Tag Archives: Mayo Clinic

Telemedicine: Pediatric Otolaryngology (Video)

Mayo Clinic is happy to offer telemedicine as an option for patients interested in seeking care. Modern technology provides a virtual platform for health care providers and patients to initiate partnership in care in a secure, safe and convenient way.

Mayo Clinic: ‘When Livers No Longer Function’

In the U.S., it’s estimated that 4.5 million adults are diagnosed with chronic liver disease. It develops over time and may be caused a number of conditions including hepatitis, genetics, alcohol overuse or cancer. Chronic liver disease is different than acute liver disease which can come on quickly and may be the result of an injury or a virus. Regardless of the cause, Dr. Bashar Aqel, a Mayo Clinic transplant hepatologist says when the liver can no longer function, a life-saving transplant may be needed.

MAYO CLINIC HEART HEALTH: ‘WHAT IS HYPERTROPHIC CARDIOMYOPATHY? ‘ (VIDEO)

Hypertrophic cardiomyopathy is a thickening of the heart muscle, making it more difficult to pump blood. Dr. Steve Ommen is a Mayo Clinic cardiologist who specializes in the disease. He says shortness of breath or chest pain, especially during exercise, are common symptoms. Many people with the disease won’t have any significant health problems. But there are cases that require treatment. If a patient has symptoms that affect quality of life, the disease is treated with medications. Surgery or other procedures also may be necessary in some cases.

MEDICINE: ADEQUATE SLEEP & CARDIOVASCULAR HEALTH

Mayo Clinic Division of Preventive Cardiology will be preparing a series of recordings focusing on Cardiovascular Disease states. This is the Sleep Series and this particular one focuses on what is adequate sleep and does it benefit Cardiovascular Health.

PHYSICIAN Q&A: SCREENING FOR COLORECTAL CANCER

Colorectal cancer is comprised of colon cancer and rectal cancer, which originate in the lower portion of the large intestine and into the rectum. As with other cancers, screening for early detection should not be delayed. “The vast majority of the time, we don’t know exactly what causes any specific cancer,” says Dr. Jeremy Jones, a Mayo Clinic oncologist. “But there are a number of factors that can increase the risk of developing colon or rectal cancer.” Dr. Jones says one risk factor is increasing age. However, he adds that over the last 30 years younger patients have seen a 50% increased risk of developing colon and rectal cancers. In this Mayo Clinic Q&A podcast, Dr. Jones talks about risk factors, symptoms, treatment, health care disparities and the latest in colorectal cancer research. ____________________________________________

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS 21: PERIPHERAL NEUROPATHY

Peripheral Neuropathy is a common problem, and almost a quarter of the population will eventually suffer from it. It is very common in diabetes and metabolic syndrome, alcoholism, and in cancer therapy.

Even getting older is a risk; almost 10% of individuals 65 years old have some symptoms. There are more than 100 different types of peripheral neuropathy, and often it is just one feature of a primary illness.

Sometimes there is no known cause, such as in 2 of my older friends. I have a diminished vibratory sense in my feet, which causes me no noticeable problem. The longer nerves are more likely to be involved, except for the rare sensory ganglionopathy which is symptomatic of some cancers ( a “paraneoplastic disorder”) , some infections and autoimmune diseases.

When the sensory ganglia are involved, the numbness, tingling or pain can be more central, such as in the face or upper arm. There are 3 types of nerves that can be involved in peripheral neuropathy; Sensory, Motor and autonomic.

The sensory nerves deal with sensations, such as hot, cold, touch, pain, tingling, and numbness. Motor nerve involvement results in weakness or paralysis of an arm, leg or other area under Voluntary control. The autonomic nervous system coordinates activities beyond voluntary control, such as sweating, salivation, food propulsion and heart rate, which can be activated or inhibited.

The symptoms of neuropathy depend upon the type of nerve involved. Balance is a complex ability that can be disturbed by a lack of proper sensory nerve function (Position sense or proprioception) motor weakness, vision or coordination which involve higher centers.

The medical evaluation of peripheral neuropathy begins with a family practitioner or internist who does a detailed history, asking about such things as diet, medications, alcohol consumption, and injuries. Vitamin intake is important, but can be overdone.

Peripheral nerve symptoms can actually be caused by excessive B6, pyridoxine. The upper limit is 100 Mg.. A physical exam checks for weakness, sensory problems, reflexes and balance. Blood tests may reveal diabetic, kidney, liver, thyroid or immune problems problems.

A major disorder associated with neuropathy may be revealed and pursued. If nothing turns up, and the neuropathy is significant, referral may be needed to a neurologist, or other appropriate specialist. Many specialized tests and treatments may be needed.

Even with the best of care, a specific “cure” may not be found. Peripheral neuropathy can often be avoided by a healthy lifestyle.

–Dr. C.

Article on Peripheral Neuropathy

VIDEOS: DIAGNOSING AND TREATING COVID-19 (MAYO)

Dr. Stacey Rizza, an Mayo Clinic infectious diseases specialist, discusses the various ways COVID-19 is diagnosed and treated.

COVID-19 can be diagnosed several ways when looking for active infection.

“The most common way that testing is done is with a swab into the nose or into the nasal pharyngeal area,” says Dr. Stacey Rizza, a Mayo Clinic infectious diseases expert.

“This polymerase chain reaction (PCR) test is essentially a test looking for the genetic material of the virus.” If it’s positive, it means that person is infected with SARS-CoV-2, the coronavirus that causes COVID-19.

COMMENTARY:

Dr. Stacey Rizza from Mayo Clinic gave the standard Academic recommendations for Covid Testing and treatment. I will comment on how this differs from the testing recommendations of Dr. Michael Mina from the Chan school at Harvard and the actual treatment given to Donald Trump as we speak.

I agree with the latter recommendations, and route that I would opt for, were I to catch Covid 19. TESTING, if it is to be Epidemiologically effective should offer results that are rapidly available so as to reduce spreading of the virus and treatment delay. One trouble with PCR- based tests is that they are slow. Another trouble, according to Dr. Mina, is that if they run for 40 cycles for maximum sensitivity, they may pick up viral shedding that is too minor to be infective, and may cause unnecessary precautions, such as quarantining. If they run for 35 or even 30 cycles to show only infective, actionable cases, they take several days, and even then labs do not usually report the number of cycles run, but only yes or no, positive or negative.

The RAPID TESTS detect viral protein are available within hours. They are less sensitive, but in Dr. Mina’s view, this can be a virtue, since only definitely infected patients are identified. They are cheaper, and can even be done on site. Frequent testing more than makes up for decreased sensitivity. Most tests currently available use only specimens from nasal swabs, which are uncomfortable.

SALIVA is almost as sensitive, and has one additional virtue, when it comes to testing school children. If school children are organized into learning “pods”, They can all spit into a common collector, and the pod tested preemptively, at least twice weekly. If positive The entire pod is individually tested to find who is positive. Of course if a full 20 kids are in a pod, The sensitivity of the protein test may be insufficient for positive to survive a 20-fold dilution, but this can be empirically worked out. Twice weekly testing vs. every other week is much better for reducing the number of the pod members infected at time of discovery, as the NYT has illustrated.

TREATMENT given to Donald Trump has so far consisted of more than Remdesivir. He is also receiving Corticosteroids, plus an experimental double antibody mixture, derived from both Covid Convalescent serum, and monoclonal antibodies from a “humanized” murine source. The antibodies should theoretically be given early. The corticosteroids are generally not given until a bit later, but with the reported drop in O2 sats, he may be later in the disease than we are led to believe. To my knowledge, he is not receiving his tweeted Hydroxychloroquine- azithromycin combination.

If I were infected, at age 88, I would also like the antibody treatment, but most likely would not be allowed to get it.

–Dr. C.

DOCTORS CALL: “CHRONIC COUGH – DIAGNOSIS AND TREATMENT” (MAYO CLINIC)

On the Mayo Clinic Radio program, Dr. Kaiser Lim, a Mayo Clinic pulmonary and critical care physician, explains chronic cough and how it can be treated.

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COMMENTARY

If you have had a cough for more than 8 weeks, the good news is that you don’t have Covid 19. The bad news is that you need a Medical evaluation, tests and imaging to find out what is going on.

COUGH is not a disease, but is a manifestation, a SYMPTOM of a disease.

Your Primary Care Doctor will do a Medical History, an examination and a chest X-Ray which may allow her to DIAGNOSE what disease or problem Is causing the cough, and allow her to treat it.

If you continue to cough, you will be referred to a specialist, such as an Allergist or a Pulmonologist. ENT (sinusitis) and Gastroenterology (GERD) are 2 other medical fields often involved.

Usually blessed relief comes when Chronic Cough is properly diagnosed and treated, but a few Patients continue to suffer, challenging the best of medical care. 2 of my friends continue to cough after Medical School Level evaluations.

Nature continues to hide some of her secrets from Medical Science.

—Dr. C.