{"title":"Highlights from the Current Issue – Audiovisual Summary","authors":"Karl A. Nath MBChB","doi":"10.1016/j.mayocp.2025.05.019","DOIUrl":"10.1016/j.mayocp.2025.05.019","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Page e1"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190029","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}
Jennifer L. St. Sauver PhD , Robert M. Jacobson MD , Susan A. Weston , Chun Fan BS , Philip O. Buck PhD , Susan A. Hall PhD
{"title":"Population-Based Incidence of Infectious Mononucleosis and Related Hospitalizations: 2010 Through 2021","authors":"Jennifer L. St. Sauver PhD , Robert M. Jacobson MD , Susan A. Weston , Chun Fan BS , Philip O. Buck PhD , Susan A. Hall PhD","doi":"10.1016/j.mayocp.2024.09.017","DOIUrl":"10.1016/j.mayocp.2024.09.017","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether the risks of infectious mononucleosis (IM) and serious IM outcomes are changing over time.</div></div><div><h3>Patients and Methods</h3><div>Individuals with a diagnosis of IM and hospitalizations due to IM were identified among persons residing in an Upper Midwest region between January 1, 2010, and December 31, 2021, using the Rochester Epidemiology Project. Infectious mononucleosis rates were calculated assuming the entire population between 2010 and 2021 was at risk, and IM-associated hospitalization rates were calculated among everyone with a diagnosis of IM. Poisson regression was used to test trends and estimate incidence and hospitalization rate ratios.</div></div><div><h3>Results</h3><div>We identified 5334 individuals with IM; the overall IM rate was 60.60 per 100,000 person-years (95% CI, 58.98 to 62.25). Rates were highest in females, individuals of White race, those with non-Hispanic ethnicity, and individuals 15 to 19 years old (all <em>P</em><.05). Infectious mononucleosis rates decreased significantly over time among all age groups (all tests for trend, <em>P</em><.05). Overall, 234 individuals (4.3%) were hospitalized with IM (43.87 per 1000 persons with IM; 95% CI, 38.43 to 49.87), and hospitalization rates among those with IM increased over time (test for trend, <em>P</em><.05). Individuals younger than 10 years, those 20 years or older, and individuals of Hispanic ethnicity had increased risk for IM-associated hospitalization (all adjusted <em>P</em><.05).</div></div><div><h3>Conclusion</h3><div>Although rates of IM diagnosis have decreased over time, risk of hospitalization in individuals with IM has increased. Age and ethnicity increase the risk of hospitalization due to IM.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 982-992"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586266","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}
Tiffany Wu MD, MS , Omar Y. Mousa MBBS, MD , Tasha Kulai MD , Cori Larson CCRP , Amy Olofson RN , Patrick S. Kamath MD , Vijay H. Shah MD , Timucin Taner MD, PhD , William Sanchez MD , Douglas A. Simonetto MD
{"title":"Safety of Acamprosate in Patients With Alcohol-Associated Liver Disease: A Single-Arm Phase 2 Trial","authors":"Tiffany Wu MD, MS , Omar Y. Mousa MBBS, MD , Tasha Kulai MD , Cori Larson CCRP , Amy Olofson RN , Patrick S. Kamath MD , Vijay H. Shah MD , Timucin Taner MD, PhD , William Sanchez MD , Douglas A. Simonetto MD","doi":"10.1016/j.mayocp.2024.12.013","DOIUrl":"10.1016/j.mayocp.2024.12.013","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the safety of acamprosate, a Food and Drug Administration–approved medication for alcohol use disorder, in patients with alcohol-associated liver disease.</div></div><div><h3>Methods</h3><div>In this phase 2 open-label study, 12 patients with alcohol use disorder and alcohol-associated liver disease were enrolled between September 2020 and May 2022. Participants received acamprosate for 12 weeks and were followed up to 24 weeks. The primary end point was drug safety profile; secondary end points included alcohol craving, measured by the Penn Alcohol Craving Scale, and relapse. All safety data were reviewed by the Data and Safety Monitoring Board.</div></div><div><h3>Results</h3><div>Patients were enrolled sequentially with Model for End-Stage Liver Disease–Sodium score below 20 (n=6) and 20 and above (n=6). Median age was 50 years, and 7 (58.3%) were female. Seven patients confirmed initiation of acamprosate, whereas 5 were lost to follow-up. There were no significant adverse events; only 1 patient reported pruritus, and no patients demonstrated worsening of liver disease. All patients experienced a decrease in or unchanged craving score from baseline to end of study.</div></div><div><h3>Conclusion</h3><div>Acamprosate may be safe for and well tolerated by patients with alcohol-associated liver disease. Further studies are needed to assess the long-term efficacy of acamprosate.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov identifier: NCT04287920.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 954-961"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710611","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":"Acamprosate for the Treatment of Alcohol Dependence With Liver Disease","authors":"Brian P. Lee MD, MAS","doi":"10.1016/j.mayocp.2025.04.020","DOIUrl":"10.1016/j.mayocp.2025.04.020","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 937-939"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189451","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}
Abdul Hamid Borghol MD , Bassel Alkhatib MD , Roaa Zayat MD , Naveen P.G. Ravikumar MD , Fadi George Munairdjy Debeh MD , Ahmad Ghanem MD , Jonathan Mina MD , Michael A. Mao MD , Neera K. Dahl MD, PhD , LaTonya J. Hickson MD , Nabeel Aslam MD , Vicente E. Torres MD, PhD , Robert D. Brown Jr. MD, MPH , Rabih G. Tawk MD , Fouad T. Chebib MD
{"title":"Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Practical Approach to Screening and Management","authors":"Abdul Hamid Borghol MD , Bassel Alkhatib MD , Roaa Zayat MD , Naveen P.G. Ravikumar MD , Fadi George Munairdjy Debeh MD , Ahmad Ghanem MD , Jonathan Mina MD , Michael A. Mao MD , Neera K. Dahl MD, PhD , LaTonya J. Hickson MD , Nabeel Aslam MD , Vicente E. Torres MD, PhD , Robert D. Brown Jr. MD, MPH , Rabih G. Tawk MD , Fouad T. Chebib MD","doi":"10.1016/j.mayocp.2025.02.003","DOIUrl":"10.1016/j.mayocp.2025.02.003","url":null,"abstract":"<div><div>Autosomal dominant polycystic kidney disease (ADPKD), the most prevalent genetic kidney disorder, is characterized by diffuse kidney cysts, hypertension, and progressive kidney function decline, often leading to kidney failure by the age of 60 years. Compared with the general population, patients with ADPKD have an increased risk for development of saccular intracranial aneurysms (IAs), which can lead to intracranial bleeding and result in significant disability and mortality. Of both modifiable and nonmodifiable risk factors, the most significant is a family history of IAs or aneurysm rupture. Other contributing factors include hypertension, cigarette smoking, age, and sex. Most IAs currently detected during screening tests are small and located in the anterior circulation. Intracranial aneurysms can be manifested with thunderclap headache, which may be indicative of subarachnoid hemorrhage. Less commonly, IAs cause symptoms related to mass effect with focal neurologic deficits. Subarachnoid hemorrhage is particularly concerning, given its high case-fatality rate, which remains around 35% despite advances in neurologic care. Therefore, control of risk factors, early detection, and treatment when indicated are important to prevent adverse outcomes. Screening for IAs in ADPKD remains controversial and can be approached either universally (screening of all ADPKD patients) or selectively (screening of high-risk patients). The preferred imaging modality is brain magnetic resonance angiography without contrast enhancement or alternatively computed tomography angiography. This review provides a practical guide for medical teams managing patients with ADPKD, detailing the characteristics of IAs and their associated symptoms. It presents an algorithm for risk assessment and screening along with recommendations for treatment and follow-up care.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 1030-1050"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017345","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}
Mitchell E. Flagg MD, MBI , Simran K. Bhandari MD , Katherine J. Pak MS , Hui Zhou PhD , Sally F. Shaw DrPH, MPH , Jiaxiao M. Shi PhD , Connie M. Rhee MD, MSc , Benjamin I. Broder MD, PhD , John J. Sim MD
{"title":"Dialysis Transition Patterns of Chronic Kidney Disease Patients With and Without Heart Failure","authors":"Mitchell E. Flagg MD, MBI , Simran K. Bhandari MD , Katherine J. Pak MS , Hui Zhou PhD , Sally F. Shaw DrPH, MPH , Jiaxiao M. Shi PhD , Connie M. Rhee MD, MSc , Benjamin I. Broder MD, PhD , John J. Sim MD","doi":"10.1016/j.mayocp.2024.11.029","DOIUrl":"10.1016/j.mayocp.2024.11.029","url":null,"abstract":"<div><h3>Objective</h3><div>To compare dialysis transition patterns of chronic kidney disease (CKD) patients with heart failure (HF) and without HF, including inpatient “crash start” initiation of long-term (“maintenance”) dialysis, early dialysis initiation as evaluated by estimated glomerular filtration rate (eGFR), and rate of central venous catheter (CVC) use for hemodialysis.</div></div><div><h3>Methods</h3><div>A cross-sectional study was performed within Kaiser Permanente Southern California of patients (age ≥18 years) with observed incidence of CKD who initiated maintenance dialysis between January 1, 2007, and December 31, 2018. Heart failure was further categorized into HF with preserved ejection fraction (>40%) or HF with reduced ejection fraction (≤40%). Associations between HF and risk of inpatient initiation of maintenance dialysis or hemodialysis vascular access were assessed by rate ratio (RR) using Poisson regression with robust variance error.</div></div><div><h3>Results</h3><div>Of 6812 patients with CKD initiating dialysis, 2498 (37%) had HF. Inpatient dialysis initiation occurred in 463 (18.5%) patients with HF vs 416 (9.6%) without HF. Mean (SD) eGFR at dialysis was 11.3 (6.2) mL/min per 1.73 m<sup>2</sup> with HF vs 9.4 (5.2) mL/min per 1.73 m<sup>2</sup> without HF (<em>P</em><.001). Of 5499 patients who initiated hemodialysis, CVC use occurred in 1302 (58.5%) HF patients vs 1698 (51.9%) non-HF patients. Compared with non-HF patients, patients with HF had multivariate RRs (95% CI) of 1.46 (1.26 to 1.69) and 1.04 (0.99 to 1.10) for inpatient dialysis initiation and CVC use, respectively. Patients with HF with reduced ejection fraction had CVC placement RR of 1.23 (1.14 to 1.33).</div></div><div><h3>Conclusion</h3><div>Patients with CKD and HF had higher rates of suboptimal dialysis initiation: more frequent inpatient dialysis starts, more frequent CVC placement for hemodialysis access, and higher eGFR at dialysis initiation. Our findings suggest that CKD patients with HF may warrant different management strategies as they progress to dialysis.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 970-981"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449278","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}
Hanna L. Erickson MD, PhD, Thomas R. Viggiano MD, Harmeet Malhi MBBS
{"title":"Mayo Clinic Proceedings and Steatohepatitis: From NASH Recognition to MASH Therapy","authors":"Hanna L. Erickson MD, PhD, Thomas R. Viggiano MD, Harmeet Malhi MBBS","doi":"10.1016/j.mayocp.2025.03.030","DOIUrl":"10.1016/j.mayocp.2025.03.030","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 930-933"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189348","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}
William M. Schmidt MD , Christopher B. Parker MD , Benjamin J. McCormick MD
{"title":"69-Year-Old Man With Acute Kidney Injury","authors":"William M. Schmidt MD , Christopher B. Parker MD , Benjamin J. McCormick MD","doi":"10.1016/j.mayocp.2024.05.037","DOIUrl":"10.1016/j.mayocp.2024.05.037","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 6","pages":"Pages 1064-1069"},"PeriodicalIF":6.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981053","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}