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Biomedical subjects

R E Gray

Publications and source records attributed to R E Gray.

At least 37 records · Page 2Linked to original sources
PubMed1998

Information needs of women with metastatic breast cancer.

Eight focus groups involving women with metastatic breast cancer were held across Ontario over approximately 6 months in 1996-97. Prevalent themes identified during the sessions are reported under 2 broad dimensions: the women's expressed desire for information in specific content areas, and issues related to whether information can be either beneficial or harmful, depending on how it is provided. The women reported high needs for information, especially that which would relate to their situation. Perceived adequacy of information is closely linked to health professional engagement and care. Although the provision of information is important, the needs of these women for maintenance of hope and provision of interpersonal support and comfort are also critical.

Adult↗
PubMed1998

Self-help groups.

OBJECTIVE: To assess Ontario family physicians' attitudes toward, awareness of, and practices related to self-help groups in general and cancer self-help groups specifically. DESIGN: Mailed survey using a modified Dillman method. SETTING: Ontario family practices. PARTICIPANTS: A random sample of 1500 Ontario members of the College of Family Physicians of Canada, of whom 949 responded. A total of 911 completed questionnaires were received, for an eligible response rate of 64%. MAIN OUTCOME MEASURES: Physician demographics, practice characteristics; extent of awareness of self-help groups and their perceived value; attitudes toward self-help groups; practices related to interactions with patients about self-help groups. RESULTS: Only 40.2% of respondents were aware of six or more self-help groups in their region; 56.8% were aware of at least one cancer self-help group. Discussions with patients about groups were reported as occurring "frequently" by 12% of respondents, who indicated they made referrals to an array of groups. Ratings of group helpfulness were relatively high (83.8% scoring 3, 4, or 5 on a 5-point scale, where 5 is "very helpful"). There were low ratings of potential harm (1% scoring 4 or 5 on a 5-point scale, where 5 is "very harmful"). Confidence intervals for proportions reported on in this paper were all within 4%. CONCLUSIONS: Family physicians have predominantly positive attitudes about the potential benefits of self-help groups, and many are recommending groups to their patients.

Female↗
PubMed1997

Interviews with men with prostate cancer about their self-help group experience.

This study reports on the results of semi-structured interviews with 12 men involved in prostate cancer self-help groups in three Canadian cities. Overall, participants reported their group involvement to be helpful, especially in terms of accessing information. Additional benefits included finding commonality with others, being able to talk about difficult issues, being productive and accomplishing tasks, advocating to make a difference, and engaging with family members around health issues. We conclude that the recent growth of self-help groups speaks to the challenge inherent for men in dealing with prostate cancer and counteracts tendencies to minimize the suffering which they experience.

Adaptation, Psychological↗
PubMed1997

Physician perspectives on unconventional cancer therapies.

The popularity of unconventional therapies has grown dramatically in recent years. This paper reports on the results of a pilot study investigating the perspectives of physicians involved with cancer care regarding their reactions to this trend and their ways of trying to meet associated challenges. Nine oncologists, nine general practitioners, and one surgeon were interviewed over the telephone, employing open-ended questions. The physicians were unanimously interested in having information available about unconventional therapies. They also expressed a desire to be supportive of patient choices in this area, provided conventional therapy was not compromised. However, there was little interest in initiating communication about unconventional therapies, with most seeing such discussions as a poor use of their time. Suggestions for future research, as well as educational and policy strategies, are addressed.

Attitude of Health Personnel↗
PubMed1996

Paget's disease of bone and unvaccinated dogs.

The etiology of Paget's disease is unknown, but several observations suggest a viral cause. Since canine distemper virus is among those proposed to be a causal agent, we investigated the hypothesis that dog ownership may increase the risk of Paget's disease of bone by means of a case control study. One hundred and fifty patients with Paget's disease and 185 controls were interviewed using a structured questionnaire administered by the same interviewer. Participants were asked about their socioeconomic background and their exposure to pets. The risk of Paget's disease was not significantly increased in individuals. However, ownership of a mongrel dog was associated with a significant increase in risk (OR = 1.6; 95% CI = 1.0-2.4) and the risk increased still further with the ownership of an unvaccinated dog (OR = 2.8; 95% CI = 1.8-4.5). Additionally, ownership of cats and birds excluding dog owners, increased the risk of Paget's disease (OR = 2.5; 95% CI = 1.0-5.0; OR = 2.3; 95% CI = 1.0-5.3, respectively). These data suggest that previous exposure to cats, birds, and dogs unvaccinated for canine distemper may increase the risk of an individual developing Paget's disease of bone.

Adult↗
PubMed1994

A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis.

The restless legs syndrome (RLS), defined by Gibb and Lees criteria, was investigated in patients with RA. RLS symptoms were more frequent in RA patients (25%) than in non-RA controls with OA or seronegative arthropathy (4%). RLS was significantly more common in females. Judged by a variety of clinical and laboratory indices, RA disease severity and current disease activity were greater in patients with RLS than in RA patients unaffected by RLS. In five out of 14 RLS patients undergoing neurophysiological study, delays in the P40 component of posterior tibial somatosensory evoked potentials (SSEPs) were observed suggesting the existence of myelopathy, whilst in another four RLS patients evidence of peripheral neuropathy was found. Though the higher frequency of neurophysiological abnormalities in RA patients with RLS was not statistically significant, possibly because of the small numbers of patients studied, these data suggest that RLS symptoms in RA may reflect the presence of neurological disorder.

Aged↗
PubMed1993

Serum amyloid P component scintigraphy and turnover studies for diagnosis and quantitative monitoring of AA amyloidosis in juvenile rheumatoid arthritis.

OBJECTIVE: To evaluate aspects of the natural history of AA amyloidosis complicating juvenile rheumatoid arthritis (JRA), and its response to therapy with chlorambucil. METHODS: Scintigraphy and 7-day turnover studies were performed in JRA patients with histologically proven (n = 35) or clinically suspected (n = 30) AA amyloidosis, following intravenous injection of 123I and 125I-labeled serum amyloid P component (SAP). Prospective monitoring studies were performed over 2-3 years in 20 patients with amyloidosis. All but 2 amyloidosis patients were treated with chlorambucil. RESULTS: Positive scanning results were obtained in all patients in whom imaging was performed within 12 years of positive biopsy findings of amyloid and in 5 patients with clinically suspected amyloidosis. Negative scanning results with normal SAP metabolism, indicating regression of amyloid, were obtained in 4 patients whose amyloidosis had been in full clinical remission for more than 12 years. Prospective monitoring studies in patients whose JRA-associated inflammatory activity was in remission demonstrated regression of amyloid in 8 patients and no substantial changes in 8 others; however, in 4 further patients with active inflammation, there was accumulation of amyloid. There was a very poor correlation between the amount of amyloid present at a particular site and the resultant organ dysfunction. CONCLUSION: Radiolabeled SAP scintigraphy and turnover studies are useful complementary tools in the diagnosis, screening, and quantitative monitoring of type AA amyloidosis in JRA. The amyloid deposits may progress and/or regress at different rates in different anatomic sites over short periods.

Adolescent↗
PubMed1992

Psychologic adaptation of survivors of childhood cancer.

When adult survivors of childhood cancer were compared with their peers, survivors were found to be at least as well adjusted. Indeed, some evidence was suggestive of survivors having adaptive advantages in everyday life. The survivors reported significantly more positive affect, less negative affect, higher intimacy motivation, more perceived personal control, and greater satisfaction with control in life situations. Despite these apparent strengths associated with surviving childhood cancer, several specific problems were documented. Survivors were more likely than peers to have repeated school grades, to be worried about issues of fertility, and to express dissatisfaction with important relationships. The latter finding was interpreted as reflecting the high expectations of survivors for relationships, based on their difficult yet interpersonally rewarding experiences during times of illness.

Adaptation, Psychological↗
PubMed1992

Persons with cancer speak out: reflections on an important trend in Canadian health care.

In this paper I have described some of the recent developments in the growth of a patient/survivor movement in Canada. Arguments for the value of increased patient participation include providing a needed balance to the traditional medical perspective, addressing patient needs free from other vested interests, providing insights available only to cancer survivors, and facilitating empowerment. A number of current and potential difficulties related to increasing cancer survivor involvement have been raised, ranging from deliberate opposition from health administrators to disapproval from professionals of survivors' emotional expression to patient unwillingness. The greatest challenge is to move beyond token patient representation to substantive participation.

Canada↗
PubMed1991

A double-blind study of deflazacort and prednisone in patients with chronic inflammatory disorders.

Deflazacort and prednisone were given to 26 patients with rheumatoid arthritis, polymyalgia rheumatica, or other chronic inflammatory diseases, in a double-blind study. Deflazacort rapidly and effectively suppressed disease activity in a manner supporting its assumed therapeutic potency of 83% that of prednisone. Prednisone induced a rapid increase in the level of daily calcium excretion that was not evident with deflazacort. Cortisol secretion was acutely inhibited by prednisone, but not by deflazacort. Neither corticosteroid had a significant effect on glucose metabolism, at the doses studied. Treatment with deflazacort may be an effective alternative to prednisone treatment, with fewer adverse effects on levels of calcium and cortisol, in patients with severe inflammatory conditions warranting the use of glucocorticoids.

Analysis of Variance↗
PubMed1991

Prevalence of anticardiolipin antibodies in the elderly British population.

In a cross-sectional study of 100 healthy elderly individuals, anticardiolipin antibodies (aCL) were measured using an ELISA technique. aCL were not detected in the majority of subjects (63%), and in the remaining 37% titres were within the laboratory reference range (mean +5 standard deviations) previously determined for adults of all ages. In contrast, significant titres of IgM rheumatoid factor were found in 10%, antimitochondrial antibody in 13%, antinuclear factor in 5%, anti-smooth muscle antibody in 18%, antiparietal cell antibody in 10%, and antireticulin antibody in 1%. Antibodies to single or double-stranded DNA were not detected in any subject. We conclude that, although other auto-antibodies may be present in the healthy aging population in Britain, abnormally elevated levels of aCL antibody do not occur, and when present may be an indicator of autoimmune-mediated pathology.

Aged↗
PubMed1990

Identification of a 66 KDa protein associated with yeast mitochondrial ATP synthase as heat shock protein hsp60.

A 66 kDa protein, denoted P66, not hitherto classified as an integral component of yeast mitochondrial ATPase, is often observed in preparations of this enzyme complex. A physical association exists between P66 and the assembled ATPase complex since both components are coimmunoprecipitated by anti-F1 beta monoclonal antibody. Two recombinant clones expressing proteins immunologically similar to P66 were isolated from a yeast genomic library in lambda gt11 by screening with a polyclonal anti-holo-ATPase antibody. Based on restriction site mapping and partial nucleotide sequence analysis, both clones encompass the gene encoding the yeast heat shock protein hsp60. The identification of P66 with hsp60, taken together with its demonstrated association with the mitochondrial ATPase complex, is consistent with recent suggestions that hsp60 is involved in assembly of the ATP synthase complex.

Cloning, Molecular↗
PubMed1990

Heroic self-healing and cancer: clinical issues for the health professions.

Increasingly over the last few decades, persons with cancer are being cured or surviving longer. As a result, the popular press has given more attention to the possibilities for "beating" cancer. The role of personal control in overcoming cancer has been promoted via a heroic formula that includes positive thinking, healing imagery, and personal growth. Empirical support for a psychospiritual influence on cancer illness is tenuous. Nevertheless, the psychological implications of belief in such influence are important in their own right. In this paper, the positive and negative consequences for patients of popular conceptions of the heroic cancer survivor are explored. Clinical and ethical issues related to the health professional's responses to patients' belief in heroic self-healing are discussed, and a rationale is presented for adopting a non-judgmental, person-centered approach.

Attitude to Health↗
PubMed1990

Empowerment and persons with cancer: politics in cancer medicine.

Persons with cancer are likely to encounter a loss of personal control as a result of their illness experience. An empowerment perspective, which emphasizes the possibility of patients "owning their own lives", is useful for understanding the interpersonal and social dynamics of patients' loss of control and for guiding the development of strategies aimed at maximizing control. Because the factors influencing an individual's sense of control are multi-leveled, optimal empowerment occurs when strategies are employed at several levels of social organization. In this paper, a number of barriers to the empowerment of cancer patients are identified and strategies recommended to enhance patient empowerment in cancer care. The empowerment needs and strategies discussed here include: (a) the provision of optimal care, (b) the enhancement of individual patient power, (c) the development of a strong consumer voice in policy decision-making processes, and (d) societal attitude change.

Attitude↗
PubMed1989

Recurrent acute proptosis in atypical systemic lupus erythematosus.

A patient is described who developed acute proptosis, a rare complication of systemic lupus erythematosus, 16 years after the onset of the disease. Treatment with intravenous methylprednisolone produced rapid improvement, but swelling recurred a few days later. Intravenous corticosteroid was again effective and was continued orally without further episodes of proptosis. This patient is unusual in the long period of mild disease before the development of systemic complications, and in having antibodies to nuclear ribonucleoprotein but persistently normal titres of DNA-binding antibodies in her serum.

Acute Disease↗