Posts (23)

2 days ago · Transplant: Research Makes More Organs Count

By Sara Nick/ Discovery’s Edge

Several years ago, a surgeon checked on his patient and was pleased to find her sipping hot coffee in her hospital bed just one day after a lung transplant. If he was looking for a sign that the operation went well, he found it that morning. Delight turned to devastation a few days later when the patient developed a serious complication. Despite extensive lifesaving efforts by her care team, she did not survive.

“It was an upsetting outcome that left me scratching my head for weeks,” recalls Mark Wylam, M.D., a Mayo Clinic pulmonologist. His patient died from excess ammonia in her blood, but no one understood the cause.

Dr. Wylam entered investigator mode. (It’s a habit around Mayo Clinic.) Poring over the patient’s tests and cultures in the month that followed, he found a tiny germ — “a little ammonia factory.” Subsequent research by Dr. Wylam; infectious diseases experts Robin Patel, M.D.; and Elena Beam, M.D.; as well as other colleagues found that the donor likely transmitted the bacteria. These bacteria have a cousin germ that can cause the same issue, and those germs are present in as many as 1 in 10 lung donors. Now this team’s Mayo-developed test can detect both microorganisms quickly.

After the death of a lung transplant recipient, Mayo Clinic researchers found the cause and developed a test to detect the issue in future donors.

Their science has saved lives. Donors and recipients are now treated with targeted antibiotics if either party’s screening test is positive for the bacteria. “We haven’t seen an ammonia infection since,” Dr. Wylam says.

This work is among many research achievements underlying the success of Mayo’s renowned three-site The William J. von Liebig Center for Transplantation and Clinical Regeneration — the largest in the U.S. In addition to celebrating its 20th anniversary this year, the center will reach another milestone: 20,000 transplants. Decades of basic and translational science through the Transplant Research Center have laid foundations for advances in transplant for the benefit of patients at Mayo and beyond.

Staying Power for Donor Kidneys

“If a patient needs a kidney donation, we want it to last their entire life,” says transplant surgeon Mark Stegall, M.D., who has collaborated on hundreds of research publications over the years. While kidney transplant is considered a highly successful operation, long-term survival of grafts remains an issue. Up to 30% of all kidney grafts will fail within the first decade after transplant, he says, meaning many patients require a second transplant down the road. Late loss of kidney transplant has been a major unresolved question in transplant medicine — a puzzle Dr. Stegall and colleagues are trying to solve.

Mark Stegall, M.D., Mayo Clinic transplant surgeon

Approaching this problem from multiple angles, they are conducting large surveillance studies of kidney transplants over time and analyzing graft tissue when things go wrong. Taken together, their findings have led to a greater understanding of the causes behind long-term kidney transplant failure. Based on their body of work, they recently challenged the larger research community to embrace a new strategy that has the power to rapidly advance this area of medicine.

Looking forward, Dr. Stegall’s team is working with Mayo Clinic’s Center for Individualized Medicine to determine whether a noninvasive biopsy and genetic test can predict which kidney and heart transplants are likely to fail. This may help physicians adjust individual immunosuppression medications that protect the organ over the long term. He and colleagues also have begun to harness the potential of artificial intelligence (AI) in transplant, teaching computers to read and analyze kidney biopsies. These analyses tell providers what’s going on in the kidney before, during and after transplant. Their eventual hope is for AI to enhance what transplant pathologists are already doing: making biopsies more accurate and efficient.

Transplant research has inherent challenges, according to Dr. Stegall. Large randomized controlled trials — the gold standard — are difficult to conduct, given relatively small numbers of transplant patients. Nonetheless, he says, Mayo’s research community has harnessed its strengths of patient volume and collaboration to drive discoveries in this area.

Artificial intelligence may never replace human insight, expertise and judgment. Then again, no one’s complaining about how it can help, especially when it comes to analyzing kidney biopsies, a laborious process that’s an intricate mix of art and science. Read more about it on the blog Advancing the Science.

New Surgery Delivers the Goods for Patients

At Mayo, operating room innovations often go hand in hand with research. Such was the case for Julie Heimbach, M.D., a Mayo Clinic transplant surgeon who has pioneered a data-backed, lifesaving procedure for a subset of liver transplant patients who may otherwise be turned away.

The expanding obesity epidemic in the U.S. has led to a rise in nonalcoholic fatty liver disease, a leading indication for liver transplant. However, because obesity is a risk factor for serious post transplant complications, many patients who would otherwise benefit from transplant are never referred. In other cases, the surgery is performed, but the obesity is ignored, leading to poor long-term outcomes.

Julie Heimbach, M.D., a Mayo Clinic transplant surgeon

Dr. Heimbach conceived an idea to combine liver transplant and a weight-loss procedure called sleeve gastrectomy into a single surgery. To investigate its efficacy, she and colleagues collected years of follow-up data for dozens of patients who underwent the tandem procedure. They found this approach to be safe and effective in the long term. Compared to obese patients who underwent liver transplant alone, those who had the double procedure enjoyed better long-term outcomes for weight loss, blood pressure, insulin resistance and fatty liver. They also were less likely to need blood pressure and cholesterol medication.

The double surgery is offered at only a handful of hospitals, but its practice is growing. “This procedure can dramatically transform the future for patients who had no other treatment options,” Dr. Heimbach says. “Its synergy gives a new freedom to patients who’ve struggled with obesity their whole lives.”

How Research Can Wipe Out Waiting Lists

Despite extensive efforts to increase donor pools, demand continues to outpace supply. Twenty people die each day waiting for a transplant in the U.S., according to the Department of Health and Human Services. To reduce shortages, researchers are finding new ways to increase the number of organs suitable for transplant. “Mayo scientists are pushing the envelope for what’s possible in this area,” says David Douglas, M.D., a Mayo transplant hepatologist.

In one such effort, Dr. Douglas and colleagues joined a large multicenter research initiative aimed at innovating and improving use of kidneys from deceased donors. Previous research has shown that donor kidneys with less-than-ideal performance ratings offer survival rates similar to higher-rated kidneys, and that transplanting lower-rated kidneys offsets the risks posed to patients who would otherwise wait longer for a higher-rated kidney. But suboptimal kidneys continue to be discarded at high rates, and the kidney waitlist is the longest of all organs, according to the United Network for Organ Sharing, which coordinated the recent study.

David Douglas, M.D., a Mayo transplant hepatologist

In this work, the investigators evaluated which policies and practices most effectively reduced the number of discarded kidneys. They turned their findings into concrete suggestions that the participating centers could implement right away. In turn, the hospitals rapidly analyzed patient data to determine whether the changes led to improvements. The study showed increased use of donor kidneys and a boost in transplant rates.

“Mayo was recognized as an innovator in this arena, and its practices are being implemented across the country,” Dr. Douglas says.

Another key way to increase the number of donations is through paired kidney exchange with living donors, a practice backed by evidence from numerous Mayo Clinic studies. Typically, when a patient needs a new kidney, the donation will come from a friend or relative. If that donor is not a good match, their goodwill need not go to waste. Through paired kidney donation, they can instead choose to give their kidney to a better-matched stranger. The initial intended recipient will then receive a suitable kidney from that stranger’s original intended donor.

Dr. Stegall’s team has conducted rigorous research to assess patient outcomes and maximize matches. In one project, Dr. Stegall; transplant surgeon Mikel Prieto, M.D.; and colleagues assessed Mayo patient data collected over a 40-month period and confirmed that considering multiple donors per recipient increases the chances of donation. In another study that included senior author Carrie Schinstock, M.D., the team conducted a retrospective analysis of Mayo’s three-site kidney paired donation program, finding a myriad of advantages. Their data led them to recommend that all living donors and recipients consider paired donation, which benefits recipients and leads to an increased donor pool for those who may otherwise be difficult to match.

“Because of the high volume and sharing of expertise made possible by Mayo’s three-site transplant program, our paired donation program has been strong and successful,” says Dr. Stegall. “About a third of kidney donations at Mayo now take place through this system.”

David Erasmus, M.B, Ch.B., M.D. a Mayo Clinic pulmonologist

Finally, a team led by pulmonologist David Erasmus, M.B., Ch.B., M.D., is working to understand how to save more lungs with a new technology called ex vivo ― or “out-of-the-body” ― lung perfusion. Because delicate lungs diminish quickly after death, only 1 in 5 deceased organ donors willing to contribute a lung can actually do so. With ex vivo lung perfusion, a lung is removed from its donor, isolated and placed in a specialized chamber where it is resuscitated and supported, making otherwise marginal donor lungs suitable for transplant.

“The goal is to increase efficiency in order to maximize the number of lungs available for donation,” Dr. Erasmus says. “Mayo patients are frequently among the first to benefit from innovative new techniques and technology. This research has already allowed us to conduct transplants for patients who wouldn’t have received a donor lung under previous circumstances.”

The researchers are evaluating the efficiency of a centralized approach to ex vivo lung perfusion, wherein a donor lung from anywhere in the U.S. could be sent to Mayo, cared for by experts using the new technology, and sent back for transplant in its intended recipient.

“Mayo has always been at the forefront of clinical medicine, and we’re in the midst of an incredible opportunity to spearhead the area of transplant,” Dr. Erasmus says. “Our large network and interdisciplinary approach to research leads to new transplant discoveries all the time, which are continually translated into new and better treatment options for patients.”

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Mon, May 18 9:02am · Mayo Clinic COVID-19 research news

Early indicators: Investigational convalescent plasma is safe for patients with COVID-19

Mayo Clinic and collaborators have reported safety data on the first 5,000 hospitalized patients transfused with investigational convalescent plasma as part of the Food and Drug Administration’s national Expanded Access Program (EAP) for COVID-19. The early indicators suggest experimental convalescent plasma is safe in treating severely ill patients. At this time, convalescent plasma is the only antibody-based therapy available for COVID-19.

The report assessed the first seven days following transfusion of 5,000 patients hospitalized with severe or life-threatening COVID-19, or who were deemed at high risk of progressing to severe or life-threatening status. The research protocol defines severe or life-threatening as dyspnea, decreased blood oxygen saturation, respiratory failure, septic shock, and multiple organ dysfunction or failure. Sixty-six percent of the patients were in an ICU, and nearly 20% carried the diagnosis of multi-organ dysfunction or failure. Importantly, the reports of serious adverse events related to transfusion of the plasma were less than 1%.

Patients received plasma between April 3 and May 3. The seven-day incidence of mortality was 14.9%. The researchers note that while the study was not designed to evaluate the efficacy of convalescent plasma, a seven-day incidence of mortality of 14.9% in this number of patients indicates “no signal of toxicity beyond what is expected in plasma use in severely ill patients.” Their next steps are to collect and review more safety data and continue studies to determine efficacy of the intervention. Read more.

FDA issues emergency use authorization for algorithm designed to improve detection of heart failure during COVID-19

The FDA granted Emergency Use Authorization to Eko, a digital health company, for the heart screening algorithm developed by Mayo Clinic. The AI-driven algorithm can detect weak heart pump, which is commonly detected by echocardiogram, a test that is not normally conducted during a physical exam, requires specially trained technicians to record, and requires prolonged contact with the patient.

“Given the danger COVID-19 poses to patients with a weak heart pump, it’s important that we rapidly identify these individuals early and monitor them closely. By embedding the heart failure screening AI into a quick, widely available, and safe test using existing medical devices, we can detect heart failure early and start appropriate treatments,” said Dr. Paul Friedman, Chair of the Department of Cardiovascular Medicine, Mayo Clinic. “Additionally, for people with COVID-19, we may be able to identify when the virus causes the development of a weak heart pump quickly, safely, and easily using these AI tools.”

Dr. Friedman led the team who developed the algorithm that was licensed to Eko.

The algorithm was first announced in a landmark publication in Nature Medicine in January 2019, describing for the first time the technology that permits a point of care ECG device combined with an AI algorithm to identify a low ejection fraction in patients.

Read full news release

VIRUS: COVID-19 registry first to track global ICU experience to shed light on trends in care of critically ill patients

The Society of Critical Care Medicine (SCCM) and Mayo Clinic have partnered to launch the first global COVID-19 registry that tracks ICU and hospital care patterns in near real-time. Created by SCCM’s Discovery, the Critical Care Research Network, the Viral Infection and Respiratory Illness Universal Study (VIRUS) will reveal practice variations and provide a rich database for research into effective treatments and care. 

The registry, which is growing daily, features a dashboard of data based on more than 3,400 patients from 110 healthcare sites in eight countries. Updated regularly, the dashboard tracks data on trends such as mechanical ventilation duration, ICU length of stay, ICU discharge details and the type of medical support patients receive, as well as patient demographics: gender, age and race.

“The COVID-19 pandemic has introduced unprecedented challenges to healthcare systems worldwide, but we live in a more connected world and we must work together and learn from each other’s experiences to help reduce the severity of the impact,” said Rahul Kashyap, M.B.B.S., MBA, Mayo Clinic researcher and principal investigator of the VIRUS COVID-19 Registry. “This dissemination of aggregated knowledge shared in a single database in a timely manner will be essential for comparative effectiveness studies. It will be a game changer.” Read more.

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Tue, May 5 11:51am · Mayo Clinic COVID-19 daily news

Understanding herd immunity

The concept of herd immunity, or community immunity, has sparked debate about whether it would control the spread of COIVD-19. According to the Centers for Disease Control and Prevention (CDC), herd immunity is a situation in which sufficient proportions of a population are immune to an infectious disease to make its spread from person to person unlikely.

Dr. Gregory Poland, a Mayo Clinic infectious diseases expert and director of the Vaccine Research Group, explains the idea behind herd immunity.

“Herd immunity basically means, if you could envision a circle, let’s say, of 100 people inside this circle and if you can imagine the susceptible people being in the center of that, the more immune people around the susceptible people, the less likely is it that the virus can penetrate in and actually infect somebody,” says Dr. Poland. Read more.

Regenerative approaches could foster healing from COVID-19

Regenerative Medicine aims not only to repair or restore the function of cells, tissues or organs, but also the whole person. The latter is particularly important amid the COVID-19 pandemic. Regenerative approaches draw on the body’s natural abilities to heal, focus on establishing the healing environments and building new, healthy ways of functioning. These aspects of regenerative medicine may nurture healing in people who’ve contracted the virus, those who treat it and the broader community whose lives have suddenly been changed by the pandemic.

Creating safe, trusting environments

When people are diagnosed with COVID-19, their illness may go beyond physical afflictions to a breakdown of the mind and spirit. Some Coronavirus patients are immediately isolated, separating them from the people they love. That may trigger confusion, fear, anxiety and mistrust.

In a normal health care environment, patients might be soothed by welcoming faces and warm touches of medical professionals. But in the new world of a virus to which no one is immune, caregivers must wear personal protective equipment for their own safety. The face masks that allow patient and clinician to come together safely may also be a barrier that increases isolation and fear. Read more.

Mayo Clinic expert discusses potential neurological effects of COVID-19

SARS-CoV-2, the virus that causes COVID-19, can take a severe toll on the respiratory system. However, recent research suggests that the virus may also infect the nervous system. A study of patients with COVID-19 out of Wuhan, China found that possible neurological signs and symptoms caused by COVID-19 can include loss of taste and smell, headache, impaired consciousness, and stroke.

Dr. Allen Aksamit Jr., a Mayo Clinic neurologist, says what’s unclear is whether that is direct effects of the virus actually getting into the nervous system and damaging the brain or an indirect effect as a consequence of the respiratory and other compromise of the rest of the body.  

“When people are sick, when their respiratory system is failing, that will have adverse effects on the brain because of poor oxygenation and other metabolic effects on the brain. Those things we know as serious, but we also know that those are not direct effects of the virus on the brain itself,” says Dr. Aksamit. Read more.

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Sat, Apr 25 7:02am · Why do diseases such as COVID-19 and cancer hit some people harder than others?

As the nation marks DNA Day on April 25 — commemorating the discovery of DNA’s double helix in 1953 and the completion of the Human Genome Project in 2003 — Mayo Clinic researcher Nicholas Chia, Ph.D., continues to search for answers to the question of why some people are more susceptible to getting a severe disease than others. A major clue can be found in DNA, the genetic code inside every cell in the body that carries the blueprint of life.

“We realize the genome — a person’s complete set of DNA — is just a blueprint,” says Nicholas Chia, Ph.D., the Bernard and Edith Waterman co-director for the Mayo Clinic Center for Individualized Medicine Microbiome Program. “But a blueprint doesn’t tell you how a building is used. It may tell you how many people the kitchen could support and that it has 25 bathrooms, but you don’t really know how exactly that building is used.”

Every person has their own unique sequence of DNA, composed of twisting paired strands that carry instructions needed for an organism to develop, survive and reproduce. DNA passes hereditary information from one generation to the next, such as skin, eye and hair colors, but it can also pass down susceptibility to diseases and genetic mutations, including those acquired in a person’s lifetime.

Taking a deeper dive into multi-omics

Mayo Clinic has spent decades exploring and sequencing the human genome, allowing doctors to tailor a range of therapies to a patient’s genes, including for hard-to-treat cancers and rare diseases. Now, they are also going a step further and focusing on “multi-omics” data in their search for answers, including proteomics (study of proteins in a cell), microbiome (study of bacteria, fungi, protozoa and viruses that live inside the body) and metabolomics (study of chemical processes) to identify the underlying causes of diseases.

Dr. Chia says taking a deeper dive into multi-omics and researching beyond DNA — into the RNA, metabolites and proteins — can paint an even more detailed picture to help uncover medical mysteries. 

“The RNA, the proteomes, the microbiome, the metabolites tell you what is actively being turned on and off,” he explains, “What is actually happening enzymatically, what your environmental exposures are and what metabolites are being exchanged. These are all really important elements because they are part of how we molecularly behave and they define our biological state, which defines our state of disease.”

Dr Chia says DNA defines a person’s potential to get disease, but it does not define the disease itself. He references a bacterial infection as an example. 

“A bacterial infection is explained by your exposure to a certain bacterium,” he says. “It’s explained by your microbiome not protecting you against that bacterium. It’s explained by how your immune system reacts to that bacterium. It’s explained by the inflammation, the fever, and by specific actions and specific subsets of cells. We’re trying to understand all the variation, how all the parts come together.”

Autoimmune diseases and the microbiome

Some of Dr. Chia’s other research is centered on autoimmune diseases and the relationship with the microbiome. He says when this population of bacteria is disrupted, it can lead to serious health problems. 

“The premise of an autoimmune disease is that part of your immune system is somehow attacking part of your body,” he says. “One-third of those patients don’t actually have an autoimmune disease — they’re reacting to something in their microbiome. It could be a virus, a bacteriophage, a virus that infects bacteria, it or could be a bacteria.”

 Dr. Chia is looking forward to the day when researchers will be able to wipe out a third of autoimmune disease by doing micro-biomedicine to alter the microbiome.

According to Dr. Chia, DNA sequencing contributes a wealth of knowledge, but researching beyond DNA to advance discoveries and diagnostics has the potential to transform human health.

Mon, Apr 20 9:22am · Mayo Clinic experts provide update on COVID-19

By Mayo Clinic News Network

Mayo Clinic doctors and researchers are working relentlessly to care for patients, search for treatments and provide people with up-to-date information and advice.

Will social distancing be the new normal? A Mayo Clinic expert discusses what the future might look like

As some states look toward relaxing restrictions and social distancing measures, such as stay-at-home orders, new projections suggest social distancing may need to continue through 2022. Researchers predict that SARS-CoV-2, the virus that causes COVID-19, will return every winter, and that prolonged or intermittent social distancing strategies could limit the strain on health care systems.

Dr. Gregory Poland, a Mayo Clinic COVID-19 expert, predicts that the COVID-19 pandemic will change many aspects of U.S. culture in the future, including the need to always practice social distancing measures.

“I think that’s going to become inevitable. I think we very well may become a culture, at least in the wintertime when there are so many respiratory viruses circulating, that we’ll be more like Asian cultures, where they more readily wear masks when outdoors. I think we’ll take more seriously in clinics and hospitals, and nursing homes, the respiratory diseases that circulate every year, and which lead to hospitalizations and deaths ― influenza being the exemplar,” says Dr. Poland, who is the director of Mayo Clinic’s Vaccine Research Group. Read more.

Ways to fight coronavirus transmission at home

Health care providers and researchers are gaining a greater understanding about the coronavirus disease 2019 (COVID-19) outbreak and how the virus can spread. Public health messages emphasize the importance of frequent, thorough hand-washing and social distancing to slow the spread of COVID-19.

You can also take steps in your home to keep the virus from spreading. No special supplies are required. You likely already have what you need.

How is COVID-19 spread?

The virus that causes COVID-19 can be spread by contact with someone who has COVID-19, as well as contact with surfaces or objects that person has touched.

When someone with COVID-19 sneezes or coughs, respiratory droplets are released into the air. Droplets typically don’t travel far — no more than 6 feet (about 2 meters). The virus may stay on surfaces from hours to days.

How can I prepare my home?

You can reduce potential spread of COVID-19 by cleaning and disinfecting frequently touched surfaces, such as tables, doorknobs, light switches, handles, desks, toilets, faucets and sinks. Do this daily if someone in your home has COVID-19.

Start by putting on gloves before cleaning and disinfecting — preferably disposable gloves, so you can throw them away immediately after you’re done. If you only have reusable gloves, don’t use them for any other purposes. Thoroughly wash your hands after removing your gloves.

Cleaning with soap and water removes dirt and lowers the number of germs on surfaces. Once surfaces are clean, you can apply disinfectant to knock out any germs that are left.

Antibody testing, in pictures

Convalescent plasma therapy for the treatment of COVID-19 virus infection is based on the function of antibodies, tiny proteins created by the immune system, that combat invaders to the body in a variety of ways. Some are capable of neutralizing a virus, while others work by mobilizing a range of other immune cells that fight off disease.

A type of serologic test known as ELISA is used to determine if the blood does actually contain antibodies specific to the virus. Blood is collected from patients who had a PCR test to diagnose their illness as COVID-19. The blood is processed through a machine that collects the plasma, since that is where the antibodies are found, and returns the blood cells to the patient. Read more.

Mayo Clinic Q&A podcast: Mayo Clinic Laboratories launches serology testing

A new serology test from Mayo Clinic Laboratories is being used to identify the presence of immune response to SARS-CoV-2, the virus that causes COVID-19. The serology test is intended only to detect antibodies to the virus. It does not diagnose recent or active infection. Mayo Clinic Laboratories also offers a molecular test to diagnose very recent or active infection. Both tests are important tools in the pandemic response.

On the Mayo Clinic Q&A podcast, Dr. Elitza Theel, director of Mayo Clinic’s Infectious Diseases Serology Laboratory, explains why serology testing is initially focused on identifying people in areas where potential immunity is key, including front-line health care workers.

Click the player below:

Learn more

Check the Centers for Disease Control and Prevention website for additional updates on COVID-19. For all your COVID-19 coverage, go to the Mayo Clinic News Network.

Join the conversation

For more information on the Mayo Clinic Center for Individualized Medicine, visit FacebookLinkedIn or Twitter at @MayoClinicCIM

Mon, Apr 13 8:28am · Mayo Clinic researchers provide updates, advice on COVID-19 pandemic

By Mayo Clinic News Network

Mayo Clinic doctors, researchers and staff are doing extraordinary work in the response against the COVID-19 pandemic. Here is the latest update:

100 days of COVID-19: Mayo Clinic expert discusses how far we’ve come and what lies ahead

It has been 100 days since the World Health Organization (WHO) was first notified about a cluster of unidentified and unusual pneumonia cases in Wuhan, China. In the short time since then, the world has changed dramatically. On Feb. 11, WHO announced “COVID-19” as the name of the disease which is caused by the SARS-CoV-2 virus. A month later, WHO declared the outbreak to be a global pandemic.

Dr. Gregory Poland, an infectious diseases expert and director of Mayo Clinic’s Vaccine Research Group, has been closely following the pandemic since the beginning, and continues to provide insight and important guidance on preventing the spread of the disease. Read more.

The new super power of handwashing

Researchers are hard at work identifying ways to help patients with COVID-19, which is caused by the SARS-CoV-2 virus. But in the meantime, one common household object can be used to help prevent infection.

Soap.

Good old soap, the Clark Kent of clean, is really the superhero fatty acid salt, the Superman of clean. Soap is made from a reaction between a fat, and either sodium hydroxide (lye), or potassium hydroxide (caustic potash). When these substances combine, they form a substance that is both attracted to water and repelled by it.

The part that is repelled by water is attracted to oil — naturally occurring on your hands, from whatever you were doing, such as eating, and what’s found in the protective envelope around some viruses. You can see this when you put water and oil together. It naturally separates into two layers. But when you add dish soap, and swish it around, the layers blend. The molecules of soap are attracted to the oil/fat, causing the layer to bead up into droplets. Read more.

Mayo Clinic experts offer guidance on treating COVID-19 patients with signs of acute heart attack

Much remains unknown about COVID-19, but many studies already have indicated that people with cardiovascular disease are at greater risk of being susceptible to COVID-19. There also have been reports of ST-segment elevation (STE), a signal of obstructive coronary artery disease, in patients with COVID-19 who after invasive coronary angiography show no sign of the disease.

This false signal of coronary artery disease may cause patients to undergo procedures that present unnecessary risks, especially in the COVID-19 environment, according to a special article published in Mayo Clinic Proceedings. The article, written by a team of Mayo Clinic cardiovascular experts and radiologists, proposes algorithms for evaluating patients and determining a course of treatment.

“The impact of false activation of the catheterization laboratory includes inherent risks, beginning with the invasive arterial procedure itself and related care for these patients,” says J. Wells Askew, M.D., a Mayo Clinic cardiologist. In cases where patients test positive for COVID-19, the risks include respiratory failure, and potential exposure of medical staff and the downstream effects on cardiac catheterization laboratories and cardiac imaging services. Read more. 

Mayo Clinic Q&A podcast: Pregnancy during the COVID-19 pandemic

COVID-19 is the disease caused by the SARS-CoV-2 virus. Because SARS-CoV-2 is a novel coronavirus, researchers are still learning how the virus affects the body. And this raises questions for pregnant women. Can COVID-19 affect pregnancy? Is breastfeeding safe? How can a pregnant woman protect herself from the disease?

On the Mayo Clinic Q&A podcast, Dr. Nipunie Rajapakse, a pediatric infectious diseases specialist, will discuss COVID-19 and pregnancy.

Click the player below:

Connecting Patients: A different kind of grief in these times

Grief is the natural reaction to loss. Grief is both a universal and a personal experience. Individual experiences of grief vary and are influenced by the nature of the loss. 

During this time of the COVID-19 pandemic there has been and continues to be much loss. And different definitions of grief are being revealed. The Mayo Clinic Connect community is opening this conversation and inviting you join.

_________________________________________________

Shared from a Mayo Clinic Connect Member/Mentor:

If you are like me, you might be feeling uncomfortable, unsteady in your daily activities, perhaps unable to pinpoint just why you feel “off”.

Our lives have been turned upside recently, and this might continue for the near future, but it is not permanent. How we relate to people has changed, how we spend our days is quieter [unless you have kids at home!], a nonchalant hug to a friend is not a good idea. Gatherings, like a meeting, a health club, a place of worship, a sports activity, even school, are but a temporary memory. We have had to become better versed in technology to stay connected, if we want to visit. Celebrations and memorials are on hold. Read more.

Learn more

Check the Centers for Disease Control and Prevention website for additional updates on COVID-19. For all your COVID-19 coverage, go to the Mayo Clinic News Network.

Join the conversation

For more information on the Mayo Clinic Center for Individualized Medicine, visit FacebookLinkedIn or Twitter at @MayoClinicCIM

Wed, Apr 8 8:32am · Mayo Clinic experts offer advise and tips on coping with COVID-19

By Mayo Clinic News Network

Mayo Clinic doctors and researchers are providing daily updates and information to help keep people healthy and safe. 

Mayo Clinic Q&A podcast: Cardiac risks of off-label drugs to treat COVID-19

A study published recently in Mayo Clinic Proceedings details information about potential cardiac side effects when using off-label drugs to treat COVID-19. Off-label means the drug has been approved by the Food and Drug Administration to treat a different condition. Some of the off-label drugs being used to treat COVID-19 have a risk of sudden cardiac arrest and death.

On the Mayo Clinic Q&A podcast, Dr. Michael Ackerman, a Mayo Clinic genetic cardiologist and director of the  Windland Smith Rice Sudden Death Genomics Laboratory, explains how heart monitoring is important to identify at-risk patients. Read more.

Tips for people with neurologic issues, such as epilepsy and seizure disorders

Though patients with chronic neurologic conditions like epilepsy are not at increased risk to contract COVID-19, they are more susceptible to increased seizures as a result of growing stress and anxiety over the pandemic.

“We know that stress increases the environment for seizures to occur,” says Dr. Joseph Sirven, a Mayo Clinic neurologist. “So with all that’s going on in the world, one can be at increased risk for seizures.”

Dr. Sirven shares three recommendations to help patients with epilepsy or seizure disorders:

  1. Reduce stress.
    To reduce stress, Dr. Sirven advises limiting news to twice daily and taking time for relaxation.
  2. Create a seizure action plan.
    “I suggest that you talk to your neurologist or other provider, and develop a seizure action plan,” says Dr. Sirven. “That means figuring out in advance when should you call 911, when should you call the physician or provider about it, and when should you worry?”
  3. Have all your medication on hand ― both what you need for daily use and to aid in reducing stress.
    “This may be the time to do the three-month prescription refill plan so that you have plenty of medication regardless and you don’t have to call anyone for any urgent refills of those prescriptions.” Read more.

Convalescent Plasma: A Therapy for COVID-19?

To develop a treatment for patients with COVID-19, researchers around the world are steadfastly exploring numerous angles, including testing existing antiviral drugs and new compounds. One potential treatment that has garnered attention is known as convalescent plasma therapy. The approach involves giving patients an infusion of antibody-rich plasma from people who have recovered from an infection with SARS-CoV-2, the virus that causes COVID-19.

“Mayo Clinic has mobilized quickly to advance convalescent plasma in a scientific way,” says anesthesiologist Michael J. Joyner, M.D., principal investigator of the Convalescent Plasma Expanded Access Program.

Mayo Clinic is the lead institution providing coordinated access to investigational convalescent plasma for hospitalized patients with severe or life-threatening COVID-19, or those at high risk of progression to severe or life-threatening disease. This national effort will collect plasma from donors who meet several criteria established by the Food and Drug Administration. Read more.

Your questions answered

How does the coronavirus that causes COVID-19 enter the body?

“COVID-19 disease is spread through respiratory droplets. So what that means is that if someone with the infection coughs or sneezes, they generate droplets. These are generally large droplets so they can spread about 3-6 feet from the person that generates them. That’s pretty close contact that’s required. If those droplets land on a surface and you touch that surface and  then you touch your eyes, nose or mouth, then you are at risk of becoming infected as well,” says Dr. Nipunie Rajapakse, a Mayo Clinic infectious diseases specialist.

What are the symptoms of COVID-19?

According to the Centers for Disease Control, reported illnesses have ranged from mild symptoms to severe illness and death.

The following symptoms may appear 2-14 days after exposure.*

  • Fever
  • Cough
  • Shortness of breath

Why are some cases worse than others?

“Coronaviruses, including COVID-19, can create a spectrum of illness, and, so, some people will be very mildly affected and some people can have more severe disease,” says Nipunie Rajapakse, M.D., M.P.H., an infectious disease specialist. “So the severity of illness can range from having a cold or a flu-type illness all the way to needing to be hospitalized or be in an intensive care unit.”

Will the COVID-19 pandemic end? Is it seasonal?

“We don’t know yet. One possibility is that this would become what’s called an endemic community transmissible disease,” says Dr. Gregory Poland, head of Mayo Clinic’s Vaccine Research group. “SARS did not go that way. SARS disappeared and we don’t know exactly why.  MERS is one where there continues to be zoonotic transmission and small outbreaks here and there. What this one will do, we don’t know. I think what we can say is that coronaviruses are here to stay. We’ve had three novel coronaviruses in the last 18 years. It will happen again.”

What groups of people are at greatest risk from COVID-19?

Illness due to COVID-19 infection is generally mild, especially for children and young adults, according to the World Health Organization. Older people and people with certain underlying health conditions like heart disease, lung disease and diabetes, for example, seem to be at greater risk of serious illness, according the Centers for Disease Control and Prevention (CDC).

Will warmer temperatures affect how COVID-19 spreads?

“We know that for Influenza, cases dwindle down in the spring and summer seasons. However, no one can say for sure how it will affect COVID-19. “At this point, we don’t know enough about this virus to understand how it’s going to behave over time,” says Dr. Pritish Tosh, a Mayo Clinic infectious diseases specialist.

Check the CDC website for additional updates on COVID-19.
For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

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For more information on the Mayo Clinic Center for Individualized Medicine, visit FacebookLinkedIn or Twitter at @MayoClinicCIM

Mon, Apr 6 11:37am · Mayo Clinic accelerates COVID-19 research

Mayo Clinic researchers and doctors are working to combat COVID-19, from the front lines to the laboratories. Here is the latest information to help keep your family healthy and safe.

Mayo Clinic named national site for Convalescent Plasma Expanded Access Program

By Mayo Clinic News Network

Mayo Clinic will be the lead institution providing coordinated access to investigational convalescent plasma for hospitalized patients with severe or life-threatening COVID-19, or those at high risk of progression to severe or life-threatening disease. The Food and Drug Administration (FDA) announced the designation on Friday, April 3.

Convalescent plasma refers to blood plasma collected from people who have recovered from COVID-19. That plasma is then used to treat others with advanced illness. The plasma donor must have recovered from, and tested negative for, COVID-19 and be otherwise healthy. The patient is transfused with the donor’s plasma, which contains antibodies that can attack the virus and may help patients recover more rapidly. Read more.

Working toward a COVID-19 vaccine

The push to create a vaccine that prevents people from contracting SARS-CoV-2, the virus that causes COVID-19, continues. Dr. Stacey Rizza, a Mayo Clinic infectious diseases specialist, says developing a vaccine takes research, money and time.

“Everyone wants to have a vaccine ready right now,” says Dr. Rizza. “Researchers around the globe and at Mayo Clinic are working as fast as they can to make it happen. But before we have a vaccine for general use, we have to make sure it is properly developed and tested.”

Dr. Rizza says that Mayo Clinic is heavily involved in vaccine development for the SARS-CoV-2 virus, investigating several different approaches. In addition, Mayo Clinic is in discussions with biotechnology firms and pharmaceutical companies about co-developing and testing additional vaccine possibilities. Read more.

How does COVID-19 affect the heart?

The effects of COVID-19 on the lungs are well-known. As the COVID-19 pandemic continues, more information is becoming available about the role the virus, called SARS-CoV-2, has on the heart. “Individuals with known cardiovascular disease are at an increased risk of more severe complications from respiratory viral illnesses, including the flu and COVID-19,” says Dr. Leslie Cooper, chair of the Department of Cardiology at Mayo Clinic.

“We know that during severe SARS-CoV-2 infection,  heart function may decrease. Sometimes this decrease is a consequence of the systemic inflammatory response to infection, and occasionally, in some people, because of direct viral infection in the heart.” Read more.

Mayo Clinic Q&A podcast: The ‘unprecedented challenge’ of fighting COVID-19

The ongoing fight against the COVID-19 pandemic has heavily burdened front-line health care providers. “Our nation and our medical community is facing an unprecedented challenge,” says Dr. Elie Berbari, chair of the Division of Infectious Diseases at Mayo Clinic.

On the Mayo Clinic Q&A podcast, Dr. Berbari discusses how Mayo Clinic is minimizing exposure to staff, while providing safe and compassionate care to patients.

Click the player below:

COVID-19 expert explains what soap does to SARS-CoV-2 virus

 Your hand has oils on it, and viruses stick to that oil. They have an electrostatic charge to them. But when you’re washing with soap, soap has things that decrease surface tension in them so you are physically rubbing by friction and washing away that virus. It is the most effective thing we know to do. That’s why surgeons, for example, scrub their hands so very carefully before they go into an OR. It works, and it works really well.

 Dr. Gregory Poland, an infectious diseases expert and director of Mayo Clinic’s Vaccine Research Group, explains what soap does to SARS-CoV-2, and other viruses and bacteria. Read more.

Learn more

Check the Centers for Disease Control and Prevention website for additional updates on COVID-19. For all your COVID-19 coverage, go to the Mayo Clinic News Network.

Join the conversation

For more information on the Mayo Clinic Center for Individualized Medicine, visit FacebookLinkedIn or Twitter at @MayoClinicCIM

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