Mayo Clinic proceedings
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Mayo Clinic proceedings · Apr 2007
Comparative StudyFurther validation of the FOUR score coma scale by intensive care nurses.
The FOUR (Full Outline of UnResponsiveness) score is a new coma scale that consists of 4 components (eye, motor, brainstem, and respiration). The scale was recently validated, but variability among nursing staff has been documented. ⋯ The FOUR score provides more neurologic information than the GCS. The FOUR score can be used by any ICU nurses, even those with minimal experience.
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Mayo Clinic proceedings · Apr 2007
ReviewMalignant melanoma in the 21st century, part 2: staging, prognosis, and treatment.
Critical to the clinical management of a patient with malignant melanoma is an understanding of its natural history. As with most malignant disorders, prognosis is highly dependent on the clinical stage (extent of tumor burden) at the time of diagnosis. The patient's clinical stage at diagnosis dictates selection of therapy. ⋯ Substantial progress has been made in this regard during the past 2 decades. This progress is primarily reflected in the development of sentinel lymph node biopsies as a means of reducing the morbidity associated with regional lymph node dissection, increased understanding of the role of neoangiogenesis in the natural history of melanoma and its potential as a treatment target, and emergence of innovative multimodal therapeutic strategies, resulting in significant objective response rates in a disease commonly believed to be drug resistant. Although much work remains to be done to improve the survival of patients with melanoma, clinically meaningful results seem within reach.
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Mayo Clinic proceedings · Apr 2007
Comparative StudyIntrapleural fibrinolytics combined with image-guided chest tube drainage for pleural infection.
To present our method of treating pleural infection by using a combination of image-guided chest tube drainage and intrapleural fibrinolytics. ⋯ In the treatment of pleural infection, intrapleural urokinase or tissue-type plasminogen activator in combination with careful image-guided placement of chest tubes is highly effective in resolving the effusion and curing the infection.
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Mayo Clinic proceedings · Mar 2007
ReviewMalignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis.
Malignant melanoma is an aggressive, therapy-resistant malignancy of melanocytes. The incidence of melanoma has been steadily increasing worldwide, resulting in an increasing public health problem. Exposure to solar UV radiation, fair skin, dysplastic nevi syndrome, and a family history of melanoma are major risk factors for melanoma development. ⋯ Management of systemic melanoma is a challenge because of a paucity of active treatment modalities. In the first part of this 2-part review, we discuss epidemiology, risk factors, screening, prevention, and diagnosis of malignant melanoma. Part 2 (which will appear in the April 2007 issue) will review melanoma staging, prognosis, and treatment.