Pub Date : 2024-12-01DOI: 10.1016/j.mayocp.2024.10.009
Margaret R. Wentz BA
Art is integrated into the Mayo Clinic environment. Since the original Mayo Clinic Building was finished in 1914, many pieces have been donated or commissioned for patients and staff to enjoy. Each issue of Mayo Clinic Proceedings features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses.
{"title":"Ocean Blue by Claudia Diller","authors":"Margaret R. Wentz BA","doi":"10.1016/j.mayocp.2024.10.009","DOIUrl":"10.1016/j.mayocp.2024.10.009","url":null,"abstract":"<div><div>Art is integrated into the Mayo Clinic environment. Since the original Mayo Clinic Building was finished in 1914, many pieces have been donated or commissioned for patients and staff to enjoy. Each issue of <em>Mayo Clinic Proceedings</em> features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 12","pages":"Page 2014"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.mayocp.2024.09.001
William Yang MPH, Linda N. Dao MD, Lori A. Erickson MD
{"title":"Follicular Lymphoma Presenting in the Small Bowel Mesentery","authors":"William Yang MPH, Linda N. Dao MD, Lori A. Erickson MD","doi":"10.1016/j.mayocp.2024.09.001","DOIUrl":"10.1016/j.mayocp.2024.09.001","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 12","pages":"Pages 2012-2013"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.mayocp.2024.07.022
Rodrigo Funes-Ferrada MD , Alejandra Yu Lee-Mateus MD , Alanna Barrios-Ruiz MD , Ryan M. Chadha MD , Kelly S. Robertson APRN , Sebastian Fernandez-Bussy MD , Ricardo Diaz Milian MD , David Abia-Trujillo MD, MB
Objective
To provide a standardized step-by-step guide for continuous positive airway pressure (CPAP) titration during dynamic flexible bronchoscopy (DB).
Patients and Methods
This descriptive study included patients referred to Mayo Clinic for concern regarding expiratory central airway collapse (ECAC) who underwent DB with CPAP titration from April 5, 2023, to February 9, 2024. Demographic characteristics, comorbidities, pulmonary function test results, and procedural details such as anesthesia protocols, CPAP settings, outcomes of pneumatic stenting, complications, and severity of ECAC were recorded. The procedure is performed with the patient under light sedation. After assessing dynamic breathing maneuvers for airway collapsibility, a CPAP mask is attached with initial pressure set at 6 cm H2O and titrated in increments of 2 cm H2O until successful pneumatic stenting of the airway.
Results
The study group included 33 patients. The mean ± SD age was 67.45±8.73 years, 21 (63.6%) were female, and 26 (78.8%) presented with shortness of breath. The median ECAC severity score was 11 (IQR, 7 to 13). Of the 32 patients who underwent pulmonary function tests, 20 (62.5%) had normal results and 12 (37.5%) had a serrated flow-volume loop. The median CPAP setting to maintain airway patency was 12 cm H2O (IQR,10 to 14 cm H2O). We reported no intraprocedural or postprocedural complications.
Conclusion
This study provides a detailed guide to performing CPAP titration during DB. We believe that this description of technique will support a systematic approach for further research to assess the impact of pneumatic stenting in ECAC.
目的：为动态柔性支气管镜（DB）术中持续气道正压（CPAP）滴定提供标准化的分步指南。患者和方法：本描述性研究纳入了2023年4月5日至2024年2月9日期间因担心呼气性中央气道塌陷（ECAC）而转至梅奥诊所接受DB伴CPAP滴定治疗的患者。记录人口统计学特征、合并症、肺功能检查结果和手术细节，如麻醉方案、CPAP设置、气压支架置入结果、并发症和ECAC严重程度。手术是在轻度镇静的情况下进行的。在评估气道塌陷的动态呼吸操作后，将CPAP面罩附着在6 cm H2O的初始压力上，并以2 cm H2O的增量滴定，直到气道气管支架置入成功。结果：研究组纳入33例患者。平均±SD年龄67.45±8.73岁，女性21例（63.6%），呼吸短促26例（78.8%）。ECAC严重程度评分中位数为11 （IQR, 7 ~ 13）。在32例接受肺功能检查的患者中，20例（62.5%）结果正常，12例（37.5%）有锯齿状的流量-容量环。维持气道通畅的中位CPAP设置为12 cm H2O （IQR,10 ~ 14 cm H2O）。我们没有报告术中或术后并发症。结论：本研究提供了在颅脑损伤期间进行CPAP滴定的详细指南。我们相信，这项技术的描述将支持进一步研究的系统方法，以评估气动支架在ECAC中的影响。
{"title":"Expiratory Central Airway Collapse and Pneumatic Stenting With Continuous Positive Pressure Titration: A Technique Description","authors":"Rodrigo Funes-Ferrada MD , Alejandra Yu Lee-Mateus MD , Alanna Barrios-Ruiz MD , Ryan M. Chadha MD , Kelly S. Robertson APRN , Sebastian Fernandez-Bussy MD , Ricardo Diaz Milian MD , David Abia-Trujillo MD, MB","doi":"10.1016/j.mayocp.2024.07.022","DOIUrl":"10.1016/j.mayocp.2024.07.022","url":null,"abstract":"<div><h3>Objective</h3><div>To provide a standardized step-by-step guide for continuous positive airway pressure (CPAP) titration during dynamic flexible bronchoscopy (DB).</div></div><div><h3>Patients and Methods</h3><div>This descriptive study included patients referred to Mayo Clinic for concern regarding expiratory central airway collapse (ECAC) who underwent DB with CPAP titration from April 5, 2023, to February 9, 2024. Demographic characteristics, comorbidities, pulmonary function test results, and procedural details such as anesthesia protocols, CPAP settings, outcomes of pneumatic stenting, complications, and severity of ECAC were recorded. The procedure is performed with the patient under light sedation. After assessing dynamic breathing maneuvers for airway collapsibility, a CPAP mask is attached with initial pressure set at 6 cm H<sub>2</sub>O and titrated in increments of 2 cm H<sub>2</sub>O until successful pneumatic stenting of the airway.</div></div><div><h3>Results</h3><div>The study group included 33 patients. The mean ± SD age was 67.45±8.73 years, 21 (63.6%) were female, and 26 (78.8%) presented with shortness of breath. The median ECAC severity score was 11 (IQR, 7 to 13). Of the 32 patients who underwent pulmonary function tests, 20 (62.5%) had normal results and 12 (37.5%) had a serrated flow-volume loop. The median CPAP setting to maintain airway patency was 12 cm H<sub>2</sub>O (IQR,10 to 14 cm H<sub>2</sub>O). We reported no intraprocedural or postprocedural complications.</div></div><div><h3>Conclusion</h3><div>This study provides a detailed guide to performing CPAP titration during DB. We believe that this description of technique will support a systematic approach for further research to assess the impact of pneumatic stenting in ECAC.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 12","pages":"Pages 1913-1920"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.mayocp.2024.02.010
Ashwin Ganti MD , Jose F. de Melo MD , Seth Sweetser MD
{"title":"21-Year-Old Man With Fever, Jaundice, and Dark Urine","authors":"Ashwin Ganti MD , Jose F. de Melo MD , Seth Sweetser MD","doi":"10.1016/j.mayocp.2024.02.010","DOIUrl":"10.1016/j.mayocp.2024.02.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 12","pages":"Pages 1995-1999"},"PeriodicalIF":6.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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