Mayo Clinic proceedings最新文献

{"title":"Blood Pressure Time in Target Range Within 24 Hours and Cardiovascular Diseases and Mortality: Perspectives From a Real-World Cohort Study","authors":"Xue Tian PhD ,&nbsp;Yijun Zhang PhD ,&nbsp;Shuohua Chen MD ,&nbsp;Xue Xia PhD ,&nbsp;Qin Xu PhD ,&nbsp;Yi Wang MD ,&nbsp;Shouling Wu MD ,&nbsp;Anxin Wang PhD","doi":"10.1016/j.mayocp.2024.08.012","DOIUrl":"10.1016/j.mayocp.2024.08.012","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association of 24-hour, daytime, and nighttime ambulatory systolic blood pressure (SBP) time in target range (TTR) with the risk of cardiovascular disease (CVD) and mortality in real-world settings.</div></div><div><h3>Patients and Methods</h3><div>Data were obtained from the Kailuan study. Systolic blood pressure TTR was calculated using linear interpolation, with 110 to 140 mm Hg as the target range. Cox regressions were performed to assess the associations of SBP TTR with outcomes.</div></div><div><h3>Results</h3><div>Among 5099 participants in this analysis, 396 cases of CVD (7.77%) and 490 cases of all-cause mortality (9.61%) occurred during a median follow-up of 6.96 years. After multivariable adjustment, each 1-SD increment in 24-hour SBP TTR was associated with an 11% lower risk of CVD (hazard ratio [HR], 0.89; 95% CI, 0.79 to 0.99; <em>P</em>=.008) and all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; <em>P</em>=.01). Consistently, each 1-SD increment in daytime SBP TTR was associated with 14% lower risk of CVD (HR, 0.86; 95% CI, 0.78 to 0.95; <em>P</em>=.005) and 13% lower risk of all-cause mortality (HR, 0.87; 95% CI, 0.79 to 0.95; <em>P</em>=.003). However, the associations for nighttime SBP TTR did not reach statistically significant levels.</div></div><div><h3>Conclusion</h3><div>Higher SBP TTR was associated with lower risk of CVD and mortality among Chinese adults in real-world settings. Efforts to attain SBP within 110 to 140 mm Hg over time may be an effective strategy to prevent CVD.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 657-667"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567307","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":"In the Limelight: April 2025","authors":"Karl A. Nath MBChB (Editor-in-Chief)","doi":"10.1016/j.mayocp.2025.02.017","DOIUrl":"10.1016/j.mayocp.2025.02.017","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 587-589"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738871","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":"Advance Insulin Injection Technique and Education With FITTER Forward Expert Recommendations","authors":"David C. Klonoff MD, FACP, FRCP (Edin), Fellow AIMBE ,&nbsp;Lori Berard RN, CDE ,&nbsp;Denise Reis Franco MD ,&nbsp;Sandro Gentile MD, PhD ,&nbsp;Olga Victoria Gomez MD ,&nbsp;Zanariah Hussein MBBS, MRCP ,&nbsp;Akshay B. Jain MD ,&nbsp;Sanjay Kalra DM ,&nbsp;Henry Anhalt DO ,&nbsp;Julia K. Mader MD ,&nbsp;Eden Miller DO ,&nbsp;Miguel Augusto O’Meara MD ,&nbsp;Michelle Robins ANP ,&nbsp;Felice Strollo MD, PhD ,&nbsp;Hirotaka Watada MD, PhD ,&nbsp;Lutz Heinemann PhD","doi":"10.1016/j.mayocp.2025.01.004","DOIUrl":"10.1016/j.mayocp.2025.01.004","url":null,"abstract":"<div><div>Injectable insulin therapy is a valuable therapeutic option for millions of people with diabetes worldwide. However, many people with diabetes undergoing insulin therapy experience suboptimal outcomes and/or have complications because of inadequate injection technique and training. Practical, current, evidence-based recommendations are mandatory for primary care practitioners and diabetes specialists alike to address unmet needs in insulin injection technique, education, and consequent outcomes. The most recent global insulin injection technique best practices were published in 2016 by the Forum for Injection Technique and Therapy Expert Recommendations (FITTER). While injection technique efforts in different regions have reflected some developments since 2016, a global effort was warranted to comprehensively capture new evidence and modern expert perspectives. In this article, we share the output of the “FITTER Forward” initiative, authored by 16 diabetes specialists from 13 countries who met virtually in 2023-2024. FITTER Forward provides an updated rationale for the importance of proper injection technique training and its impact on diabetes management. The FITTER Forward recommendations are organized for use in clinical practice and include 4 sections describing (1) the foundational science informing injection device design, experiences, and outcomes, (2) proper injection technique procedures for insulin pens and syringes from insulin storage to needle disposal, (3) lipodystrophy risk reduction, with a focus on lipohypertrophy, and (4) structured injection technique training programs for people with diabetes. Overall, FITTER Forward aims to better equip health care professionals to advance diabetes care by empowering people with diabetes and their caregivers to correctly and safely deliver insulin.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 682-699"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739717","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}

{"title":"Composite Gangliocytoma/Neuroma and Neuroendocrine Tumor (CoGNET)","authors":"Jorge Torres-Mora MD,&nbsp;Rumeal D. Whaley MD,&nbsp;Lori A. Erickson MD","doi":"10.1016/j.mayocp.2025.02.011","DOIUrl":"10.1016/j.mayocp.2025.02.011","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 757-758"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739715","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":"Diagnostic Approach to Abnormal Alkaline Phosphatase Value","authors":"Salvatore Minisola MD ,&nbsp;Cristiana Cipriani MD, PhD ,&nbsp;Luciano Colangelo MD, PhD ,&nbsp;Giancarlo Labbadia MD ,&nbsp;Jessica Pepe MD, PhD ,&nbsp;Per Magnusson (Professor)","doi":"10.1016/j.mayocp.2024.11.019","DOIUrl":"10.1016/j.mayocp.2024.11.019","url":null,"abstract":"<div><div>Alkaline phosphatase (ALP) is abundantly represented in nature, being fundamental for a number of processes. In addition to its fundamental function in skeletal mineralization, its roles in the pathogenesis of other diseases are being explored. The measurement of total ALP activity in serum or in plasma is a useful biomarker in clinical practice. Indeed, routine measurement of serum total ALP is a long-standing established part of initial biochemical evaluation of patients both in the hospital setting and on an ambulatory basis. Raised or reduced values of this enzyme activity are indicative of a number of diseases, most commonly affecting the skeleton and the biliary tract. Electrophoretic assays are preferable for visualizing and investigating the cause of increased serum total ALP activities, and bone ALP immunoassays are preferable for investigating and monitoring individuals with bone and mineral metabolic abnormalities. Here, we give a holistic vision of this fundamental enzyme, suggesting a clinical approach to the identification of diseases causing abnormal values. Finally, a therapeutic role has emerged as substitutive therapy in patients with hypophosphatasia, even though ongoing and future studies are exploring its role in other therapeutic areas. This narrative review was based on articles found by searching PubMed from its inception until July 2024 for the terms <em>alkaline phosphatases</em>, <em>isozymes</em>, <em>isoforms</em>, <em>bone alkaline phosphatase</em>, <em>liver alkaline phosphatase</em>, <em>intestinal alkaline phosphatase</em>, <em>placental alkaline phosphatase</em>, <em>liver function tests</em>, γ-<em>glutamyltransferase</em>, <em>skeletal diseases</em>, and <em>liver diseases</em>. We limited our research to papers published in the English language, with emphasis placed on those describing differential diagnosis whenever available.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 712-728"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523717","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":"Bullhead Sign in SAPHO Syndrome","authors":"Chrong-Reen Wang MD, PhD ,&nbsp;Ta-Wei Tai MD, PhD ,&nbsp;Nan-Tsing Chiu MD","doi":"10.1016/j.mayocp.2025.01.006","DOIUrl":"10.1016/j.mayocp.2025.01.006","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 680-681"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542569","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":"Neutrophilic Dermatosis in Chronic Myelomonocytic Leukemia","authors":"Steven Tessier MD, MS ,&nbsp;Carilyn Wieland MD ,&nbsp;Kebede Begna MD, MS","doi":"10.1016/j.mayocp.2024.09.030","DOIUrl":"10.1016/j.mayocp.2024.09.030","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 603-604"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542572","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":"33-Year-Old Man With Fatigue","authors":"Jordan S. Nunnelee MD ,&nbsp;Mackenzie D. Maberry MD ,&nbsp;Ronald S. Go MD","doi":"10.1016/j.mayocp.2024.03.014","DOIUrl":"10.1016/j.mayocp.2024.03.014","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 729-734"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586190","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":"76-Year-Old Man With Fever and Chills","authors":"David Bayless MD ,&nbsp;Jack McHugh MB BCh BAO ,&nbsp;Abinash Virk MD","doi":"10.1016/j.mayocp.2024.04.018","DOIUrl":"10.1016/j.mayocp.2024.04.018","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 741-746"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586191","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":"Early Rhythm Control for Atrial Fibrillation in Patients With End-Stage or Chronic Kidney Disease","authors":"Dong-Seon Kang MD ,&nbsp;Daehoon Kim MD ,&nbsp;Eunsun Jang MS ,&nbsp;Hee Tae Yu MD ,&nbsp;Tae-Hoon Kim MD ,&nbsp;Jae-Sun Uhm MD ,&nbsp;Jung-Hoon Sung MD ,&nbsp;Hui-Nam Pak MD ,&nbsp;Moon-Hyoung Lee MD ,&nbsp;Pil-Sung Yang MD ,&nbsp;Boyoung Joung MD","doi":"10.1016/j.mayocp.2024.10.006","DOIUrl":"10.1016/j.mayocp.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the benefits and risks of early rhythm control (ERC) in patients with atrial fibrillation (AF) and chronic kidney disease (CKD).</div></div><div><h3>Patients and Methods</h3><div>This population-based cohort study included 5224 patients with AF (58.2% male, median age 70 years) with end-stage kidney disease (ESKD; n=1660) and CKD stage 3 to 4 (n=3564), who underwent ERC or rate control between January 1, 2005, and December 31, 2015. A primary outcome consisted of cardiovascular death, ischemic stroke, heart failure–related hospitalization, and acute myocardial infarction.</div></div><div><h3>Results</h3><div>During a median follow-up of 3.5 years, compared with rate control, ERC was associated with a reduced risk of the primary outcome (hazard ratio [HR], 0.85; 95% CI, 0.74 to 0.98) without an increase in the composite safety outcome in CKD stage 3 to 4 (HR, 0.99; 95% CI, 0.86 to 1.13). In patients with ESKD, there was no difference between rate control and ERC in the primary outcome (HR, 0.97; 95% CI, 0.81 to 1.17) but an increase in composite safety outcome (HR, 1.29; 95% CI, 1.11 to 1.50). During follow-up, 65.0% of patients with ESKD and 57.3% with CKD stage 3 to 4 failed to maintain ERC. In the on-treatment (HR, 0.79; 95% CI, 0.62 to 0.99) and time-varying regression (HR, 0.81; 95% CI, 0.68 to 0.98) analyses, ERC was associated with a lower risk of primary outcome even in patients with ESKD.</div></div><div><h3>Conclusion</h3><div>Early rhythm control revealed a modest risk-benefit profile in patients with ESKD compared with CKD stage 3 to 4, with poor adherence to ERC playing a major role. Therefore, an approach tailored to renal function should be considered for choosing AF treatment strategies.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 634-646"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586250","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}