Mayo Clinic proceedings
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Mayo Clinic proceedings · Jan 2025
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
ReviewHypertension Management in Women With a Multidisciplinary Approach.
Current clinical practice guidelines were established by several organizations to guide the diagnosis and treatment of hypertension in men and women in a similar manner despite data demonstrating differences in underlying mechanisms. Few publications have provided a contemporary and comprehensive review focused on characteristics of hypertension that are unique to women across their life spectrum. ⋯ Here, we discuss potential factors contributing to hypertension in women, differences related to effects of lifestyle modifications and drug therapy between men and women, the impact of sleep, and the importance of recognizing disparities in socioeconomic conditions and access to care. This review outlines several opportunities for future studies to fill gaps in knowledge to achieve optimal control of hypertension in women using a multidisciplinary approach, particularly related to sex-specific treatment approaches while considering socioeconomic conditions and life stages from premenopause through the transition to menopause.
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Statins are the mainstay of cholesterol treatment to prevent atherosclerotic cardiovascular disease. However, significant barriers, including physician and patient factors, prevent the optimal use of this drug class. ⋯ Within the tips, we discuss key components of the guidelines, assessing cardiovascular risk profiles, evaluating drug-drug interactions, addressing adverse effects, and developing treatment plans that include statins and nonstatins. The tips will be useful for primary and specialty clinicians, such as cardiologists, endocrinologists, and nephrologists.
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Mayo Clinic proceedings · Dec 2024
ReviewPost-Pulmonary Embolism Syndrome-A Diagnostic Dilemma and Challenging Management.
Historically, research on pulmonary embolism (PE) management has focused on short-term outcomes, such as acute cardiovascular collapse, change in right ventricular function, and in-hospital mortality. However, long-standing functional impairments from acute PE occur in up to half of all patients. ⋯ This review seeks to increase awareness of the syndrome that affects a significant portion of PE survivors. The epidemiology, pathophysiology, and clinical features are discussed, followed by a description of imaging findings and management options across the entire spectrum of post-PE syndrome.
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Mayo Clinic proceedings · Nov 2024
Review Practice GuidelineClinician's Guide to Geriatric Assessment.
The population of older adults is rapidly growing worldwide. Because of the substantial shortage of geriatricians, all clinicians need basic fluency in older adult care. In our approach to evaluating an older adult in the clinic or at the bedside, we apply the "Geriatric 5Ms" framework to manage the patient's care. ⋯ Fourth, ask what matters most to the patient. Fifth, assess multicomplexity: how the intersection of multiple chronic conditions and social determinants of health influence the patient's health care management. Herein, we provide clinicians with practical suggestions and resources for quickly and effectively applying the Geriatric 5Ms to the care of older adults.