Mayo Clinic Health Matters

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Treating birth defects before a baby is born Sep 10, 2021

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Birth defects affect 1 in every 33 babies born in the U.S. each year, according to the Centers for Disease Control and Prevention. Before a baby is born, early intervention using fetal surgery can treat life-threatening birth defects and improve outcomes in some cases.

Fetal surgeons at Mayo Clinic Children's Center treat many conditions, including:

Spina bifida (myelomeningocele).
Twin anemia-polycythemia sequence (TAPS).
Twin reversed arterial perfusion (TRAP) sequence.
Twin-twin transfusion syndrome (TTTS).
Lower urinary tract obstruction (LUTO).

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, is joined by Dr. Mauro Schenone, a Mayo Clinic maternal fetal surgeon, to discuss advances in technology and treatments. Dr. Schenone is also the director of the Fetal Diagnostic and Intervention Center at Mayo Clinic in Rochester, Minnesota, and chair of the Division of Maternal Fetal Medicine.

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Cancer is the leading disease-related cause of death in children Sep 09, 2021

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One in every 266 children and adolescents will be diagnosed with cancer by age 20, according to the American Cancer Society.

Sarcoma — the term for a group of cancers that begin in the bones and in the soft or connective tissues — is one of the more common types of childhood cancer.

Fortunately, recent treatment advances have increased survival rates. Of children diagnosed with cancer, 84% now survive five years or more. One of the advances in treatment has been improvement in radiation therapy techniques and the use of proton beam therapy for treating pediatric cancers.

"Radiation therapy works very well for sarcomas," says Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. "And the difference between conventional radiation and proton therapy radiation is that our radiation oncologists are able to contour a little bit tighter with proton therapy. Therefore, the surrounding tissue that is normal is spared from some of the side effects. This is really important in children who are growing because we want them to be able to grow normally."

In addition to sparing healthy tissue from the effects of radiation, people who must undergo radiation therapy early in life are less likely to have long-term side effects and complications, such as secondary cancers, with proton beam therapy than with conventional radiation therapy.

September is Childhood Cancer Awareness Month. On the Mayo Clinic Q&A podcast, Dr. Allen-Rhoades discusses pediatric sarcomas and the importance of funding for research and support of families dealing with pediatric cancer.

Watch: Dr. Allen-Rhoades disscuss pediatric cancer.

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Onco-regeneration — Restoring function after a soft tissue cancer diagnosis Sep 08, 2021

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Soft tissue sarcoma is a rare form of cancer that has typically been treated using limb salvage surgery combined with radiation therapy. While limb salvage surgery helps patients avoid amputation, patients are often left with substantial functional limitations.

Now advancements in microsurgery are making it possible to harness the body's ability to regenerate muscle strength after surgery to remove soft tissue sarcoma. Mayo Clinic orthopedic oncologists are teaming up with plastic surgeons in a procedure they've coined "onco-regeneration", with a goal of improving a patient’s function and quality of life after surgery.

"Advancements are changing the way we approach patients," says Dr. Matthew Houdek, a Mayo Clinic orthopedic surgeon. "And a big part is the teamwork required to take care of these patients."

Orthopedic surgeons partner with plastic surgeons to deconstruct and reconstruct the tumor location. That includes removing and replacing muscles, nerves and the lymphatic system.

"Advancements in microsurgery techniques have made what we can repair and what we can restore much better," says Dr. Steven Moran, a Mayo Clinic plastic surgeon. "The latest technology now allows us to tension and insert the muscle directly back into the bone. That has been very favorable to restoring function, and it helps us get these patients back to doing what they want to do."

On the Mayo Clinic Q&A podcast, Drs. Houdek and Moran discuss advances in treating soft tissue sarcoma.

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Breathing easier with COPD Sep 03, 2021

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Chronic obstructive pulmonary disease, or COPD, is the third leading cause of death worldwide according to the World Health Organization. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.

The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking or heating in poorly ventilated homes. People with COPD are at increased risk of other diseases too, such as heart disease, lung cancer and a variety of other conditions. Although COPD is a progressive disease, it is also treatable.

"If you catch it at an early phase, treatment may consist of helping the patient to stop smoking or taking the patient away from the polluted environment that may be contributing to the disease," says Dr. John Costello, a consultant pulmonologist at Mayo Clinic Healthcare in London. "For those with more advanced disease, long term rehabilitation programs have been very successful in centers that specialize in pulmonary disease."

As a part of rehabilitation, treatment for advanced COPD can include the use of medications, inhalers and oxygen therapy.

On the Mayo Clinic Q&A podcast, Dr. Costello discusses how COPD is diagnosed and the treatment options for COPD.

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COVID-19 modeling shows 100,000 people in the U.S. could die over the next 3 months Sep 01, 2021

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U.S. hospitalizations for patients with COVID-19 have risen almost 500% over the past two months, according to news reports. Also, the number of ICU beds in the South is dwindling.

"We have over 101,000 Americans in the hospital with COVID-19," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Many of them fighting for their lives in ICUs and on ventilators. We are having over 160,000 new cases and just below 1,000 deaths reported each day."

Dr. Poland says the people who have been vaccinated for COVID-19 have substantially protected themselves, including against the delta variant.

"But for those who are unvaccinated, there is a grave concern," says Dr. Poland. "In fact, if you look at the latest model, in the next three months, it suggests that another 100,000 Americans are likely to die of COVID."

Dr. Poland also responds to concerns that some people are choosing to take an animal medication called ivermectin.

"If I said to you, 'Instead of an FDA-approved vaccine that's been tested in hundreds of thousands of people, let's take a drug that's used to treat parasites — that hasn't been studied, which makes people sick, can cause hallucinations and coma, and can cause birth defects — what would you say?'" asks Dr. Poland.

In this Mayo Clinic Q&A podcast, Dr. Poland talks about waning antibody levels, COVID-19 vaccine boosters, teenagers needing to be vaccinated, and the sharp increase in COVID-19 cases and hospitalizations for young people. He also answers several listener questions.

Research disclosures for Dr. Gregory Poland.

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Pancreas transplant can be a cure for diabetes Aug 30, 2021

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Many advances have been made in diabetes treatments over the past decade. Diabetes is a lifelong chronic disease with the potential for significant complications. Despite the advances, many people with diabetes struggle with the disease.

"Diabetes is an abnormality in consuming or metabolizing blood glucose," says Dr. Tambi Jarmi, a Mayo Clinic nephrologist. "So diabetic patients have a hard time adjusting their blood sugar to the level that their cells needed. It could be a result of a deficiency in the production of the insulin that comes from the pancreas or it could be a result of resistance to that insulin."

To restore normal insulin production and improve blood sugar control, a pancreas transplant may be an option.

Most pancreas transplants are performed to treat Type 1 diabetes. A pancreas transplant can potentially cure this condition. But such a transplant is typically reserved for those with serious complications of diabetes because side effects can be significant.

In some cases, a pancreas transplant also can treat Type 2 diabetes. A pancreas transplant is often done in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.

"The idea of a pancreas transplant is to actually cure the diabetes," says Dr. Jarmi. "While treatment with a mechanical pump does a great job, it is not a cure. An organic pump, meaning a pancreas transplant, does cure diabetes."

On the Mayo Clinic Q&A podcast, Dr. Jarmi discusses pancreas transplant as a cure for diabetes.

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Running injuries in youth athletes Aug 27, 2021

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Running is a great way for kids to get active and participate in sports. Cross country and track are two of the most popular sports in middle school and high school.

But injuries in young runners are common, often are caused by improper technique or lack of strength and conditioning training. Another cause of injury is increasing mileage too quickly.

Common injuries include patellar tendonitis, Osgood-Schlatter disease, illiotibial band syndrome, and shin splints.

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, discusses injury prevention in young runners with Dr. David Soma, a Mayo Clinic sports medicine specialist and pediatrician; Dr. Luke Radel, a Mayo Clinic pediatrician; and Dr. Stephanie J. Lopez, a Mayo Clinic sports physical therapist.

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COVID-19 taking toll beyond patients Aug 25, 2021

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The Pfizer COVID-19 vaccine has received full approval from the Food and Drug Administration (FDA), as have booster doses of COVID-19 vaccines. These are welcome developments as the COVID-19 delta variant wave continues to rip through many U.S. communities, exhausting and wearing people down.

"I cannot tell you the emotional toll this has taken on us as physicians, nurses, respiratory therapists, and many, many others," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.

"One of my colleagues said, 'I walk around now and can see people with comorbidities, not wearing a mask, and I can tell you what size tracheal tube they're going to need.' We don't normally think like that, but it's illustrative of the steady 18-month drumbeat of seeing people sick and dying of something we can prevent," says Dr. Poland.

In this Mayo Clinic Q&A, Dr. Poland talks more about FDA approvals for COVID-19 vaccines, goes into detail about the COVID-19 virus replication rate and he answering a listener question about the reliability of home COVID-19 tests. Dr. Poland also explains and speaks to the importance of "cocooning" for protection, especially with newborns and toddlers.

Research disclosures for Dr. Gregory Poland.

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Expanding the donor pool – hepatitis C no longer a barrier to transplant Aug 23, 2021

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With a goal of shortening the wait time for a solid organ transplant, Mayo Clinic is leading efforts to expand the donor pool by making more organs suitable for transplantation.

Organs from deceased donors are screened thoroughly, and donated organs that tested positive for hepatitis C were previously discarded. But research at Mayo Clinic has changed that.

A recent Mayo Clinic study found that livers from donors exposed to hepatitis C can be safely used for transplant, thanks to improved treatments for hepatitis C infection. New antiviral drugs are so effective that recipients are protected from the infection.

Now, Mayo Clinic Transplant Center has expanded the protocol to use in other organ transplants.

"We were able to expand to kidney transplant, heart transplant and lung transplant within the past few years, and we have been able to do close to 150 kidney transplants, and 25 heart and lung transplants, using organs from donors with hepatitis C," explains Dr. Bashar Aqel, medical director of the Liver Transplant Program at Mayo Clinic in Arizona. "We had in place a treatment protocol and we treat them for hepatitis C immediately after transplant. Treatment was well tolerated, and everybody was cured from the infection. So more than 200 lives saved with organ transplant from donors with hepatitis C, and everybody has achieved the outcome that we are looking for."

On the Mayo Clinic Q&A podcast, Dr. Aqel discusses progress in expanding the donor pool for lifesaving solid organ transplants.

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Back to school: reading, writing and pandemic Aug 20, 2021

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COVID-19 and especially the spread of the delta variant have created a whole new set of challenges this year. And now, children across the US are returning to school during this same time, creating many questions for families.

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, is joined by two experts in pediatric infectious disease to discuss the important precautions families can take to keep their kids safe and in school. Also on the program, tips from an elementary school principal to help your child prepare for the school year.

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