Sharon Theimer (@stheimer)
Activity by Sharon Theimer
Meeting non-medical needs ahead of operations can aid recovery, cut health care costs, study suggests
ROCHESTER, Minn. — How well patients recover from cancer surgery may be influenced by more than their medical conditions and the operations themselves. Family conflicts and other non-medical problems may raise their risk of surgical complications, a Mayo Clinic study has found. Addressing such quality-of-life issues before an operation may reduce patients’ stress, speed their recoveries and save health care dollars, the research suggests. The study specifically looked at colon cancer patients, and found that patients with a poor quality of life were nearly three times likelier to face serious postoperative complications.
The findings are published in the Journal of Gastrointestinal Surgery.
“We know that quality of life is a very complex thing, but we can now measure it and work with it almost like blood pressure,” says lead author Juliane Bingener, M.D., a gastroenterologic surgeon at Mayo Clinic in Rochester. “We can say, ‘This is good, this is in the normal range, but this one here, that is not good, and maybe we should do something.’”
Quality of life as measured in the study is about more than happiness and how well people feel physically, Dr. Bingener says. It also includes the financial, spiritual, emotional, mental and social aspects of their lives and whether their needs are being met. [...]
Study: younger, older people likelier to visit ER repeatedly with gallstone pain before surgery
ROCHESTER, Minn. — Gallstone pain is one of the most common reasons patients visit emergency rooms. Figuring out who needs emergency gallbladder removal and who can go home and schedule surgery at their convenience is sometimes a tricky question, and it isn’t always answered correctly. A new Mayo Clinic study found that 1 in 5 patients who went to the emergency room with gallbladder pain and were sent home to schedule surgery returned to the ER within 30 days needing emergency gallbladder removal. The surgical complication rate rises with the time lag before surgery, the researchers say.
“It makes a big difference if you get the right treatment at the right time,” says co-lead author Juliane Bingener-Casey, M.D., a gastroenterologic surgeon at Mayo Clinic in Rochester. The study is published in the Journal of Surgical Research.
Often it’s obvious who needs emergency gallbladder removal, a procedure known as cholecystectomy, who can delay it and who doesn’t need surgery at all. But sometimes patients fall into a gray area. Mayo researchers are working to develop a reliable tool to help determine the best course of action in those cases, and the newly published study is a first step, Dr. Bingener-Casey says. [...]
Rochester, Minn. — Enzyme supplements available without a prescription are becoming increasingly popular, but should everyone add them to their shopping list? Brent Bauer, M.D., director of the Mayo Clinic Complementary and Integrative Medicine Program, is co-author of a new paper in the medical journal Mayo Clinic Proceedings on the pros and cons of over-the-counter enzymes. Here, Dr. Bauer answers some common questions about these dietary supplements:
What’s the issue?
Dr. Bauer: “They’ve become so popular. Like so many dietary supplements, patients are looking for something to help their health, so they’re reading about over-the-counter enzymes as one of those many dietary supplements, and all of a sudden we’re seeing sales go through the roof. A huge challenge with dietary supplements is that most haven’t been tested as most drugs are. We have a lot of information, but we don’t have definitive information. So our patients hear a lot of positive things, but they do not always hear the negatives or the side effects. So we’re trying to be very evidence-based. We don’t want to say no, there’s no reason to ever take an over-the-counter enzyme. By the same token, we don’t want to just rush out and buy it because we heard somebody say something positive on TV.”
What are some of the reasons people take enzyme supplements?
Dr. Bauer: “We have a lot of natural enzymes in our bodies. They help us digest food. There are clearly medical reasons to use enzymes. If a patient’s pancreas isn’t working, for example, that patient may need to take a medically prescribed enzyme supplement. That’s a little different story from a healthy person who wants to use over-the-counter bromelain, or papain — the enzymes that come from the pineapple and the papaya — or trypsin, or chymotrypsin. [...]
Bulges in body’s major blood vessel can cause potentially lethal ruptures, blood clots
An abdominal aortic aneurysm is a potentially life-threatening condition: If the body’s major blood vessel ruptures, it can prove deadly. The U.S. Preventive Services Task Force recently updated its recommendations on screening. Mayo Clinic vascular surgeon Peter Gloviczki, M.D., explains who should be watched for abdominal aortic aneurysms, how they are diagnosed and how surgery, which now includes a less invasive endovascular option, is improving survival rates:
What abdominal aortic aneurysms are: a bulge in the aorta, which is the body’s largest artery and is located in the abdomen above the belly button. The greatest risk is that the aneurysm will rupture.
“With every heartbeat there is increased pressure on the area of the aorta that has a weak wall and it bulges out, and ultimately when it reaches a certain size, it is going to rupture,” says Dr. Gloviczki, the Joe M. and Ruth Roberts Professor of Surgery at Mayo Clinic and past president of the Society for Vascular Surgery. “And rupture is a lethal complication.” [...]
The U.S. Preventive Services Task Force released recommendations Tuesday on which symptom-free patients should be screened for abdominal aortic aneurysms, potentially deadly ruptures of the body's major blood vessel.
The panel recommended one-time screening with an ultrasound for men 65 to 75 who smoke, and also for those who have smoked at least 100 cigarettes in their lifetimes. It says more research is needed to determine whether screening women in that age group who smoke or have smoked would be helpful.
Non-smoking men 65 to 75 should consult with their physician to see whether they should be screened based on their health history, such as a family history of abdominal aortic aneurysms. It recommended against screening non-smoking women.
Mayo Clinic vascular surgeon Peter Gloviczki, M.D., welcomed the task force recommendation to screen older men with a history of tobacco use.
"It is important to screen patients because most people with abdominal aortic aneurysms don't have symptoms," says Dr. Gloviczki, a past president of the Society for Vascular Surgery.
Male gender, older age, a history of smoking, a family history of abdominal aortic aneurysms and medical conditions such as coronary artery disease, high blood pressure and high cholesterol are risk factors for abdominal aortic aneurysms, he says.
The question of whether to screen becomes more complicated among women, Dr. Gloviczki says.
"These are the recommendations I am sure will stir some controversy," Dr. Gloviczki says. "I think there are certain situations, particularly when there's a family history of abdominal aortic aneurysms, when women should be screened."
Journalists: Soundbites of Dr. Gloviczki explaining and reacting to the task force recommendations are available in the downloads below. To arrange an interview with Dr. Gloviczki, please contact Sharon Theimer in Mayo Clinic Public Affairs at email@example.com or 507-284-5005.
June is Home Safety Month; July 4 fireworks also cause for special attention to risk
Facial hair and home oxygen therapy can prove a dangerously combustible combination, a Mayo Clinic report published in the peer-reviewed medical journal Mayo Clinic Proceedings finds. To reach that conclusion, researchers reviewed home oxygen therapy-related burn cases and experimented with a mustachioed mannequin, a facial hair-free mannequin, nasal oxygen tubes and sparks. They found that facial hair raises the risk of home oxygen therapy-related burns, and encourage health care providers to counsel patients about the risk.
More than 1 million people in the United States use home oxygen therapy, and it is on the rise around the world, especially in countries where smoking is increasing, the researchers say.
Mustaches and other facial hair can act as kindling for nasal oxygen tubes when a spark joins the mix, even if the spark is just a tiny ember that flies at an oxygen tank user from a match, grill or fireworks. [...]
Rochester, Minn. — Rheumatoid arthritis patients overall are twice as likely as the average person to develop heart problems. Pinpointing which rheumatoid arthritis patients need stepped-up heart disease prevention efforts has been a challenge; research by Mayo Clinic and others has found that standard heart disease risk assessment tools may underrate the danger a particular person faces. To better pinpoint rheumatoid arthritis patients’ heart disease risk, an international team that includes Mayo researchers has created a heart disease risk calculator tailored to rheumatoid arthritis.
Details on the new method, known as the Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis, or ATACC-RA, were presented at the European League Against Rheumatism annual meeting June 11-14 in Paris. The research team includes institutions from around the United States, Canada, Mexico, South Africa and Europe; Mayo is gathering and analyzing the group’s data.
Flying is as safe as ground travel after chest surgery, Mayo study finds
Rochester, Minn. — Summer travel isn’t for vacation alone. For some people, it may include a trip to an out-of-town hospital for surgery. If you are traveling for chest surgery, you may wonder whether it is safer to return home by car or plane. A new Mayo Clinic study found that, contrary to conventional wisdom, air travel is just as safe as ground travel after chest surgery, and there is often no reason to wait for weeks after an operation to fly home. Lead study author Stephen Cassivi, M.D., a Mayo Clinic thoracic surgeon, offers these five tips for safer, more comfortable travel home after surgery: