Biomedical subjects

W C Hunt

Publications and source records attributed to W C Hunt.

15 recordsLinked to original sources

PubMed1992

Geographic variation in the treatment of localized breast cancer.

BACKGROUND: Breast-conserving surgery followed by radiation therapy is as effective as modified radical mastectomy in treating women with localized breast cancer, as demonstrated by clinical trials reported during the 1980s. The extent to which breast-conserving surgery has been adopted in various regions of the United States is not known. METHODS: We assessed variations in the use of breast-conserving surgery from 1983 to 1986 in 18,399 non-Hispanic white, 324 Hispanic, and 1174 black women with breast cancer in nine areas of the United States, using data from the Surveillance, Epidemiology, and End-Results Program of the National Cancer Institute. RESULTS: The proportion of white women with localized breast cancer who underwent breast-conserving surgery ranged from 9.2 percent (Iowa) to 32.1 percent (Seattle) in 1983-1984 and from 19.6 percent (Iowa) to 41.5 percent (Seattle) in 1985-1986. Between 1983 and 1986, the use of breast-conserving surgery increased in each area, but the relative rankings of the areas changed little. The frequency of the use of breast-conserving surgery in black and Hispanic women was comparable to that in white women. The proportion of women who received radiation therapy after breast-conserving surgery also varied geographically and increased from 1983 to 1986 in all areas. Older women in all areas and black women in Atlanta and Detroit were less likely than other women to receive radiotherapy after breast-conserving surgery. CONCLUSIONS: There is marked variation in the United States in the use of breast-conserving surgery for localized breast cancer. The variation is not explained by demographic factors, although race and age affect the use of radiotherapy after breast-conserving surgery.

Black or African American↗

PubMed1992

Longitudinal study of dietary intakes and plasma lipids in healthy elderly men and women.

Dietary intakes and blood lipid concentrations were assessed in elderly men (n = 65) and women (n = 92) from 1980 through 1989. Mean age in 1980 was 70 y (range 60-84 y). Health and socioeconomic status was above that found in the general US elderly population. Cross-sectional and longitudinal changes in variables were determined by using least-squares linear regression. No significant cross-sectional differences in energy (kJ/kg), protein (g/kg), total fat, and carbohydrate intake with age was noted. Significant longitudinal decreases in total fat, saturated and polyunsaturated fatty acids, and cholesterol intakes were noted in both men and women. Significant decreases in total, HDL, and LDL plasma cholesterol concentrations were noted over time in both men and women. Ratios of both total and LDL cholesterol to HDL cholesterol increased over time. The decrease in total fat and cholesterol intakes were significantly correlated with the decrease in total plasma cholesterol.

Aged↗

PubMed1992

Work stress, burnout, and sense of coherence among dialysis nurses.

The overall goal of this study was to examine the relationship among work stressors, burnout, and sense of coherence (SOC) in dialysis nurses. Two hundred thirty-eight registered nurses from 56 dialysis units completed a demographic data form, the Nursing Stress Scale, the Maslach Burnout Inventory, and Antonovsky's Sense of Coherence Scale. The results indicated that work load was the major contributing factor to both overall stress and burnout. Understanding the stressors that affect responses to the work environment will allow for successful interventions to alter the risk of exhaustion and burnout.

Adult↗

PubMed1992

Meat, poultry, and fish consumption and nutrient intake in the healthy elderly.

Food selection of the healthy elderly may be influenced by life-styles, the food supply, and recommendations related to diet and disease. This study used food group analysis of 3-day diet records to examine red meat, poultry, and fish consumption by free-living, healthy elderly individuals. Dietary data were from 122 women and 97 men (median age = 75 years) who were participants in the New Mexico Aging Process Study in 1984. Mean dietary intake was 1,494 kcal/day for women and 2,079 kcal/day for men--82% and 94% of the Recommended Dietary Allowance (RDA), respectively. Protein, iron, and selected B vitamins were above 100% of the RDA. Women's mean daily intake of meat/poultry/fish was 87.7 g (52.1 g meat, 23.6 g poultry, 12.0 g fish); men's intake of meat/poultry/fish was 121.2 g (78.4 g meat, 21.2 g poultry, 21.6 g fish). Of the total red meat, more than 50% was beef, 20% was pork/ham, and more than 10% was processed meat. For women, meat/poultry/fish provided 14% of total dietary energy, 37% of protein, 13% to 32% of selected B vitamins and iron, 20% of fat, and 34% of cholesterol. Percentages were similar for men. There was no significant association between age and total dietary intake, but food group consumption had distinct associations with age for women and men. Our findings indicate that a moderate but not excessive intake of meat/poultry/fish made a substantial contribution to nutrient intake. The fat contribution of these food groups could be decreased by emphasizing lower-fat selections of meat, poultry, and fish.

Age Factors↗

PubMed1991

Survival of children and adolescents with acute lymphoid leukemia. A study of American Indians and Hispanic and non-Hispanic whites treated in New Mexico (1969 to 1986).

During the period 1969 to 1986, 196 American Indian and Hispanic and non-Hispanic white children and adolescents (ages, 0 to 19 years) were treated for acute lymphoid leukemia (ALL) at the University of New Mexico affiliated institutions. There were 28 American Indians (14%), 91 Hispanic whites (46%), and 77 non-Hispanic whites (39%). Median survivals for patients undergoing antileukemic therapy ranged from 8 months for American Indian boys to 140 months for non-Hispanic white girls. American Indian boys had the highest initial median leukocyte count (WBC) at 23.8 X 10(9)/l. Compliance problems occurred most commonly among American Indian children of both genders. Other clinical and pathologic features evaluated in this study were distributed similarly among the ethnic gender groups. Multi-variate analysis revealed that independent prognostic variables for survival included initial WBC, age, and gender. Ethnicity and compliance problems were possible, but confounded, prognostic variables. To the authors' knowledge this represents the most comprehensive study to date of ALL in American Indian patients.

Adolescent↗

PubMed1991

Thyroid function in a healthy elderly population: implications for clinical evaluation.

Evaluation of thyroid function in elderly people is complex and has generated some controversy about what is normal. This study analyzed thyroid function assays in an identified healthy elderly population of 216 subjects. Thyroxine, free thyroxine, triiodothyronine, T3 uptake, "supersensitive" thyrotropin, and thyroid antibody titers were performed. Histories of treatment for thyroid conditions were present in 13.9% (n = 30) of the population, and test results for an additional 4.3% (n = 8) revealed some hypothyroidism. These subjects were excluded from statistical analysis. Test results revealed significant differences from younger controls as well as skewed distributions for T4, FT4, and TSH. There were no significant correlations with increasing age or gender within the elderly population. 11.8% (n = 21) of the population exhibited elevated TSF levels with normal T4 values, and 23.0% (n = 41) exhibited a titer of one or both thyroid antibodies. Current reference ranges for thyroid tests are broad enough to include the range of values seen in the healthy elderly, but some cautions are discussed.

Adult↗

PubMed1991

A population-based study of functional status and social support networks of elderly patients newly diagnosed with cancer.

We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.

Activities of Daily Living↗

PubMed1990

Determinants of cancer stage. A population-based study of elderly New Mexicans.

To assess the role of delay and other factors in determining stage of cancer at diagnosis, the authors interviewed a population-based sample of 800 elderly persons with newly diagnosed cancer at selected sites. Lengthening delay interval was associated with a declining proportion of local stage cases for breast cancer but not other sites. Of the other determinants of stage examined, older age, having a family physician, receiving medical checkups, having greater knowledge of cancer, and having no functional loss were most strongly predictive of local stage. For breast cancer, performance of breast self-examination also predicted local stage.

Activities of Daily Living↗

PubMed1990

Changes in surgical treatments: the example of hysterectomy versus conization for cervical carcinoma in situ.

From 1969 through 1985, 4584 women in the state of New Mexico were diagnosed with carcinoma in situ of the cervix. Of these women, 65.5% underwent hysterectomy while 31.1% had a conservative therapy (primarily conization). Over the 17-year period, there was a steady increase in the percentage of women receiving conservative therapies, from 11.8% in 1969 to 50.3% in 1985. Younger women, unmarried women and American Indian women were more likely to receive conservative therapy. This marked shift in therapeutic approach occurred during a time of apparent controversy as to the optimal treatment for cervical carcinoma in situ, and illustrates a rapid change in surgical practice in the absence of any controlled trials comparing the two major treatment modalities.

Adolescent↗

PubMed1990

Histologic correlations with the clinical diagnosis of dysplastic nevus.

In melanoma kindreds the presence of dysplastic nevi correlates with greatly increased melanoma risk. The relative importance of sporadic, nonfamilial dysplastic nevi as a risk factor for melanoma is less certain. Although the clinical features of dysplastic nevi have been well described, the histologic basis for the diagnosis is not as firmly established. This study examines the degree of correspondence between the clinical and histopathologic diagnosis of dysplastic nevus. Histologic review of nevi with clinical features of dysplasia from 1,000 individuals demonstrated classic histologic features of dysplasia (as previously demonstrated in melanoma kindreds) in 54.7%. In 20.4% of patients, nevi displayed less convincing or only partially developed features of dysplasia. The remaining patients (24.9%) had nevi of other types. Correspondence between the clinical and histologic diagnosis of dysplasia was best for lesions from the trunk and in individuals beyond the age of 20 years. This study supports the validity of the dysplastic nevus as a clinical and pathologic entity.

Adolescent↗

PubMed1990

Alcohol intake in the healthy elderly. Changes with age in a cross-sectional and longitudinal study.

Several cross-sectional studies have shown a decline in alcohol intake with increasing age. Longitudinal studies have failed to confirm this trend, which suggests that cohort effects may account for the reported decline. To address this, both cross-sectional and longitudinal analyses of alcohol use in 270 healthy elderly persons over a seven-year period (1980-1987) were performed. Alcohol consumption was assessed by three-day diet records. One hundred sixty-five subjects (61.1%) remained in the study until 1987; 143 (53%) completed diet records for every year. Longitudinal analysis showed a statistically significant decline in the percent of subjects consuming any alcohol over time (slope = -2% per year; 95% confidence interval -2.8, -1.1%). A cross-sectional analysis of the 1980 data revealed a similar decline in percent drinkers with increasing age (slope = -2.7% per year; 95% confidence interval -4.4, -1.1%). Mean alcohol intake for those who continued to drink did not change over time except among heavy drinkers (consumption of greater than 30 g per day in 1980), who did show a significant decline in mean alcohol intake (P = .02). Thus, in our population the decline in percent of drinkers with age found by a cross-sectional analysis was confirmed in longitudinal analyses, suggesting that this represents a true age-related decline rather than a cohort effect.

Age Factors↗

PubMed1989

Clinical chemistry reference intervals for healthy elderly subjects.

In 1979, 304 healthy elderly individuals in New Mexico were recruited for a longitudinal study of nutrition and aging. Repeat measurements on a yearly basis of commonly requested clinical chemistry analytes allowed the calculation of reference intervals, between and within-subject variance components, and percentiles for change in concentration between two yearly measurements. The latter was further divided into analytical and biological variance components. The upper 95th percentile for the difference between two yearly measurements, expressed as a percent of the population mean, ranged from 4% for Na+ to approximately 20% for total cholesterol and to greater than 90% for ferritin. Year-to-year differences attributable to the biological component ranged from a low of 2% of the population mean for Na+ to 70% for gamma-glutamyltransferase.

Adult↗

PubMed1989

Carbon dioxide laser vaporization: relationship of scar formation to power density.

A direct relationship exists between the power density of a carbon dioxide laser and the thickness of scars it produces in rat skin. Statistically significant positive relationships were noted between laser power and scar thickness at days 14, 21, and 32. The slope of the curve increased as the number of days elapsed. At day 32, the ratio of scar thickness to CO2 laser power density delivered was 0.3 microns/W-cm2. Scar formation took longer for completion at higher wattages of irradiation.

Animals↗

PubMed1989

Survival after cancer surgery of elderly patients in New Mexico, 1969-1982.

To examine the effects of advancing age, sex, and ethnicity on estimated 30-day survival after surgery for cancer, we reviewed population-based data on 16,130 cancer cases collected by the New Mexico Tumor Registry from 1969-1982. For surgery at most sites, mortality increased with increasing age. The highest mortality was observed for sites requiring laparotomy or thoracotomy. Sex and ethnicity (Hispanic versus non-Hispanic white) had little effect on short-term survival. Comparison of short-term survival for two time periods, 1969-1975 and 1976-1982, showed a strong trend of improving survival for many sites.

Age Factors↗

PubMed1988

Physician acceptance of the hepatitis B vaccine at a university medical center.

To examine how physicians at different training levels accepted the hepatitis B vaccine (Heptavax), we mailed questionnaires to all medical students, residents, and faculty at our university medical center. Eighty-one per cent responded; 57 per cent of those had been vaccinated. Attitudes of vaccine safety and efficacy and the perception of increased risk of getting hepatitis B were associated with having been vaccinated. The associations were strongest for the faculty and weak or negative for the medical students.

Academic Medical Centers↗