
SCOTTSDALE, Ariz. — The perception that doctors who are based in hospitals burn out quicker than doctors in outpatient settings is just wrong – doctor burnout happens equally, according to a new Mayo Clinic study, published in the November issue of the Journal of Hospital Medicine. MULTIMEDIA ALERT: Video of Dr. Roberts is available for download from the Mayo Clinic News Network. Researchers at Mayo Clinic reviewed 54 burnout studies worldwide to see if there is any validity to the longstanding belief that practicing in the hospital incites greater burnout. The studies included data from more than 5,000 outpatient physicians and more than 1,300 inpatient physicians. Burnout is defined in the study as a syndrome affecting the entirety of work life and characterized by cynicism, detachment and inefficiency. The Mayo Clinic study looked at these factors to determine overall burnout. While there were slight differences in the effect of burnout of inpatient and outpatient doctors, overall burnout was equal. "Burnout is everywhere and if you look for it you'll find it," says Daniel Roberts, M.D., an Internal Medicine physician at Mayo Clinic Hospital in Arizona and lead author of the study. "What this study tells us is that it is as much a problem for clinic-based doctors as it is for hospitalists and others who work in shifts. It's a little reassuring to find that hospitalists aren't particularly prone, but it's more concerning how burnout spans different specialties and practice locations." The studies reviewed in this research represented a board range of burnout related issues, various physician specialties and diverse inpatient and outpatient settings. Although the Mayo Clinic study focused on the difference between the two groups, past studies have suggested factors both leading to and avoiding burning.
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.
AVH becomes first member of Mayo Clinic Care Network in Colorado ASPEN, Colo. — Mayo Clinic and Aspen Valley Hospital officials announced today that the hospital was recently selected to be a member of the Mayo Clinic Care Network, which was established by Mayo to extend its knowledge and expertise to physicians and providers interested in working together to enhance the delivery of health care within their communities. Aspen Valley Hospital (AVH) is the first network member in Colorado. "AVH is honored to be the first hospital in Colorado selected to be a Mayo Clinic Care Network member," says John Sarpa, interim CEO at Aspen Valley Hospital. "Sharing a common philosophy, commitment and mission to improve the delivery of health care through the use of best practices and evidence-based medical care provides a solid foundation for this collaboration." Aspen Valley Hospital providers now have access to Mayo Clinic resources to enhance patient care, including the latest Mayo-vetted medical information through its AskMayoExpert database and electronic consulting that connects physicians with Mayo Clinic experts on questions of diagnosis, therapy or care management. "It's a pleasure to formalize this relationship with Aspen Valley Hospital," says Wyatt Decker, M.D., vice president of Mayo Clinic and CEO of Mayo Clinic in Arizona. "Collaborating with other medical providers to provide the best possible care for patients has always been part of Mayo Clinic's culture. The Mayo Clinic Care Network helps Mayo and community hospitals like Aspen Valley work closer together, in new ways, to enhance the lives of patients. We are delighted to welcome Aspen Valley Hospital as the first Colorado location." Chris Beck, M.D., president of the Aspen Valley Hospital medical staff is excited about the possibilities. "The challenges of medicine in this modern age demand that we seek and share vast amounts of knowledge, says Dr. Beck. "Things constantly and rapidly change — new protocols, new technology, new medications, etc. This collaboration with Mayo Clinic will enhance the outstanding care AVH physicians already provide." "This is one more step in Aspen Valley Hospital's evolution," says Barry Mink, M.D., president of the hospital board of directors and member of the medical staff for 40 years. "Our small-town hospital provides a level of care one would expect in a major medical center, and becoming a member of the Mayo Clinic Care Network reflects our commitment to the highest standards of medical care for local residents and visitors to the area."
JACKSONVILLE, Fla. — Thomas G. Brott, M.D., a neurologist and director for research at Mayo Clinic in Florida, has been named the recipient of the American Heart Association's 2013 Clinical Research Prize. The award recognizes and rewards an individual who is making outstanding contributions to the advancement of cardiovascular science and who currently heads an outstanding cardiovascular clinical research laboratory, according to the American Heart Association (AHA). Dr. Brott will be honored on stage during the opening ceremony of the American Heart Association's 2013 annual meeting in Dallas. He is the first Mayo Clinic investigator to receive the prestigious prize, which has been awarded annually by the American Heart Association since 2005. "This award is well deserved. Dr. Brott is a pioneer in the field of stroke and cerebrovascular disease research, and his mission to find the best therapies possible for patients has certainly saved lives," says William C. Rupp, M.D., chief executive officer at Mayo Clinic in Florida. Dr. Brott was a leading investigator in the studies that identified tissue plasminogen activator (t-PA) as an effective acute treatment for ischemic stroke. He and his team treated the very first patients using this therapy. Along with his colleagues, Dr. Brott defined the evolution of spontaneous intracerebral hemorrhage during the first hours after onset. In 1998, Dr. Brott came to Mayo Clinic's campus in Florida where he and his colleagues initiated the first NIH-funded genome-wide screen for stroke susceptibility. Dr. Brott has led federally funded national clinical trials that aim to discover best treatment for stroke and uncover risk factors for the disorder. For example, he is principal investigator for the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), a study that compares two different treatments for their ability to reduce risk for stroke. The study was supported by the National Institute of Neurological Disorders and Stroke. He also played a key role in designing the National Institutes of Health Stroke Scale (NIHSS), a tool used internationally that measures stroke-related neurologic deficits.
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."
JACKSONVILLE, Fla. — The Blood and Marrow Transplantation Program of Mayo Clinic, Nemours Children's Clinic, Jacksonville, and Wolfson Children's Hospital has been awarded a three-year accreditation renewal by the Foundation for the Accreditation of Cellular Therapy (FACT). The foundation awarded the accreditation renewal after thorough site visits at all collection, transplantation and laboratory facilities at the three locations. "We are pleased that Mayo Clinic, Nemours Children's Clinic and Wolfson Children's Hospital have met the requirements of the Foundation and have been granted accreditation for their joint Blood and Marrow Transplantation Program," said Phyllis Warkentin, M.D., FACT medical director. "The teamwork and cooperation between all three organizations in the program has never been better," said Blood and Marrow Transplant Program Director Michael Joyce, M.D., Ph.D., a pediatric hematologist/oncologist at Nemours Children's Clinic, Jacksonville. "FACT accreditation is a promise to our patients that we are adhering to and meeting the highest standards in the field. The hematology/oncology physicians, nurses, laboratory and support staff of Nemours, Wolfson Children's and Mayo Clinic work very hard to achieve maintain these standards." The joint program was created in 2001 to allow for greater collaboration in physician and staff expertise, research and clinical protocols. Wolfson Children's Hospital and Nemours Children's Clinic, Jacksonville, will celebrate their Blood and Marrow Transplant Program's 20th anniversary next year. Many patient referrals to the Blood and Marrow Transplant Program come from physicians in Jacksonville, across Florida and south Georgia, across the United States and internationally. Since it was established, the combined program has transplanted patients with a variety of illnesses including leukemia, neuroblastoma, sickle cell disease, bone marrow disorders, multiple myeloma, lymphoma, brain tumors, Ewing's sarcoma, and amyloidosis. Stem cell sources include the patient, immediate family members, volunteer unrelated adult marrow donors or donated umbilical cord blood donor units. More than 970 transplants have been completed during this time. The program shares a single cryopreservation laboratory (where hematopoietic stem cells are frozen and processed) at Mayo Clinic. Mayo maintains the program's adult Blood and Marrow Transplant Unit, and Wolfson Children's Hospital maintains Pediatric Blood and Marrow Transplant beds on the Hematology/Oncology Unit in the J. Wayne and Delores Barr Weaver Tower. The joint program shares information systems, quality and other clinical and administrative staff. "We are excited to receive this accreditation. It is a welcome recognition and 'badge of honor' for our program. It also informs and assures our patients, referring physicians and insurance companies of the highest standards of patient care and laboratory practices in our program," said Vivek Roy, M.D., hematologist/oncologist at Mayo Clinic in Florida and medical director of the adult Blood and Marrow Transplant Program.
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., ...
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