis using 10 years of international data, showed that countries with a higher MDS showed a positive association with HALE.
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Affiliation(s)
- A Sezaki
- Ayako Sezaki, Nagoya University of Arts and Sciences, Nagoya Gakugei Daigaku, Japan,
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21
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Miyamoto K, Koizumi Y, Tamura S, Nakashima T, Kobai K, Tanaka R, Shibata M, Shima N, Nemoto S, Fukumoto N, Kato S. Multisystem inflammatory syndrome in adults after acute coronavirus disease 2019 in a Japanese woman: A case report. J Infect Chemother 2021; 28:99-102. [PMID: 34620535 PMCID: PMC8486615 DOI: 10.1016/j.jiac.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 01/13/2023]
Abstract
Multisystem inflammatory syndrome in adults (MIS-A) is a rare and emerging syndrome after coronavirus disease 2019 (COVID-19). To the best of our knowledge, Japanese cases of MIS-A are rarely reported. Here, we describe a case of MIS-A in a 44-year-old Japanese woman presenting with multiorgan dysfunction (i.e., cardiovascular and mucocutaneous involvement) and markedly elevated inflammatory markers 2 weeks after recovery from COVID-19. Treatment with intravenous immunoglobulins and corticosteroids resolved her symptoms. On the 13th day, she was discharged from the hospital with no recurrences on follow-up. This study highlights the importance of recognizing this emerging syndrome when treating patients with multiorgan dysfunction after COVID-19.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan; Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan.
| | - Yusuke Koizumi
- Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Shinobu Tamura
- Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan; Department of Hematology/Oncology, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Kaori Kobai
- Department of Anesthesiology, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Rikako Tanaka
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Nozomu Shima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Shigeki Nemoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Nobu Fukumoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
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22
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Kato K, Akeda K, Miyazaki S, Yamada J, Muehleman C, Miyamoto K, Asanuma YA, Asanuma K, Fujiwara T, Lenz ME, Nakazawa T, An H, Masuda K. NF-kB decoy oligodeoxynucleotide preserves disc height in a rabbit anular-puncture model and reduces pain induction in a rat xenograft-radiculopathy model. Eur Cell Mater 2021; 42:90-109. [PMID: 34284523 DOI: 10.22203/ecm.v042a07] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
While it is known that the degenerated intervertebral disc (IVD) is one of the primary reasons for low-back pain and subsequent need for medical care, there are currently no established effective methods for direct treatment. Nuclear factor-κB (NF-κB) is a transcription factor that regulates various genes' expression, among which are inflammatory cytokines, in many tissues including the IVD. NF-κB decoy is an oligodeoxynucleotide containing the NF-κB binding site that entraps NF-κB subunits, resulting in suppression of NF-κB activity. In the present preclinical study, NF-κB decoy was injected into degenerated IVDs using the rabbit anular-puncture model. In terms of distribution, NF-κB decoy persisted in the IVDs up to at least 4 weeks after injection. The remaining amount of NF-κB decoy indicated that it fit a double-exponential-decay equation. Investigation of puncture-caused degeneration of IVDs showed that NF-κB decoy injection recovered, dose-dependently, the reduced disc height that was associated with reparative cell cloning and morphological changes, as assessed through histology. Gene expression, by quantitative real-time polymerase chain reaction (qRT-PCR), showed that NF-κB decoy attenuated inflammatory gene expression, such as that of interleukin-1 and tumor necrosis factor-α, in rabbit degenerated IVDs. NF-κB decoy also reduced the pain response as seen using the "pain sensor" nude rat xenograft-radiculopathy model. This is the first report demonstrating that NF-κB decoy suppresses the inflammatory response in degenerated IVDs and restores IVD disc height loss. Therefore, the intradiscal injection of NF-κB decoy may have the potential as an effective therapeutic strategy for discogenic pain associated with degenerated IVDs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - K Masuda
- Department of Orthopedic Surgery, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093,
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23
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Shima N, Miyamoto K, Kato S, Yoshida T, Uchino S. Primary success of electrical cardioversion for new-onset atrial fibrillation and its association with clinical course in non-cardiac critically ill patients: sub-analysis of a multicenter observational study. J Intensive Care 2021; 9:46. [PMID: 34238390 PMCID: PMC8268199 DOI: 10.1186/s40560-021-00562-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Electrical cardioversion (ECV) is widely used to restore sinus rhythm in critically ill adult patients with atrial fibrillation, although its prognostic value is uncertain. This study aims to elucidate the clinical meaning of successful ECV. Methods This is a sub-analysis of the AFTER-ICU study, a multicenter prospective study with a cohort of 423 adult non-cardiac patients with new-onset atrial fibrillation (AF). Patients that underwent ECV within 7 days after initial onset of AF were included in the sub-analysis. We compared intensive care unit (ICU) and overall hospital mortality, survival time within 30 days, cardiac rhythm at ICU discharge, and the length of ICU and overall hospital stay between patients whose sinus rhythm was restored immediately after the first ECV session (primary success group) and those in whom it was not restored (unsuccessful group). To find the factors related to the primary success of ECV, we also compared patient characteristics, the delivered energy, and pretreatment. Results Sixty-five patients received ECV and were included in this study. Although 35 patients (54%) had primary success, recurrence of AF occurred in 24 of these patients (69%). At ICU discharge, three patients still had AF in the unsuccessful group, but no patients in the primary success group still had AF. ICU mortality was 34% in the primary success group and 17% in the unsuccessful group (P = 0.10). Survival time within 30 days did not differ between the groups. Delivered energy and pretreatment were not associated with primary success of ECV. Conclusions The primary success rate of ECV for new-onset AF in adult non-cardiac ICU population was low, and even if it succeeded, the subsequent recurrence rate was high. Primary success of ECV did not affect the rate of mortality. Pretreatment and delivered energy were not associated with the primary success of ECV. Trial registration UMIN clinical trial registry, the Japanese clinical trial registry (registration number: UMIN000026401, March 31, 2017). Supplementary Information The online version contains supplementary material available at 10.1186/s40560-021-00562-8.
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Affiliation(s)
- Nozomu Shima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan.
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan
| | - Takuo Yoshida
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan.,Present address: Department of Intensive Care Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Shigehiko Uchino
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan
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24
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Kinoshita T, Kouda K, Umemoto Y, Yasuoka Y, Minoshima Y, Mikami Y, Nishimura Y, Miyamoto K, Kato S, Tajima F. Case Report: A Rehabilitation Practice Report During ICU Management for a Patient With Multiple Disabilities Due to COVID-19 Pneumonia and COPD. Front Med (Lausanne) 2021; 8:692898. [PMID: 34262919 PMCID: PMC8274657 DOI: 10.3389/fmed.2021.692898] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/02/2021] [Indexed: 01/08/2023] Open
Abstract
Patients with severe coronavirus disease (COVID-19) and admitted to the intensive care unit (ICU) are at high risk of developing ICU-acquired weakness and disuse syndrome. Although their medical management may include prolonged deep sedation for pulmonary protection and ventilator management, we aim for early mobilization of these patients with COVID-19. We present the case of a 71-year-old man with chronic obstructive pulmonary disease (COPD) and COVID-19 pneumonia. Passive range of motion training and sitting on the edge of the bed were started in the ICU while the patient was under deep sedation. His activities of daily living eventually improved to where he could independently walk to the toilet without respiratory distress. Patients with severe COVID-19 who require mechanical ventilation are at risk of muscle weakness and exercise intolerance. These patients require rehabilitation therapy, beginning in the acute phase of illness, to recover their physical function. Although validation with a larger cohort is necessary, our results suggest that patients with COPD and COVID-19 pneumonia should undergo rehabilitation concurrently with status-driven changes in respiratory management.
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Affiliation(s)
- Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.,Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Ken Kouda
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshinori Yasuoka
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.,Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Yuta Minoshima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.,Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, Iwate, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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25
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Kinoshita T, Umemoto Y, Yasuoka Y, Yoshikawa T, Kouda K, Hori S, Mikami Y, Nishimura Y, Miyamoto K, Kato S, Tajima F. Feasibility of sit training for patients with severe COVID-19 pneumonia during deep sedation: A case report. Medicine (Baltimore) 2021; 100:e26240. [PMID: 34087910 PMCID: PMC8183700 DOI: 10.1097/md.0000000000026240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
RATIONALE There have been a few reports on the early rehabilitation of patients with coronavirus disease (COVID-19), and none on the effectiveness and adverse events of early mobilization for mechanical ventilation patients (other than COVID-19) during deep sedation. This report indicates that sitting without adverse events is possible in patients with severe COVID-19 pneumonia during deep sedation with muscle relaxation. PATIENT CONCERNS A 65-year-old man with a history of diabetes mellitus, lacunar infarction, and Parkinson's disease was admitted to a local hospital for pneumonia due to COVID-19. After admission, the patient was managed on a ventilator under deep sedation with muscle relaxants and sedatives. Twelve days after admission, the patient was transferred to our hospital due to his worsening respiratory status. DIAGNOSIS Pneumonia due to COVID-19 was diagnosed using a polymerase chain reaction-dependent method. INTERVENTIONS The day following transfer, a physical therapist started passive range of motion training and sitting. OUTCOMES The period spanning his initial rehabilitation to muscle relaxant medication interruption was 9 days, and he underwent 7 rehabilitation sessions. The patient was unable to sit during only one of the 7 sessions due to pre-rehabilitation hypoxemia. In 5 of the 6 sitting sessions, PaO2/FiO2 transiently decreased but recovered by the time of subsequent blood sampling. The patient's PaCO2 decreased during all sessions. His blood pressure did not drastically decrease in any sitting session, except the first. Sputum excretion via sputum suction increased during sitting, and peak inspiratory pressure did not change. LESSONS The patient eventually died of pneumonia due to COVID-19. However, sitting during deep sedation with muscle relaxants did not cause any serious adverse events nor did it appear to cause obvious negative respiratory effects.
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Affiliation(s)
- Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University
- Division of Rehabilitation, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama, Wakayama
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University
| | - Yoshinori Yasuoka
- Department of Rehabilitation Medicine, Wakayama Medical University
- Division of Rehabilitation, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama, Wakayama
| | | | - Ken Kouda
- Department of Rehabilitation Medicine, Wakayama Medical University
| | - Shinnosuke Hori
- Department of Rehabilitation Medicine, Wakayama Medical University
- Division of Rehabilitation, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama, Wakayama
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Wakayama Medical University
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, 2-1-1 Idaidouri, Yahaba-cho, Shiwa-gun, Iwate
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University
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Grenz PJ, Thonig D, Holtmann M, Miyamoto K, Kumar S, Schwier E, Okuda T, Henk J, Donath M. Adlayer influence on Dirac-type surface state at W(110). J Phys Condens Matter 2021; 33:285504. [PMID: 33946058 DOI: 10.1088/1361-648x/abfdf3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
In a combined experimental and theoretical study, we investigated how Fe and Co adlayers on W(110) affect the Dirac-type surface state (DSS). Angle-resolved photoelectron spectroscopy data show an increase in binding energy of 75 meV and 107 meV for Fe and Co, respectively. In order to identify the origin of the energy shift we performed first-principles calculations of the surface electronic structure. The inward surface relaxation of the uncovered W(110) surface is lifted by the adlayers. This structural change is one reason of the energy shift of the DSS. Furthermore, the Fe and Co adlayers change the surface potential, which results in an additional energy shift of the DSS.
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Affiliation(s)
- P J Grenz
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | - D Thonig
- Department of Physics and Astronomy, Material Theory, University Uppsala, Box 516, 75120 Uppsala, Sweden
- School of Science and Technology, Örebro University, 701 82 Örebro, Sweden
| | - M Holtmann
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - S Kumar
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - E Schwier
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - J Henk
- Institute of Physics, Martin Luther University Halle-Wittenberg, 06099 Halle, Saale, Germany
| | - M Donath
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
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Dai J, Frantzeskakis E, Aryal N, Chen KW, Fortuna F, Rault JE, Le Fèvre P, Balicas L, Miyamoto K, Okuda T, Manousakis E, Baumbach RE, Santander-Syro AF. Experimental Observation and Spin Texture of Dirac Node Arcs in Tetradymite Topological Metals. Phys Rev Lett 2021; 126:196407. [PMID: 34047592 DOI: 10.1103/physrevlett.126.196407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/08/2021] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
We report the observation of a nontrivial spin texture in Dirac node arcs, i.e., novel topological objects formed when Dirac cones of massless particles extend along an open one-dimensional line in momentum space. We find that such states are present in all the compounds of the tetradymite M_{2}Te_{2}X family (M=Ti, Zr, or Hf and X=P or As) regardless of the weak or strong character of the topological invariant. The Dirac node arcs in tetradymites are thus the simplest possible textbook example of a type-I Dirac system with a single spin-polarized node arc.
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Affiliation(s)
- J Dai
- Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, 91405 Orsay, France
| | - E Frantzeskakis
- Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, 91405 Orsay, France
| | - N Aryal
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
| | - K-W Chen
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
| | - F Fortuna
- Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, 91405 Orsay, France
| | - J E Rault
- Synchrotron SOLEIL, L'Orme des Merisiers, Saint-Aubin-BP48, 91192 Gif-sur-Yvette, France
| | - P Le Fèvre
- Synchrotron SOLEIL, L'Orme des Merisiers, Saint-Aubin-BP48, 91192 Gif-sur-Yvette, France
| | - L Balicas
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
| | - K Miyamoto
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
| | - T Okuda
- Hiroshima Synchrotron Radiation Center (HSRC), Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - E Manousakis
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, National and Kapodistrian University of Athens, Panepistimioupolis, Zografos, 157 84 Athens, Greece
| | - R E Baumbach
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32306, USA
- Department of Physics, Florida State University, Tallahassee, Florida 32306, USA
| | - A F Santander-Syro
- Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, 91405 Orsay, France
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Furuta K, Akamatsu H, Sada R, Miyamoto K, Teraoka S, Hayata A, Ozawa Y, Nakanishi M, Koh Y, Yamamoto N. Comparison of Systemic Inflammatory Response Syndrome and quick Sequential Organ Failure Assessment scores in predicting bacteremia in the emergency department. Acute Med Surg 2021; 8:e654. [PMID: 33968417 PMCID: PMC8088398 DOI: 10.1002/ams2.654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/08/2022] Open
Abstract
Aim The emergency department requires simple and useful clinical indicators to identify bacteremia. This retrospective study explored the Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) scores for predicting bacteremia. Methods Between April and September 2017, we assessed blood cultures of 307 patients in our emergency department. We calculated the SIRS and qSOFA scores for these patients and evaluated their correlation with bacteremia. Results Of 307 patients, 66 (21.5%) had bacteremia, 237 (77.2%) were SIRS-positive, and 123 (40.0%) were qSOFA-positive. The sensitivity and specificity of the SIRS score for predicting bacteremia were 87.9% and 25.7%, respectively. The sensitivity and specificity of the qSOFA score were 47.0% and 61.8%, respectively. Multivariate analysis revealed that body temperature (odds ratio, 2.16; 95% confidence interval, 1.22-3.84; P = 0.009) and blood pressure (odds ratio, 2.72; 95% confidence interval, 1.39-5.35; P = 0.004) significantly associated with bacteremia. Conclusions The SIRS score was a more sensitive indicator than the qSOFA score for predicting bacteremia.
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Affiliation(s)
- Katsuyuki Furuta
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Hiroaki Akamatsu
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Ryuichi Sada
- Department of General Internal Medicine Tenri Hospital Tenri Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Shunsuke Teraoka
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Atsushi Hayata
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Yuichi Ozawa
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | | | - Yasuhiro Koh
- Internal Medicine III Wakayama Medical University Wakayama Japan
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Sato T, Kawazoe Y, Miyagawa N, Yokokawa Y, Kushimoto S, Miyamoto K, Ohta Y, Morimoto T, Yamamura H. Effect of age on dexmedetomidine treatment for ventilated patients with sepsis: a post-hoc analysis of the DESIRE trial. Acute Med Surg 2021; 8:e644. [PMID: 33859826 PMCID: PMC8033411 DOI: 10.1002/ams2.644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/18/2021] [Indexed: 11/07/2022] Open
Abstract
Aim There are no definitive data to determine whether age influences the effects of dexmedetomidine (DEX) treatment. Thus, we investigated whether older age was associated with more favorable sedative action by DEX in sepsis patients who required mechanical ventilation. Methods This study involved a post‐hoc analysis of data from the Dexmedetomidine for Sepsis in the ICU Randomized Evaluation (DESIRE) trial. The patients were categorized based on median age into elderly and younger groups. The two groups were then compared during the first 7 days after ventilation based on proportion of patients with well‐controlled sedation (Richmond Agitation–Sedation Scale score between −3 and +1), days free from delirium (based on the Confusion Assessment Method for ICU), and days free from coma (Richmond Agitation–Sedation Scale score between −4 and −5). Results One hundred and one patients were assigned to the elderly group and 100 patients were assigned to the younger group. In the elderly group, 50 patients received DEX treatment and 51 patients received non‐DEX treatment, with the DEX arm having significantly better‐controlled sedation (range, 14–52% versus 16–27%; P = 0.01). In the younger group, 50 patients received DEX treatment and 50 patients received non‐DEX treatment, with no significant difference in the proportions of well‐controlled sedation (range, 20–64% versus 24–60%; P = 0.73). There were no significant differences in the numbers of days free from delirium or coma between the groups. Conclusion In elderly sepsis patients who require ventilation, dexmedetomidine could be more effective than other sedative agents for achieving proper sedation.
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Affiliation(s)
- Tetsuya Sato
- Department of Emergency and Critical Care Medicine Tohoku University Hospital Sendai Japan
| | - Yu Kawazoe
- Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Noriko Miyagawa
- Emergency and Critical Care Department Sendai City Hospital Sendai Japan
| | - Yuta Yokokawa
- Department of Emergency and Critical Care Medicine Tohoku University Hospital Sendai Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Yoshinori Ohta
- Education and Training Center for Students and Professionals in Healthcare Hyogo College of Medicine Nishinomiya Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology Hyogo College of Medicine Nishinomiya Japan
| | - Hitoshi Yamamura
- Osaka Prefectural Nakakawachi Emergency and Critical Care Center Higashiosaka Japan
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Miyamoto K, Shibata M, Shima N, Nakashima T, Kida M, Matsumoto H, Oka N, Yazaki A, Uchigaki A, Takemoto A, Kato S. Combination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study. J Crit Care 2021; 63:76-82. [PMID: 33618284 DOI: 10.1016/j.jcrc.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/15/2020] [Accepted: 01/17/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE We aimed to determine any associations between delirium and comas during intensive care unit (ICU) stay, and long-term psychiatric symptoms and disability affecting activity of daily living (ADL). MATERIALS AND METHODS In this prospective observational study, we enrolled critically ill adult patients that were emergently admitted to an ICU. We assessed psychiatric symptoms and disability affecting ADL at three and twelve months after ICU discharge. RESULTS Among the 81 and the 47 patients that responded to the questionnaires at three and twelve months, 22 (27%) and 13 (28%) patients experienced delirium, respectively. During their ICU stay, 28 (35%) and 21 (45%) had been in comas, respectively. At three and twelve months, 51 (63%) and 23 (49%) of patients experienced composite psychiatric symptoms or disability affecting ADL, respectively. After adjusting predefined confounders, the combination of delirium and comas was an independent risk factor for the presence of composite psychiatric symptoms or disability affecting ADL (adjusted odds ratio [aOR] 3.38; 1.10-10.38 at three months; aOR 8.28; 1.48-46.46 at twelve months). CONCLUSIONS In critically ill adults, combination of delirium and comas during ICU stay is a predictor of psychiatric symptoms or ADL disability. TRIAL REGISTRATION UMIN Clinical Trial Registry no. UMIN000023743, September 1, 2016.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan.
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
| | - Nozomu Shima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
| | - Maki Kida
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
| | - Haruka Matsumoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
| | - Natsuki Oka
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City 641-8510, Wakayama, Japan
| | - Akina Yazaki
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City 641-8510, Wakayama, Japan
| | - Akiko Uchigaki
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City 641-8510, Wakayama, Japan
| | - Aya Takemoto
- Department of Nursing, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama City 641-8510, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan
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Fuchigami J, Miyamoto K, Shibata N, Yonemitsu T, Ueda K, Kato S. Aortoduodenal fistula successfully treated with endovascular repair. Clin Case Rep 2021; 9:1039-1040. [PMID: 33598297 PMCID: PMC7869376 DOI: 10.1002/ccr3.3641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/07/2020] [Accepted: 11/17/2020] [Indexed: 11/09/2022] Open
Abstract
Aortoduodenal fistula is a rare cause of life-threatening upper gastrointestinal bleeding. Accurate diagnosis is essential to initiate definitive treatment because endoscopic hemostasis, which is the usual initial intervention for upper gastrointestinal bleeding, may be ineffective. This case underscores timely intervention using endovascular treatment for achieving hemostasis in aortoduodenal fistula.
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Affiliation(s)
- Junya Fuchigami
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Naoaki Shibata
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Takafumi Yonemitsu
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Kentaro Ueda
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Seiya Kato
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Ota M, Aiba T, Nakajima T, Fukuda T, Kusano K. Ventricular tachycardia in cardiac sarcoidosis -prognosis, characterization of ventricular substrates and outcomes of treatment-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prognosis, the underlying substrate and clinical outcomes of treatment are unclear in patients with cardiac sarcoidosis (CS)-related ventricular tachycardia (VT).
Objective
This study investigated the prognosis and the relationship between electroanatomical mapping (EAM) and imaging findings in patients with CS-related VT.
Methods
A total of 203 CS patients (Age 68.1±11.6 years, 87 males) were enrolled at two tertiary care medical centers between 2000 and 2018. All met the 2016 Japanese Circulation Society guidelines for diagnosis of CS. They were followed for a composite of major adverse cardiac events (MACE) including cardiac death, heart transplantation, unscheduled hospitalization for heart failure, and life-threatening ventricular arrhythmias. Distribution of late gadolinium enhancement (LGE) on cardiac MRI (CMR) and/or an abnormal myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography at diagnosis were examined. The relationship between EAM and the image findings were also analyzed in patients with radiofrequency ablation (RFA) for VT.
Results
During a median follow-up of 53 months, 87 of the 203 patients (43%) experienced a MACE. Baseline factors associated with MACE were presence of sustained VT (HR, 2.43, 95% CI 1.54–3.85, P<0.001), left ventricular ejection fraction below 50% (HR, 1.95 95% CI 1.07–3.56, P=0.029), and abnormal myocardial FDG uptake (HR, 2.42 95% CI 1.04–5.61, P=0.039). Overall, 69 of the 203 patients (34%) experienced sustained VT. Abnormal myocardial FDG uptake was significantly more prevalent in patients with VT than in those without (92.7% vs. 78.5%, P=0.02). A total of 25 patients (9.9%) required RFA for CS-related VT (Age 64.0±8.7 years, 12 males, 1.32±0.56 RFAs per patient). Abnormal electrocardiograms (EGM) were observed in 22 of the 25 patients (88%). LGE was more frequent than abnormal FDG uptake in areas with an abnormal EGM (77% vs. 41%; P=0.002). Over a mean follow-up period of 67-months, 13 of the 25 patients with RFA (52%) remained free of VT episodes (Figure). VT recurred in nine of the 12 patients with RFA and in 17 of the 47 patients without RFA, but was suppressed by intensive pharmacologic therapy such as the combined use of amiodarone and sotalol. In patients with CS-related VT, survival without experiencing a MACE did not differ in participants with or without RFA.
Conclusions
In our 203 CS patients, sustained VT and abnormal FDG uptake were associated with worse cardiac outcomes. The prevalence of abnormal FDG uptake was significantly higher in patients with CS-related VT, LGE on CMR was more frequent within localized areas of an abnormal EGM, suggesting that both scar itself and the associated inflammation were involved in the pathogenesis of CS-related VT. Successful RFA of CS-related VT is still challenging, and recurrence is common. Preprocedural CMR can be useful in detecting abnormal EGMs that are potential targets for substrate ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Ota
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Nakajima
- Saitama Cardiovascular and Respiratory Center, Department of Cardiology, Kumagaya, Japan
| | - T Fukuda
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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Miyamoto K, Nakashima T, Shima N, Kato S, Kawazoe Y, Morimoto T, Ohta Y, Yamamura H. Utility of a prediction model for delirium in intensive care unit patients (PRE-DELIRIC) in mechanically ventilated patients with sepsis. Acute Med Surg 2020; 7:e589. [PMID: 33173589 PMCID: PMC7640736 DOI: 10.1002/ams2.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 07/31/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022] Open
Abstract
Aim Delirium frequently develops in patients with sepsis during their intensive care unit (ICU) stay, which is associated with increased morbidity and mortality. A prediction model for delirium in patients in ICU, PRE‐DELIRIC, has been utilized in overall ICU patients, but its utility is uncertain among patients with sepsis. This study aims to examine the utility of PRE‐DELIRIC to predict delirium in mechanically ventilated patients with sepsis. Methods This is a post hoc analysis of a randomized clinical trial in eight Japanese ICUs, which aimed to evaluate the sedative strategy with/without dexmedetomidine in adult mechanically ventilated patients with sepsis. The Confusion Assessment Method for the ICU was used every day to assess for delirium throughout their ICU stay. We excluded patients who were delirious on the first day of ICU, those who were under sustained coma throughout their ICU stay, and those who stayed in the ICU less than 24 h. The discriminative ability of PRE‐DELIRIC was evaluated by measuring the area under the receiver operating characteristic curve (AUROC). Results Of the 201 patients enrolled in the trial, we analyzed 158 patients. The mean age was 69.4 ± 14.0 years, and 99 patients (63%) were men. Delirium occurred at least once during the ICU stay of 63 patients (40%). The AUROC of PRE‐DELIRIC was 0.60 (95% confidence interval, 0.50–0.69). Subgroup analyses indicated that PRE‐DELIRIC was useful in those with Sequential Organ Failure Assessment score >8 with AUROC of 0.65 (95% confidence interval, 0.51–0.77). Conclusions The PRE‐DELIRIC model could not predict delirium in mechanically ventilated patients with sepsis.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Nozomu Shima
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Yu Kawazoe
- Department of Emergency and Critical Care Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology Hyogo College of Medicine Nishinomiya Japan
| | - Yoshinori Ohta
- Education and Training Center for Students and Professionals in Healthcare Hyogo College of Medicine Nishinomiya Japan
| | - Hitoshi Yamamura
- Osaka Prefecture Nakakawachi Critical Care and Emergency Center Higashiosaka Japan
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Cardiac function at diagnosis is important prognostic factor in patients with cardiac sarcoidosis -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic non-caseating granulomatous disease of unknown etiology. Cardiac involvement (cardiac sarcoidosis, CS) has been reported to be an important prognostic factor in this disease because of heart failure and/or ventricular arrhythmia, and corticosteroid therapy is usually prescribed to prevent cardiac events. However, little is known about the relationship of cardiac function and concomitant corticosteroid therapy on later cardiac events in CS.
Objective
We evaluated the relationship between prognosis and left ventricular ejection fraction (LVEF) at the time of diagnosis in CS patients from the Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, mean age 60±13 years old, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The relationship of adverse events (all-cause death, cardiovascular death, and appropriate ICD [Implantable Cardioverter Defibrillator] discharge) and LVEF (with corticosteroid 84%) (low LVEF: LVEF≤35% n=98 [with corticosteroid in 78%], moderate LVEF: LVEF 35–50% n=104 [with corticosteroid in 93%], normal LVEF: 50≤LVEF n=218 [with corticosteroid in 83%]) were evaluated respectively.
Results
89 CS patients developed all-cause death (n=50), cardiovascular death (n=30) or appropriate ICD discharge (n=48). The frequency of corticosteroid therapy was not different in the each LVEF group, but Kaplan-Meier analysis revealed that all-cause death, cardiovascular death, and all cardiovascular adverse events were more observed in lower LVEF group (log-rank p<0.0001). Furthermore, multivariate Cox hazard analysis revealed that LVEF was a most important independent prognostic factor in CS.
Conclusion
This Japanese nationwide questionnaire survey data showed that initial LVEF was an independent and strong prognostic predictor in CS, therefore primary prevention would be needed even after starting corticosteroid in patients with decreased cardiac function.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long time clinical course of cardiac sarcoidosis with corticosteroid therapy -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement has been reported to be an important prognostic factor in this disease. An autopsy study has reported that the frequency of this cardiac involvement (cardiac sarcoidosis: CS) varies in the different countries and races and very frequent in Japanese patients. We therefore performed the nationwide questionnaire survey and try to clarify the clinical characteristics and corticosteroid effect in CS, especially focused on arrhythmic events in this disease.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The clinical outcome and corticosteroid effect were evaluated.
Results
Clinical characteristics at diagnosis was as follows: female dominant (68%), mean age of 60±13 years old, mean left ventricular ejection fraction was 49±16%. Arrhythmic events were very frequently observed as an initial cardiac manifestation in 263 patients (62%) of CS, of which atrioventricular block (AVB) in 174 (41%), ventricular tachycardia (VT) in 73 (17%) and AVB with VT in 17 (4%) (Figure 1A). Pacemaker was implanted in 166 patients (40%) and defibrillators was 137 patients (33%). Corticosteroid was prescribed in 144 (83%) of 174 patients with AVB and in 62 (85%) of 73 patients with VT. Initial dose was mean 47.9 mg and maintenance dose of mean 7.3 mg. Corticosteroid improved VT as good as AVB (27% vs. 29%). However, corticosteroid sometimes worsened VT events compared with AVB (10% vs. 2%) (Figure 1B). During the course of follow-up, 32 patients were needed to increase corticosteroid in 23 of AVB and 10 of VT cases. However, there were no difference in mortality between the groups, whether or not to increase corticosteroid. All survival rate was 92% (5-year mortality), 83% (10-year mortality) and free from all cause death and defibrillator charge was 81% (5 year), 71% (10 year).
Conclusion
Fatal arrhythmia is commonly observed in CS as a primary symptom. Corticosteroid sometimes worsen ventricular arrhythmia and appropriate defibrillator discharge was common. Thus, careful attention for activating ventricular arrhythmia would be needed during the follow-up period even after corticosteroid therapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long-term follow up ventricular tachycardia patients with preserved cardiac function -from Japanese cardiac sarcoidosis nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Prior ventricular tachycardia (VT) and low left ventricular ejection fraction (LVEF) are the most important prognostic factors in cardiac sarcoidosis (CS). Recently diagnosis of CS was renewed according to Japanese new guidelines. Patients with preserved cardiac function often have VT events, thus new guidelines recommends to assess the implantable cardioverter defibrillator (ICD) implantation for CS patients with preserved LVEF (35%≤LVEF<50%). However, the long-term prognosis of CS patients with preserved LVEF is unclear.
Objective
In CS patients with preserved LVEF, we evaluated the prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis from Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, who had LVEF≤35%, LVEF>50%, or who underwent cardiac transplantations were excluded. 104 patients with LVEF 35–50% (67 females, mean age 60±15 years old, median follow-up periods 2134 days [interquartile range: 758–2935 days]) were analyzed. The prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis were evaluated.
Results
30 patients had VT manifestation at CS diagnosis and 24 patients (80%) received ICDs. 74 patients had no VT manifestation at CS diagnosis and 19 patients (44%) received ICDs during follow up period. All-cause mortality was not different between two groups (Figure). Appropriate ICD therapy of non-VT manifestation group was significantly lower compared with that of VT manifestation group (log-rank p=0.001), however considerable number (n=7, 15%) of non-VT manifestation group had appropriate ICD therapy event during follow-up period. Cox hazard analysis revealed that concomitant non-sustained VT (NSVT) with atrioventricular block (AVB) was a predictor of appropriate ICD therapy in non-VT manifestation group.
Conclusion
This nationwide survey showed that considerable number of CS patients with preserved LVEF had VT events, independent of VT manifestation. Concomitant NSVT with AVB was a predictor of VT events, and ICD implantation should be assessed.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Kamakura T, Yamagata K, Wada M, Ishibashi K, Inoue Y, Noda T, Nagase S, Aiba T, Kusano K. Micro-embolic risks during radiofrequency and cryoballoon-ablation of atrial fibrillation -analysis from real-time carotid artery doppler monitoring-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Catheter ablation of atrial fibrillation (AF) is associated with risks of silent cerebral events. However, the timing of intraprocedural micro-embolic events or differences between open-irrigated radiofrequency (RF) and cryoballoon (Cryo) ablation are unclear. Newly developed real-time carotid artery Doppler is a simple non-invasive method to detect micro-embolic signals (MESs) during ablation.
Objective
We investigated the timing of detecting MESs during RF and Cryo ablation of AF.
Methods
During the first pulmonary vein isolation (PVI) session of AF, MESs were monitored by real-time carotid artery Doppler monitoring throughout the procedure. The MES counts were collected and evaluated separately during the different steps of the procedure (Figure).
Results
Thirty-three AF patients (RF/Cryo: 22/11 cases, 9 females, 69.5±11.6 y.o) were included. PVI was successfully accomplished in all patients with no major complications. The MES count was significantly greater in the RF group than Cryo group (table). In both groups, left atrial (LA) access (interatrial puncture) and sheaths insertion to the LA generated a significant number of MESs (RF: 1690 of 9116 MESs [18.5% of the total MESs], Cryo: 793 of 2285 MESs [34.7%]). In the RF group, MESs were observed incessantly during PVI (Figure). The LA dwell time was significantly longer in the RF group than Cryo group (table). In the RF group, the MES count was significantly greater in the longer LA dwell time group (LA dwell time >130min) than the shorter group (464.2±179.7 vs 302.6±138.2: P=0.049). During the cryo-applications in the Cryo group, the MESs were greatest during the first cryoballoon application (625 of 2285 MESs [27.4%]).
Conclusions
There were more MESs during RF ablation than cryoablation. MESs were recorded during a variety of steps throughout the procedure. In the RF group, most of MESs were recorded incessantly during radiofrequency ablation and greater number of MESs were recorded in patients with longer LA dwell time. In the Cryo group, most of MESs occurred during phases with a high probability of gaseous emboli.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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Yokoyama Y, Miyamoto K, Nakai M, Sumita Y, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Nagase S, Noda T, Aiba T, Kusano K. The safety of catheter ablation of atrial fibrillation in elderly patients -analysis of the nationwide database in Japan, JROAD-DPC-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
“Age” is one of the major concerns and determinants of the indications for catheter ablation (CA) of atrial fibrillation (AF). There are little safety data on CA of AF according to the age. This study aimed to assess the safety of CA in elderly patients undergoing CA of AF.
Methods and results
We investigated the complication rate of CA of AF for the different age groups (<60 years, 60–65, 65–70, 70–75, 75–80, 80–85, and ≥85) by a nationwide database (Japanese Registry Of All cardiac and vascular Diseases [JROAD]-DPC). The JROAD-DPC included 73,296 patients (65±11 years, 52,883 men) who underwent CA of AF from 516 hospitals in Japan. Aged patients had more comorbidities and a significantly increased CHADS2 score and higher rate of female according to a higher age. The overall complication rate was 2.6% and in-hospital mortality was 0.05%. By comparing each age group, complications occurred more frequently in higher aged groups. A multivariate adjusted hazard ratio revealed an increased age was independently and significantly associated with the overall complications (odds ratio was 1.25, 1.35, 1.72, 1.86, 2.76 and 3.13 respectively; reference <60 years).
Conclusions
The frequency of complications was significantly higher according to a higher age. We should take note of the indications and procedure for CA of AF in aged patients.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Intramural Research Fund 17 (Kusano) for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center
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Affiliation(s)
- Y Yokoyama
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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Yoda T, Saengrut B, Rattanasathien R, Ishimoto Y, Saito T, Miyamoto K, Chunjai K, Pudwan R, Sirimuengmoon K, Katsuyama H. Differences in body composition and grip between Japanese and Thai older people living in Thailand. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Age-related muscle mass loss is one of the main risk factors for osteoporosis and fractures among older people. Thus, prevention of muscle mass loss in older people is an important issue. We examined ethnic group-related differences in body composition and grip strength among older people living in the same area.
Methods
We measured body composition and grip strength among local Thai older people living in Chiang Mai Province, as well as in Japanese older people who emigrated to Chiang Mai Province in their retirement. A self-reported questionnaire regarding socio-demographic status was also administered. Measurement items were averaged and compared by sex and ethnic group. Questionnaire items were also categorized by sex and ethnic group.
Results
A total of 119 older people participated, including 47 Japanese participants (26 men, 21 women) and 72 Thai participants (16 men, 56 women). The average age of Japanese participants was 71.1 years (standard deviation: 4.89), and the average age of Thai participants was 68.8 years (standard deviation: 5.61). Significant differences between ethnic groups were found in percentage of body fat in women (Japanese average: 32.9% vs. Thai average: 37.6%, p < 0.05), skeletal muscle mass index (SMI) in men (Japanese average: 7.85 kg/m2 vs. Thai average: 7.31 kg/m2, p < 0.05) and average grip strength in men (Japanese: 35.1 kg vs. Thai: 30.7 kg, p < 0.05).
Conclusions
Our preliminary results suggest that Thai older people, particularly men, are weaker than Japanese older people. Decreased muscle mass is directly responsible for functional impairment, involving loss of strength, increased likelihood of falls, and loss of autonomy. Preventing muscle weakness among older people is important. In future studies, we plan to analyze and clarify the differences between Thai and Japanese older people to identify effective methods to prevent muscle mass decreases.
Key messages
There were significant differences in average % body fat between older Japanese and Thai women. There were significant differences in average SMI and grip strength between older Japanese and Thai men.
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Affiliation(s)
- T Yoda
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
- Department of Public Health, Kawasaki Medical School, Kurashiki, Japan
| | - B Saengrut
- Nursing Department, Faculty of Medicine, Chiang Mai Univeristy, Chiang Mai, Thailand
| | - R Rattanasathien
- Nursing Department, Faculty of Medicine, Chiang Mai Univeristy, Chiang Mai, Thailand
| | - Y Ishimoto
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - T Saito
- Department of Sports Science, Japan Institute of Sports Science, Tokyo, Japan
| | - K Miyamoto
- Faculty of Education, Kagawa University, Takamatsu, Japan
| | - K Chunjai
- Nursing Department, Faculty of Medicine, Chiang Mai Univeristy, Chiang Mai, Thailand
| | - R Pudwan
- Nursing Department, Faculty of Medicine, Chiang Mai Univeristy, Chiang Mai, Thailand
| | - K Sirimuengmoon
- Faculty of Associated Medical Science, Chiang Mai University, Chiang Mai, Thailand
| | - H Katsuyama
- Department of Public Health, Kawasaki Medical School, Kurashiki, Japan
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Ohta Y, Miyamoto K, Kawazoe Y, Yamamura H, Morimoto T. Effect of dexmedetomidine on inflammation in patients with sepsis requiring mechanical ventilation: a sub-analysis of a multicenter randomized clinical trial. Crit Care 2020; 24:493. [PMID: 32778146 PMCID: PMC7416813 DOI: 10.1186/s13054-020-03207-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Administration of dexmedetomidine has been reported to improve inflammatory response in animals. We explored the effects of administering dexmedetomidine on the levels of C-reactive protein (CRP) and procalcitonin, and thus on inflammation, in patients with sepsis enrolled in a randomized clinical trial. METHODS The DESIRE trial was a multicenter randomized clinical trial in which adult patients with sepsis were sedated with (DEX group) or without (non-DEX group) dexmedetomidine while on mechanical ventilators. As a prespecified sub-analysis, we compared CRP and procalcitonin levels during the first 14 days of treatment between the two groups. The 14-day mortality rate, albumin level, and the number of patients with disseminated intravascular coagulation (DIC) were also assessed. We used generalized linear models to estimate the differences in these outcomes between groups. We also used the Kaplan-Meier method to estimate the 14-day mortality rate and the log-rank test to assess between-group differences. RESULTS Our study comprised 201 patients: 100 in the DEX group and 101 in the non-DEX group. CRP and procalcitonin levels were lower in the DEX vs. non-DEX group during the 14-day treatment period [CRP-range, 5.6-20.3 vs. 8.3-21.1 mg/dL (P = 0.03); procalcitonin-range, 1.2-37.4 vs. 1.7-52.9 ng/mL (P = 0.04)]. Albumin levels were higher in the DEX group (range, 2.3-2.6 g/dL) than in the non-DEX group (range, 2.1-2.7 g/dL; P = 0.01). The percentage of patients with DIC did not significantly differ between the groups (range, 21-59% and 17-56% for the DEX and non-DEX groups, respectively; P = 0.49). The 14-day mortality rates in the DEX and non-DEX groups were 13 and 21%, respectively (P = 0.16). CONCLUSION Sedation using dexmedetomidine reduced inflammation in patients with sepsis requiring mechanical ventilation. TRIAL REGISTRATION ClinicalTrials.gov, NCT01760967 . Registered on 4 January 2013.
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Affiliation(s)
- Yoshinori Ohta
- Education and Training Center for Students and Professionals in Healthcare, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yu Kawazoe
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hitoshi Yamamura
- Osaka Prefectural Nakakawachi Emergency and Critical Care Center, Higashiosaka, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
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Shikin AM, Estyunin DA, Klimovskikh II, Filnov SO, Schwier EF, Kumar S, Miyamoto K, Okuda T, Kimura A, Kuroda K, Yaji K, Shin S, Takeda Y, Saitoh Y, Aliev ZS, Mamedov NT, Amiraslanov IR, Babanly MB, Otrokov MM, Eremeev SV, Chulkov EV. Nature of the Dirac gap modulation and surface magnetic interaction in axion antiferromagnetic topological insulator [Formula: see text]. Sci Rep 2020; 10:13226. [PMID: 32764583 PMCID: PMC7413556 DOI: 10.1038/s41598-020-70089-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022] Open
Abstract
Modification of the gap at the Dirac point (DP) in axion antiferromagnetic topological insulator [Formula: see text] and its electronic and spin structure have been studied by angle- and spin-resolved photoemission spectroscopy (ARPES) under laser excitation at various temperatures (9-35 K), light polarizations and photon energies. We have distinguished both large (60-70 meV) and reduced ([Formula: see text]) gaps at the DP in the ARPES dispersions, which remain open above the Neél temperature ([Formula: see text]). We propose that the gap above [Formula: see text] remains open due to a short-range magnetic field generated by chiral spin fluctuations. Spin-resolved ARPES, XMCD and circular dichroism ARPES measurements show a surface ferromagnetic ordering for the "large gap" sample and apparently significantly reduced effective magnetic moment for the "reduced gap" sample. These observations can be explained by a shift of the Dirac cone (DC) state localization towards the second Mn layer due to structural disturbance and surface relaxation effects, where DC state is influenced by compensated opposite magnetic moments. As we have shown by means of ab-initio calculations surface structural modification can result in a significant modulation of the DP gap.
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Affiliation(s)
- A. M. Shikin
- Saint Petersburg State University, 198504 Saint Petersburg, Russia
| | - D. A. Estyunin
- Saint Petersburg State University, 198504 Saint Petersburg, Russia
| | | | - S. O. Filnov
- Saint Petersburg State University, 198504 Saint Petersburg, Russia
| | - E. F. Schwier
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima, Japan
| | - S. Kumar
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima, Japan
| | - K. Miyamoto
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima, Japan
| | - T. Okuda
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima, Japan
| | - A. Kimura
- Department of Physical Sciences, Graduate School of Science, Hiroshima University, Hiroshima, Japan
| | - K. Kuroda
- ISSP, University of Tokyo, Kashiwa, Chiba 277-8581 Japan
| | - K. Yaji
- ISSP, University of Tokyo, Kashiwa, Chiba 277-8581 Japan
| | - S. Shin
- ISSP, University of Tokyo, Kashiwa, Chiba 277-8581 Japan
| | - Y. Takeda
- Materials Sciences Research Center, Japan Atomic Energy Agency, Sayo, Hyogo 679-5148 Japan
| | - Y. Saitoh
- Materials Sciences Research Center, Japan Atomic Energy Agency, Sayo, Hyogo 679-5148 Japan
| | - Z. S. Aliev
- Azerbaijan State Oil and Industry University, AZ1010 Baku, Azerbaijan
- Institute of Physics, ANAS, AZ1143 Baku, Azerbaijan
| | | | - I. R. Amiraslanov
- Institute of Physics, ANAS, AZ1143 Baku, Azerbaijan
- Baku State University, AZ1148 Baku, Azerbaijan
| | - M. B. Babanly
- Baku State University, AZ1148 Baku, Azerbaijan
- Institute of Catalysis and Inorganic Chemistry, ANAS, AZ1143 Baku, Azerbaijan
| | - M. M. Otrokov
- Centro de Física de Materiales (CFM-MPC), Centro Mixto CSIC-UPV/EHU, 20018 Donostia-San Sebastián, Basque Country Spain
- IKERBASQUE, Basque Foundation for Science, 48011 Bilbao, Basque Country Spain
| | - S. V. Eremeev
- Saint Petersburg State University, 198504 Saint Petersburg, Russia
- Institute of Strength Physics and Materials Science, 634055 Tomsk, Russia
- Tomsk State University, 634050 Tomsk, Russia
| | - E. V. Chulkov
- Saint Petersburg State University, 198504 Saint Petersburg, Russia
- Tomsk State University, 634050 Tomsk, Russia
- Donostia International Physics Center (DIPC), 20018 Donostia-San Sebastián, Basque Country Spain
- Departamento de Física de Materiales, Facultad de Ciencias Químicas, UPV/EHU, Apdo. 1072, 20080 San Sebastián, Spain
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Miyamoto K, Shibata N, Ogawa A, Nakashima T, Kato S. Prehospital and in-hospital quick Sequential Organ Failure Assessment (qSOFA) scores to predict in-hospital mortality among trauma patients: an analysis of nationwide registry data. Acute Med Surg 2020; 7:e532. [PMID: 32587706 PMCID: PMC7311801 DOI: 10.1002/ams2.532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/30/2020] [Accepted: 05/22/2020] [Indexed: 01/31/2023] Open
Abstract
Aim The quick Sequential Organ Failure Assessment (qSOFA) score can be used to predict in‐hospital mortality in trauma patients. We sought to determine whether repeatedly calculating the qSOFA score improves its discriminative ability in predicting in‐hospital mortality in trauma patients. Methods We undertook a multicenter retrospective study, analyzing 90,974 trauma patients registered in the Japan Trauma Data Bank (a nationwide trauma registry) from 2004 to 2017. Patients included were ≥18 years old and transferred directly to hospitals from their respective scenes of injury. We calculated the qSOFA score at two time points: at the scene (prehospital qSOFA score) and on arrival at the hospital (hospital qSOFA score). We evaluated the discriminative ability of repeated calculations of the qSOFA score. The primary outcome in consideration was in‐hospital mortality. Results In‐hospital mortality occurred in 5604 patients (6.2%). The predictive accuracy of the hospital qSOFA score was higher than that of the prehospital qSOFA (area under the receiver operating characteristics curve [AUROC] 0.74 vs. 0.69, P < 0.0001) in predicting in‐hospital mortality. However, the mean qSOFA score had the highest predictive accuracy (AUROC 0.76, P < 0.0001). If the hospital qSOFA score was increased compared to the prehospital score, this indicated an approximately 2‐fold to 4‐fold increase in in‐hospital mortality. Conclusions Repeated calculations of qSOFA score improved its ability to predict in‐hospital mortality in trauma patients. Specifically, we should consider an increasing qSOFA score as a “red flag” to clinicians in the emergency department.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Naoaki Shibata
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Atsuhiro Ogawa
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
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Miyamoto K, Yonemitsu T, Tanaka R, Nakashima T, Shibata M, Funahashi R, Yamasaki K, Yamada M, Tamoto K, Akamatsu K, Nishio M, Yamaue H, Kato S. Protracted course of coronavirus disease with severe acute respiratory distress syndrome: a case report. Acute Med Surg 2020; 7:e521. [PMID: 32566237 PMCID: PMC7276737 DOI: 10.1002/ams2.521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 01/15/2023] Open
Abstract
Background Coronavirus disease (COVID‐19) is a growing concern worldwide. Approximately 5% of COVID‐19 cases require intensive care. However, the optimal treatment for respiratory failure in COVID‐19 patients is yet to be determined. Case presentation A 79‐year‐old man with severe acute respiratory distress syndrome due to COVID‐19 was admitted to our intensive care unit. Prone ventilation was effective in treating the patient’s hypoxemia. Furthermore, the patient received lung protective ventilation with a tidal volume of 6–8 mg/kg (predicted body weight). However, the patient’s respiratory failure did not improve and he died 16 days after admission because of multiple organ failure. Serial chest computed tomography revealed a change from ground‐glass opacity to consolidation pattern in both lungs. Conclusions We report a protracted case of COVID‐19 in a critically ill patient in Japan. Although prone ventilation could contribute to treating hypoxemia, its efficacy in preventing mortality from COVID‐19 is unknown.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan.,Department of Infection Prevention and Control Wakayama Medical University Wakayama Japan
| | - Takafumi Yonemitsu
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Rikako Tanaka
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Ryosuke Funahashi
- Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama Japan
| | - Keiko Yamasaki
- Department of Anesthesiology Wakayama Medical University Wakayama Japan
| | - Mario Yamada
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Kaori Tamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Keiichiro Akamatsu
- Department of Infection Prevention and Control Wakayama Medical University Wakayama Japan.,Third Department of Internal Medicine Wakayama Medical University Wakayama Japan
| | - Machiko Nishio
- Department of Infection Prevention and Control Wakayama Medical University Wakayama Japan.,Department of Microbiology Wakayama Medical University Wakayama Japan
| | - Hiroki Yamaue
- Second Department of Surgery Wakayama Medical University Wakayama Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
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44
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Usachov DY, Nechaev IA, Poelchen G, Güttler M, Krasovskii EE, Schulz S, Generalov A, Kliemt K, Kraiker A, Krellner C, Kummer K, Danzenbächer S, Laubschat C, Weber AP, Sánchez-Barriga J, Chulkov EV, Santander-Syro AF, Imai T, Miyamoto K, Okuda T, Vyalikh DV. Cubic Rashba Effect in the Surface Spin Structure of Rare-Earth Ternary Materials. Phys Rev Lett 2020; 124:237202. [PMID: 32603174 DOI: 10.1103/physrevlett.124.237202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/13/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
Spin-orbit interaction and structure inversion asymmetry in combination with magnetic ordering is a promising route to novel materials with highly mobile spin-polarized carriers at the surface. Spin-resolved measurements of the photoemission current from the Si-terminated surface of the antiferromagnet TbRh_{2}Si_{2} and their analysis within an ab initio one-step theory unveil an unusual triple winding of the electron spin along the fourfold-symmetric constant energy contours of the surface states. A two-band k·p model is presented that yields the triple winding as a cubic Rashba effect. The curious in-plane spin-momentum locking is remarkably robust and remains intact across a paramagnetic-antiferromagnetic transition in spite of spin-orbit interaction on Rh atoms being considerably weaker than the out-of-plane exchange field due to the Tb 4f moments.
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Affiliation(s)
- D Yu Usachov
- St. Petersburg State University, 7/9 Universitetskaya Naberezhnaya, St. Petersburg, 199034, Russia
| | - I A Nechaev
- Department of Electricity and Electronics, FCT-ZTF, UPV-EHU, 48080 Bilbao, Spain
| | - G Poelchen
- Institut für Festkörperphysik und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany
| | - M Güttler
- Institut für Festkörperphysik und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany
| | - E E Krasovskii
- Donostia International Physics Center (DIPC), 20018 Donostia/San Sebastián, Basque Country, Spain
- Departamento de Física de Materiales UPV/EHU, 20080 Donostia/San Sebastián, Basque Country, Spain
- IKERBASQUE, Basque Foundation for Science, 48013, Bilbao, Spain
| | - S Schulz
- Institut für Festkörperphysik und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany
| | - A Generalov
- Max IV Laboratory, Lund University, Box 118, 22100 Lund, Sweden
| | - K Kliemt
- Kristall- und Materiallabor, Physikalisches Institut, Goethe-Universität Frankfurt, Max-von-Laue Strasse 1, D-60438 Frankfurt am Main, Germany
| | - A Kraiker
- Kristall- und Materiallabor, Physikalisches Institut, Goethe-Universität Frankfurt, Max-von-Laue Strasse 1, D-60438 Frankfurt am Main, Germany
| | - C Krellner
- Kristall- und Materiallabor, Physikalisches Institut, Goethe-Universität Frankfurt, Max-von-Laue Strasse 1, D-60438 Frankfurt am Main, Germany
| | - K Kummer
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, Grenoble, France
| | - S Danzenbächer
- Institut für Festkörperphysik und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany
| | - C Laubschat
- Institut für Festkörperphysik und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany
| | - A P Weber
- Donostia International Physics Center (DIPC), 20018 Donostia/San Sebastián, Basque Country, Spain
| | - J Sánchez-Barriga
- Helmholtz-Zentrum Berlin für Materialien und Energie, Elektronenspeicherring BESSY II, Albert-Einstein-Strasse 15, D-12489 Berlin, Germany
| | - E V Chulkov
- St. Petersburg State University, 7/9 Universitetskaya Naberezhnaya, St. Petersburg, 199034, Russia
- Donostia International Physics Center (DIPC), 20018 Donostia/San Sebastián, Basque Country, Spain
- Departamento de Física de Materiales UPV/EHU, 20080 Donostia/San Sebastián, Basque Country, Spain
- Centro de Física de Materiales CFM-MPC and Centro Mixto CSIC-UPV/EHU, 20018 Donostia/San Sebastián, Basque Country, Spain
- Tomsk State University, Lenina Avenue 36, 634050, Tomsk, Russia
| | - A F Santander-Syro
- Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, 91405, Orsay, France
| | - T Imai
- Graduate School of Science, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - D V Vyalikh
- Donostia International Physics Center (DIPC), 20018 Donostia/San Sebastián, Basque Country, Spain
- IKERBASQUE, Basque Foundation for Science, 48013, Bilbao, Spain
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45
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Mitsuishi N, Sugita Y, Bahramy MS, Kamitani M, Sonobe T, Sakano M, Shimojima T, Takahashi H, Sakai H, Horiba K, Kumigashira H, Taguchi K, Miyamoto K, Okuda T, Ishiwata S, Motome Y, Ishizaka K. Switching of band inversion and topological surface states by charge density wave. Nat Commun 2020; 11:2466. [PMID: 32424170 PMCID: PMC7235022 DOI: 10.1038/s41467-020-16290-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/25/2020] [Indexed: 11/10/2022] Open
Abstract
Topologically nontrivial materials host protected edge states associated with the bulk band inversion through the bulk-edge correspondence. Manipulating such edge states is highly desired for developing new functions and devices practically using their dissipation-less nature and spin-momentum locking. Here we introduce a transition-metal dichalcogenide VTe2, that hosts a charge density wave (CDW) coupled with the band inversion involving V3d and Te5p orbitals. Spin- and angle-resolved photoemission spectroscopy with first-principles calculations reveal the huge anisotropic modification of the bulk electronic structure by the CDW formation, accompanying the selective disappearance of Dirac-type spin-polarized topological surface states that exist in the normal state. Thorough three dimensional investigation of bulk states indicates that the corresponding band inversion at the Brillouin zone boundary dissolves upon the CDW formation, by transforming into anomalous flat bands. Our finding provides a new insight to the topological manipulation of matters by utilizing CDWs' flexible characters to external stimuli.
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Affiliation(s)
- N Mitsuishi
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan
| | - Y Sugita
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
| | - M S Bahramy
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - M Kamitani
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan
| | - T Sonobe
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan
| | - M Sakano
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan
| | - T Shimojima
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - H Takahashi
- Division of Materials Physics, Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, 560-8531, Japan
| | - H Sakai
- Department of Physics, Osaka University, Toyonaka, Osaka, 560-0043, Japan
| | - K Horiba
- Condensed Matter Research Center and Photon Factory, Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, 305-0801, Japan
| | - H Kumigashira
- Condensed Matter Research Center and Photon Factory, Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, 305-0801, Japan
| | - K Taguchi
- Hiroshima Synchrotron Radiation Center (HSRC), Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center (HSRC), Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center (HSRC), Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, 739-0046, Japan
| | - S Ishiwata
- Division of Materials Physics, Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, 560-8531, Japan
| | - Y Motome
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan
| | - K Ishizaka
- Department of Applied Physics, The University of Tokyo, Tokyo, 113-8656, Japan.
- Quantum-Phase Electronics Center (QPEC), The University of Tokyo, Wako, 113-8656, Japan.
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan.
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46
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Sakano M, Hirayama M, Takahashi T, Akebi S, Nakayama M, Kuroda K, Taguchi K, Yoshikawa T, Miyamoto K, Okuda T, Ono K, Kumigashira H, Ideue T, Iwasa Y, Mitsuishi N, Ishizaka K, Shin S, Miyake T, Murakami S, Sasagawa T, Kondo T. Radial Spin Texture in Elemental Tellurium with Chiral Crystal Structure. Phys Rev Lett 2020; 124:136404. [PMID: 32302163 DOI: 10.1103/physrevlett.124.136404] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
The chiral crystal is characterized by a lack of mirror symmetry and inversion center, resulting in the inequivalent right- and left-handed structures. In the noncentrosymmetric crystal structure, the spin and momentum of electrons are expected to be locked in the reciprocal space with the help of the spin-orbit interaction. To reveal the spin textures of chiral crystals, we investigate the spin and electronic structure in a p-type semiconductor, elemental tellurium, with the simplest chiral structure by using spin- and angle-resolved photoemission spectroscopy. Our data demonstrate that the highest valence band crossing the Fermi level has a spin component parallel to the electron momentum around the Brillouin zone corners. Significantly, we have also confirmed that the spin polarization is reversed in the crystal with the opposite chirality. The results indicate that the spin textures of the right- and left-handed chiral crystals are hedgehoglike, leading to unconventional magnetoelectric effects and nonreciprocal phenomena.
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Affiliation(s)
- M Sakano
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
- Quantum-Phase Electronics Center (QPEC) and Department of Applied Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - M Hirayama
- Department of Physics, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8551, Japan
- Tokodai Institute for Element Strategy (TIES), Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8551, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Saitama 351-0198, Japan
| | - T Takahashi
- Materials and Structures Laboratory (MSL), Tokyo Institute of Technology, Yokohama, Kanagawa 226-8503, Japan
| | - S Akebi
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
| | - M Nakayama
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
| | - K Kuroda
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
| | - K Taguchi
- Graduate School of Science, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - T Yoshikawa
- Graduate School of Science, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center (HiSOR), Hiroshima University, Higashi-Hiroshima, Hiroshima 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center (HiSOR), Hiroshima University, Higashi-Hiroshima, Hiroshima 739-0046, Japan
| | - K Ono
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - H Kumigashira
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Institute of Multidisciplinary Research for Advanced Materials (IMRAM), Tohoku University, Sendai 980-8577, Japan
| | - T Ideue
- Quantum-Phase Electronics Center (QPEC) and Department of Applied Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Y Iwasa
- Quantum-Phase Electronics Center (QPEC) and Department of Applied Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Saitama 351-0198, Japan
| | - N Mitsuishi
- Quantum-Phase Electronics Center (QPEC) and Department of Applied Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - K Ishizaka
- Quantum-Phase Electronics Center (QPEC) and Department of Applied Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, Saitama 351-0198, Japan
| | - S Shin
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
| | - T Miyake
- Research Center for Computational Design of Advanced Functional Materials (CD-FMat), AIST, Tsukuba, Ibaraki 305-8568, Japan
| | - S Murakami
- Department of Physics, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8551, Japan
- Tokodai Institute for Element Strategy (TIES), Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8551, Japan
| | - T Sasagawa
- Materials and Structures Laboratory (MSL), Tokyo Institute of Technology, Yokohama, Kanagawa 226-8503, Japan
| | - Takeshi Kondo
- Institute for Solid State Physics (ISSP), The University of Tokyo, Kashiwa 277-8581, Japan
- AIST-UTokyo Advanced Operando-Measurement Technology Open Innovation Laboratory (OPERANDO-OIL), Kashiwa, Chiba 277-8581, Japan
- Trans-scale Quantum Science Institute, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
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Kai M, Miyamoto K, Akamatsu K, Tsujita A, Nishio M. Effect of a bundle-approach intervention against contamination of blood culture in the emergency department. J Infect Chemother 2020; 26:785-789. [PMID: 32249163 DOI: 10.1016/j.jiac.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/04/2020] [Accepted: 03/09/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND To prevent contamination when taking blood culture, there are various effective interventions. Whether there is greater efficacy by using a combination of these interventions has not been widely evaluated. METHODS Our six-element intervention bundle aimed to prevent contamination of blood culture in our emergency department (ED). Elements were: use of 1% chlorhexidine alcohol, alcohol wiping, hand hygiene, using sterile gloves, using holed sterile cover, and selection of upper extremities as the site of venipuncture. We compared the contamination rate of blood culture between the pre- and the post-intervention periods among all cases with two or more blood cultures taken in our ED. We also evaluated the rate of patients receiving vancomycin among all those transferred to the hospital from the ED. RESULTS During the pre- and post-intervention periods, 460 and 450 cases were included in analysis, respectively. Contamination of blood culture occurred in 29 pre-intervention cases (6.3%) and five post-interventional cases (1.1%) (relative risk 0.18, 95% confidence interval 0.07 to 0.45; P < 0.001). After bundle implementation, there was significant increase in adherence to using 1% chlorhexidine alcohol, alcohol wiping, hand hygiene, and using holed sterile covers. Among patients admitted to hospital, fewer patients received vancomycin during the post-intervention period than in the pre-intervention period (5.4% vs. 3.2%, P = 0.03). CONCLUSIONS Our intervention bundle dramatically reduced the contamination rate when drawing blood culture in our ED.
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Affiliation(s)
- Masato Kai
- Department of Nursing, Wakayama Medical University Hospital, Japan.
| | - Kyohei Miyamoto
- Department of Infection Prevention and Control, Wakayama Medical University Hospital, Japan; Department of Emergency and Critical Care Medicine, Wakayama Medical University, Japan.
| | - Keiichiro Akamatsu
- Department of Infection Prevention and Control, Wakayama Medical University Hospital, Japan; Third Department of Internal Medicine, Wakayama Medical University, Japan.
| | - Ai Tsujita
- Department of Infection Prevention and Control, Wakayama Medical University Hospital, Japan; Clinical Laboratory Department, Wakayama Medical University Hospital, Japan.
| | - Machiko Nishio
- Department of Infection Prevention and Control, Wakayama Medical University Hospital, Japan; Department of Microbiology, School of Medicine, Wakayama Medical University, Japan.
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48
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Yamamoto T, Mizobata Y, Kawazoe Y, Miyamoto K, Ohta Y, Morimoto T, Yamamura H. Incidence, risk factors, and outcomes for sepsis-associated delirium in patients with mechanical ventilation: A sub-analysis of a multicenter randomized controlled trial. J Crit Care 2020; 56:140-144. [DOI: 10.1016/j.jcrc.2019.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 11/28/2019] [Accepted: 12/20/2019] [Indexed: 11/25/2022]
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Yasuda H, Horibe M, Sanui M, Sasaki M, Suzuki N, Sawano H, Goto T, Ikeura T, Takeda T, Oda T, Ogura Y, Miyazaki D, Kitamura K, Chiba N, Ozaki T, Yamashita T, Koinuma T, Oshima T, Yamamoto T, Hirota M, Sato M, Miyamoto K, Mine T, Misumi T, Takeda Y, Iwasaki E, Kanai T, Mayumi T. Etiology and mortality in severe acute pancreatitis: A multicenter study in Japan. Pancreatology 2020; 20:307-317. [PMID: 32198057 DOI: 10.1016/j.pan.2020.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/20/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Severe acute pancreatitis (SAP) has a high mortality rate despite ongoing attempts to improve prognosis through a various therapeutic modalities. This study aimed to delineate etiology-based routes that may guide clinical decisions for the treatment of SAP. METHODS Using data from a recent retrospective multicenter study in Japan, we analyzed the association between clinical outcomes, mainly in-hospital mortality and pancreatic infection, and various etiologies while considering confounding factors. We performed additional multivariate analyses and built decision tree models. RESULTS The 1097 participating patients were classified into the following groups by etiology: alcohol (n = 436, 39.7%); cholelithiasis (n = 230, 21.0%); idiopathic (n = 227, 20.7%); and others (n = 204, 18.6%). Mortality at hospital discharge was 8.4%, 12.2%, 16.7%, and 16.2% in the alcohol, cholelithiasis, idiopathic, and others groups, respectively. According to multivariable analysis, early enteral nutrition (EN) was significantly associated with reduced in-hospital mortality only in the cholelithiasis group. However, there was a consistent association between age and the need for mechanical ventilation and increased mortality, regardless of etiology. Our decision tree models presented different contributing factors depending on the etiology and patient background. Interaction analysis showed that EN and the use of prophylactic antibiotics may influence these results differently according to etiology. CONCLUSIONS No study has yet used comprehensive models to investigate etiology-related prognostic factors for SAP; our results can, therefore, be used as a reference for improving clinical decisions.
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Affiliation(s)
- Hideto Yasuda
- Department of Intensive Care Medicine, Kameda Medical Center, 929, Higashi-chou, Kamogawa-shi, Chiba, Japan; Department of Clinical Research Education and Training Unit, Keio University Hospital Clinical and Translational Research Center (CTR), Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Masayasu Horibe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, Japan; Department of Gastroenterology and Hepatology, Tokyo Metropolitan Tama Medical Center, 2-8-29, Musashidai, Fuchu City, Tokyo, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku, Saitama, Japan.
| | - Mitsuhito Sasaki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Japan
| | - Naoya Suzuki
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Musashino Hospital, 1-26-1, Kyounancho, Musasino City, Tokyo, Japan
| | - Hirotaka Sawano
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, Japan
| | - Takashi Goto
- Department of Anesthesiology and Intensive Care, Hiroshima City Hiroshima Citizens Hospital, 7-33, Motomachi, Naka-ku, Hiroshima City, Hiroshima, Japan
| | - Tsukasa Ikeura
- Department of Gastroenterology and Hepatology, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, Osaka, Japan
| | - Tsuyoshi Takeda
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Takuya Oda
- Department of General Internal Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka-shi, Fukuoka, Japan
| | - Yuki Ogura
- Department of Gastroenterology and Hepatology, Tokyo Metropolitan Tama Medical Center, 2-8-29, Musashidai, Fuchu City, Tokyo, Japan
| | - Dai Miyazaki
- Advanced Emergency Medical and Critical Care Center, Japanese Redcross Maebashi Hospital, 3-21-36, Asahi-cho, Maebashi City, Gunma, Japan; Department of Medicine, Harima Rehabiritation Program Center, 675-1297, 544 Sousa, Yahata-chou, Kakogawa-city, Hyogo, Japan
| | - Katsuya Kitamura
- Department of Gastroenterology and Hepatology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, Japan; Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Nobutaka Chiba
- Department of Emergency and Critical Care Medicine, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo, Japan
| | - Tetsu Ozaki
- Department of Acute Care and General Medicine, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Minami-ku, Kumamoto City, Kumamoto, Japan
| | - Takahiro Yamashita
- Emergency Medical Center, Fukuyama City Hospital, 5-23-1, Zaocho, Fukuyama City, Hiroshima, Japan; Acute Care Medical Center, Hyogo Prefectural Kakogawa Medical Center, 203 Kanno, Kanno-cho, Kakogawa City, Hyogo, Japan
| | - Toshitaka Koinuma
- Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - Taku Oshima
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba, Japan
| | - Tomonori Yamamoto
- Department of Traumatology and Critical Care Medicine, Osaka City University, Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka City, Osaka, Japan
| | - Morihisa Hirota
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, Japan
| | - Mizuki Sato
- Department of Critical Care and Emergency Medicine, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki City, Okayama, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama-City, Wakayama, Japan
| | - Tetsuya Mine
- Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Takuyo Misumi
- Department of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Japan
| | - Yuki Takeda
- Internal Medicine (Gastroenterology), Tokyo Rosai Hospital, 4-13-21, Ohmori-Minami, Ohta-ku, Tokyo, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Toshihiko Mayumi
- Department of Emergency Medicine, School of Medicine University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahata Nishi, KitaKyushu, Fukuoka, Japan
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Nakashima T, Kawazoe Y, Iseri T, Miyamoto K, Fujimoto Y, Kato S. The effect of positive-end-expiratory pressure on stroke volume variation: An experimental study in dogs. Clin Exp Pharmacol Physiol 2020; 47:1014-1019. [PMID: 31984534 DOI: 10.1111/1440-1681.13262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 01/10/2023]
Abstract
Stroke volume variation (SVV) may be affected by ventilation settings. However, it is unclear whether positive-end-expiratory pressure (PEEP) affects SVV independently of the effect of driving pressure. We aimed to investigate the effect of driving pressure and PEEP on SVV under various preload conditions using beagle dogs as the animal model. We prepared three preload model, baseline, mild and moderate haemorrhage model. Mild and moderate haemorrhage models were created in nine anaesthetized, mechanically ventilated dogs by sequentially removing 10 mL/kg, and then an additional 10 mL/kg of blood, respectively. We measured cardiac output, stroke volume (SV), SVV, heart rate, central venous pressure, pulmonary capillary wedge pressure and the mean arterial pressure under varying ventilation settings. Peak inspiratory pressure (PIP) was incrementally increased by 4 cmH2 O, from 9 cmH2 O to 21 cmH2 O, under PEEP values of 4, 8, and 12 cmH2 O. The driving pressure did not significantly decrease SV under each preload condition and PEEP; however, significantly increased SVV. In contrast, the increased PEEP decreased SV and increased SVV under each preload condition and driving pressure, but these associations were not statistically significant. According to multiple regression analysis, an increase in PEEP and decrease in preload significantly decreased SV (P < .05). In addition, an increase in the driving pressure and decrease in preload significantly increased SVV (P < .05). Driving pressure had more influence than PEEP on SVV.
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Affiliation(s)
- Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Japan
| | - Yu Kawazoe
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshie Iseri
- Department of Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi City, Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Japan
| | - Yuka Fujimoto
- Veterinary Science, Osaka Prefecture University, Izumisano City, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Japan
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