Biomedical subjects

S D Kaplan

Publications and source records attributed to S D Kaplan.

At least 19 recordsLinked to original sources

PubMed2003

Urolithiasis in pediatric patients with acute lymphoblastic leukemia.

We evaluated the incidence, timing, and consequences of urolithiasis in children with acute lymphoblastic leukemia (ALL). A total of 20 patients with urolithiasis were identified from 2095 patients with ALL treated at St Jude Children's Research Hospital on consecutive protocols between 1968 and 1998. For remission induction therapy, all patients received daily prednisone; continuation chemotherapy regimens differed by protocol with some including pulses of prednisone or dexamethasone and others no glucocorticoid. Patients with urolithiasis were older at diagnosis of ALL than those without urolithiasis (median age, 7.5 vs 5.0 years; P=0.03) and less likely to be black (P=0.03) than white or Hispanic, but sex and treatment era did not differ. Presenting symptoms included abdominal or flank pain, hematuria, and dysuria. All stones analyzed biochemically were calcium stones. The incidence of urolithiasis after completion of therapy was 1.8 per 10 000 person-years. Compared to this baseline rate, the relative risk of urolithiasis was 45 (P<0.01) during induction therapy, 22 (P<0.01) during continuation therapy with glucocorticoids, and 5.1 (P>0.05) during continuation therapy without glucocorticoids. Urolithiasis occurred 4.5 times more often during continuation treatment with glucocorticoids than without (P<0.05). Seven patients (35%) had recurrent urolithiasis. Patients with ALL are at risk of developing calcium renal stones during chemotherapy, especially when a glucocorticoid is included.

Adolescent↗

PubMed1992

Cardiac manifestations of the antiphospholipid syndrome.

The antiphospholipid syndrome has been associated with multiple cardiac abnormalities. The earliest reports were of valvular disease, including verrucous endocarditis, as well as valvular thickening and insufficiency. Subsequently, antiphospholipid antibodies were implicated in coronary artery disease manifested by premature myocardial infarction and coronary artery bypass graft occlusion. In addition, there have been rare reports of intracardiac thrombi and diffuse cardiomyopathy in association with antiphospholipid antibodies. In this review, we discuss the nature and prevalence of the cardiac manifestations of the antiphospholipid antibody syndrome as well as some of the proposed pathophysiologic mechanisms. We also provide examples from our own experience. The expanding spectrum of cardiac disease associated with antiphospholipid antibodies suggests an important role for these antibodies in certain types of cardiac pathology.

Antiphospholipid Syndrome↗

PubMed1988

Retrospective cohort mortality study of Roman Catholic priests.

In order to test the hypothesis that Roman Catholic priests are at low risk for prostatic cancer because of their celibacy, a cohort of 10,026 men who were active or retired diocesan (parish) Roman Catholic priests in the United States on January 1, 1949 were followed until death, leaving the priesthood, or January 1, 1978. The overall standardized mortality ratio (SMR) was 103 and the SMR for cancer of the prostate was 81. Other interesting findings include increased SMRs for cancer of the larynx (147), cirrhosis of the liver (147), and diabetes (182) and decreased SMRs for lung cancer (59), emphysema (26), and suicide (13).

Adult↗

PubMed1987

Retrospective cohort mortality study of dry cleaner workers using perchloroethylene.

To evaluate the carcinogenic potential from occupational exposure to perchloroethylene (PCE), a retrospective cohort mortality study of workers employed in the dry cleaning industry was conducted among 1,690 workers from four labor unions. The majority of the cohort had potential exposure to petroleum solvents as well as to PCE while working in the dry cleaning industry. Mortality from primary cancer of the liver was of particular interest, due to the findings of excess liver cancer in mice exposed to PCE. Other sites of cancer were also of interest. A total of 493 deaths were observed, whereas 575.5 were expected based on US mortality rates. Mortality from all cancers combined was greater than expected (142 observed v 122.9 expected). No deaths due to liver cancer were observed. Urinary tract cancer was the only specific site where there was a statistically significant excess in observed deaths (12 observed v 4.7 expected). There was some consistency in these findings across the four individual unions and across race/sex groups. A subcohort of workers who were employed only in dry cleaning shops that used PCE as their primary solvent was identified from the union records. There was only one death from urinary tract cancer, whereas 1.3 deaths were expected in this subcohort.

Actuarial Analysis↗

PubMed1986

Update of a mortality study of workers in petroleum refineries.

A large cohort of petroleum refinery workers with long duration of employment, long latency, and relatively young age at hire had its vital status updated through Dec. 31, 1980. The standardized mortality ratio (SMR) for all causes was 78. Each nonneoplastic cause had an SMR below 100, including SMRs of 63 for emphysema and for all diseases of the genitourinary system and of 73 for chronic nephritis. The SMR for all cancers was 87. SMRs for specific neoplasms included digestive system, 90; lung, 85; kidney, 68; brain, 89; leukemia, 101; multiple myeloma, 123; unspecified lymphoma, 112; polycythemia vera (four deaths), 455; myelofibrosis (three deaths), 201; and benign and unspecified brain neoplasms, 108. There were nine deaths from mesothelioma; all nine employees had more than 20 years of employment, with an SMR of 241.

Humans↗

PubMed1985

Mortality of paint and coatings industry workers. A follow-up study.

Extensive follow-up of production workers in the paint and coatings industry failed to indicate any important hazard that was previously unsuspected. The authors are more confident of the results of their original study since studying a subsample of persons lost to follow-up in the original study. Some efforts to investigate certain diseases (skin and liver cancer) more vigorously met with failure, which illustrates the problem of attempting retrospective studies by using death certificates for case ascertainment. Of the successful studies, the leukemia case-control analysis showed a possible relationship to lacquer production, which probably included benzene exposure. For lung cancer, no exposure category was associated with increased risk. The bowel cancer excesses, concentrated in three plants, are probably not job related and in any case do not represent an industry-wide problem. Cerebrovascular accidents showed a mild elevation of risk for vehicle workers. Although strong statements concerning the safety of this industry probably await more studies or further follow-up of this cohort, there is every indication that it is an industry without a major excess of any job-related disease. In drawing this conclusion, however, one must be aware that an individual job or individual plant could harbor health problems that would not be detected by a study of this type.

California↗

PubMed1985

Texaco mortality study. I. Mortality among refinery, petrochemical, and research workers.

The Texaco mortality study is a retrospective follow-up study of all persons who were employed for at least five years in a refining, petrochemical, or research facility and who worked at some time during the period 1947 through 1977. Of the 19,077 white men in the cohort, 14,609 were alive, 4,024 were known to be dead, and the vital status of the remaining 444 was unknown as of Dec. 31, 1977. The standardized mortality ratio (SMR) of 75 for all causes was significantly low, on the basis of 5,332 expected deaths. Statistically significant deficits also were seen for all major causes of death and for cancer of many sites, including lung, stomach, bladder, and colon. The SMR was greater than 100 for six causes of death: pancreas cancer, brain cancer, leukemia, Hodgkin's disease, other lymphatic cancer, and benign neoplasms. However, none of these increases was statistically significant, and all SMRs except that for benign neoplasms (SMR = 148) were under 119.

Adult↗

PubMed1982

A comparison of the marginal leakage of retrograde techniques.

An investigation of the apical seal of the most popular retrograde techniques was attempted. Ninety extracted maxillary central incisors were instrumented and obturated, and various apical procedures were performed. The depth of penetration of 2 percent methylene blue dye was used to evaluate the apical seal. Retrograde amalgam, heat-sealed gutta-percha, and the apicoectomy control showed average depths of penetration of 3.1, 4.0, and 4.6 mm., respectively, while cold-burnished gutta-percha yielded an average depth of penetration of 1.5 mm. The apical seal produced by cold-burnished gutta-percha allows less than half the penetration of the best of the other techniques and gave the most consistent results.

Apicoectomy↗

PubMed1981

A general mortality study of production workers in the paint and coatings manufacturing industry. A preliminary report.

Information has been obtained on a cohort of 16,243 men employed for at least one year in the manufacture of paint or vanish after January 1, 1946, and for seven subgroups on the basis of exposure. These workers experienced a level of mortality that compares favorably with that of the U.S. white male population. The workers' pattern of mortality differed somewhat from the U.S. pattern, with considerably reduced mortality from psychiatric, metabolic, respiratory, and violent causes. There was an increased mortality due to bowel and rectal cancer. While the numbers are smaller, there are also increased rates for liver and skin cancer. Lung cancer rates, while not in excess of the national average, did not match the low mortality from nonmalignant, noninfectious respiratory disease. The authors have concluded that work in this industry presents no major health hazard.

Carcinogens, Environmental↗

PubMed1981

Mortality among ethylene oxide workers.

Because of reports linking an increased risk of leukemia with exposure to ethylene oxide, a mortality study of workers with potential exposure to ethylene oxide at the Texaco Chemical Company Plant in Port Neches, Tex., was undertaken. A total of 767 males with potential exposure to ethylene oxide were identified. Forty-six deaths occurred in this cohort with 80 expected (standardized mortality ratio; SMR = 58). No deaths from leukemia were seen, nor were there any statistically significant excesses from any specific causes of death.

Ethylene Oxide↗

PubMed1981

Airborne carcinogens and human cancer.

There is as yet little convincing evidence that air pollution contributes to cancer risk, save for the strong suspicion of an increase in risk for persons living adjacent to arsenic emitters. The lack of any demonstrated direct and strong relationship between pollution and cancer, as well as the absence of any easily identifiable cancer epidemic in polluted areas, leads us to suspect that if a relationship exists, it is relatively weak and contributes little to the total cancer burden, especially in comparison to hazards such as cigarette smoking. There is a need for further research to verify our conclusions.

Adult↗

PubMed1978

Incidence rates and risk factors of benign breast neoplasms.

A case-control study of benign breast disease was conducted in Greater Boston in 1968-1969. Cases were nearly all women living in the reference population who were initially diagnosed as having fibrocystic disease, fibroadenoma or a "mixed" lesion during the study period. Controls were a random sample of the entire reference population. A mail questionnaire was completed for 678 cases and for 1807 controls. For fibrocystic disease the age-standardized incidence rate was 89.4 per 100,000 woman-years; for fibroadenoma it was 32.8. Fibrocystic disease rises in incidence to age 45 and then declines sharply. The incidence rate of fibroadenoma peaks during the 20's, while that of mixed tumors has a mode at 30 to 34. Among young women, the highest rates occur in married nulliparae, but this is not so at higher ages. Neither for fibroadenoma nor fibrocystic disease was there a consistent relationship of risk with parity or with age at first birth. Fibrocystic disease risk was strongly and directly related to age at natural menopause, directly but not strongly related to an index of socioeconomic status, and was increased among women who gave a history of arthritis. Both fibrocystic disease and fibroadenoma were much less frequent in more obese women. Neither fibrocystic disease nor fibroadenoma has an epidemiologic pattern which corresponds closely to that of breast cancer. Therefore, it seems reasonable to suggest that the apparent increased risk of breast cancer among women with benign breast disease is concentrated within a subset of these women.

Adenofibroma↗

PubMed1977

Epidemiology of endometrial cancer.

For a population-based, case-control study of cancer of the endometrium in Greater Boston from 1965 through mid-1969, 440 cases were drawn from nearly all hospitals in the area; controls were drawn at random from the general population. The age-adjusted incidence rate was 18.1/100,000 woman-years, with a peak at ages 55-59 and a gradual decline thereafter. Information was provided from 212 cases and 1,198 controls by mall questionnaire. A trend of reduced risk of endometrial cancer with increased parity was noted, the relative incidence (RI) for multiparous women being 0.3 compared to a RI of unity for married nulliparous women. The association of risk with age at first birth was irregular. Early menarche (RI=1.6) and late menopause (RI=1.7) were associated with increased risk of disease. Endometrial cancer risk was also found to be directly related to socioeconomic status, relative weight, diabetes, hypertension, and arthritis. The findings supported the idea that hormone activity during, and perhaps after, reproductive life is an important cause of this disease.

Adenocarcinoma↗

PubMed1977