Mayo Clinic proceedings
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Mayo Clinic proceedings · Jul 2020
ReviewTreatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack Thereof).
The novel severe acute respiratory syndrome coronavirus 2 is causing a worldwide pandemic that may lead to a highly morbid and potentially fatal coronavirus disease 2019 (COVID-19). There is currently no drug that has been proven as an effective therapy for COVID-19. Several candidate drugs are being considered and evaluated for treatment. ⋯ The authors conclude, based on this review, that there is still no high-quality evidence to support any of these proposed drug therapies. The authors, therefore, encourage the enrollment of eligible patients to multiple ongoing clinical trials that assess the efficacy and safety of these candidate therapies. Until the results of controlled trials are available, none of the suggested therapeutics is clinically proven as an effective therapy for COVID-19.
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Mayo Clinic proceedings · Jul 2020
ReviewLactose Intolerance: A Concise Review to Skim the Surface.
Lactose intolerance is a common but poorly understood cause of gastrointestinal symptoms. Contrary to popular belief, there is much more to its diagnosis beyond symptoms with exposure and management beyond milk- and dairy-product avoidance. In this article, we review definitions, genetic basis, pathogenesis, clinical signs, as well as diagnostic and management strategies.
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Mayo Clinic proceedings · Jul 2020
ReviewObesity and Outcomes in COVID-19: When an Epidemic and Pandemic Collide.
Obesity has reached epidemic proportions in the United States and in much of the westernized world, contributing to considerable morbidity. Several of these obesity-related morbidities are associated with greater risk for death with coronavirus disease 2019 (COVID-19). ⋯ Obese patients also have worse outcomes with COVID-19 infection, including respiratory failure, need for mechanical ventilation, and higher mortality. Clinicians need to be more aggressive when treating obese, especially severely obese, patients with COVID-19 infection.
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Mayo Clinic proceedings · Jul 2020
ReviewContemporary Management of Acute Ischemic Stroke Across the Continuum: From TeleStroke to Intra-Arterial Management.
In this comprehensive contemporary review of acute ischemic stroke management, what is new and different will be highlighted beginning with prehospital stroke systems of care, emergency medical systems, and mobile stroke units, followed by hospital stroke teams, emergency evaluation, telemedicine, and brain and vascular imaging, and finishing with emergency treatments including thrombolysis and mechanical thrombectomy.
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Mayo Clinic proceedings · Jul 2020
ReviewImmunization Strategies to Span the Spectrum of Immunocompromised Adults.
The Advisory Committee on Immunization Practices to the US Centers for Disease Control and Prevention provides annual recommendations for routine adult immunizations. Many recommendations consider patient factors such as age, medical conditions, and medications that increase an individual's risk for infection with a vaccine-preventable disease. ⋯ The provider may need to consider alternative vaccination strategies, including higher antigen dose vaccines, adjuvanted vaccines, avoidance of live vaccines, and careful timing of vaccination to optimize safety and effectiveness in immunocompromised populations. This thematic review discusses general principles regarding immunization of adults across the spectrum of immunocompromise, examines current guidelines and studies that support them, and outlines future research needs.