ErmB determinants and Tn916-Like elements in clinical isolates of Clostridium difficile

Erythromycin and tetracycline resistance was analyzed in 37 Clostridium difficile clinical isolates. Strains of different clonal origins showed different erythromycin and tetracycline resistance determinants and different genetic arrangements of the elements. In strains of recent isolation, the presence of Tn916-like elements, never found before in C. difficile clinical isolates, has been demonstrated.     

Improvement of tumor cell detection using a pool of monoclonal antibodies

It has been proven that monoclonal antibodies which are not strictly tumor specific may be useful in clinical oncology for diagnosis and in in vitro therapy. These applications, however, are hampered by the heterogeneous expression on tumor cells of the epitopes defined by the majority of monoclonal antibodies produced so far. The use of combined monoclonals could complement their antitumor specificity and solve the problem. In this perspective we selected nine monoclonal antibodies directed against different antigens of primary and metastatic breast cancer cells. The reactivity of the pool of these nine monoclonals versus a single antibody (MBr1) was determined by immunofluorescence on tumor cell lines, on frozen sections of various carcinomas, and on live cells obtained from malignant effusions. The results obtained with the pool, compared to those using MBr1 alone, showed a remarkable increase in the number of immunopositive breast and other carcinomas and the number of immunopositive cells within each positive tumor. In fact, the percentage of immunoreactive breast carcinomas increased from 79% to 100%, and the percentage of immunoreactive carcinomas of other sites from 61% to 89%. In addition, the number of positive breast carcinomas showing 100% immunoreactive cells increased from 5% with MBr1 to 71% when the pool was used.     

Interaction of a new low molecular weight heparin (OP/LMWH) with human platelets

In vitro platelet proaggregating effect of unfractionated heparin (H) and OP/LMWH were studied with human platelets. OP/LMWH produced a significant less potentiation of ADP and PAF induced aggregation and slightly counteracted the antiaggregating effect of PGI₂, in comparison with H.The proaggregating effect of both heparins was neutralized by equal contemporaneous amount of protamine sulfate.     

Antithrombotic pharmacotherapy after transcatheter aortic valve implantation: an update

Introduction: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for a large proportion of patients with severe aortic stenosis. Despite numerous technological and clinical advances, TAVI remains associated with thrombotic complications requiring antithrombotic pharmacotherapy, which exposes to the risk of bleeding, especially in elderly individuals. The optimal antithrombotic regimen following TAVI is uncertain and several investigations are ongoing.

Areas covered: Clinical guidelines are mostly driven by observational trials and experts’ opinions, thus resulting into low-grade level of evidence. The aim of the current review is to critically explore the epidemiology, pathophysiology and prognostic value of thrombotic and bleeding events after TAVI, and to review the current literature on antithrombotic strategies following the procedure.

Expert opinion: Thrombotic and bleeding events remain major complications occurring in the frail population that is currently offered TAVI. Waiting for upcoming evidence from ongoing randomized clinical trials, tailoring antithrombotic therapies based on patients’ characteristics, values and circumstances is a preferable approach.     

Primary malignant melanoma of the female urethra: a case report with immunohistochemical findings

A case of primary malignant melanoma of the female urethra is presented and the usefulness of an immunohistochemical diagnostic approach is discussed.     

Donepezil in the treatment of progressive supranuclear palsy

OBJECTIVES: To evaluate the effect of 3 month therapy with donepezil, a centrally acting cholinesterase inhibitor, on cognitive performances, motor function and daily living activities in progressive supranuclear palsy (PSP). MATERIALS AND METHODS: Six patients with a diagnosis of PSP were evaluated at baseline and after 3 months of treatment with donepezil, 10 mg given at bedtime. Cognitive functions, motor symptoms and daily activities were evaluated by means of appropriate rating scales. RESULTS: Donepezil was not effective on cognitive dysfunction and did not change ratings of daily living. Parkinsonian symptoms were unaffected by donepezil treatment. CONCLUSIONS: Cholinergic replacement therapy alone is not likely to improve symptoms in a disorder characterized by a more widespread impairment of monoaminergic systems. Larger studies may be necessary to confirm the lack of effect of donepezil in this disorder.