The anti-thrombotic effects of vitamin D and their possible relationship with antiphospholipid syndrome.

The importance of the immunomodulatory effects of vitamin D has recently been associated with autoimmune and chronic inflammatory diseases. Vitamin D deficiency has been linked to the development of autoimmune conditions. Antiphospholipid syndrome is an autoimmune disease characterized by thrombotic events and obstetric complications in patients with antiphospholipid antibodies. Current data show that patients with antiphospholipid syndrome have a high prevalence of vitamin D deficiency even without classic risk factors. Several studies have suggested vitamin D may have anti-thrombotic functions. In antiphospholipid syndrome, low vitamin D serum levels have been associated with thrombotic manifestations, suggesting a possible protective role of vitamin D in antiphospholipid syndrome. This literature review presents current evidence on the haemostatic functions of vitamin D and their possible relationship with the clinical manifestations of antiphospholipid syndrome.

[The validity of the index of pediatric mortality risk (PRISM) in a pediatric intensive care unit]. / Validez del índice de riesgo de mortalidad pediátrica (PRISM), en una Unidad de Cuidados Intensivos Pediátricos.

With the purpose to compare the observed and expected mortality rates (based on the PRISM score) in the Pediatric Intensive Care Unit (PICU) of the "Hospital para el Niño Poblano", a prospective study of 92 patients admitted from August to December of 1992 was made. More than five percent of mortality risk was observed among 60.2% of the patients at the PICU admittance. The predicted mortality was not different from the expected mortality (P < 0.05). We observed that seven of ten patients who died with less than 50% mortality risk, had inotropic treatment previously to PICU admittance, there was no haemodynamic alterations in these patients at the PICU admittance, and the PRISM score was low. We suggest that the PRISM score should be interpreted with caution in those patients whose treatment may change the physiologic variables included in the PRISM score.