Introducing students to community health.
Explore the source record for details and available documents.
Clinical Competence↗
Biomedical subjects
L Laing
Publications and source records attributed to L Laing.
How we teach . . . behavioural science.
Concern for the professional preparation of physicians who will be able to function effectively in the uncertain environment of the 21st century has led to some attention being paid to the behavioural sciences. This case study is concerned with the introduction of a course in behavioural science and the steps taken by a professor to promote excellence in instruction.
Behavioral Sciences↗
Clove cigarettes. The basis for concern regarding health effects.
The smoking of clove cigarettes has been associated with 13 cases of serious illness in the United States, including hemorrhagic pulmonary edema, pneumonia, bronchitis, and hemoptysis. We describe a patient in whom, after she smoked a clove cigarette, pneumonia complicated by lung abscess developed. Her lung disease may have been caused by aspiration pneumonia as a consequence of pharyngolaryngeal anesthesia from clove cigarette smoke. Clove cigarettes appeal to adolescents experimenting with smoking practices and may influence the development of later smoking habits.
Adolescent↗
Further studies of natural killer cell function in Chediak-Higashi patients.
Spontaneous natural killer (NK) activity and antibody-dependent cellular cytotoxicity (ADCC) of blood lymphocytes against five human tumour cell lines (K562, Molt-4, HL-60, Chang, Daudi) and three mouse tumour lines (YAC, P815, RBL-5) were ten- to 100-fold lower than normal in six patients with Chediak-Higashi (CH) disease. NK and ADCC were defective at 4 hr, and less so at 18 hr. The NK activity in normals and CH patients was mediated in part by FcR+, E- effector cells. ADCC against human erythrocytes was normal in CH patients, as were lectin-dependent cytolysis and mixed lymphocyte proliferative responses. Phagocytosis of antibody-coated ox erythrocytes was normal in CH patients as well. These observations confirm that the CH syndrome is associated with a profound and selective defect in NK and ADCC activity against tumour cells, whereas other mononuclear cell-mediated functions are normal.
Adult↗
Oestrogen-receptor status and endocrine therapy of breast cancer: response rates and status stability.
The concentration of cellular oestrogen receptor (RE) was measured in both the soluble and nuclear-pellet fractions of biopsies from 1,000 breast cancers. Data suggest that functional steroid RE is always in equilibrium between the soluble and nuclear fractions. However, biopsies from only one-third of patients contained detectable amounts of high-affinity RE in both fractions. Thirty patients out of 42 (71%) whose biopsies contained RE in both fractions, showed objective remission after receiving some form of hormonal manipulation as sole treatment. Response rates in the other categories ranged from 9% for those whose biopsies contained no detectable RE to 24% for those who displayed soluble RE alone. The presence of RE in both fractions of primary disease, whereas RE-negativity was maintained during progression from primary to secondary disease. Other aspects of RE status in relation to stage of disease are analysed.
Adult↗
Soluble and nuclear oestrogen receptor status in human breast cancer in relation to prognosis.
The relationship between oestrogen receptor (RE) content of primary breast cancer and subsequent prognosis was examined with regard to nodal status. It was found that, within a particular nodal group, patients with tumours containing fully functional RE experienced a longer disease-free interval than those with RE- disease. An earlier observation that RE- primary disease gave rise to distant metastases as first site of recurrence more frequently than did RE+ disease, was not sustained. However, patients with RE+ primary disease had a much reduced chance of dying from cancer within a 3-year period.
Adult↗
Nuclear oestrogen receptors and treatment of breast cancer.
In an attempt to improve the predictive value of oestrogen-receptor measurements in breast-tumour biopsy specimens, oestrogen receptor was measured at both cytoplasmic and nuclear levels. Although 33% of patients had receptors at both levels, another 17% had cytoplasmic but no nuclear receptors. Theoretically, this latter group would not be expected to respond to hormone therapy. 7% had nuclear but not cytoplasmic receptors. The six-month follow-up data for the group of patients with receptors at both cytoplasmic and nuclear levels suggests qualitatively that this group has a good chance of responding favourably to hormone therapy. Much larger numbers must be accumulated before quantitative conclusions can be reached.
Breast Neoplasms↗
Oestrogen-binding protein in plasma of breast-cancer patients.
Explore the source record for details and available documents.
Adenocarcinoma↗
Estrogen receptors and antiestrogen therapy in selected human solid tumors.
Tumor biopsies from a range of human cancers not normally thought to be hormone-dependent were assayed for the presence of both cytoplasmic and nuclear estrogen receptors, using strict criteria of specificity and affinity. Of 72 tumor samples assayed, only one had both cytoplasmic and nuclear receptors. However, several others showed the presence of estrogen-binding components with characteristics different from those of the normal human estrogen receptor. Thirty patients with advanced, measurable disease were treated with the antiestrogen tamoxifen. In only 25 of these was the response evaluable, and in each case, the disease progressed. This study suggests that the occurrence of the classic estrogen receptor in human cancers, other than breast and uterine, is rare; this finding is supported by the absence of response of advanced disease to antiestrogen treatment.
Binding, Competitive↗
Acute care hospital morbidity in the Blood Indian Band, 1984-87.
Acute care hospital morbidity of the Blood Indian Band was compared with that of all Albertans between April 1, 1984 and March 31, 1987. The Blood Indians had over 2.5 times as many hospital separations and 2.2 times as many patient days as the Albertans. The highest separation rare ratios by ICD-9-CM chapter for both Blood males and females were for endocrine, metabolic and nutritional disorders. Blood females had higher rate ratios for hospitalizations for all chapters except neoplasms and Blood males had higher rate ratios for all except congenital anomalies and neoplasms. For individual conditions, Blood males had the highest separation rate ratios for alcohol dependence syndrome, gastritis/duodenitis and diabetes mellitus. Bronchitis/emphysema and diabetes mellitus had the highest rate ratios for Blood females. The results are consistent with those reported in other studies of North American Indians. Their health status is more consistent with a developing country than that expected in Canada and does not appear to be improving.
Acute Disease↗