Minnesota - June 2012 Archives

ROCHESTER, Minn. — June 28, 2012.   Mayo Clinic as a three-site organization (Arizona, Florida and Minnesota) is among 66 employers nationwide receiving the Best Employers ...

ROCHESTER, Minn. — June 28, 2012.   Mayo Clinic is among 66 employers nationwide receiving the Best Employers for Healthy Lifestyles award sponsored by the National Business Group on Health's Institute on Innovation in Workforce Well-being in Washington, D.C. Mayo Clinic is receiving the Platinum Award for the second time due to its healthy living programs and ability to continue improving and innovating. Twenty-nine other employers are receiving the Platinum award. The National Business Group on Health, a nonprofit organization of large employers, initiated the awards eight years ago to honor organizations that demonstrate a commitment and dedication to promoting a healthy workplace and encouraging healthy lifestyles for employees and their families. This is the seventh year Mayo Clinic has been recognized as an employer promoting healthy lifestyles since the program began in 2005. "Receiving this award is a great honor," says Karen Ytterberg, M.D., chair of the Mayo Clinic Employee Wellness Committee. "It recognizes the commitment Mayo Clinic has made to the health of its employees and celebrates the ongoing success of many wellness programs and activities that have established a culture of healthy living at Mayo." Mayo Clinic has many health promotion programs that help its employees achieve the best quality of life possible. By utilizing existing resources, employees can access programs directly related to their individual health situations. Programs and activities at the Mayo Clinic Dan Abraham Healthy Living Center, Employee and Community Health initiatives and LiveWell health resources work together to focus on healthy lifestyle choices and help employees connect with the appropriate programs, tools and support. These include on-site resources and programs at Mayo Clinic employee wellness facilities, nutrition education, the Wellness Champion program, employee food services, health fairs, the Employee Assistance Program, the Nicotine Dependence Center, collaboration with community health and wellness organizations, telephonic and Web-based resources, as well as print communication.

ROCHESTER, Minn. — June 27, 2012.   Mayo Clinic researchers have successfully used smaller, folded DNA molecules to stimulate regeneration and repair of nerve coatings in mice that mimic multiple sclerosis (MS). They say the finding, published today in the journal PLoS ONE, suggests new possible therapies for MS patients. VIDEO ALERT: Video resources with Dr. Maher are available here. "The problem has been to find a way to encourage the nervous system to regenerate its own myelin (the coating on the nerves) so nerve cells can recover from an MS attack," says L. James Maher III, Ph.D., Mayo Clinic biochemist and senior author on the paper. "We show here that these small molecules, called aptamers, can stimulate repair in the mice we are studying." More than 200,000 people have multiple sclerosis. There is no cure and no effective therapy to stop progression or repair damage to the myelin sheath that surrounds and protects the nerves. Without that protection, nerve fibers will be damaged, leading to declining mobility and cognitive function, and other debilitating complications. MS researchers, including Mayo neurologist Moses Rodriguez, M.D., a co-author on this paper, have focused on monoclonal antibodies in mice to stimulate myelin repair. The Rodriguez and Maher teams, working together, have determined that the aptamers are not only effective, but they are easy and cheap to synthesize — an important point for drug developers. They also are stable and not likely to cause an immune response. This new approach must be validated in other mouse models to see if it might be a candidate for human clinical trials.

ROCHESTER, Minn. — June 26, 2012.  Preventive mammography rates in women in their 40s have dropped nearly 6 percent nationwide since the U.S. Preventive Services Task Force (USPSTF) recommended against routine mammograms for women in this age group, a Mayo Clinic analysis shows. That represents a small but significant decrease since the controversial guidelines were released, the researchers say. Their findings are being presented at the Academy Health Annual Research Meeting, June 24-26, in Orlando, Fla. VIDEO ALERT: Video resources, including an interview with Sandhya Pruthi, M.D., are available for journalists at the Mayo Clinic News Network. "The 2009 USPSTF guidelines resulted in significant backlash among patients, physicians and other organizations, prompting many medical societies to release opposing guidelines," says co-author Nilay Shah, Ph.D., a researcher at the Mayo Clinic Center for the Science of Health Care Delivery. "We were interested in determining the impact that the recommendations and subsequent public debate had upon utilization of mammography in younger women." Using a large, national representative database of 100 health plans, researchers identified the number of screening mammograms performed between January 2006 and December 2010, and compared rates before and after the task force report. Nearly 8 million women ages 40 to 64 were included in the analysis. Comparing mammography rates before and after publication of the new guidelines, researchers found that the recommendations were associated with a 5.72 percent decrease in the mammography rate for women ages 40-49. Over a year, nearly 54,000 fewer mammograms were performed in this age group. "For the first year after the guidelines changed, there was a small but significant decrease in the rate of mammography for women ages 40–49," Dr. Shah says. "This is consistent with the context of the guidelines change. A modest effect is also in line with the public resistance to the guidelines change and the subsequent release of conflicting guidelines."

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 21, 2012.  Mayo Clinic researchers have discovered an association between a commonly prescribed blood pressure drug, Olmesartan, and severe gastrointestinal issues such as nausea, vomiting, diarrhea, weight loss and electrolyte abnormalities — symptoms common among those who have celiac disease. The findings are published online today in the medical journal Mayo Clinic Proceedings. TELECONFERENCE BRIEFING: Mayo Clinic gastroenterologist Joseph Murray, M.D., will host a teleconference on his findings at 3:30 p.m. ET today, June 21. Call 877-358-3883. Please RSVP to sheirer.lori@mayo.edu if you plan to call in. VIDEO ALERT: Visit the Mayo Clinic News Blog for links to downloadable video and audio of Joseph Murray, M.D., discussing the findings. From 2008-11, Mayo Clinic physicians treated 22 patients with symptoms similar to celiac disease, including intestinal inflammation and abnormalities. Patients came from 17 states, and some had been diagnosed with celiac disease. They had chronic diarrhea and weight loss; the median weight loss was 39 pounds, and one patient lost 125 pounds. Fourteen of the 22 were hospitalized because of the severity of their symptoms. When given a blood test, however, these patients didn't come back with results typical of celiac disease. They also didn't respond to treatments such as gluten-free diets. After examining their medications, Mayo Clinic gastroenterologist Joseph Murray, M.D., pulled several of the patients off Olmesartan. Their symptoms dramatically improved. Eventually, all 22 were taken off the drug, and all showed improvement. Eighteen of the 22 patients had intestinal biopsies after stopping the medication and showed improvement. "We thought these cases were celiac disease initially because their biopsies showed features very like celiac disease, such as inflammation," says Dr. Murray, the lead author. "What made them different was they didn't have the antibodies in their blood that are typical for celiac disease." Olmesartan — prescribed for the treatment of hypertension, or high blood pressure — works by blocking substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently, according to the U.S. National Library on Medicine.

ROCHESTER, Minn. — June 20, 2012.  Mayo Clinic and its collaborators have been awarded nearly $60 million from the Center for Medicare and Medicaid Innovation (CMMI) to improve health care delivery. The grants will improve critical care for Medicare and Medicaid beneficiaries in intensive care units, improve care and outcomes for patients who have depression and diabetes or cardiovascular disease, and work with patients with chronic conditions and their families to better engage them in medical decisions. "We're grateful that CMMI has recognized the commitment of our physicians, scientists and collaborators to drive patient-centered, high-value care," says John Noseworthy, M.D., president and CEO of Mayo Clinic. "Our commitment to innovation and patient-centered, high-value care will continue regardless of how the Supreme Court rules on the Affordable Care Act or how health care reform evolves politically. What will remain constant is our unfailing focus on meeting the needs of patients." The Health Care Innovation Awards fund up to $1 billion in grants to applicants who will implement compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program, particularly those with the highest health care needs. "These grants provide the funding needed to transform the way patients in the United States experience health care," says Veronique Roger, M.D., M.P.H., director of Mayo Clinic's Center for the Science of Health Care Delivery, which rigorously studies, validates and implements innovative health care delivery models. "At the end of the day, health care is about treating patients in a manner that delivers optimal outcomes and quality of life in the most efficient way possible." Project I: Patient-centric electronic environment for improving acute care performance Role: Leader Mayo Clinic Lead Investigators: Ognjen Gajic, M.D.; Brian Pickering, M.B., B.Ch. Geographic Reach: Minnesota, Massachusetts, New York, Oklahoma Funding Amount: $16,035,264 Estimated Three-Year Savings for Government Programs: $81,345,987 Summary: Mayo Clinic, in collaboration with US Critical Illness and Injury Trials Group and Philips Research North America, is receiving an award to improve critical care performance for Medicare and Medicaid beneficiaries in intensive care units (ICUs). Data show that 27 percent of such Medicare beneficiaries face preventable treatment errors due to information overload among ICU providers. Mayo Clinic's model will enhance effective use of data using a Cloud-based system that combines a centralized data repository with electronic surveillance and quality measurement of care responses. As a result, Mayo expects to reduce ICU complications and costs. Over a three-year period, Mayo Clinic will train 1,440 existing ICU caregivers in four diverse hospital systems to effectively use new health information technologies to manage ICU patient care. Mayo Clinic's expertise: Mayo Clinic brings informatics expertise to translate data into actionable clinical knowledge. Other grant-supported Mayo Clinic initiatives that rely heavily on informatics include the Rochester Epidemiology Project, Beacon, Strategic Health IT Advanced Research Projects (SHARP) Program and the Mayo Clinic Center for Translational Science Activities.

ROCHESTER, Minn. — June 20, 2012.  Researchers have long been aware that the progressive loss of muscle mass and bone density is a natural part of aging. But little work has investigated how muscle tissue affects the inner and outer layers of bone microstructure. A Mayo Clinic study looked at skeletal muscle mass and bone health across the life span and discovered distinct differences in how muscle affects the two layers of bone in men and women. The findings are published in the Journal of Bone & Mineral Research. VIDEO ALERT: Video resources available on Mayo Clinic's YouTube Channel. "Our study adds to the growing body of evidence supporting the highly integrated nature of skeletal muscle and bone, and it also provides new insights into potential biomarkers that reflect the health of the musculoskeletal system," says lead author Nathan LeBrasseur, Ph.D., of the Department of Physical Medicine and Rehabilitation and the Robert and Arlene Kogod Center on Aging at Mayo Clinic. Researchers reviewed records from a long-standing Mayo Clinic study of bone health involving 272 women and 317 men ages 20 to 97. They examined the association of skeletal muscle mass (relative to participants' height) with bone architecture and strength, using several high-resolution imaging technologies that distinguish the outer cortical layer of bone from the inner trabecular layer. The study found that muscle mass is associated with bone strength at particular places in the body. In women, muscle mass was strongly connected to cortical health at load-bearing locations such as the hip, lumbar spine and tibia. Researchers also found that muscle mass was associated with the microarchitecture of trabecular bone in women's forearms, a non-load-bearing site, at higher risk of fracture following menopause. The higher the level of the circulating protein, IGFBP-2, the lower relative muscle mass overall, they discovered. "We found IGFBP-2, which has already been linked to osteoporotic fractures in men, is a negative biomarker of muscle mass in both sexes," Dr. LeBrasseur says. "This finding could potentially be used to determine people who are at a particular risk for falls and associated fractures." The subject of muscle and bone health is vital, especially for the elderly. Weakened muscle can lead to bone-breaking accidents that result in loss of independence and even death. In the context of health care costs, the adverse health effects of frailty reach up to $18.5 billion annually.

ROCHESTER, Minn. — June 18, 2012.  With the hot, muggy summer season arriving, kids will be heading to the pool to cool off. While swimming is refreshing, fun and good exercise, even chlorinated pools contain many germs that can make them ill. Mayo Clinic pediatric experts warn that many swimmers may not be aware of the water illnesses associated with pools due to the germs that can linger. VIDEO ALERT: To download broadcast quality video of this report, please register for the Mayo Clinic News Network. "A swimming pool is basically a community bathtub without the shampoo," says Thomas Boyce, M.D., pediatric infectious diseases specialist, Mayo Clinic Children's Center. "Children can still get sick in a properly chlorinated pool. Chlorine does not kill germs instantly and, in fact, does not kill cryptosporidium at all, which is a common germ that causes water-associated gastrointestinal illness." Recreational water illness outbreaks peak in summer. According to the Centers for Disease Control and Prevention, 21.6 percent of Americans don't know that swimming while they have diarrhea puts other swimmers at risk for water-associated illnesses. To help keep germs from entering the water, Dr. Boyce advises parents to take young children on bathroom breaks often; change their diapers in the bathroom, not poolside; and wash a toddler's bottom with soap and water before entering the water. Swimming is a great way for kids to cool off and get exercise in the summer, however, Dr. Boyce cautions that children who swallow water while they swim can be at risk for diarrhea, viral meningitis and other illnesses. Parents can keep children safe by having their children rinse off before entering the pool, not allowing children with diarrhea to swim and teaching children not to swallow the pool water that they swim in, he says.

ROCHESTER, Minn. — June 14, 2012.  Stopping smoking — at any age — offers almost immediate health benefits, according to the June issue of Mayo Clinic Health Letter. Recent reports about side effects of drugs used to help stop smoking shouldn't dissuade smokers from trying to quit. Side effects from these medications are usually infrequent, minor, and manageable — either by reducing doses or switching to another medication. Stopping smoking has many significant health benefits. Just 20 minutes after the last cigarette, the heart rate decreases. Twelve hours later, carbon monoxide in the blood returns to normal. A year after stopping, the risk of having a heart attack related to smoking drops by half. Stopping is difficult, and most smokers make many attempts before they have long-term success. Smokers who are successful often take advantage of behavior counseling and medications. A variety of drug options can help ease withdrawal symptoms and reduce cravings. Mayo Clinic Health Letter provides an overview of medication options and potential side effects or risks. Nicotine patch: With a steady dose of nicotine, smokers double their odds of successfully quitting. The odds nearly triple when patches are combined with fast-acting nicotine replacement. Potential side effects include skin irritation, dizziness, racing or irregular heartbeat, sleep problems, headaches and nausea. Sleep problems can be minimized by removing the patch at night. Nicotine gum, nasal spray, inhalers and lozenges: These fast-acting nicotine replacements help minimize cravings. Using these products doubles the odds of successfully stopping. However, nicotine replacements may irritate the mouth, nose and throat, plus they can cause coughing, nausea, headache and minor digestive issues. Varenicline (Chantix): This drug decreases withdrawal symptoms and reduces the feelings of pleasure from smoking. It increases the odds of successfully stopping by at least 2.5 times. Possible side effects are nausea, headache, insomnia and vivid dreams. Rarely, it's associated with serious psychiatric symptoms such as depressed mood, agitation and suicidal thoughts. Bupropion (Zyban): Use of bupropion doubles the odds of successfully stopping and may help minimize weight gain. It increases the levels of brain chemicals that are also boosted by nicotine, decreasing withdrawal symptoms and reducing pleasure from smoking. Possible side effects are sleep disturbances, dry mouth and headache. It's very rarely associated with serious psychiatric symptoms.

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.

ROCHESTER, Minn. — June 14, 2012.  Associating palliative care with hospice or end-of-life care is not uncommon — but they aren't exactly the same. The ...