Mayo Clinic proceedings
-
Optic disk edema with a macular star is a descriptive term encompassing a heterogeneous group of disorders. The clinical features include sudden visual loss, swelling of the optic disk, peripapillary and macular exudates that may occur in a star pattern, and cells in the vitreous. Herein we describe the clinical features, potential etiologic factors, differential diagnosis, work-up, and natural history of this entity. ⋯ Patients with a recurrent type of the disease may not experience pronounced improvement in optic nerve function. The macular exudate may not develop in cases of disk edema until 2 weeks after the patient's initial assessment; thus, patients who have acute papillitis with a normal macula should be reexamined within 2 weeks for development of a macular star. The presence of a macular star militates strongly against subsequent development of multiple sclerosis.
-
Mayo Clinic proceedings · Jun 1996
ReviewDescriptive epidemiology of epilepsy: contributions of population-based studies from Rochester, Minnesota.
Studies based on the Rochester Epidemiology Project medical records-linkage system have provided important insights into the epidemiology of epilepsy. The incidence of all convulsive disorders in Rochester, Minnesota, during a 50-year period exceeded 130 per 100,000 person-years. The age-adjusted incidence of epilepsy was 44 per 100,000 person-years; of a first unprovoked seizure, 61; and of acute symptomatic seizures excluding febrile convulsions, 31. ⋯ Prevalence was low in the first decade of life, increased to a plateau in the adult years, and further increased in the elderly population. Almost 1.5% of the population older than 75 years of age had active epilepsy. About 25% of prevalence cases had an identified cause; 60% experienced partial epilepsy.
-
To describe the indications, rationale, techniques, alternatives, contraindications, complications, and efficacy of lumbar and caudal epidural corticosteroid injections. ⋯ A thorough analysis of the few available controlled studies and their limitations indicates that this treatment is probably efficacious for patients with certain lower-extremity radicular pain syndromes when intermediate-term (2 weeks to 3 months) results are assessed after injection. More studies are needed to elucidate further the most beneficial candidates and techniques.
-
To describe the role of geriatric rehabilitation, the methods of practice, and the mechanisms underlying integrated care in rehabilitation medicine. ⋯ Rehabilitation of elderly patients can assist in preserving functional independence and improving the quality of life. Assessment and management in an individual patient are best performed by a team approach.
-
Mayo Clinic proceedings · Dec 1995
ReviewCurrent concepts in airway management for cardiopulmonary resuscitation.
To describe the methods of maintaining airway patency for oxygenation during cardiopulmonary resuscitation (CPR) that do not require expertise in mask ventilation or endotracheal intubation by direct laryngoscopy. ⋯ When CPR is compromised by airway obstruction that remains unresponsive to traditional techniques, using alternative methods is appropriate. The techniques selected must be based on individual familiarity and expertise.