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Sommaires des Revues - Mayo Clinic Proceedings

Mayo Clinic Proceedings

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Real-Time Cineangiography Visualization of Cerebral Aneurysm Rupture in an Awake Patient: Anatomic, Physiological, and Functional Correlates  Voir?

Intracranial aneurysms are common and, on a population-based perspective, are a major cause of morbidity and mortality as a result of mass effect or rupture. Cerebral angiography is the primary technique used for the diagnosis of cerebral aneurysms, and the imaging data have additional utility for planning medical, endovascular, or surgical treatments. An extremely rare periprocedural complication of cerebral angiography is rupture of the aneurysm, either as a chance phenomenon or as a result of some physiologic change or mechanical effect.

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69-Year-Old Man With Abdominal Pain and Obstipation  Voir?

A 69-year-old man presented with a 4-day history of progressive, sharp, nonradiating, nonpositional diffuse abdominal pain and obstipation (inability to pass stool or flatus). Associated symptoms included a 1-day history of intermittent nausea without emesis. He reported no fevers, chills, night sweats, melena, hematochezia, weight loss, or altered bowel habits. Of note, he had presented 5 years earlier with similar symptoms, which resolved with conservative management. Otherwise, he had no history of altered bowel habits.

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Incidence and Effects of Seasonality on Nonpurulent Lower Extremity Cellulitis After the Emergence of Community-Acquired Methicillin-Resistant Staphylococcus aureus  Voir?

Nonpurulent lower extremity cellulitis (NLEC) is a common clinical diagnosis, with β-hemolytic streptococci and Staphylococcus aureus considered to be the most frequent causes. In 1999, the US Public Health Service alerted clinicians to the presence of community-acquired methicillin-resistant S aureus (CA-MRSA) infections in 4 children in the upper Midwest. Since then, it has become a well-recognized cause of skin and soft-tissue infections, in particular, skin abscess. A previous population-based study of NLEC in Olmsted County, Minnesota, reported an unadjusted incidence rate of 199 per 100,000 person-years in 1999, but it is unknown whether CA-MRSA subsequently has affected NLEC incidence.

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Association Between Caffeine Intake and All-Cause and Cause-Specific Mortality: A Population-Based Prospective Cohort Study  Voir?

To assess whether caffeine intake is associated with all-cause and cause-specific mortality.
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60-Year-Old Woman With Headache and Fatigue  Voir?

A 60-year-old woman presented with a 6-month history of progressive fatigue and frequent headache. The fatigue was worse in the afternoon and prevented the patient from performing her regular daily activities. She reported occasional blood-tinged urine and hematochezia, and no hematemesis or melena. Her medical history was notable for an unprovoked lower-extremity deep vein thrombosis (DVT) 1 year earlier, for which she had completed 6 months of warfarin therapy. Medications included omeprazole, zolpidem, and a daily calcium/vitamin D supplement.

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38-Year-Old Man With Asthma and Eosinophilia  Voir?

A 38-year-old man with a history of asthma, depression, and anxiety presented with a 3-year history of recurrent dyspnea and wheezing. He had previously been active with his local ice hockey team and had no respiratory symptoms. On presentation, he reported frequent nighttime waking, dyspnea on minimal exertion, and frequent (6-10 times daily) albuterol rescue inhaler use. He noted marked worsening of his symptoms over the preceding 9 months and had been taking continuous oral steroids for the preceding 6 months.

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57-Year-Old Woman With Abdominal Pain  Voir?

A 57-year-old woman with no remarkable medical history presented to the emergency department with worsening right upper quadrant abdominal pain and nausea of 1 day's duration. Her vital signs included the following: temperature, 36.6°C; heart rate, 93 beats/min; respiratory rate, 14 breaths/min; and blood pressure, 164/86 mm Hg. She was alert and oriented. Physical examination findings were notable for absent breath sounds at bilateral lung bases, abdominal distention with shifting dullness, moderate tenderness on palpation of the right upper abdominal quadrant with a tender, smooth liver edge palpable 4 cm below the costal margin, 2+ pitting edema up to the knees bilaterally, and no asterixis.

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The Search Continues for Optimal Intensive Care Unit Glucose Management and Measurement  Voir?

The optimal management of critical illness–induced dysglycemia, defined as hyperglycemia, hypoglycemia, and glucose variability during and after critical illness, continues to be sought, as does the most acceptable method to measure glucose in a timely manner in the intensive care unit (ICU) and acute care environment.1,2 A plethora of studies have heightened our awareness of the potential effect of dysglycemia in adult ICU patients. Strict or “tight” glycemic control (80-110 mg/dL [to convert to mmol/L, multiply by 0.0555]) in critically ill adults was advocated from 2001 through 2009.

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Glucose Control, Diabetes Status, and Mortality in Critically Ill Patients  Voir?

To describe the relationships among glycemic control, diabetes mellitus (DM) status, and mortality in critically ill patients from intensive care unit (ICU) admission to hospital discharge.
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Blood Gas Analyzer Accuracy of Glucose Measurements  Voir?

To investigate the comparability of glucose levels measured with blood gas analyzers (BGAs) and by central laboratories (CLs).
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Decreasing Patient Stress and Physician/Medical Workforce Burnout Through Health Care Environments: Uncovering the Serious Leisure Perspective at Mayo Clinic's Campus in Rochester, Minnesota  Voir?

Health care environments are places of high stress for both patients and medical professionals. Although organizational efforts of workload and efficiency are often implemented to decrease both patient and physician/medical workforce stress, what is often overlooked is how leisure opportunities and programs located in day-to-day experiences and in physically built environments can increase both patient and medical staff enjoyment and pleasure, thus lowering patient stress and physician/medical staff burnout.

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Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome  Voir?

To determine the association of resistance exercise, independent of and combined with aerobic exercise, with the risk of development of metabolic syndrome (MetS).
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Scleroderma Induced by Pembrolizumab: A Case Series  Voir?

Immune checkpoint inhibitors are approved for select cancer treatment and have shown survival benefit in patients with advanced melanoma. Adverse events, including immune-related adverse events, are common and potentially life-threatening. We describe cases of 2 patients with scleroderma (patient 1 had diffuse scleroderma, and patient 2 had limited scleroderma) that developed while they were receiving pembrolizumab therapy for metastatic melanoma. Prompt recognition and treatment of immune-related adverse events may improve tolerance to immune checkpoint inhibitors and contribute to an understanding of the manifesting autoimmune disease.

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59-Year-Old Man With Sore Throat and Fever  Voir?

A 59-year-old man with a history of end-stage liver disease secondary to hepatitis C and alcohol abuse presented to the emergency department with a 2-week history of fever and sore throat. Acute bacterial pharyngitis had been diagnosed 1 week previously by his primary care physician, who prescribed a 7-day course of amoxicillin. One week after completing antimicrobial therapy, pain and swelling involving the right side of his neck developed, and he presented to the emergency department for evaluation.

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54-Year-Old Woman With Progressive Dyspnea on Exertion and Syncopal Episodes  Voir?

A 54-year-old woman with hypertension (HTN) presented to the emergency department with a 6-month history of progressive dyspnea on exertion. The dyspnea was associated with exertional chest discomfort, orthopnea, and paroxysmal nocturnal dyspnea. Symptoms were worse after eating. She had reported 2 episodes of unexplained syncope within the previous 2 years. The most recent syncopal episode occurred after the addition of chlorthalidone to her antihypertensive regimen, which included minoxidil, lisinopril, diltiazem, and labetalol.

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One- vs 2-Stage Bursectomy for Septic Olecranon and Prepatellar Bursitis  Voir?

To assess the optimal surgical approach and costs for patients hospitalized with septic bursitis.
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Crohn Disease: Epidemiology, Diagnosis, and Management  Voir?

Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills.

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A Diagnostic Approach to Recurrent Orofacial Swelling: A Retrospective Study of 104 Patients  Voir?

To identify patients evaluated in an outpatient setting at our institution with a presentation of recurrent orofacial swelling and to review the spectrum of causes to outline a diagnostic approach.
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Exposure to Surgery and Anesthesia After Concussion Due to Mild Traumatic Brain Injury  Voir?

To describe the epidemiology of surgical and anesthetic procedures in patients recently diagnosed as having a concussion due to mild traumatic brain injury.
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Highlights from the Current Issue – Audiovisual Summary  Voir?

Karl A. Nath, MBChB, Editor-in-Chief of Mayo Clinic Proceedings, discusses the Editor’s Choice and Highlights articles appearing in the July 2017 issue.
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General Information  Voir?

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Table of Contents  Voir?

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Editorial Board  Voir?

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Affirming the Mission of Mayo Clinic Proceedings  Voir?

During the summer of 1975, the midpoint of my years in medical school at the University of Edinburgh, Scotland, I returned to the island of my birth and upbringing, Trinidad, West Indies. While there I attended teaching-ward rounds and clinical tutorials at the Port-of-Spain General Hospital, a teaching hospital affiliated with the University of the West Indies Medical School, the latter based in Mona, Jamaica. During this clinical experience in Trinidad, I remember visiting a small library with a select number of journals, which included, alongside the West Indian Medical Journal, the only North American medical journal I can recall seeing there—Mayo Clinic Proceedings.

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Squamous Cell Carcinoma of the Tongue  Voir?

The image below shows structures resected for deeply invasive squamous cell carcinoma extensively involving the tongue and extending to abut the larynx.
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Leukemic Transformation in Myeloproliferative Neoplasms  Voir?

Myeloproliferative neoplasms (MPNs) operationally include essential thrombocythemia, polycythemia vera, primary myelofibrosis (PMF), and prefibrotic PMF. All 4 MPN variants might progress into blast-phase disease (MPN-BP). For essential thrombocythemia, reported risk factors for leukemic transformation include advanced age, extreme thrombocytosis, anemia, leukocytosis, and sequence variants/mutations involving TP53 and EZH2 (for expansion of gene symbols, see www.genenames.org); for polycythemia vera, advanced age, leukocytosis, abnormal karyotype, mutations involving SRSF2 and IDH2, and treatment with pipobroman, chlorambucil, or P32; and for PMF, increased blast percentage, thrombocytopenia, abnormal karyotype, triple-negative driver mutational status, and sequence variants/mutations involving SRSF2, RUNX1, CEBPA, and SH2B3.

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Prediction of Response to Targeted Treatment in Rheumatoid Arthritis  Voir?

Rheumatoid arthritis is an autoimmune syndrome presenting with chronic inflammation of the joints. Patients with the same diagnosis can present with different phenotypes. In some patients severe joint inflammation and early joint destruction are observed, whereas a milder phenotype can be seen in others. Conversely, patients with the same signs and symptoms may exhibit different immunological and molecular abnormalities. Since the introduction of early treatment in clinical practice, the treat to target principle, and new medicines such as biologic disease-modifying antirheumatic drugs, clinical remission can be achieved early in the disease course, albeit not in all patients.

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Dose-Response Relationship Between Severe Hypercholesterolemia and Body Mass Index in Healthy Young Adults  Voir?

Heterozygous familial hypercholesterolemia (FH) is a common genetic disorder associated with elevation of low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Familial hypercholesterolemia is underdiagnosed, partly because current diagnostic methods (eg, genetic testing) are unsuitable for population screening.1 The American Heart Association has provided more practical diagnostic criteria for adults: elevation of cholesterol to 190 mg/dL (5 mmol/L) or more and a family history of cholesterol levels of 190 mg/dL (5 mmol/L) or more or premature CHD.

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Adolf Lorenz – The Bloodless Surgeon of Vienna  Voir?

Adolf Lorenz was born April 21, 1856, in Weidenau, a small town in Silesia (then part of Austria, now named Vidnava and part of the Czech Republic). His father Johann was an innkeeper and harness maker. In 1866, Adolf left for Graz, Austria, to become a grocer's apprentice in a shop owned by his maternal uncle, but he did not enjoy the work and soon left to attend a grammar school in the Lavant Valley in Southern Austria. In 1874, he graduated from a high school in Klagenfurt, also in southern Austria, and went to Vienna to study medicine.

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East River and East River #2 by Mitchell Johnson  Voir?

Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as interpreted by the author.

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MYH9-Related Thrombocytopenia  Voir?

A 28-year-old Caucasian male with Asperger syndrome presented to the emergency department with an enlarged hematoma on his right calf secondary to minor trauma. Complete blood cell count revealed severe thrombocytopenia (platelets, 5000/μL). The patient's mother also had chronic thrombocytopenia and an unknown mental disorder. Peripheral smear at 100× (oil immersion) power revealed giant platelets (Figure A, arrow) and neutrophils with Döhle-like bodies (Figure B-D, arrow), consistent with MYH9-related thrombocytopenia.

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Bisphosphonates and Osteonecrosis of the Jaw  Voir?

In the January 2017 issue of Mayo Clinic Proceedings, Goodwin et al1 provide reassuring information on the incidence of osteonecrosis of the jaw (ONJ) in patients treated with intravenous bisphosphonates. Although the causal relationship between this class of bone antiresorptive medications and ONJ has long been known, this specific complication of osteoporosis treatment appears to be a rarity. Nevertheless, the perception among patients and some health care professionals is that ONJ is a relatively common occurrence.

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In Reply—Bisphosphonates and Osteonecrosis of the Jaw  Voir?

Dr Khoo makes an important point—that hip fracture can initiate a trajectory of complications, rapid functional decline, and death, and that these potential adverse outcomes of nontreatment should be discussed with patients for whom bisphosphonate therapy is indicated.
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Financial Conflict of Interest and Academic Influence Among Experts Speaking on Behalf of the Pharmaceutical Industry at the US Food and Drug Administration's Oncologic Drugs Advisory Committee Meetings  Voir?

Six groups of speakers participate in US Food and Drug Administration (FDA) advisory meetings: (1) FDA staff, (2) employees of the sponsoring company, (3) voting members, (4) patient and consumer representatives, (5) public speakers, and (6) experts speaking on behalf of a pharmaceutical company. Financial conflict of interest has been established in all but one of these groups, specifically voting members,1 patient and consumer representatives,2 and public speakers.3 Among FDA staff, subsequent employment in the biopharmaceutical industry is prevalent.

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Chronic Obstructive Pulmonary Disease Phenotypes: Implications for Care  Voir?

Chronic obstructive pulmonary disease (COPD) phenotyping can help define clusters of patients with common characteristics that relate to clinically meaningful outcomes. In this review, we describe 7 clinically meaningful COPD phenotypes that can be identified by primary care physicians as well as specialists and that have specific management and prognostic implications: (1) asthma-COPD overlap phenotype, (2) frequent exacerbator phenotype, (3) upper lobe–predominant emphysema phenotype, (4) rapid decliner phenotype, (5) comorbid COPD phenotype, (6) physical frailty phenotype, and (7) emotional frailty phenotype.

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Parkinson Disease and Melanoma  Voir?

To examine an association between melanoma and Parkinson disease (PD).
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Evaluation and Management of Atherosclerotic Carotid Stenosis  Voir?

Medical therapies for the prevention of stroke have advanced considerably in the past several years. There can also be a role for mechanical restoration of the lumen by endarterectomy or stenting in selected patients with high-grade atherosclerotic stenosis of the extracranial carotid artery. Endarterectomy is generally recommended for patients with high-grade symptomatic carotid stenosis. Stenting is considered an option for patients at high risk of complications with endarterectomy. Whether revascularization is better than contemporary medical therapy for asymptomatic extracranial carotid stenosis is a subject of several ongoing randomized clinical trials in the United States and internationally.

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Dernière mise à jour : 25/07/2017 : 13:15


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