Mayo Clinic proceedings
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Mayo Clinic proceedings · Dec 2020
ReviewSubstance Use Disorders and Telehealth in the COVID-19 Pandemic Era: A New Outlook.
During the current coronavirus disease 2019 epidemic, many outpatient chemical dependency treatment programs and clinics are decreasing their number of in-person patient contacts. This has widened an already large gap between patients with substance use disorders (SUDs) who need treatment and those who have actually received treatment. ⋯ Although there is ample evidence to support telemedical interventions, these can be difficult to implement, especially in the SUD population. This article reviews current literature for the use of telehealth interventions in the treatment of SUDs and offers recommendations on safe and effective implementation strategies based on the current literature.
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Venous thromboembolism (VTE) is a preventable cause of postoperative morbidity and mortality; however, audits suggest that the use of thromboprophylaxis is underused. In this review, we describe our approach to prevention of postoperative VTE and provide guidance on how to formulate an optimal VTE prophylaxis plan. We recommend that all patients undergo thrombosis- and bleeding-risk assessment as part of their preoperative evaluation. ⋯ Patients at high risk of bleeding should receive mechanical prophylaxis until their risk of bleeding is reduced and pharmacological prophylaxis can be reconsidered. Populations for which the Caprini score has not been validated (such as orthopedic surgery) are recommended prophylaxis based on individual and procedure-specific risk factors. Prophylaxis is typically continued until the patient is ambulatory or until hospital dismissal; however, longer durations can be considered in certain circumstances (high-risk patients undergoing malignant abdominopelvic operations, bariatric operations, and certain orthopedic operations).
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Mayo Clinic proceedings · Dec 2020
Mortality Due to Mitral Regurgitation Among Adults in the United States: 1999-2018.
To evaluate the nationwide trends in mortality due to mitral regurgitation (MR) among American adults from 1999 to 2018. ⋯ Mortality due to MR in American adults declined at an annual rate of approximately 4% until 2012 and has since then increased by about 1.5% annually. These mortality trends warrant further investigation.
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Mayo Clinic proceedings · Dec 2020
A Cohort Study Examining the Interaction of Alcohol Consumption and Obesity in Hepatic Steatosis and Mortality.
To study the interaction of alcohol consumption with body mass index (BMI) in the development of hepatic steatosis and mortality. ⋯ In obese individuals, even moderate alcohol use is associated with the development of hepatic steatosis. Moderate alcohol consumption is associated with lower mortality in normal-BMI and overweight individuals but not in those who are obese.