Minnesota - November 2013 Archives

ROCHESTER, Minn. — People with epilepsy may have a new high-tech way to manage hard-to-control seizures. A new implantable medical device that delivers responsive neurostimulation has been approved by the U.S. Food and Drug Administration. The technology is designed to detect abnormal activity in the brain and respond and deliver subtle levels of electrical stimulation to normalize brain activity before an individual experiences seizures. The treatment is available at all Mayo Clinic sites. MULTIMEDIA ALERT: For audio and video of Dr. Joseph Sirven talking about the device, visit the Mayo Clinic News Network. Mayo Clinic in Arizona, Florida and Minnesota were all involved in the clinical trials for the device (and have collectively enrolled the highest number of patients into the trials). The device is indicated for use as an adjunctive therapy in reducing the frequency and severity of seizures in people 18 years of age or older with partial onset seizures who have undergone diagnostic testing that localized no more than two epileptogenic foci, are refractory to two or more antiepileptic medications, and currently have frequent and disabling seizures (motor partial seizures, complex partial seizures and/or secondarily generalized seizures).

ROCHESTER, Minn. — Daily food choices present an opportunity to score some healthy, flavorful, antioxidant-positive nutrition points, according to the November issue of Mayo Clinic Health Letter. Why pay attention to antioxidants? They help minimize the impact of free radicals, which are an unstable byproduct of natural cell metabolism. Free radicals also are found in the environment, in exposure to sunlight, air pollution and cigarette smoke. Free radicals trigger cell and tissue damage through a process called oxidation. This damage may play a part in the development of many different diseases including cancer, cardiovascular disease, diabetes, Alzheimer's disease, Parkinson's disease and some eye diseases. The Mayo Clinic Health Letter details many of the foods that pack a high-antioxidant punch, including: Berries: Colorful berries, particularly blueberries and strawberries, appear to have heart-healthy effects. Research suggests they may lower blood pressure and positively influence blood vessel health. Curcumin: Curcumin is found in the spice turmeric, the main spice used to prepare curry. Curcumin is thought to have antioxidant properties, as it may decrease swelling and inflammation. Preliminary research suggests that curcumin may prevent cancer and possibly slow the spread of cancer. Cruciferous vegetables: This family includes broccoli, cauliflower, Swiss chard, Brussels sprouts, kale and turnips. Research suggests these foods have a protective effect in preventing prostate, colorectal and lung cancers. Corn: Corn often gets a bad rap as a starchy vegetable. But yellow corn, and even cornmeal, contain substances known for strong antioxidant and anti-inflammation activities.

ROCHESTER, Minn. — Most people have accumulated some unnecessary stuff they find hard to toss, donate or recycle. But for people with a hoarding disorder, the urge to accumulate — and an inability to discard — spirals out of control. The November issue of Mayo Clinic Health Letter covers hoarding disorder and treatment approaches. A key distinction between a hoarder and a collector — or someone who is just messy and disorganized — is when the haphazard accumulation of stuff begins to interfere with social life and the ability to do necessary work. At its extreme, hoarding results in cramped, often unsanitary living conditions with only narrow passageways winding through stacks of clutter. Health risks increase as piles accumulate. Risks include the increased likelihood of falls and fires, social isolation, difficulty with finances, and even eviction. Hoarding tends to run in families. Signs of hoarding often emerge as early as the teens and become more severe by middle age. The death of a spouse, divorce, children moving away or health problems may tilt an older adult toward more extreme hoarding. About 75 percent of the time, hoarding occurs in conjunction with other mental issues such as depression, obsessive-compulsive disorder, alcohol dependence, dementia or anxiety. For some, hoarding is a distinct syndrome. In this case, people may not experience much, or any, embarrassment, worry or stress about hoarding. Those who recognize their problem often are ready to seek treatment. Therapy for the underlying mental condition often is a first step and it may help reduce hoarding impulses. Still, sticking with therapy and clearing out possessions will likely be challenging. For those who don't see hoarding as a concern, successful intervention typically works best with a team of professionals, loved ones and friends. The approach is to build trust and help the hoarder gain insight into the need to clear out the living space. Dwellings that are cleaned up without the consent of the hoarder won't address the underlying problem. And, a forced cleanup may make the hoarder more suspicious of help and cling to possessions even more.

ROCHESTER, Minn. — Mayo Clinic researchers found that improvement of mood over the course of post-acute brain rehabilitation is associated with increased participation in day-to-day activities, independent living, and ability to work after rehabilitation is complete. MULTIMEDIA ALERT: Video of Dr. Bergquist is available for download from the Mayo Clinic News Network. Each year, millions of patients are diagnosed with acquired brain injuries, such as concussion, strokes and brain tumors, many of whom go on to have persistent symptoms. For these patients, brain rehabilitation is an important part of their recovery. "People should not ignore psychological issues, such as mood swings or ability to communicate with family members," says Thomas Bergquist, Ph.D., of Mayo Clinic's Departments of Physical Medicine and Rehabilitation and Psychiatry and Psychology. "Comprehensive brain rehabilitation can address both physical and personal problems to help improve outcomes for patients, including improved physical function, the ability to live independently and maintain a job." Dr. Bergquist recommends a holistic approach to brain injury rehabilitation. Focusing solely on physical function, for example, represents, "medical myopia and care givers might miss the biggest problem," he says.

ROCHESTER, Minn. — Patients waiting for a lifesaving transplant rely heavily on the public to make the choice to be organ donors. The shortage of deceased donor organs has reached a crisis, with almost 120,000 people in need of a lifesaving organ nationwide. Over 3,000 of those are Mayo Clinic patients. For kidney, liver and bone marrow transplant, living donors can help shorten the wait time for many patients. MULTIMEDIA ALERT: Videos of Dr. Phil Fischer, recent kidney donor; and Dr. Mikel Prieto, kidney transplant surgeon, are available for download on the Mayo Clinic News Network. According to data from the United Network for Organ Sharing (UNOS), in the United States in 2012, there were 5,617 kidney transplants from living donors; 161 of those were from anonymous donors. In 1992, there were 2,534 kidney transplants from living donors; and none of those were from anonymous donors. Despite the increase in living donor transplants, however, there are now twice as many people being added to the waiting list each year, compared to the waiting list 20 years ago.

Low-dose dopamine or low-dose nesiritide tested in hospitalized heart failure patients DALLAS — Two drugs tested in a larger trial did not improve kidney function in acute heart failure patients, contrary to results of smaller studies. The results were presented today at the American Heart Association's Scientific Sessions 2013 in Dallas and simultaneously published in the Journal of the American Medical Association. Previous smaller studies showed that low-dose dopamine or low-dose nesiritide could improve kidney function and reduce fluid overload that is often present in hospitalized acute heart failure patients by increasing urine production. MULTIMEDIA ALERT: Video of Dr. Horng Chen will be available for download on the Mayo Clinic News Network. In the Renal Optimization Strategies Evaluation in Acute Heart Failure (ROSE-AHF) randomized 26-site trial in the U.S. and Canada, researchers analyzed data on 360 hospitalized acute heart failure patients with kidney dysfunction from September 2010 to March 2013. Compared to placebo, researchers found that neither dopamine nor nesiritide, when also used with diuretic (water pills) therapy, was better at increasing urine volume or improving levels of serum cystatin-C, an indicator of kidney function, at the end of a 72-hour treatment. "Kidney-enhancing therapies in acute heart failure continue to elude us," says Horng Chen, M.B., B.Ch., lead author and Mayo Clinic cardiologist. "In the past five years, all the major acute heart failure therapeutic clinical trials have not demonstrated beneficial effects of the therapies tested. This could be partly because the definition of acute heart failure is broad, and hence it includes a diverse group of patients." Therefore, one take-away from the results of ROSE-AHF is that future studies in acute heart failure may need to target specific subgroups of these patients. For example, some patients have preserved ejection fraction, where the heart's lower chambers are stiff and cannot relax enough to fill fully between beats, and others may have reduced ejection fraction, where the heart is weak, Dr. Chen says. Heart failure occurs when the heart doesn't pump blood as well as it should. Acute heart failure — when heart failure patients require hospitalization — is the most common cause of hospitalization in patients 65 years and older in the U.S., according to the American Heart Association.

Notes that exercise remains the 'silver bullet' to maintain muscle mass in the aging ROCHESTER, Minn. — The progressive loss of skeletal muscle during aging, known as sarcopenia, underlies limitations in physical function and mobility, which in turn lead to falls, loss of independence, institutionalization and even death. Mayo Clinic researcher Nathan LeBrasseur, Ph.D., of Mayo Clinic's Robert and Arlene Kogod Center on Aging and Department of Physical Medicine and Rehabilitation, presented an update on promising strategies and therapies to restore skeletal muscle health in the face of aging and disease during a symposium at the American Congress of Rehabilitation Medicine Annual Conference. MULTIMEDIA ALERT: Video of Dr. LeBrasseur is available for download from the Mayo Clinic News Network. What is the significance of muscle for overall health? Dr. LeBrasseur: "We achieve peak muscle mass by our early 40s, and have a progressive deterioration from that point on, resulting in as much as a 50 percent loss by the time we are in our 80s or 90s. Most of us will lose approximately 30 percent over our lifetime. Muscle is a fundamental organ as we age, helping to maintain physical function, including the ability to walk, climb stairs, get out of a chair, or lift objects. These are things that determine our autonomy and independence as we age. "Muscle is also critically important for metabolism in the context oftype 2 diabetes, because it is the primary site where we store sugars and a primary determinant of our metabolic rate. It is also able to improve our resiliency to various stressors as we age, both physical and psychological, and as a result, fends off frailty. Interestingly, we and others are increasingly looking at muscle as an endocrine organ, and examining how it interacts with other organs, such as the brain. Therefore, by maintaining muscle health as we age, we can have a better overall quality of life." What types of therapies are available to mitigate muscle loss? Dr. LeBrasseur: "We are looking at promising therapies, including inhibiting the protein myostatin for those who require therapeutic intervention. Muscles naturally produce myostatin and its role is to prevent the growth of and cause the degradation of muscle. By administering a myostatin blocker, we and other researchers have demonstrated robust increases in muscle mass in mice and other animals. Our goal is to find ways to combine pharmacological and behavioral strategies to enhance muscle health to improve musculoskeletal function and metabolism, and reduce frailty as people age."

COLUMBUS, GA. — Building on its reputation for delivering high quality and compassionate care to the communities in which it serves, St. Francis in Columbus, Ga., ...

ROCHESTER, Minn. — The public is invited to enjoy three Rosemary and Meredith Willson Harmony for Mayo Program concerts in December. Performances will be on Mondays from 12:10 to 1 p.m. in Barbara Woodward Lips Atrium, subway level, Rochester Methodist Hospital, Charlton Building, 10 Third Ave. NW. The schedule is: Dec. 2: John Gorka will perform in Lips Atrium. This world-renowned singer-songwriter has toured across the globe sharing his soulful baritone and original songs. His 11 albums, collector's box set and greatest hits collection have garnered popular and critical acclaim. Gorka lives in Minnesota and continues to tour North America and Europe. Dec. 9: Minnesota natives Sally Barris and Jon Vezner will perform a holiday concert in Lips Atrium. Barris is an expressive soprano and Grammy-nominated songwriter. Vezner received a Grammy for Best Country Song in 1990 and is a talented singer and bassist.

Two-year study of Plavix and Brilinta to include approximately 5,300 patients from 15 hospitals worldwide; participant DNA biobank to help elucidate genomics of coronary artery ...

ROCHESTER, Minn. — Research has shown that the intestinal microbiome plays a large role in the development of Type 1 diabetes. Now, researchers at Mayo Clinic have demonstrated that gluten in the diet may modify the intestinal microbiome, increasing incidences of Type 1 diabetes. The research was published Nov. 13, in the journal PLOS ONE. MULTIMEDIA ALERT: Click here to retrieve video and photography from the Mayo Clinic News Network. These researchers demonstrated that mice fed a gluten-free diet had a dramatically reduced incidence of Type 1 diabetes. These mice were non-obese diabetic mice, or mice that grow to develop Type 1 diabetes. The gluten-free diet worked to protect the mice against Type 1 diabetes. When the researchers added gluten back into the diets of mice it reversed the protective effect the gluten free diet had provided. There also was a measurable impact of the gluten on the bacterial flora of the mice that might be one way in which gluten could affect the risk for diabetes. "These changes suggest that the presence of gluten is directly responsible for the diabetes-creating effects of diet and determines the gut microflora," says Govindarajan Rajagopalan, Ph.D., a Mayo Clinic immunologist and study author.

ROCHESTER, Minn. — Patients with rheumatoid arthritis, lupus and other chronic forms of inflammatory arthritis can face life-threatening complications, and heart disease tops the list. People with such rheumatic diseases are twice as likely as the average person to develop heart problems. Catching heart disease early is critical. Mayo cardiologists and rheumatologists have joined forces to create the Mayo Clinic Cardio-Rheumatology Clinic to pioneer new diagnostic tools and break this dangerous disease connection. MULTIMEDIA ALERT: Video of Dr. Matteson is available for download from the Mayo Clinic News Network. Mayo Clinic has found that the traditional methods used to pinpoint heart disease risk, such as the Framingham Risk Score, do not work very well in rheumatic disease patients, because their heart disease may manifest itself in a different and more subtle way. To prevent, detect and treat heart problems as early as possible, the Cardio-Rheumatology Clinic examines a broader spectrum of risk factors. "We offer patients a more detailed assessment of their cardiovascular status and a more detailed examination of risk factors besides the usual conventional risk factors such as lipids, cholesterol and smoking," says Eric Matteson, M.D., Mayo Clinic rheumatology chair, who is moderating a presentation Saturday on "cardio rheumatology" during an American Heart Association scientific meeting in Dallas. "We also are taking into account the rheumatic disease burden, the disease activity and the treatment of the rheumatic disease as a factor for mitigating cardiovascular risk." In part based on Mayo Clinic research, Cardio-Rheumatology Clinic physicians are employing new ultrasound techniques to evaluate blood vessels for the earliest signs of heart disease. "By evaluating and educating our patients early on in their rheumatic disease processes, we hope to be able to understand the mechanisms and make a difference in the development and severity of their atherosclerotic complications," says Sharon Mulvagh, M.D., a cardiologist and director of the Mayo Clinic's Women's Heart Clinic, noting heart attack and stroke risk in particular. Because women are more commonly affected by autoimmune disorders, the Cardio-Rheumatology Clinic will be located within the Women's Heart Clinic. Physicians plan to publish their findings from the clinic as part of a long-standing Mayo Clinic effort to identify the factors driving heart disease in rheumatic disease patients, reduce risk and slow the progression of heart disease. There is some evidence that moderating inflammation through treatment reduces the risk of heart disease in patients with rheumatic diseases, Dr. Matteson says. But, physicians do not really know why there is this connection between heart problems and rheumatic diseases, he adds. "We think it must have to do with the inflammatory burden of the rheumatic disease; that is, the same process that leads to inflammation in the joints, for instance in rheumatoid arthritis, may also affect the lining of the blood vessels," Dr. Matteson says.