Mayo Clinic proceedings
-
Mayo Clinic proceedings · Oct 2003
ReviewMinimally invasive procedures for disorders of the lumbar spine.
In the past decade, there has been a substantial increase in interest in minimally invasive procedures in all areas of medicine, particularly for spinal disorders. Some of these techniques represent notable advances in spinal care and have major roles in the care of patients with back-related symptoms. Other techniques appear to offer no benefit and in some cases may be less effective than conventional treatments. ⋯ Percutaneous vertebral augmentation, including vertebroplasty and kyphoplasty, has become the treatment of choice for many patients with intractable back pain secondary to vertebral insufficiency fractures. Spinal injections are important for evaluating and managing spinal pain and can be extremely useful diagnostically and therapeutically. This multidisciplinary review outlines the status of these procedures and offers suggestions for their use in patient care.
-
Mayo Clinic proceedings · Sep 2003
ReviewWest Nile virus: epidemiology, clinical presentation, diagnosis, and prevention.
West Nile virus was recognized in the United States for the first time in 1999, when it caused an epidemic of encephalitis and meningitis in New York City, NY. Since then, the disease has been steadily moving westward, and human cases were recognized in 39 states and the District of Columbia in 2002. The infection is caused by a flavivirus that is transmitted from birds to humans through the bite of culicine mosquitoes. ⋯ In 2002, 5 new modes of transmission were recognized: blood product transfusion, organ transplantation, breast-feeding, transplacental transmission, and occupational exposure in laboratory workers. The transmission season was long, with cases occurring into December in some parts of the United States. Currently, there is no specific drug treatment or vaccine against the infection, and avoiding mosquito bites is the best way to protect against the disease.
-
We treated a patient who developed transient multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, and limb dystonia) in temporal proximity to ondansetron administration on emergence from general anesthesia. No other medications known to cause extrapyramidal reactions were administered. ⋯ Ondansetron is used frequently as an antiemetic agent in many clinical settings and is not limited to surgical patients. Therefore, the entire medical community should be cognizant of this potential adverse reaction.
-
Mayo Clinic proceedings · Sep 2003
Interferon gamma-1b therapy for advanced idiopathic pulmonary fibrosis.
To report on observations made in a group of patients with idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP) who were treated with interferon gamma-1b. ⋯ These observations do not support the use of interferon gamma-lb therapy for patients with advanced IPF/UIP.