Abstract:
:Intraoperative (IO) transesophageal echocardiography (TEE) is widely used for assessing the results of valvular heart disease (VHD) surgery. Epiaortic ultrasonography (EAU) has been recommended for prevention of perioperative strokes. To what extent does high-quality evidence justify the widespread use of these imaging modalities? In March 2009, we searched MEDLINE (PubMed and OVID interfaces) and EMBASE for studies published in English using database-specific controlled vocabulary describing the concepts of IOTEE, cardiac surgery, VHD, and EAU. We found no randomized trials or studies with control groups assessing the impact of IOTEE in VHD surgery. Pooled analysis of 8 observational studies including 15,540 patients showed an average incidence of 11% for prebypass surgical changes and 4% for second pump runs, suggesting that patients undergoing VHD surgery may benefit significantly from IOTEE, particularly from postcardiopulmonary bypass IOTEE in aortic repair and mitral repair and replacement, but less so in isolated aortic replacement. Further available indirect evidence was satisfactory in the test accuracy and surgical quality control aspects, with low complication rates for IOTEE. The data supporting EAU included 12,687 patients in 2 prospective randomized studies and 4 nonrandomized, controlled studies, producing inconsistent outcome-related results. Despite low-quality scientific evidence supporting IOTEE in VHD surgery, we conclude that indirect evidence supporting its use is satisfactory and suggests that IOTEE may offer considerable benefit in valvular repairs and mitral replacements. The value of IOTEE in isolated aortic valve replacement remains less clear. Evidence supporting EAU is scientifically more robust but conflicting. These findings have important clinical policy and research implications.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Michelena HI,Abel MD,Suri RM,Freeman WK,Click RL,Sundt TM,Schaff HV,Enriquez-Sarano Mdoi
10.4065/mcp.2009.0629subject
Has Abstractpub_date
2010-07-01 00:00:00pages
646-55issue
7eissn
0025-6196issn
1942-5546pii
S0025-6196(11)60169-9journal_volume
85pub_type
杂志文章,meta分析,评审abstract::B-cell chronic lymphocytic leukemia (B-CLL) is a relatively indolent hematologic malignant disease that, despite a good response to nonaggressive orally administered chemotherapy, currently remains incurable. The overall median duration of survival is more than 5 years, and the presence of anemia or thrombocytopenia a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61551-1
更新日期:1992-04-01 00:00:00
abstract::A patient simulator has been developed for training, certification, modeling, and demonstrating problems in the management of critical-care patients. The Critical Care & Hemodynamic Monitoring Training System consists of a personal computer, software, and a replica of a human torso designed to enable students to pract...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65158-1
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVES:To describe the development and implementation process and assess the effect on self-reported clinical practice changes of a multidisciplinary, collaborative, interactive continuing medical education (CME)/continuing education (CE) program on chronic obstructive pulmonary disease (COPD). METHODS:Multidiscip...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2012.02.028
更新日期:2012-09-01 00:00:00
abstract::Primary sclerosing cholangitis (PSC) predisposes to the development of cholangiocarcinoma, a usually fatal complication that is difficult to diagnose. Serum concentrations of CA 19-9, a tumor-associated antigen, are frequently increased in patients with only cholangiocarcinoma. The aim of this study was to assess the ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60696-x
更新日期:1993-09-01 00:00:00
abstract::Psychosocial and spiritual factors influence a broad spectrum of medical and surgical disorders. The adverse effects of stress have been most clearly documented in cardiovascular disease. In cancer, unresolved questions include the following: Do emotional factors have a causal role in either initiating or promoting a ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/72.2.160
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To report the clinicopathologic findings in patients with Grover's disease. MATERIAL AND METHODS:We reviewed the medical records and biopsy specimens from 72 patients with transient acantholytic dermatosis (Grover's disease) examined at Mayo Clinic Rochester. Hematoxylin-eosin-stained biopsy specimens (from ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/74.3.229
更新日期:1999-03-01 00:00:00
abstract::Of 53 patients with horseshoe kidney (9 in the present series), 45 underwent operation for an abdominal aortic aneurysm: 40 electively and 5 on an emergency basis. The remaining eight patients underwent revascularization for arteriosclerosis obliterans. Of the 53 patients, 35 (66%) had renal artery anomalies. The anom...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::Treatment responses to imatinib vary among patients with chronic myeloid leukemia (CML), and definitions of treatment failure and suboptimal response have been published. This article discusses monitoring and treatment of patients with CML after failure of or suboptimal response to imatinib therapy. We reviewed articl...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)60824-0
更新日期:2009-02-01 00:00:00
abstract::Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as interpreted by the author. ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2017.07.004
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To derive risk models for percutaneous coronary intervention (PCI) outcomes from clinical and laboratory variables available before the procedure so they can be used for preprocedure risk stratification. PATIENTS AND METHODS:Using the Mayo Clinic registry, we analyzed 9035 PCIs on 7640 unique patients from J...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/82.6.701
更新日期:2007-06-01 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::Breast cancer is the most common cancer among women in the United States, with an estimated 200,000 new cases diagnosed annually. A multidisciplinary focus that entails prevention, diagnosis, and treatment has led to significant strides in the reduction of breast cancer incidence and mortality. Additionally, breast ca...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/82.8.999
更新日期:2007-08-01 00:00:00
abstract::In a study of 49 consecutive patients for whom a test for platelet antibodies had been ordered, tests were performed for both cell-bound and serum platelet antibodies. In cases of autoimmune thrombocytopenia (ITP), the test result for cell-bound antibody was more likely to be positive than was the test result for seru...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65623-7
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:To provide external validation of the diagnostic accuracy of the Sleep Apnea Clinical Score (SACS) tool in a new setting and patient population. PATIENTS AND METHODS:We conducted a prospective cohort study. Potential participants were adult family medicine patients. We excluded patients with a SACS of 0, kno...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.01.022
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To characterize public perception of physicians' conflicts of interest (COIs) across medical and surgical specialties. PATIENTS AND METHODS:A cross-sectional 6-arm randomized survey of a nonprobability sample from Amazon's Mechanical Turk occurred on December 11 to 16, 2018. Survey respondents were randomly...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.07.009
更新日期:2019-12-01 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::The sport of snow skiing by the physically disabled, which originated in Europe in 1935 and first received attention in the United States in the 1940s, is reviewed in terms of opportunities available, instructions, adaptive equipment necessary, and benefits provided. Persons with a wide variety of disabilities (such a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60488-1
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the rate of and potential risk factors for bloodstream infections (BSIs) using data from the REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension [PAH] Disease Management) REGISTRY(®), which provides current information about patients with PAH. PATIENTS AND METHODS:Pat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.mayocp.2012.05.014
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009. PATIENTS AND METHODS:Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.06.028
更新日期:2016-11-01 00:00:00
abstract::Platelets from normal pigs and pigs with von Willebrand's disease were studied by ultrastructural and scanning electron microscopy. The majority of resting platelets were discoid or abortive-dendritic in gross morphology with an average size of 2.6 micrometer. The number of alpha-granules per platelet section was vari...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVE:To report the third known and documented occurrence of malignant disease as a complication of immunosuppression associated with low-dose methotrexate therapy for rheumatoid arthritis. MATERIAL AND METHODS:We present a case report of a 64-year-old woman with rheumatoid arthritis who had received low-dose meth...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61065-9
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of laparoscopy in the diagnosis of intra-abdominal lymphoma. PATIENTS AND METHODS:The medical records of patients with suspected primary or recurrent lymphoma who underwent laparoscopy between March 1991 and March 2003 were reviewed. Demographic, clinical, operative, and pathologic dat...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/80.5.625
更新日期:2005-05-01 00:00:00
abstract::An 87-year-old woman was referred for evaluation of nervousness, tremor, insomnia, and fatigue of 2 months' duration. Initial laboratory evaluation revealed a suppressed thyrotropin level and an elevated triiodothyronine level. A review of her medications revealed that she had started taking several dietary supplement...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/77.6.587
更新日期:2002-06-01 00:00:00
abstract::Duodenal duplication cysts are rare malformations that characteristically manifest with intestinal obstruction. In a 50-year experience, we found a duodenal duplication cyst in only three patients, one of whom had massive gastrointestinal bleeding as the initial symptom. Six other duplication cysts (two esophageal, on...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60419-4
更新日期:1985-11-01 00:00:00
abstract::Continuous spontaneous electromyographic activity and responses to electrical stimulation of the facial nerve in the surgical field were monitored in 48 patients undergoing primary removal of an acoustic neuroma. The operative and postoperative results in these patients were compared with the results in 48 patients wh...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61876-x
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:To explore the current epidemiological profile of Marfan syndrome in a general population. PATIENTS AND METHODS:Patients who had received a diagnosis of Marfan syndrome were identified from the Taiwan National Health Insurance database records from January 1, 2000, through December 31, 2012 (average populati...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.08.022
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To prospectively assess the safety and effectiveness of the investigational phosphodiesterase 5 inhibitor avanafil to treat erectile dysfunction in men with diabetes mellitus. PATIENTS AND METHODS:This 12-week, multicenter, double-blind, placebo-controlled study conducted between December 15, 2008, and Febru...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.mayocp.2012.06.016
更新日期:2012-09-01 00:00:00
abstract::Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance of this disease make timely accurate diagnosis and cost-effective management of CAD of the utmost importance. This comprehensi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2009.0391
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To verify preliminary studies on patients with melanoma exposed to β-blockers that suggested a reduced risk of disease recurrence and death. PATIENTS AND METHODS:Data were obtained from all consecutive patients diagnosed as having melanoma between January 1, 1993, and December 31, 2009, at the Department of ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.09.001
更新日期:2013-11-01 00:00:00
abstract::Diverticulitis has long been known to affect the right colon, and in recent years, our understanding has evolved in regard to the underlying cause. Appendiceal diverticulitis has yet to gain widespread recognition despite the fact that it was first described in 1893. Commonly dismissed by surgeons and pathologists as ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/74.9.890
更新日期:1999-09-01 00:00:00