Comparison of Intravenous and Topical Tranexamic Acid in Total Joint Arthroplasty.

PURPOSE OF THE STUDY To compare topical and intravenous (IV) administration of tranexamic acid (TXA) 2 g in patients undergoing total hip arthroplasty (THA), or total knee arthroplasty (TKA). MATERIAL AND METHODS In total, 452 patients undergoing THA or TKA were randomised to 3 groups: 1) the IV TXA group received 2 doses of TXA 1 g intravenously 3 hours apart; 2) the topical TXA group received TXA 2 g topically, and 3) the NO TXA - control group. Furthermore, each group was divided in two subgroups by performed surgery (THA versus TKA).

Mortality in acquired thrombotic thrombocytopenic purpura in the pre-caplacizumab era.

Despite the effectiveness of plasma exchange (PEX) and immunosuppressants in the treatment of acquired thrombotic thrombocytopenic purpura (aTTP), a number of patients still die as a result of the disease. Whether caplacizumab could rescue these patients remains still unsettled. The objective of this study was to characterise mortality patterns and prognostic factors in the first episode of aTTP.

[Acute Limb Ischemia after Total Hip Arthroplasty in a High-Risk Patient - Is Tranexamic Acid to Blame?].

Tranexamic acid (TXA) is widely used to limit the blood loss during total joint arthroplasty without an increased risk of thromboembolic events. We present a case of acute limb ischaemia due to thrombotic occlusion of the superficial femoral artery on the non-operated limb following a total hip arthroplasty in a 64-year-old male patient. Untreated peripheral artery disease, intravenous TXA administration, surgery, obesity and hypertension were identified as predisposing factors of the occlusion.

Residential proximity to green spaces and breast cancer risk: The multicase-control study in Spain (MCC-Spain).

Background: Breast cancer is the main cause of cancer mortality among women. Green spaces have been recently associated with reduced cancer mortality among women. Mechanisms explaining the beneficial effect of green spaces include increased levels of physical activity and reduced exposure to air pollution, which have been both associated with cancer development.

Possible role of chondroitin sulphate and glucosamine for primary prevention of colorectal cancer. Results from the MCC-Spain study.

A safe and effective colorectal cancer (CRC) chemoprevention agent remains to be discovered. We aim to evaluate the association between the use of glucosamine and/or chondroitin sulphate and risk of colorectal cancer (CRC) in the MCC-Spain study, a case-control study performed in Spain that included 2140 cases of CRC and 3950 population controls. Subjects were interviewed on sociodemographic factors, lifestyle, family and medical history and regular drug use.

HLA specificities are associated with prognosis in IGHV-mutated CLL-like high-count monoclonal B cell lymphocytosis.

Introduction: Molecular alterations leading progression of asymptomatic CLL-like high-count monoclonal B lymphocytosis (hiMBL) to chronic lymphocytic leukemia (CLL) remain poorly understood. Recently, genome-wide association studies have found 6p21.3, where the human leukocyte antigen (HLA) system is coded, to be a susceptibility risk region for CLL.

Genetic basis of congenital erythrocytosis: mutation update and online databases.

Congenital erythrocytosis (CE), or congenital polycythemia, represents a rare and heterogeneous clinical entity. It is caused by deregulated red blood cell production where erythrocyte overproduction results in elevated hemoglobin and hematocrit levels. Primary congenital familial erythrocytosis is associated with low erythropoietin (Epo) levels and results from mutations in the Epo receptor gene (EPOR).

The impact of hypertonic saline inhalation on mucociliary clearance and nasal nitric oxide.

Nitric oxide (NO) has an influence on airway physiology by mediation in ciliary activity, inflammation, host defence, bronchial tone, and pulmonary vascular resistance. However, the clinical relevance of the measurement of nasal NO (nNO) in different physiological and pathological conditions has yet to be established before it can be used as a diagnostic tool. The aim of our study was to establish the relation between nNO and mucociliary clearance (MCC) and the impact of hypertonic saline inhalation on these markers.

[Prevalence of nosocomial infection in Navarre. Aggregated data of the EPINE study for 2005].

Nosocomial infection is a serious problem of morbidity and mortality that, according to the 2003 national prevalence data affected 6,5-7% of all the patients admitted in Spanish hospitals. Our aim is to assess the prevalence of nosocomial infection in Navarre, from the aggregated data of each participant in the EPINE (Study of Prevalence of Nosocomial Infection in Spain) in 2005, and to analyse different features of the nosocomial infections to compare them with the global data for Spain. The prevalence of patients with nosocomial infection was 5,6% and the prevalence of patients with community infection was 13,2%.

Onset of X-linked sideroblastic anemia in the fourth decade.

We report the case of a 40-year female who manifested late onset, pyridoxine-refractory X-linked sideroblastic anemia, heterozygous for the first described frameshift ALAS2 mutation, CD506-507 (-C). On presentation she had macrocytic anemia with severe iron overload.

Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review.

Background: Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly.

Hypothesis: This study examines the epidemiologic, clinical, and morphologic characteristics of a cohort of patients with PLSVC draining into the coronary sinus.

Methods: We examined the clinical and morphologic characteristics of patients with PLSVC draining into the coronary sinus diagnosed at a single referral hospital for a defined population in northwestern Spain.

Infective endocarditis due to Streptococcus bovis in a series of nonaddict patients: clinical and morphological characteristics of 20 cases and review of the literature.

Background And Objectives: Controversy frequently exists about the actual frequency of Streptococcus bovis infective endocarditis (IE), its incidence of malignancy and its outcome. Consequently, the characteristics of S bovis IE were examined in an unselected population of nondrug-addicted patients. The literature was also reviewed.

HLA-DRB1 status affects endothelial function in treated patients with rheumatoid arthritis.

Purpose: To examine endothelial function in rheumatoid arthritis patients and to assess whether clinical or genetic factors affect the development of endothelial dysfunction.

Methods: Fifty-five patients fulfilling the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis were recruited from Hospital Xeral-Calde, Lugo, Spain. Patients were required to have been treated for at least 5 years, including current treatment with one or more disease-modifying antirheumatic drugs.

Single lead DDD pacing using electrodes with longitudinal and diagonal atrial floating dipoles.

In this study, an assessment was made of the possibilities of single lead DDD pacing in two groups: a group of 15 patients in whom a lead with a longitudinal atrial "floating" dipole was implanted, and another group of 10 patients with a lead with a diagonal atrial "floating" dipole. In both groups, the electrodes were connected to a SLD generator. At discharge, atrial capture was achieved with the unipolar mode in 17 of 25 patients, whereas in the group carrying the longitudinal atrial dipole, atrial capture was achieved with the overlapping biphasic impulses (OLBI) system in 12 of 15 patients and in all 10 patients in the group with the diagonal atrial dipole.

Rheumatic manifestations of infective endocarditis in non-addicts. A 12-year study.

Infective endocarditis (IE) is due to a microbial infection of the heart valves or of the endocardium in close proximity to either congenital or acquired cardiac defects. This infection is associated with a high risk of complications. Rheumatic manifestations are known to be frequent complications of IE.

Serum proteolytic activities and antiproteases in human colorectal carcinoma.

Some proteolytic enzymes, trypsin, cathepsin B, cathepsin D, collagenase, elastase and their inhibitors, API and AMG, in serum of patients with colorectal carcinoma have been evaluated. Twenty patients belonged to stage B of colorectal carcinoma, twenty two patients to stage D (Astler and Coller classification) and a control group of thirty healthy volunteers were evaluated. Except in cathepsin D, patients exhibit higher enzymatic activities than healthy subjects, and both groups have all the proteolytic activities assayed in serum.

[Analysis of suggestive endoscopic characteristics in the preoperative diagnosis of gastric lymphoma].

We study the diagnostic value of some macroscopic features which might be considered suspicious of lymphoma (RESL): thickened gastric folds, diffuse involvement, shallow star shaped ulcers, net lesion limits, size > 6 cm., supracisural location and duodenal involvement. We analyze their overall incidence in 36 primary gastric lymphomas, considering possible differences of each feature between pre and post surgery diagnostic achievement.

[Massive lower digestive hemorrhage caused by colonic ulcers secondary to cholesterol embolism].

Cholesterol crystal embolization has been considered an unusual entity with poor short term prognosis. However, it is an underestimated complication according to post-mortem findings. Patients have quite characteristic risk and precipitating factors which may be an aid to suspect the diagnosis.

[A patient with Mirizzi's syndrome. The diagnostic and therapeutic considerations].

A 35-year-old woman presented with a 4-month history of jaundice and pruritus. Endoscopic retrograde cholangiography (ERC) showed a partially obstructed common hepatic duct with a smooth and curved laterally based compression defect having the appearance of being secondary to an impacted gallbladder stone. Gallbladder filled with contrast medium but the cystic duct was not visualized, thus suggesting cholecystobiliary fistula formation.

[Complications and possible risk factors in endoscopic polypectomy of the colon].

We review the incidence of iatrogenic complications in a serie of 661 patients who underwent endoscopic polypectomy, performed by the same team of endoscopists and using similar technique. We discuss the role of age, sex, associated diseases, coagulation abnormalities and polyp features (size, location, shape and malignancy) in the development of complications. Five severe complications (0.