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
Multiple Esophageal Diverticula in Achalasia
A woman in her late 60s presented with a 40-year history of progressively worsening dysphagia to solids and liquids and regurgitation. Timed barium esophagography showed dilated and distorted mid-distal esophagus with beaking of the lower esophageal sphincter (LES; Supplemental Figure 1, available online at http://www.mayoclinicproceedings.org) and evidence of esophageal barium retention (Figure 1). Esophageal manometry showed incomplete LES relaxation (integrated relaxation pressure of 23.9 mm Hg) and panesophageal pressurization consistent with type II achalasia (Supplementa l Figure 2, available online at http://www...
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Amrit K. Kamboj, Alex Chan, D. Chamil Codipilly Tags: Medical image Source Type: research
Dolichoectatic Basilar Artery Causing Trigeminal Neuralgia
A patient in their late 60s presented to our community neurology clinic because of a 1-year history of paroxysms of “shooting” pain in the right maxillary division of the trigeminal nerve (V2), occurring hundreds of times a day, made worse with chewing, drinking, and brushing teeth. Multiple medications for neuropathic pain due to trigeminal neuralgia (TN) were trialed, with partial response to lamotrigine. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Ryan P. Coburn, Karen A. Truitt, David R. DeLone Tags: Medical image Source Type: research
Outcomes From a Physician Health Center
We report personal and professional demographics and types of medical conditions in this cohort. An ordinal logistic regression analysis was used to identify factors associated with occupational outcomes. Physicians in a wide variety of specialties from 34 different states presented for evaluation of diverse medical problems. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Melanie D. Swift, Gregory P. Couser, Philip T. Hagen, Mitchell A. Nelson, Clayton T. Cowl, M. Hassan Murad Tags: Brief report Source Type: research
Does the Expanded Controlled Evidence Now Mandate the Routine Use of Machine Perfusion in Kidney Transplantation?
The quality of donor kidneys may be improved by taking therapeutic measures that begin before transplant. A recent large-scale prospective trial from the United States by Malinoski et al1 reported that machine perfusion (MP) was superior to targeted donor hypothermia in reducing delayed graft function (DGF) after kidney transplant from a brain-dead donor (DBD). Delayed graft function was defined as need for dialysis during the first 7 days after transplant. However, the trial f ound no measurable effect on 1-year graft survival. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Peter Schnuelle, Bernhard K. Kr ämer Tags: Perspectives and controversies Source Type: research
Real-World Clinical Equivalence of Generic and Branded Tofacitinib: A Prospective Longitudinal Cohort Study in Patients With Rheumatoid Arthritis
To explore the clinical efficacy and safety of generic tofacitinib vs brand name tofacitinib in patients with rheumatoid arthritis (RA) in a single-center comparative study based on a prospective real-world cohort. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Juan Zhao, Hong Huang, Yu Wang, Xuerong Deng, Yan Geng, Xiaohui Zhang, Lanlan Ji, Zhibo Song, Zhuoli Zhang Tags: Original article Source Type: research
Impact of Thyroid Status on Incident Kidney Dysfunction and Chronic Kidney Disease Progression in a Nationally Representative Cohort
To examine the relationship between thyroid status and incident kidney dysfunction/chronic kidney disease (CKD) progression. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Amy S. You, Kamyar Kalantar-Zadeh, Gregory A. Brent, Yoko Narasaki, Andrea Daza, John J. Sim, Csaba P. Kovesdy, Danh V. Nguyen, Connie M. Rhee Tags: Original article Source Type: research
Blood Volume Explains the Relationship of Lean Body Mass With the Cardiovascular System in Men but Not in Women
Lean body mass (LBM) and the functional capacity of the cardiovascular (CV) system, including the strongest prognostic factors for mortality, were recently discovered to constitute a robust relationship in humans.1-3 Essentially any fundamental phenotypic attribute of the main pumping chamber (ie, the left ventricle) determining the capacity to deliver and consume oxygen is associated with LBM independently of adiposity and established CV risk factors.1-3 Thus far, these findings apply to European American women and Hans Chinese women and men, the latter being characterized by low (female-like) LBM. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Meihan Guo, Candela Diaz-Canestro, David Montero Tags: Research letter to the editor Source Type: research
Pancreatic Neuroendocrine Tumor in a Patient With Multiple Endocrine Neoplasia Type 4
A man in his 50s, with a history of elevated prolactin and primary hyperparathyroidism, was found to have a pancreatic lesion. He underwent a distal pancreatectomy, and histopathologic evaluation revealed a grade 2, well-differentiated neuroendocrine tumor forming a 3.5-cm mass (Figure 1). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - January 1, 2024 Category: Internal Medicine Authors: Sounak Gupta, Rumeal D. Whaley, Lori A. Erickson Tags: Path to patient image quiz Source Type: research
Animals in Habitat by Sue Tirrell
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 - January 1, 2024 Category: Internal Medicine Authors: Margaret R. Wentz Tags: Art at Mayo clinic Source Type: research
