Wrist Pain Twitter Chat

November 5, 2009 – 5:50 pm

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:

By Lee Aase | Posted in Orthopedics | Tagged , , , , | Comments (2)

Research results key for understanding, interpreting genetic testing for Long QT Syndrome, other genetic diseases

November 3, 2009 – 3:30 pm

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.

By traciklein | Posted in Children, Heart, Pediatrics, Research | Tagged , , , , | Comments (1)

Mayo Clinic Physician: “H1N1 Vaccine Is Safe”

October 28, 2009 – 3:22 pm

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.

By Lee Aase | Posted in Infectious Diseases | Tagged , , | Leave a Comment

Mayo Validates Zebrafish as Nicotine Research Model

October 26, 2009 – 2:36 pm

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.

Why this research is important:   WMV MP3

By Bob Nellis | Posted in Cancer, Prevention, Research | Tagged , , , | Leave a Comment

Deadly Stomach Infection Rising in Community Settings

October 26, 2009 – 11:08 am

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.

Study overview:   WMV   MP3

What is Clostridium difficile:   WMV   MP3

Key Message:    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.

By tiedera | Posted in Digestive Disorders, Prevention, Research | Tagged , , , , , , , | Leave a Comment

Mayo Clinic Physician Publishes Editorial on Sudden Unexplained Death in Epilepsy

October 26, 2009 – 10:13 am

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.

SUDEP: WMV   MP3

Epilepsy Overview: WMV   MP3

Epilepsy Treatment: WMV   MP3

Epilepsy Research: WMV   MP3

Below is a video of Dr. So discussing SUDEP.

Below is a video of Dr. So providing an overview of epilepsy treatment and research.

By Elizabeth Rice | Posted in Neurology | Tagged , , , , , | Leave a Comment

Lower Dose Dexamethasone Can Be Used To Treat Newly Diagnosed Myeloma

October 22, 2009 – 3:05 pm

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.

By Karl Oestreich | Posted in Cancer, Research | Tagged | Leave a Comment

Phillies outfielder credits Mayo Clinic surgeon for comeback chance

October 22, 2009 – 11:22 am

Jayson Werth, the right fielder whose two home runs last night helped to send for the Philadelphia Phillies to their second straight World Series, has come back from a career-threatening wrist injury thanks to Mayo Clinic orthopedic surgeon Richard Berger, M.D., Ph.D.

Earlier this year, Jayson told his story on our Sharing Mayo Clinic blog. Here are excerpts of his story, in his own words:

The first day of spring training 2005, I was hit by a pitch. Originally it was diagnosed…as an evulsion fracture. I was out two weeks, and then two weeks turned into two months, and my pain wasn’t really where the evulsion fracture was….I played two-thirds of the season, I would say—didn’t play very well, played with pain…it was rough, I was injured.

At the end of the year, the hand specialist for the Dodgers did a surgery that didn’t help. I was actually worse after the surgery because of the trauma with the surgery…. Going into ’06 spring training, I was still in bad shape. The doctors couldn’t really find anything wrong with me….I was injured, but I really didn’t have any answers. I spent the better part of the season getting second opinions, third opinions….In the middle of the season I was home one day, which was unusual, and I was met at the mailbox by a family friend who was an orthopedic surgeon…and he said I needed to go to the Mayo Clinic…

In August I went up to Rochester and saw Dr. Berger…and the next day had surgery. He was very confident about what I had, and it was really the first time I had any answers in almost two years…about what really was causing my pain…

You know, there was a time, probably six weeks before I was going up to the Mayo Clinic, I was like, “If this doesn’t work, I don’t know what I’m going to do. Baseball’s over, and I’m going to be looking for a job, and I’ve done nothing but play baseball my whole life. It was a trying period, and going up to Mayo Clinic and meeting Dr. Berger and going through the whole thing was a blessing, really. It was remarkable.

You know, the summer of 2006 was rough…there was a time when I didn’t know whether I was ever going to play again. I felt like my career was over…. So to go from where I was and to be healthy and able to play in any capacity in the big leagues is really amazing to me…but to just a short few years later to be world champion, and have an opportunity to play every day again…is just really cool.

See Jayson describe his injury and the process that led to him coming to Mayo Clinic, his diagnosis and surgery at Mayo Clinic and subsequent recovery (including how the Phillies signed him based on Dr. Berger’s recommendation), and his reflections on the overall experience and going from nearly out of baseball to becoming a World Series champ, on the Mayo Clinic YouTube channel. For more information on Jayson’s type of injury, including links to an animation and a podcast describing the UT split tear and its diagnosis and treatment, see Jayson’s Sharing Mayo Clinic story.

The Phillies go for their second-straight World Series crown beginning Wednesday, October 28 against either the New York Yankees or Los Angeles Angels of Anaheim.

Journalists: To request an interview with Dr. Berger, call 507-284-5005 or send your request via email.

By Lee Aase | Posted in Orthopedics | Tagged , , , , , , , | Comments (2)

Dr. Michael Brennan on PBS’ “Dancing with Doctors”

October 22, 2009 – 9:16 am

BrennanonPBS

Mayo Clinic endocrinologist Michael Brennan, M.D. is featured in the PBS series Life (Part 2), in an episode entitled “Dancing with Doctors.” While you won’t see him “bust a move,” he does provide some insights into physician-patient interactions. As the PBS site introduces it:

Why do we often feel scared, rushed, and powerless in the doctor’s office? Can this affect how we heal? Why do doctors behave the way they do? How can we improve the “dance” we do with doctors?

Host Robert Lipsyte, a two-time cancer survivor, asks the insiders. Grey’s Anatomy consultant psychologist Dan Shapiro, Ph.D., head of Penn State College of Medicine’s Department of Humanities, explains the difficulty of teaching brainy medical students to be “human.” N.I.H. researcher and author Esther M. Sternberg, M.D. talks about her extensive study of the effects of stress on health and her own bout with crippling rheumatoid arthritis caused by stress. The Mayo Clinic’s Dr. Michael Brennan offers pointers on getting and keeping your physician’s attention and reaping the greatest benefits from a visit to the doctor. The conversation will help you understand your doctor-and how to get your doctor to understand you!

Watch the program on the PBS Web site.

By Lee Aase | Posted in Endocrinology | Tagged , , , , , | Comments (1)

Mayo Clinic Tests Non-Surgical, Endoscopic Ulcer Repair

October 14, 2009 – 1:30 pm

Mayo Clinic surgical researchers are reporting a 93 percent success rate in recent animal tests of endoscopic repair of perforated ulcers. The goal is to advance the use of an endoscope — which allows access to organs through natural openings, such as the mouth —

for a less invasive alternative to laparoscopic techniques (surgery performed through a small incision) or conventional surgery. They will present their findings from recent animal studies today at the American College of Surgeons 95th Clinical Congress in Chicago.

“Laparoscopic surgery for this condition is only 80 percent successful for a variety of reasons,” says Juliane Bingener, M.D., senior author on the study. “In our laboratory experiments we were over 90% successful. We also hope to ultimately reduce the risk to the patient overall and reduce postoperative complications.”

The process is called natural orifice translumenal endoscopic surgery (NOTES). The goal is to ultimately limit the physiological impact on the patient. While endoscopic repair limits the level of anesthesia used, in the distant future, it may be done without anesthesia, thus limiting one possible procedural side effect.

“Laparoscopy is great, but not all surgeons do it. It’s not easy to do. It’s technically advanced,” says Erica Moran, M.D., Mayo surgeon and researcher. “But it’s already been shown that there are many benefits if we can do noninvasive procedures with people who are actually quite ill.”

The researchers are seeking regulatory approval to begin a human clinical trial using the technique in the near future. The advantages of NOTES for ulcer repair:

No surgical incision
Less discomfort for patient than laparoscopy
50 percent less air is introduced into the body
Shorter recovery time than conventional surgery
Provides ulcer-repair option for candidates too ill for conventional surgery
The doctors emphasize that the endoscopic approach may not be appropriate for all cases. Each patient’s background symptoms and other medical conditions would need to be considered in determining which approach to use.

A third co-author on the study and presentation is Christopher Gostout, M.D., Mayo surgeon and researcher. The research was supported by Mayo Clinic and NOSCAR (Natural Orifice Surgery Consortium for Assessment and Research).

By Bob Nellis | Posted in Research | Tagged , , , | Comments (1)