基本情報
研究分野
1経歴
7-
2020年10月 - 現在
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2020年4月 - 2021年9月
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2016年4月 - 2020年3月
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2014年4月 - 2016年3月
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2013年4月 - 2014年3月
学歴
3-
2015年4月 - 2019年3月
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2000年4月 - 2006年3月
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1997年4月 - 2000年3月
論文
103-
The American journal of emergency medicine 82 183-189 2024年6月15日BACKGROUND: Status epilepticus (SE) is potentially life-threatening, however, it is unclear which antiepileptic drugs (AEDs) should be used as second-line AEDs. OBJECTIVE: We conducted a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing multiple second-line AEDs for SE to investigate the efficacy of AEDs. METHODS: We searched MEDLINE, CENTRAL, ClinicalTrials.gov, and World Health Organization International Clinical Trials Platform Search Portal and included RCTs for patients aged ≥15 years with SE on December 31, 2023. We compared multiple second-line AEDs for SE including fosphenytoin (fPHT), lacosamide (LCM), levetiracetam (LEV), phenytoin (PHT), phenobarbital (PHB), and valproate (VPA). The primary and secondly outcomes were termination of seizures integrating the absence of seizure recurrence at 30 min and 60 min, and adverse events associated with AEDs, respectively, with expressing as relative risk (RR) with a 95% confidence interval (CI). We conducted a NMA using frequentist-based approach with multivariate random effects, and assessed the certainty based on the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS: Seven RCTs (n = 780) were included, and statistically significant difference was detected between VPA vs. PHB (RR, 0.67; 95% CI, 0.53-0.85; very low certainty), fPHT vs. PHB (RR, 0.66; 95% CI, 0.48-0.90; very low certainty), LCM vs. PHB (RR, 0.62; 95% CI, 0.41-0.93; very low certainty), and LEV vs. PHB (RR, 0.69; 95% CI, 0.51-0.94; very low certainty). Moreover, PHB was the highest in the ranking for termination of seizures. For adverse events, no significant reduction was observed owing to the selection of AEDs, although the ranking of PHB was the lowest. CONCLUSIONS: PHB may have been the most effective for seizure termination as second-line AEDs in adult patients with SE. However, the certainty of almost all comparisons was "very low", and careful interpretation is essential.
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European journal of trauma and emergency surgery : official publication of the European Trauma Society 2024年5月23日PURPOSE: While follow-up CT and prophylactic embolization with angiography are often conducted during non-operative management (NOM) for BLSI, particularly in a high-grade injury, the utility of early repeated CT for preventing unexpected hemorrhage remains unclear. This study aimed to elucidate whether early follow-up computerized tomography (CT) within 7 days after admission would decrease unexpected hemostatic procedures on pediatric blunt liver and spleen injury (BLSI). METHODS: A post-hoc analysis of a multicenter observational cohort study on pediatric patients with BLSI (2008-2019) was conducted on those who underwent NOM, in whom the timing of follow-up CT were decided by treating physicians. The incidence of unexpected hemostatic procedure (laparotomy and/or emergency angiography for ruptured pseudoaneurysm) and complications related to BLSI were compared between patients with and without early follow-up CT within 7 days. Inverse probability weighting with propensity scores adjusted patient demographics, comorbidities, mechanism and severity of injury, initial resuscitation, and institutional characteristics. RESULTS: Among 1320 included patients, 552 underwent early follow-up CT. Approximately 25% of patients underwent angiography on the day of admission. The incidence of unexpected hemostasis was similar between patients with and without early repeat CT (8 [1.4%] vs. 6 [0.8%]; adjusted OR, 1.44 [0.62-3.34]; p = 0.40). Patients with repeat CT scans more frequently underwent multiple angiographies (OR, 2.79 [1.32-5.88]) and had more complications related to BLSI, particularly bile leak (OR, 1.73 [1.04-2.87]). CONCLUSION: Follow-up CT scans within 7 days was not associated with reduced unexpected hemostasis in NOM for pediatric BLSI.
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Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2024年4月8日OBJECTIVE: The objective was to investigate whether early advanced airway management during the entire resuscitation period is associated with favorable neurological outcomes and survival in patients with out-of-hospital cardiac arrest (OHCA). METHODS: We performed a retrospective cohort study of patients with OHCA aged ≥18 years enrolled in OHCA registry in Japan who received advanced airway management during cardiac arrest between June 2014 and December 2020. To address resuscitation time bias, we performed risk set matching analyses in which patients who did and did not receive advanced airway management were matched at the same time point (min) using the time-dependent propensity score; further, we compared early (≤10 min) and late (>10 min) advanced airway management. The primary and secondary outcome measures were favorable neurological outcomes using Cerebral Performance Category scores and survival at 1 month after cardiac arrest. RESULTS: Of the 41,101 eligible patients, 21,446 patients received early advanced airway management. Thus, risk set matching was performed with a total of 42,866 patients. In the main analysis, early advanced airway management was significantly associated with favorable neurological outcomes (risk ratio [RR] 0.997, 95% confidence interval [CI] 0.995-0.999) and survival (RR 0.990, 95% CI 0.986-0.994) at 1 month after cardiac arrest. In the sensitivity analysis with early advanced airway management defined as ≤5 min and ≤20 min, the results were comparable. CONCLUSIONS: Although early advanced airway management was statistically significant for improved neurological outcomes and survival at 1 month after cardiac arrest, the RR was very close to 1, indicating that the timing of advanced airway management has minimal impact on clinical outcomes, and decisions should be made based on the individual needs of the patient.
MISC
448-
日本集中治療医学会学術集会(Web) 43rd SY9‐3 (WEB ONLY) 2016年1月15日
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日本静脈経腸栄養学会雑誌 31(1) 240-240 2016年1月
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日本集中治療医学会雑誌 23(Suppl.) 233-233 2016年1月
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日本集中治療医学会雑誌 23(Suppl.) 353-353 2016年1月
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日本集中治療医学会雑誌 23(Suppl.) 354-354 2016年1月
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救急・集中治療 27(11-12) 949‐958 2015年11月25日
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救急・集中治療 27(11-12) 949-958 2015年11月<POINT>急性腎障害に対する腎代替療法の適応には大まかな基準はあるが、各項目に明確な基準はなく、各々の病態を考慮した適応を考えることが必要である。重症患者に対する腎代替療法には間欠的腎代替療法(IRRT)、持続的腎代替療法(CRRT)、SLEDがあるが、循環動態不安定な場合も含めてどの方法が最適なのかは病態によって異なり、明確な基準はない。腎代替療法における抗凝固薬は基本的にはヘパリンが推奨されるが、出血傾向などの全身状態を考慮して、メシル酸塩ナファモスタット、クエン酸、および抗凝固薬無投与を選択することもある。(著者抄録)
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呼吸器・循環器達人ナース 36(6) 35-43 2015年10月20日
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Intensivist 7(4) 900‐908-908 2015年10月1日
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呼吸器・循環器達人ナース 36(6) 35-43 2015年10月
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ICUとCCU 39(8) 449-456 2015年8月日本版重症敗血症診療ガイドライン2016(日本版GL 2016)作成において、「アカデミックガイドライン(GL)推進班」と呼ばれる、どの領域にも属さないグループが組織された。全領域を俯瞰的に眺めながら、各領域のクリニカルクエスチョン(CQ)作成・システマティックレビュー(SR)工程に関し、サポート・監査を行うことが本班の主な任務である。CQ案策定の過程において、1)SSCG 2012と日本版GL 2012のCQ・推奨度の比較、2)新規のランダム化比較試験、および3)日本版GL 2016のCQ案を含めたデータベースを構築した。CQ作成はGLの骨子であり最重要事項である。本データベースを参考に査読を行い、CQ案の改訂を各ワーキンググループで行っていただいた。作成されたCQ案は、委員会を経てさらに改定され、パブリックコメント募集まで至った。今後は各領域におけるSRのサポートをアカデミックGL推進班の活動として継続していく予定である。(著者抄録)
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日本救急医学会雑誌 26(8) 312-312 2015年8月
書籍等出版物
6講演・口頭発表等
39所属学協会
5-
2012年8月 - 現在
共同研究・競争的資金等の研究課題
3-
日本学術振興会 科学研究費助成事業 基盤研究(C) 2021年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2019年4月 - 2024年3月
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日本学術振興会 科学研究費助成事業 2017年4月 - 2019年3月