Mayo Clinic proceedings
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Mayo Clinic proceedings · Apr 2005
ReviewSubarachnoid hemorrhage: neurointensive care and aneurysm repair.
Aneurysmal subarachnoid hemorrhage (SAH) is often a neurologic catastrophe. Diagnosing SAH can be challenging, and treatment is complex, sophisticated, multidisciplinary, and rarely routine. This review emphasizes treatment in the intensive care unit, surgical and endovascular therapeutic options, and the current state of treatment of major complications such as cerebral vasospasm, acute hydrocephalus, and rebleeding. Outcome assessment in survivors of SAH and controversies in screening of family members are discussed.
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Mayo Clinic proceedings · Feb 2005
Review Case Reports76-year-old man with back pain and progressive leg weakness.
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Mayo Clinic proceedings · Feb 2005
Clinical Trial Controlled Clinical TrialA curricular initiative for internal medicine residents to enhance proficiency in internal jugular central venous line placement.
To determine the feasibility, efficacy, and outcomes of teaching Internal Jugular (IJ) central venous line placement (CVLP) to internal medicine residents in a hands-on training experience with adult patients. ⋯ Training internal medicine residents to perform IJ-CVLP is feasible in the cardiac catheterization laboratory with supervision from an attending cardiologist. Trained residents performed significantly more IJ-CVLPs independently during their third year compared with their first year of training. We believe this initiative may be implemented successfully in graduate medical education curriculums.
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Mayo Clinic proceedings · Feb 2005
ReviewPreoperative smoking cessation: the role of the primary care provider.
Millions of cigarette smokers require surgery each year. Those who quit smoking may reduce their risk of respiratory, cardiovascular, and wound-related complications. ⋯ Primary care providers can play an important role in helping their patients scheduled for surgery quit smoking before their operation and maintain their abstinence after surgery. To do so effectively, physicians need to understand (1) the consequences of smoking in the perioperative period and how quitting can mitigate these problems, (2) how surgery can serve as a "teachable moment" to aid in smoking cessation, and (3) specific techniques that can be used to help their patients quit smoking, including brief counseling and pharmacotherapy.