Mayo Clinic proceedings最新文献

{"title":"Characterization of Cardiovascular Events and Prognosis in Immune Checkpoint Inhibitor-Related Myocarditis.","authors":"Milagros Pereyra Pietri, Juan M Farina, Isabel G Scalia, Michael Roarke, Ahmed K Mahmoud, Rajeev Masson, Beman Wasef, Cecilia Tagle-Cornell, Courtney R Kenyon, Mohammed Tiseer Abbas, Nima Baba Ali, Kamal Awad, Moaz A Kamel, Ebram F Said, Michael O'Shea, Timothy Barry, Hema Narayanasamy, Jordan C Ray, Hicham El Masry, Carolyn M Larsen, Joerg Herrmann, Reza Arsanjani, Chadi Ayoub","doi":"10.1016/j.mayocp.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.12.017","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incidence, timing, and characteristics of immune checkpoint inhibitor-related myocarditis (ICIrM) and associated cardiovascular events at 3-year follow-up.</p><p><strong>Methods: </strong>All patients treated with immune checkpoint inhibitors (ICIs) at a multicenter institution from 2011 to 2022 were retrospectively reviewed for ICIrM. A propensity score-matched control group was identified from patients treated with ICIs without development of myocarditis (ratio of 1:4). Baseline characteristics, cardiovascular events, and mortality outcomes were manually curated during extended 3-year follow-up. Major adverse cardiovascular events (MACE) were defined as transient ischemic attack/stroke, heart failure, and myocardial infarction.</p><p><strong>Results: </strong>Of 5423 patients treated with ICIs, ICIrM occurred in 59 (1.1%), and 236 propensity score-matched patients who received ICIs without myocarditis were identified as controls. Mean age was 68.5 ± 12.3 years; 65.4% were male. Median time to development of ICIrM was 44 days (interquartile range, 28 to 102 days), with median troponin value of 364 ng/L (interquartile range, 115 to 1224 ng/L). Patients with ICIrM had increased risk of cardiac death (hazard ratio [HR], 34.0; 95% CI, 7.8 to 148.0; P<.001), MACE (HR, 5.0; 95% CI, 3.1 to 8.1; P<.001), ventricular tachycardia (HR, 12.3; 95% CI, 1.3 to 118.4; P=.03), and complete heart block (HR, 2.3; 95% CI, 1.0 to 5.1; P=.046); these occurred predominantly within 120 days after diagnosis of ICIrM. Triple-M syndrome (myocarditis, myasthenia, and myositis) occurred in 12 (20.3%), with increased risk for all-cause mortality (HR, 2.1; 95% CI, 1.0 to 4.1; P=.04) but not for cardiac death or MACE.</p><p><strong>Conclusion: </strong>Immune checkpoint inhibitor-related myocarditis is associated with increased cardiovascular events that are further characterized on extended follow-up, with most occurring in the first 4 months after diagnosis.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811750","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":"60-Year-Old Man With Low Hemoglobin and Elevated Creatinine Levels.","authors":"Daniel Montes, Samiddhi D Weerasiri, Maria Gonzalez Suarez","doi":"10.1016/j.mayocp.2024.05.034","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.05.034","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811748","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":"Trends in the Incidence of Hypertension Among Healthy Adults Across 6 Decades.","authors":"Andrew D Rule, Daniel C Waller, Erika S Helgeson, Alanna M Chamberlain, Alison C Saiki, Eliabe Silva de Abreu, Salma Kiwan, Naim S Issa, Aidan F Mullan, Gary L Schwartz, Arthur J Matas, David M Vock","doi":"10.1016/j.mayocp.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.10.025","url":null,"abstract":"<p><strong>Objective: </strong>To determine long-term trends in the incidence of hypertension.</p><p><strong>Patients and methods: </strong>Healthy adults in Olmsted County, Minnesota, from 1962 to 2012 were identified and studied with follow-up through 2024. One blood pressure (BP) reading for each calendar year (as available) through follow-up was identified. Hypertension was defined by BP ≥130/80 mm Hg or ≥140/90 mm Hg in 2 different calendar years or by use of antihypertensive medication. Analyses were adjusted for calendar period, age, sex, race, tobacco smoking, nontobacco substance use, depression/anxiety, dyslipidemia; family history of diabetes mellitus or hypertension, body mass index, systolic and diastolic BP, and fasting blood glucose level. Cumulative incidence estimates of hypertension accounted for death as a competing risk and were adjusted to characteristics of the 2000-2012 subcohort.</p><p><strong>Results: </strong>There were 8323 healthy adults studied (mean age, 39 years). Risk factors for hypertension were older age, male sex, Black race, past and current tobacco smoking, current substance use, depression/anxiety, family history of diabetes or hypertension, higher systolic and diastolic BP, higher blood glucose level, higher body mass index, and period. For the baseline periods of 1963-1969, 1970-1979, 1980-1989, 1990-1999, and 2000-2012, the adjusted 20-year cumulative incidence of hypertension defined by BP ≥130/80 mm Hg was 45%, 47%, 54%, 70%, and 67%; by BP ≥140/90 mm Hg was 22%, 24%, 26%, 35%, and 33%; and by medication use alone was 13%, 12%, 13%, 17%, and 19%, respectively.</p><p><strong>Conclusion: </strong>A large increase in the incidence of hypertension among healthy adults occurred in the 1990s, with subsequent stabilization.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803677","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":"Benign Prostatic Hyperplasia Increases Long-term Chronic Kidney Disease Risk.","authors":"Chenxi Ouyang, Liang Zhou, Jiahao Liu, Long Wang, Yao Lu","doi":"10.1016/j.mayocp.2024.11.024","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.11.024","url":null,"abstract":"<p><strong>Objective: </strong>To assess the long-term association between benign prostatic hyperplasia (BPH) and chronic kidney disease (CKD) while considering the potential role of BPH medications in any observed associations.</p><p><strong>Methods: </strong>This study used a prospective cohort design. A total of 198,399 male patients without CKD at baseline were recruited from the UK Biobank from 2006 to 2010. Cox proportional hazards models were used to analyze the relationships between BPH, its medication, and the incidence of CKD and end-stage kidney disease (ESKD).</p><p><strong>Results: </strong>After a median follow-up of 13.58 years, 3710 patients with BPH were diagnosed with CKD (hazard ratio [HR], 1.26; 95% CI, 1.10 to 1.45), and 322 patients with BPH were diagnosed with ESKD (HR, 1.49; 95% CI, 0.72 to 3.08), compared with non-BPH patients. Furthermore, BPH medication significantly increased the risk of CKD (HR, 1.48; 95% CI, 1.18 to 1.85) in individuals with BPH compared with those without medication.</p><p><strong>Conclusion: </strong>This study found that people with BPH and those taking BPH medications have a higher long-term risk of CKD. Benign prostatic hyperplasia may contribute to the progression of CKD to ESKD. These findings highlight the importance of monitoring kidney function in patients with BPH.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803621","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":"Persistent Gender Gap in the Authorship of Hematology/Oncology Clinical Trials During the Past Two Decades.","authors":"Subhash Chander, Roopa Kumari, Milan Khealani, Om Parkash, Fnu Sindhu, Sheena Shiwlani, Fnu Sorath","doi":"10.1016/j.mayocp.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.02.004","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811751","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":"Fast-Tracking Renal Failure: A Classic Case of ANCA-Associated Glomerulonephritis.","authors":"Vijayvardhan Kamalumpundi, Alyssa K W Maclean, Mariam P Alexander","doi":"10.1016/j.mayocp.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.02.002","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803666","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":"Imaging the Histopathologic Spectrum of Substantia Nigra Changes in Parkinson Disease Using 7T MRI.","authors":"Erik H Middlebrooks, Xiangzhi Zhou, Ashley B Peña","doi":"10.1016/j.mayocp.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.02.001","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803668","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":"71-Year-Old Man With Chest Pain and Shortness of Breath.","authors":"Brent J Gawey, Teodora Donisan, Nandan S Anavekar","doi":"10.1016/j.mayocp.2024.05.033","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.05.033","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803615","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":"Reversal of Coma With Trendelenburg Position in Spontaneous Intracranial Hypotension.","authors":"Tony Zhang, Sara J Hooshmand, Nathaniel P Rogers, David O Sohutskay, Michel Toledano, Ajay A Madhavan, John L Atkinson, Jeremy L Fogelson, Alejandro A Rabinstein, Jeremy K Cutsforth-Gregory, Rafid Mustafa","doi":"10.1016/j.mayocp.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.02.006","url":null,"abstract":"<p><p>Spontaneous intracranial hypotension (SIH) is a clinical and radiologic syndrome caused by spinal leakage of cerebrospinal fluid due to a dural tear, leaking meningeal diverticulum, or cerebrospinal fluid-venous fistula. Whereas the hallmark clinical feature of SIH is orthostatic headache, in rare instances, life-threatening complications may include altered consciousness and even coma as a result of extreme downward displacement of the midbrain and brainstem. We describe the clinical features, neuroimaging findings, management strategies, and short-term outcomes of 2 unique cases of severe SIH and the role of Trendelenburg position to reverse coma. Both patients demonstrated remarkable recovery to normal mentation (Glasgow Coma Scale score of 15) within 1 hour of placement in Trendelenburg position and recurrence of coma if allowed to be upright. These cases serve to highlight the importance of this simple maneuver for acute management of severe SIH while awaiting definitive leak localization and treatment.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803674","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":"Trends and Sociodemographic Disparities in the Prevalence of Obesity Among US Children and Adolescents, 2011 to 2023.","authors":"Jia-Shuan Huang, Zhao-Cong He, Rema Ramakrishnan, Min-Shan Lu, Dan-Tong Shao, Xiu Qiu, Jian-Rong He","doi":"10.1016/j.mayocp.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.02.020","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795753","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}