The economics of cancer care in Canada.
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Biomedical subjects
Publications and source records attributed to B C Lentle.
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Sixty female patients with chronic low back pain have been studied clinically, radiographically, and by radionuclide bone scanning for evidence of sacroiliac disease. Twenty-four patients had quantitative sacroiliac scintigraphy (QSS) results suggesting sacroiliitis. In only one of these patients was the radiograph abnormal. Clinical and laboratory examinations failed to reveal any possible associated aetiological factors. Six-month follow-up of 18 patients showed that subjective improvement of pain is associated with a return to normal of QSS results, often secondary to anti-inflammatory medication. It is concluded that sacroiliac disease may be a common cause for chronic low back pain in women and that its presence may be missed if radiographs are relied upon to confirm the diagnosis. Its aetiology remains obscure.
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A patient is described in whom the postoperative management after renal transplantation was complicated by a wound discharge. A radionuclide technique of solving the clinical dilemma is discussed, using scintilymphangiography and qualitative assays.
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A patient with non-African Burkitt's lymphoma is reported in whom bilateral breast involvement was detected by both mammography and 67-Ga-citrate scintigraphy. The causes of breast uptake of 67Ga-citrate are reviewed, and it is noted that not only asymmetrical increases in uptake of 6767Ga-citrate are indicative of disease.
Nineteen patients with Paget's disease of bone were studied 7 months to 5 years after therapy with mithramycin in a dose averaging 11.5 microgram/kg body weight daily for 10 days. Thirteen patients, including 3 with the longest followup intervals, remained free of pain. Objective measures of disease activity (serum alkaline phosphatase level and 99mtechnetium pyrophosphate bone scan) were less favorable. There was no evidence of long term toxicity.
A follow-up study of 48 patients with Reiter's syndrome was carried out in an attempt to clarify the clinical course of the disease. The mean age at the onset of Reiter's syndrome was 27.1 years (range 15 to 52 years) and when seen at follow-up 32.5 years (range 19 to 58 years). The average time from the onset of the first attack of peripheral arthritis to the time of follow-up was six and a half years (range 0.5 to 27 years). Only three patients had diarrhea prior to the onset of Reiter's syndrome. At follow-up 22 per cent of the patients were asymptomatic, 24 per cent had recurrent minor symptoms, 24 per cent had recurrent moderate symptoms, and 30 per cent had recurrent major symptoms. However, even in the last group, all patients were in functional classes 1 or 2 between the flares of disease. No patients in the series were in functional class 3 or 4, and 30 per cent were in class 1.
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