Mayo Clinic proceedings
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Mayo Clinic proceedings · Feb 2008
ReviewRecent advances in the diagnosis and management of malignant pleural effusions.
Malignant pleural effusions (MPEs) are an important complication for patients with intrathoracic and extrathoracic malignancies. Median survival after diagnosis of an MPE is 4 months. Patients can present with an MPE as a complication of far-advanced cancer or as the initial manifestation of an underlying malignancy. ⋯ Management of an MPE remains palliative; it is critical that the appropriate management approach is chosen on the basis of available expertise and the patient's clinical status. This review summarizes the pathogenesis, diagnosis, and management of MPE. Studies in the English language were identified by searching the MEDLINE database (1980-2007) using the search terms pleura, pleural, malignant, pleurodesis, and thoracoscopy.
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Mayo Clinic proceedings · Feb 2008
ReviewTrastuzumab-induced cardiotoxicity: heart failure at the crossroads.
Trastuzumab, a drug targeting human epidermal growth factor receptor 2, improves survival rate in women with metastatic breast cancer. Symptomatic heart failure, a serious adverse effect of trastuzumab, occurs in 1% to 4% of patients treated with the antibody, whereas left ventricular ejection fraction declines substantially in 10% of patients. ⋯ Serial assessment of left ventricular function with 2-dimensional echocardiography or radionuclide ventriculography is the most practical means of monitoring cardiotoxicity. Patients who develop cardiotoxicity while receiving trastuzumab therapy generally improve once use of the agent is discontinued.
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Mayo Clinic proceedings · Feb 2008
Risk factors for venous thromboembolism in nursing home residents.
To determine risk factors for venous thromboembolism (VTE) among nursing home (NH) residents. ⋯ Administrative data from NHs reveal important VTE risk factors not routinely documented in hospital or ambulatory records. However, ascertainment of VTE from NH administrative data appears biased toward surviving cases, highlighting concerns about using such data to assess provider quality and pointing to the need for studies that track individuals through multiple data sources across institutional settings.