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L B Travis

Publications and source records attributed to L B Travis.

162 records · Page 9Linked to original sources
PubMedDate not supplied

Clinically significant differences in antibiograms of morphologic variants of blood culture isolates.

The present environment of cost containment frequently forces laboratories to reassess various strategies for the diagnostic work-up of patient specimens. The necessity for the performance of antimicrobial susceptibility testing on all morphologic variants of blood culture isolates was examined in this study. Over a 4-year period, of 143 such organisms that were identified, 56 (39%) exhibited clinically significant differences in antibiogram profiles. Coagulase-negative Staphylococcus represented the largest proportion of isolates (n = 115), 39% of which demonstrated clinically significant differences in antibiograms. The authors conclude that these results justify the current practice in their laboratory of performing separate antimicrobial susceptibility testing on all morphologic variants of isolates.

Anti-Bacterial Agents↗
PubMedDate not supplied

Impact of a camp experience on choice of coping strategies by adolescents with insulin-dependent diabetes mellitus.

Summer camps for children with IDDM have allowed educators to expand diabetes curricula and test novel approaches to education. Yet few evaluations have been published assessing the effectiveness of these types of educational interventions. The present study was designed as a formative assessment to provide preliminary evaluation of the impact of a life skills curriculum designed to increase awareness of different techniques that may be useful in managing stress. Life skills curricula are included each year as part of the teen session at the Texas Lions Camp for Children with Diabetes. Following the intervention, campers reported an intent to use more problem-focused and fewer detachment strategies to deal with a personally identified stressor. Limitations of the current pilot study are used to illustrate problems inherent in evaluation of camp programs.

Adaptation, Psychological↗
PubMedDate not supplied

Reliability and validity of the Diabetes Family Behavior Scale (DFBS).

The Diabetes Family Behavior Scale (DFBS) was designed to measure diabetes-specific family support. The purposes of this study were to refine the scale and to assess reliability and criterion validity in terms of relationship to metabolic control. The DFBS was administered to 321 children and adolescents with insulin-dependent diabetes mellitus (IDDM). Blood was drawn for determination of glycosylated hemoglobin (HbA1c). Based on an item-analysis procedure, the DFBS was revised to include 47 items with two subscales, one to reflect guidance-control and one to reflect warmth-caring. Acceptable internal consistency was found for the DFBS total score (.86), and for the guidance-control (.81) and warmth-caring (.79) subscales. There was a statistically significant relationship in the expected direction between DFBS total score and HbA1c (r = -.12, P < .03), and between the guidance-control subscale and HbA1c (r = -.17, P < .002).

Adolescent↗
PubMedDate not supplied

Teaching assertive communication skills to adolescents with diabetes: evaluation of a camp curriculum.

Diabetes management requires consistently implementing adherence behaviors in a variety of settings. For some adolescents, consistency may be difficult due to problems in communication and assertiveness. The purpose of the present study was to evaluate the impact of a camp curriculum to teach assertive communication skills to adolescents with diabetes. The curriculum included didactic information, sharing of personal experiences, and role playing. Results showed a significant increase in adolescents' perceptions of their assertiveness from before to after the camp experience, an increase that was still apparent at a 3-month follow-up. No changes were reported in parental perceptions of their adolescents' degree of openness in communicating or in communication problems. In contrast, adolescents reported a significant decrease in their degree of openness in communicating with fathers, with a similar trend for mothers. These results suggest that the curriculum was successful in meeting the primary goal of enhancing the adolescents' assertive communication skills but had a questionable impact on their general communications with parents.

Adolescent↗
PubMedDate not supplied

Progressive retinopathy with improved control in diabetic dwarfism (Mauriac's syndrome).

We report four children aged 11-18 1/2 yr first seen 7-14 yr after the diagnosis of insulin-dependent diabetes. At presentation, all had marked short stature, two had hepatomegaly, and the older three had delayed adolescence. They had been severely underinsulinized. Initial funduscopy demonstrated only occasion microaneurysms in two children and a single intraretinal hemorrhage in another. The youngest was normal. Improved control required large increases in insulin dosage. Growth rate improved significantly and hepatomegaly regressed. Puberty progressed rapidly in two older patients with poor final height. Paradoxically, with improved control, retinopathy progressed rapidly with appearance of multiple microaneurysms, nerve fiber layer infarctions, intraretinal microangiopathic changes, hemorrhages, exudates, and macular edema in all the patients and severe proliferation changes in three. One child with proliferative retinopathy in both eyes developed vitreous hemorrhage and blindness in one eye. Two required panretinal photocoagulation with no further progression of their retinopathy. These rapidly progressive retinal changes remain unexplained. We advise caution when correcting metabolic derangements of diabetic patients who have been poorly controlled for a prolonged period.

Adolescent↗
PubMedDate not supplied

Urinary excretion of N-acetyl-beta-D-glucosaminidase in children with type I diabetes mellitus.

N-acetyl-beta-D-glucosaminidase (NAG), a lysosomal enzyme, has been shown to be increased in the urine of patients with various glomerulonephritides, tubulointerestitial diseases, renal allograft rejection, toxic renal injury, and diabetes mellitus. Although it has been suggested that urinary NAG may reflect blood glucose control, no studies have correlated this with other measures of metabolic control. Thirty-four children from a diabetic summer camp were found to have urinary NAG to creatinine ratios significantly above those of normal controls of similar age (5.22 +/- 1.19 versus 1.51 +/- 0.17 U). Urinary NAG was found to positively correlate with an arbitrary control index (r = 0.82; P less than 0.05) and in seven patients with hemoglobin A1c (r = 0.70; P less than 0.001). In a closely followed group of 40 clinic patients, urinary NAG to creatinine ratio was again found to be significantly increased over normal controls (7.55 +/- 0.70 versus 1.51 +/- 0.17 U; P less than 0.05). Again, urinary NAG was positively correlated with HbA1c (r = 0.62; P less than 0.001) and urinary albumin to creatinine ratio (r = 0.47; P less than 0.01). In neither group was there a correlation with UNAG:UCr and duration of disease. Thus, these data suggest that urinary NAG to creatinine ratio appears to be a reflection of blood sugar control.

Acetylglucosaminidase↗
PubMedDate not supplied

Effect of exercise on urinary N-acetyl-beta-D-glucosaminidase activity and albumin excretion in children with type I diabetes mellitus.

Urinary N-acetyl-beta-D-glucosaminidase (NAG), a proximal tubule lysosomal enzyme, has been used as an indicator of subtle renal injury. Since it has been positively and significantly correlated with hemoglobin A1c and microalbuminuria, it has been suggested that this enzyme may also reflect metabolic control. Albumin excretion is exacerbated in adult diabetic individuals during exercise; such exercise-induced albuminuria may be a forerunner of diabetic nephropathy. Metabolic control, degree of exertion, and duration of diabetes have been suggested to influence this increase in albuminuria during exercise. Studies of children are few and have produced inconsistent results. Thus we studied 28 insulin-dependent diabetic children ranging in age from 5 yr to 16 yr and 27 age-matched controls using treadmill exercise; two exercise periods consisting of (1) graded increases in speed and grade at 3-min intervals until exhaustion and (2) a constant speed and grade necessary to produce 2/3-3/4 maximal heart rate for 30 min were performed. Capillary blood glucose, urinary NAG/creatinine (cr) ratios (UNAG/Ucr) and urinary albumin/creatinine ratio (Ualb/Ucr) were measured before and after each exercise period; hemoglobin A1c was also measured. The latter averaged 11.8 +/- 0.6% (mean +/- SEM); contrary to previous studies, this was not correlated with pre- or postexercise UNAG/Ucr. During both exercise periods, blood glucose dropped 271 +/- 19 mg/dl to 213 +/- 21 mg/dl (period 1) and 230 +/- 22 mg/dl to 157 +/- 21 mg/dl (period 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗
PubMedDate not supplied

Isolated antinuclear antibody-negative lupus nephropathy in young children.

Systemic lupus erythematosus (SLE) is a multisystem disease in which the kidneys are frequently involved. The clinical and histopathologic diagnosis of SLE is based on the American Rheumatism Association (ARA) and the World Health Organization classification, respectively. A few adults who qualify as SLE by the ARA criteria but are antinuclear antibody (ANA)-negative have been reported. We found only one report of a child with SLE where renal disease was the only manifestation but who had a positive ANA. This report describes 3 children who presented with the nephrotic syndrome and in whom the renal histology is highly suggestive of SLE. Short-term follow-up as failed to demonstrate other systemic involvement and the ANA has continued to be negative.

Antibodies, Antinuclear↗