The use of ritodrine and magnesium sulfate in the arrest of premature labor.

Sixty-seven cases of premature labor (48 with unruptured and 19 with ruptured membranes) were treated with ritodrine or magnesium sulfate infusion supplemented with oral ritodrine in case of initial success. Both treatment regimens were found effective irrespective of maternal age, parity, ethnic background and number of previous abortions. The study supports the clinical experience indicating that early administration of tocolytic agents is highly successful in arresting premature labor and preventing its dire consequences.

Cancer among blacks in Newark, New Jersey, 1970-1976: a national and international comparison.

Newark black men had age-adjusted cancer rates comparable to those of Washington, D. C., but lower than the other three American city blacks. Rates for Newark black women were generally similar to other American black women. American blacks, like those of Newark, had cancer rates higher than the African blacks in three out of four countries studied. Only blacks of Rhodesia had cancer experience like that of American blacks. Except for cancer of the cervix, the African blacks had generally lower rates compared to the American blacks for the ten sites investigated. However, high rates did occur for certain sites, e.g., esophagus and bladder cancers in Bulawayo, Rhodesia. Newark blacks also had higher rates for certain sites (prostate, lung, breast and cervix) compared to Washington, D. C., and certain other U. S. cities. Thus, the total risk of malignancies to develop among Newark blacks was no greater than that expected, based upon the four U. S. cities' experience.

Management of an extensive cervicofacial lymphovenous malformation of the maxillofacial region.

The operative approach to extensive vascular anomalies of the maxillofacial region with significant skeletal involvement demands considerable preoperative planning and orthodontic intervention guided by a creative surgical design. A case of a 17-year-old male with a middle and lower face lymphovenous malformation, requiring a complex orthodontic and surgical approach, is reported here. Details regarding the preoperative examination, orthodontic maneuvering, and the surgical procedures are given. An overview of the classification and clinical implications of craniofacial vascular anomalies is also presented.

A study of early fetal growth patterns in twin pairs.

The relationships of sitting heights and body weights of fetal twin pairs were analyzed in comparison with established growth rate standards of singleton fetuses. The apparent rate of growth of individual twins scattered around the average growth curve in the same manner as singletons. In contrast, members of 12 twin pairs with < 125 mm sitting heights, were closely similar in terms of bodily dimensions. Among the 7 pairs with crown-rump lengths of > 125 mm, 4 were discordant, suggesting a deceleration of growth in one of the twin fetuses, starting after the 18th week of gestation.

Effects of rilmenidine on stress-induced peak blood pressure and renal function.

Rilmenidine is an imidazoline I1-receptor agonist that centrally acts by reducing the sympathetic tone. There is strong experimental evidence that natriuresis could be evoked by proximal tubular I1-receptors that have also been isolated in human kidneys. However, in humans, the natriuretic effects of proximal tubular I1-receptors have never been demonstrated. Because stress tests elicited a sympathetically mediated increase in blood pressure and in sodium reabsorption, this study examined whether a short-term infusion of rilmenidine (1 mg) may interfere with stress-induced cardiovascular response and renal sodium handling in normotensive men, in a double-blind, crossover, placebo-controlled study. The stress test used is an efficient and reproducible computerized version of the Stroop's stress test. During the experimental sessions, both basal and stress renal functional parameters were determined: glomerular filtration rate, renal plasma flow, filtration fraction, sodium excretion, and segmental sodium tubular reabsorption (lithium clearance). During the placebo phase, stress induced a significant increase in systolic blood pressure (SBP; 22.2+/-10.1 mm Hg) and diastolic blood pressure (DBP; 11.0+/-5.0 mm Hg). During stress, glomerular filtration rate and renal plasma flow tended to decrease, resulting in a nonsignificant increase in filtration fraction. Despite the increase in BP, stress induced a significant decrease in sodium excretion that was due mainly to a nonsignificant increase in sodium reabsorption in the proximal parts of the tubules. Rilmenidine significantly reduced rest and stress BP, but the cardiovascular reactivity to stress was not altered. The treatment slightly decreased basal glomerular filtration rate and increased renal plasma flow, so that the filtration fraction significantly decreased. The treatment-related decrease in BP was associated with a significant increase in basal sodium reabsorption. Stress-induced modifications in renal function and sodium handling were not altered by the treatment. In conclusion, rilmenidine reduced rest BP and preserved stress-induced reactivity in BP and heart rate. Renal effects of rilmenidine are characterized by a decrease in glomerular filtration rate and in filtration fraction and an increase in sodium reabsorption. The study failed to demonstrate any effect of rilmenidine on stress-induced increase in sodium reabsorption.

Cancer incidence and mortality in Newark, N. J. 1970-1974: a national comparison.

New Jersey has acquired the invidious label "Cancer Alley U. S. A." based upon a national cancer mortality analysis. However, a cancer incidence survey conducted in Newark, the largest metropolitan industrial city in New Jersey, showed that age-adjusted Newark rates for all sites were comparable to the Third National Cancer Survey (TNCS) and Surveillance, Epidemiology and End Results (SEER) populations, except for black males who had statistically lower rates compared with the SEER population only. However, Newark did have statistically higher incidence of the following: (a) esophagus cancer among white men, black men, and black women; and (b) cervix, uterus, ovary, and bladder cancers among black women. Age-adjusted Newark cancer mortality for all sites was not statistically different from the SEER experience, except for an excessive cancer mortality among white men for stomach and esophagus; white women for stomach, colon-rectum, and uterus; black men for esophagus and colon-rectum; black women for colon-rectum, cervix, uterus, and ovary. An analysis of Newark mortality/incidence ratios suggests that the excessive cancer burden for the majority of sites studied resulted from poor end results of therapy, probably due to either late diagnosis, poor compliance, and/or suboptimal therapy. The Newark data cast doubt on the validity of the use of mortality data only in referring pejoratively to New Jersey as "Cancer Alley U. S. A."

[Blood cholesterol profile of the Lebanese population]. / Profil cholestérolémique de la population libanaise.

During survey of a representative sample of the lebanese population, serum cholesterol level was determined on 913 persons. Mean cholesterol level was found to be 225.6 mg%. After mean adjustment for age, mean cholesterol for the entire lebanese population ages 10 years or more would be 201.1 mg%, mean HDL-cholesterol level 46.5 mg% and the average total cholesterol over HDL-cholesterol ratio 4.7. It is noteworthy that 68.8% of our population have a serum cholesterol level higher than 200 mg%.

Effects of moxonidine on stress-induced peak blood pressure and renal function: a randomized, double-blind, placebo-controlled crossover study.

Moxonidine is an imidazoline I1-receptor agonist that centrally acts by reducing the sympathetic tone. Furthermore, proximal tubular I1-receptors have been isolated in human kidneys, but their natriuretic effects have never been demonstrated. Because stress tests elicited a sympathetically mediated increase in blood pressure and in sodium reabsorption, the aim of this study was to assess the effects of moxonidine (0.4 mg/day; 1 month) on stress-induced cardiovascular response and renal sodium handling in hypertensives, in a double-blind, crossover, placebo-controlled study. The stress test used is an efficient and reproducible computerized version of Stroop's stress test. During the experimental sessions, both rest and stress renal functional parameters were determined: glomerular filtration rate (inulin clearance), renal plasma flow (para-aminohippurate clearance), filtration fraction, sodium excretion, and segmental sodium tubular reabsorption (lithium clearance). During the placebo phase, stress induced a significant increase in systolic blood pressure (deltaSBP; 15.8+/-10.7 mm Hg) and diastolic blood pressure (deltaDBP; 8.2+/-6.1 mm Hg). During stress, glomerular filtration rate tended to decrease, whereas renal plasma flow significantly decreased, resulting in a significant increase in filtration fraction. Despite the increase in BP, stress induced a decrease in sodium excretion that was mainly due to a nonsignificant increase in sodium reabsorption in the proximal parts of the tubules. Moxonidine significantly reduced rest and stress BP, but the stress cardiovascular reactivity was not altered. At rest, renal function was well preserved by the treatment. Stress-induced modifications in renal function and sodium handling were not altered by the treatment. In conclusion, moxonidine reduced rest and stress-induced peak BP and preserved basal renal function. The study failed to demonstrate any effect of moxonidine either on basal renal sodium handling or on stress-induced increase in sodium reabsorption.

A new non-invasive statistical method to assess the spontaneous cardiac baroreflex in humans.

1. A new method was developed to evaluate cardiac baroreflex sensitivity. The association of a high systolic blood pressure with a low heart rate or the converse is considered to be under the influence of cardiac baroreflex activity. This method is based on the determination of the statistical dependence between systolic blood pressure and heart rate values obtained non-invasively by a Finapres device. Our computerized analysis selects the associations with the highest statistical dependence. A 'Z-coefficient' quantifies the strength of the statistical dependence. The slope of the linear regression, computed on these selected associations, is used to estimate baroreflex sensitivity. 2. The present study was carried out in 11 healthy resting male subjects. The results obtained by the 'Z-coefficient' method were compared with those obtained by cross-spectrum analysis, which has already been validated in humans. Furthermore, the reproducibility of both methods was checked after 1 week. 3. The results obtained by the two methods were significantly correlated (r = 0.78 for the first and r = 0.76 for the second experiment, P < 0.01). When repeated after 1 week, the average results were not significantly different. Considering individual results, test-retest correlation coefficients were higher with the Z-analysis (r = 0.79, P < 0.01) than with the cross-spectrum analysis (r = 0.61, P < 0.05). 4. In conclusion, as the Z-method gives results similar to but more reproducible than the cross-spectrum method, it might be a powerful and reliable tool to assess baroreflex sensitivity in humans.