Controlled trial of long term oral potassium supplements in patients with mild hypertension

A 15 week randomised double blind placebo controlled trial of oral potassium supplements (48 mmol daily) was conducted in 37 patients who had mildly increased blood pressure and a normal dietary intake of sodium. After a two month run in and a one week baseline period the patients were randomly assigned to receive either potassium supplements (n = 18) or placebo (n = 19). By the third week of treatment blood pressure in the actively treated group had decreased significantly compared with that in the placebo group, though the decrease reached its maximum after 15 weeks. Urinary potassium excretion increased significantly in the group who received potassium supplements, but no significant changes were found in plasma sodium and potassium concentrations or in urinary sodium excretion. In a subgroup of 13 patients who underwent a further nine weeks of treatment with oral potassium supplements at half of the previous dose (24 mmol daily) their blood pressure, at the end of this second study period, was still significantly lower compared with their baseline value but not with that of the placebo group. These results show that moderate oral potassium supplements are associated with a long term reduction in blood pressure in patients who have mild hypertension.     

Non-Hodgkin's lymphoma. Extranodal localizations in the head and neck. Clinical and therapeutic evaluations

The staging, therapy and course of 91 patients with extranodal NHL of the head and neck treated between 1970 and 1985, were analyzed. The sites involved were: Waldeyer's ring 71 patients, tonsil 59, nasopharynx 12 and extralymphatic sites 20 patients (larynx 6, paranasal sinus 5, orbit 5, oral cavity 3, salivary gland 1). Sixty-three patients had unfavourable histology with 22 patients in stage I; 33 in II; 21 in III; 15 in IV. Chemotherapy plus radiotherapy was used in 43 patients and 34 obtained Complete Remission (CR). Chemotherapy alone was used in 30 patients and in 11 CR was achieved, radiotherapy alone in 18 patients and 11 obtained CR. The actuarial survival rate was 55% and recurrence-free survival, evaluated only in those patients who achieved complete remission, was 80%. Results, as survival and freedom from recurrence, are analyzed in relation to main prognostic factors and therapy, and patterns of recurrence are reported. The present study confirmed the view that radiotherapy combined with chemotherapy represents the best treatment for NHL of the head and neck.     

Preliminary experience of the study of the hand using digital radiology with photo-excitable phosphors and direct magnification. Comparison with the traditional high resolution technique

Photostimulable phosphor computed radiography (CR) is a new technique. The authors applied direct magnification CR to hand study (IP matrix: 1770 x 2370), and compared the results with conventional radiography ones (high MTF industrial type film, without screens, 5 x optic enlargement reading). In both cases, a mammographic unit was employed for acquiring the images. Thirty patients affected with renal osteodystrophy, psoriatic arthropathy or rheumatoid arthritis, and 20 normal subjects were examined. Digital images were processed by a particular sensitometry curve and spatial filtering with unlinear unsharp masking: we obtained good visualization of small lesions (subperiosteal resorption, cortical bone tunnelling, minute periosteal necrosis), not inferior to that obtained with conventional techniques. CR has further advantages, such as low economic and biological cost, wide exposure and recording range, image processing, easy archiving and networking.     

Study on Ki-67 immunoreactivity as a prognostic indicator in patients with advanced gastric cancer

BACKGROUND: Cell proliferation characteristics may reflect the aggressiveness of gastric tumors and their eventual prognosis. The aim of this study was to evaluate whether the proliferative activities determined by the antibody Ki-67 could be used as a prognostic predictor in patients affected by advanced gastric cancer. METHODS: The prognostic significance of proliferative activity was investigated in 56 patients who underwent curative gastrectomy (R0) for advanced gastric cancer using the monoclonal antibody Ki-67. The patients were divided into three groups according to the Ki-67 labeling index of the tumors: < 10% (18 cases), 10-40% (21 cases) and > 40% (17 cases). The Cox regression model was used to evaluate the prognostic significance of the Ki-67 index controlling for age, gender, histology, depth of tumor invasion and node metastasis. RESULTS: There was no significant relationship between the Ki-67 index and wall invasion (P = 0.80) or nodal status (P = 0.73). The cumulative 3-year survival rates (95% Cl) were 61.0% (35.3-79.2%) in patients with Ki-67 index < 10%, 52.4% (29.7-70.9%) with Ki-67 index 10-40% and 52.9% (27.6-73.0%) with Ki-67 index > 40% and the differences were not statistically significant (P = 0.93). Also in multivariate analysis the proliferative activity did not independently affect survival (P = 0.98). An interaction between Ki-67 index and age was found and Ki-67 index > 40% was significantly associated with a poor prognosis in patients over 68 years old (P = 0.004). CONCLUSION: Our study indicated that the proliferative activity in gastric cancer, determined with the monoclonal antibody Ki-67, does not influence the survival except in elderly patients (> or = 68 years old).      

The value of prenatal sonography in the diagnosis of congenital malformations

Three hundred and forty-one prenatal ultrasound tests performed in 79 cases who presented congenital malformations at birth were studied retrospectively. A correct prenatal diagnosis was only made in 24 cases (30.3%), whereas there were 50 false negative (63.3%) and 5 dubious cases (6.3%). The percentage of false negative was greater in the group of cases examined in peripheral centres (56%) in comparison to those examined in our institute (35%).     

From social distress to psychic pain]

Regarding 75 subjects of both sex sent to psychiatric and alcological consultations by social departments to which they required some help, the authors ask the question about limits between social alienation and mental alienation for people in precarity and poverty position. They inquire into role part and position of the psychiatrist beside them.     

Long-term follow-up results after surgical repair of esophageal atresia

Fiftytwo of 55 children, surviving surgical repair of tracheo-esophageal fistula between 1975 and 1985, were reviewed in relation to birth weight and Waterston's risk group after a mean follow-up of 7.5 years. The long-term results of esophageal atresia patients seem good in 30% of the follow-ups. Esophageal dysfunctions and respiratory difficulties were found respectively in 23 (44.2%) and 26 (50%) of the children; all the patients were improving after the first years of life. Scoliosis affected 27 children (51.9%) and its incidence increased with growth. Waterston's classification was a poor prognostic guide, but children weighing less than 2500 g at birth remained of relatively lower weight. The frequent development of scoliosis with age leads to continue evaluations after that respiratory and alimentary problems which might occur in the early years have been overcome.