Mayo Clinic proceedings
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Mayo Clinic proceedings · Feb 1989
Case ReportsProper use of aerosol corticosteroids to control asthma.
Aerosol glucocorticoids are highly effective in the treatment of bronchial asthma. Clinically apparent systemic hypercortisolism is virtually nonexistent in patients who receive such therapy, although local effects of candidiasis or dysphonia may occur. ⋯ Furthermore, many patients with asthma require 2 or 3 times the conventional dose of aerosol corticosteroids for optimal control of pulmonary function. Careful coaching is essential for the successful use of aerosol corticosteroids.
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Mayo Clinic proceedings · Dec 1988
Idiopathic cyclic nausea and vomiting--a disorder of gastrointestinal motility?
Eight patients (five men and three women) with previously unexplained recurrent cyclic episodes of nausea and vomiting are described. In these patients, the symptoms developed a mean of once every 3.2 months and persisted a mean of 3.5 days. None of the patients had an identifiable cause of their symptoms on conventional diagnostic tests. ⋯ Gastric hypomotility was substantiated in five patients, small bowel dysmotility in six, delayed gastric emptying in two, and gastric dysrhythmia in two. The data demonstrate that abnormal gastrointestinal motility occurs during an asymptomatic state in patients with cyclic episodes of nausea and vomiting. Because all patients with this syndrome had abnormal gastrointestinal motility but normal results of other gastrointestinal studies, idiopathic cyclic nausea and vomiting may be related to altered gastrointestinal motility.
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Mayo Clinic proceedings · Sep 1988
Review Comparative StudySurgical pathology of the tricuspid valve: a study of 363 cases spanning 25 years.
Surgical pathologic features of the tricuspid valve were reviewed in 363 patients who had undergone tricuspid valve replacement at our institution during the period 1963 through 1987. Valves were purely regurgitant in 74%, stenotic and regurgitant in 23%, and purely stenotic in 2%; two valves were neither stenotic nor regurgitant. Among 269 purely insufficient tricuspid valves, the four most common causes were postinflammatory disease (41%), congenital disorder (32%), pulmonary venous hypertension (21%), and infective endocarditis (4%). ⋯ This trend may reflect the decreasing incidence of acute rheumatic fever reported in Western countries. During the same time interval, the relative frequency of congenital heart disease as a cause of tricuspid dysfunction increased from 7% to 53%, and it is currently the most common cause in our surgical population. This finding apparently reflects changes in patient referral practices and the development of new operative procedures.