Abstract：
OBJECTIVE:To examine whether the outcome of patients with primary systemic amyloidosis (AL) has improved over time and to identify predictors of early mortality in patients with AL. PATIENTS AND METHODS:We studied 2 separate cohorts of patients. The first cohort, consisting of 1998 patients with AL seen at Mayo Clinic between January 1977 and August 2006, was used to examine the trends in overall survival (OS) from diagnosis during this 30-year period. The second cohort, consisting of 313 patients seen between September 2006 and August 2009, was used to validate a model for predicting early mortality. RESULTS:The 4-year OS from diagnosis improved during each decade of follow-up: 21%, 24%, and 33%, respectively, for the periods 1977-1986, 1987-1996, and 1997-2006 (P<.001). Within the last group (1997-2006), 4-year OS during 1997-1999, 2000-2002, and 2003-2006 was 28%, 30%, and 42%, respectively (P=.02). However, the 1-year mortality remained high during the 30-year period. A risk stratification score using cardiac troponin T, N-terminal probrain natriuretic peptide, and uric acid identified patients at risk of early mortality. The 1-year mortality with 0, 1, 2, or 3 risk factors was 19%, 37%, 61%, and 80%, respectively, in this training cohort of 459 patients. This was confirmed in a validation cohort of 313 patients. CONCLUSION:Survival in AL has improved over time, with maximum improvement occurring in the past decade. However, early mortality remains high, and prospective identification of patients at risk of early mortality may allow development of risk-adapted strategies.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Kumar SK,Gertz MA,Lacy MQ,Dingli D,Hayman SR,Buadi FK,Short-Detweiler K,Zeldenrust SR,Leung N,Greipp PR,Lust JA,Russell SJ,Kyle RA,Rajkumar SV,Dispenzieri Adoi
10.4065/mcp.2010.0480subject
Has Abstractpub_date
2011-01-01 00:00:00pages
12-8issue
1eissn
0025-6196issn
1942-5546pii
S0025-6196(11)60113-4journal_volume
86pub_type
杂志文章abstract：:Ulcerative colitis diagnosis and management represent a challenge for clinicians. The disguises of ischemia and acute infectious colitis continue to confound the diagnosis. The therapeutic options have remarkably expanded in the way of immunomodulators, biologics, or ileoanal pouch surgery, yet all carry potential con...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.05.001
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:To determine whether a simple clinical score, which was shown previously to predict the likelihood of severe coronary artery disease (CAD) in patients referred for coronary angiography, could predict prognosis in a separate cohort of patients with normal or mildly abnormal findings on their resting electrocar...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/77.6.515
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:To determine the frequency of fetal urinary tract anomalies and to characterize the types of such abnormalities detected on ultrasonography and the outcome of affected patients during a 15-year period at our institution. DESIGN:We retrospectively reviewed the findings on maternal prenatal ultrasound examinat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/70.6.526
更新日期：1995-06-01 00:00:00
abstract：:Duodenal duplication cysts are rare malformations that characteristically manifest with intestinal obstruction. In a 50-year experience, we found a duodenal duplication cyst in only three patients, one of whom had massive gastrointestinal bleeding as the initial symptom. Six other duplication cysts (two esophageal, on...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60419-4
更新日期：1985-11-01 00:00:00
abstract：OBJECTIVE:To assess whether caffeine intake is associated with all-cause and cause-specific mortality. PATIENTS AND METHODS:We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey 1999-2010. Cox proportional hazards models were used to compare the multivariate-adjus...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2017.03.010
更新日期：2017-08-01 00:00:00
abstract：OBJECTIVE:To explore the influence of referral bias on complication rates after vaginal hysterectomy. PATIENTS AND METHODS:Community-based (local) and referral patients had benign indications and underwent vaginal hysterectomy from January 1, 2004, through December 31, 2005. We retrospectively evaluated patient charac...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/mcp.2009.0299
更新日期：2010-02-01 00:00:00
abstract：:The metabolic syndrome is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including various combinations of abdominal obesity, glucose intolerance, hypertension, and atherogenic dyslipidemia (elevated triglyceride values, low high-density lipoprotein cholesterol levels, and small ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/81.12.1615
更新日期：2006-12-01 00:00:00
abstract：:During the 1960s, the Mustard or Senning operation was the conventional palliative therapy for patients with transposition of the great arteries. Many of these patients are now adults, and the durability of the morphologic right ventricle to function as the systemic ventricle is being questioned. Surgical options for ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/72.3.245
更新日期：1997-03-01 00:00:00
abstract：:Iatrogenic injury-injury caused unintentionally by medical treatment-breaks the oldest and most famous rule of medical ethics: primum non nocere, or above all, do no harm. Medical malpractice law, however, focuses on whether an injury was caused by negligence, not on whether an injury was iatrogenic. Iatrogenic injury...
journal_title：Mayo Clinic proceedings
pub_type： 传,历史文章,杂志文章,评审
doi：10.1016/j.mayocp.2014.05.004
更新日期：2014-09-01 00:00:00
abstract：:A careful clinical history and physical examination are the most important components of the preoperative assessment of the cardiac patient who is to undergo a noncardiac surgical procedure. From these factors and the nature of the surgical procedure planned, a reasonable estimate of potential cardiac risk can be form...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)64980-5
更新日期：1989-09-01 00:00:00
abstract：:Vitamin K antagonists were the only class of oral anticoagulants available to clinicians for decades. However, with the US Food and Drug Administration approval of new oral anticoagulants, such as dabigatran, rivaroxaban, and apixaban, clinicians now have a broader choice. Given the recent approval and availability of...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2013.03.006
更新日期：2013-05-01 00:00:00
abstract：OBJECTIVE:To determine how all-cause hospitalizations within 12 months preceding an index heart failure (HF) hospitalization affect risk stratification for 30-day all-cause readmission. PATIENTS AND METHODS:Early readmission of inpatients with HF is challenging to predict, yet this outcome is used to compare hospital ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.12.018
更新日期：2014-05-01 00:00:00
abstract：:Frequently, the presence of endocarditis is disguised. The emphasis of this description of the clinical manifestations of endocarditis is on the various modes of presentation, rather than on individual symptoms and signs. Endocarditis can manifest with cardiac, pulmonary, ophthalmic, central nervous system, renal, ort...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：OBJECTIVE:To assess the frequency and significance of GB virus-C infection in type 1 autoimmune hepatitis. MATERIAL AND METHODS:Serum specimens from 94 patients with type 1 autoimmune hepatitis were tested for GB virus-C RNA by reverse transcription and polymerase chain reaction. Serum samples from 50 normal subjects ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63722-1
更新日期：1998-05-01 00:00:00
abstract：OBJECTIVE:To investigate whether the use of systemic glucocorticoids is a risk factor for community-acquired Staphylococcus aureus bacteremia (CA-SAB). PATIENTS AND METHODS:We used population-based medical registries in Northern Denmark to conduct a case-control study including all adults with first-time CA-SAB and ma...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.04.023
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the frequency and pattern of complementary and alternative medicine (CAM) use in patients referred to a fibromyalgia treatment program at a tertiary care center. PATIENTS AND METHODS:Patients referred to the Mayo Fibromyalgia Treatment Program between February 2003 and July 2003 were invited on t...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)62958-3
更新日期：2005-01-01 00:00:00
abstract：:The aim of this study was to determine whether the characteristics of esophageal symptoms may be of diagnostic utility in distinguishing dysphagia of various causes. Included in the study were a total of 499 patients with three types of dysphagia: 234 with dysphagia related to an obstructive lesion in the esophagus, 1...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62266-6
更新日期：1993-10-01 00:00:00
abstract：:Of 53 patients with horseshoe kidney (9 in the present series), 45 underwent operation for an abdominal aortic aneurysm: 40 electively and 5 on an emergency basis. The remaining eight patients underwent revascularization for arteriosclerosis obliterans. Of the 53 patients, 35 (66%) had renal artery anomalies. The anom...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1979-02-01 00:00:00
abstract：OBJECTIVE:To examine the association of medical knowledge acquisition with attendance at specific conference types during internal medicine residency. PARTICIPANTS AND METHODS:Attendance at residency core curriculum, morbidity and mortality, and medical grand rounds conferences was tracked for 195 residents who took t...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/83.4.449
更新日期：2008-04-01 00:00:00
abstract：:Effective antituberculous drugs have radically improved the prognosis of the patient with active tuberculosis. Surgical therapy is rarely needed, and sanitoriums have largely vanished. Triple-drug therapy may be indicated initially for cavitary pulmonary disease, meningitis, miliary disease, and moderate to severe ren...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1983-04-01 00:00:00
abstract：:Considerable advances in the diagnosis and treatment of migraine headache have occurred during the past decade, but treatment options for acute migraine attacks have expanded at a faster rate than those for prophylaxis. We describe a patient whose migraine headaches responded dramatically to sustained-release niacin a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/78.6.770
更新日期：2003-06-01 00:00:00
abstract：:Since the early 1970s, investigators have been interested in the relationship between dietary marine fish oils and plasma lipoproteins. Previous studies have shown that consumption of a diet rich in marine fatty acids results in altered lipid profiles, prolonged bleeding times, reduced platelet aggregation, and decrea...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章,评审
doi：10.1016/s0025-6196(12)61879-5
更新日期：1987-02-01 00:00:00
abstract：:The clinical impact of the association between oral contraceptive (OC) use and breast cancer risk is important given that OCs are the most commonly prescribed contraceptive agent and that more than a quarter of a million women are diagnosed as having breast cancer in the United States annually. Substantial changes to ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/83.1.86
更新日期：2008-01-01 00:00:00
abstract：:Sarcopenia is a debilitating condition that occurs with senescence. The present study places this entity in the context of life expectancy, then discusses the mechanism of muscle loss. The findings show deficits in muscle protein synthesis with advancing age and suggest that these deficits are specific to certain musc...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：
更新日期：2000-01-01 00:00:00
abstract：:Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension, and its management poses a challenge to busy primary care practices. The Patient Health Questionnaire-9, a simple self-administered tool of proven validity and reliability, is a commonly used scree...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/82.11.1395
更新日期：2007-11-01 00:00:00
abstract：OBJECTIVE:To review the association of coronary artery calcification with coronary atherosclerosis and its potential clinical application as detected on electron beam computed tomography (EBCT). DESIGN:A literature review of coronary artery calcification, coronary artery disease, and EBCT is presented, and clinical ap...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/71.4.369
更新日期：1996-04-01 00:00:00
abstract：:We describe a woman with an unusual case of thromboembolism of the mesenteric artery in whom multiple thrombi were subsequently found in the aorta and right heart chambers on transesophageal echocardiography. Further evaluation revealed a deficiency of protein C and S plasma proteins, inhibitors of the clotting system...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/76.3.319
更新日期：2001-03-01 00:00:00
abstract：:A prospective, stratified, randomized 3-year clinical trial was conducted on the effect of rigorous versus conventional glucose control on peripheral nerve function in 33 insulin-treated diabetic patients with a duration of diabetes of less than 2 years. The goals for conventional glucose control were the mean of fast...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-05-01 00:00:00
abstract：:An inexpensive and reproducible model to help in developing the technical skills for, and to investigate experimentally, a microvascular anastomosis resembling the superficial temporal-middle cerebral artery bypass is described. The model is used to illustrate the important principles of microvascular surgery. Using a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1976-05-01 00:00:00
abstract：:Studies were undertaken to determine the effects of lidocaine on ischemic myocardium, which was induced by coronary artery constriction in open-chested dogs. A real-time epicardial fluorescent technique to detect in vivo-reduced nicotinamide adenine dinucleotide (NADH) during 60 seconds of ischemia was used. Blood flo...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-07-01 00:00:00
