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Biomedical subjects

S S Donaldson

Publications and source records attributed to S S Donaldson.

At least 127 records · Page 7Linked to original sources
PubMed1982

Effects of therapy on nutritional status of the pediatric cancer patient.

Children with cancer are at high risk for major nutrition problems both from the tumor itself and from the treatment administered. Overt malnutrition is seen in as many as 17% of children with newly diagnosed localized tumors and 37% of those with metastatic disease. Weight loss in children with cancer is directly correlated with a poor nutritional status at the time of diagnosis and with a low serum albumin. Massive surgical resections are a common source of nutritional problems and are usually not indicated as primary therapy in children with cancer. Both radiotherapy and chemotherapy are associated with recognized acute and long-term complications which may have an impact upon the nutritional status of the child. The majority of childhood cancers are best managed by a multidisciplinary approach including limited surgery, irradiation, and chemotherapy. This combined modality approach requires careful management including monitoring for known sequelae such that optimistic cure rates can be achieved without compromising the nutritional status of a child with cancer.

Antineoplastic Agents↗
PubMed1982

Complications of treatment of Hodgkin's disease in children.

An analysis of complications of therapy requires long-term and frequent followup. Reported here is a review of 179 consecutive children with Hodgkin's disease from Stanford University Medical Center who were seen, treated, and followed over a 20-year period. Complications of treatment are related to the extent of disease and the aggressiveness of therapy. Severe complications from radiotherapy are associated with high-dose, extended-field treatment in preadolescent children. Severe chemotherapy-associated complications include immunosuppression, sterility, and secondary oncogenesis. As cure rates are increasingly optimistic among children with Hodgkin's disease, successful treatment with minimal morbidity remains our greatest challenge. Therapy programs require continual refinement utilizing assessment of short- and long-term side effects of treatment.

Adolescent↗
PubMed1981

A study of the nutritional status of pediatric cancer patients.

The records of 455 children were reviewed to investigate the relationship of nutritional status at time of first referral to various measurements of disease and survival. Initial symptoms of weight loss, anorexia, fatigue, and early satiety were all directly correlated. Serum albumin level and nutritional status were not directly correlated. Likewise, there was no direct relationship between performance status and nutritional status. However, higher values of serum albumin were associated with better performance status. Nutritional status was directly related to freedom from relapse among children with solid tumors whether they had localized or non-localized disease. In addition, improved survival was related to good nutritional status for children with localized disease, whereas those with advanced disease had a poorer survival regardless of their nutritional status. Nutritional status appears to have prognostic implications among children with cancer.

Body Height↗
PubMed1981

Management of the pregnant patient with Hodgkin's disease.

Fifteen pregnant women with Hodgkin's disease were followed. Five patients had irradiation, 1000 to 3000 rad to the neck, mediastinum, or both, during the second or third trimester with normal outcome of pregnancy. One patient had a spontaneous abortion in the first trimester after radiotherapy of 4400 rad to the breast, an estimated fetal dose of 9 rad. One patient who received chlorambucil throughout pregnancy delivered a normal infant. Six patients had therapeutic abortions; one had early induction of labor. In one patient previously treated for supradiaphragmatic Hodgkin's disease, detection of a supradiaphragmatic relapse was delayed because of pregnancy. We recommend abortion for patients who develop Hodgkin's disease early in pregnancy or who have received chemotherapy or irradiation during the first trimester. During the latter half of pregnancy, asymptomatic disease may be closely followed but early delivery is recommended. Supradiaphragmatic, symptomatic disease can be treated with modified irradiation. For subdiaphragmatic, symptomatic, or extranodal disease, single-agent chemotherapy may be preferable. Treatment requires individualization to insure that the patient will be cured and the fetus protected.

Abortion, Therapeutic↗
PubMed1980

Posterior ocular abnormalities after irradiation for retinoblastoma: a histopathological study.

Radiation-induced ocular lesions in the posterior eye and orbit were investigated in 33 surgical specimens of patients with retinoblastoma. The eyes were obtained from children 7 months to 6 years of age. Seventeen eyes were irradiated; 16 eyes had not received irradiation and served as controls. The majority of the irradiated eyes were treated with 6000 rads of external beam radiation. They were removed at a mean of 23 months after radiotherapy. All specimens were examined simultaneously by 2 observers without knowledge of treatment and analysed for the presence or absence of 15 lesions. The most consistent lesions in the irradiated eyes were abnormalities of the retinal vessels (11 of 17 eyes) and striking changes in the ciliary arteries (13 of 17 eyes). The retinal vessels showed thickening of the wall, often caused by deposition of fibrillary material, sometimes with fibrin deposits. The most consistent lesion was myointimal proliferation with narrowing of the ciliary arteries. Lesions of the central retinal artery were less common but occurred only in irradiated patients.

Child↗
PubMed1980

John Caffey Award: chemotherapy-induced inhibition of compensatory renal growth in the immature mouse.

Minimal-lethal-doses (LD1/21) of Actinomycin-D (AMD), Vincristine (VCR), or Adriamycin (ADR) inhibited compensatory renal growth in unilaterally nephrectomized weanling mice. AMD transiently inhibited compensatory renal and body growth. VCR transiently inhibited kidney growth only, while ADR produced persistent kidney and body growth inhibition. 3H thymidine uptake was decreased at 5 days from controls with AMD and ADR, and increased at 14 days from controls with ADM, VCR, and ADR. Kidney DNA concentration was increased from controls at 3 days with AMD and at 8 and 14 days with ADR, but decreased from controls of 8 days with AMD and VCR. AMD and ADR inhibit compensatory renal growth and body growth in the immature mouse. VCR selectively inhibits renal growth. Renal growth inhibition with AMD, VCR, and ADR is related, in part, to a delay in the renal mitotic response to contralateral nephrectomy, and with AMD and ADR to generalized body growth supression. Chemotherapy injury to the growing mammalian kidney may be manifest as growth inhibition.

Animals↗
PubMed1979

Alterations of nutritional status: impact of chemotherapy and radiation therapy.

The nutritional status of a cancer patient may be affected by the tumor, the chemotherapy and/or radiation therapy directed against the tumor, and by complications associated with that therapy. Chemotherapy-radiotherapy is not confined exclusively to malignant cell populations; thus, normal tissues may also be affected by the therapy and may contribute to specific nutritional problems. Impaired nutrition due to anorexia, mucositis, nausea, vomiting, and diarrhea may be dependent upon the specific chemotherapeutic agent, dose, or schedule utilized. Similar side effects from radiation therapy depend upon the dose, fractionation, and volume irradiated. When combined modality treatment is given the nutritional consequences may be magnified. Prospective, randomized clinical trials are underway to investigate the efficacy of nutritional support during chemotherapy-radiotherapy on tolerance to treatment, complications from treatment, and response rates to treatment. Preliminary results demonstrate that the administration of total parenteral nutrition is successful in maintaining weight during radiation therapy and chemotherapy, but that weight loss occurs after discontinuation of nutritional support. Thus, long-term evaluation is mandatory to learn the impact of nutritional support on survival, disease-free survival, and complication rates, as well as on the possible prevention of morbidity associated with aggressive chemotherapy-radiation therapy.

Abdominal Neoplasms↗
PubMed1979

Appearance of Graves' disease on orbital computed tomography.

Extraocular muscle enlargement was symmetrical in 70% and asymmetrical in 30% of patients with Graves' ophthalmopathy. True unilateral muscle involvement occurred in 6%. Computed tomography (CT) showed bilateral orbital involvement in 50% of patients presenting clinically with unilateral eye signs. In patients without a clinically apparent ophthalmopathy, CT demonstrated muscle enlargement in 40%. The medial and inferior rectus muscles were the most frequently and most severely involved. Orbital radiation therapy can result in a decrease in size of involved muscles.

Graves Disease↗
PubMed1978

Visual results and ocular complications following radiotherapy for retinoblastoma.

Between 1956 and 1974, 28 children with retinoblastoma have been irradiated with the linear accelerator at the Stanford University Medical Center. Twenty-seven children (96%) have been cured of their tumor, with follow-up ranging from 2 1/2 to 21 years. In these survivors, 50 eyes were affected. Twelve were treated by primary enucleation and 38 were irradiated. Sixteen of the 38 irradiated eyes (42%) were ultimately enucleated for recurrent tumor, neovascular glaucoma, or inability to observe the tumor through opaque media. Thus, 22 (58%) irradiated eyes were saved. Of these, five eyes had visual acuity of 20/40 or better, five had 20/50 to 20/100, nine had 20/200 to hand motion, and three had light perception or no light perception. Radiation therapy can sterilize the tumor and maintain useful vision in many children with retinoblastoma.

Cataract↗
PubMed1978

Herpes zoster and varicella infections in children with Hodgkin's disease: an analysis of contributing factors.

181 children with Hodgkin's disease were analyzed with respect to the occurrence of herpes zoster and varicella (HZ-V) infections, possible contributing factors, and prognostic significance. The overall frequency of HZ-V was 34.8%. The occurrence in stage I was significantly lower than in other stages. Previous splenectomy was not found to increase significantly the risk of infection. High-risk patients were those receiving extensive radiotherapy plus combination chemotherapy; 56% developed HZ-V infections in this group. The frequency with extensive field radiotherapy alone was 23.8%. 80% of infections occurred during the first year after completion of treatment. Their occurrence was not a poor prognostic sign in terms of relapse or fatality, even when occurring late. The high frequency of disseminated infection (27%) with its subsequent morbidity should lead toward a better understanding of the immunologic deficiencies in these patients and the possible role of prophylactic measures, in patients undergoing extensive radiotherapy in combination with multiagent chemotherapy.

Adolescent↗
PubMed1978

Epithelioid granulomas associated with Hodgkin's disease: clinical correlations in 55 previously untreated patients.

Non-caseating sarcoid-like epithelioid granulomas associated with Hodgkin's disease have been found in 55 patients initially staged and treated at the Stanford University School of Medicine. These patients are compared to 553 concurrent patients not having granulomas associated with their Hodgkin's disease. Pre-treatment parameters of the two groups are presented and found not to be different. Patterns of relapse in granuloma patients are presented and no relationship between location of granulomas and subsequent relapse is found. Survival and relapse-free survival curves are significantly different in favor of the granuloma group (p = 0.005 and p = 0.03, respectively). Correlation with skin test data has been attempted using a matched control analysis and no difference is found in reaction to intradermal antigens between the two groups.

Adult↗