Mayo Clinic proceedings
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Mayo Clinic proceedings · Apr 2021
Review Comparative StudySex Differences in Alcohol Consumption and Alcohol-Associated Liver Disease.
Alcohol-associated liver disease is becoming increasingly prevalent throughout the United States. Previously alcohol-associated liver disease was known to affect men more often than women; however, this gap between the sexes is narrowing. Studies show that women develop liver disease with lesser alcohol exposure and suffer worse disease as compared with men. ⋯ Due to the paucity of literature on some of the relevant subject matter and inclusion of landmark studies, no date range was selected. Studies were included if their methods were sufficiently robust and they made a comparison between the sexes that is clinically relevant. Understanding of the changing epidemiology and mechanisms of liver disease development unique to women are paramount in creating appropriate and effective interventions for women who represent a rapidly growing subset of patients with alcohol-associated liver disease.
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Mayo Clinic proceedings · Apr 2021
ReviewPreventing Breast Cancer Through Identification and Pharmacologic Management of High-Risk Patients.
Breast cancer remains the most common cancer in women in the United States. For certain women at high risk for breast cancer, endocrine therapy (ET) can greatly decrease the risk. Tools such as the Breast Cancer Risk Assessment Tool (or Gail Model) and the International Breast Cancer Intervention Study risk calculator are available to help identify women at increased risk for breast cancer. ⋯ Among the various ETs, which include tamoxifen, raloxifene, anastrozole, and exemestane, tamoxifen is the only one available for premenopausal women aged 35 years and older. A shared decision-making process should be used to increase the usage of ET and must be individualized. This individualized approach must account for each woman's medical history and weigh the benefits and risks of ET in combination with the personal values of the patient.
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Mayo Clinic proceedings · Apr 2021
ReviewChronic Coronary Syndromes in Women: Challenges in Diagnosis and Management.
Sex matters in science. This particularly applies to ischemic heart disease, which displays key differences in pathophysiology, presentation, and effectiveness in diagnostic strategies and management between women and men. However, underrepresentation of women in randomized trials has led to an evidence gap in clinical practice. ⋯ This novel concept has recently been referred to as chronic coronary syndromes, which better meets the female phenotype of ischemic heart disease, questioning current management recommendations that still largely apply to flow-limiting stenoses in epicardial coronary arteries typically found in men. The goal of this review is to highlight the most recent scientific advances in understanding chronic coronary syndromes in women. It provides practical advice with focus on challenges in diagnosis and management, and discusses perspectives towards the implementation of sex-specific, safer, and more effective therapeutic strategies.
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Mayo Clinic proceedings · Apr 2021
Adherence to Chronic Kidney Disease Screening Guidelines Among Patients With Type 2 Diabetes in a US Administrative Claims Database.
To examine the screening rates for kidney damage and function among patients with type 2 diabetes (T2D) and chronic kidney disease stage at diabetes diagnosis using a US administrative claims database. ⋯ Physicians treating patients with diabetes are selectively adhering to chronic kidney disease screening guidelines, as indicated by high rates of eGFR testing, but less frequent UACR testing. Despite recommendations to monitor both eGFR and UACR, less than half of patients were screened for albuminuria during the 1-year follow-up.
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Mayo Clinic proceedings · Apr 2021
Adherence to Public Health Measures Mitigates the Risk of COVID-19 Infection in Older Adults: A Community-Based Study.
To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. ⋯ We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.