Malignant lymphoma of gastric mucosa-associated lymphoid tissue in Jamaica

The recently appreciated concept of Mucosa-Associated Lymphoid Tissue (MALT) and the characteristics of the lymphomas arising therein are discussed with reference to the clinical, histological and immunohistochemical features of the first four cases of gastric MALT lymphomas diagnosed at the University Hospital of the West Indies. These tumours are low-grade B-cell lymphoas, which may undergo high-grade transformation. They are aetiologically associated with Helicobacter pylori (H pylori) infection in the stomach and may be cured in the early stages with antibiotics. Our cases were diagnosed from gastrectomy specimens removed for suspected carcinoma. All were high-grade, and associated with H pylori; 3 cases presented as advanced disease. Documentation of the features of these lymphomas will increase awareness and earlier recognition (AU)

Lupus anticoagulant in Jamaican Primiparae and the clinical significance in asymptomatic patients

Sera from one thousand pregnant primiparous women from the antenatal clinic of the University Hospital of the West Indies (UHWI) were screened for lupus anticoagulant. Twenty-three women (2.3 percent) were seropositive. A review was performed after delivery and eight hundred and sixty-eight (87 percent) of the case notes were found: 20/23 (87 percent) of those with positive tests and 848/977 (87 percent) of those with negative tests. The outcome variables examined were pre-eclampsia, postpartum haemorrhage, type of delivery, birth weight of the baby, foetal outcome, foetal distress, still birth, neonatal death, Apgar score at birth and need for admission to the special care nursery. No differences were found between the two groups for any of these variables (AU)

Zidovudine and interferon therapy for adult T-cell leukaemia/lymphoma: results of a preliminary study at UHWI-Mona

Seven patients with adult T-cell leukaemia/lymphoma(ATL) were treated with a combination of zidovudine (AZT) and interferon after failed chemotherapy. One patient showed a major response for nine months. The remainder showed progressive disease further complicated by drug toxicity. The poor responses could be explained by patient selection, since most patients had advanced disease refractory to chemotherapy. A larger more protracted study is required for further evaluation of this treatment option. (AU)

Induction of labour with intravaginal misoprostol versus dinoprostone in intrauterine death: a retrospective study

Between March 1992 and November 1994, 48 patients with intrauterine death had labour induced, 36 with the prostaglandin analogue misoprostol and 12 with the prostaglandin dinoprostone. Both were used as a single dose in 24 hours intravaginally. The patients were all of low parity and all but one were in the third trimester. Of those getting misoprostol, 92 percent, and of those getting dinoprostone, 67 percent, went into spontaneous labour. Eighty-one percent of those getting misoprostol and 67 percent of those getting dinoprostone delivered within 24 hours without the need for further prostaglandin or oxytocin, a difference that was not significant. No difference were found in other outcome variables such as diagnosis or induction to delivery time or need for ocytocin, between the two groups. Only one maternal medical complication occurred, chorioanmionitis in a patient who had misoprostol, and in whom labour was delayed 6 days.(AU)

Successful pregnancies in patients with the antiphospholipid syndrome treated with low-dose aspirin

Four patients with bad obstetrical histories and with positive lupus anticoagulant tests were treated with low-dose aspirin, prednisone or heparin. They had pre-term deliveries of live babies who all survived (AU)

Successful pregnancies in patients with the antiphospholipid syndrome treated with low-dose aspirin

Four patients with bad obstetrical and with positive lupus anticoagulant tests were treated with low-dose aspirin, prednisone or heparin. They had pre-term deliveries of live babies who all survived.

Factor VIII:C activity in cryoprecipitate prepared at the Blood Bank, University Hospital of the West Indies, Jamaica - abstract

Cryoprecipitate is the blood product rich in factor VIII: C activity used in the treatment of haemophhlia A. The University Hospital Blood Bank makes most of this product used in Jamaica. Commercially prepared factor VIII concentrates are expensive. We examined the effect of donor variables and techniques of preparation on the potency of cryoprecipitates in order to determine the most efficient production method. Factor VIII: C activity of cryoprecipitate was measured using the activated partial thromboplastin time with a normal plasma pool being used as reference plasma. Donor age and method of freezing the plasma had no effect on potency. Blood group B had a higher yield of factor VIII: C than groups A and O. Potency was decreased by prolonged storage of blood prior to processing (p = 0.015) but was increased by increasing volumes of cryprecipitate (p<0.01). The mean potency of the factor VIII: C was 184 i.u., surprisingly higher than the usually assumed 70 i.u. used for calculating the requirements of our haemophiliacs. We recommend that plasma from fresh tested blood, frozen in - 40§C be used for preparing cryoprecipitate and that a higher value than 70 i.u. of factor VIII: C be used for each bag of cryoprecipitate (AU)

Cerebral sinovenous thrombosis in a patient with paroxysmal nocturnal haemoglobinuria

Paroxysmal nocturnal haemoglobinuria may be complicated by life-threatening thrombosis. A patient who presented with the classical clinical picture of cerebral sinus thrombosis is described. Management of the condition is discussed. (AU)