Mayo Clinic proceedings
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Mayo Clinic proceedings · Aug 2005
ReviewClinical diagnosis of prolonged states of impaired consciousness in adults.
A prolonged state of impaired consciousness is a devastating consequence of severe structural brain injury but fortunately is uncommon. Patients may be diagnosed as being in a persistent vegetative state, having akinetic mutism, or being in a minimally conscious state. ⋯ For patients diagnosed as being in a permanent (irreversible) vegetative state, hope for a clinically meaningful recovery is unrealistic after 1 year. Prolonged survival is possible only with meticulous care and aggressive medical intervention to prevent and treat systemic complications.
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Mayo Clinic proceedings · Jul 2005
Review Case ReportsSinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.
Sinus headache is a widely accepted clinical diagnosis, although many medical specialists consider it an uncommon cause of recurrent headaches. The inappropriate diagnosis of sinus headache can lead to unnecessary diagnostic studies, surgical interventions, and medical treatments. ⋯ This committee reviewed available scientific evidence from multiple disciplines and concluded that considerable research and clinical study are required to further understand and delineate the role of nasal pathology and autonomic activation in migraine and headaches of rhinogenic origin. However, this group agreed that greater diagnostic and therapeutic attention needs to be given to patients with sinus headaches.
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Mayo Clinic proceedings · Jul 2005
ReviewHow to interpret and pursue an abnormal complete blood cell count in adults.
A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. ⋯ In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.
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Mayo Clinic proceedings · Jul 2005
Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients.
To estimate the magnitude of association between intraoperative hyperglycemia and perioperative outcomes in patients who underwent cardiac surgery. ⋯ Intraoperative hyperglycemia is an independent risk factor for complications, including death, after cardiac surgery.
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To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. ⋯ Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.