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Biomedical subjects

L B Travis

Publications and source records attributed to L B Travis.

At least 73 records · Page 4Linked to original sources
PubMed1992

Cancer risk following exposure to Thorotrast: overview in relation to a case report.

Radioactive measurements and histopathologic findings are described in a patient administered Thorotrast, a radiographic contrast agent, 36 y prior to death and compared with cancer risks noted in epidemiologic studies. This person [designated as U.S. Uranium Registry (USUR) Case 1001] had prearranged for donation of her body to the USUR and the National Cancer Institute for study. Elevated levels of radioactivity were noted in those organs in which excess cancers have been reported in epidemiologic surveys of Thorotrast-exposed subjects. Hepatic tissue in USUR Case 1001 was estimated to have received an average lifetime absorbed dose of 16.2 Gy, based on radiochemical analyses, consistent with the high risks for liver tumors reported in all studied populations. Thorotrast was present throughout the bone marrow of USUR Case 1001, who died secondary to complications of refractory anemia with excess blasts (RAEB). Elevated risks for acute myeloid leukemia have been noted in Thorotrast patients, and more recently, cases of RAEB and RAEB in transformation have been reported. The thorium decay series includes the bone-seeking radionuclides 224Ra and 228Ra, which have been associated with high risks for osteosarcomas, although the association between Thorotrast and bone cancer is not as convincing. The skeleton of USUR Case 1001, however, contained significant levels of radioactivity. Other tissues evaluated in USUR Case 1001 included lung, eye, kidney, and breast, which did not contain elevated levels of radioactivity.

Aged↗
PubMed1991

Second cancers following non-Hodgkin's lymphoma.

The risk of second malignancies following non-Hodgkin's lymphoma (NHL) was estimated in 29,153 patients diagnosed with NHL between 1973 and 1987 in one of nine areas participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Compared with the general population, NHL patients were at a significantly increased risk of developing second cancers (observed/expected [O/E] = 1.18; O = 1231). The O/E ratio increased significantly with time to reach 1.77 in 10-year survivors. Significant excesses were noted for acute nonlymphocytic leukemia (O/E = 2.88), cancers of the bladder (O/E = 1.30), kidney (O/E = 1.47), and lung (O/E = 1.57), malignant melanoma (O/E = 2.44), and Hodgkin's disease (O/E = 4.16). Chemotherapy appeared related to subsequent acute nonlymphocytic leukemia (ANLL) and bladder cancer. Radiation therapy was associated with ANLL and possibly cancers of the lung, bladder, and bone. Malignant melanoma was not clearly related to initial NHL treatment.

Antineoplastic Agents↗
PubMed1991

A prospective cohort study of nutrient intake and age at menarche.

A cohort of 213 girls (aged 10 y, range +/- 9 mo) whose parents reported their dietary intakes (including nutritional supplements) using a semiquantitative food frequency questionnaire, was followed for 4 y until 82% of the 194 parents who responded to follow-up letters had reported that their daughters had had their first menstrual periods. The relative risk (RR) of menarche before age 12.5 y was 2.0 [95% confidence interval (CI) = 1.1-3.8] for the tallest girls (greater than 150 cm) compared with the shortest girls (less than 130 cm). The RR was 2.1 (95% CI = 1.1-3.8) for the fattest girls [Quetelet's index of relative weight (in kg/m2) greater than 19] vs the leanest girls (less than 15). After adjusting for height and Quetelet's index, menarcheal age was not associated with intake of energy nor energy-adjusted intake of protein, fat, or carbohydrate. The overall results are consistent with the hypothesis that nutritional factors influence age at menarche mainly through their effects on accumulation of adipose tissue.

Age Factors↗
PubMed1991

Clinical and microbiological observations on CDC group DF-3, a gram-negative coccobacillus.

Sequential stool cultures submitted for routine culture were screened for the presence of CDC group DF-3. Of 690 specimens, 11 (1.6%) yielded moderate to heavy growth of DF-3. Information on the 11 patients from whom these specimens were obtained showed that 4 had a history of prolonged diarrheal disease that resolved after specific therapy to eradicate DF-3, while for the other 7 patients no clear role could be established. Microbiological characterization of the stool isolates and 10 CDC strains of DF-3 suggested the presence of two subtypes within the group. Antibiotic susceptibility studies showed DF-3 to be relatively resistant to a wide variety of antibiotics.

Adolescent↗
PubMed1991

Renal transplantation in children: experience of 23 years at the children's renal center of the University of Texas Medical Branch at Galveston.

This report describes a 23-year experience with renal transplantation in infants, children, and adolescents at the Children's Renal Center of the Division of Pediatric Nephrology at The University of Texas Medical Branch at Galveston. One hundred ninety-four transplants have been performed in 162 persons. Patient and graft survival is illustrated and is similar to that from other US centers. The data suggest an enhanced graft survival in transplants from living, related donors and from cadaveric donors after introduction of cyclosporine A as the primary immunosuppressive agent. The data for infants and small children are similar to that reported for adolescents and adults. Thus, all infants, children, and adolescents with chronic renal failure are potential candidates for renal transplantation. The timing of the transplant appears more critical than in the adult due to the need to consider growth and developmental milestones as well as the level of renal function. It is recommended that the counsel of a pediatric nephrologist be sought early in the course of any renal disease where progression to end-stage renal disease is probable.

Adolescent↗
PubMed1990

Psychosocial correlates of hemoglobin Alc in young adults with type I diabetes.

To determine whether psychosocial variables are related to long-term glycemic control; trait anxiety, depression, loneliness and life stress were assessed in 48 Type I diabetic patients. Hemoglobin A1c (HbA1c), an indicator of long-term glycemic utilization, was assayed from blood samples drawn shortly before the self-report instruments were administered. Of the psychosocial variables, anxiety was significantly related to current values of HbA1c. The association between anxiety and current HbA1c remained after statistically controlling for potentially confounding variables, including the previous value of HbA1c. Despite the stability of HbA1c values over time, anxiety scores were not significantly correlated with follow-up HbA1c. The implications of the significant relationships between psychological constructs and glycemic control are discussed.

Adolescent↗
PubMed1990

Hyperphosphaturia and hypermagnesuria in children with IDDM.

Urinary excretion of calcium, inorganic phosphorus, magnesium, glucose, and creatinine was measured in first-void spot urine samples collected 4 days apart in 220 insulin-dependent diabetic (IDDM) children (mean age 11.9 yr) attending a summer camp. A single control urine sample was obtained from 33 healthy nondiabetic siblings (mean age 11.2 yr). Mean +/- SD urinary calcium-creatinine ratios (UCa/Cr) did not significantly differ between IDDM and control subjects (0.14 +/- 0.09 vs. 0.12 +/- 0.09, respectively, P = 0.156). Mean urinary magnesium-creatinine ratios (UMg/Cr) were elevated in IDDM compared with control subjects (0.15 +/- 0.06 vs. 0.08 +/- 0.03, respectively, P = 0.0001). Similarly, mean urinary phosphorus-creatinine ratios (UP/Cr) were significantly increased over those in control subjects (1.12 +/- 0.33 vs. 0.40 +/- 0.22, respectively, P = 0.0001). UCa/Cr, UMg/Cr, and UP/Cr were correlated with increasing mean urine glucose content (P = 0.0001). No correlations were found when UCa/Cr, UMg/Cr, or UP/Cr were compared with patient age, duration of diabetes, glycosylated hemoglobin, or insulin dosage. Urine losses of phosphorus and magnesium were present even when glycemic control was considered good by several methods (glycosylated hemoglobin, short-term glycemic index, or urinary glucose content). Glomerular hyperfiltration was unable to account for increased urinary mineral content. In conclusion, the data indicate that urinary excretion of phosphorus and magnesium is elevated in children with IDDM, regardless of glycemic control. In the presence of glucosuria, this loss is further enhanced. Urinary calcium excretion is significantly higher only during periods of glucosuria. The data suggest that children with IDDM could be at risk for mineral deficiencies in the absence of intensive insulin management.

Adolescent↗
PubMed1989

Twenty-six patients with hematologic disorders and X chromosome abnormalities. Frequent idic(X)(q13) chromosomes and Xq13 anomalies associated with pathologic ringed sideroblasts.

In our experience, acquired structurally abnormal X chromosomes are found in about 1% of patients with hematologic disorders who have a chromosomally abnormal clone. Over a 10-year period, we identified 26 patients with hematologic disorders who had an acquired X chromosome abnormality. In 13 of these patients, the breakpoints were at Xq13, and in 13 the had idic(X)(q13) chromosomes. The 13 patients with Xq13 breakpoints were all older females, and 12 had pathologic ringed sideroblasts with dysmyelopoietic syndromes or a history of these syndromes. Among the 13 patients with breakpoints other than Xq13, seven were male and six were female; only one of these patients had pathologic ringed sideroblasts, and all of these patients had a variety of hematologic disorders. Xq13 may contain genes that, when altered by the formation of chromosome abnormalities, may be associated with neoplastic disorders involving pathologic ringed sideroblasts.

Anemia, Sideroblastic↗
PubMed1988

Renal transplantation in the infant and young child.

Fourteen renal transplantations were performed in 13 children, aged 5 years or younger, including three infants. The mean duration of follow-up was 68 months, with a range of 14 to 203 months. Eleven children are alive; of these, nine had prolonged graft function. Graft survival rate was 92% at one year and 73% at two and five years following surgery. Sustained catch-up growth occurred in all growth-retarded children who underwent successful transplantation. At this writing, the oldest patient is 20 years of age and a junior in college; all school-age children are functioning at the appropriate grade level, except one, who is one year behind. The youngest child is 3 years old and is developing normally. Infants and young children appear to be good candidates for renal transplantation.

Child Development↗
PubMed1988

Sex of the parental donor and cellular rejection of renal allografts in children.

The survival of renal allografts of maternal and paternal origin has been assumed to be identical, and in reports concerning graft survival the outcome of parental transplants is not analyzed by sex of the donor. Fifty-five children received a parental kidney between January 1973 and March 1987 at one institution. There were 6 technical failures. Analysis of renal graft survival in the remaining 49 children indicates a disparity between maternal and paternal graft survival, with an increased propensity for loss of paternal grafts from cellular rejection. Nine of 22 parental grafts are no longer functioning; 7 were lost from cellular rejection. In comparison, cellular rejection resulted in the loss of only 2 of 27 maternal grafts. This disadvantage of paternal grafts is most conspicuous in patients followed for 2 or more years; 7 of 15 paternal but only 1 of 20 maternal grafts were lost because of cellular rejection (P = 0.01). With causes of graft loss other than cellular rejection treated as withdrawal, actuarial survival of the 27 maternal grafts at 1 and 5 years is 96% and 91%, respectively, while that of the 22 paternal grafts is 83% and 58% (P = 0.017). Analysis of data from other centers will help determine whether our observation is of clinical significance.

Child↗
PubMed1987

Somatostatin limits rise in glomerular filtration rate after a protein meal.

To evaluate the glomerular filtration rate (GFR) response to a protein meal in patients with diabetes and to study the role of glucagon and growth hormone, we studied inulin clearance for three 30-minute periods before and 3 hours after an 80 g protein meal in seven healthy volunteers and 10 patients with diabetes. Patients with diabetes were chosen because their renal response to such a meal has been reported to be abnormal. All had an increase in GFR and plasma glucagon levels after the protein meal. The peak rise in GFR occurred from 1 to 2 1/2 hours after the meal (mean +/- SEM, delta 26 +/- 5 mL/min/m2, controls; delta 22 +/- 7 mL/min/m2, patients with diabetes), with the mean time to normal rise in GFR occurring at 2 hours after the meal. Similarly, plasma glucagon values peaked at different times in individual patients (delta 769 +/- 532 pg/mL, controls; delta 267 +/- 69 pg/mL, patients with diabetes), with the mean plasma glucagon rise occurring 1 hours after the meal. Premeal growth hormone levels tended to be higher in the patients with diabetes (7.6 +/- 1.4 vs 2.1 +/- 0.4 ng/mL), and did not change after the meal. To allow study of the contribution of the increased plasma glucagon to the rise in GFR, eight of these patients (five with diabetes) volunteered to undergo a second GFR response test with a simultaneous infusion of somatostatin. The glucagon response was significantly lowered at all time periods during the infusion (P less than 0.05); no significant change in growth hormone occurred. Without somatostatin in these eight patients, peak increase in postmeal GFR average 20.6 +/- 1.5 mL/min/m2; with the somatostatin, peak increase in GFR was 6.0 +/- 1.8 mL/min/m2 (P less than 0.01). Neither metabolic control nor degree of albuminuria was significantly different at the time of the two studies. Thus, as has been shown in animals, somatostatin infusion limits the rise in GFR after a protein meal in humans.

Adolescent↗