Please select the eligibility criteria that correspond to the clinical trial below.
Title: Randomized and Controlled Clinical Trial of Transfusional Requirements in Patients With Acute Gastrointestinal Bleeding.
Brief Summary: Recently it has been suggested that a restrictive transfusion of units of Red Cells (URC) may improve the outcome of ICU patients with anemia. Furthermore, it has been suggested that the transfusion of URC may be deleterious for the hemostatic process of bleeding lesions, which suggest that a restrictive transfusion may be valuable in patients which gastrointestinal bleeding. Transfusion of URC may also increase portal pressure which may be detrimental to control acute portal hypertensive bleeding.

The aim of the present study is to assess whether a restrictive transfusions may improve the outcome of patients with acute nonvariceal gastrointestinal bleeding, and also whether such a restrictive strategy may improve the outcome of bleeding episodes related with portal hypertension.

The study will be carried out with a prospective, randomized and controlled design comparing the restrictive transfusion strategy with the usual nonrestrictive transfusional strategy. Overall 860 patients will be included; 430 in each group.

The main outcome measure will be survival. All deaths occurred within the 30 days after admission, will be considered. Secondary outcomes will include rebleeding and complications related to treatment, and related to the bleeding episode itself. Portal pressure will be measured to assess the influence of the transfusions strategy on fluctuations of this parameter, and the relationship with the clinical course of bleeding episode.

The study will be performed at the Bleeding Unit of our hospital during a period of 3 years.


Options:
A: Inclusion Criteria:

* All patients with acute upper GI hemorrhage who do not have any criterion of exclusion.

Exclusion Criteria:

* \< 18 years old.
* Pregnancy.
* Negative of the patient to receive transfusions.
* Negative of the patient to participate in the study.
* Patients with therapeutic restrictions (as terminally ill patients).
* Previous recent surgery requiring transfusion.
* Recent (less than 90 days) or unstable acute myocardic ischemia. Peripheral vasculopathy with secondary.
* To have been included in this same study in the 30 previous days.
B: Inclusion Criteria:

* Primary hip fracture
* capable of informed consent
* independently dwelling
* able to ambulate independent of human assistance
* no active heart condition defined as no AMI within 3 months, no unstable angina or present incompensation/pulmonary oedema
* no regular transfusion demand or terminal disease.

Exclusion Criteria:

* Multiple fractures
* postop. immobilization due to to surgical reasons
* patient refusal to participate in relevant rehabilitation
* reoperation within 4. postoperative day.
C: Inclusion Criteria:

* age 18 or older;
* STEMI (ST segment elevated myocardial infarction)
* NSTEMI (Non ST segment elevation myocardial infarction)
* unstable angina
* stable coronary artery disease (undergoing cardiac catheterization during the index hospitalization);
* written informed consent has been obtained
* hemoglobin concentration less than 10 g/dL at the time of random allocation.

Exclusion Criteria:

* bleeding cannot be controlled at the cardiac catheterization puncture site and/or require surgery to repair vessel
* retroperitoneal bleeding requiring surgery
* clinically important hemodynamic instability based on the judgment of the treating physician
* terminal malignancy or life expectancy less than 6 months
* scheduled for cardiac surgery within the next 30 days
* symptomatic at the time of randomization
* declines blood transfusion
* history of a clinically significant transfusion reaction
* inability to provide informed consent;
* enrolled in a competing study
* previous participation in the MINT trial
* any patient who in the judgment of the research team should not be enrolled in the trial. This would include, but not be limited to, factors such alcohol or drug dependence, or psychiatric illness.
D: Inclusion Criteria:

* Has undergone surgical repair for a hip fracture
* Has a postoperative Hgb level below 10 g/dL within three days of surgery
* Diagnosis of cardiovascular disease (e.g., coronary artery disease, congestive heart failure, stroke or transient ischemic attack, or peripheral vascular disease) or cardiovascular risk factors (e.g., diabetes mellitus, hypertension, hypercholesterolemia, tobacco use, or creatinine levels greater than 2.0 mg/dL)

Exclusion Criteria:

* Unable to walk prior to hip fracture
* Declines blood transfusions
* Suffered multiple traumas
* Pathologic fracture of the hip due to malignancy
* Clinically recognized acute myocardial infarction within the 30 days prior to study entry
* Previously participated in the trial and fractured the other hip
* Symptoms associated with anemia (e.g., ischemic chest pain) or actively bleeding at the time of randomization

Answer: A