Treatment of Temporomandibular Dysfunction With Hypertonic Dextrose Injection (Prolotherapy): A Randomized Controlled Trial With Long-term Partial Crossover
To assess the efficacy and longer-term effectiveness of dextrose prolotherapy injections in participants with temporomandibular dysfunction. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 13, 2019 Category: Internal Medicine Authors: Wynand Francois Louw, K. Dean Reeves, Stanley K.H. Lam, An-Lin Cheng, David Rabago Tags: Original article Source Type: research

Association of Muscular Strength and Incidence of Type 2 Diabetes
To examine the association between muscular strength and incident type 2 diabetes, independent of cardiorespiratory fitness (CRF). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 11, 2019 Category: Internal Medicine Authors: Yuehan Wang, Duck-chul Lee, Angelique G. Brellenthin, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Steven N. Blair Tags: Original article Source Type: research

Cognitive Frailty and Mortality in a National Cohort of Older Adults: the Role of Physical Activity
To examine the association between cognitive frailty and long-term all-cause mortality and the stratified and combined associations of physical activity and cognitive frailty with long-term all-cause mortality in a population-based cohort of older adults from Spain. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 11, 2019 Category: Internal Medicine Authors: Irene Esteban-Cornejo, Ver ónica Cabanas-Sánchez, Sara Higueras-Fresnillo, Francisco B. Ortega, Arthur F. Kramer, Fernando Rodriguez-Artalejo, David Martinez-Gomez Tags: Original article Source Type: research

Fluoroscopically Guided vs Landmark-Guided Sacroiliac Joint Injections: A Randomized Controlled Study
To determine the prevalence of intra- and extra-articular sacroiliac joint (SIJ) pain, which injection is more beneficial, and whether fluoroscopy improves outcomes. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 7, 2019 Category: Internal Medicine Authors: Steven P. Cohen, Mark C. Bicket, Connie Kurihara, Scott R. Griffith, Ian M. Fowler, Michael B. Jacobs, Richard Liu, Mirinda Anderson White, Aubrey J. Verdun, Sunil B. Hari, Rick L. Fischer, Paul F. Pasquina, Yakov Vorobeychik Tags: Original article Source Type: research

Decisions to Withdraw Extracorporeal Membrane Oxygenation Support: Patient Characteristics and Ethical Considerations
To describe the prevalence and context of decisions to withdraw extracorporeal membrane oxygenation (ECMO), with an ethical analysis of issues raised by this technology. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 7, 2019 Category: Internal Medicine Authors: Erin S. DeMartino, Nicholas A. Braus, Daniel P. Sulmasy, J. Kyle Bohman, John M. Stulak, Pramod K. Guru, Kayla R. Fuechtmann, Nausheen Singh, Gregory J. Schears, Paul S. Mueller Tags: Original article Source Type: research

Trends in Hospital Admissions for and Readmissions After Cardiac Implantable Electronic Device Procedures in the United States: An Analysis From 2010 to 2014 Using the National Readmission Database
To evaluate inpatient trends in de novo complete cardiac implantable electronic device (CIED) procedures and subsequent all-cause 30-day readmissions in the United States. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 7, 2019 Category: Internal Medicine Authors: Deepak Kumar Pasupula, Arun Rajaratnam, Rohit Rattan, Muhammad Bilal Munir, Shahzad Ahmad, Evan Adelstein, Sandeep Jain, Norman C. Wang, Samir Saba Tags: Original article Source Type: research

58-Year-Old Diabetic Man With a Warm, Erythematous Foot
A 58-year-old man with type 1 diabetes mellitus (hemoglobin A1c level, 6.5% [reference range, 4.0%-5.6%]) complicated by diabetic nephropathy (chronic kidney disease stage 3A), retinopathy, and severe peripheral neuropathy presented to his local urgent care center with a 24-hour history of right dorsal midfoot erythema and mild pain. Two weeks previously, the patient sustained a right foot injury after falling out of bed. The patient had not experienced fevers, chills, night sweats, nausea, vomiting, or malaise but reported somewhat labile blood sugar levels that day with an afternoon glucose measurement of 170 mg/dL (refe...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Alexandra Higgins, Miguel Teixeira, Jason H. Szostek Tags: Residents ’ clinic Source Type: research

Severity of White Matter Hyperintensities and Effects on All-Cause Mortality in the Mayo Clinic Florida Familial Cerebrovascular Diseases Registry
To compare all-cause mortality rates across the severity range of white matter hyperintensities (WMH). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Tasneem F. Hasan, Kevin M. Barrett, Thomas G. Brott, Mohammed K. Badi, Elizabeth R. Lesser, David O. Hodge, James F. Meschia Tags: Original article Source Type: research

Is There an “Asymptote of Gain” Beyond Which Further Increases in Cardiorespiratory Fitness Convey No Additional Benefits on Mortality and Atrial Fibrillation?
The debate exists on whether the dose-response relationship between physical activity (PA) and mortality benefits is, in fact, a curvilinear, U-shaped, or J-shaped curve.1,2 Cardiorespiratory fitness (fitness), highly reflective of habitual PA, is a strong protector against various adverse health outcomes including cardiovascular disease (CVD)3,4 and is also associated with lower health care costs.5 It has been suggested that high levels of fitness may be at least as important as lower body mass index in the prevention of CVD. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Sae Young Jae, Sudhir Kurl, Hyun Jeong Kim, Barry A. Franklin, Setor K. Kunutsor, Mira Kang, Jari A. Laukkanen Tags: Letter to the editor Source Type: research

Exfoliative Esophagitis Induced By Sunitinib
An 86-year-old man who had been treated with sunitinib for renal cell carcinoma vomited blood 70 days after beginning sunitinib therapy. On admission, esophagogastroduodenoscopy (EGD) showed widespread exfoliation of the esophageal epithelium and hematoma (Figure  1A, B), and computed tomography showed high-density substance filling in the esophagus (Figure 2). These findings were limited in the middle to lower portion of the esophagus. We discontinued sunitinib and began injection of a proton pump inhibitor (PPI). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Kazuyoshi Nagata, Yuko Akazawa Tags: Medical images Source Type: research

Postoperative Trouble
A 73-year-old man presented 2 weeks after bilateral total knee arthroplasty with painful ulcerative lesions on bilateral surgical sites. The patient first noticed erythema around the incisions 1 week after surgery, which was followed by the development of ulcerations. These lesions progressed despite wound care and a course of oral doxycycline. On examination, both knees had ulcerative lesions with violaceous undermined borders (Figure  1). The radiograph showed well-fixed prosthesis. Synovial fluid analysis showed cell count of 3342 cells/uL with 42% neutrophils and 3035 with 53% neutrophils from the right and left k...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Madiha Fida, Omar Abu Saleh Tags: Medical images Source Type: research

Methamphetamine-Associated Cardiomyopathy in Pregnancy: A Case  Series
Methamphetamines have become one of the most widely abused illicit drugs and are increasingly common in the obstetric population, with prevalence estimates up to 5% in some regions.1 Methamphetamine use has been associated with adverse cardiac events, including arrhythmia, acute coronary syndrome, malignant hypertension, and cardiomyopathy.2-5 However, information on the cardiovascular effects of methamphetamine use during pregnancy is sparse. Herein we describe 5 patients with a diagnosis of methamphetamine-associated cardiomyopathy (MAC) in pregnancy. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Stephanie L. Pierce, Emily W. Zantow, Sabrina D. Phillips, Marvin Williams Tags: Letter to the editor Source Type: research

Mona Lisa and Postpartum Hypothyroidism
Mehra and Campbell1 presented the interesting clinical case of Mona Lisa, the portrait by Leonardo da Vinci of the wife of a rich merchant in Florence, in whom they diagnose postpartum hypothyroidism. The hypothesis is likely as autoimmunity may develop after delivery, and autoimmune thyroid diseases were and still are extremely prevalent in Italy, as these researchers rightly point out.1 Mehra and Campbell hypothesized that iodine deficiency could be a plausible explanation for putative hypothyroidism; however, it is difficult to believe that the diet of a rich merchant ’s wife would lack fishes, mollusks, and oyste...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Antonio Ponzetto, Natale Figura, John Holton Tags: Letter to the editor Source Type: research

In reply —Mona Lisa and Postpartum Hypothyroidism
The interest by Ponzetto and colleagues in our work defining the medical diagnosis of the iconic Mona Lisa painting is appreciated.1 The authors agree with the diagnosis presented, but offer another pathophysiological hypothesis, that of autoimmune implications of Helicobacter pylori infection, and argue that this could account for provoking autoimmune thyroiditis during pregnancy. They also go on to contest that nutritional deficiency of iodine was less central in elucidating the uncanny findings recorded in the painting by Leonardo da Vinci. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Mandeep R. Mehra Tags: Letter to the editor Source Type: research

Burnout Among Physicians Compared With Individuals With a Professional or Doctoral Degree in a Field Outside of Medicine
Medicine is a demanding profession with a long and arduous training process. Once physicians complete training, they engage in meaningful and professionally fulfilling work. They also typically work long hours and deal with a number of profession-specific challenges (eg, dealing with medical errors, risk of malpractice suits, frequent exposure to human suffering, and a rigorous maintenance of the certification process). In recent years, a host of regulatory changes and the more widespread use of electronic health records have increased clerical burden and changed the nature of the physician ’s workday. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Tait D. Shanafelt, Christine Sinsky, Lotte N. Dyrbye, Mickey Trockel, Colin P. West Tags: Letter to the editor Source Type: research

Hospitalization Is an Underutilized Opportunity to Vaccinate for Influenza
Influenza is a common viral cause of acute respiratory tract infections with substantial morbidity and mortality. In the 2017 to 2018 season, influenza resulted in an estimated 49 million illnesses, 960,000 hospitalizations, and 79,000 influenza-associated deaths.1 Although the Advisory Committee on Immunization Practices recommends annual influenza vaccination for all individuals 6 months and older without a contraindication, vaccination rates remain low.2 Unfortunately, influenza vaccination rates declined by 6% in 2017 to 2018 to only 37% in those 18 years and older. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Evan J. Anderson, Carol Kao, Inci Yildirim Tags: Editorial Source Type: research

Progress in Drug Discovery in Academia and Persistent Challenges of “the Valley of Death”
At its core, Mayo Clinic works as a team. Teamwork to enhance patient care was championed by the Mayo brothers from the outset. With the astounding advances in the biomedical sciences, the concepts of teamwork are of even greater importance as we have entered a new era of team science in research.1-3 Anderson and his colleagues4 from Mayo Clinic provide a clear outline of new components of the team science enterprise as it relates to drug and device development. The early infrastructure for various components in this new discovery pipeline stems from the clinical translational science award that Mayo Clinic successfully co...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Richard J. Barohn, Scott J. Weir, Robert D. Simari Tags: Editorial Source Type: research

White Matter Hyperintensities on Magnetic Resonance Imaging: What Is a Clinician to Do?
As a neurologist, I am often asked to see patients because they have a magnetic resonance image (MRI) of the brain showing white matter hyperintensities (WMHs). These patients, and the clinicians who refer them to me, want to know the answers to several questions: What are WMHs and what causes them? Are they the same as a stroke? Are they a marker for impending stroke, dementia, or death? Do they get worse over time and can the progression be slowed? Studies such as the one by Hasan et  al1 in this issue of Mayo Clinic Proceedings have expanded our understanding of the etiology and clinical significance of WMHs. (Sour...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Jos é G. Merino Tags: Editorial Source Type: research

Posterior Mediastinal Schwannoma (Neurilemmoma)
A posterior mediastinal mass was identified by routine chest radiography and further evaluated by computed tomography (4.5-cm uncalcified homogeneous mass in the right posterior chest) and magnetic resonance imaging. A neurogenic tumor was suspected based on the clinical and imaging studies. The photograph shows the cross section of the resected schwannoma (neurilemmoma). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Lori A. Erickson Tags: Path to patient image quiz Source Type: research

Institutional Review Boards: What Clinician Researchers Need to Know
The institutional review board (IRB) is a group federally mandated to review and monitor research involving humans to ensure protection of their rights and welfare as research participants. Clinicians engaged in research require IRB approval for all research involving human participants, whether living individuals, data, or specimens. The process for obtaining IRB approval may seem like a daunting task. However, it is critical for clinical researchers to conduct research in a manner that protects human participants, and it is the mission of the IRB to help researchers accomplish this task. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Maria I. Lapid, Bart L. Clarke, R. Scott Wright Tags: Concise review for clinicians Source Type: research

A 50-Year-Long Study of Waldenstr öm Macroglobulinemia
Waldenstr öm macroglobulinemia (WM) is a rare low-grade lymphoma in which lymphoplasmacytic cells infiltrate the bone marrow and produce monoclonal IgM protein.1 It has a well-defined immunophenotype, although exclusion of other low-grade lymphoproliferative disorders is required to confirm diagnosis.2 The c linical features of WM include a constellation of signs and symptoms related to infiltration of the bone marrow or other organs by the clonal cells, the production of the monoclonal immunoglobulin M (IgM) and its unique physicochemical and immunologic properties, as well as the production of cytokin es that may ca...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Efstathios Kastritis, Meletios A. Dimopoulos Tags: Commentary Source Type: research

John Shaw Billings: Civil War Surgeon, Medical Librarian, Founder of Index Medicus, and First Director of the New York Public Library
John Shaw Billings was born on April 12, 1838, in Allensville, Switzerland County, Indiana, which was near the frontier of the European-American settlement at the time. His father, James, was from New York and worked as a postmaster and operated a general store. His mother, Abby Shaw, was from Massachusetts and a direct Mayflower descendant, whom Billings remembered for her love of reading. John Shaw Billings took after his mother in this respect and began to read widely as a child, including finishing Plutarch, John Bunyan's Pilgrim's Progress, and other religious texts, as well as the works of James Fenimore Cooper by th...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Robert A. Kyle, David P. Steensma Tags: Stamp vignette on medical science Source Type: research

Neither Here nor There: Intracardiac Thrombus in Transit Wedged in a Patent Foramen Ovale
Patent foramen ovale (PFO) is common (27% of the population1) but frequently asymptomatic. Intracardiac thrombus in transit (TinT) wedged in a PFO is associated with high mortality (30-day mortality of 18.4%, with 62.5% of deaths during the first 24 hours of presentation2), and morbidity (isolated pulmonary [53%], isolated systemic [7%], or combined [40%] embolism3). Diagnosis of TinT is often presumptive given the lack of thrombus visualization at the time of investigational echocardiography. Surgical extraction, systemic anticoagulation, and thrombolysis are potential therapeutic approaches, with no consensus on optimal ...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Michel T. Corban, Omar W.J. Alothman, William P. Martin, Thomas C. Gerber, Ana I. Casanegra, Jae K. Oh, Guy S. Reeder Tags: Letter to the editor Source Type: research

Joy by Anne Moran and Robert A. Brown
Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as interpreted by the author. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Margaret R. Wentz Tags: Art at mayo clinic Source Type: research

New Insights Into a Multifaceted Disease
Systemic amyloidoses are a group of clinically overlapping conditions characterized by misfolding and extracellular deposition of one of a diverse array of circulating proteins in different tissues and organs in the form of amyloid fibrils.1 Among these conditions, immunoglobulin light chain (AL) amyloidosis is caused by a plasma cell clone secreting toxic, amyloidogenic light chains, most often of λ isotype, targeting vital organs, mainly the heart and the kidneys.2 The conversion of soluble light chains into amyloid fibrils is catalyzed by the presence of fibrils, and even at very low concentration, the light chai...
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Mario Nuvolone, Giampaolo Merlini Tags: Editorial Source Type: research

Robert A. Kyle, MD: Lessons From a Legend
In this issue of Mayo Clinic Proceedings, there are 2 articles authored by a living legend in medicine: Robert A. Kyle, MD.1,2 The scientific contributions of Dr Kyle over a remarkable 60-year career in medicine have no parallel. From his first publication in 19593 to his latest articles in this issue of the Proceedings, Dr Kyle has defined and redefined the epidemiology, diagnosis, risk stratification, prognosis, and management of the entire spectrum of plasma cell disorders. From monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma,4-6 his academic legacy is unmatched. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: S. Vincent Rajkumar Tags: Editorial Source Type: research

Correction
In the November 2018 issue of  Mayo Clinic Proceedings in a Review entitled "Glucose-Lowering Therapies for Cardiovascular Risk Reduction in Type 2 Diabetes Mellitus: State-of-the-Art Review" by Carbone (Mayo Clin Proc 2018;93:1629-1647), an error needs correction. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Tags: Correction Source Type: research

Editorial Board
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Source Type: research

Table of Contents
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Source Type: research

General Information
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Source Type: research

Highlights from the Current Issue – Audiovisual Summary
Karl A. Nath, MBChB, Editor-in-Chief of Mayo Clinic Proceedings, discusses the Editor ’s Choice and Highlights articles appearing in the March 2019 issue. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - March 1, 2019 Category: Internal Medicine Authors: Karl A. Nath Tags: Issue summary Source Type: research

Age-Related 2-Year Mortality After Transcatheter Aortic Valve Replacement: the Young TAVR Registry
To comparatively assess the natural history of patients of different ages undergoing transcatheter aortic valve replacement (TAVR). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 27, 2019 Category: Internal Medicine Authors: Eliano P. Navarese, Felicita Andreotti, Michalina Ko łodziejczak, Wojciech Wanha, Alexander Lauten, Verena Veulemans, Lara Frediani, Jacek Kubica, Emanuela de Cillis, Wojciech Wojakowski, Andrzej Ochala, Tobias Zeus, Alessandro Bortone, Antonio Buffon, C Tags: Original article Source Type: research

3023 Mayo Clinic Patients With Myeloproliferative Neoplasms: Risk-Stratified Comparison of Survival and Outcomes Data Among Disease Subgroups
To document the Mayo Clinic decades-long experience with myeloproliferative neoplasms (MPNs) and provide mature risk-stratified survival data and disease complication estimates. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 26, 2019 Category: Internal Medicine Authors: Natasha Szuber, Mythri Mudireddy, Maura Nicolosi, Domenico Penna, Rangit R. Vallapureddy, Terra L. Lasho, Christy Finke, Kebede H. Begna, Michelle A. Elliott, C. Christopher Hook, Alexandra P. Wolanskyj, Mrinal M. Patnaik, Curtis A. Hanson, Rhett P. Kette Tags: Original article Source Type: research

Optimization Sprints: Improving Clinician Satisfaction and Teamwork by Rapidly Reducing Electronic Health Record Burden
To evaluate a novel clinic-focused Sprint process (an intensive team-based intervention) to optimize electronic health record (EHR) efficiency. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 26, 2019 Category: Internal Medicine Authors: Amber Sieja, Katie Markley, Jonathan Pell, Christine Gonzalez, Brian Redig, Patrick Kneeland, Chen-Tan Lin Tags: Original article Source Type: research

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017
To evaluate the prevalence of burnout and satisfaction with work-life integration among physicians and other US workers in 2017 compared with 2011 and  2014. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 22, 2019 Category: Internal Medicine Authors: Tait D. Shanafelt, Colin P. West, Christine Sinsky, Mickey Trockel, Michael Tutty, Daniel V. Satele, Lindsey E. Carlasare, Lotte N. Dyrbye Tags: Original article Source Type: research

Leprosy in a Midwestern Dermatology Clinic: Report of 9 Patients
To describe the clinical features and epidemiology of leprosy in patients evaluated in a Midwestern dermatology clinic. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 20, 2019 Category: Internal Medicine Authors: Spencer A. Bezalel, Oluwakemi Onajin, Tania M. Gonzalez-Santiago, Robin Patel, Bobbi S. Pritt, Abinash Virk, Lawrence E. Gibson, Margot S. Peters Tags: Original article Source Type: research

Global Village, International Travel, and Risk of Communicable Disease
Travel and migration may communicate many things, including the risk of infectious diseases. In this issue of Mayo Clinic Proceedings, Bezalel et  al1 present their retrospective analysis of patients diagnosed with leprosy over a 23-year period at Mayo Clinic in Rochester, Minnesota. Six of the 9 patients were born outside the United States, whereas the remaining 3 were born in the United States. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 20, 2019 Category: Internal Medicine Authors: Priya Sampathkumar, Karl A. Nath Tags: Editorial Source Type: research

Peer Review Bias: A Critical Review
Various types of bias and confounding have been described in the biomedical literature that can affect a study before, during, or after the intervention has been delivered. The peer review process can also introduce bias. A compelling ethical and moral rationale necessitates improving the peer review process. A double-blind peer review system is supported on equipoise and fair-play principles. Triple- and quadruple-blind systems have also been described but are not commonly used. The open peer review system introduces “Skin in the Game” heuristic principles for both authors and reviewers and has a small favorab...
Source: Mayo Clinic Proceedings - February 20, 2019 Category: Internal Medicine Authors: Samir Haffar, Fateh Bazerbachi, M. Hassan Murad Tags: Review Source Type: research

Yoga: Safe for All?
This study identifies various medically documented yoga injuries, with the spine being the most common cited location of injury. Spinal flexion and extension seem to be particularly high-ri sk positions. Although soft tissue injuries were more common, bony injuries, including osteoporotic compression fractures, were also noted, and these types of injuries pose an increased risk of morbidity. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 18, 2019 Category: Internal Medicine Authors: Raza Awan, Edward R. Laskowski Tags: Editorial Source Type: research

Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis
To investigate the efficacy of yoga as antihypertensive lifestyle therapy and identify moderators that account for variability in the blood pressure (BP) response to yoga. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 18, 2019 Category: Internal Medicine Authors: Yin Wu, Blair T. Johnson, Rebecca L. Acabchuk, Shiqi Chen, Holly K. Lewis, Jill Livingston, Crystal L. Park, Linda S. Pescatello Tags: Original article Source Type: research

Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management
To analyze injuries that were directly associated with yoga practice and identify specific poses that should be avoided in patients with osteopenia or osteoporosis. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 18, 2019 Category: Internal Medicine Authors: Melody Lee, Elizabeth A. Huntoon, Mehrsheed Sinaki Tags: Original article Source Type: research

Yoga, Safe for All?
This study identifies various medically documented yoga injuries, with the spine being the most common cited location of injury. Spinal flexion and extension seem to be particularly high-ri sk positions. Although soft tissue injuries were more common, bony injuries, including osteoporotic compression fractures, were also noted, and these types of injuries pose an increased risk of morbidity. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 18, 2019 Category: Internal Medicine Authors: Raza Awan, Edward R. Laskowski Tags: Editorial Source Type: research

A Modern Primer on Light Chain Amyloidosis in 592 Patients With Mass Spectrometry –Verified Typing
To describe the clinical and laboratory characteristics of patients with meticulously typed light chain (AL) amyloidosis. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 13, 2019 Category: Internal Medicine Authors: Eli Muchtar, Morie A. Gertz, Robert A. Kyle, Martha Q. Lacy, David Dingli, Nelson Leung, Francis K. Buadi, Suzanne R. Hayman, Prashant Kapoor, Yi Lisa Hwa, Amie Fonder, Miriam Hobbs, Wilson Gonsalves, Taxiarchis V. Kourelis, Rahma Warsame, Stephen Russell Tags: Original article Source Type: research

65-Year-Old Woman With Abdominal Pain and Jaundice
A 65-year-old woman with no previous medical history was admitted to the hospital for management of abdominal pain of 2 weeks ’ duration. She described the pain as dull and diffuse but worst in the right upper quadrant without radiation to the back or shoulder. Her pain was associated with nausea, nonbloody diarrhea, anorexia, early satiety, and increased abdominal girth. She reported no medication or intravenous drug us e. Her social history was notable for daily alcohol use since the age of 16 years, with recent consumption of approximately 2 L of vodka every 10 to 12 days. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 12, 2019 Category: Internal Medicine Authors: Mitchell M. Pitlick, Dharma B. Sunjaya, Christopher R. Stephenson Tags: Residents ’ clinic Source Type: research

64-Year-Old Man With Subacute Altered Mental Status and Headache
A 64-year-old man from Iowa with a medical history of sarcoidosis, managed with prednisone, 20 mg/d, for the past 5 months, presented to the emergency department with gradual-onset, progressive altered mental status and headaches of 1 month ’s duration. Previously, he was cognitively intact according to his daughter. He had become unable to perform normal daily tasks such as unlocking doors and holding normal conversations. Additionally, he reported a generalized, throbbing, constant headache associated with intermittent blurry visio n. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 12, 2019 Category: Internal Medicine Authors: Nandini S. Mehra, Robert C. Ward, Meltiady Issa Tags: Residents ’ clinic Source Type: research

69-Year-Old Woman With Fevers, Diarrhea, and Abdominal Pain
A 69-year-old woman from Wisconsin with a history of rheumatoid arthritis (RA) treated with methotrexate and prednisone presented as a transfer from an outside hospital with new-onset fever and acute severe epigastric abdominal pain as well as several weeks of fatigue and decreased exercise tolerance. She had had an average of 3 loose stools per day for the previous few weeks. She had no recent illnesses or sick contacts. She had traveled recently to Missouri but had no international travel or animal exposures. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 9, 2019 Category: Internal Medicine Authors: Courtney E. Harris, Claire L. Jansson-Knodell, Abinash Virk Tags: Residents ’ clinic Source Type: research

Translation to Practice: Accelerating the Cycle of Innovation to Impact
The Office of Translation to Practice (OTP) is housed in the Center for Clinical and Translational Sciences at Mayo Clinic. Established in 2015, the office was tasked with developing and managing novel tools, mechanisms, and processes to facilitate and accelerate the translation of products, such as drugs, biological agents, and medical devices, into practice. Since its inception, the OTP is credited with creating valuable services through several strategic alliances and active scientific and project management involvement. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 6, 2019 Category: Internal Medicine Authors: Jeff R. Anderson, Thomas D.Y. Chung, Leon Clark, Jennifer A. Weis, Andrew J. Danielsen, Sundeep Khosla, Gregory J. Gores, Andrew D. Badley Tags: Special article Source Type: research

How Low to Go With Lipid-Lowering Therapies in a Cost-effective and Prudent Manner
The 2013 American College of Cardiology/American Heart Association guideline on the treatment of blood cholesterol was a landmark document guiding health care professionals around the globe on how to administer lipid-lowering therapies. Those guidelines were primarily focused on statin therapy benefit groups. The writing committee found insufficient evidence for specific low-density lipoprotein cholesterol (LDL-C) treatment targets. There have been many important updates in the lipid literature since the publication of that document. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 6, 2019 Category: Internal Medicine Authors: Rhanderson Cardoso, Roger S. Blumenthal, Stephen Kopecky, Francisco Lopez-Jimenez, Seth S. Martin Tags: Review Source Type: research

56-Year-Old Man With Abdominal Pain and Dyspnea
A 56-year-old man presented with abdominal pain, dyspnea, and back pain. His medical history included eosinophilic fasciitis and chronic abdominal pain. Several months previously, he was diagnosed elsewhere as having deep morphea with features of eosinophilic fasciitis and idiopathic thrombocytopenic purpura (ITP), initially treated with prednisone, 70 mg/d for 2 weeks. However, his platelet count decreased from 51 to 29  × 109/L (reference range, 150-450 × 109/L). Given the inadequate response, he subsequently received rituximab for 8 weeks. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 6, 2019 Category: Internal Medicine Authors: Manuel B. Braga Neto, Paul V. Viscuse, Karna K. Sundsted Tags: Residents ’ clinic Source Type: research

Apixaban and Rivaroxaban in Patients With Acute Venous Thromboembolism
To compare the clinical efficacy and safety of apixaban with those of rivaroxaban for the treatment of acute venous thromboembolism (VTE). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - February 6, 2019 Category: Internal Medicine Authors: Dalene M. Bott-Kitslaar, Robert D. McBane, Ana I. Casanegra, Damon E. Houghton, David A. Froehling, Danielle T. Vlazny, Aneel A. Ashrani, David O. Hodge, Emily R. Vargas, Matthew A. Bartlett, Rayya A. Saadiq, Paul R. Daniels, Raymond C. Shields, Charles J Tags: Original article Source Type: research