Mayo Clinic proceedings最新文献

{"title":"45-Year-Old Man With Joint Pain and Polyneuropathy.","authors":"Madeline M DeAngelo, Griffin J Reed, John M Davis","doi":"10.1016/j.mayocp.2025.03.036","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.03.036","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275177","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}

{"title":"Different Intensities of Physical Activity Substituted for Sedentary Time and Risk of Type 2 Diabetes: Integration of Genetics and Wearable Data.","authors":"Qiaoxin Shi, Haeyoon Jang, Paul James Collings, Mengyao Wang, Ziyuan Chen, Shan Luo, Shiu Lun Au Yeung, Yuk Fai Eric Wan, Simon J Griffin, Stephen J Sharp, Felix Day, Ken K Ong, Soren Brage, Youngwon Kim","doi":"10.1016/j.mayocp.2025.04.033","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.04.033","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether substituting different intensities of physical activity (PA) for sedentary time (ST) can benefit the prevention of type 2 diabetes (T2D) across varying levels of T2D genetic susceptibility.</p><p><strong>Participants and methods: </strong>We included 73,272 White British participants from the UK Biobank without prevalent T2D. Wrist-worn accelerometry was used to derive sleep, ST, light PA, and moderate-to-vigorous PA (MVPA) based on machine learning. Polygenic risk scores for T2D were computed based on 138 genome-wide important, unrelated genetic markers. We used compositional isotemporal substitution modeling in logistic regression, with adjustment for putative confounders. Accelerometer data were collected between June 1, 2013, and December 23, 2015. Follow-up continued until December 9, 2022 (England/Wales) and December 19, 2022 (Scotland).</p><p><strong>Results: </strong>Over a median 8.1-year follow-up, 1399 incident T2D cases were identified. Reallocating 30 minutes/day of ST into time-equivalent light PA and MVPA was associated with 5% (odds ratio, 0.95; 95% CI, 0.94 to 0.97) and 18% (odds ratio, 0.82; 95% CI, 0.79 to 0.85) lower odds of T2D, respectively, independent of genetic risk. Shifting 15 minutes/day of ST to MVPA or 60 minutes/day of ST to light PA was associated with similar odds of T2D.</p><p><strong>Conclusion: </strong>Irrespective of genetic susceptibility to T2D, replacing ST with equivalent physically active time (either at light or moderate-to-vigorous intensity) is associated with lower T2D odds. Individuals at all genetic risk levels may achieve the same degree of T2D odds reduction by substituting a larger volume of light PA for ST as they would by replacing ST with a smaller volume of MVPA.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238907","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}

{"title":"Retirement: Fostering Physician Well-being Over the Career Life Cycle.","authors":"Kirk J Brower, Iris F Litt, Tait D Shanafelt","doi":"10.1016/j.mayocp.2025.05.027","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.05.027","url":null,"abstract":"<p><p>This manuscript is the last chapter in a series of 5 articles considering physician well-being during the course of a career. It focuses on the retirement stage, which follows planning for retirement and deciding when and how to retire. We view retirement as a process, characterized by recalibrating professional and personal activities while maintaining a sense of purpose and meaning in life. Some retirees may continue to work in medicine by seeing patients part-time or mentoring medical students, residents, and junior colleagues. Others may leave their lifelong work and seek joy and meaning in travel, spending time with family and friends, volunteering, and developing their personal interests and activities. Ideally, well-being in retirement includes having sufficient energy for activities and relationships that are meaningful, provide purpose, and are enjoyable. Stress during retirement usually shifts from occupational concerns to personal challenges with professional identity, caring for family and friends, maintaining one's health, and relationship losses. Programs that specifically support retired physicians exist at some large health systems and select academic centers, which can complement resources provided by general medical associations and specialty societies. These can serve as models for other medical centers and a foundation for extending and expanding support to retired physicians.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238851","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}

{"title":"Late Career: Fostering Physician Well-being Over the Career Life Cycle.","authors":"Keith Frey, Marla Arata, Tait Shanafelt","doi":"10.1016/j.mayocp.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.05.028","url":null,"abstract":"<p><p>This manuscript is the fourth chapter in a series of 5 articles exploring the challenges and opportunities experienced by physicians across different career stages. This article focuses on the late-career phase. Late career can be a great career stage characterized by meaning and contribution as well as by preparation. Physicians in this phase hold a tremendous amount of experience and wisdom that they can use to benefit their patients and colleagues. Finishing well and deciding when to leave are also pressing concerns on the mind of many late-career physicians. To successfully navigate this transition, late-career physicians must simultaneously recognize and celebrate what they have accomplished, consider how to optimize meaning in current work, and reflect on their next chapter. Viewing the remaining years in practice as an opportunity for an \"encore\" and considering the desired focus can be a helpful mind set. Late-career physicians must also consider how they will facilitate the transition of their leadership roles through mentoring and development of colleagues. Finally, preparing well for the next season of life requires attending not only to financial planning but to social, emotional, and relationship planning. Investing in relationships and interests at the beginning of the last career stage can set the stage for a more optimal transition to the retirement phase when that time comes.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238871","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}

{"title":"Langerhans Cell Histiocytosis Mimicking Spinal Tuberculosis.","authors":"Binglin Lai","doi":"10.1016/j.mayocp.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.06.009","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238912","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}

{"title":"Icefish: Peculiar Creatures Without Hemoglobin or Red Blood Cells.","authors":"David P Steensma, William C Aird","doi":"10.1016/j.mayocp.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.09.002","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238829","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}

{"title":"Tumor-to-Tumor Metastasis.","authors":"Sunpil Hwang, Clint D Kingsley","doi":"10.1016/j.mayocp.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.06.014","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232999","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}

{"title":"Multimorbidity and the Risk of Sudden Cardiac Death: Findings From a Prospective Cohort Study.","authors":"Jari A Laukkanen, Jussi Kauhanen, Sudhir Kurl, Carl J Lavie, Setor K Kunutsor","doi":"10.1016/j.mayocp.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.06.021","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prospective associations of multimorbidity status and level with the risk of sudden cardiac death (SCD).</p><p><strong>Methods: </strong>Multimorbidity was defined as the presence of at least two multiple long-term conditions (hypertension, cardiovascular disease, type 2 diabetes, chronic kidney disease, chronic bronchitis, and other chronic lung conditions) among 2598 men 42 to 61 years of age who were recruited into the KIHD (Kuopio Ischemic Heart Disease) study from March 1, 1984, to December 31, 1989. Hazard ratios with 95% CIs were estimated.</p><p><strong>Results: </strong>During a median follow-up of 27.8 years, 296 SCDs were recorded. In analysis adjusted for several established cardiovascular risk factors including socioeconomic and lifestyle characteristics, the HR (95% CI) for SCD comparing men with multimorbidity vs no multimorbidity was 1.97 (95% CI, 1.54 to 2.51). Compared with men with no multimorbidity, the corresponding adjusted HRs (95% CIs) for SCD were 1.93 (95% CI, 1.50 to 2.47) for men with two to three conditions and 2.66 (95% CI, 1.34 to 5.28) for men with four to five conditions.</p><p><strong>Conclusion: </strong>In middle-aged and older men, multimorbidity is strongly linked to an increased risk of SCD, independent of known cardiovascular risk factors. Furthermore, the risk of SCD rises progressively with the number of coexisting health conditions.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238897","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}

{"title":"Surrounded by Angels fabricated by Cathedral Crafts","authors":"Margaret R. Wentz BA","doi":"10.1016/j.mayocp.2025.07.031","DOIUrl":"10.1016/j.mayocp.2025.07.031","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":"100 10","pages":"Page 1860"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189987","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}

{"title":"Blood Pressure Thresholds for Hypertension in Pregnancy and Future Cardiovascular Risk","authors":"Andrea G. Kattah MD ,&nbsp;Thais D. Coutinho MD ,&nbsp;Jane Vermunt MD ,&nbsp;Lisa E. Vaughan MS ,&nbsp;Sonja Suvakov MD, PhD ,&nbsp;Yvonne S. Butler Tobah MD ,&nbsp;Alanna M. Chamberlain PhD ,&nbsp;Sue J. Bielinski PhD ,&nbsp;Vesna Garovic MD, PhD","doi":"10.1016/j.mayocp.2025.04.028","DOIUrl":"10.1016/j.mayocp.2025.04.028","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of blood pressure threshold (≥140/90 vs ≥130/80 mm Hg) and cardiovascular disease (CVD) risk factors on the association of hypertensive disorders of pregnancy (HDP) and CVD.</div></div><div><h3>Patients and Methods</h3><div>A cohort of parous women 45 years of age were followed up for an average of 18.6 years. Hypertension in pregnancy was defined using 2 thresholds: ≥140/90 and ≥130/80 mm Hg (with more than 50% of readings greater than or equal to threshold after first elevation). Cox proportional hazards models were used to evaluate the association between HDP and CVD after adjusting for CVD risk factors (at age 45 or as time-dependent covariates after 45), age at first pregnancy, and parity.</div></div><div><h3>Results</h3><div>Among 1755 women, 263 (15.0%) had HDP during one or more of their pregnancies using the 140/90 mm Hg or greater threshold, while 780 (44.4%) had HDP based on the 130/80 mm Hg or greater threshold. Adjusting for age at pregnancy, parity, body mass index, and CVD risk factors after age 45, both term and preterm preeclampsia were associated with an increased risk of CVD using the 140/90 mm Hg or greater threshold (hazard ratio (HR), 1.45; 95% CI, 1.00 to 2.09; <em>P</em>=.048; and HR, 2.25; 95% CI, 1.25 to 4.06; <em>P</em>=.007, respectively) and the 130/80 mm Hg or greater threshold (HR, 1.42; 95% CI, 1.01 to 1.99; <em>P</em>=.042; and HR, 1.98; 95% CI, 1.09 to 3.60; <em>P</em>=.024, respectively). Women who had HDP only at 130/80 mm Hg or greater (not ≥140/90 mm Hg) had a lower prevalence of hypertension at 45 years compared with the higher threshold (11.0% [57 of 517] vs 24.7% [63 of 263]; <em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Lowering the blood pressure threshold increased the incidence of HDP but did not impact the association of HDP and future CVD.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 10","pages":"Pages 1745-1757"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690702","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}