
ROCHESTER, Minn. — April 3, 2012. Add lower gastrointestinal (GI) problems such as ulcers, bleeding and perforations to the list of serious complications facing many rheumatoid arthritis patients. They are at greater risk for GI problems and gastrointestinal-related death than people without the disease, a Mayo Clinic study shows. Researchers say their findings point out the need for new ways to prevent and treat lower GI disease in rheumatoid arthritis patients; the incidence of lower gastrointestinal complications is rising even as upper GI problems decrease significantly among rheumatoid arthritis patients. Smoking, the use of steroids known as glucocorticoids, prior upper GI disease and abdominal surgery were associated with lower GI problems in rheumatoid arthritis patients, the study found. The research was published online this week in The Journal of Rheumatology. Rheumatologists have long recognized that rheumatoid arthritis patients are at higher risk for upper GI problems such as stomach ulcers and bleeding. The study suggests increased awareness of that and likely, modern treatment strategies that emphasize the need to prevent ulcers and bleeding and control rheumatoid arthritis without relying as much on nonsteroidal drugs and corticosteroids have reduced upper GI complications, says co-author Eric Matteson, M.D., Chair of the Department of Rheumatology at Mayo Clinic in Rochester. "What we are also seeing for the first time in a systematic way is that patients with rheumatoid arthritis also are at risk for problems of bleeding and ulcers in the lower gut, especially the colon," Dr. Matteson says. Lung disease, heart problems, osteoporosis and carpal tunnel syndrome are among other potential complications for patients with rheumatoid arthritis, an often debilitating disorder in which the immune system attacks tissues, inflaming joints. To study the incidence of GI problems in rheumatoid arthritis patients, Mayo researchers identified 813 patients with rheumatoid arthritis and 813 without it, using data from 1980-2008 in the Rochester Epidemiology Project, a National Institutes of Health-supported effort in which Mayo and other Olmsted County, Minn., health care providers pool medical records. The incidence of upper GI problems in rheumatoid arthritis patients declined over the years but was still higher in that group: 2.9 for every 100 person years compared with 1.7 in non-rheumatoid arthritis patients. The rate of lower GI problems in rheumatoid arthritis patients was 2.1, compared with 1.4 in others, the study found. Of the arthritis patients studied, 229 died. GI problems were significantly associated with their deaths, including bleeds, perforations and obstructions.
JACKSONVILLE, Fla. — Findings of an extensive investigation at Mayo Clinic, published in the April 3 issue of the Annals of Internal Medicine, serve as a warning to other health care institutions that drug diversion by a health care worker can spread hepatitis C, a potentially fatal viral infection, to patients. The report details the effort that Mayo Clinic in Florida undertook to find the source of a genetically related hepatitis C virus that appeared in three patients over a 2 to 3 year period of time. Investigators eventually traced the source to a radiology technician who was using a portion of narcotics contained within syringes intended for patients, and then replacing the missing fluid with saline. The process contaminated the syringes with hepatitis C. Mayo Clinic then identified 3,929 patients who were at risk for exposure to hepatitis C, and invited them to be screened. Of the 3,444 patients who were tested, two additional cases of genetically related hepatitis C infection attributed to the employee were identified. The report, written by infectious disease experts and epidemiologists at Mayo Clinic, the Florida Department of Health, and the U.S. Centers for Disease Control and Prevention, is the most thoroughly documented instance of hepatitis C transmission caused by drug diversion in an American hospital or clinic, according to the report's lead author, Walter Hellinger, M.D., a health care epidemiologist. Four other instances have been reported to date in the United States and, of these, only one in which narcotic diversion was suspected but not confirmed has been published in a peer-reviewed medical journal, he says. "We owe our patients the best care possible, which meant conducting a thorough, investigation," says Dr. Hellinger, who also serves as chair of Infection Control at the Mayo Clinic campus in Florida.
SCOTTSDALE, Ariz. — April 2, 2012. A new report released today from the Institute of Medicine highlights numerous gaps in the knowledge and management of epilepsy and recommends actions for improving the lives of those with epilepsy and their families and promoting better understanding of the disorder. Effective treatments for epilepsy are available but access to treatment and timely referrals to specialized care are often lacking, the report's expert committee found. Joseph Sirven, M.D., chair of Neurology at Mayo Clinic in Arizona was one of the 16 members of the committee which met for more than a year to create the report. Among the key highlights of the more than 400-page report: Misperceptions about epilepsy persist and a focus on raising public awareness and knowledge is needed, the report adds. Educating community members such as teachers, employers, and others on how to manage seizures could help improve public understanding of epilepsy. Reaching rural and underserved populations, as well as providing state-of-the art care for people with persistent seizures, is particularly crucial. The report's recommendations for expanding access to patient-centered health care include early. Identification and treatment of epilepsy and associated health conditions, implementing measures that assess quality of care, and establishing accreditation criteria and processes for specialized epilepsy centers. Some causes of epilepsy, such as traumatic brain injury, infection, and stroke, are preventable. Prevention efforts should continue for these established risk factors. People with epilepsy need additional education and skills to optimally manage their disorder. Consistent delivery of accurate, clearly communicated health information from sources that include health care professionals and epilepsy organizations can better prepare those with epilepsy and their families to cope with the disorder and its consequences. Living with epilepsy can affect employment, driving ability, and many other aspects of quality of life. The report stresses the importance of improved access to a range of community services, including vocational, educational, transportation, transitional care, and independent living assistance as well as support groups. The report suggests several strategies for stakeholders to improve public knowledge of the disorder, including forming partnerships with the media, establishing advisory councils, and engaging people with epilepsy and their families to serve as advocates and educators within their communities.
SCOTTSDALE, Ariz. — April 2, 2012. The combination of the novel drug TH-302 with the standard drug gemcitabine has shown early signs of delaying the ...
ROCHESTER, Minn. — The dietary supplement gamma-linolenic acid can inhibit the growth of a subset of pancreatic cancer cells and selectively promote cancer cell death in mice, a Mayo Clinic study has found. The supplement, a fatty acid also known as GLA, worked particularly well when combined with the chemotherapy drug gemcitabine, the researchers say. The findings were presented today by Mayo Clinic pathologist Ruth Lupu, Ph.D., at the American Association for Cancer Research (AACR) Annual Meeting 2012. "One of the most devastating facts about pancreatic cancer is the paucity of effective drugs that exist to halt a tumor," Dr. Lupu says. "We knew from studies done about 20 years ago that polyunsaturated fatty acids such as GLA could influence cancers in general, but we didn't know which type of fatty acids and to what degree." Dr. Lupu's team first tested GLA against a variety of pancreatic cancer cell lines, and found that it was effective only against a subtype, expressing a gene for fatty acid synthase (FASN). Earlier studies by Dr. Lupu's team had demonstrated that FASN is highly expressed in pancreatic adenocarcinomas and appears to be a marker for poor overall survival in patients. "This was very exciting finding, because we realized that GLA was working selectively and had a particular target within cells," Dr. Lupu says. As researchers tested the GLA against cells with high levels of FASN, they found GLA inhibited about 85 percent of cell growth, while gemcitabine alone, the standard chemotherapy for pancreatic cancer, had a modest effect on cell inhibition. When researchers combined GLA with gemcitabine, the cell growth was inhibited completely. Then the team investigated the combination in mouse models of pancreatic cancer and found GLA in combination with gemcitabine significantly inhibited tumor growth. "The two treatments worked synergistically, and we achieved a significantly higher inhibition of cell growth and higher incidence of dead pancreatic carcinoma cells," Dr. Lupu says. "We don't yet know why the combination works better, but we know that many drugs work better when used together." Dr. Lupu says that because GLA targets FASN, which is present in high levels in certain pancreatic cancers, the supplement has real potential for individualized therapy. Dr. Lupu cautions that patients or healthy individuals should not rush to take GLA or alter their chemotherapy without consulting their oncologist. Her next stage of research will be to develop a Phase I clinical trial to test the GLA-gemcitabine combination in human patients. Her group will also test GLA in combination with other chemotherapy drugs currently used to treat pancreatic cancer.
PHOENIX — March 29, 2012. An emerging fungal infection of the gastrointestinal tract that mimics cancer and inflammatory bowel disease appears to be emerging in the Southwestern United States and other desert regions, according to Mayo Clinic researchers in Arizona investigating the disease. The invasive fungus, Basidiobolus ranarum, is typically found in the soil, decaying organic matter and the gastrointestinal tracts of fish, reptiles, amphibians, and bats. VIDEO ALERT: Click here to watch. Mayo researchers studied 44 cases of human gastrointestinal basidiobolomycosis reported from around the world, including 17 from Arizona, one from southern Utah and one from elsewhere in the U.S. Eight of the 44 patients died. Mayo's review of the cases is published online in the journal Clinical Infectious Diseases. Basidiobolomycosis is usually a subcutaneous infection in the tropical and subtropical regions of the world that develops following traumatic inoculation of the fungus under the skin. The emergence of gastrointestinal involvement with Basidiobolus in arid regions has been considered unusual. "The exact mode of acquisition of this gastrointestinal infection is unclear, although consumption of contaminated food or dirt is the favored hypothesis," says lead author H.R. Vikram, M.D., an infectious diseases physician at Mayo Clinic, where seven of the 19 U.S. cases studied were treated. "The infection is still considered so rare that no one had put together a complete description." He adds that more study needs to be done to determine how this infection is contracted, what underlying diseases might predispose patients to this infection and how best to treat it. He emphasizes that early recognition is key to successful treatment. The first U.S. case of gastrointestinal Basidiobolus infection was reported in 1986. The CDC subsequently investigated six cases in Arizona between 1994 and 1999. This sparked the interest of researchers at Mayo Clinic in Arizona to study this infection.
SCOTTSDALE, Ariz. — Most patients undergo a colonoscopy with the expectation that any suspicious lesions that may signal evidence of colorectal cancer will be detected. ...
ROCHESTER, Minn. — A delegation from the Health Ministry of the Czech Republic, led by Minister Leos Heger, M.D., will visit Mayo Clinic in Rochester ...
ROCHESTER, Minn. — The Mayo Clinic Center for Social Media will hold its first conference in New York City May 17–18, 2012, at Roosevelt Hospital, ...
Phoenix — Mayo Clinic in Arizona and the American Cancer Society have announced that construction is projected to begin in the fall of 2012 for ...
ROCHESTER, Minn. — March 26, 2012. Even as the rates of some cancers are falling, Mayo Clinic is seeing an alarming trend: the dramatic rise ...
ROCHESTER, Minn. — Spring has only just arrived, but tick season is well under way. Physicians are seeing new cases of tick-borne illness several weeks earlier than usual, likely because a mild winter in much of the country made life easier for ticks and their offspring. That means it's time for gardeners, hikers, pet owners and others who spend time outdoors to take steps to protect themselves — and to watch for symptoms of tick-borne illness if they do come in contact with the tiny bloodsuckers. "We've already started getting positives for tick-borne disease such as Lyme disease, anaplasmosis and babesiosis," says Bobbi Pritt, M.D., a Mayo Clinic microbiologist and director of the Clinical Parasitology and Virology Laboratories. That is a month or two earlier than normal for Minnesota and other states with unusually warm weather in recent months are likely seeing the same. Dr. Pritt says there are several things people can do to protect themselves from ticks. "The first thing is just tick avoidance — staying out of areas where ticks are going to be present: tall grasses, shrubs, leaf litter," Dr. Pritt says. "Also using insect repellant, such as DEET. You can also buy clothing that has been impregnated with pyrethroids, which is another type of insect repellant, and there are certain types of insect repellants for pets." Other countermeasures Dr. Pritt suggests: Keep grass short in yards and avoid ungroomed areas. Wear long clothing to prevent ticks from getting to your skin. Check yourself, your children and your pets after spending time outdoors. To reduce risk on hikes, stay on trails. If you leave the path, wear long pants tucked into your socks. If you find ticks, remove them right away. Use force and pinch the tick near its mouth parts, pulling the tick out slowly in a continuous motion. Don't twist it, which may leave mouth parts embedded in the skin. If you've been exposed to ticks, be alert for fever, headache and muscle pains, and if you experience them, see a physician and mention you've been exposed to ticks, Dr. Pritt says. A hallmark of Lyme disease is a bull's-eye-patterned rash. If you do not recall getting a tick bite but have been working outdoors or visited other tick habitats and develop such symptoms, it is important to tell your doctor, she says. One tick-related illness Dr. Pritt plans to keep special watch for this year is ehrlichiosis. She and other researchers in Minnesota, Wisconsin and the Centers for Disease Control announced last year they had found a new tick-borne bacterium causing ehrlichiosis in humans.
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