Treatment of intracardiac thrombi with argatroban

Intracardiac thrombi are well known complications associated with diverse cardiac diseases and venous thromboembolism. Therapeutic recommendations like thrombolysis, surgical thrombectomy, or treatment with low molecular heparin and intravenous unfractionated heparin based on small numbers of patients or retrospective case series have failed to reach a consensus. We report on the use of argatroban, a new direct thrombin inhibitor in 4 patients with intracardiac thrombi. Therapy was effective in all patients with complete resolution of thrombi. Treatment was complicated by recurrent strokes with complete neurological recovery in one patient. Therapy of intracardiac thrombi by argatroban is safe and effective. The drug requires no dosage adjustments for age, sex, or renal impairment, including in dialysis-dependent patients. Argatroban has been found to increase predictably activated partial thromboplastin time (aPTT) and activated clotting time (ACT) in a dose-dependent manner.     

Insight Into the Central Control of Overactive Bladder Symptoms by Functional Brain Imaging

Purpose of Review

The goal of this paper is to review the data on brain activity in individuals with overactive bladder that has been gleaned by the use of functional neuroimaging.

Recent Findings

Recent studies have demonstrated that there are differences in brain activity in individuals with overactive bladder (including anterior cingulate cortex, insula, and prefrontal cortex activation) and have shown that treatment of overactive bladder results in brain activity changes.

Summary

Functional neuroimaging has provided considerable insight into central nervous system control of micturition and the alterations seen in individuals with overactive bladder. Further work may improve our understanding of the pathogenesis of overactive bladder and how its treatments work and thereby allow identification of patient factors that permit individualized counseling.

     

Online tools for polyphasic analysis of Mycobacterium tuberculosis complex genotyping data: now and next

Molecular diagnostics and genotyping of pathogens have become indispensable tools in clinical microbiology and disease surveillance. For isolates of the Mycobacterium tuberculosis complex (MTBC, causative agents of tuberculosis), multilocus variable number tandem repeat analysis (MLVA) targeting mycobacterial interspersed repetitive units (MIRU) has been internationally adopted as the new standard, portable, reproducible, and discriminatory typing method. Here, we review new sets of specialized web based bioinformatics tools that have become available for analyzing MLVA data especially in combination with other, complementary genotyping markers (polyphasic analysis). Currently, there are only two databases available that are not restricted to store one kind of genotyping data only, namely SITVIT/SpolDB4 and MIRU-VNTRplus. SITVIT/SpolDB4 (http://www.pasteur-guadeloupe.fr:8081/SITVITDemo) contains spoligotyping data from a large number of strains of diverse origin. However, besides options to query the data, the actual version of SITVIT/SpolDB4 offers no functionality for more complex analysis e.g. tree-based analysis. In comparison, the MIRU-VNTRplus web application (http://www.miru-vntrplus.org), represents a freely accessible service that enables users to analyze genotyping data of their strains alone or in comparison with a currently limited but well characterized reference database of strains representing the major MTBC lineages. Data (MLVA-, spoligotype-, large sequence polymorphism, and single nucleotide polymorphism) can be visualized and analyzed using just one genotyping method or a weighted combination of several markers. A variety of analysis tools are available such as creation of phylogenetic and minimum spanning trees, semi-automated phylogenetic lineage identification based on comparison with the reference database and mapping of geographic information. To facilitate scientific communication, a universal, expanding genotype nomenclature (MLVA MtbC15-9 type) service that can be queried via a web- or a SOAP-interface has been implemented. An extensive documentation guides users through all application functions. Perspectives for future development, including generalization to other bacterial species, are presented.     

Effects of age condition on the distribution and integrity of inorganic fillers in dental resin composites

Objectives

The aim of this study is to evaluate the distribution of the filler size along with the zeta potential, and the integrity of silane-bonded filler surface in different types of restorative dental composites as a function of the material age condition.

Materials and methods

Filtek P60 (hybrid composite), Filtek Z250 (small-particle filled composite), Filtek Z350XT (nanofilled composite), and Filtek Silorane (silorane composite) (3M ESPE) were tested at different stage condition (i.e., fresh/new, aged, and expired). Composites were submitted to an accelerated aging protocol (Arrhenius model). Specimens were obtained by first diluting each composite specimen in ethanol and then dispersed in potassium chloride solution (0.001 mol%). Composite fillers were characterized for their zeta potential, mean particle size, size distribution, via poly-dispersion dynamic light scattering. The integrity of the silane-bonded surface of the fillers was characterized by FTIR.

Results

The material age influenced significantly the outcomes; Zeta potential, filler characteristics, and silane integrity varied both after aging and expiration. Silorane presented the broadest filler distribution and lowest zeta potential. Nanofilled and silorane composites exhibited decreased peak intensities in the FTIR analysis, indicating a deficiency of the silane integrity after aging or expiry time.

Conclusion

Regardless to the material condition, the hybrid and the small-particle-filled composites were more stable overtime as no significant alteration in filler size distribution, diameter, and zeta potential occurred. A deficiency in the silane integrity in the nanofilled and silorane composites seems to be affected by the material stage condition.

Clinical significance

The materials conditions tested in this study influenced the filler size distribution, the zeta potential, and integrity of the silane adsorbed on fillers in the nanofilled and silorane composites. Thus, this may result in a decrease of the clinical performance of aforementioned composites, in particular, if these are used after inappropriate storage conditions.

     

Characteristics of hepatitis B virus in Ghana: full length genome sequences indicate the endemicity of genotype E in West Africa

Hepatitis B virus (HBV) genotypes from A to H have distinct geographical distributions and have been shown to affect the clinical features as well as the course of the HBV infection. HBV genotype E has been found only in Africa. However, the complete genomes of this genotype, which were isolated mainly from West Africa, were available only for a few samples. In this study, five full-length genomes and seven other small S genes of HBV strains from Ghanaian blood donors were sequenced and investigated. Following phylogenetic analysis, all of the Ghanaian HBV strains were clustered closely in genotype E. All of the 12 small S genes showed the same characteristic of subtype ayw4. The complete genomes of the five Ghanaian strains showed marked similarity with each other and with the reported genotype E strains (96.7%-99.1%). Genotype E strains showed low intra-genotypic diversity (1.8%) and carried the conserved signature pattern in pre-S1 as well as in the full genome sequence. Of note, the finding of the G145R escape mutant in an unvaccinated Ghanaian blood donor might raise concern as to the ongoing nation-wide hepatitis B vaccination program in Ghana.