Anticardiolipin antibodies in women with thromboembolic disorders and in primiparae

Our aims were to determine if the presence of anticardiolipin antibodies (aCL) is an independent risk factor for venous thromboembolism (VTE), myocardial infarction (MI) and stroke (CVA) and to estimate the prevalence of aCL among primiparae and its influence on pregnancy outcome. aCL antibody concentration and isotype were measured using an anticardiolipin ELISA. 50 cases of VTE, CVA and MI along with 149 age-matched controls were recruited from a hospital based case control study. Ages ranged from 15 to 49 years. 1,212 primiparae with uncomplicated pregnancies were recruited from clinics in Kingston and St. Andrew. aCL antibodies were present in 16/50 (32 percent) of CVA, VTE and MI cases and in 23/149 (15.4 percent) of the controls (X = 6.5, p = 0.0107). The estimated relative risk for VTE, CVA and MI associated with aCL antibodies is 2.58 (OR = 2.58; 95 percent CI 1.15-5.77). Among the primiparae 137/807 (16.9 percent) were aCL positive. The impact of aCL antibody presence on pregnancy outcomes has not yet been assessed. aCL antibodies confer a significant risk of VTE, CVA, and MI among women 15-49 years old.(AU)

Causes of death in sickle-cell disease in Jamaica

A review of the causes of death in 276 patients with sickle-cell disease showed that although the greatest mortality occurred in the first five years of life, roughly one-quarter were aged over 30. Commonest causes of death in the first ten years included acute splenic sequestration, septicaemia, meningitis, aplastic crises, and gatroenteritis. In older patients cerebrovascular accidents and renal failure became common. The acute chest syndrome affected all age groups about equally but appeared to result predominantly from infection in the young and embolism or thrombosis in the old.(AU)