[Anesthetic management for cesarean delivery in a pregnant patient with congenital antithrombin III deficiency and pulmonary thromboembolism]

Antithrombin III (AT III) deficiency is a rare hereditary disease that predisposes a patient to thromboembolic complications. Anticoagulation is essential for preventing recurrence of thrombi. Concentrated AT III replacement is reserved for acute periods of thromboembolism or moments of increased risk. Hemostatic anomalies are generally considered a contraindication for regional anesthesia, due to the potential risk of spinal hematoma. This paper describes a woman with congenital AT III deficiency and heparin-treated pulmonary embolism whose pregnancy of 29 weeks had to be terminated by cesarean section upon signs of fetal distress. We discuss the pathophysiology and treatment in such cases.

Research on factors allowing a risk assessment of spore-forming pathogenic bacteria in cooked chilled foods containing vegetables: a FAIR collaborative project

Vegetables are frequent ingredients of cooked chilled foods and are frequently contaminated with spore-forming bacteria (SFB). Therefore, risk assessment studies have been carried out, including the following: hazard identification and characterisation--from an extensive literature review and expertise of the participants, B. cereus and C. botulinum were identified as the main hazards; exposure assessment--consisting of determination of the prevalence of hazardous SFB in cooked chilled foods containing vegetables and in unprocessed vegetables, and identification of SFB representative of the bacterial community in cooked chilled foods containing vegetables, determination of heat-resistance parameters and factors affecting heat resistance of SFB, determination of the growth kinetics of SFB in vegetable substrate and of the influence of controlling factors, validation of previous work in complex food systems and by challenge testing and information about process and storage conditions of cooked chilled foods containing vegetables. The paper illustrates some original results obtained in the course of the project. The results and information collected from scientific literature or from the expertise of the participants are integrated into the microbial risk assessment, using both a Bayesian belief network approach and a process risk model approach, previously applied to other foodborne hazards.