Abstract:
OBJECTIVE:To estimate the 3-month cumulative incidence of thromboembolism (TE), bleeding, and death among consecutive patients with nonvalvular atrial fibrillation (AF) who were receiving long-term anticoagulation therapy and were referred to the Thrombophilia Center at Mayo Clinic for periprocedural anticoagulation management. PATIENTS AND METHODS:In a prospective cohort study of consecutive patients receiving long-term anticoagulation therapy who were referred to the Thrombophilia Center for periprocedural anticoagulation management over the 7-year period, January 1, 1997, to December 31, 2003, 345 patients with nonvalvular AF were eligible for inclusion. Warfarin was stopped 4 to 5 days before and was restarted after surgery as soon as hemostasis was assured. The decision to provide bridging therapy with heparin was individualized and based on the estimated risks of TE and bleeding. RESULTS:The 345 patients with AF (mean +/- SD age, 74+/-9 years; 33% women) underwent 386 procedures. Warfarin administration was not interrupted for 44 procedures. Periprocedural heparin was provided for 204 procedures. Patients receiving heparin were more likely to have prior TE (43% vs 24%; P<.001) and a higher CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke) score (2.2 vs 1.9; P=.06). Four patients had 6 episodes of TE (3 strokes and 3 acute coronary episodes; TE rate, 1.1%; 95% confidence interval, 0.0%-2.1%). Nine patients had 10 major bleeding events (major bleeding rate, 2.7%; 95% confidence interval, 1.0%-4.4%). There were no deaths. Neither bleeding nor TE rates differed by anticoagulant management strategy. CONCLUSION:The 3-month cumulative incidence of TE and bleeding among patients with AF in whom anticoagulation was temporarily interrupted for an invasive procedure was low and was not significantly influenced by bridging therapy.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Wysokinski WE,McBane RD,Daniels PR,Litin SC,Hodge DO,Dowling NF,Heit JAdoi
10.4065/83.6.639subject
Has Abstractpub_date
2008-06-01 00:00:00pages
639-45issue
6eissn
0025-6196issn
1942-5546pii
S0025-6196(11)60891-4journal_volume
83pub_type
杂志文章abstract::Crohn's disease can involve any portion of the digestive tract, but isolated gastric Crohn's disease is a rare entity. In the few previously reported cases, the inflammatory disorder has involved only a portion of the stomach. Herein we describe a patient with diffuse involvement of the entire stomach and an associate...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61750-9
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of fetal urinary tract anomalies and to characterize the types of such abnormalities detected on ultrasonography and the outcome of affected patients during a 15-year period at our institution. DESIGN:We retrospectively reviewed the findings on maternal prenatal ultrasound examinat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.6.526
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To describe the two variants of Castleman's disease--the hyaline-vascular type and the plasma-cell type--and discuss the associated histologic features. DESIGN:We present a case of the hyaline-vascular type and review the literature. RESULTS:Castleman's disease was once thought to be localized and self-limi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/70.10.969
更新日期:1995-10-01 00:00:00
abstract:FINDINGS:The prostate-specific antigen (PSA) level alone does not facilitate precise pathologic staging on an individual basis, although advanced stage tends to correlate with an increased PSA level. The staging accuracy of PSA, however, can be enhanced by considering the variables of tumor grade and clinical stage. St...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61615-2
更新日期:1994-01-01 00:00:00
abstract::Health-care organizations have recognized the need to prepare physicians for various leadership and management positions within their own institutions. In the past, those who desired further education had to search beyond the boundaries of their practice to fulfill this need. The demands of a dynamic and changing heal...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)63574-X
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:To determine the effect of psychologic distress, measured with a commonly used screening questionnaire, on 6-month morbidity and rehospitalization costs in coronary patients. DESIGN:Psychologic distress was determined by screening with the Symptom Checklist-90--Revised (SCL-90-R) self-report inventory during...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.8.734
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To investigate the predictors of monoclonal gammopathy of undetermined significance (MGUS) by considering not only the initial features but also the pattern of evolution of the M protein during the first years after diagnosis. PATIENTS AND METHODS:This study consisted of 359 patients diagnosed as having MGUS...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/82.4.428
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To compare coronary artery bypass grafting (CABG) with percutaneous transluminal coronary angioplasty (PTCA) in patients with proximal, isolated de novo left anterior descending coronary artery disease and left ventricular ejection fraction of 45%. PATIENTS AND METHODS:In the multicenter Stenting vs Internal...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.4065/75.11.1116
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of pulmonary lymphangioleiomyomatosis (LAM), a rare cystic lung disorder that occurs almost exclusively in women of reproductive age, in women with tuberous sclerosis complex (TSC), an inheritable multiorgan hamartomatosis. PATIENTS AND METHODS:In this retrospective cohort study, t...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.6.591
更新日期:2000-06-01 00:00:00
abstract::During the past decade, major advances have been made in vitamin D research that transcend the simple concept that vitamin D is Important for the prevention of rickets in children and has little physiologic relevance for adults. Inadequate vitamin D, in addition to causing rickets, prevents children from attaining the...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/81.3.353
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To investigate presenting signs and symptoms of ovarian cancer and stage of tumor in a community cohort of women with the diagnosis of ovarian cancer. PATIENTS AND METHODS:We reviewed retrospectively the medical records of all women who sought primary and specialty care in Olmsted County, Minnesota, between ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/79.10.1277
更新日期:2004-10-01 00:00:00
abstract::We developed and validated a radioimmunoassay for circulating human parathyroid hormone-related peptide (PTHrP), based on a commercial antiserum to the synthetic 1-34 fragment of PTHrP, 125I-Tyr degrees-PTHrP(1-34) as radioligand, and prior extraction of the native peptide from plasma with C-2 cartridges. We determine...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62163-6
更新日期:1990-11-01 00:00:00
abstract::Brugada syndrome (BrS) is a common occult cause of sudden cardiac arrest in otherwise healthy-appearing adults. The pathognomonic electrocardiographic pattern may be unmasked only by certain medications, many of which are unknown. We report a case of a depressed but otherwise healthy man with an asymptomatic right bun...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2014.08.010
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To determine the risk of congenital cardiac abnormalities associated with use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy. PATIENTS AND METHODS:We conducted a retrospective review of the medical records of all pregnant women presenting at Mayo Clinic's site in Rochester, MN, from Janu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/84.1.23
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To report a case of eosinophilic myocarditis with remarkable initial clinical manifestations and outcome. MATERIAL AND METHODS:A 67-year-old woman with hypertension and a history of asthma and drug hypersensitivity was referred to our institution with a diagnosis of acute myocardial infarction on the basis o...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
abstract::During the 11-year period 1975 through 1985, 1,063 surgical procedures were performed on 795 Mayo Clinic patients 90 years of age or older. Preoperative conditions, surgical setting, and perioperative morbidity and mortality were analyzed in a comparison of the local residents of Olmsted County, Minnesota (N = 224), w...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62742-6
更新日期:1990-09-01 00:00:00
abstract::A 36-year-old man sought medical attention because of pressure in his head and distention of the veins in his neck. Physical examination disclosed a murmur of aortic insufficiency, and a chest roentgenogram showed a dilated ascending aorta. Two-dimensional echocardiography and angiography demonstrated a large intimal ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65202-1
更新日期:1986-02-01 00:00:00
abstract::Unintentional intra-arterial injection of medication, either iatrogenic or self-administered, is a source of considerable morbidity. Normal vascular anatomical proximity, aberrant vasculature, procedurally difficult situations, and medical personnel error all contribute to unintentional cannulation of arteries in an a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)61533-4
更新日期:2005-06-01 00:00:00
abstract::We describe a woman in whom hypogammaglobulinemia and severe granulomatous cutaneous lesions had developed during childhood; subsequently, Hodgkin's disease and necrobiotic xanthogranuloma were diagnosed. This case illustrates an apparent association with disease activity and raises the question of a direct relationsh...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62473-2
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the frequency and appropriateness of nil per os (nothing by mouth) (NPO) orders and determine the number of meals missed because of these orders among hospitalized patients. PATIENTS AND METHODS:We retrospectively analyzed inpatient NPO orders at an academic institution in the United States. The ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2015.07.013
更新日期:2015-09-01 00:00:00
abstract::The patient with a hypersensitive carotid sinus reflex and syncope may pose special challenges in evaluation and treatment. Specifically, although the finding of carotid sinus hypersensitivity may indeed indicate an exaggerated vagal tone that causes syncope, it may also be a chance association in a patient with synco...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62417-3
更新日期:1984-09-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章
doi:10.4065/77.11.1159
更新日期:2002-11-01 00:00:00
abstract::The medical records of 293 patients who underwent renal transplantation were analyzed for the occurrence of Streptococcus pneumoniae and Haemophilus influenzae infections in relation to splenectomy. Splenectomy was done in 236 (81%) graft recipients before or concomitant with transplantation. Bacteremia developed in f...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::Ever since ancient times, man has been searching for the proper artificial substitute for living tissue. This has been a most frustrating and challenging task for the scientific community involved. Prosthetic restoration is the only alternative to reconstructive surgery for the facially deformed. This paper reviews th...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::High blood pressure is a major individual and public-health issue because of its wide prevalence and associated complications. More women than men have hypertension, but until recently, women have been relatively underrepresented in clinical trials. Gender differences in the physiology, genetics, and treatment benefit...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63649-5
更新日期:1998-02-01 00:00:00
abstract::Constipation is a common symptom that may be primary (idiopathic or functional) or associated with a number of disorders or medications. Although most constipation is self-managed by patients, 22% seek health care, mostly to primary care physicians (>50%) and gastroenterologists (14%), resulting in large expenditures ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2019.01.031
更新日期:2019-11-01 00:00:00
abstract::Dural arteriovenous malformations of the transverse sinus are relatively well localized to the occipitomastoid regions and occur predominantly in women who are more than 40 years of age. The signs and symptoms, except for pulsatile tinnitus, vary and apparently depend on the presence of impaired venous drainage, which...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract::Chest pain in a young person is often caused by chest wall tenderness, associated with mitral valve prolapse, or attributed to psychologic factors. Ischemic cardiac pain may be overlooked because of its rare occurrence in this age group. A 35-year-old woman complained of substernal chest pressure precipitated by exert...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)64859-9
更新日期:1988-04-01 00:00:00
abstract::Reports in the popular press have suggested that exposure to diethylstilbestrol (DES) is followed by an abnormally high incidence of breast cancer. The reports were based on a reanalysis of data not considered ominous originally; and both data and analyses are summarized here. In addition, new data are presented on mo...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To assess whether amiodarone, as part of a strategy to achieve sinus rhythm, is safe and effective compared with a placebo or rate control drug in patients with persistent atrial fibrillation (AF) of more than 30 days' duration. METHODS:Randomized controlled trials comparing amiodarone with a placebo or rate...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/S0025-6196(11)61140-3
更新日期:2009-03-01 00:00:00