Mayo Clinic proceedings
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Mayo Clinic proceedings · Feb 2005
Review Case Reports76-year-old man with back pain and progressive leg weakness.
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Mayo Clinic proceedings · Feb 2005
ReviewPreoperative smoking cessation: the role of the primary care provider.
Millions of cigarette smokers require surgery each year. Those who quit smoking may reduce their risk of respiratory, cardiovascular, and wound-related complications. ⋯ Primary care providers can play an important role in helping their patients scheduled for surgery quit smoking before their operation and maintain their abstinence after surgery. To do so effectively, physicians need to understand (1) the consequences of smoking in the perioperative period and how quitting can mitigate these problems, (2) how surgery can serve as a "teachable moment" to aid in smoking cessation, and (3) specific techniques that can be used to help their patients quit smoking, including brief counseling and pharmacotherapy.
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Mayo Clinic proceedings · Feb 2005
Comparative Study Clinical TrialImportance of device evaluation for point-of-care prothrombin time international normalized ratio testing programs.
To determine the accuracy of 2 commercially available point-of-care devices relative to plasma international normalized ratio (INR) values. ⋯ Optimal warfarin treatment requires accurate measurement of the INR. The choice of a point-of-care device for INR management depends on the reliability of INR data generated by the device.
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Mayo Clinic proceedings · Feb 2005
Evaluating the performance of an institution using an intensive care unit benchmark.
To describe the performances of selected intensive care units (ICUs) in a single institution using the Acute Physiology and Chronic Health Evaluation (APACHE) III benchmark and to propose interventions that may improve performance. ⋯ A national benchmarking database can highlight the strengths and weaknesses of ICUs. The performances of ICUs in a single institution may differ; therefore, the performance of each unit should be evaluated individually.
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Mayo Clinic proceedings · Feb 2005
Resource utilization and outcome in gravely ill intensive care unit patients with predicted in-hospital mortality rates of 95% or higher by APACHE III scores: the relationship with physician and family expectations.
To assess resource utilization and outcome in gravely ill patients admitted to an intensive care unit (ICU) and the potential association with health care workers' and family members' expectations. ⋯ Despite better-than-predicted survival outcomes, patient functionality and 1-year survival were poor. Unrealistic family expectations were associated with increased resource utilization without significant survival benefit, whereas absence of physician documentation of likely impending death (which correlated with improved survival) may denote the prognostication skills of experienced clinicians.