JA Clinical Reports最新文献

{"title":"Hypermagnesemia caused by fecal-mass obstruction in stenotic rectal cancer following preoperative administration of magnesium citrate.","authors":"Yuri Sato, Eiji Hashiba, Yuuma Yamazaki, Koudai Kato, Hirotaka Kinoshita, Satoko Noguchi, Tomoyuki Kudo, Kazuyoshi Hirota","doi":"10.1186/s40981-024-00759-4","DOIUrl":"10.1186/s40981-024-00759-4","url":null,"abstract":"<p><strong>Background: </strong>Hypermagnesemia is a rare complication, leading to fatal cardiovascular and respiratory conditions. We present severe hypermagnesemia developed in a patient with a rectal stenosis after pretreatment with oral magnesium citrate for rectosigmoid surgery.</p><p><strong>Case presentation: </strong>A 78-year-old woman demonstrated consciousness disturbance, muscle weakness, and respiratory depression requiring tracheal intubation after preparation with oral magnesium for rectosigmoid surgery. Endoscopic examination showed a rectal obstruction due to fecal impaction. General condition improved after emergency Hartmann's surgery. Blood test revealed a remarkable increase of serum magnesium level to 17.5 mg/dL when the general condition deteriorated, which would have been responsible for her symptoms. She was discharged from the ICU after extubation on the third postoperative day with a normal magnesium level.</p><p><strong>Conclusions: </strong>Pretreatment with large doses of oral magnesium-containing bowel cleanser may cause severe hypermagnesemia in patients with colorectal stenosis.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"77"},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma.","authors":"Takehito Sato, Shigeru Inoue, Ichiko Asano, Takahiro Ando, Yasuyuki Shibata","doi":"10.1186/s40981-024-00760-x","DOIUrl":"10.1186/s40981-024-00760-x","url":null,"abstract":"<p><strong>Background: </strong>Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved voiding function.</p><p><strong>Case presentation: </strong>A 45-year-old woman with multiple metastases of malignant pheochromocytoma suffered severe anal pain that worsened, especially when sitting, and was unresponsive to opioid rescue therapy. With her NRS score of 9, a sacral epidural catheter was placed, and a continuous infusion of 2% lidocaine was administered overnight. This is followed by a 1.5mL bolus of ethanol and continuous ethanol administration at 2 mL/h. After administration, her anal pain decreased to approximately NRS 0-1, and she was subsequently discharged.</p><p><strong>Conclusion: </strong>We report successful pain control using continuous sacral epidural ethanol injection therapy in a patient with anal pain due to malignant pheochromocytoma metastasis.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"75"},"PeriodicalIF":0.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of factors related to anesthetic management affecting acute kidney injury occurring within 72 h after esophagectomy for esophageal cancer: a historical cohort study.","authors":"Seiji Ishikawa, Junko Hirashima, Makiko Hiroyama, Shojiro Ozato, Masayuki Watanabe, Katsuyuki Terajima","doi":"10.1186/s40981-024-00756-7","DOIUrl":"10.1186/s40981-024-00756-7","url":null,"abstract":"<p><strong>Background: </strong>The effects of factors related to anesthetic management, including anesthesia methods and infusion volume, on acute kidney injury (AKI) after esophagectomy have not been thoroughly investigated.</p><p><strong>Methods: </strong>A historical cohort study of patients who underwent esophagectomy between January 2008 and December 2022 was conducted. AKI was defined according to the Kidney Disease Improving Global Outcomes creatinine criteria within 72 h after esophagectomy. Logistic regression was used to model the association between perioperative factors, including factors related to anesthetic management, and postoperative AKI.</p><p><strong>Results: </strong>Of 1005 patients, 48 patients (4.8%) had AKI (40 stage 1 and 8 stage 2). AKI patients were older (67.8 vs. 65.0 years, P = 0.046) and more likely to have hypertension (72.9 vs. 37.9%, P < 0.001), chronic kidney disease (39.6 vs. 14.3%, P < 0.0001), red blood cell (RBC) transfusions (12.5 vs. 3.4%, P = 0.0085), and longer duration of anesthesia (518 vs. 490 min, P = 0.0058) than non-AKI patients. AKI patients were less likely to have epidural anesthesia (72.9 vs. 91.5%, P < 0.001). The distribution of inhaled anesthetics chosen was not significantly different between AKI and non-AKI patients. On multivariable logistic regression analysis, AKI was associated with the Brinkman index (per 100 units, odds ratio (OR) = 1.06), hypertension (OR = 3.39), chronic kidney disease (OR = 2.58), duration of anesthesia (per 10 min, OR = 1.03), epidural anesthesia (OR = 0.35) and RBC transfusion (OR = 3.27).</p><p><strong>Conclusions: </strong>Except for epidural anesthesia, no significant association was found between AKI and factors related to anesthetic management. Epidural anesthesia may protect against early postoperative AKI in patients undergoing esophagectomy.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"74"},"PeriodicalIF":0.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae.","authors":"Hayato Arime, Takashi Asai, Asuka Fujishiro, Tomoyuki Saito","doi":"10.1186/s40981-024-00757-6","DOIUrl":"10.1186/s40981-024-00757-6","url":null,"abstract":"<p><strong>Background: </strong>Anesthetic management of a patient with multiple giant bullae is generally difficult due to an increased risk of respiratory complications, and there is no consensus regarding safe extubation methods. We report a case of an effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae, in whom a double-lumen bronchial tube was being used during anesthesia.</p><p><strong>Case presentation: </strong>A 52-year-old man with multiple giant bullae underwent video-assisted pulmonary resections, while the ventilation was controlled via a double-lumen bronchial tube. After successful thoracoscopic surgery, an i-gel™ was inserted while the double-lumen tube was still in place, and the double-lumen tube was subsequently removed under deep anesthesia. The i-gel™ was removed without complications after the patient had become able to respond to verbal command.</p><p><strong>Conclusion: </strong>We believe that this method would minimize the risk of trauma to the respiratory system during emergence from anesthesia in patients with multiple giant bullae.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"73"},"PeriodicalIF":0.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Postoperative hyperammonemic encephalopathy due to unexpected constipation in a patient with hyperornithinemia-hyperammonemia-homocitrullinuria syndrome: a case report.","authors":"Haruka Tachibana, Nobuhiko Ohashi, Gaku Okumura, Ryusuke Tanaka, Satoshi Fuseya, Sayako Gotoh, Takashi Ishida, Sari Shimizu, Mikito Kawamata, Satoshi Tanaka","doi":"10.1186/s40981-024-00753-w","DOIUrl":"10.1186/s40981-024-00753-w","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"72"},"PeriodicalIF":0.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of endotracheal tube cuff leakage with no detectable decrease in cuff pressure.","authors":"Keiichi Nagasawa, Masayuki Nishibata, Sarah Kyuragi Luthe, Tomoyuki Kawamata","doi":"10.1186/s40981-024-00754-9","DOIUrl":"10.1186/s40981-024-00754-9","url":null,"abstract":"<p><strong>Background: </strong>Common causes of air leakage around an endotracheal tube include insufficient endotracheal tube cuff inflation and damage to the cuff, while damage to the pilot balloon or pilot balloon tubing is relatively rare.</p><p><strong>Case presentation: </strong>A 74-year-old female with vertebral osteomyelitis was scheduled for an extreme lateral interbody fusion followed posterior fixation. A fiber-optic light was utilized as part of the surgical illuminator. A sudden decrease in tidal volume and airway pressure was noted intraoperatively. We suspected leakage around the endotracheal tube cuff; however, no decrease in cuff pressure was detected. Despite the normal cuff pressure, we decided to inject a small amount of air which led to a significant increase in the cuff pressure. Upon careful inspection of the endotracheal tube, we discovered that the pilot balloon tubing was damaged as a result of thermal energy emitted by the fiber-optic light, which had ignited the surgical drape. The pilot balloon tubing was partially severed in which the section proximal to the endotracheal tube cuff was burned and punctured, causing the cuff leak. Meanwhile, the section proximal to the pilot balloon had melted and occluded the lumen, resulting in a falsely normal cuff pressure reading followed by an elevated cuff pressure when a small amount of air was injected into the pilot balloon during troubleshooting. Appropriate ventilation was resumed after extubation and re-intubation with a new endotracheal tube.</p><p><strong>Conclusions: </strong>We experienced an endotracheal tube cuff leakage caused by a damaged pilot balloon tubing due to thermal energy of the fiber-optic light. Our case report emphasizes the importance of suspecting damage to the endotracheal tube cuff and inflation system despite a normal cuff pressure reading, given that the measurement may be falsely elevated depending on the specific location of the damage. In addition, all operating personnel should be familiarized with safety warnings and cautions related to handling.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"71"},"PeriodicalIF":0.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with postoperative shivering in patients with maintained core temperature after surgery.","authors":"Kazuhiro Shirozu, Masako Asada, Ryotaro Shiraki, Takuma Hashimoto, Ken Yamaura","doi":"10.1186/s40981-024-00755-8","DOIUrl":"10.1186/s40981-024-00755-8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative shivering is mainly associated with low body temperature. However, postoperative shivering can develop even at normal or high core temperatures. This study aimed to investigate the factors associated with postoperative shivering in patients with maintained core temperature after surgery.</p><p><strong>Methods: </strong>This retrospective study involved 537 patients who had undergone radical surgery for pancreatic cancer under general anesthesia from January 2013 to December 2023. The final analysis included 441 patients whose core temperatures after surgery were ≥ 36.5℃. Logistic regression analysis was performed to estimate the odds ratio (OR) of the incidence of postoperative shivering.</p><p><strong>Results: </strong>Postoperative shivering occurred in 119 patients. After multivariable-adjusted logistic regression, postoperative shivering was significantly associated with patient age (per 1 year increase; OR = 0.98; 95% confidence interval [CI]: 0.96-0.996; p = 0.02), operation time (per 30 min increase; OR = 1.10; 95% CI: 1.01-1.19; p = 0.03), postoperative core temperature (restricted cubic spline, p = 0.001), postoperative peripheral temperature (restricted cubic spline, p = 0.001), effect site fentanyl concentration at extubation (OR = 0.66; 95% CI: 0.24-0.99; p = 0.049), and acetaminophen use (OR = 0.32; 95% CI: 0.18-0.58; p < 0.001).</p><p><strong>Conclusions: </strong>Low peripheral temperature was a risk factor for the occurrence of shivering, even if the core temperature was maintained postoperatively. Peripheral temperature monitoring could be utilized to prevent postoperative shivering. In addition, fentanyl and acetaminophen reduced the occurrence of shivering in patients with maintained core temperature after surgery.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"70"},"PeriodicalIF":0.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical landmark-guided compartment block in pediatric lateral thoracotomy: implications for the vertebral arch surface.","authors":"Tomohiro Yamamoto, Marian Mikus","doi":"10.1186/s40981-024-00751-y","DOIUrl":"10.1186/s40981-024-00751-y","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"68"},"PeriodicalIF":0.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate use of inhaled nitric oxide in line with sustainable development goals.","authors":"Keisuke Yoshida, Fumika Kawamata, Takayuki Hasegawa, Taichi Shiraishi, Satoki Inoue","doi":"10.1186/s40981-024-00752-x","DOIUrl":"10.1186/s40981-024-00752-x","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"69"},"PeriodicalIF":0.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management of anaphylactic shock prior to elective cesarean delivery: a case report.","authors":"Kaede Watanabe, Nazuha Mohd Najid, Yusuke Mazda","doi":"10.1186/s40981-024-00750-z","DOIUrl":"10.1186/s40981-024-00750-z","url":null,"abstract":"<p><strong>Background: </strong>Anaphylactic cardiovascular collapse is complicated by aortocaval compression during pregnancy, exacerbated by neuraxial anesthesia. Despite recommendations to administer perioperative antibiotics before anesthesia, common practice in Japan involves administering them after anesthesia induction. We report a case of possible antibiotics-induced anaphylaxis just before anesthesia for cesarean delivery.</p><p><strong>Case presentation: </strong>A 24-year-old woman at 37 weeks of gestation presented for a scheduled repeat cesarean under spinal anesthesia. After starting administration of cefazolin prior to anesthesia, she developed anaphylactic symptoms. Hypotension refractory to adrenaline necessitated conversion to an emergency cesarean section under general anesthesia. A neonate was delivered with favorable Apgar scores. Post-delivery, the mother's hemodynamics stabilized significantly. Elevated plasma tryptase confirmed anaphylaxis. Both mother and infant were discharged without further complications.</p><p><strong>Conclusions: </strong>This case emphasizes the importance of administering prophylactic antibiotic before anesthesia in mitigating severity of shock induced by anaphylaxis and the crucial role of prompt emergency cesarean in achieving successful outcomes.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"67"},"PeriodicalIF":0.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}