Mayo Clinic proceedings
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Mayo Clinic proceedings · Sep 2005
ReviewEpidemiology, treatment, and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections.
Since first described In 1961, methicillin-resistant Staphylococcus aureus (MRSA) has become a common nosocomial pathogen. Substantial increases in MRSA infections among nonhospitalized patients are being reported. ⋯ Community-acquired MRSA strains differ from nosocomial strains in clinically relevant ways, such as in their propensity to cause skin and soft tissue infection and severe necrotizing pneumonia. Clinicians in numerous specialties, particularly primary care physicians, will likely evaluate patients presentIng with community-acquired MRSA and should become familiar with the epidemiology and clinical characteristics of and evolving therapeutic and preventive strategies for this infection.
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Mayo Clinic proceedings · Sep 2005
Meta Analysis Comparative StudyCiprofloxacin vs an aminoglycoside in combination with a beta-lactam for the treatment of febrile neutropenia: a meta-analysis of randomized controlled trials.
To compare the effectiveness and toxicity of ciprofloxacin vs an aminoglycoside, both in combination with a beta-lactam, for the treatment of febrile neutropenia in the inpatient setting. ⋯ The combination of ciprofloxacin with a beta-actam antibiotic should be considered an important therapeutic option in hospitalized febrile neutropenic patients who have not received a quinolone for prevention of infections and in settings in which quinolone resistance is not common.
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Mayo Clinic proceedings · Aug 2005
ReviewClinical diagnosis of prolonged states of impaired consciousness in adults.
A prolonged state of impaired consciousness is a devastating consequence of severe structural brain injury but fortunately is uncommon. Patients may be diagnosed as being in a persistent vegetative state, having akinetic mutism, or being in a minimally conscious state. ⋯ For patients diagnosed as being in a permanent (irreversible) vegetative state, hope for a clinically meaningful recovery is unrealistic after 1 year. Prolonged survival is possible only with meticulous care and aggressive medical intervention to prevent and treat systemic complications.
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Mayo Clinic proceedings · Jul 2005
Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients.
To estimate the magnitude of association between intraoperative hyperglycemia and perioperative outcomes in patients who underwent cardiac surgery. ⋯ Intraoperative hyperglycemia is an independent risk factor for complications, including death, after cardiac surgery.
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Mayo Clinic proceedings · Jul 2005
ReviewHow to interpret and pursue an abnormal complete blood cell count in adults.
A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. ⋯ In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.