Mayo Clinic proceedings
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Mayo Clinic proceedings · Dec 2007
Advance directives among health care professionals at a community-based cancer center.
To determine the proportion of health care professionals at our community-based cancer center who had completed advance directives (ADs) and to identify barriers to their doing so. ⋯ Despite work experience with patients who have a high mortality rate, health care professionals at our cancer center do not adequately communicate (via a written AD) end-of-life planning decisions to their own primary care physicians.
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Mayo Clinic proceedings · Dec 2007
Safety of percutaneous dilatational tracheostomy with direct bronchoscopic guidance for solid organ allograft recipients.
To determine the safety of percutaneous dilatational tracheostomy (PDT) for solid organ allograft recipients, who have increased risks of bleeding and infection. ⋯ Percutaneous dilatational tracheostomy was tolerated well in recipients of solid organ allografts and had a relatively low risk of major complications and a low procedure-related mortality rate. This method should be considered an acceptable alternative to surgical tracheostomy.
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Mayo Clinic proceedings · Dec 2007
Comparative StudyPrevalence of monoclonal gammopathy of undetermined significance among men in Ghana.
To determine the prevalence of monoclonal gammopathy of undetermined significance (MGUS), a precursor of multiple myeloma (MM), in Ghanaian men vs white men and to test for evidence to support an underlying race-related predisposition of the 2-fold higher prevalence of MGUS in African Americans vs whites. ⋯ The prevalence of MGUS in Ghanaian men was twice that in white men, supporting the hypothesis that race-related genetic susceptibility could explain the higher rates of MGUS in black populations. An improved understanding of MGUS and MM pathophysiology would facilitate the development of strategies to prevent progression of MGUS to MM.
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Mayo Clinic proceedings · Nov 2007
ReviewA system-based approach to depression management in primary care using the Patient Health Questionnaire-9.
Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension, and its management poses a challenge to busy primary care practices. The Patient Health Questionnaire-9, a simple self-administered tool of proven validity and reliability, is a commonly used screening instrument for depression in primary care practice. This review article provides a system-based approach to depression management using the Patient Health Questionnaire-9 to guide clinicians in the identification and treatment of depression and its follow-up care.
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Central nervous system tumors are relatively common in the United States, with more than 40,000 cases annually. Although more than half of these tumors are benign, they can cause substantial morbidity. Malignant primary brain tumors are the leading cause of death from solid tumors in children and the third leading cause of death from cancer in adolescents and adults aged 15 to 34 years. ⋯ Metastases to the brain remain a frequent and morbid complication of solid tumors but are frequently controlled with surgery or radiation therapy. Unfortunately, the mortality rate from malignant brain tumors remains high, despite initial disease control. This article provides an overview of current diagnostic and treatment approaches for patients with primary and metastatic brain tumors.