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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Frequently, the analysis of environmental health hazards using ecological data does not involve explicit recognition of the difficulties in translating health effects expressed in the aggregate to the health risks of individuals. We discuss these difficulties and suggest the need for the appropriate conceptualization of risk mechanisms at the individual level and of the population processes that determine the form in which these risk mechanisms are expressed in aggregate data. To illustrate the implications of these concepts we develop a biologically motivated model of lung cancer risk and apply it to both national and county data. In addition, to measure the total health effects of the long term elevation or depression of lung cancer incidence rates, we calculate prevalence distributions from the time series analysis of incidence patterns in county data.
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PMID:Strategies for analysing ecological health data: models of the biological risk of individuals. 698 8

150 patients with lung cancer have been studied from the immunological point of view: the two years that elapsed between the study and processing of the data permitted an evaluation of the prognosis in terms of immunology also. This study has been carried out in vivo by means of skin tests (BCG, PPD, Candida, Varidase, CCB, Mumps, BNCB) and in vitro with lymphocyte blastization in the presence of PHA and dependent antibody cytotoxicity. Serum factors which can interfere with lymphocyte cytotoxicity have also been studied. Peri- and intra-tumour lymphocyte infiltration and the lymph node activation stage have been analyzed in patients who underwent surgery. A real depression of the cell mediated immunity observed in the negative response to skin tests has been found. The study of in vitro parameters showed a deficient blast response in 86% of the cases examined, decreased cytotoxicity in 62% and the presence of inhibiting serum factors in 53%. No correlation was observed between positivity to skin tests, normal response to PHA, normal concentration of inhibiting serum factors on the one hand and survival on the other. The only finding which seems to be correlated with survival is lymphocyte infiltration; its peri- and intrastromal presence on the neoplasia may be associated with a significantly better prognosis.
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PMID:[Relationships between clinico-therapeutic parameters and immunological status in patients with lung cancer]. 699 79

We performed a battery of tests on peripheral blood samples from 94 patients with lung cancer to determine the extent to which immunological depression was due to abnormal lymphocyte function, as compared to changes in the number of lymphoid cells in the peripheral blood or in the efficiency of purification of cells in Ficoll-Hypaque gradients in preparation for testing. The percentage of lymphocytes in the gradient-derived cell suspension (%LG) was the most informative test. It decreased significantly with advancing stage of cancer and could predict survival of patients with uniform stage. The %LG correlated with survival better than any other test when multivariate analyses of all test combinations were performed. Low values of %LG reflected both the depressed lymphocyte counts and the altered buoyant density of the leucocytes of many patients with advanced cancer. A large proportion of the depression in other immune function tests was statistically attributed to changes in %LG. We concluded that this simple measurement provides valuable information about patients with lung cancer.
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PMID:Prognostic significance of immunological tests in lung cancer. 702 61

In addition to the commonly accepted aetiological agents of cancer, such as chemical carcinogens, oncogenic viruses, hereditary factors, irradiation, and chronic trauma, multiple psychological factors are also important. Among these are psychological depression, impaired emotional outlets, and perceived lack of closeness to parents. The effect of addressing these factors in addition to standard medical factors in addition to standard medical management is an important question to be answered. A pilot study is in progress, in which patients with medically advanced malignant disease are being counselled in addition to receiving appropriate medical treatment. Standard mental health processes of counselling are employed in a combination of individual and group counselling sessions. From 1974 through 1978, a total of 193 patients with medically advanced malignant disease have received counselling in addition to their medical treatment. The three most frequent diagnoses are breast cancer (71), bowel cancer (28), and lung cancer (24). These are also the three most common diagnoses in the United States. In this study we have observed median survival times of 38.5 months in advanced breast cancer, 22.5 months in advanced bowel cancer, and 14.5 months in advanced lung cancer. These survival times are considerably longer than expected median survival times reported in the literature. Our primary concern in using this approach was that the counselling be helpful and not detrimental to the duration of life, quality of life, and quality of death of the individual. Preliminary results indicate that counselling can be helpful and can also be detrimental, depending upon the dynamics of the relationships among the counsellor, the patients, the medical team and the family. This is a preliminary study, and many major questions remain unanswered.
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PMID:Cancer and stress: counselling the cancer patient. 727 51

Lung cancer patients were found to score significantly higher on a social isolation scale when compared to a group of patients with other chronic lung diseases as well as to a control group of apparently healthy adults. Social isolation in lung cancer patients did not correlate with their apparent isolation, depression or with their physicians' estimations of their attitudes. Social workers involved in the care of lung cancer patients should be aware that these patients may be actually, if not obviously, socially isolated.
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PMID:Social isolation in lung cancer patients. 743 45

A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen.
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PMID:A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. 750 4

We describe a case in whom an unusual alteration of the atrial repolarization observed on routine electrocardiogram (Ta segment depression) led to the echocardiographic diagnosis of metastatic involvement of the left atrium by a lung cancer. Electrocardiographic abnormalities in the metastatic involvement of the heart are non specific but observation of new changes may suggest the diagnosis and modify the staging and the treatment.
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PMID:Metastatic involvement of the left atrium revealed by electrocardiographic Ta segment change. 799 68

We evaluated humoral immunity by measuring IgG, IgA, IgM, and IgE concentrations in 274 male workers in an iron foundry in Cracow, Poland. There were two groups: 199 coke oven workers and 76 cold-rolling mill workers. The groups were similar with respect to age, length of work (average 15 years), and smoking habits. Exposure to polycyclic aromatic hydrocarbons (PAHs), assessed by personal and area monitoring, ranged from 0.2 to 50 micrograms/m3 benzo[a]pyrene in coke plant workers and was of 3-5 magnitudes higher than in the cold-rolling mill employees. Comparison of the two groups revealed a marked depression of mean serum IgG and IgA in coke oven workers (p < 0.001, Student's unpaired t-test). In the same subjects, serum IgM had a tendency to decrease, whereas serum IgE showed a trend toward higher values. Thus, workers exposed chronically to complex mixtures of air pollutants, composed primarily of PAHs, develop immunosuppression. It remains to be established whether the immunosuppression described here is related to the frequent development of lung cancer reported in coke plant employees. Workers exposed chronically to PAHs should have serum immunoglobulins monitored regularly.
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PMID:Humoral immunosuppression in men exposed to polycyclic aromatic hydrocarbons and related carcinogens in polluted environments. 973 2

Two-dimensional Doppler echocardiography was used as an intraoperative cardiac function monitor in anesthetic management of a 79-year-old male with hypertrophic obstructive cardiomyopathy (HOCM) who underwent pulmonary lobectomy for lung cancer. Circulatory collapse occurred after thoracic epidural anesthesia (TEA), and was aggravated with following induction of general anesthesia. The collapse did not improve with phenylephrine nor atropine and necessitated ethylephrine and dopamine. During the above course, left ventricular outflow tract pressure gradient measured with continuous wave Doppler method was almost in proportion to cardiac output measured with thermo-dilution method. This means that TEA and the administration of inotropics did not worsen the left ventricular outflow tract obstruction. Left ventricular filling property estimated by trans-mitral flow velocity spectra improved when hemodynamics was stabilized with continuous infusion of dopamine, while it had been impaired during preoperative period and at the beginning of anesthesia. Our observation suggests that TEA for HOCM patient is a relative indication because it may exert negative inotropic effect, and that careful titration with inotropics is not contraindicated when undesired cardiac depression is proved by echocardiography.
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PMID:[Echocardiographic observation of intraoperative circulatory collapse in a patient with hypertrophic obstructive cardiomyopathy]. 830 35

Unemployment has an adverse effect on health. This effect is still demonstrable when social class, poverty, age and pre-existing morbidity are adjusted for. Unemployed men and their families have increased mortality experience, particularly from suicide and lung cancer. Unemployed men also have a reduction in psychological well-being with a greater incidence of parasuicide, depression and anxiety. Unemployed men are more likely to use general practitioner and hospital services and receive more prescribed medicines. Smoking and alcohol consumption are often increased after the onset of unemployment. Women are less affected by enforced unemployment, but families are put at greater risk of physical illness, psychological stress and family breakdown. Maintaining financial security, providing proactive health care and retraining for re-employment can all reduce the impact of unemployment on health.
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PMID:Unemployment and health: a review. 851 Dec 34


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