Mycobacterium celatum is a recently described mycobacterium isolated from patients who have suppressed cell-mediated immunity, such as AIDS. We present here, to our knowledge, the first report of a fatal pulmonary infection caused by M. celatumin a 73-year-old immunocompetent female patient. The mycobacterium was identified by a 16S rRNA sequence analysis.

A 35 year old woman presented with acute myocardial infarction without any of the usual risk factors: she had never smoked; she had normal blood pressure; she did not have diabetes; plasma concentrations of total cholesterol and high and low density lipoprotein cholesterol, fibrinogen, homocysteine, and Lp(a) lipoprotein were normal. She was not taking oral contraceptives or any other medication. Coronary angiography showed occlusion of the left anterior descending coronary artery but no evidence of arteriosclerosis. Medical history disclosed a previous leg vein thrombosis with pulmonary embolism. Coagulation analysis revealed protein C deficiency. The recognition of protein C deficiency as a risk factor for myocardial infarction is important as anticoagulation prevents further thrombotic events, whereas inhibitors of platelet aggregation are ineVective. (Heart 1999;81:316-317) Keywords: myocardial infarction; risk factors; protein C deficiency; anticoagulation A small minority of patients with myocardial infarction have none of the usual and well defined risk factors. We report a 35 year old woman with recurring myocardial infarction in whom recognition of a coagulation defect led to specific preventive measures. Case reportIn March 1996, a 35 year old woman (168 cm, 65 kg) was admitted with an anterior wall myocardial infarction complicated by left sided cardiac failure. The patient had never smoked, she did not have diabetes mellitus or hypertension. She was not taking oral contraceptives or any other medication. In 1985, she had a deep leg vein thrombosis followed by pulmonary embolism. She was treated with phenprocoumon for one year. In February 1996 she experienced a transitory paralysis of the left leg. She did not seek medical attention for this condition. Family history revealed that the patient's father had died of pulmonary embolism, her sister had a calf vein thrombosis, and her mother was healthy.An ECG showed a loss of R in the anterior myocardial wall (V1-6). Transthoracic echocardiography showed highly reduced contractibility (ejection fraction ∼ 20%) as well as dilatation and akinesia of the apical and septal parts of the left ventricle. No thrombolytic treatment was provided as the infarction had occurred several days earlier. Coronary angiography showed occlusion of the left anterior

We analyzed data for women who received fondaparinux for ≥7 days during pregnancy. The study retrospectively included women who received fondaparinux pre-, peri- and/or postpartum for ≥7 days for prophylaxis/venous thromboembolism (VTE) treatment at German specialist centers (2004-2010). Data on pregnancy, VTE risk factors, anticoagulant treatment, pregnancy outcome and adverse events were extracted from medical records. 120 women (mean age 31.5 years) were included. Among 84 women with prior pregnancies, 41.0% had ≥1 abortion. Anticoagulation was indicated for prophylaxis in 92.5% cases, including 82.5% women with an elevated VTE risk (82.8% thrombophilia, 34.2% VTE history). All women received low-molecular-weight heparin (LMWH) as first-line therapy; 3 also unfractionated heparin. Treatment changed to fondaparinux, due to heparin allergy (41.7%) or heparin-induced thrombocytopenia (10.0%). Fondaparinux was generally well tolerated. Adverse events included bleeding events (n = 5), abortion (n = 2), premature births (n = 2), stillbirth (n = 1), arrested labors (n = 2), injection site erythema (n = 4) and unspecified drug hypersensitivity (n = 6). No VTE events or increased liver enzymes occurred during treatment. In this retrospective study, fondaparinux was effective and well tolerated. Trial registration: ClinicalTrials.gov NCT01004939.

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The quality of blood collection is critical for coagulation assays since it has repercussions on the quality of the results and on their reliability. The aim of the present study was to compare, in our current laboratory practice, coagulation analyses carried out on blood collected in (i) siliconized glass tubes and in (ii) polyethylene terephtalate ones. Sixty individuals gave their informed consent to be included in the study: healthy controls (n = 15), patients receiving oral anticoagulants (n = 15), patients receiving unfractionated heparin (n = 15) or low molecular heparin (n = 15). For each subject, an experienced technologist collected 2 consecutive evacuated 5 ml tubes containing 0.5 ml of