Mayo Clinic proceedings
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To identify the frequency and spectrum of clinically relevant diagnoses found at autopsy but not determined before death in adult patients admitted to an intensive care unit (ICU). ⋯ Diagnoses with impact on therapy and outcome are missed in approximately 4% of deaths of adult patients admitted to the ICU. Transplant recipients are especially likely to have occult conditions for which additional therapy might be indicated.
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Mayo Clinic proceedings · Jul 2003
ReviewThe hematologic system as a marker of organ dysfunction in sepsis.
Sepsis with acute organ dysfunction (severe sepsis) results from a systemic proinflammatory and procoagulant response to infection. Organ dysfunction in the patient with sepsis is associated with increased mortality. Although most organs have discrete anatomical boundaries and carry out unified functions, the hematologic system is poorly circumscribed and serves several unrelated functions. ⋯ The use of activated protein C may provide a survival benefit in subsets of patients with severe sepsis. The hematologic system should not be overlooked when assessing a patient with severe sepsis. A thorough clinical evaluation and panel of laboratory tests that relate to this organ system should be as much a part of the work-up as taking the patient's blood pressure, monitoring renal function, or measuring liver enzymes.
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Mayo Clinic proceedings · Jul 2003
ReviewSARS: epidemiology, clinical presentation, management, and infection control measures.
Severe acute respiratory syndrome (SARS) is a recently recognized febrile respiratory illness that first appeared in southern China in November 2002, has since spread to several countries, and has resulted in more than 8000 cases and more than 750 deaths. The disease has been etiologically linked to a novel coronavirus that has been named the SARS-associated coronavirus. ⋯ There is no specific therapy, and management consists of supportive care. This article summarizes currently available information regarding the epidemiology, clinical features, etiologic agent, and modes of transmission of the disease, as well as infection control measures appropriate to contain SARS.
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Mayo Clinic proceedings · Jul 2003
Editorial Comment ReviewSARS: 1918 revisited? The urgent need for global collaboration in public health.