Epidemiology of Rh hemolytic diseases of the newborn in the United States
Article Abstract:
Rh hemolytic disease of the newborn (RhHDN) is caused by the passage of antibodies from the mother to the fetus, usually as a result of blood group incompatibility; for example, when a mother with Rh-negative blood is carrying a child with Rh-positive blood. Symptoms of RhHDN in the newborn include anemia, jaundice, enlarged liver and spleen, and edema (the swelling of tissues as a result of too much fluid). The incidence of RhHDN was declining until the late 1970s. About 90 percent of all cases of RhHDN would be eliminated if an adequate dose of Rh immune globulin (RhIg) were given to all pregnant women with a potential blood type incompatibility. If RhIg treatments were administered prenatally and after birth, up to 99 percent of all cases of RhHDN could be prevented. There has been debate about the benefits and costs of this practice, even though it has been shown to substantially lower incidence of RhHDN. Nine hundred sixty cases of RhHDN were listed in the Birth Defects Monitoring Program (BDMP) during 1986, and records were obtained for 828 of them. The estimated incidence rate was 10.6 per 10,000 total births. Regional variations may be accounted for by differences in medical practice or in racial patterns; the incidence of RhHDN is low in blacks and Asians. Neonatal mortality was lower than expected, perhaps because infants who were transferred to other hospitals and later died were not counted. Many of the mothers lacked insurance, suggesting that adequate and early prenatal care that would have prevented the condition was lacking. About half of the cases listed as RhHDN were misclassified, leading to overestimation of incidence rates. It was not possible to determine how many cases of RhHDN were misdiagnosed, but the number is probably small. Risk factors for RhHDN should be identified to determine the reasons for its continued high rate in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Do cultural differences affect Alzheimer disease?
Article Abstract:
Studies of cultural differences in dementia can encounter several problems. A 1996 study found that Japanese-Americans living in Hawaii had higher rates of Alzheimer's dementia than their compatriots in Japan. This indicates that environmental factors may play a role in this disease. However, the Japanese who migrated to Hawaii may have been genetically different from those who remained in Japan. In addition, the diagnostic criteria for Alzheimer's dementia rest on somewhat arbitrary criteria. Many elderly people may have both Alzheimer's disease and vascular dementia and it may be hard to tell which disease is causing the symptoms.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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