JA Clinical Reports最新文献

{"title":"Unexpected difficult airway management and usefulness of high-flow nasal oxygenation for awake fiberoptic tracheal intubation: a case report.","authors":"Takero Arai, Ryosuke Osawa, Takashi Asai","doi":"10.1186/s40981-026-00850-y","DOIUrl":"10.1186/s40981-026-00850-y","url":null,"abstract":"<p><p>BACKGROUND: Unexpected difficult airway management, although rare, may occur after induction of anesthesia. In such cases, appropriate airway management is required to prevent life-threatening hypoxia. CASE PRESENTATION: In a 44-year-old woman without predicted difficult airway, after induction of general anesthesia, repeated attempts at tracheal intubation using videolaryngoscopes had failed, and ventilation using both a facemask and a supraglottic airway became difficult; the patient was awakened and the surgery cancelled. One week later, awake nasotracheal intubation using a flexible bronchoscope was attempted under high-flow nasal oxygenation. A clear view of the glottis was obtained by bronchoscopy and the trachea was intubated successfully without hypoxia. CONCLUSIONS: In patients with unexpected difficult airway management, appropriate airway management (including awakening the patient) is required to prevent life-threatening hypoxia. High-flow nasal oxygenation would be useful for awake fiberoptic intubation, by providing a clear view of the glottis and by preventing hypoxia. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131687","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":"Tracheal agenesis diagnosed by supraglottic airway-assisted endoscopic evaluation during neonatal resuscitation: a case report.","authors":"Erika Miyazaki, Kentaro Yamakawa, Marie Kusumoto, Yoshie Taniguchi, Shoichi Uezono","doi":"10.1186/s40981-026-00852-w","DOIUrl":"10.1186/s40981-026-00852-w","url":null,"abstract":"<p><p>BACKGROUND: Tracheal agenesis is an exceptionally rare and typically lethal congenital airway anomaly presenting with failed intubation. We report a case of unrecognized tracheal agenesis in which supraglottic airway-assisted ventilation enabled concurrent fiberoptic endoscopic evaluation during neonatal resuscitation. CASE PRESENTATION: A preterm male neonate born at 31 weeks and 1 day of gestation with polyhydramnios and suspected duodenal atresia developed severe respiratory failure immediately after delivery. Repeated attempts at tracheal intubation were unsuccessful despite vocal cord–like structures being seen. Placement of a size 0.5 supraglottic airway (Air-Q®) resulted in transient partial ventilation with intermittent colorimetric carbon dioxide detection, permitting fiberoptic endoscopic evaluation. Endoscopy demonstrated a blind-ending subglottic pouch and a distal tracheoesophageal fistula, strongly suggesting tracheal agenesis; computed tomography subsequently confirmed the diagnosis of Floyd type II tracheal agenesis. CONCLUSIONS: Early supraglottic airway-assisted endoscopic evaluation may facilitate rapid recognition of tracheal agenesis during neonatal resuscitation and support timely, multidisciplinary decision-making after failed intubation. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124884","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":"Delayed emergence with remimazolam after laparoscopic subsegmental hepatectomy including the intermittent pringle maneuver in a patient with preserved liver function.","authors":"Reina Miyazaki, Satoru Sekiya, Hiromu Okano, Shunsaku Goto, Hiroshi Okamoto","doi":"10.1186/s40981-026-00847-7","DOIUrl":"10.1186/s40981-026-00847-7","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"12 1","pages":"12"},"PeriodicalIF":1.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12873038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118537","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":"Laterality of injectate spread in bilateral ultrasound-guided thoracic paravertebral block: a pilot cadaveric study.","authors":"Asako Nitta, Atsushi Sawada, Sho Kumita, Yuki Ohsaki, Michiaki Yamakage","doi":"10.1186/s40981-026-00849-5","DOIUrl":"10.1186/s40981-026-00849-5","url":null,"abstract":"<p><p>BACKGROUND: Although thoracic paravertebral block (TPVB) is an established regional analgesia technique in thoracic surgery, the extent of injectate spread is variable. Furthermore, while it is known that a larger capacity exists in the left thoracic paravertebral space (TPVS) compared with the right due to mediastinal asymmetry, it remains unclear whether this characteristic translates to functional differences in injectate spread. METHODS: We performed bilateral TPVB in twelve Thiel-embalmed cadavers using an intercostal approach—six were placed in the left lateral decubitus position and six in the right lateral decubitus position. To control for positional bias, 20 mL of dye was administered to both the upper and lower sides while maintaining the same position. The numbers of stained vertebral segmental TPVSs and intercostal spaces (ICSs) were compared between the left and right sides. RESULTS: TPVB performed on the left side demonstrated significantly more stained segments (median [interquartile range]) than that performed on the right side (TPVS: 4.0 [3.0–5.0] vs. 2.0 [1.0–3.0], p = 0.01; ICS: 4.0 [3.0–5.0] vs. 3.0 [2.0–4.0], p = 0.04). This tendency remained consistent regardless of the injection side (upper or lower). In addition, we consistently observed extensive dye distribution when the parietal pleura medial to the transverse process was markedly displaced, irrespective of laterality. CONCLUSION: This study demonstrates a significant laterality in injectate spread during TPVB, with more extensive longitudinal distribution on the left side. Our findings may provide important insights for understanding the variability of injectate distribution in TPVB. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118762","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":"Evaluation of Disc-FX versus L'DISQ for percutaneous disc decompression: pilot comparative study using the minimal clinically important difference.","authors":"Haruka Takaoka, Reon Kobayashi, Ichiro Okano, Asae Taketomi, Eiko Hara, Hitoshi Mera, Masaki Ishikawa, Yoshifumi Kudo, Katsunori Oe","doi":"10.1186/s40981-026-00846-8","DOIUrl":"10.1186/s40981-026-00846-8","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation often causes disabling radicular pain and impaired quality of life (QOL). Disc-FX and L'DISQ are minimally invasive percutaneous disc decompression devices, but their comparative efficacy remains uncertain.</p><p><strong>Methods: </strong>We retrospectively reviewed adults with single-level lumbar disc herniation treated with Disc-FX or L'DISQ at a single centre (October 2018-August 2023). Eligibility required radicular pain consistent with magnetic resonance imaging and either positive provocative discography or pain relief after intradiscal injection. Pain intensity (Numerical Rating Scale [NRS]) and QOL (EuroQOL 5-Dimension 5-Levels [EQ-5D-5 L]) were assessed at baseline and up to 6 months. The primary outcome was the between-group difference in change in NRS from baseline to 6 months. Secondary outcomes included 6-month change in EQ-5D-5 L and minimal clinically important difference (MCID) attainment (NRS ≥ 2-point reduction; EQ-5D-5 L ≥ 0.08 increase).</p><p><strong>Results: </strong>Forty-two patients were included (Disc-FX n = 16; L'DISQ n = 26). Both procedures reduced NRS pain scores over 6 months, and the primary outcome showed no statistically significant between-group difference (mean difference 1.32 points; 95% CI - 0.36 to 3.01). Among patients with baseline EQ-5D-5 L data (n = 38), Disc-FX showed greater 6-month EQ-5D-5 L improvement (mean difference 0.134; 95% CI 0.013 to 0.255) and higher EQ-5D-5 L MCID attainment (83.3% vs. 50.0%), but these are secondary results from a small retrospective cohort.</p><p><strong>Conclusions: </strong>In this pilot study, Disc-FX and L'DISQ had comparable short-term pain outcomes. Any apparent QOL advantage with Disc-FX should be interpreted cautiously as exploratory and potentially confounded, and requires confirmation in adequately powered prospective comparative studies.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":"14"},"PeriodicalIF":1.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951943","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":"Increase in the end-tidal carbon dioxide concentration during mediastinoscopic esophagectomy: a comment to a report of Haraguchi et al.","authors":"Katsuhide Masui, Tomoyuki Saito, Takero Arai, Takashi Asai","doi":"10.1186/s40981-025-00837-1","DOIUrl":"10.1186/s40981-025-00837-1","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"12 1","pages":"4"},"PeriodicalIF":1.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911484","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":"Objective evaluation of facial flushing for mesenteric traction syndrome diagnosis during laparotomy: a prospective observational pilot study.","authors":"Yutaro Ikki, Takeshi Negita, Kimitoshi Nishiwaki, Takahiro Tamura","doi":"10.1186/s40981-025-00843-3","DOIUrl":"10.1186/s40981-025-00843-3","url":null,"abstract":"<p><p>BACKGROUND: We aimed to evaluate the concordance between facial flushing assessment using an objective color sensor and subjective visual assessment in patients with mesenteric traction syndrome (MTS), to inform the design of a future large-scale study that incorporates objective diagnostic tools. METHODS: In this prospective pilot study, we enrolled adult patients who underwent pancreatectomy. Anesthesiologists assessed the degree of facial flushing subjectively using a scale of levels 0–2. Simultaneously, the Nix color sensor objectively measured the facial redness (a-value) at four facial points. Heart rate and arterial blood pressure were also recorded. Based on the anesthesiologist’s diagnosis, patients were categorized into either the MTS or non-MTS group. We compared the ratio of changes in a-value, heart rate, and blood pressure between the two groups, and their thresholds were also calculated. RESULTS: We included 38 patients: 14 in the MTS group and 24 in the non-MTS group. The MTS group showed significantly higher median change ratio in a-value (0.45 vs. 0.25, P = 0.02) and heart rate (0.45 vs. 0.23, P < 0.01) and a greater decrease in mean arterial pressure (-0.26 vs. -0.14, P = 0.01) than the non-MTS group. Subjective flushing levels correlated with MTS diagnosis (P < 0.01). While the Nix sensor detected flushing in some subjectively undiagnosed cases, one patient in the non-MTS group met all three objective thresholds. CONCLUSION: Objective evaluation of facial flushing using a color sensor is feasible and may enhance conventional assessment methods. To further improve the accuracy of objective evaluation, this pilot study may lead to a larger-scale study including blood tests. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":"6"},"PeriodicalIF":1.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12783494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911511","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":"Indigo carmine extravasation from intravenous injection caused by a blood pressure cuff.","authors":"Masaya Sekiguchi, Jun Honda, Atsuyuki Hosono, Satoki Inoue","doi":"10.1186/s40981-025-00835-3","DOIUrl":"10.1186/s40981-025-00835-3","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"12 1","pages":"1"},"PeriodicalIF":1.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892631","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":"Self-reported poor sleep quality on the day of delivery is a potential risk factor for postpartum depression after cesarean delivery: a retrospective cohort study.","authors":"Kaede Watanabe, Shohei Noguchi, Yuki Shiko, Daisuke Sakamaki, Yohei Kawasaki, Yusuke Mazda","doi":"10.1186/s40981-025-00833-5","DOIUrl":"10.1186/s40981-025-00833-5","url":null,"abstract":"<p><p>BACKGROUND: Postpartum depression (PPD) affects a significant number of women. Sleep disturbances have been associated with PPD; however, it remains unclear whether immediate postpartum sleep disturbances are risk factors. We investigated the potential association between self-reported poor sleep quality on the first day after cesarean delivery and the development of PPD, measured using the Edinburgh Postnatal Depression Scale (EPDS) scores. METHODS: We conducted a retrospective cohort study of women who underwent elective cesarean delivery under neuraxial anesthesia. Patients were asked about their sleep quality on the day after surgery and divided into Poor and Good Sleep groups. The EPDS scores were recorded at one month postpartum. The postpartum EPDS scores were compared between the two groups, and potential confounding factors were adjusted for using propensity score matching. RESULTS: A total of 256 patients (55 and 201 in the Poor and Good Sleep groups, respectively) were included in the analysis. After propensity score matching, the postnatal EPDS score was significantly higher in the Poor Sleep group compared to that in the Good Sleep group (6.7 ± 5.2 vs 4.5 ± 4.3, P = 0.007). Maternal PPD (i.e., EPDS ≥ 9) was also significantly higher in the Poor Sleep group (31.5% vs 17.5%, P = 0.045, OR 2.17 [95%CI 1.01–4.67]). The Poor Sleep group had higher endocrine morbidity and a higher rate of multiple gestations. CONCLUSION: There is a strong correlation between self-reported poor sleep quality on the first day after cesarean delivery and the EPDS score one month after childbirth. Sleep disturbances on the day of delivery may be a potential risk factor for PPD. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"70"},"PeriodicalIF":1.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856281","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":"Perioperative management of emergency cesarean delivery in a pregnant woman with uncorrected diabetic ketoacidosis: a case report.","authors":"Satoshi Naruse, Takaki Kasai, Momoka Kojima, Hiroshi Ueda, Chieko Akinaga, Yoshiki Nakajima","doi":"10.1186/s40981-025-00832-6","DOIUrl":"10.1186/s40981-025-00832-6","url":null,"abstract":"<p><p>BACKGROUND: Diabetic ketoacidosis (DKA) during pregnancy is a rare but life-threatening complication associated with high fetal mortality. Prompt metabolic stabilization is essential, although emergency cesarean delivery may be required. Reports on anesthetic management are limited. CASE PRESENTATION: A 24-year-old primigravida with poorly controlled type 2 diabetes presented at 35 weeks of gestation with nausea and non-reassuring fetal status (NRFS). DKA was confirmed using laboratory tests. Emergency cesarean delivery was performed for NRFS before complete stabilization. Metabolic management was conducted by endocrinologists and anesthesiologists. Combined spinal-epidural anesthesia (CSEA) was intraoperatively administered by anesthesiologists with real-time hemodynamic and metabolic management guided by arterial blood gas analysis using an arterial line while continuing insulin and glucose therapy. Postoperatively, metabolic derangements resolved, and the mother and neonate were discharged without complications. CONCLUSIONS: This case demonstrates that emergency cesarean delivery for uncorrected DKA can be achieved using CSEA, timely hemodynamic support, and coordinated metabolic management. </p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"69"},"PeriodicalIF":1.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850016","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}