Biomedical subjects

Atsushi Hiraide

Publications and source records attributed to Atsushi Hiraide.

7 recordsLinked to original sources

PubMed2006

Outcome and characteristics of out-of-hospital cardiac arrest according to location of arrest: A report from a large-scale, population-based study in Osaka, Japan.

OBJECTIVE: To evaluate the outcome and the factors concerned with of out-of-hospital cardiac arrest patients according to the location of the collapse. METHODS: From May 1st, 1998 to April 30th, 2001, 15,211 consecutive out-of-hospital cardiac arrest cases considered for resuscitation were recorded. Of these cases 7540 arrests in subjects aged 18 years or older with cardiac aetiology were analyzed. The outcome and the related-factors, particularly incidence of ventricular fibrillation, were evaluated according to the location of the cardiac arrest. To analyze the factors that affect the incidence of ventricular fibrillation, a logistic regression model was used. RESULTS: About three-quarters of out-of-hospital cardiac arrests occurred at private residences. The outcome and characteristics were significantly different according to the location of the arrest. Arrest patients in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at a private residence. The multivariate adjusted odds ratios for ventricular fibrillation in a public or work place were significantly higher than that in private residences, after adjusting for covariates affecting initial rhythm, such as age, sex, witnessed status, bystander cardiopulmonary resuscitation, and response interval. CONCLUSION: Although the majority of out-of-hospital cardiac arrests occur at private residences, arrests in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at private residences. In order to establish a system to improve the outcome of out-of-hospital cardiac arrest, a well-considered strategy considering the location of arrest is necessary.

Aged↗

PubMed2004

Vogt-Koyanagi-Harada disease occurring during interferon alpha therapy for chronic hepatitis C.

Retinal abnormalities, including retinal hemorrhage and "cotton-wool" spots, often occur within the first 8 weeks in the course of interferon therapy in patients with chronic hepatitis C. Here, we describe a case of Vogt-Koyanagi-Harada disease occurring 4 months after the start of interferon alpha treatment, probably induced by the immunomodulatory effects of interferon. Therefore, we conclude that chronic hepatitis C patients, especially people with darkly pigmented skin, need to be closely monitored for ophthalmologic complications, by periodic check-up of the optic fundi, for a prolonged period, during interferon treatment.

Adult↗

PubMed2004

Three year longitudinal study for out-of-hospital cardiac arrest in Osaka Prefecture.

OBJECTIVE: To analyze the longitudinal changes in the treatment of out-of-hospital cardiac arrests. These analyses have focused on the time interval from the receipt of call until defibrillation of patients with ventricular fibrillation. DESIGN: Population-based, prospective longitudinal study according to the Utstein style. SETTING: Osaka Prefecture (population 8, 800, 000), served by 36 municipal fire and emergency departments. PATIENTS: Consecutive, out-of-hospital cardiac arrests occurring between May 1998 and April 2001. MAIN OUTCOME MEASURES: Change in the interval to defibrillation, and one-year survival from cardiac arrest. RESULTS: Of the 15,211 cases of confirmed cardiac arrests during the three years, resuscitation was attempted in 14,609 subjects. Of the 2957 cases of cardiac origin and witnessed by bystanders, 90 cases (3.0%) were alive 1 year following the episode. In 383 cases of defibrillation, the interval from receipt of call to defibrillation was evaluated annually. This interval decreased significantly during the three year course (14.5, 13.0, and 11.5 min expressed by the median), suggesting that this project to report the data of out-of-hospital arrests was an effective campaign for EMT. However, the outcome did not improve significantly during this period (3.0%, 2.6%, and 3.6% alive 1 year in witnessed arrests with cardiac etiology). This may be because the third year median duration of 11.5 min, is still insufficient to indicate a significant improvement in the outcome. CONCLUSIONS: This project to report the data of out-of-hospital cardiac arrest might have contributed to the reduction of the interval for defibrillation, as a campaign for the EMTs; although the decrease in this interval was still insufficient to result in a significant increase in the number of cases who are alive one year later.

Electric Countershock↗

PubMed2003

Age and sex analyses of out-of-hospital cardiac arrest in Osaka, Japan.

OBJECTIVE: To determine effective interventional targets for out-of-hospital cardiac arrests by analyzing the distribution characteristics of arrest patients according to age and sex with special emphasis on ventricular fibrillation (VF). METHODS: All patients who suffered out-of-hospital cardiac arrest in Osaka Prefecture, Japan during 2 years, were prospectively recorded based on the Utstein style. The number and the incidence rate of cases of arrest, witnessed arrest, and witnessed VF were evaluated according to age and sex. The percentage of resuscitation attempts in arrest cases was also calculated. RESULTS: We recorded 10139 consecutive out-of-hospital cardiac arrest cases. Resuscitation was attempted in 97.0% of 10139 and showed no significant differences by age and sex. The incidence rate of cardiac arrests increased exponentially with age. Men showed a significantly higher incidence rate of out-of-hospital arrests than women in every age group. Most of the witnessed VF cases showed cardiac a aetiology and were predominantly observed in men in their 50s, 60s and 70s. The incidence rates of witnessed VF were also greater in them. CONCLUSION: Our study provides evidence that there are significant age and sex related epidemiological differences in cardiac arrests and we need to understand them better. Strategies that focus on high yielded patients, those in witnessed VF, should be pursued. These efforts should be expected to yield sex and age related differences in survivors.

Age Distribution↗

PubMed2003

Incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrest with cardiac etiology in Osaka, Japan: a population-based study according to the Utstein style.

PURPOSE: To clarify the incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrests (OHCA) with cardiac etiology in Osaka Prefecture, Japan, with a population of nearly 9 million according to the Utstein style. SUBJECTS AND METHODS: 5047 consecutive OHCA cases were treated by ambulance personnel during the 12-month period starting since 1 May 1998. 974 cases were considered to be bystander-witnessed OHCA with cardiac etiology and analyzed using the Utstein style. RESULTS: Of the 974 cases (100%), 50 cases (5.1%) survived after 1 month and 28 (2.9%) of them after 1 year. The Ventricular fibrillation (VF)/ventricular tachycardia (VT) group comprised 164 (16.8%) cases and there were statistically differences between the two groups as below (the VF/VT group vs. the non-VF/VT group): gender (male: 76.8 vs. 60.7%), age (61.7+/-14.7 vs. 68.7+/-17.1), history of ischemic heart disease (IHD) (30.5 vs. 15.3%), performance rate of bystander cardiopulmonary resuscitation (CPR) (34.1 vs. 21.4%) and time interval between receipt of an emergency call and arrival at the scene (5.5+/-2.9 vs. 6.0+/-2.9 min). CONCLUSION: The incidence of bystander-witnessed (OHCA) with cardiac etiology and VF or VT were remarkably low compared with those reported by other studies conducted in some areas of Europe or the USA.

Adult↗

PubMed2002

An analysis of time factors in out-of-hospital cardiac arrest in Osaka Prefecture.

OBJECTIVE: To ascertain important factors in the improvement of out-of-hospital cardiac arrest survival rates through analysis of data for Osaka Prefecture with the focus on time factors. DESIGN: Prospective cohort study according to the Utstein style. SETTING: Osaka Prefecture (population 8,830,000) served by a single emergency medical services system. PATIENTS: Consecutive prehospital cardiac arrests occurring between May 1998 and April 1999. MAIN OUTCOME MEASURES: One-year survival from cardiac arrest, and time factors. RESULT: Of the 5047 cases of confirmed cardiac arrests, resuscitation was attempted in 4871 subjects. Of the 982 cases of cardiac origin and witnessed by bystanders, 31 (3.2%) were still alive, and of the 576 cases of non-cardiac origin and witnessed by bystanders, ten (1.7%) were still alive at the 1 year follow-up. The median time from receipt of the emergency call until ambulance arrival was 5 min and that from receipt of the call until the start of cardiopulmonary resuscitation (CPR) was 7 min. For the 214 patients for whom defibrillation was attempted, the median time from receipt of the call until the first shock was 15 min. The median time from receipt of the call until departure of the ambulance from the scene was 16 min and that until arrival of the ambulance at a hospital was 22 min. CONCLUSIONS: This study using the standardized format according to the Utstein style clearly elucidates the specific delay of the start of defibrillation by paramedics and also indicates the inappropriate rule for this procedure in Japan.

Cardiopulmonary Resuscitation↗

PubMed2002

Beta-hydroxybutyrate, a cerebral function improving agent, protects rat brain against ischemic damage caused by permanent and transient focal cerebral ischemia.

In our previous study, beta-hydroxybutyrate (BHB) was found to prolong survival time and to inhibit cerebral edema by improving energy metabolism in the hypoxia, anoxia and global cerebral ischemia models. In this study, the cerebroprotective effect of BHB was examined in rats with permanent (p)-occlusion and transient (t)-occlusion of middle cerebral artery (MCA). BHB (30 mg x kg(-1) x h(-1) was continuously administered through the femoral vein. In rats with p-MCA occlusion, BHB significantly reduced infarct area at 24 h after the occlusion, but not at 72 h after the occlusion. In rats with 2-h t-MCA occlusion followed by 22-h reperfusion, BHB significantly reduced cerebral infarct area, edema formation, lipid peroxidation and neurological deficits. Moreover, in the t-MCA occlusion model, delayed administration of BHB started at 1 h after the initiation of the MCA occlusion also significantly reduced cerebral infarct area. Taking together the results obtained in our previous study into account, these results indicate that BHB decreased cerebral edema formation and infarct area by improving of the cerebral energy metabolism during ischemia and by inhibition of lipid peroxidation after reperfusion.

3-Hydroxybutyric Acid↗