Hypertension, diuretics and breast cancer risk.

It is unclear whether hypertension and antihypertensive medication use are associated with breast cancer. In order to examine these associations, we conducted a case-control study among women aged 50-75 years. Breast cancer cases were ascertained via a population-based cancer registry (n=523) and controls were ascertained via random-digit-dialing (n=131). Participants completed a self-administered questionnaire which queried history of hypertension, antihypertensive medication use and risk factors. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for age, body mass index (BMI), diabetes, smoking, alcohol use, menopausal status, family history of breast or ovarian cancer, age at first full-term pregnancy and education. History of treated hypertension was associated with significant increased risk of breast cancer (OR, 1.77; 95% CI, 1.04-3.03) and this association appeared only in women with BMI > or =25 kg/m(2) (OR, 2.30; 95% CI, 1.12-4.71). Diuretic use was also associated with elevated breast cancer risk (OR, 1.79; 95% CI, 1.07-3.01). The risk associated with diuretic use increased with duration of use (P for trend, <0.01). Use of other blood pressure medications was not found to be associated with breast cancer risk. These results support a positive association between treated hypertension, diuretic use and breast cancer risk among women aged 50-75 years.

Visceral aortic aneurysm in a 4 1/2-year-old child: an unusual complication of umbilical artery catheterization.

A 4 1/2-year-old girl had a 2.2 cm in diameter abdominal aortic pseudoaneurysm extending from above the celiac artery to 4 cm above the aortic bifurcation. This lesion developed after umbilical artery catheterization in the neonatal period, which also resulted in thrombosis of the right renal artery and renal atrophy. Patch graft angioplasty with polytetrafluoroethylene (Gore-Tex) was performed after excision of the aneurysm via a retroperitoneal approach.

Age-related renal, hematologic, and hemostatic abnormalities in FH/Wjd rats.

This longitudinal study compared the renal morphologic changes and hemostatic defects of FH/Wjd rats at different ages. A second aim was to determine whether the bleeding tendency becomes intensified in older animals by the concomitant renal disease. Results indicated that reduced capacity for platelet 14C-serotonin release (P less than 0.01) was found for each age group studied in comparison with Wistar controls. The nephropathy of old FH/Wjd male rats was more severe than that in either FH/Wjd females or age-matched Wistars of both sexes. The mesangial lesions showed abundant deposits of factor VIII-related antigen, fibronectin, and immunoglobulins, but not C3, along with tightly packed or loose electron-dense material. Polyethylene glycol precipitation and platelet aggregation tests detected small amounts of circulating immune complex-like material. Old FH/Wjd rats did not develop edema, and the glomerular filtration rate remained normal despite the persistent proteinuria, hematuria, and arterial hypertension characteristic of this strain. Our data indicated that the congenital platelet dysfunction does not become more severe in older animals and that the nephropathy seems unrelated, does not appear to be mediated by immune complexes, and, in contrast to the focal segmental glomerulosclerosis of persons, the lesions progress without a parallel impairment of renal function.

A scoring system to predict outcome following neonatal seizures.

Ninety-six newborn infants with seizures were scored during the initial hospitalization on abnormality of EEG, neurologic examination, etiology of seizures, length of seizure, type of seizure, and birth weight under or over 1,500 gm. At 3 months, corrected for gestational age, the 80 surviving infants were scored on abnormality of current EEG, neurologic examination, etiology of seizure, presence or absence of seizure since hospital discharge, and birth weight under or over 1,500 gm. At age 10 months, 76 of 77 surviving infants were evaluated with the Gesell Developmental Inventory, physical examination, and neurologic examination. Chi square analysis documented that the scoring system was an accurate predictor of those infants with seizure disorders, mental retardation, and motor dysfunction. The score may assist the clinician in making decisions in regard to anticonvulsant therapy during initial hospitalization or at age 3 months.

Association of infectious mononucleosis with nephrotic syndrome.

A patient had infectious mononucleosis (IM) associated with transient nephrotic syndrome (NS). A kidney biopsy sample studied by light and electron microscopy demonstrated minimal glomerular lesions. Immunofluorescent studies revealed mainly granular mesangial deposits of IgM, and to a lesser extent, deposits of IgG and of C4 and C3. No Epstein-Barr virus-related antigen could be detected in the kidney. This, and three other cases reported in the literature, suggest a causal relationship between IM and NS.

Immunologic mechanism of childhood renal diseases.

Antigen-antibody complexes and antibasement antibodies are involved in the pathogenesis of most immune-mediated renal diseases. The major feature of these two kidney tissue-damaging mechanisms, and their interrelations with amplification systems (complement, coagulation, and kinin) are outlined. A brief discussion of current immunologic concepts applicable to representative experimental models and pediatric nephropathies, and of their immunohistopathologic and ultrastructural expressions is presented.

Computed tomography in child abuse and cerebral contusion.

Cerebral contusion is considered to be the lesion leading to neurological sequelae of mental retardation and cerebral palsy in abused children. This has been difficult to document other than at autopsy or craniotomy by previously available techniques. Acute contusion or hemorrhage presumably secondary to contusion is readily documented by computed tomography (CT). We are reporting the cases of four children with alleged or suspected abuse and CT evidence of cerebral contusion. The contusion has been found both with and without external evidence of head injury.