Abstract:
OBJECTIVE:To assess whether patients with pancreatic cancer-associated pain living near a pain control center were more likely to undergo neurolytic celiac plexus block (NCPB) than those living at a distance and to determine the rationale of physicians at our institution for referring patients for NCPB. DESIGN:We retrospectively reviewed the frequency of use of NCPB in patients with pancreatic cancer and conducted an anonymous physician survey of referral patterns for NCPB for such patients. MATERIAL AND METHODS:A prospective database of medical diagnoses and a clinical database at our institution were used to identify patients with pancreatic cancer within three geographic regions who were assessed during the inclusive years 1980 through 1989: group I ("local") = all patient with pancreatic cancer in Olmsted County, Minnesota; group II ("surrounding") and group III ("distant") = patients referred for pancreatic cancer evaluation who lived within 100 miles of our institution (excluding Olmsted County) or more than 100 miles from our institution, respectively. Medical records were retrospectively reviewed to assess the use of NCPB at any time during the course of pancreatic cancer. For the physician survey component, all medical oncologists, gastroenterologists, and general surgeons at our institution who might be responsible for the care of patients with pancreatic cancer were sent a questionnaire about their referral patterns for NCPB among patients with pancreatic cancer. RESULTS:Overall, approximately 15% of the 292 patients with pancreatic cancer studied underwent NCPB. Distance from our pain control center was not found to be associated with frequency of use of NCPB. Of the 78 physicians surveyed, 59 (76%) responded, and 35 of the responders (59%) had encountered at least 1 patient with pancreatic cancer during the preceding 12 months. In that subset of physicians, perceived barriers for referral for NCPB were limited appointment availability and need for repeating the procedure. CONCLUSION:On the basis of this study, referral patterns for NCPB in patients with pancreatic cancer do not seem to be associated with the geographic distance of a patient's residence from a pain control center. Improving appointment availability for NCPB might increase the number of patients offered this technique for control of pain.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Brown DL,Caswell RE,Wong GY,Nauss LA,Offord KPdoi
10.4065/72.9.831subject
Has Abstractpub_date
1997-09-01 00:00:00pages
831-4issue
9eissn
0025-6196issn
1942-5546pii
S0025-6196(11)63498-8journal_volume
72pub_type
杂志文章abstract::There is overwhelming evidence that racial and ethnic minorities face multiple health care disparities. Recognizing and addressing cultural and religious/spiritual (RS) values is a critical aspect of providing goal-concordant care for patients facing a serious illness, especially at the end of life. Failure to address...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2016.08.024
更新日期:2017-01-01 00:00:00
abstract::The metabolic syndrome is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including various combinations of abdominal obesity, glucose intolerance, hypertension, and atherogenic dyslipidemia (elevated triglyceride values, low high-density lipoprotein cholesterol levels, and small ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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abstract:OBJECTIVE:To evaluate, in this before-and-after study, the results of 5 strategies for improving attendance at medical grand rounds at a tertiary care academic medical center. METHODS:The strategies included (1) using electronic card readers to improve understanding of attendance patterns, (2) conducting yearly needs ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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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::Q fever, a zoonosis caused by Coxiella burnetii, is seen throughout the world. Recent reports suggest that its incidence in the United States is increasing, with more than 30 cases reported in the US military. The disease has many acute and chronic manifestations. Endocarditis is the most common form of chronic diseas...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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更新日期:2006-05-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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更新日期:1999-08-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/79.2.169
更新日期:2004-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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更新日期:2011-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61933-8
更新日期:1986-04-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
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更新日期:2020-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2002-02-01 00:00:00
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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
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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
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journal_title:Mayo Clinic proceedings
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:
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journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章
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更新日期:1999-02-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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更新日期:2009-12-01 00:00:00
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journal_title:Mayo Clinic proceedings
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doi:10.1016/j.mayocp.2012.02.015
更新日期:2012-06-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.04.036
更新日期:2019-10-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/82.3.342
更新日期:2007-03-01 00:00:00
abstract::Use of amiodarone, an investigational antidysrhythmic agent, has been associated with cases of pulmonary toxicity. The mechanism of amiodarone pulmonary toxicity is unknown, and recommendations for the assessment and treatment of patients with this condition continue to evolve. In two patients with clinically diagnose...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60983-5
更新日期:1985-09-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2020.04.028
更新日期:2020-07-01 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
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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::For primary care physicians, obesity is one of the most challenging problems confronted in office practice. The disorder is Increasing in prevalence despite the efforts of both patients and physicians. Treatment requires a multimodality approach that addresses diet, physical activity, and behavioral issues. Medication...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/82.1.93
更新日期:2007-01-01 00:00:00