For Stewart, the desire to become a scientist began at home. From a young age, she was aware of her father's diagnosis with cancer and the struggles he faced as his body became resistant to some treatments. Four years ago, when she became a predoctoral student at Mayo Clinic Graduate School of Biomedical Sciences, she chose a research project addressing blood cancers like his.

Working under the mentorship of Mayo Clinic hematologist oncologist Saad Kenderian, M.B., Ch.B., she has studied specially engineered immune cells, called chimeric antigen receptor-T cells or CAR-T cells, that are used to treat blood cancers like leukemia. She identified a signaling protein that, when neutralized, boosts the function of CAR-T cells by keeping them from reaching a state of "exhaustion." She and Dr. Kenderian's team published their findings in Nature Communications.

Stewart was delighted to learn that the journey of the new concept didn't stop there. "The approach she explored is novel, and her findings show there's a solid rationale to see whether it may help patients," says Dr. Kenderian.

'An incredible learning curve'

As the opportunity to advance the idea has emerged, Stewart has begun to learn about developing a clinical trial. "It's been an incredible learning curve," she says of taking a discovery beyond the lab space.

Close collaboration between researchers and clinicians at Mayo is what makes the steps of translation — from discovery to the clinic — happen efficiently, says Dr. Kenderian. Students like Stewart have opportunities to learn about the steps that shape clinical trials to bring new treatments to patients.

She and Dr. Kenderian met with a panel of Mayo physicians to get feedback about the design of a phase 1 clinical trial, which tests the safety of a new approach in a small cohort of patients who are interested in participating. "It was a great opportunity for me to hear how things are translated into the clinic, what questions and concerns clinicians may have, and how feasible our approach may be," she says.

"CAR-T cell therapy can be remarkable for some patients who have no other options, and the hope is to develop a more durable, lasting approach. This part of the research is still in early stages, but it's a very exciting project, and I feel lucky to be a part of it."

'Beyond what seemed possible'

Many Ph.D. students at Mayo Clinic are preparing for future careers in academia and industry. Another way they can learn about research that involves human participants is through an internship at Mayo Clinic's Office of Clinical Trials. Working with Mayo's clinical trials coordinators, students have followed a clinical trial underway and learned about designing a study that provides meaningful data and protects the rights, safety and welfare of patients who volunteer to participate.

But for some students, like Olivia Sirpilla, who is graduating in May from Mayo Clinic Graduate School of Biomedical Sciences, a long series of successful experiments in Dr. Kenderian's lab has opened the door to the next stages. Sirpilla's Ph.D. research looked at developing specially engineered stem cells from fat tissue as a treatment to calm the inflammation that occurs in immune diseases.

The team's results, published in Nature Biomedical Engineering, have set the stage for two potential clinical trials. One may be applicable to graft-versus-host-disease, an immune system complication that can occur after a stem cell transplant. The findings also may be applicable to the treatment of inflammatory bowel disease, particularly for patients who no longer respond to medications.

To design these clinical trials, Sirpilla and Dr. Kenderian are working with teams of Mayo clinicians who specialize in these disorders and their standard treatments. "I chose to come to Mayo Clinic for my Ph.D. to conduct lab research that would be highly translational," she says. "But to spend my thesis work developing a new cell therapy platform that is ready to be translated into a clinical trial is beyond what I thought possible in a Ph.D."

Research that reaches patients' daily lives  

Stephanie Zawada began her Ph.D. with an interest in computational approaches to research, but she has always strived to make advances that reach patients' daily lives.

Her thesis project aimed to help physicians assess people who have experienced a stroke and may be at risk for another.  She engaged two Ph.D. mentors who shared their expertise: Bart Demaerschalk, M.D.,  and  Bradley Erickson, M.D., Ph.D. Dr. Demaerschalk is a professor of neurology who treats patients with stroke at Mayo Clinic in Arizona and has a longstanding interest in digital health and using telemedicine to reach remote patients, and Dr. Erickson is a professor of radiology who leads artificial intelligence studies at his lab at Mayo Clinic in Minnesota.

Zawada "took a very innovative approach, exploring digital tools that may help a healthcare team continue to monitor and evaluate patients who have been discharged from the hospital but remain at risk for stroke recurrence," says Dr. Demaerschalk.

First, Zawada scoured available databases to identify attributes, including mood changes and sleep patterns, that can signal an oncoming stroke and can be captured by smartphone-based technology known as "wearables." Then she worked with her mentors and members of the Center for Digital Health to develop a pilot clinical trial with patients who volunteered to participate in a study from their homes.

Zawada designed a study that met the requirements of an institutional review board, or IRB, to address regulatory compliance. Aiming to get information from a "real-world" setting — where patients interact with app-based tools and the tools account for the range of daily activities — added logistical and mathematical complexity to the project. She worked with Dr. Demaerschalk and Mayo Clinic hospital-based stroke teams to recruit a cohort of 35 patients who gave consent to be part of the clinical trial.  

"Interacting with patients and hearing their concerns is the best way to advance useful technologies," Zawada says of designing the trial. "You want the clinical trial process to be as simple as possible for participants, and the only way to learn what tools and designs can make their lives better is to listen to them."

Her results showed that several behavioral and mood changes related to cerebrovascular disease can be captured with the use of wearable devices, even from patients going about their daily routines far from a hospital. The approach will need further investigation as a strategy to improve care and in the development of clinical trial measures, but the training to conduct a clinical trial is something that Zawada will take to the next stages of her career.

"Setting up a clinical trial is a complex process and really involves a team," says Zawada, who graduates in May and plans to continue researching wearables for patients who have other severe health conditions. "My thesis project was a multi-site collaborative effort — putting together the clinical questions, the new technology and the data analysis, the connection with patients — it's why I came to train at Mayo in the first place. As a student, I couldn't have done this project anywhere else."

The post Graduate students’ research pushes discoveries toward clinical trials appeared first on Mayo Clinic News Network.

Newly minted physicians and scientists graduated from Mayo Clinic Alix School of Medicine and Mayo Clinic Graduate School of Biomedical Sciences in Jacksonville, Florida, on Wednesday, May 14. As the graduate school has grown on the Florida campus, this year marks the second commencement ceremony for Mayo Clinic Graduate School of Biomedical Sciences in Florida for students receiving Ph.D. and master's degrees. 

The 12 medical school graduates who earned their medical degrees were part of an innovative program that allows students to complete their first two years of classroom study in Arizona or Minnesota, and then complete two years of clinical study in Jacksonville. They join more than 80 other Mayo Clinic Alix School of Medicine students in Arizona and Minnesota graduating on those campuses this week.

Graduation speakers encouraged students to lean into the Mayo Clinic values emphasized during their training. "Remember our core values as embodied in the acronym RICH TIES, which stands for Respect, Integrity, Compassion, Healing, Teamwork, Innovation, Excellence and Stewardship," said Dr. Fredric Meyer, Waugh Executive Dean of Education, Mayo Clinic. "They are guideposts that should help guide you as a physician, scientist and human being."

Dr. Olayemi Sokumbi, a dermatologist who attended medical school and residency at Mayo Clinic and now serves as an attending physician, researcher and mentor, delivered the keynote address. She shared wisdom from her life and journey, encouraging students to trust the wisdom from their life experiences. 

"Where you come from is not a limitation. It is your launchpad. Your story — every chapter of it — is your strength. It has given you perspective. It has shaped your voice. It has taught you how to see the unseen, how to care deeply, and how to rise when nothing around you said you could," she said, adding, "The truth is the world doesn't just need more degrees — it needs more compassion. It needs scientists who think ethically, doctors who listen like the patient is their own mother, leaders who ask not just what's efficient, but about what's just — those who put the needs of the patients first." 

Dr. Stephanie Oatman was the student speaker from the Mayo Clinic Graduate School of Biomedical Sciences. She received her Ph.D. following research studying Alzheimer's disease, and she spoke about the importance of teamwork and community in science and medicine. "Ask for help," she encouraged the graduates. "Offer help. Share what you have learned and pay forward what you have been given. Regardless of where you go, lift others up and leave it a better place than when you found it." 

Dr. Abba Zubair, vice dean of the medical school in Florida, inspired graduates to perpetuate the contributions of Mayo Clinic as they take the next steps in their careers. "I am reminded of the profound legacy of Mayo Clinic and its unwavering dedication to excellence in patient care, research and medical education," he said. "Go forth and make a difference in the world, for you are the future of medicine." 

Commencement recordings

Visit the Mayo Clinic College of Medicine and Science website to view the commencement ceremony recordings from Arizona, Florida and Minnesota.

Please courtesy: "Mayo Clinic."

About Mayo Clinic Alix School of Medicine
Mayo Clinic Alix School of Medicine is a national medical school with four-year medical degree programs in Rochester and Arizona. The school also offers a Florida program, enabling students to complete their first two years of medical studies in Arizona or Minnesota, and their final two years of learning in Florida. For more information, visit Mayo Clinic Alix School of Medicine.

About Mayo Clinic Graduate School of Biomedical Sciences
Mayo Clinic Graduate School of Biomedical Sciences offers world-class graduate education leading to Ph.D. and M.D.-Ph.D. degrees, as well as master's degree programs. The school offers research opportunities on campuses in Arizona, Florida and Minnesota, with training by leading investigators and clinicians in cutting-edge biomedical fields. For more information, visit Mayo Clinic Graduate School of Biomedical Sciences. 

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

The post The future of medicine: Mayo Clinic celebrates commencement in Florida appeared first on Mayo Clinic News Network.

Thirty-six medical students graduated from Mayo Clinic Alix School of Medicine in Phoenix, Arizona, on Monday, May 12. They join more than 50 other Mayo Clinic Alix School of Medicine students in Florida and Minnesota graduating on those campuses throughout May.

The medical school and Mayo Clinic Graduate School of Biomedical Sciences jointly celebrated the first M.D.-Ph.D. student to graduate in Arizona. The M.D.-Ph.D. program on the Arizona campus provides a unique opportunity for students to pursue world-class training to become a physician-scientist, fostering both clinical excellence and scientific discovery.

Graduates will take their next steps as residents and researchers at Mayo Clinic and across the country, pioneering discoveries, easing the physician shortage, and becoming healthcare leaders.

Speakers focused their remarks on reinforcing the importance of character and values.

"I urge you to return to the values that have anchored your training here,” said Dr. Jewel Kling, the vice dean of Mayo Clinic Alix School of Medicine and the Suzanne Hanson Poole Dean of Mayo Clinic Alix School of Medicine in Arizona. An internal medicine physician and division chair of Women's Health, she described Mayo Clinic values that include respect, integrity and compassion.  

"These are not just aspirational words — they are lived commitments," she added. "They are what make Mayo Clinic what it is and what will shape the kind of physician you choose to be."

Dr. Vikram Gill delivered the student commencement remarks, and, as a graduate and soon-to-be physician, reflected on his time in medical school. "How would you like to be remembered?" he asked graduating classmates. 

"The residents and attendings I remember the best are the kind and gracious ones. Not necessarily the smartest or most accomplished ones or the ones with the most publications, but the ones that asked me my name, asked me where I am from, asked me about my hobbies, and showed that they cared about me as a person. Medical school taught us to think like doctors, but I hope we never forget how to also think and feel like human beings," said Dr. Gill.

Dr. Annie Rusk, a Mayo Clinic pulmonary and critical care physician, was the commencement address speaker. Dr. Rusk shared the significance of storytelling in her life and the importance of self-determination. "There will be unexpected turns on your journey," said Dr. Rusk. "Your character and actions during these challenges will ultimately be what defines you. Take these moments in stride, and when faced with a challenge, ask yourself, 'Does this path lead to the physician and person I would like to be?'" 

Graduates have worked side by side with world-renowned experts at Mayo Clinic to create new ways to address patients' future needs and lead positive change in medicine. They will lead innovative and transformative efforts in healthcare, and they will apply their knowledge to develop creative solutions for some of the most complex problems facing patients and health systems today.

Commencement recordings

Visit the Mayo Clinic College of Medicine and Science website to view the commencement ceremony recordings from Arizona, Florida and Minnesota.

Please courtesy: "Mayo Clinic News Network."

About Mayo Clinic Alix School of Medicine
Mayo Clinic Alix School of Medicine is a national medical school with four-year medical degree programs in Rochester and Arizona. The school also offers a Florida program, enabling students to complete their first two years of medical studies in Arizona or Minnesota, and their final two years of learning in Florida. For more information, visit Mayo Clinic Alix School of Medicine.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

The post Mayo Clinic Alix School of Medicine students graduate in Arizona appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I was recently diagnosed with advanced-stage endometriosis and I am told I need to have surgery. I still want children someday — should I be worried about my future fertility? What else should I know about recovering from surgery?

ANSWER: As you are learning, endometriosis is a condition in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It can cause serious pain. 

With advanced-stage endometriosis and things such as uterine fibroids and large ovarian cysts, we do our best to minimize the negative effects on fertility and instead actually optimize for pregnancy. A myomectomy for uterine preservation, for example, allows women to maintain their uterus, even with large fibroids. Similarly, removing endometriosis but leaving the uterus, fallopian tubes and ovaries intact ensures there is still the possibility of future pregnancy and can even promote a successful pregnancy. Even when large, endometriosis-filled cysts are present (endometriomas), we are able to remove the abnormal tissue but leave the normal, healthy ovarian tissue in place for future fertility and hormonal needs.

The biggest question I get from patients after surgery is, "When can I get back to life?" Patients have families, jobs or responsibilities outside of their own health. We know that women especially can struggle with that balance of taking care of themselves while also taking care of everyone around them. Understanding what those constraints are from a personal perspective and getting women back to their lives as quickly as possible are among the key things that we focus on.

The best recommendation I have for anyone going into surgery is to be the healthiest you that you can be. The less stress you have, the better your diet is and the more rest and exercise that you've been getting is all going to support your body through the stress of surgery, which in turn is going to help speed along the recovery. The other thing I always make sure my patients are aware of is that, after surgery, be prepared to need some assistance doing daily things until the pain and fatigue lifts. It's normal to need a bit of help, so be prepared for that. 

The advances that we've had in technology when it comes to surgical procedures have pushed the envelope and allowed us to do the majority of gynecologic procedures through a minimally invasive approach. This means most patients are back at work a couple of weeks after surgery, depending on the procedure, but have a speedy recovery because we're not negatively affecting their bodies any more than necessary. 

The other thing to keep in mind from a recovery perspective is not every surgery is the same. There are some surgical procedures where the total downtime is only the day of surgery. In contrast, if we're doing something such as a hysterectomy to remove the uterus— even if it's done through small incisions — we want to ensure that healing happens well. So we don't want any heavy lifting or strenuous exercise for typically six weeks after surgery. However, we do want normal physical activity to start even the day of surgery because that really helps maintain strength and normal body function, which helps speed along the recovery.

My team and I like to develop a close relationship with our patients to make sure that we know what their fertility goals are for the future and any barriers that might potentially stand in that way. Talk to your healthcare team about any other concerns, and best wishes to you during this time. — Megan Wasson, D.O., Gynecology, Mayo Clinic, Phoenix

The post Mayo Clinic Q and A: Postsurgery recovery for women, what to know with endometriosis appeared first on Mayo Clinic News Network.

When Tiffany Coco steps into a room at Mayo Clinic Transplant Center in Arizona, she focuses on the patient's needs beyond the medical updates.

"Often, patients put their best face forward with the physicians," says Coco, "And when they talk to us, they let their guard down and open up about how transplant affects their day-to-day life."

As a licensed clinical social worker embedded in multidisciplinary care teams, Coco uses her clinical expertise to assess patients' emotional, psychological and social needs to help them navigate their transplant experience.

Coco leads a team of 20 social work professionals who work alongside nursing and medical staff to deliver an unparalleled experience to patients and organ donors before, during and after their care at Mayo Clinic. Her commitment to this work is deeply personal.

From personal loss to professional calling

At age 15, Coco experienced a tragic loss when her mother passed away unexpectedly. Following this, her family faced a difficult decision: They chose to donate her mother's organs.

"I've been that family on the other side of the conversation," she says. "We woke up that morning not knowing our world would change forever that afternoon, that my mom was going to be gone and we would have to make that decision."

Coco had known from a young age that she wanted to pursue a career helping people; her experience as a donor family solidified her resolve and led her to social work. During graduate school, she began an internship at Mayo Clinic, which led to a full-time role. She joined the Transplant Center in 2013.

"Transplant is a second chance at life ― for the patient, their family and their community," Coco says. "No matter how many transplants I witness, it amazes me each time because I know there is another family that gets a chance that mine didn't."

Helping patients on 'a journey of cautious hope'

Across Mayo Clinic, more than 480 social workers in the Department of Nursing serve patients in all care settings. Social workers are licensed professionals whose work ranges from therapy and counseling to crisis intervention and connecting patients to resources to meet basic needs such as housing, child care and transportation.

In transplant care, social workers help patients and families navigate the emotional, financial and logistical challenges surrounding organ transplantation and left ventricular assist device (LVAD) therapy.

Coco calls the patients' experience "a journey of cautious hope" that begins well before the procedure day and sometimes ends without a transplant.

One of the most sensitive areas her team helps patients navigate is the experience of receiving an organ from a deceased donor.  

"To prepare for a transplant, you're preparing for a wave of emotions. It's the excitement. It's the nerves. It's worry. It's everything at once," Coco says. She helps them realize the donor's death would have happened regardless, and the decision to donate is a beautiful gift.

Coco and her team conduct comprehensive psychosocial assessments to identify factors that may affect care outcomes — such as a patient's occupation, housing situation, literacy skills and family dynamics — and bring their insights to the care team.

They serve patients during pre-transplant planning, the patient's hospital stay and post-transplant follow-up, sometimes providing lifelong support.

"We truly do walk along the journey, and we, as the social workers, are there making sure that they have a journey to walk on," says Coco.  

"If they don't have a house to go back to after their care, or if they have to choose between meds and meals, that's not quality of life." 

Holding patients' stories until they can carry them again

Coco says that from the time she first came to Mayo Clinic, she has been inspired by its culture of accountability and excellence. She admires the way healthcare professionals show deep respect for each patient as a person. This means remembering patients' stories and celebrating transplant anniversaries with them, sometimes 15 years or more after their procedures.

"A patient is not just their diagnosis. It's not just a heart patient ― it's Mr. John Doe, and his motivation for a transplant is to walk his daughter down the aisle. Or Miss Jane Doe, who wants to finish her degree and get married. These stories are the motivation that we hold for patients while they're going through it, and that we give back when they're ready to carry them again."

On her arm, Coco wears tattoos of the organs she's seen in her career. They're a visible reminder of the work she's devoted her life to and of how she is honoring her mother.

"Though I wish I still had my mom, her legacy lives on in not just those lives that were impacted through her organ donation but the patients I come in contact with and impact in a different way," she says.

"I went from being a little 15-year-old girl just trying to figure out her place in the world to being the supervisor who guides the helpers."  

Learn more

• Learn about social work at Mayo Clinic in Rochester and medical social worker careers.

The post Social worker helps patients on transplant ‘journey of cautious hope’ appeared first on Mayo Clinic News Network.

For Anthony Maita, 'Buddy' is not just any other dog.

"He's the best thing that's ever happened to me," says Anthony.

It's no wonder, considering Buddy was right by Anthony's side during one of the most challenging times of his life — when Anthony began having epileptic seizures.

Watch: When seizures don't stop: Anthony's battle against drug-resistant epilepsy

Journalists: Broadcast-quality video (2:38) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I started having the seizures, noticeable seizures, and from there, it just started getting worse and worse," recalls Anthony.

It began after Anthony graduated from high school. He was making plans for his future and looking forward to attending college. That's when the seizures began.

Initially, the seizures were mild but quickly became more severe. "The experience (seizure) is like a loss of time, like a blank spot in your memory — like you're waking up without any recollection of what happened," says Anthony.

"The seizures were several times a week. His lips would be blue. His mouth would be blue," says Patricia Maita, Anthony's mother. "It so hard to see your child go through that and feel so helpless."

Doctors tried to manage Anthony's seizures with medication, but nothing worked. Eventually Anthony was diagnosed with drug-resistant epilepsy, or DRE.

In search of hope, Anthony's family turned to Mayo Clinic in Arizona.

"Up to a third of patients who develop epilepsy during their life will become resistant to medication," explains Jonathon J. Parker, M.D., Ph.D., a neurosurgeon at Mayo Clinic who specializes in treating the most serious and complex cases of epilepsy, including DRE.

"These patients have tried at least two medications, and they're still having seizures. At that point, we know the chances of seizure freedom unfortunately become very low, and that's when we start looking at other options," says Dr. Parker.

A battle for millions worldwide

Anthony is one of approximately 50 million people worldwide diagnosed with epilepsy. It is one of the most common neurological disorders globally. It is characterized by recurrent unprovoked seizures caused by abnormal electrical activity in the brain.

Of those diagnosed with epilepsy, approximately 30%, or 15 million people, are considered medication-resistant. Uncontrolled seizures often rob many people of their ability to live and function independently.

While it is rare, seizures can lead to sudden unexplained death in epilepsy, or SUDEP. "We know that more frequent seizures mean the patient is at higher risk of SUDEP, so that's why we are very aggressive about treating epilepsy with all the tools we have available," says Dr. Parker.

Current treatment options for patients with DRE include surgical procedures such as brain resection to remove a portion of the brain tissue responsible for generating seizures. A less invasive procedure involves laser ablation therapy that pinpoints and destroys abnormal brain tissue. While often effective, these surgical approaches carry the risk of possible side effects, such as memory impairment, motor deficits and speech difficulties. 

Neuromodulation is another surgical approach that uses electrical or magnetic stimulation to interrupt abnormal neural activity without removing brain tissue.

Unlocking new hope for patients

Now, a growing number of scientists across the globe are part of an innovative trend in research, investigating novel ways to treat DRE. It involves the use of regenerative medicine as a "reparative" approach to help the brain heal. 

Dr. Parker is the lead investigator of the first-in-human clinical trial at Mayo Clinic which studies the use of implanted specialized inhibitory brain cells as a potential reparative treatment for DRE. Dr. Parker's clinical trial is underway in Arizona.

Mayo Clinic in Arizona is one of 29 sites nationwide participating in the inhibitory brain cell implant clinical trial for patients with focal epilepsy, where seizures originate in a specific region of the brain. 

Anthony became Mayo Clinic's first patient to undergo the investigational brain cell implant. 

"We use a very minimally invasive technique where we inject the inhibitory cells through a pencil eraser-sized incision in the back of the head. Our hope is that, over time, these cells become part of the brain and help repair the neural circuitry, and reduce or prevent seizures without the side effects," says Dr. Parker. The cells are implanted in a one-time, single-dose procedure.

"Honestly, it was pretty easy," says Anthony. "I had no trouble with it." Anthony was discharged from the hospital the next day.

Doctors say it is still too early to determine whether the brain cell implant was effective, but they are hopeful.

"Anthony has been doing great since the procedure," says Dr. Amy Z. Crepeau, a neurologist at Mayo Clinic. "We have a great deal of optimism in regard to the potential of this brain cell therapy. Developing a safe and effective, minimally invasive treatment that does not carry the possible negative side effects could be a game changer in treating patients with DRE and improving their quality of life."

Tabitha's life-long struggle to control seizures

Tabitha Wilson lives in fear, never knowing when or where the next seizure will strike.

The Florida resident was diagnosed with epilepsy at the age of 2. She was placed on medication that adequately managed her seizures — until the week before her high school graduation. 

"I was 17 years old sitting in history class when the seizure happened," recalls Tabitha. "They had to load me up in an ambulance in front of the whole school."

Tabitha tried new types of medications, but the seizures only got worse.

"I fell down a flight of stairs, burned myself while cooking. I've completely blacked out and don't know where I am or who you are," says Tabitha. She was eventually diagnosed with drug-resistant epilepsy.

Tabitha underwent three brain surgeries to treat her DRE. Still, the seizures continued.

"I'll have good days and bad days. Some days, I'll have two, three, four seizures, back-to-back," says Tabitha.

Her uncontrolled seizures have robbed Tabitha of the ability to live independently. "I can't drive. I can't cook. I can't go swimming alone. I can't take a bath, only a shower and if someone is home with me," says Tabitha.

Watch: Tabitha Wilson shares what it's like to live with drug-resistant epilepsy.

Tabitha turned to Mayo Clinic in Florida where she learned about a clinical trial also investigating the potential of regenerative medicine as a possible treatment for DRE.

Dr. Sanjeet S. Grewal, director of stereotactic and functional neurosurgery at Mayo Clinic, is leading a team of researchers studying the use of implanted stem cells in conjunction with deep brain stimulation for patients like Tabitha.

Deep brain stimulation is one of the most recent FDA-approved methods of neuromodulation therapy for epilepsy. Studies show that patients who undergo deep brain stimulation experience median seizure reduction up to 70% after five years. However, Dr. Grewal says it is uncommon for patients to become seizure-free. 

"Unfortunately, neuromodulation doesn't give us the seizure freedom we want, and that's why we are trying to combine deep brain stimulation with stem cell therapy to see if we can increase the efficacy of neuromodulation," he says. 

Tabitha became the first patient to undergo the investigational treatment. Dr. Grewal says she is also the first person in the world to undergo surgery for deep brain stimulation and receive stem cell therapy in the thalamus in her brain as a potential treatment for DRE. 

Watch: Dr. Sanjeet Grewal, neurosurgeon, explains how Mayo researchers are leading a new trend in research for treating patients with drug-resistant epilepsy.

The clinical trial involves the use of mesenchymal stem cells, a type of adult stem cell that has anti-inflammatory properties. MSCs may also support tissue repair and healing. Further scientific research is needed to confirm their therapeutic potential in the field of regenerative medicine.

The MSCs used in the clinical trial are derived from fat tissue and created at the Human Cell Therapy Laboratory at Mayo Clinic in Jacksonville, Florida under the leadership of Abba Zubair, M.D., Ph.D., a pioneer in cell therapy.

Dr. Zubair's research teams have developed a cost-effective method of producing MSCs for use in potential treatments for conditions such as stroke.

Dr. Zubair has also led innovative research, including sending stem cells to the International Space Station to investigate how microgravity impacts their growth.

"My mission is to discover ways to address problems that patients have been struggling with and find a solution for them.
I believe the future is bright. "

Dr. Abba Zubair, Pioneer in Cell therapy, Mayo Clinic in Florida

Dr. Zubair has several research projects scheduled to launch into space in 2025.

"MSCs are what we call multipotent, meaning they can differentiate into different cell types based on where they're placed. If they are placed near blood vessels, they can become blood vessel types. If they're placed by heart cells, they can become heart cell types," explains Dr. Grewal.

The hope is the MSCs eventually become neural or brain cell types and interact in the part of the brain where the seizures occur. "It's called paracrine signaling, where they're releasing signals to the brain tissue around them and interacting in a way to try to repair that tissue."

Since undergoing the procedure, there has been an improvement in Tabitha's seizure management. However, Dr. Grewal says it is too early to know whether this is due to the deep brain stimulation, stem cells or both. 

Drs. Grewal and Parker say there is still a long road ahead to determine whether these cell therapies are proven safe and effective for patients with DRE. But they agree each day brings them one step closer to a potential treatment or cure for patients like Tabitha and Anthony.

"We've thought about this for generations, we just didn't have these technologies to enable it. Now we do," says Dr. Grewal. "So, whether it's wound healing, neurodegeneration, epilepsy or stroke, there are so many different studies going on investigating the potential of regenerative or reparative therapies."

Related articles

• Mayo Clinic researchers lead transformative shift toward neurorestorative treatment strategies for most severe forms of epilepsy
• Epilepsy Treatment
• Minimally invasive epilepsy treatment
• Mayo Clinic Minute: Demystifying epilepsy
• Epilepsy Surgery
• Laser ablation surgery helps treat young man’s epilepsy

The post (VIDEO) When seizures don’t stop: The battle against drug-resistant epilepsy appeared first on Mayo Clinic News Network.

Mayo Clinic is taking epilepsy research in a bold new direction, exploring treatment approaches to help patients living with the most severe and difficult-to-treat forms of epilepsy. About 50 million people worldwide are impacted by epilepsy. Approximately 30% of patients, or about 15 million people, suffer with drug-resistant epilepsy (DRE). While some patients experience only a few seizures per month, others may endure hundreds each day — ranging from episodes that are mild to life-threatening. 

Current treatment options for patients with DRE include surgical procedures such as brain resection to remove a portion of the brain tissue responsible for generating seizures. A less invasive procedure involves laser ablation therapy that pinpoints and destroys abnormal brain tissue. While often effective, these surgical approaches carry the risk of possible side effects, such as memory impairment, motor deficits and speech difficulties. Neuromodulation is another surgical approach that uses electrical or magnetic stimulation to interrupt abnormal neural activity without removing brain tissue.

Now, a growing number of scientists across the globe are part of an innovative trend in research investigating novel ways to DRE. It involves the use of regenerative medicine as a "reparative" approach to help the brain heal. 

Neurosurgeon Jonathon J. Parker, M.D., Ph.D., is the lead investigator of the first-in-human clinical trial at Mayo Clinic studying the use of implanted specialized inhibitory brain cells as a potential reparative treatment for DRE. The clinical trial is underway at Mayo Clinic in Arizona.

"This is an exciting time for regenerative medicine and the potential it may have for millions of people who suffer from the debilitating side effects of DRE," says Dr. Parker. "We use a very minimally invasive technique where we inject the inhibitory cells through a pencil eraser-sized incision in the back of the head. Our hope is that, over time, these cells become part of the brain and help repair the neural circuitry, and reduce or prevent seizures without the side effects," says Dr. Parker.

Mayo Clinic in Arizona is one of 29 sites nationwide participating in the inhibitory brain cell implant clinical trial for patients with focal epilepsy, where seizures originate in a specific region of the brain. 

Arizona resident Anthony Maita was the first person at Mayo Clinic to participate in the clinical trial. He underwent the one-time, single-dose procedure and was discharged from the hospital the next day. "I had no trouble with it," says Anthony. "My biggest hope is that, one day, I don't have to deal with this. My other biggest hope is that other people won't have to either."

It is still too early to determine whether the brain cell implant was effective for Anthony. Doctors are monitoring his progress closely. "Anthony has been doing great since the procedure," says Amy Crepeau, M.D., neurologist at Mayo Clinic. "We have a great deal of optimism in regard to the potential of this brain cell therapy. Developing a safe and effective, minimally invasive treatment that does not carry the possible negative side effects could be a game changer in treating patients with DRE and improving their quality of life."

Another clinical trial is underway at Mayo Clinic in Florida investigating the potential of regenerative medicine as a reparative treatment for DRE. Researchers are exploring the use of implanted stem cells in conjunction with neuromodulation.

One of the most recent FDA-approved methods of neuromodulation therapy for epilepsy is deep brain stimulation. While patients who undergo deep brain stimulation experience median seizure reduction up to 70% after five years, it is uncommon for patients to become seizure-free. Sanjeet Grewal, M.D., director of stereotactic and functional neurosurgery at Mayo Clinic, is hoping to change that. "Unfortunately, neuromodulation doesn't give us the seizure freedom we want, and that's why we are trying to combine deep brain stimulation with stem cell therapy to see if we can increase the efficacy of neuromodulation," says Dr. Grewal. 

Dr. Grewal is the lead investigator of the clinical trial which involves the use of implanted adipose-derived mesenchymal stem cells (MSCs) as an adjunct to deep brain stimulation for DRE patients. MSCs are a special type of adult stem cell with anti-inflammatory properties that may also have potential for healing.

Many, like Dr. Grewal, hope MSCs will serve a pivotal role in the future of regenerative medicine to treat conditions like epilepsy. "There are some patients whose seizures are just much harder to treat with the technology we have today. Our hope is that by adding stem cells and their regenerative potential, we can increase treatment success," says Dr. Grewal.

The clinical trial is using MSCs derived from fat tissue and produced at the Human Cell Therapy Laboratory at Mayo Clinic in Florida under the leadership of Abba Zubair, M.D., Ph.D. His research teams have developed a cost-effective method of producing MSCs for use in potential treatments for conditions such as stroke and osteoporosis. "My mission is to discover ways to address problems that patients have been struggling with and find a solution for them. I want to give them hope," says Dr. Zubair. "I truly believe the future is bright."

"MSCs are what we call multipotent, meaning they can differentiate into different cell types based on where they're placed. If they are placed near blood vessels, they can become blood vessel types. If they're placed by heart cells, they can become heart cell types," explains Dr. Grewal. It is hoped the MSCs in Dr. Grewal's clinical trial will become neural or brain cell types and interact in the part of the brain where seizures occur. "It's called paracrine signaling, where they're releasing signals to the brain tissue around them and interacting in a way to try to repair that tissue."

Tabitha Wilson began having seizures at the age of 2. The Florida resident says her seizures were well controlled until her mid-20s when her medication stopped working. Tabitha tried numerous other medications and underwent three brain surgeries, none of which provided the relief she needed.

"There are days when I'll have two, three or four seizures, back-to-back," says Tabitha. "I fell down a flight of stairs. I've burned myself while cooking. I've completely blacked out and don’t know where I am." Like many people who have epilepsy, Tabitha says uncontrolled seizures have robbed her ability to live independently. "I can't drive, can't cook or swim alone. I can't take a bath, only a shower and someone has to be in the house," says Tabitha.

Tabitha became the first person to participate in the Florida clinical trial. Dr. Grewal says she is also the first person in the world to undergo surgery for deep brain stimulation and receive stem cell therapy in the thalamus in her brain as a potential treatment for DRE. "I'm willing to try everything and anything to get some sort of control over these seizures because I've been living with this for so long," says Tabitha. "I hope to be a mother someday."

Since the surgery, Dr. Grewal says there has been an improvement in Tabitha's seizure management. However, he says it is too early to know whether this is due to the deep brain stimulation, stem cells or both. 

Drs. Grewal and Parker say there is a long road ahead to determine whether these cell therapies are proven safe and effective for patients with DRE. But they agree each day brings them one step closer to a potential treatment or even a cure for patients like Tabitha and Anthony.

"We've thought about this for generations, we just didn't have these technologies to enable it. Now we do," says Dr. Grewal. "So, whether it's wound healing, neurodegeneration, epilepsy or stroke, there are so many different studies going on investigating the potential of regenerative or reparative therapies."

Press kit, including b-roll, photos and interviews, available here.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Marty Hames, Mayo Clinic Communications, newsbureau@mayo.edu

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Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:02) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Many patients will wonder: 'I have a lump on my arm or my leg. Should I have this evaluated? Who should I see, and when are these symptoms concerning?'" says Dr. Krista Goulding, a Mayo Clinic orthopedic surgeon.

She explains when you should seek medical care, "If you have a lump on your arm or your leg that is growing rapidly or is bigger than the size of a golf ball, this needs rapid attention."

The first step in diagnosing a lump is to get advanced imaging, typically starting with a radiograph or X-ray.

"The next step is to get cross-sectional imaging, which means either an MRI or a CT scan," says Dr. Goulding.

Imaging is then followed by a biopsy to remove a sample of tissue for testing.

"And this helps our multidisciplinary team make decisions about how to treat these tumors because these tumors can be benign. They can be benign aggressive, meaning that they are not cancerous, but they can cause problems locally. And then there can be cancer diagnosis similar to sarcomas and other types of cancers that will need rapid attention," says Dr. Goulding.

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Phoenix — Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack. One of those people is country rap music artist Colt Ford.

"I couldn't have been anymore on death's door. I died twice that day," recalls Colt, describing the massive heart attack that nearly claimed his life following a concert performance last year. "When one of the top heart doctors in the world looks at you and goes, 'You're 1% of 1%,' it can't get more dire than that."

The 55-year-old musician was performing a sold-out show with his band in Gilbert, Arizona, last April. After what Colt describes as "one of the band's best shows ever," he walked backstage, and moments later, he was found slumped over in a chair due to a massive heart attack. Colt says he was feeling great during the concert. "When I played the show that night, I could do anything," he recalls. Emergency crews quickly responded to the scene and rushed Colt to the hospital. "I woke up eight days later, and I couldn't pick up a cup with ice in it and feed it to myself," he says.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Kwan Lee, M.B., B.Ch., M.D., interventional cardiologist at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or a silent myocardial infarction.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Eight months after suffering his heart attack, tests show Colt is healing well and on the road to recovery. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. While his strength improves, Colt admits the health scare has left him with anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that, and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Colt is back to writing his signature blend of music that combines country, rap and hip-hop. The Georgia-born singer just released a new song and is about embark on a new tour. He's hoping his music and his story will serve as inspiration for others. "Be happy that you're here and you're alive and you get a chance," Colt says. "I get a second chance, and I want to do something positive with it. I hope I can make a difference in somebody else's life."

You can watch more about Colt's story here.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network to learn more.

Media contact:

• Marty Velasco Hames, Mayo Clinic Communications, newsbureau@mayo.edu

Media kit including interviews, video and photos available for download here.

The post ‘I died twice that day’: Country rap superstar Colt Ford on surviving a near-fatal heart attack appeared first on Mayo Clinic News Network.

It was the evening of April 4, 2024 on a concert stage in Gilbert, Arizona.

Colt Ford and his band were performing their signature blend of country, rap and hip-hop music. It was a sold-out crowd. Colt was feeling at the top of his game, and the concert was shaping up to be one of the band's best shows ever.

No one expected how this night would end.

Watch Colt Ford's story of survival

Journalists: Broadcast-quality video (3:52) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Like it was really clicking. We had just made some changes in the set and it was feeling really good. The vibe was good, it all felt good," remembers Colt. "My stage manager said 'That's the best show we've done this year, man, you killed it,' It was incredible."

At the end of the show Colt thanked fans, turned and exited the stage.

No one expected what happened minutes later

"I woke up seven or eight days later, whatever, and I woke up in the hospital and was like 'What's going on?' I had no concept of anything," says Colt. "When I played the show that night I could do anything but when I woke up in the hospital I couldn't pick up a cup with ice in it and feed it to myself."

Minutes after exiting the stage, Colt suffered a massive heart attack. He was found slumped over in a chair backstage by one of his fellow band members. Emergency crews responded immediately and Colt was rushed to the hospital.

"When one of the top heart doctors in the world looks at you and goes 'You're 1% of 1%,' it can't get anymore dire than that," says Colt about his odds of surviving his heart attack.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Dr. Kwan Lee, interventional cardiologist at Mayo Clinic. Lee is part of the multidisciplinary team overseeing Colt's care at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

A silent killer

Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or silent myocardial infarction.

Colt says he had recently undergone a regular check-up at a different medical center and got a clean bill of health.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Nearly nine months after his heart attack, test results at Mayo Clinic indicate Colt is making excellent progress. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. "I'm about back to being in my college shape," says Colt, who played on the golf team for the University of Georgia before his singing career took off.

While his physical health improves, Colt admits the health scare has left him battling anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Dr. Lee says it is not uncommon for patients to experience anxiety, panic attacks and even depression following a heart attack. He recommends patients maintain an open dialogue with their health care team and discuss any issues that arise.

"I'm back, baby!"

Colt has been open about sharing his experience with his nearly three million followers on social media. "I'm back, baby!" Colt shared recently on Instagram. "It's been quite a journey but you guys have inspired me, you kept loving me, kept praying for me, kept sending me messages and I'm working hard to get better."

Just a year shy of his heart attack, Colt has released a new song and is embarking on a new tour. He is hoping his music and story will serve as inspiration for others.

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