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Article ; Online: Chronicles of change for the future: The imperative of continued data collection in French ICUs.

Tagami, Takashi

Anaesthesia, critical care & pain medicine

2023 Volume 42, Issue 5, Page(s) 101294

MeSH term(s)	Humans ; Surveys and Questionnaires ; Intensive Care Units
Language	English
Publishing date	2023-09-07
Publishing country	France
Document type	Editorial ; Comment
ISSN	2352-5568
ISSN (online)	2352-5568
DOI	10.1016/j.accpm.2023.101294
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Venous Congestive Ischemic Colitis After Sigmoid Colectomy: A Case Report.

Ishimaru, Naoki / Tagami, Takashi / Takayasu, Kohei

Cureus

2024 Volume 16, Issue 2, Page(s) e53880

Abstract: Venous congestion is a possible cause of ischemic colitis following colorectal surgery. As such, congestive ischemic colitis should be considered in such cases where the mesenteric artery is preserved. Herein, we describe the case of a 73-year-old man ... ...

Abstract	Venous congestion is a possible cause of ischemic colitis following colorectal surgery. As such, congestive ischemic colitis should be considered in such cases where the mesenteric artery is preserved. Herein, we describe the case of a 73-year-old man who presented to the hospital with a two-week history of difficult defecation and frequent mucous stools and was subsequently diagnosed with refractory ischemic enterocolitis due to venous congestion. The patient had undergone resection of the sigmoid colon cancer with preservation of the inferior mesenteric artery 11 months before presentation. Contrast-enhanced abdominal computed tomography revealed edematous wall thickening on the anal side of the anastomosis. A colonoscopy revealed a normal mucosa extending from the anastomosis to the descending colon; however, mucosal swelling, erythema, and erosion were observed on the rectal side of the anastomosis. Based on these findings, he was diagnosed with ischemic colitis. After two months of ineffective conservative treatment, the patient underwent surgery. Ischemic colitis was diagnosed as venous congestion based on the histopathological examination. Preservation of the mesenteric artery may result in ischemic colitis due to an imbalance between the arterial and venous blood flow. Chronic ischemic colitis due to venous congestion should be considered in cases of mesenteric artery preservation to reduce anastomotic leakage.
Language	English
Publishing date	2024-02-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.53880
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Article ; Online: Changes of practice on out of hospital cardiopulmonary arrest during the COVID-19 pandemic: a cross-sectional survey of SOS-KANTO 2017 study.

Kitamura, Nobuya / Tagami, Takashi / Takeda, Munekazu / Shinozaki, Koichiro

Annals of clinical epidemiology

2023 Volume 6, Issue 1, Page(s) 12–16

Language	English
Publishing date	2023-11-10
Publishing country	Japan
Document type	Journal Article
ISSN	2434-4338
ISSN (online)	2434-4338
DOI	10.37737/ace.24003
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Article ; Online: Evaluation of clinical response to empirical antimicrobial therapy on day 7 and mortality in the intensive care unit: sub-analysis of the DIANA study Japanese data.

Tanaka, Chie / Tagami, Takashi / Kuno, Masamune / Unemoto, Kyoko

Acute medicine & surgery

2023 Volume 10, Issue 1, Page(s) e842

Abstract: It is not clear whether evaluating the clinical response to antibiotic use at day 7 among critically ill patients accurately predicts outcomes. We aimed to evaluate the relationship between clinical response to the initial empiric therapy on day 7 and ... ...

Abstract	It is not clear whether evaluating the clinical response to antibiotic use at day 7 among critically ill patients accurately predicts outcomes. We aimed to evaluate the relationship between clinical response to the initial empiric therapy on day 7 and mortality. Methods: The determinants of antimicrobial use and de-escalation in critical care (DIANA) study was an international, multicenter, observational study on antibiotic use in the intensive care unit (ICU). ICU patients ages over 18 years in whom an empiric antimicrobial regimen in Japan was initiated were included. We compared patients who were evaluated as cured or improved ("effective") 7 days after starting antibiotic treatment with patients who were evaluated as deteriorated ("failure"). Results: Overall, 217 (83%) patients were in the effective group, and 45 (17%) were in the failure group. Both the infection-related mortality rate in the ICU and the in-hospital infection-related mortality rate in the effective group were lower than those in the failure group (0% versus 24.4%; Conclusion: Assessment of efficacy of empiric antimicrobial treatment on day 7 may predict a favorable outcome among patients suffering from infection in the ICU.
Language	English
Publishing date	2023-05-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2751184-4
ISSN	2052-8817 ; 2052-8817
ISSN (online)	2052-8817
ISSN	2052-8817
DOI	10.1002/ams2.842
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Article ; Online: Pumping infusions with a syringe may cause contamination of the fluid in the syringe.

Kawakami, Yutaka / Tagami, Takashi

Scientific reports

2021 Volume 11, Issue 1, Page(s) 15421

Abstract: Clinicians often perform pumping of infusions with a syringe (PIS) to quickly deliver fluid or blood transfusion to patients, especially during an emergency. Despite the efforts of the clinicians, critically ill patients are prone to acquire catheter- ... ...

Abstract	Clinicians often perform pumping of infusions with a syringe (PIS) to quickly deliver fluid or blood transfusion to patients, especially during an emergency. Despite the efforts of the clinicians, critically ill patients are prone to acquire catheter-related bloodstream infections. Although clinicians have reported the possibility of PIS contamination, no group of researchers has studied nor confirmed this possibility. Here, we examined whether PIS can cause bacterial contamination of the fluid inside the syringes, using microbiological tests, including the analysis Escherichia coli DH-5 alpha growth by measuring the absorbance at OD
MeSH term(s)	Anti-Infective Agents, Local/pharmacology ; Bacteriological Techniques ; Catheter-Related Infections/microbiology ; Catheter-Related Infections/prevention & control ; Disinfection/methods ; Disposable Equipment/microbiology ; Drug Delivery Systems/methods ; Equipment Contamination/prevention & control ; Escherichia coli/drug effects ; Escherichia coli/growth & development ; Escherichia coli Infections/microbiology ; Escherichia coli Infections/prevention & control ; Ethanol/pharmacology ; Gloves, Surgical/microbiology ; Hand/microbiology ; Hand Disinfection/methods ; Humans ; Infusion Pumps ; Syringes/microbiology
Chemical Substances	Anti-Infective Agents, Local ; Ethanol (3K9958V90M)
Language	English
Publishing date	2021-07-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-94740-1
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Article ; Online: Performance of a large language model on Japanese emergency medicine board certification examinations.

Igarashi, Yutaka / Nakahara, Kyoichi / Norii, Tatsuya / Miyake, Nodoka / Tagami, Takashi / Yokobori, Shoji

Journal of Nippon Medical School = Nippon Ika Daigaku zasshi

2024

Abstract: Background Emergency physicians need a broad range of knowledge and skills to address critical medical, traumatic, and environmental conditions. Artificial intelligence (AI), including large language models (LLMs), has potential applications in ... ...

Abstract	Background Emergency physicians need a broad range of knowledge and skills to address critical medical, traumatic, and environmental conditions. Artificial intelligence (AI), including large language models (LLMs), has potential applications in healthcare settings; however, the performance of LLMs in emergency medicine remains unclear.Methods To evaluate the reliability of information provided by ChatGPT, an LLM was given the questions set by the Japanese Association of Acute Medicine in its board certification examinations over a period of 5 years (2018-2022) and programmed to answer them twice. Statistical analysis was used to assess agreement of the two responses.Results The LLM successfully answered 465 of the 475 text-based questions, achieving an overall correct response rate of 62.3%. For questions without images, the rate of correct answers was 65.9%. For questions with images that were not explained to the LLM, the rate of correct answers was only 52.0%. The annual rates of correct answers to questions without images ranged from 56.3% to 78.8%. Accuracy was better for scenario-based questions (69.1%) than for stand-alone questions (62.1%). Agreement between the two responses was substantial (kappa = 0.70). Factual error accounted for 82% of the incorrectly answered questions.Conclusion An LLM performed satisfactorily on an emergency medicine board certification examination in Japanese and without images. However, factual errors in the responses highlight the need for physician oversight when using LLMs.
Language	English
Publishing date	2024-03-02
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2091563-9
ISSN	1347-3409 ; 1345-4676
ISSN (online)	1347-3409
ISSN	1345-4676
DOI	10.1272/jnms.JNMS.2024_91-205
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Article ; Online: Risk factors for the need for advanced care among prescription and over-the-counter drug overdose patients.

Tanaka, Chie / Tagami, Takashi / Nagano, Makihiko / Nakayama, Fumihiko / Kaneko, Junya / Kuno, Masamune

Acute medicine & surgery

2024 Volume 11, Issue 1, Page(s) e942

Abstract: Aim: Prescription drug and over-the-counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced ... ...

Abstract	Aim: Prescription drug and over-the-counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care among overdose patients. Methods: This was a single-center retrospective cohort study. We included overdoses patients of prescription drugs or OTC drugs, who admitted to our hospital between 2016 and 2021. We grouped them into advanced care and non-advanced care. The main outcome was the need for advanced care. We performed a multiple logistic regression analysis, calculated the PAV score ( Results: There were 229 subjects. The logistic regression analysis revealed that alcohol, paracetamol, and the abnormal vital signs on scene were associated with advanced care (alcohol-odds ratio [OR]: 2.95; 95% confidence interval [CI]: 1.29-6.75; paracetamol-OR: 5.47; 95% CI: 2.18-13.71; abnormal vital signs-OR: 4.61, 95% CI: 2.07-10.27). The rate of advanced care in the high PAV score (2 and 3) group was statistically higher than that in the low PAV score (0-1) group ( Conclusion: Alcohol, paracetamol use and abnormal vital signs on scene might be risk factors for advanced care among prescription drugs or OTC drugs overdose patients, and the PAV score may predict the need for advanced care.
Language	English
Publishing date	2024-03-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2751184-4
ISSN	2052-8817 ; 2052-8817
ISSN (online)	2052-8817
ISSN	2052-8817
DOI	10.1002/ams2.942
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Article ; Online: Evaluating the impact of ELSO guideline adherence on favorable neurological outcomes among patients requiring extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest.

Kawauchi, Akira / Okada, Yohei / Aoki, Makoto / Ogasawara, Tomoko / Tagami, Takashi / Kitamura, Nobuya / Nakamura, Mitsunobu

Resuscitation

2024 , Page(s) 110218

Abstract: Aim: Selecting the appropriate candidates for extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) is challenging. Previously, the Extracorporeal Life Support Organization (ELSO) guidelines suggested the example ... ...

Abstract	Aim: Selecting the appropriate candidates for extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) is challenging. Previously, the Extracorporeal Life Support Organization (ELSO) guidelines suggested the example of inclusion criteria. However, it is unclear whether patients who meet the inclusion criteria of the ELSO guidelines have more favorable outcomes. We aimed to evaluate the relationship between the outcomes and select inclusion criteria of the ELSO guidelines. Methods: We conducted a post-hoc analysis of a multicenter prospective study conducted between 2019 and 2021. Adult patients with OHCA treated with ECPR were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days. An ELSO criteria score was assigned based on four criteria: (i) age < 70 years; (ii) witness; (iii) bystander CPR; and (iv) low-flow time (< 60 min). Subgroup analysis based on initial cardiac rhythm was performed. Results: Among 9,909 patients, 227 with OHCA were included. The proportion of favorable neurological outcomes according to the number of ELSO criteria met were: 0.0% (0/3), 0 points; 0.0% (0/23), 1 point; 3.0% (2/67), 2 points; 7.3% (6/82), 3 points; and 16.3% (7/43), 4 points. A similar tendency was observed in patients with an initial shockable rhythm. However, no such relationship was observed in those with an initial non-shockable rhythm. Conclusion: Patients who adhered more closely to specific inclusion criteria of the ELSO guidelines demonstrated a tendency towards a higher rate of favorable neurological outcomes. However, the relationship was heterogeneous according to initial rhythm.
Language	English
Publishing date	2024-04-20
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2024.110218
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Article ; Online: Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial.

Kosaki, Yoshinori / Hongo, Takashi / Hayakawa, Mineji / Kudo, Daisuke / Kushimoto, Shigeki / Tagami, Takashi / Naito, Hiromichi / Nakao, Atsunori / Yumoto, Tetsuya

World journal of emergency surgery : WJES

2024 Volume 19, Issue 1, Page(s) 1

Abstract: Background: The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion ... ...

Abstract	Background: The appropriateness of a restrictive transfusion strategy for those with active bleeding after traumatic injury remains uncertain. Given the association between tissue hypoxia and lactate levels, we hypothesized that the optimal transfusion strategy may differ based on lactate levels. This post hoc analysis of the RESTRIC trial sought to investigate the association between transfusion strategies and patient outcomes based on initial lactate levels. Methods: We performed a post hoc analysis of the RESTRIC trial, a cluster-randomized, crossover, non-inferiority multicenter trials, comparing a restrictive and liberal red blood cell transfusion strategy for adult trauma patients at risk of major bleeding. This was conducted during the initial phase of trauma resuscitation; from emergency department arrival up to 7 days after hospital admission or intensive care unit (ICU) discharge. Patients were grouped by lactate levels at emergency department arrival: low (< 2.5 mmol/L), middle (≥ 2.5 and < 4.0 mmol/L), and high (≥ 4.0 mmol/L). We compared 28 days mortality and ICU-free and ventilator-free days using multiple linear regression among groups. Results: Of the 422 RESTRIC trial participants, 396 were analyzed, with low (n = 131), middle (n = 113), and high (n = 152) lactate. Across all lactate groups, 28 days mortality was similar between strategies. However, in the low lactate group, the restrictive approach correlated with more ICU-free (β coefficient 3.16; 95% CI 0.45 to 5.86) and ventilator-free days (β coefficient 2.72; 95% CI 0.18 to 5.26) compared to the liberal strategy. These findings persisted even after excluding patients with severe traumatic brain injury. Conclusions: Our results suggest that restrictive transfusion strategy might not have a significant impact on 28-day survival rates, regardless of lactate levels. However, the liberal transfusion strategy may lead to shorter ICU- and ventilator-free days for patients with low initial blood lactate levels.
MeSH term(s)	Adult ; Humans ; Erythrocyte Transfusion/adverse effects ; Erythrocyte Transfusion/methods ; Blood Transfusion ; Hospitalization ; Intensive Care Units ; Lactic Acid
Chemical Substances	Lactic Acid (33X04XA5AT)
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2233734-9
ISSN	1749-7922 ; 1749-7922
ISSN (online)	1749-7922
ISSN	1749-7922
DOI	10.1186/s13017-023-00530-7
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Article ; Online: Pumping infusions with a syringe may cause contamination of the fluid in the syringe

Yutaka Kawakami / Takashi Tagami

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Clinicians often perform pumping of infusions with a syringe (PIS) to quickly deliver fluid or blood transfusion to patients, especially during an emergency. Despite the efforts of the clinicians, critically ill patients are prone to acquire ... ...

Abstract	Abstract Clinicians often perform pumping of infusions with a syringe (PIS) to quickly deliver fluid or blood transfusion to patients, especially during an emergency. Despite the efforts of the clinicians, critically ill patients are prone to acquire catheter-related bloodstream infections. Although clinicians have reported the possibility of PIS contamination, no group of researchers has studied nor confirmed this possibility. Here, we examined whether PIS can cause bacterial contamination of the fluid inside the syringes, using microbiological tests, including the analysis Escherichia coli DH-5 alpha growth by measuring the absorbance at OD600. We confirmed that contamination of fluid in the barrel was almost proportional to the applied volume of bacterial fluid. Aliquots of DH-5 alpha artificially applied on the surface of the gloved hand of an examiner, the plunger or the inner side of the barrel of a syringe could permeate inside the syringe. Furthermore, disinfection with ethanol before PIS almost successfully prevented bacterial multiplication. Our findings suggest that PIS can cause intraluminal contamination when performed with unsterilized hands, and that previous disinfection with ethanol can effectively prevent PIS-induced contamination. These results highlight the risk of PIS-induced contamination and the importance of disinfection in the daily clinical practice.
Keywords	Medicine ; R ; Science ; Q
Subject code	532
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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