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2. The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Author

Cohen, At, Gitt, Ak, Bauersachs, R, Fronk, Em, Laeis, P, Mismetti, P, Monreal, M, Willich, Sn, Bramlage, P, Agnelli, G, Brodmann, M, Rief, P, Eischer, L, Stoshikj, S, Hirschl, M, Weinmann, S, Peter Marschang, P, Abbadie, F, Achkar, A, Addala, A, Reynaldo, P, Adnet, F, Alexandra, Jf, Aquilanti, S, Belhassane, A, Benaroya, B, Berremili, T, Grenot, Mc, Birr, V, Holtea, D, Bonnin, C, Bosler, F, Bresin Durand MG, Brisot, D, Brousse, C, De La Fuente, T, Cayman, C, Cazaubon, M, Champion, O, Chanut, M, Chevalet, P, Connault, J, Durant, C, Constans, J, Cordeanu, M, Couturaud, F, Lacut, K, De Dedker, L, Piloquet, Fx, Decoulx, E, Derrien, B, Diamand, Jm, Diard, A, Douadi, Y, Dupas, S, Modeliar Remond SS, Sevestre, Ma, Edhery, S, Falvo, N, Farcas Taralunga, C, Ferrari, E, Gaillard, C, Garrigues, D, Gillet, Jl, Giordana, P, Grange, C, Vital-Durand, D, Grare, F, Hadj Henni, A, Heuser, S, Schmidt, J, Hidden-Henic, V, Hottin, D, Imbert, B, Pernod, G, Jakob, D, Jacquinandi, V, Jurus, C, Lacoste, A, Laroche, Jp, Martin, M, Mazollier, C, Mersel, T, Miserey, G, Nedey, C, Nou, M, Quere, I, Ouvry, P, Peuch, B, Pichot, O, Poulain, V, Ray, P, Rifai, A, Roy, Pm, Saby, Jc, Simon, F, Simonot-Lalandec, E, Stephan, D, Tissot, A, Vodoungnon, H, Adamczyk, A, Schnabl, S, Al Ahmad, W, Weber, H, Axthelm, C, Axthelm, P, Bergmann, K, Beschorner, U, Knittel, M, Binias, Kh, Pasligh, M, Boral, M, Girke, F, Bratsch, H, Brauer, G, Burghard, S, Demann, C, Rennebaum, C, Emter, E, Demmig, A, Eberlein, U, Enger, F, Eschenburg, J, Eschenburg, Ju, Forkmann, L, Frank, J, Freischmidt, H, Gassauer, M, Fritsche, I, Kubicek–hofmann, C, Goebels, Mc, Guggenbichler, S, Härtel, D, Hartmann, K, Heilberger, P, Heinsius, A, Held, M, Schnupp, S, Herman, G, Herold, J, Hertrich, F, Hommel, H, Hütte, G, Kalka, C, Jungandreas, K, Ramthor, M, Karcher, J, Werner, N, Karl-Wollweber, S, Keilhau, Da, Kittel, K, Knolinski, T, Köhler, C, Werth, S, Kopplin, U, Körner, I, Wittig, K, Dres, P, Kröger, K, Moysidis, T, Kroschel, U, Leschke, M, zur Nieden, T, Lübbert, G, Lutz, A, Wucherpfennig, P, Marencke, Gh, Mortensen, K, Reppel, M, Nelles, H, Nestler, K, Neumeister, A, Schlosser, A, Oettler, W, Ott, I, Otto, A, Pertermann, A, Pfister, R, Pindur, P, Pourhassan, S, Predel, D, Pudollek, T, Reimer, D, Richter, R, Eberhad Rieker, E, Rothenbücher, G, Rothhagen, B, Rudolff, S, Stücker, M, Schäfer, A, Sonnenschein, K, Schafnitzl, W, Schellong, S, Voigts, B, Schiller, M, Schmeink, T, Schmeink, P, Schneider, H, Schön, N, Schulze, M, Sechtem, U, Sedl, S, Werno, Hs, Stachowitz, J, Thieme, M, Tiefenbacher, C, Tsantilas, D, Vieth, P, vom Dahl, J, Grün-Himmelmann, K, von Bilderling, P, von Maltik, T, Weinrich, K, Weyer, M, Wirtz, P, Wittig, I, Zierock, P, Ageno, W, Caprioli, C, Rancan, E, Guercini, F, Mommi, V, Amitrano, M, Cannavacciuolo, F, Amore, M, D'Antoni, S, Angelini, E, La Forgia, S, Antignani, Pl, Calandra, G, Arone, A, Perticone, F, Sciacqua, A, Asaro, G, Bellisi, M, Attanzio, Mt, Pinto, A, Attinasi, V, Cillari, E, Sorvillo, S, Balbarini, A, Santini, C, Violo, C, Banfi, E, Lodigiani, C, Barcellona, D, Delpin, S, Marongiu, S, Barillari, G, Pasca, S, Bartolini, C, Verdecchia, P, Bartone, M, Mancuso, G, Bellanuova, I, Felis, S, Bellizzi, A, Masotti, L, Bianchi, M, Carugati, A, Bianchini, G, Guarnera, G, Boari, B, Gallerani, M, Pasin, M, Bortoluzzi, C, Parisi, R, Brucoli, C, Palasciano, G, Camporese, G, Tonello, C, Canafoglia, L, Rupoli, S, Cancellieri, E, Paoletti, O, Testa, S, Carlizza, A, Carnovali, M, Sada, S, Samaden, A, Casarsa, C, Mearelli, F, Pivetti, G, Catalini, R, Zingaretti, O, Cavazza, S, Cosmi, B, Cenci, C, Prisco, D, Silvestri, E, Ceresa, F, Patanè, F, Ciampa, A, Siniscalchi, V, Ciarambino, T, De Bartolomeo, G, Clemente, M, Conti, F, Paiella, L, D’Avino, M, D'Alessandro, A, Placentino, M, Sollazzo, V, D'Angelo, A, Viganò, S, De Campora, P, Sangiuolo, R, De Franciscis, S, Serra, R, De Gaudenzi, E, De Santis, F, Piccinni, Gc, De Tommaso, I, Di Francesco, L, Vincentelli, Gm, Di Maggio, R, Saccullo, G, Siragusa, S, Di Micco, P, Fontanella, A, Di Michele, D, Di Minno, G, Tufano, A, Di Nisio, M, Porreca, E, Donadio, F, Imberti, D, Enea, I, Fabbian, F, Manfredini, R, Pala, P, Falanga, A, Milesi, V, Fiore, V, Signorelli, Ss, Franco, E, Giudice, G, Frausini, G, Rovinelli, M, Fuorlo, M, Landolfi, R, Morretti, T, Gamberini, S, Salmi, R, Ghirarduzzi, A, Ghizzi, G, Pepe, C, Gianniello, F, Martinelli, I, Iosub, Di, Piovella, F, Iozzi, E, Talerico, A, La Regina, M, Orlandini, F, Marconi, L, Palla, A, Marcucci, R, Poli, D, Margheriti, R, Sala, G, Marra, A, Marrocco, F, Montagna, Es, Silvestris, F, Vallarelli, S, Mos, L, Rossetto, V, Mugno, F, Di Salvo, M, Nitti, C, Pennacchioni, M, Salvi, A, Olivieri, O, Tosi, F, Zorzi, F, Onesta, M, Pagliara, V, Villalta, S, Paolucci, G, Severino, S, Pierri, F, Russo, V, Pizzini, Am, Quintavalla, R, Rubino, P, Ria, L, Schenone, A, Strafino, C, Tropeano, P, Vetrano, V, Zanatta, N, Adarraga Cansino MD, Gutierrez, Ja, de las Revillas FA, Amado Fernández, C, Calvo Mijares, N, Blanco-Molina, Ma, Garcia, Ma, Joya Seijo, D, Aranda Blazquez, R, López-Sáez, Jb, Arellano Rodrigo, E, Villalta Blanch, J, Armengou Arxe, A, García-Bragado Dalmau, F, Ballaz Quincoces, A, García Loizaga, A, Beato Pérez JL, Bedate Díaz, P, Quezada Loaiza, A, Castellote, Mc, Cañas Alcántara, I, Lluís Padierna, M, Carrasco Expósito, M, Millón Caño JA, Carrasco Mas, A, Cereto Castro, F, Castrodeza Sanz, R, Ortiz de Saracho, J, Cisneros de la Fuente, E, de Ancos Aracil, C, Ruiz, J, de Daborenea González MD, Fernández Iglesias, A, de la Fuente Aguado, J, González, Lg, del Carmen Fernández-Capitán, M, Lorenzo Hernández, A, del Toro Cervera, J, Pérez Rus, G, Delgado Bregel JL, Díez Fernández, F, Santalla Valle EA, Elias Hernández, T, Jara Palomares, L, Ferri Bataler, R, Nieto Rodríguez JA, García García JM, Villanueva Montes MA, González Porras JR, Guil García, M, San Román Terán CM, Hernando López, E, Roncero Lázaro, A, Jaras, Mj, Jiménez Castro, D, Jiménez-Rodríguez Madridejos, R, Pedrajas Navas JM, Lecumberri, R, Martínez, N, López Castellanos GT, Manzano Espinosa, L, López Jiménez, L, Madridano Cobo, O, Mainez Saiz, C, Romero Pizarro, Y, Marchena Yglesias PJ, Martín del Pozo, M, Melibovsky, L, Altarriba, Es, Monreal Bosch, M, Monte Secades, R, Mora Luján JM, Riera Mestre, A, Moral Moral, P, Todolí Parra JA, Moreno Flores, A, Sánchez Muñoz-Torrero JF, Muñoz Rodríguez FJ, Núñez Fernández MJ, Oncala Sibajas, E, Vaquero de Sedas, M, Parra Caballero, P, Pons Martín del Campo, I, Portillo Sánchez, J, Rivera Gallego, A, Villaverde Álvarez, I, Rodríguez Beltrán EM, Sánchez Fuentes, D, Roldán Schilling, V, Sánchez Álvarez, J, López, Gt, Suriñach Caralt JM, Tirado Miranda, R, Usandizaga de Antonio, E, Banyai, M, Frank, U, Jörg, Gr, Jeanneret, C, Staub, D, Ackroyd, A, Agarwal, G, Mearns, B, Alikhan, R, Allameddine, A, Al-Refaie, F, Arden, C, Austin, A, Bakhai, A, Barton, T, Ewad, H, Body, R, Thachil, J, Chacko, J, Chandra, D, Charters, F, Church, A, Mcgrane, F, Clements, J, Clifford, P, Cox, D, Crouch, M, Crowther, M, Davies, E, Davies, M, Dimitri, S, Drebes, A, Franklin, S, George, J, Irvine, N, Gerofke, H, Gibbs, C, Goh, T, Gupta, S, Holmes, J, Jackson-Voyzey, E, Jones, N, Kallat, A, Kerr, P, Kesteven, P, Lench, T, Lester, W, Lowe, G, Lewis, M, Mccormack, T, Mccoye, A, Moriarty, A, Morris, W, Narayanan, M, Oo, N, Reed, M, Rose, P, Saja, K, Sivakumaran, M, Sohal, M, Solomons, G, Sultanzadeh, Sj, Venton, T, Wakeling, J, Walby, C, Waldron, M, Watt, S, Willcock, W, and Zafar, A.

Subjects
Male, Time Factors, Databases, Factual, Administration, Oral, Disease, Comorbidity, 030204 cardiovascular system & hematology, registry, Direct oral anticoagulants, 0302 clinical medicine, Recurrence, Risk Factors, Epidemiology, 030212 general & internal medicine, Prospective Studies, Registries, anticoagulation, LS4_7, Venous Thrombosis, Hematology, Venous Thromboembolism, Vitamin K antagonist, Middle Aged, Thrombosis, Pulmonary embolism, Europe, vitamin K antagonists, Treatment Outcome, Administration, Female, Coagulation and Fibrinolysis, Venous thromboembolism, Oral, Adult, medicine.medical_specialty, Registry, medicine.drug_class, Socio-culturale, Hemorrhage, direct oral anticoagulants, Venous thromboembolism, anticoagulation, direct oral anticoagulants, registry, vitamin K antagonists, Anticoagulation, Vitamin K antagonists, Aged, Anticoagulants, Humans, Pulmonary Embolism, 03 medical and health sciences, Databases, Disease registry, Internal medicine, medicine, cardiovascular diseases, Intensive care medicine, Factual, business.industry, medicine.disease, equipment and supplies, Clinical trial, business
Abstract

SummaryVenous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0% were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5%). The diagnosis was deep-vein thrombosis (DVT) in 59.5% and pulmonary embolism (PE) in 40.5%. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5%), hypertension (42.3%) and dyslipidaemia (21.1%). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2%), almost half received a vitamin K antagonist (48.7%) and nearly a quarter received a DOAC (24.5%). Almost a quarter of all presentations were for recurrent VTE, with >80% of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes.

Published
2016

3. Recidiva de empiema subdural postquirúrgico

Author

Romero-Pizarro, Y., Muñoz-Algarra, M., Fernández-Mateos, C., and Sánchez-Romero, I.

Subjects
Infección Post-quirúrgica, Postoperative infection, Proprionibacterium
Abstract

Se presenta un caso de recidiva de infección postquirúrgica en forma de empiema subdural por Proprionibacterium acnes tras un primer empiema drenado en el que no se llegó al diagnóstico microbiológico. P acnes es un microorganismo gram positivo, anaerobio, que forma parte de la flora saprófita de la piel y de otras zonas del organismo. Sin embargo puede producir infecciones, entre otras localizaciones, en el sistema nervioso central (SNC), especialmente infecciones postquirúrgicas en las que puede llegar a ser el segundo germen en frecuencia después de Staphylococcus aureus. Es de crecimiento lento y suele crecer mejor en medios anaeróbicos líquidos. Suele ser resistente al metronidazol y sensible a penicilinas. En las infecciones postquirúrgicas del sistema nervioso central hay que tener en cuenta la posibilidad de este microorganismo, procesar las muestras de forma adecuada y mantenernos en contacto con el Servicio de Microbiología. We present a case of recurrent subdural post-surgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a gram-positive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. However, it can cause infections, as in the central nervous system, especially post-surgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possibility of this organism, process the sample properly and keep touch with the Microbiology Department.

Published
2011

8. [Clostridium difficile enteritis].

Author

Ramos Martínez A, Romero Pizarro Y, Martínez Arrieta F, Balandín Moreno B, Múñez Rubio E, Cuiñas León K, Sánchez Romero I, Cantos López de Ibargüen B, and Asensio Vegas A

Subjects
Adult, Anti-Bacterial Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bleomycin administration & dosage, Bleomycin adverse effects, Cisplatin administration & dosage, Cisplatin adverse effects, Combined Modality Therapy, Enteritis diagnosis, Enteritis drug therapy, Enteritis surgery, Enterocolitis, Pseudomembranous epidemiology, Enterocolitis, Pseudomembranous microbiology, Enterocolitis, Pseudomembranous surgery, Etoposide administration & dosage, Etoposide adverse effects, Gastrostomy, Humans, Ileostomy, Intestinal Obstruction etiology, Male, Multiple Organ Failure etiology, Neoplasms, Germ Cell and Embryonal drug therapy, Neoplasms, Germ Cell and Embryonal secondary, Neoplasms, Germ Cell and Embryonal surgery, Nephrectomy, Opportunistic Infections diagnosis, Opportunistic Infections drug therapy, Opportunistic Infections surgery, Orchiectomy, Postoperative Complications diagnosis, Postoperative Complications drug therapy, Spain epidemiology, Superinfection, Testicular Neoplasms drug therapy, Testicular Neoplasms pathology, Testicular Neoplasms surgery, Clostridioides difficile isolation & purification, Enteritis microbiology, Enterocolitis, Pseudomembranous diagnosis, Opportunistic Infections microbiology, Postoperative Complications microbiology
Abstract

Introduction: Clostridium difficile infection of the small intestine is infrequent., Method: We present the first case of C. difficile enteritis (CDE) diagnosed in Spain and provide a review of the literature., Results: A 30-year-old man underwent surgery for recurrence of a retroperitoneal germ cell tumor. Seven days later the patient developed vomiting, diarrhea and, finally, intestinal obstruction due to pseudomembranes caused by CDE. Only 57 cases of CDE have been reported in the literature. The mean age was 52±17 years with a range of 18 to 86 years. Twenty-nine patients (50%) had inflammatory bowel disease. Forty-seven (81%) had a history of colon or small intestine surgery. Mortality was higher in older patients and in those without inflammatory bowel disease., Conclusion: CDE is characterized by high severity and mortality., (2011 Elsevier España, S.L. All rights reserved.)

Published
2011
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9. [Postoperative recurrence of subdural empyema].

Author

Romero-Pizarro Y, Muñoz-Algarra M, Fernández-Mateos C, and Sánchez-Romero I

Subjects
Aged, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Anti-Bacterial Agents therapeutic use, Combined Modality Therapy, Decompressive Craniectomy, Drainage, Drug Resistance, Microbial, Empyema, Subdural drug therapy, Empyema, Subdural microbiology, Gram-Positive Bacterial Infections drug therapy, Gram-Positive Bacterial Infections microbiology, Humans, Male, Meningeal Neoplasms surgery, Meningioma surgery, Metronidazole pharmacology, Postoperative Complications drug therapy, Postoperative Complications microbiology, Propionibacterium acnes drug effects, Propionibacterium acnes physiology, Recurrence, Surgical Wound Dehiscence, Surgical Wound Infection drug therapy, Surgical Wound Infection microbiology, Empyema, Subdural surgery, Gram-Positive Bacterial Infections surgery, Postoperative Complications surgery, Propionibacterium acnes isolation & purification, Surgical Wound Infection surgery
Abstract

We present a case of recurrent subdural post-surgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a gram-positive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. However, it can cause infections, as in the central nervous system, especially post-surgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possibility of this organism, process the sample properly and keep touch with the Microbiology Department.

Published
2011

10. Central pontine myelinolysis as a cause of bilateral vocal fold immobility due to hyponatremia.

Author

Górriz Gil C, Tuñón Gómez M, Escamilla C, Romero Pizarro Y, Goizueta G, García-López F, and García-Berrocal JR

Subjects
Adult, Humans, Magnetic Resonance Imaging, Male, Myelinolysis, Central Pontine diagnosis, Vocal Cords, Hyponatremia complications, Myelinolysis, Central Pontine complications, Vocal Cord Paralysis etiology
Abstract

We report a patient admitted with severe dyspnea due to bilateral vocal fold immobility (BVFI), associated with hyponatremia and pneumonia that required emergency tracheotomy. Cerebral magnetic resonance imaging showed a pons lesion compatible with central pontine myelinolysis. Hyponatremia is thought to be caused by hypovolemia. The hyponatremia, and not its correction, is speculated to be the cause of central pontine myelinolysis in this patient. To our knowledge, this is the first case reported of a bilateral vocal fold immobility caused by central pontine myelinolysis induced by hyponatremia., (Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.)

Published
2011
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11. [Prognosis of urinary tract infections with discordant antibiotic treatment].

Author

Ramos-Martínez A, Alonso-Moralejo R, Ortega-Mercader P, Sánchez-Romero I, Millán-Santos I, and Romero-Pizarro Y

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Medication Errors, Middle Aged, Prognosis, Prospective Studies, Young Adult, Anti-Bacterial Agents therapeutic use, Urinary Tract Infections drug therapy
Abstract

Introduction: This study aims to evaluate the prognosis of urinary tract infections (UTI) treated empirically with inadequate antibiotic treatment., Material and Methods: Prospective cohort study of patients over 18 years of age, attended in the hospital emergency service between 01/02 and 31/05 of 2007, due to micturation symptoms, accompanied by pyuria (>10 leukocytes/mm(3) of uncentrifuged urine) or positive reactive strip for nitrites-leukocytes and urine culture with >10(3) colony forming units. It was considered that the antibiotic treatment prescribed empirically was adequate if the bacteria isolated was sensitive and had been prescribed for the correct time. It was considered that there was therapeutic failure when the symptoms persisted after 5 days of treatment. Age, gender, presence of indwelling bladder catheter, type of UTI, hospitalization in the previous 3 months, origin of the patient and associated diseases were recorded., Results: A total of 177 bacteria were isolated in 168 patients. In 29 cases (17.3%), the microorganism isolated was resistant to the antibiotic prescribed. There was thereaputic failure in only 6 patients, although they did not required hospital admission. The patients who lived in a residential home for the elderly (13.7% vs 2.2%, P = 0.015) or who had been hospitalized during the previous 3 months (20.6% vs 4.3%, p = 0.039) had a greater risk of receiving inadequate treatment., Conclusions: The prognosis of the patients attended in the emergency hospital service due to UTI with discordant antibiotic treatment is favorable in most of the cases. Performing urine culture in patients with greater risk of suffering UTI due to a resistant microorganism would be recommendable., (Copyright © 2009 Elsevier España, S.L. All rights reserved.)

Published
2010
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13. [Treatment of systemic lupus erythematosus].

Author

Yebra Bango M, Vargas Núñez JA, Gea-Banacloche JC, and Romero Pizarro Y

Subjects
Adrenal Cortex Hormones therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Humans, Lupus Erythematosus, Systemic physiopathology, Lupus Erythematosus, Systemic therapy
Published
1995

14. [The prevalence of hepatitis C virus markers in a series of 14 patients with essential mixed cryoglobulinemia].

Author

Yebra Bango M, Berrocal Valencia E, Vargas Núñez JA, Gea Banacloche JC, Ruiz Ruiz J, Romero Pizarro Y, Blanco Jiménez J, Diego Marín FJ, and Durántez Martínez A

Subjects
Adult, Aged, Biomarkers blood, Cryoglobulinemia epidemiology, Female, Hepatitis Antibodies blood, Hepatitis B Antibodies blood, Hepatitis B Surface Antigens blood, Humans, Lupus Erythematosus, Systemic epidemiology, Lupus Erythematosus, Systemic immunology, Male, Middle Aged, Prevalence, Seroepidemiologic Studies, Spain epidemiology, Cryoglobulinemia immunology, Hepacivirus immunology
Abstract

This paper studies the prevalence of antibodies against hepatitis B and C virus in 14 patients with essential mixed cryoglobulinemia (EMC), comparing the results with those of 14 systemic erythematosus lupus (SEL) patients and 14 health people. Our results show a very low positivity rate of virus B markers in patients with EMC. In other hand, 10 of 14 patients with EMC have antibodies against hepatitis C virus, both with ELISA and Innolia confirmatory method--and none SEL patient or health people. We conclude, according with other published series, that a very high prevalence of antibodies against hepatitis C is found in patients with EMC.

Published
1994

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