[Hyperthrombophilia status in a patient without thrombotic events]. / Paciente en estado de hipertrombofilia sin eventos trombóticos.

Some case reports have been published in the literature about thrombosis associated with several risk factors, especially in hypercoagulability state. Nevertheless, we have not found any description of a case like this of hyperthrombophilia status without thrombotic events. We present a 75 year old woman who was assessed for thrombophilia state on occasion of a deep venous thrombosis which affected to her daughter. Many thrombosis risk factors were detected (13 altogether), both inherited and acquired, arterial and venous, that surprisingly, have not led to any thrombosis event. Its description led us to highlight the risk factors of this patient and to open questions about the present knowledge on etiology and etiopathogenesis of thrombotic phenomena.

Minimal illegitimate levels of cytokeratin K19 expression in mononucleated blood cells detected by a reverse transcription PCR method (RT-PCR).

Cytokeratin K19 (CK19) expression was evaluated by a reverse transcription PCR method (RT-PCR) in the RNA obtained from peripheral blood stem cell collections (PBSC) from four patients with breast cancers (BC) and 34 mononucleated blood cell (MBC) negative controls (17 PBMC from normal subjects 12 PBSC from different types of leukaemias--M3, M4Eo, M2, etc.--and two from patients with Hodgkin's lymphoma; and three bone marrow (BM) collections). Two BC tissues were taken as positive controls. The method studied (Datta YH, Paul T, Adams PT, Drobyski WR. Sensitive detection of occult breast cancer by reverse transcription polymerase chain reaction. J Oncol 1994;12:475-8) is sensitive enough to allow the detection of CK19 transcripts in a 10(-6) dilution of cDNA reverse transcribed from 1 microgram of BC RNA, but CK19 transcripts were also detected in 64% of the RNA obtained from the MBC controls. However, the amplified product detected in the control samples represents the transcript of the CK19 gene as confirmed by the results of Mae III digestion. It should be pointed out that although the CK19 expression was detected, the levels of expression in PBMC were almost negligible for they disappeared at 1:5 cDNA dilution. Moreover, a direct relationship between the number of BC cells added to PBMC and the increasing dilution levels of the cDNA necessary to prevent CK19 expression was observed. This allows us to conclude that the cDNA dilutions make it possible to distinguish the false from the true positive samples and that, in addition, the cDNA dilutions inform about the degree of BC cell contamination.

[Incidence of hepatitis C infection among donors of femur heads to the tissue bank]. / Incidencia de infección por hepatitis C en donantes de cabezas femorales para el banco de tejidos.

Living donors of femoral heads belong to a highly specific group in terms of age and pathological characteristic, forming the core of the group who supply many tissue banks with spongy bone, to cover the needs of several specialties in the field of repair and corrective surgery. Analysis for the presence of the hepatitis C virus in this population was conducted as a part of quality control programs, while habitual blood donors from the same geographical location were used as the control group. Although the comparison of results could give rise to erroneous interpretations, due to the lack of qualitative fit between the groups, a much higher incidence of infection by VHC was found in the donors of spongy bone than was the case for blood donors (3.816% vs. 0.569%), although a smaller proportion of donors had hepatic alterations (measured by transaminases). In spite of the fact that the prevalence of VHC is almost 6 times that corresponding to the control group, the elimination of live donors of spongy bone would create serious problems with supply to tissue banks. We therefore propose that more severe exclusion criteria be applied to the selection of bone donors, and also that sterilisation techniques be employed, using physical-chemical procedures (liophilisation, dehydration, chemical treatment, irradiation) to process these tissues. We also recommend that younger multiple organ tissue donors be used as sources of spongy bone for cold storage that is not to be subjected to any additional sterilisation treatment.

Paciente en estado de hipertrombofilia sin eventos trombóticos / Hyperthrombophilia status in a patient without thrombotic events

Se han publicado diferentes casos clínicos de pacientes afectos de trombosis con asociación de factores de riesgo, especialmente estados de hipercoagulabilidad. Sin embargo, no hemos encontrado en la literatura un caso como el que presentamos: una mujer de 75 años, evaluada paratrombofilia a raíz de un episodio de trombosis venosa profunda que afectóa su hija, a la que se le ha detectado una acumulación factores de riesgo (13 en total), tanto congénitos como adquiridos, arteriales como venosos que, sorprendentemente, no ha abocado a evento trombótico alguno. Su exposición nos permite incidir sobre los factores de riesgo de la paciente y abrir interrogantes sobre el conocimiento actual de la etiología y etiopatogenia de los fenómenos trombóticos

Some case reports have been published in the literature about thrombosis associated with several risk factors, specially in hypercoagulability state. Nevertheless, we have not found any description of a case like this of hyperthrombophilia status without thrombotic events. We present a 75 years old woman who was assessed for thrombophilia state on occasion of a deep venous thrombosis which affected to her daughter. Many thrombosis risk factors were detected (13 altogether), both inherited and acquired, arterial and venous, that surprisingly, have not led to any thrombosis event. Its description led us to highlight the risk factors of this patient and to open questions about the present knowledge on etiology and etiopathogenesis of thrombotic phenomena

Prevención de la transmisión intrauterina del virus de la hepatitis B en procedimientos invasivos / Prevention of intrauterine hepatitis B virus infection in invasive procedures: a case report

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