40 Burst results for "Mayo Clinic"
FDA chief: Emergency plasma order based on "sound science"
"Controversial therapy is in the news. It's plasma therapy, which was just okayed for use in an emergency authorization Now, after taking some heat, the FDA is defending the decision. FDA Commissioner Stephen Han says he could have done a better job explaining how and why it all came about I can assure the American people that this decision was made based upon sound science and data. The move came after President Trump accused the agency of stalling for political purposes, even using the phrase deep state. While some doctors say the use of convalescent plasma hasn't been proven until CBS this morning, Mayo Clinic data show Otherwise. These data totally support the emergency use authorization that we issued Peter King CBS News.
Fresh update on "mayo clinic" discussed on Mayo Clinic Radio
"The takeaway is you know in the right conditions for the right patient antibiotics are a potential option with the caveat that in about five years. You have a 40% chance of getting appendicitis again, what are the risks of surgery because it kind of makes you wonder why why don't we treat this like wisdom teeth where if we don't need it just get rid of it wage everybody. Yeah. And so typically in this country, we do appendectomies laparoscopically or with small incisions. We make small incisions. We put in kind of long-handled instruments and a camera. The appendix out that way. It's almost I would say ninety percent of the time done that way very rarely. Are we doing open up and ducked Meson a routine patient. Now the study actually did open up and ducked me routinely so it kind of makes the results a little bit tougher to interpret from a surgery perspective. The reason we don't just do surgery on everybody is you know, there are risks with surgery, right? There's risk small risk of bleeding small risk of infection. You can get Scar Tissue on the inside that can lead to challenges down the road. You could injure other organs. You do need a general anesthesia. So an overnight stay in the hospital, so it's not for nothing which is why we don't just take it out. Yep. Already going to if you don't have a clinical indication or you're not having surgery for other reasons, but what we're trying to do and correct me if I'm wrong is find ways to use less antibiotics so that we go build up antibiotic resistance. So that's what I thought was interesting about this. Why would you choose antibiotics when a relatively safe surgery relatively easy finger quotes surgery would avoid that job. The other interesting parts of the study. So as I said, it was a very strict regimen I would say they had three days of IV antibiotics which mandated it that they stick the patients were in hospital for those three days and then they did a week of oral antibiotics, which is a pretty extensive regimen very broad spectrum antibiotics. As you mentioned antibiotic resistance is a real risk and they talked about that kind of in their commentary on their study that this is a risk and in future studies. They should look at naked in the spectrum of antibiotics, but because it's so, you know knew it would be tough for anybody to say. Well, how long would you treat that for and what antibiotics would be the right? So that's why they did such a broad spectrum but there's risk if we treated everybody with that, you know that level of antibiotics that we could be developing antibiotic resistance in their study they found it was relatively better or not really better but less inferior to the surgery because they did a lot of open surgeries. So the cost was lower with antibiotics the time away from work was lower whereas in this country if you have the surgery usually in the hospital Night and go home the next day. You're probably out of work for True 714 days. Maybe at the most you're back to work. So it's it's a pretty limited amount of time. Why when you were we were starting to talk about this survey. Did you say this is was done in Finland only a place where Finland could do something like explain that comment to me can be a tough it can you know, it's a it's really amazing that the study got done cuz you're really proud of being a patient, you know with here's a potential way that this could be treated. We don't know if it will work or not when they did their initial study and we don't know if you're going to have increased complications if we give you antibiotics, right so they didn't know would people get more complicated appendicitis where they all going to rupture where they going to miss cancers. They didn't they just didn't know so often in our in our country getting that approved through our I Arby's that would be a potential Challenge and then getting patients to agree that when they're in the emergency department. They're in a lot of pain and now yep. Tell them well, you could have this kind of, you know, new age thing that may or may not work you can have the surgery that we've done for a long time, and we know that it works. So that was a really impressive part to get that done. They've had really good follow-up. You know, there was like two hundred fifty Seven patients treated with antibiotics and in five years, they followed 256 of them that's amazing to find that many patients for five years and have that information off that's really amazing. So they did a really great job, and they should and the team should be commended on that. They did an amazing job. It's fascinating. We've been talking about treatment for appendicitis with Mayo Clinic trauma and Critical Care Specialists, Erica Loomis. Thanks for joining us. Dr. Loomis. Thank you so much. And that's our program for this week. For more information visit the Mayo Clinic News Network for today's podcast and.
FDA chief apologizes for overstating plasma effect on virus
"The food and drug administration's chief is apologizing for overstating the life saving benefits of treating covert nineteen patients with convalescent plasma on Sunday president trump announced the FDA would issue emergency approval for using convalescent plasma holy get a historic breakthrough that which treatment value has not been established FDA commissioner Steven Hahn echo the president in saying the treatment showed a thirty five percent improvement in survival a hundred people who are sick with co in nineteen thirty five would have been saved that clean the vastly overstated preliminary Mayo Clinic observations and medical experts pushed hard to correct the record today he says the criticism is entirely justified tweeting what he should have said is the data show a relative risk reduction not an absolute one soccer make ani Washington
Fresh "Mayo Clinic" from Mayo Clinic Radio
"From 20 feet up to where your book is down only pulls from twenty feet into a job like two feet and your books at one foot. And is it changing what's new? You know, it's a very mature field. There's some fine-tuning four people have more complex. Distortion and there's some things that can take people who maybe were unintentionally worked on and have a distortion post-op that can slow it down or stop it before gets any worse, but overall it's a pretty stable mature part of the law practice much different than the wild west days of the the 1980s and so on we've been talking about laser eye surgery with Mayo Clinic opthamologist. Dr. Leo McGuire. Thanks for joining us after you're very welcome. If you develop right sided pain in your abdomen, it could be the Telltale.
FDA issues emergency authorization for COVID-19 plasma treatment
"FDA granted emergency use authorization for convalescent plasma treatment that uses antibodies created by people who recovered from covid nineteen to treat those infected with the virus according to research from the Mayo Clinic the treatment appears reduced mortality in those transfer us within three days copen nineteen
Fresh "Mayo Clinic" from Mayo Clinic Radio
"Frostbite is more common and often more serious than many people think the good news is it's fairly easy to avoid that's according to dr. Sands. Kaka are a Mayo Clinic orthopedic surgeon. As winter drags on and temperatures drop way down your risk of cold related injuries such as frostbite can go way up doctor cat car says frostbite is literally a freezing of the tissues and he sees frostbite. For example, when the temperature is 5 degrees Fahrenheit even with minimal wind chill if the wind shield drops below -15 degrees Fahrenheit, which is not unheard of the northern half the US frostbite can set in within half an hour. The area's most vulnerable to frostbite are your nose ears fingers and toes with the milder.
Trump announces plasma treatment authorized for COVID-19
"The U. S Food and Drug Administration has issued an emergency use authorization for the use of convalescent plasma to treat covert 19 convalescent plasma is taken from the blood of people who have recovered from coma 19 as a treatment for others, President Trump says the treatment shows promise We provided $48 Million to fund the Mayo Clinic study that tested the Efficacy of convalescent plasma for patients with the virus. Through this study over 100,000 Americans have already enrolled. To receive this treatment, and it has proven to reduce mortality by 35%. The FDA says. More than 70,000 patients have been treated with convalescent plasma made using the blood of people who have recovered from Kobe
Fresh update on "mayo clinic" discussed on Mayo Clinic Radio
"To rise from any soft tissue like muscle or any bone. Issue of the arms the legs pelvis the shoulder the trunk meaning the ribs and spine now the tumors are malignant or cancer as they're called sarcomas and they can metastasize or spread out are causing all kinds of trouble compared to tumors at other sites like the breast prostate kidney or lung towards of the bones and soft tissues are relatively rare and are often treated by a team of Physicians. One of whom is a surgeon called an orthopedic oncologist. Someone specially trained to manage these patients and here to join us today is the division chair of Orthopedic oncology at Mayo Clinic. Dr. Rose. Welcome to the program doctorow's. It's nice to have you here. Thank you. Thank you very much extra is nice to see you next time. So it's a complicated subject. It took years of training for you to be able to do what you do is divided up into two segments. First of all, bone tumors and then soft tissue tumors and then benign versus malignant and let's talk about the relatively good to start with and that would be benign bone tumor. How often do you see those, you know, they're pretty common that we see their lot of different things which can arise in the bone most often during development in childhood different cysts or areas where the calcium doesn't participate fully in to the Bone these can lead to a benign bone tumor and there are other benign bone tumors, which can arise most commonly in young adulthood which can be locally destructive. But what separates a benign bone from a malignant or cancerous bone tumor is the benign tumor is fundamentally a local problem is our job is to control it in the knee or the shoulder or wherever it is because it can severely compromised or even destroy the function of the knee if it's neglected. But thankfully they don't have the potential to spread elsewhere in your body and cause a threat to your life. So we balance our treatment to maintain function will also gain control of the tumor these can occur in any age group, correct? Yes. They're more common in children or young adults, but they can current any age and how do these kids usually present? It's usually pain is the most common way that we fight off. Benign bone tumor they can also present with a mass a bump on the leg about one in ten times. They'll have a fracture through them. So child is doing some regular childhood activity playing soccer Wing set of the lake and they'll break their arm or their leg. It's usually a very mild fracture but it breaks through bone that's been weakened by this and then hurts. Yes. So once you see these patients and you suspect that there may be something wrong with their bone. What do you next? I assume a plane x-ray gives you a lot of information. X-ray is the single most important test that we have for this and often times. We can come to a surge the diagnosis or near the diagnosis down to one of a couple entities just with an x-ray alone. And if that doesn't give you enough information, what's the next test you might do and why would you do it? Usually the next test would be a scan and an MRI scan allows us to look with detail into the bone and into the bone marrow to understand how a tumor is behaving there and if we really need to we'll get a biopsy of something to biopsy dog. A small sample of the lesion is taken for pathology team to study under the microscope to give us a fairly definitive diagnosis. And then once you have identified the tumor do most of these require surgery know many of them. Typically the ones in childhood children will just grow out of on their own as the bone grows. There are some cysts which will commonly resolved with age or if a child has a fractured through the cyst sometimes money alone will cause it to heal but there are a large number of these which do require some form of a surgery usually to go in clean out the area of abnormal tissue often put bone graft in if there's a worry that the bone is weakened from the presence of tumor. We may have to put in a plate or screws to help strengthen it as heals and then these bone grafts serve as scaffolding for their own new bone to grow into and allowed to leave their resorbed in the bone returns to its normal State. That's right in the older individual are they a different kind of tumor that you see benign tumor, you know, the more common tumor that we see in an older individual Benign tumor for example is a giant cell tumor of bone. And this is something which classically in younger adults up until about middle-aged and these are locally destructive. They will dissolve away the calcium from the bone lead to pain the lead to compromise of the joint function. And if you don't get a hold of them and on top of them, then they can really compromise the bone. These are ones which essentially always require surgery to go in and clear out the tumor itself treat the margin of the boundary tumor and then fill things up with bone graft or bone cement to restore the strength where they most often found most commonly about the need for reasons that I am not entirely clear about the most common location of a bone tumor is near the end of the femur or top of the tibia. Yeah interesting and nobody really knows why. All right. Let's talk about the malignant bone tumors down and let's start with children because they're not too uncommon in children and the most common one osteosarcoma. Tell us about that Sasha sarcoma is pretty rare primary can log Arbonne and it usually Rises and children or young adults. There are a couple hundred total in the United States each year, probably about five or six hundred and this is a cancer where the cancer itself arises in the bone almost always occasionally outside of the bone. It'll grow pretty aggressively and surgery and chemotherapy are the key aspects of the treatment of children with osteosarcoma either surgery or chemo therapy alone is very rarely successful, but the two together give a cure rate that's come about tremendously in the last several decades. We're up to probably at least a 75% rate of long-term cure in these children. And when I started it was 20% huge difference that happens, is it a family history or what do children get that in most cases? We don't know they're a couple of rare genetic conditions in which we know the children are predisposed to develop bone cancer, but honestly the vast majority of children who developed bone cancer don't have one of those conditions tell.
Study hints, can't prove, survivor plasma fights COVID-19
"Mayo Clinic researchers are reporting a strong hint that blood plasma from covert 19 survivors may help other patients recover. AP Correspondent Jackie Quinn has details preliminary data from 35,000 Corona virus patients who received plasma from people who had recovered from Cove in 19 produced signals of efficacy. There were You were deaths among people given plasma within three days of diagnosis and those who got plasma with high levels of antibodies, But this wasn't a formal study and the data comes from a number of hospitals so patients could have simply received different care. I'm Jackie
Fresh update on "mayo clinic" discussed on Mayo Clinic Radio
"I'm dr. Tom Shives and I'm Tracey McRae tumors both benign and malignant can originated in the bones or the soft tissues of the trunk and extremities off. They are generally referred to as musculoskeletal tumors. Now bone tumors most commonly affect the pelvis or the long bones that is the arms and legs the most common types of soft tissue is usually occur in the arms and legs and the abdomen on today's program will talk with a Mayo Clinic expert on musculoskeletal tumors. Also on the program will learn about LASIK surgery to correct, vision problem and treatment options for appendicitis both benign and malignant. Tumors are neoplasms going.
"Been reading about forgiveness and I came across a simple but pretty powerful article on. The website from the Mayo Clinic Mayo Clinic Dot Org mark, and this is an article that I'll be sharing with you today it's titled Forgiveness letting go of Grudges and bitterness. So this is some insight to take into your meditation today. Holding. A grudge. Can impact you pretty dramatically both physically and emotionally. If you are unforgiving. A Ken. Bring anger and bitterness into your relationships, and also into most any of your experiences, they can always seem a little tinged by bitterness. You can become wrapped up. In, the wrong that was done to you that you have a hard time enjoying the president or it consumes you so much that. Even when you're having fun and you're getting together with people, a lot of times you bond over the issue of the wrong that has been done to you. You can become depressed and anxious. You can feel like your life lacks meaning or purpose. and. You can begin to lose your hope in life your spiritual beliefs. You can lose. Connection with those that mean most to you. Or feel detached from people. That you love because you're hurting so much. So wrapped up in. This bitterness. It's so pervasive around you. And I want to share with you a story that someone in my own spiritual group I meet with every morning. She is a former teacher for special needs children. And she talked about how there was a teacher that she used to work with in the classroom and this person would. Be So negative and so heavy that it was like a dark cloud in the classroom it affected every wine. And people tried to gloss over it and be positive but. She was really bitter. And on days when she was absent from school. It was like a breath of fresh air flowed in the classroom. And she had real sorrow in her life. Her brother. Was a missing person. And I don't believe they ever found him. So, you can imagine the grief and the sorrow. From having no closure over her brother. Suddenly Missing This was heartbreak in her life and it permeated everything and you can understand it. You can have compassion. For what she was going through. But imagine. How she cast such a cloud over so many others. She may have even traumatized many people. Because she was so negative. I'm sure that you have met people like that. So have you can have compassion for. Someone who is struggling they're had dark their negative they're angry. This can help you to soften. The impact of their anger and bitterness. And you might find that you may act in the same way. So. What happens to your mind and body when you forgive Well, there are many things as you can imagine, but I'll share. Some of the positive impacts when you forgive someone from this article. You begin to have healthier relationships. You Improve Your mental health. Anxiety and stress and hostility are lessened. Your blood pressure goes down you have fewer symptoms of depression and your immune system is stronger.
The prohibition against marijuana in the hospital
"Francis has just been hospitalized for the third time for cancer while at home. She's been managing the chemotherapy much better than expected in the hospital. She's frustrated at home. She's treating her nauseousness and her anxiety with marijuana, but in the hospital she's not allowed to use marijuana even if she brings her own edibles or vape pen for Francis, a hospitalization is already an anxiety provoking experience, but is now even more so because she can't use what she knows will calm her down. The majority of states thirty five have legalized marijuana for medicinal uses and millions of Americans use it for. For medicinal purposes, and even more for recreation to relax well many state governments have chilled around marijuana use and focused their drug enforcement efforts elsewhere. Hospitals cling to the past. They feel a strong need to forbid marijuana. No, surely there are a few patients are on medications that might interact with marijuana and doctors and patients should discuss these situations, but what hospitals are doing as forcing patients to be sneaky what Francis has found is that the only way she can reliably relax is with marijuana, so she's forced to act the way she did when she was a teenager and sneak into her hospital room. This is complete nonsense and And it creates a situation where Frances and her doctors are not focused on her best health so now. Doctors don't know what she's taking, so they can't advise her against US marijuana. If there is a really good medical reason for her to abstain, there are many reasons to allow people to use marijuana, the hospital or nursing home if they wish most importantly for conditions, such as chronic pain, anxiety and nausea, it is effective therapy and is often better than prescribed expensive medicines, and if the person is using marijuana and his force to suddenly stop when they come into the hospital, it can cause her symptoms to worsen. Yes, the. The feds are still in the dark ages and consider marijuana a schedule one drug, but they're not pursuing law enforcement at hospitals and healthcare facilities. When a doctor provides a medical need, there are some hospitals, even the Mayo Clinic that have allowed patients to use marijuana in the hospital and in states like California were having. Marijuana is not a crime. There are no state prohibitions on hospital. Use so like much in medicine policies are often remnants of days gone by, and they had not change to keep up with science or demand. Hospitals seemed to be more concerned about upsetting regulators than helping patients, assuming that there's not sound medical. Against Marijuana use a particular person. Francis can't wait to get out of the hospital, but in the meantime she has her stashed marijuana that she takes twice a day and not a single staff member knows about it.
Major Retailers Ask States to Mandate Face Masks
"Retail Industry Leaders Association, which represents target Home Depot, another major change is asking all 50 governors to make masks mandatory nationwide. They say different rules around the country have made it confusing for shoppers often lead to conflict between customers and workers trying to enforce store rules. Right Right now, now, fewer fewer than than half half of of US US states states require require face face mass mass in in public. public. Is Is what what they they said. said. This This is is the the retail retail industry industry Leaders Leaders Association Association retailers retailers are are alarmed alarmed with with the the instances instances of of hostility hostility and violence. Frontline employees are experiencing by vocal minority of customers ran a poll yesterday. Majority of you either wear a mask or think of mandate is coming. That's a majority of you listening. We also spoke with a psychologist on why some people are so against masks and at the root of it is politics. Government controlled a right thing. It shouldn't be because this is not that this is a public health issue. CDC. The Mayo Clinic are telling you to wear masks, and pretty soon you're governor will be too
Unexpected Results on Lithium and the Kidneys
"Sometimes? It's the uncontrolled Frau's that changed practice particularly when the results go against the grain. That's what happened in twenty seventeen when Lars casting than colleagues published their seminal paper on lithium in renal disease, they looked at seven hundred and fifty four patients with chronic kidney disease, who are taking lithium or an anti convulsant. Some were continued on the medication during the renal disease while others stopped it. Now you'd expect the renal function to improve here when lithium was stopped, but they found the opposite patients who stopped the mood stabiliser whether lithium or the Anti convulsant had worse renal outcomes than those who continued it, but wait. You do kind of expect that I mean it's likely that the doctors stopped these meds in patients who are getting sicker and they just continued to get sicker since this is not a controlled trial. They did try to control for that selection bias and they're finding still held up. But. There was one more finding that starts to raise questions. Dr cussing honed in on the patients with bipolar disorder. He found that their renal function fared even better when continued on lithium versus switching them to an anti convulsant. That was an unusual finding. Suggesting that renal function is actually going to do better bipolar disorder if we keep them on lithium instead of switching them to something else. How do you explain that we don't really know? But perhaps it's all about the TUBUL 's at least one anti convulsant vow pro Depakote is associated with renal damage in the PROXIMAL tubular bells. Now that is a rare side, effect, Daviau but bear with me, and you'll see the point, so vow pro eight is hitting the proximal to Buell's lithium in contrast, causes damage in the distant Tubul 's so switching develop row aid could just damage the healthier half of the kidneys. These folks so if that theory is true, then keeping them on, lithium would sound like a better idea. Now while Dr Kessler's study gave us some reassurance for continuing lithium. Even as the Croat Nin starts to rise, it did start a lot of confusion, and it definitely needed replication, and that's what we got in a poster presentation by Dr. Me Hawk power on colleagues at the Mayo Clinic. The data was once again observational, and they arrived at the same conclusion, the risk of progressing to end stage renal disease was the same in patients with chronic kidney disease who continued versus stopped lithium. Sadly that risk was high, the risk of going on to end stage renal disease was about fifty percent in both groups. Remember though these are patients who already have chronic kidney disease. And stage. Renal disease is a very sad disease. The risk of suicide is seven times higher in this population and its highest in the first year of dialysis, so we need to take that into consideration when thinking about stopping lithium lithium prevents about one in eight suicides in bipolar disorder, and the risk of suicide goes up twenty fold in the first few months after lithium is, stop forty fold if lithium has stopped abruptly, that's why it's best to stop lithium slowly over one to two months to prevent drastic worsening of mood. Lithium's effects on the kidneys are also dose dependent with some studies showing no renal effects if the level is kept below zero point eight. The bottom line you see the creatine new rising at one point five or above you're gonNA need to consultant a frolic just on this complex question, but the answer is not always to stop lithium, and from these two studies, it looks like patients are GonNa fare just as well whether the lithium is stopped continued, and they might even fare better if it is continued. We also need to keep in mind that patient's entire history, and how well they did on off lithium, and how high the risk of suicide is. The first step is usually to lower lithium as low as you can get it in someone with renal disease without getting their mood worse.
Hotels Clean Up Their Acts to Win Guests' Confidence
"If we needed another reminder of how hard the hotel industry has been hit by Covid nineteen on Tuesday, Hilton Worldwide Holdings announced that it would cut two thousand one hundred corporate jobs across the US, roughly sixty percent of hotel rooms are empty, according to research firm SDR and that doesn't include the thousands of hotels it of closed for good since the beginning of the pandemic. But summer vacation season is upon us, and Hilton is trying to convince customers. It's safe to check in again to do so. They're coming clean about their virus. Safety measures and launching a new campaign called the clean stay program to WANNA. Be Vacationers out of their homes. Hilton has assembled a virus fighting a team that includes the maker of Lysol and the Mayo. Clinic's infection prevention and control team. Team goal is to enhance existing disinfecting and safety measures and ultimately to bolster travelers confidence. The hotel is looked at virtually every area. It's operations and found ways to reduce infection risk loyalty program members can use an APP for contactless check in each room is secured with a clean stay seal after cleaning to show. It's been disinfected with the hotels. New rigorous standards frequently touched areas like lights. Lights which is door handles. TV, remotes get extra cleaning, attention and disinfecting wipes are provided for gas use common areas like lobbies restaurants, fitness centers have been rearranged for social distancing and restaurants ditched buffets in favor of safer options like covered dishes and grab and go items not to be left in the dust. Marriott is also calling in the COVID nineteen reinforcements. The Hilton competitor created the Marriott Global. Global Cleanliness Council, recruiting infection, prevention and food safety experts from ECOLAB adventist health care and purdue and Cornell University's virus fighting upgrades include hospital grade disinfectant increased surface, cleaning, limited contact and additional training Marriott has also rolling out enhanced technologies, including electrostatic sprayers, which can quickly disinfect fitness, centers, pool, areas, and other spaces, and the companies, testing ultraviolet light technology to sanitize keys and devices shared by associates. But is an extreme safety makeover enough to coax customers out of their homes. It might be the pandemic has created pent up, demand for travel also called revenge spending a June survey by destination analysts family at one in five people are already traveling with no hesitation and seven ten have plans to do so by the end of the year. As these brands try to do each other's squeaky clean practices. Third Party experts are getting in the game to the global bio. Risk Advisory Council a division of the Cleaning Trade Association Issa. Now offers the Gbi A. C. Star certification, hotels, restaurants, and other venues can earn the distinction by having the proper chemicals, equipment and procedures in place to remove harmful pathogens. The program began accepting applications may seventh Marriott and Hilton. Competitor Hyatt is the first hotel brand to commit to getting. All of its property certified the Chicago Tribune reports. Of course such change requires big investments in products, technology and training at a time when revenue is down, but new virus hotspots are emerging, and a vaccine or cure is still on the relatively distant horizon, so hotel brands are doubling down on better hygiene to get nervous trawlers back on the road. Booking those empty hotel rooms.
"mayo clinic" Discussed on Mayo Clinic Radio
"To successfully work remotely from many different domains, and we've invested in technology, management practices necessary really to operate a tele workforce. We really just didn't expect this happen within a few short weeks. We look what you've done in such a short period of time. You've done this relatively seamlessly, so let's switch gears now. You mentioned the new normal. Let's talk about our patients. Pre Pre cove it. Was telehealth part of the of Mayo Clinic practice in in managing patients demands. It absolutely was telehealth environment. has always been something. That Mayo has had the volumes are just different. In recent months pre covid telehealth volumes averaged maybe around one thousand visits per day by the first week of April our telehealth appointments reached around two thousand visits daily. This number continued to double so by the end of April approximately four thousand daily telehealth visits were occurring with actually a few peaks over six thousand daily telehealth visits, so that obviously doesn't happen just on his own. Tell us what's happened in the background to allow. Physicians and Colleagues to interact and enhance connection without patients. Yeah, you know really there's. A couple of things that it had to do here to accomplish this it was a dynamic situation that posed a lot of challenges. To really accommodate this level of demand, and the technology needed. Several things had to happen I. One of the things was that we really had to outfit our our staff with equipment at home to perform remote administrative in clinical work we we anticipated the need for several thousand laptops to support that work from home. This created a challenge due to our own lack of laptop inventory caused by market deficit of around two million units nationwide. which was really caused by the factory shutdowns and China that were occurring in January and earlier parts of the year, so we just didn't have the equipment to deploy that kind of technology to the homes initially. We We made a call to our mayoclinic employees that if anybody had laptops or equipment that wasn't being used that, we could redistribute that, and in once again staff just really stepped up and provided several hundred devices to return. That could be redeployed. But we also made a call out to the industry to our our sales team at Hewlett Packard that one of our partners for laptops and desktops, and they reached out on our behalf to their Minnesota based customers. Unfortunately three M actually responded to our need. three M had several thousand laptops that were unused in their warehouse and provided us an opportunity to purchase two thousand of those devices. So that just as an example that was on a Tuesday and by the end of the week, our staff had over two thousand devices boxed, inventoried, tagged software loaded already for staff to take home, and we also had a significant expansion needed in our infrastructure to support that remote access to our network. The the existing remote access system was architect many years ago and really architect to support a maximum of maybe six thousand concurrent connections. You know this this really served us well for many years, and we rarely exceeded that system capacity, maybe once or twice, or those rare crippling midwest snowstorms that forces us to stay home. But the new level of demand that were seen who's going to require several times that capacity, and from our networking team and telecommunications quickly configured the system for additional speed and capacity, other things that happen in the background that that most people probably didn't see of course was reaching out to our telephone. Systems are local Internet service providers to make them aware that increased demand was going to be coming. And that they were gonNA. See Large increase from the home of Utilization So. Those telecommunication companies and Internet service providers really had to add additional capacity as well to meet that higher demand. You know the other thing that happened to was Mayo Clinic has numerous context centers those are folks taking calls from employees to the help desk, our patients calling appointments call in centers that were related to over questions and many of those call centers also relocated to home, and those are folks that use special equipment for computers and phone systems, and so specially configured systems had to be set up for them to to get ready. It was really a very busy period of long days over several weeks to repair equipment, rewrite. Policies draft setup guides. Your systems answering calls for help and staff across it. Many departments really stepped up to make that happen. Well, that's that's an amazing depiction of what happened behind the scenes as you said as a physician and as an end user, one has no idea this is happening behind the back behind the scenes, and not only just in mayor clinic shows what an interconnected well we have from how these computers are made. And as he said partners stepping up and helping us. It truly is a a success story. You have. Yeah, there's absolutely every day brought something different and. It was. A lot of challenges that were just worked through by everybody. So as you know Mayo Clinic Prides itself not only in patient care, but. In Education and research as well tell us how it is helped our colleagues in education. Also, be able to still educate and continue continue doing research behind the scenes. Yeah, fortunately, the the technology and the tools that are used not only tele visits for patients with providers also works with our students and our research. Colleagues so I know while students were unable to be on campus doing side by side. education with their their colleagues and and educators. They were able to do things using the zoom video technology like we're using today. we leveraged other collaboration tools like black or for the education environment skype. was another popular tool that was used to reach out to colleagues and stay connected research has some unique environments as well with their equipment and through the remote access systems that were set up staff working at home. We're able to reach in through. Those technologies connect to remote systems continue to run the equipment and analyzers and things that they have. And even in some cases. Those equipment that were special in the labs. were taken home to continue their work and maintain productivity, and then brought back into the lab later when when things settle down, but early had a flexible dynamic situation across all fronts at Mayo. Including International. Where we have operations that needed continuing London and Dhabi, and those those technologies allowed us to continue. Those operations is truly is a as you said a national and international effort here he said not only do. We have a sites in the United States but also internationally as well so to bring them on board as just an amazing story and congratulations to you and your department. Well, thank you. I would say an exciting time, not one that we certainly plan for, but it really leveraged a lot of the skills that folks have. Mark. Is there anything else that we didn't cover that you'd like to add? Well. I think the other one. It is just how. Are Patients are reacting to the whole telehealth environment and feedback. I hear from patients has really been positive telemedicine and opportunity to advance our patients access to medical treatments or extended hours through phones and video visits and patients. Tell us that's made access to medical care easier, and I.
New Frontiers in Addiction Medicine
"Hello and welcome to let's talk an award. Winning series of podcast produced and delivered by the Hazelton. Betty Ford Foundation. Each podcast focuses on a topic related to addiction to alcohol and other drugs from prevention, research, treatment, current events, advocacy, and of course recovery from addiction to alcohol and other drugs. I'm your host William Lawyers and today, joining us is Dr. Martin Sepla the chief. Chief medical officer, the Hazel. Betty Ford Foundation Welcome MARV thinks in good to be here. Nice to have you with us again here at the Betty Ford. Center on this podcast, and it's rather appropriate that our topic for today is talking about the collaboration with the Mayo. Clinic on a couple of studies which I want you to talk about, but I think it's interesting that. This collaborations with Mayo Clinic and that's where a lot of your story comes from. It sure does I was I got sober. While was working at the Mayo Clinic after high school actually before I graduated from high school because I dropped out and I was working there. And and able to get my diploma once I got so. They didn't really I told her department. I haven't graduated, but. nobody else, really new in the lab work. So, somehow I, still get a job without a high school diploma while in was. Absolutely influenced to go into medicine while working there and addiction medicine. No. I wanted to be a cardiac surgeon because I worked with cardiovascular research lab, and the primary person who influenced me was a Brazilian cardiac surgeon and. He he? We would be doing surgery on these animals and he'd tell me all these stories of healing. From his work, and this is just want to be like. Was My goal. So. Cardiac surgeon than halfway through medical school back at mail. I still had that plan in doing clinical rotations and all these patients had. And or other type of diction, and I had identify that and bring it up with my attending the physician on staff, the residents and they would listen to me and then tell you we're not gonNA do anything about that Mar.. And we didn't put it in the chart. We didn't refer people for care for consultation. Nothing and it was often the cause of the hospitalization. We're doing nothing about it and I was complaining about this at A. Meeting ended weekly in after a few weeks, these two doctors in the meeting took me aside one night and said. Mark you've got to quit bitching about this and do something about it. Kind opened my eyes defensibility. His actually that discussion the. resulted in me, going into psychiatry and folk. Specializing in addiction, we're. We're glad that you did. Aged now it has. And did you ever think that the day would come? When the Hazel Betty Ford Foundation would be collaborating with male. you know I didn't I'd hoped so all along, but it just didn't have an didn't Evans I kinda lost. Hope about though here. We are doing it to studies. Tell us about him. Yeah, so we're doing. an NIH grant funded study that we partnered with Mayo clinic onto study of Medication for alcohol. Use Disorders, the medicines that camper sate. Hardly gets used because it only works for about ten percent of people, alcohol use disorder. So for me as attack. It's hard to convince myself to prescribe it to somebody and especially hard to convince him to take it because it works so infrequently you know and nine out of ten. It doesn't work for but. There's always this underlying thought that it must be a genetic sub type of alcoholics. So that respond to. So we've decided with. Mayo is to find out if that's true, because one of the main researchers there who I actually knew. Since I worked in that lab as a kid Dick, wind chill bomb, he helped develop technologies for examining genetic and metabolic biomarkers, which are just kind of. The human genome of testing that to see if an individual's going to respond to medicine or not, but also these metabolic biomarkers are just normal metabolic byproducts floating around our blood, so we can take simple blood test. And check it out to see who responsive medicine and who doesn't as a result of determining that. We put it into artificial intelligence computers to to examine the the characteristics of those bio markers, and those who respond versus those who
"mayo clinic" Discussed on Mayo Clinic Radio
"Successfully thankfully Mayo Clinic. Radio returns right after this when you talk about the outpatient practice. Obviously there's many moving parts you know. We talk about patients coming into mayoclinic safely being seen by the providers in clinic moving seamlessly through the flow of Mayo Clinic and then if it deems necessary having surgery can you talk a little bit about the safety measures that you've implemented for this to happen. Tremendous work has been put in by many teams to ensure that we have optimized our safety for patients. And it's really begins at the very beginning of the patient journey when we call the patient to schedule an appointment. We firstly have a screening mechanism when we call we don't want to be overly invasive. That's but we want to ensure that the patient is saved travel. We want to ensure that our environment to safety is optimizing. Our care teams are safe as well. So we we have a questionnaire screening at questionnaire where we ask questions with regards to Symptoms may be related to corona virus. We ask if there were any exposure All contacts and a series of questions takes place on the telephone at the appointment is being made. We also educate our patients at that time. With regard to some of the changes they can expect when they come to to male particularly with respect to universal masking. So we do ask that. All patients are mad than we asked. All our master on the campus and all of our employees are of course masked as well and that has been a tremendous benefits in terms of reducing risk. We also inform our patients visitors. That unfortunately this time. We can't allow a lot of visitors on campus. In the outpatient practice we allow one visit her with it with a patient and in hospital environment or no visitors with patients. There are exceptions. Small small number of exceptions that have to be signed off upon on a case by case basis. So that first telephone Telephone calls the initial level of screening before the patient arrives we again reach out to the patient or TA hours before they're appointed time as you can imagine. There may be three or four more weeks between the time of the appointment and the time the patients physically due to be here and things can change so we reach out to the patient. Forty eight hours. Before they're arriving we again screened and the same questionnaire as on at the time of appointment we actually then proceed if they have passed that questionnaire for the second time we proceed with a virtual check in process so we actually go through their medications. We go over there. Check in virtually at fourteen hours prior to appointment such as when they arrive there movements. True that traffic is more efficient. And let's face to face contact with our check in process physically with our staff members when the patient is here so once they've gone to the forty eight hour check then. They arrived on campus and we have additional screening as the patient arrives on campus. I just walked by arch. Gonda lobby front door. Busy down there. We've got screening with multiple staff members nursing staff right there where we ask the questions again. we actually measure the patients temperatures and visitors temperatures as their arriving on campus. That's not with a thermometer. That's with an infrared screening device. We've just screen your forehead and we can tell your temperature very quickly. And then or the fourth level screening. We actually questioned the patient again as they arrive at the at our desks at. Mayo Clinic to ensure.
"mayo clinic" Discussed on Mayo Clinic Radio
"Many patients have been touched in this manner but we also have to think about awfully have done for the past one. Hundred and fifty years are face-to-face. Practice is absolutely second to none. And that's face to face practice where we bring a patient to Mayo Clinic. We have an itinerary which is very very organized. A very efficient seen multiple providers in a short period of time. That's been our main stay that span an absolute differentiator and I see telemedicine as enhancing that face to face practice in most cases as opposed to replacing it. So we're now hard wiring in for example a couple of examples once we have patients scheduled to come new patients have Mayo Clinic. I see that we will be. I believe that we will use video consoles or telephone consults up front in many cases to connect with the patient ahead of time. I'm Dr Loftus. I'M DR CA-CAR I'm going to be meeting you in a couple of weeks time. I want to ensure that we have everything in place that maybe a provider reaching out of. Maybe unearth reaching out. May maybe another colleague reaching out to ensure that we have at the itinerary as it should be. We're prepared for the patient. Such begin to get as best care at Mayo Clinic. Another example may be established patients. Dr Takhar has operated on them and six their hands. They need to be back here at Mayo Clinic. Or could that be potentially a virtual consultation as opposed to the patient traveling along distance if they don't need additional surgery or diagnostic test but then many patients in the vast majority of our patients was still needs to come to Milton for that? Face to face multidisciplinary practice for the surgery or the procedure for the advanced diagnostic testing. That has always differentiated. Cares me authentic for for century for one hundred fifty years so in summary? Telemedicine is definitely here to say it's an enhancement but I see it has Enhancing the face to face practice as opposed to replacing the face of practice. And I couldn't say that any better as you said the word enhancement is absolutely there and it's extending that human touch to somebody when you can't see them physically it means so much to our patients and I'm so glad that you expanded on that and how it sort of enhancing out practice both face to face and virtually I would just extend tremendous thanks across the board for firstly to to you Dr ca-car into your your colleagues for arranging this interview. Amines extremely important that our patients notice. We're here for them. We're all was here for them. In Times of difficulty. We're here to be a guide to be of help in any way we can mail. Panic is safe safe. And it's we're here to care for all patients needs now I also want to thank any staff members who are listening. Our staff have been absolutely unbelievable in their response across the board to ensure that we are able to continue in our mission our mission in practice our mission in education our mission research to continue to advance medicine to care for all the patients who need us. Thanks to chair of Mayo. Clinic's outpatient practice.
"mayo clinic" Discussed on Mayo Clinic Radio
"They truly feel safe coming back to see us. Having their problems dealt with in the way that we traditionally do Mayo Clinic. So thank you for that. This is obviously face to face interactions. But as your Lou to earlier when the executive order came down and before that there was a shift to telemedicine. Do you think moving forward. That telemedicine is still here to stay and telemedicine is fantastic enhancement to our face to face practice. Telemedicine is definitely here to stay We of course we're working hard and telemedicine as all other institutions. Were before this. We have tremendous team of connected care colleagues who were working in the telemedicine space that we we had a plan for telemedicine to to be heavily. Invested in our practice over over many years at plan was accelerated effectively overnight at bought telephone Consultations and video consultations effectively exploded in those weeks. Where the executive order was in place we wanted to remain in contact with our patients want to ensure our patients that we were here for them and save for them if they needed to be here on campus physically. We wanted to be able to continue to deliver the care if they need to ensure that their Their their needs were were taken care of during this during this period Telemedicine has been tremendously valuable. I I think about one patient where I delivered video. Consult to a very very graceful lady on an on an island off the coast of Maine and this lady is living on an island off the coast of Maine. She unfortunately has a bowel obstruction due to a problem. And she's on nutrition by vein and she's got a chew coming out of her stomach so so traveling to Mayo Clinic with all of these. Very difficult Cesary reason speeding would have been tremendously difficult for her. We were able to deliver into her home..
"mayo clinic" Discussed on Mayo Clinic Radio
"The At our desks at Mayo Clinic to ensure that again with the are no symptoms are going to compromise safety. So you can see. It's it's very very very thorough and thankfully has been very effective at all and I would hate tremendous credit to our patients have been so patients. True all of this and they understand. They're willing to go along with all of this to ensure that they are staff members. Remain safe so the screening mechanisms are extremely extremely thorough number. One number two universal. Masking that has been huge. All patients all visitors all employees mask. That's a huge huge change but also very very very important in terms of efficacy and then the other two other big spaces one is management of our patients and facilities as our patients are on campus. We ensure that social distancing is made contained. We ensure that we don't have crowds of patience in waiting areas or in the areas or anyplace else we have a colleagues from are from various teams helping our patients to ensure that they remain masks that they remain socially distance offering a hand sanitizers. And if we do were observing patients as they go through the process as well we observe any patient. It's coughing or maybe symptomatic. We actually asked him to step aside and we put them through an initiative. More thorough screening a mechanism as well so multiple multiple steps in the final step is patients who are coming in for a surgery or for higher risk procedure so if a patient is going to surgery they're tested With a as a foreign shield swab two days before surgery to ensure that they don't have corona virus likewise patients were going through a number of different procedures are tested ahead.
"mayo clinic" Discussed on Mayo Clinic Q&A
"Many patients have been touched in this manner but we also have to think about what we have done for the past. One hundred and fifty years are face-to-face. Practice is absolutely second to none. And that's face to face practice where we bring a patient to Mayo Clinic. We have an itinerary which is very very organized. A very efficient seen multiple providers in a short period of time. That's been our main stay that span an absolute differentiator and I see telemedicine as enhancing that face to face practice in most cases as opposed to replacing it. So we're now hard wiring in for example a couple of examples once we have patients scheduled to come new patients have Mayo Clinic. I see that we will be. I believe that we will use video consoles or telephone consults up front in many cases to connect with the patient ahead of time. I'm Dr Loftus. I'm Dr ca-car I'm going to be meeting you in a couple of weeks time. I want to ensure that we have everything in place at maybe a provider reaching out of maybe unearth reaching out. May maybe another colleague reaching out to ensure that we have at the itinerary as it should be. We're prepared for the patient. Such get to get as Best Care Mayo Clinic. Another example may be established patients. Dr Takhar has operated on them and six their hands. They need to be back here at Mayo Clinic or could be potentially a virtual consultation as opposed to the patient traveling along distance if they don't need additional surgery or diagnostic test but then many patients in the vast majority of our patients was still needs to come to Milton for that. Face to face multidisciplinary practice for the surgery or the procedure for the advanced diagnostic testing. That has always differentiated. Cares me authentic for for century for one hundred fifty years so in summary? Telemedicine is definitely here to say it's an enhancement but I see it has Enhancing the face to face practice as opposed to replacing. The face of practice. Couldn't say that any better as you said the word enhancement is absolutely there and it's extending that human touch to somebody when you can't see them physically it means so much to our patients and I'm so glad that you expanded on that and how it sort of enhancing out practice both face to face and virtually I would just extend tremendous thanks across the board for firstly to to you Dr ca-car into your your colleagues for arranging this interview. Amines extremely important that our patients were here for them. We're all was here for them. In Times of difficulty. We're here to be a guide to be of help in any way we can mail. Panic is safe safe. And it's we're here to care for all patients needs now I also want to thank any staff members who are listening. Our staff have been absolutely unbelievable in their response across the board to ensure that we are able to continue in our mission our mission in practice our mission in education our mission research to continue to advance medicine to care for all the patients who need us. Thanks to chair of Mayo. Clinic's outpatient practice.
"mayo clinic" Discussed on Mayo Clinic Q&A
"They truly feel safe coming back to see us. Having their problems dealt with in the way that we traditionally do Mayo Clinic. So thank you for that. This is obviously face to face interactions. But as your Lou to earlier when the executive order came down and before that there was a shift to telemedicine. Do you think moving forward. That telemedicine is still here to stay and telemedicine is fantastic enhancement to our face to face practice. Telemedicine is definitely here to stay We of course we're working hard and telemedicine as all other institutions. Were before this. We have tremendous team of connected care colleagues who were working in the telemedicine space that we we had a plan for telemedicine to to be Heavily invested in our practice over over many years at plan was accelerated effectively overnight at bought telephone Stations and video consultations effectively exploded in those weeks. Where the executive order was in place we wanted to remain in contact with our patients want to ensure our patients that we were here for them and save for them if they needed to be here on campus physically. We wanted to be able to continue to deliver the care if they need to ensure that their Their their needs were were taken care of during this during this period Telemedicine has been tremendously valuable. I I think about one patient where I delivered video. Consult to a very very graceful lady on an on an island off the coast of Maine and this lady is living on an island off the coast of Maine. She unfortunately has a bowel obstruction due to a problem. And she's on nutrition by vein and she's got a chew coming out of her stomach so traveling to Mayo Clinic with all of these very difficult Accessories and speeding would have been tremendously difficult for her. We were able to deliver into her home.
"mayo clinic" Discussed on Mayo Clinic Q&A
"The At our desks at Mayo Clinic to ensure that again with the are no symptoms are going to compromise safety. So you can see. It's it's very very very thorough and thankfully has been very effective at all and I would hate tremendous credit to our patients have been so patients. True all of this and they understand. They're willing to go along with all of this to ensure that they are staff members. Remain safe so the screening mechanisms are extremely extremely thorough number. One number two universal. Masking that has been huge. All patients all visitors all employees mask. That's a huge huge change but also very very very important in terms of efficacy and then the other two other big spaces one is management of our patients and facilities as our patients are on campus. We ensure that social distancing is made contained. We ensure that we don't have crowds of patience in waiting areas or in the area or anyplace else. We have a colleagues from are from various teams helping our patients to ensure that they remain masks that they remain socially distance offering a hand sanitizers. And if we do were observing patients as they go through the process as well we observe any patient. It's coughing or maybe symptomatic. We actually asked him to step aside and we put them through an initiative. More thorough screening a mechanism as well so multiple multiple steps in the final step is patients who are coming in for a surgery or for higher risk procedure so if a patient is going to surgery they're tested With a as a foreign shield swab two days before surgery to ensure that they don't have corona virus likewise patients were going through a number of different procedures are tested ahead.
"mayo clinic" Discussed on Mayo Clinic Q&A
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Coronavirus found in semen of COVID-19 survivors, study says
"Traces of the corona virus have been found in the semen of some severely infected man raising the possibility that the virus might be sexually transmitted researchers in China found evidence of the virus and six men out of a group of thirty eight covert patients who provided samples but a vaccine researcher at the Mayo Clinic announced the new study only detects traces of genetic material from the corona virus it doesn't tell you if it's viable and
NBA players, staff asked to help virus researchers
"NBA teams are trying to help researchers find a possible solution to the corona virus crisis they're teaming up with the Mayo Clinic for a study centered around antibodies is voluntary and open to both players and staff the study may also help doctors understand how widespread the virus is among people who are a symptomatic or experience mild symptoms Dave Packer
Pence says he should have worn a mask at Mayo Clinic
"You know I I going back to Mike pence not wearing a mask at the Mayo Clinic he has since said he told fox and friends he should have worn a mask I like Mike pence mmhm and I I think you should have worn out a mask at the Mayo
Pence says he should have worn a mask at Mayo Clinic
"Show president trump visits a mass factory in Phoenix today here's Alex don't last week vice president pence was criticized for not wearing one of the Mayo Clinic bands now says he should have worn a mask president trump saying yeah he's willing to I have no problem wearing a mask I don't know I'm supposed to make a speech I just don't know should I speak in a mess you have to tell me if that's politically correct after he stopped at the factory the president will return to the White
Trump willing to wear mask, Pence says he should have worn a mask at Mayo Clinic
"Tell my president trump wear a mask a mask when he visits a mask factory in Phoenix today here's Alex stone last week vice president pence was criticized for not wearing one of the Mayo Clinic bands now says he should have worn a mask president trump saying yeah he's willing to I have no problem wearing a mask I don't know I'm supposed to make a speech I just don't know should I speak in a mass you have to tell me if that's politically correct after he stopped at the factory the president will return to the
Pence says he should have worn a mask at Mayo Clinic
"Mike pence said yeah I should have worn a mask when I was at the Mayo Clinic I didn't think it was necessary but I should warn the mask at the Mayo Clinic and I wore it when I visited the ventilator plant in Indiana and I think it's it's it really is a statement about the American people the way people have been willing to step forward practice social distancing wear masks in settings where they can't do that and and I just have to tell you that I couldn't be more grateful to see the way the American
Vice President Mike Pence on Mayo Clinic visit: 'I should have worn a mask'
"Peterson vice president Mike pence says he was wrong for not wearing a protective mask during a visit to the Mayo Clinic in Rochester last week at a town hall on fox news pence said he didn't think it was necessary to wear one considering how often he's tested for corona virus but he admitted he should have worn one
"mayo clinic" Discussed on Mayo Clinic Talks
"So this is all happened in the last one hundred days Dr Badly. Obviously the everything's changing it's evolving. How do you foresee the next one hundred days moving forward so I heard within the next hundred days there are likely to be drugs? Identify which make meaning all favorable impact into patients who have disease. And it's possible that one or two of those therapies cocoa as far as being approved and therefore made available to everyone be prescribed outside of well. That's an uplifting note absolutely to to end on there and you're anything else that you wanted to add base has been a tremendous response from the entire male immunity. Everybody at every role has come together. The synergy is to move and advance everything. We're doing into clinical and did spend a unbelievable thing to observe and everybody who played A. I believe help. These patients number one number two when we're faced with such devastating illness. It's hard to see his overlying. If there is a silver lining to be had from this. I'd like to thank several things number. One is that will begin to appreciate and recognize and implement practices of public health more widely across. Us number two is that we implement those public health policies that we know make a difference or example we know that influenza vaccination makes a difference and Save Wise I am hopeful that the public option of those interventions will increase time. Those and then number three is we are in the position of having such a depth of scientific understanding today and such a depth of good therapeutic candidates in our disposal that it talk literally weeks to get the first trials in place and that's because obey robust basic and clinical science pipeline. That is so critical and my third hope is that increasingly recognized and basic urged will continue to be patented thanks to Dr Andrew Baddeley chair of Mayo Clinic's covered nineteen research hospitals too badly. Thank you time and hard work. You all Mayo Clinic. Qna is a production of the Mayo Clinic. News Network is available wherever you get and subscribe to your favorite podcasts. To see a list of all male clinic podcasts visit news network DOT Mayoclinic Dot Org. Then Click on podcast. Thanks for listening and be well. We hope you'll offer a review of this other episodes when the option is available comments and questions can also be sent to Mayo Clinic News Network at Mayo Dot Edu..
"mayo clinic" Discussed on Mayo Clinic Radio
"To both external medical centers but also for us. Because there's been a lot of Idea exchanges between us and and other clinicians so that's been really beneficial and then also we are physically offering on our test to be order -able by Other medical centers across the across the country. And I think that's really beneficial because it allows those hospitals to focus on providing molecular testing. Which is a much more crucial and essential. Need at the moment cinch does Actually diagnose active infection compared to see your logic testing which tells you yes. This individual has been infected at some point in the past. But it's not really to be used as a diagnostic so that urgency and need for a result is not as great as it is for molecular test. When I was a child I remember hearing guy now knows an old wives tale have going to medical school. But if you've had a virus once you can never get it again. In fact I use this example before but my parents sent me to a girlfriend's house when she had the chicken pox hoping that I would get the chicken pox so that I'd never get it again now. I know the chicken pox in covert nineteen are very distinctly different viruses. But I'm wondering what is known about immunity after someone has been infected with covert nineteen. Yet you know that is really one of the key questions right now. After recovery does an individual have complete or partial immunity to Kobe nineteen eighteen. And so how long does that last to be honest because we really only been dealing with this virus for four or five months? We don't have a good sense of the duration of that protective immunity. That you're talking about I think we can say that based on prior studies during the SARS outbreak in the early two thousands we know that protective immunity against that virus which is closely related to SARS Kobe to that protective immunity seemed to be detectable for about two years after infection. And then there's been some preliminary studies in In monkeys suggesting that they have at least short term immunity one month after recovery of from Kobe. Nineteen as we see more and more information I think there will probably be at least some short term and immunity But we really need more studies in this area before we can make any conclusive comments on the duration of that protection from reinfection. I just have one last question for you because this brought it to mind for me. I saw on the news yesterday. I believe it was that some patients were becoming a according to the news that reinfected with cove in nineteen soon after having a suffered from it is that reinfection or is it just persistence or do we know that yet. Yeah I think I think that's a really important thing that we all need to consider whether this is truly reinfection versus whether we're still detecting residual nuke lake acid from these individuals Is is something that we're really learning more about so I think only time will tell to be honest at this point. Thank you very much touch with the owns very informative visiting with Dr led. Today she's the director of our Infectious Disease Serology Laboratory at the Mayo Clinic in Rochester Minnesota..
"mayo clinic" Discussed on Mayo Clinic Q&A
"To both external medical centers but also for us. Because there's been a lot of Idea exchanges between us and and other clinicians so that's been really beneficial and then also we are physically offering on our test to be order -able by Other medical centers across the across the country. And I think that's really beneficial because it allows those hospitals to focus on providing molecular testing. Which is a much more crucial and essential. Need at the moment cinch does Actually diagnose active infection compared to see your logic testing which tells you yes. This individual has been infected at some point in the past. But it's not really to be used as a diagnostic so that urgency and need for a result is not as great as it is for molecular test. When I was a child I remember hearing guy now knows an old wives tale going to medical school. But if you've had a virus once you can never get it again. In fact I use this example before but my parents sent me to a girlfriend's house when she had the chicken pox hoping that I would get the chicken pox so that I'd never get it again now. I know the chicken pox in covert nineteen are very distinctly different viruses. But I'm wondering what is known about immunity after someone has been infected with covert nineteen. Yet you know that is really one of the key questions right now. After recovery does an individual have complete or partial immunity to Kobe nineteen eighteen. And so how long does that last to be honest because we really only been dealing with this virus for four or five months? We don't have a good sense of the duration of that protective immunity. That you're talking about I think we can say that based on prior studies during the SARS outbreak in the early two thousands we know that protective immunity against that virus which is closely related to SARS Kobe to that protective immunity seemed to be detectable for about two years after infection. And then there's been some preliminary studies in In monkeys suggesting that they have at least short term immunity one month after recovery of from Kobe. Nineteen as we see more and more information I think there will probably be at least some short term and immunity But we really need more studies in this area before we can make any conclusive comments on the duration of that protection from reinfection. I just have one last question for you because this brought it to mind for me. I saw on the news yesterday. I believe it was that some patients were becoming a according to the news that reinfected with cove in nineteen soon after having a suffered from it is that reinfection or is it just persistence or do we know that yet. Yeah I think I think that's a really important thing that we all need to consider whether this is truly reinfection versus whether we're still detecting residual nucleic acid from these individuals Is is something that we're really learning more about so I think only time will tell to be honest at this point. Thank you very much touch with the owns very informative visiting with Dr led. Today she's the director of our Infectious Disease Serology Laboratory at the Mayo Clinic in Rochester Minnesota..
"mayo clinic" Discussed on Mayo Clinic Talks
"But it but it works. I think we're going to start to see that in other areas of the US as this moves away from the two coasts and more and more into the center of the US. So here's a listener. Who has obviously listening closely? She says two weeks ago you advised us to use contemptuously appropriate levels of protection explained again what that means and does it still apply it. It not only applies but it is a dynamic or moving target based on the context. I is simple analogy. And then we'll apply it If you live in safe area of the country where I do Rochester Minnesota When I go to bed at night I locked the front and back door later one. I closed my first floor. Windows layer to flip outside light on layers tree. That's all I need. If I lived in a in a more difficult area of the nation I might add layer for an alarm system layer. Five window bars. Maybe layer six the panic button. You get the idea. So what does that mean for us in the in the US again? Are you in a high risk or low risk situation and that can change over time? Low risk situation. Tell the work if you can social distance thing being sure in your hands or cling slayers two and three. Nobody comes in your home without him. Sanitizing layer or nobody comes into your home period. And unless it's absolutely necessary you just keep layering things on like that based on your particular context based on the transmission dynamics in your area recognizing they lag by two weeks or so. So you're sticking with that is your motto. You don't have a new one correct. Well the only knew it. I added more cultural and that is and we're beginning to see this. You Know Saint Paul Ramsey hospital up in the twin cities Among their greatest number of VR. Visit not Kobe. Nineteen it's mental health issues and my motto is. We really have to turn from a mean culture to way week culture and you see that in a grassroots through healthcare providers movement where you see them in the hospital with the same thing. I'm staying here. You stay home. If it's every man for himself we will do poorly as history shows in pandemics. I'm to take care of my neighbor. I'm to take care of my community to help at any level that I can and if we all do that and if we all take care of each other we will do better together all right. It's not me it's we all right. Yeah next question. Do Surgical Masks help or not only do surgical masks help but a mask of almost anything helps now the original reason that CDC and other organizations that don't wear masks is because they wanted to preserve those for frontline healthcare workers but you can have an effective mascot of a folded over Bandanna or handkerchief. The way it helps is in disregard. It decreases the risk that you'll breathe in these respiratory droplets that somebody else may have cost coughed or sneezed. And now you're breathing and it is a reminder not put your fingers in your eyes nose or mouth so from that perspective is protective now. It can't do anything against Aristotelian virus but that's probably not the primary mode of transmission air again. I think because they were. They didn't want people to go out and buy all the end ninety five and surgical masks because they were needed for healthcare workers think. That was the motivation behind that. Not Dia- Interesting Hell. Would you like to comment on the cure being worse than the disease thinking? Yeah I think this really get to cultural and personal values. What price a light? How much economic disruption for. How long can we take? What does it mean particularly for the most vulnerable members of our society who are often living paycheck to paycheck? This is where government comes in government is to do for the people what they cannot do for themselves. I'm fine I don't need anything but I know that there are neighbors of mine that do need help and we help them. How how far do you go with it? And how do you balance it? I think it is phased approach. You wait till the curve bent you. Wait till you start saying a great deal munition in case and then you wait two weeks more you begin to loosen restrictions. I with young people because there while they can still want occasion have severe disease. They are dying up there and we watch weight. We do it carefully the same way you might think of sort of the canary in the money's Mindset of you know you don't expose. Everybody wants to open up all the schools and colleges do it all right. Isn't it okay for people with no symptoms or who have tested negative to go back to work your difficult difficult question the no symptoms. You actually don't have any information It is apparent that ace symptomatic transmission. That is you have no symptoms but are still carrying the virus and can transmit it to somebody else does occur the more people you congregate in a building in a room in an area the greater the risk that you re spark that pandemic and start having cases. They get so. It's really important that we know that the other thing that's really important is that we. We begin to have very rapid tests to tell us whether somebody is immune even if it's in the short term so that they can go back to work in in particularly in essential job they can be frontline healthcare workers and responders. If I have a sick family member can I go to work or should I stay home? You should stay on you. Are you are risking. Other people by transmitting that disease I would say that if you're not in ential worker than than you need to be at all right next question the. Us and South Korea apparently had their first detected case of covert one thousand nine on the same day but it appears they have. They have flattened the curve and started the fourteen day timer. What can we learn from on how they have handled the outbreak? You know what the key thing that I know people bring up. Well you know SARS in in two thousand two wasn't like this. That was different. There was not a dramatic transmission. What drives this is that we do. Have people transmitting the disease? Who Don't know they have it. And so when if you really you have two choices in stopping this pandemic and there are only two absent antivirals and vaccines you either. Get everybody infected. In which case you will have millions in the hospital and Lou and and lose tens of thousands to hundreds of thousands of people to the disease or you shut things down now. Both are disrupted both have closed or Kahn. Both are value judgments about what to do but if the goal is stopped widespread transmission. You say everything isn't essential or that is not a part of national security Supply Chain Hospital Workers Federa telework. We are out of time basically but I have one last question. Because I've been getting this on nonstop for the last thirty six hours and it's about Ibuprofen What do we know about Ibuprofen Safety? So we know a lot about. Ib program safety though not in the context of this particular infection so I do pro fin regardless those a context is a drug. That can cause water and salt retention. It can elevate blood pressure and can cause bleeding as well as kidney dysfunction. Now you take a drug like that into somebody with a viral infection. As it help or harm I think despite the warnings of WHO and the government of France. I think most of US scientists recognized there really is not any solid scientific data saying that that represents a unique risk in code nineteen now having said that the only reason to take a drug like that is for fever. Reduction muscle aches and pain uses. See the benefits. Are stapler all right. Well Dr Greg Poland Infectious Disease Expert vaccine expert. Thanks so much again for answering all of our listeners questions on the covert nineteen outbreak We'll be talking to you again soon. We'll look forward to that. But hopefully we'll reach the apex of number of cases pretty soon and number of deaths and start to go on the other down on the other side of the curve. We all go. Yeah thank you moment Mayo Clinic. Qna is a production of Mayo Clinic News Network and is available wherever you get and subscribe to your favorite podcasts to see a list of all mayoclinic. Qna podcast visit news network. Got Mayoclinic Dot Org. Then Lick podcasts. Thanks for listening.
"mayo clinic" Discussed on Mayo Clinic Talks
"If you're looking for special. Cme credits to fulfill controlled substance prescribing requirements we will be re releasing popular mayoclinic talks opioid edition on Thursdays these meet Arezzo Wisconsin and updated Minnesota state guidelines to claim. Cme credit for listening to these episodes visit C. E. Dot Mayo Dot edu slash opioid pc. Coming up on Mayoclinic. Uncertainty is something that we're all uncomfortable with mental health and coping during the Cova nineteen crisis social distancing is meant to be a health guideline but unfortunately limits a sense of intimacy that many of us need during uncertain. Times here ideas for finding comfort amid uncertainty. One thing that works very well is coming up with the schedule and advice about continuous news coverage. I think it's important to evaluate the sources of information that you're listening to any amount of time. You're spending on those sources learn strategies for managing worry amid a national emergency. If we're not handling stress while we can't expect our children to handle it very well question. How can you be better prepared for the cove in nineteen pandemic? It's important that we do that so that we don't spread our anxiety to other people. The answer next on Mayoclinic Q&A. I'm Dr Tom. Shives and I'm Tracy mccray during today's podcast on the covert nineteen pandemic. We'll share portions of a recent interview with Dr Beth. Rush a clinical neuropsychologist at Mayo Clinic. If you're feeling stressed out by the sweeping changes created in the virus outbreak. This discussion is for you. We'll find out why both structure and flexibility are needed in these days and Dr Russia's thoughts about connection and how it's possible even amid social distancing. Let's start with a wave of uncertainty. That's washed over our lives and Dr Russia's thoughts on dealing with that when people have to respond to change the best thing to think about is whether or not we need to fear what's uncertain uncertainty is something that we're all uncomfortable with and win we're uncomfortable. We tend to become anxious so if we can learn to embrace incertainty as something that we can handle. And we take the time to address then it becomes more bearable. It becomes something we can live through as for addressing that uncertainty. Dr Rush has several thoughts. I she says there can be comfort in structure. I think one thing that works very well is coming up with the schedule. We know from all of the literature that having his schedule being able to journal things having set times that we do things helps allay some of the fear and anxiety. We know what's coming up in our own home so maybe designing a households schedule and this is something had been considering doing with my own. Family is doing things at certain times during the day. Despite the fact that we're not in a structured school schedule or structured work schedule but I think having some structure in place or a schedule in place helps with the uncertainty. That's especially true in this crisis. Which could continue for a while. We're already at the beginning of the soft quarantine and we may be at it for several weeks at a time and we need to think about. How are we going to stay well? During that time and the structure the routine becomes really important being able to exercise on a routine basis being able to eat well and not just eat. What's available to us? Make sure you don't use all of the emergency oreos at once. I think that's really important. Take pause once in a while. And my feeling overwhelmed. Why am I feeling overwhelmed? And what do I have within me to be able to manage that? It's important that we do that so that we don't spread our anxiety to other people are children knowingly or unknowingly if we're not handling stress while we can't expect our children to handle it very well so make sure that you know you need to be checking in with yourself and monitoring your own stress and how it surfaces so that you can make sure you're setting a good example for your children that includes how you digest the news about the crisis. Dr Rush says one thing you might WanNa leave off your family's schedule or at least limit is time spent with news and social media. I think it's really hard to figure out how much news we need. And how much social media we need during a time of isolation such as self quarantining or being at home with our kids. I think you know yourself bass you know whether you're an introvert or an extrovert. You know how much information you need. I think it's important to evaluate the sources of information that you're listening to the amount of time you're spending on those sources for instance you may want to spend more time listening to CDC UPDATES and reference sake websites and less time on facebook listening to someone's reaction to a CDC update and remember. There's a difference between being in the know and obsessing about every alert that flashes across the screen at some point. You're GonNa feel totally overwhelmed and you're going to need a time out and you can respond to it with any of these things exercise. Meditation journaling a moment with your family or even a nap in those low moments. Dr Rush says it's important to be kind to yourself. Try not to eat a lot of fast food or a lot of carbs but I don't deprive myself if I wanNA cook. You ate a cookie. I think about it. Maybe donate ten for eight. The cookie I try to exercise regularly that becomes important for just managing my stress level and managing the way that I think. I try to make sure that I'm around people who care about and who don't introduce extra stress to me. I try to stick with my family. Tell my kids I love them. They try to be present for them. Dr Rush says the practice of being present can help replace the loss of intimacy and feelings of isolation that are happening in this pandemic social distancing is meant to be a health guideline but it unfortunately limits a sense of intimacy that many of us need during uncertain times. We can still have that intimacy but we have to go about it in a different way. We have to lock eyes with the person that we're talking to and be present. We have to listen actively to what they're saying and respond to them with true feeling when we do that were able to communicate the sense of constancy security that a hug creates and for healthy people in your own home Dr Rush says you can take it one step further. It's called the twenty second hug during times of uncertainty embrace someone that you love and hold them be still with them do nothing else for twenty seconds and that communicates a sense of calm and certainty. That wasn't president before the hug started. If you're healthy hug if you're not isolate heads up kids twenty seconds of hugging when I get home today this edition of Mayoclinic. Qna as part of a continuing series on the Cova nineteen pandemic other episodes delve more into the virus itself. It's spread in what you can do to protect yourself from getting it. We hope you'll consider listening to other conversations in this series. Meanwhile thanks to clinical neuropsychologist Dr Breath rush for her time and her stress reducing ideas until next time take Dr Russia's advice find some structure. Remember to be kind to yourself and be will mayoclinic. Qna is production of Mayo Clinic News Network and is available wherever you get then. Subscribe to your favorite podcast to see a list of all male clinic. Podcasts visit news network DOT Mayoclinic Dot Org. Then Click on podcasts. Thanks for listening and be well. We hope you'll offer a review of this and other episodes when the option is available comments and questions can also be sent to Mayo Clinic News Network at Mayo Dot Edu..
"mayo clinic" Discussed on Mayo Clinic Health Minute
"From the studios of the mayo clinic news network. This is Mayo Clinic Radio, exploring the latest developments in health and medicine and what they mean to you, welcome everyone to Mayo Clinic Radio. I'm Dr Tom shy, and I'm Tracy McCray problems with the bones, muscles, ligaments, tendons of the shoulder, a common, especially as we age. In fact, almost eight million people go to the doctor's office for a shoulder problem. Every year on today's program, we'll talk about shoulder problems and treatments with a mayo clinic experts. It's actually pretty common in what had happened in the past. People were probably under treated for it. So actually the rate of shoulder replacement surgery is growing at three to four times the rate of hip and knee replacements in the United States. So the rate has really increased also on the program will learn about treating and preventing osteo prosise had what causes cellulite. And can you do anything about it all that along with this week's health and medical news right after this. Welcome back to Mayo Clinic Radio. I'm Dr Tom shy, and I'm Tracy McCray. The shoulder. Finally, gonna talk about. They're showing it's a shallow ball and socket joint with a actually a remarkable range of motion and because of the shoulder joint, his so mobile, it tends to be more susceptible to injury. Shoulder pain can stem from a lot of different causes, including sprains strains tendonitis or an injury to the rotator cuff, that group of tendons on the top of your shoulder that allow you to move it so far in so many different directions, conservative treatments such as rest, ice and physical therapy are sometimes all that's needed to recover. But if you're injury is severe and it involves a complete tear of the muscle or tendon, you might need surgery here to discuss shoulder problems and what to do about them as mayo clinic, orthopedic surgeon, Dr. John Sperling, welcome back to the program. Dr Sperling, it's great to have you here. Wonderful to be here. Thank you so much. My golly gutter Sperling. Good to have you with us. Wonderful. Tell us why. It is that the shoulder joint can move so far in so many different directions. That's right. Tom, it's incredible the range of motion the shoulder has compared to other joints in the body. But along with that range of motion comes more susceptibility to injuries, particularly when people perhaps overdo it with activity or sustained falls or things such as that most common injuries, most comedies are partial tears or full thickness, tears of the rotator cuff, very common injury that we see. All right now, a lot of people come in and may say, I got a problem with rotary Cup. It's rotator cuff, right? And tell me. That's right. That's right. Exactly. Like my prostrate. That's right. So it is Tom, the partial or full thickness. Tears are incredibly common. So getting Terry of your rotator cuff is like getting gray hair, losing your hair or both as we get older, so incredibly common problem that we see in folks and some people tolerate them in some people. It causes significant pain particularly at night when they try to sleep. A question I have about that range of motion that we were talking about when we got started. If as you age, you don't do enough stretching or strengthening of the shoulder, do you lose that range of motion people as they do lose ranch, motions, great questions overtime. Most people do lose some motion in their shoulder. So maintaining flexibility and strengthen your shoulders is important as we all get older. So the rotator Cup, this group of tendons on the top of your shoulder degenerates with time or it can tear. Correct. So as we get older, they fray the rotator cuff tendons do fray with aging time and they do become more susceptible to injury. There's no question about that. So perhaps a fall that you would take when you're younger, throw tater can sustain that or do okay with that. As we get older, the we, the tendons do tend to weaken and their more susceptible to have a full Tare. Can the tear ever repair itself? It doesn't. It's interesting. So rotator cuff, tears, like a hole in a pair of pants. It does not heal itself. Its own. We try to treat these and particularly people who may be a little bit older with simple non operative things at first medication injection physical therapy, but people have if they have continued pain. Despite that, that's when we think more about operative intervention because the rotator cuff is less like a Muslim that way because cana- muscle repair itself. So the rotator cuff is actually the part where the muscle turns into ten attendant inserts into the bone. So typically what happens is the tendon actually rips off the bone says a actually a real gap there between the tenant in the bone and the tendon it's self, cannot heal itself back to the bone that way when they're particularly when there's a full tear and tell us about the surgery, can you do that through the scope and how successful is it? It's interesting. It's really come a long way Tom. So in the past, there were these horror stories of going through shoulder surgery and the pain and disability, and how long the procedures were take. But most rotator cuff surgeries really are amenable to either and arthroscopic repair or repair through a small incision and the surgery is typically take about an hour to do. Many or done as an outpatient or perhaps one night in the hospital. So it's come a long way in terms of the surgical technique to minimise pain, so you can so the tendon repair the rent in the tendon, or they're tearing the tendon or so it back to the bone? Correct. So it depends where the tendon tears. Sometimes it tears in the tenant itself. Usually it's the tendon off the bone, and we can usually repair that Arthur Scott with three or four little one centimeter incisions or perhaps one incisions about inch and a half, two inches on the top of the shoulder itself. So smaller, incisions, less post operative pain. The patient will will typically have outpatient surgery outpatient. So most most times in the United States,
"mayo clinic" Discussed on Mayo Clinic Health Minute
"And then it can spread like wildfire. All right. We'll keep worrying about it. When it comes to that foodborne illness thing stick with hot dish. Everything will be fine. Don't worry. All right. We'll be talking about shingles and other infectious diseases with the mayo clinic, infectious disease specialist. Dr Tosh Dr. Tosh. Thanks for being with us still to come. A Mayo Clinic. Radio will learn about treatment for cleft lip and cleft palate, birth defects. And later on the program, the latest addition of the mayo clinic, family health book coming up the latest health and medical news. Vivian Williams. You're listening to Mayo Clinic Radio on the mayo clinic news network. I am Vivian Williams for the mayo clinic news networks with roughly one in ten Americans over sixty-five living with Alzheimer's, any progress in the effort to fight this Z's would be a welcome advancement for millions of people. Experts at mayo clinic are cautiously optimistic that a new antibody known as band twenty four zero one will continue to show an ability to delay progression of Alzheimer's, reducing amyloid accumulation in the brain as it has during early phase clinical trials. Doctor, Ronald Peterson is the director of the mayo clinic Alzheimer's disease research center. He says, Alzheimer's is the most costly diseased to our society. Right now, there is no cure for Alzheimer's and all currently available drugs can do is treat symptoms. But this new drugs purpose is to slow the progression of the disease. Dr Peterson says, the drugs approach to Alzheimer's treatment is based on what's called the amyloid hypothesis, which is. Is basically that certain proteins deposit in the brain lead to death of nerve cells and eventually symptoms happen. Even though it's an early phase two trial, the results suggest the drug may remove one of the toxic proteins from the brain that causes Alzheimer's disease. If the results continue to hold up through continued testing and trials, it may eventually be possible to offer the drug to people to prevent or delay the symptoms of Alzheimer's disease from developing. Again, Dr Peterson says he's cautiously optimistic, and the results are encouraging, but turning this into a treatment could be a long way off. In the meantime, in addition to drug interventions to treat symptoms of the disease, he says, people can make lifestyle modifications to lower their risk. He recommends people stay intellectually active, stay involved in their social networks. And from a dietary perspective, perhaps a heart healthy diet. A Mediterranean diet may be useful in delaying the onset and slowing the progression of the disease. Now moving on. Most people know that when the weather heats up drinking, plenty of water can prevent dehydration, but you may not know that consuming lots of liquid in the heat of summer may also reduce your risk of developing kidney stones. Dr, Ivan ported. The second, a mayo clinic nephrologist says more patients go to the doctor with painful kidney stones in summer than during any other time of the year, especially if you've had them before. He says, when thinking about what a kidney stone is, you have to think about what a kidney does. The kidney filters out talks ins takes out things that shouldn't be there and the way it gets rid of this is by putting it into the urine. If you get dehydrated, your urine can become concentrated to the point where stones form Dr porter has summertime, tips out event, kidney stones. I drink plenty of fluid, eight to ten glasses a day, stay away from overly salty processed foods and meats that increase sodium will increase your risk of kidney stones. And if you've ever had a kidney stone. You know how painful they can be. So listen to these tips. They could help for the mayo clinic news network. I'm Vivian Williams. Bucko backtra Mayo Clinic, Radio. I'm Dr Tom shy, and I'm Tracy McCray cleft lip and cleft palate or among the most common birth defects resulting in openings or splits in the upper lip, the roof of the mouth called the pallet or vote cleft lip and cleft palate result when facial structures that are developing in an arm. Born baby don't completely close. Having a baby born with a cleft can be upsetting to the parents. And I'd say grandparents do, but cleft lip and cleft palate can be corrected. It's done with a series of surgeries to restore normal function and Chievo more normal appearance with minimal scarring care to discuss treatment for cleft lip and palate is Dr John voles Dr. Voles is an orthodontist in the cleft and craniofacial clinic at mayo clinic. Welcome to the program Dr. Voles. Thank you. Thank you. Nice to meet you. Have you on the program? We all know somebody with cleft lip or cleft palate. So it seems like it's a fairly common a problem, but how common is it really in the US about one, seven hundred births or cleft palate or that's pretty common. Is there anything more any birth defect more common? No, I think this is about the most common of all of them top of the list and facial genetic problem is at a birth defect. What what exactly is it a summer syndrome or or genetic other ones are just spontaneously happen. So does it tend to run in families if one of your parents has had a cleft lip or palate? Are you more likely? Not necessarily. It just depends genetically based or just a just a common happening during during the. Just Asian period is with more prenatal care. This generation and then previous generations of the last few generations. Are there less cleft, palates, cleft lips? I don't think so. I think because it happened so early in the process that sometimes you don't even know you're pregnant and when it could be happening already, the cleft lip are developing ultrasound of the newborn of the fetus have gotten so good. Are you able to detect a cleft lip and palate before birth? Those three d. ones that you can see. But you know about sixteen to twenty weeks into the pregnancy they can do the tra- sounds in their pre distinctive. It's gotta be at the right angle, and sometimes you still miss them, but it's really helped a lot to prepare the family and get them ready and get them over to us. Because a lot of times we're going to be doing things right after birth for the cleft palate and cleft lip you are, is it better for recovery to do the surgery right away or why. Why not wait a little while the surgery usually for the repair. The cleft lip is usually done about twelve to twenty some weeks, but we do some pre surgical modeling or molding the palate and the lip previous to that right after they're born. We usually take an impression about maybe two to three days after they're born if we can, and we start the process of molding the lip and the pieces in the in the palate together. I'll always in in preparation for the ultimate surgery surgery that's required. I mean, there's no other treatment for this. There's other things that can do that can do lip adhesions and things like that. But nowadays it's more common probably to do than 'nam appliance nasal LV molding appliance, which is a little like denture device that we make manufacturer, and we of mold the child's developing arches together and then make kind of close at cleft site down. So the surgeon could do a better job with the lip repair. They're not stretching that tissue quite as far dimension. The lip repair isn't as in as invasive as the palate repair. No, the palate repair come little bit later, the ten to twelve months after the child is born the Palo appear, but they're lip repairs done pretty much twelve weeks or so after the child is born. Now, does an orthodontist do all of this or plastic surgery involved? Are you a one man show or. No, this is definitely a team effort from start to finish. I mean, it's it's from birth. Maybe before birth, preparing the individuals in the family and all the way up. Until eighteen twenty years old at the team is working together at different points and it stage it's not. A continuum is definitely kind of stage member has a different involvement and we try to team up and do things that maybe require surgery. You want to keep the surgeries to a minimum. So we try to do surgeries that maybe fall back on one another where ENT Kadduh something put ear to in. We could do. They could do the lip repair that can do other things along the way and do it in one surgery instead of having multiple anesthesia's and things like that. What types of problems does it? Cleft palate present, FRA child a feeding? Probably the biggest thing because there's a lot of times there's no pallet. So they have to use different types of bottles feed. The parents have to different types of bottles because there's no Paletta push against with their tongue to get the the, the formula or the, you know, the milk into the pallet is the roof, the mount, right? There's a roof of the mouth. Exactly. Yeah. It's the biggest problem is is feeding early on. Exactly. Right away is the big thing to start gaining. Wait and get get them out of the hospital. So several mobile take a couple of days to get out of the hospital where normally you could be gone maybe within a day or two somewhere there a couple of weeks until they can get their body weight up and they're not losing. And I assume that this is not a problem that we only see in the United States. There must be other countries where cleft palate develops in in newborns that aren't as fortunate as the kids here who can can get it repaired. What happens if it's never repaired, really, I think it's more kind of psychological or social type of thing. Because really, if you just left the cleft lip and cleft palate, go growth will be better speech public, however, will not be that. That's my the main thing about the palatal closure. The lip repair is getting the person to be able to speak right away in those first two to three years. And that's why we have a speech pathologist or speech therapists on the team with us because that's the first couple years or released trying to get that go along. So they can speak in here. You're to have to play sometimes. So the patient can gain language skills pretty quickly. Otherwise they fall behind pretty quickly. And then by the time they're, you know, kindergartener. So they're going to be behind the curve. The other individuals we have been doing multiple dental type of topics, anticipation of the anniversary, the centennial celebration, what has changed? I'm not saying that you've been here for all one hundred years by any means, but over the course of your practice, how has has this changed repairing the pallet in the lip? I think so. I think the more involvement with the nasal Vural molding appliance before when I first got here, we use a planet was surgically done where we put it in place in the surgery. There'd be a surgery done. We'd actually place it in the patient's mouth during the surgery, and the parents would turn it and it would kind of close bring the segments together. However, we didn't have the option of kind of molding. The nasal part of it is knows. But then you alvie alert. What over is taking, you know your jaws kind of an arch form. And when the cleft is air, that art form could be broken down into two pieces. One that's a little bit larger and or could be broken onto three. Please pieces where you have three pieces the pre maximal or where you're your anterior teeth. Are your laterals in central incisors are all forward out of the mouth, their their protruding out. So what you're trying to bring that back into the mouth and kind of get it ready for the lip repair. Did you really run the BUSTER marathon? This I did. Yes, I did this year. Oh, good for you. Was it called? It was cold, but you soon ring and a win about thirty seven miles an hour first time first time, Boston thirty. I guess. Right? Cleft lip cleft palate with mayo clinic orthodontist, John voles. Thanks so much religious pleasure meeting with pleasant. We're going to take a short break. When we come back, we'll learn what's new in the latest edition of the mayo clinic family health. You're listening to Mayo Clinic Radio on the mayo clinic news network. Back to Mayo Clinic Radio. I'm Dr Tom shy, and I'm Tracy McCray. The mayo clinic family health book was first published in nineteen ninety, and it has become a classic home medical reference selling more than a million and a half copies. It's now in its fifth edition and the first update since two thousand nine just occurred the newly revised and the lowest rated volume offers the latest in medical knowledge and strongly emphasizes self care. The mayo clinic family health book is based on the expertise of hundreds of mayo clinic healthcare providers, and the advice that they give their patients every day here to discuss is the medical editor of the latest edition of the mayo clinic, family health book, Dr Scott Lytton. Welcome back to the program Dr Linton. Well, thanks, Tom, Tracy, happy to be here. So I knew that you were a highly respected internal medicine specialist and all-star and Dr to some stars. How did you ever get involved at. Editing books. Well, by entire career is a general internist taking care of patients. I've been involved in caring for patients and teaching patients how to care for themselves. So this same lake just a natural progression when I had the opportunity to edit actually the last three copies of this book. Well, you have let let's see it. No, our listeners on the radio can't hear that YouTube, they can see those beautiful thirteen hundred ninety one pages what we
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"From the studios of the mayo clinic news network. This is Mayo Clinic Radio, exploring the latest developments in health and medicine and what they mean to you, welcome everyone to Mayo Clinic Radio. I'm Dr Tom shy, and I'm Tracy McCray. Shingles is a viral infection that causes a painful rash most often appearing as a single stripe of blisters. That wraps around one side of your torso or one side of your body while it's not life-threatening. Shingles can be very painful, and there are some potential long term complications. On today's program, we'll discuss treatment and prevention of shingles with the mayo clinic expert also on the program will learn about treatment for cleft lip and cleft palate, and we'll hear what's new in the fifth edition of the mayo clinic, family health book all that along with this excelled in medical news right after this. Welcome back to Mayo Clinic Radio. I'm Dr Tom shy. I'm Tracy McCray according to this centers for disease control and prevention. Almost one out of every three people in the US we'll develop shingles and their lifetime, and the risk goes up as you get older. In fact, if he can make it to eighty five, your risk of getting shingles is probably fifty percent shingles as you may know, is that painful blistering rash that happens when the chicken pox virus is reactivated. It's like a jolt chicken pox I guess you could say it's the worst you had. I have had it, yes. When it comes to shingles, some common questions arise, shingles contagious, and maybe more importantly, how can I prevent shingles in the first place here to discuss this and other infectious disease topics as mayo clinic, infectious disease specialist, Dr pritish Tosh welcome back to the program. Dr Tosh for Dr Tosh good to have you. So tell us about shingles herpes zoster and why it is that for. Whatever reason that chicken pox virus in your body would all of a sudden become reactivated sure. When people get chicken pox the infection, this go away, they get a fever, they get these rashes, but the fire is sort of stays in the nerves for the rest of your life, dormant, dormant, and your immune system specifically called the cellular immune system, keeps it at bay and over time, people's immune system just starts to wane and especially with age people, cellular immunity will wane. And so the older you get your immunity to various l. zoster virus that causes chickenpox will start to decrease. And so this immune system that is keeping the virus in the nerves, keeping it at bay at some point will fail, and then then the virus sort of comes out from the nerve and then goes into the the skin. In causes very painful blisters. More importantly, however, is there's a complication called poster Pedic neuralgia, which after the the actual blisters have gone away, people can have that pain, long lasting debilitating for years potentially for the rest of their life happens at twenty percent of people who have shingles. It's about right, it's about right, and it's a real problem. And that's really what we're trying to prevent. And so there have been now to vaccines, one alive vaccine. Now in newer killed vaccine. Basically that helps people boost their cellular immune response to fair Sylla's Ostra virus so that their immune system is able to keep the virus at bay for much longer if the shingles shows up along nerve path, which is what it usually does is that the only thing that it does. It is always on some sort of nerve bath isn't it? It usually is the vast majority of. Circumstances that is the case we call it Dermot Tomo meaning that from the nerves that are enervating the skin, those nerves are the virus. In those nurse reactivated goes down those paths and activates, which is why you get it down one arm or on one side of your face, then not the other usually. So does the chicken pox virus? Does that lay dormant in your nerves? Why does it show up in the nerve path when it doesn't do that? When you've got chicken pox it does lay dormant in the nerve cell. Now, I said, usually in most often singled Dermot Thome. But occasionally, if people have really severe reductions in unity, people have had organ transplants were on chemotherapy that virus reactivation can go all over and called disseminated and that can cause disease all over. But it's also caused really bad things including Hepatix. Titus, which is usually fatal meningitis, pneumonia, all kinds of stuff. And so it is usually self limited in terms of the the rash, but especially in people who have bad immune systems that can be really, really bad is it contagious? So when people have the eruption of the blister, so we're talking about reactivation or shingles. The virus is there. It is contagious. So somebody who is not immune to chickenpox if they were to be exposed to somebody with shingles, they wouldn't developed shingles. They would develop chickenpox. And so the recommendation really right now is for everyone over age fifty to get the the new vaccine which is much better than the old one really efficacious looking at ninety percent range even into advanced here and it's called shin creeks. Yes. All right. And. It is available. There was in limited supply there for a while, but now pretty much widely available. Oh, I think we're still running into manufacturing delays. The really it's been such an amazing vaccine and the demand for it has been high. Is it better to wait for that or take the won't previous one? That's not as good. It depends on your risk profile. Okay. But honestly, I at this point I would wait and you get this newer vaccine unless there is a strong consideration while we really need to do this. Now, if you catch shingles early, is there a treatment? Is there an antiviral medication that might help there are? So there are anti viral medications that would be very effective in reducing the symptoms. And actually this is same antivirus that are used to treat herpes simplex. So cold sores genital. Herbie's valley cycling cycling beer. These are all drugs that are available and they are -ffective against many of the herpes viruses, including herpes, simplex one and two, but also very Sylla's Ostra virus, which is also a herpes virus, but you have to catch it really early, right? I mean, it doesn't do any good if the if you've got the blisters and they've been there for a week right at a week, it's probably not gonna be helpful, but if it is early on, yeah, I think the the antivirus going to be useful chicken pox, incredibly itchy. That's the big problem there for shingles. They are so painful. Can you just take a pain medication to get you through your shingles outbreak? It is crazy painful. That's the hallmark is the pain, and sometimes you're your routine kinds of pain. Medications may not touch because it's kind of a nerve pain. And so yeah, we can give IB profound or I see them. Defen-, but sometimes we need to give some nerve pain kinds of medication to help people who have who have pain from shingles. All right. Talking about shingles with infectious disease specialist, Dr, Petit's toss. Remember the new vaccination is called shin grits. You knew need two doses anywhere between eight two months and six months apart, right? Everybody over the age of fifty right on all right time for short break. When we come back, we'll tackle some other infectious disease hot topic this summer, everything from chicken Hunia, chick. Chicken, young, goon, young, we'll get the credential. You're listening to Mayo Clinic Radio on the mayo clinic news network. Welcome back to male Clinic Radio. I'm Dr Tom shy, and I'm Tracy McCray your back with Dr Tosh