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Biomedical subjects

M Grace

Publications and source records attributed to M Grace.

At least 289 records · Page 16Linked to original sources
PubMed1977

The increasing incidence of breast cancer in Alberta 1953-1973.

The incidence of female breast cancer in Alberta increased steadily by one case per 100,000 per year from 1953 to 1973 to a current rate of 68.6 per year when adjusted to the 1950 U.S. population. Incidence rates of breast cancer in Alberta and Saskatchewan were identical after population adjustment. The incidence increased in women over 40, implicating an increase in the postmenopausal type of breast cancer. Birth cohort analysis showed increased age-specific incidence rates in middle-aged women occurring in successive cohorts from 1903 to 1918, a result similar to that found in Saskatchewan, Connecticut, and Finland. The menopausal hook is disappearing in Alberta data, apparently due to cohort-specific increases in incidence. Possible etiological factors involved in these incidence changes are discussed; a detailed analysis of specific etiological factors is currently underway on over 3,000 patients with malignant or benign breast disease who were examined at the Dr. W. W. Cross Cancer Institute in Edmonton from 1971 to 1974.

Adult↗
PubMed1977

Cigarette smoking and diabetic retinopathy.

A sample of 181 diabetics with diabetic retinopathy was statistically investigated with regard to association of smoking with proliferative retinopathy. The numbers of patients with proliferative retinopathy rose with increasing tobacco consumption. In non-smokers no association existed between diabetes duration and proliferative retinopathy, but in smokers the number with proliferative retinopathy rose with increasing diabetes duration.

Adolescent↗
PubMed1977

Anemia in hemodialysis patients.

The association between anemia and chronic renal failure has been recognized since the early 19th century. With the introduction of regular dialysis treatment, an understanding of all aspects of this uremic complication has become of great importance, including an appreciation of the hazards of multiple blood transfusions. This analysis of hemoglobin levels and transfusion requirements in 84 dialysis patients focuses specific attention on hemolytic mechanisms, blood loss, and the effect of bilateral nephrectomy on erythropoiesis. Because no replacement for renal erythropoietin is available, particular attention must be paid to less important, but partially correctable factors that contribute to anemia. Blood transfusion requirements can then be reduced to a minimum, together with the risks of hypersplenism, hepatitis, and sensitization of the patient to alloantigens.

Adolescent↗
PubMed1976

Restaging of breast cancer in a northern Alberta registry.

All breast cancer patients presenting preoperatively at the Dr. W.W. Cross Cancer Institute, Edmonton, since 1971 are included in a registry that provides detailed clinical and epidemiologic information on the nature of this disease in northern Alberta. For the 141 female patients who were seen preoperatively in 1971 and thereafter followed regularly, disease was restaged according to the 1973 revision of the tumour-nodes-metastases (TNM) formula of Union internationale contre le cancer (UICC) to permit comparison with staging according to the 1968 formula. The staging distribution was altered greatly because of major changes in the staging system. With the 1973 revision stage II includes disease without palpable lymph nodes and greater emphasis is placed on tumour size. Accurate preoperative staging and registration are essential for meaningful statistics and as an aid in patient management.

Alberta↗
PubMed1976

The relative significance of factors affecting postoperative survival in astrocytomas, grades one and two.

The records of 107 patients with supratentorial astrocytomas, Grades 1 and 2 treated surgically between 1960 and 1970 were analyzed. Abstracted clinical data was retrospectively analyzed with respect to the relative significance of different factors affecting survival. Twenty-eight patients were alive at the time of follow-up in 1974. Age, clinical grade at surgery and radiation therapy were the most important determinants of prolonged postoperative survival. The more malignant astrocytomas occurring in the Province of Alberta had previously been reviewed. The present study was carried out to demonstrate the relative influence of histologic grade of astrocytomas and to analyze the factors affecting postoperative survival in the low grade, supratentorial astrocytomas.

Age Factors↗
PubMed1976

The use of computerized patient management problems in a certifying examination.

The 1974 paediatric certification process of the Royal College of Physicians and Surgeons of Canada included four CPMPs, in addition to the conventional MCQs and orals. The CPMP's were successfully administered to 160 candidates in eight cities across Canada on the same day. The examination was judged by the candidates to be a better test of clinical skill than MCQs. The CPMP examination did not penalize French-speaking candidates, was economically feasible, and a good security risk. Correlations between MCQ, orals and CPMPs, indicated that each examination measured some aspects of paediatric competence not tested by the others.

Canada↗
PubMed1976

Paediatric candidates' attitudes to computerized patient management problems in a certifying examination.

In September 1974 candidates who had taken a computerized patient managment problem examination (CPMP), as part of the certification process in paediatrics required by the Royal College of Physicians and Surgeons of Canada, completed a questionnaire designed to elicit their reactions to CPMPs. The results indicated that respondents were favourable to CPMPs, that there was little distraction caused by the equipment, logic or semantics of the problems, and that CPMPs were an acceptable examination technique. It was recommended that, in the future, CPMP examinees be allowed practice time to familiarize themselves with the equipment, that pre-examination instructions should be clarified, and that problems judged inadequate by candidates be revised.

Attitude of Health Personnel↗
PubMed1976

Bone demineralization in renal failure: a longitudinal study of the distal femur using photon absorptiometry.

The bone mineral content (BMC) of the lower end of the femur was measured by photon absorptiometry in 87 patients with chronic renal failure. The gamma-ray photon source was Am241. Serial measurements were obtained for up to two years. The mean BMC of the adult patients, comprising: 18 pre-dialysis (CRF), 41 chronic haemodialysis (CHD) and 19 renal transplant (RT) patients were all significantly lower than controls with the exception of the male CRF group. Two adults and one child on chronic haemodialysis showed a significant rate of bone loss (less than 2% per year). In one of these adults the addition of daily oral 1 alpha hydroxycholecalciferol was associated with no further reduction in BMC. Two children and one adult on chronic haemodialysis showed a significant rate of increase in BMC (less than 2% per year). This adult had had a tendency to loss of BMC on standard CHD treatment but after receiving parenteral 1,25 dihydroxycholecalciferol three times weekly showed a significant rate of loss of BMC on serial measurement. Two adults and one child with CRF had a significant rate of increase in BMC on standard treatment.

Adolescent↗
PubMed1976

Radiotherapy and CCNU in the treatment of high-grade supratentorial astrocytomas.

Forty-one consecutive patients with supratentorial primary brain tumors (38 Grade III and IV astrocytomas, one giant-cell astrocytoma, and two cases with insufficient tissue for diagnosis) were randomly allocated within 2 weeks of surgery to one of three therapeutic groups. Group 1 (15 patients) received radiation therapy totaling 4000 to 4500 rads in 4 to 5 weeks. Group 2 (13 patients) received 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea CCNU) 130 mg/sq m orally every 6 weeks. Group 3 (13 patients) received radiation therapy plus CCNU as for Groups 1 and 2. When the disease progressed, patients in Groups 1 and 2 were crossed over to receive CCNU and irradiation respectively. The median survival time in these groups was 188, 259, and 252 days, and the mean survival 263, 262, and 329 days. The median time from diagnosis to crossover (Groups 1 and 2) or to progression (Group 3) was 163, 99, and 220 days, and the mean time was 172, 108, and 231 days. There was no statistically significant difference between the means or medians in any of these situations.

Astrocytoma↗
PubMed1976

Clinical evaluation of an automated cleaning device for dialyzers.

This paper describes the clinical evaluation of dialyzer efficiency after cleaning and sterilization using an automated dialyzer cleaner. In vivo clearance measurements of small molecules and an in vitro measurement of BSP showed no diminution after 5 uses, and ultrafiltration rate did not decrease with an increase in dialyzer use. Scanning and transmission electron microscopy of the membrane showed an increase in accumulation of cellular debris and fibrin with increasing use. Our experience using the automated dialyzer clearner for more than one year leads us to conclude that it is an effective way to clean dialyzers and that no patient ill-health occurs as a result of re-using dialyzers cleaned by this technique.

Automation↗
PubMed1976

Blood access in hemodialysis.

Four hundred seventy blood access procedures performed on 170 dialysis patients during the period 1962-1975 have been analyzed according to survival of access with respect to age, sex and cause of failure. Subcutaneous forms of blood access have a significantly longer life and are more free of complications than external shunts. Although the mode of access can now be tailored to the individual patient, the arterio-venous fistula remains the least expensive and simplest surgical procedure. It should therefore remain as the first choice of access for most patients.

Adolescent↗
PubMed1975

Relative prognostic significance of vasospasm following subarachnoid hemorrhage.

A retrospective analysis of 274 patients with intracranial aneurysms, diagnosed either angiographically or at autopsy between 1968 and 1973 at the University of Alberta, was carried out. One hundred and forty-six patients had intracranial clipping of the aneurysm. Clinical and radiologic data were abstracted from the chart and the angiographic studies. Probability of survival curves were constructed. Associations between various clinical factors and survival at two months were demonstrated. The most important prognostic factors were the clinical grade at angiography or surgery, followed by the presence of preoperative spasm, hematoma or focal edema, elevated blood pressure on admission, time of interval from hemorrhage to surgery and age. The data lends some support to the policy of operating on patients in good neurological condition, even if their pre-operative angiogram shows spasm.

Age Factors↗
PubMed1975

Analysis of 128 patients with angiogram in acute head trauma.

A computerized analysis of 128 patients admitted with acute head injury and who underwent angiography is shown. Patients were divided into groups according to: age, sex, type of accident, state of consciousness and presence of localizing signs on admission, types of cerebral lesions on angiography, and discharge condition. There is a preponderance of young males in this series of patients, related mainly to MVA. A total of 71% of the patients had abnormal angiograms, but the incidence of normal and abnormal results did not correlate significantly with any of the chosen parameters. The same parameters were also analysed to assess their value as a prognostic index for the patient. The conclusion was drawn that the angiogram per se has no significant value as a prognostic tool, and that state of consciousness on admission is the best single index for prognosis.

Accidents, Traffic↗
PubMed1975

The relationship of autoantibodies to depression of cell-mediated immunity in infectious mononucleosis.

It has been postulated that autoantibody formation occurs as a consequence of a depression of function of certain thymus-derived lymphocytes (T cells). We have examined cell-mediated immunity, a T-cell function, in infectious mononucleosis, a condition in which autoantibodies are known to develop. We have shown some evidence of depressed cell-mediated immunity in patients with infectious mononucleosis but have been unable to correlate this with autoantibody production. These results do not support the hypothesis that depression of T-cell function leads to autoantibody formation.

Antibodies, Antinuclear↗
PubMed1975

Judgmental questions processed by a drug information center.

The number of judgmental questions handled by a pharmacy-operated, university-based drug information center was studied. Judgmental questions were defined as those requiring the integration of data or knowledge and experience in the process of making a decision regarding a specific therapeutic problem. Less than 5% of 720 questions handled by the drug information center during a three-month period were of the judgmental type. Based on this result, and because of the need to use resources most efficiently, it is suggested that it may be advisable to develop more regional (and fewer hospital) drug information centers.

Decision Making↗