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 symptoms. In most situations, a computed tomographic scan of the head provides sufficient neuroimaging and allows one to monitor the effects of therapy. Magnetic resonance imaging has become increasingly useful in the diagnosis and management of brain metastases. It can detect computed tomographic occult metastases, identify associated leptomeningeal disease, and reveal early therapeutic complications. CONCLUSION:Treatment options for patients with brain metastases include corticosteroids, whole-brain radiation therapy (WBRT), surgical intervention, stereotactic radiosurgical techniques, and chemotherapy. Corticosteroids produce prompt improvement in most patients; however, prolonged use is associated with considerable risks. For most patients, WBRT is the preferred treatment. Nonetheless, it has associated nonneurologic and neurologic complications, some of which are serious. In patients with a single metastasis, surgical removal should be considered. Recent studies have suggested that resection of a single metastatic lesion followed by radiation therapy offers better survival than does radiation therapy alone. The subsequent administration of WBRT after radiosurgical treatment has become standard practice. The role of chemotherapy is uncertain.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
O'Neill BP,Buckner JC,Coffey RJ,Dinapoli RP,Shaw EGdoi
10.1016/s0025-6196(12)61374-3subject
Has Abstractpub_date
1994-11-01 00:00:00pages
1062-8issue
11eissn
0025-6196issn
1942-5546pii
S0025-6196(12)61374-3journal_volume
69pub_type
杂志文章,评审abstract::Myocarditis, an inflammatory disease of heart muscle, is an important cause of dilated cardiomyopathy worldwide. Viral infection is also an important cause of myocarditis, and the spectrum of viruses known to cause myocarditis has changed in the past 2 decades. Several new diagnostic methods, such as cardiac magnetic ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)60670-8
更新日期:2009-11-01 00:00:00
abstract::Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is a common disorder, occurring at least twice a week and causing at least moderate distress in 1.5% to 2.7% of the population. It is important for primary care physicians to be familiar with this disorder and its management. Much has changed in its management si...
journal_title:Mayo Clinic proceedings
pub_type: 共识发展会议,杂志文章
doi:10.1016/j.mayocp.2013.06.016
更新日期:2013-09-01 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::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::A 71-year-old man had painful blue toes after an episode of protracted vomiting. Abdominal, cardiac, and transesophageal ultrasound studies were performed before angiography was considered. A large mobile mass in the proximal descending thoracic aorta, which suggested thrombus, was identified by transesophageal echoca...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60048-2
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:To document our evolving surgical management of colonoscopic perforation and examine factors crucial to the improvement of patient care. DESIGN:We conducted a computer-based retrospective analysis of medical records (1980 through 1995). MATERIAL AND METHODS:Among 57,028 colonoscopic procedures performed, 43...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)63592-1
更新日期:1997-08-01 00:00:00
abstract::Sleep disorders and neurodegenerative diseases are commonly encountered in primary care. A common, but underdiagnosed sleep disorder, rapid eye movement sleep behavior disorder (RBD), is highly associated with Parkinson disease and related disorders. Rapid eye movement sleep behavior disorder is common. It is estimate...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2016.07.019
更新日期:2016-10-01 00:00:00
abstract::Traditional treatments for men with localized prostate cancer have included both surgical removal and radiation therapy, with their potential adverse effects on patient quality of life. Thus, there has been increasing interest in the development of minimally invasive procedures that use various technologies to deliver...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/79.12.1547
更新日期:2004-12-01 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:OBJECTIVE:To review the diagnostic evaluation and the clinical course of patients with pretruncal nonaneurysmal subarachnoid hemorrhage. MATERIAL AND METHODS:The study population consisted of a consecutive series of patients with a pretruncal nonaneurysmal subarachnoid hemorrhage encountered at Mayo Clinic Rochester d...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/73.8.745
更新日期:1998-08-01 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::Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has rapidly caused a global pandemic associated with a novel respiratory infection: coronavirus disease-19 (COVID-19). Angiotensin-converting enzyme-2 (ACE2) is necessary to facilitate SARS-CoV-2 infection, but-owing to its essential metabolic roles-it may b...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2020.06.018
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To determine the effect of adding a trained intensivist on patient care and educational outcomes in a community teaching hospital. MATERIAL AND METHODS:We retrospectively reviewed outcomes for patients admitted to the medical intensive-care unit (MICU) of a 270-bed community teaching hospital between July 19...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.5.391
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. SUBJECTS AND METHODS:Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in The Netherlands (age range, 50-80 years), wom...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/77.7.629
更新日期:2002-07-01 00:00:00
abstract::The prevalence of skin and soft tissue infections (SSTIs) has been increasing in the United States. These infections are associated with an increase in hospital admissions. Hospitalists play an increasingly important role in the management of these infections and need to use hospital resources efficiently and effectiv...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2014.04.018
更新日期:2014-10-01 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::Arterial calcification in the coronary arteries frequently indicates concomitant atherosclerotic plaque but can be present in the medial layers with no evidence of plaque. Calcification of the medial layer of arteries is seen most often in the peripheral arteries but also is widely recognized In the coronary arteries....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)61536-X
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To assess the reliability, durability, and safety of primary and revision total hip arthroplasty (THA) in patients 90 years of age and older. PATIENTS AND METHODS:Between 1970 and 1997, 66 THAs, 48 primary and 18 revision, were done for 65 patients aged 90 to 104 years (mean, 92 years). The Harris hip score ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/78.3.285
更新日期:2003-03-01 00:00:00
abstract::The development of advanced laparoscopic techniques and robot-assisted technology has resulted in several new surgical approaches for treating organ-confined prostate cancer. Outcomes with these new or minimally Invasive techniques should be assessed carefully to ensure that they are similar to or surpass patients' on...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/79.9.1169
更新日期:2004-09-01 00:00:00
abstract::This report represents a retrospective analysis of preoperative echophonocardiographic studies in 118 patients who had surgery for the repair or replacement of malfunctioning prosthetic valves. A variety of prostheses implanted in the mitral, aortic, and tricuspid positions were assessed. The most frequent prosthetic ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:To provide a practical formula for fresh frozen plasma (FFP) dosing for warfarin reversal. PATIENTS AND METHODS:We reviewed data on all adult patients who received a total of 7778 units of FFP for warfarin reversal at Sentara Norfolk General Hospital (Norfolk, VA) between April 1, 2009, and March 31, 2010. P...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2012.12.011
更新日期:2013-03-01 00:00:00
abstract::Abdominal wall pain (AWP) is a common and underrecognized cause of chronic abdominal pain. The etiology of AWP varies. History and physical examination are critical to an accurate diagnosis of AWP. Trigger point injection using either a corticosteroid, a local anesthetic, or a combination of both often gives relief of...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2018.04.031
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To ascertain the incidence and timing of fever in patients at risk for temperature modulation of brain injury resulting from ischemia or trauma. DESIGN:We retrospectively reviewed the medical records of patients admitted between January 1991 and December 1994. MATERIAL AND METHODS:We investigated three grou...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)64885-4
更新日期:1998-07-01 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::Management of the global crisis of the coronavirus disease 2019 pandemic requires detailed appraisal of evidence to support clear, actionable, and consistent public health messaging. The use of cloth masks for general public use is being debated, and is in flux. We searched the MEDLINE and EMBASE databases and Google ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2020.07.020
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To determine whether a simple clinical score, which was shown previously to predict the likelihood of severe coronary artery disease (CAD) in patients referred for coronary angiography, could predict prognosis in a separate cohort of patients with normal or mildly abnormal findings on their resting electrocar...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/77.6.515
更新日期:2002-06-01 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::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::Vitamin K antagonists were the only class of oral anticoagulants available to clinicians for decades. However, with the US Food and Drug Administration approval of new oral anticoagulants, such as dabigatran, rivaroxaban, and apixaban, clinicians now have a broader choice. Given the recent approval and availability of...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2013.03.006
更新日期:2013-05-01 00:00:00
abstract::Anesthesia support for patients undergoing orthotopic liver transplantation can be complicated because of multiple medical problems in such patients and rapid hemodynamic, metabolic, and coagulation changes intraoperatively. Preoperative assessment should include careful review of the cardiovascular, respiratory, and ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65677-8
更新日期:1989-02-01 00:00:00