
JACKSONVILLE, Fla. — August 29, 2012. Removing the entire pancreas in patients with cancer or precancerous cysts in part of the organ does not result in unmanageable diabetes — as many physicians previously believed, research at Mayo Clinic in Florida has found. The study, published online Sunday in the journal HPB Surgery, evaluates how well patients who had their entire pancreas removed could control their resulting diabetes. The pancreas produces insulin to remove sugar from the blood, so when the organ is gone, insulin must be replaced, usually through an external pump or with injections. The researchers examined control of insulin over several years in 14 patients whose entire pancreas was removed. They compared their findings with 100 people with type 1 diabetes, and must use insulin replacement. They found both groups had little difficulty controlling their blood sugar, and no complications resulted. The findings should reassure physicians and surgeons that removing the entire pancreas is reasonably safe and effective, says senior investigator Michael B. Wallace, M.D., chair of the Division of Gastroenterology & Hepatology at Mayo Clinic in Florida. "What has confounded surgery for pancreatic cancers and precancerous cysts for a long time is the notion that if the entire organ is removed, patients will have great difficulty in controlling the resulting diabetes," Dr. Wallace says. "Most surgeons try to leave as much of the pancreas as possible". "What we have shown here is that, due to wonderful recent improvements in insulin therapy, patients without a pancreas can control their blood sugar as effectively as type 1 diabetes patients can," he says. Although this study was small, Dr. Wallace says the findings are mirrored in the experiences of patients treated at Mayo Clinic in Florida with total pancreas removal. Even though the approach of preserving as much of the pancreas as possible benefits most patients, leaving part of the pancreas in some patients may put them at risk of developing hard-to-detect cancer in the remaining organ, he says.
ROCHESTER, Minn. — August 24, 2012. Concerns are growing about the prevalence of concussions in children and teens who play sports, as well as in professional athletes. The August issue of Mayo Clinic Health Letter covers what happens when concussions occur and why they can be dangerous. Concussion is a form of traumatic brain injury. It occurs when a blow to the head or a sudden jolt shakes the head and causes the brain's gelatin-like cortex to rapidly collide with the inside the skull or turn within it. Immediately after a concussion, the brain is in crisis. Many brain cells become activated at once, which can cause a sudden release of brain chemicals called neurotransmitters. Within minutes to hours after a concussion, the brain's power drain can cause headache, dizziness, nausea or vomiting, imbalance, slurred speech, fatigue and being unaware of surroundings. Symptoms that may appear later include: Difficulty concentrating or remembering. Sensitivity to light and noise. Persistent headache. Unexplained irritability or other personality changes. Sleep disturbances. Depression and problems adjusting psychologically. Altered sense of taste and smell. If symptoms are present, avoiding another concussion is critical, because the brain is vulnerable to rare but fatal brain swelling. The focus during recovery is physical and mental rest. Most people recover completely within a week or two and have no further symptoms. When recovery takes longer, persistent headaches are common. For someone who has had multiple concussions, recovery becomes less certain with each concussion.
ROCHESTER, Minn. — August 24, 2012. A flushed face along with the presence of pimple-like bumps could indicate rosacea (roe-ZAY-she-uh), a common inflammatory skin condition. The August issue of Mayo Clinic Health Letter provides an overview of this progressive condition and ways to manage it. Rosacea can begin with a tendency to blush. While anyone can develop rosacea, most often the condition occurs in women between 30 and 60 with fair skin and light eye and hair colors. Persistent red areas may develop in the center area of the face, especially the nose. Over time, small blood vessels on the nose and cheeks may swell and become more visible. Small red bumps may appear. More than half of people with rosacea experience a burning or gritty eye sensation called ocular rosacea. Rarely, late in the course of the disease and most often in men, tissue can build up on or around the nose, giving it a bulbous appearance. Rosacea typically requires treatment to clear up, but symptoms can often be controlled with medication and self-care. The first step is avoiding triggers that cause facial flushing. They include: Temperature extremes. Sunlight exposure. Hot foods and beverages. Spicy foods. Alcohol. Stress, anger or embarrassment. Hot baths and saunas. Medications that dilate blood vessels including some blood pressure medications.
ROCHESTER, Minn. — August 24, 2012. The progression from insulin resistance and prediabetes to diabetes likely can be stopped with changes in diet and lifestyle, according to the August issue of Mayo Clinic Health Letter. In people with insulin resistance, cells do not respond normally to insulin, and the body's fuel, glucose. As a result, the body produces more insulin to overcome the resistance. Over time, cells become more resistant, and the body can't keep up with insulin production. Blood glucose levels rise and eventually, type 2 diabetes develops. But the progression from prediabetes to type 2 diabetes often can be stopped. One large study, the Diabetes Prevention Program, found that modest lifestyle changes reduced the risk of progression by 71 percent in adults age 60 and older. Participants who reduced their risk the most: Consumed fewer calories and cut back on fat. Exercised the equivalent of brisk walking 30 minutes a day, five days a week. Lost a little weight. The goal was 7 percent of body weight; for example, 14 pounds for a person weighing 200 pounds. Insulin resistance appears to be caused by a combination of genetic and lifestyle factors. A sedentary lifestyle and a family history of diabetes are risk factors. So is being black, Native American, Asian-American, Hispanic or a Pacific Islander. Being overweight, especially with excess fat around the abdomen, is the greatest modifiable risk factor for progressing to type 2 diabetes among those who already have insulin resistance.
Jacksonville, Fla. — August 24, 2012. As another storms brews in the Atlantic, residents of coastal communities are starting to prepare for a potential severe weather emergency. But hurricane shutters, flashlights and batteries are not the only things to consider. Food safety is critical to maintaining wellbeing during a natural disaster, and finding creative ways to feed a family can become an issue if refrigeration and electricity are unavailable. MULTIMEDIA ALERT: Video and audio clips of Ron Stone, Nutrition Services at Mayo Clinic, are available for journalists to download on the Mayo Clinic News Network. "Whether it's a hurricane or another natural disaster, it's critical to understand basic food and water safety, particularly if power outages or flooding occur. Having a plan in place will ensure proper nutrition, energy, and long-term wellness," says Sherry Mahoney, director of Nutrition and Food Services at Mayo Clinic in Florida. She advises creating a meal plan in advance, "since most people aren't thinking about recipes (during a disaster), and refrigeration and cooking may become a problem." But eating out of a can doesn't have to be boring, says Ron Stone, Assistant Director of Nutrition. "There are many options to mix and match from your pantry, and with advanced planning and a little creativity, you can provide healthy and delicious meals for your family," he says." Under their direction, Mayo Clinic dietetic interns recently created sample three-day meal plans (PDF) to feed a family of four. The recipes do not require the use of power or refrigeration, but are still "colorful, exciting and nutritious," Mahoney says. The recipe list (PDF) includes "Coconut Oatmeal Energy Bars," "Stir It Up Vanilla Pudding Parfait," "Reggie's Chopped Barbecue Chicken Salad on Flatbread" or "Chocoholic Peanut Butter Pie." Here are tips from Stone for prepping your pantry and planning an emergency menu: Know the safe temperature zones of perishable food. When the power goes out, keep the refrigerator and freezer doors closed as much as possible to maintain the cold. The refrigerator, if unopened, will keep food cold for about four hours. A full freezer will maintain its temperature for around 48 hours (24 hours if it is half full) if the door remains closed. Stock up on condiments, particularly those that are vinegar-based, which have a long shelf life and are versatile, such as ketchup, mustard, soy sauce and BBQ sauce. Consider travel-sized containers for convenience. Keep canned protein on hand (chicken, salmon, beans and peanut butter). Don't forgo the milk: Keep boxes of powdered milk or shelf-stable cartons on hand for cereal or deserts. Dried fruits, nuts and spices can add a boost of flavor to otherwise bland dishes. Don't forget a manual can opener.
SCOTTSDALE, Ariz. — August 23, 2012. Mayo Clinic in Arizona has been designated a Breast Imaging Center of Excellence by the American College of Radiology. By awarding facilities the status of a Breast Imaging Center of Excellence, the ACR recognizes breast imaging centers that have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy). Mayo Clinic in Arizona provides comprehensive diagnostic breast imaging services including: Screening and Diagnostic Mammograms Breast Ultrasounds MRI of the Breast Stereotactic Breast Biopsies Ultrasound Breast Biopsies MRI Breast Biopsies Seed Localizations Peer-review evaluations, conducted in each breast imaging modality by board-certified physicians and medical physicists who are experts in the field, have determined that Mayo Clinic in Arizona has achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs.
SCOTTSDALE, Ariz. — August 22, 2012. One of the most unpleasant aspects of colorectal cancer screening for many patients is the amount of laxative they must drink the night before. Some become so anxious about drinking so much liquid that they avoid the entire procedure, putting them at risk of undiagnosed cancer. Under a new practice at Mayo Clinic in Arizona, four pills replace the multiple liters of laxative for people having a CT colonography also known as a virtual colonoscopy. Colonoscopies, in which a tiny camera is inserted into the body to examine the bowels, and virtual colonoscopies, in which a CT scan is used to provide three-dimensional imaging of the colon and rectum, are commonly performed for early detection of colon cancer in people over 50. Both colon exams require the use of a laxative to empty the colon. In the new Mayo protocol that began this summer, patients having virtual colonoscopies simply take four tablets of the cleansing agent bisacodyl. "Our hope is that this will make people less anxious and more likely to get screened and will ultimately result in fewer deaths from colorectal cancer," says C. Daniel Johnson, M.D., chair of the Department of Radiology at Mayo Clinic in Arizona. Click here for a video of Dr. Johnson talking about the new protocol. The development of the new protocol was based on a study co-by Dr. Johnson and published in Abdominal Imaging journal last year. The study found that the new four-tablet procedure worked as well as the standard liquid laxative for virtual colonoscopies. The new protocol is not intended for standard colonoscopies because the cleansing requirements between the two procedures differ. Virtual colonoscopy was found to be highly accurate for detection of intermediate (6-9 millimeters) and large (greater than 1 centimeter) polyps. Because the majority of patients will not have a polyp, no further workup is necessary. Only the 12 percent of patients identified with a polyp during a colonography would then need to have a colonoscopy. Because most colon cancer arises from preexisting polyps, detection and removal of these lesions can help eradicate it. Dr. Johnson says that how people get screened should be an individual decision, based on discussions with their medical providers. Virtual colonoscopies may be considered for patients who: Have had a difficult time with previous colonoscopy procedures Are on anti-coagulant drugs Have a colon obstruction Prefer not to have a standard colonoscopy.
PHOENIX, Arizona — August 20, 2012. Mayo Clinic has been granted approval for construction of a 217,200 square-foot building on its Phoenix campus, a major expansion that will create a single-site, integrated Cancer Center. Mayo Clinic Cancer Center is the only National Cancer Institute-designated comprehensive cancer center with a multi-site, national presence, which allows us to serve a broad and diverse group of patients. The $130 million facility features three additional floors of clinical and office space that will be built above the first level of Mayo Clinic's Proton Beam Therapy Building currently under construction. Proton beam therapy is a precise form of cancer treatment that allows greater control over radiation doses, using pencil-beam scanning. Project design and programming for the new building is expected to take three years, with staged occupancy expected in 2015. The project signals a significant milestone for Mayo Clinic in Arizona in that it creates a consolidated and integrated Cancer Center on one campus, providing enhanced convenience for cancer patients and their families. Pivotal to that consolidation will be the relocation of the Hematology/Oncology Department from its current location on the Scottsdale campus to the new building on the Phoenix campus. Other cancer-related units such as Bone Marrow Transplant, Chemotherapy Infusion and Research will also transfer to the new building. Consolidation to one campus will also include relocation of 32 chemotherapy infusion stations currently located on the Scottsdale campus to the new cancer facility, as well as the planned addition of 18 more infusion stations. The vertical expansion project will also include three outpatient operating rooms, expanded space for Transplant and relocation of some clinical units from the adjacent Mayo Clinic Hospital to create 12 more inpatient hospital beds. Future plans include moving other units from the hospital to create space for 24 additional hospital beds. Exam rooms in the new cancer building will feature a new design concept intended to accommodate the integrated team care concept for the evaluation and treatment of patients. Also planned for the convenience of patients are kiosks that will allow virtual check-in and access to timely information.
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