Advancing the Science

Mayo Clinic Medical Science Blog

January 19th, 2017

Stereotactic radiosurgery is best for some brain tumors

By Elizabeth Zimmermann Young elizabethzimmermann

Shift in practice may reserve whole-brain radiation for patients with extensive disease.

Patients with three or fewer metastatic brain tumors who received treatment with stereotactic radiosurgery (SRS) had less cognitive deterioration three months after treatment than did patients who received SRS combined with whole-brain radiation therapy.
This finding is among the results of a federally funded Mayo Clinic-led multi-institution study whose results were published in the July 26, 2016, issue of JAMA.

Photograph of Paul D. Brown, M.D.

Paul D. Brown, M.D.

"Metastatic brain tumors are, unfortunately, common in patients with cancer," said Paul D. Brown, M.D., a radiation oncologist at Mayo [...]

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Tags: brain tumor, Cancer, Mayo Clinic Cancer Center, Paul D Brown, stereotactic radiosurgery

January 17th, 2017

Avoid routine double mastectomy when possible

By Elizabeth Zimmermann Young elizabethzimmermann

Consensus group urges weighing pros, cons and patient preference in unilateral breast cancer.

A position paper issued by the American Society of Breast Surgeons recommends against contralateral prophylactic mastectomy (CPM) for average-risk women with breast cancer in only one breast.

The recommendation on prophylactic mastectomy, published online July 28, 2016, in the Annals of Surgical Oncology, addresses the growing trend to remove the healthy breast (contralateral prophylactic mastectomy) along with the breast with breast cancer.

Photograph of Judy C. Boughey, M.D.

Judy C. Boughey, M.D.

"Contralateral prophylactic mastectomy is a growing trend that has generated significant discussion among physicians, patients, breast cancer [...]

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Tags: American Society of Breast Surgeons, Breast Cancer, double mastectomy, Forefront, Judy Boughey, Mayo Clinic Cancer Center

January 12th, 2017

Health Disparities Research Retreat Focuses on Closing Gaps for Underserved

By Elizabeth Zimmermann Young elizabethzimmermann

Over 100 researchers, clinicians, educators and administrators from across Mayo Clinic, as well as outside community members, gathered in Rochester, Minnesota, for the Office of Heath Disparities Research (OHDR) Annual Retreat in October. The meeting was a platform to share science updates, learn about study support and other resources, delve into health disparities topics and collaborate on future research projects and publications.

Keynote speaker Eliseo J. Pérez-Stable, M.D., director of the National Institute on Minority Health and Health Disparities (NIMHD), gave the talk “NIMHD’s Research Agenda to Improve the Health of Racial and Ethnic Minorities.”
Dr. Pérez-Stable made several key points about the NIMHD’s agenda:

  • Minority health and health disparities research are [...]

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Tags: disparities research, diversity, health disparity, NIMHD, Office of Health Disparities Research, underserved

January 10th, 2017

Meet the Investigator: Jamie N. Bakkum-Gamez, M.D.

By Elizabeth Zimmermann Young elizabethzimmermann

At the Mayo Clinic Cancer Center, hundreds of researchers dedicate their professional lives to reducing the burden of cancer. Each one has a unique story. In this issue, Jamie N. Bakkum-Gamez, M.D., a gynecologic oncologist at Mayo Clinic in Rochester, Minnesota, discusses her research.

This is one of a series of Meet the Investigator interviews available in Forefront, the online magazine of Mayo Clinic Cancer Center.  Other recent interviews include:

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Tags: Alan Bryce, cancer research, Forefront, Jamie Bakkum-Gamez, Joseph Mikhael, Mayo Clinic Cancer Center, Meet the Investigator, Minetta Liu, richard joseph

January 9th, 2017

Single Allele Mutation Heightens Risk of Early-Onset Parkinson’s

By Bob Nellis bobnellis

A collaboration of 32 researchers in seven countries, led by scientists at Mayo Clinic’s campus in Florida, found that a mutation in only one allele of a Parkinson’s gene, known as PINK1, increases the risk of early-onset disease. The finding, published recently in the journal Brain, addresses a longstanding debate about whether individuals need to inherit two copies of the mutation for an early form of the disease to occur.

Wolfdieter Springer, Ph.D.

Wolfdieter Springer, Ph.D.

The familial form of early-onset Parkinson’s, affecting patients as soon as age 45, is known to occur in individuals with mutations in both inherited alleles of the PINK1 (PTEN-induced putative kinase 1) gene. “This study showed [...]

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Tags: Mayo Clinic research, neurology, Neurosciences, Parkinson's, Wolfdieter Springer

January 5th, 2017

Stool DNA test added to colorectal screening

By Elizabeth Zimmermann Young elizabethzimmermann

Updated guidelines make noninvasive colorectal cancer screening option available to millions.

 

The U.S. Preventive Services Task Force has issued its final colorectal cancer screening recommendations for 2016.

The task force assigns an overall "A" grade to colorectal cancer screening in people ages 50 to 75 and fully recommends several screening exams that now include Cologuard, the stool DNA test co-developed by Mayo Clinic and Exact Sciences Corp.

Photograph of David A. Ahlquist, M.D.

David A. Ahlquist, M.D.

"The task force decision to include Cologuard will make this accurate and noninvasive new colorectal cancer screening option available to millions of people [...]

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Tags: Cologuard, colon cancer, David Ahlquist, Forefront, US Preventive Services Task Force

January 3rd, 2017

Integrating patient preferences in the delivery of Emergency Care. Kano analysis predicts change in experience.

By Elizabeth Zimmermann Young elizabethzimmermann

providers-with-prone-patient-3329540_0066In our publication in Annals of Emergency Medicine, Pilot Study of Kano “Attractive Quality” Techniques to Identify Change in Emergency Department Patient Experience, we describe our efforts to improve our patient’s perception of receiving concern and sensitivity from their healthcare providers.

The project originated in 2012, when our patients reported lower than expected ratings of receiving compassion by their emergency department (ED) providers. We used point-of-service survey cards to reassess this measure. We distributed 200 cards and received 193 (97% response rate) returned that gave a median rating of 4 out of 5 (IQR 3,5) with a top box percentage of 33% for provider concern and sensitivity.

A team of us [...]

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Tags: Annals of Emergency Medicine, Emergency Medicine, Kano model, Venkatesh Bellamkonda

December 29th, 2016

Drug combo stems tumor growth in lung cancer

By Nicole Brudos Ferrara nicoleferrara

Researchers on Mayo Clinic's campus in Jacksonville, Florida, have shut down one of the most common and lethal forms of lung cancer by combining the rheumatoid arthritis drug auranofin with an experimental targeted agent.

The combination therapy worked in a laboratory study to stop lung adenocarcinoma associated with mutation of the KRAS gene. The study was published in the March 14, 2016, issue of Cancer Cell.

Alan Fields, Ph.D.

Alan Fields, Ph.D.

"If our approach works in KRAS-mediated lung adenocarcinoma, it may work in other KRAS-mediated cancers, such as pancreatic cancer and colon cancer, as well as other cancer types," said [...]

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Tags: Alan Fields, auranofin, cancer stem cells, chemotherapy, Florida, KRAS gene, Lung Cancer, PKCiota, Forefront

December 27th, 2016

Using the Discovery-Translation-Application cycle to enhance recovery after surgery

By meghanknoedler meghanknoedler

old-way-new-way

Seventeen years is the average amount of time it takes for research to reach the patient bedside.  But this is not always the case, as a team of clinician researchers in gynecological surgery are showing. “It shouldn’t take 17 years for new discoveries to reach patients,” says Sean C. Dowdy, M.D., deputy director for practice in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery and chair, Division of Gynecologic Surgery, “One of our goals at the Kern Center is to not only discover new ways of delivering quality health care, but to improve the interface between discovery and translation to facilitate wide-spread dissemination. [...]

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Tags: discovery-translation-application, enhanced recovery after surgery, enhanced recovery pathway, ERAS, ERP, kern center, Sean C Dowdy

December 22nd, 2016

Is there method in the madness: observation vs. full admission

By Elizabeth Zimmermann Young elizabethzimmermann

older man experiencing chest painLast night a 68-year old male presented to the Emergency Department with chest pain. His pain lasted 45 minutes and resolved with 2 nitroglycerin tablets. He has history of coronary artery disease, stents placed within the past 2 years and a previous myocardial infarction. He has hypertension and diabetes. He was pain free by the time he arrived to the ED and hemodynamically stable.

We had a discussion with him regarding his risk, goals and preferences and decided for admit for acute coronary syndrome rule out. Our ED observation unit is full, so we admit him to the Cardiology floor for “observation” and continue acute coronary syndrome rule out with serial troponins [...]

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Tags: AARP, Academic Emergency Medicine, chest pain, Emergency Medicine, Fernanda Bellolio, observation status, OptumLabs

December 20th, 2016

New breast cancer treatment increases chances women can save their breasts

By meghanknoedler meghanknoedler

breast-canerA very close family friend was just recently diagnosed with breast cancer. Even before all of her tests results came back she said, “Take both of my breasts, I don’t care.”  When someone you know or love is diagnosed with breast cancer, it’s terrifying.  All too commonly, our minds go to surgery.  This is what we believe will save our mom, our sister, our friend from breast cancer.  For my friend, like many others, the thought of cancer growing inside of her was scary and surgery to remove the cancer was her first thought.

Many women with early stage breast cancer have the choice between breast conserving surgery and mastectomy. Historically management of breast cancer has [...]

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Tags: Breast Cancer, breast surgery, cancer treatment, cancer trials, clinical trials, Judy Boughey

December 15th, 2016

Combination therapy improves survival in adults with glioma

By Nicole Brudos Ferrara nicoleferrara

Radiation plus three-drug combo boosts progression-free survival and overall survival.

Patients with a low-grade type of brain tumor called glioma who received radiation therapy plus a chemotherapy regimen, including procarbazine, lomustine and vincristine (PCV), experienced a longer progression-free survival and overall survival than did patients who received radiation therapy alone.

These are the results of a clinical trial called Radiation Therapy Oncology Group (RTOG) 9802 that were published in the April 7, 2016, issue of the New England Journal of Medicine.

Jan Buckner, M.D.

"This is the first phase III trial to demonstrate conclusively a [...]

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Tags: brain cancer, cancer reseach, glioma, Jan Buckner, lomustine, PCV, procarbazine, radiation therapy, vincristine

December 13th, 2016

Nipple-sparing mastectomy may be a good option

By Elizabeth Zimmermann Young elizabethzimmermann


Technique offers a safe way to reduce breast cancer risk
in carriers of the BRCA mutation.

Mastectomies that preserve the nipple and surrounding skin prevent breast cancer as effectively as do more-invasive surgeries for women with a genetic mutation called BRCA, a multi-institution study led by Mayo Clinic Cancer Center found.

The study findings were presented at the annual meeting of The American Society of Breast Surgeons in April in Dallas.

The research should reassure patients and surgeons that nipple-sparing mastectomies, which leave women with more natural-looking breasts than do other mastectomies, are a safe way to reduce breast cancer risk in carriers of [...]

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Tags: BRCA, Breast Cancer, Forefront, James Jakub, mastectomy, Mayo Clinic Cancer Center, nipple-sparing

December 7th, 2016

Sex- and age-related differences in parkinsonism

By Elizabeth Zimmermann Young elizabethzimmermann

Researchers at Mayo Clinic have found that drug-induced parkinsonism occurs more often in women than in men. It is also the most common type of parkinsonism among people younger than age 40.

These findings, made possible by the Rochester Epidemiology Project, were published online in Movement Disorders. They give a different perspective from the team’s earlier findings published in June of 2016 showing that overall rates of Parkinson’s disease and parkinsonism have gone up over the last 30 years, more so in men. (Read June 2016 news release.)

savica3188949_0017

Rodolfo Savica, M.D., Ph.D.

Epidemiology studies are the backbone of our understanding [...]

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Tags: Epidemiology, medical research, Parkinson's, parkinsonism, REP, Rochester Epidemiology Project, Rodolfo Savica

December 6th, 2016

New strategies could make laryngectomies a thing of the past

By Elizabeth Zimmermann Young elizabethzimmermann

David Lott, M.D., and his team are developing a larynx fully regenerated from a person's own stem cells harvested from fat tissue.

About 60,000 Americans have had their larynx removed due to disease or trauma. These people are missing out on many of life's little pleasures because the procedure's resultant hole left them without a voice and created an opening directly into their lungs. A simple shower is dangerous as even the slightest amount of water in the lungs can be deadly. Bad weather can be lethal. Things that used to be a mere annoyance — such as a housefly — are now life-threatening.

At Mayo Clinic, David Lott, M.D., and a team of researchers [...]

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Tags: Arizona, Center for Regenerative Medicine, David Lott, laryngectomy, medical research, regenerative medicine, stem cells

December 1st, 2016

State-of-the-art nanomedicine research launched

By Elizabeth Zimmermann Young elizabethzimmermann

Nanomedicine program will improve diagnosis and treatment for patients with cancer.

With support from the state of Florida, Mayo Clinic's campus in Jacksonville, Florida, has opened a state-of-the-art laboratory for nanotechnology research, an emerging field of science that studies and applies materials that are the size of an atom.

The laboratory is a key part of Mayo Clinic's new Translational Nanomedicine Program. The goal is to develop, test and apply tiny materials in diagnosing and treating patients, particularly those with cancer.

Photograph of Gianrico Farrugia, M.D.

Gianrico Farrugia, M.D.

Findings made in the lab will help expand and enhance cancer research, [...]

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Tags: Cancer, Debabrata Mukhopadhyay, Dev Mukhopadhyay, Florida, Gianrico Farrugia, Mayo Clinic Cancer Center, nanomedicine, nanotechnology

November 29th, 2016

Rising health care costs: Are physicians Choosing Wisely?

By meghanknoedler meghanknoedler

choicesPhysicians are burned out.  The reasons for which are seemingly endless:  for one, the health care system is asking them to continually add more to their plate.  More diagnosis codes, more communication and oversight with more complex patients, more administrative duties such as charting and patient emails and portal systems, yet no more time.

Physicians are expected to stay on top of ever-changing guidelines, and provide their patients effective, compassionate, high value care.  More and more, reimbursement is tied to patient experience, but yet doctors have less time to actually spend WITH their patients ensuring the best possible experience.

It’s a nasty spiral that is difficult to control.  Then, add on the increasingly complex issue [...]

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Tags: Choosing Wisely, Choosing Wisely Campaign, Family Medicine, kern center, Michael Grover, value

November 21st, 2016

Physician heal thyself

By Elizabeth Zimmermann Young elizabethzimmermann

In recent months, we have heard a lot about physician burnout, medical student suicide, and other health care provider health and wellness issues. A growing problem, and one that is difficult to combat, as physician shortages are predicted to rise in the future, placing ever more burden on those in the system.

Shortages lead to issues accessing care. We worry about whether it will become more difficult for patients to access health care services, leading to poorer health outcomes. Before now, not much attention was paid to whether or not the doctors themselves had difficulty accessing care.

Little is known about the contribution to physician health of access to care. One might assume that for a medical doctor, care access is as simple as walking across the hall.

Unfortunately, nothing is that simple. [...]

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Tags: BMC Health Services Research, burnout, Hassan Murad, Philip Hagen, physician burnout, preventive medicine, kern center

November 17th, 2016

Aspirin use may help prevent bile duct cancer

By Elizabeth Zimmermann Young elizabethzimmermann

Bile duct cancer is an uncommon cancer that forms in the slender tubes (bile ducts) that carry digestive fluid through the liver. Bile duct cancer occurs mostly in people older than age 50. Symptoms include yellowing of the skin and eyes, intense itchiness of the skin, and white stools. Bile duct cancer is an aggressive type of cancer that progresses quickly and is difficult to treat.

Photograph of Lewis R. Roberts, M.B., Ch.B., Ph.D.

Lewis R. Roberts, M.B., Ch.B., Ph.D.

Mayo Clinic Cancer Center researchers found that individuals who regularly used aspirin were significantly less likely to develop bile duct cancer.

"The evidence has been accumulating that regular, long-term [...]

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Tags: bile duct cancer, Cancer, Lewis Roberts, Mayo Clinic Cancer Center

November 15th, 2016

The Sangre Por Salud Biobank: Bringing Precision Medicine Research to an Underrepresented Latino Community

By Elizabeth Zimmermann Young elizabethzimmermann

salud-bionews

Inaugural issue:  Sangre Por Salud BioNews.

The Sangre Por Salud (Spanish for Blood for Health) Biobank was created to expand precision medicine research to underrepresented Latino patients in order to enhance the diversity of the Mayo Clinic Biobank. The biobank enables researchers to examine biological samples and data collected from Latino patients in order to develop better prevention, diagnostic tools and treatments for health issues specific to this group.

Created in 2013, the Sangre Por Salud Biobank is a collaboration between Mayo Clinic Center for Individualized Medicine, Mountain Park Health Center in Phoenix, and Arizona State University.

Mountain Park Health Center, a [...]

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Tags: Arizona, Arizona State University, Biobank, Center for Individualized Medicine, Eleanna De Filippis, genomic, Latino, Mayo Clinic biobank, Mountain Park Health Center, personalized medicine, precision medicine, Sangre Por Salud

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