Mayo Clinic Health Matters

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What parents should know about the new hepatitis outbreak in children May 05, 2022

Show notes

At least 16 countries and 10 U.S. states have identified unusual hepatitis cases in children. Experts advise that cases are extremely rare, with about 200 children affected worldwide.

Hepatitis is inflammation of the liver. It is most commonly caused by a viral infection, although there are other potential causes. A common adenovirus is being investigated as a potential cause for this hepatitis outbreak. Adenoviruses are a group of viruses that typically cause respiratory and GI tract infections.

On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke discusses the recent hepatitis outbreak in children with Mayo Clinic Children’s Center experts Dr. Nipunie Rajapakse, a pediatric infectious diseases expert, and Dr. Sara Hassan, a pediatric transplant hepatologist and gastroenterologist.

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Ask the Mayo Mom: How and why endoscopy is used in children May 03, 2022

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Endoscopy is a nonsurgical procedure used to visually examine the digestive system with a tiny camera on the end of a long, flexible tube. An upper endoscopy examines the stomach, esophagus and small intestines. A colonoscopy, which is another type of endoscopy, is used to examine the rectum, large intestine and colon.

In children, endoscopy can be used to look for causes of unexplained abdominal pain, to diagnose swallowing disorders or to identify conditions including Crohn's disease, ulcerative colitis and polyps.

Undergoing any type of procedure can be stressful for kids, parents or caregivers. Dr. Pua Hopson, a pediatric gastroenterologist at Mayo Clinic Children’s Center, explains endoscopy is a relatively quick and painless procedure.

"An upper endoscopy typically takes 10 minutes, while colonoscopy may take 30 minutes," says Dr. Hopson. "I tell the kids it takes longer to put them to sleep with anesthesia or sedation than the actual procedure. And once you wake up, your parents will be right by your side."

One condition Dr. Hopson commonly treats in children is eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), known as EoE. This is a chronic immune system disease in which a type of white blood cell (eosinophil) builds up in the lining of the esophagus. This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow. EoE is diagnosed through biopsy using an upper endoscopy.

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Hopson to discuss how and why endoscopy is used in children.

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COVID-19 news update Apr 29, 2022

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An estimated 3 out of 4 U.S. children and more than half of all adults have been infected with COVID-19, according to a report released on Tuesday, April 26 by the Centers for Disease Control and Prevention. But a Mayo Clinic expert says more information is needed to get the complete picture.

"This was a convenient sample. In other words, people who were having blood drawn for other reasons were tested,"explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That does not reflect the full population or differences by race or geographic location. And the detection of antibodies does not necessarily mean that you are protected from infection. So, there's a lot of nuance around understanding that headline."

The research study looked at more than 200,000 blood samples and found that signs of past infection rose dramatically during the omicron surge between December 2021 and February.

Other COVID-19 news this week includes a push to make treatments more available, the rising incidence of new omicron subvariants, and changes in mask recommendations. Dr. Poland cautions that COVID-19 is still present and encourages wearing a mask in crowded spaces, even when there isn't a requirement to do so.

"If only one of us is wearing a mask and the other one isn't and is infected, you still have pretty high protection — but not the same level of protection as if both of us wearing one," says Dr. Poland. "So, it's it is not futile to be the only one wearing a mask. In fact, I think it sends a message."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and answers listener questions.

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Advances in oral cancer treatment, reconstruction Apr 26, 2022

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Oral cancer refers to cancers that originate in the mouth, tongue and back of the throat. Treatment options, which can vary based on the cancer's location and stage, include surgery, radiation and chemotherapy. The use of anatomic modeling and 3D printing have led to advances in surgical treatments for oral cancer.

"One of the advances that we've seen in the last 20 or 30 years in the treatment of head and neck cancers certainly has to do with the reconstruction," says Dr. Kevin Arce, an oral and maxillofacial surgeon at Mayo Clinic. "Often, we have to remove not only the cancer, but also the surrounding tissue that is normal. And to replace that can be quite challenging. We now have better abilities to reconstruct the structures that have been lost."

Dr. Arce explains advances in the treatment of head and neck cancers now allow surgeons to bring in tissues from different areas of the body and reconstruct a tongue or rebuild a jaw. And the anatomical lab and 3D printing allow surgeons to perform patient-specific reconstruction that helps maintain function.

"With these advancements, patients can obviously not only look the same, but speak and eat as they did prior to the surgery," says Dr. Arce. "At Mayo Clinic, we can do that all in house. We have a group of neuroradiologists and biomedical engineers who are a part of the institution, and we collaborate with them in these types of reconstructions."

Early detection of oral cancer can lead to better treatment options and outcomes.

April is Oral Cancer Awareness Month, aimed at reminding the public about the steps to take to reduce your risk of developing oral cancer. The two main risk factors are tobacco and alcohol use.

"Awareness of oral cancer is important," says Dr. Arce. "It's important to maintain that relationship with either your dentist or your primary care physician so they do at least an annual screen of the oral cavity to make sure that there is nothing unusual or a lesion that needs more attention."

On the Mayo Clinic Q&A podcast, Dr. Arce discusses oral cancer treatment and prevention.

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People, partnerships drive innovation in patient care Apr 22, 2022

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The Department of Medicine, which is the largest department at Mayo Clinic, is helping lead the transformation of health care. Important innovations include moving to digital and virtual care to meet patients where they are, and addressing health equity, all while keeping patients front and center.

"Patients are our North Star," says Dr. Vijay Shah, chair of the Department of Medicine at Mayo Clinic. "We're all about patients all day, every day. So, all of our strategies cascade out of that."

Dr. Shah explains those strategies include practice innovations, digital transformation and internal and external partnerships. Internal partnerships include working alongside the Mayo Clinic Cancer Center, the Center for Digital Health, Mayo Clinic Platformand others focused on improving patient care and developing cures.

These partnerships are leading to innovations in teleheath and at-home care models, as well as new ways to use health data to improve treatments.

And at the core of it all?

"The most important pillar is our people and our culture," explains Dr. Shah. "Because our people are our greatest asset, and we're nowhere without them."

On the Mayo Clinic Q&A podcast, Dr. Shah and Natalie Caine, associate administrator, discuss the innovations happening in the Department of Medicine at Mayo Clinic.

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Patient navigators help guide the cancer journey Apr 19, 2022

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A cancer diagnosis can be overwhelming, and patients often have many questions about what their cancer journey will entail. At Mayo Clinic Cancer Center, patient navigators help guide patients through the health care system.

Patient navigators are active members of the health care team, assessing and addressing a patient's immediate needs and identifying obstacles that might prevent them from getting the care they need. Patient navigators help patients and their families access cancer information, find resources to meet day-to-day needs, and offer emotional support.

"Our role as patient navigators is to support with a lot of the nonclinical sides of their cancer journey, whether that's logistics, transportation or issues with lodging when they're coming to a Mayo Clinic site for care," explains Laura Kurland, a Mayo Clinic Cancer Center patient navigator. "Oftentimes, we're helping them understand the finances, whether that's insurance, or other things that are going to be coming up that are going to be financial stressors for them as they're going through their cancer care. And certainly, we're there to lend an ear and offer support as they're learning how to truly navigate the medical system."

The Mayo Clinic Cancer Center has both general patient navigators who assist all patients and patient navigators who serve specific cultural patient populations. Mayo Clinic currently has navigators on staff serving these communities: Hispanic/Latino, American Indian/Alaskan Native and African descent.

Kurland serves the Hispanic/Latino population and explains the important role the culture-specific patient navigators play.

"The patient populations that we work with come with different experiences," says Kurland."So our goal is to understand the values they bring and support them with what their needs are. Whether there are language barriers, or there are just gaps in cultural misunderstandings, our role is to help bridge those gaps, clarify misunderstandings and also be advocates to those populations."

On the Mayo Clinic Q&A podcast, Kurland discusses the importance of patient navigators, why culture-specific navigators are needed, and how she helps patients access the care and support they need.

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Ask the Mayo Mom: Climate change and global childhood health Apr 15, 2022

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From allergies and asthma to infectious diseases and even malnutrition, the indirect effects of climate change are taking a toll on our most valuable resource, kids!

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Dr. Molly Herr, a pediatric anesthesiologist at Mayo Clinic Children’s Center to discuss climate change and its effects on children's health.

In addition to her clinical care for children, Dr. Herr has been an advocate and leader in Mayo Clinic’s Green initiatives. She has also been involved with creating sustainable practices at Mayo Clinic and medical student education related to these topics.

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Understanding the connection between diabetes and heart disease Apr 12, 2022

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The World Health Organization reports that the number of people with diabetes has risen from 108 million in 1980 to 422 million by 2014. And that number is estimated to reach 552 million by 2030.

One big concern for people with diabetes is the connection between diabetes and cardiovascular disease. People with diabetes are more likely to develop heart disease and are at higher risk of premature death.

"In people with diabetes, the risk of death due to heart diseases is approximately four or five times higher than in general population," explains Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And this, obviously, is a major concern. There is now a strong research and scientific evidence about this link and association between cardiovascular disease and metabolic diseases, especially diabetes."

So what can be done to help patients?

Dr. Wamil explains that research has shown positive lifestyle changes such as quitting smoking, losing weight, exercising more, developing a healthy diet and controlling blood pressure, can all contribute to better heart health.

"We try to develop personalized management plans, we listen to our patients and try to understand what are the steps that they can take to improve their quality of life and to improve their future life and their health, " says Dr. Wamil.

On the Mayo Clinic Q&A podcast, Dr. Wamil discusses the diabetes and heart disease connection.

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Ted Garding is a rare two-time living organ donor Apr 08, 2022

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Fifty-seven-year-old Ted Garding is Mayo Clinic’s first altruistic living liver donor. The living liver donation program allows a healthy person to donate a portion of his or her liver, which then regenerates over time. What makes Ted’s story even better? He's a two-time altruistic organ donor, having previously donated a kidney back in 2010. An altruistic, or nondirected living donor, is a person who donates an organ, usually a kidney, and does not name or have an intended recipient.

"We were taught to help people in need, and we were blessed with good health in our family," says Ted. "And I am well aware that there are a lot of people that aren't as fortunate. Being kind to people and helping people in need has always been the most important thing to me."

When Ted heard about living liver donation, he applied at Mayo Clinic, but expected he might get denied because he has one kidney and is in his 50s. But Ted was accepted, and in October 2021, the transplant happened in Rochester, Minnesota. The recipient reached out a few days later to thank him and told Ted he was her "guardian angel."

"My own personal experience as a double living organ donor, personally, it's changed my life for the better," says Ted. "When you help someone in need, you're naturally going to feel better. I feel as though I've been blessed and that I am the one who received a gift."

April is National Donate Life Month to raise awareness of the need for organ donors. In honor of Donate Life Month, Ted joins the Mayo Clinic Q&A podcast to share his story.

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Meeting the unique needs of adolescent and young adult patients with cancer Apr 05, 2022

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While some adolescent and young adult (AYA) patients with cancer receive care in pediatrics, the majority are cared for in adult cancer systems. One of the challenges is that people in the AYA group don't fit well with either patient population.

"If you think about the kinds of things that people in this age group are going through, there's a lot of life transition happening there," explains Dr. Allison Rosenthal, a Mayo Clinic hematologist and oncologist. "So this group really has a lot of unique needs as far as psychosocial development."

AYA patients are 15-39. They may be students in high school or college, may be living on their own, and often are caught between losing coverage under parental health insurance and finding their own. Another common issue is the desire to start a family as fertility can be impacted by cancer and its treatment, which makes conversations about fertility preservation very important.

"There's never a convenient time to be diagnosed with cancer, but particularly inconvenient in this group," says Dr. Rosenthal. "And they often get overlooked because I think people just don't recognize that cancer is really common in this age population as well."

Dr. Rosenthal is leading an effort at Mayo Clinic Cancer Center to change that. The adolescent and young adult cancer center program aims to help AYA patients receive access to age-appropriate care and support. This multidisciplinary approach will include not only cancer specialists but also social workers, health psychologists, and financial and vocational counselors. Another important piece is helping AYA patients transition from pediatric to adult care and plan for cancer survivorship.

"One of the most important things is having survivorship care that focuses on the needs of these patients as they move forward," says Dr. Rosenthal. "We're really fortunate that the majority of young adult patients who get cancer care are going to do well. Thankfully, there are going to be a lot of long-term survivors."

April 4-10 is Adolescent and Young Adult Cancer Awareness Week. On the Mayo Clinic Q&A podcast, Dr. Rosenthal discusses the needs of AYA patients with cancer.

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