Timing of umbilical cord occlusion, delayed vs early, in preterm babies: A randomized controlled trial (CODE-P Trial).

Introduction: Our hypothesis was that delayed cord clamping (DCC) (not earlier than 30 s; at 30-60 s) in premature neonates (born between 26.0 and 32.6 weeks of gestation), as compared with the usual early cord clamping (ECC), significantly reduces the need for blood transfusions and incidence of intraventricular haemorrhage (IVH) without an increased rate of maternal postpartum haemorrhage.

Comparing self-management of oral anticoagulant therapy with clinic management: a randomized trial.

Background: Control of oral anticoagulant treatment has been reported to be suboptimal, but previous studies suggest that patient self-management improves control.

Objective: To compare the quality of control and the clinical outcomes of oral anticoagulant treatment in self-managed patients versus patients following conventional management.

Design: Randomized, controlled trial.

Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study.

Background And Objective: It has been suggested that the determination of serum erythropoietin (sEpo) may be useful in distinguishing between polycythemia vera (PV), relative polycythemia and secondary polycythemia (SP), but no conclusive evidence has yet been provided for this. In the present work, we evaluated the role of sEpo in the differential diagnosis of polycythemia vera and its usefulness in the follow-up of PV patients.

Methods: sEpo was assessed in 190 patients with polycythemia of different etiologies.

Epidemiologic evidence of transmission of donor-related bacterial infection through a transplanted heart.

This study describes a patient who had fulminant infectious myocarditis as a result of methicillin-resistant Staphylococcus aureus after receiving a heart transplant from an infected donor. There was complete concordance of typing results between donor and recipient strains that were different from the 20 isolates with which they were compared. Molecular epidemiologic study provided compelling evidence that a transplanted organ can transmit a bacterial infection from the donor to the recipient.

[Erythroblastopenia during recurrence of a thymoma associated with myasthenia gravis. Apropos of a new case].

A new case of thymoma, myasthenia gravis and pure red cell aplasia is presented. Pure red cell aplasia came out 10 years after the diagnosis of the two other diseases in one of several relapses of metastatic thymoma with clinical signs of myasthenia. Surgery, chemotherapy and radiotherapy besides pyridostigmine treatment were used in the clinical course of the patient.

Adverse reaction to streptokinase with multiple systemic manifestations.

We report the case of a 47-year-old woman with a history of mitral valve replacement with a mechanical prosthesis who was admitted to the hospital with a 3-month history of progressive exertional dyspnoea and was diagnosed as suffering from prosthetic valve thrombosis. Two consecutive courses of streptokinase were given as an intravenous infusion over 90 min at a dose of 1,500,000 IU each. Twenty minutes after the start of the second infusion (3 h and 20 min after the first one) she developed chills, fever, tachycardia and hypotension: symptomatic treatment was given and the infusion was completed.

Comparison of macrorestriction analysis of genomic DNA by pulsed-field gel electrophoresis and ribotyping with conventional methods for differentiation of Escherichia coli 0124 isolates.

OBJECTIVE: To evaluate the usefulness of different phenotypic and genotypic markers for epidemiological typing of enteroinvasive Escherichia coli 0124 (EIEC 0124). METHODS: Seven sporadic EIEC 0124 isolates and 22 isolates from two different outbreaks were characterized. Chromosomal deoxyribonucleic acid (DNA) macrorestriction analysis with XbaI resolved by pulsed-field gel electrophoresis (PFGE) and ribotyping with each of the three restriction endonucleases BglII EcoRI, and ClaI were compared with biotyping, antimicrobial susceptibility patterns and plasmid profiles.

[Application of molecular epidemiology techniques in the study of food poisoning caused by Staphylococcus aureus].

Background: The use of molecular epidemiology techniques has provided better knowledge as to the clonal organization of bacterian populations and thus allows better follow up of epidemics. An alimentary toxiinfection in a Barcelona school produced by Staphylococcus aureus was analyzed by the combination of epidemiologic, phenotype and genotype markers with the aim of determining the source of the alimentary contamination.

Methods: Nine strains of Staphylococcus aureus isolated in 6 food manipulators and 3 patients were studied with the following markers: biotype, antibiotype, phagotype, plasmid profile, polymorphism of the size of the restriction fragments of total DNA and ribotype.

Lack of effect of influenza vaccine on anticoagulation by acenocoumarol.

Objective: To analyze the effects of influenza vaccine on patients receiving chronic anticoagulant therapy with acenocoumarol.

Design: A prospective trial.

Setting: Hospital de la Santa Creu i Sant Pau, Barcelona.

[Pregnancy and thrombophilia in women with congenital deficit of antithrombin III, protein C, protein S or plasminogen: analysis of 39 cases].

Background: Pregnancy, delivery and puerperium are situations which increment the risk of thromboembolic complications in women who are carriers of congenital heterozygotic deficits of type I antithrombin III (ATIII), protein C (PC) or protein S (PS). The aim of this study was to analyze the experience of the authors and propose therapeutic conduct in each case. Furthermore, the spontaneous losses of pregnancy related with these deficits were studied.

[Markers of hypercoagulability during pregnancy: thrombin-antithrombin-III complexes and D dimer].

Pregnancy can be regarded as a secondary hyper-coagulability state. The development of thrombin-anti-thrombin complexes (TATC), D dimer and anti-thrombin III (AT III) was analysed in the present work on 33 pregnant women. A significant increase of the TATC records was found between the first and third trimesters and between the second and third trimesters (p = 0.

[Detection of thrombin-antithrombin complexes in hypercoagulability conditions. Analysis of 182 cases].

The detection of TATC may inform about the presence of thrombin generation and, and hence of a pre-thrombotic status. An ELISA test (Enzygnst TAT) has been developed here in order to evaluate the predictive role played by TATC, and it was applied on 182 patients who distributed in 14 with cirrhosis of the liver, 11 with sepsis, 17 with chronic arterial insufficiency, 55 with neoplasms, 9 with thrombosis, 15 in postoperative period, 15 with pneumonia, 16 with disseminated intravascular coagulation (DIC), 14 with multiple injuries and 16 with pancreatitis. TATC levels were significantly increased in all groups with regard to the control group.

[Successful fibrinolytic treatment in a patient with acute mitral prosthetic thrombosis].

A case is described of a 50 year-old man with an acute prosthetic dysfunction due to valve thrombosis and cardiogenic shock, on a prosthesis in the mitral position (Bjork-Shiley). The patient was promptly treated with a streptokinase in two infusions 1.5 x 10(6) UI over 180 and 90 minutes, respectively.