Mayo Clinic proceedings
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Mayo Clinic proceedings · Jun 2024
ReviewSurgical Coronary Revascularization in Patients With Underlying Atrial Fibrillation: State-of-the-Art Review.
The number of individuals referred for coronary artery bypass grafting (CABG) with preoperative atrial fibrillation (AF) is reported to be 8% to 20%. Atrial fibrillation is a known marker of high-risk patients as it was repeatedly found to negatively influence survival. Therefore, when performing surgical revascularization, consideration should be given to the concomitant treatment of the arrhythmia, the clinical consequences of the arrhythmia itself, and the selection of adequate surgical techniques. ⋯ Preoperative arrhythmia should always be considered for surgical ablation because such an approach improves prognosis without increasing perioperative risk. While planning a revascularization strategy, it should be noted that although off-pump coronary artery bypass provides better short-term outcomes, conventional on-pump approach may be beneficial at long-term follow-up. By collecting the current evidence, addressing knowledge gaps, and offering practical recommendations, this state-of-the-art review serves as a valuable resource for clinicians involved in the management of patients with AF undergoing CABG, ultimately contributing to improved outcomes and enhanced patient care.
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Mayo Clinic proceedings · Jun 2024
ReviewPart Two: Managing Physicians as Patients and Their Safe Return to Work.
This second installment in a 3-part series about physicians as patients explores challenges in communication and role definition while managing their care and safe return to work. In the first article of the series, authors reviewed unique characteristics that make physicians different as patients, with some general guidance about how to approach their care. ⋯ The treating clinician reading this paper will learn to avoid common pitfalls and be better equipped to provide initial assessments and interventions to keep physicians working safely, keeping in mind licensure issues and reporting requirements. Part Three of the series will focus on the most common mental health issues seen in physicians.
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Mayo Clinic proceedings · Jun 2024
Calf rEF: Impact of Calf Muscle Pump Dysfunction With Reduced Ejection Fraction on All-Cause Mortality.
To evaluate mortality outcomes by varying degrees of reduced calf muscle pump (CMP) ejection fraction (EF). ⋯ Mortality rates are higher in patients with reduced CMP EF and seem to increase with each 10% decrement in CMP EF. The mortality mechanism does not seem to be impacted by venous valvular incompetence and may represent variables intrinsic to muscular physiology.
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Mayo Clinic proceedings · Jun 2024
Observational StudyChange in Body Mass Index and Cardiovascular Outcomes in Patients With Cancer.
To investigate the association between body mass index (BMI) changes and the risk of cardiovascular disease (CVD) in patients with cancer. ⋯ Cancer survivors with BMI loss and gain were at greater risk of CVD. Body mass index loss is associated with a higher risk of CVD.
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Mayo Clinic proceedings · Jun 2024
Observational StudyIncident Diuretic Use and Subsequent Risk of Bone Fractures: A Large Nationwide Observational Study of US Veterans.
To investigate the association of incident use of diuretics with subsequent risk of incident bone fractures. ⋯ Incident use of diuretics, particularly loop diuretics, was independently associated with higher risk of incident bone fractures. Our findings suggest distinct pathophysiologic contributions of diuretics to bone metabolism and the need for careful attention to skeletal outcomes when initiating diuretics.