Cardiovascular - June 2012 Archives

ROCHESTER, Minn. — June 26, 2012.  In the realm of deadly and disabling diseases, conditions such as cancer and Alzheimer's seem to attract the most media attention. But there are others that take a similarly high toll, and rheumatoid arthritis is one of them, Mayo Clinic researchers say. It is a common cause of disability: 1 of every 5 rheumatoid arthritis patients is unable to work two years after diagnosis, and within five years, that rises to one-third. Life expectancy drops by up to five years, they write in the July issue of Mayo Clinic Proceedings in an article taking stock of current diagnosis and treatment approaches. Rheumatoid arthritis patients also have a 50 percent higher risk of heart attack and twice the danger of heart failure, Mayo researchers say. Much progress has been made in recognizing the importance of early diagnosis and prompt and aggressive treatment, but gaps in understanding of the disease remain, say the authors, Mayo Clinic rheumatologists John Davis III, M.D., and Eric Matteson, M.D. "There are many drug therapies available now for management of rheumatoid arthritis, but the challenge for patients and their physicians is to decide on the best approach for initial management and then subsequent treatment modification based on the response," Dr. Davis says. "In our article, we reveal our approach including algorithms for managing the disease that we believe will enhance the probability that patients will achieve remission, improved physical function, and optimal quality of life." In rheumatoid arthritis, the immune system assaults tissue, causing swollen and tender joints and sometimes involving other organs. The top goal of treatment is to achieve remission, controlling the underlying inflammation, easing pain, improving quality of life and preserving patients' independence and ability to work and enjoy other pursuits. Long-term goals include preventing joint destruction and other complications such as heart disease and osteoporosis. Dr. Davis and Dr. Matteson offer several tips and observations: "It is very important to have rheumatoid arthritis properly diagnosed, and treatment started early on. Getting the disease under control leads to better outcomes for the patient, ability to continue working and taking care of one's self, less need for joint replacement surgery, and reduced risk of heart disease," Dr. Matteson says. More than medication is needed to best manage rheumatoid arthritis. Educating patients about how to protect their joints and the importance of rest and offering them orthotics, splints and other helpful devices can substantially reduce pain and improve their ability to function. Cognitive behavioral therapy can make patients feel less helpless. Exercise programs that include aerobic exercise and strength training help achieve a leaner body; even modest weight loss can significantly reduce the burden on joints. No treatment approach or guidelines can ever take into account every possibility; when a patient describes joint tenderness, fatigue and disease activity worse than the physician thinks they are, the physician should investigate the causes of symptoms. Non-inflammatory causes of pain such as osteoarthritis or regional musculoskeletal pain syndromes may be to blame. Unanswered questions in rheumatoid arthritis include the relative benefits and harms of emphasizing initial treatment with prednisone; the effects of treatment on the risk of developing cardiovascular disease and other potentially deadly complications; and how to better predict how well treatments will work for specific patients and what the side effects will be.

ROCHESTER, Minn. — June 14, 2012.  Symptoms of gastric discomfort — indigestion, heartburn and stomach cramps — usually diminish in just a few hours. But for some people, digestive distress persists and becomes a constant concern. An eight-page Special Report in the June issue of Mayo Clinic Health Letter focuses on digestive health problems, which often can be successfully treated or managed. Highlights include: Many causes, many treatments: The Special Report covers treatments for digestive problems including ulcers, celiac disease, pancreatitis, Crohn's disease, diverticular disease, gallstones and liver disease. Seeking medical care sooner, rather than later, can help manage or even cure these conditions. Early action also may prevent a serious condition from becoming life threatening. Aging alone isn't the problem: People often blame aging for digestive problems. With aging, changes do occur. For example, the stomach loses elasticity and doesn't hold as much food. But, in general, changes due to aging have a mild impact on digestion. Heartburn (or heart attack?): Emergency care is recommended when heartburn seems different or worse than usual, especially if it occurs during physical activity or is accompanied by shortness of breath, sweating, dizziness, nausea or pain radiating into the shoulder and arm. The heart and esophagus are in close proximity and share similar nerve connections. They both can cause chest pain, ranging from mild to severe. And distinguishing heartburn from heart attack is not always easy. Don't blame spicy food: Most ulcers develop because of a bacterial infection or as a side effect of medications, not because of last night's dinner. The most common ulcer symptom is gnawing pain in the upper abdomen between the navel and breastbone. Treatment usually involves antibiotics and medications to reduce the level of acid in the stomach and give it a chance to heal. Being 'regular' doesn't mean every day: Constipation — one of the most common complaints among older adults — is generally defined as having fewer than three bowel movements a week with stools that are hard and painful. In contrast, easy bowel movements, even if they occur just every other day, would be considered normal. Constipation may be caused by dehydration, overuse of laxatives, medication side effects, a pattern of delaying bowel movements or underlying medication conditions. Exercise and adequate fiber in the diet can help. A physician can recommend other treatments such as fiber supplements or a brief course of laxatives.

Mayo Clinic Expert Discusses What's New For CPR Awareness Month ROCHESTER, Minn. - June 8, 2012.  Just the idea of performing CPR can intimidate the ...

Heart disease can become a deadly complication for rheumatoid arthritis patients, but it has often been difficult for physicians to spot early. A Mayo Clinic study ...