Abstract：
:Low back pain (LBP) is a leading cause of disability worldwide. In the absence of a classification system for pain syndromes, classification of LBP on the basis of the distribution of pain as axial (pain generally localized to the low back) or radicular neuropathic (pain radiating to the lower extremities) is relevant to clinical practice because the distribution of pain is often a corollary of frequently occurring disease processes involving the lumbar spine. Common sources of axial LBP include the intervertebral disc, facet joint, sacroiliac joint, and paraspinal musculature, whereas common sources of radicular pain include a herniated intervertebral disc and spinal stenosis. The accuracy of historical and physical examination findings has been established for sacroiliac joint pain, radiculopathy, and lumbar spinal stenosis. However, the accuracy of similar data, so-called red flags, for identifying the underlying medical sources of LBP has been overstated. Diagnostic imaging studies can be useful, and adherence to established guidelines can protect against overuse. Multiple pharmacological trials exist for the management of LBP; however, the long-term outcomes of commonly used drugs are mixed. For carefully selected patients with axial LBP, radiofrequency denervation techniques can provide sustained pain relief. In patients with radicular pain, transforaminal epidural steroid injections may provide short-term pain relief, but neurostimulation may confer more enduring benefits of refractory symptoms. Pain-related indications for commonly performed operations include spinal decompression for radicular symptoms as well as spinal fusion or disc prosthesis for discogenic LBP. Physical modalities and psychological treatments can improve pain and functioning, but patient preferences may influence treatment adherence.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Hooten WM,Cohen SPdoi
10.1016/j.mayocp.2015.10.009subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1699-718issue
12eissn
0025-6196issn
1942-5546pii
S0025-6196(15)00804-6journal_volume
90pub_type
杂志文章,评审abstract：OBJECTIVE:To evaluate the safety, diagnostic yield, and therapeutic implications of flexible bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy in patients with febrile neutropenia and pulmonary infiltrates. PATIENTS AND METHODS:We retrospectively reviewed the medical records of all patients with...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/80.11.1414
更新日期：2005-11-01 00:00:00
abstract：:Prospective data and follow-up information were collected on the initial 200 patients who underwent laparoscopic cholecystectomy at the Mayo Clinic. The operation was completed laparoscopically in all but five patients, who required conversion to laparotomy because of dense scarring or stones in the common bile duct. ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60390-5
更新日期：1992-05-01 00:00:00
abstract：:A case is reported in which a herpes zoster infection caused recurrence of phantom limb pain in a man whose left arm had been amputated 7 years previously. It is, to our knowledge, the first such case reported, and it shows the importance of peripheral mechanisms in the generation of phantom limb pain. ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1978-05-01 00:00:00
abstract：:The increasing prevalence and far-reaching medical, social, and economical implications of obesity have made it a national health-care crisis in the United States. About one in every three persons is at least 20% above "ideal" body weight, and approximately 5% have direct weight-related serious health problems (morbid...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/72.6.551
更新日期：1997-06-01 00:00:00
abstract：OBJECTIVE:To assess the frequency and clinical implications of positive autoimmune serologies in patients with biopsy-confirmed idiopathic pulmonary fibrosis (IPF). PATIENTS AND METHODS:We reviewed the records of patients at our institution with biopsy-confirmed usual interstitial pneumonia (UIP) from January 1, 1995,...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.11.018
更新日期：2014-03-01 00:00:00
abstract：:Treatment of seniors with Parkinson disease is within the domain of primary care physicians and internists. A good working knowledge of carbidopa/levodopa principles should allow excellent care of most patients, at least during the early years of the disease. Even later, when levodopa responses become more complicated...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/mcp.2011.0443
更新日期：2011-12-01 00:00:00
abstract：:Two cases are presented and a third is cited from the literature in which the onset of hyperthyroidism exacerbated acute weakness in previously undiagnosed myotonic dystrophy. In two of the cases a return to the euthyroid state after treatment was associated with marked clinical improvement in muscle weakness. In the ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:We treated a patient who developed transient multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, and limb dystonia) in temporal proximity to ondansetron administration on emergence from general anesthesia. No other medications known to cause extrapyramidal reactions were ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/78.9.1150
更新日期：2003-09-01 00:00:00
abstract：:Guidelines for the use of antibiotics in infants and children must take into account drug absorption, distribution, metabolism, and excretion. In the developing human being, these factors may differ significantly from those in the adult, and so there are differences in therapeutic efficacy and toxicity. Certain drugs ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：:Extending a study of the period 1935-1964, we determined the incidence rates of leukemia in Olmsted County during the decade 1965-1974. In this decade, the overall crude annual incidence rate was 9.5 per 100,000. The ratio of males to females was 2.4 to 1; and the incidence rate was significantly higher among males th...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Emerging preclinical and clinic evidence described herein suggests that the mechanism of action of rifaximin is not restricted to direct antibacterial effects within the gastrointestinal tract. Data from this study were derived from general and clinical trial-specific PubMed searches of English-language articles on ri...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.04.016
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To study differences in treatment outcomes between patients with chronic noncancer pain taking vs those not taking maintenance opioids at admission to a pain rehabilitation program. PATIENTS AND METHODS:A nonrandomized 2-group prepost design was used to compare 356 patients admitted to the Mayo Comprehensive...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章
doi：10.4065/79.6.759
更新日期：2004-06-01 00:00:00
abstract：:In the years 1960 through 1966, vagotomy and pyloroplasty was performed for duodenal ulceration in 182 patients. Elective operation was performed in 84% of cases, and intractability of symptoms was the major indication. For emergency operations, bleeding was the main indication. Eight of 182 patients died in the posto...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：:At the McGill University neuro-ophthalmology unit, 52 patients with superior oblique palsy were seen during the 2-year period October 1973 to August 1975; these included patients with congenital, traumatic, vascular, and other more rare causes of trochlear paralysis. Half of the patients with congenital palsy had dipl...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：:In almost all dialysis patients, bone aluminum content (BAC) is elevated in comparison with levels in normal subjects. Extremely high BAC (200 micrograms or more of aluminum per gram of bone) is significantly associated with classic aluminum-related osteomalacia. We noted three patients with elevated BAC but without h...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60539-4
更新日期：1985-05-01 00:00:00
abstract：:Between Jan. 1, 1976, and Dec. 31, 1985, at our institution, 37 patients who had undergone prior complete surgical resection of non-small-cell lung cancer received definitive thoracic radiation therapy (TRT) for locally recurrent disease. Of the 37 recurrences, 33 were in the pulmonary parenchyma or the hilar, mediast...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61141-0
更新日期：1992-12-01 00:00:00
abstract：:Cataract operations are commonly performed in either a primary-care or a tertiary-care center. A plethora of information (some of which is unfounded) has been disseminated in the lay news media about the advances in the surgical techniques of cataract removal. This article reviews some of the recent concepts about the...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)61494-3
更新日期：1984-08-01 00:00:00
abstract：OBJECTIVE:To determine whether N-acetylcysteine rinse was safe and could improve thickened secretions and dry mouth during and after radiotherapy. PATIENTS AND METHODS:We designed a prospective pilot double-blind, placebo-controlled randomized clinical trial (Alliance MC13C2). Adult patients (age ≥18 years) were enrol...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.mayocp.2019.03.031
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the association between coffee consumption and mortality from all causes and from cardiovascular disease. PATIENTS AND METHODS:Data from the Aerobics Center Longitudinal Study representing 43,727 participants with 699,632 person-years of follow-up were included. Baseline data were collected by an...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.06.020
更新日期：2013-10-01 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：OBJECTIVE:To investigate the impact of obesity and underweight on adverse in-hospital outcomes in pulmonary embolism (PE). PATIENTS AND METHODS:Patients diagnosed as having PE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification code I26 in the G...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2019.04.035
更新日期：2019-10-01 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：OBJECTIVE:To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). PATIENTS AND METHODS:We performed a retrospective search of electronic medical records of all ou...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.07.025
更新日期：2015-11-01 00:00:00
abstract：:We describe a woman with an unusual case of thromboembolism of the mesenteric artery in whom multiple thrombi were subsequently found in the aorta and right heart chambers on transesophageal echocardiography. Further evaluation revealed a deficiency of protein C and S plasma proteins, inhibitors of the clotting system...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/76.3.319
更新日期：2001-03-01 00:00:00
abstract：:Hypochondriasis (HC), which involves preoccupation with the fear of having a serious illness despite appropriate medical examination, is often encountered in medical settings. The most conspicuous feature of this disorder is seeking excessive reassurance from physicians, medical references, or self-inspection; however...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/77.12.1323
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVE:To examine current therapeutic modalities for acute lymphocytic leukemia (ALL) in adults, analyze prognostic variables, and offer treatment recommendations. DESIGN:We reviewed our experience with 90 adult patients with ALL examined at the Mayo Clinic between 1982 and 1992 and used it as a background for disc...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61817-5
更新日期：1994-10-01 00:00:00
abstract：:Transesophageal echocardiography (TEE) is used frequently in patients with cerebrovascular ischemia. On TEE, a typical appearance of a cardiac fibroelastoma is that of a pedunculated, mobile mass attached to a leaflet of a valve. Surgical excision of the lesion may lead to resolution of the symptoms and prevent furthe...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63944-X
更新日期：1995-09-01 00:00:00
abstract：OBJECTIVE:To analyze the effect of adjuvant perfusion techniques of the distal aorta on the outcome of traumatic thoracic aortic transections. PATIENTS AND METHODS:From 1973 to 2004, 72 patients (mean age, 39 years) with thoracic aortic transections arrived alive at the emergency department. Nineteen patients arrived ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/81.5.625
更新日期：2006-05-01 00:00:00
abstract：OBJECTIVE:To determine whether women who had a hypertensive pregnancy disorder (HPD) have elevated uric acid concentrations decades after pregnancy as compared with women who had normotensive pregnancies. PATIENTS AND METHODS:The Genetic Epidemiology Network of Arteriopathy study measured uric acid concentrations in H...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.05.020
更新日期：2015-09-01 00:00:00
abstract：:Management of a solitary liver mass necessitates reliable distinction between primary hepatocellular carcinoma and metastatic lesions. The histologic differentiation can be difficult even with special stains such as alpha-fetoprotein, cytokeratin, and carcinoembryonic antigen. Albumin is a specific product of hepatocy...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/73.6.533
更新日期：1998-06-01 00:00:00
