Consumption of calcium among African American adolescent girls.

OBJECTIVE: To determine the adequacy of calcium intake of children by demographic group in the Lower Mississippi Delta (LMD) and compare to national statistics. DESIGN: FOODS 2000 was used to examine the dietary calcium intake of LMD children and compare it to US children in the Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996, 1998. SETTING AND PARTICIPANTS: The sample of 465 non-Hispanic children 3-17 years of age who live in 36 counties of the LMD was identified by using list-assisted random digit dialing methods. MAIN OUTCOME MEASURES: The t tests and z tests were performed for within- and between-sample comparisons. Logistic regression, controlling for energy, race, sex, age, and nutrition assistance was used as a measure of the association of sample characteristics with meeting adequate intake (AI) for calcium. An algorithm was used to calculate the rankings of calcium consumption from food categories. RESULTS: Children in the LMD consumed significantly less calcium (P < .05) than children in the US sample. Percent of AI for calcium decreased as age increased. Persons who consumed less than the AI for calcium include females, Blacks, those not receiving nutritional assistance, and older children. Less than 22% of LMD and 27% of US 9- to 17-year-old children met their calcium AI. Sources of calcium were similar across subgroups and all included milk as their top contributor to calcium intake. CONCLUSION: Interventions are needed to increase adolescents' calcium consumption, with particular focus on 9- to 17-year-old African American girls.

Synergistic effects of high molecular weight polyethylene oxide (PEO) and cationic cellulosic polymers on conditioning properties of hair care products [corrected].

A hair cleansing composition containing both high molecular weight PEO and cationic hydroxyethyl cellulose (HEC) was found to provide superior conditioning performance. Hair treated with a formulation containing both cationic HEC and high molecular weight PEO showed 30% better wet combing reduction than the formulation containing cationic HEC only. In conjunction with PEO, cationic HEC-dependent deposition of silicone oil and octyl methoxycinnamate (OMC) onto hair was enhanced 27% and 25%, respectively. When examined with a polarized microscope, the appearance of the polymer-surfactant complex (coacervate) of the diluted formation differed in the presence of PEO. In particular, the particle size of the coacervate in the formulation containing both PEO and cationic HEC was smaller. This result indicates PEO reduces the size of the deposition precipitate by preventing the coacervate from agglomerating. Surface analysis also showed that the presence of PEO in formulations containing cationic HEC deposited insoluble actives more evenly on the hair surface.

Palatal metastases in renal cell carcinoma.

Renal cell carcinoma may metastasize early in its course and sometimes before the primary lesion becomes apparent. Two cases of renal cell carcinoma with the initial manifestation of metastases to the roof of the mouth are presented. The mode of metastases to the palate is discussed.

Mortality and morbidity in pretransplant bilateral nephrectomy: analysis of 305 cases.

The surgical riks were analyzed in 305 patients with end stage renal failure who underwent bilateral nephrectomy through midabdominal approach in preparation for kidney transplantation. The over-all mortality rate was 3.6 per cent. Age was the most significant risk factor in the mortality. Patients less than fifty years of age had an operative mortality rate of 3.1 per cent while those more than fifty years had an operative mortality of 11.1 per cent. Other pertinent risk factors were preoperative complications of renal failure and additional surgical procedures at the time of bilateral nephrectomy. The leading causes of death were those of cardiovascular complications and infection. The morbidity rate was 58.7 per cent being major in 18 per cent and minor in 40.7 per cent. Bilateral nephrectomy is recommended selectively in patients with (1) chronic pyelonephritis with urinary tract infection, (2) major vesicoureteral reflux, (3) immunologically active glomerulonephritis, (4) severe hypertension uncontrollable by adequate dialysis, and (5) extremely large or infected polycystic kidneys.

Avascular necrosis following renal transplantation. Experience with 449 allografts with and without high-dose steroid therapy.

From January 1, 1971, to January 1, 1976, 173 renal allografts were transplanted into 146 patients. Intravenous methylprednisolone (IVMP) was given to all mismatched recipients in a dose of 1 Gm. on the day of transplant and in varying amounts during acute allograft rejection. In 7 patients, 4.8 per cent of 146 patients and 4 per cent of 173 allografts, with a minimum follow-up of fifteen months avascular necrosis of one or more joints developed with an average of 9.4 months after transplantation and a range of five to eighteen months. The total dose of IVMP given to the patients with aseptic necrosis varied between 3 and 18 Gm. from the time of transplantation until the onset of skeletal symptoms. This incidence was nearly identical to the 5 per cent of 242 patients and 4.3 per cent of 276 renal allografts from the same center performed between January 1, 1963, and January 1, 1971, when intravenous steroid pulse therapy was not utilized. Since January, 1971, total joint replacement of the hip or knee were performed in 4 of the 7 affected patients six to sixteen months after the onset of symptoms. Renal function remained stable after surgery in all 4 patients. Virtually normal range of motion was present within three months after surgery. Although the controversy of steroid therapy in the pathogenesis of avascular necrosis still exists, judicious use of high-dose IVMP therapy does not appear to increase its incidence. Early surgery is recommended when the radiologic evidence confirms the clinical findings of avascular necrosis in order to ameliorate pain, correct restriction of movement, and promote full rehabilitation.

Ruptured human renal allograft. Pathogenesis and management.

From January, 1963, to January, 1977, 4 cases of acute allograft rupture occurred in 474 renal transplants performed at the Cleveland Clinic, an incidence of 0.8 per cent. Rupture developed between the fifth and sixteenth day after transplantation during a period when the patients required dialysis because of poor allograft function. All patients had surgical exploration and successful repair of the laceration. Biopsies in each case at the site of laceration revealed findings consistent with acute allograft rejection. The rejections were mild in 2 cases, moderate in one, and severe in another. Two kidneys failed to sustain function, and the patients were returned to chronic hemodialysis two to five months later. None required a nephrectomy. The other two kidneys are functioning well, with serum creatinine values of 1.3 and 1.5 mg./100 ml. one year after allograft rupture. Since rupture of a renal allograft does not appear to increase the intensity of rejection nor does it represent a severe type of rejection, transplant nephrectomy can be avoided unless hemorrhage is uncontrollable from the site of laceration.

A case of a giant pheochromocytoma.

A case of a large pheochromocytoma weighing 1,150 gm. is reported. The surgical approach to this massive tumor is discussed. Early recognition of the various clinical and metabolic manifestations of the tumor are important objectives in the cure of this potentially lethal neoplasm.

Regression of prostatic cancer metastasis by high doses of diethylstilbestrol diphosphate.

Diethylstilbestrol diphosphate (DES-P) has shown effective symptomatic relief in patients with metastatic carcinoma of the prostate. Although there is little known about its role in soft tissue metastasis, our experience in 3 patients with advanced carcinoma of the prostate infiltrating the trigone and ureterovesical junction revealed significant improvement of hydronephrosis. All patients failed to respond to conventional doses of stilbestrol. Diethylstilbestrol diphosphate is recommended in the treatment of advanced carcinoma of the prostate with soft tissue metastasis. It is safe and effective, and the tumor responses outweigh the side effects of the drug. The mechanism of action of this compound is discussed.

Complete duplication of urethra.

Complete duplication of the urethra with a single bladder is an exceptional finding. The anomalous urethral canal originates from the bladder separately, runs parallel and usually dorsal to the normally situated urethra, and opens on the dorsum of the penis. To our knowledge there are 41 reported cases of this anomaly. We present 2 cases of complete urethral duplication originating from a single bladder, one in a male patient and the other in a female. It is concluded that conservative therapy is the treatment of choice, and that surgery should be reserved for incontinent patients only. The complications of surgery have been emphasized.

Phenolization of bladder in treatment of massive intractable hematuria.

Intractable hemorrhagic cystitis secondary to radiation or cyclophosphamide (Cytoxan) therapy could lead to serious complications; however, intravesical instillation of phenol has reduced the dilemma of this life-threatening problem. We present a case of intractable hemorrhagic cystitis secondary to cyclophosphamide therapy treated with 100 per cent phenol with no untoward side effects. Since formalin instillation into the bladder has been associated with severe complications, phenol appears to be safer and more effective in the treatment of intractable hematuria, and, therefore, its clinical trial is recommended.