Nihon Kyukyu Igakkai Zasshi最新文献

COVID–19ワクチン接種後に副腎クリーゼ，たこつぼ心筋症を発症しショックとなり多腺性自己免疫症候群2型の診断に至った1例(A patient with post COVID–19 vaccination presented with convulsions and cardiogenic shock due to adrenal crisis and Takotsubo cardiomyopathy diagnosed with autoimmune polyendocrine syndromes type II and Addison’s disease) COVID - 19疫苗接种后肾上腺蠕变，发生章鱼罐心肌病后休克，被诊断为多腺性自身免疫症候群2型1例(A patient with post COVID - 19 vaccination presented withconvulsions and cardiogenic shock due to adrenal crisis and Takotsubo cardiomyopathy diagnosed withautoimmune polyendocrine syndromes type II and Addison’s disease)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-11-30 DOI: 10.1002/jja2.12750

久下晶子, 森下幸治, 朝田慎平, 中堤啓太, 高山渉, 木内英美, 大友康裕

{"title":"COVID–19ワクチン接種後に副腎クリーゼ，たこつぼ心筋症を発症しショックとなり多腺性自己免疫症候群2型の診断に至った1例(A patient with post COVID–19 vaccination presented with convulsions and cardiogenic shock due to adrenal crisis and Takotsubo cardiomyopathy diagnosed with autoimmune polyendocrine syndromes type II and Addison’s disease)","authors":"久下晶子, 森下幸治, 朝田慎平, 中堤啓太, 高山渉, 木内英美, 大友康裕","doi":"10.1002/jja2.12750","DOIUrl":"https://doi.org/10.1002/jja2.12750","url":null,"abstract":"ABSTRACT A 49–year–old woman with a history of Basedow’s disease and vitiligo during her 30s was presented with 5 days of dizziness, nausea, and fatigue after being administered the third COVID–19 vaccination and transported via emergency medical service to the emergency department with sudden loss of consciousness and convulsions. Head and whole body computed tomography were normal but laboratory examination showed severe hyponatremia, which could be the cause of severe consciousness disturbance. Similar to what is observed in Takotsubo cardiomyopathy, echocardiography revealed a mid–ventricular and apical heart–wall motion, appearing as hypokinesis; in contrast, the basal segment showed preserved features. The left ventricular dysfunction caused the progressive hypotension and cardiogenic shock. Empiric treatment with corticosteroid considering the adrenal insufficiency, mechanical circulatory support with intra–aortic balloon pumping, and proper correction of hyponatremia were effective. The patient was extubated by day 7, leading to full recovery. Additional tests confirmed the diagnosis of autoimmune polyendocrine syndromes type II (Schmidt syndrome) and Addison’s disease. This case shows that adrenal crisis is caused by the vaccine’s stress and autoimmune reaction in specific individuals. Since it is an acute life–threatening emergency, early identification and prompt management is essential.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121223180","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}

引用次数: 0

重症COVID–19肺炎の急性期の循環動態は比較的安定している～単施設・症例対照研究～(Critically ill patients with novel coronavirus infectious disease (COVID–19) are relatively hemodynamically stable in the acute phase: a single–centered, retrospective, observational study) 重症COVID - 19肺炎急性期循环动态相对稳定~单设施病例对照研究~ (Critically ill patients with novel coronavirusinfectious disease (COVID - 19) are relatively hemodynamically stable in the acute phase:a single - centered, retrospective, observational study)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-09-01 DOI: 10.1002/jja2.12739

船登有未, 松田航, 植村樹, 小林憲太郎, 佐々木亮, 岡本竜哉, 木村昭夫

{"title":"重症COVID–19肺炎の急性期の循環動態は比較的安定している～単施設・症例対照研究～(Critically ill patients with novel coronavirus infectious disease (COVID–19) are relatively hemodynamically stable in the acute phase: a single–centered, retrospective, observational study)","authors":"船登有未, 松田航, 植村樹, 小林憲太郎, 佐々木亮, 岡本竜哉, 木村昭夫","doi":"10.1002/jja2.12739","DOIUrl":"https://doi.org/10.1002/jja2.12739","url":null,"abstract":"ABSTRACT To clarify the clinical course of severe COVID–19 pneumonia requiring ventilator support, we investigated the difference of SOFA scores between severe COVID–19 pneumonia and severe pneumonia patients before the emergence of COVID–19. In this single–centered, retrospective, observational study, we enrolled 14 COVID–19 patients requiring ventilator management between February 2020 and May 2020 (COVID–19 group) and 14 patients with pneumonia requiring ventilator management between January 2017 to December 2018 (non–COVID–19 group). We investigated demographic data, laboratory values, treatment, and the SOFA scores on Day 0, 1, and 3, with Day 0 being the day of intubation. The mean age of the 14 COVID–19 patients was 68.3 years and there was no difference in comorbidities and in–hospital mortality with the two groups. The mean SOFA scores (COVID–19 vs. non–COVID–19 group) on the day of intubation were 3.0 vs. 3.1 for respiratory system, 0.1 vs. 2.8 for cardiovascular system, 0.5 vs. 0.6 for coagulation, 0.3 vs. 0.6 for hepatobiliary system, 0.8 vs. 1.6 for central nervous system, and 0.4 vs. 1.3 for renal system, respectively. Significant differences were recognized in cardiovascular system (p<0.01) and central nervous system (p=0.049). The SOFA subscores for cardiovascular system remained significantly lower in the COVID group on Day 1 and 3. The rate of patients who used any vasopressors and the median fluid volume on the day of intubation were significantly lower in COVID–19 group. In conclusion, the hemodynamics were seemed to be more stable in severe COVID–19 pneumonia compared to non–COVID–19 severe pneumonia.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"22 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116266956","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}

引用次数: 0

COVID–19によるARDSを来した短頚の高度肥満女性に対し両側大腿静脈カニュレーションによるECMOを用いて救命した1例(A case of extracorporeal membrane oxygenation with bilateral femoral vein cannulation in a morbidly obese woman with a short neck who had acute respiratory distress syndrome due to coronavirus disease 2019) COVID - 19引起ARDS的短颈曲高度肥胖女性使用双侧大腿静脉曲张的ECMO救命1例(A case of extracorporeal membrane)oxygenation with bilateral femoral vein cannulation in a morbidly obese woman with a short neck whohad acute respiratory distress syndrome due to coronavirus disease 2019)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-07-01 DOI: 10.1002/jja2.12733

宮下浩平 (Kohei Miyashita), 川野恭雅 (Yasumasa Kawano), 伊與田比呂人 (Hiroto Iyota), 竹内慎哉 (Shinya Takeuchi), 盛實篤史 (Atsushi Morizane), 杉村朋子 (Tomoko Sugimura), 齋坂雄一 (Yuichi Saisaka)

{"title":"COVID–19によるARDSを来した短頚の高度肥満女性に対し両側大腿静脈カニュレーションによるECMOを用いて救命した1例(A case of extracorporeal membrane oxygenation with bilateral femoral vein cannulation in a morbidly obese woman with a short neck who had acute respiratory distress syndrome due to coronavirus disease 2019)","authors":"宮下浩平 (Kohei Miyashita), 川野恭雅 (Yasumasa Kawano), 伊與田比呂人 (Hiroto Iyota), 竹内慎哉 (Shinya Takeuchi), 盛實篤史 (Atsushi Morizane), 杉村朋子 (Tomoko Sugimura), 齋坂雄一 (Yuichi Saisaka)","doi":"10.1002/jja2.12733","DOIUrl":"https://doi.org/10.1002/jja2.12733","url":null,"abstract":"ABSTRACT We present a case of a morbidly obese 44–year–old woman with a short neck who had nasal discharge 3 days prior to admission. She was diagnosed with acute respiratory distress syndrome due to coronavirus disease 2019 (COVID–19) using severe acute respiratory syndrome–coronavirus–2 polymerase chain reaction test and was admitted to our hospital the following day. Her respiratory condition gradually worsened. On day 9 of hospitalization, she was intubated and transferred to our department. On day 4 after admission to the intensive care unit (ICU), her P/F ratio was 82.6. Therefore, extracorporeal membrane oxygenation (ECMO) was warranted. Since she had a short neck, the cannula could not be inserted through the jugular vein. Therefore, veno–venous ECMO was initiated through the left and right femoral veins. On day 30, the patient was weaned off ECMO. On day 36, she was extubated, and on day 47, she was discharged from the ICU. Finally, on day 55, she was discharged from the hospital. In morbidly obese patients with short necks, VV–ECMO with bilateral femoral venipuncture may be a treatment option. Thus, it is important to understand its advantages and disadvantages to ensure proper management.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114967785","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}

引用次数: 0

重症COVID–19におけるデルタ株流行の影響と予後：単施設後方視研究(Prognostic impact of delta variant in COVID–19 patients requiring mechanical ventilation in comparison with other variants: a single center retrospective analysis) 重症COVID - 19三角株流行的影响和预后:单设施后视研究(Prognostic impact of delta variant in COVID - 19patients requiring mechanical ventilation incomparison with other variants: a单一center retrospective analysis)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-07-01 DOI: 10.1002/jja2.12728

加藤史人 (Fumito Kato), 関原圭吾 (Keigo Sekihara), 岡本竜哉 (Tatsuya Okamoto), 井熊　玲央 (Reo Iguma), 小島原知大 (Tomohiro Kojimahara), 植村樹 (Tatsuki Uemura), 木村昭夫 (Akio Kimura)

{"title":"重症COVID–19におけるデルタ株流行の影響と予後：単施設後方視研究(Prognostic impact of delta variant in COVID–19 patients requiring mechanical ventilation in comparison with other variants: a single center retrospective analysis)","authors":"加藤史人 (Fumito Kato), 関原圭吾 (Keigo Sekihara), 岡本竜哉 (Tatsuya Okamoto), 井熊　玲央 (Reo Iguma), 小島原知大 (Tomohiro Kojimahara), 植村樹 (Tatsuki Uemura), 木村昭夫 (Akio Kimura)","doi":"10.1002/jja2.12728","DOIUrl":"https://doi.org/10.1002/jja2.12728","url":null,"abstract":"ABSTRACT Background : Spike protein mutations are known to affect the infectivity and virulence of coronavirus disease 2019 (COVID–19). The number of severe COVID–19 cases and deaths has increased due to the Delta variant. We aimed to evaluate the clinical characteristics and treatment outcomes of severe COVID–19 patients. Methods: Fifty–three consecutively presenting patients requiring mechanical ventilation for respiratory failure due to COVID–19 were seen at our institution between February 2020 and October 2021. We divided these patients into two groups: 13 patients admitted from July to October 2021 (the Delta period) and 40 patients admitted from February 2020 to June 2021 (the non–Delta period). We retrospectively compared overall survival between these groups (median observation period, 90 days). Results : All patients were unvaccinated. No L452R mutations were detected during the non–Delta period, whereas 10 (77%) such mutations were detected during the Delta period. Patient characteristics (non–Delta vs. Delta) were as follows: age, 68 vs. 56 years (P<0.01); body mass index, 27 vs. 30kg/m2 (P=0.02); P/F ratio (PaO2/FiO2), 136 vs. 80 (P<0.01); and days to hospitalization, 6 vs. 8 days (P=0.03). The 90–day survival rate was lower in the Delta group (71% vs. 37%, P<0.01). Multivariate analysis showed that the Delta variant was an independent unfavorable prognostic factor (hazard ratio 6.35, 95% confidence interval 1.96–20.6). Conclusion : Despite a younger patient age, survival rate was significantly worse in the Delta period. This is probably due to the infectivity and virulence of the Delta variant and delays in treatment caused by difficulty in transportation.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116095679","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}

引用次数: 1

COVID–19流行下における自殺企図患者の推移(Changes in suicide attempt patients during the COVID–19 pandemic) COVID - 19流行时期企图自杀患者的变化(Changes in suicide attempt patients during the COVID - 19 pandemic)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-07-01 DOI: 10.1002/jja2.12726

加藤明裕 (Akihiro Kato), 茅田洋之 (Hiroyuki Kayata), 米花紫乃 (Shino Beika), 藥師寺秀明 (Hideaki Yakushiji), 森田正則 (Masanori Morita), 中田康城 (Yasuki Nakata), 松嶋麻子 (Asako Matsushima)

{"title":"COVID–19流行下における自殺企図患者の推移(Changes in suicide attempt patients during the COVID–19 pandemic)","authors":"加藤明裕 (Akihiro Kato), 茅田洋之 (Hiroyuki Kayata), 米花紫乃 (Shino Beika), 藥師寺秀明 (Hideaki Yakushiji), 森田正則 (Masanori Morita), 中田康城 (Yasuki Nakata), 松嶋麻子 (Asako Matsushima)","doi":"10.1002/jja2.12726","DOIUrl":"https://doi.org/10.1002/jja2.12726","url":null,"abstract":"ABSTRACT Aim : We aimed to investigate the influence of the COVID–19 pandemic on suicide and suicide attempts in Japan. Methods: We retrospectively reviewed the clinical records of patients with suicide and suicide attempts who were transferred to our hospital during the COVID–19 pandemic period (January to December 2020) and a similar non–COVID–19 pandemic period (January 2018 to December 2019). We also investigated the age and monthly number of patients with suicide and suicide attempts during the COVID–19 pandemic period and compared them with the number of patients with COVID–19. Results : In 2020, 39% of patients attempting suicide were in their 20s or younger, an increase in the proportion of younger patients compared to 27% in the non–COVID–19 pandemic period. During the COVID–19 pandemic period, the monthly number of suicide attempts showed an inverse variation with the increase or decrease in the number of COVID–19 patients. The same trend was also observed for patients committing suicide. Conclusion : The number of suicide attempts among young people increased during the COVID–19 pandemic and the number of suicide attempts seemed to be affected with the number of COVID–19 patients. Further analysis of the impact of the pandemic on suicide attempts is needed.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132113762","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}

引用次数: 0

多彩な免疫再構築症候群の症状を呈した重症COVID–19の1例(Various IRIS–like symptoms following severe COVID–19 infection: a case report) 表现出多种免疫重建症候群症状的重症COVID - 19的一个例子(Various IRIS - like symptoms following severe COVID - 19 infection:a案例报告)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-06-01 DOI: 10.1002/jja2.12716

皆川裕祐 (Yusuke Minagawa), 萩原祥弘 (Yoshihiro Hagiwara), 佐藤綾美 (Ayami Sato), 笠原道 (Wataru Kasahara), 小林孝臣 (Takaomi Kobayashi), 藤田健亮 (Kensuke Fujita), 小. (Takayuki Ogura)

{"title":"多彩な免疫再構築症候群の症状を呈した重症COVID–19の1例(Various IRIS–like symptoms following severe COVID–19 infection: a case report)","authors":"皆川裕祐 (Yusuke Minagawa), 萩原祥弘 (Yoshihiro Hagiwara), 佐藤綾美 (Ayami Sato), 笠原道 (Wataru Kasahara), 小林孝臣 (Takaomi Kobayashi), 藤田健亮 (Kensuke Fujita), 小. (Takayuki Ogura)","doi":"10.1002/jja2.12716","DOIUrl":"https://doi.org/10.1002/jja2.12716","url":null,"abstract":"ABSTRACT Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction associated with organ failure. DRESS’s pathogenesis is related to immune reconstitution inflammatory syndrome (IRIS). We report a coronavirus disease (COVID–19) case with severe pneumonia, wherein DRESS developed as a symptom of IRIS. A 56–year–old man underwent venovenous extracorporeal membrane oxygenation (VV–ECMO) to treat severe COVID–19. He developed ventilator–associated pneumonia and was treated with Meropenem from the third to the sixth day. During treatment, lung abscess caused by multidrug–resistant Pseudomonas aeruginosa and Enterobacter cloacae bacteremia developed, but he was weaned from VV–ECMO within a month. On the 37th day, papules and an erythematous rash appeared throughout his body, and fever, tachycardia, hypotension, and acute kidney injury (AKI) were reported. The condition was diagnosed as DRESS according to the RegiSCAR criteria. Meropenem was suspected as the cause based on the drug–induced lymphocyte stimulation test. The patient’s vitals stabilized, skin rash, and AKI improved after steroid administration. However, generalized herpes zoster and Ramsay–Hunt syndrome developed upon decreasing the steroids; hence, the steroid dose was increased. DRESS and zoster reactivation can occur during severe COVID–19 recovery. Therefore, it is advisable to use steroids appropriately and reduce the dose carefully.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124029894","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}

引用次数: 0

妊娠中期に重症化した新型コロナウイルス感染症に対して集学的加療を行い母子ともに救命した1例(A case of a pregnant woman with severe COVID–19 who was treated by multidisciplinary therapy) 针对妊娠中期严重的新型冠状病毒感染，进行集学治疗，母子都救命的1例(case of A pregnant woman with severe COVID - 19whowas treated by multidisciplinary therapy)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-04-01 DOI: 10.1002/jja2.12699

原田巽矢 (Tatsuya Harada), 荻野聡之 (Satoyuki Ogino), 笹沢俊吉 (Shunkichi Sasazawa), 浅野史男 (Fumio Asano), 谷垣伸治 (Shinji Tanigaki), 海田賢彦 (Yasuhiko Kaita), 山口芳裕 (Yoshihiro Yamaguchi)

{"title":"妊娠中期に重症化した新型コロナウイルス感染症に対して集学的加療を行い母子ともに救命した1例(A case of a pregnant woman with severe COVID–19 who was treated by multidisciplinary therapy)","authors":"原田巽矢 (Tatsuya Harada), 荻野聡之 (Satoyuki Ogino), 笹沢俊吉 (Shunkichi Sasazawa), 浅野史男 (Fumio Asano), 谷垣伸治 (Shinji Tanigaki), 海田賢彦 (Yasuhiko Kaita), 山口芳裕 (Yoshihiro Yamaguchi)","doi":"10.1002/jja2.12699","DOIUrl":"https://doi.org/10.1002/jja2.12699","url":null,"abstract":"ABSTRACT We report a case of a patient with coronavirus disease (COVID–19) in the second trimester of pregnancy who was started on venovenous extracorporeal membrane oxygenation (VV–ECMO) immediately after a cesarean section with ventilation and prone positioning, resulting in a good outcome for both the mother and the child. The patient, a woman in her 30s was transferred to our hospital due to worsening respiratory status at 28 weeks and 0 days of gestation, 8 days after the onset of COVID–19. On the second day, she was started on mechanical ventilation. Although the period of pregnancy was prolonged by prone ventilation, because the PaO2/FiO2 ratio (P/F) decreased to 76, we performed a cesarean section on the eighth day. She was started on VV–ECMO on the ninth day. Thereafter, her respiratory condition gradually improved, and she was weaned from VV–ECMO on the twenty–second day. Later, she was extubated on the twenty–fourth day and transferred from the intensive care unit to the general ward on the thirtieth day. In cases of COVID–19 that become severe in the second trimester of pregnancy, multidisciplinary treatment is necessary, taking into consideration the number of weeks of pregnancy.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129637405","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}

引用次数: 0

重症COVID–19患者における侵襲的人工呼吸管理中のステロイドの投与終了と28日死亡率の関連の検討，後方視的コホート研究(Association between corticosteroid treatment termination during invasive mechanical ventilation and 28–day mortality in severe COVID–19 patients, a retrospective cohort study) 重症COVID - 19患者在侵入性人工呼吸管理中终止使用类固醇与28天死亡率之间的关系后视队列研究(Association between corticosteroid treatment termination during invasive mechanical)ventilation and 28—day mortality in severe COVID—19 patients, a retrospective cohort study)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-03-01 DOI: 10.1002/jja2.12694

恒光健史 (Takefumi Tsunemitsu), 鈴木崇生 (Takao Suzuki), 松本優 (Masaru Matsumoto)

{"title":"重症COVID–19患者における侵襲的人工呼吸管理中のステロイドの投与終了と28日死亡率の関連の検討，後方視的コホート研究(Association between corticosteroid treatment termination during invasive mechanical ventilation and 28–day mortality in severe COVID–19 patients, a retrospective cohort study)","authors":"恒光健史 (Takefumi Tsunemitsu), 鈴木崇生 (Takao Suzuki), 松本優 (Masaru Matsumoto)","doi":"10.1002/jja2.12694","DOIUrl":"https://doi.org/10.1002/jja2.12694","url":null,"abstract":"ABSTRACT Aims : To investigate the association between corticosteroid treatment termination during invasive mechanical ventilation and 28–day mortality in severe COVID–19 patients. Method s: The study was a single–center, retrospective cohort study of COVID–19 patients undergoing invasive mechanical ventilation on their scheduled corticosteroid termination day between March 1, 2020, and June 30, 2021. The scheduled corticosteroid termination day was scheduled 10 days after initiation of dexamethasone 6mg orally or 6.6mg intravenously. Patients who terminated corticosteroids during the ventilatory period and did not receive corticosteroids thereafter were defined as the termination group, whereas patients who continued to receive corticosteroids in some form after the scheduled corticosteroid termination day were defined as the continuation group. The primary endpoint was 28–day mortality, and the difference was evaluated using the log–rank test. Results : The 28–day mortality was found to be 61% (14 of 23 patients) in the termination group, which was significantly higher than the 28–day mortality of 22% (5 of 23 patients) in the continuation group (Hazard Ratio: 3.82, 95% CI: 1.37–10.68; p=0.005). Conclusions : In severe COVID–19 patients, corticosteroid termination during invasive ventilation is associated with an increased 28–day mortality.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123573288","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}

引用次数: 0

新型コロナウイルス感染症（COVID–19）に伴う難治性大量下痢症の1例(A case of refractory massive diarrhea in a patient with COVID–19) 新型冠状病毒感染(COVID - 19)导致的难治性大量腹泻一例(A case of refractory massive diarrhea in A patient with)covid - 19)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2022-01-01 DOI: 10.1002/jja2.12653

清水健太郎 (Kentaro Shimizu), 平田陽彦 (Haruhiko Hirata), 德平夏子 (Natsuko Tokuhira), 上田安希子 (Akiko Ueda), 元岡大祐 (Daisuke Motooka), 中村昇太 (Shota Nakamura), 小倉裕司 (Hiroshi Ogura)

{"title":"新型コロナウイルス感染症（COVID–19）に伴う難治性大量下痢症の1例(A case of refractory massive diarrhea in a patient with COVID–19)","authors":"清水健太郎 (Kentaro Shimizu), 平田陽彦 (Haruhiko Hirata), 德平夏子 (Natsuko Tokuhira), 上田安希子 (Akiko Ueda), 元岡大祐 (Daisuke Motooka), 中村昇太 (Shota Nakamura), 小倉裕司 (Hiroshi Ogura)","doi":"10.1002/jja2.12653","DOIUrl":"https://doi.org/10.1002/jja2.12653","url":null,"abstract":"ABSTRACT The new coronavirus disease (COVID–19) causes gastrointestinal symptoms as well as respiratory symptoms. We report a case of massive refractory diarrhea from the perspective of gut microbiota. A 60–year–old man was transferred with dyspnea. He was diagnosed as having COVID–19 and was intubated on mechanical ventilation with extracorporeal membrane oxygenation. He was administered anti–viral drug therapy and antibiotics. He suffered from diarrhea from day 12 and produced a maximum of about 6,384mL/day of watery diarrhea on day 21. He required massive transfusion and catecholamines for circulatory support. Adsorbents, pectin–containing oligomeric formulas and synbiotics were administered, which decreased the amounts of diarrhea. After day 30, the amount of diarrhea decreased to less than 1,000mL/day. Fecal metagenomic analysis showed the proportions of Enterococcus and Staphylococcus in the phylum Firmicutes were the most dominate at the genus level. The proportion of Bacteroidetes was less than 1%, and the gut microbiota had dramatically changed. Thereafter, his diarrhea decreased to occasional instances, and he was transferred to another ward on day 104. Therapy for intestinal complications might be important in treating COVID–19. Intestinal therapy such as adsorbents might be effective in patients with massive diarrhea.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127557467","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}

引用次数: 0

病院敷地外に設営された本邦初の新型コロナウイルス感染症中等症専用の臨時仮設医療施設についての報告：神奈川県第2波までの経過(A report of a 180–bed temporary prefabricated field hospital for COVID–19 in Japan) 关于在医院用地外设置的本邦第一个新型冠状病毒感染中等症专用临时临时医疗设施的报告:到神奈川县第2波的经过(A report of a180 - bed temporary prefabricated field hospital for COVID - 19 in Japan)

Nihon Kyukyu Igakkai Zasshi Pub Date : 2021-08-01 DOI: 10.1002/jja2.12623

小山洋史 (Hiroshi Koyama), 會田悦久 (Yoshihisa Aida), 山上浩 (Hiroshi Yamagami), 熊谷知博 (Tomohiro Kumagae), 西口翔 (Sho Nishiguchi), 神尾直 (Tadashi Kamio), 河内順 (Jun Kawachi)

{"title":"病院敷地外に設営された本邦初の新型コロナウイルス感染症中等症専用の臨時仮設医療施設についての報告：神奈川県第2波までの経過(A report of a 180–bed temporary prefabricated field hospital for COVID–19 in Japan)","authors":"小山洋史 (Hiroshi Koyama), 會田悦久 (Yoshihisa Aida), 山上浩 (Hiroshi Yamagami), 熊谷知博 (Tomohiro Kumagae), 西口翔 (Sho Nishiguchi), 神尾直 (Tadashi Kamio), 河内順 (Jun Kawachi)","doi":"10.1002/jja2.12623","DOIUrl":"https://doi.org/10.1002/jja2.12623","url":null,"abstract":"ABSTRACT Background: On May 18, 2020, Kanagawa Prefecture in Japan set up a 180–bed temporary prefabricated field hospital to provide care to coronavirus disease 2019 (COVID–19) patients. The field hospital was designated as a COVID–19 specific medical institution exclusively for moderately ill patients, with mainly elderly patients aged over 65 years, patients with underlying diseases at a high risk of severe COVID–19, and patients with oxygen demands not requiring mechanical ventilation. The purpose of this report is to describe the details of the field hospital and the epidemiological characteristics of the patients. Methods: COVID–19 patients admitted between May 18 and October 23, 2020 were retrospectively analyzed. Results: During the study period, 399 patients were hospitalized. Of the 388 new cases, oxygen was administered to 57 patients (14.7%) at the time of admission and 103 patients (26.5%) during hospitalization. Of the 103 patients, 90 (87.3%) received steroid treatment. Thirty–seven patients (9.5%) had a high oxygen demand of 6L/min or more; of these, 12 (3.1%) were transferred to intensive care facilities, and 15 (3.9%) died. Conclusion: The temporary COVID–19 field hospital dedicated to moderate illness possibly contributed to preventing progression to critical COVID–19.","PeriodicalId":200165,"journal":{"name":"Nihon Kyukyu Igakkai Zasshi","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131959477","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}

引用次数: 0