Mayo Clinic Proceedings RSS feed: Current Issue. The flagship journal of Mayo and arguably one of the premier peer-reviewed clinical journals in general medicine, Mayo Clinic Proceedings is among the most widely read and highly cited scientific publication for physicians, with a circulation of approximately 124,000. While the Journal is sponsored by Mayo Clinic, it welcomes submissions from authors worldwide, publishing articles that focus on clinical medicine and support the professional and educational needs of its readers. Continuously published since 1926, the Proceedings content includes Nobel-prize-winning research. The Journal has an impact factor of 5.712. Ranked #13 in Impact Factor and #13 in Immediacy Index of the 153 journals in the category of General and Internal Medicine, the Journal has increased its Impact Factor every year for 11 years. No other journal in the Medicine category of ISI has done this. The Journal welcomes studies in clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings carries approximately 15 individual articles and features each month, consisting of original research, reviews, clinical content, editorials, commentaries, brief reports, special articles, and other short items. The Journal also offers unique features such as Concise Review for Clinicians, Residents' Clinics, and specially commissioned Symposia. In addition, the Journal carries one to two articles per issue with free CME credit from Mayo Clinic. New types of editorial content are added on a regular basis. For example, effective January 2012 the feature "My Treatment Approach" will be added, providing content highly valuable for the clinician. Finally, the Journal carries significant online-only content as well as supplemental material and videos directly related to the individual articles. The Journal has been completely redesigned in print and online for improved readability, features, and functionality and effective January 2012 will be published in full color throughout. For authors, the time from receipt of submission to first decision is usually 3 weeks and from acceptance to publication is 12 weeks. The Journal 's acceptance rate is approximately 25%, with 72% of manuscripts submitted by non-Mayo authors. For novel, time-sensitive research, an expedited review is available upon request and at the discretion of the Editorial Board. http://www.mayoclinicproceedings.org/?rss=yesElsevier Inc.en © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. Mayo Clinic Proceedings0025-6196875May 2012 © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.mayoclinicproceedings.org/article/PIIS0025619612003060/abstract?rss=yesMost sleep clinicians know the sinking feeling associated with encountering patients who are frantic about their inability to sleep. Such patients have often taken most hypnotics that we have heard of (and some that we haven't) and visited several other practitioners for this problem. They report being fearful that their insomnia is causing problems with daytime functioning and with health. They are often able to quote recent media reports associating “poor sleep” or “sleep disorders” with bad outcomes, including death. Indeed, North Americans regularly encounter news articles, Web alerts, direct-to-consumer advertisements, and evening news stories emphasizing the importance of a “good night's sleep.” These alerts often feature medical sleep experts, and they frequently do 2 things that may be a disservice to the field of sleep medicine and to the consumers of these reports. The first is to blur the lines between sleep deprivation and insomnia, which are 2 very different entities with very different causes and outcomes. The second problem is that news stories proclaiming the deadly effects of “sleep disorders” often lump all sleep problems together. Some sleep disorders (notably sleep apnea) have well-documented, serious consequences, but others do not. We in the sleep community, in our struggle to gain recognition for Sleep Medicine as a legitimate entity, may have unwittingly undercut our credibility.Insomnia, Hypnotic Drug Use, and Patient Well-being: First, Do No HarmBarbara A. Phillips10.1016/j.mayocp.2012.03.002Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XEditorial417418http://www.mayoclinicproceedings.org/article/PIIS0025619612002959/abstract?rss=yesIntimate partner violence (IPV) is defined as “any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship.” Its role as a major public health issue affecting both men and women, regardless of social class, sexual orientation, or racial/ethnic group, was reinforced by the recently released population-based 2010 National Intimate Partner and Sexual Violence Survey. Results indicate that women have a lifetime IPV prevalence rate of 29%, with 1 in 7 injured by an intimate partner. With a lifetime prevalence rate of 10% (1 in 25 injured as a result of IPV),2 men are significantly less likely than women to experience physical or sexual IPV. While less is known about the long-term impact of IPV among male victims, both male and female victims of IPV experience high rates of adverse physical, social, emotional, and mental health outcomes. Being a victim of IPV is strongly associated with a host of behavioral risks such as sexually transmitted diseases, human immunodeficiency virus infection, and the use of tobacco, alcohol, and drugs and is linked to all other forms of violence. As a significant contributor to health, social, and economic disparities, IPV jeopardizes the fabric of families and transcends all levels of socioeconomic status. Due to high rates of health care utilization by both victims and perpetrators of IPV, health care settings have abundant opportunities for early identification, intervention, and secondary prevention of IPV—but have consistently failed in these endeavors.Taking a Fresh Look at Routine Screening for Intimate Partner Violence: What Can We Do About What We Know?Karin Verlaine Rhodes10.1016/j.mayocp.2012.02.006Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XCommentaries419423http://www.mayoclinicproceedings.org/article/PIIS0025619612002984/abstract?rss=yesThe credibility of industry-sponsored clinical research has suffered in recent years, undercut by reports of selective or biased disclosure of research results, ghostwriting and guest authorship, and inaccurate or incomplete reporting of potential conflicts of interest. In response, many pharmaceutical companies have integrated best practices and recommendations from groups such as the International Committee of Medical Journal Editors (ICMJE), the Good Publication Practice guidelines, the Committee on Publication Ethics, the EQUATOR (Enhancing the QUAlity and Transparency Of health Resources) Network, and the Medical Publishing Insights and Practices (MPIP) initiative into their internal policies and standard operating procedures. However, a credibility gap remains: some observers, including some journal editors and academic reviewers, maintain a persistent negative view of industry-sponsored studies. Given industry's pivotal role in the development of new therapies, further improvements in research conduct and disclosure are needed across the industry-investigator-editor enterprise to restore confidence in industry-sponsored biomedical research.Ten Recommendations for Closing the Credibility Gap in Reporting Industry-Sponsored Clinical Research: A Joint Journal and Pharmaceutical Industry PerspectiveBernadette A. Mansi, Juli Clark, Frank S. David, Thomas M. Gesell, Susan Glasser, John Gonzalez, Daniel G. Haller, Christine Laine, Charles L. Miller, LaVerne A. Mooney, Maja Zecevic10.1016/j.mayocp.2012.02.009Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XCommentaries424429http://www.mayoclinicproceedings.org/article/PIIS0025619612003059/abstract?rss=yesAbstract: Objective: To evaluate the relationship between the use of zolpidem and subsequent cancer risk in Taiwanese patients. Methods: We used data from the National Health Insurance system of Taiwan to investigate whether use of zolpidem was related to cancer risk. For the study cohort, we identified 14,950 patients who had received a first prescription for zolpidem from January 1, 1998, through December 31, 2000. For each zolpidem user, we selected randomly 4 comparison patients without a history of using zolpidem who were frequency-matched by sex, age, and year of the index date. Incidence rates of all cancers and selected site-specific cancers were measured by the end of 2009, and related hazard ratios (HRs) and 95% confidence intervals (CIs) of the cancer were measured as well. Results: The risk of developing any cancer was greater in patients using zolpidem than in nonusers (HR, 1.68; 95% CI, 1.55-1.82). The stratified analysis showed that the overall HR for high-dosage zolpidem (≥300 mg/y) was 2.38. The site-specific cancer risk was the highest for oral cancer (HR, 2.36; 95% CI, 1.57-3.56), followed by kidney cancer, esophageal cancer, breast cancer, liver cancer, lung cancer, and bladder cancer (HR, 1.60; 95% CI, 1.06-2.41). Men were at higher risk than women. Conclusion: This population-based study revealed some unexpected findings, suggesting that the use of zolpidem may be associated with an increased risk of subsequent cancer. Further large-scale and in-depth investigations in this area are warranted. Relationship of Zolpidem and Cancer Risk: A Taiwanese Population-Based Cohort StudyChia-Hung Kao, Li-Min Sun, Ji-An Liang, Shih-Ni Chang, Fung-Chang Sung, Chih-Hsin Muo10.1016/j.mayocp.2012.02.012Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XOriginal Articles430436http://www.mayoclinicproceedings.org/article/PIIS0025619612003047/abstract?rss=yesAbstract: Objective: To examine the association between computer use, physical exercise, aging, and mild cognitive impairment (MCI). Patients and Methods: The Mayo Clinic Study of Aging is a population-based study of aging and MCI in Olmsted County, Minnesota. The study sample consists of a random sample of 926 nondemented individuals aged 70 to 93 years who completed self-reported questionnaires on physical exercise, computer use, and caloric intake within 1 year of the date of interview. The study was conducted from April 1, 2006, through November 30, 2008. An expert consensus panel classified each study participant as cognitively normal or having MCI on the basis of published criteria. Results: Using a multivariable logistic regression model, we examined the impact of the presence during the study period of 2 lifestyle factors (physical exercise and computer use) after adjusting for a third lifestyle factor (caloric intake) on aging and MCI. We also adjusted for age, sex, education, medical comorbidity, and depression. The median daily caloric intake was significantly higher in participants with MCI than in controls (odds ratio, 1.04; 95% confidence interval, 1.02-1.06; P=.001). Participants who engaged in both moderate physical exercise and computer use had significantly decreased odds of having MCI (odds ratio [95% confidence interval], 0.36 [0.20-0.68]) compared with the reference group. In the interaction analyses, there was an additive interaction (P=.012) but not multiplicative interaction (P=.780). Conclusion: In this population-based sample, the presence of both physical exercise and computer use as assessed via survey was associated with decreased odds of having MCI, after adjustment for caloric intake and traditional confounders. Computer Activities, Physical Exercise, Aging, and Mild Cognitive Impairment: A Population-Based StudyYonas E. Geda, Taryn C. Silber, Rosebud O. Roberts, David S. Knopman, Teresa J.H. Christianson, V. Shane Pankratz, Bradley F. Boeve, Eric G. Tangalos, Ronald C. Petersen10.1016/j.mayocp.2011.12.020Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XOriginal Articles437442http://www.mayoclinicproceedings.org/article/PIIS0025619612002662/abstract?rss=yesAbstract: Objective: To investigate associations of cardiorespiratory fitness (CRF) and different measures of adiposity with cardiovascular disease (CVD) and all-cause mortality in men with known or suspected coronary heart disease (CHD). Patients and Methods: We analyzed data from 9563 men (mean age, 47.4 years) with documented or suspected CHD in the Aerobics Center Longitudinal Study (August 13, 1977, to December 30, 2002) using baseline body mass index (BMI) and CRF (quantified as the duration of a symptom-limited maximal treadmill exercise test). Waist circumference (WC) and percent body fat (BF) were measured using standard procedures. Results: There were 733 deaths (348 of CVD) during a mean follow-up of 13.4 years. After adjustment for age, examination year, and multiple baseline risk factors, men with low fitness had a higher risk of all-cause mortality in the BMI categories of normal weight (hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.24-2.05), obese class I (HR, 1.38; 95% CI, 1.04-1.82), and obese class II/III (HR, 2.43; 95% CI, 1.55-3.80) but not overweight (HR, 1.09; 95% CI, 0.88-1.36) compared with the normal-weight and high-fitness reference group. We observed a similar pattern for WC and percent BF tertiles and for CVD mortality. Among men with high fitness, there were no significant differences in CVD and all-cause mortality risk across BMI, WC, and percent BF categories. Conclusion: In men with documented or suspected CHD, CRF greatly modifies the relation of adiposity to mortality. Using adiposity to assess mortality risk in patients with CHD may be misleading unless fitness is considered. The Obesity Paradox, Cardiorespiratory Fitness, and Coronary Heart DiseasePaul A. McAuley, Enrique G. Artero, Xuemei Sui, Duck-chul Lee, Timothy S. Church, Carl J. Lavie, Jonathan N. Myers, Vanesa España-Romero, Steven N. Blair10.1016/j.mayocp.2012.01.013Mayo Clinic Proceedings 87, 5 (2012)2012-04-13Mayo Clinic Proceedings2012-04-13875S0025-6196(12)X0017-XOriginal Articles443451http://www.mayoclinicproceedings.org/article/PIIS0025619612002650/abstract?rss=yesAbstract: Objective: To investigate associations between anthropometric measurements and total body fat, abdominal adipose tissue, and cardiovascular disease risk factors in a large biracial sample. Patients and Methods: This study is limited to cross-sectional analyses of data from participants attending a baseline visit between January 26, 1996, and February 1, 2011. The sample included 2037 individuals aged 18 to 69 years: 488 African American women (24%), 686 white women (34%), 196 African American men (9%), and 667 white men (33%). Anthropometry included weight; hip circumference; waist circumference; waist-hip, waist-height, and weight-height ratios; body adiposity index; and body mass index. Body fat and percentage of fat were measured by dual-energy x-ray absorptiometry, and abdominal visceral and subcutaneous adipose tissue were measured by computed tomography. Bivariate correlations, logistic regression models, and receiver operator characteristic curves were used, and analyses were stratified by sex and race. Results: In each sex-by-race group, all anthropometric measures were highly correlated with percentage of fat, fat mass, and subcutaneous adipose tissue and moderately correlated with visceral adipose tissue, with the exception of the waist-hip ratio. The odds of having an elevated cardiometabolic risk were increased more than 2-fold per SD increase for most anthropometric variables, and the areas under the curve for each anthropometric measure were significantly greater than 0.5. Conclusion: Several common anthropometric measures were moderately to highly correlated with total body fat, abdominal fat, and cardiovascular disease risk factors in a biracial sample of women and men. This comprehensive analysis provides evidence of the linkage between simple anthropometric measurements and the purported pathways between adiposity and health. Anthropometric Correlates of Total Body Fat, Abdominal Adiposity, and Cardiovascular Disease Risk Factors in a Biracial Sample of Men and WomenTiago V. Barreira, Amanda E. Staiano, Deirdre M. Harrington, Steven B. Heymsfield, Steven R. Smith, Claude Bouchard, Peter T. Katzmarzyk10.1016/j.mayocp.2011.12.017Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XOriginal Articles452460http://www.mayoclinicproceedings.org/article/PIIS0025619612003035/abstract?rss=yesAbstract: Objective: To identify common genetic variants influencing red blood cell (RBC) traits. Patients and Methods: We performed a genomewide association study from June 2008 through July 2011 of hemoglobin, hematocrit, RBC count, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration in 12,486 patients of European ancestry from the electronic MEdical Records and Genomics (eMERGE) network. We developed an electronic medical record–based algorithm that included individuals who had RBC measurements obtained for clinical care and excluded values measured in the setting of hematopoietic disorders, comorbid conditions, or medications known to affect RBC production or a recent history of blood loss. Results: We identified 4 new genetic loci and replicated 11 loci previously reported to be associated with one or more RBC traits in individuals of European ancestry. Notably, genes present in 3 of the 4 newly identified loci (THRB, PTPLAD1, CDT1) and in 6 of the 11 replicated loci (KLF1, ALDH8A1, CCND3, SPTA1, FBXO7, TFR2/EPO) are implicated in erythroid differentiation and regulation of cell cycle in hematopoietic stem cells. Conclusion: Genes in the erythroid differentiation and cell cycle regulation pathways influence interindividual variation in RBC indices. Our results provide insights into the molecular basis underlying variation in RBC traits. Genetic Loci Implicated in Erythroid Differentiation and Cell Cycle Regulation Are Associated With Red Blood Cell TraitsKeyue Ding, Khader Shameer, Hayan Jouni, Daniel R. Masys, Gail P. Jarvik, Abel N. Kho, Marylyn D. Ritchie, Catherine A. McCarty, Christopher G. Chute, Teri A. Manolio, Iftikhar J. Kullo10.1016/j.mayocp.2012.01.016Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XOriginal Articles461474http://www.mayoclinicproceedings.org/article/PIIS0025619612003011/abstract?rss=yesAbstract: Osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma are the most common malignant musculoskeletal tumors in children and adolescents. Today, most patients can be cured. Numerous factors have contributed to improved outcome for these patients over the past several decades. These include multidisciplinary care involving oncologists, radiation oncologists, surgeons, pathologists, and radiologists and enrollment of patients in clinical trials. Better understanding of molecular mechanisms of disease have resulted in studies using molecular targets in addition to standard chemotherapeutic agents, which hopefully will lead to better outcomes in the future. Moreover, new orthopedic techniques and devices as well as new technologies in radiation oncology hold promise for better local control of primary tumors and the potential for fewer late adverse effects. Despite this progress, patients must undergo lifelong follow-up for possible late effects of intense chemotherapy and radiation therapy. We review the diagnosis, prognosis, staging, multidisciplinary therapy, new directions in therapy, and long-term complications of treatment for these tumors. For this review, we searched MEDLINE using the terms rhabdomyosarcoma, osteosarcoma, Ewing sarcoma, biology, and humans and limited the search to articles from 2000 to September 2011. Additional references found in these articles were utilized as appropriate, as well as references from the background information in current therapeutic studies of the Children's Oncology Group. The same database and time frame were searched for articles written by leading authorities in the field. Common Musculoskeletal Tumors of Childhood and AdolescenceCarola A.S. Arndt, Peter S. Rose, Andrew L. Folpe, Nadia N. Laack10.1016/j.mayocp.2012.01.015Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XReview475487http://www.mayoclinicproceedings.org/article/PIIS0025619612002996/abstract?rss=yesAbstract: Fibromyalgia is a chronic widespread pain disorder commonly associated with comorbid symptoms, including fatigue and nonrestorative sleep. As in the management of other chronic medical disorders, the approach for fibromyalgia management follows core principles of comprehensive assessment, education, goal setting, multimodal treatment including pharmacological (eg, pregabalin, duloxetine, milnacipran) and nonpharmacological therapies (eg, physical activity, behavioral therapy, sleep hygiene, education), and regular education and monitoring of treatment response and progress. Based on these core management principles, this review presents a framework for primary care providers through which they can develop a patient-centered treatment program for patients with fibromyalgia. This proactive and systematic treatment approach encourages ongoing education and patient self-management and is designed for use in the primary care setting. A Framework for Fibromyalgia Management for Primary Care ProvidersLesley M. Arnold, Daniel J. Clauw, L. Jean Dunegan, Dennis C. Turk, FibroCollaborative10.1016/j.mayocp.2012.02.010Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XConcise Review for Clinicians488496http://www.mayoclinicproceedings.org/article/PIIS0025619612002960/abstract?rss=yesA 42-year-old man was transferred to St. Mary's Hospital, Rochester, Minnesota, for evaluation of hemoptysis. He was born in Laos and immigrated to the United States at age 6 years. He had a history of mitral valve commissurotomy 25 years previously in the setting of rheumatic mitral stenosis (MS). He also had known esophageal varices from cirrhosis secondary to chronic hepatitis B. He had been in a normal state of health until 6 months before presentation, when he began experiencing increasing dyspnea on exertion. He also complained of progressively worsening nocturnal cough exacerbated by lying supine, forcing him to sleep in a recliner. The cough progressed to become productive of blood-tinged sputum. He denied having any syncopal episodes, fevers, chills, or night sweats. He was a lifelong nonsmoker and denied any intravenous drug use, recent travel, or history of incarceration. 42-Year-Old Man With Hemoptysis, Dyspnea, and OrthopneaJackson J. Liang, Kalkidan G. Bishu, Nandan S. Anavekar10.1016/j.mayocp.2012.02.007Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XResidents' Clinic497500http://www.mayoclinicproceedings.org/article/PIIS0025619612002972/abstract?rss=yesMetabolic acidosis is a clinical disturbance characterized by low pH in body tissues and blood and a variety of neuromuscular and cardiorespiratory responses. Besides treating the initial disorder, the main goal for patients with acidosis is to increase the systemic pH with alkalizing agents, such as bicarbonates; however, adverse reactions linked to the administration of sodium bicarbonate (eg, metabolic alkalosis, edema due to sodium overload, and congestive heart failure) could limit its use in the treatment of metabolic acidosis.Serum Alkalinization and Hydrogen-Rich Water in Healthy MenSergej M. Ostojic10.1016/j.mayocp.2012.02.008Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XLetters to the Editor501502http://www.mayoclinicproceedings.org/article/PIIS002561961200359X/abstract?rss=yesWe read with interest the article by Simonetto et al on cannabinoid hyperemesis (CH) that was published in the February 2012 issue of Mayo Clinic Proceedings. Indeed, this entity is underdiagnosed due to a lack of awareness. Marijuana users presenting to the emergency department with nausea, vomiting, and abdominal pain are a common occurrence; these patients typically undergo several futile investigations and present repeatedly to the hospital with similar symptoms. Many of them are branded as ”drug seekers,” especially since they might have a history of using other recreational drugs along with marijuana.Cannabinoid and HyperemesisPallawi Torka, Rajeev Sharma10.1016/j.mayocp.2012.03.004Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XLetters to the Editor502503http://www.mayoclinicproceedings.org/article/PIIS0025619612003588/abstract?rss=yesWe appreciate Dr Torka's thoughtful letter, which both highlighted his experience with patients with cannabinoid hyperemesis (CH) and posed the important question of how many criteria need to be met in order to establish a diagnosis of CH. Although an important question, validation of diagnostic criteria was beyond the scope of our article. The intent of our article was simply to refine the previously proposed criteria by identifying the characteristic symptoms, signs, and test results in a larger sample size of patients with CH.In replyDouglas A. Simonetto, Amy S. Oxentenko, Margot L. Herman, Jason H. Szostek10.1016/j.mayocp.2012.03.003Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XLetters to the Editor503503http://www.mayoclinicproceedings.org/article/PIIS0025619612003916/abstract?rss=yesIn the article entitled “79-Year-Old Woman With Forgetfulness” published in the April 2012 issue of Mayo Clinic Proceedings (Mayo Clin Proc. 2012;87(4):408-411), the term electromyography should have been used in place of electromyelography.Correction Notice10.1016/j.mayocp.2012.04.001Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XCorrection503503http://www.mayoclinicproceedings.org/article/PIIS0025619612003084/abstract?rss=yesAn elderly man with a history of stage I lentigo maligna melanoma of the right jawline was followed up regularly in the dermatology clinic for skin cancer surveillance. During his visits, progressive, asymptomatic discoloration of his head, neck, and distal aspect of the lower extremities was incidentally noted. Physical examination findings included bluish gray hyperpigmented patches of the face and neck, legs, and sclera, consistent with a diagnosis of minocycline-induced hyperpigmentation. Six years earlier, the patient had undergone resection of an infected left knee implant followed by total knee reimplantation; postoperatively, long-term suppressive therapy with minocycline was initiated. He was not bothered by the pigmentary changes of his skin, and given the risks associated with reinfection, continued lifelong use of minocycline was recommended by the orthopedic surgeon.Minocycline HyperpigmentationDavid A. Wetter10.1016/j.mayocp.2012.02.013Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XMedical Imagese33e33http://www.mayoclinicproceedings.org/article/PIIS0025619612002716/abstract?rss=yes Although the American engineer Charles Frederick Kettering is known primarily for his contributions to the development and evolution of the automobile, he also made valuable contributions to medicine and science. As a philanthropist, in 1927 he established the C. F. Kettering Foundation for the Study of Chlorophyll and Photosynthesis at Antioch College (Yellow Springs, Ohio), and in 1945, in collaboration with American industrialist Alfred Pritchard Sloan (1875-1966), he funded the Sloan-Kettering Institute for Cancer Research at the Memorial Cancer Center in New York City. As an inventor, Kettering designed and built the “Kettering hypertherm,” a device used to treat neurosyphilis (syphilis of the brain) by intensely heating the body.Charles F. Kettering—Medical Philanthropist and InventorMarc A. Shampo, Robert A. Kyle, David P. Steensma10.1016/j.mayocp.2012.01.014Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XStamp Vignette on Medical Sciencee35e35http://www.mayoclinicproceedings.org/article/PIIS0025619612003072/abstract?rss=yesNoted glass artist Ivan Mares was born February 12, 1956, in Decin, Czeck Republic. He received his education at the Specialized Secondary Glass School in Kamenicky Senov, Czechoslovakia, from 1971 to 1975 and the Academy of Art, Architecture, and Design in Prague, Czechoslovakia, from 1975-1983, where he was a student of Stanislav Libensky. His vibrant and multifaceted works are in public and private collections throughout the world.Egg by Ivan MaresMargaret R. Wentz10.1016/j.mayocp.2011.11.019Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XArt at Mayo Clinice37e37http://www.mayoclinicproceedings.org/article/PIIS0025619612004405/abstract?rss=yesDr Thomas Gerber, Associate Editor for Mayo Clinic Proceedings, discusses the articles featured on the cover page and inside of the May 2012 issue. These include: “Relationship of Zolpidem and Cancer Risk: A Taiwanese Population-Based Cohort Study,”Highlights from the Current Issue – Audiovisual SummaryThomas C. Gerber10.1016/j.mayocp.2012.04.003Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XIssue Summarye39e39http://www.mayoclinicproceedings.org/article/PIIS0025619612003977/abstract?rss=yesEditorial Board10.1016/S0025-6196(12)00397-7Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XFrontmatterA4A4http://www.mayoclinicproceedings.org/article/PIIS0025619612003990/abstract?rss=yesTable of Contents10.1016/S0025-6196(12)00399-0Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XFrontmatterA7A7http://www.mayoclinicproceedings.org/article/PIIS0025619612004016/abstract?rss=yesGeneral Information10.1016/S0025-6196(12)00401-6Mayo Clinic Proceedings 87, 5 (2012)2012-05-01Mayo Clinic Proceedings2012-05-01875S0025-6196(12)X0017-XFrontmatterA16A16