Inhibition of erythropoietin production by cyproterone acetate

A patient with polycystic kidney disease, secondary hyperparathyroidism, and relative hypercalcemia developed severe symptomatic hypocalcemia following bilateral nephrectomy. Acute depletion of 1,25-dihydroxycholecalciferol is proposed as a possible cause of the hypocalcemia.     

Histopathological changes in autotransplanted baboon kidneys after 24-hour hyperbaric, hypothermic preservation perfusion

Baboon kidneys were preserved at 4 C and 3 atm for 24 hr. Thirty-two kidneys were perfused with G.S.H. replacement solution or Plasmalyte B during preservation. Fifteen kidneys were flushed with the same solution prior to preservation but not perfused during preservation. Twenty-six kidneys were flushed with serum prior to preservation and also not perfused during preservation. The preserved kidneys were autotransplanted to the iliac fossa. Histopathological studies of the kidneys were undertaken between the second and twenty-fourth day after reinsertion. It was found that preservation perfusion was frequently accompanied by glomerular thrombosis, glomerular and interstitial fibrosis as well as endarteritis in many kidneys. These changes were rarely observed in unperfused preserved kidneys. The observed renal alterations are similar to those described in the literature as chronic pyelonephritis in long-term studies of preserved dog kidneys.     

An experimental design for the development of adaptive treatment strategies

In adaptive treatment strategies, the treatment level and type is repeatedly adjusted according to ongoing individual response. Since past treatment may have delayed effects, the development of these treatment strategies is challenging. This paper advocates the use of sequential multiple assignment randomized trials in the development of adaptive treatment strategies. Both a simple ad hoc method for ascertaining sample sizes and simple analysis methods are provided.     

Elective Caesarean section is associated with a reduction in developmental dysplasia of the hip in term breech infants

We wished to establish whether delivery by Caesarean section influenced the incidence of developmental dysplasia of the hip in term breech infants compared with those delivered vaginally. We used maternal charts, singleton term breech presentation, mode of delivery and incidence of developmental dysplasia of the hip for births between January 1997 and October 2002. During the study period 46 089 infants were born. We analysed a total of 941 breech infants of whom 756 were delivered by Caesarean section (515 pre-labour, 241 intrapartum) and 185 vaginally. The incidence of developmental dysplasia of the hip according to the mode of delivery was 19 of 515 (3.69%) following pre-labour Caesarean section, 16 of 241 (6.64%) for intrapartum Caesarean section and 15 of 185 (8.11%) after vaginal delivery. There was a lower incidence of developmental dysplasia of the hip among those infants delivered by elective Caesarean section compared with those delivered vaginally (p < 0.02). These results demonstrate a significantly lower incidence of developmental dysplasia of the hip in term singleton breech births delivered by elective, pre-labour Caesarean section and suggest that labour and delivery influence hip stability in predisposed infants.