Mayo Clinic proceedings
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Pelvic organ prolapse (POP) is a common clinical entity that can have a significant impact on a patient's quality of life secondary to symptoms of pelvic pressure, vaginal bulge, urinary and bowel dysfunction, or sexual dysfunction. It is highly prevalent, with roughly 13% of women undergoing surgery for prolapse in their lifetime. Vaginal prolapse is diagnosed by history and physical examination. ⋯ When it is indicated, surgery can be performed through transvaginal, laparoscopic/robotic, or open approaches, using either the patient's own tissue or mesh augmentation. Deciding between these is based on the compartments involved, extent of prolapse, medical and surgical comorbidities, differences in durability and risk between operations, and shared decision-making with the patient. Here, we review pertinent clinical considerations in the evaluation and management of POP.
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Mayo Clinic proceedings · Dec 2021
ReviewViral Endothelial Dysfunction: A Unifying Mechanism for COVID-19.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus with significant global impact, morbidity, and mortality. The SARS-CoV-2 virus may result in widespread organ manifestations including acute respiratory distress syndrome, acute renal failure, thromboembolism, and myocarditis. ⋯ Several studies have associated various viral infections including SARS-CoV-2 infection with inflammation, endothelial dysfunction, and subsequent innate immune response and cytokine storm. Noninvasive monitoring of endothelial function and identification of high-risk patients who may require specific therapies may have the potential to improve morbidity and mortality associated with subsequent inflammation, cytokine storm, and multiorgan involvement.
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Mayo Clinic proceedings · Dec 2021
U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study.
To investigate the association between the duration of weekly leisure-time sports activity and all-cause mortality. ⋯ We observed a U-shaped association between weekly duration of leisure sports activities and cardiovascular and all-cause mortality, with lowest risk for those participating in 2.6 to 4.5 weekly hours, being consistent across subgroups. Participation in sport activities should be promoted, but the potential risk of very high weekly hours of sport participation should be considered for inclusion in guidelines and recommendations.
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Mayo Clinic proceedings · Dec 2021
Development and Validation of a Multivariable Risk Prediction Model for COVID-19 Mortality in the Southern United States.
To evaluate clinical characteristics of patients admitted to the hospital with coronavirus disease 2019 (COVID-19) in Southern United States and development as well as validation of a mortality risk prediction model. ⋯ We have developed an easy-to-use, robust model for systematically evaluating patients presenting to acute care settings with COVID-19 infection.