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Mayo Clinic Proceedings

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https://www.readbyqxmd.com/read/29141774/47-year-old-man-with-abdominal-pain-and-diarrhea
#1
Don Chamil Codipilly, Victor Chedid, Arthur Beyder
No abstract text is available yet for this article.
November 12, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29141773/47-year-old-woman-with-anemia-and-thrombocytopenia
#2
Praful Ravi, Roberto Leon-Ferre, Carrie A Thompson
No abstract text is available yet for this article.
November 12, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29108842/increased-risk-of-multimorbidity-in-patients-with-sarcoidosis-a-population-based-cohort-study-1976-to-2013
#3
Patompong Ungprasert, Eric L Matteson, Cynthia S Crowson
OBJECTIVE: To evaluate the risk and pattern of multimorbidity in patients with sarcoidosis. PATIENTS AND METHODS: A cohort of all residents of Olmsted County, Minnesota, first diagnosed with sarcoidosis between January 1, 1976, and December 31, 2013, was identified through the medical record linkage system of the Rochester Epidemiology Project. Diagnosis was verified by individual medical record review. A cohort of sex- and age-matched comparators without sarcoidosis was assembled from the same population...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29108841/a-conceptual-framework-for-understanding-unintended-prolonged-opioid-use
#4
W Michael Hooten, Chad M Brummett, Mark D Sullivan, Jenna Goesling, Jon C Tilburt, Jessica S Merlin, Jennifer L St Sauver, Ajay D Wasan, Daniel J Clauw, David O Warner
An urgent need exists to better understand the transition from short-term opioid use to unintended prolonged opioid use (UPOU). The purpose of this work is to propose a conceptual framework for understanding UPOU that posits the influence of 3 principal domains that include the characteristics of (1) individual patients, (2) the practice environment, and (3) opioid prescribers. Although no standardized method exists for developing a conceptual framework, the process often involves identifying corroborative evidence, leveraging expert opinion to identify factors for inclusion in the framework, and developing a graphic depiction of the relationships between the various factors and the clinical problem of interest...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29108840/use-of-the-coronary-artery-calcium-score-in-discussion-of-initiation-of-statin-therapy-in-primary-prevention
#5
Erin D Michos, Michael J Blaha, Roger S Blumenthal
Clinical guidelines for instituting pharmacotherapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD), specifically lipid management and aspirin, have long been based on absolute risk. However, lipid management in the current era remains challenging to both patients and clinicians in the setting of somewhat discordant recommendations from various organizations. All guidelines endorse the use of statins for primary prevention for those at sufficient absolute risk, and treatment recommendations are generally "risk-based" rather than exclusively targeting specific low-density lipoprotein cholesterol levels...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29110886/the-incidence-of-primary-vs-secondary-focal-segmental-glomerulosclerosis-a-clinicopathologic-study
#6
Musab S Hommos, An S De Vriese, Mariam P Alexander, Sanjeev Sethi, Lisa Vaughan, Ladan Zand, Kharmen Bharucha, Nicola Lepori, Andrew D Rule, Fernando C Fervenza
OBJECTIVES: To describe the change in the incidence rates of primary and secondary focal segmental glomerulosclerosis (FSGS) from 1994 through 2013 in Olmsted County, Minnesota, and to identify the clinical and biopsy characteristics that distinguish primary from secondary FSGS. PATIENTS AND METHODS: Olmsted County adult residents with native kidney biopsy from January 1, 1994, through December 31, 2013, and FSGS as the only glomerulopathy were identified. The clinical and pathologic characterstics of primary and secondary FSGS were described and compared, and incidence rates were calculated...
October 27, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101944/wolf-hat-by-preston-singletary
#7
Margaret R Wentz
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.
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101943/thalassemia-and-thomas-benton-cooley
#8
Salahuddin Siddiqui, David P Steensma, Robert A Kyle
No abstract text is available yet for this article.
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101942/gestational-trophoblastic-disease
#9
J Kenneth Schoolmeester, Lori A Erickson
No abstract text is available yet for this article.
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101941/brunner-gland-adenoma
#10
Lucas X Marinacci, Farrin A Manian
No abstract text is available yet for this article.
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101940/rem-sleep-behavior-disorder-diagnosis-clinical-implications-and-future-directions
#11
REVIEW
Erik K St Louis, Bradley F Boeve
Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especially synucleinopathies such as Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. A history of RBD may begin several years to decades before onset of any clear daytime symptoms of motor, cognitive, or autonomic impairments, suggesting that RBD is the presenting manifestation of a neurodegenerative process...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101939/pharmacogenomics-precision-medicine-and-drug-response
#12
REVIEW
Richard M Weinshilboum, Liewei Wang
Pharmacogenomics is the use of genomic and other "omic" information to individualize drug selection and drug use to avoid adverse drug reactions and to maximize drug efficacy. The science underlying pharmacogenomics has evolved rapidly over the 50 years since it was first suggested that genetics might influence drug response phenotypes. That process has occurred in parallel with advances in DNA sequencing and other molecular technologies, with striking increases in our understanding of the human genome. There are now many validated examples of the clinical utility of pharmacogenomics, and this type of clinical genomic information is increasingly being generated in clinical laboratories, incorporated into electronic health records, and used to "tailor" or individualize drug therapy...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101938/practical-considerations-for-the-diagnosis-and-management-of-asthma-in-older-adults
#13
REVIEW
Barbara P Yawn, MeiLan K Han
Although often considered a disease of childhood, the prevalence of asthma in US adults aged 65 years or older is similar to that in children, with the number of older patients needing care for asthma likely to continue to increase. As with most chronic diseases, there are challenges associated with the diagnosis and management of asthma in an older population. This review discusses these challenges, suggesting practical management strategies for primary care physicians and their teams. Asthma comprises a spectrum of phenotypes, some associated with adult onset...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101937/an-organization-model-to-assist-individual-physicians-scientists-and-senior-health-care-administrators-with-personal-and-professional-needs
#14
REVIEW
Tait D Shanafelt, Deborah J Lightner, Christopher R Conley, Steven P Petrou, Jarrett W Richardson, Pamela J Schroeder, William A Brown
Working as a physician, scientist, or senior health care administrator is a demanding career. Studies have demonstrated that burnout and other forms of distress are common among individuals in these professions, with potentially substantive personal and professional consequences. In addition to system-level interventions to promote well-being globally, health care organizations must provide robust support systems to assist individuals in distress. Here, we describe the 15-year experience of the Mayo Clinic Office of Staff Services (OSS) providing peer support to physicians, scientists, and senior administrators at one center...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101936/propofol-frenzy-clinical-spectrum-in-3-patients
#15
Diego Z Carvalho, Ryan A Townley, Christopher M Burkle, Alejandro A Rabinstein, Eelco F M Wijdicks
Postsedation neuroexcitation is sometimes attributed to intravenous injection of the sedative-hypnotic drug propofol. The movements associated with these events have strongly suggested convulsive activity, but they rarely have been comprehensively evaluated. We present video recordings of 3 healthy young patients who underwent elective surgery under conscious sedation and emerged from sedation with transient but repetitive violent motor activity and impaired consciousness. These manifestations required considerable mobilization of multiple health care workers to protect the patient from inflicting harm...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101935/the-association-of-serum-free-light-chains-with-mortality-and-progression-to-end-stage-renal-disease-in-chronic-kidney-disease-systematic-review-and-individual-patient-data-meta-analysis
#16
Simon D S Fraser, Anthony Fenton, Scott Harris, Adam Shardlow, Sophie Liabeuf, Ziad A Massy, Anne Burmeister, Colin A Hutchison, Martin Landray, Jonathan Emberson, Phil Kalra, James P Ritchie, Paul Cockwell, Maarten W Taal
OBJECTIVE: To clarify the associations between polyclonal serum free light chain (sFLC) levels and adverse outcomes in patients with chronic kidney disease (CKD) by conducting a systematic review and individual patient data meta-analyses. PATIENTS AND METHODS: On December 28, 2016, we searched 4 databases (MEDLINE, Embase, CINAHL, and PubMed) and conference proceedings for studies presenting independent analyses of associations between sFLC levels and mortality or progression to end-stage renal disease (ESRD) in patients with CKD...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101934/effect-of-cardiac-rehabilitation-dose-on-mortality-and-morbidity-a-systematic-review-and-meta-regression-analysis
#17
Carolina Santiago de Araújo Pio, Susan Marzolini, Maureen Pakosh, Sherry L Grace
OBJECTIVE: To ascertain the effect of cardiac rehabilitation (CR) dose (ie, duration × frequency/wk; categorized as low [<12 sessions], medium [12-35 sessions], or high [≥36 sessions]) on mortality and morbidity. METHODS: The Cochrane, CINAHL, EMBASE, PsycINFO, and MEDLINE databases were systematically searched from inception through November 30, 2015. Inclusion criteria included randomized or nonrandomized studies with a minimum CR dose of 4 or higher and presence of a control/comparison group...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101933/extremely-elevated-erythrocyte-sedimentation-rates-associations-with-patients-diagnoses-demographic-characteristics-and-comorbidities
#18
Lisa M Daniels, Pritish K Tosh, Justin A Fiala, Cathy D Schleck, Jay N Mandrekar, Thomas J Beckman
OBJECTIVE: To study associations between extreme erythrocyte sedimentation rate (ESR) elevations (≥100 mm/h) and diseases, age, sex, race, Charlson Comorbidity Index (CCI), and C-reactive protein (CRP) level. PATIENTS AND METHODS: This was a retrospective cohort study of 4807 patients with extreme ESR values examined at Mayo Clinic, Rochester, Minnesota, from January 1, 2002, through December 31, 2011. Independent variables included diseases (infection, autoimmune, malignancy, renal disease, or miscellaneous), subcategories of diseases, patient demographic characteristics (age, sex, and race), CRP level, and CCI...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101932/professional-satisfaction-and-the-career-plans-of-us-physicians
#19
Christine A Sinsky, Lotte N Dyrbye, Colin P West, Daniel Satele, Michael Tutty, Tait D Shanafelt
OBJECTIVE: To evaluate the relationship between burnout, satisfaction with electronic health records and work-life integration, and the career plans of US physicians. PARTICIPANTS AND METHODS: Physicians across all specialties in the United States were surveyed between August 28, 2014, and October 6, 2014. Physicians provided information regarding the likelihood of reducing clinical hours in the next 12 months and the likelihood of leaving current practice within the next 24 months...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101931/safety-and-efficacy-of-fecal-microbiota-transplant-for-recurrent-clostridium-difficile-infection-in-patients-with-cancer-treated-with-cytotoxic-chemotherapy-a-single-institution-retrospective-case-series
#20
Mehrdad Hefazi, Mrinal M Patnaik, William J Hogan, Mark R Litzow, Darrell S Pardi, Sahil Khanna
OBJECTIVE: To study the safety and efficacy of fecal microbiota transplant (FMT) for Clostridium difficile infection (CDI) in patients with cancer treated with cytotoxic chemotherapy in a single-institution retrospective case series. PATIENTS AND METHODS: Twenty-three consecutive patients with underlying hematologic (n=13) or solid (n=10) malignancies who underwent FMT for recurrent CDI from August 1, 2012, through June 30, 2016, were studied. RESULTS: All the patients had received cytotoxic chemotherapy a median of 12 months (range, 1-340 months) before FMT...
November 2017: Mayo Clinic Proceedings
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