Mayo Clinic proceedings最新文献

{"title":"Impact of Tumor Burden and Cardiac Factors on Survival After Valve Surgery for Carcinoid Heart Disease.","authors":"Tedy Sawma, Hartzell V Schaff, Gokce Belge Bilgin, Anita Zheng, Defne Gunes Ergi, Austin Todd, A Tuba Kendi, Sushil Allen Luis, Cornelius A Thiels, Thorvardur R Halfdanarson, Patricia A Pellikka, Heidi M Connolly, Juan A Crestanello","doi":"10.1016/j.mayocp.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.01.026","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association of preoperative cardiac status and tumor characteristics with long-term survival after valve surgery for carcinoid heart disease (CHD).</p><p><strong>Methods: </strong>A retrospective review was conducted of patients surgically treated for CHD at our institution between 2000 and 2023.</p><p><strong>Results: </strong>A total of 168 patients (median age, 63.2 years; 48.2% women) with CHD who underwent valvular surgery from 2000 to 2023 were included. The primary site of the neuroendocrine tumor was the small bowel in 89.3% of the patients. All patients had liver metastasis, with 31% of the patients having more than 75% involvement of the liver parenchyma, and 28% had bone metastases. Tricuspid valve replacement was performed in 98.2%, pulmonary valve replacement in 79.2%, and both in 78.6%. Operative mortality was 6%. After a median follow-up of 8.3 years, median survival was 2.9 (2.2 to 4.1) years (5-year survival was 34.1% for the overall cohort, 16.2% for patients with more than 75% liver metastasis, and 13.1% for those with bone metastases). Independent predictors of long-term mortality included more than 75% metastatic liver involvement (hazard ratio [HR], 1.5; 95% CI, 1.1 to 2.3), presence of bone metastases (HR, 2.0; 95% CI, 1.2 to 3.0), New York Heart Association class III or IV (HR, 2.3; 95% CI, 1.5 to 3.6), and severe right ventricular dysfunction (HR, 3.3; 95% CI, 1.4 to 7.6).</p><p><strong>Conclusion: </strong>Valve surgery in patients with CHD relieves symptoms of right-sided heart failure. However, long-term survival is limited in patients with significant metastatic liver burden, bone metastases, or severe right ventricular dysfunction, underscoring the importance of incorporating these prognostic factors into preoperative risk assessment.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768772","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":"Bidirectional Association of Rheumatoid Arthritis and Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study.","authors":"Yijun Chen, Yesheng Zhou, Si Liu, Qian Zhang, Shutian Zhang, Shengtao Zhu, Shanshan Wu","doi":"10.1016/j.mayocp.2025.04.031","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.04.031","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the bidirectional prospective association between rheumatoid arthritis (RA) and irritable bowel syndrome (IBS) in a large-scale, long-term population-based cohort.</p><p><strong>Patients and methods: </strong>Participants without any cancer at baseline were included between 2006 and 2010. Overall, 5455 prevalent RA cases and 419,670 non-RA participants in cohort 1 were included to examine the risk of incident IBS, and 22,126 prevalent IBS cases and 419,670 non-IBS participants in cohort 2 were included to assess the risk of incident RA. A multivariable Cox proportional hazards model was employed to estimate adjusted hazard ratio.</p><p><strong>Results: </strong>Overall, 8984 new IBS cases were identified in cohort 1 during a total of 5,980,083 person-years of follow-up. After adjustment for multiple confounders, RA patients exhibited a 1.30-fold increased risk (95% CI, 1.12 to 1.51) for development of IBS, with an even 1.4-fold higher risk in those with RA duration of 10 years or more. By contrast, a total of 5777 incident RA cases were identified during a median follow-up of 14.3 years in cohort 2. Patients with IBS demonstrated a 1.53-fold increased risk (95% CI, 1.39 to 1.68) for development of RA. Sensitivity and subgroup analyses yielded similar results.</p><p><strong>Conclusion: </strong>The findings indicate that RA is associated with an increased risk for development of IBS, and conversely, IBS is associated with an increased risk for development of RA. Further research is necessary to confirm these findings and to elucidate the underlying biologic mechanisms.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768769","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 Chronic Graft-Versus-Host Disease.","authors":"Yen T H Le, Emma F Johnson, Julia S Lehman","doi":"10.1016/j.mayocp.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.05.004","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768770","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":"Spiny Keratoderma in Association With Extramammary Paget Disease.","authors":"Reese L Imhof, Thomas Trischman, Burak Tekin","doi":"10.1016/j.mayocp.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.05.018","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768774","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":"Real-World Effectiveness and Dose-Response of ON101 Therapy for Healing of Diabetic Foot Ulcers.","authors":"Shun-Cheng Chang, Chen-Yi Yang, Ching-Uen Huang, Yi-Chun Wu, Feng-Chou Tsai, Hao-Chin Chang, Jung-Hsuan Chang, Xin-Yi Lin, Yu-Fen Chiu, Nai-Chen Cheng, Huang-Tz Ou","doi":"10.1016/j.mayocp.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.01.019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the real-world effectiveness and dose-response of ON101 , especially for high-risk patients with poor healing outcomes.</p><p><strong>Patients and methods: </strong>ON101 cream, a novel treatment for diabetic foot ulcers (DFUs), modulates the function of macrophages and accelerates the emergence and expansion of anti-inflammatory properties. In this study, 80 and 98 patients with DFU who were treated using ON101 and standard care with adjuvant therapy (denoted as nonuse), respectively, from January 1, 2020, to December 31, 2022, were identified from Taipei Medical University-Shuang Ho Hospital, Taiwan. The primary outcome was a complete healing event within 120 days following treatment initiation. Secondary outcomes included ulcer recurrence, amputation, and all-cause mortality within 1 year of follow-up. Cox proportional hazard model analysis was applied to determine the treatment effect on study outcomes. The dose-response of ON101 on healing outcomes was modeled using a regression analysis.</p><p><strong>Results: </strong>Compared with nonuse, ON101 use significantly increased the complete healing outcome by 79% (HR, 1.79; 95% CI, 1.24 to 2.58), with an average of 1.85 ON101 tubes used per person with healed ulcers. Favorable healing outcomes were consistently shown in the analyses of high-risk patients. The dose-response analysis results suggest 25%, 107%, 33%, and 19% decreases in the ulcer size per additional ON101 tube use for all study patients and those with Wagner grade 1, 2, and 3 ulcers, respectively (all P<.01).</p><p><strong>Conclusion: </strong>Promising healing outcomes following ON101 therapy at lower doses among real-world patients with DFU are corroborated, with a potential therapeutic benefit for clinically disadvantaged patients and practical feasibility for use in routine practice.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768773","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":"Risk Factors for Contemporary Heart Failure—Respecting the Old (Hypertension) While Accepting the New (Obesity)","authors":"Yogesh N.V. Reddy MBBS, MSc,&nbsp;Nicholas Bergeron MD","doi":"10.1016/j.mayocp.2025.06.010","DOIUrl":"10.1016/j.mayocp.2025.06.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1275-1277"},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748652","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":"Cross-sectional and Longitudinal Associations Between Family History of Type 2 Diabetes Mellitus, Hypertension, and Dyslipidemia and Their Prevalence and Incidence","authors":"Izumi Ikeda RD, PhD ,&nbsp;Risa Igarashi DDS, RD, MS ,&nbsp;Kazuya Fujihara MD, PhD ,&nbsp;Yasunaga Takeda RD, PhD ,&nbsp;Efrem d'Ávila Ferreira PhD ,&nbsp;Khin Lay Mon MD ,&nbsp;Satoru Kodama MD, PhD ,&nbsp;Yasumichi Mori MD, PhD ,&nbsp;Takashi Kadowaki MD, PhD ,&nbsp;Ritsuko Honda MD, PhD ,&nbsp;Yasuji Arase MD, PhD ,&nbsp;Hirohito Sone MD, PhD, FACP","doi":"10.1016/j.mayocp.2024.10.020","DOIUrl":"10.1016/j.mayocp.2024.10.020","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between a positive family history (parents, siblings, and grandparents) of type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia and their prevalence and incidence in the same population.</div></div><div><h3>Patients and Methods</h3><div>Data on 41,361 participants who underwent health examinations between January 1, 1997, and December 31, 2007, were analyzed, and the results of logistic and Cox regression analyses in the same cohort were examined.</div></div><div><h3>Results</h3><div>Cross-sectional analyses showed that the prevalence of all three diseases increased with a positive family history, especially T2DM, with an odds ratio (OR) of 12.00 (95% CI, 7.82 to 18.41) when the number of affected relatives was greater than or equal to 3 with an OR of 20.43 (95% CI, 11.0 to 37.8) for a positive family history across three generations compared with no family history. However, redefining family history from \"parents, siblings, and grandparents\" to \"parents and siblings\" or \"parents only\" did not significantly change ORs for each disease. Among those with a positive family history and body mass index greater than or equal to 30.0 kg/m² hypertension was 19 times more prevalent compared with no family history and body mass index of 18.5 to 24.9 kg/m². In the longitudinal study, family history strongly influenced incident T2DM (hazard ratio[HR], 2.40; 95% CI, 1.93 to 2.98), hypertension (HR, 1.43; 95% CI, 1.26 to 1.62), and dyslipidemia (HR, 1.41; 95% CI, 1.08 to 1.83), respectively.</div></div><div><h3>Conclusion</h3><div>Obtaining a family history of these diseases was useful in identifying high-risk groups. Also, for T2DM, the influence of a positive family history was strongest with a marked increase in risk with overlap of affected family members, suggesting that a family history is useful for early detection and prevention.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1370-1382"},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080599","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":"78-Year-Old Woman With Altered Mental Status and Hypoxia","authors":"Lai Jiang MD ,&nbsp;Devika M. Das MD, MS ,&nbsp;Allison L. Ducharme-Smith MD","doi":"10.1016/j.mayocp.2024.07.029","DOIUrl":"10.1016/j.mayocp.2024.07.029","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1420-1425"},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011581","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":"59-Year-Old Man With Malaise and Vague Chest Discomfort","authors":"Reid P. Schlesinger MD ,&nbsp;Iuri Ferreira Felix MD ,&nbsp;Francisco López-Jiménez MD, MSc","doi":"10.1016/j.mayocp.2024.07.028","DOIUrl":"10.1016/j.mayocp.2024.07.028","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1426-1431"},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971373","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":"Plasma Levels of Fibroblast Growth Factor 21 and Adverse Kidney Outcomes","authors":"Hee Byung Koh MD ,&nbsp;Hyo Jeong Kim MD ,&nbsp;Hyung Woo Kim MD ,&nbsp;Tae Ik Chang MD, PhD ,&nbsp;Jung Tak Park MD, PhD ,&nbsp;Tae-Hyun Yoo MD, PhD ,&nbsp;Shin-Wook Kang MD, PhD ,&nbsp;Seung Hyeok Han MD, PhD","doi":"10.1016/j.mayocp.2024.10.026","DOIUrl":"10.1016/j.mayocp.2024.10.026","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between fibroblast growth factor 21 (FGF21) and adverse kidney outcomes.</div></div><div><h3>Methods</h3><div>From the prospective observational cohort study using data from the UK Biobank between March 13, 2006, and August 31, 2017, a total of 32,281 individuals with estimated glomerular filtration rate of 60 mL/min per 1.73 m² and higher and urine albumin to creatinine ratio below 30 mg/g (cohort 1) and 3339 individuals with estimated glomerular filtration rate below 60 mL/min per 1.73 m² or urine albumin to creatinine ratio of 30 mg/g and higher (cohort 2), all with baseline plasma FGF21 measurements, were included. The primary predictor was plasma FGF21 levels measured by proximity extension assay. The primary outcomes were incident chronic kidney disease (CKD) for cohort 1 and incident kidney failure requiring replacement therapy (KFRT) for cohort 2.</div></div><div><h3>Results</h3><div>In cohort 1, 804 (5.6%) participants experienced the CKD outcome during a median 13.7 years of follow-up. A cause-specific competing model revealed adjusted hazard ratios with 95% CIs of 1.01 (0.88 to 1.17), 1.01 (0.87 to 1.17), and 1.25 (1.08 to 1.44) for Q2 to Q4 compared with Q1 (<em>P</em>_trend=.002). In cohort 2, 83 (2.5%) participants had KFRT during a median 13.7 years of follow-up. Elevated FGF21 levels were similarly associated with a higher KFRT risk, with adjusted hazard ratios of 2.79 (0.97 to 8.05), 3.91 (1.44 to 10.66), and 3.81 (1.44 to 10.08) for Q2 to Q4 (<em>P</em>_trend=.01). Subgroup analysis revealed stronger association in non-CKD participants with obesity and dyslipidemia, whereas for CKD participants, this association was stronger in those with increased inflammatory markers.</div></div><div><h3>Conclusion</h3><div>Higher FGF21 levels correlated with heightened risks of adverse kidney outcomes in individuals with and without CKD. However, the metabolic abnormalities potentially influencing this association varied according to baseline kidney function.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 8","pages":"Pages 1345-1359"},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540783","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}