This blog provides video, audio and graphic resources to journalists working on news stories. It also gives patients and consumers who are interested in learning more about stories in the news direct access to additional information and video featuring Mayo Clinic physicians and scientists. For a complete explanation of why posts are sometimes password protected for a brief time before being made available to everyone, see the FAQ page.
Neuromyelitis Optica (NMO), also known as Devic’s Disease, is an inflammatory disease of the central nervous system in which there are episodes of inflammation and damage to the myelin (fatty, protective covering of nerves) that almost exclusively affect the optic (eye) nerves and spinal cord. It can cause blindness and lead to varying degrees of weakness or paralysis in the legs or arms, painful spasms, loss of sensation, and bladder or bowel dysfunction from spinal cord damage. NMO resembles multiple sclerosis, but requires a different course of treatment for optimal results.
According to Mayo Clinic neurologist Dean Wingerchuk, M.D., the prevalence and incidence of NMO have not been firmly established.
“It has a worldwide distribution and reported risk factors include females and non-Caucasian racial background,” says Dr. Wingerchuk. “Population-based studies of clinically diagnosed NMO have indicated prevalence rates from 0.32-2.5 cases per 100,000 population. In aggregate, the data suggests that there are likely more than 4,000 people with NMO in the United States.”
Mayo Clinic is a nationally-known leader in NMO and MS-related disease research, including studies on the treatment of severe acute attacks with the use of plasma exchange and intravenous immunoglobulin, as well as the evaluation of clinical and serological factors that assist with diagnosis and may predict response to treatment. Mayo Clinic researchers also are conducting immunological and molecular genetic research to identify the specific target of the damaging immune response that leads to NMO.
Dr. Wingerchuk is presenting a review of the prevalence and incidence of NMO today at the Guthy-Jackson Charitable Foundation’s 2nd Annual Neuromyelitis Optica Roundtable Conference. The foundation is working with Mayo Clinic and other top medical research institutions toward the prevention, treatment and eventual cure of NMO.
Journalists: For links to web-video and audio files, see the bottom of this post.
New Mayo Clinic research studied the association between prostate-specific antigen (PSA) levels and prostate size and found that routine annual evaluation of prostate growth is not necessarily a predictor for the development of prostate cancer. But the study suggests that if a man’s PSA level is rising quickly, a prostate biopsy is reasonable to determine if he has prostate cancer. These findings are being presented this week at the North Central Section of the American Urological Association in Scottsdale, Ariz.
Of the 616 men, 58 (9.4 percent) developed prostate cancer. Men who were diagnosed with prostate cancer had a faster rise in PSA (6 percent/year) compared to men who were not diagnosed with cancer (3.3 percent/year). However, the increase in prostate size was similar between these two groups (median change of 2.2 percent/year).
PSA is a substance produced in the prostate gland. Normally, a small amount of PSA enters the bloodstream. A higher amount of PSA or an abrupt rise in PSA levels can indicate a problem, possibly cancer.
“The question we’re trying to answer is, if we see a man with a rising PSA level, could this change in PSA be explained by a proportional increase in prostate size?” says Dr. Breau. “Our data indicate that men with or without prostate cancer have similar rates of prostate growth. If a man’s PSA is quickly rising, he likely deserves a prostate biopsy to determine if he has prostate cancer. Assessment of change in prostate size should not influence the decision to biopsy.”
Journalists: The following web-video and audio clips from Dr. Breau are available for download and use in your stories.
Below is a link to an edited youtube video with Dr. Breau that you can embed with your stories.
Journalists: For links to web-video and audio files, see the bottom of this post.
New Mayo Clinic research has found that robotic surgery for vaginal prolapse dramatically reduces patient hospital stay and recovery time. These findings are being presented this week at the North Central Section of the American Urological Association in Scottsdale, Ariz.
Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, from their normal positions. Without treatment or surgery, these structures may eventually prolapse farther into the vagina or even through the vaginal opening if their supports weaken enough.
“Vaginal prolapse is a common, yet distressing physical and cosmetic condition that 10–15 percent of women will suffer in their lifetimes,” says Daniel Elliott, M.D., Mayo Clinic urologist and senior author on the study. “Robotic sacrocolpopexy surgery appears to offer many new benefits for patients — including decreased hospital stay and quicker recovery. Our study looked at longer-term results post-surgery to find out how patients fared.”
From 2002 to 2008, 48 women with symptomatic high-grade post-hysterectomy vaginal vault prolapse underwent robotic sacrocolpopexy, or vaginal wall repair. Researchers monitored these patients for three years to evaluate the success rate of the procedure. Overall, researchers found better outcomes for robotic sacrocolpopexy patients than traditional surgery, which included: 1) less-invasive, laparoscopic surgery took less time in the operating room; 2) fewer postoperative complications; 3) shorter hospital stay; and 4) faster postoperative recovery and return to work or normal activities.
“Traditional abdominal sacrocolpopexy is a very durable procedure, but recovery is long and sometimes dissuades women from having surgery,” says Dr. Elliott “This new robotic surgery is a major improvement and offers more options for women who want to have their prolapse repaired and are looking for a less-invasive type of procedure.”
Journalists: The following web-video and audio clips from Dr. Elliot are available for download and use in your post-embargo stories.
Problem is not uncommon: WMV MP3
Advantages to procedure: WMV MP3
Robotics vs Laparscopy: WMV MP3
Below is a link to an edited youtube video with Dr. Elliot that you can embed with your stories. It will be made public when the embargo lifts.
Dr. Richard Berger, the Mayo Clinic orthopedic surgeon who discovered the type of wrist injury that nearly ended Jayson Werth’s baseball career — as well as the successful surgical treatment that has helped him return to baseball and play in two World Series for the Philadelphia Phillies — will participate in a live chat about the issue on Twitter on Tuesday night Thursday afternoon.
Dr. Berger will be available to discuss his research on the UT Split Tear, as well as its diagnosis and treatment, from 4-5 p.m. EST on Thursday, November 12, using the #wristpain hash tag.
Dr. Berger has developed a non-invasive test for diagnosing this wrist injury, which he believes may be as common as an ACL tear in the knee, and the surgical treatment and rehabilitation are straightforward, with 95 percent success.
View the Fovea Sign illustration
Below are some resources describing the condition and its treatment, including a television story, an interview with Jayson Werth, a podcast discussion with Dr. Berger and links to some of his scientific research publications about the injury and its treatment, along with a list of orthopedic surgeons he has trained in this procedure.
Journal of Hand Surgery article on diagnosing the UT split tear.
In Part 1 of an interview conducted earlier this year, Jayson Werth describes his injury and symptoms and how he came to seek treatment from Dr. Berger at Mayo Clinic:
See also Part 2 and Part 3 of his story.
Click here for an extended audio discussion with Dr. Berger.
If you think you may have this type of injury and want to see a physician near you, you may download a list of surgeons who have trained with Dr. Berger in diagnosing and treating these injuries by clicking here. For information on appointments with Dr. Berger, call 888-509-8773 or contact him by email.
Results of a Long QT Syndrome study in the current issue of Circulation play an important role in understanding genetic testing’s role in diagnosing disease, according to the senior author, Michael Ackerman, M.D., Ph.D., the Mayo Clinic pediatric cardiologist who directs Mayo’s Long QT Syndrome Clinic and is the director of the Mayo Clinic Windland Smith Rice Sudden Death Genomics Laboratory.
LQTS is a disorder of the electrical system of the heart and affects 1 in 2,500 people. In the multi-center study that involved Dr. Arthur Wilde in the Netherlands and scientists from PGxHealth, genetic testing results of nearly 400 “slam dunk” LQTS patients and nearly 1,400 healthy volunteers showed that there is a background noise rate of rare variants present in about 4 percent of healthy Caucasian volunteers and that mutation type and mutation location are critical determinants to distinguish this background noise from true LQTS-causative mutations, Dr. Ackerman says.
“Our research shows that genetic testing is just one piece of the information a physician needs to look at,” he says. The results demonstrate that genetic testing does not give a “yes or no” answer for LQTS or other diseases, and it means that physicians need to meticulously interpret this particular diagnostic test with the same scrutiny and tenacity as any other diagnostic test, such as the electrocardiogram (ECG). “It’s proving what we’ve long know in genetic testing circles — that these are not binary tests but are probabilistic tests whereby some test results are going to provide ‘no-doubt-about-it’ diease mutations. Whereas other test results may report a mutation whose pathogenicity is uncertain.”
The Circulation paper is another critical piece in the maturation of LQTS genetic testing from discovery, translation, implementation and now post-implementation interpretation, Dr. Ackerman says. First clinically described in 1957, it took until 1995 until the first genes were discovered. In 2004, the first clinically available test for LQTS became available in North America.
In LQTS, approximately 5 percent to 10 percent of the time, its first symptom is sudden death, often related to physical exertion or auditory triggers such as an alarm clock. However, most cases can be diagnosed following warning signs (sudden, without warning, fainting spells or concerning family history) that suggest its potential presence and from objective data derived from an electrocardiogram (ECG), exercise or adrenalin stress testing, and genetic testing.
Mayo Clinic and Dr. Ackerman have a financial interest in LQTS technology. This technology has been licensed to a commercial entity and both Mayo Clinic and Dr. Ackerman receive royalties from that license.
Dr. Ackerman discusses the study in the video below.
Priya Sampathkumar, M.D., of Mayo Clinic’s Department of Infectious Diseases, today reiterated the H1N1 vaccine is safe. Understanding the public has concerns about the vaccine and questions about who can and should get it, Dr. Sampathkumar sat down to discuss the issues, facts, and myths about H1N1 vaccine.
Journalists: For links to web-video and audio files, see the bottom of this post.
Mayo Clinic researchers and collaborators have validated the zebrafish as a functional model for nicotine addiction research. The findings appear in the Proceedings of the National Academy of Sciences (PNAS). The zebrafish is valuable because it is easy to study and exhibits many of the genetic and behavioral aspects of humans. The fish are essentially transparent – and multiple generations can be developed in a short time. Principal researcher, Stephen Ekker, Ph.D., says the zebrafish will be an essential tool for studying new therapies for nicotine addiction in the 21st Century. More on his research can be found in Mayo’s research magazine, Discovery’s Edge.
Journalists: The following web-video and audio clips with Dr. Ekker are available for download and use in your stories.
Journalists: For links to web-video and audio files, see the bottom of this post.
Mayo Clinic researchers have found that a sometimes deadly stomach bug, Clostridium difficile, is on the rise in outpatient settings. Clostridium difficile is a serious bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. These findings were presented today at the 2009 American College of Gastroenterology (ACG) Annual Meeting in San Diego.
“Recent reports have shown increasing incidence and severity of C. difficile infection — especially in the older population,” says Darrell Pardi, M.D., Mayo Clinic gastroenterologist and senior author on the study. “Our study examines why the cases are on the rise and who is getting the infection.”
In this population-based study, researchers reviewed 385 cases of C. difficile bacterial infection from 1991 to 2005 to determine how many cases were hospital-acquired versus community-acquired infections. Of the cases, 192 were hospital-acquired, and 35 occurred in residents of nursing homes. Of these hospital-acquired cases, the median age of infection was 72 years; in contrast, 158 cases were community-acquired and the median age was 50 years. Thirty-five percent of the hospital infections resulted in a severe illness, compared to 22 percent of community infections that caused severe illness.
The patients with community-acquired infection were also less likely than the hospital-acquired group to have been exposed to antibiotics before their infection. Thus, many of the community-acquired infections lacked the traditional risk factors for infection, namely recent hospitalization and exposure to antibiotics.
According to the Centers for Disease Control and Prevention, each year in the United States, C. difficile is responsible for tens of thousands of diarrhea cases and at least 5,000 deaths.
Journalists: The following web-video and audio clips from Dr. Pardi are available for download and use in your post-embargo stories.
What is Clostridium difficile: WMV MP3
Below is a link to an edited youtube video with Dr. Pardi that you can embed with your stories. It will be made public when the embargo lifts.
Journalists: For links to web-video and audio files, see the bottom of this post.
An editorial on Sudden Unexplained Death in Epilepsy (SUDEP) authored by Mayo Clinic neurologist Elson So, M.D. was published in this month’s issue of the Journal of Clinical Neurophysiology.
Dr. So writes, “The phenomenon of SUDEP is unique in that it occurs during normal and usual daily activities in persons without pre-existing cardiorespiratory illness of a serious nature…The mystery of SUDEP is further supported by failure of autopsy to yield plausible explanations for the death, even in prospective series of autopsy cases. The lack of clues for the cause of death only adds to the anguish of bereaved families and friends.”
The editorial discusses three articles resulting from a symposium on the neurophysiology of SUDEP held last year. One, Clinical Features of Sudden Unexpected Death in Epilepsy by Asadi-Pooya and Sperling defines SUDEP and discusses its incidence and risk factors. Schuele reviews the potential acute and chronic effects of seizures in Effects of Seizures on Cardiac Function, and the third article, Respiratory Physiology of Seizures by Blum, discusses the effects of seizures on respiration.
Dr. So notes that “clinical neurophysiologic studies will continue to have a major role in SUDEP research. Future research in SUDEP may involve simultaneous assessments of multiple organ systems to study the effects of seizures in antiepileptic medications on vital functions and to identify persons with the highest SUDEP risk.”
Journalists: The following web-video and audio clips are available for download and use in your stories.
Below is a video of Dr. So discussing SUDEP.
Below is a video of Dr. So providing an overview of epilepsy treatment and research.
High-dose dexamethasone is a mainstay of therapy for multiple myeloma. However, a study published today online and in the November edition of The Lancet Oncology concludes that lenalidomide plus low-dose dexamethasone is associated with better short-term overall survival and lower toxicity than lenalidomide plus high-dose dexamethasone in patients with newly diagnosed myeloma; and is thus a viable treatment option for these patients.
“High-dose dexamethasone in a community-setting seems more toxic than low-dose dexamethasone, with more early deaths in the first 4 months, increased risk of thromboembolic complications, and higher overall risk of serious adverse
events, particularly in patients older than 65 years,” said S. Vincent Rajkumar, M.D., consultant, hematology, Mayo Clinic, and the lead author on the study.
The researchers found that 79% of 214 patients receiving high-dose therapy and 68% of 205 patients on low-dose therapy had complete or partial response within four cycles. However, at the second interim analysis at 1 year, overall survival was 96% in the low-dose dexamethasone group compared with 87% in the high dose group. As a result, the trial was stopped and patients on high dose therapy were crossed over to low-dose therapy. 117 (52%) patients on the high-dose regimen had grade 3 or worse toxic effects in the first 4 months, compared with 35% of the 220 on the low-dose regimen for whom toxicity data were available. Preliminary findings of this study were previously reported in abstract form at American Society of Hematology’s annual meeting in December 2007.
For interviews with Dr. Rajkumar, contact Mayo Clinic’s Karl Oestreich or Amy Tieder at 507-284-5005.
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