Acute Medicine & Surgery最新文献

{"title":"Fulminant myocarditis in immune-mediated thrombotic thrombocytopenic purpura: A case report","authors":"Haruka Ishikita,&nbsp;Akira Endo,&nbsp;Keisuke Suzuki,&nbsp;Tomohiro Akutsu,&nbsp;Yuichi Araki,&nbsp;Koji Morishita","doi":"10.1002/ams2.70075","DOIUrl":"https://doi.org/10.1002/ams2.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thrombotic thrombocytopenic purpura is a life-threatening thrombotic microangiopathy characterized by systemic microvascular thrombosis. Cardiovascular complications, including myocardial ischemia and necrosis, are a leading cause of acute mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 54-year-old man was diagnosed with immune-mediated thrombotic thrombocytopenic purpura. On Day 2, he developed sudden cardiac arrest, requiring venoarterial extracorporeal membrane oxygenation for circulatory support. Echocardiography revealed diffuse severe hypokinesis, ventricular hypertrophy, and pericardial effusion. Myocardial biopsy performed on Day 3 showed no findings of microthrombi or necrosis. These findings suggested fulminant myocarditis rather than myocardial ischemia. The patient was successfully treated with multidisciplinary treatment including plasma exchange, achieving full recovery by Day 44.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights fulminant myocarditis as a complication of immune-mediated thrombotic thrombocytopenic purpura. As myocarditis is potentially reversible, providing appropriate supportive therapy may contribute to an improved prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647080","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":"JAPAN Registry of Self-harm and Suicide Attempts: Study protocol and profile in 2022–2023","authors":"Mayumi Hangai,&nbsp;Yudai Iwama,&nbsp;Satoshi Kobayashi,&nbsp;Yoshiharu Fukuda,&nbsp;Chiaki Toida,&nbsp;Tomoyuki Yamashita,&nbsp;Satoshi Hashimoto,&nbsp;Yasufumi Miyake","doi":"10.1002/ams2.70081","DOIUrl":"https://doi.org/10.1002/ams2.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-harm and suicide attempts (SA) are a significant cause of emergency department visits in Japan, where over 20,000 suicides occur annually. Each suicide death is estimated to correspond to over 20 attempts, highlighting the urgent need for intervention strategies. Therefore, in 2022, the JAPAN Registry of Self-harm and Suicide Attempts (JA-RSA) was established as the first nationwide prospective registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study describes the design, objectives, and initial findings of JA-RSA and evaluates its potential to inform national suicide prevention policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>JA-RSA collects comprehensive data on patients presented to critical care centers in Japan for self-harm or SA. Between December 2022 and December 2023, data from 1987 registered cases from 44 institutions were analyzed. Patient demographics, self-harm methods, and treatment outcomes were examined and compared with national suicide statistics for 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of patients was 39.3 years (36.9% male). Self-harm was inflicted through intentional drug overdose (58.2%), jumping from a height (12.1%), self-cutting (11.2%), and hanging (10.8%). Of the 1987 cases, 68.4% required intensive care treatment, 11.9% received outpatient care, and 8.3% died. Compared with national suicide statistics, JA-RSA revealed that more females and individuals aged below 20 engage in self-harm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>JA-RSA provides critical insights into the characteristics and treatment outcomes of patients who engage in self-harm. The registry's findings underscore the need for greater participation of institutions and further improvement in prevention strategies. By offering unique data, JA-RSA could help improve suicide prevention and intervention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615081","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":"Gastric anisakiasis suspected by point-of-care ultrasound finding in the emergency department","authors":"Yuya Kitai,&nbsp;Ryota Sato,&nbsp;Tetsuya Inoue","doi":"10.1002/ams2.70080","DOIUrl":"https://doi.org/10.1002/ams2.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The diagnosis of gastric anisakiasis is typically confirmed by detecting larvae during upper gastrointestinal endoscopy. Therefore, it is important to raise clinical suspicion to prompt this procedure. While abdominal computed tomography is often performed for this purpose, the utility of ultrasound as a workup for gastric anisakiasis is not well established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 40-year-old male with a past medical history significant for IgA vasculitis visited the emergency department with acute onset epigastric pain. The patient had sushi containing horse mackerel, mackerel, and sardines the night before admission. Point-of-care ultrasound revealed the thickened gastric wall, which enabled us to suspect gastric anisakiasis, prompting an emergent upper gastrointestinal endoscopy. An emergency upper gastrointestinal endoscopy revealed the presence of three <i>Anisakis</i> larvae penetrating the gastric mucosa. Following treatment, his symptoms completely resolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case suggests that point-of-care ultrasound can be a powerful diagnostic tool when clinicians suspect gastric anisakiasis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606552","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":"Superior-lateral patella dislocation with rotation along its vertical axis","authors":"Patrick McNeal,&nbsp;Elizabeth B. Winton,&nbsp;Marc T. Bartman","doi":"10.1002/ams2.70078","DOIUrl":"https://doi.org/10.1002/ams2.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patellar dislocations are common, but superior-lateral dislocation with vertical axis rotation is rare and challenging to reduce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A woman in her 20s presented with left knee pain and deformity after minor trauma. Traditional reduction attempts failed due to a vertical rotational component. Reduction was achieved using a technique involving hip flexion, a modified varus–valgus force, and knee extension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Emergency clinicians must recognize complex patellar dislocations and consider early orthopedic consultation to minimize complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606553","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 predictive model of delayed pseudoaneurysm formation in paediatric patients with isolated blunt splenic injury using logistic regression analysis","authors":"Haruka Taira,&nbsp;Hideto Yasuda,&nbsp;Morihiro Katsura,&nbsp;Takatoshi Oishi,&nbsp;Yutaro Shinzato,&nbsp;Yuki Kishihara,&nbsp;Shunsuke Amagasa,&nbsp;Masahiro Kashiura,&nbsp;Yutaka Kondo,&nbsp;Shigeki Kushimoto,&nbsp;Takashi Moriya","doi":"10.1002/ams2.70073","DOIUrl":"https://doi.org/10.1002/ams2.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop and evaluate a predictive model for delayed pseudoaneurysm formation after non-operative management (NOM) in children with blunt splenic injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A post hoc analysis of a multicenter cohort study in Japan included patients aged ≤16 years who underwent NOM for isolated blunt splenic injuries. The outcome was the formation of a pseudoaneurysm, which was not identified on admission and confirmed at least 24 h after admission. Predictors were determined from data available within 24 h of hospital arrival. Five predictive models were developed using logistic regression analysis and evaluated using discrimination (receiver operating characteristic [ROC] and precision-recall curve [PRC]), calibration (calibration plot and Brier score) and decision curve analysis (DCA) with bootstrap resampling data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pseudoaneurysms developed in 41 (9.4%) of 434 cases of isolated splenic injury in our cohort. Model 1 (19 predictors) had the highest ROC (0.828) and PRC (0.358), followed by model 5 (8 predictors; ROC 0.805, PRC 0.295). Calibration was similar across models, indicating good calibration. Models 1 and 5 outperformed the other DCAs. Overall, model 5, incorporating factors such as age, sex, Injury Severity Score, American Association for the Surgery of Trauma-Organ Injury Scale, contrast extravasation on computed tomography, concomitant injuries, cryoprecipitate dose and NOM details, was simpler and showed better predictive ability than the other models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A predictive model for delayed pseudoaneurysm formation was developed with moderate discrimination and calibration. Further improvement using different modelling methods, such as machine learning, may be necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606554","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":"Preoperative interventional radiology in penetrating posterior abdominal trauma with bowel injury: A case report","authors":"Takafumi Ono,&nbsp;Nobuichiro Tamura,&nbsp;Keisuke Sasaguchi,&nbsp;Haruka Yano,&nbsp;Sayaka Nakahara,&nbsp;Akira Yamada,&nbsp;Sumio Kunikami,&nbsp;Yuto Sakano,&nbsp;Yukio Ishisaka,&nbsp;Tetsunori Ikegami","doi":"10.1002/ams2.70077","DOIUrl":"https://doi.org/10.1002/ams2.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Penetrating posterior abdominal injuries pose a significant risk of retroperitoneal and intra-abdominal damage. Although interventional radiology (IR) is commonly used for hemorrhage control in trauma cases, the role of IR in penetrating bowel injuries is unclear because these injuries often require urgent surgical repair, limiting the use of IR as a primary intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 76-year-old man sustained a penetrating posterior abdominal injury from a pruning shear, damaging the descending colon and lumbar arteries. Preoperative contrast-enhanced computed tomography (CT) revealed active extravasation into the colonic lumen and a retroperitoneal hematoma. A two-stage approach was implemented, starting with transcatheter arterial embolization of the lumbar artery, followed by surgical repair of the descending colon. Preoperative IR effectively controlled bleeding, enabling safe and efficient surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative IR can help manage penetrating posterior abdominal injuries, including bowel damage, when active extravasation complicates surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573510","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 stratified approach to hospital surge capacity during the COVID-19 pandemic in Tokyo","authors":"Yuzo Kodaira,&nbsp;Masataka Inokuchi,&nbsp;Taketomo Omomo,&nbsp;Kyoji Okazaki,&nbsp;Yasuhiro Takayama,&nbsp;Haruhide Miyagi,&nbsp;Tomoyo Narita","doi":"10.1002/ams2.70076","DOIUrl":"https://doi.org/10.1002/ams2.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surge capacity preparedness is critical for maintaining adequate healthcare delivery during pandemics and disasters. Urbanization and aging populations have heightened the need for innovative capacity strategies. Temporary hospitals provide a flexible solution, enabling adaptive responses through adjustable bed counts, tailored patient criteria, and strategic activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine temporary hospitals with 842 beds were established across Tokyo to manage COVID-19 surges, focusing on elderly patients with comorbidities, such as dementia, cardiovascular conditions, and chronic respiratory disorders. Admission criteria included age, absence of ventilator dependency, specific comorbidities, and an expected hospital stay of up to 10 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 2 years, the temporary hospitals admitted more than 10,000 patients, providing surge capacity for outbreaks and reducing the strain on permanent hospitals. Elderly patients requiring prolonged bedside care benefited from comprehensive medical management and rehabilitation, improving their functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Temporary hospitals designed for stratified patient populations offer a viable model for managing surge capacity in disaster medicine. This approach underscores the importance of adaptive strategies to address healthcare demands during public health emergencies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573511","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":"Excessive dynamic airway collapse leading to cardiac arrest due to airway obstruction","authors":"Shinichi Kida,&nbsp;Reiki Kumashiro,&nbsp;Naoki Yonezawa","doi":"10.1002/ams2.70074","DOIUrl":"https://doi.org/10.1002/ams2.70074","url":null,"abstract":"<p>An 85-year-old woman (body mass index 30.7 kg/m²), a never-smoker with a two-year history of a seal-like barking cough, presented with sudden-onset dyspnea. Examination revealed a respiratory rate of 21 breaths/min, expiratory wheezing, and an oxygen saturation of 90% on room air. Chest radiography revealed superior mediastinal widening with rightward tracheal deviation (Figure 1A), later attributed to an incidental thoracic aortic aneurysm. Computed tomography revealed pronounced posterior tracheal membrane collapse (Figure 1B) in the absence of emphysema. Shortly after imaging, the patient experienced a severe coughing episode, followed by stridor, choking, and cardiac arrest. Spontaneous circulation was restored after one cardiopulmonary resuscitation cycle and emergency intubation. Fiberoptic bronchoscopy (Video S1), performed with pressure support (positive end-expiratory pressure of 5 cm H₂O), showed a normal trachea during inspiration (Figure 1C) and pronounced posterior wall bulging during expiration (Figure 1D). These findings confirmed severe excessive dynamic airway collapse (EDAC), implicated in the cardiac arrest. On day 11, an uncovered self-expanding metallic stent was placed in the trachea, enabling successful extubation.</p><p>EDAC, often underdiagnosed, can mimic or coexist with inflammatory airway diseases.<span>¹</span> It is characterized by expiratory collapse of the posterior membranous tracheal wall, hypothesized to result from an imbalance between intraluminal and pleural pressures, exacerbated by reduced wall tone and pressure drops caused by the Bernoulli effect in tapering airways,<span>²</span> particularly when elastic recoil is reduced.<span>^{3, 4}</span></p><p>The authors declare no conflicts of interest.</p><p>Approval of the research protocol: None.</p><p>Informed consent: Published with the written consent of the patient.</p><p>Registry and the registration no. of the study/trial: None.</p><p>Animal studies: None.</p>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551078","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":"Hydrogen inhalation therapy alone may not alleviate intestinal mucosal damage in NOMI without total-layer necrosis: An experimental swine model study","authors":"Yasutaka Tanaka,&nbsp;Yosuke Matsumura,&nbsp;Yosuke Hayashi,&nbsp;Makoto Aoki,&nbsp;Yoshimitsu Izawa,&nbsp;Kazuhiro Endo,&nbsp;Takashi Mato","doi":"10.1002/ams2.70072","DOIUrl":"https://doi.org/10.1002/ams2.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Hydrogen inhalation therapy, a novel therapy for reducing oxidative stress in post-cardiac arrest syndrome, was beneficial for superior mesenteric artery (SMA) occlusion. We assessed the efficacy and feasibility of hydrogen inhalation therapy in swine models of critically ill conditions leading to non-occlusive mesenteric ischemia (NOMI) without acute surgical intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>NOMI was induced in eight 3- to 4-month-old female swine under general anesthesia. We defined the initiation of epinephrine administration via the SMA as T = 0 and the initiation of phlebotomy as T = −30 relative to this point. Hemorrhagic shock was induced by combining phlebotomy (T = −30 to −10), continuous systemic norepinephrine administration (T = −30 to 240), and continuous epinephrine injection through the SMA (T = 0–240). The extent of mesenteric ischemia was assessed through gross observation of the intestinal serosa, biomarkers, intestinal pathology, and computed tomography angiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Control (<i>n</i> = 4) and hydrogen (<i>n</i> = 4) groups with similar baseline characteristics were included. All animals survived until euthanasia (T = 240). The serosa became dark during local epinephrine administration. At T = 240, lactate levels in the control and hydrogen groups were 7.4 (4.7–11.3) and 5.6 (5.0–6.4) mmol/L, respectively, while median 8-hydroxy-2'-deoxyguanosinelevels were 0.15 (0.14–0.18) and 0.15 (0.13–0.16) ng/mL. The pH, base excess, and potassium levels were similar. No significant differences existed in the ischemic grade of the intestinal tract at any time or site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although critically ill conditions can trigger NOMI, the model used in this study did not involve transmural necrosis. Under such conditions, hydrogen inhalation therapy did not reduce histological ischemic damage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551077","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":"Bickerstaff brainstem encephalitis developed quickly after COVID-19 infection","authors":"Daiki Mori,&nbsp;Takahiro Yamada,&nbsp;Hiroshi Fukuma,&nbsp;Shota Nakao,&nbsp;Tetsuya Matsuoka","doi":"10.1002/ams2.70071","DOIUrl":"https://doi.org/10.1002/ams2.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bickerstaff brainstem encephalitis (BBE) is an autoimmune disease characterized by impaired consciousness, ophthalmoplegia, and ataxia. We report two cases of BBE following COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Case 1: A 51-year-old male was diagnosed with COVID-19 4 days after fever. He had prolonged loss of consciousness, and developed ophthalmoplegia and ataxia. He was treated with steroids and immunoglobulin, which improved his consciousness. Case 2: A 28-year-old female was diagnosed with COVID-19 because of fever 4 days after contact with a COVID-19 patient. She suffered from prolonged loss of consciousness, ophthalmoplegia, and myoclonus. She was treated with steroids, immunoglobulin, and plasmapheresis, which ameliorated her consciousness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both patients developed central nervous system (CNS) symptoms within a week of COVID-19 onset, indicating that BBE develops immediately after prior infection. This disease should be considered if CNS symptoms appear rapidly after COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524591","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}