Mineralogy, Three Dimensional Structure, and Oxygen Isotope Ratios of Four Crystalline Particles from Comet 81P/Wild 2

Preliminary examinations of small dust particles from comet 82P/Wild 2 revealed many expected and unexpected features. Among them the most striking feature is the presence of abundant crystalline material in the comet. Synchrotron radiation X-ray diffraction and microtomography are the most efficient methods to detect and describe bulk mineralogical features of crystalline cometary particles. In the present study, in addition to these two non-destructive techniques, electron microscopy and ion-probe mass spectrometry were carried out on the four crystalline particles

Venous thromboembolism after total joint arthroplasty: results from a Japanese multicenter cohort study

INTRODUCTION: Real-world evidence of the effectiveness of pharmacological thromboprophylaxis for venous thromboembolism (VTE) is limited. Our objective was to assess the effectiveness and safety of thromboprophylactic regimens in Japanese patients undergoing joint replacement in a real-world setting. METHOD: Overall, 1,294 patients (1,073 females and 221 males) who underwent total knee arthroplasty (TKA) and 868 patients (740 females and 128 males) who underwent total hip arthroplasty (THA) in 34 Japanese national hospital organization (NHO) hospitals were enrolled. The primary efficacy outcome was the incidence of deep vein thrombosis (DVT) detected by mandatory bilateral ultrasonography up to post-operative day (POD) 10 and pulmonary embolism (PE) up to POD28. The main safety outcomes were bleeding (major or minor) and death from any cause up to POD28. RESULTS: Patients undergoing TKA (n = 1,294) received fondaparinux (n = 360), enoxaparin (n = 223), unfractionated heparin (n = 72), anti-platelet agents (n = 45), or no medication (n = 594). Patients undergoing THA (n = 868) received fondaparinux (n = 261), enoxaparin (n = 148), unfractionated heparin (n = 32), anti-platelet agents (n = 44), or no medication (n = 383). The incidence rates of sonographically diagnosed DVTs up to POD10 were 24.3% in patients undergoing TKA and 12.6% in patients undergoing THA, and the incidence rates of major bleeding up to POD28 were 1.2% and 2.3%, respectively. Neither fatal bleeding nor fatal pulmonary embolism occurred. Significant risk factors for postoperative VTE identified by multivariate analysis included gender (female) in both TKA and THA groups and use of a foot pump in the TKA group. Only prophylaxis with fondaparinux reduced the occurrence of VTE significantly in both groups. Propensity score matching analysis (fondaparinux versus enoxaparin) showed that the incidence of DVT was lower (relative risk 0.70, 95% confidence interval (CI) 0.58 to 0.85, P = 0.002 in TKA and relative risk 0.73, 95% CI 0.53 to 0.99, P = 0.134 in THA) but that the incidence of major bleeding was higher in the fondaparinux than in the enoxaparin group (3.4% versus 0.5%, P = 0.062 in TKA and 4.9% versus 0%, P = 0.022 in THA). CONCLUSIONS: These findings indicate that prophylaxis with fondaparinux, not enoxaparin, reduces the risk of DVT but increases bleeding tendency in patients undergoing TKA and THA. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry: UMIN000001366. Registered 11 September 2008

Current Status and Trends in the Treatment of Acute Pulmonary Thromboembolism

application/pdfUntreateda cutep ulmonartyh romboembolis(mA PTE)is associatewd ithh ighm ortalityw, hichi s reducedb y prompt treatmentA. nticoagulatioins fundamentainl the treatmenot f APTE and shouldb e initiatedfr om suspicionT. he efficacya nd safetyo f novela nticoagulandtr ugs,s ucha s orala nti-Xaa nd anti-llai nhibitorsa, ret opicsi n the treatment of APTEa nda ren owu nderi nvestigatioTn.h rombolytitch erapyis a widelya cceptedtr eatmenst trategyfo r massive APTE,b uti tsu sef or submassivAe PTEi s controversiaCl.a theteirn terventionp,e rcutaneoucsa rdiopulmonasryu pporta nds urgicael mbolectomayr ea lson ecessaray nde ffectivefo r somep atientsw ithA PTE.A retrievablien ferior venac avaf ilteri s preferredfo r transienpt rotectiona gainsAt PTE.S omes tudiesh aved emonstratetdh e feasibility of outpatienttr eatmenitn patientsw ithA PTEa fterr isks tratificationjournal articl

Darexaban for the Prevention of Venous Thromboembolism in Asian Patients Undergoing Orthopedic Surgery

Objective: To evaluate the efficacy and safety of darexaban (YM150) in Asian patients undergoing total hip or total knee arthroplasty. Methods: In 2 phase II/III multicenter, randomized, double-blind, placebo-controlled, parallel-group studies, patients were randomized to oral darexaban 15 mg twice daily (bid), darexaban 30 mg bid, oral placebo bid, or subcutaneous enoxaparin 20 mg bid. Primary efficacy outcome for both studies was total venous thromboembolism (VTE) incidence. Results: Both darexaban doses were statistically significantly superior to placebo for total VTE incidence (hip study: darexaban 15 mg bid [2.9%] vs placebo [17.1%], P &lt; .001; darexaban 30 mg bid [5.2%] vs placebo [17.1%], P = .003; and knee study: darexaban 15 mg bid [27.2%] vs placebo [52.8%], P = .002; darexaban 30 mg bid [15.5%] vs placebo [52.8%], P &lt; .001). In both studies, the incidence of bleeding events was low across all treatment groups. Conclusion: Darexaban is effective and well tolerated as VTE prophylaxis in Asian patients undergoing elective major orthopedic surgery. </jats:sec