Pub Date : 2025-02-01DOI: 10.1016/j.mayocp.2025.01.010
Karl A. Nath MBChB
{"title":"Highlights from the Current Issue – Audiovisual Summary","authors":"Karl A. Nath MBChB","doi":"10.1016/j.mayocp.2025.01.010","DOIUrl":"10.1016/j.mayocp.2025.01.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Page e1"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135132","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.2024.10.007
Camilla Mattiuzzi MD , Giuseppe Lippi MD
{"title":"Twenty-Four Years of Lung Cancer Mortality in the United States","authors":"Camilla Mattiuzzi MD , Giuseppe Lippi MD","doi":"10.1016/j.mayocp.2024.10.007","DOIUrl":"10.1016/j.mayocp.2024.10.007","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 2","pages":"Pages 388-389"},"PeriodicalIF":6.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008079","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}
Objective: To examine the association between a positive family history (parents, siblings, and grandparents) of type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia and their prevalence and incidence in the same population.
Patients and methods: Data on 41,361 participants who underwent health examinations between January 1, 1997, and December 31, 2007, were analyzed, and the results of logistic and Cox regression analyses in the same cohort were examined.
Results: Cross-sectional analyses showed that the prevalence of all three diseases increased with a positive family history, especially T2DM, with an odds ratio (OR) of 12.00 (95% CI, 7.82 to 18.41) when the number of affected relatives was greater than or equal to 3 with an OR of 20.43 (95% CI, 11.0 to 37.8) for a positive family history across three generations compared with no family history. However, redefining family history from "parents, siblings, and grandparents" to "parents and siblings" or "parents only" did not significantly change ORs for each disease. Among those with a positive family history and body mass index greater than or equal to 30.0 kg/m2 hypertension was 19 times more prevalent compared with no family history and body mass index of 18.5 to 24.9 kg/m2. In the longitudinal study, family history strongly influenced incident T2DM (hazard ratio[HR], 2.40; 95% CI, 1.93 to 2.98), hypertension (HR, 1.43; 95% CI, 1.26 to 1.62), and dyslipidemia (HR, 1.41; 95% CI, 1.08 to 1.83), respectively.
Conclusion: Obtaining a family history of these diseases was useful in identifying high-risk groups. Also, for T2DM, the influence of a positive family history was strongest with a marked increase in risk with overlap of affected family members, suggesting that a family history is useful for early detection and prevention.
{"title":"Cross-sectional and Longitudinal Associations Between Family History of Type 2 Diabetes Mellitus, Hypertension, and Dyslipidemia and Their Prevalence and Incidence: Toranomon Hospital Health Management Center Study (TOPICS24).","authors":"Izumi Ikeda, Risa Igarashi, Kazuya Fujihara, Yasunaga Takeda, Efrem d'Ávila Ferreira, Khin Lay Mon, Satoru Kodama, Yasumichi Mori, Takashi Kadowaki, Ritsuko Honda, Yasuji Arase, Hirohito Sone","doi":"10.1016/j.mayocp.2024.10.020","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.10.020","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between a positive family history (parents, siblings, and grandparents) of type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia and their prevalence and incidence in the same population.</p><p><strong>Patients and methods: </strong>Data on 41,361 participants who underwent health examinations between January 1, 1997, and December 31, 2007, were analyzed, and the results of logistic and Cox regression analyses in the same cohort were examined.</p><p><strong>Results: </strong>Cross-sectional analyses showed that the prevalence of all three diseases increased with a positive family history, especially T2DM, with an odds ratio (OR) of 12.00 (95% CI, 7.82 to 18.41) when the number of affected relatives was greater than or equal to 3 with an OR of 20.43 (95% CI, 11.0 to 37.8) for a positive family history across three generations compared with no family history. However, redefining family history from \"parents, siblings, and grandparents\" to \"parents and siblings\" or \"parents only\" did not significantly change ORs for each disease. Among those with a positive family history and body mass index greater than or equal to 30.0 kg/m<sup>2</sup> hypertension was 19 times more prevalent compared with no family history and body mass index of 18.5 to 24.9 kg/m<sup>2</sup>. In the longitudinal study, family history strongly influenced incident T2DM (hazard ratio[HR], 2.40; 95% CI, 1.93 to 2.98), hypertension (HR, 1.43; 95% CI, 1.26 to 1.62), and dyslipidemia (HR, 1.41; 95% CI, 1.08 to 1.83), respectively.</p><p><strong>Conclusion: </strong>Obtaining a family history of these diseases was useful in identifying high-risk groups. Also, for T2DM, the influence of a positive family history was strongest with a marked increase in risk with overlap of affected family members, suggesting that a family history is useful for early detection and prevention.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080599","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 : 2025-01-01DOI: 10.1016/j.mayocp.2024.11.017
David P. Steensma MD
{"title":"The “Dear Doctor” Postcards of the 1950s and 1960s: An Advertising Method With A Global Philatelic Flair","authors":"David P. Steensma MD","doi":"10.1016/j.mayocp.2024.11.017","DOIUrl":"10.1016/j.mayocp.2024.11.017","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 1","pages":"Pages 171-172"},"PeriodicalIF":6.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927492","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 : 2025-01-01DOI: 10.1016/j.mayocp.2024.08.010
Steven P. Cohen MD , Winnie L. Liu BS , Tina L. Doshi MD, MHS , Eric J. Wang MD , Evelien van Gelderen BS , Resham Mawalkar BS , Eellan Sivanesan MD , Kayode A. Williams MD, MBA , Paul J. Christo MD, MBA , Shravani Durbhakula MD, MPH, MBA , Glenn Treisman MD , Annie Hsu MD
Objective
To determine variables associated with difficult clinical encounters.
Patients and Methods
This was a cross-sectional study of 428 new patients evaluated from 2022 to 2023. Demographic, clinical, social (eg, missed appointments, prior felony conviction, prior pain physicians, medical assistance) and visit-related (eg, visit took longer than expected, difficulty communicating) information was recorded, supplemented by in-person history gathered by the trainee and attending whose demographic data were also recorded. Physicians independently rated the “difficulty” of the encounter on a 6-point Likert scale from 1 = very easy/pleasant, 2 = easy/pleasant, 3 = neutral/average, 4 = difficult, 5 = very difficult, to 6 = extremely difficult. A difficult encounter was a combined trainee and attending rating of one IQR above the median of 2.0±1.75.
Results
Among 428 participants, mean ± SD age was 54.2±15.8 years and 261 (61.0%) were female. Attending gender, gender concordance, race and racial concordance, and years of physician experience were not associated with difficulty. In multivariable analysis, requesting opioids (P=.001), lengthier than expected visit (P<.001), hostile/demanding behavior (P=.003), refusal to try recommended treatment (P=.002), unrealistic expectations (P<0.001), and difficulty communicating (P=.02) were associated with difficult encounters.
Conclusion
Most variables associated with physician impressions of difficult encounters were visit-related, suggesting some patient-related factors (eg, prior substance abuse, translator requirement) may be less relevant in pain patients. Future research should evaluate interventions designed to decrease the difficulty of encounters and determine their effect on patients and physicians.
{"title":"Difficult Encounters in Chronic Pain Patients","authors":"Steven P. Cohen MD , Winnie L. Liu BS , Tina L. Doshi MD, MHS , Eric J. Wang MD , Evelien van Gelderen BS , Resham Mawalkar BS , Eellan Sivanesan MD , Kayode A. Williams MD, MBA , Paul J. Christo MD, MBA , Shravani Durbhakula MD, MPH, MBA , Glenn Treisman MD , Annie Hsu MD","doi":"10.1016/j.mayocp.2024.08.010","DOIUrl":"10.1016/j.mayocp.2024.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To determine variables associated with difficult clinical encounters.</div></div><div><h3>Patients and Methods</h3><div>This was a cross-sectional study of 428 new patients evaluated from 2022 to 2023. Demographic, clinical, social (eg, missed appointments, prior felony conviction, prior pain physicians, medical assistance) and visit-related (eg, visit took longer than expected, difficulty communicating) information was recorded, supplemented by in-person history gathered by the trainee and attending whose demographic data were also recorded. Physicians independently rated the “difficulty” of the encounter on a 6-point Likert scale from 1 = very easy/pleasant, 2 = easy/pleasant, 3 = neutral/average, 4 = difficult, 5 = very difficult, to 6 = extremely difficult. A difficult encounter was a combined trainee and attending rating of one IQR above the median of 2.0±1.75.</div></div><div><h3>Results</h3><div>Among 428 participants, mean ± SD age was 54.2±15.8 years and 261 (61.0%) were female. Attending gender, gender concordance, race and racial concordance, and years of physician experience were not associated with difficulty. In multivariable analysis, requesting opioids (<em>P</em>=.001), lengthier than expected visit (<em>P</em><.001), hostile/demanding behavior (<em>P</em>=.003), refusal to try recommended treatment (<em>P</em>=.002), unrealistic expectations (<em>P</em><0.001), and difficulty communicating (<em>P</em>=.02) were associated with difficult encounters.</div></div><div><h3>Conclusion</h3><div>Most variables associated with physician impressions of difficult encounters were visit-related, suggesting some patient-related factors (eg, prior substance abuse, translator requirement) may be less relevant in pain patients. Future research should evaluate interventions designed to decrease the difficulty of encounters and determine their effect on patients and physicians.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 1","pages":"Pages 30-41"},"PeriodicalIF":6.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786243","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 : 2025-01-01DOI: 10.1016/j.mayocp.2024.03.022
Adil E. Bharucha MBBS, MD , Michelle L. Bublitz MHA, CCRP , Robert A. Vierkant MS , Tony C. Luehrs MS , Karen A. Konzen MS , David A. Weiss , Tony A. Hart MBA , Christine M. Boos , Alina M. Allen MD , Kent R. Bailey PhD , Konstantinos N. Lazaridis MD
Objective
To assess whether the mode and formatting of invitations affect enrollment in a large, decentralized study.
Patients and Methods
Between July 1, 2022, and October 30, 2022, we prospectively compared various approaches to enroll patients in the Tapestry DNA Sequencing Research Study, a decentralized exome-sequencing study. In phase 1, patients were randomized to receive invitations via the electronic health record (EHR) patient portal or email (cohort 1, 69,852 patients). Phase 2 randomized in a 2×2 factorial design to receive (by portal or email) standard or enhanced (ie, more visually appealing) invitations (cohort 2, 26,198 patients). Factors that predicted enrollment rates were analyzed.
Results
The enrollment rate was greater in cohort 2 (1,785 of 24,550, 7.27%) than 1 (1,758 or 69,765, 2.52%) and remained significant after multivariable adjustment (odds ratio, 1.31; 95% CI, 1.19-1.45). Enrollment rates were greater in women than men, patients 50 to 70 years of age than younger patients, White or non-Hispanic or Latino patients than those in other racial categories, urban than rural residents, and patients who had more health care encounters or more recent health care before this study (P<.02). The enrollment rate was also greater when invitations were delivered via EHR than email (odds ratio, 1.56; 95% CI, 1.44-1.68; P<.001).
Conclusion
Invitations via EHR rather than email facilitate enrollment to large, decentralized studies. Enhanced display of invitation material did not increase enrollment. Lower enrollment rates in men, younger individuals, non-White and Hispanic individuals, and rural residents highlight a continued need to focus enrollment strategies on these subgroups.
{"title":"Factors Associated With Enrollment to a Decentralized Study","authors":"Adil E. Bharucha MBBS, MD , Michelle L. Bublitz MHA, CCRP , Robert A. Vierkant MS , Tony C. Luehrs MS , Karen A. Konzen MS , David A. Weiss , Tony A. Hart MBA , Christine M. Boos , Alina M. Allen MD , Kent R. Bailey PhD , Konstantinos N. Lazaridis MD","doi":"10.1016/j.mayocp.2024.03.022","DOIUrl":"10.1016/j.mayocp.2024.03.022","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the mode and formatting of invitations affect enrollment in a large, decentralized study.</div></div><div><h3>Patients and Methods</h3><div>Between July 1, 2022, and October 30, 2022, we prospectively compared various approaches to enroll patients in the Tapestry DNA Sequencing Research Study, a decentralized exome-sequencing study. In phase 1, patients were randomized to receive invitations via the electronic health record (EHR) patient portal or email (cohort 1, 69,852 patients). Phase 2 randomized in a 2×2 factorial design to receive (by portal or email) standard or enhanced (ie, more visually appealing) invitations (cohort 2, 26,198 patients). Factors that predicted enrollment rates were analyzed.</div></div><div><h3>Results</h3><div>The enrollment rate was greater in cohort 2 (1,785 of 24,550, 7.27%) than 1 (1,758 or 69,765, 2.52%) and remained significant after multivariable adjustment (odds ratio, 1.31; 95% CI, 1.19-1.45). Enrollment rates were greater in women than men, patients 50 to 70 years of age than younger patients, White or non-Hispanic or Latino patients than those in other racial categories, urban than rural residents, and patients who had more health care encounters or more recent health care before this study (<em>P</em><.02). The enrollment rate was also greater when invitations were delivered via EHR than email (odds ratio, 1.56; 95% CI, 1.44-1.68; <em>P</em><.001).</div></div><div><h3>Conclusion</h3><div>Invitations via EHR rather than email facilitate enrollment to large, decentralized studies. Enhanced display of invitation material did not increase enrollment. Lower enrollment rates in men, younger individuals, non-White and Hispanic individuals, and rural residents highlight a continued need to focus enrollment strategies on these subgroups.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 1","pages":"Pages 52-67"},"PeriodicalIF":6.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786251","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 : 2025-01-01DOI: 10.1016/j.mayocp.2024.05.002
Shau-Huai Fu MD, PhD , Hung-Kuan Yen MD , Rong-Sen Yang MD, PhD , Chih-Chien Hung MD , Jou-Wei Lin MD, PhD , Ming-Tsung Lee PhD , Ho-Min Chen MS , Chih-Hsing Wu MD, PhD , Chih-Cheng Hsu MD, PhD , Chung-Yi Li PhD , Olivier Q. Groot MD , Chen-Yu Wang PhD
Objective
To evaluate the relationship between different dosing intervals of antiosteoporosis medications (AOMs) and the subsequent fracture risk among patients with newly initiated AOM therapies.
Patients and Methods
In a nationwide population-based cohort study based on Taiwan’s National Health Insurance Research Database, osteoporosis patients with 50 years of age or older who newly initiated AOM from January 1, 2008, to December 31, 2018 (n=336,229) were included. We categorized AOMs into short dosing intervals (oral AOMs) or long dosing intervals (parenteral AOMs). The adherence of treatment by medication possession ratio and subsequent fracture after treatment for 3 years were measured.
Results
Among patients who initiated parenteral AOMs, the percentage of patients with high adherence (medication possession ratio ≥75%) increased from 33% in 2008 to 69% in 2018. However, among patients who initiated oral AOMs, the percentage of high adherence remained stable (30%) between 2008 and 2018. The use of parenteral AOMs increased from 1% in 2008 to 62% in 2018. At the same time, the percentage of high adherence of those initiated AOMs significantly increased from 34% in 2008 to 61% in 2018. The risk of subsequent fracture decreased significantly between 2008 and 2018 after controlling for all potential confounders (HR, 0.85; 95% CI, 0.81 to 0.89).
Conclusion
AOMs with long dosing intervals not only increased adherence but also associated with the decrease in subsequent fracture risk at a nationwide scale.
{"title":"Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk","authors":"Shau-Huai Fu MD, PhD , Hung-Kuan Yen MD , Rong-Sen Yang MD, PhD , Chih-Chien Hung MD , Jou-Wei Lin MD, PhD , Ming-Tsung Lee PhD , Ho-Min Chen MS , Chih-Hsing Wu MD, PhD , Chih-Cheng Hsu MD, PhD , Chung-Yi Li PhD , Olivier Q. Groot MD , Chen-Yu Wang PhD","doi":"10.1016/j.mayocp.2024.05.002","DOIUrl":"10.1016/j.mayocp.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the relationship between different dosing intervals of antiosteoporosis medications (AOMs) and the subsequent fracture risk among patients with newly initiated AOM therapies.</div></div><div><h3>Patients and Methods</h3><div>In a nationwide population-based cohort study based on Taiwan’s National Health Insurance Research Database, osteoporosis patients with 50 years of age or older who newly initiated AOM from January 1, 2008, to December 31, 2018 (n=336,229) were included. We categorized AOMs into short dosing intervals (oral AOMs) or long dosing intervals (parenteral AOMs). The adherence of treatment by medication possession ratio and subsequent fracture after treatment for 3 years were measured.</div></div><div><h3>Results</h3><div>Among patients who initiated parenteral AOMs, the percentage of patients with high adherence (medication possession ratio ≥75%) increased from 33% in 2008 to 69% in 2018. However, among patients who initiated oral AOMs, the percentage of high adherence remained stable (30%) between 2008 and 2018. The use of parenteral AOMs increased from 1% in 2008 to 62% in 2018. At the same time, the percentage of high adherence of those initiated AOMs significantly increased from 34% in 2008 to 61% in 2018. The risk of subsequent fracture decreased significantly between 2008 and 2018 after controlling for all potential confounders (HR, 0.85; 95% CI, 0.81 to 0.89).</div></div><div><h3>Conclusion</h3><div>AOMs with long dosing intervals not only increased adherence but also associated with the decrease in subsequent fracture risk at a nationwide scale.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 1","pages":"Pages 68-79"},"PeriodicalIF":6.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813693","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 : 2025-01-01DOI: 10.1016/j.mayocp.2024.02.027
Nader James Al-Shakarchi MBBS , Jenny J. Cao MBBChir , Ivan D. Carabenciov MD
{"title":"50-Year-Old Man With Malaise, Chills, and Weight Loss","authors":"Nader James Al-Shakarchi MBBS , Jenny J. Cao MBBChir , Ivan D. Carabenciov MD","doi":"10.1016/j.mayocp.2024.02.027","DOIUrl":"10.1016/j.mayocp.2024.02.027","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 1","pages":"Pages 141-145"},"PeriodicalIF":6.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142730121","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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