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Biomedical subjects

A W Lees

Publications and source records attributed to A W Lees.

At least 37 records · Page 2Linked to original sources
PubMed1980

Oophorectomy versus radiation ablation of ovarian function in patients with metastatic carcinoma of the breast.

A retrospective study of two methods of ovarian ablation as primary therapy for metastatic carcinoma of the breast was carried out using records from this cancer institute. Sixty-one radiation and 97 surgical ovarian ablations, performed from 1972 to 1977, were assessed. Rigid criteria were used to classify response. Over-all response was similar for the surgical and irradiation groups. Survival from the time of ovarian ablation was greater in both groups in those who responded positively than in those who did not. Factors other than estrogen receptor status can determine the response of patients with metastatic carcinoma of the breast to ovarian ablation. These include the disease-free interval, menopausal status, weight and the presence of skeletal or ovarian metastases. The results indicate that clinical determinates and not the efficiency of one method over the other should be the main criteria for choosing between ovarian ablation by irradiation or by oophorectomy.

Adult↗
PubMed1979

Five-year survival of women with breast cancer in northern Alberta.

Five-year survival rates for all 519 women with breast carcinoma in northern Alberta in 1971 and 1972 were analysed with the use of data from the computerized northern Alberta breast registry and the Alberta cancer registry. The relative 5-year survival was 73%, which is higher than most rates reported from other centres. Lymph node involvement was significant as a prognostic factor, with the relative 5-year survival falling from 92% in the group without lymph node involvement to 58% in the group with three or more involved nodes. The prognosis was also significantly affected by the stage of the disease according to the 1973 TNM classification: the 5-year survival rates ranged from 88% for patients with stage 1 disease to 17% for those with stage IV disease. Women 40 to 59 years of age had a higher survival rate (79%) than those under 40 years (65%) or over 60 years (66%) of age. Analyses by 5-year age groups showed that women 35 to 39 years old had a particularly poor survival rate (59%). Postmenopausal women less than 55 years old had a higher survival rate than did perimenopausal or premenopausal women in the same age group. Further follow-up is indicated to correlate possible high-risk factors with survival.

Adult↗
PubMed1979

A fatal case of Legionnaires' disease originating in Scotland.

A 21-year-old female died in May 1976 from a pneumonic illness presenting with a right pleural effusion. Histopathology showed florid hyaline membrane disease of the left lung only, and focal pneumonitis in the lower lobe. Further investigations carried out by the Center for Disease Control, Atlanta, Georgia, showed that this patient had Legionnaires' disease infection, the first indigenous case diagnosed in Scotland. Post-mortem examination showed features differing from those in other published cases.

Adult↗
PubMed1979

Management of pleural effusions in breast cancer.

Ninety-seven patients with breast cancer developed pleural effusions between January, 1971 and December, 1976. A retrospective analysis of 170 treatment procedures showed that 75 involved thoracocentesis alone, 23 involved thoracocentesis plus therapy with an alkylating agent, 22 involved drainage via a chest tube plus instillation of an alkylating agent, and 50 involved drainage via a chest tube plus instillation of tetracycline. The results are presented as censored survival curves. When management by chest tube plus instillation of an alkylating agent or tetracycline was compared with management by thoracocentesis plus therapy with an alkylating agent, analysis at six months after treatment showed that 42 percent (30/72) of the procedures left patients free of effusion using the former method, compared with 22 percent (5/23) of the procedures using the latter method. This is not quite significant at the 5 percent level using a summary chi2 procedure. The reasons for preferring tetracycline as a sclerosing agent are discussed.

Alkylating Agents↗
PubMed1979

False negative mammograms causing delay in breast cancer diagnosis.

Eighty patients with negative mammograms and proven breast cancer are described. The incidence of negative mammograms is 5 to 7% of all breast cancer in Northern Alberta. In 30 patients, immediate biopsy because of clinical abnormality, and mastectomy, revealed only 3.3% axillary node involvement. The remaining 50 patients gave a history of finding a lump and then had a negative mammogram. Biopsy was delayed for a mean of 45 weeks. Their incidence of axillary node involvement was 42%. The mean age of both groups of patients was seven to eight years younger than the mean for all breast cancer patients. The implications of such delay on prognosis and survival are obvious. More public and medical education is needed.

Adult↗
PubMed1978

Oral contraceptives and breast disease in premenopausal Northern Albertan women.

The results of a prospective study on oral contraceptive use and breast disease in northern Alberta are presented. The study groups comprised all women aged 30 to 49 examined in diagnostic breast clinics at the Cross Cancer Institute between 1971 and 1974. Three hundred and one patients had breast cancer, 692 had a subsequent biopsy for a benign breast condition, and 548 had no subsequent biopsy. A tendency for an increased relative risk (RR) of breast cancer in women taking oral contraceptives for periods of 1 to 5 years was evident, with relative risk decreased or unaffected in users of less than 12 months (RR = 0.6) or more than 5 years (RR = 1.0). A slightly increased risk was apparent in patients using oral contraceptives within a year prior to attendance at the clinic (recent users); this increase was emphasized when recent users with a prior biopsy for benign breast disease were analyzed alone (RR = 5.0). In women with a prior breast biopsy, use of oral contraceptives for more than 5 years increased risk of breast cancer nine-fold. Former users who had taken oral contraceptives for less than a year showed a significant reduction in breast cancer risk (RR = 0.3). The risk of benign breast disease was also reduced in former users (RR = 0.6) as well as in long-term users (RR = 0.5).

Adult↗
PubMed1977

Ethambutol plus isoniazid compared with rifampicin plus isoniazid in antituberculosis continuation treatment.

Patients with bacteriologically positive pulmonary tuberculosis were treated initially for an average of three and a half months with isoniazid, rifampicin, and ethambutol and then a total of one year's treatment was completed with either rifampicin plus isoniazid (R+I) or with ethambutol plus isoniazid (E+I). 63 patients in each continuation group were followed up for at least one year, and no relapses occurred. Continuation treatment with E+I was as effective and acceptable as that with R+I and was much less costly.

Drug Therapy, Combination↗
PubMed1975

Probenecid and rifampicin serum levels.

Serum-levels of rifampicin were investigated in patients receiving rifampicin alone or with other antituberculosis drugs. 2 g of probenecid given 30 min before 300 mg of rifampicin did not result in raising serum levels to more than half those achieved with the standard 600 mg dose of rifampicin. Hence probenecid should not be used to reduce rifampicin dosage in antituberculosis therapy.

Administration, Oral↗