[The use of antithrombotic drugs in patients with chronic atrial fibrillation in a local health area]. / Utilización de fármacos antitrombóticos en pacientes con fibrilación auricular crónica en un área sanitaria comarcal.

BACKGROUND: The objective of the study is to assess the degree of ambulatory use of prophylactic antithrombotic therapy in patients with chronic atrial fibrillation (CAF) in a county health area. PATIENTS AND METHODS: A cross-sectional, prospective survey carried out in patients admitted at a community-hospital, detected 44 patients with CAF. RESULTS: The inappropriateness of anti-thrombotic therapy (48%) was associated with no having a previous echocardiography (p < 0.004), not being controlled in a hospital (p < 0.02) and in patients without information on the cardioembolic risks (p < 0.0007). CONCLUSIONS: The antithrombotic prophylaxis is scarcely used in patients affected by CAF in the county health area studied.

Transverse myelitis in systemic lupus erythematosus: two cases with magnetic resonance imaging.

Transverse myelitis is one of the most serious neurological complications occurring in the course of systemic lupus erythematosus. We describe two lupus patients, with transverse myelitis, one of whom had associated optic neuritis. In both, magnetic resonance imaging of the spinal cord showed an abnormal signal. In one case a good response to steroid and immunosuppressive therapy was observed; the other case failed to improve despite the therapy applied.

Thrombotic thrombocytopenic purpura preceding systemic lupus erythematosus.

The case of a patient admitted with thrombotic thrombocytopenic purpura nine years after developing systemic lupus erythematosus (SLE) is reported. Thrombotic thrombocytopenic purpura associated with SLE has been described on other occasions, but in most patients the diagnosis of SLE precedes that of thrombotic thrombocytopenic purpura. The unusual sequence and the chronological separation of the two diseases is emphasised.