Mayo Clinic proceedings
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Mayo Clinic proceedings · Nov 2005
Safety, diagnostic yield, and therapeutic implications of flexible bronchoscopy in patients with febrile neutropenia and pulmonary infiltrates.
To evaluate the safety, diagnostic yield, and therapeutic implications of flexible bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy in patients with febrile neutropenia and pulmonary infiltrates. ⋯ The favorable safety record, good diagnostic yield, and frequent therapeutic implications support the routine use of BAL for the evaluation of pulmonary inflitrates in neutropenic patients. Bronchoalveolar lavage should be combined with the analysis of several sputum specimens. Transbronchial biopsy did only change the management of 1 patient.
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To reassess the clinical and radiological features of chronic nitrofurantoin-induced lung disease and eventual clinical outcome. ⋯ Chronic nitrofurantoin-induced lung disease is seen predominantly in older women who present with respiratory symptoms after a year or more of nitrofurantoin therapy. Associated radiological features are relatively nonspecific but usually include bilateral areas of ground-glass opacities on computed tomography of the chest. Cessation of nitrofurantoin therapy leads to improvement and suffices in the management of some patients, although corticosteroid therapy may be helpful in those more severely affected.
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Mayo Clinic proceedings · Sep 2005
Meta Analysis Comparative StudyCiprofloxacin vs an aminoglycoside in combination with a beta-lactam for the treatment of febrile neutropenia: a meta-analysis of randomized controlled trials.
To compare the effectiveness and toxicity of ciprofloxacin vs an aminoglycoside, both in combination with a beta-lactam, for the treatment of febrile neutropenia in the inpatient setting. ⋯ The combination of ciprofloxacin with a beta-actam antibiotic should be considered an important therapeutic option in hospitalized febrile neutropenic patients who have not received a quinolone for prevention of infections and in settings in which quinolone resistance is not common.
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Mayo Clinic proceedings · Sep 2005
Randomized Controlled Trial Comparative Study Clinical TrialBotulinum toxin type A for the prophylactic treatment of chronic daily headache: a randomized, double-blind, placebo-controlled trial.
To identify a treatment-responsive population for botulinum toxin type A (BoNTA) and to evaluate the safety and efficacy of 3 different doses of BoNTA as prophylactic treatment of chronic daily headache (CDH). ⋯ Although the primary efficacy end point was not met, all groups responded to treatment. The 225 U and 150 U groups experienced a greater decrease in headache frequency than the placebo group at day 240. The placebo response was higher than expected. BoNTA was safe and well tolerated. Further study of BoNTA prophylactic treatment of CDH appears warranted.
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Mayo Clinic proceedings · Sep 2005
ReviewEpidemiology, treatment, and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections.
Since first described In 1961, methicillin-resistant Staphylococcus aureus (MRSA) has become a common nosocomial pathogen. Substantial increases in MRSA infections among nonhospitalized patients are being reported. ⋯ Community-acquired MRSA strains differ from nosocomial strains in clinically relevant ways, such as in their propensity to cause skin and soft tissue infection and severe necrotizing pneumonia. Clinicians in numerous specialties, particularly primary care physicians, will likely evaluate patients presentIng with community-acquired MRSA and should become familiar with the epidemiology and clinical characteristics of and evolving therapeutic and preventive strategies for this infection.