Mayo Clinic proceedings. Innovations, quality & outcomes最新文献

{"title":"Post-Coronavirus Disease 2019 Effects in an Active University Population: A Within-Campus Cross-Sectional Study at a Major Educational Institution","authors":"Marcelo Hernández-Mora MD ,&nbsp;René Arredondo-Hernández PhD ,&nbsp;Carmen A. Castañeda-Camacho MD ,&nbsp;Pamela X. Cervantes-Gutierrez MD ,&nbsp;Gonzalo Castillo-Rojas PhD ,&nbsp;Samuel Ponce de León MD ,&nbsp;Yolanda López-Vidal PhD","doi":"10.1016/j.mayocpiqo.2024.09.004","DOIUrl":"10.1016/j.mayocpiqo.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the associations among post-coronavirus disease 2019 (COVID-19) prevalence; risk factors and comorbidities have not been firmly established within a university outpatient population.</div></div><div><h3>Patients and Methods</h3><div>Records from 881 COVID-19 outpatient patients (504 females [57.9%] and 366 males [42.07%]), most of whom were between 30 and 40 years of age (mean=37.3 years old; 95% CI, 36.5-38.2), with initial infection data from February 2020 to August 2022 were reviewed once, whereas the survey took place during 2 different moments during the pandemic. The first period (April 20, 2021, to June 21, 2021) yielded 279 responses, whereas in the second period (June 23, 2021, to October 4, 2021), 602 responses were recorded. The instrument used contained 20 questions across 3 main domains: general information, data related to infection and adverse effects, and service satisfaction experience.</div></div><div><h3>Results</h3><div>All the patients were positive for immunoglobulin G antibodies against nucleocapsid by the third week. Post-COVID-19 symptoms arose at least 2 weeks after recovery from the initial illness; 654 individuals reported at least one symptom after the acute COVID-19 period, for a post-COVID-19 prevalence of 74.96%. The most frequent symptoms were fatigue (84%), headache (71%), and difficulty concentrating (71%). More than 60% of participants reported at least one comorbidity, among which the most common ones were obesity (35.9%), smoking (17.5%), and hypertension (12.2%).</div></div><div><h3>Conclusion</h3><div>In this study, we assessed post-COVID-19 prevalence among outpatients and found that comorbidities were strongly related to consequences impacting quality of life and mental health burden.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 521-529"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a New Instrument to Measure Workplace Mental Health and Well-Being","authors":"Neil J. MacKinnon PhD ,&nbsp;Preshit N. Ambade DrPH ,&nbsp;Zach T. Hoffman MS ,&nbsp;Kaamya Mehra BS, MD(c) ,&nbsp;Brittany Ange EdD ,&nbsp;Alyssa Ruffa MPH ,&nbsp;Denise Kornegay MSW ,&nbsp;Nadine Odo MPH","doi":"10.1016/j.mayocpiqo.2024.09.002","DOIUrl":"10.1016/j.mayocpiqo.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and pilot test a new instrument measuring workplace mental health and well-being among health professionals.</div></div><div><h3>Participants and Methods</h3><div>A new survey instrument (hereafter referred to as the <em>Augusta Scale</em>) was developed using Qualtrics on the basis of the 5 essentials in the Office of the Surgeon General’s (OSG) framework for workplace mental health and well-being (protection from harm, connection and community, work-life harmony, mattering at work, and opportunity for growth). The <em>Augusta Scale</em> contains 22 core questions (on a 1-5 Likert scale) and several demographic characteristic questions. We piloted the <em>Augusta Scale</em> from May 9, 2023, to June 5, 2023, with health professionals serving as preceptors for the Georgia Area Health Education Centers and assessed the instrument’s psychometric properties under the classical test theory paradigm.</div></div><div><h3>Results</h3><div>The survey’s response rate was 97.8% (583 responses out of 596 surveyed). Physicians comprised the largest health professional group surveyed (307, 52.7%), followed by advanced practice nurses (207, 35.5%), and physician assistants (69, 11.8%). The domain-specific Cronbach’s α ranged from 0.71 (0.67-0.75) to 0.90 (0.87-0.92), whereas the overall scale α was 0.94 (0.93-0.95), suggesting strong reliability. The Ω (high-order) score was 0.91, confirming that all items measured the latent construct. The convergent validity analysis confirmed the inverse relationship between total scale score and perception of burnout.</div></div><div><h3>Conclusion</h3><div>To our knowledge, the <em>Augusta Scale</em> is the first instrument to assess workplace mental health and well-being using the OSG’s framework. Findings from this pilot test of Georgia health professionals offer evidence to support its validity in certain domains.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 507-516"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Risk in Hypertrophic Cardiomyopathy: Assessing the Role of Myocardial Fibrosis and Left Ventricular Hypertrophy in Sudden Cardiac Death","authors":"Amro Badr MD ,&nbsp;Juan Farina MD ,&nbsp;Reza Arsanjani MD ,&nbsp;Srekar Ravi MD ,&nbsp;Michael O'Shea MD ,&nbsp;Omar Baqal MD ,&nbsp;Olubadewa Fatunde MD ,&nbsp;Jeffrey B. Geske MD ,&nbsp;Konstantinos C. Siontis MD ,&nbsp;Said Alsidawi MD","doi":"10.1016/j.mayocpiqo.2024.09.001","DOIUrl":"10.1016/j.mayocpiqo.2024.09.001","url":null,"abstract":"<div><div>The American College of Cardiology/American Heart Association guidelines recommend implantable cardioverter-defibrillator (ICD) implantation for patients with hypertrophic cardiomyopathy (HCM) with a wall thickness of ≥30 mm (class IIA), whereas they give a class IIB recommendation for the implantation of an ICD on the basis of extensive late gadolinium enhancement alone. In this analysis, we show that in a high-risk population with ICD implanted for primary prevention of sudden cardiac death (SCD) in the setting of HCM, the presence of massive left ventricular hypertrophy predicts a higher incidence of ICD therapy than other traditional SCD risk factors. The presence of extensive myocardial fibrosis, however, identifies a subgroup of patients without massive left ventricular hypertrophy who have an equally high incidence of receiving appropriate device therapy. These findings suggest that the presence of extensive late gadolinium enhancement on cardiac magnetic resonance can be used as a risk modifier for traditional SCD risk factors in patients with HCM to better understand their overall risk of ventricular arrhythmias.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 517-520"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Health Records, Health Outcomes, and Vital Statistics: Opportunities and Challenges","authors":"Aaron C. Spaulding PhD, MHA","doi":"10.1016/j.mayocpiqo.2024.08.005","DOIUrl":"10.1016/j.mayocpiqo.2024.08.005","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 505-506"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Outcome Ascertainment in Long-Term Mortality After Coronary Artery Bypass Grafting","authors":"Kensuke Yokoi MD ,&nbsp;Atsushi Tanaka MD ,&nbsp;Goro Yoshioka MD ,&nbsp;Masahiko Hara MD ,&nbsp;Keiji Kamohara MD ,&nbsp;Koichi Node MD","doi":"10.1016/j.mayocpiqo.2024.08.006","DOIUrl":"10.1016/j.mayocpiqo.2024.08.006","url":null,"abstract":"<div><div>Long-term outcome ascertainment can be affected by the follow-up performance and needs to use a different data source for more comprehensive data capture. However, a universal tracking system is absent in Japan, and long-term outcomes are often ascertained through electronic medical records (EMRs), the reliability of which is uncertain. In this study, we compared EMR-based and direct outreach–based collections on outcome ascertainment accuracy in 500 patients who underwent coronary artery bypass grafting. Mortality data for all patients were extracted from the EMR, as standard data collection. When patient death was not confirmed in the EMR, we enhanced to collect updated mortality information by direct outreach to patients, their family, or their physicians, as enhanced direct outreach data. As a result, the Kaplan-Meier curves found a notable separation between different data sources analyzed. Interestingly, mortality events in the latter half of the follow-up period (median, 6.5 years) were overestimated in the EMR-based data collection analysis because of the reduced number of actively tracked cases, highlighting a potential bias in the EMR-based data collection on long-term prognoses. Our findings suggest that an active follow-up strategy with better adherence will enhance the accuracy of long-term outcome ascertainment and be helpful to build more reliable real-world evidence.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 502-504"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac Shunts Among Patients Undergoing Oil-Based Contrast Lymphangiography: Prevalence and Rate of Systemic Arterial Embolic Complications","authors":"Wade Nedderman MD ,&nbsp;Emily Bendel MD ,&nbsp;Jason Anderson MD ,&nbsp;Chris Reisenauer MD ,&nbsp;Edwin Takahashi MD ,&nbsp;Erica Knavel Koepsel MD ,&nbsp;Stephanie Polites MD ,&nbsp;Scott Thompson MD, PhD","doi":"10.1016/j.mayocpiqo.2024.08.003","DOIUrl":"10.1016/j.mayocpiqo.2024.08.003","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence of systemic embolic complications after oil-based contrast lymphangiography.</div></div><div><h3>Patients and Methods</h3><div>A retrospective medical record review of all patients undergoing oil-based lymphangiographic procedures from January 1, 2000, to December 31, 2021 was performed to identify the following: (a) the rate of systemic embolic complications after the procedure; (b) the presence of preprocedure echocardiographic assessment for right-to-left shunting; and (c) the presence of right-to-left shunting after a systemic embolic complication.</div></div><div><h3>Results</h3><div>A total of 350 patients (200 male, 57%) underwent 400 oil-based lymphangiographic procedures. A total of 2 systemic embolic complications occurred for a prevalence of 0.5% (2/400). Preprocedure echocardiography was performed in 226 patients (226/350, 65%). Identification of a right-to-left shunt was made in 25 patients (25/226, 11%, with the majority reporting shunting at rest (23/25, 92%). Of the patients with systemic embolic complications, one had multifocal systemic oil contrast emboli, and one had a large territorial cerebrovascular infarct without the presence of oil-based contrast noted. Both cases underwent preprocedure echocardiography reporting a structurally normal heart with no evidence of a shunt through color flow Doppler evaluation, but neither case had undergone a true shunt study. Both patients were identified to have a right-to-left shunt during the dedicated echocardiographic shunt study postprocedure.</div></div><div><h3>Conclusion</h3><div>Risk of a systemic embolic complication after oil-based contrast lymphangiography is rare but can be catastrophic. A standardized assessment for patients undergoing the procedure may be necessary to identify those at risk and to allow for appropriate preventive strategies to be employed.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 494-501"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/j.mayocpiqo.2024.08.004","DOIUrl":"10.1016/j.mayocpiqo.2024.08.004","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Page 493"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors and Epidemiology of Amyotrophic Lateral Sclerosis in Southeastern United States","authors":"Erica Engelberg-Cook PhD ,&nbsp;Jaimin S. Shah MD ,&nbsp;Andre Teixeira da Silva Hucke MS ,&nbsp;Diana V. Vera-Garcia MD ,&nbsp;Jany E. Dagher ,&nbsp;Megan H. Donahue BS ,&nbsp;Veronique V. Belzil MS, PhD ,&nbsp;Björn Oskarsson MD","doi":"10.1016/j.mayocpiqo.2024.07.008","DOIUrl":"10.1016/j.mayocpiqo.2024.07.008","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the performance of known survival predictors and evaluate their stratification capability in patients with amyotrophic lateral sclerosis (ALS).</p></div><div><h3>Patients and Methods</h3><p>We analyzed demographic and clinical variables collected at the Mayo Clinic, Florida ALS center during the first clinical visit of 1442 (100%) patients with ALS.</p></div><div><h3>Results</h3><p>Our cohort had a median (interquartile range [IQR]) age at diagnosis of 64.8 (57-72) years; 1350 (92%) were non-Hispanic White; and 771 (53.5%) were male. The median (IQR) diagnostic delay was 10.1 (6-18) months, body mass index was 25.4 (23-49), and forced vital capacity was 72% (52%-87%). Approximately 12% of patients tested carried a pathologic <em>C9orf72</em> hexanucleotide repeat expansion. Median (IQR) ALS functional rating scale-revised score was 35 (29-40) and ALS cognitive behavioral screen score was 15 (12-17). The median (IQR) survival after diagnosis was 17.2 (9-31) months, and survival from symptom onset was 30 (20-48) months. We found that older age decreased forced vital capacity, and fast-progressing ALS functional rating scale-revised scores significantly (<em>P</em>&lt;.0001) influence survival curves and associated hazard risk.</p></div><div><h3>Conclusion</h3><p>Although results obtained from our cohort are consistent with other reports (eg, men with spinal onset experience a longer survival than women with bulbar onset), they remind us of the complexity of the disease’s natural history and the limited prognostic power of the most common clinical predictors.</p></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 5","pages":"Pages 482-492"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542454824000523/pdfft?md5=a5e3c1695eb2a43f63cf5c69f1afb112&pid=1-s2.0-S2542454824000523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/j.mayocpiqo.2024.08.002","DOIUrl":"10.1016/j.mayocpiqo.2024.08.002","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 5","pages":"Page 481"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542454824000547/pdfft?md5=b523cbff122c08855578da6523edadf9&pid=1-s2.0-S2542454824000547-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/j.mayocpiqo.2024.06.004","DOIUrl":"10.1016/j.mayocpiqo.2024.06.004","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 5","pages":"Page 480"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542454824000419/pdfft?md5=be1165306f045c068c0c4517b3f96812&pid=1-s2.0-S2542454824000419-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}