Antithrombin may benefit septic patients with DIC but not the overall sepsis cohort. Despite potential hemorrhagic risks, considering indications is crucial for balancing benefits and harms. Optimal dosage remains unknown; large-scale studies are needed to identify the patient population, dosage, administration duration, and target activity levels for effective antithrombin treatment in sepsis. Abstract Aims There have been inconsistent reports regarding the effect of antithrombin on sepsis; furthermore, there are limited reports on how dosage affects therapeutic efficacy. Thus, we aimed to ..read more

eGFR was associated with neurological prognosis among OHCA patients with initial shockable rhythm at the scene but not among those with non-shockable rhythm (PEA or asystole). Additionally, eGFR was associated with neurological prognosis among young (<65 years) OHCA patients with initial shockable rhythm but not among older patients. Abstract Aim We aimed to investigate the association between estimated glomerular filtration rate and prognosis in out-of-hospital cardiac arrest patients and explore the heterogeneity of the association. Methods Patients experiencing out-of-hospital cardiac ..read more

Up to 40% of elderly patients who were critically ill could not walk without assistance at hospital discharge, even if they had been living independently before hospitalization. The prognostic factors with mobility discharge were CFS ≥5, SOFA ≥6, and neurological disorders. Abstract Aim We aimed to evaluate the clinical characteristics and outcomes of elderly critically ill patients and identify prognostic factors for mobility disability at discharge. Methods This single-center, retrospective cohort study investigated the period from April 2020 to January 2021. Patients ≥75 years old transfe ..read more

A 69-year-old man was injured in a motor vehicle accident, and a penetrating cardiac injury was detected and surgically treated via video-assisted thoracoscopic surgery (VATS). Exploratory VATS may play a key role in the primary diagnosis of patients with high energy chest traumas with cardiac injury and simultaneously allow for the appropriate surgical interventions. Abstract Background Penetrating cardiac injuries are usually fatal and associated with poor survival rates. Case Presentation A 69-year-old man was injured in a motor vehicle accident and suffered from left hemothorax and multi ..read more

The critically ill patients’ background is heterogeneous and requires individually optimized treatment. Advances in comprehensive biomolecular information measurement and bioinformatics technologies have made it possible to analyze molecular pathogenesis in detail and this enabled reverse translational research for drug discovery. Abstract Each patient with a critical illness such as sepsis and severe trauma has a different genetic background, comorbidities, age, and sex. Moreover, pathophysiology changes dynamically over time even in the same patient. Therefore, individualized treatment is ..read more

Coronary computed tomography–angiography can diagnose coronary artery transection in patients with chest stab wounds before surgery. Unless a resuscitative thoracotomy is required, performing coronary CTA might be considered in patients with chest stab wounds. Abstract Background Penetrating thoracic trauma with coronary artery transection is a lethal injury, but is rare. We report a case of a cardiac stab wound with coronary artery transection that was successfully treated after preoperative diagnosis. Case Presentation A 36-year-old man was transferred to our emergency department with a le ..read more

Acute Medicine &Surgery, Volume 11, Issue 1, January/December 2024 ..read more

Acute Medicine &Surgery, Volume 11, Issue 1, January/December 2024 ..read more

In patients who have overdosed on prescription or over-the-counter drugs, logistic regression analysis identified paracetamol, alcohol, and abnormal vital signs at the scene as risk factors for requiring advanced care. Furthermore, the PAV score, which comprises these three factors, may be predictive of the need for advanced care. Abstract Aim Prescription drug and over-the-counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care ..read more

There have been rare reports of chest tubes penetrating the liver and reaching the inferior vena cava. In our case, chest tube replacement caused this type of injury, and elective surgery saved the patient's life. Abstract Background Several reports on organ injury and death due to incorrect chest tube insertion exist; however, reports on the chest tube penetrating the liver and reaching the inferior vena cava are limited. Case Presentation A 79-year-old man presented with a clamped tube because of massive bleeding from the tube following right chest tube replacement in the hospital of origi ..read more