Two-week administration of rivaroxaban resolved left atrial thrombus

AbstractAn 89-year-old man visited our hospital complaining of palpitation. Electrocardiography showed atrial fibrillation, and transthoracic echocardiography demonstrated a mobile thrombus of 28.6mm×20.8mm in the left atrium. Administration of a direct factor Xa inhibitor rivaroxaban (10mg/day) was started. The thrombus reduced its size and disappeared completely 2 weeks after the commencement of rivaroxaban treatment. To our knowledge, this is the first case report that rivaroxaban successfully dissolved left atrial thrombus during a short period. Rivaroxaban might have a potential, not only to prevent de novo thrombus formation, but also to dissolve established thrombi by direct inhibition of free and thrombus-associated factor Xa.<Learning objective: The incidence of nonvalvular atrial fibrillation is increasing, and left atrial thrombus is the major cause of cardiogenic thrombo-embolism that we need to prevent. Recently, novel oral anticoagulants have been developed. The effects of these agents on intracardiac thrombus resolution have not been fully elucidated. Data from a large cohort study would be required to assess efficacy of novel oral anticoagulants for thrombus resolution.

Thermally stable amorphous tantalum yttrium oxide with low IR absorption for magnetophotonic devices

Thin film oxide materials often require thermal treatment at high temperature during their preparation, which can limit them from being integrated in a range of microelectronic or optical devices and applications. For instance, it has been a challenge to retain the optical properties of Bragg mirrors in optical systems at temperatures above 700 °C because of changes in the crystalline structure of the high-refractive-index component. In this study, a ~100 nm-thick amorphous film of tantalum oxide and yttrium oxide with an yttrium-to-tantalum atomic fraction of 14% was prepared by magnetron sputtering. The film demonstrated high resistance to annealing above 850 °C without degradation of its optical properties. The electronic and crystalline structures, stoichiometry, optical properties, and integration with magnetooptical materials are discussed. The film was incorporated into Bragg mirrors used with iron garnet microcavities, and it contributed to an order-of-magnitude enhancement of the magnetooptical figure of merit at near-infrared wavelengths.National Science Foundation (U.S.) (Award ECCS-1607865

Demonstration of a robust magnonic spin wave interferometer

Magnonics is an emerging field dealing with ultralow power consumption logic circuits, in which the flow of spin waves, rather than electric charges, transmits and processes information. Waves, including spin waves, excel at encoding information via their phase using interference. This enables a number of inputs to be processed in one device, which offers the promise of multi-input multi-output logic gates. To realize such an integrated device, it is essential to demonstrate spin wave interferometers using spatially isotropic spin waves with high operational stability. However, spin wave reflection at the waveguide edge has previously limited the stability of interfering waves, precluding the use of isotropic spin waves, i.e., forward volume waves. Here, a spin wave absorber is demonstrated comprising a yttrium iron garnet waveguide partially covered by gold. This device is shown experimentally to be a robust spin wave interferometer using the forward volume mode, with a large ON/OFF isolation value of 13.7 dB even in magnetic fields over 30 Oe

Osteosynthesis for Geriatric Acetabular Fractures: An Epidemiological and Clinico-Radiological Study Related to Marginal or Roof Impaction

This retrospective study sought to elucidate the incidence rates of roof impaction (RI) and marginal impaction (MI) and radiological and clinical outcomes of open reduction and internal fixation (ORIF) for RI and MI in geriatric acetabular fractures. The cases of 68 patients aged ≥ 65 years (mean 71 years) treated with ORIF were analyzed. MI was present in 12 fractures (67%) and an RI of the weight-bearing surface was present in 24 (46%) of the potential fracture types. Regarding the reduction quality, 54% of the reductions were graded as anatomical, 37% as imperfect, and 9% as poor. In the clinical evaluations of the 45 patients who had > 1-year follow-up (follow-up rate: 66.2%), 18% were graded as excellent, 53% as good, 16% as fair, and 13% as poor. An anatomic reduction was strongly associated with good or excellent clinical and radiological outcomes. CT was superior to radiographs for detecting the residual displacement postoperatively. Postoperative deep infection occurred in four patients. Three patients (6.7%) underwent a total hip arthroplasty conversion due to secondary osteoarthritis of the hip. We recommend ORIF as the preferred surgical treatment option for displaced acetabular fractures in elderly patients

Application of therapeutic drug monitoring of imatinib for individual treatment of gastrointestinal stromal tumor

Many molecular target agents are continuously administered at fixed dosages. Imatinib, which can control the growth of a gastrointestinal stromal tumor, is administrated at 400 mg/day. However, many patients cannot continue treatment because of adverse events, such as neutropenia. To obtain the best therapeutic response while maintaining quality of life, individualization should be considered. Study participants were gastrointestinal stromal tumor patients who required treatment with imatinib. Therapeutic drug monitoring was conducted using high-performance liquid chromatography. In our study, the trough (lowest) concentration that a drug reaches before the next dose is administered differed among patients. The grades of adverse events also differed individually. Moreover, the dosage that was necessary to shrink gastrointestinal stromal tumor differed in cases by cases. Dosage was modified according to the balance between blood concentration and therapeutic responses in order to minimize adverse events for individual patients, and to maximize the effect as the responses differed among patients. It was shown that based on therapeutic drug monitoring, individualization enabled the patients who may not normally continue the typical treatment to tolerate imatinib. According to the therapeutic drug monitoring, individualization of dosage of imatinib could improve the patients’ outcomes in both ends, therapeutic and adeverse responses.