Physician Health Series Part One: Characteristics of Physicians as Patients
This is the first article of a 3-part series about physician health. In this installment, we outline the unique characteristics of physicians as patients, challenges and opportunities presented by physician-patients, and recommendations for treating physicians. Future articles will delve into role clarity, occupational considerations, mental health, and interactions with third parties such as the physician ’s employer or licensing board. Ultimately, this series will help treating clinicians provide the best care to their physician-patients and successfully navigate the unique challenges that may arise, especially when th...
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Greg P. Couser, Philip T. Hagen, Melanie D. Swift, Richard D. Newcomb, Clayton T. Cowl Tags: Thematic Review on Physician Health Source Type: research
Capillary Telangiectasia
A female in her late 40s presented for a second opinion regarding a pontine lesion concerning for a possible glial neoplasm that has been present for at least 10 years by imaging. Prior magnetic resonance imaging scans showed a solitary well-circumscribed T1-hypointense and subtle T2/T2-fluid-attenuated inversion recovery hyperintense lesion in the lower pons with homogenous gadolinium enhancement but no overt hemosiderin deposition on gradient echo sequence and no evidence of any other suspicious lesions in the brain or spinal cord. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Ehab Harahsheh, Justin Cramer Tags: Medical image Source Type: research
Focused Monitoring After Heart Failure Trials
Cardiovascular death and hospitalization for heart failure (HF) are prevailing end points in randomized controlled trials (RCTs) in patients who have HF with reduced ejection fraction (HFrEF). The low incidence of cardiovascular death and hospitalization in recent RCTs contrasts with the 5-year mortality rate of 75.5% and readmission risk of 48.5% among hospitalized HFrEF patients, indicating enrollment of stable New York Heart Association (NYHA) class II-III patients.1,2 However, inclusive enrollment in RCTs may yield incomplete therapeutic information. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Thierry H. Le Jemtel, Rohan Samson Tags: Perspective and controversy Source Type: research
Competencies for Those Who Coach Physicians: A Modified Delphi Study
The rapidly evolving coaching profession has permeated the health care industry and is gaining ground as a viable solution for addressing physician burnout, turnover, and leadership crises that plague the industry. Although various coach credentialing bodies are established, the profession has no standardized competencies for physician coaching as a specialty practice area, creating a market of aspiring coaches with varying degrees of expertise. To address this gap, we employed a modified Delphi approach to arrive at expert consensus on competencies necessary for coaching physicians and physician leaders. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Angela M. Passarelli, Gail Gazelle, Leslie E. Schwab, Robert F. Kramer, Margaret A. Moore, Raja G. Subhiyah, Nicole M. Deiorio, Mamta Gautam, Priscilla Gill, Sharon K. Hull, Cara R. King, Andrea Sikon Tags: Special article Source Type: research
Acute and Complicated Inflammatory Pericarditis
Inflammatory disease of the pericardium represents a relatively common presentation, especially among the young. For the most part, inflammatory pericardial disease can be expeditiously and effectively managed without significant sequelae. However, some individuals present with severe and recurrent illness, representing significant therapeutic challenges. During the past decade, there have been great strides made in developing an evidence-based approach to management of inflammatory pericardial disease, the result of which has been the development of (1) a systematic, protocoled approach to initial care; (2) targeted thera...
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Awais A. Malik, James W. Lloyd, Nandan S. Anavekar, Sushil Allen Luis Tags: Review Source Type: research
Weight Loss Surgery Increases Kidney Transplant Rates in Patients With Renal Failure and Obesity
To describe the outcomes of kidney transplant (KT) candidates with obesity undergoing sleeve gastrectomy (SG) to meet the criteria for KT. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Aleksandra Kukla, Sukhdeep S. Sahi, Pavel Navratil, Roberto P. Benzo, Byron H. Smith, Dustin Duffy, Walter D. Park, Meera Shah, Pankaj Shah, Matthew M. Clark, David C. Fipps, Aleksandar Denic, Carrie A. Schinstock, Patrick G. Dean, Mark D. Stegall, Yogish Tags: Original article Source Type: research
Prescription Opioids and Brain Structure in Community-Dwelling Older Adults
To evaluate the associations between prescription opioid exposures in community-dwelling older adults and gray and white matter structure by magnetic resonance imaging. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Nafisseh S. Warner, Andrew C. Hanson, Phillip J. Schulte, Firat Kara, Robert I. Reid, Christopher G. Schwarz, Eduardo E. Benarroch, Jonathan Graff-Radford, Prashanthi Vemuri, Clifford R. Jack, Ronald C. Petersen, David O. Warner, Michelle M. Mielke, Kejal Tags: Original article Source Type: research
Sclerosing Mesenteritis: A Concise Clinical Review for Clinicians
Sclerosing mesenteritis (SM), an idiopathic nonneoplastic condition affecting 0.18% to 3.14% of the population, is characterized by chronic fat necrosis, inflammation, and fibrosis most commonly of the mesentery of the small intestine. Sclerosing mesenteritis typically presents in the fifth or sixth decade of life, where patients with a history of abdominal surgery and/or autoimmune disease may be at higher risk. While many patients are asymptomatic, clinical features and complications are related to the mass effect resulting from the inflammation and fibrosis involved in the pathogenesis of SM. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Bibek Saha, June Tome, Xiao Jing Wang Tags: Concise review Source Type: research
New Developments in Psychiatric Boarding in Emergency Departments
In July 2023, the New Hampshire Department of Health and Human Services and a group of New Hampshire hospitals reached a settlement in a 5-year-long legal dispute over the practice of psychiatric boarding in hospital emergency departments. The hospitals successfully made the novel argument that boarding violates their rights, as well as those of patients. The case is a new and significant development in the legal battles among patients, advocates, hospitals, and states that have arisen as psychiatric boarding remains a pervasive challenge in American emergency departments. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Michael J. Redinger, Tyler S. Gibb, Kathryn E. Redinger Tags: Commentary Source Type: research
Sebaceous Neoplasm With Defective DNA Mismatch Repair
A woman in her 70s presented with a cutaneous lesion composed of a mixture of basaloid cells and sebocytes arranged in lobules, most consistent with a sebaceous adenoma (Figure 1). Immunohistochemistry for mismatch repair genes showed loss of nuclear expression of MSH2 and MSH6 in the tumor cells. Representative images are depicted in Figure 2. Microsatellite instability testing showed instability in all of the 7 informative markers analyzed, indicative of defective DNA mismatch repair function within the tumor. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Burak Tekin, Sounak Gupta, Lori A. Erickson Tags: Path to patient image quiz Source Type: research
Physician Coaching: Establishing Standards and Core Competencies
These are dynamic and challenging times for physicians. Changes to practice structures within health care have decreased autonomy and flexibility, leaving many physicians feeling as if they are cogs in the wheel of an impersonal system. Other structural changes to health care delivery have also contributed to frustration, eroded meaning in work, and occupational distress for many physicians. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Kerri Palamara, Tait D. Shanafelt Tags: Editorial Source Type: research
Opioids and Accelerated Brain Aging: The White Matter Matters
Opioids are most highly prescribed in older adults, and because of aging and multimorbidity, this demographic is also most likely to suffer adverse events from this drug class. The article by Warner et al1 reports on the cross-sectional associations between prescription opioid exposures in community-dwelling older adults (older than 65 years) and gray and white matter structure assessed by magnetic resonance imaging. The primary exposure was the duration of opioid availability with a secondary e xposure of total morphine milligram equivalents (MME). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Robert J. Pignolo Tags: Editorial Source Type: research
Improving Kidney Transplant Rates in Obese CKD Patients by Sleeve Gastrectomy
Obesity is a central obstacle to health and wellness in people with chronic kidney disease (CKD). It is linked to progression of CKD, a greater burden of disease and disability, and reduced access to kidney transplant.1-3 Moreover, obesity is a common condition in CKD, being seen in nearly 50% of individuals with CKD stages 3 and 4.4 As a highly prevalent and major risk factor for adverse outcomes, obesity has been receiving increasing attention from the nephrology community as an urgent problem that needs addressing. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Allon N. Friedman Tags: Editorial Source Type: research
Oracle, Merakai, Appollo, Yang by Claire Roche
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. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Margaret R. Wentz Tags: Art at mayo clinic Source Type: research
In the Limelight: May 2024
This month ’s feature highlights three articles that appear in the current issue of Mayo Clinic Proceedings. These articles are also featured on the Mayo Clinic Proceedings’ YouTube Channel (https://youtu.be/G-hg8TqQZMs). (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - May 1, 2024 Category: Internal Medicine Authors: Karl A. Nath Tags: In the limelight Source Type: research
