Mayo Clinic proceedings
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Mayo Clinic proceedings · Sep 2021
Multicenter Study Comparative StudyIncreased Utilization of Virtual Visits and Electronic Approaches in Clinical Research During the COVID-19 Pandemic and Thereafter.
To assess the impact of the COVID-19 pandemic on clinical research and the use of electronic approaches to mitigate this impact. ⋯ After a sharp early decline, the enrollment of new participants and ongoing study visits recovered during the COVID-19 pandemic. This recovery was accompanied by the increased use of electronic tools.
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Mayo Clinic proceedings · Sep 2021
ReviewSynopsis of the 2020 US Department of Veterans Affairs/US Department of Defense Clinical Practice Guideline: The Non-Surgical Management of Hip and Knee Osteoarthritis.
In July 2020, the US Department of Veterans Affairs (VA) and US Department of Defense (DoD) approved a new joint clinical practice guideline for the non-surgical management of hip and knee osteoarthritis. This synopsis highlights some of the recommendations. ⋯ This synopsis summarizes key recommendations in all 6 topics covered in the guideline. These topics are diagnosis, self-management, physical therapy, pharmacotherapy, orthobiologics, and complementary and integrative health.
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Mayo Clinic proceedings · Sep 2021
ReviewRational Fluid Resuscitation in Sepsis for the Hospitalist: A Narrative Review.
Administration of fluid is a cornerstone of supportive care for sepsis. Current guidelines suggest a protocolized approach to fluid resuscitation in sepsis despite a lack of strong physiological or clinical evidence to support it. Both initial and ongoing fluid resuscitation requires careful consideration, as fluid overload has been shown to be associated with increased risk for mortality. ⋯ Traditionally selected resuscitation targets, such as lactate elevation, are fraught with limitations. For developing or established septic shock, a focused hemodynamic assessment is needed to determine if fluid is likely to be beneficial. When initial fluid therapy is unable to achieve the blood pressure goal, initiation of early vasopressors and admission to intensive care should be favored over repetitive administration of fluid.
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Mayo Clinic proceedings · Sep 2021
Nonlinear Associations Between Cumulative Dietary Risk Factors and Cardiovascular Diseases, Cancer, and All-Cause Mortality: A Prospective Cohort Study From UK Biobank.
To develop a score from cumulative dietary risk factors and examine its nonlinear associations with cardiovascular disease (CVD) and cancer incidence and mortality, as well as all-cause mortality. ⋯ Our findings show that dietary risk factors contributed to a large proportion of CVD and cancer events, as well as deaths, among those who did not meet most dietary recommendations.
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Mayo Clinic proceedings · Sep 2021
Identification of Genetic Causes of Focal Segmental Glomerulosclerosis Increases With Proper Patient Selection.
To increase the likelihood of finding a causative genetic variant in patients with a focal segmental glomerulosclerosis (FSGS) lesion, clinical and histologic characteristics were analyzed. ⋯ In adults with FSGS lesions, proper selection of patients increases the rate of positive genetic testing significantly. The majority of individuals with undetermined FSGS in whom the clinical presentation and histologic parameters are discordant had a genetic diagnosis.