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Biomedical subjects

P E Burns

Publications and source records attributed to P E Burns.

At least 19 recordsLinked to original sources
PubMed1994

Diarrhea and the patient receiving enteral feedings: a multifactorial problem.

Diarrhea is often considered an inevitable consequence of enteral tube feeding. The pathogenesis of diarrhea in patients receiving enteral feeding is not well understood, but it has been attributed to hypoalbuminemia, bacterial contamination of formula, characteristics of enteral feeding formula, and concomitant drug therapy. The purpose of this article is to review research regarding the etiology and treatment of diarrhea in patients receiving enteral feeding and to identify implications for nursing practice and future research.

Diarrhea↗
PubMed1986

Association of breast cancer with meningioma. A report of five cases.

Five patients with diagnosed breast cancer who developed meningiomas are reported. The literature contains reports of an additional 25 such patients. Some authors have noted hormonal sensitivity and the presence of hormone receptors in some meningiomas. Because breast cancer is a common tumor of women, it is probable that any association between breast cancer and meningioma is fortuitous. Two patients in this small series each had a sister with breast cancer, one of them also had three other first-degree relations with colon cancer. Three of the patients had other tumors as well as breast cancer. It is important to fully investigate brain lesions in patients with breast cancer so that potentially curable meningiomas are not mistaken for metastases.

Adult↗
PubMed1985

The accuracy of estimated gestational age based on ultrasound measurement of biparietal diameter in preterm premature rupture of the membranes.

The management of patients with preterm premature rupture of the membranes is often influenced by the ultrasound measurement of biparietal diameter. The cephalic index has been used in pregnancies with intact membranes to predict the presence of an abnormal biparietal diameter that may be unreliable in estimating gestational age. This study analyzed 100 patients with rupture of the membranes between the beginning of gestation week 28 and the end of week 34. The cephalic index was found to be abnormal 45% of the time; all were in the brachiocephalic range. The biparietal diameter was affected by presentation and presence or absence of amniotic fluid (p less than 0.05). Use of the biparietal diameter was found to be unreliable in estimating gestational age with preterm premature rupture of the membranes. Use of the cephalic index did not enable prediction of which biparietal diameters would be abnormal; therefore use of the biparietal diameter or the cephalic index in preterm premature rupture of the membranes is not recommended. The use of the head circumference, abdominal circumference, and femur measurements may be a better way of predicting gestational age in this select population.

Amniotic Fluid↗
PubMed1984

Bilateral breast cancer in northern Alberta: risk factors and survival patterns.

Of 2231 women with stage I, II or III breast cancer who were registered and seen between 1971 and 1979 and followed to the end of 1981, 48 (2.2%) had synchronous and 58 (2.6%) asynchronous bilateral breast cancer. The unadjusted incidence rate for a second breast cancer was 6.4/1000 breast-years at risk, compared with a rate of 0.70 for the risk of a first breast cancer in women. When calculated from the date of diagnosis of the first breast cancer the survival rate was better for the group with asynchronous disease than for the group with synchronous disease or for a group with unilateral disease, but when calculated from the date of diagnosis of the second cancer the rate was the same in all three groups. Comparison of known risk factors showed a significant association between the development of bilateral cancer and a later age at the birth of the first child and a longer interval between menarche and that birth. There was a trend towards greater age and more stage III cancer in the group with synchronous disease. There was no correlation between receiving radiotherapy for the first breast cancer and development of the second cancer. Annual mammography and clinical examination of asymptomatic women at a cancer centre resulted in the detection of a significantly higher proportion of minimal breast cancers in the second breast compared with the first. Such screening practices should be even more valuable in the earlier detection of unilateral breast cancer in asymptomatic women who have not had breast cancer.

Actuarial Analysis↗
PubMed1983

Interactions between benign breast disease and other risk factors for breast cancer.

A population-based incident case-control study of breast cancer in Northern Alberta, Canada, provided an opportunity to evaluate interactions between the occurrence of benign breast disease (BBD) and other potential risk factors. Overall there was a 2-fold excess risk of breast cancer among women with BBD. This excess persisted regardless of the number of years from first biopsy for BBD to diagnosis of breast cancer, suggesting a permanent alternation in risk with BBD. Significant variations of the BBD--breast cancer association were noted with several factors. The excess risk of breast cancer among women with BBD was enhanced by having a later age at menarche, a later age at first birth, or lower parity. The usual protective effect of late age at menarche was seen only among women without BBD, and was supplanted by a 4-fold elevated risk among women with BBD. The deleterious effects of later age at first birth and nulliparity were greater among women with BBD. These patterns generally support the notion that hormonal factors mediate the relation between BBD and the development of breast cancer.

Adult↗
PubMed1983

Trends in the incidence of cancer of the female breast and reproductive tract in Alberta, 1953 to 1977.

A log-linear model was used to separate age, secular, and cohort trends in the incidence of cancer of the breast, ovary, corpus uteri, cervix uteri, vagina, and vulva in female residents in Alberta over the period 1953 to 1977. The age trends are similar for each cancer site increasing sharply in the premenopausal period and then leveling off. In the case of breast cancer, a point of inflection at the menopause (Clemmesen's hook) persists. A gradually increasing secular trend in incidence was evident for all sites except cervix uteri, the incidence of which declined after 1960. Cyclical cohort trends were found for cancers of the breast, ovary, and corpus uteri, inversely correlated with early fertility. The cohort trends for cervix uteri, vagina, and vulva increased sharply for cohorts born after 1940.

Adult↗
PubMed1982

Risk factors for breast cancer in women in northern Alberta, Canada, as related to age at diagnosis.

A population-based case-control study involving interviews with 577 female breast cancer patients and 826 controls in northern Alberta. Canada, revealed that some determinants of breast cancer varied according to age. Among women under age 45, risk factors included a younger age at menarche, late age at last birth, high parity, and recent use of oral contraceptives. At older ages risk was related to natural as opposed to surgical menopause, late age at first birth, low parity, late age at natural menopause, and tonsillectomy. At all ages there was an increased risk of breast cancer associated with difficulty in conceiving, benign breast disease, not having breast fed, and a history of breast cancer among mothers or sisters. For some variables the age differences were pronounced; the combination of low parity and late age at first birth was associated with a sevenfold increase in breast cancer risk at risk at ages 55-80 but a slight decrease at ages under 45. The effect of tonsillectomy steadily increased with age and represents a new lead, but certain features of the data suggest that the link to oral contraceptives among among younger women and the inverse relation to breast feeding at all ages may not be causal. Even though design limitations (cases interviewed in a different setting from controls) appeared not to influence conclusions, the results may have been subjected to interview bias and thus should be interpreted cautiously.

Adult↗
PubMed1981

Reproductive events and family history as risk factors for breast cancer in northern Alberta.

Reproductive events and family history as risk factors for breast cancer in northern Alberta were investigated with the use of data from a computerized population-based registry. Women aged 30 to 79 years attending diagnostic breast clinics at the Cross Cancer Institute from 1971 through 1975 constituted the two study groups; 1232 women had diagnosed breast cancer (malignant disease group) and 602 women were clinically free of all types of breast disease (control group). An increased relative risk of breast cancer was found in women with a family history of breast cancer, those who gave birth to their first term infant at age 30 years or older, those in whom more than 15 years elapsed between menarche and that birth, and those with a late natural menopause. There was a decreased risk, relative to nulliparity, in the postmenopausal women who first gave birth to a term infant 5 years or less after menarche. Artificial menopause (bilateral oophorectomy), parity and age at menarche had no apparent effect on the risk. The pattern of risk factors in northern Alberta differed from that reported for other geographic areas, including other provinces of Canada, thus emphasizing the need for local studies in the planning of screening programs.

Adult↗
PubMed1981

Dietary factors and breast cancer risk.

As part of a case-control study in northern Alberta, Canada, 577 women aged 30-80 with breast cancer diagnosed during 1976-77 and a population-based age-stratified random sample of 826 disease-free female controls were questioned about certain aspects of their diet. Computing relative risks (RRs) by tertiles, significant increasing trends were found with more frequent consumption of beef (RRs of 1.0, 2.3, 1.5; test for trends, p less than 0.001), pork (RRs of 1.0, 1.6, 2.2; test for trend, p less than 0.001), and sweet desserts (RRs of 1.0, 1.3, 1.5; test for trend, p = 0.01). Elevated risks were also noted for use of butter at the table and for frying with butter or margarine, as opposed to vegetable oils. The association of total beef and pork consumption with breast cancer was not materially affected by controlling for age at first birth, family history of breast cancer, previous benign breast biopsy or socioeconomic status. Nor was the association reduced by controlling for ages of menarche and menopause, even though within the control series the intake of beef and pork reported in adult life was higher among those with a lower age at menarche or a older age at natural menopause.

Adult↗
PubMed1980

Oophorectomy versus radiation ablation of ovarian function in patients with metastatic carcinoma of the breast.

A retrospective study of two methods of ovarian ablation as primary therapy for metastatic carcinoma of the breast was carried out using records from this cancer institute. Sixty-one radiation and 97 surgical ovarian ablations, performed from 1972 to 1977, were assessed. Rigid criteria were used to classify response. Over-all response was similar for the surgical and irradiation groups. Survival from the time of ovarian ablation was greater in both groups in those who responded positively than in those who did not. Factors other than estrogen receptor status can determine the response of patients with metastatic carcinoma of the breast to ovarian ablation. These include the disease-free interval, menopausal status, weight and the presence of skeletal or ovarian metastases. The results indicate that clinical determinates and not the efficiency of one method over the other should be the main criteria for choosing between ovarian ablation by irradiation or by oophorectomy.

Adult↗
PubMed1979

Five-year survival of women with breast cancer in northern Alberta.

Five-year survival rates for all 519 women with breast carcinoma in northern Alberta in 1971 and 1972 were analysed with the use of data from the computerized northern Alberta breast registry and the Alberta cancer registry. The relative 5-year survival was 73%, which is higher than most rates reported from other centres. Lymph node involvement was significant as a prognostic factor, with the relative 5-year survival falling from 92% in the group without lymph node involvement to 58% in the group with three or more involved nodes. The prognosis was also significantly affected by the stage of the disease according to the 1973 TNM classification: the 5-year survival rates ranged from 88% for patients with stage 1 disease to 17% for those with stage IV disease. Women 40 to 59 years of age had a higher survival rate (79%) than those under 40 years (65%) or over 60 years (66%) of age. Analyses by 5-year age groups showed that women 35 to 39 years old had a particularly poor survival rate (59%). Postmenopausal women less than 55 years old had a higher survival rate than did perimenopausal or premenopausal women in the same age group. Further follow-up is indicated to correlate possible high-risk factors with survival.

Adult↗
PubMed1979

Log-linear analysis of dental caries occurrence in four skeletal series.

Four skeletal series (Corinth, Greece; Gran Quivira, New Mexico; Semna South, Sudanese Nubia, and a large group from scattered sites in England) were coded for sex, jaw, tooth group, dental attrition, dental caries, site and time period. Through thec concepts of a basal level of caries and a cariosity gradient, a single model was found which best described the occurrence of this disease in these samples. All factors were found to contribute significantly to the model. Within the possible subsamples the general characteristics are that the profiles of males, of the mandibulae and of those with light attrition are more likely to have lower overall dental caries levels and to be relatively more carious in the back of the mouth than the front when compared to the pooled sample of all teeth and caries. The opposite is also found to be generally true; the teeth of females, maxillae and heavy attrition are associated with more caries, especially toward the front of the mouth. These results imply that samples appearing otherwise homogeneous display much variation. They also reveal distinct regularities in the reactions of diverse human groups to dental caries.

Dental Caries↗
PubMed1979

False negative mammograms causing delay in breast cancer diagnosis.

Eighty patients with negative mammograms and proven breast cancer are described. The incidence of negative mammograms is 5 to 7% of all breast cancer in Northern Alberta. In 30 patients, immediate biopsy because of clinical abnormality, and mastectomy, revealed only 3.3% axillary node involvement. The remaining 50 patients gave a history of finding a lump and then had a negative mammogram. Biopsy was delayed for a mean of 45 weeks. Their incidence of axillary node involvement was 42%. The mean age of both groups of patients was seven to eight years younger than the mean for all breast cancer patients. The implications of such delay on prognosis and survival are obvious. More public and medical education is needed.

Adult↗