Acute Pulmonary Embolism During Pregnancy and Puerperium
To investigate the trend and outcomes of acute pulmonary embolism (PE) during pregnancy and puerperium using a large national database. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 15, 2021 Category: Internal Medicine Authors: Islam Y. Elgendy, Mohamed M. Gad, Hend Mansoor, Ahmed N. Mahmoud, Ayman Elbadawi, Anas Saad, Marwan Saad, Ahmed Elkaryoni, Eric A. Secemsky, Mamas A. Mamas, Manuel Monreal, Ido Weinberg, Carl J. Pepine Tags: Original article Source Type: research

Antiarrhythmic Drugs for Atrial Fibrillation in the Outpatient Setting: Common Clinical Scenarios and Pearls for the Primary Care Clinician
The management of atrial fibrillation (AF) in the outpatient setting has become more complex with the utilization of antiarrhythmic drugs (AADs) and increasing complexity of comorbid conditions. The primary care clinician is critically involved in the pharmacologic management of AF, whether it be direct prescription of AADs or managing potential drug-drug interactions with other medications. In this review, we provide instructive, high-yield clinical scenarios and quick clinical references to increase familiarity and comfort with the use of AADs. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 10, 2021 Category: Internal Medicine Authors: Andrew S. Tseng, Gurukripa N. Kowlgi, Christopher V. DeSimone Tags: Review Source Type: research

Identification of Genetic Causes of Focal Segmental Glomerulosclerosis Increases With Proper Patient Selection
To increase the likelihood of finding a causative genetic variant in patients with a focal segmental glomerulosclerosis (FSGS) lesion, clinical and histologic characteristics were analyzed. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 10, 2021 Category: Internal Medicine Authors: Jing Miao, Filippo Pinto e Vairo, Marie C. Hogan, Stephen B. Erickson, Mireille El Ters, Andrew J. Bentall, Aleksandra Kukla, Eddie L. Greene, Loren Herrera Hernandez, Sanjeev Sethi, Konstantinos N. Lazaridis, Pavel N. Pichurin, Emily Lisi, Carri A. Proch Tags: Original article Source Type: research

Pituitary Tumor Surgery: Comparison of Endoscopic and Microscopic Techniques at a Single Center
To understand the transition from microscopic surgery (MS) to endoscopic surgery (ES) on the pituitary across the United States, we assessed a single institution practicing both procedures to discern advantages and disadvantages for each. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 10, 2021 Category: Internal Medicine Authors: Jamie J. Van Gompel, John L.D. Atkinson, Garret Choby, Jan L. Kasperbauer, Janalee K. Stokken, Jeffrey R. Janus, Erin K. O ’Brien, Jason T. Little, Irina Bancos, Caroline J. Davidge-Pitts, Dhanya Ramachandran, Justine S. Herndon, Dana Erickson, William Tags: Original article Source Type: research

Cost-Related Nonadherence to Medications Among US Adults With Chronic Liver Diseases
To estimate the prevalence, risk factors, and consequences of cost-related medication nonadherence (CRN) in individuals with chronic liver diseases (CLDs) in the United States. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 10, 2021 Category: Internal Medicine Authors: Carlos Lago-Hernandez, Nghia H. Nguyen, Rohan Khera, Rohit Loomba, Sumeet K. Asrani, Siddharth Singh Tags: Original article Source Type: research

Artificial Intelligence –Augmented Electrocardiogram Detection of Left Ventricular Systolic Dysfunction in the General Population
To validate an artificial intelligence –augmented electrocardiogram (AI-ECG) algorithm for the detection of preclinical left ventricular systolic dysfunction (LVSD) in a large community-based cohort. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 10, 2021 Category: Internal Medicine Authors: Anthony H. Kashou, Jose R. Medina-Inojosa, Peter A. Noseworthy, Richard J. Rodeheffer, Francisco Lopez-Jimenez, Itzhak Zachi Attia, Suraj Kapa, Christopher G. Scott, Alexander T. Lee, Paul A. Friedman, Paul M. McKie Tags: Original article Source Type: research

Cost Effectiveness of an Electrocardiographic Deep Learning Algorithm to Detect Asymptomatic Left Ventricular Dysfunction
To evaluate the cost-effectiveness of an artificial intelligence electrocardiogram (AI-ECG) algorithm under various clinical and cost scenarios when used for universal screening at age  65. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 9, 2021 Category: Internal Medicine Authors: Andrew S. Tseng, Viengneesee Thao, Bijan J. Borah, Itzhak Zachi Attia, Jose Medina Inojosa, Suraj Kapa, Rickey E. Carter, Paul A. Friedman, Francisco Lopez-Jimenez, Xiaoxi Yao, Peter A. Noseworthy Tags: Original article Source Type: research

Frequently Reported Adverse Events With Smoking Cessation Medications: Post Hoc Analysis of a Randomized Trial
To compare the incidence, severity, and clinical course of frequently reported adverse events (AEs) after treatment with smoking cessation pharmacotherapies. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 8, 2021 Category: Internal Medicine Authors: Jon Ebbert, Carlos Jimenez-Ruiz, Michael P. Dutro, Matt Fisher, Jing Li, J. Taylor Hays Tags: Original article Source Type: research

Readability of Participant Informed Consent Forms and Informational Documents From Phase III COVID-19 Vaccine Clinical Trials in the United States
To assess the readability of the informed consent forms from the phase III COVID-19 vaccine trials conducted in the United States. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 3, 2021 Category: Internal Medicine Authors: Luke S. Bothun, Scott E. Feeder, Gregory A. Poland Tags: Original Article Source Type: research

Trust-Based Partnerships Are Essential — and Achievable — in Health Care Service
When people think about trust in the context of health care, they typically focus on whether patients trust the competence of doctors and other health professionals. But for health care to reach its full potential as a service, trust must also include the notion of partnership, whereby patients see their clinicians as reliable, caring, shared decision-makers who provide ongoing “healing” in its broadest sense. Four interrelated service-quality concepts are central to fostering trust-based partnerships in health care: empathetic creativity, discretionary effort, seamless service, and fear mitigation. (Source: Ma...
Source: Mayo Clinic Proceedings - June 2, 2021 Category: Internal Medicine Authors: Leonard L. Berry, Rana L.A. Awdish, Sunjay Letchuman, Karina Dahl Steffensen Tags: Special article Source Type: research

Comparison of Transcatheter and Open Mitral Valve Repair Among Patients With Mitral Regurgitation
In 2013, the Food and Drug Administration approved the first transcatheter mitral valve repair (TMVr) device for degenerative mitral regurgitation for patients at prohibitive surgical risk. To better understand contemporary utilization trends and outcomes, we reviewed hospitalizations, identified using International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes, in which the patient underwent TMVr or mitral valve repair (MVr) with a diagnosis of mitral regurgitation, without stenosis, from the National (Nationwide) Inpatient Sample from 2014 to 2017. (Source: ...
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Bradley Kay, Fouad Chouairi, Katherine A.A. Clark, Samuel W. Reinhardt, Michael Fuery, Avirup Guha, Tariq Ahmad, Ryan K. Kaple, Nihar R. Desai Tags: Brief report Source Type: research

My Treatment Approach to Giant Cell Arteritis
Giant cell arteritis (GCA) is the most common primary systemic vasculitis in adults 50 years or older. Expanded use of advanced arterial imaging has assisted both in the diagnosis of GCA and recognition of disease subsets. Although glucocorticoids have been the mainstay of treatment for almost 7 decades, new therapeutic options have emerged. This review aims to provide the clinician with a pragmatic approach to evaluating and managing patients with GCA while also addressing recent diagnostic and therapeutic developments. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Thomas D. Garvey, Matthew J. Koster, Kenneth J. Warrington Tags: Diagnosis and treatment guidelines Source Type: research

Metastatic Thyroid Carcinoma in Bone
A White man in his 70s with a recent diagnosis of prostatic adenocarcinoma (Gleason score 4  + 5) and prostate-specific antigen of 36 ng/mL was found to have bone lesions in his right sacral ala and left femoral neck. Image-guided fine needle aspiration of the left femoral neck confirmed osseous metastasis, morphologically compatible with known prostatic carcinoma. A subsequent chest comp uted tomography (CT) scan showed a large, heterogeneously enhancing, lobulated, destructive mass involving the right anterior second rib (Figure 1A) as well as other lytic osseous lesions. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Charles D. Sturgis, Aishwarya Ravindran, Darin White Tags: Medical image Source Type: research

Emphysematous Cystitis
A 49-year-old woman with type 2 diabetes mellitus and nonadherence to insulin therapy presented to the emergency department with several weeks of urinary frequency, urinary incontinence, and pneumaturia. Blood laboratory studies revealed severe hyperglycemia. Computed tomography of the abdomen and pelvis (Figures  1 and 2) showed marked distention of the urinary bladder and extensive gas within the bladder wall and lumen, consistent with emphysematous cystitis. Antibiotics were initiated and urinary catheter was placed for decompression. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Benjamin A. Nelson, Will M. Schouten Tags: Medical image Source Type: research

Mycoplasma pneumoniae –Induced Rash and Mucositis
A 38-year-old man presented to the emergency department with a 5-day history of productive cough, shortness of breath, fever, and rash. Physical examination revealed crackles in the right mid-lung field, conjunctival injection (Supplementary Figure  1, available online at http://www.mayoclinicproceedings.org), oral ulcerations, sloughing of the lips (Figure 1), and scattered targetoid lesions over his trunk (Supplementary Figure 2, available online at http://www.mayoclinicproceedings.org) and extremities. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: John Raymond Go, Nora S. Ali, Elie F. Berbari Tags: Medical image Source Type: research

57-Year-Old Woman With Fatigue and Lower-Extremity Edema
A 57-year-old woman with a medical history of hypertension, type 2 diabetes mellitus with chronic kidney disease stage 3a, and coronary artery disease presented to the emergency department with a subacute history of progressive fatigue and bilateral leg swelling despite increasing doses of furosemide. Over the next several weeks, she reported feeling generally unwell with profound malaise, frequent urination, and increasing lower-extremity edema despite taking extra doses of her normal diuretic. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Eugene P. Harper, Samantha M. Espinosa, Priyanka Vijapura Tags: Residents ’ clinic Source Type: research

23-Year-Old Female With Right-Sided Weakness and Aphasia
A 23-year-old right-handed woman developed sudden right-sided weakness, right-sided facial droop, and aphasia. She was in her usual state of health prior and presented 70 minutes after symptom onset. Just before symptom onset she had been bearing down for a bowel movement. Recently she had undergone a 6-hour car journey. Her medical history was significant for attention deficit disorder treated with lisdexamfetamine. She does not use any insulin or oral hypoglycemic medications. On presentation she was afebrile, her blood pressure was 130/77 mm Hg, and she had a heart rate of 89 beats/min and a respiratory rate of 16 breat...
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Hollie Saunders, Megan Melody, Razvan Chirila Tags: Residents ’ clinic Source Type: research

66-Year-Old Man With Recurrent Hypotension and Flank Pain
A 66-year-old man with hyperlipidemia and erectile dysfunction presented to the emergency department with bilateral flank discomfort and dizziness that started on the day of presentation. He denied any history of fever, cough, chills, dysuria, abdominal pain, nausea/vomiting, hematemesis/melena, dyspnea/chest pain, or exposure to any known allergens. He did not have any history of coagulopathy, immobilization, or active malignancy. He was diagnosed with influenza B a week before his presentation, which had been managed as an outpatient with complete recovery before his current presentation. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Saurabh Zanwar, Abdullah S. Al Saleh, Morie Gertz Tags: Residents ’ clinic Source Type: research

Treatment of AL Amyloidosis: Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Statement 2020 Update
Immunoglobulin light chain (AL) amyloidosis is a clonal plasma cell disorder leading to progressive and life-threatening organ failure. The heart and the kidneys are the most commonly involved organs, but almost any organ can be involved. Because of the nonspecific presentation, diagnosis delay is common, and many patients are diagnosed with advanced organ failure. In the era of effective therapies and improved outcomes for patients with AL amyloidosis, the importance of early recognition is further enhanced as the ability to reverse organ dysfunction is limited in those with a profound organ failure. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Eli Muchtar, Angela Dispenzieri, Morie A. Gertz, Shaji K. Kumar, Francis K. Buadi, Nelson Leung, Martha Q. Lacy, David Dingli, Sikander Ailawadhi, P. Leif Bergsagel, Rafael Fonseca, Suzanne R. Hayman, Prashant Kapoor, Martha Grogan, Omar F. Abou Ezzeddine Tags: Consensus recommendation Source Type: research

Ocular Toxicity Associated With Pentosan Polysulfate Sodium
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a common disorder that affects 7.9 million adult women in the United States.1 Pentosan polysulfate sodium (PPS) is the only Food and Drug  Administration-approved oral medication for treating IC/BPS. A recent study within the Kaiser Permanente Northern California (KPNC) system suggested that a substantial number of patients with IC/BPS (up to 42%) take long-term PPS.2 A bilateral pigmentary maculopathy associated with long-term use o f PPS (Figure, panel A) has been described recently, with the initial report published in November 2018. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Konstantin V. Astafurov, Sophie J. Bakri, Andrew J. Barkmeier Tags: Letter to the editor Source Type: research

The Undulating Life of Omega-3 Fatty Acids
The cardiovascular protective effects of omega-3 fatty acids are still under intense debate. Recent results from the Long-Term Outcomes Study to Assess Statin Residual Risk with Epanova in High  Cardiovascular Risk Patients with Hypertriglyceridemia (STRENGTH),1 which enrolled 13,078 patients with high cardiovascular risk and high prevalence of diabetes, showed that 4 g per day of omega-3 carboxylic acids (a final concentration of 75% of eicosapentaenoic acid [EPA] and docosahexaenoic ac id) did not reduce cardiovascular events in high-risk patients. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Xiaoqun Xu, Houyong Zhu, Long Cai Tags: Letter to the editor Source Type: research

Fecal Microbiota Transplantation for Recurrent C difficile Infection During the COVID-19 Pandemic
To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Sahil Khanna, Aaron Tande, David T. Rubin, Alexander Khoruts, Stacy A. Kahn, Darrell S. Pardi Tags: Original article Source Type: research

Racism in Pain Medicine: We Can and Should Do More
The long history of racism in the United States, including racist medical practices, has strongly influenced Black people ’s perceptions of health care delivery for generations. Unethical practices have included the performance of painful procedures without anesthesia on enslaved Black women by J. Marion Sims in the 1840s, the Tuskegee study that intentionally withheld effective treatment from Black men with syphilis in the 1930s through the 1970s, and the sterilization procedures performed without consent (“Mississippi appendectomy”) on Black men and women as recently as the 1970s. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Natalie H. Strand, Edward R. Mariano, Johnathan H. Goree, Samer Narouze, Tina L. Doshi, John A. Freeman, Amy C.S. Pearson Tags: Commentary Source Type: research

Achieving Racial Equity Within Medical Institutions: An Appeal for Action
In late May 2020, a global outpouring of grief and rage swept our world as news emerged that George Floyd, an unarmed Black man in police custody, was publicly murdered on a busy street in Minneapolis. The cruel and casual disregard for Mr Floyd ’s humanity as he cried for his mother has since haunted our public conscience, shattering widely held perceptions of a color-blind, post-racial era. Intractable structural racism—the sum of mutually reinforcing policies, institutional practices, and cultural norms that systematically discrimina te against persons of color1—continues to exact a terrible toll in al...
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Lawson Ung, Aalok V. Agarwala, James Chodosh Tags: Perspective and Controversy Source Type: research

Mid-Cavitary Obstruction in Hypertrophic Cardiomyopathy
The diagnostic features of left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HCM) were characterized>50 years ago.1-3 In contrast, the features of mid-cavitary obstruction (MCO) at cardiac catheterization remain poorly understood and limited to case reports.4-6 Accordingly, we describe the invasive hemodynamic findings in MCO using a novel technique. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: William R. Miranda, Darrell B. Newman, Mackram F. Eleid, Rick A. Nishimura, Hartzell V. Schaff Tags: Letter to the editor Source Type: research

Be SMART About AL Amyloidosis
In this issue, Muchtar et  al1 update the comprehensive Mayo Clinic recommendations for diagnosis, staging, and treatment, including supportive therapy, of light chain (AL) amyloidosis. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Giovanni Palladini, Giampaolo Merlini Tags: Editorial Source Type: research

Fused Glass Rounds by Lynn Latimer
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 - June 1, 2021 Category: Internal Medicine Authors: Margaret R. Wentz Tags: Art at mayo clinic Source Type: research

Primary Renal Well-Differentiated Neuroendocrine Tumor (Carcinoid) in a Horseshoe Kidney
A female patient was found to have a horseshoe kidney on imaging studies when undergoing evaluation for recurrent urinary tract infections when she was in her 20s. Now in her late 40s, she presented with gross hematuria. A computed tomography urogram revealed the presence of a 14.9-cm mass arising from the isthmus of the horseshoe kidney (Figure  1). Also present was an enlarged retroperitoneal lymph node suspicious for metastatic disease. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Sounak Gupta, Lori A. Erickson Tags: Path to patient image quiz Source Type: research

Breaking Down the Web of Structural Racism in Medicine
Soon after the first reported US case of coronavirus disease 2019 (COVID-19) in January 2020, the pandemic piled on centuries of adversities from systemic racism and social injustice in communities of color. Then, on May 25, 2020, George Floyd, an unarmed Black man, died from being pinned at the neck to the ground in handcuffs by a hand-pocketed White police officer, sparking outrage globally, effects of which were captured in a Black community study.1 A flurry of antiracism statements ensued, but in February 2021, the Journal of the American Medical Association posted a podcast and tweet asserting that “no physician...
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Chyke A. Doubeni Tags: Editorial Source Type: research

In the Limelight: June 2021
This month ’s feature highlights three articles, one of which focuses on COVID-19, that appear in the current issue of Mayo Clinic Proceedings. These articles are also featured on the Mayo Clinic Proceedings’ YouTube Channel (https://youtu.be/GD7YUqXt2Vo). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Karl A. Nath Tags: In the limelight Source Type: research

Editorial Board
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Source Type: research

Table of Contents
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Source Type: research

General Information
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 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 June 2021 issue. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - June 1, 2021 Category: Internal Medicine Authors: Karl A. Nath Tags: Issue summary Source Type: research

Prothrombotic State in COVID-19: Myth or Reality?
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 24, 2021 Category: Internal Medicine Authors: Philippe R. Bauer Tags: Editorial Source Type: research

The Only Way Around is Through the Co-vital Impacts of the Shadow Pandemic of COVID-19
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 24, 2021 Category: Internal Medicine Authors: Avni Y. Joshi Tags: Editorial Source Type: research

Prognostic Value of Cardiac Magnetic Resonance Imaging in Acute Coronary Syndrome Patients With Troponin Elevation and Nonobstructive Coronary Arteries
To define the diagnostic yield of cardiac magnetic resonance (CMR) in differentiating the underlying causes of myocardial infarction with nonobstructive coronary arteries (MINOCA) and to determine the long-term prognostic implications of such diagnoses. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 12, 2021 Category: Internal Medicine Authors: Sushil Allen Luis, Chris R. Luis, Mohsen Habibian, Myo T. Lwin, Tahlia C. Gadowski, Jonathan Chan, Christian Hamilton-Craig, Owen Christopher Raffel Tags: Original article Source Type: research

Diagnosis and Treatment of Unruptured Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage
Unruptured intracranial aneurysms (UIAs) are commonly acquired vascular lesions that form an outpouching of the arterial wall due to wall thinning. The prevalence of UIAs in the general population is 3.2%. In contrast, an intracranial aneurysm may be manifested after rupture with classic presentation of a thunderclap headache suggesting aneurysmal subarachnoid hemorrhage (SAH). Previous consensus suggests that although small intracranial aneurysms ( (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 12, 2021 Category: Internal Medicine Authors: Rabih G. Tawk, Tasneem F. Hasan, Caitlin E. D ’Souza, Jeffrey B. Peel, William D. Freeman Tags: Thematic review on neurovascular diseases Source Type: research

The Elevated High-Sensitivity Cardiac Troponin T Pilot
To identify the diagnoses and outcomes associated with elevated high sensitivity cardiac troponin T (hs-cTnT) compared with the 4th-generation troponin T and to validate the Mayo Clinic hs-cTnT myocardial infarction algorithm cutoff values. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 12, 2021 Category: Internal Medicine Authors: Korosh Sharain, Vlad C. Vasile, Yader Sandoval, Leslie J. Donato, Casey M. Clements, James S. Newman, Brad S. Karon, Allan S. Jaffe Tags: Original article Source Type: research

Post COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at the Mayo Clinic and Characteristics of the Initial Patient Cohort
To describe characteristics of a series of patients reporting prolonged symptoms after an infection with COVID-19. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 11, 2021 Category: Internal Medicine Authors: Greg Vanichkachorn, Richard Newcomb, Clayton T. Cowl, M. Hassan Murad, Laura Breeher, Sara Miller, Michael Trenary, Daniel Neveau, Steven Higgins Tags: Original Article Source Type: research

Seeking Joy in Medicine During Uncertain Times – COVID-19 and Social Unrest
(Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 9, 2021 Category: Internal Medicine Authors: Rahma Warsame, Katharine A.R. Price Tags: Letter to the Editor Source Type: research

Macrovascular Thrombotic Events in a Mayo Clinic Enterprise-wide Sample of Hospitalized COVID-19 Positive Compared to Negative Patients
To determine the difference in the rate of thromboembolic complications between hospitalized COVID-19 positive compared COVID-19 negative patients. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 4, 2021 Category: Internal Medicine Authors: Rahul Chaudhary, Leslie Padrnos, Ewa Wysokinska, Rajiv Pruthi, Sanjay Misra, Meera Sridharan, Waldemar Wysokinski, Robert D. McBane, Damon E. Houghton Tags: Original Article Source Type: research

Utility of Transbronchial Biopsy in the Immunocompromised Host With New Pulmonary Radiographic Abnormalities
To assess how often transbronchial biopsy (TBBx) added unique positive findings apart from other synchronous bronchoscopic sampling techniques including the bronchoalveolar lavage –immunocompromised host (BAL-ICH) panel that justified changes in management in an array of immunocompromised patients with new pulmonary radiographic abnormalities. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 3, 2021 Category: Internal Medicine Authors: Michael H. Bourne, Mark S. Norton, David E. Midthun, John J. Mullon, Ryan M. Kern, James P. Utz, Darlene R. Nelson, Eric S. Edell Tags: Original article Source Type: research

Microvascular Disease and Risk of Cardiovascular Events and Death From Intensive Treatment in Type 2 Diabetes
To assess whether the presence of microvascular complications modifies the effect of intensive glucose reduction on long-term outcomes in patients with type 2 diabetes. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 2, 2021 Category: Internal Medicine Authors: David E. Kloecker, Kamlesh Khunti, Melanie J. Davies, Dario Pitocco, Francesco Zaccardi Tags: Original article Source Type: research

Intracerebral Hemorrhage
Spontaneous intracerebral hemorrhage (ICH) is a medical emergency and is disproportionately associated with higher mortality and long-term disability compared with ischemic stroke. The phrase “time is brain” was derived for patients with large vessel occlusion ischemic stroke in which approximately 1.9 million neurons are lost every minute. Similarly, this statement holds true for ICH patients due to a high volume of neurons that are damaged at initial onset and during hematoma expan sion. Most cases of spontaneous ICH pathophysiologically stem from chronic hypertension and rupture of small perforating vessels ...
Source: Mayo Clinic Proceedings - May 2, 2021 Category: Internal Medicine Authors: Cumara B. O ’Carroll, Benjamin L. Brown, W. David Freeman Tags: Solicited review Source Type: research

Using Reticulocyte Hemoglobin Equivalent as a Marker for Iron Deficiency and Responsiveness to Iron Therapy
To assess the accuracy of a simplified approach for the diagnosis of iron deficiency anemia (IDA) based on the complete blood cell count (CBC) and reticulocyte analysis. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 2, 2021 Category: Internal Medicine Authors: Michael Auerbach, Steven J. Staffa, Carlo Brugnara Tags: Original article Source Type: research

Barriers to ACEI/ARB Use in Proteinuric Chronic Kidney Disease: An Observational Study
To assess present angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) use among patients with proteinuric chronic kidney disease (CKD) and examine barriers limiting this guideline-concordant care. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 2, 2021 Category: Internal Medicine Authors: Ian E. McCoy, Jialin Han, Maria E. Montez-Rath, Glenn M. Chertow Tags: Original article Source Type: research

Lower Extremity Arterial Disease as a Predictor of Incident Atrial Fibrillation and Cardiovascular Events
To evaluate the relationship between peripheral arterial disease (PAD) and incident atrial fibrillation (AF) and its clinical and pathophysiologic implications on ischemic stroke and all-cause mortality. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2021 Category: Internal Medicine Authors: Andrew S. Tseng, Marlene Girardo, Christine Firth, Shubhang Bhatt, David Liedl, Paul Wennberg, Win-kuang Shen, Leslie T. Cooper, Fadi E. Shamoun Tags: Original article Source Type: research

Toward Eliminating Perinatal Comfort Care for Prenatally Diagnosed Severe Congenital Heart Defects: A Vision
Over the past 40 years, the medical and surgical management of congenital heart disease has advanced considerably. However, substantial room for improvement remains for certain lesions that have high rates of morbidity and mortality. Although most congenital cardiac conditions are well tolerated during fetal development, certain abnormalities progress in severity over the course of gestation and impair the development of other organs, such as the lungs or airways. It follows that intervention during gestation could potentially slow or reverse elements of disease progression and improve prognosis for certain congenital hear...
Source: Mayo Clinic Proceedings - May 1, 2021 Category: Internal Medicine Authors: Elizabeth H. Stephens, Joseph A. Dearani, Muhammad Yasir Qureshi, Leal G. Segura, Katherine W. Arendt, Ellen M. Bendel-Stenzel, Rodrigo Ruano Tags: Review Source Type: research

The Role of Biological Effective Dose in Predicting Obliteration After Stereotactic Radiosurgery of Cerebral Arteriovenous Malformations
To determine whether biological effective dose (BED) was predictive of obliteration after stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVMs). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2021 Category: Internal Medicine Authors: Cody L. Nesvick, Christopher S. Graffeo, Paul D. Brown, Michael J. Link, Scott L. Stafford, Robert L. Foote, Nadia N. Laack, Bruce E. Pollock Tags: Original article Source Type: research