MGUS has long been thought to be a precursor of serious disease, such as multiple myeloma, primary amyloidosis and Waldenström macroglobulinemia. However, for years physicians have reported possible association of MGUS with many more diseases. As a result, some patients with MGUS who had these disorders were subjected to investigations and sometimes additional treatments as a precaution.

MGUS is a fairly common disorder, affecting roughly 3 percent of the U.S. population. This study was supported in part by grants from the National Institutes of Health and the U.S. Public Health Service.

In this study, researchers looked at the records of 17,398 patients, all of whom were uniformly tested for the presence or absence of MGUS. Among the 17,398 samples tested, 605 cases of MGUS were identified. The researchers then looked at the incidence of over 16,000 different diagnosis codes in those with MGUS and those without. They identified 14 real disease associations, while 61 disease associations with MGUS were determined to be likely coincidental. In addition to multiple myeloma, the associations deemed real include vertebral and hip fractures and osteoporosis. “In addition to the article, we have made available on the journal Web site an appendix that has the raw data on all 16,062 hospital diagnosis codes which we think will be valuable to other researchers in the field,” says S. Vincent Rajkumar, M.D., of Mayo Clinic’s Department of Hematology and senior author on the study.

A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at http://mayoclinicproceedings.com/

Below is a video of Dr. Rajkumar discussing the research.

“Deep brain stimulation has long been seen as valuable for controlling movement disorders,” according to the review, written by Susannah Tye, Ph.D., Mark Frye, M.D., from the Mayo Clinic Department of Psychiatry and Psychology, and Kendall Lee, M.D., Ph.D., Mayo Clinic Department of Neurosurgery. “It now is being investigated for hard-to-treat psychiatric disorders,” according to the authors.

“Early results indicate the effect on depression and obsessive compulsive disorder is beneficial, but the therapy needs further study,” Dr. Lee says. The potential for this breakthrough treatment is enormous in reducing the toll of mental illness on patients, their families and society, according to the review.  Unlike electroshock therapy (ECT), which stimulates the entire brain, DBS stimulates specific parts of the brain. DBS is thought to be functionally equivalent to creating a lesion on the brain, but with the advantage of being adjustable and reversible.

“It is like implanting a pacemaker for the brain,” says Dr. Lee. The patient is awake during deep brain stimulation surgery while a neurosurgeon implants the electrodes. Patients are able to give immediate feedback. Additionally, patients do not feel any pain during the implantation procedure since the brain is without pain receptors.

In the developed world, major depression is second only to cardiovascular disease in premature mortality and time lived with disability according to the review. In persons aged 15 to 44 years, depression is the most disabling medical illness in the United States. The prevalence of major depression, known to be a chronic and relapsing illness, is approximately 17 percent, affecting almost 1 in 5 persons.

Medications and psychiatric therapy can effectively treat many patients with major depression; however, up to 20 percent of these patients fail to respond to these non-surgical therapeutic interventions.
“DBS is not a miracle cure and should not be used to treat all depression,” says Dr. Lee. “It should be reserved for those patients who have treatment-resistant depression, and approved by a multi-disciplinary team.” Ongoing advances in DBS technologies represent an important new field that could greatly advance the understanding of psychiatric neurobiology, according to the review.

Below is a link to an edited youtube video with Dr. Lee.

Researchers at Mayo Clinic compared two popular television shows, CSI and CSI: Miami, to actual U.S. homicide data, and discovered clear differences between media portrayals of violent deaths versus actual murders. This study complements previous research regarding media influences on public health perception. Mayo Clinic researchers presented their findings at the American Psychiatric Association annual meeting in San Francisco.

Previous studies have indicated television influences individual health behaviors and public health perceptions. Timothy Lineberry, M.D., a psychiatrist at Mayo Clinic, says “We make a lot of our decisions as a society based on information that we have, and television has been used to provide public health messages.” Researchers chose to compare the crimes on CSI and CSI: Miami to real homicides because of the shows’ combined audiences of more than 43 million viewers annually. They sought to determine how representative the portrayal of violent death crimes on the two series compared with data from the Centers for Disease Control (CDC) National Violent Death Reporting System.

When researchers compared the shows to the CDC data, they discovered the strongest misrepresentations were related to alcohol use, relationships, and race among perpetrators and victims. Previous studies of actual statistics have shown that both perpetrator and victim were often under the influence of alcohol and/or drugs when the crime occurred, differing from what the shows portrayed.

Also, CSI and CSI: Miami were more likely to have described the victim and the attacker as Caucasian, which is misrepresentative. Finally, according to the CDC data, homicide victims typically knew their assailant; however, the television series were more likely to have portrayed the perpetrator as a stranger. All of these findings were significantly different when compared to the data.

Dr. Lineberry says, “If we believe that there is a lack of association with alcohol, that strangers are more likely to attack, and that homicide doesn’t represent particular groups of people, it’s difficult to create public health interventions that the general public supports.”

Below is a link to an edited youtube video with Dr. Lineberry.

“Psychiatric care costs represented only a portion of the specialty care costs for these chronic conditions, explains Mark Williams, M.D., a Mayo Clinic psychiatrist and lead researcher. This suggests that many of the specialty costs for bipolar patients are not directly related to seeing a mental health provider.”

A data review of health care claims over a four-year period, showed patients with BPD had significantly higher total per member per month costs when compared with the other groups. Only patients with both CAD and diabetes had higher costs than patients with BPD. Total costs, specialty care visits, specialty care costs, outpatient psychiatric costs and outpatient psychiatric visits were compared.

Below is a link to an edited youtube video with Dr. Williams.