Mayo Clinic proceedings最新文献_第5页

22-Year-Old Woman With Dystonic Movements 22岁女性肌张力障碍。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-10-01 Epub Date: 2026-08-11 DOI: 10.1016/j.mayocp.2025.08.027

Grace Ibitamuno MD, PhD, Joshua I. Daum MD, John G. Park MD

引用次数: 0

Clinical Realities of Multimodal Imaging in Papillary Fibroelastoma in 385 Pathology-Proven Cases. 385例经病理证实的乳头状纤维弹性瘤多模态影像的临床特点。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-28 DOI: 10.1016/j.mayocp.2026.09.016

Omar Aboukhatwa, Muhannad Abbasi, Simona Botezatu, Hayat Memis, Peter Misun, Elias Akiki, Sri Charan Bhyravajosyula, Shubham N Patel, Reto D Kurmann, Phillip M Young, Kyle W Klarich

{"title":"Clinical Realities of Multimodal Imaging in Papillary Fibroelastoma in 385 Pathology-Proven Cases.","authors":"Omar Aboukhatwa, Muhannad Abbasi, Simona Botezatu, Hayat Memis, Peter Misun, Elias Akiki, Sri Charan Bhyravajosyula, Shubham N Patel, Reto D Kurmann, Phillip M Young, Kyle W Klarich","doi":"10.1016/j.mayocp.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.016","url":null,"abstract":"Objectives: To evaluate the diagnostic utility of computed tomography (CT) and cardiac magnetic resonance (CMR) imaging compared to transesophageal echo (TEE) in detecting cardiac papillary fibroelastomas (PFE), using the largest dataset of pathologically-confirmed cases to date, and characterize imaging findings across modalities.Patients and methods: We retrospectively reviewed 385 patients with pathologically proven PFEs identified during cardiac surgery from January 1, 1998, through December 31, 2024. We assessed TEE, CT and CMR for lesion detection and imaging characteristics. The study was approved by the Mayo Clinic Institutional Review Board (IRB 23-009539).Results: Of 384 patients who underwent TEE, PFEs were detected in 310 (80.7%; 95% CI, 76.5%-84.4%). CMR detected PFEs in 11 of 48 patients (22.9%; 95% CI, 13.0%-36.1%), whereas CT detected PFEs in 39 of 91 patients (42.9%; 95% CI, 33%-53%), predominantly left-sided, especially on the aortic valve. Detection was higher when CT or CMR was performed specifically for cardiac mass evaluation (80.0% and 88.9%, respectively) than for other indications. All CT and CMR-detected PFEs were also seen on TEE. TEE demonstrated the ability to detect very small lesions, including PFEs measuring less than 1 mm.Conclusion: TEE remains the primary imaging modality for suspected PFEs. CT and CMR provide complementary information when TEE is contraindicated or inconclusive, but detection varies with study indication, protocol, lesion characteristics, and prior knowledge of lesion location. A targeted multimodality approach may improve diagnostic confidence in selected cases.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075176","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}

引用次数: 0

66-Year-Old Man Presents With Back Pain. 66岁男子背部疼痛。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-28 DOI: 10.1016/j.mayocp.2026.07.032

Claire Ashmead-Meers, Natalie Griffin

引用次数: 0

51-Year-Old Woman With Severe Transaminitis, Thrombocytopenia, Abdominal Pain, and a Progressive Rash. 51岁女性，严重转氨炎，血小板减少，腹痛，进行性皮疹。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-25 DOI: 10.1016/j.mayocp.2026.06.030

Kindalem Fentie, Iryna Lasiichuk, Ebone D Hill

引用次数: 0

55-Year-Old Man With Pruritus, Weight Gain, Lower Extremity Edema, and Diffuse Excoriations. 55岁男性，瘙痒，体重增加，下肢水肿，弥漫性擦伤。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-25 DOI: 10.1016/j.mayocp.2026.05.024

Mohammed Al Kurnas, Noah Takacs, Joelle N Friesen

引用次数: 0

Contrast-Associated Acute Kidney Injury: Comprehensive Review of Risk Factors, Pathophysiology, Definition and Management. 对比剂相关急性肾损伤：危险因素、病理生理学、定义和管理的综合综述。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-25 DOI: 10.1016/j.mayocp.2026.09.012

Frederick Berro Rivera, Jose Arriola-Montenegro, Arjunmohan Mohan, Benjamin Bizer, Charanjit S Rihal, Kianoush B Kashani, John J Dillon, Guy Reeder, Wisit Cheungpasitporn, Robert J McDonald, Jennifer S McDonald, Karl A Nath, Mandeep Singh

{"title":"Contrast-Associated Acute Kidney Injury: Comprehensive Review of Risk Factors, Pathophysiology, Definition and Management.","authors":"Frederick Berro Rivera, Jose Arriola-Montenegro, Arjunmohan Mohan, Benjamin Bizer, Charanjit S Rihal, Kianoush B Kashani, John J Dillon, Guy Reeder, Wisit Cheungpasitporn, Robert J McDonald, Jennifer S McDonald, Karl A Nath, Mandeep Singh","doi":"10.1016/j.mayocp.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.012","url":null,"abstract":"Contrast-associated acute kidney injury (CA-AKI) remains an important clinical concern, especially as percutaneous coronary interventions (PCI) are being increasingly performed. This review provides a comprehensive, evidence-based synthesis of CA-AKI, acknowledging a shift in terminology from \"contrast-induced\" to \"contrast-associated\" to reflect the interplay of co-existing non-contrast factors and patient comorbidities. A comprehensive literature search was performed in PubMed/MEDLINE, Embase, and the Cochrane Library from inception through June 2025 using terms related to contrast-associated acute kidney injury, risk factors, pathophysiology, prevention, and management; studies were selected based on relevance, methodological quality, and clinical applicability. While the exact causal relationship between contrast exposure and AKI is debated, CA-AKI is associated with adverse outcomes, including prolonged hospitalization, increased healthcare costs, and higher morbidity and mortality, as well as procedural variables such as contrast volume. Pathophysiological mechanisms include afferent arteriolar dilatation, medullary ischemia, direct tubular epithelial injury, and mitochondrial dysfunction, which can lead to maladaptive repair and progression to CKD. Management focuses on preventive strategies- maintaining hemodynamic stability, optimizing volume status, minimizing contrast dose, and implementing nephrotoxin stewardship. Despite the use of validated risk scores and emerging biomarkers for earlier detection, management remains largely supportive. Future paradigms emphasize individualized clinical decision-making, digital health solutions, and the potential for targeted therapies to prevent the AKI-to-CKD transition.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149062285","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}

引用次数: 0

Organizational Response to Professionalism Lapses and U.S. Physician Well-being. 组织对专业失误的反应和美国医生的福祉。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-24 DOI: 10.1016/j.mayocp.2026.09.011

Liselotte N Dyrbye, Colin P West, Mickey Trockel, Michael Tutty, Hanhan Wang, Lindsey E Carlasare, Christine Sinsky, Tait D Shanafelt

{"title":"Organizational Response to Professionalism Lapses and U.S. Physician Well-being.","authors":"Liselotte N Dyrbye, Colin P West, Mickey Trockel, Michael Tutty, Hanhan Wang, Lindsey E Carlasare, Christine Sinsky, Tait D Shanafelt","doi":"10.1016/j.mayocp.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.011","url":null,"abstract":"Objective: To evaluate US physicians' perceptions of their organization's response to professionalism lapses and to examine associations with burnout, career regret, and intent to leave (ITL).Methods: Between October 19, 2023, and March 3, 2024, we surveyed US physicians. A random subset received four items assessing perceptions of their organization's response to unprofessional behavior. Responses were summed to generate the Standards, Accountability, Fairness, Reporting Safety (SAFeR) Scale score (range, 4-20; higher scores indicate more favorable view). Participants also rated the appropriateness of consequences for unprofessional behavior, completed the Maslach Burnout Inventory, and responded to items about career regret and ITL.Results: Of the 3219 physicians invited to complete the professionalism items, 3119 did so. Women held less favorable views of their organization's response to professionalism lapses relative to men. Approximately half (55%) of physicians believed the process to evaluate allegations of unprofessional behavior was just. Less favorable rating on each professionalism lapse items and higher SAFeR Scale score were strongly correlated with occupational burnout, career regret, and ITL. On multivariable analysis, each 1-point increase in SAFER Scale score was associated with an 8% decrease in the odds of burnout (OR [95% CI], 0.92 [0.90-0.94]), 9% decrease in career choice regret (0.91 [0.89-0.94]), and 7% decrease in ITL (0.93 [0.88-0.98], all P < 0.01).Conclusions and relevance: More favorable perceptions of organizational response to professional lapses were independently associated with lower odds of burnout, career regret, and turnover intentions. Interventions to improve organizational response to professionalism lapses may enhance physician well-being and retention.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039574","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}

引用次数: 0

Physical Activity and Risk of Depression: Does the Type, Frequency and Number of Activities Matter? UK Biobank Prospective Cohort Study. 体育活动与抑郁症的风险：运动的类型、频率和数量有关系吗？英国生物银行前瞻性队列研究。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-24 DOI: 10.1016/j.mayocp.2026.09.010

Verónica Cabanas-Sánchez, David Martínez-Gómez, Fernando Rodríguez-Artalejo, Frederick Ho, Jill P Pell, Carlos Celis-Morales

{"title":"Physical Activity and Risk of Depression: Does the Type, Frequency and Number of Activities Matter? UK Biobank Prospective Cohort Study.","authors":"Verónica Cabanas-Sánchez, David Martínez-Gómez, Fernando Rodríguez-Artalejo, Frederick Ho, Jill P Pell, Carlos Celis-Morales","doi":"10.1016/j.mayocp.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.010","url":null,"abstract":"Objective: To examine the risk of incident depression according to volume, type, frequency, and duration of physical activity (PA) in adults from the UK Biobank cohort.Methods: We included 160,358 individuals (55.1% women), aged 38-70 years, free of depression and other mental health disorders, who underwent baseline assessment between Mar-2006 and Oct-2010. Participants reported their participation in walking, light do-it-yourself (DIY), heavy DIY, strenuous sports, and other exercises. Depression onset was extracted from primary care and hospital admission records (censored: 2016 to 2021).Results: During a median follow-up of 10.01 years, 5,363 participants developed depression. The risk of depression onset was lower in participants who participated in walking (hazard ratio [95% confidence interval]=0.84 [0.75, 0.93]), light DIY (0.86 [0.76, 0.96]), heavy DIY (0.76 [0.67, 0.87]), sports (0.62 [0.49, 0.78]), and other exercises (0.78 [0.69, 0.88]). Those performing one, two, three, four and five types of PA had a 15%, 20%, 26%, 36% and 54% lower risk of incident depression, respectively. Combining walking, DIY and structured PA resulted in a 29% reduced risk of depression. Overall, moderate PA volume (150-300 min/week), frequency (1-3 times/week), and session duration (60-120 min) were associated with the largest reductions in the risk of developing depression.Conclusion: Engaging in a variety of light and moderate-vigorous PA, over relatively low frequency or session duration, was associated with substantial reductions in the risk of depression. Promoting the incorporation of PA into daily routines might be a useful population-level strategy for preventing depression.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039566","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}

引用次数: 0

Emergency Department Length of Stay and 72-Hour Returns in Uncomplicated Abdominal Pain. 无并发症腹痛的急诊住院时间和72小时复诊。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-24 DOI: 10.1016/j.mayocp.2026.08.026

Yen-Hung Liu, Fen-Wei Huang, Yen-Wei Chiu, Chi-Syuan Pan, Shih-Hao Wu

{"title":"Emergency Department Length of Stay and 72-Hour Returns in Uncomplicated Abdominal Pain.","authors":"Yen-Hung Liu, Fen-Wei Huang, Yen-Wei Chiu, Chi-Syuan Pan, Shih-Hao Wu","doi":"10.1016/j.mayocp.2026.08.026","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.08.026","url":null,"abstract":"Objective: To evaluate whether a shorter emergency department (ED) length of stay (LOS) is associated with an increased risk of adverse outcomes in adults discharged with uncomplicated non-traumatic abdominal pain.Patients and methods: In this retrospective multilevel cohort study (January 1, 2021, through December 31, 2023), adult ED visits for non-traumatic abdominal pain were analyzed. A primary Uncomplicated Cohort (N=28,803) excluded complex comorbidities. The primary exposure was ED LOS quartiles (Q1: Shortest to Q4: Longest). The primary and secondary outcomes were 72-hour return visits and high-risk returns (requiring admission), respectively. Multilevel logistic regression adjusted for confounders, with sensitivity analyses in a general cohort (N=32,247) and a Triage Level 3 subgroup.Results: Among uncomplicated visits, the shortest LOS quartile (Q1) exhibited significantly lower odds of 72-hour return visits compared with the longest quartile (Q4) (adjusted odds ratio [aOR], 0.63; 95% CI, 0.52-0.75). Similarly, Q1 demonstrated significantly lower odds of high-risk returns (aOR, 0.44; 95% CI, 0.31-0.61). This association persisted in the Triage Level 3 subgroup (aOR, 0.64; 95% CI, 0.52-0.79) and the general cohort (aOR, 0.48; 95% CI, 0.41-0.57). Physician-level variance was minimal (intraclass correlation coefficient <0.01), suggesting outcomes were largely driven by patient and system factors rather than individual provider practice.Conclusion: In this uncomplicated cohort, decreased ED LOS was associated with lower odds of adverse outcomes. This suggests expedited disposition does not correlate with a higher risk of short-term return visits or subsequent admissions. Rather than serving as a protective safety net, prolonged evaluation likely signals underlying diagnostic ambiguity or patient complexity.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039616","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}

引用次数: 0

The Burden of Pancreatic Cancer in ASEAN Member States (1990-2023) and Future Trends Forecasting: A GBD 2023 Analysis. 东盟成员国胰腺癌负担（1990-2023）和未来趋势预测：GBD 2023分析。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-21 DOI: 10.1016/j.mayocp.2026.09.008

Kang Fu, Yangdong Wu, Zhenyuan Liu, Qisheng Hao, Haoxin Duan, Xiao Hu

{"title":"The Burden of Pancreatic Cancer in ASEAN Member States (1990-2023) and Future Trends Forecasting: A GBD 2023 Analysis.","authors":"Kang Fu, Yangdong Wu, Zhenyuan Liu, Qisheng Hao, Haoxin Duan, Xiao Hu","doi":"10.1016/j.mayocp.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.09.008","url":null,"abstract":"Objective: To characterize temporal trends, demographic drivers, and socioeconomic inequalities in pancreatic cancer burden across the 11 Association of Southeast Asian Nations (ASEAN) member states and to project burden through 2050.Patients and methods: We analyzed Global Burden of Disease 2023 estimates for 11 ASEAN member states from January 1, 1990, through December 31, 2023. Trends were assessed using age-standardized rates, estimated annual percentage changes, and joinpoint regression; drivers and inequalities were assessed using decomposition and inequality analyses, respectively; and burden from 2024 through 2050 was projected using autoregressive integrated moving average models. Data were downloaded from the Global Health Data Exchange on October 31, 2025.Results: In 2023, ASEAN had 26,568 incident cases, 25,717 deaths, and 720,507 disability-adjusted life years (DALYs), increases of 360%, 355%, and 343%, respectively, from 1990. Regional age-standardized incidence, mortality, and DALY rates were 3.82, 3.70, and 103.70 per 100,000, respectively. Burden patterns varied across countries: Indonesia and Thailand had the largest absolute burdens, Singapore had the highest age-standardized rates, and Vietnam showed the fastest increases. The contributions of population aging and changes in age-specific rates also differed among countries. Model-based projections suggested that the regional age-standardized mortality rate may reach 7.02 per 100,000 by 2050.Conclusion: Pancreatic cancer burden in ASEAN increased substantially and is projected to continue increasing, requiring country-specific prevention and health-system strategies.","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017290","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}

引用次数: 0