Blood donation clusters in Québec, Canada (2003-2008): spatial variations according to sex and age.

BACKGROUND AND OBJECTIVES: The detection of spatial clusters of blood donation rate is an important issue, especially for targeting spatial units with significantly low rates, where it could be possible to increase the numbers of donors. The objective of this study is to detect spatial clusters of high or low blood donation rate in Québec according to sex and age of the donors. MATERIALS AND METHODS: Blood donation data were obtained from Héma-Québec over a period of 5 years. We aggregated these data for each of 101 municipalités regionales de comté (i.e. counties) for men, women and four age groups. To detect spatial high/low donation rate areas, we used the Kulldorff's scan statistics. Kappa coefficient was used to assess discordance between clusters obtained for the different groups (18-29, 30-39, 40-49, 50-59, 60-69 years old). T-test analyses were conducted to identify significant associations between spatial clusters and socio-economic variables. RESULTS: The results indicate the presence of several geographical areas with high or low blood donation rates for each group. The size, the location and the socio-demographic profiles of low/high clusters vary according to sex and age categories. CONCLUSION: The Kulldorff's scan statistics are an efficient tool to assess the blood donation performance across a country or even a specific region over a period of several years. In terms of strategic planning and monitoring, it can be used as a fully operational tool to target areas with significantly low rates (for all donors or specific demographic groups) in future blood donation campaigns.

Production and characterisation of a candidate hyper-immune serum for the replacement of the Bordetella pertussis mouse antiserum Biological Reference Preparation.

For acellular pertussis (aP) vaccines, the current European Pharmacopoeia (Ph. Eur.) monograph Pertussis vaccine (acellular, component, adsorbed) (1356) requires an immunogenicity assay in mice or guinea pigs to assess the potency of each lot of vaccine (Ph. Eur. general method 2.7.16. Assay of pertussis vaccine (acellular)). This biological assay, carried out on the final bulk of the vaccine lot, is based on the measurement of the specific antibody response to the 5 antigenic components (pertussis toxin (PT), Fimbrial haemagglutinin (FHA), pertactin (PRN) and Fimbriae 2 and 3 (FIM2/3)) that are present in the combined aP vaccines. In the mouse assay, serum antibody levels are measured by ELISA. The immunogenicity of a vaccine under test is estimated versus a homologous reference vaccine and a reference antiserum e.g. the first Ph. Eur. Biological Reference Preparation for Bordetella (B.) pertussis mouse anti-serum (BRP1), established in 1998, is used to normalise the titre of antibodies (expressed in ELISA Units (ELU)/mL). In anticipation of the depletion of BRP1 stocks, a project was launched in 2013 by the Biological Standardisation Programme (BSP) of the European Directorate for the Quality of Medicines & HealthCare (EDQM) in order to establish a new standardised reference serum. The project, referred to herein as BSP129, was conducted in 2 phases: 1) the production and characterisation of a mouse serum pool (using a multicomponent aP vaccine marketed in Canada similar to the vaccine used in the BRP1 production as immunogen) and of candidate BRP batches (cBRPs) and 2) an international collaborative study aimed at calibrating the cBRPs in terms of antibody levels against PT, FHA, PRN and FIM2/3. This article presents the design and results of the first phase of the collaborative study to establish the optimal conditions for immunisation and bleeding of mice in order to produce a large pool of hyper-immune serum against the 5 antigens. After the characterisation of this pool, cBRP pilot lots were manufactured by freeze-drying diluted solutions of the hyper-immune serum pool. The pilot lots were then characterised in two Official Medicines Control Laboratories (OMCLs) for their antibody contents against aP vaccine antigens using in-house ELISA (based on methods developed by 2 European vaccine manufacturers) and Multiplex Immunoassay (MIA) methods. The antibody titres recovered demonstrated that a dilution factor of 1/40 could be considered for the scaled-up manufacture of candidate reference preparations (cBRPs). Three batches (15 000 vials) of cBRP were manufactured and fully characterised. In light of the data obtained, and although titration results between the ELISA methods were sometimes discrepant, it was agreed that the establishment study (phase 2) could be launched. Real-time and accelerated stability studies were also included in the first study phase to document the stability of the cBRPs in freeze-dried form and after reconstitution and storage at -20°C±5°C. The results showed that the stability of the freeze-dried cBRPs at usual storage and shipment temperatures is acceptable and that reconstituted cBRP solutions are stable for 12 months at -20°C±5°C. It could therefore be recommended to freeze small aliquots of the 1 mL solution obtained by the reconstitution of one BRP vial in order to store them for use in separate assays. With the application of this strategy, the stocks of the BRP1 replacement batches should cover the needs of OMCLs and manufacturers for at least the next decade.

Impact of a checklist used by pharmacists on hospital antimicrobial use: a patient-level interrupted time series study.

BACKGROUND: Antimicrobial misuse leading to drug resistance is a growing concern for clinicians. Improving antimicrobial stewardship programmes through development of new tools could be part of the solution. AIM: To evaluate antimicrobial use in hospitalized patients after implementation of an antimicrobial checklist for ward-based clinical pharmacists. METHODS: A checklist based on quality indicators of optimal antimicrobial use was implemented to standardize hospital pharmacists' assessments of antimicrobial therapy. Antimicrobial use metrics from adults hospitalized during the control and intervention periods were assessed in an interrupted time series analysis of individual patient data. The primary endpoint was days of therapy (DOT) for all antimicrobials per 1000 days present for included patients. Secondary endpoints were the DOT of extended-spectrum antimicrobials (DOT-ES), length of therapy of all antimicrobials (LOT) and the number of pharmacist interventions. FINDINGS: One-thousand six-hundred and nineteen patients were included: 800 and 819 in the pre- and post-checklist implementation periods, respectively. As indicated by the point estimates and their 95% confidence intervals (CIs), there were no changes in trend for DOT, DOT-ES or LOT. A change in level was not found for the DOT, while a change of -118 DOT-ES [-209,-28] and -51 LOT [-97,-4] was documented. Furthermore, pharmacists' interventions regarding antimicrobials increased by 18.7% (14.0, 23.5) and progress notes by 32.3% (27.8, 36.8). CONCLUSION: An antimicrobial checklist used by ward-based clinical pharmacists did not decrease DOT for all antimicrobials, but decreased DOT-ES and LOT upon its implementation.

Efficacy of oxonia active against selected spore formers.

Alternatives to hydrogen peroxide are being sought for use in aseptic packaging systems because this sterilant is efficacious at temperatures higher than some of the newer packaging materials can tolerate. Earlier in this century, peracetic acid was known to be bactericidal, sporicidal, and virucidal but was not widely used because of handling, toxicity, and stability problems. Sanitizer suppliers have capitalized on the efficacy of hydrogen peroxide, acetic acid, and peracetic acid stabilized with a sequestering agent. Formulations have been improved and marketed as Oxonia Active, and its use as an alternative sterilant to hydrogen peroxide merits evaluation. Oxonia was assessed at a concentration of 2% and a temperature of 40 degrees C against a number of spore-forming organisms, including foodborne pathogens. Spores tested in aqueous suspension showed an order of sensitivity (least to greatest) to Oxonia as follows: Bacillus cereus > B. subtilis A > B. stearothermophilus > B. subtilis var. globigii > B. coagulans > Clostridium sporogenes (PA3679) > C. butyricum > C. botulinum type B (nonproteolytic) > C. botulinum type B (proteolytic) = C. botulinum type A = C. botulinum type E. B. subtilis A and B. stearothermophilus spores tested in the dry state were less sensitive to Oxonia than when tested in aqueous suspension. B. cereus, a foodborne pathogen, proved to be markedly less sensitive to Oxonia under the described test conditions. The decreased sensitivity to Oxonia by the foodborne pathogen B. cereus raises concern about the efficacy of the sterilant for aseptic packaging of low-acid foods. Further work will be needed to determine if this decreased sensitivity is an inherent property of the organism that affords unusual protection against Oxonia or if the challenge parameters selected were at the minimum conditions for efficacy.

[Is chemotherapy with cisplatin useful in non small cell bronchial cancer at staging IV? Results of a randomized study]. / La chimiothérapie comportant du cisplatine est-elle utile dans le cancer bronchique non microcellulaire au stade IV? Résultats d'une étude randomisée.

The benefit of chemotherapy for patients with disseminated non small cell lung cancer (NSCLC) is controversial. The introduction of cisplatinum in the combination chemotherapy for NSCLC gave rise to higher response rates. To study the question of the usefulness of cisplatinum-based chemotherapy in disseminated NSCLC we conducted a prospective randomized trial comparing best supportive care to vindesine + cisplatin. Between December 1985 and March 1988, 49 patients with stage IV NSCLC were enrolled. Of the 46 eligible patients 24 were in the chemotherapy group and 22 in the best supportive care group. The treatment groups were not significantly different in terms of age, performance status, histology. Toxicity on the chemotherapy arm grade 3 or more was observed in 17.5% for neutropenia, in 8.75% for vomiting. There was one death related to treatment. The overall response rate in the chemotherapy group was 41.7%. Patients of the chemotherapy group had a median survival time of 199 days and the patients of the best supportive care group had a median survival time of 73 days. The difference in survival is highly significant (p less than 0.001).

Investigation of foreign substances in food.

Scanning electron microscopy (SEM) together with energy-dispersive spectroscopy (EDS) and Fourier transform infrared spectroscopy (FTIR) were used to investigate foreign substances from seven categories of foreign substances in food. (1) Naturally occurring foreign substances--Using FTIR, a foreign substance was identified as a natural resin probably from the product. (2) Foreign substances introduced during food processing. Scanning electron microscopy-EDS was used to identify a foreign material found on surf clams as calcium phosphate from a product/ingredient interaction. Using SEM-EDS, a crystalline material in a meat product was identified as calcium salts of chloride and phosphate. Fourier transform infrared spectroscopy was used to identify foreign material that clogged an aerosol valve as chipboard. Using SEM-EDS, the metal in the heel of a glass bottle was identified as copper sulfide-containing metal inclusion. (3) Insects, reptiles, and rodents--Scanning electron microscopy was used to determine that a mouse found in food was not processed with the food, but entered the container after it left the factory. (4) Glass fragments--Glass from various sources can be distinguished from one another using SEM-EDS either by the level of the major elements in glass or by the presence of elements in one glass, but not in another. (5) Glass-like particles--Using SEM-EDS, glass-like particles found on beets were determined to be a fatty acid. (6) Metal foreign objects--Using SEM-EDS, metals from a variety of sources can be easily distinguished. For example, a tin-soldered container can be distinguished from a lead-soldered can. Using SEM-EDS, the metal fiber found on the bottom of a two-piece can likely enter the can during the final stage of the manufacture of the drawn and ironed food can. (7) Drug capsule identification--Fourier transform infrared spectroscopy was used to determine that a pill found in food was ibuprofen.

Investigation of corrosion and container integrity in metal food containers using scanning electron microscopy-X-ray microanalysis.

Scanning electron microscopy and x-ray microanalysis were used to investigate microleakage, two incidences of loss of coating integrity, filiform corrosion, and sulfide black corrosion in enamel-lined metal food containers. Microleakage developed in a canned cheese sauce at the side seam weld and was traced to a hot weld and a cold weld defect. An enamel-blistering problem developed in an aseptically processed milk-based product when the tinplate was heated above its melting point; the tin melted under the enamel coating, causing the blistering. An enamel-blistering problem, due to silicon contamination of the metal surface prior to enameling, developed on the bottom of a two-piece can that contained a chicken-based product. A sulfide black problem developed in canned clams, caused by scratches in the coating that were introduced during can manufacturing. A filiform corrosion problem developed on the outside of the easy score line of enameled tinplate lids with a light tin coating 0.08 microns thick.

Recent case histories of food product-metal container interactions using scanning electron microscopy-x-ray microanalysis.

Scanning electron microscopy (SEM) and x-ray microanalysis (EDS) were used to investigate stress corrosion cracking (SCC) in plain tinplate food cans, product discoloration, filiform corrosion, pitting/perforation corrosion, and loss of coating adhesion in enameled food cans. Intergranular SCC of uncoated tinplate occurred in canned pineapple juice. This is a rare occurrence in acid food products. The fracture developed in the can headspace only at the product line/metal interface by an interaction of the detinned metal surface with stress-inducing compounds in the product. Black discoloration of rice granules in the can headspace of a chicken and rice product was caused by the formation of metal sulfides. The source of the metal contamination was traced to metallic dirt in the coating on the tin-free-steel end. Blackening of light tan-colored olives and brine occurred after 1 year of storage in enameled tinplate containers as a result of pitting corrosion at the side seam weld. The cause of the pitting was a defective side seam stripe which failed to protect the weld. A perforation problem occurred at the score line of aluminum-tinplate bimetallic cans. The failure was caused by the high chloride content of the fruit product. Filiform corrosion resulted in perforations that occurred on the outside surfaces of two-piece tin-free steel cans packed with tuna. The cause of the corrosion was related to scratch defects in the exterior coating and the presence of chloride and sulfate cannery residues in the corroded areas. An enamel adhesion failure developed inside two-piece tin-free steel cans that contained mushrooms. Wrinkles in the coating which were introduced during can manufacture were cracked. The fractures were pathways for product-steel interaction which resulted in container failure.

Investigation of foreign substances in food using scanning electron microscopy-x-ray microanalysis.

Scanning electron microscopy (SEM) and x-ray microanalysis (EDS) were used to conduct forensic investigations on metal and glass foreign objects. SEM-EDS is an excellent method for identifying metal foreign objects in food, such as wire, dental fillings, bone, and metal packaging, based on their element composition. From a determination of the extent of corrosion of a metal foreign object using SEM-EDS, it is sometimes possible to determine whether the material has been processed with the food product. Case histories of processed aluminum, unprocessed nickel-coated steel, and corrosion resistant stainless steel foreign objects are discussed. A potential product-tampering problem involving a hole defect in a paperboard package was resolved using SEM-EDS. Blue fibers found in the hole were found to contain brass particles from a ball point pen rather than a syringe needle. SEM-EDS has been used to determine the elemental composition of glass foreign objects and is able to distinguish between many types of glass including container, electrical, and bakeware. A case history is presented to show that although container glasses cannot, in general, be distinguished from one another using SEM-EDS, they can be distinguished by trace element semiquantitative spectrograghic analysis. SEM-EDS can be used to distinguish glass-like foreign objects from glass. Case histories of struvite crystals found in salmon and cream of tartar crystals found in grape juice are discussed. Fourier transform infrared (FTIR) identified the cream of tartar crystal as calcium tartrate, and this complemented the calcium, carbon, and oxygen components of the compound found using SEM-EDS.

[Sexual abuse and negligence: same causes, same effects, same treatment?]. / Abuse sexuels et négligence: mêmes causes, mêmes effets, même traitement?

The issues surrounding sexual abuse and negligence are rarely examined in parallel by researchers and social workers. Based on a review of relevant literature and on a preliminary analysis of data collected during two surveys, the authors present in this article a comparison of these two subjects. In short, sexual abuse and negligence do not seem to differ fundamentally when it is a matter of establishing the state of health of victims once under the care of authorities and of choosing a type of psychosocial intervention. However, the researchers do look closely at very different risk factors when analyzing the family environment and the characteristics of the actors involved.

[Psychosocial impact of the 1998 Québec Ice Storm.]. / Les impacts psychosociaux de la tempête de verglas au Québec.

Between January 5th and January 9th 1998, Quebec was struck by a natural disaster, an ice storm that disrupted the daily lives of millions of people. The ice accumulated on electric wires and installations caused the collapse of part of the system leaving millions of people without power for periods of up to a month. These events thus compelled many people to reorganize their daily lives in some of the most densely populated areas in Québec. Many elements make this disaster distinct from others. It is in this particular context that we must understand results of studies conducted for the Commission mandated by the Québec government to examine the consequences of the ice storm. These studies examined among other things, the psychosocial consequences of the disaster. By comparing the ice storm to other disasters, we see that the temporality of the phases of impact are somewhat different. The confusion between the phases of anticipation and the lengthy duration of the phase of impact are important characteristics which are also linked to some psychosocial impacts such as uncertainty and the more or less prolonged disorganization of daily life. The types of impact underlined in the studies lie in continuity with reactions generally expected in this area (stress, distress, vulnerability for example), and described in the literature but also reveal the specificity of a disaster occurring in a cold country. Here, there are no massive material destruction but help is diverse. However, as elsewhere, there is a context where some people are in a greater situation of vulnerability.

Protection of hybridoma cells against apoptosis by a loop domain-deficient Bcl-xL protein.

The ectopic expression of several members of the Bcl-2 family of anti-apoptotic proteins is a promising strategy to improve the viability of hybridoma cells in culture. However, the impact of post-translational modifications on the function of these proteins in murine hybridomas is unknown. To address this issue, the anti-apoptotic properties of a mutant of Bcl-xL devoid of the so-called "loop domain" (Bcl-xLtriangle up 46-83) were investigated using the Sp2/ O-Ag14 hybridoma model. Clones of Sp2/ O-Ag14 cells expressing Bcl-xLtriangle up 46-83 exhibited resistance against L-glutamine deprivation to similar levels than cells expressing the wild type protein. In contrast, protection against the cytotoxic effects of cycloheximide (CHX) was highly dependent on the level of expression of the Bcl-xLtriangle up 46-83 mutant. Analysis of the growth behaviour of the transfected cells showed that Bcl-xLtriangle up 46-83 was superior to the wild type protein in prolonging Sp2/ O-Agl4 cell viability in stationary batch culture. Furthermore, the prolongation of cell viability in batch culture was directly proportional to the level of expression of the mutated protein. Our results indicate that removal of the loop domain improves the anti-apoptotic activity of Bcl-xL in hybridoma cells grown in stationary batch culture.

Adjunctive strategies to enhance peripheral warming: clinical techniques.

This study investigates common successful strategies to increase peripheral temperature with biofeedback. Eighteen BCIA-certified therapists (average years of practice, 7.5) were interviewed by telephone for 30 to 45 minutes regarding successful peripheral warming strategies. The practitioners reported using multiple teaching strategies, either concurrently or sequentially. These responses were organized into an interrelated four-category model that consists of the following: (1) Attentional Category--shifting from active to passive attention; (2) General Arousal Category--shifting from hyper- to hypoarousal; (3) Proprioceptive/Kinesthetic Awareness Category--shifting from decreased to increased body awareness; (4) Self-Image/Self-Esteem Category--shifting from negative to positive self-image/self-esteem. These four categories and their corresponding techniques can be used to facilitate peripheral warming.

Prolongation of murine hybridoma cell survival in stationary batch culture by Bcl-xL expression.

While the ectopic expression of the anti-apoptoticprotein Bcl-2 has been shown to significantly increaseboth cell viability and antibody production in batchculture, some cell lines are refractory to thesemanipulations. For example, the NS/O and theP3x63Ag8.653 murine myelomas, which express highendogenous levels of the Bcl-2 homologue Bcl-xL, areboth resistant to the anti-apoptotic effect of Bcl-2.This indicates that, in these cells, Bcl-2 and Bcl-xLmay be functionally redundant. In order to define therole which Bcl-xL plays in hybridoma cultures, we usedthe Sp2/0-Ag14 cell line. This murine hybridomaexpresses low levels of Bcl-xL and is highly sensitiveto apoptosis induction by cycloheximide (CHX) and byamino acid depletion. Bcl-xL-transfected Sp2/0-Ag14cells were more resistant than the wild type and theplasmid-containing cells to apoptosis induced by CHXand by glutamine depletion. Moreover, when compared tothe vector-transfected control, Bcl-xL-Sp2/0 cellsexhibited a substantial increase in viability instationary batch culture. Interestingly, Sp2/0-Ag14cells overexpressing Bcl-xL showed a growth behaviourthat was similar to the parent myeloma cell lineP3x63Ag8.653. Our results suggest that Bcl-xLexpression levels are sufficient to account for therelative robustness of some hybridoma cell lines instationary batch cultures.

Role of carbohydrate structures in CEA-mediated intercellular adhesion.

Human carcinoembryonic antigen (CEA) is a member of a family of cell surface glycoproteins representing a subset of the immunoglobulin superfamily and is a major tumor marker. CEA has been demonstrated to function in vitro, at least, as a homotypic intercellular adhesion molecule. CEA can also inhibit the differentiation of several different cell types and contribute to tumorigenesis, an activity that requires CEA-CEA interactions. Post-translational modifications that could modulate CEA-CEA binding are therefore of interest. CEA is heavily glycosylated with 28 consensus sites for the addition of asparagine-linked carbohydrate structures, leading to a molecule with a bottle brush-like structure. In order to modulate the glycosylation of CEA, we transfected the functional cDNA of CEA into Chinese hamster ovary (CHO) mutant cells, Lec1, Lec2, and Lec8, which are deficient in enzymes responsible for various steps in the glycosylation processing pathway. Aggregation assays of cells in suspension were performed with stable CEA transfectants of these cell lines and showed that all of the aberrant CEA glycoforms could still mediate adhesion. In addition, the specificity of adhesion of these glycoforms was unchanged, as shown by homotypic and heterotypic adhesion assays between the transfectants. Lec1 and Lec2 transfectants did, however, show an increased speed and final extent of aggregation, which is consistent with models in which sugar structures interfere with binding through protein domains. Lec8 transfectants, on the other hand, with more truncated sugar structures than Lec2, showed less aggregation than wild type (WT) transfectants. We therefore conclude that carbohydrates do not determine the adhesion property of CEA or its specificity, in spite of the unusually high degree of glycosylation; they do, however, modulate the strength of adhesion.

Ondansetron: perioperative use of a serotonin receptor antagonist for the prevention and treatment of nausea and vomiting.

Postoperative nausea and vomiting (PONV) are common side effects after surgery and have numerous patient factors and etiologies. Although self-limiting, PONV is not without risks and complications. In the past numerous antiemetics have been used successfully in the management of PONV; however, these drugs are associated with adverse effects. Ondansetron is a serotonin receptor antagonist that is effective in preventing and treating PONV. It is believed that ondansetron binds at the serotonin receptor both in the vagal afferents of the gastrointestinal tract and in the chemoreceptor trigger zone. The reported side effects from ondansetron are minor compared with those of the more commonly used antiemetics such as droperidol and metoclopramide and include headache, dizziness, musculoskeletal pain, drowsiness and sedation, and shivers.

Impact of fatigue on the quality of life of patients with primary biliary cirrhosis.

OBJECTIVE: Fatigue is a frustrating symptom frequently reported by patients with primary biliary cirrhosis (PBC), but it is still poorly understood and not well evaluated. Our aim was to determine its importance and its impact on the quality of life and mental health status of patients with PBC. METHODS: Patients with PBC (103 women and 13 men with a mean age of 52.6 yr) completed self-report questionnaires to evaluate the impact of fatigue on their quality of life (Fatigue Impact Scale, FIS), the perception of their own mental health (Symptom Check list-90-R, SCL), and depression (Beck Depression Inventory, BDI). A cohort of age-matched healthy blood donors served as controls. RESULTS: Fatigue was present in 99 patients (85.3%) and was the worst or one of the worst symptoms in about half of them. In PBC patients, the mean FIS and SCL indexes were significantly increased, compared to healthy controls (1.49 +/- 1.11 vs 0.6 +/- 0.6 and 0.72 +/- 0.55 vs 0.36 +/- 0.35, respectively). Unexpectedly, 52 patients (44.8%) could be classified as having depression (BDI score > 10). Significant correlations were found between the FIS and SCL indexes, between the FIS index and the BDI score, as well as between the BDI score and the SCL index. Finally, fatigue was not related to the disease severity parameters, that is, clinical, biochemical, metabolic, and pathological. CONCLUSIONS: Fatigue is a frequent and disabling complaint that impairs the quality of life of PBC patients and their perception of their own mental health, which may be associated with an unexpected depressive condition. In addition, the FIS questionnaire can be considered as a useful tool to assess fatigue in PBC patients and may be used in the evaluation of specific treatments aimed at reducing this complaint in such patients.

[Current deaths due to tuberculosis in France. Analysis of 126 deaths recorded in tuberculosis sufferers in 1975 and 1976 in the Bas-Rhin region (author's transl)]. / Décès actuels par tuberculose en France. Analyse des 126 décès enregistrés chez des tuberculeux en 1975 et 1976 dans le département du Bas-Rhin.

The authors present a study involving 103 cases of death during active tuberculosis and 23 cases of death as a result of complications related to sequelae of tuberculosis recorded in the Bas-Rhin region in 1975 and 1976. Whilst amongst these 103 deaths, the majority concerned elderly individuals, there were nevertheless 20% of deaths due to tuberculosis below the age of 55. The majority of these tuberculosis sufferers had advanced pulmonary lesions where specific therapy had not had time to act. A certain number of deaths could have been avoided, even in the elderly subjects. Of the 23 cases of death due to sequelae, 2/3 died of respiratory failure and 1/5 of secondary aspergillus infection, illustrating the grave prognosis in certain sequelae of tuberculosis.

[Hereditary antithrombin III deficiency causing recurrent thrombo-embolic problems (author's transl)]. / Déficit héréditaire en anti-thrombine III responsable d'accidents thrombo-emboliques récidivants.

A marked deficiency in antithrombin III (AT III) was demonstrated in a 39-year-old man suffering from recurrent thrombo-embolic problems. The patient's father had died following a thrombo-embolic disorder. A certain number of members of the family also showed evidence of a marked decrease in AT III levels. Although it was not possible to study the patient's parents, it would seem reasonable to conclude that the diagnosis was one of hereditary deficiency in AT III. The various aspects of this disorder discovered by Egeberg are reviewed: early onset, in several members of the same family, or recurrent thrombo-embolic problems, accompanied by a decrease in functional activity of one of the principal inhibitors of thrombin (AT III), with autosomal dominant transmission and treatment based upon anti-vitamin K agents.