The Week in Review provides an overview of the past week’s top health care content, including industry news and trends, Mayo Clinic and Mayo Medical Laboratories news, and upcoming events.
For Cervical Cancer Patients, Less Invasive Surgery Is Worse for Survival
A treatment for early stage cervical cancer that has rapidly gained acceptance in the United States turns out to be worse than standard surgery, according to two studies. The practice, now thrown into question, is called minimally invasive surgery. Instruments are threaded through small incisions, and surgeons use those to remove a diseased uterus. This technique has been growing in popularity since 2006 and has been widely adopted. But it turns out that minimally invasive surgery for early stage cervical cancer has unexpected risks. The studies were published online in the New England Journal of Medicine. Via NPR.
Why We Stereotype Strangers
Research shows that all of us—even the most well-meaning and open-minded—have some type of implicit, or unconscious, biases, says Dolly Chugh. She is an expert on implicit bias and unethical behavior and the author of “The Person You Mean to Be: How Good People Fight Bias.” We hold attitudes or stereotypes about people subconsciously. These may be different from the ones we have intentionally. And, like it or not, they may influence our behavior, says Dr. Chugh, a social psychologist and an associate professor at New York University’s Stern School of Business. Unconscious biases run the gamut of experience. A person might feel a flicker of disappointment that his or her pilot is a woman. Or assume that the Asian waiter at a sushi restaurant won’t speak fluent English. Or bristle when walking down a street at night and seeing a group of black teenage boys approaching. Or see a homeless person asking for money and think: “Get a job.” These are unconscious biases at work, Dr. Chugh says. Via Wall Street Journal.
Being Too Fat or Too Thin Can Cost Four Years of Life
The report, one of the largest of its kind, involved nearly 2 million people who were registered with doctors in the UK. Researchers found that, from the age of 40, people at the higher end of the healthy Body Mass Index (BMI) range had the lowest risk of dying from disease. But people at the top and bottom ends of the BMI risked having shorter lives. BMI is calculated by dividing an adult's weight by the square of their height. The study, published in the Lancet Diabetes and Endocrinology, showed that life expectancy for obese men and women was 4.2 and 3.5 years shorter respectively than people in the entire healthy BMI weight range. The difference for underweight men and women was 4.3 (men) and 4.5 (women) years. BMI was associated with all causes of death categories, except transport-related accidents, including cancer, cardiovascular diseases and respiratory diseases. The places where too many are fat and too many are thin. Via BBC.
CDC Director Says Polio-Like Illness Acute Flaccid Myelitis "Doesn’t Appear to Be Transmissible"
The director of the Centers for Disease Control and Prevention tells "CBS This Morning" that while the agency still doesn't know what's causing the polio-like illness acute flaccid myelitis, it "doesn't appear to be transmissible from human to human." The U.S. has seen a recent spike in cases of the rare neurological condition that largely affects children. "The CDC's been working very hard on this, since 2014, to try to understand causation and etiology. As we sit here today, we don't have understanding of the cause. We are, you know, continuing to strengthen our efforts, working in partnership with state and territorial health departments, and academic experts to try to figure this out," Dr. Robert Redfield told "CBS This Morning" co-host John Dickerson in his first TV interview as CDC director. Via CBS Health.
Thousands Die Waiting for Liver Transplants. This Tactic Could Yield More Organs.
Each year in the United States, more than 2,500 people die while waiting to receive liver transplants or become too sick to undergo the surgery and must be removed from the wait list. As with hearts, kidneys, and lungs, there simply are not enough livers to go around. To increase the supply, researchers are pursuing a variety of strategies to rejuvenate "marginal" organs—those discarded because they are decayed, diseased in some way, or simply too old. Reich, also a professor at Drexel University College of Medicine, has high hopes for the pump-like contraption that was turning the brownish liver pink. The technique is called machine perfusion, and it flips a long-accepted practice on its head. Rather than keep livers on ice to prevent decay until the moment they are transplanted, physicians use such devices to maintain organs at body temperature, with blood and other fluids circulating as they do in a living person. Via Philly.com.
Mayo Clinic News
Mayo Researchers Working on Vaccines to Treat, Possibly Prevent, Breast Cancer
A Mayo Clinic immunologist in Jacksonville envisions a not-so distant future where vaccines could help stop the relapse of cancer in patients who have already been successfully treated for breast cancer. Keith Knutson, Ph.D., and his team of researchers are also trying to develop a preventive vaccine that would be given to healthy women to stop the disease from showing up in the first place. “This is huge, by the way,” he said. “If you had a prevention vaccine for breast cancer, this would be huge.” Multiple studies across the country suggest that immunotherapy could one day treat breast cancer patients. The Mayo research is among those aiming to come up with such treatments. “There are no vaccines yet approved for use for any type of cancer,” said Dr. Knutson. “But there will be, probably within the next decade. We hope that some of ours are among them.” Dr. Knutson is principal investigator for a Jacksonville team that’s already enrolled women in clinical trials for a vaccine against what he called the “secondary prevention” of breast cancer. Via Florida Times.
Why Some People May Be More Susceptible to Deadly C. difficile Infections
Gastroenterologist Purna Kashyap, M.B.B.S., of Mayo Clinic in Rochester, Minnesota, and colleagues conducted experiments transplanting feces from people with normal or disturbed gut microbes into mice. Mice that got transplants from people with normal gut microbiomes were able to fight off or control C. difficile infections better than mice that got transplants from people with disturbed mixes. Fecal transplants were even more effective in keeping the mice’s C. difficile levels under control, says Dr. Kashyap. That suggests that probiotics containing other proline-eating bacteria might outcompete C. difficile and help restore the balance of gut microbes, he says. Via Science News.
Acute Kidney Injury: Increasingly Common, Often Insidious, Possibly Deadly. But Worth Testing for?
So far, the evidence linking use of AKI biomarkers to improve patient outcomes is limited, according to John Lieske, M.D.,Professor of Medicine at Mayo Clinic. “A couple of papers have been published very recently, suggesting they may have a niche for directing the postoperative management strategy of patients undergoing major operative procedures,” he says. Dr. Lieske said findings published in the November 2017 issue of Intensive Care Medicine showed improved hemodynamic parameters and reduced rates of moderate to severe AKI among high-risk cardiac patients whose AKI was monitored with the two urinary biomarkers that NephroCheck tests for. A second study, published June 2018 in the Annals of Surgery, showed good results for patients undergoing major abdominal surgery. Via Managed Care.
Colorectal Cancer Microbiomes May Differ with Mismatch Repair Status
The microbial communities found in and around colorectal cancer (CRC) tumors may differ depending on the DNA mismatch repair status of the CRC involved, new research suggests. As they reported online yesterday in Genome Medicine, researchers from Mayo Clinic, Rochester, Minnesota, and elsewhere used 16S ribosomal RNA gene sequencing to assess tumor and matched normal colon tissue and mucosa samples from dozens of individuals with CRC, bolstering the microbiome data with metabolic modeling based on metabolomic measurements for a subset of participants. "Integrating tumor biology and microbial ecology highlighted distinct microbial, metabolic, and ecological properties unique to dMMR and pMMR CRC," senior author Nicholas Chia, Ph.D., a microbiome and surgery researcher at Mayo Clinic, and his colleagues wrote, adding that their approach "could critically improve our ability to define, predict, prevent, and treat colorectal cancers." Via GenomeWeb.
November Is C. diff Awareness Month
November is C. diff awareness month, a time to focus on raising awareness about the prevention and treatment of Clostridium Difficile infections. Mayo Clinic experts are available for interviews. Via Mayo Clinic News Network.