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Rochester, MN, United States

Mayo Medical School is a research institution and medical school which is a part of the Mayo Clinic in Rochester, Minnesota, United States. It grants degrees in medicine, and is accredited by the North Central Association of Colleges and Schools. Currently, it is considered the most selective school in terms of acceptance rates. It had an acceptance rate of 2.1% in the year 2012. It is also considered one of the least expensive private medical schools in the country in the 2012-2013 academic school year. Wikipedia.

Swiecicki P.L.,Mayo Medical School
Blood | Year: 2013

Cold agglutinin disease is a rare and poorly understood disorder affecting 15% of patients with autoimmune hemolytic anemia. We reviewed the clinical and pathologic features, prognosis, and management in the literature and describe our institutional experience to improve strategies for accurate diagnosis and treatment. Retrospective analysis identified 89 patients from our institution with cold agglutinin disease from 1970 through 2012. Median age at symptom onset was 65 years (range, 41 to 83 years), whereas the median age at diagnosis was 72 years (range, 43 to 91 years). Median survival of all patients was 10.6 years, and 68 patients (76%) were alive 5 years after the diagnosis. The most common symptom was acrocyanosis (n = 39 [44%]), and many had symptoms triggered by cold (n = 35 [39%]) or other factors (n = 20 [22%]). An underlying hematologic disorder was detected in 69 patients (78%). Thirty-six patients (40%) received transfusions during their disease course, and 82% received drug therapy. Rituximab was associated with the longest response duration (median, 24 months) and the lowest proportion of patients needing further treatment (55%). Our institution's experience and review of the literature confirms that early diagnostic evaluation and treatment improves outcomes in cold agglutinin disease.

Roger V.L.,Mayo Medical School
Circulation Research | Year: 2013

Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public health problem, associated with significant mortality, morbidity, and healthcare expenditures, particularly among those aged ≥65 years. The case mix of HF is changing over time with a growing proportion of cases presenting with preserved ejection fraction for which there is no specific treatment. Despite progress in reducing HF-related mortality, hospitalizations for HF remain frequent and rates of readmissions continue to rise. To prevent hospitalizations, a comprehensive characterization of predictors of readmission in patients with HF is imperative and must integrate the impact of multimorbidity related to coexisting conditions. New models of patient-centered care that draw on community-based resources to support HF patients with complex coexisting conditions are needed to decrease hospitalizations. © 2013 American Heart Association, Inc.

Stewart E.A.,Mayo Medical School
New England Journal of Medicine | Year: 2015

A 47-year-old black woman has heavy menstrual bleeding and iron-deficiency anemia. She reports nocturia and urinary frequency. A colonoscopy is negative. Ultrasonography shows a modestly enlarged uterus with three uterine fibroids. She is not planning to become pregnant. How should this case be evaluated and managed? Copyright © 2015 Massachusetts Medical Society.

Immunotherapy that facilitates endogenous T-cell activity has the potential to target therapy-resistant tumor clones. In vitro studies have demonstrated that lenalidomide repairs the T-cell immunologic synapse defect in chronic lymphocytic leukemia (CLL). Pentostatin, cyclophosphamide, and rituximab (PCR) in CLL is clinically active with modest toxicity, indicating suitability of this chemoimmunotherapy (CIT) platform for combination with immunotherapy. Here we report on a trial of PCR followed by lenalidomide consolidation. Of 34 patients who received lenalidomide, 24% improved their quality of response and 4 patients converted to minimal residual disease negative status. Retrospective comparison to a historical PCR trial indicated that lenalidomide consolidation extends time to progression requiring salvage therapy. Longitudinal analysis showed that antitumor T-cell immune synapse activity improved post-PCR and was further enhanced after lenalidomide consolidation. These novel data showing repair of T-cell defects provide proof-of-principle that lenalidomide-based consolidation after CIT could have a beneficial clinical and immunologic role in CLL.

Singh M.,Mayo Medical School
Journal of the American College of Cardiology | Year: 2015

Bleeding avoidance strategies for percutaneous coronary interventions continue to evolve with the availability of newer antiplatelet and anticoagulation therapies. Advances in interventional practices have altered the balance between ischemic and bleeding complications. With the availability of rapidly-acting platelet adenosine diphosphate-receptor antagonists, the need for routine glycoprotein IIb/IIIa inhibitors has diminished. Recent meta-analyses and trials have advanced our knowledge of vascular access and different anticoagulation regimens. Vascular closure devices have long been used for early ambulation; however, more recent results demonstrating lower bleeding complications from observational registries are encouraging. This review synthesizes this information, taking into account changes in the landscape of interventional practice with respect to current bleeding avoidance strategies. © 2015 American College of Cardiology Foundation.

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