Mayo Clinic proceedings最新文献

{"title":"79-Year-Old Woman With Leg Weakness.","authors":"Ahauve M Orusa, Selene Rubino, Alecia Anyim","doi":"10.1016/j.mayocp.2026.01.032","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.01.032","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216429","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":"The Burden of Type 1 Peri-Operative Myocardial Infarction After Non-Cardiac Surgery: Insights From the Myocardial Ischaemia National Audit Project From 2010-2023.","authors":"Nicholas Weight, Thomas Butler, Muhammad Rashid, Andrew Cole, Harindra Wijeysundera, Dmitry Abramov, Ching-Hui Sia, Louise Y Sun, Robert Butler, Mamas A Mamas","doi":"10.1016/j.mayocp.2026.09.024","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.024","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prevalence of perioperative myocardial infarction (PMI), the quality-of-care patients receive and their outcomes, and how this varies across different operations.</p><p><strong>Methods: </strong>We included adults from England with AMI between Jan 2010 and March 2023 from the Myocardial Ischaemia National Audit Project registry, linked to Hospital Episode Statistics (HES). Cox-regression models compared risk of all-cause mortality at thirty-days and five-years, subgroup analyses compared operation type (orthopaedic, vascular, upper (UGI) and lower gastrointestinal (LGI) and urological).</p><p><strong>Results: </strong>We identified 2,821 episodes of type 1 PMI in 533,026 eligible patients (0.5%). Orthopaedics were the largest contributing speciality (45%). Risk of thirty-day mortality was significantly higher in PMI patients at thirty-days (adjusted Hazard Ratio):1.34 [95% CIs 1.21-1.49]) and five-years (1.36 [1.29-1.43]) (both P<0.001). For thirty-day mortality, risk was not significant in orthopaedics and urology but was for vascular (1.75 [1.40-2.18]), UGI (1.95 [1.43-2.66) and LGI surgery (1.94 [1.50-2.51]) (all P<0.001). For those who survived to hospital discharge, PMI patients had higher mortality risk at five-years (1.26 [1.19-1.34), especially high in the UGI (1.76 [1.44-2.13]), LGI (1.34 [1.13-1.59]) and urology groups (1.61 [1.34-1.93]) (all P<0.001).</p><p><strong>Conclusions: </strong>PMI mortality is significantly higher than AMI all-comers, seen across all subspecialties up to five-years, with variation in the risk of mortality from PMI according to operation type. PMI may identify a high-risk vulnerable group of patients, whose increased mortality risk persists long term, even in those who survive to discharge.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195261","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":"Clinical Relevance of Magnesium Supplementation In Type 2 Diabetes Mellitus.","authors":"Chandan Alenahalli Narayana, Jasvin K Manha, Shreyaa Rajpalm, Sumanth Kumar Bandaru","doi":"10.1016/j.mayocp.2026.10.006","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.10.006","url":null,"abstract":"<p><p>Magnesium deficiency is common in type 2 diabetes mellitus (T2DM), affecting up to 48% of patients, yet remains underrecognized in routine clinical practice. A bidirectional relationship between hypomagnesemia and insulin resistance has been well characterized, and observational data consistently link higher magnesium intake to reduced risks of T2DM, hypertension, stroke, and heart failure. However, supplementation trials have yielded inconsistent results, limited by small sample sizes, short follow-up, heterogeneous formulations with differing bioavailability, and variable glycemic endpoints. Serum magnesium, the most widely used clinical measure, reflects less than 1% of total body stores and may fail to detect clinically significant depletion. No randomized trial has been powered for hard clinical outcomes such as diabetes prevention or cardiovascular events. Current American Diabetes Association guidelines recommend magnesium screening and supplementation only in high-risk groups with documented deficiency, with emphasis on dietary optimization as a first-line strategy. A literature search was conducted using PubMed/MEDLINE from inception through December 2025, with priority given to meta-analyses, randomized controlled trials, prospective cohort studies, and clinical practice guidelines, particularly the ADA position statement and the NIH Office of Dietary Supplements Magnesium Fact Sheet. This narrative review critically examines the evidence linking magnesium to glycemic control and cardiovascular risk in T2DM, highlights key methodological limitations, and identifies research priorities such as biomarker validation, formulation comparison trials, and adequately powered cardiovascular outcome studies needed to determine whether magnesium optimization should be incorporated into routine diabetes care.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195247","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":"The Multidimensional Components of Peer Support: Toward Shared Definitions and Program Evaluation.","authors":"Daniel Saddawi-Konefka, Tait D Shanafelt","doi":"10.1016/j.mayocp.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.10.001","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137233","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":"Associations of Pre-Diagnostic Cardiorespiratory Fitness and Handgrip Strength With All-Cause Mortality and 15-Year Survival After Cancer Diagnosis.","authors":"Andrea Tur-Boned, Joaquín Calatayud, Rodrigo Núñez-Cortés, Lars L Andersen, Luis Suso-Martí, Lin Yang, Rubén López-Bueno","doi":"10.1016/j.mayocp.2026.09.023","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.023","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prospective dose-response associations of pre-diagnostic estimated CRF and handgrip strength with all-cause mortality and 15-year survival probability.</p><p><strong>Patients and methods: </strong>Prospective cohort study using UK Biobank data from cancer-free participants who completed submaximal cycle ergometry and handgrip dynamometry at baseline (2006-2010) and were subsequently diagnosed with cancer (ICD-10 C00-C97). All-cause mortality was modelled using Royston-Parmar flexible parametric models with restricted cubic splines. Fifteen-year post-diagnosis survival probabilities were estimated from Poisson regression.</p><p><strong>Results: </strong>Among 10,462 participants (mean age 60.0 years, 55% men, median follow-up 12.5 years), 2,101 deaths occurred. Estimated CRF showed a curvilinear inverse association with mortality: relative to the median (27.9 ml·kg^-1·min^-1), a VO₂max of 12.5 ml·kg^-1·min^-1 was associated with 59% higher mortality (HR 1.59;95% CI 1.28-1.98), with risk declining continuously without plateau (HR 0.71;0.56-0.89 at 44.5 ml·kg^-1·min^-1). Handgrip strength showed a weaker, curvilinear inverse association that plateaued at the median (32 kg): at 12 kg, mortality was 37% higher (HR 1.37;1.11-1.67), with no further reduction beyond the reference. Fifteen-year survival rose linearly from 39.3% to 77.4% across the estimated CRF range versus 49.8% to 71.7% for handgrip strength.</p><p><strong>Conclusion: </strong>Among participants who later developed cancer, estimated CRF showed a stronger association with mortality than handgrip strength in this cohort. These findings highlight the importance of pre-diagnostic lifestyle interventions to improve long-term survival, though both fitness components may contribute through distinct physiological pathways.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136908","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":"How an Insulinoma Went Undetected for Six Years.","authors":"Aileen H Lee, Brian A Parker, Camille F Hawkins","doi":"10.1016/j.mayocp.2026.09.020","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.020","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111557","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":"Self-Reported Health, Stress, and Lifestyle Behaviors Among U.S. Chief Executive Officers: A Comparison of Two Cohorts.","authors":"Ivana T Croghan, Michael A Casey, Erin M Pagel, Karen M Fischer, Melanie Nolen, Brian M Dougan, Darrell R Schroeder, Shawn C Fokken, Elizabeth A Gilman, Steven W Ressler, Sara L Bonnes, Chrisandra L Shufelt, Daniel V Dudenkov, Michael Hayden, Michael Emperor, Bright P Thilagar, Christina D VerNess, Stephanie L Anderson, Karthik Ghosh, Ryan T Hurt","doi":"10.1016/j.mayocp.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.021","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate self-reported health and lifestyle behaviors among U.S. Chief Executive Officers (CEOs) and to identify patterns relevant to executive healthcare delivery.</p><p><strong>Patients and methods: </strong>An anonymous health and lifestyle survey was distributed to two populations: patients enrolled in the Mayo Clinic Executive Health Program (MC-EHP; n=14,240) and members of the Chief Executive Group (CEG; n=146,641). Data were collected between August 8 and October 2, 2025. Descriptive statistics were summarized for CEO survey responders (MC-EHP, n=792; CEG, n=613). Group comparisons were performed using Kruskal-Wallis and chi-square tests. No adjustment was made for multiple comparisons; therefore, inferential findings should be interpreted as exploratory.</p><p><strong>Results: </strong>Compared with CEG CEOs, MC-EHP CEOs were older (P<.001), more likely to be male (83.5% vs 76.1%; P<.001) and White (97.0% vs 93.0%; P=.001). MC-EHP CEOs self-reported less sedentary time (6.1 vs. 6.8 hours/day; P<.001), fewer work hours (40.3 hours vs 53.8 hours/week; P<.001), and lower stress levels (4.6 vs. 6.3, P<.001). They also reported fewer sleep disturbances (P=.003), fewer chronic medical conditions and higher quality-of-life (P<.001). Use of prescription medications was higher among the MC-EHP CEOs (78.6% vs 72.0%, P=.004), whereas use of over-the-counter medications/supplements was lower (P=.022). Several statistically significant differences were modest in absolute magnitude.</p><p><strong>Conclusion: </strong>Among surveyed U.S. CEOs, participation in a comprehensive executive health program was associated with lower self-reported stress, healthier lifestyle behaviors, and higher quality-of-life. The findings underscore lifestyle factors relevant to overall health and highlight areas for clinicians to prioritize when treating CEO patients. Prior research suggests that CEO well-being may have broader implications for employee well-being, further supporting the need for regular patient feedback to help executive health programs adapt healthcare services to the evolving needs of their patients.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111706","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":"Cybersecurity Hygiene in Health Care: Practical Steps for Clinicians to Protect Themselves and Their Organizations","authors":"Pritish K. Tosh MD,&nbsp;Brian W. Decker MBA, CISSP,&nbsp;Ashton L. Boon JD","doi":"10.1016/j.mayocp.2026.05.022","DOIUrl":"10.1016/j.mayocp.2026.05.022","url":null,"abstract":"<div><div>Cybersecurity has become a critical determinant of patient safety, business continuity, and organizational resilience in health care. Health care organizations are increasingly targeted by ransomware, data theft, and related attacks that disrupt clinical operations, threaten patient safety, delay care, and compromise sensitive information. Although often viewed as technical failures, many incidents originate in routine human behaviors, including phishing responses, credential misuse, unsafe downloads, and inappropriate use of personal devices or applications. This review focuses on clinician-level actions that can reduce both personal and organizational risk, including strong and unique passwords, multifactor authentication, phishing recognition and reporting, timely software updates, secure network use, careful management of personal devices and apps, and avoidance of risky removable media or untrusted downloads. It also emphasizes preparedness for extended network downtime, including familiarity with business continuity processes for documentation, ordering, communication, and care coordination when core digital systems are unavailable.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 10","pages":"Pages 1837-1844"},"PeriodicalIF":6.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078624","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":"Highlighting Breast and Other Cancers—Limelight, October 2026","authors":"Karl A. Nath MBChB (Editor-in-Chief)","doi":"10.1016/j.mayocp.2026.08.011","DOIUrl":"10.1016/j.mayocp.2026.08.011","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 10","pages":"Pages 1667-1669"},"PeriodicalIF":6.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078462","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":"Resting Heart Rate—An Independent Prognostic Marker for Cancer Mortality and a Modifiable Target of Physical Activity: A Prospective Cohort Study of 615,730 Asian Participants","authors":"Chi Pang Wen MD, DrPH,&nbsp;Javaid Nauman PhD,&nbsp;Min Kuang Tsai PhD,&nbsp;Jackson Pui Man Wai DrPH,&nbsp;Shan Pou Tsai PhD,&nbsp;June Han Lee MS,&nbsp;Hung Yi Chiou PhD,&nbsp;Christopher Wen MD,&nbsp;Ta-Wei David Chu MD, PhD,&nbsp;Chien Hua Chen MD,&nbsp;Ulrik Wisloff PhD","doi":"10.1016/j.mayocp.2026.04.016","DOIUrl":"10.1016/j.mayocp.2026.04.016","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the independent and joint associations of resting heart rate (RHR) and physical activity (PA) with cancer mortality and whether reducing elevated RHR through PA enhances its protective effects.</div></div><div><h3>Participants and Methods</h3><div>This prospective cohort study included 615,730 cancer-free Taiwanese individuals aged 20 years or older who attended a medical screening program between January 1, 1994, and December 31, 2017. Participants were followed up through December 31, 2020 (maximum, 26 years; median, 17 years). Resting heart rate was measured by resting electrocardiography. Self-reported PA was categorized as inactive, low active, or active. Cox models estimated hazard ratios for cancer mortality, adjusting for demographic characteristics, lifestyle, and clinical factors.</div></div><div><h3>Results</h3><div>Each 10-beats/min increase in RHR was associated with 10% higher cancer mortality and a 3- to 4-year shorter life expectancy. Inactivity was associated with 14% to 30% higher cancer mortality vs being active (<em>P</em>&lt;.001). Inactive adults with RHR of 90 to 99 beats/min had a 56% higher cancer mortality risk than active adults with RHR of 60 to 69 beats/min (<em>P</em>&lt;.001). Among individuals with initial RHR of 90 to 99 beats/min, PA was associated with 47% to 84% lower cancer mortality (<em>P</em>&lt;.001), depending on the initial RHR level. Higher PA volume and lower RHR had consistent dose-response associations across several cancer sites.</div></div><div><h3>Conclusion</h3><div>Elevated RHR independently predicts higher cancer mortality. Regular PA is associated with lower risk, particularly when accompanied by lower RHR. Resting heart rate may serve as a practical marker to guide and motivate effective PA for cancer prevention.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 10","pages":"Pages 1724-1737"},"PeriodicalIF":6.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}