March 15, 2019

Mayo Clinic in the News Weekly Highlights for March 15, 2019

By Emily Blahnik

NBC News, Improved detection and treatment of pancreatic cancer provides hope by Elizabeth Chuck — While there are currently no approved early detection tests for pancreatic cancer, researchers say there are promising possibilities — particularly in blood tests that can pick up biomarkers for it. "We are slowly making inroads," said Gloria Petersen, a professor of epidemiology at the Mayo Clinic who has researched pancreatic cancer for 20 years. "I think we will probably be seeing some [biomarker tests] being offered up within the next five years for early detection for pancreatic cancer."… Petersen believes the blood tests currently under development would result in a diagnosis one to three years earlier than the average diagnosis being given now. "We know from a lot of research that with earlier detection, there are better treatment options, so that is our goal," she said.

NBC News, Amazon removes books promoting autism cures and vaccine misinformation by Brandy Zadrozny — Amazon is removing from its online marketplace “autism cure” books that unscientifically claim children can be cured of autism with pseudoscientific methods such as ingesting and bathing in a potentially toxic form of bleach and taking medication meant to treat arsenic and lead poisoning… The other removed title, “Fight Autism and Win” advises parents on chelation — an unproven treatment for autism that involves medicating a child with an antidote for mercury poisoning. The cure springs from the debunked theory that autism is caused by mercury exposure in childhood vaccines. Chelation therapy can cause serious side effects, including potentially deadly kidney damage, according to the Mayo Clinic.

AARP, Rochester Aims for Age-friendly Expansion by Mary Van Beusekom — A massive effort is underway to transform Rochester into an international destination, but its residents also want the city to become a place that’s more walkable, affordable and all-around livable for those who call it home. AARP Minnesota is ensuring area residents have a voice as the 20-year, $5.6 billion economic development project proceeds. The effort to establish a “destination medical center” includes a Mayo Clinic expansion and construction of new hotels, multifamily housing and shops. … Although Rochester is home to the Mayo Clinic, access to health care can still be an issue. “Mayo’s got hundreds of different specialties, but if you talk about geriatrics, it’s kind of similar to other places,” he said. “There are a lot more seniors who need specialized medical care than can get it.” Olmsted County is expected to submit its Age-Friendly Community application this spring, Haapala said. When the five-year process is complete, the county will join Alexandria, Maple Grove, Minneapolis, Northfield and more than 300 other communities nationwide as part of AARP’s age-friendly network. Olmsted County Public Health Services, Family Service Rochester, Olmsted Medical Center, the Mayo Clinic and multiple community groups are also involved.

AARP, What's Next for Alex Trebek as He Faces Pancreatic Cancer? by Christina Ianzito — When famed Jeopardy! host Alex Trebek, 78, announced his recent diagnosis of stage 4 pancreatic cancer this week, he vowed to defy the odds. “I plan to beat the low survival rate statistics for this disease,” he told fans in a video message. What are the odds? Only 8.2 percent of pancreatic cancer patients survive for five years, according to the National Cancer Institute (NCI). Some 55,000 people in the United States are diagnosed with pancreatic cancer each year; the average age of diagnosis is about 70. “Pancreas cancer is fortunately not a particularly common cancer, but it is among the most deadly,” said Mark Truty, a surgical oncologist specializing in advanced pancreatic cancer at the Mayo Clinic in Rochester, Minn. Because it usually comes with no or nonspecific symptoms, it’s often discovered very late in the cancer’s progression, he explained, which is why about half of those diagnosed each year are at stage 4. That means it has spread to other organs (most commonly the liver, lungs or abdominal cavity).

NPR, How Much Difference Will Eli Lilly's Half-Price Insulin Make? by Bram Sable-Smith — One twist in this story is that Lilly's new insulin is just a repackaged version of Humalog, minus the brand name. It's called an "authorized generic." "Whoever came up with the term, 'authorized generic' ?" Dr. Vincent Rajkumar says laughing. Rajkumar is a hematologist fat the Mayo Clinic in Rochester, Minn. "It's the same exact drug" as the brand name, he continues. Typically, Rajkumar says, authorized generics are introduced by brand-name drugmakers to compete with generic versions of their drugs made by rival companies. But in the case of Humalog and other insulins, there are no generics made by competitors, as there are for, say, the cholesterol medicine Lipitor or even other diabetes drugs, such as metformin. So when Lilly's authorized generic comes to market, the company will have both Humalog insulin and the authorized generic version of that medicine on the market. Rajkumar says it's a public relations move. "There's outrage over the price of insulin that is being discussed in Congress and elsewhere. And so the company basically says, 'Hey, we will make the identical product available at half price.' On the surface that sounds great," Rajkumar says.

CNN, Conjoined twins return home after lifesaving surgery in Australia by James Griffiths and Bianca Britton — Two Bhutanese conjoined twins who traveled to Australia to be separated have returned home this week, completing a nearly 12,000-mile round trip to receive the life-saving surgery. Nima and Dawa Pelden, along with their mother, Bhumchu, arrived in Bhutan on Thursday, according to the Children First Foundation (CFF), a charity which funded their medical treatment…Scientists believe that conjoined twins develop from a single fertilized egg that fails to separate completely as it divides."The success of surgery depends on where the twins are joined and how many and which organs are shared, as well as the experience and skill of the surgical team," according to the Mayo Clinic.

CNN, Diabetes study ties lower risk to just a moderate amount of body strength by Jacqueline Howard — Strength has been tied to a lower risk of Type 2 diabetes, but you don't need to overdo the weightlifting to reap the benefits, according to a new study. Moderate amounts of muscle strength, but not beyond that, were associated with a 32% reduced risk of developing Type 2 diabetes in the study, published in the journal Mayo Clinic Proceedings on Monday. Additional coverage: Yahoo!, US News & World Report, Science Daily, Men’s Health, Hindustan Times, Free Malaysia TodayHealthDay

Associated Press, Evers proposes $109 million for UW-Eau Claire building — Tony Evers wants to spend $109 million to help University of Wisconsin-Eau Claire officials replace their science building. Evers announced Thursday he’ll include the funding in his capital budget proposal. The money would go to help UW-Eau Claire replace Phillips Hall with a new science and health sciences building. The project is a collaboration with Mayo Clinic. The clinic’s researchers would work alongside UW-Eau Claire students and faculty. Additional coverage: KTTC, Volume One

Associated Press, Roger Penske received kidney from son in 2017 at Mayo Clinic — Motorsports giant Roger Penske disclosed Friday that he received a kidney transplant shortly after the 2017 IndyCar season finale. Penske told The Associated Press he received the kidney from his son, Greg. The 82-year-old owner of Team Penske and the Penske Corp. kept the transplant private and was working and at the race track roughly 10 days after the procedure. It came up Friday as Tim Cindric, president of Team Penske, was discussing his own hip replacement surgery done at the Mayo Clinic in Rochester, Minnesota. Cindric noted doctors had him up and using a walker four hours after surgery, and that prompted Penske to reveal his transplant. “When I did that transplant, we were up at the end of the day. They said ‘Would you get up and walk over to the window?'” Penske said. “Next day, I’m over in my son’s room. They get you going. It’s amazing. It’s a good spot, good spot.” Additional coverage: New York Times, Star Tribune, KTTC, NBC Sports

USA Today, #NationalNappingDay is here for you, this Monday after daylight saving time by Ashley May — People who regularly don't get enough sleep are usually most affected by the lost hour, said Timothy Morgenthaler, Mayo Clinic's co-director of the Center for Sleep Medicine. People who are sleep-deprived might struggle with memory, learning, social interactions and overall cognitive performance. Some advocate that napping could help. Short naps (10 to 30 minutes) in the afternoon can be a great way to recharge, Lois Krahn, a psychiatrist and a sleep specialist at Mayo Clinic Arizona says.

New York Times, Exercise vs. Drugs to Treat High Blood Pressure and Reduce Fat by Gretchen Reynolds — …The methods in the exercise studies also often were less tidy and precise than in the drug tests, the researchers point out. Volunteers in the exercise studies rarely were blinded, for instance, since it’s hard to prevent people from knowing whether or not they are working out. There also was little long-term follow-up of exercisers. Some of these same issues bedeviled the exercise science highlighted in the other new review, which was published in February in Mayo Clinic Proceedings. For this study, the researchers zeroed in on fat and, in particular, visceral fat, a particularly hazardous type of fat that accumulates around our middles and deep beneath the skin, smothering internal organs and heightening the risk of metabolic problems.

The Atlantic, Why So Many Babies Are Getting Their Tongues Clipped by Rachel Morgan Cautero — “There are probably children who could benefit from [a frenotomy]. But we don’t have great criteria to determine who those children are,” says Karthik Balakrishnan, a pediatric-otolaryngology professor at Mayo Clinic Children’s Center…Much of the research on the subject relies on mothers self-reporting the effect a frenotomy had on breastfeeding, which is highly subjective. In short, moms might see a change post-frenotomy because they want to. “If you’re a mom that has put her child through this procedure because you thought it was the right thing to do, you might be more inclined to look upon the outcome favorably,” explains Balakrishnan. “You might say, ‘Well, it still hurts, but my kid is feeding better.’ Whether it’s a real effect or a placebo effect, I don’t think that matters.”

Post-Bulletin, National Kidney Month: Mayo Clinic Radio — March is National Kidney Month — an awareness effort to encourage people who are at risk of chronic kidney disease, often due to diabetes or high blood pressure, to get screened. On the Mayo Clinic Radio podcast, Dr. Ladan Zand, a Mayo Clinic nephrologist, discusses chronic kidney disease and offers tips to keep your kidneys healthy.

Post-Bulletin, Get an evaluation for that hurting knee — DEAR MAYO CLINIC: One year ago, I fell and broke my arm. While my arm has healed, my knees also have been bothering me since I fell. I have arthritis in both knees and a slight tear in the meniscus on one knee, but both knees are extremely painful when I walk. Is it possible that arthritis is causing this much pain, or could there be another reason, perhaps related to my fall? I am 59…It's possible that your knee pain could be traced back to your fall. You may have injured your knees without realizing it when you fell, or the trauma of the fall could have caused your arthritis to flare. Either way, you should make an appointment to have your condition evaluated. That evaluation will guide treatment going forward. — David Hartigan, M.D., Orthopedic Surgery, Mayo Clinic, Phoenix

Post-Bulletin, Area Innovators Changing the world, from our backyard by Steve Lange — Vriad: Hoping to cure cancer with a single shot….It’s 4 p.m. on Valentine’s Day, and Dr. Kah-Whye Peng (wearing a red shirt—she says she planned ahead) and Dr. Stephen Russell (he says he didn’t) have peeled off from their day jobs to meet us in the new offices of Vyriad, the clinical stage, cancer-fighting biopharmaceutical company they co-founded in 2014. Those day jobs (she’s a professor of oncology in Mayo’s Department of Molecular Medicine; he’s a professor of molecular medicine at Mayo Clinic) helped them kickstart Vyriad, after Mayo loosened the rules for these kinds of companies with its groundbreaking Employee Entrepreneurship Program.

Post-Bulletin, Sleep-deprived teen? Here's the study for you by John Molseed — If you’re a teen or know a teen who has trouble falling asleep until the early morning, Mayo Clinic and Rush University in Chicago want to hear from you. The two institutions are teaming up to do a sleep study on teens who likely have delayed sleep phase disorder. Although studies show it’s typical for teenagers to stay up later, researchers want to study teens who have the disorder to learn if wearing glasses that block out different types of light could help. Depending on the studies’ findings, teens with the sleep disorder could find some relief, said Dr. R. Robert Auger, sleep medicine specialist at Mayo Clinic. “Virtually all high school and middle school students are chronically sleep-deprived,” Auger said. Teen patients present a unique challenge for sleep disorder specialists.

Post-Bulletin, Answer Man: But will they believe you if you call in sick? — Dear Answer Man, I’ve heard of a handful of people in town taking part in “medical acting” at Mayo Clinic. What exactly is a “medical actor” and how does one get into that line of work? Sincerely, Not an actor… A standardized patient or medical actor is different than pretending to be sick to get out of work/school/life responsibilities. But in fairness to Ferris Bueller, you don’t have to be a trained actor to be a successful standardized patient. The Multidisciplinary Simulation Center at Mayo Clinic’s campus in Rochester comprises 11,500 square feet of dedicated experiential learning space and employs 90 to 100 people to serve as standardized patients. Those “patients” range in age from about 16 to upwards of 80 and come from all walks of life, according to Kathy Keech, the Standardized Patient Program supervisor. While some the standardized patients are actors by trade, Keech said the most important trait is being believable, up close and personal.

Post-Bulletin, Answer Man: Rochester's best building began life as a library — Dear Answer Man: Now that I go past it every day on my way to work, I've decided that Mayo Clinic's Mitchell Student Center is the most attractive building in town. A co-worker mentioned that it used to be the public library. I figure you're an architecture nut (or some kind of nut!), so can you fill us in on the history of this beautiful building? — Downtown Worker…The building was designed by Harold Crawford, the architect of so many fine homes and structures in the city, and was completed in 1938. The Depression-era Public Works Administration paid for nearly half of the construction cost of $178,000. The library was located in the building until 1972, when it moved to the former JC Penney store at 11 First St. SE. That was supposed to be temporary, but it took 20 years for the library to get its new home in its current location at Second Street and Civic Center Drive Southeast. Meanwhile, Mayo Clinic took over ownership of the building, and it became the Mitchell Student Center — think of it as a student union/study hall for Mayo's medical school students.

KTTC, Long winter months lead to decrease in blood donors at Mayo Clinic — With heavy snowfall and extreme temperatures, the historic winter has impacted lives, businesses and our environment in unprecedented ways – including blood donations. Mayo Clinic said that blood donations are significantly down since winter kicked into gear. The Mayo Clinic Blood Donor Center has already cancelled four blood drives due to weather. It also closed for the first time in its history on Feb. 25 during the blizzard. According to the Mayo Clinic, blood donations are most crucial right now due to the increase in car crashes and trauma from the weather. Blood Donor Program Medical Director Dr. Justin Kreuter said that they are currently looking for donors of all blood types. “Blood transfusion is actually the most common procedure done in the hospital today. So that’s just kind of an indicator for just how important, how much of a cornerstone it is for enabling a lot of treatments that we’re doing now.” said Dr. Kreuter.

KTTC, Rochester leaders swarm over State Capitol trying to influence lawmakers by Noel Sederstrom — Minnesota state legislators got a big dose of the Med City on Monday as about a hundred local business and government leaders took part in Rochester’s Day at the Capitol. Organized by the Rochester Area Chamber of Commerce, it’s an effort to get the city’s needs and wants directly to the people who make the big decisions in St. Paul. This year’s messages were focused on a looming work force shortage for a booming Rochester metro area, with Mayo Clinic and Destination Medical Center driving the economic expansion. Additional coverage: FOX 47

MedCity Beat, County gets full $5 million for crisis center — Olmsted County has learned that it will receive $5 million — the full amount it had requested — in state funding to build a mental health crisis center on its campus in southeast Rochester…While the state grant will cover much of the construction costs, it will not fund operations of the facility. That will be left up to a consortium of community partners, including Olmsted County, Mayo Clinic, Olmsted Medical Center and NAMI Southeast Minnesota.

Star Tribune, Mayo Clinic going slow on potential clinic in Hudson, Wis. by Christopher Snowbeck — Mayo Clinic is not in a hurry to shake up the market for medical care in the St. Croix Valley. Last year, Mayo asked the plan commission in Hudson, Wis., for a conditional-use permit to develop a 100,000-square-foot medical facility on about 9 acres of vacant land near Interstate 94. The move was seen as a competitive threat to some health systems in the Twin Cities, but Mayo Clinic’s chief financial officer said a facility in Hudson isn’t currently on the list of capital projects at Mayo. “There are currently no plans to build anything in Hudson,” Dennis Dahlen, the CFO, said during an interview. “The land is still there. It’s there for future expansion, should that be a location we wanted to grow into.”

Pioneer Press, Twins make second round of cuts, including Nick Gordon by Betsy Helfand — …Third baseman Miguel Sano has been in Minnesota and was scheduled to arrive back to Fort Myers on Tuesday and be in the clubhouse on Wednesday. Sano has been in Minnesota after undergoing a debridement procedure at the Mayo Clinic a week ago. He is expected to be out until May as he recovers from a cut on his lower-right Achillies area. Additional coverage: Duluth News Tribune

Minneapolis/St. Paul Business Journal, The Time’s Up movement comes to health care, with Mayo Clinic leading the charge by Maddy Kennedy — Mayo Clinic is one of eight founding signatories of Time’s Up Healthcare, an affiliate dedicated to creating safe, fair and dignified working conditions for women and non-binary workers in the medical industry. Additional coverage: Minne Inno

Minneapolis/St. Paul Business Journal, Developer plans 'midscale brand' hotel near Mayo Clinic by Mark Reilly — Rochester continues to draw interest from hotel developers, with a local company headed to the city's Planning and Zoning Board this week to pitch a midrange, extended stay hotel between Mayo Clinic's two main campuses.

MPR, Miscarriage: A common experience, a private pain by Angela Davis — Miscarriages are sad, private events, difficult to talk about. But they are not rare; Mayo Clinic reports they occur in 10 to 20 percent of pregnancies. Given how common they are, experts believe that open and honest dialogue about miscarriages can help mothers and partners grieve.

WJCT, Colorectal Cancer Awareness Month — March is Colorectal Cancer Awareness Month. Dr. Brian E. Lacy, Senior Associate Consultant, Gastroenterology, at the Mayo Clinic's Jacksonville campus, joined us to answer questions of who’s at risk for it, and what can be done to prevent it. Segment begins at 29:55 mark.

South Florida Reporter, Which Snacks Can Trick Your Body Into Being Satisfied On Fewer Calories? — Snack time can be a tricky time when you try to satisfy the urge to eat while avoiding a calorie overload. Katherine Zeratsky, a Mayo Clinic dietitian, says there are a few simple ways to trick your body into feeling full quicker and for a longer period of time without consuming extra calories.

AZ Family, The good, the bad and the ugly: The need for Fentanyl by Tess Rafols — You have heard it before, "We are in the middle of a public health crisis." Fentanyl is wreaking havoc across the nation and in Arizona. It is not a new drug as it was created in the 1960s. Since then, it has been used in the medical community as a pain reliever. Dr. Natalie Strand is a pain management expert at the Mayo Clinic in north Phoenix. She wants people to understand that opioids are useful in the right scenarios. “If its prescribed in a controlled setting for the right diagnosis, it can be safe and it can be effective," Strand said. Strand added that fentanyl also helps with acute pain and it is used in certain surgeries and to treat cancer pain.

Arizona Daily Star, Mayo Clinic: How to treat pain with integrative approaches by Dana Sparks — “Integrative medicine typically refers to practices that are not usually offered in conventional care, for example, using yoga as a way to address someone’s pain, in addition to taking a prescription medication," says Dr. Tina Ardon, a Mayo Clinic family medicine physician. "Other names for this include complementary or alternative medicine, but, nowadays, integrative medicine really refers to all those practices that can help.

KJZZ-Radio, Concerns Raised Over Cremation Of Bodies Exposed To Radiation Treatments by Lauren GIlger — There are a number of protocols in place for how to handle radiation treatment for patients when they’re in the hospital, but what happens to their bodies after they die? New research from the Mayo Clinic raised concerns about how the bodies of people who have been treated with radiation are handled at crematoriums. Dr. Kevin Nelson, a doctor in the radiology department at Mayo who coauthored the letter, said they looked at one particular case of a cancer patient who had been treated with radiation and was then cremated after their death. After, they found radiation contamination in the crematorium and tested the crematory operator. The Show spoke with Dr. Nelson about the research.

KTAR-Radio, Arizona lawmakers hope to close insurance gap for telemedicine by Veronica Graff — Virtual doctors visits connecting patients and physicians who are miles apart are increasing, but insurance coverage hasn’t caught up with the move toward telemedicine, Arizona doctors and lawmakers say. A proposed law would expand insurance beyond the sliver of conditions that are covered now… Dr. Bart Demaerschalk, a professor of neurology at the Mayo Clinic in Phoenix, said telemedicine can reduce costs by eliminating emergency air and ground transportation. Doctors can evaluate patients’ situation remotely while paramedics are treating them in their home.

KEYC Mankato, Views On Pink Eye Are Changing — Dr. Jennifer Johnson with Mayo Clinic Health System joined KEYC News 12 This Morning to talk about pink eye. Dr. Johnson explained that pink eye is more commonly viral than once thought.

Fairmont Sentinel, Mayo clinic success: Harvest cafe wows hospital by Judy Bryan — The Harvest Cafe at Mayo Clinic Health System in Fairmont has been reaping a bumper crop of praise. Often referred to as the hospital cafeteria, the cafe has changed its look and its menu, much to the enjoyment of Mayo staff and patients as well as vigilant area residents who have discovered an economical place to dine. “It’s one of our hidden gems,” said Amy Long, Fairmont Mayo administrator.

Caledonia Argus, Pair of Caledonia seniors accepted to first ever Mayo five year track physicians assistant program by Daniel McGonigle — The Caledonia high school graduating class of 2019 will be represented by two of its members in the first ever Physicians Assistant program through the Mayo Clinic.

Albert Lea Tribune, The Baby Place to move to Austin mid- to late-2020 by Sam Wilmes — The Baby Place is now slated to move from Albert Lea to Austin in mid- to late 2020. “We’re closer to a date now than we were,” said Mayo Clinic Health System in Albert Lea and Austin Operations Administrator Tricia Dahl. “We were expecting it to be 2020, but now we’re looking at mid- to late-2020.” The birthing center is expected to be in the current women’s special care unit on the third floor of the Austin hospital and have additional space added to accommodate the renovations. Dahl noted the hospital system aims to start construction in July, but that is contingent on state approval.

Albert Lea Tribune, Naeve Hospital Auxiliary to host ‘Books are Fun’ event — Naeve Hospital Auxiliary in Albert Lea will host a “Books are Fun” sale from 8 a.m. to 5 p.m. Wednesday and Thursday, according to a press release. The event will take place in the lower level rotunda of Mayo Clinic Health System in Albert Lea. According to the release, a variety of books — such as children’s books, cook books and informational books — will be available for purchase. Proceeds support auxiliary projects at Mayo Clinic Health System in Albert Lea. The auxiliary is a group of volunteers who serve Mayo Clinic Health System patients and families in Albert Lea and raises funds for equipment and patient care items.

Winona Daily News, Winona Health, Mayo Clinic Health System to collaborate on referrals — Winona Health announced on Monday a collaborative arrangement with Mayo Clinic Health System to facilitate referrals between the two health systems. Beginning in March, Mayo Clinic Health System in La Crosse will provide a full-time on site referral coordinator for Winona Health. In cases where specialty services cannot be provided by Winona Health, the referral coordinator will facilitate those appointments at Mayo Clinic Health System sites. This is the first such arrangement in the region, and one intended to expand the reach of specialty services to meet the needs of our community and provide personalized support when specialty care is necessary. Additional coverage: WKBT La Crosse

WEAU Eau Claire, Nursing network helps local moms through their breastfeeding journey by Sarah Winkelmann — A new support group in the Chippewa Valley is opening their doors to help moms who are nursing to network with other moms and professionals. Mayo clinic health system has started a new nursing mom’s network that is open to anyone in the community and free to attend. You do not have to be a mayo patient to attend and the sessions are open for moms, dads, siblings and of course their babies. “Breastfeeding is very natural and it's normal but it's not without ups and downs, tears, laughter,” said Melissa Thompson, and RN Lactation Consultant from Mayo Health System.

Eau Claire Leader-Telegram, Sobering reminder by Christena T. O’Brien — On Jan. 21, 2002, Tammy was sweeping up dust from a window project in her basement when she felt lightheaded. Crawling up the stairs, Tammy laid down on the couch. The dizziness didn’t go away, her body began to feel tingly, and her right side went numb. She also got a bad headache. “I knew something was wrong,” said Tammy, whose husband, Jeff, took her to Mayo Clinic Health System’s emergency department, where she immediately threw up…After she underwent several tests, including a CT scan, which didn’t reveal anything, Tammy was sent home. Doctors thought she was suffering from a migraine. Once home, her symptoms — dizziness, numbness on her right side and slurred speech — continued. They later returned to the hospital, and Tammy was admitted. “Stroke never entered my mind on the way to the hospital,” she said. “My mom thought of it instantly, and my husband kind of suspected it,” though.

WKBT La Crosse, Cooking With N8TM: Carrot Cake Overnight Oats by Leah Rivard

Harvard Business Review, How employers are fixing health care by Lisa Woods, Jonathan R. Slotkin and Ruth Coleman — Walmart had traditionally used various insurance carriers to manage its health benefits, but those companies were huge and often had limited ability to innovate and to negotiate on Walmart’s behalf for high-value deals. In 2012, building on its experience with a long-term relationship with the Mayo Clinic for organ transplants, the company set out to develop similar arrangements with other providers for an expanded set of conditions. Early in the discussions its benefits plan leadership zeroed in on the procedures with the greatest opportunity for improvement: common and expensive surgeries (those costing more than $20,000, on average) with high variation in cost and clinical outcomes across providers. Heart and spine surgeries meet those criteria.

MedPage Today, Patient-on-Provider Violence in the Pain Clinic by Judy George — In a special session at the 2019 American Academy of Pain Medicine (AAPM) meeting, David Fishbain, MD, of the University of Miami in Florida, and W. Michael Hooten, MD, of the Mayo Clinic in Rochester, Minnesota, highlighted research about pain patients, health care providers, and potential violence. The impetus for the session was the 2016 murder of northern Indiana physician Todd Graham, MD, by the husband of a chronic pain patient, Fishbain said. Threats against pain clinicians are common, Fishbain added, citing survey data published in Pain Medicine that showed 51.5% of chronic pain care providers have received threats from patients, with 7.1% of those threats involving guns.

MedPage Today, CDC Guideline Harms Pain Patients, Panel Says by Judy George — The CDC's 2016 opioid guideline is being implemented in ways that harm chronic pain patients, a panel of physicians said here. At the 2019 American Academy of Pain Medicine (AAPM) meeting, a consensus panel convened by the AAPM Foundation highlighted problems with how the CDC guideline has been applied, raising concerns that it has been interpreted as a regulation and used to impose rigid dose and duration limits…The CDC guideline also failed to appreciate the importance of involving patients in the decision to taper or discontinue opioids, added panel member W. Michael Hooten, MD, of the Mayo Clinic in Rochester, Minnesota.

MedPage Today, Pain: Yes, There's an App for That by Judy George — Pain-focused mobile and electronic health apps were associated with improvements in pain intensity and emotional functioning in chronic pain patients, albeit small, according to a systematic review and meta-analysis reported here. Pain-focused technology was tied to slight but statistically significant effects on pain intensity and depression over short-term and intermediate-term follow-up periods, reported Rajat Moman, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues in presentations at the 2019 American Academy of Pain Medicine meeting. "With the almost universality of computer and cell phone use, this technology could widely impact patients," Moman told MedPage Today. "We wanted to better understand how these interventions helped patients with chronic pain."

Everyday Health, A Second Patient Appears to Have Been Cured of HIV by Becky Upham — “So far, this is a case of functional cure or functional control, and time will tell how long it’s going to persist,” says Andrew Badley, MD, an infectious disease specialist at Mayo Clinic in Rochester, Minnesota, who was not involved in this research. “Dr. Gupta said it best when he presented these findings at the conference. He’s calling this a ‘remission-free control of HIV,’ which I think is a very appropriate term. The term ‘cure’ is probably a little premature at this point,” says Dr. Badley. “I think this study offers hope in that it shows that such prolonged rebound-free states of remission are possible,” says Badley. There are other cases that have had essentially the same treatment regiments where the person did not achieve a prolonged state of remission, he notes.

TIME, Do Gummy Vitamins Work? Here's What Experts Say by Markham Heid — That whole-foods-first advice applies to all supplements, not just gummies. While many people assume that supplements are a safe and convenient way to get a lot of the good stuff found in food, that’s often not true. “[Supplements] can’t replicate all of the nutrients and benefits of whole foods,” according to the Mayo Clinic. Also, the vast majority of supplements are not tested for safety or efficacy, experts warn.

Bloomberg, Ranking the U.S. States by Gender Equality by Shelly Hagan and Wei Lu — Second to Vermont, Minnesota stood out for high rates of health coverage and low poverty rate. One of Minnesota’s largest employers is the world-renowned Mayo Clinic, an advantage for women, who make up 75 percent of health-care practitioners. Relative to other industries, female workforce participation in the health-care industry is particularly high, according to Iris Bohnet, an economist and professor at the Harvard Kennedy School.

Slate, A Tub of My Own by Shannon Palus — Baths were recommended as treatments for everything from jaundice to fevers to epilepsy, usually in concert with drugs or other lifestyle changes. It’s probably no surprise that even thousands of years later, after modern medicine has found better solves for many of these things, we still regard baths as healthy. Warm baths (specifically, ones with Epsom salts) are a home remedy recommended for the ever-mysterious ritual of “detoxing.” They’re also recommended for muscle pain and (by the Mayo Clinic, no less) for arthritis. But even in cases where baths aren’t doing anything per se, the pomp and circumstance of setting them up, the prescriptive feel of specially preparing for and indulging in the experience, could be enough to at least induce some placebo effect.

Woman’s Day, The 20 Most Ignored Cancer Symptoms in Women and Men — Frequent Headaches: We all get a headache here an there, but if you notice any unusual new patterns of headaches or growth in severity, Mayo Clinic says this could be a sign of a brain tumor.

Thrive Global, Big Ideas: “Clothing that provides patients with privacy and dignity ” with Dr. Bruce Levy, CEO of COVR Medical by Christina D. Warner — As a part of my series about “Big Ideas That Might Change The World In The Next Few Years” I had the pleasure of interviewing Dr. Bruce Levy — Co-Founder and CEO of COVR Medical, LLC. Dr. Bruce Levy is an Orthopedic and Sports Medicine Surgeon at the Mayo Clinic in Rochester MN, one of the top-ranked orthopedic hospitals in the world. He completed his Fellowship at the Minneapolis Sports Medicine Center, his Orthopedic Surgical Residency at the Mayo School of Graduate Medical Education; and his Medical Degree at the University of Montreal. Dr. Levy is a Professor of Orthopedics, a published expert in knee and hip arthroscopy, a member of the Arthroscopy Association of North America, the American Orthopedic Society for Sports Medicine, and the American Board of Orthopedic Surgery.

Wired, Have we reached peak big? by Michael Joyner — Big Data. Big Tech. Big Science. Big Medicine. Big Money Billionaires. Right now, it seems to be all big all the time with more bigness on the way. In fact, it’s arguable we’ve reached the era of “Peak Big”—and people are tired of just how gargantuan everything has become. Consider just a small slice of the ample evidence…Michael J. Joyner, M.D. is a physiologist and anesthesiologist at the Mayo Clinic.

Outside, How Likely Is a Sub-Two Hour Marathon in 2020? by Alex Hutchinson — There are two basic approaches to predicting the athletic future. One is to start with the human body, try to understand how it works, and use that physiological insight to estimate what some future human might be capable of. That’s the approach that Michael Joyner, a Mayo Clinic physiologist, used back in 1991 to forecast that an ultimate marathon time of 1:57:58 might someday be possible.

Becker’s Hospital Review, Top 7 health systems leading transformation, according to 300+ hospital leaders by Jackie Drees — More than 300 hospital leaders designated Rochester, Minn.-based Mayo Clinic as the top thought leader among hospitals in the U.S., according to a Reaction Data report. Reaction Data gathered survey responses from 341 U.S. hospital executives as part of its "Hospital Brand Equity" 2019 report. Participants were asked to determine which organizations among their peers are most innovative, as well as what hospitals they deem top thought leaders.

Becker’s Hospital Review, US News: 'Best Medical Schools 2020' by Alyssa Rege — U.S. News & World Report released its rankings for the best medical schools in the U.S. for research and primary care on March 12. The annual rankings are part of U.S. News' Best Graduate Schools rankings…Here are the top 10 best medical schools for research, including ties:.. Mayo Clinic Alix School of Medicine (Rochester, Minn.). Additional coverage: Advisory Board

Radiology Business, Groups continue push for FDA to remove 'black box' warning from ultrasound contrast agents by Michael Walter — “The unnecessary presence of a black box results in unfounded fears of utilization of these extremely beneficial agents, and patients are thus exposed to potentially more harmful investigative procedures, or worse, have no information due to uninterpretable, or misinterpreted ultrasound studies, resulting in missed or wrong diagnoses,” Sharon L. Mulvagh, MD, professor of medicine emeritus at Mayo Clinic in Rochester, Minnesota, and professor of medicine at Dalhousie University in Halifax, Canada, said in the same statement.

MD Linx, No survival difference between men and women after septal myectomy by Marilynn Larkin — Although women with hypertrophic cardiomyopathy (HCM) are older and sicker than men on presentation, survival after septal myectomy is similar between the sexes, researchers say. Dr. Hartzell Schaff and colleagues at Mayo Clinic in Rochester, MN, studied 2,506 patients who underwent septal myectomy at their institution from 1961 through 2016 to tease out differences between men and women. The women—who accounted for 45% of the cohort—were older at the time of surgery (median age, 59.5 vs 52.9 for men), with a higher rate of New York Heart Association (NYHA) class III or IV status at presentation (90.8% vs 84.8%), and more severe obstructive physiology, as reflected in a higher resting left ventricular outflow tract gradient (67.0 mm Hg vs 50.0 mm Hg). Women also were more likely to have moderate or severe mitral regurgitation (55.2% vs 43.1%) and higher right ventricular systolic pressure (36.0 mm Hg vs 33.0 mm Hg).

WPIX New York, Facts about pancreatic cancer, the third deadliest cancer across the U.S. by Mariya Moseley — "Jeopardy" host Alex Trebek's shocking news about his pancreatic cancer diagnosis has put on spotlight on the deadly disease. As the 78-year-old longtime game show host remains positive amid his stage four battle with pancreatic cancer, health experts believe that's an important trait. Dr. Mark Truty, an Oncologist at Mayo Clinic, said that despite a low survival rate of nine percent, "patients with a better attitude during therapy tend to do better." Dr. Truty told PIX11 that early detection is key to fighting the deadly disease. However, it can be hard to catch early with vague symptoms such as stomach pain, fatigue and nausea.

Bend Bulletin, How to create a heart-healthy sandwich — Packing a healthy lunch seems like an easy task, but sometimes all the sandwich choices may seem daunting. Many deli, or processed meats, are packed with preservatives, nitrates and sodium that could raise your risk of heart disease and other health issues. So is there a better choice to build a lunch you’ll love and feel good about?  Katherine Zeratsky, a Mayo Clinic registered dietitian nutritionist, says what you pack with your lunch may help balance what you pack in your sandwich.

Medscape, America's Opioid Epidemic: Hardest Hit States Identified by Fran Lowry — As the US opioid epidemic rages on, new research shows some states have been hit much harder than others. Using a large, government-funded database, investigators found that the nation's capital and the state of Massachusetts had the highest rates of inpatient and emergency department (ED) use for opioid-related causes in 2015, while Iowa had the lowest rates. Arizona had the greatest increase in inpatient admissions from 2005 to 2015, whereas hospital admissions in Maryland declined. "We wanted to determine if the opioid crisis was uniform throughout the entire country as a whole, or if there were any state-to-state differences," lead author Sahil Gupta, MD, Mayo Clinic, Jacksonville, Florida, told Medscape Medical News. "The hope is that by honing in on why some states are more vulnerable than others, experts will be able to find better ways to cope with the crisis," Gupta said.

Healio, Genomic alterations in prostate cancer could help define disease risk — Chromosomal alterations could potentially identify men with low-risk prostate cancer detected by needle biopsy who have higher-risk disease in their prostate glands, according to results of a study published in Mayo Clinic Proceedings. “We have discovered new molecular markers that can help guide men in their decisions about the course of their prostate cancer care,” George Vasmatzis, PhD, co-director of the Center for Individualized Medicine Biomarker Discovery Program at Mayo Clinic in Rochester, Minnesota, said in a press release. “Overtreatment has been [an] issue for the group of men that our study targets. We found that the presence of genetic alterations in low-risk cancer can help men decide whether treatment or active surveillance is right for them.”

Atlanta Journal-Constitution, Why nurses should ask for mental health days and what to do with them by Shari Perkins — For nurses who find themselves in need of a break, mental health days can be the perfect way to step back and regroup…The Mayo Clinic defines job burnout as "a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of identity." In practice, though, job burnout can be seen in many different forms.

CBC, Tuberculosis rate among Inuit is 290 times higher than for non-Indigenous people in Canada. Here's why by Stephanie Hogan — Tuberculosis, or TB, is a highly infectious and contagious disease caused by a germ called Mycobacterium tuberculosis that mainly affects the lungs. According to the Mayo Clinic, symptoms include: Coughing for more than three weeks. Coughing up blood. Chest pain with breathing or coughing. Weight loss. Fatigue. Fever. Night sweats. Chills…It can also affect the kidneys, spine and brain.

ASCO Post, Reshaping the Treatment Landscape in Refractory Multiple Myeloma by Shaji K. Kumar, M.D. — Given the chronic nature of multiple myeloma today, patients continue to require repeated lines of therapy to maintain adequate disease control over long periods. As a result, the sequence of use of the different available therapies has taken on more significance. The uniform adoption of proteasome inhibitors and immunomodulatory drugs in the setting of newly diagnosed disease and the increasing use of continuous therapy in the initial treatment setting have a major impact on the therapeutic choices at the time of relapse.6 In particular, lenalidomide along with a proteasome inhibitor forms the backbone of initial treatment in older, frailer patients and is used for maintenance after autologous stem cell transplant in transplant-eligible patients, as well as the rest of patients after triplet induction. As a result, increasingly, patients are refractory to lenalidomide at the time of initial relapse. — Dr. Kumar is Professor of Medicine, Mayo Clinic, Rochester, Minnesota.

Cancer Network, Evidence on Nicotinamide for High-Risk Non-Melanoma Skin Cancers by Naveed Saleh — Nicotinamide offers various photoprotective and anti-inflammatory effects, and phase III evidence now supports its ability to reduce non-melanoma skin cancers and actinic keratoses in high-risk patients, according to a recent review article published in the journal Experimental Dermatology. “Theoretically, nicotinamide may be able to protect against UV-induced immune suppression and possibly skin cancer development. However, the jury may still be out,” said Jerry D. Brewer, MD, MS, a professor of dermatology at the Mayo Clinic in Rochester, Minnesota, in an interview with Cancer Network.

Cancer Network, Study Compares Impact of Two Therapies on Survival in Squamous Cell Carcinoma by Naveed Saleh — Survival rates in patients with cutaneous squamous cell carcinoma were similar in those receiving high-dose chemoradiotherapy vs conventional radical surgery, according to the results of a recent study published in the British Journal of Dermatology. “Although the authors suggest CRT [chemoradiotherapy] offers similar long-term survival, surgery is still the treatment of choice with adjuvant measures, which includes radiation and/or chemotherapy,” noted Jerry D. Brewer, MD, MS, a professor of dermatology at the Mayo Clinic in Rochester, Minnesota, in an interview with Cancer Network.

Savannah Morning News, Komen Coastal Georgia awards $259K for Savannah community services — This year, the Coastal Georgia Affiliate of Susan G. Komen awarded five grants to programs in the area. These include: St. Joseph’s/Candler Health System; Southeast Georgia Health System’s Mammograms in Motion; Coastal Health District; Diversity Health Center; Hearts and Hands Clinic; and Curtis V. Cooper. Joining the announcement was guest speaker Dr. Keith Knutson, a Komen scholar and professor of immunology at the Mayo Clinic who is researching a potential vaccine for breast cancer. Knutson spoke about his research at a free public event Tuesday evening at Georgia Southern University’s Armstrong Campus. Additional coverage: Savannah Tribune

Bustle, How Having Just 2 Alcoholic Drinks Affects Your Sleep, According To Science by JR Thorpe — Two drinks per day goes over the 'moderate' threshold for alcohol consumption for women, according to the Mayo Clinic; one drink is 12 fluid ounces of beer, 5 fluid ounces of wine or 1.5 fluid ounces of a distilled spirit like whiskey. Very Well Health has noted that when we drink, our bodies require time to metabolize the alcohol, and on average it takes around one hour for each serving to be processed by the body. Two drinks will take two hours to process, and that processing time — and its consequences — can have some pretty remarkable effects on your slumber. If you don't know why you're waking up feeling groggy after two drinks, here's the science behind it.

Romper, Savannah Guthrie Says This Is How She Entertains Her Kids Without Screens by Christina Montoya Fiedler — Guthrie is the author of her own children's book, Princesses Wear Pants, and it happens to be available of Amazon's Audible for $10 or free with subscription. The recommended amount of screen time for kids aged 2 through 5, is just one hour or less a day, according to Dr. Angela Mattke, a Mayo Clinic pediatrician who spoke with Mayo Clinic News Network.

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Editors: Emily BlahnikKarl Oestreich

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