Consensus opinion for the selection and use of therapeutic products for the treatment of haemophilia in Spain.

The period between isolation of HIV in the early 1980s and the development of effective viral inactivation procedures able to eradicate the virus from the blood supply was long and unfortunately many recipients of blood-derived products became infected; this translated into a devastating impact on their quality of life, quality of care as well as on their life expectancy. Some years later, hepatitis C virus infection was identified as another known blood-borne disease complicating the treatment of haemophilia. Nowadays, the potential threat of emerging new pathogens has stressed the need to provide effective but primarily safe products with regard to infectious agents, as well as to regularly update therapeutic guidelines for haemophilia. The aim of the present publication was to review some of the crucial aspects related to the choice of haemostatic concentrates for the treatment of haemophilia and other inherited bleeding disorders, to analyse the current situation in the United States, Canada and European Union countries and to report the most relevant aspects of the Spanish consensus opinion of haemophilia-treating doctors for the use of therapeutic products for haemophilia recently issued. Essentially, it suggests that a gradual switch to recombinant concentrates may be a beneficial decision for patients with haemophilia and for the National Health Service.

A prospective controlled study of a computer-assisted acenocoumarol dosage program.

The increase in oral anticoagulant (OA) treatment has led to development of new strategies for its control. We tested the efficacy of the GAO software (Dade Behring) in providing adequate acenocoumarol dosages for patients whose international normalised ratios (INRs) were no more than 0.5 points out of range. From December 1998 to August 1999, all outpatients in this setting were randomly assigned to receive computer-generated or traditionally fixed OA doses. Patients in their first 4 weeks of treatment were excluded. Overall, 8352 dosages were calculated by the computer and 7586 by the medical staff. The main endpoint of the study was the time spent in target INR range. The computer matched the traditional dosing, achieving a small but statistically significant greater efficacy in maintaining patients within the INR target range. The percentage of INR determinations over 5.5 was very low in both groups. Our results validate the computerised acenocoumarol dosing in our centre, achieving at least similar levels of effectiveness and safety compared with traditional dosage by medical staff.

Efecto del limón en la eliminación de pediculosis del cuerpo cabelludo en niños de 1er y 2do grado de educación primaria del Puericultorio Pérez Aranibar / Effect of the lemon in the elimination of pediculosis of the hairy leather in children of first and second degree of primary education of Puericultorio Perez Aranibar

Se estudió el efecto del limón en la eliminación de pediculosis del cuero cabelludo durante los meses de junio, julio y agosto de 1997 en niños de 1er y 2do. grado de educación primaria del Puericultorio Pérez Aranibar. Se examinaron a 135 niños de 5 a 12 años considerándose como positivos aquellos infectados al momento del diagnóstico. Se aplicó los tratamientos con jugo de limón, con champú común y con Nopucid loción más champú. Se encontró un alta prevalencia en los alumnos de 1er. 2do. grado el efecto del limón fue relativamente bajo, no se pudo comprobar científicamente su acción sobre el piojo, sólo se observó que lo endurecía y se desprendía del cabello permitiendo su eliminación. Los efectos del uso del jugo de limón y champú fue menor que el Nopucid pero ninguno ofreció un 100 por ciento de efctividad, en cambio la adecuada higiene al cuero cabelludo y cabello más la utilización del peine fino serían lo más aconsejable. Palabras claves: Piojo de la cabeza, infestación, tratamiento, limón.