Long-term results of simple and radical nephrectomy for renal cell carcinoma

From 1974 to 1983, simple and radical nephrectomies were performed at the Chaim Sheba Medical Center (Tel Hashomer, Israel) for renal cell carcinoma. The authors reviewed 109 cases that were followed for a period ranging from 5 to 14 years. Simple nephrectomy was performed in 55 patients, and 54 patients underwent radical nephrectomy. The selection of the surgical procedure was based on the surgeon's preference and not on the basis of clinical stage, age, or sex. The surgical results and survival rates were assessed according to the pathologic stage of the tumors. Among patients with Stage I tumor, radical nephrectomy produced better survival rates at 5 and 10 years (P = 0.03); however, when the non-cancer deaths were excluded, the difference in survival was not statistically significant. For Stage I tumors the survival free of disease at 5 years was better for the radical nephrectomy group, but this difference was not statistically significant. No difference was noticed in the local recurrence rate between the two groups. Nephrectomy in patients with Stage IV disease did not alter survival regardless of the type of operation.     

Resident parents and shorter hospital stay.

A total of 586 admissions for 12 medical conditions were reviewed. The stay of children accompanied by a resident parent was 31% shorter than those whose parents were not resident. Resident parents benefit the emotional well being of the child and increase hospital efficiency; accommodation for parents should therefore be an integral part of a unit admitting children.     

Fetal lung growth in laryngeal atresia and tracheal agenesis

Three cases of airway obstruction in fetuses born at 21, 32 and 40 weeks gestation are reported. The first had laryngeal atresia, cystic dysplastic kidneys, oligohydramnios and immense fluid-filled lungs. The second had upper tracheal agenesis, a tracheo-oesophageal fistula, a cystic dysplastic horseshoe kidney, oligohydramnios and normal-sized lungs. The third had a pin-hole mucosal tract through an otherwise atretic larynx, normal kidneys, no oligohydramnios and normal-sized lungs. Lung weight:body weight ratios, radial alveolar or radial canalicular counts and point-counting of sections of lungs in cases 1 and 2 show that laryngeal or tracheal obstruction may prevent or reduce the pulmonary hypoplasia associated with renal dysplasia, and in cases 2 and 3, that grossly enlarged, hyperplastic lungs may not be seen unless obstruction is complete.     

Dental changes in children with malabsorption

The paper reviews existing reports on relations between pathologies leading to malabsorption and dental lesion in children. The following dental alterations are reported in the literature: delayed eruption of deciduous teeth, hypoplasia of enamel and dental caries. These lesions have been observed in gastrointestinal pathologies, for example, coeliac disease, chronic diarrhea and recurrent vomiting, intolerance of cow's milk protein, Crohn's disease and salmonellosis. The delayed eruption of deciduous teeth and hypoplasia of the enamel are certainly correlated to malabsorption and maldigestion, especially if these are protracted over time. Dental caries may be due to poor oral hygiene, poor diet and to the presence of modified calcification. Only a comparative study with a control group will enable the effective prevalence to be assessed.     

Induced hypoglycemia. A unusual case of child battering

We describe a case of Munchausen's syndrome by proxy in a 12 years old child. The administration of glibenclamide by the mother led to severe hypoglycemias in the child, who underwent various instrumental researches and a subtotal pancreatectomy before the final diagnosis could be reached. The diagnosis also was possible with the substantial help of an accurate psychological survey. The case solution, with disappearance of hypoglycemias, was made possible by the removal of the maternal presence settled by the juvenile court.     

Efficacy of nasal cytology

Nasal Cytogram is a simple, economical and reliable investigation. Although its utility was recognised as early s1927, it has not gained much popularity. Here an attempt is madeto assess the efficacy of nasal cytology in the light of histology, to diagnose various nasal conditions.127 cases of common rhinological problem were studied at Govt. Medical College, Nagpur. This investigation was found to be simple, reliable & economical.     

Estimating profits in a capitation program. Planning for cost

This article is designed to help dentists make better decisions regarding capitation programs. It focuses on approaches to costs that can be useful. An example is given that illustrates how these cost concepts might be used to analyze a capitation proposal.