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 for diagnostic testing and treatments. There is strong evidence that stimulant and osmotic laxatives, intestinal secretagogues, and peripherally restricted μ-opiate antagonists are effective and safe; the lattermost drugs are a major advance for managing opioid-induced constipation. Constipation that is refractory to available laxatives should be evaluated for defecatory disorders and slow-transit constipation using studies of anorectal function and colonic transit. Defecatory disorders are often responsive to biofeedback therapies, whereas slow-transit constipation may require surgical intervention in selected patients. Both efficacy and cost should guide the choice of treatment for functional constipation and opiate-induced constipation. Currently, no studies have compared inexpensive laxatives with newer drugs that work by other mechanisms.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Bharucha AE,Wald Adoi
10.1016/j.mayocp.2019.01.031subject
Has Abstractpub_date
2019-11-01 00:00:00pages
2340-2357issue
11eissn
0025-6196issn
1942-5546pii
S0025-6196(19)30123-5journal_volume
94pub_type
杂志文章,评审abstract::Risedronate sodium is a pyridinyl bisphosphonate effective for treatment and prevention of postmenopausal and glucocorticoid-induced osteoporosis. Some bisphosphonates have been associated with upper gastrointestinal (GI) tract adverse effects. The objective of this study was to determine the frequency of upper GI tra...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,meta分析
doi:10.4065/77.3.262
更新日期:2002-03-01 00:00:00
abstract::Many types of psychotherapeutic drugs (especially antidepressants) directly and indirectly interact with neurotransmitter receptors, the recognition sites for the chemical messengers released by neurons. These interactions can result in increased or decreased sensitivity of certain receptors. Hypotheses exist to expla...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::During the period November 1979 to October 1984, 19 patients at our institution underwent balloon angioplasty of partial or complete obstruction of aortocoronary artery saphenous vein bypass grafts. The procedures were performed a mean of 38 months after a coronary bypass operation to relieve recurrent angina of at le...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61392-5
更新日期:1986-01-01 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
abstract:OBJECTIVE:To describe lymphoma associated with human immunodeficiency virus (HIV) infection. DESIGN:A review of HIV-related lymphoma and its associated epidemiology, etiopathogenesis, and clinicopathologic characteristics is presented. Major studies of therapeutic regimens for HIV-related lymphoma are discussed. Facto...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/70.7.665
更新日期:1995-07-01 00:00:00
abstract::Despite the successful growth of the hospice movement during the past 30 years in the United States, almost 85% of Americans continue to die in hospitals or nursing homes. While the benefits of palliative care principles are well established, palliative care interventions remain underused in clinical practice in the s...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/75.12.1305
更新日期:2000-12-01 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 investigate whether the use of systemic glucocorticoids is a risk factor for community-acquired Staphylococcus aureus bacteremia (CA-SAB). PATIENTS AND METHODS:We used population-based medical registries in Northern Denmark to conduct a case-control study including all adults with first-time CA-SAB and ma...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.04.023
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The efficacy of fine-needle aspiration (FNA) biopsy and its role in the management of a nodular goiter are clearly established. The accuracy of cytologic diagnosis approaches 95%. FINDINGS:FNA biopsy is a reasonable approach to thyroid nodules; it has decreased costs substantially because it facilitates sel...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61611-5
更新日期:1994-01-01 00:00:00
abstract::Understanding the sequence of events responsible for pressure-related natriuresis and their pathophysiologic alterations may be useful in distinguishing various types of essential hypertension of renal origin. The perturbation of a distal step in the sequence is likely to be reflected in a simple physiologic defect. F...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65384-1
更新日期:1989-11-01 00:00:00
abstract::To identify the wishes of patients with amyotrophic lateral sclerosis (ALS) for information, participation in decision making, and life-sustaining therapy and to determine whether these wishes are stable over time, we conducted a prospective survey (baseline and 6-month follow-up interviews) of 38 consecutive patients...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61577-8
更新日期:1991-09-01 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::Pacemaker therapy is most commonly initiated because of symptomatic bradycardia, usually resulting from sinus node disease. Randomized multicenter trials assessing the relative benefits of different pacing modes have made possible an evidence-based approach to the treatment of bradyarrhythmias. During the past several...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/83.10.1170
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To characterize the findings associated with acute febrile neutrophilic dermatosis (Sweet's syndrome [SS]) and the response of SS to treatment. DESIGN:We retrospectively reviewed 48 cases of SS encountered at the Mayo Clinic between 1980 and 1992. MATERIAL AND METHODS:Histopathologic specimens and medical r...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.3.234
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To describe current concepts in the diagnosis and treatment of brain metastases. RESULTS:More than 25% of all autopsy-proven brain metastases have a pulmonary source. Most brain metastases manifest with a combination of focal and generalized symptoms and signs. Typically, patients have subacute, progressive ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61374-3
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To determine the sensitivity and specificity of a quantitative plasma fibrin D-dimer latex immunoassay (LIA) for the diagnosis of acute pulmonary embolism. SUBJECTS AND METHODS:Study subjects were Mayo Clinic Rochester inpatients and outpatients with suspected acute pulmonary embolism; all had undergone quan...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/82.5.556
更新日期:2007-05-01 00:00:00
abstract::Serum cystatin C has been proposed as a kidney biomarker to inform drug dosing. We conducted a systematic review to synthesize available data for the association between serum cystatin C and drug pharmacokinetics, dosing, and clinical outcomes in adults (≥18 years). PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.08.002
更新日期:2019-03-01 00:00:00
abstract::The feasibility and accuracy of continuous-wave Doppler echocardiography in measuring pressure gradients across the pulmonary artery band were assessed. Simultaneous continuous-wave Doppler and catheter pressure measurements were prospectively performed in 20 patients with complex congenital heart disease and prior pu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65584-0
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:To assess the effects of glutathione on pain-free walking distance (PFWD) and hemodynamic parameters in patients with peripheral artery disease. PATIENTS AND METHODS:Forty patients with Fontaine stage II peripheral artery disease who were seen between September 2000 and March 2001 at the vascular laboratory ...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.4065/77.8.754
更新日期:2002-08-01 00:00:00
abstract::Seven cases of bacteremia following transrectal needle biopsy of the prostate were reviewed. Symptoms developed within 24 to 72 hours after the procedure and required hospitalization and treatment with parenteral antibiotics. Escherichia coli was the causative agent in five patients and Klebsiella pneumoniae in two. A...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::THE purpose of this study was to determine the difference in prognosis among patients with transient ischemic attacks (TIA) in the carotid arterial system and those with TIA in the vertebral-basilar arterial system. Nearly twice as many patients had TIA in the carotid system as had TIA in the vertebral-basilar system....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVE:To report the long-term follow-up of a matched comparison of radical nephrectomy (RN) and nephron-sparing surgery (NSS) in patients with single unilateral renal cell carcinoma (RCC) and a normal contralateral kidney. PATIENTS AND METHODS:Between August 1966 and March 1999, 1492 and 189 patients with unilater...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.12.1236
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To comparatively assess the natural history of patients of different ages undergoing transcatheter aortic valve replacement (TAVR). PATIENTS AND METHODS:For this study, we used the YOUNG TAVR, an international, multicenter registry investigating mortality trends up to 2 years in patients with aortic valve st...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.mayocp.2019.01.008
更新日期:2019-08-01 00:00:00
abstract::Patients with ectatic coronary arteries often have occlusion of the affected arteries. Because ectatic arteries are considered to have medial damage, they are normally assumed to have little capacity to constrict; therefore, spasm has not been considered a factor in the occlusive process. In two patients who had diffu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)64787-9
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To gain information regarding long-term follow-up in patients with synchronous bilateral solid renal neoplasms in whom renal-preserving surgery is imperative. PATIENTS AND METHODS:We examined our surgical experience and the survival outcome, as evaluated by Kaplan-Meier and log-rank analysis, of 94 patients ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.10.1020
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To describe 3 patients who presented with chest pain and intermittent Q waves on the electrocardiogram (ECG) and were subsequently found to have latent preexcitation. PATIENTS AND METHODS:During a span of 8 years, 3 patients were evaluated because of atypical chest pain and pathologic Q waves in the inferior...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/78.7.840
更新日期:2003-07-01 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::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::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::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