17 results on '"Kuroda, Yasuhiro"'
Search Results
2. Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan
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Inoue, Akihiko, Hifumi, Toru, Sakamoto, Tetsuya, Okamoto, Hiroshi, Kunikata, Jun, Yokoi, Hideto, Sawano, Hirotaka, Egawa, Yuko, Kato, Shunichi, Sugiyama, Kazuhiro, Bunya, Naofumi, Kasai, Takehiko, Ijuin, Shinichi, Nakayama, Shinichi, Kanda, Jun, Kanou, Seiya, Takiguchi, Toru, Yokobori, Shoji, Takada, Hiroaki, Inoue, Kazushige, Takeuchi, Ichiro, Honzawa, Hiroshi, Kobayashi, Makoto, Hamagami, Tomohiro, Takayama, Wataru, Otomo, Yasuhiro, Maekawa, Kunihiko, Shimizu, Takafumi, Nara, Satoshi, Nasu, Michitaka, Takahashi, Kuniko, Hagiwara, Yoshihiro, Kushimoto, Shigeki, Fukuda, Reo, Ogura, Takayuki, Shiraishi, Shin-ichiro, Zushi, Ryosuke, Otani, Norio, Kikuchi, Migaku, Watanabe, Kazuhiro, Nakagami, Takuo, Shoko, Tomohisa, Kitamura, Nobuya, Otani, Takayuki, Matsuoka, Yoshinori, Aoki, Makoto, Sakuraya, Masaaki, Arimoto, Hideki, Homma, Koichiro, Naito, Hiromichi, Nakao, Shunichiro, Okazaki, Tomoya, Tahara, Yoshio, and Kuroda, Yasuhiro
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- 2022
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3. Low-flow time and outcomes in hypothermic cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation: a secondary analysis of a multi-center retrospective cohort study.
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Shoji, Kosuke, Ohbe, Hiroyuki, Matsuyama, Tasuku, Inoue, Akihiko, Hifumi, Toru, Sakamoto, Tetsuya, Kuroda, Yasuhiro, Kushimoto, Shigeki, Sawano, Hirotaka, Egawa, Yuko, Kato, Shunichi, Sugiyama, Kazuhiro, Bunya, Naofumi, Kasai, Takehiko, Ijuin, Shinichi, Nakayama, Shinichi, Kanda, Jun, Kanou, Seiya, Takiguchi, Toru, and Yokobori, Shoji
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CARDIOPULMONARY resuscitation ,CARDIAC arrest ,CARDIAC patients ,SECONDARY analysis ,COHORT analysis - Abstract
Background: In out-of-hospital cardiac arrest (OHCA) patients with extracorporeal cardiopulmonary resuscitation (ECPR), the association between low-flow time and outcomes in accidental hypothermia (AH) patients compared to those of patients without AH has not been fully investigated. Methods: This was a secondary analysis of the retrospective multicenter registry in Japan. We enrolled patients aged ≥ 18 years who had been admitted to the emergency department for OHCA and had undergone ECPR between January, 2013 and December, 2018. AH was defined as an arrival body temperature below 32 °C. The primary outcome was survival to discharge. Cubic spline analyses were performed to assess the non-linear associations between low-flow time and outcomes stratified by the presence of AH. We also analyzed the interaction between low-flow time and the presence of AH. Results: Of 1252 eligible patients, 105 (8.4%) and 1147 (91.6%) were in the AH and non-AH groups, respectively. Median low-flow time was 60 (47–79) min in the AH group and 51 (42–62) min in the non-AH group. The survival discharge rates in the AH and non-AH groups were 44.8% and 25.4%, respectively. The cubic spline analyses showed that survival discharge rate remained constant regardless of low-flow time in the AH group. Conversely, a decreasing trend was identified in the survival discharge rate with longer low-flow time in the non-AH group. The interaction analysis revealed a significant interaction between low-flow time and AH in survival discharge rate (p for interaction = 0.048). Conclusions: OHCA patients with arrival body temperature < 32 °C who had received ECPR had relatively good survival outcomes regardless of low-flow time, in contrast to those of patients without AH. [ABSTRACT FROM AUTHOR]
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- 2024
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4. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)
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Egi, Moritoki, Ogura, Hiroshi, Yatabe, Tomoaki, Atagi, Kazuaki, Inoue, Shigeaki, Iba, Toshiaki, Kakihana, Yasuyuki, Kawasaki, Tatsuya, Kushimoto, Shigeki, Kuroda, Yasuhiro, Kotani, Joji, Shime, Nobuaki, Taniguchi, Takumi, Tsuruta, Ryosuke, Doi, Kent, Doi, Matsuyuki, Nakada, Taka-aki, Nakane, Masaki, Fujishima, Seitaro, Hosokawa, Naoto, Masuda, Yoshiki, Matsushima, Asako, Matsuda, Naoyuki, Yamakawa, Kazuma, Hara, Yoshitaka, Sakuraya, Masaaki, Ohshimo, Shinichiro, Aoki, Yoshitaka, Inada, Mai, Umemura, Yutaka, Kawai, Yusuke, Kondo, Yutaka, Saito, Hiroki, Taito, Shunsuke, Takeda, Chikashi, Terayama, Takero, Tohira, Hideo, Hashimoto, Hideki, Hayashida, Kei, Hifumi, Toru, Hirose, Tomoya, Fukuda, Tatsuma, Fujii, Tomoko, Miura, Shinya, Yasuda, Hideto, Abe, Toshikazu, Andoh, Kohkichi, Iida, Yuki, Ishihara, Tadashi, Ide, Kentaro, Ito, Kenta, Ito, Yusuke, Inata, Yu, Utsunomiya, Akemi, Unoki, Takeshi, Endo, Koji, Ouchi, Akira, Ozaki, Masayuki, Ono, Satoshi, Katsura, Morihiro, Kawaguchi, Atsushi, Kawamura, Yusuke, Kudo, Daisuke, Kubo, Kenji, Kurahashi, Kiyoyasu, Sakuramoto, Hideaki, Shimoyama, Akira, Suzuki, Takeshi, Sekine, Shusuke, Sekino, Motohiro, Takahashi, Nozomi, Takahashi, Sei, Takahashi, Hiroshi, Tagami, Takashi, Tajima, Goro, Tatsumi, Hiroomi, Tani, Masanori, Tsuchiya, Asuka, Tsutsumi, Yusuke, Naito, Takaki, Nagae, Masaharu, Nagasawa, Ichiro, Nakamura, Kensuke, Nishimura, Tetsuro, Nunomiya, Shin, Norisue, Yasuhiro, Hashimoto, Satoru, Hasegawa, Daisuke, Hatakeyama, Junji, Hara, Naoki, Higashibeppu, Naoki, Furushima, Nana, Furusono, Hirotaka, Matsuishi, Yujiro, Matsuyama, Tasuku, Minematsu, Yusuke, Miyashita, Ryoichi, Miyatake, Yuji, Moriyasu, Megumi, Yamada, Toru, Yamada, Hiroyuki, Yamamoto, Ryo, Yoshida, Takeshi, Yoshida, Yuhei, Yoshimura, Jumpei, Yotsumoto, Ryuichi, Yonekura, Hiroshi, Wada, Takeshi, Watanabe, Eizo, Aoki, Makoto, Asai, Hideki, Abe, Takakuni, Igarashi, Yutaka, Iguchi, Naoya, Ishikawa, Masami, Ishimaru, Go, Isokawa, Shutaro, Itakura, Ryuta, Imahase, Hisashi, Imura, Haruki, Irinoda, Takashi, Uehara, Kenji, Ushio, Noritaka, Umegaki, Takeshi, Egawa, Yuko, Enomoto, Yuki, Ota, Kohei, Ohchi, Yoshifumi, Ohno, Takanori, Ohbe, Hiroyuki, Oka, Kazuyuki, Okada, Nobunaga, Okada, Yohei, Okano, Hiromu, Okamoto, Jun, Okuda, Hiroshi, Ogura, Takayuki, Onodera, Yu, Oyama, Yuhta, Kainuma, Motoshi, Kako, Eisuke, Kashiura, Masahiro, Kato, Hiromi, Kanaya, Akihiro, Kaneko, Tadashi, Kanehata, Keita, Kano, Ken-ichi, Kawano, Hiroyuki, Kikutani, Kazuya, Kikuchi, Hitoshi, Kido, Takahiro, Kimura, Sho, Koami, Hiroyuki, Kobashi, Daisuke, Saiki, Iwao, Sakai, Masahito, Sakamoto, Ayaka, Sato, Tetsuya, Shiga, Yasuhiro, Shimoto, Manabu, Shimoyama, Shinya, Shoko, Tomohisa, Sugawara, Yoh, Sugita, Atsunori, Suzuki, Satoshi, Suzuki, Yuji, Suhara, Tomohiro, Sonota, Kenji, Takauji, Shuhei, Takashima, Kohei, Takahashi, Sho, Takahashi, Yoko, Takeshita, Jun, Tanaka, Yuuki, Tampo, Akihito, Tsunoyama, Taichiro, Tetsuhara, Kenichi, Tokunaga, Kentaro, Tomioka, Yoshihiro, Tomita, Kentaro, Tominaga, Naoki, Toyosaki, Mitsunobu, Toyoda, Yukitoshi, Naito, Hiromichi, Nagata, Isao, Nagato, Tadashi, Nakamura, Yoshimi, Nakamori, Yuki, Nahara, Isao, Naraba, Hiromu, Narita, Chihiro, Nishioka, Norihiro, Nishimura, Tomoya, Nishiyama, Kei, Nomura, Tomohisa, Haga, Taiki, Hagiwara, Yoshihiro, Hashimoto, Katsuhiko, Hatachi, Takeshi, Hamasaki, Toshiaki, Hayashi, Takuya, Hayashi, Minoru, Hayamizu, Atsuki, Haraguchi, Go, Hirano, Yohei, Fujii, Ryo, Fujita, Motoki, Fujimura, Naoyuki, Funakoshi, Hiraku, Horiguchi, Masahito, Maki, Jun, Masunaga, Naohisa, Matsumura, Yosuke, Mayumi, Takuya, Minami, Keisuke, Miyazaki, Yuya, Miyamoto, Kazuyuki, Murata, Teppei, Yanai, Machi, Yano, Takao, Yamada, Kohei, Yamada, Naoki, Yamamoto, Tomonori, Yoshihiro, Shodai, Tanaka, Hiroshi, and Nishida, Osamu
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- 2021
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5. Hospital-level intracranial pressure monitoring utilization and functional outcome in severe traumatic brain injury: a post hoc analysis of prospective multicenter observational study
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Okazaki, Tomoya, Kawakita, Kenya, and Kuroda, Yasuhiro
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- 2021
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6. Association of abnormal carbon dioxide levels with poor neurological outcomes in aneurysmal subarachnoid hemorrhage: a retrospective observational study
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Yokoyama, Shota, Hifumi, Toru, Okazaki, Tomoya, Noma, Takahisa, Kawakita, Kenya, Tamiya, Takashi, Minamino, Tetsuo, and Kuroda, Yasuhiro
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- 2018
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7. Mild decrease in heart rate during early phase of targeted temperature management following tachycardia on admission is associated with unfavorable neurological outcomes after severe traumatic brain injury: a post hoc analysis of a multicenter randomized controlled trial
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Inoue, Akihiko, Hifumi, Toru, Kuroda, Yasuhiro, Nishimoto, Naoki, Kawakita, Kenya, Yamashita, Susumu, Oda, Yasutaka, Dohi, Kenji, Kobata, Hitoshi, Suehiro, Eiichi, Maekawa, Tsuyoshi, and on behalf of the Brain Hypothermia (B-HYPO) Study Group in Japan
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- 2018
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8. Aneurysmal subarachnoid hemorrhage: intensive care for improving neurological outcome
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Okazaki, Tomoya and Kuroda, Yasuhiro
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- 2018
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9. Association between physical restraint requirement and unfavorable neurologic outcomes in subarachnoid hemorrhage.
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Akiyama, Kyoko, Inoue, Akihiko, Hifumi, Toru, Nakamura, Kentaro, Taira, Takuya, Nakagawa, Shun, Jinno, Keisuke, Manabe, Arisa, Kinugasa, Sayaka, Matsumura, Hikaru, Shishido, Hajime, Yokoyama, Shota, Okazaki, Tomoya, Hamaya, Hideyuki, Takano, Koshiro, Kiridume, Kazutaka, Shinohara, Natsuyo, Kawakita, Kenya, and Kuroda, Yasuhiro
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SUBARACHNOID hemorrhage ,RESTRAINT of patients ,DRUG efficacy ,LOGISTIC regression analysis ,INTENSIVE care units - Abstract
Background: Physical restraint has been commonly indicated to patients with brain dysfunction in neurocritical care. The effect of physical restraints on outcomes of critically ill adults remains controversial as no randomized controlled trials have compared its safety and efficacy, and the association between physical restraint requirement and neurological outcome in patients with subarachnoid hemorrhage (SAH) has not been fully examined. The aim of this study was to examine the association between physical restraint requirement and neurological outcomes in patients with SAH. Methods: A single-center, retrospective study was conducted on patients with acute phase SAH treated for > 72 h in the intensive care unit from 2014 to 2020. Patients were divided into three groups based on the amount of time required for physical restraint during the first 24–72 h after admission: no, intermittent, and continuous use of physical restraint. Unfavorable neurologic outcome, assessed using the modified Rankin scale upon hospital discharge, has been considered as primary end point. Results: Overall, 101 patients were included in the study, with 52 patients (51.5%) having unfavorable neurological outcomes. Among them, 46 patients (45.5%) did not use physical restraint, and 55 (54.5%) patients used physical restraint during the first 24–72 h after admission: 26 (25.7%) intermittent and 29 (28.7%) continuous. Multivariable logistic regression analysis showed that continuous use of physical restraint during the first 24–72 h after admission was significantly associated with unfavorable neurological outcomes in patients with SAH (odds ratio, 3.54; 95% confidence interval, 1.05–13.06; p = 0.042) compared with no physical restraint. Conclusions: Continuous use of physical restraint during the first 24–72 h after admission was more significantly associated with unfavorable neurological outcomes than no physical restraint among patients with SAH during the acute phase. [ABSTRACT FROM AUTHOR]
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- 2021
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10. Therapeutic hypothermia in patients with coagulopathy following severe traumatic brain injury.
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Hifumi T, Kuroda Y, Kawakita K, Yamashita S, Oda Y, Dohi K, and Maekawa T
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- Adult, Aged, Blood Coagulation, Blood Coagulation Disorders etiology, Blood Coagulation Tests, Brain Injuries, Traumatic therapy, Female, Glasgow Outcome Scale, Hospital Mortality, Humans, Male, Middle Aged, Partial Thromboplastin Time, Blood Coagulation Disorders therapy, Brain Injuries, Traumatic complications, Hypothermia, Induced methods
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Background: Coagulopathy in traumatic brain injury (TBI) has been associated with poor neurological outcomes and higher in-hospital mortality. In general principle of trauma management, hypothermia should be prevented as it directly worsens coagulopathy. Therefore, we examined the safety of mild therapeutic hypothermia (MTH) in patients with coagulopathy following severe TBI., Methods: We re-evaluated the brain hypothermia (B-HYPO) study data based on coagulopathy and compared the Glasgow Outcome Scale scores and survival rates at 6 months using per protocol analyses. Coagulopathy was defined as an activated partial thromboplastin time (APTT) > 60 s and/or fibrin/fibrinogen degradation product levels (FDP) > 90 μg/mL on admission. Baseline characteristics, coagulation parameters, and outcomes were compared between the control and MTH groups with or without coagulopathy., Results: In patients with coagulopathy, 12 patients were allocated to the control group (35.5-37.0 °C) and 20 patients to the MTH group (32-34 °C). In patients without coagulopathy, 28 were allocated to the control group and 59 patients were allocated to the MTH group. In patients with coagulopathy, favorable neurological outcomes and survival rates were comparable between the control and MTH groups (33.3% vs. 35.0%, P = 1.00; 50.0% vs. 60.0%, P = 0.72) with no difference in complication rates. On admission, no significant differences in APTT or FDP levels were observed between the two groups; however, APTT was significantly prolonged in the MTH group compared to the control group on day 3., Discussion: Based on our study, MTH did not seem to negatively affect the outcomes in patients with coagulopathy following severe TBI on admission; therefore, the present study indicates that MTH may be applicable even in patients with severe TBI and coagulopathy., Conclusions: Our study suggests that in comparison to control, MTH does not worsen the outcome of patients with coagulopathy following severe TBI., Trial Registration: UMIN-CTR, No. C000000231 , Registered 13 September 2005.
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- 2017
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11. Erratum to: Neurocritical care update.
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Kuroda Y
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[This corrects the article DOI: 10.1186/s40560-016-0141-8.].
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- 2016
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12. Neurocritical care update.
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Kuroda Y
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This update comprises six important topics under neurocritical care that require reevaluation. For post-cardiac arrest brain injury, the evaluation of the injury and its corresponding therapy, including temperature modulation, is required. Analgosedation for target temperature management is an essential strategy to prevent shivering and minimizes endogenous stress induced by catecholamine surges. For severe traumatic brain injury, the diverse effects of therapeutic hypothermia depend on the complicated pathophysiology of the condition. Continuous electroencephalogram monitoring is an essential tool for detecting nonconvulsive status epilepticus in the intensive care unit (ICU). Neurocritical care, including advanced hemodynamic monitoring, is a fundamental approach for delayed cerebral ischemia following subarachnoid hemorrhage. We must be mindful of the high percentage of ICU patients who may develop sepsis-associated brain dysfunction.
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- 2016
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13. Effectiveness of lower target temperature therapeutic hypothermia in post-cardiac arrest syndrome patients with a resuscitation interval of ≤30 min.
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Kaneko T, Kasaoka S, Nakahara T, Sawano H, Tahara Y, Hase M, Nishioka K, Shirai S, Hazui H, Arimoto H, Kashiwase K, Motomura T, Kuroda Y, Yasuga Y, Yonemoto N, Yokoyama H, Nagao K, and Nonogi H
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Background: Therapeutic hypothermia (TH) is a standard strategy to reduce brain damage in post-cardiac arrest syndrome (PCAS) patients. However, it is unknown whether the target temperature should be adjusted for PCAS patients in different states., Methods: Participants in the J-PULSE-Hypo study database were divided into lower (32.0-33.5 °C; Group L) or moderate (34.0-35.0 °C; Group M) temperature groups. Primary outcome was a favourable neurological outcome (proportion of patients with a Glasgow-Pittsburgh Cerebral Performance Category [CPC] of 1-2 on day 30). We compared between the two groups and in subgroups of patients divided by age and resuscitation interval (interval from collapse to return of spontaneous circulation) by propensity score (PS) analysis., Results: Overall, 467 participants were analysed. The proportions of patients with favourable neurological outcomes were as follows (Group L vs. Group M) (OR; Odds ratio): all patients, 64 % (n = 42) vs. 55 % ((n = 424) (PS; OR 1.381 (0.596-3.197)), P = 0.452) and resuscitation interval ≤ 30 min, 88 % (n = 24) vs. 64 % ((n = 281) (PS; OR 7.438 (1.769-31.272)), P = 0.007)., Conclusions: PCAS patients with a resuscitation interval of <30 min may be candidates for TH with a target temperature of <34 °C., Trial Registration: University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000001935; available at: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000002348&language=J.
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- 2015
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14. Venomous snake bites: clinical diagnosis and treatment.
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Hifumi T, Sakai A, Kondo Y, Yamamoto A, Morine N, Ato M, Shibayama K, Umezawa K, Kiriu N, Kato H, Koido Y, Inoue J, Kawakita K, and Kuroda Y
- Abstract
Snake bites are life-threatening injuries that can require intensive care. The diagnosis and treatment of venomous snake bites is sometimes difficult for clinicians because sufficient information has not been provided in clinical practice. Here we review the literature to present the proper management of bites by mamushi, habu, and yamakagashi snakes, which widely inhabit Japan and other Asian countries. No definite diagnostic markers or kits are available for clinical practice; therefore, definitive diagnosis of snake-venom poisoning requires positive identification of the snake and observation of the clinical manifestations of envenomation. Mamushi (Gloydius blomhoffii) bites cause swelling and pain that spreads gradually from the bite site. The platelet count gradually decreases due to the platelet aggregation activity of the venom and can decrease to <100,000/mm(3). If the venom gets directly injected into the blood vessel, the platelet count rapidly decreases to <10,000/mm(3) within 1 h after the bite. Habu (Protobothrops flavoviridis) bites result in swelling within 30 min. Severe cases manifest not only local signs but also general symptoms such as vomiting, cyanosis, loss of consciousness, and hypotension. Yamakagashi (Rhabdophis tigrinus) bites induce life-threatening hemorrhagic symptoms and severe disseminated intravascular coagulation with a fibrinolytic phenotype, resulting in hypofibrinogenemia and increased levels of fibrinogen degradation products. Previously recommended first-aid measures such as tourniquets, incision, and suction are strongly discouraged. Once airway, breathing, and circulation have been established, a rapid, detailed history should be obtained. If a snake bite is suspected, hospital admission should be considered for further follow-up. All venomous snake bites can be effectively treated with antivenom. Side effects of antivenom should be prevented by sufficient preparation. Approved antivenoms for mamushi and habu are available. Yamakagashi antivenom is used as an off-label drug in Japan, requiring clinicians to join a clinical research group for its use in clinical practice.
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- 2015
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15. Update of antivenom supply for redback spider bites in Japan.
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Hifumi T, Taki H, Yamamoto A, Ato M, Koido Y, and Kuroda Y
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In autumn 2014, with great effort by the Ministry of Health, Labour and Welfare, the research group will obtain several vials of redback spider (RBS) antivenom for emergency use. However, these small amounts of antivenom are insufficient to cover the demands from majority of hospitals in Japan. The research group carefully discussed the domestic RBS antivenom production by themselves for this emergency. We have now entered the second stage for large-scale antivenom production. Although the domestic production of RBS antivenom has started, great caution is required as we move forward with this plan.
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- 2015
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16. Plasmodium berghei circumsporozoite protein encapsulated in oligomannose-coated liposomes confers protection against sporozoite infection in mice.
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Terkawi MA, Kuroda Y, Fukumoto S, Tanaka S, Kojima N, and Nishikawa Y
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- Animals, Disease Models, Animal, Female, Injections, Subcutaneous, Malaria immunology, Malaria Vaccines administration & dosage, Mannose, Merozoite Surface Protein 1 immunology, Mice, Mice, Inbred BALB C, Liposomes immunology, Malaria prevention & control, Malaria Vaccines immunology, Plasmodium berghei immunology, Protozoan Proteins immunology, Sporozoites immunology
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Background: The design and development of an effective malaria vaccine against the pre-erythrocytic and erythrocytic-stages of infection present a great challenge., Methods: In the present study, protective efficacy of oligomannose-coated liposome (OML)-entrapped merozoite and sporozoite antigens against Plasmodium berghei challenge infection in BALB/c mice was evaluated., Results: Subcutaneous immunization with truncated merozoite surface protein 1 entrapped with OML (OML-PbMSP1) prolonged survival, but failed to protect the mice from erythrocytic-stage infection, despite the antigen-specific antibody responses induced by the immunization regimen. In contrast, immunization with circumsporozoite protein entrapped with OML (OML-PbCSP) elicited antigen-specific humoral and cellular responses, which correlated with substantial protection against sporozoite challenge infections., Conclusions: The current results represent the use of an oligomannose-coated liposome-based vaccine against pre-erythrocytic and erythrocytic stages malaria infection. This approach may offer a new vaccination strategy against malaria infection.
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- 2014
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17. Clinical characteristics of redback spider bites.
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Hifumi T, Fujimi S, Yamagishi T, Arai S, Sawabe K, Yamamoto A, Ato M, Shibayama K, Ginnaga A, Kiriu N, Kato H, Koido Y, Inoue J, Kishikawa M, Abe Y, Kawakita K, Hagiike M, and Kuroda Y
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Background: Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia. Since the first case report in 1997 (Osaka), RBS bites have been a clinical and administrative issue in Japan; however, the clinical characteristics and effective treatment of RBS bites, particularly outside Australia remains unclear. This study aimed to elucidate the clinical characteristics of RBS bites and to clarify the effectiveness of the administration of antivenom for treatment., Methods: We performed a retrospective questionnaire survey from January 2009 to December 2013 to determine the following: patient characteristics, effect of antivenom treatment, and outcomes. To clarify the characteristics of patients who develop systemic symptoms, we compared patients with localized symptoms and those with systemic symptoms. We also examined the efficacy and adverse effects in cases administered antivenom., Results: Over the 5-year study period, 28 patients were identified from 10 hospitals. Of these, 39.3% were male and the median age was 32 years. Bites most commonly occurred on the hand, followed by the forearm. Over 80% of patients developed local pain and erythema, and 35.7% (10 patients) developed systemic symptoms. Baseline characteristics, vital signs, laboratory data, treatment-related factors, and outcome were not significantly different between the localized and systemic symptoms groups. Six patients with systemic symptoms received antivenom, of whom four experienced symptom relief following antivenom administration. Premedication with an antihistamine or epinephrine to prevent the adverse effects of antivenom was administered in four patients, which resulted in no anaphylaxis. One out of two patients who did not receive premedication developed a mild allergic reaction after antivenom administration that subsided without treatment., Conclusions: Approximately one third of cases developed systemic symptoms, and antivenom was administered effectively and safely in severe cases. Further research is required to identify clinically applicable indications for antivenom use.
- Published
- 2014
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