Mayo Clinic Minute: What high triglycerides mean and why it matters to your heart

You may be familiar with high-density lipoproteins (HDL), or good cholesterol; low-density lipoproteins (LDL), or bad cholesterol; and their connections to heart health. But what about triglycerides? Often that word gets skimmed over when talking about cholesterol levels.

Dr. Regis Fernandes, a Mayo Clinic cardiologist, says triglycerides provide the body with energy from food. High levels can indicate signs of other conditions, like diabetes or prediabetes, that can increase the risk of heart disease and stroke.

5 things to know about fainting: The heart's role and when it may signal a serious condition

You may have heard that people who feel faint should sit with their heads between their knees, but is that true? And how can you tell whether you or someone else who has fainted should go to the emergency department or perhaps even see a cardiologist? ⁠
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Dr. Elijah Behr, a cardiologist at Mayo Clinic Healthcare in London, explains five things it is important to know about fainting.

Mayo Clinic Q and A: 5 things to know about stroke

A stroke can happen at any time and to anyone. You might be talking to your loved one and notice they're suddenly slurring their words. Or, while grocery shopping, you realize you can't move your hand to pick up a jar from the shelf. You can go from feeling as usual to feeling sick within a matter of seconds to minutes. Here are five key things to know about stroke.

Hope for ovarian cancer: New immunotherapy target

In a study published in Science Advances, Mayo Clinic researchers found a new immunotherapy target called a cryptic antigen that may be key in helping the immune system fight tumors in ovarian cancer.⁠
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Cryptic antigens are part of a protein — known as epitopes — that are usually hidden or inaccessible to the immune system and may be present in tumor cells.⁠
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Researchers will explore cryptic antigens in designing new treatments, such as vaccines or immunotherapies, that could help the immune system target tumors more effectively. ⁠

Mayo Clinic Q and A: Struggling with IBS symptoms?

Irritable bowel syndrome (IBS) is common and affects approximately 1 in 10 adults in the U.S. IBS is characterized by abdominal pain with disordered defecation (constipation, diarrhea or both). IBS can generally be easily treated with a combination of education, reassurance, diet and medications.

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Dr. Ekta Kapoor, a co-investigator of the study, says women providing 15 or more hours of care per week are especially affected, with half of them experiencing moderate or worse symptoms. She says more menopause conversations are crucial to help women understand and navigate this life transition.

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Most caregivers are women, and a majority of them are in their late 40s and early 50s — the same time frame during which menopause happens for most women.

How do they intersect? That's what Dr. Kapoor and her colleagues wanted to find out.

"It can take a toll on their physical health. It can take a toll on their mental health. And the same can be said about menopause symptoms also, which can significantly impact the quality of life in some women," she says.

Symptoms

Menopause symptoms are divided into three domains.

"You have somatic symptoms, like hot flashes, night sweats, joint pains, fatigue and heart palpitations, etc. Then, the psychological domain has mood problems, anxiety. And the urogenital has vaginal dryness and urinary symptoms," says Dr. Kapoor.

Two findings from the study particularly stood out.

"Menopause symptoms across all domains, and not just the psychological domain, were affected, which was a surprise, No. 1. No. 2, when we tried to adjust for stress and the overall mental health of the women, this association between caregiving and menopause symptom burden persisted," says Dr. Kapoor.

The research, she says, emphasizes the need for better support for caregivers going through menopause and for better education of caregivers and their healthcare professionals regarding treatment options for menopause symptoms.

Review the study for a complete list of authors, disclosures and funding.

Related posts:

• 8 common health conditions midlife women face
• Managing menopause symptoms
• Mayo Clinic Minute: Perimenopause and menopause
• Mayo Clinic study puts price tag on cost of menopause symptoms for women in the workplace

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February is Heart Month in many countries

LONDON — You may have heard that people who feel faint should sit with their heads between their knees, but is that true? And how can you tell whether you or someone else who has fainted should go to the emergency department or perhaps even see a cardiologist? Elijah Behr, M.D., a cardiologist at Mayo Clinic Healthcare in London, explains five things it is important to know about fainting.

Fainting or blacking out, also known as syncope, is a temporary loss of consciousness due to insufficient blood flow to the brain.  

There are different types of syncope

Vasovagal syncope is the medical term for the most benign kind of fainting, simple fainting without a serious underlying cause, Dr. Behr explains. This type of fainting is common.

"In some people, if they have a drop in blood pressure from emotional distress, pain, illness or dehydration, for example, or just generally have a low blood pressure, any provocation causes a reflex in the heart," Dr. Behr says. "Rather than the heart speeding up and pumping more forcefully to maintain the blood pressure, it starts to slow down. The blood pressure drops, the heart rate slows further, and the heart can pause for many seconds; sometimes close to a minute for some people who have more severe fainting episodes."

Usually with this type of fainting, the person falls to the floor, blood pressure returns to the brain and the person starts to recover. However, if someone faints in a vulnerable location or vulnerable position, it can be dangerous to that person and others, Dr. Behr notes.

The syncope that most concerns healthcare professionals is cardiac syncope, blacking out due to an underlying heart disease such as a heart rhythm abnormality, or arrhythmia, he explains.

"This is usually a more abrupt loss and return of consciousness than in simple fainting. If you're older, you're more likely to have underlying heart disease that you may or may not be aware of. That's one of the reasons to be more concerned about loss of consciousness in older individuals," Dr. Behr says. "Young people can also have heart diseases that can cause cardiac syncope that may be a warning sign of something more serious to come, so it is important to investigate it."

Others for whom a blackout can be a warning sign of a serious heart problem include people with a family history of inherited heart problems, unexplained deaths or premature sudden deaths; people whose fainting is related to exercise; and people whose fainting is associated with heart palpitations or the heart feeling like it's racing away, he adds.

Before a simple faint, you might experience one or more signs that you should sit or lie down

"There will be a sensation of lightheadedness. There may be a sensation of nausea or buzzing or ringing in the ears," Dr. Behr says. "Some people describe tunnel vision — their vision closing in on them before they actually pass out — and some may actually lose vision but still be aware, not lose consciousness completely, and then recover. Other typical signs include feeling sweaty and clammy."

Some people get about a half-hour of warnings before fainting; some people may get 30 seconds, he adds.

What to do if you faint or someone else does:

• Check that the person is breathing and has a pulse. If not, call for emergency help, and if you know how to provide cardiopulmonary resuscitation, initiate it.
• If the person is still breathing and has a pulse, ensure they are lying flat, and their airway is open using the recovery position and call for help.
• If you feel like a faint may be coming on, position your head lower than your heart: for example, between the knees.
• Rest after coming out of the faint.
• Drink water after the faint, adding electrolytes if you have them.

"If your blood pressure is getting low and you're getting those symptoms, it means the blood doesn't get into your brain, and if your heart is trying to push the blood to your brain against gravity, then it's struggling. You really need to get your head level or below your heart so the blood pressure gets back to the brain, and that will avert all the symptoms and the vicious cycle that ensues," Dr. Behr advises. "Get your head between your knees or lie down and put your head down and your feet up in the air, depending on where you are and what is feasible to do."

Getting up and walking around straight away is probably the worst thing to do, he warns.

"Your blood pressure will drop further, and you’ll feel worse, and collapse and fall and injure yourself," Dr. Behr says. "The best thing is to stay where you are and get flat, and when you're feeling better, drink some water, maybe with some electrolytes if you're dehydrated. For general preventive measures, we advise most people who have fainted to drink more water and to sometimes add a bit of salt to their food, because generally they're running a low blood pressure."

Sometimes, getting hydrated and adding salt to the diet may not be enough. Occasionally people need to take medications to improve blood pressure control and increase blood pressure to prevent fainting episodes, Dr. Behr says.

When to seek medical help

"If somebody has had simple fainting with the clear precipitants that I described, it is best to have a chat with your GP (your primary care physician) to talk about it. Particularly if it's a first onset of symptoms, it's best not to ignore it," Dr. Behr says. "Often people go to the emergency department after a first faint, which I think is very fair to do and I would encourage."

If someone has had simple faints before, the circumstances that bring them on are typical for them and they have been evaluated by their primary care physician or a cardiologist before, they may not need to go to the emergency department every time, he adds.

The more concerning situations are older people having faints where other conditions may also be having an effect, people who are having recurrent faints despite keeping well hydrated, if there has been an injury due to a faint, and if the blackout comes on abruptly and with other signs that there may be an underlying cardiac condition.

"We need to make sure that they are treated and that something else isn't being missed," Dr. Behr says. "Also, sometimes faints can look like seizures. They can cause fitting activity, and differentiating a seizure and epilepsy from fainting requires involvement of a cardiologist and neurologist."

If you faint at the sight of blood, you may be able to condition yourself not to

"It's very common, but it can be surmounted by various means," Dr. Behr says.

For example, cognitive behavioural therapy (CBT) may help, he suggests. In CBT, you work with a mental health counselor such as a psychotherapist or therapist to become aware of inaccurate or negative thinking, so you can view challenging situations more clearly and respond to them more effectively.

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About Mayo Clinic Healthcare
Mayo Clinic Healthcare, located in London, is a wholly owned subsidiary of Mayo Clinic, a not-for-profit academic medical center. Mayo Clinic is top ranked by U.S. News & World Report in more specialties than any other hospital for a reason: quality of care. Mayo Clinic Healthcare is the U.K.'s front door to that unparalleled experience. Visit Mayo Clinic Healthcare for more information.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

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Mayo Clinic Q and A: Melanoma stage determines treatment plan

While melanoma is much less common than other types of skin cancer, it is the most serious because it is more likely to metastasize, or spread, to other parts of the body. The ABCDE guide helps you determine if a mole or a spot may indicate melanoma or another type of skin cancer.

Mayo Clinic Q and A: Cholesterol — know your numbers

Cholesterol is a type of fat in our blood. Our bodies need a small amount of cholesterol to build the structure of cell membranes, make certain hormones and help with metabolism, such as producing vitamin D. The catch: We don't need too much cholesterol.

Mayo Clinic Minute: Help for a sinus infection

If you catch a cold or upper respiratory infection and it lingers long enough, it may turn into a sinus infection known as sinusitis. Symptoms can include a runny nose and nasal congestion accompanied by pain, swelling, and pressure around the eyes, nose, cheeks or forehead that gets worse when bending over.⁠⁠

Expert explains how to improve heart health, even if your family has history of heart conditions

Despite the prevalence of heart disease, many people are still unclear about how genetics can affect heart disease and, most importantly, what they can do to lower their risk. ⁠
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Dr. Stephen Kopecky, a cardiologist at Mayo Clinic, explains how you can improve your heart health, even if your family has a history of cardiovascular problems.

Asthma burden score reflecting patient experience may improve symptom management

Current asthma guidelines define asthma severity based on a patient's medication dose — without taking into consideration the healthcare burden, such as how successfully patients can control their asthma, how often they visit their doctor, visit the emergency room and receive other healthcare services.⁠
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Mayo Clinic researchers propose a new, personalized approach to asthma using patient-centered information based on healthcare burden data instead of prescribed medication.

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Asthma is a condition in which the airways in the lungs narrow and swell and may produce extra mucus, making breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma affected an estimated 262 million people in 2019 and caused 455,000 deaths, according to the World Health Organization.

There is no cure for asthma, but its symptoms can be controlled. For patients with asthma, remission is considered the primary treatment goal, with fewer or no symptoms, and the patient requiring minimal to no medication to manage their condition.

Current asthma guidelines, including those of the European Respiratory Society and the American Thoracic Society, define asthma severity based on a patient's medication dose — without taking into consideration the healthcare burden, such as how successfully patients can control their asthma, how often they visit their doctor, visit the emergency room and receive other healthcare services. In other words, what has been missing from the research behind current guidelines is data from the perspective of the patient's quality of life.

Mayo Clinic researchers propose a new, personalized approach to asthma using patient-centered information based on healthcare burden data instead of prescribed medication, according to a study published in The Lancet Respiratory Medicine.

The Mayo-led study is the first to use two longitudinal asthma cohorts from the U.S. and 11 European countries to introduce a tool that measures both asthma control and severity and translates that data into a quantifiable exacerbation – a way to measure the risk of an asthma attack.

The investigators analyzed data from 1,037 adult participants from the Severe Asthma Research Program III in the U.S. and the European Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes to calculate a composite asthma burden score based on asthma attacks and healthcare. They also added the number of instances each patient needed a rescue bronchodilator to reflect asthma symptom burden.

The lead author, Joe Zein, M.D., Ph.D., a pulmonary medicine and asthma researcher at Mayo Clinic in Arizona, says the findings show discrepancies between the current definition of asthma severity and the research team's burden score.

"The standard definition of severe asthma is based on prescribed asthma medications," says Dr. Zein. "Our personalized healthcare burden score includes patient-centered data that reflect disease severity and accurately predicts asthma remission."

Dr. Zein says the study looks at asthma remission using two well-characterized asthma cohorts. "Asthma remission has been proposed as a hypothesis. That is something we look at, but no one was analyzing the data to test it. This is the first study to test the concept of asthma remission," he says.

If further studies support the team's method of calculating asthma burden, it ultimately could help care teams better manage cases of high-risk individuals with asthma and improve their treatment.

For a complete list of authors, disclosures and funding sources, read the manuscript.

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A sinus infection is inflammation of the sinuses — the spaces inside your nose and head. When the sinuses are swollen, they can't drain, causing mucus to build up.

"A typical sinus infection is caused by the common cold, or most common viruses out there, typically lasting anywhere from three days to seven days. And it typically goes away on its own," says Dr. Jesse Bracamonte, a Mayo Clinic family physician.

He says there are some simple home treatments you can do to ease the symptoms, such as drinking plenty of fluids, taking over-the-counter pain relievers and decongestants, and using a saline nasal rinse or nasal spray. When it comes to sinus infections, in general, he says time is often the best medicine.

"But if somehow you start getting better and then start getting worse and feel more facial pressure — can be teeth pressure, fever, lot of facial pain, fatigue — after a period of a week, you should seek care and get evaluated by a clinician," says Dr. Bracamonte.

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Mayo Clinic Minute: Alcohol and cancer risk

The Office of the Surgeon General recently released a new Advisory on Alcohol and Cancer Risk. It outlines a connection between drinking alcohol and increased risk of cancer, specifically cancers of the mouth, throat, voice box, esophagus, breast, liver and colon.

According to Dr. Donald Hensrud, a Mayo Clinic physician specializing in preventive medicine and nutrition, the number of cancer cases caused by drinking alcohol may surprise you.

Mayo Clinic Minute: What to do for a healthier heart

Heart disease is the leading cause of death in the U.S., according to the American Heart Association. Heart disease refers to a range of conditions, of which many can be prevented or treated by making healthy lifestyle choices.

Dr. Demilade Adedinsewo, a Mayo Clinic cardiologist, says that to keep the heart healthy, there are eight behaviors and numbers to keep in check.

Mayo Clinic hospitals named among America’s Best Hospitals by Healthgrades

Mayo Clinic hospitals in Arizona, Florida, Rochester, Minnesota, and Mayo Clinic Health System in Mankato, Minnesota, were named among America's 50 Best Hospitals by Healthgrades, an independent healthcare ratings company. In addition, Mayo Clinic Health System in Eau Claire, Wisconsin, was included in the Healthgrades 100 Best Hospitals list.

Mayo Clinic Minute: Suffering from cold feet?

Do your feet always feel cold, even when it's not chilly outside? While cold weather can be a common cause, persistent cold feet might point to something more — like circulatory issues, immune problems or nerve disorders.

Dr. Jesse Bracamonte, a Mayo Clinic family medicine physician, says it's important to seek medical advice if the condition persists. Getting evaluated can help identify and treat any underlying health conditions.

H5N1 bird flu infections continue to rise: What you need to know

H5N1 bird flu, also known as avian influenza, continues to spread, with reports of a third human case from an unknown exposure source. To date, 67 cases have been confirmed, and one death has been reported in the U.S.

There are no reports of the virus spreading from person to person, and the public health risk remains low. 

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The advisory has recommendations to increase awareness, including updating the existing Surgeon General's health warning label on alcohol-containing beverages.

According to Dr. Donald Hensrud, a Mayo Clinic physician specializing in preventive medicine and nutrition, the number of cancer cases caused by drinking alcohol may surprise you.

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"About 100,000 cases of cancer each year in the United States are due to alcohol consumption — and about 20,000 deaths. So this isn't a small problem," says Dr. Hensrud.

He says alcohol is the third-leading preventable cause of cancer in the U.S., behind tobacco use and obesity.

"The risk starts with actually relatively low intakes of alcohol over a long period of time," says Dr. Hensrud. "Consuming it once in a while probably isn't going to increase the risk that much. But there are many people who consume it regularly, and there are many people who assume that there are health benefits on the heart. And these benefits probably aren't as strong as what we used to believe."

He says when drinking alcohol is combined with tobacco use, the risk of cancer increases significantly.

"Some studies have suggested the optimal amount of alcohol for people less than 50 is zero. So we need to dial back, I think, a little bit on our alcohol consumption. Be aware of it. An occasional drink of alcohol is not going to increase long-term risk, but we need to be aware of it and keep a lid on our consumption over time," says Dr. Hensrud.

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H5N1 bird flu, also known as avian influenza, continues to spread, with reports of a third human case from an unknown exposure source. To date, 67 cases have been confirmed, and one death has been reported in the U.S.

"Most of the people are interacting with infected birds and animals, and there have been several cases where we don't have a specific history of that individual interacting with an animal or a bird that might be infected," says  Dr. Matthew Binnicker, director of the Clinical Virology Laboratory at Mayo Clinic. "And that's why we're cautious and somewhat concerned because the question arises, how did those several individuals become infected?"

There are no reports of the virus spreading from person to person, and the public health risk remains low. 

Watch: Dr. Matthew Binnicker provides update on H5N1 bird flu outbreak

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Avian influenza spreads as migratory birds carrying the virus travel between hemispheres. Wild birds can transmit the virus to poultry, farm animals and backyard flocks through respiratory secretions, droppings or shared water. Dr. Binnicker says most cases of infection in humans are from animals to humans at dairy and poultry farms.

"Right now, the primary means of transmission is from individuals interacting with an infected bird or an animal like a dairy cow, handling a sick or dead bird, and then self-inoculating the virus into your eyes, nose or mouth, or working with a dairy cow and becoming infected during the process of collecting milk. We have not seen documented human-to-human transmission of H5N1 yet," he says.

Precautions

U.S. dairy and poultry workers are encouraged to take precautions to prevent infections.

"It's really important for those who work in bird facilities or on farms where there are dairy cattle when interacting with the animals or debris from the animals that those individuals wear a mask, eye protection and gloves. Many individuals who have been affected following exposure to dairy cattle are coming down with conjunctivitis because the virus is being introduced into the eyes. There are receptors that the virus binds to in the eyes, so wearing eye protection is also important," says Dr. Binnicker.

How to protect yourself from bird flu at home:

• Cook poultry, meat and eggs to their recommended internal temperatures.
• Use only pasteurized dairy products.
• Practice good hand hygiene, especially when handling food.
• Use separate utensils for raw and cooked meat to avoid cross-contamination.

Dr. Binnicker says the U.S. is seeing the most infections due to increased testing and screening, but the virus is likely prevalent in many countries. Health officials are concerned about the potential for a large outbreak in humans. 

"We've seen now for years this growing outbreak among birds and animals and in mammals, with millions of poultry being affected in the U.S. and worldwide. We're seeing a growing number of human cases. Fortunately, those cases have been mild so far, but what we know about influenza is that the more it infects animals and humans, the better the chance it has to change and mutate. And it's a numbers game. The more times that happens, the greater the probability that a virus will arise that can transmit effectively between one person and another and cause severe disease," says Dr. Binnicker.

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Mayo Clinic opens new doors in cancer treatment innovation

Mayo Clinic researchers have developed a pioneering strategy to improve targeted cancer therapies.⁠ The approach combines antibody-drug conjugates with proteolysis-targeting chimeras. These molecular tools break down specific proteins to improve how cancer cells internalize the cancer-fighting therapy.

Who should get screened for cervical cancer, and when?

Cervical cancer is almost always caused by a persistent infection with high-risk strains of HPV. Routine screening has dramatically reduced cervical cancer deaths, and regular screenings are essential because early detection makes precancer treatment more effective.

Living kidney donation can start a chain reaction

Living-donor transplantation is an option for some organs. For people over 18 born with two functioning kidneys, they can donate one and continue to live a healthy life. An altruistic living-donor kidney transplant chain begins when someone donates a kidney without a specific person in mind. That can start a chain effect of donors. ⁠

Mayo Clinic Q and A: Clot buster? Surgery? What is the right treatment for stroke?

There are excellent treatments to reverse stroke symptoms, but these treatments are incredibly time dependent. This is a good opportunity to remind people to seek emergency medical care — call 911 — as soon as possible at the first sign of a stroke. Treatments also depend on the type of stroke.⁠

Mayo Clinic Minute: Dual procedure combines liver transplant, bariatric surgery

Obesity can be a barrier to liver transplant. Dr. Julie Heimbach, director of the Mayo Clinic Transplant Center in Rochester, Minnesota, says that combining gastric sleeve surgery, a type of bariatric surgery, with liver transplantation is effective in addressing both health issues.⁠
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