Mayo Clinic proceedings最新文献

英文中文

37-Year-Old Man With Chest Pain. 37 岁男子胸痛。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-25 DOI: 10.1016/j.mayocp.2024.01.004

Naba Farooqui, Sara S Inglis, Francisco Lopez-Jimenez

引用次数: 0

Pemphigus Foliaceus. 天疱疮。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-25 DOI: 10.1016/j.mayocp.2024.07.019

Alexandra L McLennan, Clay J Cockerell, Vicky Z Ren

引用次数: 0

Impact of Work on Personal Relationships and Physician Well-being 工作对人际关系和医生福祉的影响。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.03.010

Mickey T. Trockel MD, PhD , Liselotte N. Dyrbye MD, MHPE, FACP , Colin P. West MD, PhD , Christine A. Sinsky MD , Hanhan Wang MPS , Lindsey E. Carlasare MBA , Michael Tutty PhD, MHA , Tait D. Shanafelt MD

Objective

To assess the impact of work on personal relationships (IWPR) by specialty and demographic variables in a national sample of physicians, to assess the association between the IWPR and burnout, and to determine the effect of adjusting for IWPR on the risk of burnout associated with being a physician.

Methods

Analysis was conducted of data from a representative sample of US physicians surveyed between November 20, 2020, and March 23, 2021, and from a probability-based sample of other US workers. IWPR and burnout were measured with published assessments.

Results

Of the 7360 physicians who responded to the survey, 6271 (85.2%) completed the IWPR assessment. In multivariable analysis, moderate or higher IWPR was associated with female sex (odds ratio [OR], 1.26; 95% CI, 1.11 to 1.43), married vs single (OR, 0.59; 95% CI, 0.48 to 0.71), and emergency medicine (OR, 1.93; 95% CI, 1.43 to 2.60) or physical and rehabilitative medicine (OR, 1.67; 95% CI, 1.12 to 2.50) vs internal medicine subspecialty. Physicians were more likely than workers in other fields (OR, 2.65; 95% CI, 2.33 to 3.02) to endorse the statement “In the past year, my job contributed to me feeling more isolated or detached from the people who are important to me” as at least moderately true. After adjustment for responses to this statement, work hours, and demographic characteristics, being a physician was not associated with the risk of burnout.

Conclusion

IWPR is associated with burnout. Adjustment for IWPR eliminated the observed difference in burnout between physicians and workers in other fields. Interventions that identify and mitigate work practices that have a negative impact on physicians’ personal relationships and interventions that support affected individual physicians are warranted.

目的在全国医生样本中按专业和人口统计学变量评估工作对个人关系（IWPR）的影响，评估 IWPR 与职业倦怠之间的关联，并确定调整 IWPR 对与医生身份相关的职业倦怠风险的影响：对 2020 年 11 月 20 日至 2021 年 3 月 23 日期间调查的具有代表性的美国医生样本数据以及其他美国工人的概率样本数据进行了分析。IWPR和职业倦怠采用已公布的评估方法进行测量：在 7360 名回复调查的医生中，有 6271 人（85.2%）完成了 IWPR 评估。在多变量分析中，中度或更高的 IWPR 与女性性别（几率比 [OR]，1.26；95% CI，1.11 至 1.43）、已婚与单身（OR，0.59；95% CI，0.48 至 0.71）、急诊医学（OR，1.93；95% CI，1.43 至 2.60）或物理和康复医学（OR，1.67；95% CI，1.12 至 2.50）与内科亚专业相关。对于 "在过去一年中，我的工作使我感到更加孤立或与对我很重要的人疏远 "这一说法，医生比其他领域的工作者更有可能（OR，2.65；95% CI，2.33 至 3.02）认为至少是中度正确的。在对该陈述的回答、工作时间和人口特征进行调整后，医生身份与职业倦怠风险无关：结论：IWPR 与职业倦怠有关。对 IWPR 的调整消除了观察到的医生与其他领域工作者在职业倦怠方面的差异。有必要采取干预措施，识别并减轻对医生个人关系产生负面影响的工作方式，并为受影响的医生个人提供支持。

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引用次数: 0

Bariatric and Metabolic Surgery in the Adult Population 成人减肥和代谢手术：初级保健提供者须知。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.05.022

Betemariam Sharew BA , Nandan Kodur BS , Ricard Corcelles MD , Yael Mauer MD, MPH

Obesity is a significant public health concern worldwide and a leading cause of preventable death and morbidity, but the management of this condition remains a challenge. Metabolic and bariatric surgery (MBS) is safe and currently has the most consistent and robust data among anti-obesity interventions for ameliorating obesity and its associated complications. Despite the benefits and safety of MBS, it is significantly underused. There are several proposed reasons for this underuse, one of which is a knowledge gap among primary care physicians, contributing to low referral rates. The purpose of this review is to summarize key points of the 2022 American Society for Metabolic and Bariatric Surgery/International Federation for the Surgery of Obesity and Metabolic Disorders guidelines regarding MBS, as well as to discuss indications, benefits and risks, most common types of MBS, and barriers to access, thereby increasing awareness of MBS among primary care physicians. This narrative review was based on articles found by searching PubMed from its inception until April 2024 for the terms sleeve gastrectomy, gastric bypass, and metabolic and bariatric surgery. Our search was confined to English-language publications, with emphasis placed on evidence derived from systematic literature reviews, meta-analyses, and randomized clinical trials whenever available.

肥胖症是全球重大的公共卫生问题，也是可预防的死亡和发病的主要原因，但肥胖症的管理仍然是一项挑战。代谢和减肥手术（MBS）是安全的，目前在改善肥胖及其相关并发症的抗肥胖干预措施中，它拥有最一致、最可靠的数据。尽管代谢与减重手术具有诸多益处和安全性，但其使用率却非常低。造成使用不足的原因有多种，其中之一是初级保健医生对其缺乏了解，导致转诊率低。本综述旨在总结 2022 年美国代谢与减重外科协会/国际肥胖与代谢紊乱外科联合会关于 MBS 的指南要点，并讨论适应症、益处和风险、最常见的 MBS 类型以及使用障碍，从而提高初级保健医生对 MBS 的认识。本叙述性综述基于从 PubMed 开始到 2024 年 4 月搜索袖带胃切除术、胃旁路术以及代谢和减肥手术等词条所找到的文章。我们的搜索仅限于英文出版物，重点是系统文献综述、荟萃分析和随机临床试验中获得的证据。

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引用次数: 0

Interventional Radiology Partial Splenic Embolization for Refractory Thrombocytopenia in Still Disease 介入放射学部分脾栓塞治疗静止期难治性血小板减少症。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.07.018

Frank G. Lee MD, Maxwell J. Jabaay DO, MS, John M. Zietlow MD, Chris J. Reisenauer MD

引用次数: 0

Trimethylamine-N-Oxide and Related Metabolites: Assessing Cardiovascular Risk in the Dallas Heart Study 三甲胺氧化物及相关代谢物：评估达拉斯心脏研究中的心血管风险。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2023.12.021

Objective

To evaluate the association between trimethylamine N-oxide (TMAO) and related metabolites with adverse cardiovascular events in a multiethnic urban primary prevention population.

Methods

We performed a case-control study of 361 participants of the Dallas Heart Study, including 88 participants with an incident atherosclerotic cardiovascular disease (ASCVD) event and 273 controls matched for age, sex, and body mass index without an ASCVD event during 12 years of follow-up (January 1, 2000, through December 31, 2015). Plasma levels of TMAO, choline, carnitine, betaine, and butyrobetaine were measured by mass spectrometry. The differential odds for incident ASCVD by metabolite levels between cases and controls were compared by a conditional logistic regression model adjusted for cardiovascular risk factors.

Results

Participants with incident ASCVD had higher levels of TMAO and related metabolites compared with those without ASCVD (P<.05 for all). Those with plasma TMAO concentrations in quartile 4 had a more than 2-fold higher odds of ASCVD compared with those in quartile 1 (odds ratio, 2.77 [95% CI, 1.05 to 7.7; P=.04] for hard ASCVD and 2.41 [95% CI, 1.049 to 5.709; P=.04]). Similar trends were seen with the related metabolites choline, betaine, carnitine, and butyrobetaine.

Conclusion

Our results suggest that TMAO and related metabolites are independently associated with ASCVD events. Although further studies are needed, measurement of TMAO and related metabolites may have a role in ASCVD risk stratification for primary prevention.

目的评估多种族城市一级预防人群中三甲胺 N-氧化物（TMAO）及相关代谢物与不良心血管事件之间的关系：我们对达拉斯心脏研究的 361 名参与者进行了病例对照研究，其中包括 88 名发生过动脉粥样硬化性心血管疾病（ASCVD）事件的参与者和 273 名在 12 年随访期间（2000 年 1 月 1 日至 2015 年 12 月 31 日）年龄、性别和体重指数匹配且未发生过 ASCVD 事件的对照者。通过质谱法测量了血浆中TMAO、胆碱、肉碱、甜菜碱和丁基甜菜碱的水平。通过调整心血管风险因素的条件逻辑回归模型，比较了病例与对照组之间代谢物水平不同的ASCVD发病几率差异：结果：与非 ASCVD 患者相比，ASCVD 患者的 TMAO 和相关代谢物水平较高：我们的研究结果表明，TMAO 和相关代谢物与 ASCVD 事件有独立关联。尽管还需要进一步研究，但TMAO和相关代谢物的测量可能会在初级预防的ASCVD风险分层中发挥作用。

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引用次数: 0

COVID-19 Vaccination–Related Pericarditis 与 COVID-19 疫苗接种相关的心包炎：韩国全国性研究

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.03.026

Nuri Lee MD , Kye Hun Kim MD, PhD , Jae-Hyeong Park MD, PhD , Jae Yeong Cho MD, PhD , Soo Hyeon Cho MPH , Dong Keun Kim MD , Seung Yun Kim MD , Eun Kyoung Kim MS , Eui-Young Choi MD, PhD , Jin-Oh Choi MD, PhD , Suji Cho MD , Ga Hui Choi MD , Hyukjin Park MD, PhD , Hyung Yoon Kim MD, PhD , Hyun Ju Yoon MD, PhD , Youngkeun Ahn MD, PhD , Myung Ho Jeong MD, PhD

Objective

To investigate the incidence, characteristics, and outcomes of COVID-19 vaccine–related pericarditis (VRP) without myocarditis, we analyzed nationwide Korean data.

Patients and Methods

This is a retrospective nationwide report including all vaccinated Koreans with COVID-19 vaccine of any platform (BNT162b2, mRNA-1273, ChAdOx1, or Ad26.COV2.S) from February 26 to December 31, 2021. We analyzed the confirmed cases of COVID-19 VRP by the Expert Adjudication Committee. The incidence, clinical characteristics, and outcomes of COVID-19 VRP were analyzed.

Results

Among 44,322,068 Koreans with least one dose of COVID-19 vaccination, COVID-19 VRP was confirmed in 179 cases, with 1.73 per million shots (95% CI, 1.48 to 2.00 per million shots). The incidence of VRP was significantly higher in males than females (2.01 per 1 million doses vs 1.45 per 1 million doses, respectively; P=.029), in mRNA vaccines than in other vaccines (2.09 per 1 million doses vs 0.36 per 1 million doses, respectively; P<.001), and in those younger than 40 years of age than those older than 40 years of age (3.52 per 1 million doses vs 0.89 per 1 million doses, respectively; P<.001). The incidence of VRP was highest in males between the ages of 12 and 17 years (7.38 per 1 million doses; 95% CI, 2.01 to 16.07). Although there was no case of mortality, hemodynamically significant pericardial effusion requiring pericardial drainage was noted in 10 cases (5.6%).

Conclusion

COVID-19 VRP was very rare and developed mainly in association with mRNA vaccines, especially in males younger than 40 years of age. The clinical course of VRP was excellent, and there were no cases of mortality. However, the development of hemodynamically significant pericardial effusion should be carefully monitored.

摘要为了调查不伴有心肌炎的 COVID-19 疫苗相关心包炎 (VRP) 的发病率、特征和结果，我们分析了韩国全国范围内的数据：这是一份全国范围内的回顾性报告，包括2021年2月26日至12月31日期间所有接种过任何平台（BNT162b2、mRNA-1273、ChAdOx1或Ad26.COV2.S）COVID-19疫苗的韩国人。我们对专家评审委员会确认的 COVID-19 VRP 病例进行了分析。我们对 COVID-19 VRP 的发病率、临床特征和结果进行了分析：结果：在接种过至少一剂 COVID-19 疫苗的 44,322,068 名韩国人中，有 179 例确诊了 COVID-19 VRP，每百万针中有 1.73 例（95% CI，每百万针中有 1.48 至 2.00 例）。男性的 VRP 发生率明显高于女性（分别为每 100 万剂 2.01 例与每 100 万剂 1.45 例；P=.029），mRNA 疫苗的 VRP 发生率明显高于其他疫苗（分别为每 100 万剂 2.09 例与每 100 万剂 0.36 例；P=.029）：COVID-19 VRP非常罕见，主要与mRNA疫苗有关，尤其是40岁以下的男性。VRP 的临床病程良好，无死亡病例。不过，应仔细观察是否出现血流动力学意义上的心包积液。

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引用次数: 0

Pseudoendocrine Sarcoma 假性内分泌肉瘤

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.08.004

Jorge Torres-Mora MD, Jorge Trejo-Lopez MD, Lori A. Erickson MD

引用次数: 0

General Information 一般信息

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/S0025-6196(24)00444-0

引用次数: 0

Mpox (Monkeypox) or Money-Pox? Unjust Global Responses Toward Infectious Diseases 猴痘还是钱痘？全球对传染病的不公正反应。

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings

Pub Date : 2024-10-01 DOI: 10.1016/j.mayocp.2024.06.008

Zhaohui Su PhD, Dean McDonnell PhD, Barry L. Bentley PhD, Ali Cheshmehzangi PhD, Sabina Šegalo PhD, Claudimar Pereira da Veiga PhD, Yu-Tao Xiang PhD, MD

引用次数: 0

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

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