Mayo Clinic proceedings最新文献_第9页

78-Year-Old Woman With Shortness of Breath 78岁妇女呼吸短促。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1016/j.mayocp.2025.08.026

Nanthaya Tisavipat MD, MS, Jenna M. Davison MD, MPH, Yi Lin MD, PhD

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Revisiting Myasthenia Gravis in Immune Checkpoint Inhibitor–Associated "Triple M Syndrome" 重症肌无力在免疫检查点抑制剂相关的“三重M”综合征。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2026-06-26 DOI: 10.1016/j.mayocp.2026.06.017

Elke S. Schipani MD, Teerin Liewluck MD, Eelco F.M. Wijdicks MD, PhD

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General Information 一般信息

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 DOI: 10.1016/S0025-6196(26)18672-8

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Living Paired Exchange Donation: Unlocking New Horizons in Kidney Transplantation 活体配对交换捐赠：开启肾移植新视野。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2025-12-11 DOI: 10.1016/j.mayocp.2025.07.033

Boyukkhanim Ahmadzada MD, Ahmer Sultan MD, Julio Cisneros Correa MD, Kamal H. Hussein PhD, Byron H. Smith MS, Kay L. Kosberg RN, CCTC, Sara Kazeminia MD, Ty S. Diwan MD, Timucin Taner MD, PhD, Julie K. Heimbach MD, Mikel Prieto MD, Walter K. Kremers PhD, Carrie A. Schinstock MD, Mark D. Stegall MD, Scott L. Nyberg MD, PhD

{"title":"Living Paired Exchange Donation: Unlocking New Horizons in Kidney Transplantation","authors":"Boyukkhanim Ahmadzada MD, Ahmer Sultan MD, Julio Cisneros Correa MD, Kamal H. Hussein PhD, Byron H. Smith MS, Kay L. Kosberg RN, CCTC, Sara Kazeminia MD, Ty S. Diwan MD, Timucin Taner MD, PhD, Julie K. Heimbach MD, Mikel Prieto MD, Walter K. Kremers PhD, Carrie A. Schinstock MD, Mark D. Stegall MD, Scott L. Nyberg MD, PhD","doi":"10.1016/j.mayocp.2025.07.033","DOIUrl":"10.1016/j.mayocp.2025.07.033","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the clinical outcomes and costs of kidney paired donation (KPD) with other kidney transplant options in patients who are unable to undergo living donor transplant because of blood- or tissue-type incompatibility.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed kidney transplants at our center using data from the United Network for Organ Sharing and Mayo Clinic in Rochester, Minnesota, from January 1, 2017, to January 1, 2023. Patients were categorized by kidney source as follows: deceased donor kidney (DDK), living donor traditional (LDT), KPD-local, and KPD-external. Financial data were collected to assess the cost benefits of KPD compared with traditional options.</div></div><div><h3>Results</h3><div>We analyzed 1266 adult kidney transplants, including 406 DDK, 611 LDT, 151 KPD-external, and 98 KPD-local transplants. Graft failure rates were higher in the KPD-external group (3.3% [5 of 151]) than in the DDK (2.7% [11 of 406]), KPD-local (1.0% [1 of 98]), and LDT (2.5% [15 of 611]) groups, although these differences were not statistically significant. The medical costs were assessed at 30, 90, and 365 days. At 30 days, costs were DDK, $86,769±$69,989; LDT, $115,597±$28,002; KPD-external, $109,769±$32,704; and KPD-local, $124,660±$88,627 (<em>P</em>=.001 for DDK).</div></div><div><h3>Conclusion</h3><div>Our findings provide insights into transplant outcomes, suggesting that KPD is similar to traditional kidney transplant.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"101 9","pages":"Pages 1519-1528"},"PeriodicalIF":6.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

52-Year-Old Woman Presenting With Pain and Worsened Erythema Around Port Site 52岁女性，Port部位疼痛，红斑加重。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2026-07-13 DOI: 10.1016/j.mayocp.2025.07.038

Robert M. Seby MD, Krista N. Grennan MD, Tuhama Rihani MD

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55-Year-Old Woman With Recurrent Intractable Nausea and Vomiting 55岁女性，反复出现难治性恶心呕吐。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2026-07-14 DOI: 10.1016/j.mayocp.2025.07.039

Samantha L. D’Amico DO, Sabrina A. Billings MD, Adrian G. Dumitrascu MD

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69-Year-Old Woman With Subacute Low Back Pain 69岁女性，患有亚急性腰痛。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 Epub Date: 2026-07-14 DOI: 10.1016/j.mayocp.2025.08.025

Ashley J. Han MD, Sanjna Rajput MD, Meltiady Issa MD, MBA

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When Real-World Evidence Meets the Randomized Record: Angiotensin Receptor Blockers, ACE Inhibitors, and the Limits of Inference 当真实世界的证据符合随机记录：血管紧张素受体阻滞剂，ACE抑制剂，和推理的限制

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 DOI: 10.1016/j.mayocp.2026.07.011

Stefano Masi MD, PhD, Carl J. Lavie MD, Martin H. Strauss MD

引用次数: 0

Barriers and Facilitators to Innovation: A Qualitative Study in a Non-Profit Health Care System. 创新的障碍和促进因素：非营利性医疗保健系统的定性研究。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-09-01 DOI: 10.1016/j.mayocp.2026.08.014

Melissa Gulden, Pierre Noel, Christopher Russi, Amy Low, Brian Kilen, Erik Hollander

{"title":"Barriers and Facilitators to Innovation: A Qualitative Study in a Non-Profit Health Care System.","authors":"Melissa Gulden, Pierre Noel, Christopher Russi, Amy Low, Brian Kilen, Erik Hollander","doi":"10.1016/j.mayocp.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.08.014","url":null,"abstract":"<p><strong>Objective: </strong>To explore how users within a non-profit healthcare system perceive, navigate, and engage with the organization's innovation management process and to identify barriers and facilitators influencing innovation participation PATIENTS AND METHODS: A qualitative study using Constructivist Grounded Theory was conducted at Mayo Clinic from May 1, 2025, through June 30, 2025. Thirteen semi-structured interviews were completed with team members representing multiple innovation adopter categories. Interview transcripts were analyzed using Constructivist Grounded Theory methods, including open, axial, and selective coding to identify recurring patterns related to innovation barriers and facilitators.</p><p><strong>Results: </strong>Thematic analysis identified six primary barriers to innovation engagement: fragmented pathways, siloed communication, limited resources, lack of clarity, cultural inertia, and leadership inconsistency. Five primary facilitators emerged: leadership support, mentorship, collaboration, recognition, and risk tolerance. Participants emphasized the importance of transparent innovation pathways, organizational alignment, and psychological safety in supporting innovation efforts and advancing ideas toward implementation.</p><p><strong>Conclusion: </strong>Innovation within large non-profit healthcare systems is shaped by both structural and cultural factors. Findings suggest that formalized, transparent innovation frameworks supported by leadership engagement, collaboration, and resource accessibility may strengthen participation, improve navigation of innovation processes, and facilitate the translation of ideas into meaningful organizational outcomes.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873751","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

Frailty Attenuates the Prognostic Value of Multimorbidity in Heart Failure - Insights From the Largest Tertiary Center in the Middle East. 虚弱削弱心力衰竭多病的预后价值——来自中东最大的三级中心的见解。

IF 6.5 2区医学

Mayo Clinic proceedings Pub Date : 2026-08-31 DOI: 10.1016/j.mayocp.2026.07.030

Viana Copeland, Boris Fishman, Shir Elimeleh, Ranel Loutati, Noam Makmal, Assi Milwidsky, Yishay Wasserstrum, Yariv Gerber, Elad Maor

{"title":"Frailty Attenuates the Prognostic Value of Multimorbidity in Heart Failure - Insights From the Largest Tertiary Center in the Middle East.","authors":"Viana Copeland, Boris Fishman, Shir Elimeleh, Ranel Loutati, Noam Makmal, Assi Milwidsky, Yishay Wasserstrum, Yariv Gerber, Elad Maor","doi":"10.1016/j.mayocp.2026.07.030","DOIUrl":"https://doi.org/10.1016/j.mayocp.2026.07.030","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether frailty modifies the association of multimorbidity in HF.</p><p><strong>Methods: </strong>A retrospective cohort study of HF patients. Multimorbidity was quantified using 26 conditions and categorized as low (≤4), intermediate (5-7), or high (>8). Frailty was defined using a multimodal construct integrating functional, nutritional, and biochemical domains. All-cause mortality was assessed using cox models with frailty-multimorbidity interaction testing. Charlson Comorbidity Index (CCI) was used for validation.</p><p><strong>Results: </strong>Among 18,058 patients (median age 74 years; 62% male; 64% frail), 57% died over a median follow-up of 4.0 years (IQR 1.3-7.7). Multimorbidity burden comprised 30.5% low, 48% intermediate, and 21.5% high. Frailty was associated with a 91% higher mortality risk (adjusted HR 1.91; 95% CI 1.85-2.00). Compared with low multimorbidity, intermediate and high burden were associated with an independent 8% and 20% higher mortality risks, respectively (95% CI 1.02-1.14 and 1.13-1.27; both p<.001). However, the association of multimorbidity differed by frailty such that among non-frail patients, intermediate and high multimorbidity increased mortality by 18% and 42% whereas in frail patients, the association was attenuated, with no excess risk for intermediate burden and only 13% increase for high burden (p-for-interaction <.001). CCI analyses was consistent, though differed among females and HFpEF.</p><p><strong>Conclusion: </strong>Frailty fundamentally attenuates risk in HF, while multimorbidity stratifies prognosis only when physiological reserve is preserved.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865660","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