Mayo Clinic proceedings
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Mayo Clinic proceedings · Nov 2006
Comparative StudyThe impact of parental leave on extending training and entering the board certification examination process: a specialty-based comparison.
To study the impact of parental leave on extending residency training and the timing of entrance into the specialty board certification examination system. ⋯ Specialty board policies regarding absence from training and entering the board certification examination process vary and could influence decisions about family planning, the length of time taken for parental leave, the use of vacation time for parental leave, and resident well-being.
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Mayo Clinic proceedings · Oct 2006
Review Case ReportsCopper deficiency myelopathy (human swayback).
The hematologic manifestations of copper deficiency are well known and include anemia and neutropenia. In the past few years, the neurological manifestations of acquired copper deficiency in humans has been recognized, the most common being a myelopathy presenting with a spastic gait and prominent sensory ataxia. The known causes of acquired copper deficiency include prior gastric surgery, excessive zinc ingestion, and malabsorption; however, often the cause is unclear. ⋯ Copper supplementation resolves the anemia and neutropenia promptly and completely and may prevent the neurological deterioration. Improvement, when it occurs, is often subjective and preferentially involves sensory symptoms. This article describes patients with copper deficiency myelopathy seen at the Mayo Clinic in Rochester, Minn, and reviews the literature on neurological manifestations of acquired copper deficiency in humans.
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Mayo Clinic proceedings · Oct 2006
Randomized Controlled Trial Multicenter StudyAssessing the ability of topiramate to improve the daily activities of patients with migraine.
To assess the impact of topiramate on the daily activities of patients with migraine. ⋯ Patient-reported migraine-specific outcomes measured by the MSQ-RR and MSQ-RP domains improved significantly for those receiving topiramate (all doses) vs placebo. The SF36-RP domain scores improved significantly for patients receiving 100 or 200 mg/d of topiramate. Improvements in all 4 prospectively selected MSQ and SF-36 domains were significantly correlated with decreases in mean monthly migraine frequency.
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Mayo Clinic proceedings · Oct 2006
ReviewPerioperative care of patients undergoing bariatric surgery.
The epidemic of obesity in developed countries has resulted in patients with extreme (class III) obesity undergoing the full breadth of medical and surgical procedures. The popularity of bariatric surgery in the treatment of extreme obesity has raised awareness of the unique considerations in the care of this patient population. Minimizing the risk of perioperative complications that contribute to morbidity and mortality requires input from several clinical disciplines and begins with the preoperative assessment of the patient. ⋯ Early recognition of perioperative complications and education of the patient regarding postoperative issues, including nutrition and vitamin supplementation therapy, can improve patient outcomes. A suitable physical environment and appropriate nursing and dietetic support provide a safe and dignified hospital experience. This article reviews the multidisciplinary management of extremely obese patients who undergo bariatric surgery at the Mayo Clinic.