Mayo Clinic proceedings最新文献

{"title":"Sex-Associated Differences in Clinical Outcomes After Septal Reduction Therapies in Hypertrophic Cardiomyopathy.","authors":"Nirav Patel, Naman S Shetty, Akhil Pampana, Mokshad Gaonkar, Nehal Vekariya, Peng Li, Anjali T Owens, Christopher Semsarian, Garima Arora, Pankaj Arora","doi":"10.1016/j.mayocp.2024.05.026","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.05.026","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate sex-associated differences in the short- and long-term outcomes of patients with hypertrophic cardiomyopathy (HCM) undergoing septal myectomy and alcohol septal ablation.</p><p><strong>Methods: </strong>This retrospective cohort study used electronic health record data from the TriNetX research database. International Classification of Diseases, Ninth Revision and Tenth Revision diagnosis and procedure codes were used to identify patients with HCM who underwent septal myectomy and alcohol septal ablation in the United States between January 2002 and March 2023. The outcomes were long-term mortality and postprocedural complications (<30 days), including death, stroke, major bleeding, and renal failure. Multivariable adjusted Cox models were used to assess the association of outcomes by sex, taking female patients as reference.</p><p><strong>Results: </strong>Of 11,680 adults (32.0% female; median age, 63 [interquartile range, 54 to 71] years), 1916 (16.4%) and 9764 (83.6%) underwent septal myectomy and alcohol septal ablation, respectively. For those who underwent septal myectomy, sex was not associated with short-term (adjusted hazard ratio [HR_adj], 1.57 [0.64 to 3.87]) and long-term (HR_adj, 1.05 [0.87 to 1.26]) mortality. Male patients had a higher risk of acute renal failure compared with female patients after septal myectomy (HR_adj, 1.69 [1.33 to 2.15]). Of those who underwent alcohol septal ablation, male patients (HR_adj, 1.07 [0.99 to 1.16]) had a similar risk of long-term mortality to that of female patients. Compared with female patients, the risk of acute renal failure was higher in male patients (HR_adj, 1.23 [1.02 to 1.48]) after alcohol septal ablation.</p><p><strong>Conclusion: </strong>This nationwide study found that the risk of short- and long-term mortality was similar for male and female patients undergoing septal myectomy and alcohol septal ablation for HCM. The sex-based differences in the clinical presentation should not prevent consideration of septal reduction therapies.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623502","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":"Agreement of Doppler Flow Velocity Reserve With PET Flow Reserve in Patients With Angina Without Obstructive Coronary Arteries.","authors":"Mahmoud Ismayl, Claire E Raphael, Abhiram Prasad, Panithaya Chareonthaitawee, John P Bois","doi":"10.1016/j.mayocp.2024.08.003","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.08.003","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648652","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":"Women Consume Less Oxygen Than Men for Muscular Work: Role of Lean Body Mass.","authors":"Meihan Guo, David Montero","doi":"10.1016/j.mayocp.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.08.002","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623507","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":"Cutaneous Clear Cell Hidradenoma.","authors":"Ruifeng Guo, Margot S Peters, Julio C Sartori-Valinotti","doi":"10.1016/j.mayocp.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.09.012","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623464","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":"Post-Pulmonary Embolism Syndrome-A Diagnostic Dilemma and Challenging Management.","authors":"Kajal P Shah, Christopher Lee, Robert D McBane, Gregory Piazza, Robert P Frantz, Damon E Houghton, Ana I Casanegra, Stanislav Henkin","doi":"10.1016/j.mayocp.2024.07.008","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.07.008","url":null,"abstract":"<p><p>Historically, research on pulmonary embolism (PE) management has focused on short-term outcomes, such as acute cardiovascular collapse, change in right ventricular function, and in-hospital mortality. However, long-standing functional impairments from acute PE occur in up to half of all patients. This chronic syndrome has been termed the post-PE syndrome, which describes patients who have persistent or worsening symptoms, functional limitations, and cardiorespiratory impairment not explained by a comorbid condition. Diagnosis and management are challenging, and post-PE syndrome remains an underrecognized and undertreated condition. This review seeks to increase awareness of the syndrome that affects a significant portion of PE survivors. The epidemiology, pathophysiology, and clinical features are discussed, followed by a description of imaging findings and management options across the entire spectrum of post-PE syndrome.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623497","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":"75-Year-Old Man With Dysuria, Urinary Frequency, and Altered Mental Status.","authors":"Savannah Whitfield, Deandra Chetram, David Rosenman","doi":"10.1016/j.mayocp.2024.02.011","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.02.011","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623460","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":"21-Year-Old Man With Fever, Jaundice, and Dark Urine.","authors":"Ashwin Ganti, Jose F de Melo, Seth Sweetser","doi":"10.1016/j.mayocp.2024.02.010","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.02.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-08","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}

{"title":"Echocardiography Screening of Consecutive Patients With Portal Hypertension Referred to Mayo Clinic for Liver Transplant Evaluation.","authors":"Charles D Burger, Hollie Saunders, David O Hodge, Robert E Safford, Scott A Helgeson, John E Moss, Hilary M DuBrock, Rodrigo Cartin-Ceba, Hector R Cajigas, Michael J Krowka","doi":"10.1016/j.mayocp.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.08.011","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of portopulmonary hypertension in patients referred for liver transplant evaluation.</p><p><strong>Methods: </strong>Medical records were reviewed for 986 consecutive patients referred for liver transplant evaluation who were screened for pulmonary hypertension with echocardiography from February 1, 2021, to January 31, 2022, across 3 liver transplant centers.</p><p><strong>Results: </strong>Of 934 patients eligible for analysis, mean (SD) age was 57 (11) years, 558 (59.7%) were men, and 859 (92.0%) were White. Alcoholic cirrhosis and nonalcoholic steatohepatitis represented 640 (68.5%) of the liver diseases. Right ventricular systolic pressure estimated by echocardiography was 35 mm Hg or greater in 147 (15.7%) and less than 35 mm Hg in 475 (50.9%; unable to estimate in 312 [33.4%]). Right-sided heart catheterization was performed in 42 (4.5%) patients; hemodynamic profiles revealed that 12 (28.6%) did not have pulmonary hypertension, 15 (35.7%) had postcapillary venous pulmonary hypertension, 7 (16.7%) had portopulmonary hypertension, 6 (14.3%) had unclassifiable pulmonary hypertension, and 2 (4.8%) had combined pre- and postcapillary pulmonary hypertension.</p><p><strong>Conclusion: </strong>The percentage of portopulmonary hypertension in patients referred for liver transplant was considerably lower, 7 of 934 (0.7%), than in previous studies, but the reason was unclear.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623493","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":"Characteristics of an Older Adult Population Without COVID-19 Infection in a Southeast Minnesota Community.","authors":"Robert J Pignolo, Katherine S King, Chung-Il Wi, Euijung Ryu, Paul Y Takahashi, Joseph D Yao, Matthew J Binnicker, Rachel E Dixon, Traci L Natoli, Young J Juhn","doi":"10.1016/j.mayocp.2024.05.025","DOIUrl":"10.1016/j.mayocp.2024.05.025","url":null,"abstract":"<p><strong>Objective: </strong>To assess demographic characteristics, public health measures, and health beliefs or behaviors that differentiate participants with a history of the coronavirus disease 2019 (COVID-19) infection from those with no history of COVID-19.</p><p><strong>Methods: </strong>A cross-sectional survey-based study nested within a larger prospective cohort study of a community-based sample of 2511 adults was conducted to assess the incidence of viral infections. Community-based adults aged 50 years and older residing in southeast Minnesota who were assessed and self-reported history of COVID-19 infection during the early to mid phase of the COVID-19 pandemic were included; 1758 participants completed the survey between June 6, 2021, and February 7, 2022. Participants were asked to complete a questionnaire containing 42 items related to COVID-19. Odds ratios were calculated for history of COVID-19 to compare sociodemographic factors, current and future health behaviors, and health beliefs, including effective preventive measures and modes of transmission.</p><p><strong>Results: </strong>We found that certain sociodemographic features and health behaviors (eg, adherence to public health measures, such as COVID-19 vaccination) are associated with protection against COVID-19 infection and that strong beliefs in effective COVID-19 protective measures and modes of transmission (eg, types of social distancing) differentiated those without from those with a history of COVID-19.</p><p><strong>Conclusion: </strong>Depending on the communicability, virulence, and pathogenicity of future COVID-19 variants, local, state, and federal governments must continue to consider the risks and benefits of public health initiatives that take into consideration these protective factors.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583251","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":"Exploring Radiofrequency Ablation for T1 Papillary Thyroid Cancer in the United States: Mayo Clinic Experience","authors":"Kharisa N. Rachmasari MD ,&nbsp;John J. Schmitz MD ,&nbsp;M. Regina Castro MD ,&nbsp;A. Nicholas Kurup MD ,&nbsp;Robert A. Lee MD ,&nbsp;Marius N. Stan MD","doi":"10.1016/j.mayocp.2024.04.010","DOIUrl":"10.1016/j.mayocp.2024.04.010","url":null,"abstract":"<div><h3>Objective</h3><div>To report the efficacy, safety, and feasibility of radiofrequency ablation (RFA) for T1 papillary thyroid carcinoma (PTC) in a large referral center in the United States.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective study of 8 patients who underwent RFA for T1 PTC at Mayo Clinic in Rochester Minnesota, between July 1, 2020, and February 28, 2023. The RFA technique and the type of anesthesia are described. Thyroid function, changes in ablated zone, and adverse events were analyzed for up to 24 months after the procedure.</div></div><div><h3>Results</h3><div>Of the 8 patients included in the study, 7 were female and 1 was male with a mean ± SD age of 53±16.4 years. Thyroid status was unaffected in 7 of the 8 patients. The median duration of RFA was 6 minutes (range, 2 to 14.5 minutes) with energy delivered at between 25 and 45 W. The mean ± SD volume of small PTCs was 0.3±0.2 mL, and the mean largest diameter was 9.5±3.3 mm (range, 6 to 15 mm). The mean ± SD ablated volume at 3 to 6 months was larger than the target lesion (0.8±0.7 mL), with a reduction in mean ± SD ablated volume of 0.4±0.4 mL at 7 to 12 months and 0.1±0.06 mL at 13 to 18 months. The ablated zone almost disappeared at 19 to 24 months (0.04±0.04 mL). There were no major adverse events during or after the RFA procedure.</div></div><div><h3>Conclusion</h3><div>This is the first reported series of T1 PTC treated with RFA in the United States. Early postablation imaging revealed that the ablated region was larger than the target lesions, followed by a serial decrease in size. Therefore, RFA at centers with such expertise appears to be a safe and effective treatment for small PTCs. Further studies are needed to evaluate its long-term efficacy and the risk of recurrence.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1702-1709"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875324","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}