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Innovations Archive

Reducing the Panic of Fecal Incontinence

Posted on November 12th, 2013 by Admin

From Mayo Clinic's Discovery's Edge magazine

Imagine the distress of waiting in a stalled checkout line, the bathrooms located at the back of the store, when your bowels begin to rumble and you have the uncontrollable urge to go. For those with fecal incontinence, panic ensues with the very thought of being caught unprepared at moments like these.

Mayo Clinic gastroenterologist Dr. Adil Bharucha has heard too many stories from his patients, mainly women over 40, about the panic created by the inability to control bowel movements, causing stool to leak unexpectedly from the rectum. In the worst cases, fecal incontinence can lead to a complete loss of bowel control.

Since one in 10 women experiences this embarrassing condition and since the prevalence increases with age, fecal incontinence was once thought to be the results of trauma during childbirth.  Dr. Bharucha discovered, however, that rectal urgency and diarrhea, rather than obstetric trauma, are the main risk factors for fecal incontinence among women

Adil Bharucha, M.D.

He also knew he needed better diagnostic tools to identify and assess anorectal function if he hoped to help women suffering from fecal incontinence. With that goal, he set about building an extensive network of collaborators both within Mayo Clinic and externally to develop new diagnostic tests and devices. This work has led him to collaborating widely across the institution to improve care for the patient.

The work of Dr. Bharucha and his research colleagues has earned international acclaim for Mayo Clinic's gastrointestinal motility clinic, the first center nationwide to introduce high resolution anorectal manometry into clinical practice; and to develop normal values and a system with which to classify patients with defecatory disorders, including fecal incontinence. It now offers a panel of tests to assess rectal stiffness, sphincter strength and urgency. This comprehensive approach provides an array of sophisticated diagnostic tools to help researchers zero in on the cause for fecal incontinence in each patient.

"Most of my collaborators had never considered working in my field," Dr. Bharucha says. "I am very grateful for their enthusiasm and expertise once they understood how common and distressing these disorders are. People say that the beauty of collaborating is that you work with smarter people. In my case, it's really true."

And, as a result, many women are also grateful to Dr. Bharucha for seeking new answers and new tests with his colleagues for this all too common and embarrassing condition.

Mayo Clinic's Genomic Study on Prostate Cancer

Posted on November 6th, 2013 by Admin

Certain types of "hard to treat" prostate cancer present an unanswerable challenge for physicians. That's a nicely worded sentence for very bad news for the patient. After hormone treatment yields no response, the patient usually has two years or less to live. Surgery isn't possible because the tumor cannot be shrunk. The reality of the condition underscores the urgency of a new study at Mayo Clinic's Center for Individualized Medicine that uses the genomic information of the patient's tumor to find possible solutions, such as more targeted drugs. For more details on the study or to learn how you might participate, check the news release Mayo issued today.

 

Regenerating Heart Tissue Through Stem Cell Therapy

Posted on November 6th, 2013 by Admin

From the pages of Mayo Clinic's Discovery's Edge --

Two years after a heart attack left him too exhausted to even tend his garden, Miroslav Dlacic is now able to walk again without becoming worn out.  An international team of Mayo Clinic doctors and researchers, led by André Terzic, M.D., Ph.D., director of Mayo Clinic’s Center for Regenerative Medicine, helped Dlacic reclaim his life by discovering a way to regenerate heart tissue through stem-cell therapy.

For decades, treating cardiac patients has typically involved managing heart damage with medication. It’s a bit like driving a car without fixing a sluggish engine; you manage the consequences as best you can and learn to live with them. But in collaboration with European colleagues, Mayo Clinic researchers have discovered a revolutionary means of repairing a damaged heart—of actually fixing the machine.

Dr. Andre Terzic

“It’s a paradigm shift,” says Dr. Terzic. “We are moving from traditional medicine, which addresses the symptoms of disease, to being legitimately able to cure disease.”

In this breakthrough process, stem cells are harvested from a cardiac patient’s bone marrow. They undergo a laboratory treatment that guides them to become cardiac cells. The treated cells are then injected into the patient’s heart in an effort to grow healthy heart tissue. The study is the first successful demonstration in human beings of the feasibility and safety of transforming adult stem cells into cardiac cells.

“We guide the stem cells to become something useful, in this case, cardioprogenitors,” Dr. Terzic explains.

This discovery has implications for millions of people. Cardiovascular disease is the leading cause of death worldwide. In the U.S. alone, about 5.8 million people have heart failure, and the number is growing. Beyond heart failure, the Mayo research also is a milestone in the emerging field of regenerative medicine, which seeks to go beyond palliative treatments to fully heal damaged tissue and organs.

 Mayo Clinic is uniquely positioned to pursue this complex therapy. In addition to its global reach, Mayo Clinic has its Center for Regenerative Medicine at the forefront of efforts to develop reparative solutions for a range of conditions.

“With the cardiopoiresis research, we have shown that regenerative medicine can really work,” Dr. Terzic says. “We are now actively working on regenerative medicine in the areas of diabetes, liver and lung disease, neurologic disorders, and orthopedic surgery.”

 To read the full story about Dr. Terzic's research into regenerative medicine, visit Discovery's Edge, Mayo Clinic's research magazine, at http://www.mayo.edu/research/discoverys-edge/regenerating-heart-tissue-stem-cell-therapy.

New Heartburn Study in at #MayoClinicFL

Posted on October 31st, 2013 by Admin

It's a common ailment, but we're trying to get to the bottom of it. Researchers at Mayo Clinic in Florida have launched a clinical trial on gastroesophageal reflux. You either need to have the condition or to be perfectly healthy, as they need people for a control group for the study.

The Gastroesophageal Reflux - Respiratory Consequence Study

To be eligible, participants must be 18-60 years old and be within traveling distance of Mayo Clinic’s campus in Jacksonville, Fla.

Read the rest of this entry »

Tweeting on Individualized Medicine

Posted on October 2nd, 2013 by Admin

SRO at the Mayo-ABC Twitter chat

Perhaps it was the topic - translating individualized medicine and what it means for medicine. Maybe it was the positive mood of the conference attendees here in Rochester. Whatever it was, it seemed to infect the noon Twitter chat held by Mayo's External Relations group...along with the Personalized Medicine Coalition in Washington, and hosted by Dr. Richard Besser, back at his desk at ABC News in New York. About half of those you see at the laptops are Mayo doctors, most taking their first stab at Tweeting. Response and participation was great: over 1,000 Tweets, over 200 participants, and more then 5 million accounts reached.

Mayo-Illinois Collaborations in Individualized Medicine

Posted on October 1st, 2013 by Admin

UIUC Leaders visiting the Center for Individualized Medicine

University of Illinois Chancellor Phyllis Wise and her administrative team attended Mayo Clinic's Individualizing Medicine Conference this week and held meetings on ongoing collaborations between the two institutions. The group from Urbana-Champaign included (l-r) Associate Vice Chancellor Jennifer Eardley; Gianrico Farrugia, M.D., director of the Center for Individualized Medicine at Mayo; Vice Chancellor Peter Schiffer; Chancellor Wise; Provost Ilesanmi Adesida; and Bryan White, Ph.D., who served as co-chair of the conference. Mayo and Illinois have been collaborating for years on medical genomic projects under the banner of the Mayo Illinois Alliance for Technology Based Health Care. Recently extensive work has been done in microbiome research and dozens of students and researchers have traveled between the campuses to work together.

Getting Genomic-Drug Alerts into the Electronic Medical Record

Posted on October 1st, 2013 by Admin

"Getting the what in the what?" That's going to be a problem if health care professionals are asking that question in the future. Many medical centers are finding that patients have allergies or will be put at considerable risk if given the wrong drug for their genetic makeup or even the standard dose of the right drug. Pharmacogenomic screening prior to prescribing medications will one day be a normal practice. It's the mantra of giving the right dose of the right drug at the right time. One size, one standard pharmaceutical practice, does not fit all. Your genome can often provide the answer. At Mayo's Individualizing Medicine Conference today, we've been hearing about how pharmacogeneomic screens are done at St. Jude Children's Hospital (thanks Dr. Mary Relling) and how those results are immediately going into those patients' electronic medical record.

The problem comes in if patients aren't exposed to appropriate screens --- or if they don't have an EMR. With an EMR, any physician can see almost immediately through a genomic-drug alert in the record (at Mayo a red flag pops up) that a patient should not be given drug X. This avoids a trial and error system of letting the patient's physiology reject the drug while exhibiting associated side-effects. We are used to hearing the slogan "There's an app for that." Well, soon we'll be able to say "There's a test for that" -- before you take a drug, any drug. There's relevance for you.

Hot Topics for Genomics for Remainder of the Decade

Posted on September 30th, 2013 by Admin

Dr. Eric Green summed up his plenary talk at Mayo's Individualizing Medicine conference by sharing his vision for what we'll see (and he and his colleagues will do) in genomics research and application before 2020.

Hot Areas in Genomic Medicine:

  • Cancer genomics
  • Pharmacogenomics…(genomic-guided prescriptions)
  • Ultra-rare genetic disease diagnosis
  • Prenatal and Newborn sequencing and analysis
  • Clinical geonmics information systems (computer/bioinformatics)
  • Genomic medicine… "It's not hypothetical anymore."

Dr. Eric Green – NIH Genomic Leader

Posted on September 30th, 2013 by Admin

Dr. Eric Green, head of the National Human Genome Research Institute, is now on the stage...explaining how "genomics is becoming increasingly relevant to the patient." He says this discipline is a marathon, that began 13 years ago with the initial mapping of the human genome. Now he talks of "base pairs to bedside" or "double helix to health"...and points to the strategic plan for his institute, published in 2011. He is now outlining advancements in our understanding of the genome, it's biology, how it impacts human biology and then how it can impact medical practice. Finally, he says, we must measure and demonstrate how genomics improves health care.

He also says we've learned much in the last decade, including the epigenomic code -- the impact of proteins on our genetic behavior based on environmental influences. He is essentially setting the stage for what will come later in the conference -- all of the knowledge thus far, he says, is a "Cliff Notes" version of the human genome and we have a lot more to learn -- including the differences in individual human genomes.

Individualizing Medicine Conference Kicks Off

Posted on September 30th, 2013 by Admin

Yes, hundreds of people have enjoyed eggs, sausage and bagels and now Dr. Gianrico Farrugia is on stage introducing Dr. John Noseworthy, President and CEO of Mayo Clinic.    He says Mayo Clinic decided that including medical genomics into Mayo's future and present was essential. "We use medical genomics every day to treat our patients."