Pub Date : 2025-02-04DOI: 10.1016/j.mayocp.2024.03.024
Jenny J L Cao, Nader James Al-Shakarchi, Dayne Voelker
{"title":"67-Year-Old Man With Syncope.","authors":"Jenny J L Cao, Nader James Al-Shakarchi, Dayne Voelker","doi":"10.1016/j.mayocp.2024.03.024","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.03.024","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.12.006
Navin Suthahar MD, MSc, PhD, FESC
{"title":"Stroke Survivors With Type 2 Diabetes: Repositioning Pioglitazone in an Era Dominated by Gliflozins","authors":"Navin Suthahar MD, MSc, PhD, FESC","doi":"10.1016/j.mayocp.2024.12.006","DOIUrl":"10.1016/j.mayocp.2024.12.006","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 187-189"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.09.010
Brenden S. Ingraham MD , Marco Valgimigli MD, PhD , Dominick J. Angiolillo MD, PhD , Davide Capodanno MD, PhD , Sunil V. Rao MD, PhD , Philip Urban MD , Mandeep Singh MD, MPH
Bleeding avoidance strategies are critical in the modern era of percutaneous coronary intervention; however, most efforts are geared toward reducing access-related complications. Improvements in procedural techniques (radial access, improved procedural anticoagulation regimens, etc) and modifications in postdischarge pharmacotherapy (shortened dual antiplatelet therapy, genotype-guided P2Y12 inhibition, etc) that led to a decline in bleeding related to percutaneous procedures were largely offset by increases in complexity and performance of percutaneous coronary intervention in high-risk patients. Among patients presenting with acute coronary syndrome, aggressive antiplatelet regimens with potent P2Y12 inhibitors are typically prescribed for a longer duration, prioritizing reduction in ischemic events over bleeding risk. Because postdischarge bleeding connotes an adverse prognosis similar to an ischemic event, postprocedure freedom from adverse outcomes can be best tailored by individualizing and recognizing the patient’s bleeding and ischemic risks. This review of the contemporary and historical literature (PubMed, EMBASE, Cochrane Library) summarizes the available data, provides strategies to navigate these complex decisions, and helps individualize antithrombotic therapy.
{"title":"Relevance of High Bleeding Risk and Postdischarge Bleeding in Patients Undergoing Percutaneous Coronary Intervention","authors":"Brenden S. Ingraham MD , Marco Valgimigli MD, PhD , Dominick J. Angiolillo MD, PhD , Davide Capodanno MD, PhD , Sunil V. Rao MD, PhD , Philip Urban MD , Mandeep Singh MD, MPH","doi":"10.1016/j.mayocp.2024.09.010","DOIUrl":"10.1016/j.mayocp.2024.09.010","url":null,"abstract":"<div><div>Bleeding avoidance strategies are critical in the modern era of percutaneous coronary intervention; however, most efforts are geared toward reducing access-related complications. Improvements in procedural techniques (radial access, improved procedural anticoagulation regimens, etc) and modifications in postdischarge pharmacotherapy (shortened dual antiplatelet therapy, genotype-guided P2Y<sub>12</sub> inhibition, etc) that led to a decline in bleeding related to percutaneous procedures were largely offset by increases in complexity and performance of percutaneous coronary intervention in high-risk patients. Among patients presenting with acute coronary syndrome, aggressive antiplatelet regimens with potent P2Y<sub>12</sub> inhibitors are typically prescribed for a longer duration, prioritizing reduction in ischemic events over bleeding risk. Because postdischarge bleeding connotes an adverse prognosis similar to an ischemic event, postprocedure freedom from adverse outcomes can be best tailored by individualizing and recognizing the patient’s bleeding and ischemic risks. This review of the contemporary and historical literature (PubMed, EMBASE, Cochrane Library) summarizes the available data, provides strategies to navigate these complex decisions, and helps individualize antithrombotic therapy.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 304-331"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.05.032
Rahma Warsame MD , Yong-Hun Kim MD , Melody Y. Ouk MEd , Kristin C. Cole MS , Martha Q. Lacy MD , Sharonne N. Hayes MD , Zamzam Shalle BS , Joyce Balls-Berry PhD , Barbara L. Jordan MS , Alexandra P. Wolanskyj-Spinner MD , Robert J. Spinner MD , Felicity T. Enders PhD
Objective
Evaluate quantitative and qualitative differences by sex and race/ethnic identities in curriculum vitae (CV) of faculty candidates for promotion.
Methods
This was a retrospective, multisite, single-institution study of all candidates who applied to be considered for promotion to associate professor or professor from January 2015 to July 2019. Data on leadership positions, grants, and publications were abstracted from CV using a standardized procedure. Demographic data, including sex, race, and part-time status were obtained from the Human Resources database. Characteristics from CV were compared between groups using χ2 or Fisher exact tests for categorical data, and Kruskal-Wallis tests for continuous data.
Results
A total of 162 women and 300 men applied for associate professorship and 89 women and 231 men applied for professorship. There were 304 White, 112 Asian, and 43 underrepresented in medicine (URM) candidates for associate professorship and 228 White, 68 Asian, and 22 URM candidates for professorship. Women were more likely to work part-time than men (associate professor: 23.5% vs 3.3%, respectively, P<.001; professor: 24.7% vs 5.6%, respectively, P<.001) and had fewer papers published overall (associate professor: median 35 vs 40, respectively, P=.001; professor: median 66 vs 77, respectively, P=.012). White candidates were more likely to have held an elected office to society (13.5% vs 3.6% Asian vs 0% URM, P=.001). Asian candidates were less likely to be a chair/co-chair compared with White individuals and other URMs (3.6% vs 10.9% vs 14.0%, respectively, P=.043). The ratios of candidates for professor-to–associate professor for women and URM was 50% compared with 25% for White men, respectively.
Conclusion
The participants’ CV demonstrated notable differences associated with the candidate’s race/ethnicity and sex.
{"title":"Academic Promotions in Medicine","authors":"Rahma Warsame MD , Yong-Hun Kim MD , Melody Y. Ouk MEd , Kristin C. Cole MS , Martha Q. Lacy MD , Sharonne N. Hayes MD , Zamzam Shalle BS , Joyce Balls-Berry PhD , Barbara L. Jordan MS , Alexandra P. Wolanskyj-Spinner MD , Robert J. Spinner MD , Felicity T. Enders PhD","doi":"10.1016/j.mayocp.2024.05.032","DOIUrl":"10.1016/j.mayocp.2024.05.032","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate quantitative and qualitative differences by sex and race/ethnic identities in curriculum vitae (CV) of faculty candidates for promotion.</div></div><div><h3>Methods</h3><div>This was a retrospective, multisite, single-institution study of all candidates who applied to be considered for promotion to associate professor or professor from January 2015 to July 2019. Data on leadership positions, grants, and publications were abstracted from CV using a standardized procedure. Demographic data, including sex, race, and part-time status were obtained from the Human Resources database. Characteristics from CV were compared between groups using χ<sup>2</sup> or Fisher exact tests for categorical data, and Kruskal-Wallis tests for continuous data.</div></div><div><h3>Results</h3><div>A total of 162 women and 300 men applied for associate professorship and 89 women and 231 men applied for professorship. There were 304 White, 112 Asian, and 43 underrepresented in medicine (URM) candidates for associate professorship and 228 White, 68 Asian, and 22 URM candidates for professorship. Women were more likely to work part-time than men (associate professor: 23.5% vs 3.3%, respectively, <em>P</em><.001; professor: 24.7% vs 5.6%, respectively, <em>P</em><.001) and had fewer papers published overall (associate professor: median 35 vs 40, respectively, <em>P</em>=.001; professor: median 66 vs 77, respectively, <em>P</em>=.012). White candidates were more likely to have held an elected office to society (13.5% vs 3.6% Asian vs 0% URM, <em>P</em>=.001). Asian candidates were less likely to be a chair/co-chair compared with White individuals and other URMs (3.6% vs 10.9% vs 14.0%, respectively, <em>P</em>=.043). The ratios of candidates for professor-to–associate professor for women and URM was 50% compared with 25% for White men, respectively.</div></div><div><h3>Conclusion</h3><div>The participants’ CV demonstrated notable differences associated with the candidate’s race/ethnicity and sex.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 249-264"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.12.008
Margaret R. Wentz BA
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.
{"title":"Historic Logo, Rochester Methodist Hospital by Robert Freeman and Ellerbe Associates, Inc","authors":"Margaret R. Wentz BA","doi":"10.1016/j.mayocp.2024.12.008","DOIUrl":"10.1016/j.mayocp.2024.12.008","url":null,"abstract":"<div><div>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 <em>Mayo Clinic Proceedings</em> features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Page 397"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.09.009
Nicholas V. Nguyen BA , Kirsten A. Riggan MS, MA , Gabriel B. Eber JD, MPH , Brie A. Williams MD, MS , Erin S. DeMartino MD
The United States has one of the highest incarceration rates in the world, with approximately 1.7 million individuals detained in jails or federal or state prisons. Chronic medical conditions are more prevalent among adults in custody than among their nonincarcerated counterparts, resulting in needs that often surpass the on-site medical treatment capabilities of carceral facilities. For this reason, many community-based health care professionals will encounter incarcerated patients in an ambulatory or inpatient setting. Yet, although carceral status engenders pragmatic and ethical complexities in patient care, health care professionals in academic and community settings receive little or no education about correctional health. This special article seeks to address this knowledge gap by providing demographic and patient characteristics of this population, describing health care delivery in the criminal legal system, summarizing incarcerated patients’ health care rights, conveying the current state of oversight and regulation for correctional health care, and presenting the role of health care professionals in advocating for the ethical care of incarcerated patients. By equipping themselves with this knowledge, clinicians may provide holistic and ethical care for persons involved in the criminal legal system.
{"title":"A Primer on Carceral Health for Clinicians: Care Delivery, Regulatory Oversight, Legal and Ethical Considerations, and Clinician Responsibilities","authors":"Nicholas V. Nguyen BA , Kirsten A. Riggan MS, MA , Gabriel B. Eber JD, MPH , Brie A. Williams MD, MS , Erin S. DeMartino MD","doi":"10.1016/j.mayocp.2024.09.009","DOIUrl":"10.1016/j.mayocp.2024.09.009","url":null,"abstract":"<div><div>The United States has one of the highest incarceration rates in the world, with approximately 1.7 million individuals detained in jails or federal or state prisons. Chronic medical conditions are more prevalent among adults in custody than among their nonincarcerated counterparts, resulting in needs that often surpass the on-site medical treatment capabilities of carceral facilities. For this reason, many community-based health care professionals will encounter incarcerated patients in an ambulatory or inpatient setting. Yet, although carceral status engenders pragmatic and ethical complexities in patient care, health care professionals in academic and community settings receive little or no education about correctional health. This special article seeks to address this knowledge gap by providing demographic and patient characteristics of this population, describing health care delivery in the criminal legal system, summarizing incarcerated patients’ health care rights, conveying the current state of oversight and regulation for correctional health care, and presenting the role of health care professionals in advocating for the ethical care of incarcerated patients. By equipping themselves with this knowledge, clinicians may provide holistic and ethical care for persons involved in the criminal legal system.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 292-303"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.12.012
Karl A. Nath MBChB (Editor-in-Chief)
{"title":"In the Limelight: February 2025","authors":"Karl A. Nath MBChB (Editor-in-Chief)","doi":"10.1016/j.mayocp.2024.12.012","DOIUrl":"10.1016/j.mayocp.2024.12.012","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 175-177"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2024.12.010
Fredric B. Meyer MD, Rafael Fonseca MD
{"title":"Mayo Clinic Proceedings and Medical Education—Medical Journals as the Partitur of Medical Knowledge","authors":"Fredric B. Meyer MD, Rafael Fonseca MD","doi":"10.1016/j.mayocp.2024.12.010","DOIUrl":"10.1016/j.mayocp.2024.12.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 178-180"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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