Minerva

Doctors from Israel report an unusual trio of women with antiphospholipid syndrome who survived pregnancy and childbirth despite a history of stroke (Seminars in Arthritis and Rheumatism1998;28:26-9). The women were treated with a cocktail of aspirin and anticoagulants during pregnancy and all had healthy babies. Although they escaped any thrombotic events, all of them eventually developed hypertension, and two were delivered by caesarean section.

Top competitive cyclists push their bodies to the limits of endurance, and injury rates are high. Endofibrosis of the external iliac arteries is a rare but potentially career stopping complication of punishing training schedules; it is thought to be due to repeated flexion and extension of the artery during cycling, combined with a high cardiac output (Vascular Surgery 1998;32:323-8). There is no consensus about treatment, but endarterectomy relieves pain and may allow the athlete to carry on competing. Long term outcome is unknown.

A gluten free diet restores the intestinal mucosa but not necessarily the wellbeing of adults with coeliac disease (Scandinavian Journal of Gastroenterology1998;33:933-8). A general health survey of 89 patients who had avoided gluten for 10 years found that the women, but not the men, …