
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 ...
SCOTTSDALE, Ariz. — June 28, 2012. Twenty-five years ago, in June 1987, a crew of just 47 physicians and 225 allied health employees rallied to formally launch Mayo Clinic in Arizona. Before the doors even opened, 1,800 patient appointments had been booked. Now, at the organization's 25th anniversary, set for Friday, June 29, 470 physicians and scientists and nearly 5,000 allied health employees, including many from the "original crew," will celebrate Mayo Clinic's many successes over the past quarter century of operation. Mayo Clinic in Arizona now spans two campuses, comprising more than 400 acres of land, and has added two research buildings on the Scottsdale campus and, on the Phoenix campus, a 244-bed hospital, a specialty clinic, housing for transplant and cancer patients and leased space for a child care center, a hospice and a hotel. Offsite family medicine practices were also added in Scottsdale and Glendale, Ariz. A visible new development on the Phoenix campus is construction currently under way for the Proton Beam Therapy Program, a precise form of cancer treatment that allows greater control over radiation doses, using pencil-beam scanning. Located just east of Mayo Clinic Hospital, the 100,000-plus square foot facility is expected to open its first treatment rooms by 2016. The center will be the first one in the Southwest. Plans were also announced in September 2011 for development of a branch of Mayo Medical School, called the Mayo Medical School – Arizona Campus, in collaboration with Arizona State University. Expected to open in 2015, the school will offer both a medical degree granted by Mayo and a master's degree in the Science of Health Care Delivery through ASU.
SCOTTSDALE, Ariz. — June 28, 2012. More than 40,000 student athletes in Arizona have taken advantage of computerized baseline concussion evaluations offered by Mayo Clinic, in the program's first year. That amounts to nearly 40 percent of the state's roughly 100,000 high school athletes. Baseline concussion evaluations measure how the brain is working before injury, and are mandatory tests for professional and college athletes. Mayo covers the cost of the cognitive evaluations for all high school and junior high school-aged interscholastic and club athletes in the state. The program was made possible through the support of benefactors and Mayo Clinic. The test takes 8–15 minutes to complete, and athletes or their parents can share the results with health care providers of their choice. After a concussion, the test can be repeated to determine if there has been a change in the cognitive capabilities of the athlete and, once symptoms have resolved, the test can be repeated to determine whether the athlete has returned to pre-injury baseline. The results of this test, combined with a thorough neurological evaluation, ensure that the health care provider can make an informed and objective determination on when and whether the athlete can safely resume normal activities — and in the case of student athletes, when they can return to their sport. "The diagnosis of concussion, assessment of its severity and knowing when an athlete can return to physical activity, competition, work or school is not always clear," says Mayo neurologist David Dodick, M.D., at Mayo Clinic in Arizona and president of the American Headache Society. "Having a baseline concussion assessment for each athlete will assist in a physician's ability to identify and quantify a change in brain function, and determine if and when the athlete has returned to his or her baseline." After a concussion, if an athlete continues to play or returns to play too early, there is a significant risk of experiencing another concussion. Dr. Dodick adds. "Repeat concussions may take longer to resolve and come with a risk of permanent neurological damage or, rarely, death," he says. Children, adolescents and female athletes appear to be at a higher risk for concussions, and may also take longer to recover. While the importance of baseline testing is clear, the results should be used with a comprehensive neurological evaluation. Although the majority of concussions resolve relatively quickly, some athletes may experience symptoms that may persist for months or longer. The medical care and rehabilitation of these athletes is best achieved by a multidisciplinary team of health professionals with expertise in the evaluation and management of concussions. Providing this baseline assessment also highlights the importance of safeguarding the brain health of young athletes.
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.
SCOTTSDALE, Ariz. — June 26, 2012. For a significant number of patients, gastric bypass surgery for weight loss can reverse Type 2 diabetes, but a new Mayo Clinic study finds that the disease can return in some 21 percent of patients within three to five years. The recurrence of diabetes was mainly influenced by the patients' longstanding history of Type 2 diabetes, explains Yessica Ramos, M.D., an internal medicine resident at Mayo Clinic in Arizona and study lead. "This suggests that early surgical intervention for obese people with diabetes can improve the chances for remission of the disease." Ramos and colleagues at Mayo Clinic studied records of 72 patients with Type 2 diabetes who had undergone a Roux-en-Y gastric bypass procedure (the most common form of gastric bypass surgery in which part of the patient's stomach is used to create a new, smaller stomach pouch) between 2000 and 2007. Of those patients, 66 (92 percent) experienced reversal of their diabetes at some point following the surgery. However, 14 of those same patients (21 percent) experienced a recurrence of their Type 2 diabetes within three to five years, according to the researchers who studied their blood work. Both groups of patients – those whose diabetes was reversed, and those whose diabetes returned – regained similar amounts of weight post-surgery. Those whose diabetes was reversed lost more weight originally and maintained a lower mean weight throughout the five years of follow-up. The Mayo researchers found that the longer the patients had diabetes previous to their weight loss surgery, the higher the probability that their diabetes would recur. In particular, patients who had diabetes for longer than five years before their surgery were 3.8 times more likely to experience a recurrence of their diabetes, compared with patients who had less than a five-year history with the disease.
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.
JACKSONVILLE, Fla. — June 20, 2012. A molecule widely believed to fight many forms of cancer actually helps deadly thyroid tumors grow, and cancer therapies now being tested in humans might boost the activity of this newly revealed bad guy, researchers at Mayo Clinic in Florida say. Their findings are published online this month in the Journal of Cell Science. The study found that in anaplastic thyroid cancer, the Forkhead transcription factor, FOXO3a, is not the helpful tumor suppressor everyone thought it was, but, instead, is a lethal promoter of tumor growth. When FOXO3a was silenced in laboratory models of human anaplastic thyroid cancer, the cells grew slowly, but when it was added, they grew much faster. "This result is exactly the opposite of what we expected," says senior author John A. Copland, Ph.D., a Mayo cancer biologist. "We were more than surprised. We were concerned." FOXO3a is known as a suppressor of tumor growth because it responds to all forms of cell stress, including that produced in cancer, by turning on genes inside the nucleus that trigger the cell's death. Cancer, in turn, is known to shut down FOXO3a by sending it out of the nucleus and into the cell's cytoplasm, where it is degraded. The molecule that ships FOXO3a out of the nucleus is Akt, which tries to keep cancer cells alive. The research team used an Akt blocker — similar to the ones now being used in human cancer clinical trials — expecting to increase nuclear FOXO3a and suppress cancer growth in anaplastic thyroid cancer. They were trying to find a treatment for one of the deadliest known cancers, which accounts for just 2 percent of thyroid cancer cases in the U.S. but is responsible for about 40 percent of thyroid cancer deaths. "The issue we are grappling with is that there are no effective treatments for this cancer. These tumors are so aggressive because there are so many genetic abnormalities," says study co-author Robert Smallridge, M.D., a Mayo endocrinologist who treats thyroid cancer patients. "We are studying what drives this cancer and how it can be treated." The study showed that FOXO3a remained in the nucleus, with the use of an Akt inhibitor, and that instead of helping to kill cancer cells, FOXO3a was accelerating their growth. This raises concern about the use of Akt inhibitors since one of the mechanisms is to cause FOXO3a to remain active in the nucleus. "We discovered a biological switch that turns FOXO3a from a good guy into a bad actor, but we don't know what that is yet, or in which cancers that might happen," says lead researcher Laura Marlow, a Mayo biologist. "Cancer researchers, including those testing Akt inhibitors, should know that FOXO3a has pro-cancer activity as well as anti-cancer properties," Dr. Copland says. "Concern should be raised that an Akt inhibitor will enhance retention of FOXO3a in the nucleus, causing FOXO3a to remain active.
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