The Canadian Society of Clinical Chemists: highlights of its first 50 years

This article has been written to mark the 50th anniversary of the Canadian Society of Clinical Chemists (CSCC). It is not an exhaustive history of CSCC's activities but rather a review of many of the highlights that the Society and its members have experienced since its founding in October 1956. The names of many members who made important contributions to CSCC's development (but by no means all) are mentioned in the text. The historical material is presented by the decade but with blurred boundaries, as noteworthy advances in CSCC's history have most often developed gradually over several years and the terms of office of several CSCC Councils. From a founding roster of slightly over 70 members, the membership has grown to several hundred. The two main objectives for the Society's founding were stated by one of the three Montrealers who extended the original invitation, Dr. William S. Bauld: "to raise the standards of performance, and to raise the professional standing of clinical chemists". The early reports of committees on Instrumentation, Methods and Quality Control had rapid impact on individual members' laboratory practices across the country. The struggle for recognition of clinical chemists by other health professions inside and outside the clinical laboratories has taken much longer and has consisted of a long series of incremental successes through certification by examination, training programs, continuing education and, ultimately, the formation in 1986 of the Canadian Academy of Clinical Biochemistry. The CSCC's means of intra- and inter-communication with external organizations consist of its newsletter CSCC News, its scientific journal Clinical Biochemistry (established in 1967), and its more recently created website www.cscc.ca (1997). These three mechanisms ensure exchange of information between the officers of CSCC Council and the general membership and among members as well. National and international conferences have offered the newest scientific discoveries pertinent to the profession, exhibits featuring the latest in increasingly sophisticated instrumentation and reagents, and abundant opportunity to exchange information informally with old and newly met colleagues. By their contributions to the International Federation of Clinical Chemistry and the International Union of Pure and Applied Chemistry, CSCC members continue to play important roles far beyond Canada's borders.     

A pivotal moment in 50 years of headache history: the first American Migraine Study

Objective.— To describe the magnitude and distribution of the public health problem posed by migraine in the United States by examining migraine prevalence, attack frequency, and attack‐related disability by gender, age, race, household income, geographic region, and urban vs rural residence. Design.— In 1989, a self‐administered questionnaire was sent to a sample of 15,000 households. A designated member of each household initially responded to the questionnaire. Each household member with severe headache was asked to respond to detailed questions about symptoms, frequency, and severity of headaches. Setting.— A sample of households selected from a panel to be representative of the US population in terms of age, gender, household size, and geographic area. Participants.— After a single mailing, 20,468 subjects (63.4% response rate) between 12 and 80 Years of age responded to the survey. Respondents and nonrespondents did not differ by gender, household income, region of the country, or urban vs rural status. Whites and the elderly were more likely to respond. Migraine headache cases were identified on the basis of reported symptoms using established diagnostic criteria. Results.— In total, 17.6% of females and 5.7% of males were found to have 1 or more migraine headaches per year. The prevalence of migraine varied considerably by age and was highest in both men and women between the ages of 35 to 45 years. Migraine prevalence was strongly associated with household income; prevalence in the lowest‐income group (less than $10,000) was more than 60% higher than in the 2 highest‐income groups (greater than or equal to $30,000). The proportion of migraine sufferers who experienced moderate to severe disability was not related to gender, age, income, urban vs rural residence, or region of the country. In contrast, the frequency of headaches was lower in higher‐income groups. Attack frequency was inversely related to disability. Conclusions.— A projection to the US population suggests that 8.7 million females and 2.6 million males suffer from migraine headache with moderate to severe disability. Of these, 3.4 million females and 1.1 million males experience 1 or more attacks per month. Females between ages 30 and 49 years from lower‐income households are at especially high risk of having migraines and are more likely than other groups to use emergency care services for their acute condition.     

Leprosy in Britain: 50 years experience in Liverpool

BACKGROUND: Leprosy is a chronic infection that presents with varying dermal and neurological symptoms, and which can lead to extensive disability and morbidity, often with accompanying social stigma. AIM: To review the patients presenting to the Liverpool School of Tropical Medicine (LSTM) between 1946 and 2003, looking specifically at country of birth and of infection, details of clinical presentation, diagnosis, management and reactions. DESIGN: Retrospective record review. METHODS: We retrieved all available clinical records for patients seen between 1946 and 2003 (n = 50), consisting of letters, hospital and LSTM casenotes, and some radiographs and photographs. Any history of tuberculosis or diabetes was recorded. RESULTS: Most patients (64%) were born in the Indian subcontinent, and most were thought to have contracted the disease there (62%). Features at presentation included anaesthetic skin lesions in 19 (36%), hypopigmentation in 15 (30%), and peripheral nerve enlargement in 25 (50%). Diagnoses were made by a combination of clinical data and biopsy (60%), and slit skin smears were positive for acid-fast bacilli in 61% of multibacillary patients. Initial presentation was with a leprosy reaction in five cases (10%), and reactions were documented in 42% of all patients. Treatments were varied, progressing from traditional Eastern medicine to the WHO-approved multidrug therapy in use today, with prophylaxis for children and close contacts. DISCUSSION: Leprosy remains an important diagnosis to consider in patients with a history of work or travel in the tropics, and is a diagnosis with far-reaching medical, social and emotional consequences.     

Blood groups: the past 50 years

Since the first issue of TRANSFUSION in 1961, there has been a tremendous expansion in not only the number of blood group antigens identified but also in our knowledge of their biochemical basis, function, and more recently, associated DNA changes. As certain techniques became available, our ability to discover and elucidate blood group antigens and appreciate their contribution to biology became possible. In particular, Western blotting, monoclonal antibodies, cloning, and polymerase chain reaction–based assays have led to an explosion of our knowledge base. The study of blood groups has had a significant effect on human genetics where they serve as useful markers in genetic linkage analyses. Indeed blood groups have provided several “firsts” in certain aspects of genetics. Blood group–null phenotypes, as natural human knockouts, have provided valuable insights into the importance of red blood cell membrane components. This review summarizes key aspects of the discovery of blood groups; the inconsistent terminology that has arisen; and the contribution of blood groups to genetics, safe transfusion, transplantation, evolution, and biology.     

Gastroenterology: the first 40 years

Functional gastroenterological disorders were diagnosed in over 50 per cent of patients aged 40 years and under, referred to a district general hospital combined gastroenterology clinic. Peptic ulceration, gastro-oesophageal reflux, biliary tract disease and inflammatory bowel disease accounted for almost 70 per cent of the organic disorders encountered. Malignant disease was rare. The implications for diagnostic investigation in this age group are discussed.     

Haem biosynthesis and porphyrias: 50 years in retrospect

This review deals with haem biosynthesis and the porphyrias and, as indicated by the title, it is largely retrospective, and discusses mainly those aspects relevant to the author's own work. An attempt is also made to show how modern concepts have developed in these inter-related fields and to illustrate their dependence upon different phases of experimental investigation.     

Cytapheresis: the first 25 years.

In vivo blood cell separator technology was originally developed in response to a perceived need for granulocytes for septic neutropenic patients. This impetus led to the development of a variety of cell separators which, paradoxically, ultimately have found their main applications in pheresis procedures other than granulocyte collection. In vivo blood cell separators are ideal for the removal of large numbers of normal or abnormal hemopoietic cells. Their early use in chronic myeloid leukemia demonstrated that leukapheresis could be used as definitive therapy for the disease. However, most hematological diseases in which the circulating malignant cells can be pheresed off have definitive and cost effective standard of care therapies, and cytapheresis is limited to specific circumstances. This paper reviews therapeutic cytapheresis and summarizes the current status of its limited specific indications.     

Association between ABO blood groups and osteoporosis severity in Chinese adults aged 50 years and over

This study investigated whether the ABO blood groups contributed to the severity of osteoporosis in 1452 community-dwelling Chinese adults aged 50-85 years. Osteoporosis severity was scored as: F(0), no osteoporosis; F(1), osteopenia; F(2), osteoporosis; and F(3), severe osteoporosis. The proportions of adults with a non-O blood group were 55.0%, 62.0%, 70.8% and 72.6% for the groups with F(0), F(1), F(2) and F(3) osteoporosis scores, respectively. Having a non-O blood group was associated with an increased severity of osteoporosis, even after adjustment for gender, age and cigarette consumption (odds ratio 1.8; 95% confidence interval 1.0, 2.9). This study demonstrated that having a non-O blood group was an independent risk factor for the progression of osteoporosis in Chinese adults with osteoporosis aged ≥ 50 years.