41 results match your criteria: "Mayo Clinic Healthcare[Affiliation]"

Purpose: Pre-procedural imaging is critical for transcatheter mitral valve repair planning in patients with mitral valve disease. As differences among various measurement techniques for valve evaluation are still poorly understood, we sought to assess the intra- and interobserver agreement of complex measurements derived from a prototype mitral evaluation tool (Siemens) and a commercially available tool (CVI42) using both saddle- and D-shaped mitral annulus techniques.

Materials And Methods: Multiphasic cardiac computed tomography angiography data were loaded into each software.

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Blood pressure management in type 2 diabetes: a review of recent evidence.

Heart

October 2024

Deep Medicine, Nuffield Department of Reproductive and Women's Health, University of Oxford, Oxford, UK

The frequent concurrence of elevated blood pressure (BP) and type 2 diabetes markedly elevates the risk of cardiovascular disease and mortality. In this review, we discuss the evidence supporting the role of BP-lowering therapies in preventing cardiovascular events in people with type 2 diabetes and the most appropriate BP treatment target in these individuals. We outline possible reasons for the heterogeneous effect of BP lowering in patients with and without diabetes and consider several pathophysiological mechanisms that could potentially explain such differences.

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Task-specific dystonia leads to loss of sensorimotor control for a particular motor skill. Although focal in nature, it is hugely disabling and can terminate professional careers in musicians. Biomarkers for underlying mechanism and severity are much needed.

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Brugada syndrome: can polygenic risk scores help the clinician?

Eur Heart J

July 2024

Cardiovascular and Genomics Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.

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Article Synopsis
  • Daratumumab is a monoclonal antibody used to treat multiple myeloma and light chain amyloidosis, with premedications typically recommended to prevent infusion reactions.
  • The Mayo Clinic changed its practice in April 2022 to omit premedications after the first cycle of daratumumab due to the rare occurrence of reactions following the initial dose.
  • A study comparing patients before and after this change showed that the omission of premedications did not increase infusion reactions, indicating it can be safely done after cycle 1.
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Article Synopsis
  • Accurate polyp size estimation is important for clinical decisions, and a new laser-based virtual scale endoscope (VSE) aims to improve measurement accuracy during colonoscopy compared to traditional visual assessment (VA) methods.
  • In a study with 10 expert endoscopists reviewing video sequences of 90 polyps, VSE showed a relative accuracy of 75.1%, outperforming VA at 65.0% and snare-based estimation at 62.0%.
  • The VSE significantly reduced errors in classifying smaller polyps as larger and vice versa, indicating it is more effective than VA or snare methods for accurate size estimation.
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Although there is consensus on the management of patients with Brugada Syndrome with high risk for sudden cardiac arrest, asymptomatic or intermediate-risk patients present clinical management challenges. This document explores the management opinions of experts throughout the world for patients with Brugada Syndrome who do not fit guideline recommendations. Four real-world clinical scenarios were presented with commentary from small expert groups for each case.

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Using neural networks to calibrate agent based models enables improved regional evidence for vaccine strategy and policy.

Vaccine

November 2023

Mayo Clinic Department of Medicine, Rochester, MN, United States; Mayo Clinic Division of Epidemiology, Rochester, MN, United States; Mayo Clinic Healthcare & Epidemiology AI Lab (HEAL), United States. Electronic address:

Distribution and administration strategy are critical to successful population immunization efforts. Agent-based modeling (ABM) can reflect the complexity of real-world populations and can experimentally evaluate vaccine strategy and policy. However, ABMs historically have been limited in their time-to-development, long runtime, and difficulty calibrating.

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In the early nineties, few years before the birth of Europace, the clinical and scientific world of familial arrhythmogenic conditions was revolutionized by the identification of the first disease-causing genes. The explosion of genetic studies over a 15-year period led to the discovery of major disease-causing genes in practically all channelopathies and cardiomyopathies, bringing insight into the pathophysiological mechanisms of these conditions. The birth of next generation sequencing allowed a further step forward and other significant genes, as CALM1-3 in channelopathies and FLN C and TTN in cardiomyopathies were identified.

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Diabetes is a heterogenous, multimorbid disorder with a large variation in manifestations, trajectories, and outcomes. The aim of this study is to validate a novel machine learning method for the phenotyping of diabetes in the context of comorbidities. Data from 9967 multimorbid patients with a new diagnosis of diabetes were extracted from Clinical Practice Research Datalink.

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Standardizing Scoring Conventions for Crohn's Disease Endoscopy: An International RAND/UCLA Appropriateness Study.

Clin Gastroenterol Hepatol

October 2023

Department of Medicine, Division of Gastroenterology, University of Western Ontario, London, Ontario, Canada; Alimentiv Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada. Electronic address:

Background And Aims: Endoscopic assessment of disease activity is integral for evaluating treatment response in patients with Crohn's disease (CD). We aimed to define appropriate items for evaluating endoscopic activity and conventions for consistent endoscopic scoring rules in CD.

Methods: A 2-round modified RAND/University of California at Los Angeles Appropriateness Method study was conducted.

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Risk Classification After Colonoscopy and Polypectomy: Are We Always Fighting the Last War?

Gastroenterology

August 2023

Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom; Division of Gastroenterology and Hepatology, Mayo Clinic Healthcare, London, United Kingdom. Electronic address:

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Subepicardial Cardiomyopathy: A Disease Underlying J-Wave Syndromes and Idiopathic Ventricular Fibrillation.

Circulation

May 2023

Cardiovascular Clinical Academic Group, St. George's University Hospitals' NHS Foundation Trust and Molecular and Clinical Sciences Institute, St. George's, University of London, UK (C.M., C.S., E.R.B.).

Article Synopsis
  • Brugada syndrome (BrS), early repolarization syndrome (ERS), and idiopathic ventricular fibrillation (iVF) are primary electrical disorders linked to serious heart issues, but recent research suggests they may involve microstructural changes in the heart tissue, particularly in the right ventricle.
  • Ablation therapy targeting these specific areas has been effective in improving heart rhythms and reducing arrhythmias for patients with BrS and potentially ERS and iVF.
  • Many patients with these syndromes have genetic changes in sodium channel genes, but the overall genetic risk appears to be influenced by multiple genes, suggesting these conditions might represent varying degrees of subepicardial heart muscle disease.
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Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions.

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Gorilla in the room: Even experts can miss polyps at colonoscopy and how AI helps complex visual perception tasks.

Dig Liver Dis

February 2023

Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine Division, John Radcliffe Hospital, University of Oxford, Oxford, UK; Division of Gastroenterology and Hepatology, Mayo Clinic Healthcare, London.

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Spigelman IV: can intensive cold snaring avoid duodenectomy in familial adenomatous polyposis?

Endoscopy

June 2023

Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.

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The number of artificial intelligence (AI) tools for colonoscopy on the market is increasing with supporting clinical evidence. Nevertheless, their implementation is not going smoothly for a variety of reasons, including lack of data on clinical benefits and cost-effectiveness, lack of trustworthy guidelines, uncertain indications, and cost for implementation. To address this issue and better guide practitioners, the World Endoscopy Organization (WEO) has provided its perspective about the status of AI in colonoscopy as the position statement.

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Importance: Sudden infant death syndrome (SIDS) remains a leading cause of death during the first year of life. The etiology of SIDS is complex and remains largely unknown.

Objective: To evaluate whether siblings of children who died of SIDS have a higher risk of SIDS compared with the general pediatric population.

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Article Synopsis
  • A Delphi study was conducted with 18 global experts to develop consensus guidelines for endoscopic management of colorectal colitis-associated neoplasia (CAN), particularly focusing on high-risk variants (HR-CAN).
  • Experts agreed on key definitions, assessment techniques, and resection strategies for HR-CAN, achieving consensus on all 14 statements discussed.
  • Despite the low quality of existing evidence, this study marks a significant step towards creating standardized recommendations that can enhance future research and clinical practices in managing CAN.
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Article Synopsis
  • The study explores the challenges of assessing bowel preparation (BP) quality in Crohn's disease (CD) patients due to their unique medical conditions, such as inflammation and surgeries.
  • Researchers created 110 statements for BP quality assessment based on literature reviews and expert opinions from a panel of gastroenterologists.
  • The findings suggest that trained central readers should evaluate BP quality using established scales, while also ensuring comprehensive analysis of endoscopic procedures to enhance clinical trial outcomes in CD patients.*
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Diabetic heart disease is a major healthcare problem. Patients with diabetes show an excess of death from cardiovascular causes, twice as high as the general population and those with diabetes type 1 and longer duration of the disease present with more severe cardiovascular complications. Premature coronary artery disease and heart failure are leading causes of morbidity and reduced life expectancy.

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Background And Aims: SCENIC (International Consensus Statement on Surveillance and Management of Dysplasia in IBD) guidelines recommend that visible dysplasia in patients with longstanding inflammatory bowel disease (IBD) should be endoscopically characterized using a modified Paris classification. This study aimed to determine the interobserver agreement (IOA) of the modified Paris classification and endoscopists' accuracy for pathology prediction of IBD visible lesions.

Methods: One hundred deidentified endoscopic still images and 30 videos of IBD visible colorectal lesions were graded by 10 senior and 4 trainee endoscopists from 5 tertiary care centers.

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