Mayo Clinic proceedings
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Mayo Clinic proceedings · Dec 2024
ReviewDecoding Obesity Management Medications and the Journey to Informed Treatment Choices for Patients.
Incretin-based obesity management medications (OMMs) fill a treatment gap in a stepped-care model between lifestyle change alone and metabolic bariatric surgery, resulting in weight loss of 15% to 20% of body weight. Public interest in and demand for OMMs has recently increased dramatically. ⋯ When considering strategies to aid patients in decision making about obesity treatment, several considerations warrant discussion because patients may have unrealistic perceptions about risk vs efficacy and may hold numerous misconceptions about long-term behavior change and outcomes. This article outlines considerations for informed obesity treatment decision making and reviews aspects of obesity treatment specific to OMMs, including adverse effects, patient expectations for treatment outcome, equitable access to care, the impact of weight bias on patient care, the risk of weight recurrence, and the need for long-term multicomponent treatment to achieve weight loss and weight maintenance.
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Mayo Clinic proceedings · Dec 2024
ReviewCardiovascular Health Considerations for Primary Care Physicians Treating Breast Cancer Survivors.
Breast cancer (BC) survivors are at increased risk for cardiovascular disease (CVD) and require their primary care physicians to manage their long-term general medical care, including cardiovascular (CV) health. Yet, evidence exists that some primary care physicians possess insufficient knowledge about survivorship care. With the goal of bridging these knowledge gaps, a PubMed review was conducted from July 7, 2020, through October 2, 2020, with an updated PubMed review from January 3, 2024, through April 28, 2024, focusing on CV health considerations in the primary care of BC survivors. ⋯ In this review, results are summarized from studies that report the presence of CV risk factors and CVD in BC survivors. Also described are the CV effects of BC therapies (chemotherapy, hormonal agents, targeted therapies, and radiotherapy) and the type of CV evaluation (cardiac imaging and measurement of biomarkers) that these patients may need. Primary care physicians have an important role in managing the CV health of BC survivors from preventing, assessing, and managing CV risk factors to referring patients to appropriate specialists when needed.
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To determine variables associated with difficult clinical encounters. ⋯ 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.
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Mayo Clinic proceedings · Dec 2024
Association of Informal Caregiving and Menopause Symptoms in Midlife Women: A Cross-Sectional Study.
To assess the association between caregiving and menopause symptom burden in midlife women. ⋯ This study identified a positive association between caregiving hours and menopause symptom burden. Given the aging US population and likely resultant increases in caregiving burden, there is a critical need to address menopause symptoms and to provide support for midlife women in caregiving roles.
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Mayo Clinic proceedings · Dec 2024
Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk: A 11-Year Nationwide Population-Based Cohort Study.
To evaluate the relationship between different dosing intervals of antiosteoporosis medications (AOMs) and the subsequent fracture risk among patients with newly initiated AOM therapies. ⋯ AOMs with long dosing intervals not only increased adherence but also associated with the decrease in subsequent fracture risk at a nationwide scale.