It has been suggested that the percentage of non-protein-bound or free oestradiol (E2) is abnormally high in patients with breast cancer. In this study, the serum oestradiol profiles of a large group of women were analysed to determine whether a significant correlation could be found between serum oestradiol and various breast diseases. In addition oestradiol levels were measured in relation to sex hormone binding globulin (SHBG), albumin levels, oestrogen receptor status and family history of breast cancer. Serum samples were taken from a total of 300 women who had either no breast disease, benign breast disease or breast cancer. The percentage of free oestradiol was found to be highest in women with breast cancer, lowest in the control group and intermediate for the women with benign breast disease. These differences were most marked in post-menopausal women. The absolute values for total and free oestradiol were not statistically different in the three groups studied. There did not appear to be a correlation between oestrogen receptor (ER) concentration in breast cancer tissue and free E2 percentage levels. Women who had a family history of breast cancer did not appear to have higher percentage levels of free E2 than those with no such history. The presence of elevated proportions of free oestradiol in the serum of women with breast cancer may be significant in regard to understanding the aetiology of breast neoplasia. There also may be important implications for the use of this measurement in the earlier diagnosis and detection of breast cancer.

Aged↗

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Use of the Hickman catheter for the treatment of lower extremity infections.

The authors discuss the use of a cuffed, Silastic catheter, which can be of great value in the reduction of morbidity when dealing with lower extremity infections. When a patient's condition demands the use of long-term antibiotic and/or aminoglyoside therapy, this indwelling central venous catheter can allow easy access to the vascular system and markedly decrease the amount of time the patient has to stay in the hospital. This form of therapy involves the patient in the treatment and displays no mortality and minimal morbidity associated with catheter placement and care.

Anti-Bacterial Agents↗

PubMedDate not supplied

An educational model to introduce staff nurses to continuous quality improvement/total quality management concepts.

A new healthcare reforms are implemented and as the Joint Commission on Accreditation of Healthcare Organization standards are revised, the demand for continuous quality improvement/total quality management in acute care settings continues to rise. In this article, the authors describe the process used to introduce nursing staff to continuous quality improvement/total quality management. A curriculum committee of staff nurses, nurse educators, and clinical specialists used the continuous quality improvement process to develop a 1-day program that included didactic and experiential activities geared toward assisting the staff nurse to participate actively in total quality management initiatives.

Curriculum↗