Targeted Temperature Management for Traumatic Asphyxia: A Case Report.

Traumatic asphyxia (TA) is a rare condition due to severe crush injury to the upper abdomen or chest region. Elevated intrathoracic pressure causes impaired venous return, which damages the small vessels. Consciousness is reportedly lost in many TA cases. In the most severe cases, hypoxic encephalopathy occurs. Since TA patients usually have other traumatic complications such as thoracic or abdominal injury, the mortality rate of this syndrome is quite variable. Hypothermia is a risk factor for mortality in trauma patients, and targeted temperature management (TTM) is rarely performed for trauma cases. There are scattered articles reporting the usefulness of TTM in severe traumatic brain injury. To our best knowledge, there have been no reports of TTM in TA cases. We herein report a TA case with decorticate rigidity having a good neurological outcome after TTM.

A Case of Loss of Consciousness Due to Thrombosis of the Inferior Vena Cava and Portal Vein.

We present a case where intraperitoneal venous thrombosis was difficult to treat. It is difficult to suspect intraperitoneal venous thrombosis in patients who have visited the hospital due to loss of consciousness, and it is necessary to administer anticoagulants early for treatment and to determine the appropriate timing for surgical intervention. The patient was a 78-year-old male who independently performed his daily activities. On the day of admission, he lost consciousness and was brought to our hospital. Computed tomography (CT) angiography revealed thrombi from the inferior vena cava and portal vein to the superior mesenteric vein, and the patient was started on anticoagulant therapy. The CT angiography images on day 7 of the illness revealed that the thrombus in the superior mesenteric vein expanded to the caudal side. Intestinal necrosis occurred on day 22 of the illness, and emergency laparotomy was performed. The chosen course of treatment was successful, and the patient was discharged on the 48th day.

Medicine at mass gatherings: current progress of preparedness of emergency medical services and disaster medical response during 2020 Tokyo Olympic and Paralympic Games from the perspective of the Academic Consortium (AC2020).

Mass gatherings are events characterized by "the concentration of people at a specific location for a specific purpose over a set period of time that have the potential to strain the planning and response resources of the host country or community." Previous reports showed that, as a result of the concentration of people in the limited area, injury and illness occurred due to several factors. The response plan should aim to provide timely medical care to the patients and to reduce the burden on emergency hospitals, and to maintain a daily emergency medical services system for residents of the local area. Although a mass gathering event will place a significant burden on the local health-care system, it can provide the opportunity for long-term benefits of public health-care and improvement of daily medical service systems after the end of the event. The next Olympic and Paralympic Games will be held in Tokyo, during which mass gatherings will occur on a daily basis in the context of the coronavirus disease (COVID-19) epidemic. The Academic Consortium on Emergency Medical Services and Disaster Medical Response Plan during the Tokyo Olympic and Paralympic Games in 2020 (AC2020) was launched 2016, consisting of 28 academic societies in Japan, it has released statements based on assessments of medical risk and publishing guidelines and manuals on its website. This paper outlines the issues and countermeasures for emergency and disaster medical care related to the holding of this big event, focusing on the activities of the academic consortium.

A Simple Screening Method for Extra Virgin Olive Oil Adulteration by Determining Squalene and Tyrosol.

A simple screening method for discrimination between commercial extra virgin olive oils and their blends with other vegetable oils was developed. Squalene, which was contained relatively high amounts in virgin olive oil, was determined by HPLC after a simple pretreatment that was carried out by dilution of oil samples with 2-propanol. Tyrosol, which was contained at relatively high concentration in virgin olive oil among phenolic compounds, was determined by HPLC after a simple liquid-liquid extraction. When using squalene and tyrosol contents as axes, extra virgin olive oils could be discriminated from pure olive oils, blended oils (extra virgin olive oils with sunflower oil or grapeseed oil) and other vegetable oils. These results suggest that determining squalene and tyrosol in seed oil samples could be useful in distinguishing between extra virgin olive oil and blended oils as a screening method.

Influence of the diameter and taper of root canals on the removal efficiency of Thermafil Plus plastic carriers using ProTaper Retreatment Files.

INTRODUCTION: This study aimed to investigate the influence of canal shape on the time required for the removal of Thermafil Plus plastic carriers (Dentsply Tulsa Dental, Tulsa, OK) using ProTaper Retreatment Files (Dentsply Maillefer, Ballaigues, Switzerland). METHODS: Sixty simulated J-shaped canals in resin blocks were divided into six groups prepared differently in terms of apical size (25/04 or 35/06) and coronal enlargement (no coronal enlargement, using a K3 orifice opener [SybronEndo, Orange, CA] 25/08, or using Gates-Glidden drills [Mani, Tochigi, Japan] #1-4) and were filled with a Thermafil Plus of the same carrier size (size 25 or 35). The carriers were removed using ProTaper D1, D2, and D3 in a crown-down sequence, and removal time was measured. A similar experiment was performed using extracted mandibular incisors prepared to 25/04 with or without coronal enlargement using Gates-Glidden drills (n = 10 each). RESULTS: Simulated canals coronally enlarged with Gates-Glidden drills required a significantly longer removal time than other groups of identical apical size (p < 0.05). When groups with similar coronal enlargement were compared, those apically prepared to 35/06 required a significantly longer removal time than those prepared to 25/04 (p < 0.05). Coronally enlarged incisors also required a significantly longer removal time than those without coronal enlargement (p < 0.05). CONCLUSIONS: Canals with a larger diameter and/or taper required more time for the removal of Thermafil Plus plastic carriers.

[Clinical analysis of cervical-spine and spinal-cord-injured patients brought in without cervical spinal immobilization].

The purpose of this study was to determine the incidence of mismanaged injury of the cervical spinal cord, to identify factors contributing to a failure to recognize such injury. Thirty-three patients with cervical spinal cord injury were transported to emergency department during the period from October, 1999 to March, 2001. Seven patients (21%) of them were transferred without cervical spine immobilization. Mechanism of injury in 7 patients was fall in 4, motor vehicle crash in 2, unknown in one. Clinical signs on admission revealed neck pain and/or back pain in 4 patients, altered mental status in 4 patients, numbness of extremities in 2 patients, paradoxical respiration in 2 patients, respiratory arrest in one. Neurological classification of Frankel grade was A in 2, B in 1, C in 2, D in 1 and E in 1. All trauma patients with a cervical spine injury or with a mechanism of injury having the potential to cause cervical spine injury should be immobilized at the scene, during transport and at the emergency room by using one of several available methods.