JA Clinical Reports最新文献

{"title":"Perioperative anaphylaxis with no identifiable cause.","authors":"Tatsuo Horiuchi, Tomonori Takazawa","doi":"10.1186/s40981-024-00688-2","DOIUrl":"10.1186/s40981-024-00688-2","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"3"},"PeriodicalIF":0.9,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519296","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":"Comment on: anesthetic management of a pediatric patient with Freeman-Sheldon syndrome undergoing atrial septal defect closure: a case report.","authors":"Mikaela I Poling, Craig R Dufresne","doi":"10.1186/s40981-023-00668-y","DOIUrl":"10.1186/s40981-023-00668-y","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"4"},"PeriodicalIF":0.9,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519137","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":"Association between preoperative frailty and surgical Apgar score in abdominal cancer surgery: a secondary analysis of a prospective observational study","authors":"Sayaka Hirai, Mitsuru Ida, Yuki Kinugasa, Masahiko Kawaguchi","doi":"10.1186/s40981-024-00687-3","DOIUrl":"https://doi.org/10.1186/s40981-024-00687-3","url":null,"abstract":"The surgical Apgar score is useful for predicting postoperative morbidity and mortality. However, its applicability in frail patients with minimal hemodynamic variation remains unknown. This study aimed to investigate the association between frailty and surgical Apgar score. This secondary analysis included 210 patients ≥ 65 years of age undergoing elective major abdominal surgery for cancer. Frailty was assessed using the Fried Frailty Phenotype Questionnaire and defined as a total score of ≥ 3. The surgical Apgar score (range, 0−10; including mean blood pressure, heart rate, and blood loss volume) was compared between patients with or without frailty using the Mann–Whitney U test. Postoperative severe complications and length of postoperative stay were compared between patients with surgical Apgar scores ≤ 7 and > 7. Among the included patients, 45 were classified as frail. The median [1st quartile, 3rd quartile] surgical Apgar scores in patients with and without frailty were 7.0 [7.0, 8.0] and 8.0 [7.0, 8.0], respectively (P = 0.03). Patients with surgical Apgar score ≤7 had a higher incidence of serious postoperative complications (P = 0.03) and longer hospital stays (P < 0.001) compared with patients with surgical Apgar score >7. Frail patients have lower SAS, and patients with lower SAS have higher postoperative complication rates and longer hospital stays in patients who underwent cancer surgery.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"2 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139465235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragile lip in a patient with macroglossia due to hemodialysis-associated amyloidosis.","authors":"Tohru Shiratori, Masahiro Nishimura, Yusuke Horitani","doi":"10.1186/s40981-024-00686-4","DOIUrl":"10.1186/s40981-024-00686-4","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10781912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402881","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":"Severe perioperative lactic acidosis in a pediatric patient with glycogen storage disease type Ia: a case report.","authors":"Tamayo Takahashi, Kana Oue, Eiji Imado, Mitsuru Doi, Yoshitaka Shimizu, Mitsuhiro Yoshida","doi":"10.1186/s40981-023-00683-z","DOIUrl":"10.1186/s40981-023-00683-z","url":null,"abstract":"<p><strong>Background: </strong>Glycogen storage disease (GSD) is a group of rare inherited metabolic disorders caused by enzyme deficiencies in glycogen catabolism. GSD type Ia is a congenital deficiency of the enzyme responsible for the final step in glucose production by glycolysis, resulting in impaired carbohydrate metabolism.</p><p><strong>Case presentation: </strong>A 14-year-old boy with GSD type Ia was scheduled for a maxillary cystectomy under general anesthesia. He was taking oral sugars such as uncooked cornstarch regularly to prevent hypoglycemia. Perioperatively, glucose was administered via the peripheral vein for fasting; however, severe lactic acidosis occurred. He also developed hypercapnia because of intraoperative poor ventilation caused by hepatomegaly.</p><p><strong>Conclusions: </strong>We experienced a child with GSD type Ia who developed severe lactic acidosis despite continuous glucose infusion. Further studies are required to determine appropriate perioperative management for patients with GSD, including fasting glucose administration.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"9 1","pages":"91"},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800033","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":"Pitfalls of continuous drug administration methods in pediatric anesthesia to reduce medication errors.","authors":"Keisuke Yoshida, Yuko Nakano, Satoki Inoue","doi":"10.1186/s40981-023-00685-x","DOIUrl":"10.1186/s40981-023-00685-x","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"9 1","pages":"90"},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800031","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":"Suspected anaphylaxis during anesthesia induction without identified allergens: a case report","authors":"Sayaka Hirai, Mitsuru Ida, Ai Arima, Masahiko Kawaguchi","doi":"10.1186/s40981-023-00684-y","DOIUrl":"https://doi.org/10.1186/s40981-023-00684-y","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;The Japanese Society of Anesthesiologists offers practical guidelines for dealing with perioperative anaphylaxis, emphasizing the importance of anesthesiologists’ involvement in identifying the causative agent to prevent recurrence [1]. However, identifying the causative agents is not always feasible. Herein, we report, with written informed consent, a case where anaphylaxis was suspected during anesthesia induction, yet no allergens were identified.&lt;/p&gt;&lt;p&gt;A 59-year-old man, 165.5 cm in height and weighing 65.1 kg, presented with congestive heart failure, chronic kidney disease, diabetes, hypertension, and hyperlipidemia, requiring coronary artery bypass grafting for triple-vessel coronary artery disease. The patient had not undergone any surgery previously and had not taken any angiotensin receptor blockers and angiotensin-converting enzyme inhibitors. In the operating room, standard vital signs were closely monitored, and non-invasive blood pressure (NIBP) was recorded at 160/120 mmHg. Anesthesia was induced using remifentanil (rate, 20 mL/h) and remimazolam (12 mg/kg/h). Upon confirming the loss of consciousness, the dosages of remifentanil and remimazolam were reduced to 5 mL/h and 1.0 mg/kg/h, respectively, four minutes after administering rocuronium (60 mg). This was followed by tracheal intubation and arterial catheter insertion. His blood pressure (BP) was 89/67 mm Hg (NIBP) and 47/25 mm Hg (arterial line) immediately before and after tracheal intubation, respectively. Despite fluid resuscitation of 500 mL and multiple boluses of ephedrine (16 mg), phenylephrine (0.3 mg), and norepinephrine (10 µg), he experienced cardiac arrest. During chest compressions, an intravenous bolus of epinephrine (0.1 mg) was administered, resulting in cardiopulmonary resuscitation with an arterial BP of 46/29 mmHg. However, due to persistent severe hypotension, continuous infusions of norepinephrine at 0.1 mcg/kg/min and dobutamine at 5 mcg/kg/min were initiated following additional boluses of epinephrine (0.3 mg). Figure 1 displays the patient’s vital signs during anesthesia. Edema with erythema of the extremities and trunk was observed throughout this sequence, and transesophageal echocardiography revealed no evidence of cardiogenic shock. Consequently, anaphylaxis was suspected, and the patient was transferred to the intensive care unit without proceeding with surgery. Blood samples taken before he left the operating room indicated an elevated serum tryptase level of 17.1 μg/L, exceeding the normal range of 1.2–5.7 μg/L. More than seven weeks after the onset, both basophil activation and skin prick tests using remimazolam and rocuronium yielded negative results. The patient declined surgery and was subsequently followed-up after percutaneous coronary intervention at coronary segments 6, 7, 11, and 14.&lt;/p&gt;&lt;figure&gt;&lt;figcaption&gt;&lt;b data-test=\"figure-caption-text\"&gt;Fig. 1&lt;/b&gt;&lt;/figcaption&gt;&lt;picture&gt;&lt;img alt=\"figure 1\" aria-describedby=\"Fig1\"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"28 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General anesthesia for cesarean section in a pregnant woman with systemic vascular malformation: a case report","authors":"Noriko Takeuchi, Misa Koshihara, Akira Motoyasu, Joho Tokumine, Harumasa Nakazawa, Mine Ozaki, Tomoko Yorozu","doi":"10.1186/s40981-023-00682-0","DOIUrl":"https://doi.org/10.1186/s40981-023-00682-0","url":null,"abstract":"Vascular malformations are composed of morphologically abnormal vascular tissue, and when located in the head and neck region, they can make it difficult to secure the airway during general anesthesia. A 28-year-old pregnant woman with vascular malformations in the pharynx was scheduled to undergo a cesarean section, for which spinal anesthesia was initially chosen. However, after magnetic resonance imaging results revealed the presence of multiple vascular malformations in the lumbar multifidus muscles, spinal anesthesia was considered to be of high risk. Thus, the patient was subjected to general anesthesia tracheal intubation under sedation, and the course of the surgery was without complications. Because the pathophysiology and clinical sequelae of vascular malformations may be involved in complications, thorough presurgical evaluation of the patient’s physical condition and careful anesthesia planning should be done.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"91 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family reunion activity may be used as an alternative item for sexual activity in the Duke Activity Status Index.","authors":"Satoki Inoue","doi":"10.1186/s40981-023-00680-2","DOIUrl":"10.1186/s40981-023-00680-2","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"9 1","pages":"87"},"PeriodicalIF":0.9,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498403","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":"Aortic valve replacement in a 41-year-old woman with uncorrected tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries: a case report.","authors":"Kazutomo Saito, Yudai Iwasaki, Takahiro Tasaki, Hidehisa Saito, Hiroaki Toyama, Yutaka Ejima, Masanori Yamauchi","doi":"10.1186/s40981-023-00674-0","DOIUrl":"10.1186/s40981-023-00674-0","url":null,"abstract":"<p><strong>Background: </strong>Tetralogy of Fallot (TOF) is a complex cyanotic congenital heart disease. As most patients with TOF undergo palliative or radical surgical repair during childhood, cardiac surgery under cardiopulmonary bypass (CPB) for adult survivors with unrepaired TOF is exceedingly rare.</p><p><strong>Case presentation: </strong>A 41-year-old woman with unrepaired TOF, pulmonary atresia (PA), and major aortopulmonary collateral arteries (MAPCAs) developed acute infectious endocarditis (IE). As vegetation gradually increased despite intravenous antibiotic administration, she was scheduled for urgent aortic valve replacement under CPB. Pulmonary blood flow was primarily provided by the MAPCAs originating from the descending aorta. Intra-aortic balloon occlusion for MAPCAs was performed to ensure a bloodless surgical field. Aortic valve replacement was successful.</p><p><strong>Conclusion: </strong>An adult with uncorrected TOF developed acute IE and subsequently had successful cardiac surgery under CPB. Understanding TOF physiology with PA and MAPCAs, particularly pulmonary blood flow through MAPCAs, is crucial.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"9 1","pages":"86"},"PeriodicalIF":0.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487494","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}