著者
Keiji Nakamura Satoshi Ide Sho Saito Noriko Kinoshita Satoshi Kutsuna Yuki Moriyama Tetsuya Suzuki Masayuki Ota Hidetoshi Nomoto Tetsuya Mizoue Masayuki Hojo Jin Takasaki Yusuke Asai Mari Terada Yutaro Akiyama Yusuke Miyazato Takato Nakamoto Yuji Wakimoto Mugen Ujiie Kei Yamamoto Masahiro Ishikane Shinichiro Morioka Kayoko Hayakawa Haruhito Sugiyama Norio Ohmagari
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
vol.2, no.3, pp.174-177, 2020-06-30 (Released:2020-07-04)
参考文献数
8
被引用文献数
7

Since the initial report of coronavirus disease (COVID-19) from the City of Wuhan, China in December 2019, there have been multiple cases globally. Reported here are 11 cases of COVID-19 at this hospital; all of the patients in question presented with relative bradycardia. The severity of the disease was classified into four grades. Of the patients studied, 3 with mild COVID-19 and 3 with moderate COVID-19 improved spontaneously. Lopinavir/ritonavir was administered to 3 patients with severe COVID-19 and 2 with critical COVID-19. Both patients with critical COVID-19 required mechanical ventilation and extracorporeal membrane oxygenation. Both patients with critical COVID-19 had a higher fever that persisted for longer than patients with milder COVID-19. The respiratory status of patients with critical COVID-19 worsened rapidly 7 days after the onset of symptoms. Relative bradycardia may be useful in distinguishing between COVID-19 and bacterial community-acquired pneumonia. In patients who have had a fever for > 7 days, the condition might worsen suddenly.
著者
Kayoko Hayakawa Satoshi Kutsuna Takeo Kawamata Yuko Sugiki Chiharu Nonaka Keiko Tanaka Michi Shoji Masaki Nagai Shunsuke Tezuka Kazuyuki Shinya Hiroki Saito Takahiro Harada Nin Moriya Motoyuki Tsuboi Masataro Norizuki Yasuo Sugiura Yasuyo Osanai Masaya Sugiyama Ayako Okuhama Kohei Kanda Yuji Wakimoto Mugen Ujiie Shinichiro Morioka Kei Yamamoto Noriko Kinoshita Masahiro Ishikane Sho Saito Yuki Moriyama Masayuki Ota Keiji Nakamura Takato Nakamoto Satoshi Ide Hidetoshi Nomoto Yutaro Akiyama Tetsuya Suzuki Yusuke Miyazato Yoshiaki Gu Nobuaki Matsunaga Shinya Tsuzuki Yumiko Fujitomo Yoshiki Kusama Hiroyuki Shichino Masao Kaneshige Junko Yamanaka Miki Saito Masayuki Hojo Masao Hashimoto Shinyu Izumi Jin Takasaki Manabu Suzuki Keita Sakamoto Yukio Hiroi Sakurako Emoto Makoto Tokuhara Toshiaki Kobayashi Koichiro Tomiyama Fumihiko Nakamura Norio Ohmagari Haruhito Sugiyama
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
vol.2, no.2, pp.107-111, 2020-04-30 (Released:2020-05-10)
参考文献数
11
被引用文献数
25

Due to the significant spread of a new type of coronavirus (SARS-CoV-2) infection (COVID-19) in China, the Chinese government blockaded several cities in Hubei Province. Japanese citizens lost a means of transportation to return back to Japan. The National Center for Global Health and Medicine (NCGM) helped the operation of charter flights for evacuation of Japanese residents from Hubei Province, and this article outlines our experiences. A total of five charter flights were dispatched, and the majority of returnees (793/829 [95.7%]) were handled at NCGM. A large number of personnel from various departments participated in this operation; 107 physicians, 115 nurses, 110 clerical staff, and 45 laboratory technicians in total. Several medical translators were also involved. In this operation, we conducted airborne precautions in addition to contact precautions. Eye shields were also used. The doctors collecting the pharyngeal swab used a coverall to minimize the risk of body surface contamination from secretions and droplets. Enhanced hand hygiene using alcohol hand sanitizer was performed. Forty-eight persons were ultimately hospitalized after the triage at NCGM operation, which was more than the number of persons triaged at the airport (n = 34). Of those hospitalized after NCGM triage, 8.3% (4/48 patients) ultimately tested positive for SARS-CoV-2, significantly higher than the positive rate among subjects not triaged (4/48 [8.3%] vs. 9/745 [1.2%]: p = 0.0057). NCGM participated in a large-scale operation to evacuate Japanese nationals from the COVID-19 epidemic area. We were able to establish a scheme through this experience that can be used in the future.
著者
Shion Miyoshi Jin Takasaki Sohtaro Mine Masanori Kono Toru Igari Yuichiro Takeda Masayuki Hojo Haruhito Sugiyama
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.56, no.9, pp.1079-1083, 2017-05-01 (Released:2017-05-01)
参考文献数
16
被引用文献数
3

Anti-tumor necrosis factor α (anti-TNFα) agents increase the risk of tuberculosis (TB), but cases are rarely fatal. This report concerns a patient who was undergoing treatment with infliximab and presented with acute respiratory distress syndrome due to miliary TB without a miliary shadow. The findings of a pathological autopsy revealed innumerable granulomas in the organs, and the miliary nodules in the lung consisted of more unstructured granulomas. Anti-TNFα agents are unusual in the presentation of TB. It is important, particularly for patients receiving anti-TNFα agents, to constantly consider the possibility of TB and to prepare for appropriate management.
著者
Kayoko Hayakawa Satoshi Kutsuna Takeo Kawamata Yuko Sugiki Chiharu Nonaka Keiko Tanaka Michi Shoji Masaki Nagai Shunsuke Tezuka Kazuyuki Shinya Hiroki Saito Takahiro Harada Nin Moriya Motoyuki Tsuboi Masataro Norizuki Yasuo Sugiura Yasuyo Osanai Masaya Sugiyama Ayako Okuhama Kohei Kanda Yuji Wakimoto Mugen Ujiie Shinichiro Morioka Kei Yamamoto Noriko Kinoshita Masahiro Ishikane Sho Saito Yuki Moriyama Masayuki Ota Keiji Nakamura Takato Nakamoto Satoshi Ide Hidetoshi Nomoto Yutaro Akiyama Tetsuya Suzuki Yusuke Miyazato Yoshiaki Gu Nobuaki Matsunaga Shinya Tsuzuki Yumiko Fujitomo Yoshiki Kusama Hiroyuki Shichino Masao Kaneshige Junko Yamanaka Miki Saito Masayuki Hojo Masao Hashimoto Shinyu Izumi Jin Takasaki Manabu Suzuki Keita Sakamoto Yukio Hiroi Sakurako Emoto Makoto Tokuhara Toshiaki Kobayashi Koichiro Tomiyama Fumihiko Nakamura Norio Ohmagari Haruhito Sugiyama
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2020.01036, (Released:2020-04-29)
参考文献数
11
被引用文献数
25

Due to the significant spread of a new type of coronavirus (SARS-CoV-2) infection (COVID-19) in China, the Chinese government blockaded several cities in Hubei Province. Japanese citizens lost a means of transportation to return back to Japan. The National Center for Global Health and Medicine (NCGM) helped the operation of charter flights for evacuation of Japanese residents from Hubei Province, and this article outlines our experiences. A total of five charter flights were dispatched, and the majority of returnees (793/829 [95.7%]) were handled at NCGM. A large number of personnel from various departments participated in this operation; 107 physicians, 115 nurses, 110 clerical staff, and 45 laboratory technicians in total. Several medical translators were also involved. In this operation, we conducted airborne precautions in addition to contact precautions. Eye shields were also used. The doctors collecting the pharyngeal swab used a coverall to minimize the risk of body surface contamination from secretions and droplets. Enhanced hand hygiene using alcohol hand sanitizer was performed. Forty-eight persons were ultimately hospitalized after the triage at NCGM operation, which was more than the number of persons triaged at the airport (n = 34). Of those hospitalized after NCGM triage, 8.3% (4/48 patients) ultimately tested positive for SARS-CoV-2, significantly higher than the positive rate among subjects not triaged (4/48 [8.3%] vs. 9/745 [1.2%]: p = 0.0057). NCGM participated in a large-scale operation to evacuate Japanese nationals from the COVID-19 epidemic area. We were able to establish a scheme through this experience that can be used in the future.
著者
Masayuki Hojo Junko Terada-Hirashima Haruhito Sugiyama
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2020.01117, (Released:2021-03-09)
参考文献数
40
被引用文献数
8

Angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2), two receptors on the cell membrane of bronchial epithelial cells, are indispensable for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ACE2 receptor is increased among aged, males, and smokers. As smoking upsurges ACE2 expression, chronic obstructive pulmonary disease (COPD) patients are prone to SARS-CoV-2 infection, and are at a higher risk for severe forms of COVID-19 (coronavirus disease 2019) once infected. The expression of ACE2 and TMPRSS2 in asthma patients is identical (or less common) to that of healthy participants. ACE2 especially, tends to be low in patients with strong atopic factors and in those with poor asthma control. Therefore, it could be speculated that asthma patients are not susceptible to COVID-19. Epidemiologically, asthma patients are less likely to suffer from COVID-19, and the number of hospitalized patients due to exacerbation of asthma in Japan is also clearly reduced during the COVID-19 pandemic; therefore, they are not aggravating factors for COVID-19. Related academic societies in Japan and abroad still lack clear evidence regarding asthma treatment during the COVID-19 pandemic, and recommend that regular treatment including biologics for severe patients be continued.
著者
Naoko Nagano Manabu Suzuki Shota Yamamoto Konomi Kobayashi Motoyasu Iikura Shinyu Izumi Masayuki Hojo Haruhito Sugiyama
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2022.01057, (Released:2022-11-20)
参考文献数
30

Bronchial artery embolization (BAE) is the first choice treatment for hemoptysis. With advances in endovascular treatment, various embolic materials have become available. However, the optimal embolic material for the treatment of cryptogenic hemoptysis has not been determined. This study aimed to investigate the short- and long-term efficacy of BAE using a gelatin sponge in the treatment of patients with cryptogenic hemoptysis. The clinical characteristics, angiographic findings, and short- and long-term outcomes of BAE were retrospectively analyzed in 22 consecutive patients who underwent BAE for control of cryptogenic hemoptysis between January 2010 and September 2018. Selective angiography and super-selective BAE were successfully performed for all patients. A gelatin sponge was used in all patients. Further, polyvinyl alcohol was mixed with the gelatin sponge in 11 patients (50%). Angiography showed that the bronchial artery was responsible for hemoptysis in all patients, along with the intercostal artery in one patient (4.5%) and the inferior phrenic artery in one patient (4.5%). Immediate hemostasis was achieved in all patients. The recurrence-free rate was 100% for 1 month, 94.1% for 3 months, 94.1% for 12 months, and 87.4% for 24 months. Of two patients with recurrent hemoptysis, one underwent bronchoscopic hemoptysis and the other received intravenous hemostatic agents. No patient underwent BAE for recurrence. No severe complications occurred. In conclusion, BAE using a gelatin sponge has short- and long-term hemostatic efficacy for treating cryptogenic hemoptysis without any severe complications. A gelatin sponge is a suitable embolic material for patients with cryptogenic hemoptysis.
著者
Kentaro Kobayashi Akio Kimura Ryo Sasaki Kayoko Hayakawa Norio Ohmagari Yasuo Sugiura Haruhito Sugiyama Norihiro Kokudo
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
vol.4, no.4, pp.230-232, 2022-08-31 (Released:2022-09-03)
参考文献数
3
被引用文献数
1

In preparation for the Tokyo 2020 Olympic and Paralympic Games, our hospital was responsible for accepting mainly media representatives, marketing partners, and other Games staff. Given that restricting our regular capacity to treat certain groups of patients could potentially result in social losses, to avoid this we made rigorous preparations for the entire hospital to accept Games-related patients. It was rational to set up a single 24-h contact point at the Emergency Department for making the decision on whether to accept the patient or not and for coordinating the patient's medical care. With respect to language support, International Health Care Center staffs were made available as interpreters on weekdays. Multilingual support was available all day via an application run on tablet devices. During a 67-day period, the hospital accepted 31 Games-related patients (mean age 43.4 years, male: female ratio 25:6). Eighteen patients were from Europe, 4 patients each were from North America and Asia, 2 each were from Central America, South America, and Africa, and 1 was from Oceania. The most common cause of visits was COVID-19, but none were severe cases. Other causes were diverse and included moderate and severe conditions. We summarized the challenges and experiences in handling Tokyo 2020 Games-related patients at a designated hospital during the COVID-19 pandemic
著者
Norihiro Kokudo Haruhito Sugiyama
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
vol.3, no.2, pp.56-59, 2021-04-30 (Released:2021-05-08)
参考文献数
8
被引用文献数
29

The rapid global spread of the COVID-19 pandemic has posed a significant challenge to various countries in terms of the capacity of hospitals to admit and care for patients during the crisis. To estimate hospital capacity during the COVID-19 pandemic, clinicians working in tertiary hospitals around the world were surveyed regarding available COVID-19 hospital statistics. Data were obtained from 8 tertiary centers in 8 countries including the United States, United Kingdom, Switzerland, Turkey, Singapore, India, Pakistan, and Japan. The correlation between the number of patients with COVID-19 per 1 million population vs. the maximum number of inpatients with COVID-19 in a representative tertiary hospital in each country was determined, as was the correlation between COVID-19 deaths per 1 million population vs. the maximum number of patients with COVID-19 in the intensive care unit (ICU). What was noteworthy was that none of the 8 hospitals reduced emergency room (ER) activity even at the peak of the pandemic although treatment of patients without COVID-19 decreased by 0-70% depending on the extent of the epidemic. Although various measures are being actively implemented to slow the spread of the virus and reduce the strain on the health care system, the reality is that there are still a significant number of hospitals at risk of being overloaded in the event of a future surge in cases.