Mayo Clinic proceedings
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Mayo Clinic proceedings · Dec 2012
ReviewPostural tachycardia syndrome: a heterogeneous and multifactorial disorder.
Postural tachycardia syndrome (POTS) is defined by a heart rate increment of 30 beats/min or more within 10 minutes of standing or head-up tilt in the absence of orthostatic hypotension; the standing heart rate is often 120 beats/min or higher. POTS manifests with symptoms of cerebral hypoperfusion and excessive sympathoexcitation. The pathophysiology of POTS is heterogeneous and includes impaired sympathetically mediated vasoconstriction, excessive sympathetic drive, volume dysregulation, and deconditioning. ⋯ A literature search of PubMed for articles published from January 1, 1990, to June 15, 2012, was performed using the following terms (or combination of terms): POTS; postural tachycardia syndrome, orthostatic; orthostatic; syncope; sympathetic; baroreceptors; vestibulosympathetic; hypovolemia; visceral pain; chronic fatigue; deconditioning; headache; Chiari malformation; Ehlers-Danlos; emotion; amygdala; insula; anterior cingulate; periaqueductal gray; fludrocortisone; midodrine; propranolol; β-adrenergic; and pyridostigmine. Studies were limited to those published in English. Other articles were identified from bibliographies of the retrieved articles.
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Mayo Clinic proceedings · Dec 2012
Association of resident fatigue and distress with occupational blood and body fluid exposures and motor vehicle incidents.
To evaluate the effect of resident physicians' distress on their personal safety. ⋯ Exposures to BBF are relatively uncommon among internal medicine residents in current training environments. Motor vehicle incidents, however, remain common. Our results confirm the importance of fatigue and sleepiness to resident safety concerns. In addition, higher levels of distress may be contributory factors to motor vehicle crashes and other related incidents. Interventions designed to address both fatigue and distress may be needed to optimally promote patient and resident safety.
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Mayo Clinic proceedings · Dec 2012
Effect of large tumor size on cancer-specific mortality in node-negative breast cancer.
To examine the relationship between large tumor size and breast cancer-specific mortality (BCSM), especially in a subset of patients with negative lymph nodes (LNs). ⋯ A relatively larger tumor size without LN involvement may be a surrogate for biologically indolent disease of distant metastasis. Our findings, if validated in other large databases, may provide better understanding of breast cancer biology.
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Mayo Clinic proceedings · Dec 2012
Using social media to improve continuing medical education: a survey of course participants.
To determine continuing medical education (CME) course participants' use of social media (SM) and their attitudes about the value of SM for enhancing CME education and to examine associations between participants' characteristics and attitudes toward SM. ⋯ We describe the first validated measure of CME course participants' use of and attitudes toward SM. Our results suggest that CME course directors should guide SM strategies toward more youthful, technology-savvy CME participants and that SM will become increasingly worthwhile in CME as younger learners continue to enter the profession.