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estimated risk of thrombotic stroke in users of second versus third generation pills. The United Kingdom and the continental countries had similar findings. These odds ratios should be assessed against the backdrop of the small absolute risk they entail and in the context of the clear benefits of use of oral contraceptives for women of reproductive age. The annual event rate is between 1-1.6 stroke events per 10 000 women aged 25-44-that is, 1 stroke per 12 000 women. Three strokes per 100 000 women per year may be attributable to the use of oral contraceptives. This risk could be controlled by avoiding prescription of the pill in women who have important cardiovascular risk factors such as high blood pressure and might be lessened by appropriate management of these risk factors.The investigators were accountable only to the Scientific Reference Board (members listed in reference 1).

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This paper estimates the incremental cost-effectiveness of providing antenatal anti-D prophylaxis in varying dose sizes to either primigravidae or all Rh D negative women. It presents a model for calculating the net cost per 1000 'at risk' women based on the costs of anti-D prophylaxis and the future NHS costs avoided. Incremental cost-effectiveness is measured in terms of the net cost per Rh D-alloimmunization and the net cost per Rh HD loss prevented. Programmes for Rh D negative primigravidae are more cost-effective than the same dose protocol extended to all Rh D negative women. The 1 x 1250 iu programme is the most cost-effective option.

Background: Hepatitis B infection can be transmitted by organ or tissue transplantation. Case Report: A 40-year-old man received a bone graft from a donor who tested negative for HbsAg with a static-mode assay. The same donor, on a subsequent donation, was found to be HbsAg-positive with a dynamic mode assay. The archival sample from the initial donation also tested HbsAg-positive with the dynamic-mode assay. The recipient of the bone, who had received HBV vaccine in the past, did not develop clinical or laboratory evidence of HBV infection. Conclusions: This case highlights the importance of sensitive microbiological test protocols in the context of tissue banking.

This case highlights the importance of sensitive microbiological test protocols in the context of tissue banking.