Pub Date : 2024-11-01DOI: 10.1016/j.mayocp.2024.08.018
William Yang MPH, Sounak Gupta MBBS, PhD, Lori A. Erickson MD
{"title":"Retroperitoneal Lymphadenopathy in a Patient With a History of Multiple Primary Malignant Neoplasms","authors":"William Yang MPH, Sounak Gupta MBBS, PhD, Lori A. Erickson MD","doi":"10.1016/j.mayocp.2024.08.018","DOIUrl":"10.1016/j.mayocp.2024.08.018","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1844-1845"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569105","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.05.021
Rosalie M. Sterner PhD, Jennifer L. Herrick MD
{"title":"Unusual Osteoclast-like Plasma Cells in a Case of IgA Lambda Light Chain-Restricted Myeloma","authors":"Rosalie M. Sterner PhD, Jennifer L. Herrick MD","doi":"10.1016/j.mayocp.2024.05.021","DOIUrl":"10.1016/j.mayocp.2024.05.021","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1771-1772"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381255","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.06.009
Sarina Schrager MD, MS , Elizabeth S. Burnside MD, MPH, MS
{"title":"Response to the New USPSTF Recommendations on Breast Cancer Screening","authors":"Sarina Schrager MD, MS , Elizabeth S. Burnside MD, MPH, MS","doi":"10.1016/j.mayocp.2024.06.009","DOIUrl":"10.1016/j.mayocp.2024.06.009","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1689-1692"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469474","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.08.008
Abraham Morgentaler MD , Sandeep Dhindsa MD , Adrian S. Dobs MD , Geoff Hackett MD , T. Hugh Jones MD , Robert A. Kloner MD , Martin Miner MD , Michael Zitzmann MD, PhD , Abdulmaged M. Traish PhD
The Androgen Society is an international, multidisciplinary medical organization committed to advancing research and education in the field of testosterone deficiency and testosterone therapy (TTh). This position paper is written in response to results of the TRAVERSE study, published in June 2023, which reported no increased risk of major adverse cardiovascular events (MACE) in men who received TTh compared with placebo.
In 2013-2014, 2 observational studies reported increased cardiovascular (CV) risks with TTh and received wide media attention. Despite strong criticism of those 2 studies, in 2015, the Food and Drug Administration added a CV warning to testosterone product labels and required pharmaceutical companies to perform a CV safety study, which became the TRAVERSE trial.
TRAVERSE enrolled 5246 men at high risk for MACE based on existing heart disease or multiple risk factors. Participants were randomized to daily testosterone gel or placebo gel, with a mean follow-up of 33 months. Results revealed no greater risk of MACE (myocardial infarction, stroke, or CV death) or venothrombotic events in men who received TTh compared with placebo.
Review of the prior literature reveals near uniformity of studies reporting no increased MACE with TTh. This includes 2 additional large randomized controlled trials, multiple smaller randomized controlled trials, several large observational studies, and 19 meta-analyses.
In view of these findings, it is the position of the Androgen Society that it has now been conclusively determined that TTh is not associated with increased risks of heart attack, stroke, or CV death.
{"title":"Androgen Society Position Paper on Cardiovascular Risk With Testosterone Therapy","authors":"Abraham Morgentaler MD , Sandeep Dhindsa MD , Adrian S. Dobs MD , Geoff Hackett MD , T. Hugh Jones MD , Robert A. Kloner MD , Martin Miner MD , Michael Zitzmann MD, PhD , Abdulmaged M. Traish PhD","doi":"10.1016/j.mayocp.2024.08.008","DOIUrl":"10.1016/j.mayocp.2024.08.008","url":null,"abstract":"<div><div>The Androgen Society is an international, multidisciplinary medical organization committed to advancing research and education in the field of testosterone deficiency and testosterone therapy (TTh). This position paper is written in response to results of the TRAVERSE study, published in June 2023, which reported no increased risk of major adverse cardiovascular events (MACE) in men who received TTh compared with placebo.</div><div>In 2013-2014, 2 observational studies reported increased cardiovascular (CV) risks with TTh and received wide media attention. Despite strong criticism of those 2 studies, in 2015, the Food and Drug Administration added a CV warning to testosterone product labels and required pharmaceutical companies to perform a CV safety study, which became the TRAVERSE trial.</div><div>TRAVERSE enrolled 5246 men at high risk for MACE based on existing heart disease or multiple risk factors. Participants were randomized to daily testosterone gel or placebo gel, with a mean follow-up of 33 months. Results revealed no greater risk of MACE (myocardial infarction, stroke, or CV death) or venothrombotic events in men who received TTh compared with placebo.</div><div>Review of the prior literature reveals near uniformity of studies reporting no increased MACE with TTh. This includes 2 additional large randomized controlled trials, multiple smaller randomized controlled trials, several large observational studies, and 19 meta-analyses.</div><div>In view of these findings, it is the position of the Androgen Society that it has now been conclusively determined that TTh is not associated with increased risks of heart attack, stroke, or CV death.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1785-1801"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469469","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.09.003
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":"Branch, Sunflower, Grass, Butterfly, Kelp, Daisy by Erin Moran","authors":"Margaret R. Wentz BA","doi":"10.1016/j.mayocp.2024.09.003","DOIUrl":"10.1016/j.mayocp.2024.09.003","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":"99 11","pages":"Pages 1848-1849"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571662","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.07.017
Sherry X. Ge NP-C, Thomas D. Atwell MD, Michael C. Jundt MD
{"title":"Renal Angiography Serves as a Crucial Diagnostic Tool in Determining Complexity and Treatment Plan of Renal Arteriovenous Malformation","authors":"Sherry X. Ge NP-C, Thomas D. Atwell MD, Michael C. Jundt MD","doi":"10.1016/j.mayocp.2024.07.017","DOIUrl":"10.1016/j.mayocp.2024.07.017","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1840-1841"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569104","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.07.004
Jonathan Myers PhD , Peter Kokkinos PhD , Cristina Cadenas-Sanchez PhD , Angelike Liappis MD , Carl J. Lavie MD , Navjit K. Goraya MD , Amy Weintrob MD , Andreas Pittaras MD , Alexandros Ladas MD , Michael Heimall MS , Charles Faselis MD
Objective
To assess the association between cardiorespiratory fitness (CRF) and COVID-19–related health outcomes including mortality, hospitalization, and mechanical ventilation.
Patients and Methods
In a retrospective analysis of 750,302 patients included in the Exercise Testing and Health Outcomes Study, we identified 23,140 who had a positive result on COVID-19 testing between March 2020 and September 2021 and underwent a maximal exercise test in the Veterans Affairs Health Care System between October 1, 1999 to September 3, 2020. The association between CRF and risk for severe COVID-19 outcomes, including mortality, hospitalization due to COVID-19, and need for intubation was assessed after adjustment for 15 covariates. Patients were stratified into 5 age-specific CRF categories (Least-Fit, Low-Fit, Moderate-Fit, Fit, and High-Fit), based on peak metabolic equivalents achieved.
Results
During a median of follow-up of 100 days, 1643 of the 23,140 patients (7.1%) died, 4995 (21.6%) were hospitalized, and 927 (4.0%) required intubation for COVID-19–related reasons. When compared with the Least-Fit patients (referent), the Low-Fit, Moderate-Fit, Fit, and High-Fit patients had hazard ratios for mortality of 0.82 (95% CI, 0.72 to 0.93), 0.73 (95% CI, 0.63 to 0.86), 0.61 (95% CI, 0.53 to 0.72), and 0.54 (95% CI, 0.45 to 0.65), respectively. Patients who were more fit also had substantially lower need for hospital admissions and intubation. Similar patterns were observed for elderly patients and subgroups with comorbidities including hypertension, diabetes, cardiovascular disease, and chronic kidney disease; for each of these conditions, those in the High-Fit category had mortality rates that were roughly half those in the Low-Fit category.
Conclusion
Among patients positive for COVID-19, higher CRF had a favorable impact on survival, need for hospitalization, and need for intubation regardless of age, body mass index, or the presence of comorbidities.
{"title":"Impact of Cardiorespiratory Fitness on COVID-19–Related Outcomes: The Exercise Testing and Health Outcomes Study (ETHOS)","authors":"Jonathan Myers PhD , Peter Kokkinos PhD , Cristina Cadenas-Sanchez PhD , Angelike Liappis MD , Carl J. Lavie MD , Navjit K. Goraya MD , Amy Weintrob MD , Andreas Pittaras MD , Alexandros Ladas MD , Michael Heimall MS , Charles Faselis MD","doi":"10.1016/j.mayocp.2024.07.004","DOIUrl":"10.1016/j.mayocp.2024.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between cardiorespiratory fitness (CRF) and COVID-19–related health outcomes including mortality, hospitalization, and mechanical ventilation.</div></div><div><h3>Patients and Methods</h3><div>In a retrospective analysis of 750,302 patients included in the Exercise Testing and Health Outcomes Study, we identified 23,140 who had a positive result on COVID-19 testing between March 2020 and September 2021 and underwent a maximal exercise test in the Veterans Affairs Health Care System between October 1, 1999 to September 3, 2020. The association between CRF and risk for severe COVID-19 outcomes, including mortality, hospitalization due to COVID-19, and need for intubation was assessed after adjustment for 15 covariates. Patients were stratified into 5 age-specific CRF categories (Least-Fit, Low-Fit, Moderate-Fit, Fit, and High-Fit), based on peak metabolic equivalents achieved.</div></div><div><h3>Results</h3><div>During a median of follow-up of 100 days, 1643 of the 23,140 patients (7.1%) died, 4995 (21.6%) were hospitalized, and 927 (4.0%) required intubation for COVID-19–related reasons. When compared with the Least-Fit patients (referent), the Low-Fit, Moderate-Fit, Fit, and High-Fit patients had hazard ratios for mortality of 0.82 (95% CI, 0.72 to 0.93), 0.73 (95% CI, 0.63 to 0.86), 0.61 (95% CI, 0.53 to 0.72), and 0.54 (95% CI, 0.45 to 0.65), respectively. Patients who were more fit also had substantially lower need for hospital admissions and intubation. Similar patterns were observed for elderly patients and subgroups with comorbidities including hypertension, diabetes, cardiovascular disease, and chronic kidney disease; for each of these conditions, those in the High-Fit category had mortality rates that were roughly half those in the Low-Fit category.</div></div><div><h3>Conclusion</h3><div>Among patients positive for COVID-19, higher CRF had a favorable impact on survival, need for hospitalization, and need for intubation regardless of age, body mass index, or the presence of comorbidities.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1744-1755"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145956","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 : 2024-11-01DOI: 10.1016/j.mayocp.2024.02.018
Objective
To examine the cardiovascular disease (CVD)–related death trends and the relationship between CVD deaths and sex, race/ethnicity, and income in California from January 1, 1999, to December 31, 2021.
Methods
The age-adjusted death rate (AADR) per 100,000 population attributable to ischemic heart disease (IHD), hypertensive heart disease (HHD) and heart failure (HF), stroke, and CVD combined were calculated using CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) for California, 1999 to 2021. We used a joinpoint log-linear regression model to determine trends in CVD death. Income disparities were assessed using the slope index of inequality and health concentration index.
Results
Between 1999 and 2021, overall death rates for CVD decreased significantly (average annual percent change, −2.2% [95% confidence interval: -2.6%, -1.7%]), IHD (−3.7% [-4.3%, -3.1%]), and stroke (−2.0% [-2.8%, -1.2%]) and increased for HHD (2.0% [0.6%, 3.5%]) and HF (2.0% [1.3%, 2.7%]). The AADR of combined CVD first decreased significantly (1999-2014; all P<.001), then increased significantly after COVID-19 (P=.02). The AADR of IHD decreased significantly (1999-2019; all P<.001) and then increased after the COVID-19 pandemic but was not statistically significant (P=.15). The AADR of HHD (2014-2021) and HF (2013-2021) increased significantly (all P<.001), and this increase accelerated after COVID-19. The AADR of stroke decreased (1999-2009), then increased after COVID-19 but was not statistically significant (P=.07). Our results revealed significant disparities with CVD death being disproportionately higher among male, non-Hispanic Black, American Indian or Alaska Native, Native Hawaiian or Pacific Islander, Asian, and poorer populations.
Conclusion
All the death rates that were decreasing, stagnant, or increasing prior to the COVID-19 pandemic increased after the pandemic. We found increasingly adverse outcomes among the poor and racial/ethnic minority populations.
{"title":"Trends in California Cardiovascular Disease Mortality: Sex–Race/Ethnicity Disparity and Income Inequality","authors":"","doi":"10.1016/j.mayocp.2024.02.018","DOIUrl":"10.1016/j.mayocp.2024.02.018","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the cardiovascular disease (CVD)–related death trends and the relationship between CVD deaths and sex, race/ethnicity, and income in California from January 1, 1999, to December 31, 2021.</div></div><div><h3>Methods</h3><div><span>The age-adjusted death rate (AADR) per 100,000 population attributable to </span>ischemic heart disease<span> (IHD), hypertensive heart disease (HHD) and heart failure (HF), stroke, and CVD combined were calculated using CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) for California, 1999 to 2021. We used a joinpoint log-linear regression model to determine trends in CVD death. Income disparities were assessed using the slope index of inequality and health concentration index.</span></div></div><div><h3>Results</h3><div>Between 1999 and 2021, overall death rates for CVD decreased significantly (average annual percent change, −2.2% [95% confidence interval: -2.6%, -1.7%]), IHD (−3.7% [-4.3%, -3.1%]), and stroke (−2.0% [-2.8%, -1.2%]) and increased for HHD (2.0% [0.6%, 3.5%]) and HF (2.0% [1.3%, 2.7%]). The AADR of combined CVD first decreased significantly (1999-2014; all <em>P</em><em><.001</em>), then increased significantly after COVID-19 (<em>P</em>=.02). The AADR of IHD decreased significantly (1999-2019; all <em>P</em><em><.001</em>) and then increased after the COVID-19 pandemic but was not statistically significant (<em>P</em>=.15). The AADR of HHD (2014-2021) and HF (2013-2021) increased significantly (all <em>P</em><em><.001</em>), and this increase accelerated after COVID-19. The AADR of stroke decreased (1999-2009), then increased after COVID-19 but was not statistically significant (<em>P</em><span>=.07). Our results revealed significant disparities with CVD death being disproportionately higher among male, non-Hispanic Black, American Indian<span> or Alaska Native<span>, Native Hawaiian or Pacific Islander, Asian, and poorer populations.</span></span></span></div></div><div><h3>Conclusion</h3><div>All the death rates that were decreasing, stagnant, or increasing prior to the COVID-19 pandemic increased after the pandemic. We found increasingly adverse outcomes among the poor and racial/ethnic minority populations.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 11","pages":"Pages 1756-1770"},"PeriodicalIF":6.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912272","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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