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258 results on '"FUJIHARA, Yuki"'

69. The effect of impactful papers on clinical practice in the US: Corticosteroid injection for patients with lateral epicondylitis

Author

Fujihara, Yuki, Huetteman, Helen E., Chung, Ting-Ting, Shauver, Melissa J., and Chung, Kevin C.

Subjects
Adult, Male, Publishing, Platelet-Rich Plasma, Tennis Elbow, Middle Aged, Article, United States, Injections, Intra-Articular, Treatment Outcome, Evidence-Based Practice, Elbow, Humans, Female, Journal Impact Factor, Administrative Claims, Healthcare, Glucocorticoids, Physical Therapy Modalities, Retrospective Studies
Abstract

BACKGROUND: Following the publication of high level evidence demonstrating that corticosteroid inject is not an effective treatment for lateral epicondylitis, a reduction in the rate of corticosteroid injection would be expected. We aimed to clarify the current clinical practice pattern for lateral epicondylitis and to identify which factors hinder or encourage the introduction of evidence into clinical practice. METHODS: In this administrative claims analysis, we used the 2009 to 2015 Truven MarketScan databases. We extracted claims for corticosteroid injection, physiotherapy, platelet-rich-plasma injection, and surgery for lateral epicondylitis. We performed multivariable analysis using generalized estimating equation model to identify the variables that potentially affect the odds of receiving a given treatment. RESULTS: We included a total of 711,726 claims. The odds of receiving a corticosteroid injection slightly increased after publication of these impactful papers (OR: 1.7 95% CI: 1.04–1.11 in 2015). Patient-related factors such as male sex (OR: 1.21 95% CI: 1.19–1.23), older age (OR: 1.16 95% CI: 1.13–1.19), and managed care insurance (OR: 1.15 95% CI: 1.13–1.18) significantly contributed to increased odds of receiving corticosteroid injections. Patients seen at facilities in the South (OR: 1.33 95% CI: 1.30–1.36 compared with Northeast) and by plastic or orthopaedic surgeons (OR: 2.48 95% CI: 2.43–2.52) also had increased odds of receiving corticosteroid injection. CONCLUSIONS: Corticosteroid injection use did not decrease after publication of impactful papers, regardless of provider specialty or other patient-related factors. This finding implies that there are various barriers for even high level evidence to overcome the inertia of current practice.

Published
2018

75. Factors Affecting the Range of Motion of the Elbow after Open Reduction of Olecranon Fractures.

Author

Fujihara, Yuki, Ota, Hideyuki, and Watanabe, Kentaro

Subjects
*RANGE of motion of joints, *ELBOW, *LOGISTIC regression analysis, *JOINT stiffness, *REOPERATION, *POSTOPERATIVE period
Abstract

Background: Although postoperative outcomes of olecranon fractures are relatively favorable, postoperative stiffness of the elbow joint occurs occasionally. We aimed to identify negative prognostic factors for unfavorable outcomes following olecranon fractures. Methods: We retrospectively reviewed the records of 100 patients with olecranon fractures and collected data on the conducted procedures, age, fracture condition, postoperative reduced position, and postoperative active range of motion (AROM) of the elbow joint. The primary outcome was the regaining of an AROM of > 130° flexion and < −30° extension of the elbow joint at the final follow-up. We performed multivariate logistic regression analysis to identify the negative prognostic factors. Results: The mean follow-up period was 11 months. All patients regained an average AROM of 121 degrees. Eighty-one patients regained a favorable AROM of the elbow joint. On univariate logistic regression analysis, diabetes mellitus (OR, 8.2; 95%CI, 1.6–41.7), comminution of the fractured site (OR, 23.1; 95% CI, 13.2–165.0), and utilization of the tension band wiring (TBW) technique (OR, 7.5; 95% CI, 1.16–48.2) were significant factors in aggravating the final result of elbow AROM. On multivariate analysis, patients with diabetes mellitus (OR, 10.9; 95% CI, 2.83–41.9), comminuted fractures (OR, 11.4; 95% CI, 2.61–50.2), or undergoing the tension band wiring technique (TBW) (OR, 5.5; 95% CI, 1.35–50.2) showed reduced postoperative AROM of the elbow joint; postoperative malreduction of the articular surface was not a negative prognostic factor. Seven of 51 patients treated with TBW underwent revision surgery because of non-union or postoperative displacement. Conclusions: TBW for olecranon fractures is a simple and cost-effective procedure; however, negative effects could develop when regaining sufficient postoperative AROM of the elbow joint. Therefore, rigid fixation without reoperation may lead to a favorable outcome. Postoperative malreduction does not always worsen the postoperative AROM of the elbow joint, at least not in the early postoperative period. [ABSTRACT FROM AUTHOR]

Published
2021
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85. Relationship Between Glucose Fluctuations and ST-Segment Resolution in Patients With ST-Elevation Acute Myocardial Infarction

Author

Tsuchida, Keiichi, primary, Nakamura, Norihito, additional, Soda, Satoshi, additional, Sakai, Ryohei, additional, Nishida, Kota, additional, Hiroki, Jiro, additional, Kashiwa, Asami, additional, Fujihara, Yuki, additional, Kimura, Shinpei, additional, Hosaka, Yukio, additional, Takahashi, Kazuyoshi, additional, and Oda, Hirotaka, additional

Published
2017
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96. Source Adaptive Blind Signal Extraction Using Closed-Form ICA for Hands-Free Robot Spoken Dialogue System

Author

Takahashi, Yu, Saruwatari, Hiroshi, Fujihara, Yuki, Tachibana, Kentaro, Mori, Yoshimitsu, Miyabe, Shigeki, Shikano, Kiyohiro, Tanaka, Akira, Takahashi, Yu, Saruwatari, Hiroshi, Fujihara, Yuki, Tachibana, Kentaro, Mori, Yoshimitsu, Miyabe, Shigeki, Shikano, Kiyohiro, and Tanaka, Akira

Abstract

In this paper, we propose a new ICA-based BSS algorithm including estimation of sources' probability density functions (PDFs) to adapt the nonlinear activation function to various noise conditions. In the proposed method, closed-form second-order ICA is introduced as a computational-cost-efficient preprocessing to extract sources' PDFs, which is beneficial for real-time application. Compared with various type of conventional ICAs, e.g., fixed activation-function type and ML-based type, our proposed algorithm can give a faster and higher convergence. Based on the proposed source-adaptive ICA, we show a real-time noise reduction results under diffuse noise environment. Also we can demonstrate our recently developed hands-free robot spoken dialogue system via real-time ICA.

Published
2009

98. Use of the G-guide for Measuring Stem Antetorsion During Total Hip Arthroplasty.

Author

YUKI FUJIHARA, SHIGEO FUKUNISHI, TOMOKAZU FUKUI, SHOJI NISHIO, SHOHEI OKAHISA, YU TAKEDA, KENJI KUROSAKA, SHINICHI YOSHIYA, Fujihara, Yuki, Fukunishi, Shigeo, Fukui, Tomokazu, Nishio, Shoji, Okahisa, Shohei, Takeda, Yu, Kurosaka, Kenji, and Yoshiya, Shinichi

Subjects
HIP joint radiography, PROSTHETICS, ARTIFICIAL joints, INTRAOPERATIVE care, EQUIPMENT & supplies, TOTAL hip replacement
Abstract

Implant positioning is one of the critical factors influencing postoperative outcomes in total hip arthroplasty (THA). Several studies have reported that the postoperative antetorsion (AT) measurement for the femoral stem inserted without navigation showed wide variability. The current authors developed a simple instrument, the Gravity-guide (G-guide), for intraoperative assessment of stem AT and adjustment. They evaluated the effectiveness of the G-guide with postoperative computed tomography (CT) examination. Ninety patients (96 hips) who underwent primary THA using the G-guide for stem adjustment were evaluated. The G-guide consists of 2 parts: one attached to the lower leg and the other attached to the handle of the rasp. The G-guide was used to evaluate the AT at the time of inserting the final rasp. In addition, the AT value in the G-guide evaluation system required correction by the angle obtained in the preoperative epicondylar view. Intraoperative stem AT was defined as the sum of the intraoperative G-guide value and the correction angle. Postoperative AT was evaluated by CT examination. The discrepancy between the intra- and postoperative measurements was 4.6°±4.1°. Acceptable accuracy with discrepancy of less than 5° and 10° was achieved in 66 (69%) hips and 85 (89%) hips, respectively. The use of the G-guide could effectively reduce the variability of stem anteversion compared with manual adjustment. This study proved the effectiveness of the newly developed G-guide system in intraoperative stem AT adjustment. [ABSTRACT FROM AUTHOR]

Published
2016
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