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Biomedical subjects

R D Hurt

Publications and source records attributed to R D Hurt.

103 records · Page 6Linked to original sources
PubMed1983

Benign teratomas of the mediastinum.

Approximately 8% of all mediastinal tumors are benign teratomas. We reviewed 86 cases of benign teratoma seen at the Mayo Clinic from 1930 through 1981. The mean age of the patients was 28 years and the sex distribution was approximately equal. The most common symptoms were chest, back, or shoulder pain, dyspnea, and cough, but 36% were asymptomatic at the time of presentation. Chest roentgenograms showed a well-circumscribed anterior mediastinal mass which often protruded into one lung field. Detectable calcification was observed in 22 patients: a calcified tumor wall in seven, bone or teeth in the mediastinum of seven, and nonspecific calcifications in eight. Surgical excision remains the best means of diagnosing and treating this benign tumor. Though the tumors are histologically benign, they may present difficult surgical problems because of the vital structures involved. Since 1952 there has been a change in the clinical presentation of patients with this entity: More patients are asymptomatic and have smaller tumors and fewer complications than prior to 1952.

Adolescent↗
PubMed1982

Primary anterior mediastinal seminoma.

A review of the Mayo Clinic experience with primary anterior mediastinal seminomas involved 17 patients who had pure anterior mediastinal seminomas and four who had mixed germ-cell tumors containing seminomas. At follow-up, of the 17 patients with pure anterior mediastinal seminoma, nine had no evidence of disease and eight had died of metastatic disease. Of the four patients with mixed germ-cell tumor containing seminoma, two were alive at follow-up and two had died of metastatic disease. In the group with pure anterior mediastinal seminoma, these factors seemed to have been associated with a greater potential for progression of disease: older than 35 years of age, presentation with fever, superior vena caval syndrome, supraclavicular or cervical adenopathy, and roentgenographic evidence of hilar disease.

Adolescent↗
PubMed1981

Nutritional status of a group of alcoholics before and after admission to an alcoholism treatment unit.

The nutritional status of the alcoholic has been presumed to be less than adequate because of the large quantity of alcohol ingested. Most reports have focused on the derelict alcoholic. In contrast, the patients in this investigation are more representative of the usual alcoholic population. The pretreatment dietary histories of 58 alcoholics were compared with their actual dietary intake while they were hospitalized for the treatment of alcoholism. Comparisons were also made between dietary intake by history and Recommended Dietary Allowances. The mean calorie, protein, fat, and carbohydrate intake of the patients was adequate and was well within the Recommended Dietary Allowances ranges. After the patients stopped drinking, they increased their intake of all major nutrients, especially carbohydrates. A subgroup of 11 patients whose recent dietary intake by history was corroborated by their urinary nitrogen excretion had no change in total caloric intake after they stopped drinking.

Adolescent↗
PubMed1981

Plasma alpha-amino-n-butyric acid/leucine ratio in alcoholics.

Fasting free amino acid concentrations in plasma of 20 control and 18 alcoholic subjects were compared in an attempt to validate previous reports that the molar ratio of alpha-amino-n-butyric acid/leucine (A/L ratio) is a marker for alcoholism. We were unable to confirm the observations of either altered alpha-amino-n-butyric acid or leucine concentrations or an increased A/L ratio in alcoholic subjects, and we conclude that the A/L ratio is not a biochemical marker for alcoholism.

Adult↗
PubMed1980

Diagnosis of alcoholism with a self-administered alcoholism screening test: results with 1,002 consecutive patients receiving general examinations.

Since 1972 we have used the Self-Administered Alcoholism Screening Test (SAAST) in impatient alcoholics and their spouses and in patients from a general medical population. The SAAST, a 35-item test with a yes/no format, was administered to 1,002 consecutive Mayo Clinic patients who generally were not acutely ill and were requesting an annual examination or a general reexamination for chornic but stable problems. Of the 1,002 patients, 5.4% gave responses to the SAAST that would indicate the presence of possible or probable alcoholism. The medical record review on a random selection of patients revealed a false-negative rate of 6.7%. We believe that the SAAST is an effective tool for the detection of alcoholism and that it can be used in the general medical setting.

Adult↗
PubMedDate not supplied

Effects of 24-hr nicotine replacement on sleep and daytime activity during smoking cessation.

BACKGROUND: This study uses wrist actigrapy to assess the effects of 24-hr transdermal nicotine replacement on the sleep and daytime activity of smokers during smoking cessation. METHODS: Seventy-one subjects grouped as light (n = 23), moderate (n = 24), or heavy (n = 24) smokers were randomly assigned to placebo or 11, 22, or 44 mg/day doses of transdermal nicotine for 1 week of intensive inpatient treatment of nicotine dependence. Outpatient patch therapy continued for 7 weeks following the inpatient stay. Those initially on placebo were randomly assigned to 11 or 22 mg/day, and those initially on 44 mg/day were reduced to 22 mg/day at Week 4. RESULTS: There was a significant decrease in daytime wrist activity during patch therapy and the 1st week off patch therapy. These changes in daytime wrist activity were positively correlated with percentage of nicotine and cotinine replacement. No changes from baseline in sleep (sleep efficiency or wrist activity) were detected, nor were there differences in sleep among the four patch doses. CONCLUSIONS: Using wrist actigraphy, this study failed to show any disturbing effects of 24-hr high-dose nicotine replacement on sleep. Lower levels of nicotine replacement were associated with a decrease from baseline in daytime wrist activity.

Administration, Cutaneous↗
PubMedDate not supplied

An integrated approach to the treatment of nicotine dependence in a medical center setting: description of the initial experience.

A nicotine-dependence treatment program can be implemented in a medical center setting by using a model that involves physician, patient, and nicotine-dependence counselor. The physician-referred and counselor-directed consultations are followed by a systematic relapse-prevention program. The counselors utilize behavioral approaches, the philosophy and principles of the addictive disorders field, and adjunctive pharmacologic therapy. The patients are chronic, heavy smokers who have had many previous quit attempts and are highly nicotine-dependent. Important factors include: 1) referral by physicians, 2) physicians' active role in the intervention, 3) expertise of the counselors, 4) structured relapse-prevention program, and 5) provision of services in a smoke-free medical center.

Adult↗
PubMedDate not supplied

Attitudes toward nicotine dependence among chemical dependence unit staff--before and after a smoking cessation trial.

As a part of a prospective study to assess the effect of nicotine dependence treatment among smokers undergoing inpatient treatment for other addictions, we surveyed the treatment staff about their attitudes toward smoking. The study was carried out in the Alcoholism and Drug Dependence Unit (ADDU), an inpatient addictions' treatment unit at Mayo Clinic. The subjects for this report were the ADDU staff. The attitude survey used was modified from that of Bobo and Gilchrist, and the survey was conducted for all staff before and after the prospective intervention study. Compared with the pre-study survey, the post-study survey indicated more staff thought nicotine dependence treatment should be provided to all smokers (p = 0.025). The percentage who thought that nicotine dependence treatment should be encouraged at the time of admission to the unit also increased (p = 0.005). Overall, staff attitudes toward nicotine dependence treatment changed toward more acceptance. While the intervention trial likely had an effect, other factors could also have played a role in this apparent change in staff attitude.

Adult↗
PubMedDate not supplied

Effect of current tobacco use and history of an alcohol problem on health status in hospitalized patients.

This prospective study assessed the relationship between current tobacco use and history of an alcohol problem to health status in hospitalized patients. Factors associated with current tobacco use and history of an alcohol problem were also evaluated. Data were collected using a self-administered survey distributed by nursing staff to adult inpatients registered on April 27, 1994 at the Mayo Clinic, Rochester, Minnesota affiliated hospitals. Respondents (N = 589, 45% female) were classified into 4 subgroups based on current tobacco use status and history of an alcohol problem: (a) current tobacco use only (n = 94, 16%); (b) history of an alcohol problem only (n = 30, 5%); (c) both (n = 27, 5%); or (d) neither (n = 438, 74%). Patients with both current tobacco use and an alcohol problem history reported markedly lower scores on health status measures of general and mental health compared to the other three subgroups. Moreover, current tobacco use and history of an alcohol problem were each associated with increased psychological distress. Current tobacco use was predictive of a history of an alcohol problem and vice versa.

Adult↗
PubMedDate not supplied

Alcoholism and psoriasis.

Using criteria for the diagnosis of alcoholism established by the National Council of Alcoholism and by scores on the Self-Administered Alcoholism Screening Test, we compared the prevalence of alcoholism in a group of 99 patients hospitalized for the treatment of psoriasis with that in an age- and sex-matched control group hospitalized for the treatment of other dermatologic disorders. Alcoholism was diagnosed in 11 psoriatic patients and 3 control patients (0.05 less than p less than 0.10); 10 of the 11 psoriatic patients were men, and 1 of the 3 control patients was a man (p less than 0.05). These differences, not noted in certain earlier studies, may reflect a basic association between the two diseases in males or indicate that alcoholism contributes to the morbidity of psoriasis.

Adult↗