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.
Journalists: For links to web-video and audio files, see the bottom of this post.
Multiple crews responded to a tour bus accident on Interstate 90 between Austin and Albert Lea, Minn., on Wednesday afternoon, Nov. 18. These crews included ground ambulance from Albert Lea Medical Center, Gold Cross ambulance from Austin, and Adams Area Ambulance Service as well as air ambulances including Mayo One helicopters from Rochester and Mankato. Injured patients were transported to Albert Lea Medical Center and Austin Medical Center, both part of Mayo Health System, and to Mayo Clinic in Rochester.
Mayo Clinic has received three patients from the I-90 tour bus accident. In addition, 11 patients were transported to Austin Medical Center and eight were admitted. Six patients were transported to Albert Lea Medical Center and three were admitted. The Minnesota Department of Public Safety confirmed that there were two fatalities.
Mayo Clinic is also responding to two additional, unrelated accidents: an auto/school bus accident on Hwy. 63 north of Rochester, with 10 patients transported to Mayo Clinic; and an ambulance/car accident in downtown Rochester with five patients transported to Mayo Clinic.
Journalists: The following web-video and audio clips are available for download and use in your stories.
The following clip is from the news conference regarding these incidents. Speaking are Mayo Clinic emergency medicine physician Christopher Farmer, M.D., and Beth Ballinger, M.D., a trauma surgeon.
No further information will be available until after 8 a.m. Thursday morning.
News Conference: WMV
News Conference: MP3
Robert Jacobson, M.D., chair of Mayo Clinic’s pediatric and adolescent medicine departments, will participate in a Mayo Clinic/USA Today Twitter chat about H1N1 flu in children with asthma on Wednesday, November 18 from 8-9 p.m. EST.
The chat, which will be led by Mary Brophy Marcus (@BrophyMarcUSAT) of USA Today and Dr. Jacobson (@RobertJMD), will enable parents to ask questions about H1N1 flu and children, and particularly about the special concerns for children with asthma. Use the #kidsflu tag in your tweets to join the conversation.
Updated 11/18/09: See Mary’s article on H1N1 and kids with asthma in this morning’s USA Today.
As background for the #kidsflu conversation, Dr. Jacobson discusses ways to prevent H1N1 and some of the implications of this flu season for parents of asthmatics:
Tweet your questions for Dr. Jacboson using the #kidsflu tag in Twitter, or ask them in the comments below.
The U.S. Preventive Services Task Force recently revised its screening recommendations for breast cancer based upon an analysis of various mammography screening schedules. Experts suggest screening every two years for average risk women ages 50 to 74 achieves most of the benefits of annual screening, but with less harm. Furthermore, although there was a decrease in mortality for women ages 40 to 49, screening resulted in additional mammograms and false positives, therefore is not being recommended.
These findings are published in the November 17, 2009 Annals of Internal Medicine. Sandhya Pruthi, M.D., director of Mayo Clinic Breast Clinic, Rochester, Minn., answers questions related to these new guidelines.
Journalists: To incorporate the raw files in your stories, right-click and “save as” to download:
How will the revised U.S. Preventive Services Task Force’s mammography screening recommendations affect Mayo Clinic practice?
What role does the early detection of breast cancer play at Mayo Clinic?
Does Mayo plan to further analyze the mammography screening recommendations?
What message do you have for referring physicians and women of all ages in wake of the revised screening recommendations?
Journalists: For links to web-video and audio files, see the bottom of this post.
ORLANDO, Fla. — Results of a Mayo Clinic study show the incidence of stroke or mini-stroke related to a coronary angioplasty remained steady over a 15-year period. Researchers say this is good news because physicians now are performing the artery-opening procedure on older patients who are sicker and need more complicated treatment.
The results will be presented today at the American Heart Association’s Scientific Sessions 2009 in Orlando, Fla.
Angioplasty, a procedure used to open clogged arteries, can improve chest pain or shortness of breath, or open an artery quickly to reduce damage to the heart during an attack. During angioplasty, also known as percutaneous coronary intervention (PCI), a tiny balloon is temporarily inserted and inflated to unclog and widen the artery. In some cases, a small metal coil called a stent is placed in the artery to keep it propped open.
In a retrospective study of 17,249 patients who had 21,502 angioplasty procedures between 1994 and 2008 at Mayo Clinic in Rochester, Minn., the researchers identified patients who suffered an angioplasty-related cerebrovascular accident (CVA), defined as a stroke, or a transient ischemic attack
(TIA or mini-stroke), and compared outcomes with the remainder of the study population, according to senior author Rajiv Gulati, M.D., Ph.D., a Mayo Clinic cardiologist. Eighty-four patients, or three or four in 1,000 patients, had a stroke or a TIA, and 23 percent of those were mini-strokes, Dr. Gulati says.
The low number of patients who had a stroke was somewhat surprising, he says. “Given that we are now dealing with older and sicker patients, with more extensive blockages requiring more complex treatment, we found the current incidence of stroke related to this procedure to still be very low indeed,” he says.
The research showed that patients with CVA were more likely to be older (average age was 74 years old versus 66 years old), female (52 percent versus 29 percent), have moderate-to-severe renal disease (8 percent versus 3.7 percent) and have a history of stroke unrelated to prior angioplasty (31 percent versus 11 percent).
This study helps physicians recognize patients who are at higher risk of stroke or TIA, Dr. Gulati says. And if a patient has a stroke or TIA related to angioplasty treatment, technologies to use clot-busting drugs or remove the clot are more readily available today. “We now have newer technologies that can deal with stroke should the worst happen,” he says. “And recognizing patients at higher risk puts us in a good position to help.”
The research also showed that other factors were predictors of CVA, such as the number of diseased coronary arteries, presence of intracoronary thrombus, an increased number of vessels treated and the need for emergency angioplasty.
Other Mayo Clinic study team members were Scott Hoffman, M.D.; Robert Simari, M.D.; Charanjit Rihal, M.D.; David Holmes Jr., M.D.; Rivaz Bashir, M.D.; Ryan Lennon and Alejandro Rabinstein, M.D.
To request an appointment at Mayo Clinic, please call 480-422-1490 for the Arizona campus,
904-494-6484 for the Florida campus, or 507-216-4573 for the Minnesota campus.
Journalists: The following web-video and audio clips are available for download and use in your stories.
Low Complication Rate: WMV MP3
Below is a link to an edited youtube video with Dr. Gulati that you can embed with your stories.
Journalists: For links to web-video and audio files, see the bottom of this post.
Mayo Clinic scientists will present research at the American Heart Association’s Scientific Sessions 2009 in Orlando on Sunday, Nov. 15, showing that postmortem testing to identify genetic mutations for sudden unexplained death could be a less expensive manner to determine first-degree relatives’ risk.
“What we wanted to explore in this study is: Might it make more sense and might it make more cost-effective sense if we put all of the initial full court press on the deceased individual who holds the answer for his or her untimely and so far unexplained death?” says Michael Ackerman, M.D., Ph.D., a pediatric cardiologist at Mayo Clinic in Rochester, Minn., and senior author of the study. “That we would focus our energy on the cardiac channel molecular autopsy on that person and for the 25 to 30 percent where the “a-ha” moment is realized, where we’ve caught the culprit — then we do a targeted exploration of those deceased individual’s relatives.”
Dr. Ackerman and David Tester, senior research technologist, compared the yield and costs of postmortem genetic/molecular autopsy testing in 146 sudden unexplained death cases. They found that 40 of the victims had two mutations that contribute to sudden death.
The total cost of doing postmortem genetic testing, genetic confirmation testing of relatives of mutation-postive victims, and then followed by doing tests for both relatives of mutation-positive and mutation-negative sudden unexplained death victims, was $6.78 million. That compares with an excess of $7.7 million total cost of what is currently recommended — providing cardiac testing all the relatives of the SUD victims, not considering mutation status, Dr. Ackerman says. “We saw that there would be a million-dollar savings in this cohort by focusing the initial energy on the deceased individual who holds the answer — or who might hold the answer,” he says.
Journalists: The following web-video and audio clips are available for download and use in your stories.
Below is a link to an edited youtube video with that you can embed with your stories.
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 Thursday afternoon.
Update 11/12/09: USA Today has a story in today’s edition about Jayson’s wrist injury that begins:
A few years ago, Phillies right fielder Jayson Werth thought he had hit the end of his career. Chronic wrist pain had sidelined him from playing baseball with his then-team, the Los Angeles Dodgers – until a surgeon at the Mayo Clinic diagnosed the root of his problem and corrected it with arthroscopic surgery that he developed.
Read the rest of the USA Today article about Jayson Werth.
Dr. Berger is conducting an ongoing conversation about this type of injury on Twitter using the #wristpain hash tag, so you can ask questions by including #wristpain in your tweet, or in the comments on this post.
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. For information on appointments with Dr. Berger, call 888-509-8773 or contact him by email.
Meanwhile, here are a couple of additional video segments I shot this weekend with Dr. Berger, in which he relates the story of how he discovered this type of injury, as well as how it’s diagnosed and treated:
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.
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