Obesity, Cardiorenal Comorbidities, and Risk of Hospitalization in Patients With Heart Failure With Preserved Ejection Fraction
To compare clinical features of patients with obesity-related heart failure (HF) with preserved ejection fraction (HFpEF) with those of patients with similar body mass index (BMI) but no HF and to examine the association between degree of obesity and risk for hospitalizations. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 9, 2023 Category: Internal Medicine Authors: Camilla S. Morgen, Christiane L. Haase, Tugce K. Oral, Volker Schnecke, Anette Varbo, Barry A. Borlaug Tags: Original Article Source Type: research
Outcomes of Arterial Bypass With the Human Acellular Vessel for Chronic Limb-Threatening Ischemia Performed Under the FDA Expanded Access Program
To report outcomes of the human acellular vessel (HAV) implanted for limb salvage through the Food and Drug Administration (FDA) Expanded Access Program for patients with chronic limb-threatening ischemia with no autologous conduit. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 2, 2023 Category: Internal Medicine Authors: Indrani Sen, W. Darrin Clouse, Alexis L. Lauria, Daniel R. Calderon, Peter B. Anderson, Randall R. DeMartino, Todd E. Rasmussen Tags: Original article Source Type: research
86-Year-Old Woman With Fever, New-Onset Dysarthria, and Ataxia
An 86-year-old woman with a medical history of hypertension, hyperlipidemia, permanent atrial fibrillation receiving anticoagulation, and chronic venous stasis causing recurrent leg cellulitis presented to the emergency department for new-onset dysarthria and imbalance, which began earlier that morning. She denied a history of stroke, chills, unintentional weight loss, diarrhea, dysuria, frequency, or recent head trauma. The patient endorsed taking her anticoagulation as prescribed without skipped doses. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Nikita Jhawar, Abdallah El Sabbagh Tags: Residents ’ Clinic Source Type: research
Knowledge Management in an Academic Medical Center
“Today we are suffering from too much knowledge too widely diffused.”William Mayo, 1927 (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Rick A. Nishimura, Jane L. Shellum, Julia-Rose Anderson, Shanda Blackmon, Bradley C. Leibovich Tags: Perspective and Controversy Source Type: research
Sensory and Motor Neurologic Presentations of Herpes Zoster (Shingles)
An elderly woman developed acute, severe, nontraumatic, and constant left knee pain. Three days later, she developed a herpetic rash along the L4 dermatome associated with allodynia. She was treated with valacyclovir, but pain continued with development of proximal leg weakness. Three weeks after onset, the rash was crusted (Figure 1), and neurologic examination demonstrated weakness in the L3/4 myotome with an absent patellar reflex (Supplemental Video, available online at http://www.mayoclinicproceedings.org). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Reece M. Hass, Forrest L. Sturgill, Nathan P. Young Tags: Medical image Source Type: research
Osseous Metastasis: An Unusual Sarcoidosis Masquerade
A man in his 50s presented to the clinic with the chief complaint of low back pain. He had served in the US Army with burn pit exposure in the Middle East. Lumbar magnetic resonance imaging revealed irregular, rounded lesions in multiple vertebral bodies (Supplemental Figure 1, available online at http://www.mayoclinicproceedings.org). Follow-up positron emission tomography revealed 18F-fluorodeoxyglucose–avid lesions throughout the entire axial skeleton, right femur, and right humerus (Figure 1 and Supplemental Figure 2). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Johnny F. Jaber, Robert W. Allan, Suzanne Mastin, Grant Lowther Tags: Medical image Source Type: research
Giant Left Atrium Causing Inferior Vena Cava Obstruction and Dysphagia
A man in his 80s with a background of rheumatic heart disease with aortic and mitral valve mechanical prostheses, high-grade atrioventricular block with dual-chamber pacemaker, and atrial fibrillation presented to his local emergency department with shortness of breath and chest pain. Electrocardiography revealed ST elevations in the inferior leads with ST depressions anteriorly. He was hypotensive requiring vasopressors and was transferred to the cardiac intensive care unit. Cardiac catheterization revealed nonobstructive coronary artery disease. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Matthew L. Vincent, Kathryn T. del Valle, Courtney E. Bennett Tags: Medical Image Source Type: research
Clinical Significance of Biological Age in Patients Undergoing Percutaneous Coronary Intervention
To test whether biological age calculated using deficits, functional impairments, or their combination will provide improved estimation of long-term mortality among older adults undergoing percutaneous coronary intervention. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Mandeep Singh, Abdallah El Sabbagh, Bradley R. Lewis, Amrit Kanwar, Carmen M. Terzic, Mohammed A. Al-Hijji, Atta Behfar, James L. Kirkland Tags: Original Article Source Type: research
Introduction to Thematic Reviews on Forward Thinking on Clinical Trials in Clinical Practice
Many advancements in medicine have been realized through the rigors of clinical trials, whether early-phase single-arm trials, multiple-arm randomized trials, or nonrandomized cohort trials. Although clinical trials are often considered to include randomization of study participants to interventions, the National Institutes of Health defines a clinical trial as “a research study in which one or more human subjects are prospectively assigned to one or more interventions (which may include placebo or other control) to evaluate the effects of those interventions on health-related biomedical or behavioral outcomes.” A key ...
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Daniel J. Schaid, Claudia F. Lucchinetti Tags: Editorial Source Type: research
Clinical Trials Overview: From Explanatory to Pragmatic Clinical Trials
Clinical trials have been the bedrock of research to evaluate the safety and efficacy of new medical, surgical, or other interventions. Traditional “explanatory” clinical trials have aimed to explain a biological cause (new treatment) and effect (patient outcome) while controlling for many factors that might impact the evaluation, such as restricted eligibility criteria, frequent follow-up visits, and multiple clinical and laboratory measur es. Despite the benefits of a well-controlled clinical trial, compromises have been made that can limit who might benefit from a new intervention, can increase complexity of the con...
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Jennifer Le-Rademacher, Heather Gunn, Xiaoxi Yao, Daniel J. Schaid Tags: Thematic Review on Forward Thinking on Clinical Trials in Clinical Practice Source Type: research
Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management
Primary aldosteronism is a prevalent but underdiagnosed cause of hypertension, contributing to increased cardiovascular and cerebrovascular events and end-organ damage independent of blood pressure. Prompt diagnosis and treatment with targeted surgical or medical therapy reduce the risk of complications and improve prognosis. This review outlines a practical approach to diagnosis and management of primary aldosteronism for global practitioners. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Prerna Dogra, Irina Bancos, William F. Young Tags: Concise review Source Type: research
Predictors of 90-Day Readmissions in Adults With Bacterial Meningitis
Most clinical features and outcomes used to describe meningitis are restricted to the initial presentation, yet ongoing complications of the infection have been shown to be a significant cause of adverse outcomes.1 However, little is known about the risk factors or reasons for readmission in these patients. Therefore, we examined 90-day readmissions of adults hospitalized with a diagnosis of bacterial meningitis using the 2016-2017 Nationwide Readmissions Database. We identified patients admitted for bacterial meningitis and their documented cause using International Classification of Diseases, Tenth Revision (ICD-10) code...
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Hunter T. Ratliff, Michael A. Hansen, Rodrigo R. Hasbun Tags: Letters to the Editor Source Type: research
Equation-Based Low-Density Lipoprotein Cholesterol Reclassification and Implications For Lipid-Lowering Therapy
There are multiple guideline-endorsed equations for calculating low-density lipoprotein cholesterol (LDL-C). Initiating or intensifying lipid-lowering therapy (LLT) is recommended for adults above certain cut-points including an LDL-C greater than or equal to 190 mg/dL for adults without atherosclerotic cardiovascular disease (ASCVD) or greater than or equal to 70 mg/dL for adults with ASCVD.1 We determined the prevalence of adults whose need for LLT intensification would be reclassified based solely on whether the Martin-Hopkins or National Institutes of Health (NIH) –2 equation was used to calculate LDL-C compared with...
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Alexander R. Zheutlin, Joshua D. Niforatos, Alexander Chaitoff Tags: Letters to the Editor Source Type: research
Exotic Species and Clusters by Glenda Kronke
Art is integrated into the Mayo Clinic environment. Since the original Mayo Clinic Building was finished in 1914, many pieces have been donated or commissioned for patients and staff to enjoy. Each issue of Mayo Clinic Proceedings features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Margaret R. Wentz Tags: Art at Mayo Clinic Source Type: research
Gynecologic-Type Adenocarcinoma With Mixed Serous and Endometrioid Features in a Male Patient
A 70-year-old presented with a 2.2-cm paratesticular mass for which he underwent a radical orchiectomy. Histopathologic examination revealed a paratesticular neoplasm that showed infiltration into the testicular parenchyma (Figure 1A), characterized by predominantly glandular and focal papillary growth patterns (Figure 1B) associated with psammomatous calcification (Figure 1C). In addition, multiple foci of endometrioid-type morphology with squamoid differentiation were seen (Figure 1D). Finally, no evidence of germ cell neoplasia in situ was seen within the seminiferous tubules. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Sounak Gupta, J. Kenneth Schoolmeester, Lori A. Erickson Tags: Path to patient image quiz Source Type: research
