Publications by authors named "Norikazu Yamada"

Article Synopsis
  • A study was conducted to compare leg length discrepancies (LLD) after total hip arthroplasty (THA) using the anterolateral-supine approach, focusing on the impact of preserving the medial iliofemoral ligament (mILFL) on postoperative outcomes.
  • The study found that resection of the mILFL resulted in a higher likelihood of excessive leg lengthening, with significant differences in the proportion of patients experiencing LLD greater than 5 mm between the preservation and resection groups.
  • Ultimately, preserving the mILFL during ALSA THA is suggested to minimize leg length discrepancies without increasing complications, particularly for patients with preoperative LLD of less than 15 mm.
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Article Synopsis
  • The study examined the risk of recurrent venous thromboembolism (VTE) in patients with isolated distal deep vein thrombosis (DVT) who might experience thrombosis extension under different treatment regimens.
  • Conducted in Japan from April 2019 to April 2022, the trial involved 87 patients who received either rivaroxaban with physical therapy or physical therapy alone for 90 days, monitoring for VTE recurrence and major bleeding.
  • Results showed that the rivaroxaban group had no cases of VTE recurrence, while the physical therapy group had a 4.4% recurrence rate; however, rivaroxaban was associated with a higher incidence of major bleeding events (9.5%).
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Background: Risks of recurrence and major bleeding with extended anticoagulation in Asian patients with venous thromboembolism (VTE) are similar to those in non-Asian patients but risks according to baseline risk factor profiles is not well documented.

Methods: Subgroup analysis of two randomized trials, which compared once-daily rivaroxaban (20 mg or 10 mg) with placebo or aspirin (100 mg) for extended treatment in Asian patients with VTE who had completed 6-12 months of anticoagulation. Index events were classified as unprovoked, provoked by major persistent risk factors, minor persistent risk factors, minor transient risk factors, or major transient risk factors.

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Article Synopsis
  • - The KUROSIO study examined the use of direct oral anticoagulants (DOACs) as the primary treatment for Japanese patients with acute venous thromboembolism (VTE), involving 993 patients after exclusions.
  • - The study found low rates of recurrent symptomatic VTE (3.2%) and major bleeding (2.2%) during the first year of treatment, suggesting DOACs are generally effective and safe.
  • - Additionally, chemotherapy and anemia were identified as significant risk factors for experiencing recurrent VTE and major bleeding, respectively.
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Purpose: Dynamic chest radiography using X-ray fluoroscopic video analysis has shown potential for the diagnosis of pulmonary embolism (PE), but its diagnostic performance remains uncertain. We aimed to evaluate the diagnostic performance of fluoroscopic video analysis for diagnosing PE.

Methods: A prospective single-center observational study was conducted between October 2020 and January 2022.

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Article Synopsis
  • The CLOT-COVID Study analyzed 2894 hospitalized patients with COVID-19, focusing on 1738 patients with mild cases who didn’t need oxygen at admission.
  • Patients were split into two groups: those receiving prophylactic anticoagulation (326 patients) and those who were not (1412 patients).
  • Results showed that those on anticoagulation had higher severity levels during hospitalization and a slightly higher incidence of thrombosis, suggesting that routine use may not be beneficial for all stable patients.
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Purpose: The conjoined external rotator tendon (CERT), composed of the tendons of the gemellus superior, obturator internus (OI), and gemellus inferior muscles, stabilizes the hip joint. The study investigates the clinical and radiological effects of the CERT release during anterolateral-supine approach (ALSA) total hip arthroplasty (THA).

Methods: A cohort of 60 patients who underwent ALSA THA was examined.

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It is unclear whether patients with acute pulmonary thromboembolism (PE) with and without residual deep vein thrombosis (DVT) have different prognoses, and there is debate over whether inferior vena cava filters (IVCFs) should be used in conjunction with oral anticoagulants in patients with venous thromboembolism (VTE). The J'xactly involved 1,016 patients and was a multicenter, prospective, observational research. In this subanalysis, 419 patients with PE with or without residual DVT who received rivaroxaban with or without IVCFs between February 2016 and April 2018 in Japan were examined.

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Background: An established treatment strategy for asymptomatic pulmonary embolism (PE) or deep vein thrombosis (DVT) remains uncertain in Japan; therefore, in this study, we clarify the characteristics and outcomes of symptomatic compared to asymptomatic patients with PE or DVT.

Methods: This prospective, multicenter sub-analysis of the J'xactly study in Japan included 1,016 patients (mean age, 68; 41% male) with venous thromboembolism (VTE) treated with rivaroxaban.

Results: Asymptomatic PE patients (47% of PE patients) were more likely to have active cancer and asymptomatic proximal DVT at lower severity than symptomatic PE patients, despite no differences in age, sex, or the proportion receiving intensive 30 mg/day-rivaroxaban.

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Background: The difference between Young's moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young's modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems.

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Background: A large-scale prospective study of the efficacy and safety of warfarin for the treatment of venous thromboembolism (VTE) has not been conducted in Japan. Therefore, we conducted a real-world prospective multicenter observational cohort study (AKAFUJI Study; UMIN000014132) to investigate the efficacy and safety of warfarin for VTE.

Methods and results: Between May 2014 and March 2017, 352 patients (mean [±SD] age 67.

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This study aimed to investigate the clinical features of arterial thrombosis and venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19). The CLOT-COVID Study was a retrospective, multicenter cohort study that enrolled 2,894 consecutively hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We compared the clinical features of arterial thrombosis and VTE.

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Background: The incidence of venous thromboembolism (VTE; pulmonary embolism [PE] and/or deep vein thrombosis [DVT]) in Japan is increasing, but relatively small numbers of patients from Japan have been included in studies investigating rivaroxaban (a direct factor Xa inhibitor) for the treatment of VTE and preventing its recurrence.

Methods and results: An open-label, prospective, observational study (XASSENT [NCT02558465]) investigated the safety profile and effectiveness of rivaroxaban for ≤2 years in the treatment of VTE and prevention of its recurrence in Japanese clinical practice. Primary outcomes were major bleeding and symptomatic recurrent VTE.

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Rivaroxaban, a direct oral anticoagulant, is used as a first-line treatment to prevent venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). However, whether 21 days is optimal for the initial treatment duration has not been investigated. In this subanalysis of the prospective multicenter observational J'xactly study, which included 1,039 Japanese patients with acute symptomatic/asymptomatic DVT/PE who were prescribed rivaroxaban, the VTE recurrence rate and incidence of bleeding complications were assessed in 667 patients who underwent intensive rivaroxaban treatment (15 mg, twice daily) for a short (1-8 days), intermediate (9-16), or standard (17-24) duration.

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The relationship between the thrombotic event and prognosis in patients with coronavirus disease 2019 (COVID-19) has not yet been fully investigated in Japan. Our study aimed to investigate the clinical outcomes and risk factors for thrombosis in hospitalized patients with COVID-19 in Japan. We compared the patient characteristics and clinical outcomes among patients with thrombosis (N=55) and those without thrombosis (N=2839) by using a large-scale data of CLOT-COVID study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800).

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Background: The simple risk index recorded in the emergency room (ER-SRI), which is calculated using the formula (heart rate × [age / 10]) / systolic blood pressure, was shown to be able to stratify the prognosis in ST-elevation myocardial infarction (STEMI) patients. However, the prognostic impact of the prehospital simple risk index (Pre-SRI) remains unknown.

Methods and results: This study enrolled 2,047 STEMI patients from the Mie Acute Coronary Syndrome (ACS) registry.

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Background: D-dimer is a biomarker of fibrin production and degradation, and changes in D-dimer concentration suggest fibrin clot formation, which is associated with thromboembolism and hypercoagulable states. Thus, an elevated D-dimer concentration could be a useful prognostic predictor for patients with venous thromboembolism (VTE).

Methods And Results: In this subanalysis of the J'xactly study, a prospective multicenter study conducted in Japan, we examined the clinical outcomes of 949 patients with VTE stratified by baseline D-dimer concentration.

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Article Synopsis
  • The study focused on understanding the use of prophylactic anticoagulation for COVID-19 patients in Japan, highlighting its clinical management strategies.
  • Conducted as a multicenter observational study, it involved 2,894 hospitalized patients, ultimately analyzing 2,889 patients based on their anticoagulation treatment.
  • Results revealed that the severity of COVID-19 at admission strongly influenced the use of pharmacological thromboprophylaxis and therapeutic dosing, particularly in patients with comorbidities.
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Objectives: We assessed the effectiveness and safety of rivaroxaban in patients with isolated distal deep vein thrombosis (IDDVT).

Methods: Symptomatic venous thromboembolism (VTE) and major bleeding were assessed.

Results: Of 1016 patients with acute symptomatic/asymptomatic DVT and/or pulmonary embolism treated with rivaroxaban, 288 had IDDVT and 294 had proximal DVT (pDVT).

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Article Synopsis
  • A study in Japan investigated how effective and safe rivaroxaban is for treating patients with venous thromboembolism (VTE) who also have active cancer, comparing them with patients without cancer.
  • Researchers found differences in patient demographics, such as age and body mass index, but the initial dosages of rivaroxaban were similar in both groups.
  • The rates of VTE recurrence and major bleeding did not differ significantly between the two groups, but patients with active cancer had a much higher overall mortality rate within six months.
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Background: Reports of mortality-associated risk factors in patients with the novel coronavirus disease 2019 (COVID-19) are limited.

Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (n = 158) and those who were alive at discharge (n = 2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study, which enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.

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The efficacy and safety of direct oral anticoagulants (DOACs) in patients with unprovoked venous thromboembolism (VTE) remain unclear. In this subanalysis of the J'xactly study, a multicenter prospective observational study, we evaluated the safety and effectiveness of rivaroxaban in patients with acute VTE according to unprovoked (n=388) or provoked (n=557) VTE status. Median follow-up was 21.

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