60-Year-Old Man With Acute-Onset Exertional Dyspnea
A 60-year-old man presented to the emergency department following acute-onset dyspnea that occurred while chasing his dogs outdoors in the winter. After spending several hours outside with his dogs, one of the dogs escaped into the woods. He began to chase the dog when he became short of breath and had to stop. He had associated nausea, light-headedness, and diaphoresis but no chest discomfort or syncope. These symptoms prompted him to sit down outdoors to catch his breath before attempting to return to his vehicle. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 6, 2024 Category: Internal Medicine Authors: Helayna Abraham, Thomas Fredrick, Jacob C. Jentzer Tags: Residents ’ clinic Source Type: research
53-Year-Old Man With Fever and Hepatomegaly
A 53-year-old man with a tobacco and remote alcohol use disorder presented with a 5-month history of recurrent fevers, fatigue, and an 18-kg unintentional weight loss. He had no notable personal or family medical history. His only medication was acetaminophen as needed. He was monogamous with his spouse of 20 years, did not use illicit drugs, and reported no recent travel outside the southeastern United States. There were no notable findings on review of systems or on the physical examination. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 6, 2024 Category: Internal Medicine Authors: Justin Call, William Mai, Razvan Chirila Tags: Residents ’ clinic Source Type: research
Trends of Lipid Concentrations, Awareness, Evaluation, and Treatment in Severe Dyslipidemia in US Adults
To evaluate the contemporary trends of lipid concentrations, cholesterol evaluation, hypercholesterolemia awareness, and statin use among individuals with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] level ≥190 mg/dL) between 2011 and 2020. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 6, 2024 Category: Internal Medicine Authors: Naman S. Shetty, Mokshad Gaonkar, Nirav Patel, Joshua W. Knowles, Pradeep Natarajan, Garima Arora, Pankaj Arora Tags: Original article Source Type: research
Hilfiker in Perspective
Medical error remains a troubling and complex issue. Just less than 40 years ago, David Hilfiker provided ground-breaking descriptions of clinician error in a landmark article in a leading medical journal, “Facing Our Mistakes,”1 and subsequent book, Healing the Wounds.2 Hilfiker reflected on his medical mistakes and his inability to cope with their emotional consequences. Against the historical backdrop of a culture of silence and denial around error, Hilfiker’s pioneering “error confession” has since been regarded as a keystone of error discourse. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 6, 2024 Category: Internal Medicine Authors: Matthew Morrell, Ian Sabroe, Chris Millard Tags: Perspectives and controversies Source Type: research
Industry Payments to Physicians in the United States From 2017 to 2021 and the Impact of the COVID-19 Pandemic
Physician-industry relationships have received growing attention in recent years following the establishment of the Physician Payments Sunshine Act of 2010.1 Previous studies have examined the magnitude and frequency of these financial interactions in the early years.2,3 Studies have also shown the concentration of industry payments to a few physicians for certain specialties.4,5 Recent trends in physician-industry relationships and the effect of the COVID-19 pandemic for all physicians in the United States are not well understood. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 6, 2024 Category: Internal Medicine Authors: Mihir Khunte, Anthony Zhong, Chris Lee, Xiao Wu, Dheeraj Gandhi, Ajay Malhotra Tags: Research letter Source Type: research
Outcomes Associated With Left Atrial Appendage Occlusion Via Implanted Device in Atrial Fibrillation
To compare outcomes after left atrial appendage occlusion (LAAO) via implanted device vs no LAAO in a matched cohort of patients with atrial fibrillation (AF). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 4, 2024 Category: Internal Medicine Authors: Baptiste Maille, Pascal Defaye, Sid Ahmed Bentounes, Julien Herbert, Jean Michel Clerc, Bertrand Pierre, Olivier Torras, Jean Claude Deharo, Laurent Fauchier Tags: Original Article Source Type: research
Pharmacotherapies for Migraine and Translating Evidence From Bench to Bedside
Migraine is a ubiquitous neurologic disorder that afflicts more than 1 billion people worldwide. Recommended therapeutic strategies include the use of acute and, if needed, preventive medications. During the past 2 decades, tremendous progress has been made in better understanding the molecular mechanisms underlying migraine pathogenesis, which in turn has resulted in the advent of novel medications targeting signaling molecule calcitonin gene –related peptide or its receptor. Here, we provide an update on the rational use of pharmacotherapies for migraine to facilitate more informed clinical decision-making. (Source: Ma...
Source: Mayo Clinic Proceedings - January 4, 2024 Category: Internal Medicine Authors: Messoud Ashina, Jan Hoffmann, H åkan Ashina, Debbie L. Hay, Yadira Flores-Montanez, Thien Phu Do, Roberto De Icco, David W. Dodick Tags: Review Source Type: research
Cancer Treatment –Related Complications in Patients With Hypertrophic Cardiomyopathy
To describe the potential clinical cardiotoxicity of oncological treatments in a cohort of consecutive patients with hypertrophic cardiomyopathy (HCM), systematically followed-up at two national referral centers for HCM. Cardiotoxicity relates to the direct effects of cancer-related treatment on heart function, commonly presenting as left ventricular contractile dysfunction. However, limited data are available regarding cardiotoxic effects on HCM as most studies have not specifically analyzed the effects of oncological treatment in HCM populations. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 4, 2024 Category: Internal Medicine Authors: Mattia Zampieri, Stephan A.C. Schoonvelde, Michele Vinci, Icro Meattini, Luca Visani, Alessandra Fornaro, Raffaele Coppini, Andrea Romei, Alberto Marchi, Ilaria Morelli, Marjon A. van Slegtenhorst, Eszter Dalma Palinkas, Lorenzo Livi, Michelle Michels, Ia Tags: Original Article Source Type: research
36-Year-Old Woman With Progressive Dyspnea, Cough, and Chills
A 36-year-old woman presented to the hospital for evaluation of progressively worsening dyspnea on exertion. She had a pertinent medical history of anxiety, polycystic ovary syndrome, and rheumatoid arthritis work-up with her primary care provider. Her home medications included escitalopram, gabapentin, glucosamine-chondroitin, loratadine, multivitamin, acetaminophen, and ibuprofen. She reported 2 weeks of progressively worsening dyspnea on exertion with associated nonproductive cough, chills, sore throat, and palpitations. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Megan M. Ellis, Nayla Ahmed, Eva M. Carmona Tags: Residents ’ clinic Source Type: research
59-Year-Old Woman With Episodic Chest Pain
A 59-year-old woman with no significant medical history presented to the emergency department (ED) for recent episodes of chest pain at rest. Her only medication is a multivitamin with calcium and iron. Her family history is significant for a mother with breast cancer diagnosed in her 40s and a son diagnosed as having a bicuspid aortic valve. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Daniel Khan, Mohamed Elhadi, Vlad C. Vasile Tags: Residents ’ clinic Source Type: research
71-Year-Old Man With Progressive Dyspnea on Exertion
A 71-year-old man presented to the emergency department complaining of 5 months of slowly progressive exertional dyspnea, worsened in the past 3 days. He was a lifelong nonsmoker who had been generally healthy until 6 months before presentation, when nonsevere COVID-19 infection developed. One month later, he suffered a fall with cervical spinal trauma, and thereafter he experienced persistent neck pain. Around the time of the fall, he noticed new exertional dyspnea, which then progressed and came to be associated with orthopnea. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Alan W. Hu, Jeremy M. Clain Tags: Residents ’ clinic Source Type: research
Parsonage-Turner Syndrome and Hereditary Brachial Plexus Neuropathy
Parsonage-Turner syndrome and hereditary brachial plexus neuropathy (HBPN) present with indistinguishable attacks of rapid-onset severe shoulder and arm pain, disabling weakness, and early muscle atrophy. Their combined incidence ranges from 3 to 100 in 100,000 persons per year. Dominant mutations of SEPT9 are the only known mutations responsible for HBPN. Parsonage and Turner termed the disorder “brachial neuralgic amyotrophy,” highlighting neuropathic pain and muscle atrophy. Modern electrodiagnostic and imaging testing assists the diagnosis in distinction from mimicking disorders. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: James B. Meiling, Andrea J. Boon, Zhiyv Niu, Benjamin M. Howe, Sumedh S. Hoskote, Robert J. Spinner, Christopher J. Klein Tags: Review Source Type: research
Extramedullary Plasmacytoma of the Larynx
Extramedullary plasmacytoma is a rare tumor of plasma cells that arises outside of the bone marrow. These tumors occur in the head and neck in approximately 80% of cases,1 and are more common in men than women.2 Progression of these tumors to multiple myeloma typically portends a poor prognosis.3 (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Tara E. Mokhtari, Peter M. Sadow, Matthew R. Naunheim Tags: Medical image Source Type: research
Thoracic Aortic Aneurysmal Disease: Comprehensive Recommendations for the Primary Care Physician
Thoracic aortic aneurysm (TAA) is a commonly encountered disease that is defined as aortic dilation with an increase in diameter of at least 50% greater than the expected age- and sex-adjusted size. Thoracic aortic aneurysms are described by their size, location, morphology, and cause. Primary care clinicians and other noncardiologists are often the first point of contact for patients with TAA. This review is intended to provide them with basic information on the differential diagnosis, diagnostic evaluation, and medical and surgical management of TAAs. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Prajwal Reddy, Kaavya S. Nair, Vinayak Kumar, Juan M. Bowen, David R. Deyle, Alberto Pochettino, Heidi M. Connolly, Nandan S. Anavekar Tags: Consensus recommendations Source Type: research
Community Engagement Strategies for Underrepresented Racial and Ethnic Populations
The representation of racial and ethnic minority populations in clinical trials continues to be a challenge despite mandates, good intentions, and concerted efforts by funding agencies, regulatory bodies, and researchers to close the clinical trials gap. A lack of diversity in research results in both continued disparities and poorer health outcomes. It is thus imperative that investigators understand and effectively address the challenges of clinical trials participation by underrepresented populations. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Folakemi T. Odedina, Mark L. Wieland, Kim Barbel-Johnson, Jennifer M. Crook Tags: Thematic review on forward thinking on clinical trials in clinical practice Source Type: research
