Mayo Clinic proceedings最新文献

{"title":"57-Year-Old Man Presenting With Abdominal Pain","authors":"Krista N. Grennan MD , Robert Seby MD , Eric Edwards MD","doi":"10.1016/j.mayocp.2025.02.024","DOIUrl":"10.1016/j.mayocp.2025.02.024","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 865-869"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504384","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":"Are Patients With Chronic Kidney Disease Different When It Comes to Considering Anticoagulation?","authors":"Niamh Corcoran MB, MRCPI, Donal Reddan MB, MHS, FRCPI","doi":"10.1016/j.mayocp.2026.03.017","DOIUrl":"10.1016/j.mayocp.2026.03.017","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 708-710"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802601","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":"Highlights from the Current Issue – Audiovisual Summary","authors":"Karl A. Nath MBChB","doi":"10.1016/j.mayocp.2026.04.005","DOIUrl":"10.1016/j.mayocp.2026.04.005","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Page e1"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807528","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":"Surreptitious Glucocorticoid-Containing Supplements Causing Severe Adrenal Insufficiency in Hospitalized Patients","authors":"Shanee Abouzaglo MD , Grant Herrington MD , Oksana Hamidi DO, MSCS , Emilia Chapa MS , Caitlin Helm MD , Jaini Sutaria MD","doi":"10.1016/j.mayocp.2026.03.008","DOIUrl":"10.1016/j.mayocp.2026.03.008","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 883-885"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494119","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":"Polycythemia vera","authors":"Martin H. Ellis MD ,&nbsp;Tiziano Barbui MD ,&nbsp;Ayalew Tefferi MD","doi":"10.1016/j.mayocp.2026.01.008","DOIUrl":"10.1016/j.mayocp.2026.01.008","url":null,"abstract":"<div><div>Polycythemia vera (PV) is a Philadelphia chromosome–negative myeloproliferative neoplasm arising from acquired <em>JAK2</em> mutations (V617F or exon 12), resulting in constitutive activation of the JAK-STAT pathway and panmyelosis. This comprehensive review of the disease is based on relevant publications retrieved from a PubMed search using the terms <em>polycythemia vera</em> and <em>epidemiology</em> or <em>pathophysiology</em> or <em>molecular pathology</em> or <em>clinical trials</em> from inception to June 2025 and a review of abstracts submitted to the American Society of Hematology for annual meetings in 2023 and 2024. Polycythemia vera manifests as erythrocytosis, often accompanied by leukocytosis and thrombocytosis, and symptoms include pruritus, headache, dizziness, and fatigue. Thromboembolism is the most important complication, and transformation to myelofibrosis or acute myeloid leukemia is a rare long-term complication. Diagnosis is guided by international consensus criteria, incorporating hematocrit levels, bone marrow morphology, and <em>JAK2</em> mutation status, alongside subnormal erythropoietin levels. Risk stratification for thrombosis is crucial and is currently primarily based on age and prior thrombosis. Management aims to maintain hematocrit levels below 45% and prevent thrombotic events. Established therapies include phlebotomy, low-dose aspirin, and cytoreductive agents such as hydroxyurea. Ropeginterferon alfa-2b has shown efficacy in achieving hematologic remission and <em>JAK2</em> V617F allele burden reduction. Ruxolitinib, a JAK1/JAK2 inhibitor, is effective for patients intolerant or resistant to hydroxyurea, improving hematocrit control, spleen volume, and symptoms. Novel agents targeting hepcidin for iron restriction and epigenetic modifiers are under investigation. Despite recent advances, PV remains incurable, and future research aimed at early detection of disease may allow the application of disease-modifying treatments and improve long-term outcomes.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 826-845"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574550","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":"Beyond Biology: Unpacking the Physician Sex Effect in Rheumatoid Arthritis Management","authors":"Lijun Ye MD,&nbsp;Wei Zhu MD,&nbsp;Yan Liang MD,&nbsp;Yingjian Ye MD,&nbsp;Wenzhi Wang MD,&nbsp;Peng An PhD","doi":"10.1016/j.mayocp.2026.02.009","DOIUrl":"10.1016/j.mayocp.2026.02.009","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 887-889"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574474","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":"Evaluating the Association of Nontumor Kidney Perirenal Fat Characteristics With Long-Term Renal Function and Mortality After Radical Nephrectomy","authors":"Neda Qosja BS ,&nbsp;Aleksandar Denic MD, PhD ,&nbsp;Aleksandra Kukla MD ,&nbsp;Aidan F. Mullan MA ,&nbsp;Vidit Sharma MD ,&nbsp;Timothy L. Kline PhD ,&nbsp;Andrew D. Rule MD, MS ,&nbsp;Laura E. Geldmaker BS ,&nbsp;David D. Thiel MD","doi":"10.1016/j.mayocp.2025.12.027","DOIUrl":"10.1016/j.mayocp.2025.12.027","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of perinephric fat thickness and stranding around the unaffected kidney on progressive chronic kidney disease (CKD) and renal cell carcinoma (RCC) outcomes after radical nephrectomy.</div></div><div><h3>Methods</h3><div>We conducted an observational cohort study of 1276 patients with RCC who underwent radical nephrectomy at Mayo Clinic between January 1, 2000, and December 31, 2021. Regression models assessed the risk of progressive CKD and noncancer and cancer mortality with lateral and posterior fat thickness and perinephric fat stranding, adjusting for age, sex, and comorbidities. The Mayo Adhesive Probability (MAP) score was generated by summing posterior fat thickness score and perinephric stranding grade. Progressive CKD was defined as onset of dialysis, kidney transplant, sustained estimated glomerular filtration rate of less than 10 mL/min per 1.73 m², or sustained 40% decline from the postnephrectomy new baseline estimated glomerular filtration rate.</div></div><div><h3>Results</h3><div>Of 1276 patients, there were 52 progressive CKD events, 258 noncancer deaths, and 129 cancer deaths. Thick or diffuse fat stranding (type 2) was associated with progressive CKD (hazard ratio [HR], 10.79; 95% CI, 4.31 to 27.05; <em>P</em>&lt;.0001). Thicker lateral and posterior perinephric fat was associated with a reduced risk of cancer mortality (HRs, 0.60 [95% CI, 0.48 to 0.75; <em>P</em>&lt;.0001] and 0.74 [95% CI, 0.60 to 0.92; <em>P</em>=.005]). Higher MAP score was associated with increased risks of noncancer mortality (HR,1.74; 95% CI, 1.30 to 2.31; <em>P</em>=.0002) but with reduced risks of cancer mortality (HR, 0.48; 95% CI, 0.29 to 0.78; <em>P</em>=.003).</div></div><div><h3>Conclusion</h3><div>Fat stranding in the remaining kidney is associated with progressive CKD. Elevated MAP score is associated with increased noncancer mortality and reduced RCC mortality.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 743-753"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593041","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":"Antithrombotic Strategies in Advanced Chronic Kidney Disease: Real-World Comparison of Oral Anticoagulation Alone vs Dual Antithrombotic Therapy","authors":"Chih-Chin Kao MD, PhD ,&nbsp;Hui-An Lin MD, PhD ,&nbsp;Chien-Yi Hsu MD, PhD ,&nbsp;Sheng-Feng Lin MD, PhD","doi":"10.1016/j.mayocp.2025.12.028","DOIUrl":"10.1016/j.mayocp.2025.12.028","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness and safety of oral anticoagulant (OAC) monotherapy vs dual antithrombotic therapy (OAC plus a single antiplatelet) in patients with advanced chronic kidney disease (CKD) with atrial fibrillation (AF) and coronary artery disease (CAD).</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective cohort study using TriNetX data from March 1, 2005, through April 1, 2024. Adults with advanced CKD (stages 4 and 5 or dialysis dependent) with AF and CAD were included. Patients treated with OAC monotherapy or dual therapy were matched 1:1 by propensity scores and observed for 12 months. Efficacy outcomes included major adverse cardiovascular events, ischemic stroke, and acute myocardial infarction; safety outcomes were major bleeding, minor bleeding, and intracranial hemorrhage.</div></div><div><h3>Results</h3><div>Of 57,447 patients (13,920 OAC monotherapy; 43,527 dual therapy), 12,589 matched pairs were analyzed. At 12 months, OAC monotherapy was associated with lower risks of major adverse cardiovascular events (hazard ratio [HR], 0.84; 95% CI, 0.81 to 0.88), acute ischemic stroke (HR, 0.67; 95% CI, 0.62 to 0.73), and acute myocardial infarction (HR, 0.48; 95% CI, 0.44 to 0.53). Safety outcomes also favored OAC monotherapy, with reduced risk of major bleeding (2.5% vs 3.1%; risk difference [RD], −0.5%; 95% CI, −0.9 to −0.1%), minor bleeding (15.5% vs 19.8%; RD, −4.3%; 95% CI, −5.2 to −3.2%), and intracranial hemorrhage (1.4% vs 1.9%; RD, −0.4; 95% CI, −0.7 to −0.1%).</div></div><div><h3>Conclusion</h3><div>In patients with advanced CKD, AF, and CAD, OAC monotherapy was associated with lower cardiovascular and bleeding risks compared with dual therapy, supporting its use as a safer and effective strategy in this high-risk population.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 727-742"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574431","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":"Madonna and Child Architectural Artifact From Saint Marys Hospital 1909","authors":"Margaret R. Wentz","doi":"10.1016/j.mayocp.2026.03.013","DOIUrl":"10.1016/j.mayocp.2026.03.013","url":null,"abstract":"<div><div>Art is integrated into the Mayo Clinic environment. Since the original Mayo Clinic Building was finished in 1914, many pieces have been donated or commissioned for patients and staff to enjoy. Each issue of <em>Mayo Clinic Proceedings</em> features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 894-895"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513334","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":"Hypertrophic Lichen Planus","authors":"Minh B. Nguyen BS ,&nbsp;Abdul H. Diwan MD, PhD ,&nbsp;Vicky Z. Ren MD","doi":"10.1016/j.mayocp.2026.01.013","DOIUrl":"10.1016/j.mayocp.2026.01.013","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 5","pages":"Pages 876-877"},"PeriodicalIF":6.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444142","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}