Mayo Clinic proceedings
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The medical complexity of surgical patients is increasing and medical specialties are frequently asked to assist with the perioperative management surgical patients. Effective pre-anesthetic medical evaluations are a valuable tool in providing high-value, patient-centered surgical care and should systematically address risk assessment and identify areas for risk modification. ⋯ It discusses the evidence supporting the use of perioperative risk calculation tools and focused preoperative testing. We also introduce important key topics that will be explored in greater detail in upcoming reviews in this series.
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Mayo Clinic proceedings · Apr 2020
Meta AnalysisAtrial Fibrillation Is Associated With Syncope and Falls in Older Adults: A Systematic Review and Meta-analysis.
To examine the potential association of atrial fibrillation (AF) to syncope and falls, we undertook a systematic review and meta-analysis given the increasing prevalence of AF in older adults as well as emerging data that it is a risk factor for dementia. ⋯ AF is independently associated with syncope and falls in older adults. Further studies are needed to delineate mechanistic links and to guide management to improve outcomes in these patients.
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Mayo Clinic proceedings · Apr 2020
ReviewUpdate on Treatment of Clostridioides difficile Infection.
Clostridioides difficile infection (CDI) is the leading cause of health care-associated infections in the United States. The increasing incidence and recurrence rates of CDI together with its associated morbidity and mortality are great concerns. ⋯ Cited references were also used to identify relevant literature. This review focuses on the current standard of therapy and emerging therapies for CDI and summarizes the updated guidelines on treatment of CDI.
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Mayo Clinic proceedings · Apr 2020
ReviewAddressing Sexual Harassment in the #MeToo Era: An Institutional Approach.
Sexual harassment is a particularly pernicious form of harassment that can result in long-lasting psychological damage to victims. In health care, it has deleterious effects on teamwork and communication and may affect patient care. Although concerns regarding sexual harassment in the workplace, including within health care, are not new, increased attention has been focused on this topic since late 2017 as a result of the #MeToo movement. ⋯ Beyond reporting and addressing, health care institutions must establish policies that clearly outline the unacceptability of harassing behaviors. Moreover, institutions must have a systematic method to thoroughly investigate allegations of sexual harassment and to impose fair and consistent corrective actions when allegations are substantiated. This article describes Mayo Clinic's approach to this complex problem, including targeted efforts toward developing a culture intolerant of sexually harassing behavior.
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Mayo Clinic proceedings · Apr 2020
ReviewFertility Preservation in Women: Indications and Options for Therapy.
Fertility preservation (FP) is a vital issue for individuals in either reproductive or prepubescent stage of life when future fertility may be compromised. The objective of any FP intervention is to minimize or eliminate primary disease burden and to ensure maintaining or preserving reproductive health. Fertility potential can be affected by cancer therapy and numerous other factors, including advancing age, metabolic conditions, autoimmune diseases, specific surgical interventions, and sex affirmation procedures. ⋯ An electronic search in PubMed, Embase, and Google Scholar databases was conducted, including retrospective studies, prospective clinical trials, meta-analyses, original reviews, and online abstracts published up to June 30, 2019. The search terms used included fertility preservation, oncofertility, embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. The meeting proceedings of the American Society for Reproductive Medicine and the European Society of Human Reproduction and Embryology were also hand searched.