
ROCHESTER, Minn. - November 29, 2012. Diabetic patients with ovarian cancer who took the drug metformin for their diabetes had a better survival rate than patients who did not take it, a study headed by Mayo Clinic shows. The findings, published early online in the journal Cancer, may play an important role for researchers as they study the use of existing medications to treat different or new diseases. Metformin is a widely prescribed drug to treat diabetes, and previous research by others has shown its promise for other cancers. The Mayo-led study adds ovarian cancer to the list. Researchers compared the survival of 61 patients with ovarian cancer taking metformin and 178 patients who were not taking metformin. Sixty-seven percent of the patients who took metformin were surviving after five years, compared with 47 percent of those who did not take the medication. When the researchers analyzed factors such as the patients' body mass index, the severity of the cancer, type of chemotherapy and quality of surgery, they found that patients taking metformin were nearly four times likelier to survive, compared with those not taking the medication. "Our study demonstrated improved survival in women with ovarian cancer that were taking metformin," says co-author Sanjeev Kumar, M.B.B.S., a Mayo Clinic gynecologic oncology fellow. "The results are encouraging, but as with any retrospective study, many factors cannot be controlled for us to say if there is a direct cause and effect. Rather, this is further human evidence for a potential beneficial effect of a commonly used drug which is relatively safe in humans. These findings should provide impetus for prospective clinical trials in ovarian cancer."
ROCHESTER, Minn. — November 29, 2012. Mayo Clinic has been inducted into the Healthcare Internet Hall of Fame Class of 2012 at the 16th Annual Healthcare Internet Conference in Las Vegas. Mayo is one of two organizations that received the honor for Innovative Products and Services. Additionally, Mayo Clinic was honored with five eHealthcare Leadership Awards, presented by eHealthcare Strategy & Trends. "When I think of trailblazing organizations that were doing things unheard of at the time, the Mayo Clinic immediately comes to mind. Mayo has always been ahead of its time in patient education, including online offerings, and continues to set the standard that others emulate," says Kathy Divis, president of Greystone.net and a judge for the Hall of Fame. "They greatly deserve a spot in the Healthcare Internet Hall of Fame for their innovations in online education and the use of social media." Mayo Clinic's five eHealthcare Leadership Awards include platinum awards for "Best Overall Internet Site" (Healthcare System category) and "Best Health/Healthcare Content" (for both Healthcare System and Consumer General Health Site categories), a gold award for "Best Overall Internet Site" (Consumer General Health Site category), and a silver award presented to Mayo Clinic Health System for "Best Overall Internet Site" (Healthcare System category). The awards were presented in mid-November. Patient and consumer education has been part of Mayo Clinic's mission since the organization's beginning nearly 150 years ago. In the early 1980s, Mayo Clinic began publishing consumer health information for the public in newsletters and books. By the early 1990s, Mayo Clinic recognized the importance of electronic media and began producing CD-ROM titles, including The Mayo Clinic Family Health Book. In 1996, Mayo Clinic started Mayo Health Oasis, one of the first health information websites. The name changed to MayoClinic.com in 2000. Now, in 2012, the site receives nearly 30 million unique visits per month from all over the world. Proceeds from the advertising and syndication of the site support medical education and research at Mayo Clinic. A team of Web and publishing professionals and medical experts work together to produce Mayo Clinic's health information. Through this collaboration, consumers everywhere have access to the experience and knowledge of the more than 3,700 physicians, scientists and researchers of Mayo Clinic.
ROCHESTER, Minn. — November 28, 2012. Next week, more than 1,200 people from 25 countries are expected to attend the 8th Annual World Stem Cell Summit" in West Palm Beach, Fla., a gathering sponsored by Mayo Clinic. As those close to the science explore potential stem cell applications, many patients have questions about what stem cells are and how they are being used. Timothy Nelson, M.D., Ph.D., director of Mayo Clinic's Regenerative Medicine Consult Service, answers some of the most commonly asked questions about stem cells: MULTIMEDIA ALERT: Multimedia resources, including a Medical Edge package, are available for journalists to download on the Mayo Clinic News Network. What are stem cells? Stem cells are the body's raw materials. These cells have the ability to renew themselves or change to become specialized cells with a more specific function, such as blood cells, brain cells, heart muscle or bone. Where do stem cells come from? Adult stem cells are found in tissues of the body, such as bone marrow. Emerging evidence suggests that adult stem cells may be more versatile than previously thought and have the ability to create other types of cells. Amniotic fluid stem cells come from the liquid that surrounds a developing fetus in the amniotic sac. More study of amniotic fluid stem cells is needed to understand their potential. Embryonic stem cells are a general stem cell found in embryos. Use of this type of stem cell has significantly declined due to the discovery of induced pluripotent stem cells. Induced pluripotent stem cells, commonly known as iPS cells, are derived from an adult stem cell that behaves like an embryonic stem cell. This new technique may help researchers avoid the controversy that comes with embryonic stem cells and prevent immune system rejection of the new stem cells. Mesenchymal stem cells are adult stem cells found in tissues such as bone marrow, blood and the fallopian tube. They can become bone, cartilage, fat and possibly other cells.
ROCHESTER, Minn. — November 27, 2012. It's one of the toughest questions patients and their loved ones can discuss with physicians: When is further medical treatment futile? The conversation can become even more difficult if patients or their families disagree with health care providers' recommendations on end-of-life care. Early, clear communication between patients and their care teams, choosing objective surrogates to represent patients and involving third parties such as ethics committees can help avoid or resolve conflicts, Mayo Clinic experts Christopher Burkle, M.D., J.D., and Jeffre Benson, M.D., write in the November issue of Mayo Clinic Proceedings. "Health care professionals in the United States have struggled with the importance of maintaining patient autonomy while attempting to practice under the guidance of treatments based on beneficial care," Dr. Burkle, the study's lead author, says. Tips from Drs. Burkle and Benson to effectively discuss end-of-life care include: Clear communication: Early and clear communication between health care providers and patients or their surrogates is the best way to avoid disagreement over whether medical care should continue. Recent studies show that more than 95 percent of such disputes are resolved through mediated meetings involving physicians and patients/surrogates. Choose objective surrogates if patients cannot represent themselves: The surrogate's role is to stand in the shoes of the patient and suppress his or her own judgment in favor of what the patient would have done. However, it is important to acknowledge that medical surrogates often struggle to balance their wishes for the patient with the patient's own wishes. Studies have found that not only do many surrogates fail to accurately predict a patient's treatment wishes, but when asked to resolve disputes, they are more likely to show bias by overestimating the patient's desire for continued treatment. Involve third parties when necessary: When health care providers and patients or their advocates cannot agree on end-of-life care, involving a third party becomes necessary. Beginning in 1992, the Joint Commission, the largest hospital accreditation organization in the United States, required hospitals to establish procedures for considering ethical issues. Hospital-based ethics committees have been the most common response to this requirement.
YUMA, Ariz. — November 26, 2012. Mayo Clinic officials today announced Yuma Regional Medical Center (YRMC) as a member of the Mayo Clinic Care Network. The collaboration between YRMC and Mayo Clinic physicians will be rolled out initially through Yuma Regional Cancer Center, with opportunities for physicians from both organizations to work together in additional specialties in the future. The Mayo Clinic Care Network extends Mayo Clinic's knowledge and expertise to physicians and providers interested in working together in the best interest of their patients. YRMC physicians now will be able to connect with Mayo Clinic specialists on questions of patient care using an electronic consulting technique called eConsults. YRMC physicians also will have access to Mayo-vetted medical information through the AskMayoExpert database. These tools, in addition to health care consulting, will help YRMC provide the best care for its patients as well as improve its systems and the health of the community. "We're proud to welcome the Yuma Regional Medical Center care team to the Mayo Clinic Care Network," says Wyatt Decker, M.D., vice president and CEO of Mayo Clinic in Arizona. "Building a closer relationship with Yuma Regional Medical Center through the Care Network provides an opportunity for our two organizations to work together in new ways to provide specialized care, which ultimately enhances the lives of patients throughout Southwestern Arizona." "YRMC and Mayo Clinic both believe that health care should be delivered as close to home as possible," says Pat Walz, President and CEO of YRMC. "By working together, physicians can improve the delivery of health care so patients need to travel outside the region for care only when absolutely necessary. Mayo Clinic and Mayo Clinic Care Network members share a common philosophy, commitment and mission to improve the delivery of health care. And the primary goal of the network is to help people gain the benefits of Mayo Clinic knowledge and expertise close to home, ensuring that patients need to travel for care only when necessary. The Mayo Clinic Care Network represents non-ownership relationships. Network members are like-minded organizations committed to the delivery of high-quality, collaborative medical care for their communities.
YUMA, Ariz. — Mayo Clinic officials today announced Yuma Regional Medical Center (YRMC) as a member of the Mayo Clinic Care Network. The collaboration between YRMC and Mayo Clinic physicians will be rolled out initially through Yuma Regional Cancer Center, with opportunities for physicians from both organizations to work together in additional specialties in the future. The Mayo Clinic Care Network extends Mayo Clinic's knowledge and expertise to physicians and providers interested in working together in the best interest of their patients. YRMC physicians now will be able to connect with Mayo Clinic specialists on questions of patient care using an electronic consulting technique called eConsults. YRMC physicians also will have access to Mayo-vetted medical information through the AskMayoExpert database. These tools, in addition to health care consulting, will help YRMC provide the best care for its patients as well as improve its systems and the health of the community. "We're proud to welcome the Yuma Regional Medical Center care team to the Mayo Clinic Care Network," says Wyatt Decker, M.D., vice president and CEO of Mayo Clinic in Arizona. "Building a closer relationship with Yuma Regional Medical Center through the Care Network provides an opportunity for our two organizations to work together in new ways to provide specialized care, which ultimately enhances the lives of patients throughout Southwestern Arizona." "YRMC and Mayo Clinic both believe that health care should be delivered as close to home as possible," says Pat Walz, President and CEO of YRMC. "By working together, physicians can improve the delivery of health care so patients need to travel outside the region for care only when absolutely necessary. Mayo Clinic and Mayo Clinic Care Network members share a common philosophy, commitment and mission to improve the delivery of health care. And the primary goal of the network is to help people gain the benefits of Mayo Clinic knowledge and expertise close to home, ensuring that patients need to travel for care only when necessary.
LA CROSSE, Wis. — Roughly 1 in 10 U.S. babies is born prematurely. Preterm labor can affect any pregnancy. To help highlight National Prematurity Awareness Month, Dennis Costakos, M.D., a neonatologist at Mayo Clinic Health System in La Crosse, explains some of the factors behind premature births. A child is considered premature when born before 37 weeks of gestation. Women who have had children prematurely are at the highest risk of having another baby early, says Dr. Costakos, who has worked in the Mayo Clinic Health System Neonatal Intensive Care Unit for 23 years. "One-third of the time, a preterm birth is due to infection, such as membranes rupturing. Another third of the time, it is due to a medical condition such as preeclampsia, or high blood pressure," Dr. Costakos says. "The other third of the time, we are not sure why a preterm birth occurs." Factors that can raise the risk of preterm labor also include: Certain problems with the uterus, cervix or placenta. Some chronic conditions, such as asthma and diabetes. Being underweight or overweight before pregnancy, or gaining too little or too much weight during pregnancy. Stressful life events, such as the death of a loved one. Domestic violence or any form of abuse during pregnancy. Multiple miscarriages. Red blood cell deficiency (anemia), particularly during early pregnancy. Too much amniotic fluid (polyhydramnios). Vaginal bleeding during pregnancy. Presence of a fetal birth defect. Carrying multiple babies such as twins or triplets.
PHOENIX, Ariz. — A program at Mayo Clinic using telemedicine technology is showing promise for patients with concussions in rural Arizona. A case study published in the December 2012 issue of Telemedicine and e-Health validates "teleconcussion" as a useful means to assess concussed patients. In the case study, doctors at Mayo Clinic in Arizona conducted a live audio-video evaluation of a 15-year-old soccer player in Show Low, Ariz., who received a concussion during a game. The teleconcussion evaluation, believed to be the first in the state to use telemedicine for concussions, supports the use of this technology to bring concussion expertise to rural locations. Similar telestroke, teleneurology, and teleepilepsy programs have been operating at Mayo Clinic in Arizona for several years. More than one-third of rural Arizona lacks access to the kind of neurological expertise found in metropolitan areas. Mayo Clinic's program aims to address this disparity by providing support through these programs. With telemedicine technology, use of a specialized remote controlled camera system allows the patient in the rural setting to be "seen" by the neurology specialist — in real time. The Mayo Clinic neurologist, whose face appears on the screen of the monitor, consults with physicians at the rural sites and evaluates the patient via Internet-based computers. "When a community doesn't have ready access to providers trained in the recognition and management of concussion, concussed athletes sometimes go unrecognized or returned to play prematurely potentially subjecting them to more serious injuries," says Bert Vargas, M.D., neurologist and assistant professor of Neurology at Mayo Clinic in Arizona. "Teleconcussion can help triage patients and help identify which people are in need of additional workup or management. In the case of sport-related concussions, this technology can provide rural physicians with assistance in making decisions about when athletes can safely return to play." Click here to hear Dr. Vargas talk about teleconcussion and the case study. Dr. Vargas says that this technology is welcome news for doctors in rural areas, especially in light of the concussion law in Arizona. SB 1521, which was signed into law in 2011, mandates evaluation and clearance athletes with concussions by trained health care providers. "Despite the current culture of increased awareness and recognition of concussions, concussed athletes go unrecognized — even at the professional level," Dr. Vargas adds. "Many professional sports organizations have voiced the need for neurologists to be on the sideline to make rapid authoritative decisions regarding return to play for athletes suspected of having a concussion. Teleconcussion may eventually be a way to address the logistical issues associated with having a neurologist on the sideline of every professional and collegiate level sporting event."
ROCHESTER, Minn. — Dentures deserve careful handling and, in many ways, taking care of them is more work than caring for natural teeth. The November issue of Mayo Clinic Health Letter covers tips to care for these precisely crafted and relatively delicate items. Prevent breaks: Dentures can break if dropped only a few inches. Cleaning should be done over a folded towel in case they are accidentally dropped. Clean gently: Dentures should be gently scrubbed every day with a soft-bristled toothbrush using a denture cleaner, mild soap or dishwashing liquid. Aggressive scrubbing can damage or bend metal clasps or other components. Soak overnight: Most dentures need to remain moist to keep their shape. Soaking them in water or mild denture solution is usually fine. A dentist may offer specific recommendations for soaking. Choose products wisely: Abrasive cleaners and harsh toothpastes such as whitening pastes are abrasive enough to damage dentures. Soaking dentures in bleach can cause the pink part of the denture to whiten. Placing dentures in hot or boiling water can cause the plastic to warp. Avoid do-it-yourself repairs: All dentures need periodic adjustment by a dentist to ensure a comfortable fit and avoid problems. Repairs should not be undertaken at home because they will likely cause damage. Repairing a cracked denture with glue from the hardware store is a particularly bad idea, as glues contain harsh chemicals not suitable for the mouth. Brush the mouth, too: Good oral hygiene helps avoid problems such as soreness, irritation and infection. Brushing the gums, tongue, palate and any remaining teeth helps remove bacteria and stimulate blood flow to these soft tissues.
ROCHESTER, Minn. — A meniscus tear — due to injury or wear and tear — is one of the most common knee injuries. The November issue of Mayo Clinic Health Letter provides an overview of this condition and treatment decisions, which can be more complex when osteoarthritis also is present in the affected knee. Meniscus is the cartilage in the knee that is a cushion between the shinbone (tibia) and thighbone (femur). A meniscus tear can occur suddenly, for example, when an athlete abruptly stops running and changes directions. A tear may develop over time with joint wear that occurs naturally, or it can be related to degenerative arthritis. Symptoms of a meniscus tear may include: Popping sensation when moving the knee Swelling or stiffness Difficulty straightening the knee Pain, especially when twisting or rotating the knee. (Tears due to regular joint wear may not cause pain.) Knee pain or other symptoms should prompt a visit to the doctor. A history and physical exam may be enough to diagnose a tear. When osteoarthritis is suspected, X-rays or other imaging may be recommended. Patients and their doctors should be cautious about magnetic resonance imaging (MRI) results. These images are so sensitive that they detect abnormalities in the knees that don't cause pain and don't need treatment. Nonoperative treatments — rest, ice and nonprescription pain relievers — are usually considered first. After the pain diminishes, physical therapy and exercise at home can help strengthen the muscles supporting the knee.
ROCHESTER, Minn. — While cosmetic surgery can't turn back time, a growing number of older adults are opting for surgery to help eliminate wrinkles, reshape breasts or suction out pockets of fat. The November issue of Mayo Clinic Health Letter covers this trend and the most popular surgeries. In 2011, about 350,000 adults older than 55 had some type of cosmetic surgery. That number is expected to increase as the baby boomer population ages. Cosmetic surgery presents the risks that are normally associated with surgery. But overall good health is a more important consideration than age. Healthy older adults who have a facelift have no greater risk of complications than younger people. However, chronic conditions such as heart disease and diabetes may make cosmetic surgery riskier. Attitude and expectations are important, too. Cosmetic surgery doesn't cure dissatisfaction with a person's body or life. Patients who are happy with their overall life and seek surgery to improve one aspect of their body are more likely to be satisfied with the results. It may take six months before final results are apparent, and scars may take longer to improve in appearance.
JACKSONVILLE, Fla. — A novel test that measures proteins from nerve damage that are deposited in blood and spinal fluid reveals the rate of progression of amyotrophic lateral sclerosis (ALS) in patients, according to researchers from Mayo Clinic's campus in Florida, Emory University and the University of Florida. Their study, which appears online in the Journal of Neurology, Neurosurgery & Psychiatry, suggests this test, if perfected, could help physicians and researchers identify those patients at most risk for rapid progression. These patients could then be offered new therapies now being developed or tested. ALS — also known as Lou Gehrig's disease — is a progressive neurodegenerative disease caused by deterioration of motor neurons (nerve cells) that control voluntary muscle movement. The rate of progression varies widely among patients, and survival from the date of diagnosis can be months to 10 years or more, says Kevin Boylan, M.D., medical director of the ALS Clinic at Mayo Clinic in Florida. "In the care of our ALS patients there is a need for more reliable ways to determine how fast the disease is progressing," says Dr. Boylan, who is the study's lead investigator. "Many ALS researchers have been trying to develop a molecular biomarker test for nerve damage like this, and we are encouraged that this test shows such promise. Because blood samples are more readily collected than spinal fluid, we are especially interested in further evaluating this test in peripheral blood in comparison to spinal fluid." There are no curative or even significantly beneficial therapies in clinics now for ALS treatment, but many are in development, Dr. Boylan says. A test like this could help identify those patients who are at risk for faster progression of weakness. With experimental treatments that primarily slow progression of ALS, detecting a treatment response in patients with faster progression may be easier to detect, says Dr. Boylan. Now, patients with varying rates of progression participate together in clinical studies, which can make analysis of a drug's benefit difficult, he says. "If there were a way to identify people who are likely to have relatively faster progression, it should be possible to conduct therapeutic trials with smaller numbers of patients in less time than is required presently," Dr. Boylan says. A longer-range goal is to develop tests of this kind to gauge how well a patient is responding to experimental therapies, he adds. The test measures neurofilament heavy form in blood and spinal fluid. These are proteins that provide structure to motor neurons, and when these nerves are damaged by the disease, the proteins break down and float free in blood serum and in the spinal fluid. Earlier research in this area was conducted by Gerry Shaw, Ph.D., a neuroscientist at the University of Florida, who is the study's senior investigator and the developer of the neurofilament assay used in the study.
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