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Biomedical subjects

L I Gardner

Publications and source records attributed to L I Gardner.

At least 55 records · Page 3Linked to original sources
PubMed1983

Does obesity explain excess prevalence of diabetes among Mexican Americans? Results of the San Antonio Heart Study.

Obesity and Type 2 (non-insulin-dependent) diabetes mellitus are common in the Mexican American population. It is not clear whether this is merely a specific instance of the more general phenomenon of excess Type 2 diabetes and obesity among poor people, or whether Mexican Americans have a discrete genetic susceptibility to Type 2 diabetes. The latter consideration arises because Mexican Americans are of mixed native American and European ancestry and native Americans may have a genetic predisposition to Type 2 diabetes which Mexican Americans could share. We studied 936 Mexican Americans and 398 Anglo-Americans randomly selected from three socially and culturally distinct neighborhoods in San Antonio, Texas. Three categories of obesity--lean, average, and obese--were defined using the Anglo-American distribution of the sum of the triceps and subscapular skinfold. Mexican Americans were two to four times as likely to fall into the obese category as Anglo-Americans, but within categories, the two ethnic groups were closely matched in terms of sum of skinfolds. The prevalence of Type 2 diabetes, however, was significantly greater in Mexican Americans than in Anglo-Americans even when the comparisons were made within the three obesity categories. The summary prevalence ratio, controlling for obesity, was 2.54 for men (p = 0.004) and 1.70 for women (p = 0.036). Thus, lean Mexican Americans are still at greater risk of Type 2 diabetes than equally lean Anglo-Americans. Conversely, although Type 2 diabetes prevalence increases as expected with increasing obesity in both ethnic groups, obese Anglo-Americans are still relatively protected compared with equally obese Mexican Americans. Plasma glucose was significantly higher in Mexican Americans than in Anglo-Americans even after controlling for obesity. These results indicate that, although obesity contributes to Type 2 diabetes in Mexican Americans, it does not by itself explain the entire excess prevalence rate.

Adult↗
PubMed1983

Ethnic differences in health knowledge and behaviors related to the prevention and treatment of coronary heart disease. The San Antonio Heart Study.

From a public health perspective, Mexican Americans are widely recognized as an understudied population. Available evidence suggests that Mexican Americans shared equally with non-Hispanic Caucasians (Anglo Americans or "Anglos") in the national decline in coronary heart disease (CHD) mortality during 1970-1976. This finding is somewhat unexpected in view of Mexican Americans' relatively lower socioeconomic status, and it suggests that studying this ethnic group may be strategic in understanding which factors have operated to produce the decline in general. Data obtained from a random sample of Mexican Americans and Anglos residing in three socioeconomically and culturally distinct neighborhoods in San Antonio, Texas, indicated that Anglos were significantly more informed than Mexican Americans about CHD prevention and generally reported engaging in more behaviors specifically aimed toward prevention than did Mexican Americans. Levels of knowledge were not particularly high in either ethnic group; moreover, reported behavior lagged considerably behind knowledge. While Mexican Americans were significantly less likely than Anglos to volunteer knowledge about major heart attack symptoms, there were negligible ethnic differences in awareness of the need for prompt utilization of medical treatment resources when a heart attack actually occurs. Awareness of the need for prompt action was notably high among both ethnic groups. Although limitations in the nature and scope of the data dictate that these findings should be interpreted with caution, the results tend to argue in the direction that prompt access to medical treatment when coronary emergencies occur may have made a relatively greater contribution to the CHD mortality decline in both Mexican Americans and Anglos than did changes in life-style. Much additional data are needed, however, before a definitive explanation of the decline will be possible.

Coronary Disease↗
PubMed1980

Activation of latent Graves' disease in children. Review of possible psychosomatic mechanisms.

In some children, psychological events have appeared to be important in the triggering of Graves' disease. This report examines the case histories of three children in whom the appearance of symptomatology of Graves' disease was associated with depression following the death of a loved one. An analysis of neuroendocrine and immunologie pathways suggests that depression, set off by bereavement, causes low levels of norepinephrine in the brain. The latter in turn may mediate an increase in ACTH and cortisol, leading to reductions in immune surveillance and resultant production of thyroid-stimulating immunoglobulins, hence the development of Graves' disease.

Adolescent↗
PubMed1979

Hypertriiodothyroninemia in hypothyroidism treated with thyroglobulin.

Hypertriiodothyroninemia during therapy with thyroglobulin was noted in six hypothyroid patients aged 9 to 25 years. Causes of hypothyroidism were thyroiditis, congenital athyreosis, cryptothyroidism, or goitrous hypothyroidism. Serum thyroxine level, measured at the same time, was below normal in three patients. Findings attributable to excess of thyroid hormones were none other than slight nervousness or transitory heat intolerance. Substitution of levothyroxine for thyroglobulin was done in all patients and was associated with return to normal of serum triiodothyronine (T3) values in those tested. A high content of T3 in thyroglobulin used for medication seems the most probable cause of the observed hypertriiodothyroninemia. Since similar findings have been reported previously for hypothyroid patients treated with desiccated thyroid preparations, it seems clear that therapy with levothyroxine offers a significant advantage over the use of desiccated thyroid or thyroglobulin.

Adolescent↗
PubMed1979

Studies of 16-androstenes in an infant with virilizing adrenal carcinoma.

An 18-month-old girl with virilization was found to have an encapsulated right adrenal carcinoma (2 x3 cm) with great variation in nuclear size, frequent mitoses, and possible blood vessel invasion. Preoperative urinary excretions of 17-ketosteroids, androsterone, etiocholanolone, dehydroepiandrosterone, testosterone, pregnanetriol, 3alpha-androstenol, and 3 beta-androstadienol were elevated; all showed a noticeable decrease postoperatively. Cortisol acetate, given preoperatively, produced a definite decrease in the urinary excretion of 17-ketosteroids and dehydroepiandrosterone; administration of corticotropin resulted in an increase in levels of urinary 17-ketosteroids, 17-hydroxycorticosteroids, and pregnanetriol. Urinary testosterone and 3beta-androstadienol may have diagnostic value since neither was suppressed by cortisol therapy. The behavior of both 3alpha-androstenol and 3beta-androstadienol in this study suggests that they are of adrenal origin.

17-Hydroxycorticosteroids↗
PubMed1979

Family with three apparently balanced t(3;15) (p27;q22) translocation carriers. Association with deficits in language acquisition and mental retardation: a possible example of position effect in man.

A father, son, and daughter had a (3;15) (p27;q22) simple reciprocal translocation. No abnormality in the G-banding pattern was noted. The girl was most severely affected; she had an abnormal phenotype, noticeable delay in receptive and expressive language development, bilateral hearing impairment, and definite mental retardation. The boy had a moderate delay in receptive language skills, had moderate hearing impairment in one ear, and showed mild mental retardation. The father has low-set ears, some deficits in receptive language skills, is illiterate, and was found to be borderline mentally retarded. The mother and younger child do not have the translocation and are normal in terms of phenotype, intellect, and verbal skills. The accumulating evidence suggests that balanced translocations are associated with an increased frequency of intellectual deficit and congenital anomalies, and the cytogenetic mechanism may be that of position effect.

Adult↗
PubMed1979

Bereavement as an antecedent factor in thyrotoxicosis of childhood: four case studies with survey of possible metabolic pathways.

Various organic and psychosomatic factors have been postulated over the years as etiologic events antedating the onset of Graves' disease. In some patients psychological events have appeared to be important in the evocation of symptoms. Although examples of the latter have been described in adults for many years, there is little published on this phenomenon in children. The present study delineates findings in two boys and two girls with an age range of 8 to 14 years. Separating experiences appeared to be related to the onset or relapse of Graves' disease in these particular cases. In three of the patients the trigger event was represented by bereavement after death of a close relative; in the fourth case the boy's loss was enforced and traumatic separation from his mother figure. In all these children depression was the common response to loss. The observed relationship between the affective disturbance and Graves' disease is compatible with one or more hypothetical models. One such pathway, via depletion of brain monoamines associated with the state of depression, could cause an activation of the hypothalamic-pituitary-adrenal axis with resultant suppression of immune surveillance. This could permit the formation of thyroid-stimulating immunoglobulins (TSI) and hence Graves' disease in genetically susceptible (HLA B-8) persons.

Adolescent↗
PubMed1977

Abnormal genitalia as a presenting sign in two male infants with hydantoin embryopathy syndrome.

Abnormal genitalia was a salient clinical finding in two unrelated male infants with the hydantoin embryopathy syndrome. Both infants also exhibited hypoplastic nails of fingers and toes, hypertelorism, and a flat nasal bridge, and one had severe developmental retardation. We review previously reported cases of the hydantoin embrypathy syndrome and discuss factors possibly affecting the teratogenicity of phenytoin. Male infants with findings such as the patients of this report need to be differentiated from patients with Noonan syndrome and Aarskog syndrome. We suggest that mothers receiving phenytoin who have given birth to one affected infant should be given a different anticonvulsant for future pregnancies.

Abnormalities, Drug-Induced↗
PubMed1977

A t(5p-;21q+) translocation in a family with Down syndrome.

A mother and daughter carrying a t(5;21)(p13;q22) chromosome were discovered after they had contacted us for genetic counseling. They were concerned because of two cases of Down syndrome in their family. Four of the mother's eight pregnancies had resulted in miscarriages; the chromosome complements of the abortuses is not known. Evidence was found indicating that individuals carrying a structurally altered chromosome 21 have an increased risk of bearing a child with Down syndrome.

Adult↗