
JACKSONVILLE, Fla. — July 31, 2012. A potentially powerful new approach to treating two lethal metastatic cancers — triple negative breast cancer and clear cell renal cell carcinoma, the most common form of kidney cancer — has been discovered by researchers at Mayo Clinic in Florida. In the online issue of Molecular Cancer Therapeutics, they report that two drugs, romidepsin and decitabine, work cooperatively to activate a potent tumor suppressor gene that is silenced in these cancers. Once the gene, secreted frizzled related protein one or sFRP1, went to work after the drugs were used, the laboratory tumor cells stopped growing and died. Both drugs are approved by the Food and Drug Administration to treat blood cancer and are being tested individually in numerous solid cancers in which sFRP1 is disabled. This study was the first to test the use of both in these metastatic cancers linked to sFRP1, and the results are very encouraging, says senior investigator John Copland, Ph.D., a Mayo Clinic molecular biologist. "We now have the basis for a clinical trial aimed at providing effective therapy for two drug-resistant cancers and perhaps many more tumor types in the future," Dr. Copland says. In addition to breast and kidney cancer, sFRP1 is disabled in colon, ovarian, lung, liver and other tumor types. Dr. Copland and his colleagues earlier discovered that sFRP1 was silenced in certain cancers. This new work demonstrates that its expression can be restored by romidepsin, which is a histone deacetylase inhibitor, and decitabine, a methyltranferase inhibitor. Both are epigenetic drugs, modifying genes in a way that affects whether they are turned on or off. "Individually, each drug did not induce any form of cell death but, together, they killed all of the different cell lines of kidney and triple negative breast cancer that we tested in the laboratory," says lead investigator Simon Cooper, Ph.D., a Mayo Clinic molecular biologist who specializes in renal cancer. The two cancers affect up to 80,000 Americans each year and therapies to treat both, especially when they are advanced, have been very limited, says co-author Edith Perez, M.D., deputy director of Mayo Clinic Cancer Center. "But now, not only do we have a very promising lead on future therapy, but if this combination treatment works as we hope it does, we will have a biomarker to be able to test which patients might benefit the most," she says. "In other words, a biopsy test could identify patients whose tumors had lost sFRP1 function." The approach to finding this potential new treatment strategy is novel, adds oncologist Michael Menefee, M.D., who is also a study co-author.
ROCHESTER, Minn. — July 31, 2012. The physical benefits of the Olympic sports are pretty obvious: strength, endurance and agility, to name a few. But ...
ROCHESTER, Minn. — July 30, 2012. Roughly 1.8 million Americans have celiac disease, but around 1.4 million of them are unaware that they have it, a Mayo Clinic-led analysis of the condition's prevalence has found. Meanwhile, 1.6 million people in the United States are on a gluten-free diet even though they haven't been diagnosed with celiac disease, according to the study published Tuesday in the American Journal of Gastroenterology. JOURNALISTS: For multimedia resources including video interviews with study authors, visit the Mayo Clinic News Network. Researchers have estimated the rate of diagnosed and undiagnosed celiac disease at similar levels prior to this study, but this is the most definitive study on the issue. "This provides proof that this disease is common in the United States," says co-author Joseph Murray, M.D., a Mayo Clinic gastroenterologist. "If you detect one person for every five or six (who have it), we aren't doing a very good job detecting celiac disease." Celiac disease is a digestive disorder brought on when genetically susceptible people eat wheat, rye and barley. A gluten-free diet, which excludes the protein gluten, is used to treat celiac disease. Roughly 80 percent of the people on a gluten-free diet do so without a diagnosis of celiac disease. There are a lot of people on a gluten-free diet, and it's not clear what the medical need for that is," Dr. Murray says. "It is important if someone thinks they might have celiac disease that they be tested first before they go on the diet. To determine its prevalence, researchers combined blood tests confirming celiac disease with interviews from a Centers for Disease Control and Prevention (CDC) nationwide population sample survey called National Health and Nutrition Examination Survey. The survey, designed to assess the health and nutrition of U.S. adults and children, is unique in that it combines interviews and physical examinations. Researchers found that celiac disease is much more common in Caucasians. "In fact, virtually all the individuals we found were non-Hispanic Caucasians," says co-author Alberto Rubio-Tapia, M.D., a Mayo Clinic gastroenterologist. But previous research in Mexico has shown that celiac disease could be just as common as it is in the U.S.
ROCHESTER, Minn. — July 30, 2012. Mayo Clinic Health System Practice-Based Research Network (PBRN) is sharing in an $11 million government grant to lead the creation of a national learning collaborative among rural health care providers. The effort is part of a national partnership using the Health Care Innovation Award funded by the Affordable Care Act. "This is a great opportunity for us to share health care knowledge and best practices with our colleagues to improve health care in rural communities nationally," says Paul Targonski, M.D., Ph.D., who leads the Mayo PBRN. "It's also a great important way for us to learn from our partners' expertise and experiences in rural health care, as well as leverage research to help solve the nation's health care problems." The network is partnering with rural clinics and communities to help them work together to deliver better health care. It is leading the efforts within the grant to create and evaluate the outcomes of sustainable local learning collaboratives that will drive health practice improvements. Partners in the project include Mineral Regional Health Center, Superior, Mont.; The Appalachian Osteopathic Postgraduate Training Institute Consortium, Pikeville, Ky.; iVantage Health Analytics, Portland, Maine; and Montana's frontier and rural health care communities. The specific award, the "Frontier Medicine Better Health Partnership," is intended to develop and implement a network to standardize operations and efficiencies across Montana's medical practices, including tertiary care centers, critical access hospitals, and rural health clinics. Training will be provided to participating sites, and support will include health improvement specialists, electronic health record specialists and data analysis.
LEBANON, N.H. — July 27, 2012. Mayo Clinic and Dartmouth-Hitchcock (D-H) today announced a formal collaboration to bring the strengths of both organizations to the goal of improving health and health care quality while lowering overall costs. Under the agreement, D-H will become a member of the Mayo Clinic Care Network, a growing network of like-minded organizations that share a commitment to serving patients and their families. Video Alert: Multimedia resources are available on the Mayo Clinic News Network. "Dartmouth-Hitchcock and Mayo share a long history of working to deliver high-quality, cost-effective, safe, value-based health care," says James Weinstein, D.O., CEO and President of D-H. "From creating the High Value Healthcare Collaborative with other partners, to advancing the patient's voice in health care decisions, Mayo and D-H have pursued a common vision, mission and commitment to a healthy population." Dartmouth-Hitchcock remains an independent entity under the agreement. As a member of the Mayo Clinic Care Network, D-H physicians and providers will have access to Mayo Clinic resources, including tools to promote physician-to-physician consultations and a point-of-care database of best-practice information on disease management, care guidelines, treatment recommendations and reference materials. "Health care in America is at a crossroads," says John Noseworthy, M.D., president and CEO of Mayo Clinic. "Providers are seeking meaningful relationships that allow them to best address their patients' needs while improving the efficiency and effectiveness of care. The Mayo Clinic Care Network is about advancing longstanding relationships with organizations that share a commitment to improving care and value for our patients. We are very proud to welcome Dartmouth-Hitchcock into the Mayo Clinic Care Network and building the long tradition of collaboration between our two organizations to serve patients throughout this region." This collaboration gives Mayo Clinic a unique relationship in the Northeast corridor of the United States and strengthens long-standing ties between the two organizations that date back to the founding of the Dartmouth-Hitchcock Clinic in 1927. More recently, D-H and Mayo have been frequent collaborators on research, grants, clinical care, health policy and health reform. "Over the past year, Mayo Clinic Care Network has worked with members across the country to ensure patients can receive care close to home whenever possible," says David Hayes, M.D., Medical Director of Mayo Clinic Care Network. "We are delighted to welcome such a prestigious institution to the network and look forward to working with Dartmouth-Hitchcock for years to come." In addition to their collaboration through the Mayo Clinic Care Network, Mayo and D-H are discussing a number of future joint projects, including advancing population health using large data systems, expanded clinical and basic research, joint educational initiatives and advancement of the science of health care delivery. "Mayo Clinic is one of the most respected health care institutions in the world," says Dr. Weinstein. "They are an exemplar of excellent patient-focused care and the highest professional standards. Dartmouth-Hitchcock has valued our long and close relationship and we are delighted to take it a step further with this formal collaboration."
ROCHESTER, Minn. — July 25, 2012. Massive crowds from around the globe will mingle in London during the Olympics, and that means a world-class array of germs will mix with them. Mayo Clinic infectious diseases expert Gregory Poland, M.D., offers several tips for avoiding illness when you are around lots of people, whether at the Olympics, a professional football game, convention, arena concert or other major event. MULTIMEDIA ALERT: Video clips of Dr. Poland will be available for journalists to download on the Mayo Clinic News Network. "The big ones that we're worried about in terms of the Olympics are things that are currently epidemic in certain parts of the world, including the U.S. Those would include pertussis, measles, mumps, rubella, and of course, when you have people coming from the Southern Hemisphere, this is their influenza season," says Dr. Poland, the Mary Lowell Leary Professor of Medicine and director of the Vaccine Research Group at Mayo Clinic. Whenever you're in a venue with hundreds of thousands of people gathering, particularly from all corners of the world, you automatically run increased risk, Dr. Poland says. The people around you may not have the same immunization programs or the same standards of personal cleanliness or food safety, he adds. Besides illnesses such as pertussis, measles, mumps, colds and flu, other heightened dangers in places with large numbers of people passing through include respiratory diseases such as tuberculosis; vermin such as head lice and bedbugs; food-borne sickness such as E. coli, salmonella, hepatitis A and traveler's diarrhea; and skin conditions including athlete's foot and staph infections. Dr. Poland offers these tips for sidestepping illness: Keep your vaccines up to date: The most important ones include the MMR vaccine for measles, mumps and rubella; the seasonal flu shot; and a relatively new vaccine called Tdap, for tetanus, diphtheria and acellular pertussis. Vaccination against pertussis, also known as whooping cough, is particularly important as epidemics spring up around the United States and the world, Dr. Poland says. England and other parts of Europe have also had measles outbreaks, he says. Wash your hands thoroughly with soap and hot water or alcohol-based hand sanitizer, particularly before leaving a restroom, eating or touching your face. Wash your hands for about 20 seconds, roughly as long as it takes to sing "Happy Birthday." When visiting a public restroom, use a paper towel to turn off the faucet and open the door when leaving, to avoid recontaminating your hands with the plethora of germs on public faucets and door handles. Dine carefully: If it's not cooked well, boiled or peeled, forget it. Seek out food that requires little handling when prepared. Make sure food that is supposed to be hot is served hot and food that is supposed to be cold is served cold, and make sure dishes and utensils are clean. Wear shower shoes/pool shoes when using the shower or pool in public places. Avoid swimming pools, hot tubs or whirlpools unless you are certain they are properly maintained. It's particularly hard for consumers to tell whether a hot tub or whirlpool is sanitary, and if it is not, bacterial, skin and pulmonary infections are a danger, Dr. Poland says. Don't smoke: It raises the odds you'll get Legionnaires' disease if you're exposed to the legionella bacteria, and can also make you more susceptible to respiratory illnesses in general. Don't try on hats in stores: To minimize the risk of getting head lice, if you buy a hat, seal it in a plastic bag to carry it home, then freeze it for several days or launder it before wearing. Scout for bedbugs before taking a hotel room, and once in a room, only place your luggage on wooden surfaces or in the bathtub, not on the floor, bed, chair or couch until you determine whether bedbugs are present. Be an advocate for your health: If someone near you is obviously ill, move away if you can, or ask to be reseated. If a server's hands touch your food or the rim of your glass or cup, don't be embarrassed or hesitant about asking for a new serving or moving on and eating elsewhere.
WHAT: Mayo Clinic and Dartmouth-Hitchcock will announce a formal agreement between the two organizations. WHO: John Noseworthy, M.D., president and CEO, Mayo ...
ROCHESTER, Minn. — July 24, 2012. Participation in competitive sports by people with long QT syndrome — a genetic abnormality in the heart's electrical system — has been a matter of debate among physicians. Current guidelines disqualify most LQTS patients from almost every sport. In a first-of-its-kind study, Mayo Clinic's LQTS Clinic recently examined its own experience, determining the outcome of LQTS patients who chose to remain athletes against guideline recommendations. The study is published online in the Journal of the American Medical Association. Journalists: For multimedia resources, visit the Mayo Clinic News Network In the study, the records of 353 LQTS patients ages 6 to 40 who were evaluated at Mayo Clinic between July 2000 and November 2010 were reviewed to determine which patients chose to continue athletic participation after LQTS diagnosis and LQTS-related events. Of the 157 patients who were athletes at the time of their evaluation, 27 (17 percent) chose to disqualify themselves, "debunking the myth" that families would never choose to quit sports, says senior author Michael Ackerman, M.D., Ph.D., pediatric cardiologist and Director of Mayo's LQTS Clinic. More importantly, of the 130 patients who chose to remain an athlete, only one experienced a LQTS-triggered event during a sport; the athlete received an appropriate shock from his implantable cardioverter-defibrillator on two separate occasions. For the study, researchers defined a competitive athlete as a person who participated in organized competitive sports at the little league, middle or high school, collegiate or professional level. "About eight years ago after I started to see some of these lives ruined by the recommendation to discontinue sports, we decided to challenge the status quo," Dr. Ackerman says. "We adopted a philosophy that empowered patients and their families with the right to make an informed and difficult decision about continuing in competitive sports, a possible LQTS risk-taking behavior." Dr. Ackerman presented these findings Sunday in Glasgow, Scotland, at a pre-2012 Summer Olympics medical conference on sports, athletes and health. Olympic swimmer Dana Vollmer as a child was found to have signs of LQTS; her mother carried a portable defibrillator to her swim meets, but by college, Vollmer no longer showed symptoms, according to her official website. Vollmer, who is not a Mayo patient, will compete in London. In LQTS, which affects one in 2,000 people, the rapid heartbeats can trigger a sudden fainting spell, seizure or sudden death. Treatment can involve medication, medical devices or surgery. "We felt that although exercise, sports, and the thrill of victory and agony of defeat could potentially trigger a dangerous heart rhythm in these patients, that in a well-counseled, well-studied and well-treated patient, these may be manageable risks," Dr. Ackerman says. "Up until now, the current status quo has been to view these things as controllable risk factors which are controlled by kicking these patients out of most sports and telling them to not get their heart rate up and not get too excited." Two sets of guidelines have medical eligibility criteria for patients with cardiovascular abnormalities: the 36th Bethesda Conference guidelines and the European Society of Cardiology guidelines. The ESC guidelines are more restrictive, Dr. Ackerman says. Both sets of guidelines are based on expert opinions and rely on the "art of medicine" because there is little evidence about the real risk of sports participation, he says. As patients in Mayo Clinic's LQTS Clinic, all 353 initially evaluated for this study received a comprehensive two- to three-day clinical and genetic evaluation, including a one- to two-hour consultation with Dr. Ackerman, all of which is standard for LQTS Mayo patients. Patients who were already athletes and chose to continue athletics received counseling on athletic participation guidelines. If the patient chose to continue competitive athletics, the decision had to be agreed on by the physician, the patient, and both parents, depending on the patient's age. In addition to the patient's treatment, such as medications, each athlete obtained an automated external defibrillator, and the athlete's school officials and coaches were notified. Of the 130 patients who remained athletes, 20 had ICDs. Forty-nine (38 percent) participated in more than one sport. Thirty-two athletes competed in high school, and eight competed at the college, university or professional level.
ROCHESTER, Minn. — July 20, 2012. In the 1920s, brothers William J. Mayo, M.D., and Charles H. Mayo, M.D., traveled the world sharing their medical ...
ROCHESTER, Minn. — July 19, 2012. Food particles in the mouth may be the source of bad breath. The July issue of Mayo Clinic Health ...
ROCHESTER, Minn. — July 19, 2012. Chronic obstructive pulmonary disease (COPD) literally takes one's breath away and is a leading cause of death in the United States. COPD refers to a group of lung diseases that limit airflow during exhalations, making it increasingly difficult to breathe out. COPD includes chronic bronchitis and emphysema. Most people with COPD have both. The July issue of Mayo Clinic Health Letter provides an overview of COPD, including causes, symptoms and treatment options. Causes — COPD is usually attributed to exposure to tobacco smoke and airborne irritants over a long period of time. Most often, it occurs in long-term or former smokers. Symptoms — Persistent shortness of breath and chronic cough lasting more than three to six weeks may signal COPD. Other symptoms may include wheezing, chest tightness and sputum or phlegm production. Symptoms usually progress slowly — more slowly in people who have stopped smoking, and faster when smoking continues. Diagnosis — Pulmonary function tests are key in diagnosing COPD. A patient blows into a device called a spirometer that measures how much air lungs exhale and how quickly. This tool also helps monitor how well treatments are working. Treatment — Doctors recommend treatments to minimize further damage, control symptoms and prevent a sudden worsening of COPD, called an exacerbation. Without prompt treatment, exacerbations may lead to lung failure and the need for hospitalization. The first step in treatment is to stop exposure to lung irritants, including tobacco smoke. Patients who stop smoking have fewer symptoms and may see slightly improved lung function. Physical activity is critically important, too. Research shows that people with COPD who exercise do better overall. Other treatments may include: Bronchodilator medications including albuterol, ipratropium (Atrovent) and others that relax muscles around the airways. Inhaled corticosteroids to reduce airway inflammation and prevent sudden exacerbations. Antibiotics to fight respiratory infections and help prevent flare-ups of COPD
ROCHESTER, Minn. — July 19, 2012. Tinnitus — the name for a ringing, buzzing, whistling or hissing noise in the ear — isn't a disease. Rather, according to the July issue of Mayo Clinic Health Letter, it's a symptom of something wrong with the hearing mechanism, hearing nerves or part of the brain that processes sound. Usually, tinnitus is believed to result from damage to the cells of the inner ear due to age-related hearing loss or exposure to loud noises. The damage results in the sensation of sound when there is none. Tinnitus can range from mildly annoying and temporary to so loud and constant that it causes fatigue and sleep problems, stress, memory problems, anxiety, depression and irritability. When tinnitus develops due to hearing loss or damage — with no correctable underlying cause — treatment focuses on finding ways to reduce the irritation from the noise. An audiologist or an ear, nose and throat (ENT) physician may recommend one or several strategies, including: Hearing aid — A hearing aid helps patients with hearing loss hear the sounds around them better, which may reduce awareness of tinnitus. Using masking noise — This strategy may include a small device worn in the ear that emits soft steady noises, tones or music. Tabletop sound machines may help with sleep. A fan or an FM radio tuned between stations may offer the same result. Tinnitus retraining therapy — Patients listen to low-level steady noise, which over time may desensitize them to the tinnitus. This approach is usually part of a long-term management program reserved for severe tinnitus.
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