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MAYO CLINIC guidelines

Patrick T Hangge, Esteban Calderon, Elizabeth B Habermann, Amy E Glasgow, Nitin Mishra
BACKGROUND: Primary colorectal lymphoma is rare, representing 0.2% to 0.6% of all colorectal cancers. Because of its low incidence and histologic variety, no treatment guidelines exist. OBJECTIVE: The purpose was to report the experience of primary colorectal lymphoma in an institutional and a national cohort. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted with institutional data composed of 3 tertiary referral centers and national data...
November 26, 2018: Diseases of the Colon and Rectum
Jae Yoon Park, Wei Guo, Mohammed Al-Hijji, Abdallah El Sabbagh, Kebede H Begna, Thomas M Habermann, Thomas E Witzig, Bradley R Lewis, Amir Lerman, Joerg Herrmann
BACKGROUND: Cancer and cardiovascular diseases are the two leading causes of death in industrialized countries. Optimal management of life-threatening presentations of both of their diseases can pose significant challenges. The current study aimed to address the incidence, management, and outcome of acute coronary syndromes (ACS) in patients with active hematological malignancies. METHODS: This retrospective registry-based cohort study included adults with active leukemia or lymphoma who were hospitalized at Mayo Clinic Rochester from 01/01/2004 to 12/31/2014...
October 5, 2018: International Journal of Cardiology
Angelica Cibrián-Ponce, Miguel A Sánchez-Alemán, Sara García-Jiménez, Eduardo Pérez-Martínez, Germán Bernal-Fernández, Miguel Castañon-Mayo, Laura Ávila-Jiménez, Cairo D Toledano-Jaimes
Introduction: The third report of the National Cholesterol Education Program guidelines recommends calculating the 10-year morbidity of atherosclerotic cardiovascular disease (ASCVD) using risk calculators when treating high blood cholesterol in adults. We analyzed the changes in cardiovascular risk (CVR) among Mexican patients with HIV. Patients and methods: This observational, prospective cohort study compared the CVR after 1 year of antiretroviral treatment among 460 HIV patients from a Mexican clinic...
2018: Therapeutics and Clinical Risk Management
Oana M Dumitrascu, Cumara B O'Carroll, Vanesa Vanderhye, Bart M Demaerschalk, Maria I Aguilar
Objective: To ensure prime blood pressure management and intracerebral hemorrhage (ICH) score documentation within 6 hours of arrival and/or before any intervention in patients admitted to Mayo Clinic Hospital with acute ICH. Patients and Methods: A quality improvement initiative was conducted between September 29, 2015, and May 30, 2017, following the Define-Measure-Analyze-Improve-Control methodology. Our prespecified goals for the first 8 months postintervention were that at least 80% of patients with ICH will have systolic blood pressure (SBP) control as per guideline-based recommendations (SBP ≤140 mm Hg) and at least 80% will have ICH score documented within 6 hours postadmission...
December 2017: Mayo Clinic proceedings. Innovations, quality & outcomes
Muhammad Hassan Majeed, Ramsha Nadeem, Muhammad Abbas Khokhar, Muhammad Nawaz Qaisar
PURPOSE: Pain is highly prevalent in advanced cancer and requires aggressive management. However, pain management in cancer is minimally investigated in Pakistan. This cross-sectional study explores the adequacy of pain management in patients with advanced stage cancer in Pakistan. METHOD: From January 2017 to May 2017, a cross-sectional study was conducted at Mayo Hospital, Lahore, Pakistan. A total of 218 patients with cancers were interviewed, and 136 patients with pain ≥5 on a Numerical Rating Scale for pain were included in the study...
September 13, 2018: Journal of Palliative Care
Sara Hocker, Sarah Clark, Jeffrey Britton
Despite phenobarbital (PB) being a key component in status epilepticus (SE) treatment algorithms for decades, it has fallen out of favor compared to newer nonsedating medications due to potential for respiratory suppression and prolonged sedation. We retrospectively analyzed all nonintubated patients with refractory SE treated with parenteral PB. Forty patients were identified as having received PB in the neurologic intensive care unit at Mayo Clinic over a 7-year period through our pharmacy dispensing database...
October 2018: Epilepsia
Issam El Naqa, Dan Ruan, Gilmer Valdes, Andre Dekker, Todd McNutt, Yaorong Ge, Q Jackie Wu, Jung Hun Oh, Maria Thor, Wade Smith, Arvind Rao, Clifton Fuller, Ying Xiao, Frank Manion, Matthew Schipper, Charles Mayo, Jean M Moran, Randall Ten Haken
With the era of big data, the utilization of machine learning algorithms in radiation oncology is rapidly growing with applications including: treatment response modeling, treatment planning, contouring, organ segmentation, image-guidance, motion tracking, quality assurance, and more. Despite this interest, practical clinical implementation of machine learning as part of the day-to-day clinical operations is still lagging. The aim of this white paper is to further promote progress in this new field of machine learning in radiation oncology by highlighting its untapped advantages and potentials for clinical advancement, while also presenting current challenges and open questions for future research...
October 2018: Medical Physics
Iftikhar J Kullo, Kent R Bailey
To inform guidelines for screening family members of patients with familial hypercholesterolemia (FH), we designed a clinical trial to compare the yield of cascade screening in FH patients with and without an identifiable pathogenic variant. Participants with hypercholesterolemia (Low-density lipoprotein cholesterol (LDL-C) > 155 mg/dL) underwent sequencing of LDLR , APOB , and PCSK9 and genotyping of six single nucleotide polymorphisms associated with LDL-C followed by calculation of a polygenic score for LDL-C...
August 23, 2018: Journal of Personalized Medicine
Moira B Hilscher, James H Tabibian, Elizabeth J Carey, Christopher J Gostout, Keith D Lindor
Dominant strictures (DSs) of the biliary tree occur in approximately 50% of patients with primary sclerosing cholangitis (PSC) and may cause significant morbidity. Nevertheless, the definition and management of DSs lacks consensus. We aimed to better understand current perceptions and practices regarding PSC-associated DSs. We conducted an anonymous, 23-question, survey-based study wherein electronic surveys were distributed to 131 faculty in the Division of Gastroenterology and Hepatology at the three Mayo Clinic campuses (Rochester, Scottsdale, and Jacksonville) as well as the affiliated practice network...
July 2018: Hepatology Communications
Mariabeatrice Principi, Giuseppe Losurdo, Andrea Iannone, Antonella Contaldo, Valentina Deflorio, Nunzio Ranaldo, Antonio Pisani, Enzo Ierardi, Alfredo Di Leo, Michele Barone
Background: Although patients with active inflammatory bowel disease (IBD) change their dietary habits according to suggestions from their healthcare team, no restriction is required in the remission phase. Accordingly, we compared eating patterns in IBD patients with drug-induced clinical remission with those in healthy subjects. Methods: A total of 150 IBD patients, 84 with Crohn's disease (CD) and 66 with ulcerative colitis (UC), in clinical remission, receiving immunomodulator/biologic therapy, and 100 healthy volunteers (controls) were enrolled...
July 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Ji Young Chang, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae-Il Kim, Won-Ho Kim
BACKGROUND: Discrepancies between clinical symptoms and mucosal inflammation have been reported in up to 50% of patients with ulcerative colitis (UC). However, there are no guidelines and only limited information for appropriate treatment manipulation. AIM: We aimed to evaluate long-term outcomes according to treatment strategies and determine predictive factors for disease relapse in UC patients who are in clinical remission (CR) but still have endoscopic inflammation...
July 9, 2018: Digestive Diseases and Sciences
S Hommeida, R M Grothe, Y Hafed, R J Lennon, C D Schleck, J A Alexander, D A Katzka, I Absah
Previous studies reported increased eosinophilic esophagitis (EoE) incidence in children. It is unclear whether this reported increased EoE incidence is true or due to increased recognition and diagnostic endoscopy among children. A population-based study that evaluated EoE incidence in OC, Minnesota, from 1976 to 2005 concluded that EoE incidence increased significantly over the past three 5-year intervals (from 0.35 [range: 0-0.87] per 100,000 person-years for 1991-1995 to 9.45 [range: 7.13-11.77] per 100,000 person-years for 2001-2005)...
July 5, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Nicole L Nollen, Lisa Sanderson Cox, Matthew S Mayo, Edward F Ellerbeck, Sheshadri Madhusudhana, Jasjit S Ahluwalia
BACKGROUND: Non-daily smokers (NDS) who smoke on some but not all days are a growing subset of United States (US) tobacco users. Racial/ethnic minorities are more likely to be NDS. African American NDS have strikingly high levels of nicotine and carcinogen exposure, making treatment of this high risk group a priority. METHODS: The current study is one of three ongoing federally-funded clinical trials of NDS and, to our knowledge the only RCT focused on racial/ethnic minority NDS...
July 2018: Contemporary Clinical Trials
Mayo Theivendran, Jason Chuen
BACKGROUND: Screening and diagnostic surveillance of latent conditions have a profound impact on public healthcare expenditure and clinical outcomes. Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. OBJECTIVE: This article is the second of two that will outline current areas of controversy and research in AAA disease in order to support a more detailed understanding of issues in managing patients with this condition, and inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
Jason Chuen, Mayo Theivendran
BACKGROUND: Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. OBJECTIVE: This article is the first of two that will outline current treatment options for AAA, including areas of controversy and research in AAA disease, to inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
Amol Utrankar, Tilicia L Mayo-Gamble, Whitney Allen, Laurie Novak, Adetola A Kassim, Kemberlee Bonnet, David Schlundt, Velma M Murry, Gretchen Purcell Jackson, Michael DeBaun, Robert M Cronin
Objective: Sickle cell disease (SCD) is a chronic condition affecting over 100 000 individuals in the United States, predominantly from vulnerable populations. Clinical practice guidelines, written for providers, have low adherence. This study explored knowledge about guidelines; desire for guidelines; and how technology could support guideline awareness and adherence, examining current technology uses, and user preferences to inform design of a patient-centered guidelines application in a chronic disease...
August 1, 2018: Journal of the American Medical Informatics Association: JAMIA
Benjamin Simmons, Waldemar Wysokinski, Rayya A Saadiq, Dalene Bott-Kitslaar, Stanislav Henkin, Ana Casanegra, Charles Lenz, Paul Daniels, Haraldur Bjarnason, Emily Vargas, David Hodge, Sara J Holton, James R Cerhan, Charles Loprinzi, Robert McBane
BACKGROUND: Low molecular weight heparin (LMWH) is the guideline-endorsed treatment for cancer-associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. METHODS: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry, were compared to contemporary cancer patients receiving enoxaparin...
April 4, 2018: European Journal of Haematology
John P Mulhall, Landon W Trost, Robert E Brannigan, Emily G Kurtz, J Bruce Redmon, Kelly A Chiles, Deborah J Lightner, Martin M Miner, M Hassan Murad, Christian J Nelson, Elizabeth A Platz, Lakshmi V Ramanathan, Ronald W Lewis
PURPOSE: There has been a marked increase in testosterone prescriptions in the past decade resulting in a growing need to give practicing clinicians proper guidance on the evaluation and management of the testosterone deficient patient. MATERIALS AND METHODS: A systematic review utilized research from the Mayo Clinic Evidence Based Practice Center and additional supplementation by the authors. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions (table 1 in supplementary unabridged guideline, http://jurology...
August 2018: Journal of Urology
Charles S Mayo, Jean M Moran, Walter Bosch, Ying Xiao, Todd McNutt, Richard Popple, Jeff Michalski, Mary Feng, Lawrence B Marks, Clifton D Fuller, Ellen Yorke, Jatinder Palta, Peter E Gabriel, Andrea Molineu, Martha M Matuszak, Elizabeth Covington, Kathryn Masi, Susan L Richardson, Timothy Ritter, Tomasz Morgas, Stella Flampouri, Lakshmi Santanam, Joseph A Moore, Thomas G Purdie, Robert C Miller, Coen Hurkmans, Judy Adams, Qing-Rong Jackie Wu, Colleen J Fox, Ramon Alfredo Siochi, Norman L Brown, Wilko Verbakel, Yves Archambault, Steven J Chmura, Andre L Dekker, Don G Eagle, Thomas J Fitzgerald, Theodore Hong, Rishabh Kapoor, Beth Lansing, Shruti Jolly, Mary E Napolitano, James Percy, Mark S Rose, Salim Siddiqui, Christof Schadt, William E Simon, William L Straube, Sara T St James, Kenneth Ulin, Sue S Yom, Torunn I Yock
A substantial barrier to the single- and multi-institutional aggregation of data to supporting clinical trials, practice quality improvement efforts, and development of big data analytics resource systems is the lack of standardized nomenclatures for expressing dosimetric data. To address this issue, the American Association of Physicists in Medicine (AAPM) Task Group 263 was charged with providing nomenclature guidelines and values in radiation oncology for use in clinical trials, data-pooling initiatives, population-based studies, and routine clinical care by standardizing: (1) structure names across image processing and treatment planning system platforms; (2) nomenclature for dosimetric data (eg, dose-volume histogram [DVH]-based metrics); (3) templates for clinical trial groups and users of an initial subset of software platforms to facilitate adoption of the standards; (4) formalism for nomenclature schema, which can accommodate the addition of other structures defined in the future...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
July 2018: International Journal of Cardiovascular Imaging
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