Pulse on Health by Jeff Hansel

Mayo Clinic discoveries

Here's a list of innovations Mayo Clinic claims during the past 100 years:

• Nobel Prize for the discovery of cortisone

• The first open-heart surgery with bypass machine

• First FDA approved total hip replacement

• First successful treatment for tuberculosis

• One-hour anthrax test

• Insulin therapy for Type 1 diabetes

• First CT scanner in North America

• Surgical repair for disabling wrist pain

• Separation of conjoined twins

• Virtual colonoscopy (The "learn more" link in the attached article is no longer in service.)

• Breakthroughs in imaging technology 

(Source:  Inside Mayo Clinic, Winter 2008)

It's interesting Mayo only claims the first CT scanner in North America because it's clear Mayo had the first non-prototype machine in the world.  The machine actually still exists .  To see it, stop at the radiology administrative offices on the second floor of the Mayo Building, 200 First St. S.W. in Rochester during normal business hours.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615      

Yogurt relief

Here's a potentially delicate topic: Probiotic yogurt. 

Dr. Michael Picco of Mayo Clinic's Jacksonville, Florida campus says on mayoclinic.com that probiotics are dietary supplements or foods with beneficial bacteria.

If you're having a problem with regularity, it might be worth a try to check out yogurt with a label of "probiotic."  

I did.  And I never knew — ahem — that things could go so smoothly.

Picco says "encouraging evidence"  suggests probiotics might help against conditions like diarrhea, vaginal yeast infections and irritable bowel syndrome.

Have you tried it?  Does it work?  Or is it placebo effect?

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615         

Norovirus continues

Calls continue to come in at Olmsted County Public Health about norovirus, a highly contagious illness that causes vomiting and diarrhea. If you go to an office party and face a buffet with grab-your-own-finger-food, or even if you find a tray of cookies sitting out at a church function, think twice before you partake.

Make sure whoever made the food, and all the people who've touched it since, washed their hands really well beforehand.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615         

      

About to start tamoxifen?

Mayo Clinic researchers say that postmenopausal women who are about to start tamoxifen therapy should get a CYP2D6 gene test. 

Women with an inherited deficiency in the gene "which is important for the metabolism of tamoxifen, have a nearly fourfold higher risk of early breast cancer recurrence compared to women who have not inherited the deficiency." 

    

Here's the Mayo statement:

Mayo Clinic Research on Tamoxifen Leads to Recommendation for CYP2D6 Gene Test
Saturday, December 13, 2008
SAN ANTONIO — Findings from a new study have prompted Mayo Clinic researchers to recommend CYP2D6 gene testing for postmenopausal women about to begin tamoxifen therapy. This data confirms that women with an inherited deficiency in the CYP2D6 gene, which is important for the metabolism of tamoxifen, have a nearly fourfold higher risk of early breast cancer recurrence compared to women who have not inherited the deficiency. The research findings, announced jointly by investigators from Mayo Clinic and the Austrian Breast and Colorectal Cancer Study Group (ABCSG) confirmed results from a previous study conducted by Mayo Clinic.
The latest findings will be presented today at the Cancer Therapy & Research Center-American Association for Cancer Research (CTRC-AACR) 31st annual San Antonio Breast Cancer Symposium.
Tamoxifen, approved by the Food and Drug Administration (FDA) to both prevent development of estrogen-receptor-positive (ER+) breast cancer and as a therapy to stop ER+ breast cancer from coming back, is a "pro-drug"; it must be metabolized in the liver to become active. Mayo researchers had previously discovered that the drug is less effective in postmenopausal breast cancer patients who had a deficiency in the CYP2D6 gene, which is key for activating tamoxifen and many other drugs. However, until now, testing for the gene has not been done routinely at most medical centers.
"These new results validate our earlier findings," says the study's lead investigator, Matthew Goetz, M.D., an assistant professor of oncology and pharmacology at Mayo Clinic, "and strongly suggest that going forward, postmenopausal patients being considered for tamoxifen therapy should be tested for CYP2D6 before beginning therapy."
The research teams examined DNA from a subset of postmenopausal women treated in the ABCSG-8 study, which previously randomized nearly 3,900 women whose ER+ breast cancer had been surgically treated. One group was randomized to five years of tamoxifen therapy, and the other randomized to tamoxifen for two years followed by three years of anastrozole, an aromatase inhibitor. The initial results of ABCSG-8, reported in 2005, concluded that women who switched to anastrozole had a 40 percent reduced risk of breast cancer recurrence compared to staying on tamoxifen.
The aim of the new study was to determine whether CYP2D6 genetic variation would identify a subgroup of patients at higher risk of recurrence within the context of the ABCSG-8 trial. "Among the patients randomized to tamoxifen, poor metabolizers had a 3.8-fold increase in risk of developing breast cancer recurrence than extensive metabolizers across the five-year span," said Michael Gnant, M.D., professor of Surgery at the Medical University of Vienna, Austria, and president of ABCSG. "That is the key message coming out of this great collaboration between the Mayo Clinic team and the Austrian Breast and Colorectal Cancer Study Group."
However, the researchers also demonstrated that among patients who switched to anastrozole, there was no increased risk of breast cancer recurrence for CYP2D6 poor metabolizers in years three to five. The benefit of switching to anastrozole, says Dr. Goetz, may be most pronounced in the group of patients with deficient CYP2D6 metabolism. "Poor metabolizers who were fortunate to not develop breast cancer recurrence in the first two years of tamoxifen appear to be rescued by anastrozole," he says.
The findings reported by Mayo and ABCSG highlight the emerging science of pharmacogenomics. Researchers in this field are studying whether genetic differences in how patients metabolize or process drugs can be used to individualize therapy.
Additionally, in collaboration with bioTheranostics (a molecular diagnostics testing firm), the researchers examined whether a tumor-based test, HOXB13: IL17BR gene expression ratio, and a 5-gene molecular grade index were prognostic markers of distant breast cancer recurrence. Dr. Goetz and his colleagues confirmed that high expression of both HOXB13:IL17BR and molecular grade index, found in 25 percent of the tumors, led to a nearly threefold higher risk of recurrence elsewhere in the body compared to patients whose tumors were considered to be low risk according to these gene markers.
These findings suggest that the combined index will identify patients with early stage breast cancer who have a higher risk of distant metastases when treated only with hormonal therapy, the researchers say.
This research was funded by R01 CA133049-01 (Goetz) Austrian Breast and Colorectal Study Group, bioTheranostics, Mayo Clinic Cancer Center, Mayo Clinic Breast Cancer SPORE (CA116201), and the Commonwealth Cancer Research Foundation.
Mayo Clinic has a potential financial interest in technology related to this research. Dr. Matthew Goetz, Dr. James Ingle, Dr. Matthew Ames and Mayo Clinic have a potential financial interest in two technologies, CYP2D6 and the combined HOXB13/IL17BR and CYP2D6, studied in this research and may stand to gain financially from the successful outcome of this research.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615         

  

Eating a plant-based diet

As part of my job, I've been to so many presentations during which a dietitian, physician or nurse says "eat a plant based diet" to stay healthy that I finally decided last summer to eat more fruits and vegetables.

I don't have scientific proof, but I sure felt better when I started eating three or four meals a week made entirely of colors like green, purple and orange.

My Saturday mornings included a trip to the Farmers Market and a search for treasures, like "ground-cherries," fresh yellow string beans and edible flowers (a late-summer discovery that made a delicious stir-fry).

Saturday's brunches usually produced leftovers enough for another two or three meals each week.  Thus, my intake of fiber, vitamins and even fluids (in the plums, watermelon, etc.) increased.  Not only that, but the experience became entertainment and I got exercise wandering around the market carrying several pounds of whatever looked good each day.

It's a little tougher this time of year, but you can still find a good, fresh zucchini in the grocery aisle.

What was your favorite Farmers Market, orchard, berry farm or fruit stand find last year?

[Above] Fresh stir-fry with "ground-cherries" along with red peppers, fresh herbs and other yummy stuff, August, 2008.

[Below] One Saturday's stash of Farmers Market veggies.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615        

New fast food in the Gonda Building

Mayo Clinic Food Services will open an "express location" from 7:30 a.m. to 2:30 p.m. for employees on the 12th floor of the Gonda Building on Jan. 6.  

Why? The employee newsletter "This Week at Mayo Clinic" doesn't say.  But it's reasonable to assume that it's tough for Mayo staff time-wise to get from the 12th floor of Gonda to University Square and back for a quick meal.

The break-room menu will include "sandwiches, salads, snacks and beverages."

Anybody take the stairs to and from the 12th floor to keep in shape and still feel like you've got enough time to eat lunch downtown?

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615         

Are beans better than whole grains for type 2 diabetes?

An article in the New York Times suggests beans and nuts might lead to better blood-sugar levels than the recommended whole-grain diet.

A study compared:

• A "brown foods" diet with whole-grain bread, cereal, brown rice and potatoes (with skin included).
• A "low-glycemic" diet emphasizing "beans, peas, lentils, pasta, quickly boiled rice and certain breads, like pumpernickel and rye." Oatmeal and oat-bran cereals were also included.

Type 2 diabetics who ate the second diet had lower blood sugar and lower cholesterol levels.

I have Type 1 diabetes myself and have seen the "recommended" diets change significantly during the past 36 years.  When I was little, sugar of any kind was taboo.  Slowly, the recommended diets changed so you could have a "food exchange."  An inch-square chunk of angel food cake equaled a slice of break or a (very) small apple.  Over time, though, fat became the 'evil' food component to avoid, less so sugar.  

These days, with an insulin pump, it seems more important, with Type 1,  to eat healthy food (i.e. fruits and vegetables) than to worry about sugar content (as long as you're "counting carbohydrates."  Fatty foods, though, remain the enemy.

What do you think?

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615        

Dr. Hillier L. "Bud" Baker, Jr. dies

I learned today that Dr. Hilliard "Bud" Baker, Jr. died on Monday. I interviewed him in May for summer Post-Bulletin articles about the 35th anniversary of Mayo Clinic acquiring the first non-prototype CT scanner in the world in 1973.

He welcomed me into his home and spoke humbly about being 'at the right place at the right time.' He and his wife fell in love with England, where Mayo had sent him to get that first CT machine.

Baker returned to England during the 1980s to investigate the emerging technology of MRI. 

But he's most well-known for the effect he had on the quick adoption of CT technology at Mayo, in the U.S. and internationally. He wrote more than 30 "solidly based manuscripts" about the effectiveness of CT scanning.

"The rapid acceptance of the CT scan in the clinical neurosciences was in no small measure due to the quality of the Mayo publications," says a biography written after he was awarded a gold medal from the American Society of Neuroradiology.

Please share your memories of Dr. Baker.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

1-800-562-17858, ext. 17615        

Can touch counter Alzheimer's disease?

A short video piece on CNN online this morning shows a woman affected by Alzheimer's disease. 

She was profoundly affected.  But one day her 89-year-old husband found inspiration, which he believes came from God. Maybe she would get a little better, he reasoned, if he held her hand, caressed her face and described how much he loved her.

"I got in bed with her and I started to love her up," he says on the video, which shows him touching his wife's face and giving sweet reassurance.

Soon after he began offering the extra attention, his wife's responsiveness improved and she became better able to communicate, although she has not completely returned to her former self.

Is it possible that physical touch by caregivers, family and friends can trigger a person's body to fight Alzheimer's?  

Carbon monoxide

The Minnesota Department of Health says Minnesota law requires all  single-family homes in the state to have at least one operational carbon monoxide alarm within 10 feet of every sleeping room.  Apartments must have CO detectors by Aug. 1, 2009.  

Do you have one?  Have you experienced carbon monoxide poisoning or a fire that changed your views on the subject of keep detectors up to date?