Mayo Clinic proceedings
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Mayo Clinic proceedings · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialProspective randomized controlled trial of extended-release oxybutynin chloride and tolterodine tartrate in the treatment of overactive bladder: results of the OBJECT Study.
To compare the efficacy and tolerability of extended-release oxybutynin chloride and tolterodine tartrate at 12 weeks in participants with overactive bladder. ⋯ Extended-release oxybutynin was more effective than tolterodine as measured by end-of-study urge incontinence, total incontinence, and micturition frequency episodes. Both groups had similar rates of dry mouth and other adverse events.
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Mayo Clinic proceedings · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of resistive heating compared with passive warming in treating hypothermia associated with minor trauma: a randomized trial.
To determine the occurrence of hypothermia in patients with minor trauma, to test the hypotheses that resistive heating during transport is effective treatment for hypothermia and that this treatment reduces patients' thermal discomfort, pain, and fear, and to evaluate the accuracy of oral temperatures obtained at the scene of injury. ⋯ Oral temperatures are sufficiently accurate for field use. Hypothermia is common even in persons with minor trauma. Resistive heating during transport augments thermal comfort, increases core temperature, reduces pain and anxiety, and improves overall patient satisfaction.
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Mayo Clinic proceedings · Apr 2001
Comparative Study Clinical Trial Controlled Clinical TrialTreating fibromyalgia with a brief interdisciplinary program: initial outcomes and predictors of response.
To evaluate the efficacy of a brief, intense treatment program for fibromyalgia and to determine which patient characteristics are associated with a better treatment response. ⋯ A brief interdisciplinary program for treating fibromyalgia reduced some associated symptoms. Patients more severely affected by fibromyalgia may benefit most from this approach. Clinicians may apply these findings to develop beneficial and convenient treatment programs for patients with fibromyalgia.
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Mayo Clinic proceedings · Apr 2001
The effect of changing transfusion practice on rates of perioperative stroke and myocardial infarction in patients undergoing carotid endarterectomy: a retrospective analysis of 1114 Mayo Clinic patients. Mayo Perioperative Outcomes Group.
To evaluate changes in the institution's red blood cell (RBC) transfusion practice during the past 15 years and the influence of these changes on neurologic or cardiac morbidity after carotid endarterectomy. ⋯ Our results suggest that elderly patients undergoing carotid endarterectomy (ie, individuals known to be at high risk for cerebral and cardiac ischemia) can tolerate modest perioperative anemia despite a considerable change in the institution's transfusion practice (lower "transfusion trigger," the hemoglobin concentration or hematocrit value below which RBC transfusion is indicated).
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Esophageal motility disorders often manifest with chest pain and dysphagia. Achalasia is a disorder of the lower esophageal sphincter and the smooth musculature of the esophageal body. In achalasia the lower esophageal sphincter typically fails to relax with swallowing, and the esophageal body fails to undergo peristalsis. ⋯ Spastic disorders of the esophagus, such as diffuse esophageal spasm and nutcracker esophagus, and nonspecific esophageal motility disorder are benign and nonprogressive, with similar findings on esophageal manometry. Although the exact cause remains unknown, these disorders may represent a manifestation of gastroesophageal reflux disease. Treatment of spastic disorders includes medical and surgical approaches and is aimed at symptomatic relief.