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  1. Results of intraoperative electron beam radiotherapy containing multimodality treatment for locally unresectable T4 rectal cancer: a pooled analysis of the Mayo Clinic Rochester and Catharina Hospital Eindhoven.

    PubMed

    Holman, Fabian A; Haddock, Michael G; Gunderson, Leonard L; Kusters, Miranda; Nieuwenhuijzen, Grard A P; van den Berg, Hetty A; Nelson, Heidi; Rutten, Harm J T

    2016-12-01

    The aim of this study is to analyse the pooled results of intraoperative electron beam radiotherapy (IOERT) containing multimodality treatment of locally advanced T4 rectal cancer, initially unresectable for cure, from the Mayo Clinic, Rochester, USA (MCR) and Catharina Hospital, Eindhoven, The Netherlands (CHE), both major referral centers for locally advanced rectal cancer. A rectal tumor is called locally unresectable for cure if after full clinical work-up infiltration into the surrounding structures or organs has been demonstrated, which would result in positive surgical margins if resection was the initial component of treatment. This was the reason to refer these patients to the IOERT program of one of the centers. In the period from 1981 to 2010, 417 patients with locally unresectable T4 rectal carcinomas at initial presentation were treated with multimodality treatment including IOERT at either one of the two centres. The preferred treatment approach was preoperative (chemo) radiation and intended radical surgery combined with IOERT. Risk factors for local recurrence (LR), cancer specific survival, disease free survival and distant metastases (DM) were assessed. A total of 306 patients (73%) underwent a R0 resection. LRs and metastases occurred more frequently after an R1-2 resection (P<0.001 and P<0.001 respectively). Preoperative chemoradiation (preop CRT) was associated with a higher probability of having a R0 resection. Waiting time after preoperative treatment was inversely related with the chance of developing a LR, especially after R+ resection. In 16% of all cases a LR developed. Five-year disease free survival and overall survival (OS) were 55% and 56% respectively. An acceptable survival can be achieved in treatment of patients with initially unresectable T4 rectal cancer with combined modality therapy that includes preop CRT and IOERT. Completeness of the resection is the most important predictive and prognostic factor in the treatment of T4

  2. Results of intraoperative electron beam radiotherapy containing multimodality treatment for locally unresectable T4 rectal cancer: a pooled analysis of the Mayo Clinic Rochester and Catharina Hospital Eindhoven

    PubMed Central

    Holman, Fabian A.; Haddock, Michael G.; Gunderson, Leonard L.; Kusters, Miranda; Nieuwenhuijzen, Grard A. P.; van den Berg, Hetty A.; Nelson, Heidi

    2016-01-01

    Background The aim of this study is to analyse the pooled results of intraoperative electron beam radiotherapy (IOERT) containing multimodality treatment of locally advanced T4 rectal cancer, initially unresectable for cure, from the Mayo Clinic, Rochester, USA (MCR) and Catharina Hospital, Eindhoven, The Netherlands (CHE), both major referral centers for locally advanced rectal cancer. A rectal tumor is called locally unresectable for cure if after full clinical work-up infiltration into the surrounding structures or organs has been demonstrated, which would result in positive surgical margins if resection was the initial component of treatment. This was the reason to refer these patients to the IOERT program of one of the centers. Methods In the period from 1981 to 2010, 417 patients with locally unresectable T4 rectal carcinomas at initial presentation were treated with multimodality treatment including IOERT at either one of the two centres. The preferred treatment approach was preoperative (chemo) radiation and intended radical surgery combined with IOERT. Risk factors for local recurrence (LR), cancer specific survival, disease free survival and distant metastases (DM) were assessed. Results A total of 306 patients (73%) underwent a R0 resection. LRs and metastases occurred more frequently after an R1-2 resection (P<0.001 and P<0.001 respectively). Preoperative chemoradiation (preop CRT) was associated with a higher probability of having a R0 resection. Waiting time after preoperative treatment was inversely related with the chance of developing a LR, especially after R+ resection. In 16% of all cases a LR developed. Five-year disease free survival and overall survival (OS) were 55% and 56% respectively. Conclusions An acceptable survival can be achieved in treatment of patients with initially unresectable T4 rectal cancer with combined modality therapy that includes preop CRT and IOERT. Completeness of the resection is the most important predictive and

  3. Mayo Clinic: An Institutional History of General Thoracic Surgery.

    PubMed

    Gillaspie, Erin A; Nichols, Francis C; Allen, Mark S

    2015-01-01

    The Mayo Clinic was started in Rochester, MN after a 1883 tornado disaster. The Mayo brothers, William and Charles began thoracic surgical procedures early in their career. Dr. Samuel Robinson is recognized as the first thoracic surgeon at Mayo. He was followed by Drs. Harrington and Claret who became famous surgeons. Many other notable surgeons have help to build the thoracic surgical practice into what is today a world renown center of excellence in thoracic surgery.

  4. Complementary and Integrative Medicine at Mayo Clinic.

    PubMed

    Pang, Ran; Wang, Shihan; Tian, Lin; Lee, Mark C; Do, Alexander; Cutshall, Susanne M; Li, Guangxi; Bauer, Brent A; Thomley, Barbara S; Chon, Tony Y

    2015-01-01

    Complementary and alternative medicine (CAM) has gained acceptance throughout the industrialized world. The present study was performed to provide information about the use of CAM at Mayo Clinic, an academic medical center in Northern Midwest of the US. We retrospectively reviewed the electronic medical records of 2680 patients visiting the CAM program at Mayo Clinic, Rochester, between 1 July 2006 and 31 March 2011. Services provided included acupuncture, massage, integrative medical consultations and executive stress management training. Data including age, gender, race, diagnosis and the number of treatment/consultation sessions were collected to describe the use of CAM in our institute over the last several years. It was found that the mean (standard deviation) age of patient was 52.6 (15.5) years. Of those, 73.1% were female and 26.9% were male. Most patients were white. The number of patients referred to CAM increased significantly from 2007 to 2010. The three most common diagnostic categories were back pain (12.9%), psychological disorders (11.8%), and joint pain (9.6%). Back pain was the most common diagnosis for patients receiving acupuncture, and fibromyalgia was the most common for patients receiving massage therapy. Psychological disorders (i.e., stress) were the major diagnosis referred to both integrative medical consults and executive stress management training. These results suggest that the diseases related to pain and psychological disorders are the main fields of CAM use. It also shows the increasing trend of the use of CAM at an academic medical center in the US.

  5. The Mayo Clinic Biobank: A building block for individualized medicine

    PubMed Central

    Olson, Janet E.; Ryu, Euijung; Johnson, Kiley J.; Koenig, Barbara A.; Maschke, Karen J.; Morrisette, Jody A.; Liebow, Mark; Takahashi, Paul Y.; Fredericksen, Zachary S.; Sharma, Ruchi G.; Anderson, Kari S.; Hathcock, Matthew A.; Carnahan, Jason A.; Pathak, Jyotishman; Lindor, Noralane M.; Beebe, Timothy J.; Thibodeau, Stephen N.; Cerhan, James R.

    2014-01-01

    OBJECTIVE To report the design and first three years of enrollment of the Mayo Clinic Biobank. PATIENTS AND METHODS Preparations for this Biobank began with a 4-day Deliberative Community Engagement with local residents to obtain community input into the design and governance of the biobank. Recruitment, which began in April 2009, is ongoing with a target goal of 50,000. Any Mayo Clinic patient who is 18+ years, able to consent, and a US resident is eligible to participate. Each participant completes a health history questionnaire, provides a blood sample and allows access to existing tissue specimens and all data from their Mayo Clinic medical record (EMR). A Community Advisory Board provides ongoing advice and guidance on complex decisions. RESULTS After three years of recruitment, 21,736 subjects have enrolled. Participants were 58% female, 95% of European ancestry, and median age of 62 years. Seventy-four percent lived in Minnesota, 42% from Olmsted County where the Mayo Clinic Rochester is located. The five most commonly self-reported conditions were hyperlipidemia (41%), hypertension (38%), osteoarthritis (30%), any cancer (29%), and gastroesophageal reflux disease (26%). Among self-reported cancer patients, the five most common types were non-melanoma skin cancer (14%), prostate cancer (12% in men), breast cancer (4%), melanoma (3%), and cervical cancer (2% in women). Fifty-six percent of participants had at least 15 years of EMR history. To date, over sixty projects and over 69,000 samples have been approved for use. CONCLUSION The Mayo Clinic Biobank has quickly been established as a valuable resource for researchers. PMID:24001487

  6. Total teamwork--the Mayo Clinic.

    PubMed

    Roberts, P

    1999-01-01

    Typical of the Mayo Clinic is its century-old team approach to treating patients. Physicians work in teams, with each team driven by the medical problems involved in a case and by the patient's preferences. Occasionally, a team will be expanded or even taken apart and reassembled. At Mayo, diagnosing a complex problem, proposing treatment and slotting the patient for surgery can happen within 24 hours of the diagnosis. The overall effect at Mayo is one of orderliness, function and, above all, vigor. Even as other medical institutions are cutting staff and reducing services, Mayo is a robust, thriving organization with revenues of $2.9 billion and a staff of roughly 30,500. Each year, more than 400,000 patients visit its seven facilities. Mayo's administrators continue to invent (and reinvent) the business side of medicine. Having developed one of the world's first systems of centralized patient records, Mayo is able to keep costs low enough to admit patients from all income levels. "The best interest of the patient is the only interest to be considered" is a motto that has become a Mayo standard on how best to practice medicine. Fearful of becoming complacent and watchful of the risks posed by its deliberative style, the clinic constantly looks for new and fresh ideas.

  7. Research Guides Mayo Clinic's Recruitment, Retention Efforts.

    ERIC Educational Resources Information Center

    Nayar, Veena R.; Morrey, Michael A.; Schneider, Kenneth J.; Purrington, Anne W.; Wilshusen, Laurie L.; Mullen, Michael P.; Seltman, Kent D.

    2001-01-01

    Discusses a collaborative study between Mayo Clinic's departments of human resources and marketing to identify the factors that influence candidates' decisions to accept or decline job offers and the reasons behind staff resignations. Study aimed to increase the effectiveness of employee recruitment advertising, streamline its interviewing…

  8. Research Guides Mayo Clinic's Recruitment, Retention Efforts.

    ERIC Educational Resources Information Center

    Nayar, Veena R.; Morrey, Michael A.; Schneider, Kenneth J.; Purrington, Anne W.; Wilshusen, Laurie L.; Mullen, Michael P.; Seltman, Kent D.

    2001-01-01

    Discusses a collaborative study between Mayo Clinic's departments of human resources and marketing to identify the factors that influence candidates' decisions to accept or decline job offers and the reasons behind staff resignations. Study aimed to increase the effectiveness of employee recruitment advertising, streamline its interviewing…

  9. Mayo Clinic Jacksonville electronic radiology practice

    NASA Astrophysics Data System (ADS)

    Morin, Richard L.; Berquist, Thomas H.; Rueger, Wolfgang

    1996-05-01

    We have begun a project to implement an Electronic (Filmless) Radiology Practice (ERP) at Mayo Clinic Jacksonville. This project is integrated with the implementation of a project (Automated Clinical Practice--ACP) to eliminate circulation and archival of the current paper Medical Record. The ERP will result in elimination of screen/film radiography and the transmittal of film throughout the institution by the end of 1996. In conjunction with the ACP, paper and film will not circulate within the clinic by the end of this year.

  10. Action on obesity: report of a mayo clinic national summit.

    PubMed

    Smith, Aynsley M; Lopez-Jimenez, Francisco; McMahon, M Molly; Thomas, Randal J; Wellik, Mary A; Jensen, Michael D; Hensrud, Donald D

    2005-04-01

    In May 2004, representatives from local, state, and national public and private organizations met in Rochester, Minn, for the Action on Obesity Summit hosted by Mayo Clinic. The overall goal of this summit was to identify creative and effective strategies to Increase the US population's physical activity and improve nutrition to reverse the increasing prevalence of obesity. Ideas generated from selected abstract presentations and breakout sessions were prioritized and incorporated into an action model (available at www.actiononobesity.org) deemed feasible for implementation into most communities. Highlights of the presentations included a company that reported lower than expected health care expenditures secondary to a work site wellness program, a national initiative to increase physical activity (www.americaonthemove.org), and innovative work site nutritional strategies. The implementation model that emerged contained certain themes. Coordinated action at all levels will be required to substantially impact the increasing prevalence of obesity. Educational messages should be simple, consistent, tailored, and linked to benefits. Healthy food options in vending machines and restaurants and increased opportunities for daily physical activity should be available in schools, work sites, and communities. Legislative and policy changes should promote physical activity and improve nutrition. Support for research should be encouraged and outcome measures for interventions documented. A second Action on Obesity Summit is planned for June 9 and 10, 2005, that will review the progress made in the intervening year and continue to refine the implementation model to help address the obesity epidemic, one of the greatest public health problems facing the United States.

  11. Liver Transplantation at Mayo Clinic Florida.

    PubMed

    Lee, David D; Croome, Kristopher P; Perry, Dana K; Burns, Justin M; Nguyen, Justin H; Keaveny, Andrew P; Taner, C Burcin

    2014-01-01

    Over the sixteen year history of liver transplantation (LT) at Mayo Clinic in Jacksonville, Florida (MCF), we have maintained a practice devoted to excellence in pre- and post-LT management for patients suffering from end stage liver disease. With an emphasis on quality, MCF has made several adjustments with the goal of better utilizing marginal grafts for both successful post-transplant outcomes and minimizing waitlist mortality. This systematic approach is most exemplified in our experience with donation after cardiac death (DCD) liver allografts. Understanding the events during procurement has been critical to reducing the complications associated with donor warm ischemia time that are unique to DCD allografts. Better matching of donors to recipients has helped identify patients who are safe to receive more marginal grafts with successful patient and graft survival. Recognizing the spectrum of degree of sickness in patients undergoing LT, we implemented a multidisciplinary approach that allows for the avoidance of the intensive care unit after LT. In these ways, MCF continues to distinguish itself as an innovator in the field of transplantation for the benefit of continued better care for our patients suffering from end stage liver disease.

  12. The Visiting Medical Student Clerkship Program at Mayo Clinic

    PubMed Central

    Mueller, Paul S.; McConahey, Linda L.; Orvidas, Laura J.; Jenkins, Sarah M.; Kasten, Mary J.

    2010-01-01

    OBJECTIVE: To describe the history, objectives, statistics, and initiatives used to address challenges associated with the Mayo Clinic Visiting Medical Student (VMS) Clerkship Program. MATERIALS AND METHODS: Mayo Clinic administrative records were reviewed for calendar years 1995 through 2008 to determine the effect of interventions to increase the numbers of appropriately qualified international VMSs and underrepresented minority VMSs. For numerical data, descriptive statistics were used; for comparisons, χ2 tests were performed. RESULTS: During the specified period, 4908 VMSs participated in the Mayo VMS Program (yearly mean [SD], 351 [24]). Most students were from US medical schools (3247 [66%]) and were male (3084 [63%]). Overall, 3101 VMSs (63%) applied for and 935 (30%) were appointed to Mayo Clinic residency program positions. Interventions to address the challenge of large numbers of international students who participated in our VMS program but did not apply for Mayo residency positions resulted in significantly fewer international students participating in our VMS program (P<.001), applying for Mayo residency program positions (P<.001), and being appointed to residency positions (P=.001). Interventions to address the challenge of low numbers of underrepresented minority students resulted in significantly more of these students participating in our VMS program (P=.005), applying for Mayo residency positions (P=.008), and being appointed to residency positions (P=.04). CONCLUSION: Our findings suggest that specific interventions can affect the characteristics of students who participate in VMS programs and who apply for and are appointed to residency program positions. PMID:20675510

  13. Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

    PubMed

    Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-01-01

    Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  14. Erysipelothrix rhusiopathiae bloodstream infection - A 22-year experience at Mayo Clinic, Minnesota.

    PubMed

    Tan, E M; Marcelin, J R; Adeel, N; Lewis, R J; Enzler, M J; Tosh, P K

    2017-02-16

    Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E. rhusiopathiae BSI at Mayo Clinic. This is a single-centre, retrospective study conducted between 1/1/1994 and 20/6/2016 at Mayo Clinic in Rochester, MN. Medical records were reviewed for demographics, E. rhusiopathiae BSI, anti-microbial susceptibilities, incidence of IE, patient comorbidities, intensive care unit (ICU) admission and duration of antibiotics. Five cases of E. rhusiopathiae BSI were identified. Risk factors included animal exposures, immunosuppression, diabetes and kidney disease. All cases involved penicillin-sensitive strains and high-grade BSI. Four cases showed no signs of IE on transesophageal echocardiogram. All patients recovered fully with intravenous antibiotics. Our retrospective review illustrates that E. rhusiopathiae can cause invasive BSI in the absence of IE and that the previously reported 90% association between BSI and IE may be overestimated due to reporting bias. E. rhusiopathiae should be suspected in any patient with Gram-positive bacilli in blood cultures and the aforementioned risk factors. A limitation of our study was the low sample size, and future studies may involve multicentre collaborations and the use of polymerase chain reaction (PCR) or serologic testing to increase the number of diagnoses..

  15. Optimizing the patient transport function at Mayo Clinic.

    PubMed

    Kuchera, Dustin; Rohleder, Thomas R

    2011-01-01

    In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

  16. Shielding design of the Mayo Clinic Scottsdale cyclotron vault

    NASA Astrophysics Data System (ADS)

    Riper, Kenneth A. Van; Metzger, Robert L.; Nelson, Kevin

    2017-09-01

    Mayo Clinic Scottsdale (Scottsdale, Arizona) is building a cyclotron vault containing a cyclotron with adjacent targets and a beam line leading to an external target. The targets are irradiated by high energy (15 to 16.5 MeV) protons for the production of radioisotopes. We performed Monte Carlo radiation transport simulations to calculate the radiation dose outside of the vault during irradiation of the cyclotron and external targets. We present the Monte Carlo model including the geometry, sources, and variance reduction methods. Mesh tallies surrounding the vault show the external dose rate is within acceptable limits.

  17. Laryngeal Schwannoma: A Case Presentation and Review of the Mayo Clinic Experience.

    PubMed

    Romak, Jonathan J; Neel, H Bryan; Ekbom, Dale C

    2017-01-01

    The aim of this study was to clarify the nature of laryngeal schwannomas through review of the experience of a single institution during a 104-year period. This is a retrospective case series. The Mayo Clinic, Rochester, Minnesota clinical and surgical pathology database was reviewed for the years 1985-2011. Four cases of laryngeal schwannoma were identified. These cases were pooled with a previously published series of laryngeal schwannomas treated at our institution between 1907 and 1986. The characteristics of all 11 cases were studied, and relevant literature was reviewed. A total of 11 cases of schwannoma of the larynx were identified. The mean age at presentation was 48 years (range 12-73 years). The most common presenting symptoms were dysphonia and dysphagia. The most frequently involved primary site was the false vocal fold (six patients), followed by the aryepiglottic fold (three), epiglottis (two), subglottis (two), ventricle (one), true vocal fold (one) and postcricoid region (one). The mean maximal tumor diameter was 2.5 cm. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 1 to 17 years. Laryngeal schwannomas, although rare, should be considered in the differential diagnosis of laryngeal tumors. They occur most frequently in the false vocal fold and present most commonly with dysphonia and/or dysphagia. Surgical excision is the treatment of choice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Intervention for erythromelalgia, a chronic pain syndrome: comprehensive pain rehabilitation center, Mayo Clinic.

    PubMed

    Durosaro, Olayemi; Davis, Mark D P; Hooten, W Michael; Kerkvliet, Jennifer L

    2008-12-01

    To describe the response in patients with erythromelalgia to the pain rehabilitation program at Mayo Clinic, Rochester, Minnesota. Retrospective case series. Comprehensive Pain Rehabilitation Center at a tertiary referral medical center. Patients Eight patients with erythromelalgia admitted to the pain rehabilitation program from January 1, 2002, through June 30, 2007. The Multidimensional Pain Inventory, the 36-Item Short Form Health Survey, the Pain Catastrophizing Scale, and the Center for Epidemiologic Studies Depression Scale were administered at admission and dismissal from the program. Mean differences in scores were compared using 2-sided paired t tests. Scores for the life interference, life control, and general activity subscales of the Multidimensional Pain Inventory showed significant improvement from admission to dismissal (all P < .05). Similarly, the scores of the Pain Catastrophizing Scale, the Center for Epidemiologic Studies Depression Scale, and the physical functioning and emotional role limitation subscales of the 36-Item Short Form Health Survey were significantly improved after intervention (all P < .01). Conclusion The results of our study indicate that pain rehabilitation is a useful method for managing pain-related impairment in physical and emotional functioning in patients with erythromelalgia.

  19. Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

    DTIC Science & Technology

    2008-05-01

    offers. The premier programs of the hospital are cancer treatment and solid organ /bone marrow transplant . (Mayo Clinic, 2007) Problem Statement In...improve revenue streams (Overdyl, Harvey, Fishman , & Shippey, 1998). Organizations have seen reduced revenues from operating room care because of lower...TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RESIDENCY SITE ADDRESS Mayo Clinic Arizona 5777 East Mayo

  20. Measuring faculty reflection on medical grand rounds at Mayo Clinic: associations with teaching experience, clinical exposure, and presenter effectiveness.

    PubMed

    Wittich, Christopher M; Szostek, Jason H; Reed, Darcy A; Kiefer, Jeanine L; Mueller, Paul S; Mandrekar, Jayawant N; Beckman, Thomas J

    2013-03-01

    To develop and validate a new instrument for measuring participant reflection on continuing medical education (CME) and determine associations between the reflection instrument scores and CME presenter, participant, and presentation characteristics. This was a prospective validation study of presenters and faculty at the weekly medical grand rounds at Mayo Clinic in Rochester, Minnesota, from January 1, 2011, through June 30, 2011. Eight items (5-point Likert scales) were developed on the basis of 4 reflection levels: habitual action, understanding, reflection, and critical reflection. Factor analysis was performed to account for clustered data. Interrater and internal consistency reliabilities were calculated. Associations between reflection scores and characteristics of presenters, participants, and presentations were determined. Participants completed a total of 1134 reflection forms. Factor analysis revealed a 2-dimensional model (eigenvalue; Cronbach α): minimal reflection (1.19; 0.77) and high reflection (2.51; 0.81). Item mean (SD) scores ranged from 2.97 (1.17) to 4.01 (0.83) on a 5-point scale. Interrater reliability (intraclass correlation coefficient) for individual items ranged from 0.58 (95% CI, 0.31-0.78) to 0.88 (95% CI, 0.80-0.94). Reflection scores were associated with presenters' speaking effectiveness (P<.001) and prior CME teaching experience (P=.02), participants' prior clinical experiences (P<.001), and presentations that were case based (P<.001) and used the audience response system (P<.001). We report the first validated measure of reflection on CME at medical grand rounds. Reflection scores were associated with presenters' effectiveness and prior teaching experience, participants' clinical exposures, and presentations that were interactive and clinically relevant. Future research should determine whether reflection on CME leads to better patient outcomes. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by

  1. Review of Adjuvant Radiochemotherapy for Resected Pancreatic Cancer and Results From Mayo Clinic for the 5th JUCTS Symposium

    SciTech Connect

    Miller, Robert C. Iott, Matthew J.; Corsini, Michele M.

    2009-10-01

    Purpose: To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. Methods and Materials: A literature review and a retrospective review of 472 patients who underwent an R0 resection for T1-3N0-1M0 invasive carcinoma of the pancreas from 1975 to 2005 at the Mayo Clinic, Rochester, MN. Patients with metastatic or unresectable disease at the time of surgery, positive surgical margins, or indolent tumors and those treated with intraoperative radiotherapy were excluded from the analysis. Median radiotherapy dose was 50.4Gy in 28 fractions, with 98% of patients receiving concurrent 5-fluorouracil- based chemotherapy. Results: Median follow-up was 2.7 years. Median overall survival (OS) was 1.8 years. Median OS after adjuvant RT/CT was 2.1 vs. 1.6 years for surgery alone (p = 0.001). The 2-y OS was 50% vs. 39%, and 5-y was 28% vs. 17% for patients receiving RT/CT vs. surgery alone. Univariate and multivariate analysis revealed that adverse prognostic factors were positive lymph nodes (risk ratio [RR] 1.3, p < 0.001) and high histologic grade (RR 1.2, p < 0.001). T3 tumor status was found significant on univariate analysis only (RR 1.1, p = 0.07). Conclusions: Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.

  2. Autoimmune Hemolytic Anemia in Children: Mayo Clinic Experience.

    PubMed

    Sankaran, Janani; Rodriguez, Vilmarie; Jacob, Eapen K; Kreuter, Justin D; Go, Ronald S

    2016-04-01

    We studied 35 pediatric patients with autoimmune hemolytic anemia seen at Mayo Clinic from 1994 to 2014. The median age was 10.0 years and 65.7% were males. Most had warm antibodies (80.0%) and some secondary to viral (14.3%) or autoimmune disorders (31.4%). Seven (20.0%) patients presented with Evans syndrome, 3 of whom also had common variable immunodeficiency. The median hemoglobin at diagnosis was 6.1 g/dL and 62.8% patients required red cell transfusions. The severity of anemia was worse among children below 10 years (median 5.5 vs. 7.0 g/dL, P=0.01). Steroid was the initial treatment for 88.5% patients, with overall response rate of 82.7% (68.5% complete, 14.2% partial) and median response duration of 10.7 months (range, 0.2 to 129.7+ mo). After median follow-up of 26.6 months, 8 (22.8%) patients relapsed. Salvage treatments included splenectomy, intravenous immunoglobulin, rituximab, and mycophenolate mofetil. Infectious complications occurred in 9 (25.7%) patients and 1 patient died of cytomegalovirus infection. Four patients had cold agglutinin disease and 3 (75.0%) responded to steroids. Autoimmune hemolytic anemia is a rare disorder in pediatric population and most respond well to steroids regardless of the type of antibody. Infectious complications are common and screening for immunodeficiency is recommended among those with Evans syndrome.

  3. Twenty years of human immunodeficiency virus care at the Mayo Clinic: Past, present and future

    PubMed Central

    Cummins, Nathan W; Badley, Andrew D; Kasten, Mary J; Sampath, Rahul; Temesgen, Zelalem; Whitaker, Jennifer A; Wilson, John W; Yao, Joseph D; Zeuli, John; Rizza, Stacey A

    2016-01-01

    The Mayo human immunodeficiency virus (HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a “Mayo Model” of HIV care that exceeds national outcomes and may be applicable in other settings. PMID:27175350

  4. Rarity of encephalopathy associated with autoimmune thyroiditis: a case series from Mayo Clinic from 1950 to 1996.

    PubMed

    Sawka, Anna M; Fatourechi, Vahab; Boeve, Bradley F; Mokri, Bahram

    2002-05-01

    Corticosteroid-responsive encephalopathy associated with autoimmune thyroiditis (also called Hashimoto's encephalopathy) is a rare, life-threatening, treatable, and possibly autoimmune condition. We identified nine patients (with the diagnosis made after 1979) who had relapsing encephalopathy compatible with previous reports of Hashimoto's encephalopathy and no other identifiable cause of encephalopathy at Mayo Clinic Rochester. Of these nine patients, three were clinically hypothyroid, four were subclinically hypothyroid, and two were euthyroid. Thyroid antibodies were positive in eight of eight patients in whom these measurements were made. Electroencephalographic abnormalities were identified in eight of the nine patients (89%). Magnetic resonance imaging (MRI) abnormalities considered etiologically related to encephalopathy were present in three patients (33%). An increased protein concentration was noted on cerebrospinal fluid examination in seven patients (78%). Of the six patients who received high-dose glucocorticoid therapy, 5 (83%) had improvement of neurologic symptoms. In conclusion, encephalopathy associated with autoimmune thyroiditis is rare but important to recognize because it may be responsive to high-dose glucocorticoid therapy. We believe that this condition is not caused by thyroid dysfunction or antithyroid antibodies but represents an association of an uncommon autoimmune encephalopathy with a common autoimmune thyroid disease. The term Hashimoto's encephalopathy is a misnomer and should not be used.

  5. Pessimistic, Anxious, and Depressive Personality Traits Predict All-Cause Mortality: The Mayo Clinic Cohort Study of Personality and Aging

    PubMed Central

    Grossardt, Brandon R.; Bower, James H.; Geda, Yonas E.; Colligan, Robert C.; Rocca, Walter A.

    2011-01-01

    Objective To study the association between several personality traits and all-cause mortality. Methods We established a historical cohort of 7216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965, and who resided within a 120-mile radius centered in Rochester, MN. A total of 7080 subjects (98.1%) were followed over four decades either actively (via a direct or proxy telephone interview) or passively (via review of medical records or by obtaining their death certificates). We examined the association of pessimistic, anxious, and depressive personality traits (as measured using MMPI scales) with all-cause mortality. Results A total of 4634 subjects (65.5%) died during follow-up. Pessimistic, anxious, and depressive personality traits were associated with increased all-cause mortality in both men and women. In addition, we observed a linear trend of increasing risk from the first to the fourth quartile for all three scales. Results were similar in additional analyses considering the personality scores as continuous variables, in analyses combining the three personality traits into a composite neuroticism score, and in several sets of sensitivity analyses. These associations remained significant even when personality was measured early in life (ages 20 to 39 years). Conclusions Our findings suggest that personality traits related to neuroticism are associated with an increased risk of all-cause mortality even when they are measured early in life. PMID:19321849

  6. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data

    PubMed Central

    Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions. PMID:20190054

  7. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data.

    PubMed

    Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions.

  8. The origins of the modern pain clinic at the Mayo Clinic.

    PubMed

    Weingarten, Toby N; Martin, David P; Bacon, Douglas R

    2011-07-01

    In the 1970s the practice of pain management evolved from the isolated anesthesiologist practicing pain "on the side" to a multi-disciplinary model. The impetus behind this change remains obscure. To understand how this national trend occurred locally and to examine national institutional challenges which should be reflected at the Mayo Clinic that stimulated the establishment of a modern academic pain practice, we interviewed appropriate staff members and reviewed relevant departmental meeting notes. Following the 1959 departure of Dr. John Lundy from Mayo, Dr. Robert Jones became the primary practitioner of pain procedures in addition to his anesthesiology practice. In 1973, close to his retirement, Jones wrote a letter to the department chairman, Dr. Richard Theye, expressing frustration because this divided practice hindered patient care, education, and research opportunities. In 1974 Dr. Lee Nauss joined Mayo upon residency completion at Virginia Mason where he received training in regional anesthesia and met Dr. John Bonica. Nauss introduced epidural steroid injections, which became in such great demand that other anesthesiologists needed to cover his rooms. Within two months, Theye asked Nauss to create a stand-alone pain clinic. Nauss recruited Dr. Tony Wang and opened the clinic that year. This pain clinic increased patient access, improved resident education, allowed for the establishment of a fellowship program, and produced ground-breaking research (e.g., the human administration of intrathecal morphine). The establishment of the pain clinic addressed the deficiencies of a mixed pain and anesthesia practice. The pain specialist could now focus attention on and provide better access for pain patients, keep current with clinical practice, engage in research, and educate future pain specialists.

  9. William and Charles Mayo: their influence on American medicine.

    PubMed

    Anaya-Prado, Roberto; Rubí, Marisol Godínez

    2007-01-01

    In a little-known Midwest town named Rochester, Minnesota, a talented physician grew in fame and respect: Dr. William Worrall Mayo, who was influential in the evolution of medicine. He was a steadfast learner and raised two sons, William and Charles, to follow in his footsteps and further medical knowledge. They were leaders in surgery and in the creation of advanced and sophisticated medical facilities. Their talents, the issues surrounding medical practice, and unexpected opportunity all came into play for the Mayos. Two hospitals, St. Mary's Hospital and later the Methodist Hospital, witnessed and influenced the advancement of medicine through the Mayo Clinic heritage and dynasty in Minnesota and the rest of the world. In this article, we focus on the role of the Mayo brothers and their influence over the increasing acceptance of hospital care in America and abroad.

  10. The Mayo Clinic cohort study of personality and aging: design and sampling, reliability and validity of instruments, and baseline description.

    PubMed

    Rocca, Walter A; Grossardt, Brandon R; Peterson, Brett J; Bower, James H; Trenerry, Max R; Ahlskog, J Eric; Sanft, Kevin R; de Andrade, Mariza; Maraganore, Demetrius M

    2006-01-01

    We established a historical cohort of 7,216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) at the Mayo Clinic from 1962 through 1965 for research (not clinical indication), and who resided within a 120-mile radius centered in Rochester, Minnesota. We describe here the overall cohort design and sampling, we report results concerning reliability and validity, and we describe age and sex patterns at baseline for four MMPI scores of primary interest (depression, anxiety, social introversion, and negativity). Subjects excluded from the cohort because of missing data had MMPI scores similar to subjects included (after appropriate rescaling). A cut-off specific for age and sex at the 75th percentile of the distribution of raw scores was valid compared with the traditional clinical cut-off (T scores plus one standard deviation). Baseline scores for all four scales were higher in women than in men at all ages (all p < 0.0001). Depression and social introversion scores showed an increasing trend with age in both sexes (Spearman rank correlation, rho = 0.05 and 0.08, respectively, p < 0.0001 for both). Baseline scores on the anxiety scale showed a decreasing trend with age in both sexes (rho = -0.06, p < 0.0001). Negativity scores remained relatively stable with age in both sexes (rho = 0.03, p = 0.01). We found a high correlation between the anxiety score and the negativity score (rho = 0.90, p < 0.0001) even after the exclusion of overlapping items (rho = 0.68, p < 0.0001). This newly established historical cohort study provides opportunities to test hypotheses regarding the link between personality and aging, aging-related diseases, and overall mortality.

  11. Challenges in Implementing Genomic Medicine: The Mayo Clinic Center for Individualized Medicine

    PubMed Central

    Farrugia, G; Weinshilboum, RM

    2014-01-01

    The Mayo Clinic Center for Individualized Medicine (CIM) is designed to discover and integrate the latest in genomic, molecular, and clinical science into personalized care for patients across a multiple-site academic medical center. Despite a highly integrated structure, fully electronic medical record, and strong administrative support, achievement of this goal has had challenges. This article will describe the activities of the CIM, with emphasis on the strategy being used to clinically implement genomics. PMID:23588321

  12. Using a silver-coated polymeric substrate for the management of chronic ulcerations: the initial Mayo Clinic experience.

    PubMed

    Moore, Rusty A; Liedl, David A; Jenkins, Sarah; Andrews, Karen L

    2008-11-01

    This retrospective observational study was designed to review the use of a silver-coated polymeric substrate on various types of chronic wounds at the Mayo Clinic in Rochester, Minnesota. The study was set in a community and referral multidisciplinary vascular wound clinic. The authors identified the first 112 patients treated with a silver dressing in the center. Of these, 15 were lost to follow-up or had incomplete data. Ninety-seven patients were included in the study. Thirty-seven of these 97 patients had multiple wounds; however, 1 wound per person was randomly chosen for analysis. The median age of these patients was 69 years. A wound was considered healed when the wound was completely epithelialized. Of the 97 wounds evaluated, the primary etiologies were as follows: 20 (20.6%) were neurotrophic, 24 (24.7%) were ischemic (arterial, arteriolar, or vasculitic), 20 (20.6%) were venous, 7 (7.2%) were traumatic, and 16 (16.5%) were multifactorial. The silver dressing was the primary wound care product on all wounds. Silverlon (Argentum LLC, Chicago, Illinois) was the silver dressing used for this study. The frequency of dressing changes and use of secondary dressings, to keep the wound moist, were based on the amount of drainage, debris, and slough on the wound. Data pertaining to patient demographics, risk factors, wound etiology, noninvasive arterial vascular studies, frequency of dressing changes, wound discomfort, wound size, and wound duration were collected by retrospective chart review. Thirty-five of the 97 wounds (36.1%) healed. The 62 nonhealed wounds (63.9%) decreased in size by a median of 55.2%. Among the 68 patients who had reported discomfort before the study, 77.9% reported no change in discomfort, 17.7% reported increased pain, and 4.4% reported decreased pain. A silver-coated polymeric substrate (Silverlon) can be used as an effective primary wound care dressing in patients with active wounds.

  13. Pediatric erythromelalgia: a retrospective review of 32 cases evaluated at Mayo Clinic over a 37-year period.

    PubMed

    Cook-Norris, Robert H; Tollefson, Megha M; Cruz-Inigo, Andres E; Sandroni, Paola; Davis, Mark D P; Davis, Dawn M R

    2012-03-01

    Erythromelalgia has not been well characterized in the pediatric population. We sought to review our experience of erythromelalgia in the pediatric age group. We conducted a retrospective review of patients 18 years of age and younger with a diagnosis of erythromelalgia who were examined at Mayo Clinic in Rochester, MN, from 1970 to 2007. The records of 32 patients (girls, 22 [69%]) were evaluated. Mean age was 14.1 years (range, 5-18 years) and mean time to diagnosis was 5.2 years. Seven patients (22%) had a first-degree relative with erythromelalgia; 4 were from the same family. Physical activity was limited because of discomfort in 21 patients (66%) and school attendance was affected in 11 patients (34%). Noninvasive vascular studies, which compared temperature, laser Doppler flow, and transcutaneous oximetry in the toes, identified vascular abnormalities in 13 (93%) of 14 patients. Neurophysiologic studies with autonomic reflex screening (including quantitative sudomotor axon reflex test and thermoregulatory sweat testing) showed evidence of a small-fiber neuropathy involving the skin in 10 (59%) of 17 patients studied; there was no evidence of large-fiber neuropathy in 20 patients in whom electromyographic and nerve conduction studies were performed. Topical lidocaine was the most commonly prescribed treatment (44%). Fifteen patients were monitored for an average of 9.1 years (median, 5.0 years; range, 0.4-23.7 years). At last follow-up, 5 patients had stable disease, 4 showed improvement, two had resolution, one reported worsening of symptoms, and 3 had died (one suicide). Conclusions are limited because this was a retrospective chart review. Erythromelalgia in pediatric patients is associated with substantial morbidity and even death. The majority of cases are not inherited. Most patients studied have associated small-fiber neuropathy. The disease course is variable. A reliable and safe treatment has not been determined. Copyright © 2011 American Academy of

  14. The centennial anniversary of the frozen section technique at the Mayo Clinic.

    PubMed

    Gal, Anthony A

    2005-12-01

    The frozen section technique has become an invaluable tool to assist the surgeon with intraoperative diagnosis. Although there were various descriptions of frozen section technique before and after the turn of the 20th century, the publication by Louis B. Wilson, MD, at the Mayo Clinic in 1905 heralded the beginning of a new era in intraoperative diagnosis. This historical review traces the circumstances that led to this landmark publication 100 years ago.

  15. Fecal microbiota transplant for recurrent Clostridium difficile infection: Mayo Clinic in Arizona experience.

    PubMed

    Patel, Neal C; Griesbach, Cheryl L; DiBaise, John K; Orenstein, Robert

    2013-08-01

    To report the initial experience of treating recurrent Clostridium difficile infection (CDI) with fecal microbiota transplant (FMT) at Mayo Clinic in Arizona. The study retrospectively reviewed FMTs performed at Mayo Clinic in Arizona between January 1, 2011, and January 31, 2013. All the recipients had multiple recurrent CDIs unresponsive to traditional antibiotic drug therapy. A standardized protocol was developed to identify patients, screen donors, perform FMT, and determine outcomes via telephone surveys. Thirty-one patients (mean ± SD age, 61.26±19.34 years) underwent FMT. Median time from index infection to FMT was 340 days. Ninety-seven percent (29 of 30) of patients reported substantial improvement or resolution of diarrhea (median time to improvement, 3 days), 74% (17 of 23) reported improvement or resolution of abdominal pain (median time to improvement, 3 days), and 55% (16 of 29) had improvement or resolution of fatigue (median time to improvement, 6 days). Three patients underwent repeated FMT owing to persistent symptoms; 2 reported improvement in diarrhea with the second therapy. No serious adverse events directly related to FMT were reported. A standardized regimen of FMT for recurrent CDI is safe, is highly effective, and can be provided using a relatively simple protocol. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  16. Performance characteristics of the Mayo/IBM PACS

    NASA Astrophysics Data System (ADS)

    Persons, Kenneth R.; Gehring, Dale G.; Pavicic, Mark J.; Ding, Yingjai

    1991-07-01

    The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archiving system for use with Mayo's MRI and Neuro CT imaging modalities. The communications backbone of the PACS is a portion of the Mayo institutional network: a series of 4-Mbps token rings interconnected by bridges and fiber optic extensions. The performance characteristics of this system are important to understand because they affect the response time a PACS user can expect, and the response time for non-PACS users competing for resources on the institutional network. The performance characteristics of each component and the average load levels of the network were measured for various load distributions. These data were used to quantify the response characteristics of the existing system and to tune a model developed by North Dakota State University Department of Computer Science for predicting response times of more complex topologies.

  17. Melorheostosis: A Retrospective Clinical Analysis of 24 Patients at the Mayo Clinic.

    PubMed

    Smith, Gabriel C; Pingree, Matthew J; Freeman, Laura A; Matsumoto, Jane M; Howe, Benjamin M; Kannas, Stephanie N; Pyfferoen, Mary D; Struss, Leah T; Wenger, Doris E; Amrami, Kimberly K; Matsumoto, Martha; Jurisson, Mary L

    2017-03-01

    Current understanding of the clinical features of persons with melorheostosis is restricted primarily to individual case reports and small case series. To assess the clinical features of patients with melorheostosis treated at our institution from 1972 through 2010. Chart review. Tertiary academic medical center. Twenty-three patients with "definite" and one patient with "probable" melorheostosis based on radiographic criteria. The eligible study cohort was identified through the Rochester Medical Index database. Further diagnostic confirmation of patients with melorheostosis was performed by radiographic review. We evaluated age at first visit to our institution, gender, affected body area, number of bones affected, presenting symptoms, surgical evaluation, and therapies provided. The average age at first evaluation at our clinic was 36.5 years (median 41.5 years, range 3-68 years). The female to male ratio was 4:1. The lower extremity was most commonly affected (66.6%), followed by upper extremity (33.3%), spine (16.6%), and head (8.3%). One-third of patients had involvement of a single bone; two-thirds had multiple bone involvement. Pain was the most common presenting concern (83.3%), followed by deformity (54.1%), limitation of movement (45.8%), numbness (37.5%), and weakness (25.0%). Most patients had a physician evaluation (87.5%); patients also underwent orthopedic surgery (45.8%), physical therapy (33.3%), and occupational therapy (12.5%). Melorheostosis is a rare sclerotic bone disease resulting in pain, deformity, and dysfunction. An interdisciplinary approach to care should include nonoperative and operative evaluation, as well as appropriate therapies. A prospective approach to evaluation, including imaging and physical examinations, would provide valuable longitudinal data. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  18. Success of a Faculty Development Program for Teachers at the Mayo Clinic.

    PubMed

    Lee, Staci M; Lee, Mark C; Reed, Darcy A; Halvorsen, Andrew J; Berbari, Elie F; McDonald, Furman S; Beckman, Thomas J

    2014-12-01

    There has been limited research on the improvement of underperforming clinical teachers. To determine whether a faculty development program could improve the evaluations of clinical teachers in an internal medicine residency program. A total of 123 teachers completed faculty development at the Mayo Clinic from 2009 to 2012. The faculty enhancement and education development program (FEED) consists of 6 interactive, small group, 2-hour sessions taught by experienced Mayo Clinic faculty over 1 year. These sessions address the following competencies: asking questions, diagnosing learners, giving feedback, using teaching frameworks, recognizing learning styles, and providing clinical supervision. Resident-of-faculty Mayo teaching effectiveness (MTE) scores have previously demonstrated content, internal structure, and criterion validity. Teachers were grouped into the top 80% or the bottom 20%, according to baseline MTE scores. Mixed linear models were used to compare these groups regarding changes in MTE scores after completion of FEED. Results were adjusted for teacher age, sex, medical specialty, academic rank, and teaching awards. For all participants combined, the adjusted MTE scores (mean; standard error) improved from baseline (3.80; 0.04) to completion of FEED (3.93; 0.04; P < .001). However, the bottom 20% had a significantly greater improvement in scores than the top 80% (score-change difference  =  0.166, P < .001). We describe a low-intensity faculty development intervention that benefited all clinical teachers, but was particularly effective for underperforming teachers in internal medicine. The approach may be suitable for adoption or adaptation in other graduate medical education programs.

  19. Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience.

    PubMed

    Hofherr, Sean E; Wiktor, Anne E; Kipp, Benjamin R; Dawson, D Brian; Van Dyke, Daniel L

    2011-11-01

    Approximately 8% of couples attempting to conceive are infertile and male infertility accounts for approximately 50% of infertility among couples. Up to 25% of males with non-obstructive infertility have chromosomal abnormalities and/or microdeletions of the long arm of the Y-chromosome. These are detected by conventional chromosome and Y-microdeletion analysis. In this study, we reviewed the results of testing performed in the Mayo Clinic Cytogenetics and Molecular Genetics Laboratories and compared our findings with previously published reports. This study includes 2,242 chromosome studies from males ≥18 years of age referred for infertility between 1989 and 2000 and 2,749 Y-deletion molecular studies performed between 2002 and 2009. 14.3% of infertile males tested by karyotyping had abnormalities identified. These include: (258) 47,XXY and variants consistent with Klinefelter syndrome, (3) combined 47,XXY and balanced autosomal rearrangements, (9) 47,XYY, (9) Y-deletions, (7) 46,XX males, (32) balanced rearrangements, and (1) unbalanced rearrangement. 3.6% of males tested for Y-microdeletion analysis had abnormalities identified, 90% of which included a deletion of the AZFc region. This study highlights the need of males suffering from non-obstructive infertility to have laboratory genetic testing performed. An abnormal finding can have significant consequences to assisted reproductive techniques and fertility treatment, and provide a firm diagnosis to couples with longstanding infertility.

  20. Detection of seizures in intracranial EEG: UPenn and Mayo Clinic's Seizure Detection Challenge.

    PubMed

    Temko, Andriy; Sarkar, Achintya; Lightbody, Gordon

    2015-01-01

    A system for detection of seizures in intracranial EEG is presented that is based on a combination of generative, discriminative and hybrid approaches. We present a methodology to effectively benefit from the advantages each classifier offers. In particular, Gaussian mixture models, Support Vector Machines, hybrid likelihood ratio and Gaussian supervector approaches are developed and combined for the task. This system participated in the UPenn and Mayo Clinic's Seizure Detection Challenge, ranking in the top 5 of over 200 participants. The drawbacks of the proposed method with respect to the winning solutions are critically assessed.

  1. Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

    PubMed

    Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

    2006-01-01

    Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

  2. A brief history of the early years of blood transfusion at the Mayo Clinic: the first blood bank in the United States (1935).

    PubMed

    Moore, S Breanndan

    2005-07-01

    At the Mayo Clinic in 1914, Francis McGrath modified an existing aspiration-injection apparatus and adapted it for arm-to-arm blood transfusions. Separately, in 1919, both Pemberton and Sanford described in detail the Mayo Clinic experience with more than 1000 transfusions between January 1915 and January 1918. Most transfusions were by the indirect citrate method from freshly drawn blood. In 1935, John Lundy established a bank of refrigerated blood for transfusions at Mayo Clinic and reported on the activity in that and subsequent years. The functioning clinical blood bank established by Lundy at Mayo Clinic predated that of Bernard Fantus in Chicago by almost 2 years.

  3. Building a protocol expressway: the case of Mayo Clinic Cancer Center.

    PubMed

    McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

    2009-08-10

    Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

  4. Building a Protocol Expressway: The Case of Mayo Clinic Cancer Center

    PubMed Central

    McJoynt, Terre A.; Hirzallah, Muhanad A.; Satele, Daniel V.; Pitzen, Jason H.; Alberts, Steven R.; Rajkumar, S. Vincent

    2009-01-01

    Purpose Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. Methods A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Results Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). Conclusion DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes. PMID:19564529

  5. Principles and process in the development of the Mayo Clinic's individual and institutional conflict of interest policy.

    PubMed

    Camilleri, Michael; Gamble, Gail L; Kopecky, Stephen L; Wood, Michael B; Hockema, Marianne L

    2005-10-01

    In 1995, federal regulations required all academic medical centers to implement policies to manage individual financial conflict of interest. At the Mayo Clinic, all staff are salaried, and all medically related intellectual property from the staff belongs to the clinic. Hence, it was necessary to develop a policy for institutional conflict of interest to complement the policy for individual conflicts of interest. This article addresses the principles and process that led to the development of the Mayo Clinic's policies that guide the management of conflict of interest of individuals and of the institution. Empowered by the Bayh-Dole Act, the Mayo Clinic participates in technology transfer through its entity Mayo Medical Ventures. Individual conflicts of interest arising from such technology transfer are associated with Institutional conflicts because all individual intellectual property belongs to the institution, per clinic policy. This policy addresses conflicts of interest that arise in research, leadership, clinical practice, investments, and purchasing. Associated with the statutory annual disclosure on personal consulting and other relationships with Industry, which are guided by federal regulations, all research protocols or grant applications require financial disclosure on initial submission and in annual progress reports. The clinic's Conflict of Interest Review Board was established to review each disclosure and recommend management of individual and institutional conflicts of interest according to policy.

  6. Mayo Clinic Cancer Center Experience of Metastatic Extramammary Paget Disease 1998-2012.

    PubMed

    Padrnos, Leslie; Karlin, Nina; Halfdanarson, Thorvardur R

    2016-11-17

    Extramammary Paget disease (EMPD) is a rare cutaneous malignancy. The most common presentation of EMPD is the vulva followed by perianal involvement. Most cases are localized to the dermis with treatment focused on surgery, topical treatment or radiotherapy. Recurrence is frequent despite therapies utilized. Metastatic extramammary Paget disease is uncommon and, as such, standard treatment guidelines do not exist. This study sought to evaluate the treatment regimens and outcomes of patients treated at a Mayo Clinic Center from 1998-2012. Cancer registry inquiry revealed 261 patients with report advanced Paget disease during these years. Ten cases of metastatic EPMD were identified with sufficient documentation for review. This review reveals support for utilizing localized radiation therapy for bulky disease sequentially with systemic chemotherapy consisting of carboplatin and paclitaxel or irinotecan. Further studies are necessary to define the optimal treatment regimen.

  7. Cortical Thickness and Anxiety Symptoms Among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging.

    PubMed

    Pink, Anna; Przybelski, Scott A; Krell-Roesch, Janina; Stokin, Gorazd B; Roberts, Rosebud O; Mielke, Michelle M; Spangehl, Kathleen A; Knopman, David S; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

    2017-01-01

    The authors conducted a cross-sectional study to investigate the association between anxiety symptoms and cortical thickness, as well as amygdalar volume. A total of 1,505 cognitively normal participants, aged ≥70 years, were recruited from the Mayo Clinic Study of Aging in Olmsted County, Minnesota, on whom Beck Anxiety Inventory and 3T brain MRI data were available. Even though the effect sizes were small in this community-dwelling group of participants, anxiety symptoms were associated with reduced global cortical thickness and reduced thickness within the frontal and temporal cortex. However, after additionally adjusting for comorbid depressive symptoms, only the association between anxiety symptoms and reduced insular thickness remained significant.

  8. Mayo Clinic Cancer Center Experience of Metastatic Extramammary Paget Disease 1998-2012

    PubMed Central

    Padrnos, Leslie; Karlin, Nina; Halfdanarson, Thorvardur R.

    2016-01-01

    Extramammary Paget disease (EMPD) is a rare cutaneous malignancy. The most common presentation of EMPD is the vulva followed by perianal involvement. Most cases are localized to the dermis with treatment focused on surgery, topical treatment or radiotherapy. Recurrence is frequent despite therapies utilized. Metastatic extramammary Paget disease is uncommon and, as such, standard treatment guidelines do not exist. This study sought to evaluate the treatment regimens and outcomes of patients treated at a Mayo Clinic Center from 1998-2012. Cancer registry inquiry revealed 261 patients with report advanced Paget disease during these years. Ten cases of metastatic EPMD were identified with sufficient documentation for review. This review reveals support for utilizing localized radiation therapy for bulky disease sequentially with systemic chemotherapy consisting of carboplatin and paclitaxel or irinotecan. Further studies are necessary to define the optimal treatment regimen. PMID:27994832

  9. The Pine Ridge-Mayo National Aeronautics and Space Administration Telemedicine Project: Program Activities and Participant Reactions

    NASA Technical Reports Server (NTRS)

    Kottke, T. E.; Little Finger, L.; Trapp, M. A.; Panser, L. A.; Novotny, P. J.

    1996-01-01

    OBJECTIVE: To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. DESIGN: We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. MATERIAL AND METHODS: Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. RESULTS: Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. CONCLUSION: These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

  10. The Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project: program activities and participant reactions.

    PubMed

    Kottke, T E; Little Finger, L; Trapp, M A; Panser, L A; Novotny, P J

    1996-04-01

    To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

  11. The Pine Ridge-Mayo National Aeronautics and Space Administration Telemedicine Project: Program Activities and Participant Reactions

    NASA Technical Reports Server (NTRS)

    Kottke, T. E.; Little Finger, L.; Trapp, M. A.; Panser, L. A.; Novotny, P. J.

    1996-01-01

    OBJECTIVE: To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. DESIGN: We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. MATERIAL AND METHODS: Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. RESULTS: Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. CONCLUSION: These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

  12. Emergency Video Telemedicine Consultation for Newborn Resuscitations: The Mayo Clinic Experience.

    PubMed

    Fang, Jennifer L; Collura, Christopher A; Johnson, Robert V; Asay, Garth F; Carey, William A; Derleth, Douglas P; Lang, Tara R; Kreofsky, Beth L; Colby, Christopher E

    2016-12-01

    To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries. From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction. During the study, neonatologists conducted 84 telemedicine consultations, and 64 surveys were completed. Prematurity was the most frequent indication for consultation (n=32), followed by respiratory distress (n=15) and need for advanced resuscitation (n=14). After the consult, nearly one-third of the infants were able to remain in the local hospital. User assessment of the technology revealed that audio and video quality were poor or unusable in 16 (25%) and 12 (18.8%) of cases, respectively. Providers failed to establish a video connection in 8 consults (9.5%). Despite technical issues, providers responded positively to multiple questions assessing teamwork (86.0% [n=37 of 43] to 100.0% [n=17 of 17] positive responses per question). In 93.3% (n=14 of 15) of surveyed cases, the local provider agreed that the telemedicine consult improved patient safety, quality of care, or both. Telemedicine consultation for neonatal resuscitation improves patient access to neonatology expertise and prevents unnecessary transfers to a higher level of care. A highly reliable technology infrastructure that provides high-quality audio and video should be considered for any emergency telemedicine service. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  13. Performance of the CogState computerized battery in the Mayo Clinic Study on Aging

    PubMed Central

    Mielke, Michelle M.; Machulda, Mary M.; Hagen, Clinton E.; Edwards, Kelly K.; Roberts, Rosebud O.; Pankratz, V. Shane; Knopman, David S.; Jack, Clifford R.; Petersen, Ronald C.

    2015-01-01

    Background The feasibility and validity of brief computerized cognitive batteries at the population-level are unknown. Methods Non-demented participants (n = 1660, age 50–97) in the Mayo Clinic Study on Aging completed the computerized CogState battery and standard neuropsychological battery. The correlation between tests was examined and comparisons between CogState performance on the personal computer (PC) and iPad (n = 331), and in the Clinic vs. at home (n = 194), were assessed. Results We obtained valid data on >97% of participants on each test. Correlations between the CogState and neuropsychological tests ranged from −0.462 to 0.531. While absolute differences between the PC and iPad were small and participants preferred the iPad, performance on the PC was faster. Participants performed faster on Detection, One Card Learning, and One Back at home compared to the Clinic. Conclusions The computerized CogState battery, especially the iPad, was feasible, acceptable, and valid in the population. PMID:25858683

  14. PhotoExam: adoption of an iOS-based clinical image capture application at Mayo Clinic.

    PubMed

    Wyatt, Kirk D; Willaert, Brian N; Pallagi, Peter J; Uribe, Richard A; Yiannias, James A; Hellmich, Thomas R

    2017-05-11

    Mayo Clinic developed an internal iOS-based, point-of-care clinical image capture application for clinicians. We aimed to assess the adoption and utilization of the application at Mayo Clinic. Metadata of 22,784 photos of 6417 patients taken by 606 users over 8040 clinical encounters between 3/1/2015 and 10/31/2015 were analyzed. A random sample of photos from 100 clinical encounters was assessed for quality using a five-item rubric. Use of traditional medical photography services before and after application launch were compared. The largest group of users was residents/fellows, accounting for 31% of users but only 18% of all photos. Attending physicians accounted for 29% of users and 30% of photos. Nurses accounted for 14% of users and 28% of photos. Surgical specialties had the most users (36% of users), followed by dermatology (14% of users); however, dermatology accounted for 54% of all photos, and surgery accounted for 26% of photos. Images received an average of 91% of possible points on the quality scoring rubric. Most frequent reasons for missing points were the location on the body not clearly being demonstrated (19% of encounters) and the perspective/scale not being clearly demonstrated (12% of encounters). There was no discernible pre-post effect of the application's launch on use of traditional medical photography services. Point-of-care clinical photography is a growing phenomenon with potential to become the new standard of care. Patient and provider attitudes and the impact on patient outcomes remain unclear. © 2017 The International Society of Dermatology.

  15. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

    PubMed

    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  16. Outcomes and patterns of failure of sarcomatoid carcinoma of the larynx: The Mayo Clinic experience.

    PubMed

    Gamez, Mauricio E; Jeans, Elizabeth; Hinni, Michael L; Moore, Eric; Young, Geoffrey; Ma, Daniel; McGee, Lisa; Buras, Matthew R; Patel, Samir H

    2017-07-06

    Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma of the head and neck. No consensus exists on its management. Our aim was to present our outcomes. Retrospective study. Median follow-up 45 months. There were 38 patients with pathologically confirmed sarcomatoid carcinoma of the larynx treated at the Mayo Clinic from 1990 to 2014. Statistical analysis of overall survival (OS), progression-free survival (PFS), and local control (LC) were conducted using the Kaplan-Meier method. The majority of patients were elderly males (92%) with a smoking history (74%) presenting with early-stage disease (71%). Surgery alone was the primary treatment in 27 patients (71%). Nine patients (25%) were treated with adjuvant radiation due to initial stage or high-risk pathologic features. Median radiation dose to the primary/surgical bed was 65 Gy (range, 60.3-75.0 Gy). A total of 15 patients (39%) had tumor recurrence, majority being local (n = 12). Sixty percent (n = 9) had multiple local recurrences. Five-year OS, PFS, and LC were 63%, 46%, and 72%, respectively. Subgroup analysis by stage I versus higher stages (II-IV) showed an OS of 80% versus 43% (P = .030), PFS of 65% versus 18% (P = .003), and LC of 84% versus 57% (P = .039). Sarcomatoid carcinoma of the larynx is rare, and frequently presents at an early stage in older men with history of smoking. Based on our outcomes and patterns of failure, it appears early-stage tumors are treated appropriately with single-modality therapy, whereas more advanced tumors require multimodality therapy. Validation in a larger cohort is warranted. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Complex Fibroadenoma and Breast Cancer Risk: A Mayo Clinic Benign Breast Disease Cohort Studya

    PubMed Central

    Nassar, Aziza; Visscher, Daniel W.; Degnim, Amy C.; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene; Radisky, Derek C.; Vachon, Celine M.; Kraft, Ruth A.; Hartmann, Lynn C.; Ghosh, Karthik

    2015-01-01

    Purpose To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. Methods The study included women aged 18 to 85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed vs expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression (nonproliferative disease, proliferative disease without atypia [PDWA], or atypical hyperplasia). Results Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85.9%]; complex, 301 [14.1%]). SIR for noncomplex fibroadenoma was 1.49 (95% CI, 1.26–1.74); for complex fibroadenoma, it was 2.27 (95% CI, 1.63–3.10) (test for heterogeneity in SIR, P=.02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (eg, incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Conclusions Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics. PMID:26264469

  18. Quality improvement education incorporated as an integral part of critical care fellows training at the Mayo Clinic.

    PubMed

    Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W

    2014-10-01

    The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

  19. An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis

    PubMed Central

    Salvarani, Carlo; Brown, Robert D.; Christianson, Teresa; Miller, Dylan V.; Giannini, Caterina; Huston, John; Hunder, Gene G.

    2015-01-01

    Abstract Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with

  20. Clinical results of ab interno trabeculotomy using the trabectome for open-angle glaucoma: the Mayo Clinic series in Rochester, Minnesota.

    PubMed

    Ahuja, Yachna; Ma Khin Pyi, Son; Malihi, Mehrdad; Hodge, David O; Sit, Arthur J

    2013-11-01

    To determine outcomes of ab interno trabeculotomy for treatment of open-angle glaucoma (OAG). Retrospective interventional single-surgeon, single-center case series. Data were collected from 246 patients undergoing ab interno trabeculotomy between September 1, 2006, and December 1, 2010, with 3 months' follow-up or longer. Kaplan-Meier analysis was performed using Criteria A (postoperative intraocular pressure [IOP] ≤21 mm Hg or ≥20% reduction from preoperative IOP) and Criteria B (IOP ≤18 mm Hg and ≥20% reduction in IOP). Failure included increased glaucoma medications or subsequent surgery. Failure risk factors were identified using Cox proportional hazards ratio (HR). Of 88 cases of ab interno trabeculotomy-only and 158 cases of ab interno trabeculotomy with cataract extraction, the retention rate was 70% for 1 year and 62% for 2 years. Preoperative mean IOP was 21.6 ± 8.6 mm Hg; the number of glaucoma medications was 3.1 ± 1.1. At 24 months postoperatively, mean IOP was reduced 29% to 15.3 ± 4.6 mm Hg (P < 0.001) and the number of glaucoma medications was reduced 38% to 1.9 ± 1.3 (P < 0.001) with a success rate of 62% (95% CI, 56%-68%) using Criteria A and 22% (95% CI, 16%-29%) using Criteria B. Failure risk factors using Criteria A included primary OAG (HR 3.14, P < 0.01, 95% CI, 1.91-5.17) and past argon laser trabeculoplasty (HR 1.81, P < 0.01, 95% CI, 1.18-2.77). Using Criteria B, the HR for pseudoexfoliative glaucoma was 0.43 (P < 0.01, 95% CI 0.27-0.67). Of the cases, 66 (26.8%) required subsequent surgery on an average of 10 months (2 days to 3.2 years) after ab interno trabeculotomy. For criteria involving IOP ≤18 mm Hg, the 24-month survival of ab interno trabeculotomy is low. This surgery is appropriate for patients requiring a target IOP of 21 mm Hg or above. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Serum Adiponectin Levels, Neuroimaging, and Cognition in the Mayo Clinic Study of Aging

    PubMed Central

    Wennberg, Alexandra M. V.; Gustafson, Deborah; Hagen, Clinton E.; Roberts, Rosebud O.; Knopman, David; Jack, Clifford; Petersen, Ronald C.; Mielke, Michelle M.

    2016-01-01

    BACKGROUND Adiponectin, a protein involved in inflammatory pathways, may impact the development and progression of Alzheimer’s disease (AD). Adiponectin levels have been associated with mild cognitive impairment (MCI) and AD; however, its association with Alzheimer-associated neuroimaging and cognitive outcomes is unknown. OBJECTIVE Determine the cross-sectional association between plasma adiponectin and neuroimaging and cognitive outcomes in an older population-based sample. METHODS Multivariable adjusted regression models were used to investigate the association between plasma adiponectin and hippocampal volume (HVa), PiB-PET, FDG PET, cortical thickness, MCI diagnosis, and neuropsychological test performance. Analyses included 535 non-demented participants aged 70 and older enrolled in the Mayo Clinic Study of Aging. RESULTS Women had higher adiponectin than men (12,631 ng/mL vs. 8,908 ng/mL, P < .001). Among women, higher adiponectin was associated with smaller HVa (B=−0.595; 95% CI −1.19, −0.005), poorer performance in language (B−0.676; 95% CI −1.23, −0.121) and global cognition (B=−0.459; 95% CI −0.915, −0.002), and greater odds of a MCI diagnosis (OR=6.23; 95% CI 1.20, 32.43). In analyses stratified by sex and elevated amyloid (PiB-PET SUVR>1.4), among women with elevated amyloid, higher adiponectin was associated with smaller HVa (B=−0.723; 95% CI −1.43, −0.014), poorer performance in memory (B=−1.02; 95% CI −1.73, −0.312), language (B=−0.896; 95% CI −1.58, −0.212), and global (B=−0.650; 95% CI −1.18, −0.116) cognition, and greater odds of MCI (OR=19.34; 95% CI 2.72, 137.34). CONCLUSION Higher plasma adiponectin was associated with neuroimaging and cognitive outcomes among women. Longitudinal analyses are necessary to determine whether higher adiponectin predicts neurodegeneration and cognitive decline. PMID:27163809

  2. Long-term outcomes of radiotherapy for stage II testicular seminoma--the Mayo Clinic experience.

    PubMed

    Hallemeier, Christopher L; Pisansky, Thomas M; Davis, Brian J; Choo, Richard

    2013-11-01

    To report long-term outcomes of patients with stage II testicular seminoma treated with radiotherapy (RT). A retrospective review was performed of 52 patients who received megavoltage RT for stage II testicular seminoma at Mayo Clinic between 1974 and 2007. Forty-eight patients (92%) had computed tomography staging. Overall survival (OS), relapse-free survival (RFS), and cause-specific survival (CSS) were determined using the Kaplan-Meier method. Major cardiac event (MCE) was defined as myocardial infarction, coronary artery bypass grafting or stenting, or valve replacement. Second malignancy (SM) was defined as biopsy-confirmed malignancy occurring in the RT field. The median patient age at diagnosis was 36 years. Stage was IIA (n = 24), IIB (n = 7), IIC (n = 17), and II not otherwise specified (NOS, n = 4). The median infradiaphragmatic RT dose was 30.7 Gy. Twenty-six patients (50%) received prophylactic mediastinal/supraclavicular (MSCV) RT. The median follow-up was 19 years. Estimates of OS, RFS, and CSS were 94%, 80%, and 96% at 10 years, and 83%, 72%, and 96% at 20 years, respectively. RFS at 10 years for stage IIA, IIB, IIC, and II NOS were 83%, 54%, 81%, and 100%, respectively (log-rank P = 0.21). Ten patients (19%) experienced disease relapse in the MSCV region (n = 7), para-aortic lymph nodes (n = 1), lung (n = 1), or peritoneal cavity (n = 1). Eight patients were successfully salvaged with chemotherapy and/or surgery, while 2 died of seminoma. Risk of MSCV relapse was significantly lower in patients who received MSCV RT vs. those who did not (10-year estimates: 4% vs. 21%, respectively, log-rank P = 0.01). MCE occurred in 10 patients (19%) at a median of 18 years (range 7-30) after RT. SM occurred in 5 patients (10%) at a median of 27 years (range 20-34) after RT. In patients with stage II testicular seminoma treated with RT, relapse in the irradiated site was uncommon. Infradiaphragmatic RT alone was associated with a significant risk of MSCV failure

  3. The Ulcerative Colitis Endoscopic Index of Severity More Accurately Reflects Clinical Outcomes and Long-term Prognosis than the Mayo Endoscopic Score

    PubMed Central

    Ikeya, Kentaro; Sugimoto, Ken; Osawa, Satoshi; Kawasaki, Shinsuke; Iida, Takayuki; Maruyama, Yasuhiko; Watanabe, Fumitoshi

    2016-01-01

    Background and Aims: The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and the Mayo endoscopic score (Mayo ES) are used to evaluate ulcerative colitis (UC) severity. This study compared UCEIS and the Mayo ES for evaluating UC severity and outcomes in patients undergoing remission induction during routine clinical practice with the aim of predicting medium- to long-term prognosis. Methods: Forty-one UC patients who received colonoscopy before and after tacrolimus remission induction therapy were included. An index of clinical activity and endoscopic findings scored by both the UCEIS and the Mayo ES were determined. Changes in UCEIS and Mayo ES before and after induction therapy were compared. Results: The mean UCEIS improved from 6.2±0.9 to 3.4±2.1 (p < 0.001). Based on the UCEIS, a significant reduction was reached in both the response and the remission groups. In contrast, the Mayo ES did not reflect a significant change in the response group. The discrepancy appeared to be due to ulcers becoming smaller and shallower during the early stages of mucosal healing; the Mayo ES seems to miss these early changes. In other words, whereas the UCEIS indicates improvements when ulcers shrink, the Mayo ES does not distinguish deep ulcers from shallow ulcers and is 3 (severe UC) for both deep and shallow ulcers. Additionally, better UCEIS strata after induction therapy were associated with lower incidences of colectomy (p = 0.0001) or relapse (p = 0.0008). Conclusions: The UCEIS accurately reflects clinical outcomes and predicts the medium- to long-term prognosis in UC patients undergoing induction therapy. These findings should support decision-making in clinical practice settings. PMID:26581895

  4. Delusional infestation: clinical presentation in 147 patients seen at Mayo Clinic.

    PubMed

    Foster, Ashley A; Hylwa, Sara A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-10-01

    Delusional infestation is the conviction that one's skin is infested with foreign organisms or materials despite contradictory objective evidence. To delineate clinical characteristics of patients presenting with delusional infestation. We performed a retrospective study of patients meeting delusional infestation criteria who were seen for diagnosis and treatment in our tertiary care academic medical center (2001-2007). Medical records were reviewed to abstract demographic, historical, and physical findings and treatment. Over 7 years, 147 patients presented with delusional infestation; 87% (123/142) for another opinion. Mean age was 57 years; female-to-male ratio was 2.89 to 1; 82 (56%) were married. Mean duration of symptoms was 31 months. Employment data were available for 145 patients: 48 (33%) were self-described as disabled, 16 of whom cited delusions as their disability; 41 (28%) were retired; and 38 (26%) were employed. Reported infestations included multiple materials (45% [64/143]), not limited to insects (79% [113/143]), worms (27% [39/143]), and fibers (20% [29/143]). Most patients presented initially to dermatology or other specialties; only 3 presented to psychiatry. A high proportion (81%) had prior psychiatric conditions. Thirty-eight (26%) of the 147 patients had a shared psychotic disorder. The retrospective nature of the study and the incompleteness of some data because not all the characteristics that were analyzed were documented for every patient. Patients were predominantly female, had a long history of symptoms, and had been seen previously at many medical centers. A large proportion were disabled or retired. Patients reported skin infestation with both animate and inanimate objects. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. What makes a Catholic hospital "Catholic" in an age of religious-secular collaboration? The case of the Saint Marys hospital and the Mayo Clinic.

    PubMed

    Swetz, Keith M; Crowley, Mary E; Maines, T Dean

    2013-06-01

    Mayo Clinic is recognized as a worldwide leader in innovative, high-quality health care. However, the Catholic mission and ideals from which this organization was formed are not widely recognized or known. From partnership with the Sisters of St. Francis in 1883, through restructuring of the Sponsorship Agreement in 1986 and current advancements, this Catholic mission remains vital today at Saint Marys Hospital. This manuscript explores the evolution and growth of sponsorship at Mayo Clinic, defined as "a collaboration between the Sisters of St. Francis and Mayo Clinic to preserve and promote key values that the founding Franciscan sisters and Mayo physicians embrace as basic to their mission, and to assure the Catholic identity of Saint Marys Hospital." Historical context will be used to frame the evolution and preservation of Catholic identity at Saint Marys Hospital; and the shift from a "sponsorship-by-governance" to a "sponsorship-by-influence" model will be highlighted. Lastly, using the externally-developed Catholic Identity Matrix (developed by Ascension Health and the University of St. Thomas, Minnesota), specific examples of Catholic identity will be explored in this joint venture of Catholic health care institution and a secular, nonprofit corporation (Mayo Clinic).

  6. The development and implementation of a strategic and tactical planning framework at Mayo Clinic Arizona.

    PubMed

    Frey, Keith; Cranmer, John Jack; Kirby, Lani J; Lenko, Paul H; Vrabel, Amy Z

    2005-01-01

    This article describes the Mayo Arizona process for developing an information technology strategic plan. The background of organizational events that gave rise to this strategic planning process is presented. A cross-functional team of key IT stakeholders was convened; the team used a facilitated process to derive a pro forma set of IT strategic objectives from the larger organization's emerging strategic plan. A broad set of leadership interviews was conducted to further identify detailed objectives that would confirm, complement, or conflict with the "strawperson." The IT strategic objectives then were refined and published by the organization. The article also describes the annual process of reviewing the IT strategic plan and translating it to a set of tactical objectives. This includes the committee structure for project prioritization, which is guided by the IT strategic plan. The outcome of the prioritization process is a five-year IT tactical plan, which is used to communicate the IT action plan for achievement of the strategic objectives. The strategic and tactical plans have resulted in stronger ownership and advocacy of IT activities by organizational leadership and a clearer view of the impact of technology on the organization's strategic plan.

  7. Highlights from the third annual Mayo Clinic conference on systems engineering and operations research in health care.

    PubMed

    Kamath, Janine R A; Osborn, John B; Roger, Véronique L; Rohleder, Thomas R

    2011-08-01

    In August 2010, the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care was held. The continuing mission of the conference is to gather a multidisciplinary group of systems engineers, clinicians, administrators, and academic professors to discuss the translation of systems engineering methods to more effective health care delivery. Education, research, and practice were enhanced via a mix of formal presentations, tutorials, and informal gatherings of participants with diverse backgrounds. Although the conference promotes a diversity of perspectives and methods, participants are united in their desire to find ways in which systems engineering can transform health care, especially in the context of health care reform and other significant changes affecting the delivery of health care.

  8. Economic analysis of a comprehensive pain rehabilitation program: a collaboration between Florida Blue and Mayo Clinic Florida.

    PubMed

    Sletten, Christopher D; Kurklinsky, Svetlana; Chinburapa, Vijit; Ghazi, Salim

    2015-05-01

    The cost of caring for patients with chronic pain conditions poses a significant burden to both the healthcare system and patients. We were interested in analyzing the financial costs and benefits of treating these patients in a comprehensive outpatient pain rehabilitation program. All participants completed the 3-week outpatient Mayo Clinic Florida Pain Rehabilitation Program (PRC) between October 2011 and September 2013. Healthcare costs were compared during the 3-, 6-, 12-, and 18-month periods pre- and post-treatment. The sample included 53 patients. Medical costs decreased by 86, 68, 64, and 90% in the 3-, 6-, 12-, and 18-month post-treatment periods, respectively, when compared with the same pretreatment periods. The appropriate use of a comprehensive outpatient rehabilitation program for chronic pain patients can result in a significant reduction in medical costs. © 2015 The Authors Pain and Medicine Published by Wiley Periodicals, Inc.

  9. Highlights From the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care

    PubMed Central

    Kamath, Janine R. A.; Osborn, John B.; Roger, Véronique L.; Rohleder, Thomas R.

    2011-01-01

    In August 2010, the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care was held. The continuing mission of the conference is to gather a multidisciplinary group of systems engineers, clinicians, administrators, and academic professors to discuss the translation of systems engineering methods to more effective health care delivery. Education, research, and practice were enhanced via a mix of formal presentations, tutorials, and informal gatherings of participants with diverse backgrounds. Although the conference promotes a diversity of perspectives and methods, participants are united in their desire to find ways in which systems engineering can transform health care, especially in the context of health care reform and other significant changes affecting the delivery of health care. PMID:21803959

  10. Thymic and Bronchial Carcinoid Tumors in Multiple Endocrine Neoplasia Type 1: The Mayo Clinic Experience from 1977 to 2013.

    PubMed

    Singh Ospina, Naykky; Thompson, Geoffrey B; C Nichols, Francis; Cassivi, Stephen D; Young, William F

    2015-12-01

    The clinical features of thymic carcinoid (TC) and bronchial carcinoid (BC) tumors as part of multiple endocrine neoplasia type 1 (MEN1) have been rarely described and their importance in clinical practice is debated. The objective of this study was to describe the clinical presentation and outcome of this uncommon manifestation of MEN1 in a tertiary care center setting. We present the clinical features of patients with MEN1 and either TC or BC evaluated at the Mayo Clinic from 1977 to 2013. A total of 348 patients with MEN1 were evaluated and the prevalence of TC was 2.0% (n = 7) and of BC 4.9% (n = 17). The majority of the patients with BC were men (61%) diagnosed on routine screening (77%) and BC was not the confirmed cause of death in any patient. In contrast, TC patients were all men and during follow-up 43% died due to TC complications. We conclude that TC and BC tumors are uncommon, but important components of MEN1. BC were most commonly diagnosed during routine screening and associated with an indolent course. TC were predominantly seen in men and associated with a more aggressive behavior.

  11. South Fork Zumbro River Stage 1B, Rochester, Minnesota (Supplement Number 1 to Design Memorandum Number 2 and Environmental Assessment)

    DTIC Science & Technology

    1988-11-01

    Rochester concerns relating to project aesthetics. The areas of most concern were the Mayo Memorial Park riverfront and the view from 2nd Avenue N.E...Fourth Street Southeast to Third Avenue Southeast. A trail will be constructed on the left bank from Second Street Northeast to Mayo Memorial Park. Trail...pedestrian trail on the left bank in Mayo Memorial Park, a pedestrian bridge, and four river accesses. 9. Aesthetic concerns over the use of riprap

  12. From mercury to malaria to penicillin: the history of the treatment of syphilis at the Mayo Clinic--1916-1955.

    PubMed

    Sartin, J S; Perry, H O

    1995-02-01

    Between 1916 and 1955 the Mayo Clinic became recognized as one of the premier institutions specializing in the treatment of syphilis. First under the direction of John H. Stokes (1916-1924) and later Paul A. O'Leary (1924-1953), its Department of Dermatology and Syphilology, together with the members of the Clinical Cooperative Study Group, oversaw the establishment of standardized methods for the administration of the existing arsenicals and the introduction of new therapies. Malaria therapy, heat therapy, penicillin, and oxytetracycline each represented important advances in the treatment of syphilis and were extensively evaluated. Two important ancillary benefits of syphilis treatment were the development of routine intravenous techniques, which would later prove invaluable for the administration of antibiotics and cancer drugs, and the establishment of large cooperative clinical trials, the first of their kind. Under the leadership of Stokes and O'Leary the department produced a stream of pivotal clinical research that contributed to the effective management of syphilis in the United States.

  13. Intraoperative hypotension - a neglected causative factor in hospital-acquired acute kidney injury; a Mayo Clinic Health System experience revisited

    PubMed Central

    Onuigbo, Macaulay Amechi Chukwukadibia; Agbasi, Nneoma

    2015-01-01

    Acute kidney injury (AKI) is a relatively common complication of cardiothoracic surgery and has both short- and long-term survival implications, even when AKI does not progress to severe renal failure. Given that currently, there are no active effective treatments for AKI, other than renal replacement therapy when indicated, the focus of clinicians ought to be on prevention and risk factor management. In the AKI-surgery literature, there exists this general consensus that intraoperative hypotension (IH) following hypotensive anesthesia (HA) or controlled hypotension (CH) in the operating room has no significant short-term and long-term impacts on renal function. In this review, we examine the basis for this consensus, exposing some of the flaws of the clinical study data upon which this prevailing consensus is based. We then describe our experiences in the last decade at the Mayo Clinic Health System, Eau Claire, in Northwestern Wisconsin, USA, with two selected case presentations to highlight the contribution of IH as a potent yet preventable cause of post-operative AKI. We further highlight the causative although neglected role of IH in precipitating postoperative AKI in chronic kidney disease (CKD) patients. We show additional risk factors associated with this syndrome and further make a strong case for the elimination of IH as an achievable mechanism to reduce overall, the incidence of hospital acquired AKI. We finally posit that as the old saying goes, prevention is indeed better than cure. PMID:26468476

  14. Comparison of MMPI Scores of Drug Abusers and Mayo Clinic Normative Groups.

    ERIC Educational Resources Information Center

    Patalano, Frank

    1980-01-01

    Compared MMPIs of 80 male and 80 female drug abusers with MMPIs of 550 male and 695 female medical patients. Male drug abusers obtained significantly higher scores than male medical patients on all clinical scales. Female drug abusers obtained significantly higher scores than female medical patients on seven scales. (Author)

  15. Predicting the risk of mild cognitive impairment in the Mayo Clinic Study of Aging

    PubMed Central

    Pankratz, V. Shane; Roberts, Rosebud O.; Mielke, Michelle M.; Knopman, David S.; Jack, Clifford R.; Geda, Yonas E.; Rocca, Walter A.

    2015-01-01

    Objective: We sought to develop risk scores for the progression from cognitively normal (CN) to mild cognitive impairment (MCI). Methods: We recruited into a longitudinal cohort study a randomly selected, population-based sample of Olmsted County, MN, residents, aged 70 to 89 years on October 1, 2004. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychological measures, and were classified as CN, MCI, or dementia. Using baseline demographic and clinical variables in proportional hazards models, we derived scores that predicted the risk of progressing from CN to MCI. We evaluated the ability of these risk scores to classify participants for MCI risk. Results: Of 1,449 CN participants, 401 (27.7%) developed MCI. A basic model had a C statistic of 0.60 (0.58 for women, 0.62 for men); an augmented model resulted in a C statistic of 0.70 (0.69 for women, 0.71 for men). Both men and women in the highest vs lowest sex-specific quartiles of the augmented model's risk scores had an approximately 7-fold higher risk of developing MCI. Adding APOE ε4 carrier status improved the model (p = 0.002). Conclusions: We have developed MCI risk scores using variables easily assessable in the clinical setting and that may be useful in routine patient care. Because of variability among populations, validation in independent samples is required. These models may be useful in identifying patients who might benefit from more expensive or invasive diagnostic testing, and can inform clinical trial design. Inclusion of biomarkers or other risk factors may further enhance the models. PMID:25788555

  16. Mortality in mild cognitive impairment varies by subtype, sex and lifestyle factors. The Mayo Clinic Study of Aging

    PubMed Central

    Vassilaki, Maria; Cha, Ruth H.; Aakre, Jeremiah A.; Therneau, Terry M.; Geda, Yonas E.; Mielke, Michelle M.; Knopman, David S.; Petersen, Ronald C.; Roberts, Rosebud O.

    2015-01-01

    Background Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods Participants aged 70–89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases vs. cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 2.03; 95% CI: 1.61 to 2.55), and was higher for non-amnestic MCI (naMCI; HR = 2.47; 95% CI: 1.80 to 3.39) than for amnestic MCI (aMCI; HR = 1.89; 95% CI: 1.48 to 2.41) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education vs. CN without these factors, and for naMCI cases vs. aMCI cases without these factors. Conclusions These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality. Delayed MCI diagnosis in persons with higher education impacts mortality, and higher mortality in men may explain similar dementia incidence by sex in our cohort. PMID:25697699

  17. Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

    PubMed Central

    2010-01-01

    Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC). We characterized injury patterns between motorcycle/all-terrain vehicles (MCC) and automobile (MVC) crashes related to dMVC (deer motor vehicle crash) with the hypotheses that MCC will present with higher Injury Severity Score (ISS) and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS). Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p < 0.001). Median Abbreviated Injury Score (AIS) of the spine for MCC riders was higher (3 vs 0, p < 0.001) if they swerved rather than collided. Seventy-seven percent of riders were not wearing a helmet which did not result in a statistically significant increase in median ISS (16 vs 10), head AIS (2 vs 0) or spine AIS (0 vs 0). Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5) and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained. PMID:20716341

  18. FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging

    PubMed Central

    Krell-Roesch, Janina; Ruider, Hanna; Lowe, Val J.; Stokin, Gorazd B.; Pink, Anna; Roberts, Rosebud O.; Mielke, Michelle M.; Knopman, David S.; Christianson, Teresa J.; Machulda, Mary M.; Jack, Clifford R.; Petersen, Ronald C.; Geda, Yonas E.

    2016-01-01

    One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer’s disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23–3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00–6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD. PMID:27447426

  19. Comparison of imaging biomarkers in the Alzheimer Disease Neuroimaging Initiative and the Mayo Clinic Study of Aging.

    PubMed

    Whitwell, Jennifer L; Wiste, Heather J; Weigand, Stephen D; Rocca, Walter A; Knopman, David S; Roberts, Rosebud O; Boeve, Bradley F; Petersen, Ronald C; Jack, Clifford R

    2012-05-01

    To determine whether magnetic resonance imaging measurements observed in the Alzheimer Disease Neuroimaging Initiative (ADNI) convenience sample differ from those observed in the Mayo Clinic Study of Aging (MCSA) population-based sample. Comparison of 2 samples. Fifty-nine recruiting sites for the ADNI in the United States and Canada and the MCSA, a population-based cohort in Olmsted County, Minnesota. Cognitively normal subjects and amnestic subjects with mild cognitive impairment were selected from the ADNI convenience cohort and MCSA population-based cohort. A simple random sample of subjects from both cohorts in the same age range was selected, and a second sample applied matching for age, sex, educational level, apolipoprotein E genotype, and Mini-Mental State Examination score. Baseline hippocampal volumes and annual percentage of decline in hippocampal volume. In the population-based sample, MCSA subjects were older, had less education, performed worse on the Mini-Mental State Examination, and had a family history of Alzheimer disease less often than did ADNI subjects. Baseline hippocampal volumes were larger in ADNI compared with MCSA cognitively normal subjects in the random sample, although no differences were observed after matching. Rates of decline in hippocampal volume were greater in the ADNI compared with the MCSA for cognitively normal subjects and those with amnestic mild cognitive impairment, even after matching. Rates of decline in hippocampal volume suggest that ADNI subjects have a more aggressive brain pathologic process than MCSA subjects and hence may not be representative of the general population. These findings have implications for treatment trials that use ADNI-like recruitment mechanisms and for studies validating new diagnostic criteria for Alzheimer disease in its various stages.

  20. A Multidisciplinary Biospecimen Bank of Renal Cell Carcinomas Compatible with Discovery Platforms at Mayo Clinic, Scottsdale, Arizona

    PubMed Central

    Ho, Thai H.; Nateras, Rafael Nunez; Yan, Huihuang; Park, Jin G.; Jensen, Sally; Borges, Chad; Lee, Jeong Heon; Champion, Mia D.; Tibes, Raoul; Bryce, Alan H.; Carballido, Estrella M.; Todd, Mark A.; Joseph, Richard W.; Wong, William W.; Parker, Alexander S.; Stanton, Melissa L.; Castle, Erik P.

    2015-01-01

    To address the need to study frozen clinical specimens using next-generation RNA, DNA, chromatin immunoprecipitation (ChIP) sequencing and protein analyses, we developed a biobank work flow to prospectively collect biospecimens from patients with renal cell carcinoma (RCC). We describe our standard operating procedures and work flow to annotate pathologic results and clinical outcomes. We report quality control outcomes and nucleic acid yields of our RCC submissions (N=16) to The Cancer Genome Atlas (TCGA) project, as well as newer discovery platforms, by describing mass spectrometry analysis of albumin oxidation in plasma and 6 ChIP sequencing libraries generated from nephrectomy specimens after histone H3 lysine 36 trimethylation (H3K36me3) immunoprecipitation. From June 1, 2010, through January 1, 2013, we enrolled 328 patients with RCC. Our mean (SD) TCGA RNA integrity numbers (RINs) were 8.1 (0.8) for papillary RCC, with a 12.5% overall rate of sample disqualification for RIN <7. Banked plasma had significantly less albumin oxidation (by mass spectrometry analysis) than plasma kept at 25°C (P<.001). For ChIP sequencing, the FastQC score for average read quality was at least 30 for 91% to 95% of paired-end reads. In parallel, we analyzed frozen tissue by RNA sequencing; after genome alignment, only 0.2% to 0.4% of total reads failed the default quality check steps of Bowtie2, which was comparable to the disqualification ratio (0.1%) of the 786-O RCC cell line that was prepared under optimal RNA isolation conditions. The overall correlation coefficients for gene expression between Mayo Clinic vs TCGA tissues ranged from 0.75 to 0.82. These data support the generation of high-quality nucleic acids for genomic analyses from banked RCC. Importantly, the protocol does not interfere with routine clinical care. Collections over defined time points during disease treatment further enhance collaborative efforts to integrate genomic information with outcomes. PMID

  1. A Multidisciplinary Biospecimen Bank of Renal Cell Carcinomas Compatible with Discovery Platforms at Mayo Clinic, Scottsdale, Arizona.

    PubMed

    Ho, Thai H; Nateras, Rafael Nunez; Yan, Huihuang; Park, Jin G; Jensen, Sally; Borges, Chad; Lee, Jeong Heon; Champion, Mia D; Tibes, Raoul; Bryce, Alan H; Carballido, Estrella M; Todd, Mark A; Joseph, Richard W; Wong, William W; Parker, Alexander S; Stanton, Melissa L; Castle, Erik P

    2015-01-01

    To address the need to study frozen clinical specimens using next-generation RNA, DNA, chromatin immunoprecipitation (ChIP) sequencing and protein analyses, we developed a biobank work flow to prospectively collect biospecimens from patients with renal cell carcinoma (RCC). We describe our standard operating procedures and work flow to annotate pathologic results and clinical outcomes. We report quality control outcomes and nucleic acid yields of our RCC submissions (N=16) to The Cancer Genome Atlas (TCGA) project, as well as newer discovery platforms, by describing mass spectrometry analysis of albumin oxidation in plasma and 6 ChIP sequencing libraries generated from nephrectomy specimens after histone H3 lysine 36 trimethylation (H3K36me3) immunoprecipitation. From June 1, 2010, through January 1, 2013, we enrolled 328 patients with RCC. Our mean (SD) TCGA RNA integrity numbers (RINs) were 8.1 (0.8) for papillary RCC, with a 12.5% overall rate of sample disqualification for RIN <7. Banked plasma had significantly less albumin oxidation (by mass spectrometry analysis) than plasma kept at 25 °C (P<.001). For ChIP sequencing, the FastQC score for average read quality was at least 30 for 91% to 95% of paired-end reads. In parallel, we analyzed frozen tissue by RNA sequencing; after genome alignment, only 0.2% to 0.4% of total reads failed the default quality check steps of Bowtie2, which was comparable to the disqualification ratio (0.1%) of the 786-O RCC cell line that was prepared under optimal RNA isolation conditions. The overall correlation coefficients for gene expression between Mayo Clinic vs TCGA tissues ranged from 0.75 to 0.82. These data support the generation of high-quality nucleic acids for genomic analyses from banked RCC. Importantly, the protocol does not interfere with routine clinical care. Collections over defined time points during disease treatment further enhance collaborative efforts to integrate genomic information with outcomes.

  2. Subacute Cutaneous Lupus Erythematosus: Clinical Characteristics, Disease Associations, Treatments, and Outcomes in a Series of 90 Patients at Mayo Clinic, 1996-2011.

    PubMed

    Alniemi, Dema T; Gutierrez, Albert; Drage, Lisa A; Wetter, David A

    2017-03-01

    To characterize the clinical presentation, laboratory studies, disease associations, and treatments of subacute cutaneous lupus erythematosus (SCLE). A retrospective review of 90 patients with SCLE at Mayo Clinic from January 1, 1996, through October 28, 2011, was performed. The mean patient age at diagnosis was 61 years; 64 patients (71%) were women, and 11 cases (12%) were drug induced (1996-2000, no drug-induced cases; 2001-2005, 2 cases; 2006-2011, 9 cases). Seventeen of 59 patients (29%) with available data were smokers at the time of diagnosis. The SCLE lesions were photodistributed in 75 patients (83%), and 52 (58%) had papulosquamous morphologic findings. Anti-Ro/SS-A positivity was present in 84 of 85 patients tested (99%), whereas 32 of the 85 patients (38%) tested positive for anti-La/SS-B. Associated autoimmune connective tissue diseases included Sjögren syndrome (n=13, 14%) and systemic lupus erythematosus (SLE) (n=8, 9%). Eighteen patients (20%) had at least 4 American College of Rheumatology criteria for SLE; 1 had lupus nephritis, and none had neurologic or notable hematologic sequelae. The most common therapy was hydroxychloroquine, with a complete response noted in 34 of 46 patients (74%) with available follow-up data. Twenty-eight percent of patients with SCLE (n=25) had an associated autoimmune connective tissue disease, although the severe sequelae of SLE, such as nephritis, were rare. The frequency of drug-induced SCLE increased during the study. Most patients responded to treatment with hydroxychloroquine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  3. Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

    PubMed

    Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

    2015-07-03

    Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

  4. Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group.

    PubMed

    Go, Ronald S; Winters, Jeffrey L; Leung, Nelson; Murray, David L; Willrich, Maria A; Abraham, Roshini S; Amer, Hatem; Hogan, William J; Marshall, Ariela L; Sethi, Sanjeev; Tran, Cheryl L; Chen, Dong; Pruthi, Rajiv K; Ashrani, Aneel A; Fervenza, Fernando C; Cramer, Carl H; Rodriguez, Vilmarie; Wolanskyj, Alexandra P; Thomé, Stephan D; Hook, C Christopher

    2016-09-01

    Thrombotic microangiopathies (TMAs) comprise a heterogeneous set of conditions linked by a common histopathologic finding of endothelial damage resulting in microvascular thromboses and potentially serious complications. The typical clinical presentation is microangiopathic hemolytic anemia accompanied by thrombocytopenia with varying degrees of organ ischemia. The differential diagnoses are generally broad, while the workup is frequently complex and can be confusing. This statement represents the joint recommendations from a multidisciplinary team of Mayo Clinic physicians specializing in the management of TMA. It comprises a series of evidence- and consensus-based clinical pathways developed to allow a uniform approach to the spectrum of care including when to suspect TMA, what differential diagnoses to consider, which diagnostic tests to order, and how to provide initial empiric therapy, as well as some guidance on subsequent management.

  5. Validation of the Mayo Sleep Questionnaire to Screen for REM Sleep Behavior Disorder in an Aging and Dementia Cohort

    PubMed Central

    Boeve, Bradley F.; Molano, Jennifer R.; Ferman, Tanis J.; Smith, Glenn E.; Lin, Siong-Chi; Bieniek, Kevin; Haidar, Wael; Tippmann-Peikert, Maja; Knopman, David S.; Graff-Radford, Neill R.; Lucas, John A.; Petersen, Ronald C.; Silber, Michael H.

    2011-01-01

    Objective To validate a questionnaire focused on REM sleep behavior disorder (RBD) among participants in an aging and dementia cohort. Background RBD is a parasomnia that can develop in otherwise neurologically-normal adults as well as in those with a neurodegenerative disease. Confirmation of RBD requires polysomnography (PSG). A simple screening measure for RBD would be desirable for clinical and research purposes. Methods We had previously developed the Mayo Sleep Questionnaire (MSQ), a 16 item measure, to screen for the presence of RBD and other sleep disorders. We assessed the validity of the MSQ by comparing the responses of patients’ bed partners with the findings on PSG. All subjects recruited in the Mayo Alzheimer’s Disease Research Center at Mayo Clinic Rochester and Mayo Clinic Jacksonville from 1/00 to 7/08 who had also undergone a PSG were the focus of this analysis. Results The study sample was comprised of 176 subjects [150 male; median age 71 years (range 39–90)], with the following clinical diagnoses: normal (n=8), mild cognitive impairment (n=44), Alzheimer’s disease (n=23), dementia with Lewy bodies (n=74), as well as other dementia and/or parkinsonian syndromes (n=27). The core question on recurrent dream enactment behavior yielded a sensitivity (SN) of 98% and specificity (SP) of 74% for the diagnosis of RBD. The profile of responses on four additional subquestions on RBD and one on obstructive sleep apnea improved specificity. Conclusions These data suggest that among aged subjects with cognitive impairment and/or parkinsonism, the MSQ has adequate SN and SP for the diagnosis of RBD. The utility of this scale in other patient populations will require further study. PMID:21349763

  6. Rochester City School District Peer Assistance Review

    ERIC Educational Resources Information Center

    Chierichella, Patrick

    2010-01-01

    In this paper the author evaluates the Peer Assistance and Review (PAR) program in the Rochester City School District, Rochester, NY. The author evaluates the system's strengths and weaknesses and discusses the program's alignment with New York State requirements.

  7. 75 FR 23801 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... to repatriate cultural items in the possession of the Rochester Museum & Science Center, Rochester... consultants from the Tonawanda Seneca Nation informed the Rochester Museum & Science Center that ethnographic...

  8. Cinco de Mayo Math

    ERIC Educational Resources Information Center

    Maida, Paula J.

    2006-01-01

    Integrating mathematics across the curriculum offers students the opportunity to link ideas in a natural, impactive way. In this article, the author shares some interactive math activities that she used in a fourth-grade class on "Cinco de Mayo," a holiday honoring Mexican independence. These fun activities not only allowed connections to be made…

  9. Efficacy of bortezomib, cyclophosphamide and dexamethasone in treatment-naïve patients with high-risk cardiac AL amyloidosis (Mayo Clinic stage III)

    PubMed Central

    Jaccard, Arnaud; Comenzo, Raymond L.; Hari, Parameswaran; Hawkins, Philip N.; Roussel, Murielle; Morel, Pierre; Macro, Margaret; Pellegrin, Jean-Luc; Lazaro, Estibaliz; Mohty, Dania; Mercie, Patrick; Decaux, Olivier; Gillmore, Julian; Lavergne, David; Bridoux, Frank; Wechalekar, Ashutosh D.; Venner, Christopher P.

    2014-01-01

    Bortezomib is an active agent in AL amyloidosis and responses to this drug in combination with cyclophosphamide and dexamethasone are both rapid and deep. Here we present an international, multicenter series of 60 patients with Mayo Clinic stage III cardiac amyloidosis to assess the impact of this regimen in improving outcomes in this poor-risk group. The median follow-up for the entire cohort is 11.8 months. The overall response rate was 68%. In a landmark analysis, examining patients who survived more than 3 months, the overall response rate was 86%. A cardiac response was seen in 32% of patients. The estimated 1-year survival rate for the whole cohort was 57% and 24 patients (40%) died while on therapy. Although unable to save the poorest risk patients, the combination of bortezomib, cyclophosphamide and dexamethasone can achieve a high number of hematologic and cardiac responses, likely improving overall survival and justifying a prospective trial. PMID:24859879

  10. The Mayo brothers: an American surgical legacy.

    PubMed

    Toledo-Pereyra, Luis H

    2010-10-01

    Few in the history of surgery and just as few in the history of medicine can reach the level of clinical visibility as achieved by the Mayo brothers. The brothers changed the face of medicine while they were alive, and their fame and influence continued to grow after their death in 1939. The Mayo American surgical legacy had incredible proportions. The brothers systematically modified the field as few others had done before. They were great surgical innovators who took the surgical techniques of others and added a touch of their own to make the surgical procedure better and more secure. The Mayos were the stars regionally, nationally, and around the world. They attracted attention from their generation and occupied center stage long after. To speak of the Mayos is to speak of the quintessential American values of professionalism, respect, commitment, and caring for their fellow human beings. Their creation, the Mayo Clinic, surpassed the wildest hopes and predictions that anyone could have had regarding their best dreams.

  11. NASA/DARPA advanced communications technology satellite project for evaluation of telemedicine outreach using next-generation communications satellite technology: Mayo Foundation participation.

    PubMed

    Gilbert, B K; Mitchell, M P; Bengali, A R; Khandheria, B K

    1999-08-01

    To describe the development of telemedicine capabilities-application of remote consultation and diagnostic techniques-and to evaluate the feasibility and practicality of such clinical outreach to rural and underserved communities with limited telecommunications infrastructures. In 1992, Mayo Foundation (Rochester, Minn, Jacksonville, Fla, and Scottsdale, Ariz), the National Aeronautics and Space Administration, and the Defense Advanced Research Projects Agency collaborated to create a complex network of fiberoptic landlines, video recording systems, satellite terminals, and specially developed data translators linking Mayo sites with other locations in the continental United States on an on-demand basis. The purpose was to transmit data via the asynchronous transfer mode (ATM) digital communications protocol over the Advanced Communications Technology Satellite. The links were intended to provide a conduit for transmission of data for patient-specific consultations between physicians, evaluation of medical imagery, and medical education for clinical staffs at remote sites. Low-data-rate (LDR) experiments went live late in 1993. Mayo Clinic Rochester successfully provided medical consultation and services to 2 small regional medical facilities. High-data-rate (HDR) experiments included studies of remote digital echocardiography, store-and-forward telemedicine, cardiac catheterization, and teleconsultation for congenital heart disease. These studies combined landline data transmission with use of the satellite. The complexity of the routing paths and network components, immaturity of available software, and inexperience with existing telecommunications caused significant study delays. These experiments demonstrated that next-generation satellite technology can provide batch and real-time imagery for telemedicine. The first-generation of the ATM and satellite network technology used in these experiments created several technical problems and inconveniences that should

  12. Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

    PubMed Central

    Eton, David T; Beebe, Timothy J; Hagen, Philip T; Halyard, Michele Y; Montori, Victor M; Naessens, James M; Sloan, Jeff A; Thompson, Carrie A; Wood, Douglas L

    2014-01-01

    Patient-reported outcomes (PROs) capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled “Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery”. The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in systematically using PROs in health care delivery science and practice. PMID:24550683

  13. Mammographic breast density and risk of breast cancer in women with atypical hyperplasia: an observational cohort study from the Mayo Clinic Benign Breast Disease (BBD) cohort.

    PubMed

    Vierkant, Robert A; Degnim, Amy C; Radisky, Derek C; Visscher, Daniel W; Heinzen, Ethan P; Frank, Ryan D; Winham, Stacey J; Frost, Marlene H; Scott, Christopher G; Jensen, Matthew R; Ghosh, Karthik; Manduca, Armando; Brandt, Kathleen R; Whaley, Dana H; Hartmann, Lynn C; Vachon, Celine M

    2017-01-31

    Atypical hyperplasia (AH) and mammographic breast density (MBD) are established risk factors for breast cancer (BC), but their joint contributions are not well understood. We examine associations of MBD and BC by histologic impression, including AH, in a subcohort of women from the Mayo Clinic Benign Breast Disease Cohort. Women with a diagnosis of BBD and mammogram between 1985 and 2001 were eligible. Histologic impression was assessed via pathology review and coded as non-proliferative disease (NP), proliferative disease without atypia (PDWA) and AH. MBD was assessed clinically using parenchymal pattern (PP) or BI-RADS criteria and categorized as low, moderate or high. Percent density (PD) was also available for a subset of women. BC and clinical information were obtained by questionnaires, medical records and the Mayo Clinic Tumor Registry. Women were followed from date of benign biopsy to BC, death or last contact. Standardized incidence ratios (SIRs) compared the observed number of BCs to expected counts. Cox regression estimated multivariate-adjusted MBD hazard ratios. Of the 6271 women included in the study, 1132 (18.0%) had low MBD, 2921 (46.6%) had moderate MBD, and 2218 (35.4%) had high MBD. A total of 3532 women (56.3%) had NP, 2269 (36.2%) had PDWA and 470 (7.5%) had AH. Over a median follow-up of 14.3 years, 528 BCs were observed. The association of MBD and BC risk differed by histologic impression (p-interaction = 0.03), such that there was a strong MBD and BC association among NP (p < 0.001) but non-significant associations for PDWA (p = 0.27) and AH (p = 0.96). MBD and BC associations for AH women were not significant within subsets defined by type of MBD measure (PP vs. BI-RADS), age at biopsy, number of foci of AH, type of AH (lobular vs. ductal) and body mass index, and after adjustment for potential confounding variables. Women with atypia who also had high PD (>50%) demonstrated marginal evidence of increased BC risk (SIR 4

  14. Effects of different hormone therapies on breast pain in recently postmenopausal women: findings from the Mayo Clinic KEEPS breast pain ancillary study.

    PubMed

    Files, Julia A; Miller, Virginia M; Cha, Stephen S; Pruthi, Sandhya

    2014-10-01

    Abstract Background: It is estimated that 70% of women in Western societies experience breast pain at least once during their lifetime. In the Women's Health Initiative (WHI), women treated with oral conjugated equine estrogen (0.625 mg) with or without continuous oral medroxyprogesterone acetate (2.5 mg) had a higher incidence of breast pain than those who received placebo. The effect of other hormone therapy regimens on breast pain is unknown. We compared breast pain among healthy, recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS) at Mayo Clinic. Women were randomized to: 0.45 mg/day oral conjugated equine estrogen (o-CEE) plus 200 mg/day micronized progesterone (m-P) for the first 12 days of the month, 50 μg/day transdermal 17β estradiol (t-E2) plus m-P for 12 days, or placebo pills and patch. Participants completed the Mayo Clinic breast pain questionnaire at baseline and yearly for the duration of the study. Participants (116) averaged 53.0 years of age and 1.6 years past their last menses at baseline. At baseline, 12 women (10%) reported breast pain with an average worst pain score [from 0 (no pain) to 10 (worst pain)] of 0.39±1.28. With treatment, the number of women reporting pain did not increase, and with either intention-to-treat or per-protocol analyses, breast pain scores did not differ significantly (p=0.39) among groups: t-E2 (0.53±1.21), o-CEE (0.32±0.78), placebo (0.23±0.87). Four years of treatment with o-CEE at a lower dose than that studied in the WHI with cyclic m-P or transdermal E2 with cyclic m-P did not increase breast pain in healthy, recently menopausal women.

  15. 78 FR 50102 - Notice of Inventory Completion: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... Association. History and Description of the Objects Sometime prior to 1924, five associated funerary objects..., 1924, the Rochester Museum & Science Center (then Rochester Museum of Arts and Sciences) purchased the...

  16. In newly diagnosed breast cancer, screening MRI of the contralateral breast detects mammographically occult cancer, even in elderly women: the mayo clinic in Florida experience.

    PubMed

    Bernard, Johnny Ray; Vallow, Laura A; DePeri, Elizabeth R; McNeil, Rebecca B; Feigel, Deborah G; Amar, Surabhi; Buskirk, Steven J; Perez, Edith A

    2010-01-01

    The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

  17. Long-term effects of bilateral oophorectomy on brain aging: Unanswered questions from the Mayo Clinic Cohort Study of Oophorectomy and Aging

    PubMed Central

    Rocca, W A; Shuster, L T; Grossardt, B R; Maraganore, D M; Gostout, B S; Geda, Y E; Melton, L J

    2009-01-01

    Summary In the Mayo Clinic Cohort Study of Oophorectomy and Aging, women who had both ovaries removed before reaching natural menopause experienced a long-term increased risk of parkinsonism, cognitive impairment or dementia, and depressive and anxiety symptoms. Here, we discuss five possible mechanistic interpretations of the observed associations: 1) the associations may be non-causal because they result from the confounding effect of genetic variants or of other risk factors; 2) the associations may be mediated by an abrupt reduction in levels of circulating estrogen; 3) the associations may be mediated by an abrupt reduction in levels of circulating progesterone or testosterone; 4) the associations may be mediated by an increased release of gonadotropins by the pituitary gland; and 5) genetic variants may modify the hormonal effects of bilateral oophorectomy through simple or more complex interactions. Results from other studies are cited as evidence for or against each possible mechanism. These putative causal mechanisms are probably intertwined, and their clarification is a research priority. PMID:19102639

  18. Prevention of Pegfilgrastim-Induced Bone Pain: A Phase III Double-Blind Placebo-Controlled Randomized Clinical Trial of the University of Rochester Cancer Center Clinical Community Oncology Program Research Base

    PubMed Central

    Kirshner, Jeffrey J.; Heckler, Charles E.; Janelsins, Michelle C.; Dakhil, Shaker R.; Hopkins, Judith O.; Coles, Charlotte; Morrow, Gary R.

    2012-01-01

    Purpose Pegfilgrastim-induced bone pain is a significant clinical problem that may result in discontinuation of pegfilgrastim and lead to less effective chemotherapy dosing. Interventions for pegfilgrastim-induced bone pain are needed. Patients and Methods The University of Rochester Cancer Center Clinical Community Oncology Program Research Base randomly assigned 510 patients at 17 sites to receive either naproxen (500 mg two times per day) or placebo on the day of pegfilgrastim administration, continuing for 5 to 8 days after pegfilgrastim. Patients recorded pain severity (using a scale of 0 to 10) and duration in daily diaries. The primary outcome measure was the area under the curve (AUC) for pain for days 1 through 5. Secondary outcome measures included the identification of risk factors for the development of pain and response to naproxen. Results Patients' mean age was 55.6 years and 86% were female. Sixty-eight percent of patients had breast cancer and 10% had lung cancer. Pain reached its peak at 3 days for both groups. The mean AUC for pain was 7.71 for the placebo group and 6.04 for the naproxen group (P = .037). Naproxen reduced maximum pain from 3.40 to 2.59 (P = .005). Naproxen also reduced overall pain incidence from 71.3% to 61.1% (P = .020) and duration from 2.40 to 1.92 days (P = .009). The reduction in severe pain (> 5 on a scale of 1 to 10) from 27.0% to 19.2% was also significant (P = .048). Risk factors could not be identified to predict incidence, severity, or ability to prevent pegfilgrastim-induced bone pain. Conclusion Our phase III randomized placebo-controlled clinical trial demonstrated that naproxen at a dose of 500 mg twice per day is effective in reducing the incidence and severity of pegfilgrastim-induced bone pain. PMID:22508813

  19. Prevention of pegfilgrastim-induced bone pain: a phase III double-blind placebo-controlled randomized clinical trial of the university of rochester cancer center clinical community oncology program research base.

    PubMed

    Kirshner, Jeffrey J; Heckler, Charles E; Janelsins, Michelle C; Dakhil, Shaker R; Hopkins, Judith O; Coles, Charlotte; Morrow, Gary R

    2012-06-01

    Pegfilgrastim-induced bone pain is a significant clinical problem that may result in discontinuation of pegfilgrastim and lead to less effective chemotherapy dosing. Interventions for pegfilgrastim-induced bone pain are needed. The University of Rochester Cancer Center Clinical Community Oncology Program Research Base randomly assigned 510 patients at 17 sites to receive either naproxen (500 mg two times per day) or placebo on the day of pegfilgrastim administration, continuing for 5 to 8 days after pegfilgrastim. Patients recorded pain severity (using a scale of 0 to 10) and duration in daily diaries. The primary outcome measure was the area under the curve (AUC) for pain for days 1 through 5. Secondary outcome measures included the identification of risk factors for the development of pain and response to naproxen. Patients' mean age was 55.6 years and 86% were female. Sixty-eight percent of patients had breast cancer and 10% had lung cancer. Pain reached its peak at 3 days for both groups. The mean AUC for pain was 7.71 for the placebo group and 6.04 for the naproxen group (P = .037). Naproxen reduced maximum pain from 3.40 to 2.59 (P = .005). Naproxen also reduced overall pain incidence from 71.3% to 61.1% (P = .020) and duration from 2.40 to 1.92 days (P = .009). The reduction in severe pain (> 5 on a scale of 1 to 10) from 27.0% to 19.2% was also significant (P = .048). Risk factors could not be identified to predict incidence, severity, or ability to prevent pegfilgrastim-induced bone pain. Our phase III randomized placebo-controlled clinical trial demonstrated that naproxen at a dose of 500 mg twice per day is effective in reducing the incidence and severity of pegfilgrastim-induced bone pain.

  20. Interprofessional Education in Gross Anatomy: Experience with First-Year Medical and Physical Therapy Students at Mayo Clinic

    ERIC Educational Resources Information Center

    Hamilton, Steven S.; Yuan, Brandon J.; Lachman, Nirusha; Hellyer, Nathan J.; Krause, David A.; Hollman, John H.; Youdas, James W.; Pawlina, Wojciech

    2008-01-01

    Interprofessional education (IPE) in clinical practice is believed to improve outcomes in health care delivery. Integrating teaching and learning objectives through cross discipline student interaction in basic sciences has the potential to initiate interprofessional collaboration at the early stages of health care education. Student attitudes and…

  1. Interprofessional Education in Gross Anatomy: Experience with First-Year Medical and Physical Therapy Students at Mayo Clinic

    ERIC Educational Resources Information Center

    Hamilton, Steven S.; Yuan, Brandon J.; Lachman, Nirusha; Hellyer, Nathan J.; Krause, David A.; Hollman, John H.; Youdas, James W.; Pawlina, Wojciech

    2008-01-01

    Interprofessional education (IPE) in clinical practice is believed to improve outcomes in health care delivery. Integrating teaching and learning objectives through cross discipline student interaction in basic sciences has the potential to initiate interprofessional collaboration at the early stages of health care education. Student attitudes and…

  2. The Power of Effective Design in e-Learning: A Study of the "Mayo Effect" Video

    ERIC Educational Resources Information Center

    Fan, Jiang Ping

    2014-01-01

    When the Mayo Effect video went live on the Mayo intranet in June 2010, it was very well received at Mayo Clinic. The message in the video was so effectively delivered that it became an instant sensation across the institution. The video contains about 461 words. In such a short video, every part of its architectural design, whether it is visual,…

  3. The Power of Effective Design in e-Learning: A Study of the "Mayo Effect" Video

    ERIC Educational Resources Information Center

    Fan, Jiang Ping

    2014-01-01

    When the Mayo Effect video went live on the Mayo intranet in June 2010, it was very well received at Mayo Clinic. The message in the video was so effectively delivered that it became an instant sensation across the institution. The video contains about 461 words. In such a short video, every part of its architectural design, whether it is visual,…

  4. Rochester Focuses: A Community's Core Competence.

    ERIC Educational Resources Information Center

    Gabor, Andrea

    1991-01-01

    Rochester, New York, is globally competitive in optics manufacturing because of cooperative, strategic use of community resources: (1) collaboration of the University of Rochester and industry in the Center for Optics Manufacturing; (2) business cooperation in reform of the schools system; and (3) emphasis on total quality. (SK)

  5. Rochester Focuses: A Community's Core Competence.

    ERIC Educational Resources Information Center

    Gabor, Andrea

    1991-01-01

    Rochester, New York, is globally competitive in optics manufacturing because of cooperative, strategic use of community resources: (1) collaboration of the University of Rochester and industry in the Center for Optics Manufacturing; (2) business cooperation in reform of the schools system; and (3) emphasis on total quality. (SK)

  6. Mayo Registry for Telemetry Efficacy in Arrest Study: An Assessment of the Utility of Telemetry in Predicting Clinical Decompensation.

    PubMed

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Harris, Dana; Bosworth, Veronica; Dumitrascu, Adrian; Clark, Brooke; Vadeboncoeur, Tyler; Kusumoto, Fred; Bowman, Cammi; Burton, M Caroline

    2016-02-17

    Our study assesses the utility of telemetry in identifying decompensation in patients with documented cardiopulmonary arrest. A retrospective review of inpatients who experienced a cardiopulmonary arrest from May 1, 2008, until June 30, 2014, was performed. Telemetry records 24 hours prior to and immediately preceding cardiopulmonary arrest were reviewed. Patient subanalyses based on clinical demographics were made as well as analyses of survival comparing patients with identifiable rhythm changes in telemetry to those without. Of 242 patients included in the study, 75 (31.0%) and 110 (45.5%) experienced telemetry changes at the 24-hour and immediately preceding time periods, respectively. Of the telemetry changes, the majority were classified as nonmalignant (n = 50, 66.7% and n = 66, 55.5% at 24 hours prior and immediately preceding, respectively). There was no difference in telemetry changes between intensive care unit (ICU) and non-ICU patients and among patients stratified according to the American Heart Association telemetry indications. There was no difference in survival when comparing patients with telemetry changes immediately preceding and at 24 hours prior to an event (n = 30, 27.3% and n = 15, 20.0%) to those without telemetry changes during the same periods (n = 27, 20.5% and n = 42, 25.2%; P = .22 and .39). Telemetry has limited utility in predicting clinical decompensation in the inpatient setting. © The Author(s) 2016.

  7. Use of Candida antigen injections for the treatment of verruca vulgaris: A two-year mayo clinic experience.

    PubMed

    Alikhan, Ali; Griffin, John R; Newman, Catherine C

    2016-08-01

    Common warts (verruca vulgaris) are one of the most common problems encountered in dermatology and may present a difficult treatment dilemma, as no particular therapy has demonstrated complete efficacy. Intralesional injection of purified Candida antigen has produced impressive treatment results in small prospective and retrospective studies and is thought to produce its effect through stimulation of a cell-mediated immune response. We report a retrospective study of adult and pediatric patients treated with Candida antigen therapy in clinical practice. Of the 100 patients treated, 80% responded to therapy: 39% demonstrated a complete response and 41% demonstrated a partial response. In addition, 6 out of 7 immunocompromised patients who were treated demonstrated a partial or complete response. Injections were generally well-tolerated and adverse events were minimal and short-lived. Our data indicate that intralesional Candida antigen therapy for cutaneous warts is an efficacious option in a clinical practice setting. The treatment may also be effective in immunosuppressed patients with cutaneous warts. Our results add to the literature one of the largest retrospective series reported to date and treatment outcomes are similar to previously reported studies evaluating this therapeutic modality.

  8. Impact of Metastasectomy in the Multimodality Approach for BRAF V600E Metastatic Colorectal Cancer: The Mayo Clinic Experience.

    PubMed

    Johnson, Benny; Jin, Zhaohui; Truty, Mark J; Smoot, Rory L; Nagorney, David M; Kendrick, Michael L; Kipp, Benjamin R; Grothey, Axel

    2017-09-13

    BRAF V600E mutations are present in 8%-10% of patients with metastatic colorectal cancer (mCRC) and portend poor prognosis. This study investigated the impact of metastasectomy for patients with BRAF V600E mCRC. Subjects, Materials, and Methods . Using prospective clinical and molecular data, patients with BRAF V600E mCRC were analyzed for clinical characteristics and survival. Statistical analyses utilized the Kaplan-Meier method, log-rank test, and Cox proportional hazard models. Fifty-two patients were identified between July 1, 2008, and January 4, 2016. Patient characteristics included median age 65 years, 61% female, Eastern Cooperative Oncology Group performance status ≤1, 71% with right-sided tumors, and 28% with liver-limited metastasis. In the first-line setting, 7% (4/52) received fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI)/bevacizumab (BEV) and 81% were treated with doublet chemotherapy consisting of fluoropyrimidine, oxaliplatin, and BEV. Median overall survival (OS) for all 52 patients was 25 months with median progression-free survival (PFS) of 9.3 months. With median follow-up of 18.3 months, 21 patients underwent metastasectomy with longer OS (29.1 months vs. 22.7 months, hazard ratio [HR] = 0.33; confidence interval [CI], 0.12-0.78; p = .01) and PFS (13.6 months vs. 6.2 months, HR = 0.53, CI, 0.28-0.97; p = .03) compared with the non-metastasectomy cohort. In multivariate analysis, metastasectomy remained significant for improved survival outcomes (HR = 0.52; 95% CI, 0.07-1.02; p = .02). Median disease-free survival after metastasectomy was 9.7 months (95% CI, 5.5-19.5). Two patients remain disease-free at the time of last follow-up, with one patient without relapse for greater than 2 years (28.9 months). Multimodality therapy incorporating metastasectomy for BRAF V600E mCRC should be considered and might be associated with improved overall survival in select patients. BRAF V600E metastatic

  9. African American Women's Perceptions and Attitudes Regarding Participation in Medical Research: The Mayo Clinic/The Links, Incorporated Partnership

    PubMed Central

    Brewer, LaPrincess C.; Parker, Monica W.; Balls-Berry, Joyce E.; Halyard, Michele Y.; Pinn, Vivian W.; Radecki Breitkopf, Carmen

    2014-01-01

    Abstract Objective: To examine perceptions and attitudes toward health-related research participation among professional African American women. Methods: Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. Results: A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, “Participation in research will mean better care,” 24% agreed “Participation in research is risky” and 3% agreed “Scientists cannot be trusted.” Fifty-two percent agreed with the statement, “Research conducted in the U.S. is ethical.” Mean ITP in research was 4.9±1.7 on a rating scale of 1 (“definitely no”) to 7 (“definitely yes”). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. Conclusion: Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types. PMID:25046058

  10. Psoriasis and palmoplantar pustulosis associated with tumor necrosis factor-α inhibitors: the Mayo Clinic experience, 1998 to 2010.

    PubMed

    Shmidt, Eugenia; Wetter, David A; Ferguson, Sara B; Pittelkow, Mark R

    2012-11-01

    Tumor necrosis factor (TNF)-α antagonists have been associated with the induction of de novo or worsening psoriasis. We sought to retrospectively examine the clinical characteristics and outcomes of patients with psoriasis associated with anti-TNF-α therapy. We performed a retrospective review of patients with new-onset or worsening psoriasis during TNF-α inhibitor therapy between 1998 and 2010. Of the 56 patients (mean age at psoriasis onset, 48.1 years), 41 (73%) were female. In all, 22 patients (39%) had Crohn's disease and 14 (25%) had rheumatoid arthritis. Thirty patients (54%) were treated with infliximab, 19 (34%) with adalimumab, and 7 (12%) with etanercept. New-onset or worsening psoriasis occurred after a mean treatment duration of 17.1 months. Plaque psoriasis (n = 27), palmoplantar pustulosis (n = 25), scalp psoriasis (n = 12), generalized pustular psoriasis (n = 7), erythrodermic psoriasis (n = 2), and inverse psoriasis (n = 2) were the cutaneous presentations. Among the 39 patients for whom full treatment response data were available, 33 (85%) had a complete or partial response; combined response rates (complete and partial) were slightly higher among those who discontinued anti-TNF-α therapy (16 of 17 patients [94%]) than among those who continued anti-TNF-α therapy (17 of 22 patients [77%]). Retrospective nature, possible referral bias, and lack of complete follow-up for some patients are limitations. Although some patients sufficiently controlled their psoriasis while continuing anti-TNF-α therapy, those who discontinued therapy achieved higher rates of complete response. Further studies should explore the efficacy and safety of switching to an alternative anti-TNF-α agent. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  11. Central Sleep Apnea - Mayo Clinic

    MedlinePlus

    ... to fall asleep while you're working, watching television or even driving Ask your doctor about any ... find yourself falling asleep at work, while watching television or even when driving. Cardiovascular problems. In addition, ...

  12. Diagnostic report acquisition unit for the Mayo/IBM PACS project

    NASA Astrophysics Data System (ADS)

    Brooks, Everett G.; Rothman, Melvyn L.

    1991-07-01

    The Mayo Clinic and IBM Rochester have jointly developed a picture archive and control system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. One of the challenges of developing a useful PACS involves integrating the diagnostic reports with the electronic images so they can be displayed simultaneously. By the time a diagnostic report is generated for a particular case, its images have already been captured and archived by the PACS. To integrate the report with the images, the authors have developed an IBM Personal System/2 computer (PS/2) based diagnostic report acquisition unit (RAU). A typed copy of the report is transmitted via facsimile to the RAU where it is stacked electronically with other reports that have been sent previously but not yet processed. By processing these reports at the RAU, the information they contain is integrated with the image database and a copy of the report is archived electronically on an IBM Application System/400 computer (AS/400). When a user requests a set of images for viewing, the report is automatically integrated with the image data. By using a hot key, the user can toggle on/off the report on the display screen. This report describes process, hardware, and software employed to integrate the diagnostic report information into the PACS, including how the report images are captured, transmitted, and entered into the AS/400 database. Also described is how the archived reports and their associated medical images are located and merged for retrieval and display. The methods used to detect and process error conditions are also discussed.

  13. Flat Epithelial Atypia and Risk of Breast Cancer: A Mayo Cohort Study

    PubMed Central

    Said, Samar M.; Visscher, Daniel W.; Nassar, Aziza; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene H.; Ghosh, Karthik; Radisky, Derek C.; Hartmann, Lynn C.; Degnim, Amy C.

    2014-01-01

    Background Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to breast cancer development. It is often referred to as an “atypical” or high-risk lesion. However, the long term risk of breast cancer in women with FEA is undefined. Methods Biopsies with FEA were identified in excisional breast biopsies in the Mayo Clinic Benign Breast Disease (BBD) Cohort, which includes 11,591 women who had benign biopsies at Mayo-Rochester 1967–2001. Breast cancer risk of FEA, non-proliferative, proliferative and atypical hyperplasia (AH) subsets was assessed using standardized incidence ratios (SIRs), relative to the Iowa Surveillance, Epidemiology, and End Results registry. Results FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in AH + FEA was 4.74 (95% CI: 3.17–6.81) versus 4.23 (3.44–5.13) for AH without FEA (p=0.59). The SIR for PDWA + FEA was 2.04 (95% CI: 1.23–3.19) versus 1.90 (1.72–2.09) for PDWA without FEA (p=0.76). Conclusions FEA is an uncommon finding in women with BBD. FEA does not convey independent risk of breast cancer beyond that of the associated PDWA or AH. PMID:25639678

  14. History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.

    PubMed

    Rocca, Walter A; Yawn, Barbara P; St Sauver, Jennifer L; Grossardt, Brandon R; Melton, L Joseph

    2012-12-01

    The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide.

  15. History of the Rochester Epidemiology Project: Half a Century of Medical Records Linkage in a US Population

    PubMed Central

    Rocca, Walter A.; Yawn, Barbara P.; St. Sauver, Jennifer L.; Grossardt, Brandon R.; Melton, L. Joseph

    2012-01-01

    The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. PMID:23199802

  16. 78 FR 11680 - Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Rochester Museum & Science Center that meet the definitions of sacred objects and objects of cultural... National Park Service Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center... & Science Center, in consultation with the appropriate Indian tribe, has determined that the cultural items...

  17. 78 FR 34582 - Safety Zone; Rochester Yacht Club Fireworks, Genesee River, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Rochester Yacht Club Fireworks, Genesee... restrict vessels from a portion of the Genesee River during the Rochester Yacht Club fireworks display... with a fireworks display. DATES: This rule will be effective between 9:30 p.m. until 11:00 p.m. on...

  18. Commentary on: "Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): A multicentre, randomised, double-blind, phase 3 trial." Kwon ED, Drake CG, Scher HI, Fizazi K, Bossi A, van den Eertwegh AJ, Krainer M, Houede N, Santos R, Mahammedi H, Ng S, Maio M, Franke FA, Sundar S, Agarwal N, Bergman AM, Ciuleanu TE, Korbenfeld E, Sengeløv L, Hansen S, Logothetis C, Beer TM, McHenry MB, Gagnier P, Liu D, Gerritsen WR, CA184-043 Investigators. Departments of Urology and Immunology and Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, MN, USA, Electronic address: kwon.eugene@mayo.edu; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and Brady Urological Institute, Baltimore, MD, USA; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA; Institut Gustave Roussy, University of Paris-Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France; VU University Medical Centre, Amsterdam, Netherlands; Vienna General Hospital, Medical University Vienna, Vienna, Austria; Institut Bergonié, Bordeaux, France; CHU Caremeau, Nimes, France; Centro Médico Austral, Buenos Aires, Argentina; Centre Jean Perrin, Clermont-Ferrand, France; St John of God Hospital, Subiaco, WA, Australia; University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy; Hospital de Caridade de Ijuí, Ijuí, Brazil; Nottingham University Hospital, Nottingham, UK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Institute of Oncology Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Herlev Hospital, Herlev, Denmark; Odense University Hospital, Odense, Denmark; University of Texas MD Anderson Cancer Center, Houston,

    PubMed

    Trump, Donald

    2016-05-01

    Ipilimumab is a fully human monoclonal antibody that binds cytotoxic T-lymphocyte antigen 4 to enhance antitumour immunity. Our aim was to assess the use of ipilimumab after radiotherapy in patients with metastatic castration-resistant prostate cancer that progressed after docetaxel chemotherapy. We did a multicentre, randomised, double-blind, phase 3 trial in which men with at least one bone metastasis from castration-resistant prostate cancer that had progressed after docetaxel treatment were randomly assigned in a 1:1 ratio to receive bone-directed radiotherapy (8Gy in one fraction) followed by either ipilimumab 10mg/kg or placebo every 3 weeks for up to four doses. Non-progressing patients could continue to receive ipilimumab at 10mg/kg or placebo as maintenance therapy every 3 months until disease progression, unacceptable toxic effect, or death. Patients were randomly assigned to either treatment group via a minimisation algorithm, and stratified by Eastern Cooperative Oncology Group performance status, alkaline phosphatase concentration, haemoglobin concentration, and investigator site. Patients and investigators were masked to treatment allocation. The primary endpoint was overall survival, assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00861614. From May 26, 2009, to Feb 15, 2012, 799 patients were randomly assigned (399 to ipilimumab and 400 to placebo), all of whom were included in the intention-to-treat analysis. Median overall survival was 11.2 months (95% CI: 9.5-12.7) with ipilimumab and 10.0 months (8.3-11.0) with placebo (hazard ratio [HR] = 0.85, 0.72-1.00; P = 0.053). However, the assessment of the proportional hazards assumption showed that it was violated (P = 0.0031). A piecewise hazard model showed that the HR changed over time: the HR for 0-5 months was 1.46 (95% CI: 1.10-1.95), for 5-12 months was 0.65 (0.50-0.85), and beyond 12 months was 0.60 (0.43-0.86). The most common grade 3

  19. Mayo de Los Capomos, Sinaloa (Mayo of Los Capomos, Sinaloa).

    ERIC Educational Resources Information Center

    Freeze, Ray A.

    This document is one of 17 volumes on indigenous Mexican languages and is the result of a project undertaken by the Archivo de Lenguas Indigenas de Mexico. This volume contains information on Mayo, an indigenous language of Mexico spoken in Los Capomos, in the state of Sinaloa. The objective of collecting such a representative sampling of the…

  20. 78 FR 50108 - Notice of Intent To Repatriate Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... is not responsible for the determinations in this notice. History and Description of the Cultural... & Science Center (then Rochester Museum of Arts and Sciences) purchased the Chilkat blanket from John...

  1. 75 FR 23800 - Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center... to repatriate one cultural item in the possession of the Rochester Museum & Science Center, Rochester... anthropological scholarly materials, support the fact that the Onondaga Nation is the Keeper of the Central Fire...

  2. 75 FR 23799 - Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center... to repatriate one cultural item in the possession of the Rochester Museum & Science Center, Rochester... is the Keeper of the Central Fire of the Haudenosaunee Confederacy, and as such has the...

  3. The prevalence of cardiovascular disease risk factors and the Framingham Risk Score in patients undergoing percutaneous intervention over the last 17 years by gender: time-trend analysis from the Mayo Clinic PCI Registry.

    PubMed

    Lee, Moo-Sik; Flammer, Andreas J; Kim, Hyun-Soo; Hong, Jee-Young; Li, Jing; Lennon, Ryan J; Lerman, Amir

    2014-07-01

    This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends. This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender

  4. The Mayo Innovation Scholars Program: Undergraduates Explore the Science and Economics of Medical Innovations

    ERIC Educational Resources Information Center

    Pellegrini, John J.; Jansen, Elizabeth

    2013-01-01

    The Mayo Innovation Scholars Program introduces undergraduates to technology transfer in biomedical sciences by having teams of students from multiple disciplines (e.g., biology, chemistry, economics, and business) analyze inventions in development at the Mayo Clinic. Over 6 months, teams consult with inventors, intellectual property experts, and…

  5. The Mayo Innovation Scholars Program: Undergraduates Explore the Science and Economics of Medical Innovations

    ERIC Educational Resources Information Center

    Pellegrini, John J.; Jansen, Elizabeth

    2013-01-01

    The Mayo Innovation Scholars Program introduces undergraduates to technology transfer in biomedical sciences by having teams of students from multiple disciplines (e.g., biology, chemistry, economics, and business) analyze inventions in development at the Mayo Clinic. Over 6 months, teams consult with inventors, intellectual property experts, and…

  6. Leadless Chip Carrier Packaging and CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) Supported Wire Wrap Interconnect Technology for Subnanosecond ECL (Emitter Coupled Logic).

    DTIC Science & Technology

    1982-12-01

    SUENAMOSECOND ECL Mayo Clinic/Mayo Foundation Special Purpose Processor Development Group Department of Physiology/Biophysics Rochester, Minnesota 55905...members of the Special- Purpose Processor Development Group, Department of Physiology and Biophysics, Mayo Clinic/Mayo Foundation, Rochester, Minnesota...was performed under the principal investigator, Barry K. Gilbert, Ph.D., Director of the Special- Purpose Processor Development Group, Mayo Clinic

  7. 77 FR 19698 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... & Science Center, in consultation with the appropriate Indian tribe, has determined that the cultural items meet the definition of both sacred objects and objects of cultural patrimony and repatriation to the...

  8. 77 FR 19699 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... & Science Center, in consultation with the appropriate Indian tribe, has determined that the cultural items meet the definition of both sacred objects and objects of cultural patrimony and repatriation to the...

  9. Developing a publicity plan for library research: the Rochester Study.

    PubMed

    Smith, B T

    1992-01-01

    The hospital librarians in Rochester, New York and a research team developed and administered a questionnaire to measure the impact of information provided by the librarian on physicians' clinical decision making. While the research was underway, the librarians also developed a publicity plan. The goal of the plan was to create awareness of the study results in the local client population, as well as in the health care community at large. The plan served to describe and put in priority order the types of media that the librarians would use to publicize the study to target groups. This article includes examples of a nationwide and an institution-specific publicity plan. those developing publicity plans for future library research may want to allocate adequate funds to hire a media consultant to increase their prospects for national exposure.

  10. The 2 + 1 paradigm: an efficient algorithm for central reading of Mayo endoscopic subscores in global multicenter phase 3 ulcerative colitis clinical trials.

    PubMed

    Ahmad, Harris A; Gottlieb, Klaus; Hussain, Fez

    2016-02-01

    Despite its importance and potential impact in clinical trials, central reading continues to be an under-represented topic in the literature about inflammatory bowel disease (IBD) clinical trials. Although several IBD studies have incorporated central reading to date, none have fully detailed the specific methodology with which the reads were conducted. Here we outline key principles for designing an efficient central reading paradigm for an ulcerative colitis (UC) study that addresses regulatory, operational and clinical expectations. As a step towards standardization of read methodology for the growing number of multicenter phase 3 clinical trials in IBD, we have applied these principles to the design of an optimal read methodology that we call the '2 + 1 paradigm.' The 2 + 1 paradigm involves the use of both site and central readers, validated scoring criteria and multiple measures for blinding readers, all of which contribute to reducing bias and generating a reliable endoscopic subscore that reflects endoscopic disease severity. The paradigm can be utilized while maintaining a practical workflow compatible with an operationally feasible clinical trial. The 2 + 1 paradigm represents a logical approach to endoscopic assessment in IBD clinical trials, one that should be considered attractive to prospective sponsors, contract research organizations, key opinion leaders and regulatory authorities and be ready for implementation and further evaluation. © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

  11. Rochester area interactive telecommunications network (RAITN): A partnership in Rochester between educators and industry

    SciTech Connect

    O`Leary, C.T.

    1994-12-31

    Primarily funded by Rochester Telephone Corporation, the RAITN system connects five area high schools, Rochester Institute of Technology (RIT), and State University of New York at Brockport. Monroe No. 1 Board of Cooperative Educational Services coordinates the interactive programming which may originate from any of the sites. Course offerings on the network range from full credit college courses to high schools sharing unique classes to increase each partners` breadth of educational options. Special events dealing with a variety of interest areas such as teen health issues, professional development, guest speakers and political leaders, and multicultural diversity topics fill out the schedule of interactive programming. {open_quotes}Electronic field trips{close_quotes} allow students and staff to {open_quotes}virtually attend{close_quotes} seminars, science fairs, and teleconferences held at RIT without leaving their schools. Internet connectivity and a new group of high school, university and industry partners are the next additions to the network.

  12. Mayo v. Prometheus: A Year Later.

    PubMed

    Dorn, Brian R

    2013-07-11

    Last year's U.S. Supreme Court decision in Mayo v. Prometheus regarding the patent eligibility of diagnostic method claims will probably have the most profound lasting effect of any recent court decision on the biopharmaceutical industry. The Mayo decision changed the evaluation of patent eligibility of a method claim under 35 U.S.C. § 101. The new evaluation is a more difficult standard to clear and needs to be considered prior to filing a patent application.

  13. Mayo v. Prometheus: A Year Later

    PubMed Central

    2013-01-01

    Last year’s U.S. Supreme Court decision in Mayo v. Prometheus regarding the patent eligibility of diagnostic method claims will probably have the most profound lasting effect of any recent court decision on the biopharmaceutical industry. The Mayo decision changed the evaluation of patent eligibility of a method claim under 35 U.S.C. § 101. The new evaluation is a more difficult standard to clear and needs to be considered prior to filing a patent application. PMID:24900711

  14. De novo HBV infection in a Mayo Clinic hemodialysis population: economic impact of reduced HBV testing and a call for changes in current US CDC guidelines on HBV testing protocols.

    PubMed

    Onuigbo, Macaulay A C; Onuigbo, Nnonyelum T C

    2012-10-01

    Hemodialysis (HD) exposes end-stage renal disease patients to significantly higher risks for Hepatitis B Virus (HBV) infection, a major public health scourge. Therefore, current US CDC guidelines, last revised in 2001, call for monthly HbsAg tests. The charge to Medicare per HbsAg test is $100. In an economic analysis, we hypothesized that in the new environment of Medicare Fee Bundling, this is unwise and wasteful if de novo HBV infection rate among HD patients is <1%. We determined de novo HBV infection rate among a Mayo Clinic HD cohort, July 2000-July 2010. A retrospective analysis of all relevant medical records of the cohort was completed to identify de novo HBV infection. Nine hundred sixty-five HD patients were analyzed. One case of de novo HBV infection was identified in a 54-year old known IV drug user, a previous Hepatitis C carrier. This translates to a de novo HBV case incidence rate of 0.1%. De novo HBV infection among HD patients in the US, 2000-2010, is only 0.1%. In the early 1970s, rates were as high as 30%. We recommend 3-monthly HbsAg testing, but to continue current monthly testing for IV drug users and other high-risk groups. Huge cost savings would result, without any compromise of quality outcomes. With over 500,000 HD patients, this represents a mind-boggling $40 billion savings in Medicare charges over 10 years. The US CDC should revise these outdated guidelines, last revised in 2001, to fall in line with current clinical realities on the ground.

  15. Comparison of Time Trends of Cardiovascular Disease Risk Factors and Framingham Risk Score Between Patients With and Without Acute Coronary Syndrome Undergoing Percutaneous Intervention Over the Last 17 Years: From the Mayo Clinic Percutaneous Coronary Intervention Registry.

    PubMed

    Lee, Moo-Sik; Flammer, Andreas J; Li, Jing; Lennon, Ryan J; Delacroix, Sinny; Kim, Hyunsoo; Lerman, Amir

    2015-12-01

    The objective of this study was to investigate cardiovascular disease risk factor (cvRF) profiles and compare their trends over 17 years in patients with and without acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Time trends of cvRF are different between ACS and non-ACS patients. This study was a time-trend analysis from 1994 to 2010 within the Mayo Clinic PCI registry. Outcome measures were incidence and prevalence of cvRF, including the Framingham Risk Score (FRS), at the time of admission for PCI. Age of non-ACS patients was higher than that of ACS patients, and age distribution slightly shifted toward older age in both groups (P for trend <0.001). There was no difference in FRS between the 2 groups; however, 10-year cardiovascular disease risk (%) remained higher in non-ACS than in ACS patients, decreasing over time. Diastolic blood pressure and high-density lipoprotein cholesterol were higher in non-ACS patients, but total cholesterol and low-density lipoprotein cholesterol were higher in ACS patients, with an improving trend over time. Prevalence of diabetes mellitus, hypertension, and history of hypercholesterolemia were higher in non-ACS patients, increasing over time. Smoking did not change over time. Use of most medications increased over time in both groups. Most cvRFs and their time trends exhibited statistically significant differences between ACS and non-ACS patients, except systolic blood pressure, body mass index, and history of myocardial infarction. A new risk-factor profile assessment may be needed for stratification of PCI patients according to ACS and non-ACS status. Clinical and public-health interventions should consider different approaches to ACS and non-ACS patients. © 2015 Wiley Periodicals, Inc.

  16. Rates and Outcomes of Follicular Lymphoma Transformation in the Immunochemotherapy Era: A Report From the University of Iowa/Mayo Clinic Specialized Program of Research Excellence Molecular Epidemiology Resource

    PubMed Central

    Link, Brian K.; Maurer, Matthew J.; Nowakowski, Grzegorz S.; Ansell, Stephen M.; Macon, William R.; Syrbu, Sergei I.; Slager, Susan L.; Thompson, Carrie A.; Inwards, David J.; Johnston, Patrick B.; Colgan, Joseph P.; Witzig, Thomas E.; Habermann, Thomas M.; Cerhan, James R.

    2013-01-01

    Purpose This study sought to characterize transformation incidence and outcome for patients with follicular lymphoma (FL) in a prospective observational series begun after diffusion of rituximab use. Patients and Methods Patients with newly diagnosed FL were prospectively enrolled onto the University of Iowa/Mayo Clinic Specialized Program of Research Excellence Molecular Epidemiology Resource from 2002 to 2009. Patients were actively followed for re-treatment, clinical or pathologic transformation, and death. Risk of transformation was analyzed via time to transformation by using death as a competing risk. Results In all, there were 631 patients with newly diagnosed grade 1 to 3a FL who had a median age at enrollment of 60 years. At a median follow-up of 60 months (range, 11 to 110 months), 79 patients had died, and 60 patients developed transformed lymphoma, of which 51 were biopsy proven. The overall transformation rate at 5 years was 10.7%, with an estimated rate of 2% per year. Increased lactate dehydrogenase was associated with increased risk of transformation. Transformation rate at 5 years was highest in patients who were initially observed and lowest in patients who initially received rituximab monotherapy (14.4% v 3.2%; P = .021). Median overall survival following transformation was 50 months and was superior in patients with transformation greater than 18 months after FL diagnosis compared with patients with earlier transformation (5-year overall survival, 66% v 22%; P < .001). Conclusion Follicular transformation rates in the immunochemotherapy era are similar to risk of death without transformation and may be lower than reported in older series. Post-transformation prognosis is substantially better than described in older series. Initial management strategies may influence the risk of transformation. PMID:23897955

  17. RadNet Air Data From Rochester, NY

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Rochester, NY from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  18. Impacts of Hospital Budget Limits in Rochester, New York

    PubMed Central

    Friedman, Bernard; Wong, Herbert S.

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end. PMID:10151889

  19. Impacts of hospital budget limits in Rochester, New York.

    PubMed

    Friedman, B; Wong, H S

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end.

  20. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, Wong YN, Hahn N, Kohli M, Cooney MM, Dreicer R, Vogelzang NJ, Picus J, Shevrin D, Hussain M, Garcia JA, DiPaola RS. Department of Medicine; Department of Biostatistics and Computational Biology; Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston; Johns Hopkins University, Baltimore; University of Wisconsin Carbone Cancer Center; School of Medicine and Public Health; Madison; Fox Chase Cancer Center, Temple University Health System, Philadelphia; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis; Mayo Clinic, Rochester, MN; University Hospitals Case Medical Center, Seidman Cancer Center; Cleveland Clinic Taussig Cancer Institute; Both in Cleveland; University of Virginia Cancer Center, Charlottesville; Comprehensive Cancer Centers of Nevada, Las Vegas; Siteman Cancer Center, Washington University School of Medicine, St. Louis; NorthShore University Health System, Evanston, IL; University of Michigan Comprehensive Cancer Center, Ann Arbor; Rutgers Cancer Institute of New Jersey, New Brunswick.N Engl J Med. 2015 Aug 20;373(8):737-46. [Epub 2015 Aug 5]. doi: 10.1056/NEJMoa1503747.

    PubMed

    Scott, Eggener

    2017-03-01

    Androgen deprivation therapy (ADT) has been the backbone of treatment for metastatic prostate cancer since the 1940s. We assessed whether concomitant treatment with ADT plus docetaxel would result in longer overall survival than that with ADT alone. We assigned men with metastatic, hormone-sensitive prostate cancer to receive either ADT plus docetaxel (at a dose of 75mg per square meter of body-surface area every 3wk for 6 cycles) or ADT alone. The primary objective was to test the hypothesis that the median overall survival would be 33.3% longer among patients receiving docetaxel added to ADT early during therapy than among patients receiving ADT alone. A total of 790 patients (median age, 63y) underwent randomization. After a median follow-up of 28.9 months, the median overall survival was 13.6 months longer with ADT plus docetaxel (combination therapy) than with ADT alone (57.6 vs. 44.0mo; hazard ratio for death in the combination group, 0.61; 95% confidence interval [CI]: 0.47-0.80; P<0.001). The median time to biochemical, symptomatic, or radiographic progression was 20.2 months in the combination group, as compared with 11.7 months in the ADT-alone group (hazard ratio, 0.61; 95% CI: 0.51-0.72; P<0.001). The rate of a prostate-specific antigen level of less than 0.2ng/ml at 12 months was 27.7% in the combination group vs. 16.8% in the ADT-alone group (P<0.001). In the combination group, the rate of grade 3 or 4 febrile neutropenia was 6.2%, the rate of grade 3 or 4 infection with neutropenia was 2.3%, and the rate of grade 3 sensory neuropathy and of grade 3 motor neuropathy was 0.5%. Six cycles of docetaxel at the beginning of ADT for metastatic prostate cancer resulted in significantly longer overall survival than that with ADT alone. (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00309985.). Copyright © 2017. Published by Elsevier Inc.

  1. Transforming Research Management Systems at Mayo Clinic

    ERIC Educational Resources Information Center

    Smith, Steven C.; Gronseth, Darren L.

    2011-01-01

    In order for research programs at academic medical centers and universities to survive and thrive in the increasingly challenging economic, political and regulatory environment, successful transformation is extremely important. Transformation and quality management techniques are increasingly well established in medical practice organizations. In…

  2. [The Mayo Clinic Nicotine Dependence Center].

    PubMed

    Hurt, Richard D; Hays, Taylor J; Croghan, Ivana T

    2017-01-01

    Since 1988, this world leading center provided treatment of tobacco dependence to tens of thousands of tobacco-dependent patients, educated thousands of health professionals and has rich research activities. Its system was a model for such similar centers including those in the Czech Republic.

  3. High temperature triaxial tests on Rochester shale

    NASA Astrophysics Data System (ADS)

    Bruijn, Rolf; Burlini, Luigi; Misra, Santanu

    2010-05-01

    Phyllosilicates are one of the major components of the crust, responsible for strength weakening during deformation. High pressure and temperature experiments of natural samples rich in phyllosilicates are needed to test the relevance of proposed weakening mechanisms induced by phyllosilicates, derived from lab experiments on single phase and synthetic polyphase rocks and single crystals. Here, we present the preliminary results of a series of high temperature triaxial tests performed on the illite-rich Rochester Shale (USA - New York) using a Paterson type gas-medium HPT testing machine. Cylindrical samples with homogeneous microstructure and 12-14% porosity were fabricated by cold and hot-isostatically pressing, <150 μm crushed Rochester Shale particles. Experiments were conducted at 500- 700 °C temperature and varying strain rate from 5x10-6 to 7x10-4 s-1, while keeping confining pressure constant at 300 MPa. Synthetic hot-pressed samples were deformed up to a total shortening of 7.5 to 13%. To study the significance of mica dehydration, iron or copper jackets were used in combination with non-porous or porous spacers. Water content was measured before and after experiments using Karl Fischer Titration (KFT). All experiments show, after yielding at 0.6% strain, rapid hardening in nearly linear fashion until about 4-5% strain, from where stress increases at reducing rates to values at 10% strain, between 400 and 675 MPa, depending on experimental conditions. Neither failure nor steady state however, is achieved within the maximum strain of 13%. Experiments performed under 500 °C and 300 MPa confining pressure show weak strain rate dependence. In addition, iron-jacketed samples appear harder than copper-jacketed ones. At 700 °C samples are 17 to 37% weaker and more sensitive to strain rate than during 500 °C experiments. Although, iron-jacketed samples behave stronger than copper-jacketed ones. By visual inspection, samples appear homogeneously shortened

  4. LLNL/Rochester 2007 TRIUMF activity

    SciTech Connect

    Wu, C; Becker, J; Hurst, A; Stoyer, M; Cline, D; Hayes, A

    2007-08-24

    Bambino is a first generation auxiliary detector for the TIGRESS array and consists of a pair of segmented annular silicon detectors, fabricated by MicronSemiconductor Inc. Bambino provides measures of both the energy and position for outgoing charged particles and main triggers for valid events. The annular Bambino detectors are placed 3.0 cm from the target both upstream and downstream. Each detector has 24 rings in q covering angles between 20.1{sup o} and 49.4{sup o} and between 130.6{sup o} to 159.9{sup o}, with 16 sectors in {phi} for 2{pi} coverage. Two sets of preamplifiers, manufactured by SwanResearch, with the sensitivity of either 5 or 50 mV/MeV are available for experiments. A special scattering chamber to accommodate this detector array was designed and fabricated in FY06 by U. of Rochester. Bambino functioned very well for the first successful TIGRESS experiment on the Coulomb excitation of radioactive {sup 20}Na and {sup 21}Na beams in Jul/Aug 2006. Bambino underwent a major upgrade in FY07 at a cost of about $80 k to increase the position resolution. This is achieved by doubling the number of sector to 32 and will improve the in-flight reaction product {gamma}-ray spectroscopy resolution to about 1% or better for the TIGRESS array. This new segmented silicon detector, called CD-S3, was designed and fabricated by MicronSemiconductor Inc. CD-S3 was installed and used for the scheduled experiment E1075 in Jul/Aug 2007 (Coulomb excitation of radioactive {sup 29}Na beam). In addition, assemble of a {Delta}E-E detector array for the light charged-particle identification is taking place for future experiments by acquiring detectors with thickness of both {approx}140 and {approx}1,000 {micro}m and associated preamplifiers.

  5. SpecTIR hyperspectral airborne Rochester experiment data collection campaign

    NASA Astrophysics Data System (ADS)

    Herweg, Jared A.; Kerekes, John P.; Weatherbee, Oliver; Messinger, David; van Aardt, Jan; Ientilucci, Emmett; Ninkov, Zoran; Faulring, Jason; Raqueño, Nina; Meola, Joseph

    2012-06-01

    A multi-modal (hyperspectral, LiDAR, and multi-spectral) imaging data collection campaign was conducted at the Rochester Institute of Technology (RIT) in conjunction with SpecTIR, LLC, in the Rochester, New York, area July 26-29, 2010. The campaign was titled the SpecTIR Hyperspectral Airborne Rochester Experiment (SHARE) and collected data in support of nine simultaneous unique experiments, several of which leveraged data from multiple modalities. Airborne imagery was collected over the city of Rochester with hyperspectral, multispectral, and Light Detection and Ranging (LiDAR) sensors. Sites for data collection included the Genesee River, sections of downtown Rochester, and the RIT campus. Experiments included sub-pixel target detection, water quality monitoring, thermal vehicle tracking and wetlands health assessment. An extensive ground truthing effort was accomplished in addition to the airborne imagery collected. The ultimate goal of this comprehensive data collection campaign was to provide a community sharable resource that would support additional experiments. This paper details the experiments conducted and the corresponding data that were collected in conjunction with this campaign.

  6. Elton Mayo and Carl Rogers: A Tale of Two Techniques.

    ERIC Educational Resources Information Center

    Mahoney, Kevin T.; Baker, David B.

    2002-01-01

    Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)

  7. Elton Mayo and Carl Rogers: A Tale of Two Techniques.

    ERIC Educational Resources Information Center

    Mahoney, Kevin T.; Baker, David B.

    2002-01-01

    Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)

  8. Bridge Builder: Susan Gibbons--University of Rochester, NY

    ERIC Educational Resources Information Center

    Library Journal, 2005

    2005-01-01

    There are many chasms in the library profession: among different libraries and between public services and technology staff, users and librarians, and research and practice. Susan Gibbons bridges all of them. As director of digital library initiatives at the University of Rochester River Campus Libraries, Gibbons was an early adopter of MIT's…

  9. Nurses Educational Needs Assessment: Rochester and Southeastern Minnesota Area.

    ERIC Educational Resources Information Center

    Kanun, Clara; Podratz, Rosalyn

    A survey of registered nurses in the Rochester area was conducted to identify needs of potentially reemployable nurses in response to the prevailing opinion that uncongenial working conditions were the primary cause for the shortage of nurses. Data were collected from 20 percent random sample of registered nurses who completed either a survey form…

  10. Evaluation of a Study Skills Class at Rochester Community College.

    ERIC Educational Resources Information Center

    Mercer, Bonnie

    In winter 1995, a study was conducted at Rochester Community College (RCC), in Minnesota, to examine the effectiveness of a study skills class (SS198). Specifically, the study sought to determine if the course met established criteria of retaining 50% of completers in good academic standing for 1 year, to compare retention rates to non-enrolled…

  11. Bridge Builder: Susan Gibbons--University of Rochester, NY

    ERIC Educational Resources Information Center

    Library Journal, 2005

    2005-01-01

    There are many chasms in the library profession: among different libraries and between public services and technology staff, users and librarians, and research and practice. Susan Gibbons bridges all of them. As director of digital library initiatives at the University of Rochester River Campus Libraries, Gibbons was an early adopter of MIT's…

  12. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Buffalo and Rochester Harbors... SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165 Buffalo and Rochester Harbors, New York. In Buffalo and Rochester Harbors, no vessel may exceed 6 miles...

  13. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Buffalo and Rochester Harbors... SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165 Buffalo and Rochester Harbors, New York. In Buffalo and Rochester Harbors, no vessel may exceed 6 miles...

  14. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Buffalo and Rochester Harbors... SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165 Buffalo and Rochester Harbors, New York. In Buffalo and Rochester Harbors, no vessel may exceed 6 miles...

  15. The Arabic Version of the Mayo-Portland Adaptability Inventory 4: A Validation Study

    ERIC Educational Resources Information Center

    Hamed, Razan; Tariah, Hashem Abu; Malkawi, Somaya; Holm, Margo B.

    2012-01-01

    The Mayo-Portland Adaptability Inventory 4 (MPAI-4) is a valid and reliable assessment tool to detect clinical impairments in patients with acquired brain injury. The tool is widely used by rehabilitation therapists worldwide, given its good psychometric properties and its availability in several languages. The purpose of this study was to…

  16. The Arabic Version of the Mayo-Portland Adaptability Inventory 4: A Validation Study

    ERIC Educational Resources Information Center

    Hamed, Razan; Tariah, Hashem Abu; Malkawi, Somaya; Holm, Margo B.

    2012-01-01

    The Mayo-Portland Adaptability Inventory 4 (MPAI-4) is a valid and reliable assessment tool to detect clinical impairments in patients with acquired brain injury. The tool is widely used by rehabilitation therapists worldwide, given its good psychometric properties and its availability in several languages. The purpose of this study was to…

  17. Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R).

    PubMed

    Carey, Michael P; Vanable, Peter A; Senn, Theresa E; Coury-Doniger, Patricia; Urban, Marguerite A

    2008-07-01

    Sexually transmitted infection (STI) clinics provide an opportune setting for HIV prevention efforts. This randomized controlled trial evaluated a unique, two-step approach to sexual risk reduction at a publicly-funded STI clinic. During an initial visit, patients completed an audio-computer assisted self-interview (ACASI), were randomized to and received one of two brief interventions, obtained medical care, and completed a post-assessment. Next, two-thirds of the patients were assigned to attend an intensive sexual risk reduction workshop. At 3, 6, and 12 months, patients completed additional ACASIs and provided urine specimens to assess behavior change and incident STIs. During a 28-month interval, 5613 patients were screened, 2691 were eligible, and 1483 consented to participate and were randomized; the modal reason for declining was lack of time (82%). Consenting patients included 688 women and 795 men; 64% of participants were African-American. The sample was low-income, with 57% reporting an annual income of less than $15,000; most participants (62%) had a high school education or less, and 51% were unemployed. Sexual risk behavior was common, as indicated by multiple sexual partners (mean=32.8, lifetime; mean=2.8, past 3 months), unprotected sex (mean=17.3 episodes, past 3 months), and prior STIs (mean=3.3, lifetime; 23% at baseline). Bivariate analyses confirmed our prediction that HIV-related motivation and behavioral skills would be related to current sexual risk behavior. All patients received a brief intervention; patient satisfaction ratings were uniformly high for both interventions (all means >or=3.7 on 4-point scales). Fifty-six percent of invited patients attended the intensive workshop, and attendance did not differ as a function of brief intervention. Patient satisfaction ratings were also uniformly positive for the workshop interventions (all means >or=3.6). Return to follow-up assessments exceeded 70%. Results demonstrate that implementing an

  18. The etiology and incidence of anaphylaxis in Rochester, Minnesota: A report from the Rochester Epidemiology Project

    PubMed Central

    Decker, Wyatt W.; Campbell, Ronna L.; Manivannan, Veena; Luke, Anuradha; St. Sauver, Jennifer L.; Weaver, Amy; Bellolio, M. Fernanda; Bergstralh, Eric J.; Stead, Latha G.; Li, James T. C.

    2009-01-01

    Background Reported incidences of anaphylaxis range from 3.2 to 20 per 100,000 population. The incidence and trend over time has meaningful public health implications but has not been well characterized because of a lack of a standard definition and deficiencies in reporting of events. Objective We sought to determine the incidence and cause of anaphylaxis over a 10-year period. Methods We performed a population-based incidence study that was conducted in Rochester, Minnesota, from 1990 through 2000. Anaphylaxis episodes were identified on the basis of symptoms and signs of mast cell and basophil mediator release plus mucocutaneous, gastrointestinal tract, respiratory tract, or cardiovascular system involvement. Results Two hundred eleven cases of anaphylaxis were identified (55.9% in female subjects). The mean age was 29.3 years (SD, 18.2 years; range, 0.8–78.2 years). The overall age-and sex-adjusted incidence rate was 49.8 (95% CI, 45.0–54.5) per 100,000 person-years. Age-specific rates were highest for ages 0 to 19 years (70 per 100,000 person-years). Ingested foods accounted for 33.2% (70 cases), insect stings accounted for 18.5% (39 cases), medication accounted for 13.7% (29 cases), radiologic contrast agent accounted for 0.5% (1 case), “other” causes accounted for 9% (19 cases), and “unknown” causes accounted for 25.1% (53 cases). The “other” group included cats, latex, cleaning agents, environmental allergens, and exercise. There was an increase in the annual incidence rate during the study period from 46.9 per 100,000 persons in 1990 to 58.9 per 100,000 persons in 2000 (P = .03). Conclusion The overall incidence rate is 49.8 per 100,000 person-years, which is higher than previously reported. The annual incidence rate is also increasing. Food and insect stings continue to be major inciting agents for anaphylaxis. PMID:18992928

  19. [Surgical treatment for Mayo II B comminuted fracture of the olecranon].

    PubMed

    Wang, Min; Ping, Li-yuan; Wang, Wei; Yang, Bao-gen

    2016-02-01

    To study clinical effects of surgery for the treatment of Mayo II B comminuted fracture in ulna olecranon. From May 2008 to March 2015, a total of 37 patients with Mayo II B comminuted fracture in ulua olecranon were treated, including 20 males and 17 females, ranging in age from 40 to 65 years old ,with an average of 53 years old. All the patients were treated with open reduction and internal fixation within 4 to 7 days after injuries. All the patients had pain and functional disorder uf elbow joint. The X-ray and CT examination showed ulna olecranon comminuted fracture of Mayo II B. Postoperative complications were observed ,and Broberg-Morrey criteria was used tu evaluate therapeutic effects. All the patients were followed up ,and the duraiton ranged from 9 to 30 months ,with a mean of 15 months. Two patients had surface infection around incision ,and were healed by changing dressings. No other complications occurred such as needle slipping to stimulate skin ,screw loosening and wire broken. One patient had slight uneveness of joint surface without obvious functional disorder. According to Broberg-Morrey elbow fracture curative effect criteria, 11 paients got an excellent result, 24 good and 2 fair,and the total score was 87.0 ± 7.3. For the Mayo II B comminuted fracture in ulna olecranon, preoperative preparation, intraoperative restoring of the articular surface smooth and reasonable internal fixation, and postoperative rehabilitation actively, can obtain satisfactory clinical effects.

  20. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    ERIC Educational Resources Information Center

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  1. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    ERIC Educational Resources Information Center

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  2. Time-trend analysis on the Framingham risk score and prevalence of cardiovascular risk factors in patients undergoing percutaneous coronary intervention without prior history of coronary vascular disease over the last 17 years: a study from the Mayo Clinic PCI registry.

    PubMed

    Lee, Moo-Sik; Flammer, Andreas J; Li, Jing; Lennon, Ryan J; Singh, Mandeep; Holmes, David R; Rihal, Charanjit S; Lerman, Amir

    2014-07-01

    There is a paucity of data on the temporal trends of cardiovascular risk factors in patients undergoing percutaneous coronary intervention (PCI). We investigated the secular trends of risk profiles of patients undergoing PCI without prior history of cardiovascular disease (CVD). CVD risk factors are changed over time. This time-trend analysis from 1994 to 2010 was performed within the Mayo Clinic PCI Registry. Outcome measures were prevalence of CVD risk factors, including the Framingham risk score (FRS), at the time of admission for PCI. During this period, 12,055 patients without a history of CVD (mean age, 65.0 ± 12.4 years, 67% male) underwent PCI at the Mayo Clinic. Age distribution slightly shifted toward older age (P for trend <0.05), but sex did not change over time. Despite a higher prevalence of hypertension, hypercholesterolemia, and diabetes mellitus over time, actual blood pressure and lipid profiles improved (P for trend <0.001). Over time, FRS and 10-year CVD risk improved significantly (7.3 ± 3.2 to 6.5 ± 3.3, P for trend <0.001; and 11.0 to 9.0, P for trend <0.001, respectively). Body mass index, not included in the FRS, increased significantly (29.0 ± 5.2 to 30.1 ± 6.2 kg/m(2) , P for trend <0.001), whereas smoking prevalence did not change. The current study demonstrates that although traditional FRS and its associated predicted 10-year cardiovascular risk declined over time, the prevalence of risk factors increased in patients undergoing PCI. The study suggests the need for a new risk-factor assessment in this patient population. © 2014 Wiley Periodicals, Inc.

  3. Technology Transfer and Outreach for SNL/Rochester ALPHA Project.

    SciTech Connect

    Sinars, Daniel

    2016-01-01

    This report describes the next stage goals and resource needs for the joint Sandia and University of Rochester ARPA-E project. A key portion of this project is Technology Transfer and Outreach, with the goal being to help ensure that this project develops a credible method or tool that the magneto-inertial fusion (MIF) research community can use to broaden the advocacy base, to pursue a viable path to commercial fusion energy, and to develop other commercial opportunities for the associated technology. This report describes an analysis of next stage goals and resource needs as requested by Milestone 5.1.1.

  4. Developing a clinical trial unit to advance research in an academic institution.

    PubMed

    Croghan, Ivana T; Viker, Steven D; Limper, Andrew H; Evans, Tamara K; Cornell, Alissa R; Ebbert, Jon O; Gertz, Morie A

    2015-11-01

    Research, clinical care, and education are the three cornerstones of academic health centers in the United States. The research climate has always been riddled with ebbs and flows, depending on funding availability. During a time of reduced funding, the number and scope of research studies have been reduced, and in some instances, a field of study has been eliminated. Recent reductions in the research funding landscape have led institutions to explore new ways to continue supporting research. Mayo Clinic in Rochester, MN has developed a clinical trial unit within the Department of Medicine, which provides shared resources for many researchers and serves as a solution for training and mentoring new investigators and study teams. By building on existing infrastructure and providing supplemental resources to existing research, the Department of Medicine clinical trial unit has evolved into an effective mechanism for conducting research. This article discusses the creation of a central unit to provide research support in clinical trials and presents the advantages, disadvantages, and required building blocks for such a unit. Copyright © 2015 Mayo Clinic. Published by Elsevier Inc. All rights reserved.

  5. An alternate approach to hospital cost control: the Rochester project.

    PubMed Central

    Sorensen, A A; Saward, E W

    1978-01-01

    The rapid escalation in health care costs has demonstrated a need to control costs in general and hospital costs in particular. In New York State, efforts at control have followed one of several paths, including reduction of Medicaid program expenditures, elimination of hospital beds, and prospective reimbursement of hospital costs. Although some success has been achieved in each of these areas, hospital costs containment has not been as successful as had been hoped. A new project called MAXICAP, being developed in the Rochester region, seeks to link payment with regional hospital planning. MAXICAP represents a voluntary attempt by hospitals, third party payers, planners, consumers, and governmental agencies to devise a prospective hospital payment system. Under this system community hospital plans in the Rochester region would be integrated and a cap imposed on both revenues and expenses for acute hospital care. The principal advantage of the MAXICAP is that it offers a mechanism for linking hospital planning with payment functions on a regional basis. The principal disadvantage is that the success of the MAXICAP depends upon the voluntary cooperation of the vast majority of the acute care hospitals in the area--hospitals that may be scattered throughout a relatively large region. PMID:98805

  6. 78 FR 28012 - Tier One Environmental Impact Statement for the Rochester, Minnesota to Twin Cities, Minnesota...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... Twin Cities, Minnesota Passenger Rail Corridor AGENCY: Federal Railroad Administration (FRA), U.S... for the Rochester, Minnesota to Twin Cities, Minnesota Passenger Rail Corridor (the Corridor) in... corridor-level passenger rail route alternatives between Rochester and the Twin Cities. The Tier One...

  7. Validation of the Mayo Dysphagia Questionnaire.

    PubMed

    Grudell, A B M; Alexander, J A; Enders, F B; Pacifico, R; Fredericksen, M; Wise, J L; Locke, G R; Arora, A; Zais, T; Talley, N J; Romero, Y

    2007-01-01

    While multiple instruments characterize upper gastrointestinal symptoms, a validated instrument devoted to the measurement of a spectrum of esophageal dysphagia attributes is not available. Therefore, we constructed and validated the Mayo Dysphagia Questionnaire (MDQ). The 27 items of the MDQ underwent content validity, feasibility, concurrent validity, reproducibility, internal consistency, and construct validity testing. To assess content validity, five esophageal subspecialty gastroenterologists reviewed the items to ensure inclusion of pertinent domains. Feasibility testing was done with eight outpatients who refined problematic items. To assess concurrent validity, 70 patient responses on the MDQ were compared to responses gathered in a structured patient-physician interview. A separate group of 70 outpatients completed the MDQ twice to assess the reproducibility of each item. A total of 148 patients participated in the validation process (78 [53%] men; mean age 62). On average, the MDQ took 6 minutes to complete. A single item (odynophagia) tested poorly with a kappa value of <0.4. Otherwise, the majority of concurrent validity kappa values were in the good to excellent range with a mean of 0.63 (95% CI 0.22-0.89). The majority of reproducibility kappa values were also in the good to excellent range with a median kappa value of 0.76 (interquartile range: 0.67-0.81). Cronbach's alpha values were excellent in the range of 0.86-0.88. Spearman rank correlation coefficients to assess construct validity were also excellent in the range of 0.87-0.98. Thus, the MDQ is a concise instrument that demonstrates overall excellent concurrent validity, reproducibility, internal consistency, and construct validity for the features of esophageal dysphagia.

  8. Evaluation of the content coverage of SNOMED CT: ability of SNOMED clinical terms to represent clinical problem lists.

    PubMed

    Elkin, Peter L; Brown, Steven H; Husser, Casey S; Bauer, Brent A; Wahner-Roedler, Dietlind; Rosenbloom, S Trent; Speroff, Ted

    2006-06-01

    To evaluate the ability of SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) version 1.0 to represent the most common problems seen at the Mayo Clinic in Rochester, Minn. We selected the 4996 most common nonduplicated text strings from the Mayo Master Sheet Index that describe patient problems associated with inpatient and outpatient episodes of care. From July 2003 through January 2004, 2 physician reviewers compared the Master Sheet Index text with the SNOMED CT terms that were automatically mapped by a vocabulary server or that they identified using a vocabulary browser and rated the "correctness" of the match. If the 2 reviewers disagreed, a third reviewer adjudicated. We evaluated the specificity, sensitivity, and positive predictive value of SNOMED CT. Of the 4996 problems in the test set, SNOMED CT correctly identified 4568 terms (true-positive results); 36 terms were true negatives, 9 terms were false positives, and 383 terms were false negatives. SNOMED CT had a sensitivity of 92.3%, a specificity of 80.0%, and a positive predictive value of 99.8%. SNOMED CT, when used as a compositional terminology, can exactly represent most (92.3%) of the terms used commonly in medical problem lists. Improvements to synonymy and adding missing modifiers would lead to greater coverage of common problem statements. Health care organizations should be encouraged and provided incentives to begin adopting SNOMED CT to drive their decision-support applications.

  9. An epidemiologic study of inflammatory bowel disease in Rochester, New York. Hospital incidence.

    PubMed

    Stowe, S P; Redmond, S R; Stormont, J M; Shah, A N; Chessin, L N; Segal, H L; Chey, W Y

    1990-01-01

    The epidemiological understanding of inflammatory bowel disease has been limited by the referral bases of most inflammatory bowel disease studies. The Colitis-Ileitis Study Group of Rochester, N.Y., developed a community-wide, computerized cumulative registry of all inflammatory bowel disease patients hospitalized at the 8 community hospitals for 1973-86. Clinical data were abstracted from each of the 1651 identified hospital charts. All of these patients resided in Monroe County (city and suburbs) and the 5 contiguous counties (Genesee/Finger Lakes Region, population 1,030,640). Of the 1651 hospital patients identified in the study, 1358 resided in Monroe County (Rochester and its immediate suburbs, population 702,238). Incidence, defined as time of onset of symptoms of inflammatory bowel disease, rose from baseline rates in the 1930s to peak in 1980 (Crohn's disease = 50.29/10(5) per decade, ulcerative colitis = 35.12/10(5) per decade) and declined through 1986. For Crohn's disease, the age-specific incidence rates peaked in the 20-29-yr-old group in each of the 5 decades studied. Ulcerative colitis seems to occur at all ages and may have a bimodal distribution. There was a period effect, with the 1970s having the highest incidence of Crohn's disease and ulcerative colitis for each age group. However, the age-specific incidence rate for Crohn's disease showed a 40% decrease in the 1980s compared with the 1970s in the 10-39-yr-old group (p less than 0.001). The age-specific incidence rate for ulcerative colitis showed a 50% decrease in the 1980s compared with the 1970s in the 10-49-yr-old group (p less than 0.001).

  10. Validation of the Mayo Hip Score: construct validity, reliability and responsiveness to change.

    PubMed

    Singh, Jasvinder A; Schleck, Cathy; Harmsen, W Scott; Lewallen, David G

    2016-01-19

    Previous studies have provided the initial evidence for construct validity and test-retest reliability of the Mayo Hip Score. Instruments used for Total Hip Arthroplasty (THA) outcomes assessment should be valid, reliable and responsive to change. Our main objective was to examine the responsiveness to change, association with subsequent revision and the construct validity of the Mayo hip score. Discriminant ability was assessed by calculating effect size (ES), standardized response mean (SRM) and Guyatt's responsiveness index (GRI). Minimal clinically important difference (MCII) and moderate improvement thresholds were calculated. We assessed construct validity by examining association of scores with preoperative patient characteristics and correlation with Harris hip score, and assessed association of scores with the risk of subsequent revision. Five thousand three hundred seven provided baseline data; of those with baseline data, 2,278 and 2,089 (39%) provided 2- and 5-year data, respectively. Large ES, SRM and GRI ranging 2.66-2.78, 2.42-2.61 and 1.67-1.88 were noted for Mayo hip scores with THA, respectively. The MCII and moderate improvement thresholds were 22.4-22.7 and 39.4-40.5 respectively. Hazard ratios of revision surgery were higher with lower final score or less improvement in Mayo hip score at 2-years and borderline significant/non-significant at 5-years, respectively: (1) score ≤55 with hazard ratios of 2.24 (95% CI, 1.45, 3.46; p = 0.0003) and 1.70 (95% CI, 1.00, 2.92; p = 0.05) of implant revision subsequently, compared to 72-80 points; (2) no improvement or worsening score with hazard ratios 3.94 (95% CI, 1.50, 10.30; p = 0.005) and 2.72 (95% CI, 0.85,8.70; p = 0.09), compared to improvement >50-points. Mayo hip score had significant positive correlation with younger age, male gender, lower BMI, lower ASA class and lower Deyo-Charlson index (p ≤ 0.003 for each) and with Harris hip scores (p < 0.001). Mayo Hip Score is

  11. The impact of robotics on treatment of localized prostate cancer and resident education in Rochester, New York.

    PubMed

    Madeb, Ralph; Golijanin, Dragan; Knopf, Joy K; Kowalczyk, John; Feng, Changyong; Rashid, Hani; Wu, Guan; Eichel, Louis; Valvo, John R

    2011-04-01

    Robot-assisted radical prostatectomy (RARP) has been performed in Rochester, NY, since 2003. Currently, 10 area urologists perform RARP, and robotic training has become an important component of the residency. We present data describing the timeline for adoption, both in clinical practice and in the residency program. We reviewed the operating logs for all surgeons who were performing prostatectomies in all hospitals in Rochester, NY, from 2003 to 2007. We examined the influence RARP had on other treatments, including brachytherapy and cryotherapy. Surgical logs of graduating chief residents were also reviewed. Eleven surgeons in Rochester regularly perform radical prostatectomy (10 perform primarily RARP, one performs only open prostatectomy). Three of the city's four hospitals have robotic systems. In 2003-2004, there were 30 open prostatectomies performed monthly and fewer than 10 performed robotically. By 2006, the trend was reversed, with 50 robot-assisted prostatectomies performed each month and fewer than 10 open prostatectomies (P<0.05). The rate of brachytherapy fluctuated, increasing in centers without a robot. The number of open prostatectomies in centers without a robot dropped significantly to fewer than 10 cases per year. There was also a significant decrease in the number of open prostatectomies performed by chief residents. Since the introduction of surgical robotics, significant changes have been seen. The volume of radical prostatectomies performed by surgeons at institutions with robotics has increased; the volume at robot-free institutions has become nominal. There is a trend toward increased radiation therapy at robot-free institutions. While radical prostatectomies logged by graduating chief residents have increased, open prostatectomy experience is now minimal.

  12. Imagine Astronomy at the Rochester Institute of Technology

    NASA Astrophysics Data System (ADS)

    Rapson, Valerie; Almeyda, T.; Freeman, M.; Lena, D.; Principe, D.; Punzi, K.; Sargent, B. A.; Vaddi, S.; Vazquez, B.; Vorobiev, D.

    2014-01-01

    The Imagine RIT Innovation and Creativity Festival is an annual free event held each year on the campus of the Rochester Institute of Technology (RIT). The purpose of the festival is to showcase the work and research conducted by students and faculty at RIT, and get the public excited about science and technology. For the past three years, graduate students, post-docs and faculty in the Astrophysical Sciences and Technology graduate program at RIT have participated in the festival by showcasing their astronomy research in a fun, interactive and hands on way. We have presented work conducted with various telescopes in the fields of star formation and galaxy evolution. Here, we present our three unique exhibits and the public’s reception to each exhibit. We found that interactive games such as astro-trivia, and hands on activities such as building a scale model of the Hubble Space Telescope were the most exciting for visitors. Interactive pieces of the exhibit in general acquired the most attention, whereas posters and videos, despite their pictorial nature, were not as well received. The most successful piece of our exhibit each year has been solar observing through eclipse glasses and telescopes. Most people who observed the sun at our exhibit were left awe-struck because this was their first experience viewing an astronomical object through a telescope. We plan to improve upon our exhibit by introducing more hands-on activities that will engage the public in current astronomy research at RIT.

  13. A new indicator of fireworks emissions in Rochester, New York.

    PubMed

    Wang, Yungang; Hopke, Philip K; Rattigan, Oliver V

    2012-12-01

    In ambient particle source apportionment studies, data for holidays such as July 4 (US Independence Day) are normally removed because of the high concentrations of chemical species and unusually high particle mass concentrations that are due to fireworks. Many cultures celebrate events with fireworks. A near real-time measurement that could indicate fireworks would be useful in indicating their impact on air quality. Commonly monitored ambient pollutants include PM(2.5), CO, SO(2), O(3), 10-500-nm particle number, and black carbon (BC). Using a two-wavelength aethalometer, another parameter, delta-C (UVBC(370 nm)-BC(880 nm), aethalometer), can be calculated. These variables were continuously monitored during July 1-7, 2005-2010, in Rochester, New York. High delta-C values are normally associated with biomass combustion particles. However, statistically higher delta-C values were observed on Independence Day compared to the other period. Back trajectory analysis showed transport of local fireworks smoke to the sampling site on the night of July 4. An enhanced correlation between delta-C and BC during the fireworks episodes suggests changes from the usual BC sources. Fireworks emissions changed the ambient carbonaceous particulate species during these intervals. The delta-C value was found to be a readily measured indicator of fireworks emissions during periods when wood combustion was not likely to be present and provides a tool for monitoring such emissions where they might be more common such as amusement parks.

  14. Overview perspective of west elevation, looking east. MonacaRochester Bridge in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Overview perspective of west elevation, looking east. Monaca-Rochester Bridge in background. - Pittsburgh & Lake Erie Railroad, Ohio River Bridge, Spanning Ohio River, West of Beaver River, Beaver, Beaver County, PA

  15. Ten-Year Study of the Stringently Defined Otitis-prone Child in Rochester, NY.

    PubMed

    Pichichero, Michael E

    2016-09-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14.8% and 2.4% receiving tympanostomy tubes, respectively. Significantly more often respiratory syncytial virus infection led to AOM in sOP than non-otitis-prone children that correlated with diminished total respiratory syncytial virus-specific serum IgG. sOP children produced low levels of antibody to Streptococcus pneumoniae and Haemophilus influenzae candidate vaccine protein antigens and to routine pediatric vaccines. sOP children generated significantly fewer memory B cells, functional and memory T cells to otopathogens following nasopharyngeal colonization and AOM than non-otitis-prone children and they had defects in antigen-presenting cells.

  16. El Cinco de Mayo. The Fifth of May.

    ERIC Educational Resources Information Center

    Lizcano, Jeannette; Garza, Laura Leticia

    "El Cinco de Mayo", a commemoration of when Mexican troops defeated French invaders, is the topic of this unit developed for the Bilingual/Multicultural Education Program of the Crystal City Independent School District (Crystal City, Texas). As unit objectives, the students are to demonstrate their comprehension of the significance of…

  17. El Cinco de Mayo. The Fifth of May.

    ERIC Educational Resources Information Center

    Lizcano, Jeannette; Garza, Laura Leticia

    "El Cinco de Mayo", a commemoration of when Mexican troops defeated French invaders, is the topic of this unit developed for the Bilingual/Multicultural Education Program of the Crystal City Independent School District (Crystal City, Texas). As unit objectives, the students are to demonstrate their comprehension of the significance of…

  18. "Quadruple whammy"- a preventable newly described syndrome of post-operative AKI in CKD II and CKD III patients on combination "Triple whammy" medications: a Mayo Clinic Health System, Eau Claire, Wisconsin experience.

    PubMed

    Onuigbo, M A; Agbasi, N

    2014-01-01

    The potential combination of diuretics- angiotensin-converting enzyme inhibitors- Non-steroidal anti-inflammatory drugs (diuretics-ACEIs-NSAIDs), the so-called 'triple whammy', to produce clinically significant nephrotoxicity in chronic kidney disease (CKD) is often unrecognized. In 2013, in the British Medical Journal, we described accelerated post-operative acute kidney injury (AKI) in CKD patients concurrently on 'triple whammy' medications, a new syndrome that we aptly named 'quadruple whammy'. Two case reports. I. A 59-year-old Caucasian male, hypertensive CKD III, serum creatinine (SCr) 1.42 mg/dL, developed accelerated oliguric AKI after elective right nephrectomy. Outpatient medications included Lisinopril-Hydrochlorothiazide and Nabumetone (NSAID). SCr rapidly more than doubled with metabolic acidosis and hyperkalemia within 24 hours, peaking at 4.02 mg/dL. 'Triple whammy' medications were promptly stopped and the hypotension was corrected. SCr was 1.64 mg/dL and stable, after three months. II. A 46-year-old Caucasian male, hypertensive CKD II, SCr 1.21 mg/dL, developed accelerated AKI after elective right hip arthroplasty. Outpatient medications included Lisinopril and Hydrochlorothiazide. Celecoxib (200 mg) was given pre-operatively. Within 36 hours, SCr rapidly more than doubled to 2.58 mg/dL, with metabolic acidosis. 'Triple whammy' medications were promptly stopped and the hypotension was corrected. SCr was 0.99 mg/dL, and stable, after one month. We have described two cases of preventable accelerated AKI following post-operative hypotension in CKD patients concurrently on 'triple whammy' medications. We dubbed this new syndrome "Quadruple Whammy". It is not uncommon. 'Renoprevention', the pre-emptive withholding of (potentially nephrotoxic) medications, including 'triple whammy' medications, pre-operatively, in CKD patients, together with the simultaneous avoidance of peri-operative hypotension would help reduce, if not eliminate such AKI - a call

  19. HLA Genes in Mayos Population from Northeast Mexico

    PubMed Central

    Arnaiz-Villena, A; Moscoso, J; Granados, J; Serrano-Vela, J.I; de la Peña, A.; Reguera, R; Ferri, A; Seclen, E; Izaguirre, R; Perez-Hernandez, N; Vargas-Alarcon, G

    2007-01-01

    HLA class I and class II alleles have been studied in 60 unrelated people belonging to Mayos ethnic group, which lives in the Mexican Pacific Sinaloa State. Mayos HLA profile was compared to other Amerindians and worldwide populations’ profile. A total of 14,896 chromosomes were used for comparisons. Genetic distances between populations, Neigbour-Joining dendrograms and correspondence analyses were performed to determine the genetic relationship among population. The new specific Mayo HLA haplotypes found are: HLA-A*02-B*35-DRB1*1406-DQB1*0301; HLA-A*02-B*48-DRB1*0404-DQB1*0302; HLA-A*24-B*51-DRB1*0407-DQB1*0302 and HLA-A*02-B*08-DRB1*0407-DQB1*0302. However, the typical Meso American HLADRB1*0407 represents a 40% of all DRB1 alleles. While common HLA characteristics are found in Amerindian distant ethnic groups, still new group specific HLA haplotypes are being found, suggesting that a common founder effect (i.e. high DRB1*0407) is noticed. Moreover, new HLA haplotypes are almost certainly appearing along time probably due to specific pathogen (?) selection for diversity. Mayo language is close to the Tarahumara one (another geographically close group); notwithstanding both groups are not genetically close according to our results, showing again the different evolution of genes and languages, which do not correlate. Finally, Sinaloa is one of the Mexican States in which more European genes are found. However, the results presented in this paper, where no European HLA genes are seen in Mayos, should have a bearing in establishing transplant programs and in HLA and disease studies. PMID:19412332

  20. A resolution commemorating the 150th anniversary of Mayo Clinic.

    THOMAS, 113th Congress

    Sen. Franken, Al [D-MN

    2014-01-27

    02/10/2014 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

  1. Patch testing with natural rubber latex: the Mayo Clinic experience.

    PubMed

    Bendewald, Margo J; Farmer, Sara A; Davis, Mark D P

    2010-01-01

    delayed hypersensitivity reactions to natural rubber latex (NRL) have been recognized. These reactions may contribute to allergic contact dermatitis. We therefore have undertaken patch testing of patients with NRL if they are suspected to have allergic contact dermatitis to rubber. to review results of patch testing with NRL (January 1, 2000, through December 31, 2007). patients suspected of having allergic contact dermatitis from rubber who underwent patch testing with NRL were identified retrospectively. For safety reasons, patients with immediate hypersensitivity to NRL were excluded from patch testing. of 148 patients patch-tested with NRL, 3 (2.0%) had an allergic patch-test reaction. NRL is as common a cause of allergic contact dermatitis as many of the other allergens included in a specialized rubber allergen series. Patients suspected to be allergic to rubber should be patch-tested with NRL (provided they do not have type 1 hypersensitivity to NRL).

  2. A resolution commemorating the 150th anniversary of Mayo Clinic.

    THOMAS, 113th Congress

    Sen. Franken, Al [D-MN

    2014-01-27

    Senate - 02/10/2014 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

  3. An Academic Healthcare Twitter Account: The Mayo Clinic Experience.

    PubMed

    Widmer, R Jay; Engler, Nicole B; Geske, Jeffrey B; Klarich, Kyle W; Timimi, Farris K

    2016-06-01

    With more than 300 million monthly active users, Twitter is a powerful social media tool in healthcare, yet the characterization of an academic healthcare Twitter account remains poor to date. We assessed basic gender and geographic data on the account's "followers," as well as categorization of each tweet based on content type. We analyzed the impressions, engagements, retweets, favorites, replies, hashtag clicks, and detail expansions using both Sprinklr and Twitter Analytics. Over a period of 12 months, the account amassed 1,235 followers, with 54 percent being male and 68 percent residing in the United States. Of the 1,635 tweets sent out over the life of the account, we report more than 382,464 impressions, 6,023 engagements, 1,255 retweets, 776 favorites, and 1,654 embedded media clicks in this period. When broken down by tweet category, publication tweets garnered the highest engagement with an estimated mean number of clicks per tweet of 8.2 ± 81.9. Original content had higher total engagement per tweet than retweeted material (2.8 ± 9.2 vs. 0.2 ± 0.9 engagements per tweet; p < 0.0001). Tweets regarding internal, national, and continuing medical education events had similar engagement. Herein is the first publication within the medical literature describing a "case series" of cardiovascular tweets over 12 months. We highlight a rapidly emerging group of interactive followers, a successful means by which to disseminate and engage in breaking topics throughout the cardiovascular field, and the importance of combining physician-led knowledge with intermittent marketing messages.

  4. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    SciTech Connect

    Bhatia, Sumita; Miller, Robert C. . E-mail: miller.robert@mayo.edu; Haddock, Michael G.; Donohue, John H.; Krishnan, Sunil

    2006-10-01

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed.

  5. Adjuvant Therapy for Gallbladder Carcinoma: The Mayo Clinic Experience

    SciTech Connect

    Gold, Douglas G.; Miller, Robert C. Haddock, Michael G.; Gunderson, Leonard L.; Quevedo, Fernando; Donohue, John H.; Bhatia, Sumita; Nagorney, David M.

    2009-09-01

    Purpose: To analyze the effect of adjuvant chemoradiotherapy on gallbladder carcinoma. Methods and Materials: We retrospectively reviewed the records from consecutive patients who underwent R0 resection of gallbladder carcinoma between January 1, 1985, and December 31, 2004. Patients had either Stage I (T1-T2N0M0) or Stage II (T3N0M0 or T1-T3N1M0) disease. Patients undergoing adjuvant therapy received 5-fluorouracil chemotherapy concurrently with radiotherapy (median dosage, 50.4 Gy in 28 fractions). Adverse prognostic factors and the effect of adjuvant treatment on overall survival (OS) were evaluated. Results: A total of 73 patients were included in the analysis; of these, 25 received adjuvant chemoradiotherapy. On univariate analysis, no adverse prognostic factors for OS reached statistical significance, but trends were noted for Stage N1 vs. N0 (p = .06), Nx vs. N0 (p = .09), Stage T3 vs. T1-T2 (p = .06), and histologic findings other than adenocarcinoma (p = .13). The median OS for patients receiving adjuvant chemoradiotherapy vs. surgery alone was 4.8 years and 4.2 years, respectively (log-rank test, p = .56). However, a significantly greater percentage of patients receiving adjuvant chemoradiotherapy had Stage II disease (p <.001). In the multivariate Cox model, increasing T and N category and histologic findings other than adenocarcinoma were significant predictors of decreased OS. Additionally, adjuvant chemoradiotherapy was a significant predictor of improved OS after adjusting for these prognostic factors (hazard ratio for death, 0.3; 95% confidence interval, 0.13-0.69; p = .004). Conclusion: After adjusting for the stage parameters and histologic findings, our data suggest that adjuvant chemoradiotherapy might improve OS for patients with gallbladder cancer.

  6. Australian influences on Elton Mayo: the construct of Revery in industrial society.

    PubMed

    Griffin, Mark A; Landy, Frank J; Mayocchi, Lisa

    2002-11-01

    Elton Mayo was born in Australia and spent most of his first 42 years living in that country. This article explores the Australian context in which he developed his views views of Australia compared with that of the United States during the time that Mayo developed his approach to psychology and the role of workers in industry. In addition, the social context in which Mayo established his career was shaped by significant political events in Australia. The construct of revery, which describes a specific state of consciousness, is central to Mayo's early theorizing and was developed by Mayo partly in reaction to political and industrial conflict occurring in Australia.

  7. A mentoring program for underrepresented-minority students at the University of Rochester School of Medicine.

    PubMed

    Abernethy, A D

    1999-04-01

    Mentoring underrepresented-minority (URM) students poses a special challenge because most medical schools have few URM faculty and many non-URM faculty hesitate to be mentors for URM students. Some medical students perform less well in the clinical years than would be expected from their pre-clinical performances. One factor is some students' difficulty in adapting to the culture of medicine, which mentors can help students overcome. The University of Rochester School of Medicine created the Medical Student Mentoring Program to address the needs of URM students and non-URM faculty who could be mentors. The program, offered in 1995-96 and 1996-97, trained mentors, created a bicultural support group for URM students, and provided structured mentoring. Interviews were conducted with faculty and students to identify critical areas that influence the success of URM students in their clinical years; URM faculty, residents, and advanced students shared their experiences with the program students at reflection group meetings. Mentors participated in an initial orientation. Of the 42 students eligible during 1995-1997, 30 participated and were assigned to 15 mentors. At the end of the program's first year, the students and mentors gave their reactions, and although there were some differences in their viewpoints, overall they considered the program useful. Non-URM faculty appreciated the support and guidance that allowed them to mentor URM students more effectively. The program ran formally for two years, and some of the mentoring relationships continued into the third year. Loss of funding and change in administrative leadership contributed to the ending of this program. Mentoring continues to be a priority at the medical center, and a new mentoring program has been developed for URM and non-URM medical students.

  8. Remembering Joseph Mayo and His Contributions to Animal Science | Poster

    Cancer.gov

    By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.

  9. Remembering Joseph Mayo and His Contributions to Animal Science | Poster

    Cancer.gov

    By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.

  10. Comparison of tension band wiring and precontoured locking compression plate fixation in Mayo type IIA olecranon fractures.

    PubMed

    Schliemann, Benedikt; Raschke, Michael J; Groene, Philipp; Weimann, André; Wähnert, Dirk; Lenschow, Simon; Kösters, Clemens

    2014-03-01

    Aim of the present study was to compare the clinical and radiographic outcome of tension band wiring and precontoured locking compression plate fixation in patients treated surgically for an isolated olecranon fractures type IIA according to the Mayo classification. Of 26 patients presenting with an isolated Mayo type IIA olecranon fracture, 13 underwent fixation with a precontoured locking compression plate (group A), 13 patients were treated with tension band wiring (group B). At a mean follow-up of 43 months, patients were clinically and radiographically re-examined using the DASH score, the Mayo Elbow Performance score (MEPS) and anteroposterior and lateral radiographs. The mean DASH score was 14 points in group A and 12.5 points in group B. Regarding the MEPS, 92% of the patients in group A achieved a good to excellent results in comparison to 77% in group B. No significant differences between the two groups could be detected regarding the clinical and radiographic outcome. Implant-related irritations requiring hardware removal occurred more frequently in group B (12 vs. 7). Procedure and implant related costs were significantly higher in group A. Tension band wiring is still a preferable surgical method to treat simple isolated olecranon fractures. The patient must be informed that in all likelihood implant removal will be required once the fracture has healed. Fixation with precontoured locking compression plates does not provide better functional and radiographic outcome but is more expensive than tension band wiring.

  11. 76 FR 25300 - Foreign-Trade Zone 141-Rochester, NY; Application for Manufacturing Authority, Firth Rixson, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 141--Rochester, NY; Application for Manufacturing Authority, Firth Rixson, Inc. d/b/a Firth Rixson Monroe (Aircraft Turbine Components), Rochester, NY A request has been submitted to the Foreign-Trade Zones...

  12. Conceptual design report for the University of Rochester cryogenic target delivery system

    SciTech Connect

    Fagaly, R.L.; Alexander, N.B.; Bourque, R.F.; Dahms, C.F.; Lindgren, J.R.; Miller, W.J.; Bittner, D.N.; Hendricks, C.D.

    1993-05-01

    The upgrade of the Omega laser at the University of Rochester`s Laboratory for Laser Energetics (UR/LLE) will result in a need for large targets filled with D{sub 2} or Dt and maintained at cryogenic temperatures. This mandates a cryogenic target delivery system capable of filling, layering, characterizing and delivering cryogenic targets to the Omega Upgrade target chamber. The program goal is to design, construct, and test the entire target delivery system by June 1996. When completed (including an operational demonstration), the system will be shipped to Rochester for reassembly and commissioning in time for the Omega Upgrade cryogenic campaign, scheduled to start in 1998. General Atomics has been assigned the task of developing the conceptual design for the cryogenic target delivery system. Design and fabrication activities will be closely coordinated with the University of Rochester, Lawrence Livermore National laboratory (LLNL) and Los Alamos National Laboratory (LANL), drawing upon their knowledge base in fuel layering and cryogenic characterization. The development of a target delivery system for Omega could also benefit experiments at Lawrence Livermore National Laboratory and the other ICF Laboratories in that the same technologies could be applied to NOVA, the National Ignition Facility or the future Laboratory Microfusion Facility.

  13. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor to...

  14. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor to...

  15. Optimization Evaluation, General Motors Former AC Rochester Facility, Sioux City, Iowa

    EPA Pesticide Factsheets

    The General Motors (GM) Former AC Rochester Facility (site) is located within the valley of the Missouri River in Sioux City, Iowa and is bounded by a steep loess bluff to the north, commercial properties to the east, and undeveloped properties to the...

  16. Process and Results of an Immunization Requirement at the University of Rochester.

    ERIC Educational Resources Information Center

    Hopkins, Ruth A.; And Others

    1984-01-01

    The University of Rochester (New York) has implemented a process to ensure that all students receive necessary immunizations. The immunization requirement is combined with a required health history form and has helped the college facilitate significant increases in immunity to rubella, measles, mumps, and tetanus. A description of the program is…

  17. SOURCE CHARACTERIZATION AND CONTROL TECHNOLOGY ASSESSMENT OF METHYLENE CHLORIDE EMISSIONS FROM EASTMAN KODAK COMPANY, ROCHESTER, NY

    EPA Science Inventory

    The report gives results of an assessment of potential control technologies for methylene chloride (also known as dichloromethane or DCM) emission sources at Eastman Kodak Company's Kodak Park facility in Rochester, NY. DCM is a solvent used by Kodak in the manufacture of cellulo...

  18. Process and Results of an Immunization Requirement at the University of Rochester.

    ERIC Educational Resources Information Center

    Hopkins, Ruth A.; And Others

    1984-01-01

    The University of Rochester (New York) has implemented a process to ensure that all students receive necessary immunizations. The immunization requirement is combined with a required health history form and has helped the college facilitate significant increases in immunity to rubella, measles, mumps, and tetanus. A description of the program is…

  19. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  20. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  1. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  2. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Buffalo and Rochester Harbors, New York. 162.165 Section 162.165 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165...

  3. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Buffalo and Rochester Harbors, New York. 162.165 Section 162.165 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165...

  4. Writing Assessment in the Department of Mathematics at Rochester Institute of Technology.

    ERIC Educational Resources Information Center

    Birken, Marcia

    The goal of writing assessment in the Department of Mathematics at Rochester Institute of Technology (RIT) is to assure that students can communicate about mathematics or statistics in a manner appropriate to their future careers. A five-member writing committee, composed of mathematics faculty, assess students at three different times during…

  5. Increased risk of head tremor in women with essential tremor: longitudinal data from the Rochester Epidemiology Project.

    PubMed

    Hardesty, David E; Maraganore, Demetrius M; Matsumoto, Joseph Y; Louis, Elan D

    2004-05-01

    In one cross-sectional study of a community in northern Manhattan, women with essential tremor (ET) were more likely to have head tremor than were men. In that study, patients were seen at one point in time, rather than followed longitudinally. Head tremor often develops after arm tremor, and its appearance in patients with ET may therefore be a function of duration of follow-up. In a second epidemiological study utilizing the Rochester Epidemiology Project, in which ET subjects were followed from disease diagnosis to death, we determined whether there was an association between female gender and head tremor. We utilized the records-linkage system of the Rochester Epidemiology Project to identify ET cases. Records were reviewed and clinical data abstracted by a neurologist specializing in movement disorders. A second neurologist reviewed a subsample of records. There were 107 ET cases (69 women, 38 men) followed for 10.1 +/- 9.1 years from ET diagnosis to death. Head tremor was present in 37 (53.6%) women and 5 (13.2%) men (odds ratio [OR] = 7.6, 95% confidence interval [CI] = 2.7-21.9, P < 0.001). In a multivariate linear regression analysis, women remained at high risk for head tremor (OR = 6.5, 95% CI = 2.2-19.0, P = 0.001) independent of disease duration. We found in this longitudinal epidemiological study that women with ET were six times more likely to develop head tremor over the course of their illness than were men. The reason for the association between gender and head tremor, which has now been demonstrated in several studies, is not known, but it could reflect gender differences in the distribution of disease pathology within the brain.

  6. Comparison of sources of submicron particle number concentrations measured at two sites in Rochester, NY.

    PubMed

    Kasumba, John; Hopke, Philip K; Chalupa, David C; Utell, Mark J

    2009-09-01

    Sources contributing to the submicron particles (100-470 nm) measured between January 2002 and December 2007 at two different New York State Department of Environmental Conservation (NYS DEC) sites in Rochester, NY were identified and apportioned using a bilinear receptor model, positive matrix factorization (PMF). Measurements of aerosol size distributions and number concentrations for particles in the size range of 10-500 nm have been made since December 2001 to date in Rochester. The measurements are being made using a scanning mobility particle sizer (SMPS) consisting of a DMA and a CPC (TSI models 3071 and 3010, respectively). From December 2001 to March 2004, particle measurements were made at the NYS DEC site in downtown Rochester, but it was moved to the eastside of Rochester in May 2004. Each measurement period was divided into three seasons i.e., winter (December, January, and February), summer (June, July, and August), and the transitional periods (March, April, May, September, October, and November) so as to avoid experimental uncertainty resulting from too large season-to-season variability in ambient temperature and solar photon intensity that would lead to unstable/non-stationary size distributions. Therefore, the seasons were analyzed independently for possible sources. Ten sources were identified at both sites and these include traffic, nucleation, residential/commercial heating, industrial emissions, secondary nitrate, ozone- rich secondary aerosol, secondary sulfate, regionally transported aerosol, and a mixed source of nucleation and traffic. These results show that the measured total outdoor particle number concentrations in Rochester generally vary with similar temporal patterns, suggesting that the central monitoring site data can be used to estimate outdoor exposure in other parts of the city.

  7. Mayo Genome Consortia: A Genotype-Phenotype Resource for Genome-Wide Association Studies With an Application to the Analysis of Circulating Bilirubin Levels

    PubMed Central

    Bielinski, Suzette J.; Chai, High Seng; Pathak, Jyotishman; Talwalkar, Jayant A.; Limburg, Paul J.; Gullerud, Rachel E.; Sicotte, Hugues; Klee, Eric W.; Ross, Jason L.; Kocher, Jean-Pierre A.; Kullo, Iftikhar J.; Heit, John A.; Petersen, Gloria M.; de Andrade, Mariza; Chute, Christopher G.

    2011-01-01

    OBJECTIVE: To create a cohort for cost-effective genetic research, the Mayo Genome Consortia (MayoGC) has been assembled with participants from research studies across Mayo Clinic with high-throughput genetic data and electronic medical record (EMR) data for phenotype extraction. PARTICIPANTS AND METHODS: Eligible participants include those who gave general research consent in the contributing studies to share high-throughput genotyping data with other investigators. Herein, we describe the design of the MayoGC, including the current participating cohorts, expansion efforts, data processing, and study management and organization. A genome-wide association study to identify genetic variants associated with total bilirubin levels was conducted to test the genetic research capability of the MayoGC. RESULTS: Genome-wide significant results were observed on 2q37 (top single nucleotide polymorphism, rs4148325; P=5.0 × 10–62) and 12p12 (top single nucleotide polymorphism, rs4363657; P=5.1 × 10–8) corresponding to a gene cluster of uridine 5′-diphospho-glucuronosyltransferases (the UGT1A cluster) and solute carrier organic anion transporter family, member 1B1 (SLCO1B1), respectively. CONCLUSION: Genome-wide association studies have identified genetic variants associated with numerous phenotypes but have been historically limited by inadequate sample size due to costly genotyping and phenotyping. Large consortia with harmonized genotype data have been assembled to attain sufficient statistical power, but phenotyping remains a rate-limiting factor in gene discovery research efforts. The EMR consists of an abundance of phenotype data that can be extracted in a relatively quick and systematic manner. The MayoGC provides a model of a unique collaborative effort in the environment of a common EMR for the investigation of genetic determinants of diseases. PMID:21646302

  8. 1991 Summer research program for high school juniors at the University of Rochester`s Laboratory for Laser Energetics. Student research reports

    SciTech Connect

    Not Available

    1991-09-01

    Ten students participated in the 1991 summer high school student research program at the University of Rochester`s Laboratory for Laser Energetics (LLE). The participants spent 8 weeks working and learning at LLE. They spent most of their time working on individual research projects. Each student was assigned a project, upon which he/she worked under the direct supervision of one of the staff members of the laboratory. The students, their high schools, and their projects are listed in Table 1. The program culminated in oral and written reports describing their work. The oral reports were presented at a symposium on 23 August 1991, at which the student`s parents and teachers and members of the LLE staff were present. The written reports are collected in this volume. The titles of the works are UV alignment table; neutron yields can be measured by using the relative gain of a photomultiplier tube; scattering in isotropic and anisotropic media; a better approximation of the diffusion equation; use of the SLAC code to produce a photoemissive electrostatic electron gun; spatial resolution deteriorates with increasing film exposure; analysis of refractive image distortion; making of pinholes for x-ray pinhole cameras; does perturbation theory accurately describe multiphoton ionization? and wave front analysis using shearing interferometry.

  9. [Cytomegalovirus in ulcerative colitis in "Hospital Nacional 2 de Mayo"].

    PubMed

    Arévalo Suarez, F; Cerrillo Sánchez, G; Sandoval Campos, J

    2007-01-01

    The association between cytomegalovirus and ulcerative colitis has been reported by many authors, but the exact pathogenesis of this relationship remains unclear. We reviewed all ulcerative colitis cases whose diagnosis were made in Hospital dos de Mayo, during period 2000-2005, these cases were evaluated for Cytomegalovirus using inmunohistochemistry, also we described histological features of our cases. CMV was identified in 22.2% of all cases, none of them had been treated with inmunosuppressants previously, histological activity was reported in all positive cases and 42.8% negative cases for CMV; Crypt architectural abnormality was the most often histological finding, and the frequency of ulcerative colitis was 1.5 per year. Our findings are similar to those reported by foreign authors and is consistent with theory which maintains inflammatory changes of UC would help CMV's activation without using inmunosuppressants.

  10. Conceptual design report for the University of Rochester cryogenic target delivery system

    SciTech Connect

    Fagaly, R.L.; Alexander, N.B.; Bourque, R.F.; Dahms, C.F.; Lindgren, J.R.; Miller, W.J. ); Bittner, D.N.; Hendricks, C.D. )

    1993-05-01

    The upgrade of the Omega laser at the University of Rochester's Laboratory for Laser Energetics (UR/LLE) will result in a need for large targets filled with D[sub 2] or Dt and maintained at cryogenic temperatures. This mandates a cryogenic target delivery system capable of filling, layering, characterizing and delivering cryogenic targets to the Omega Upgrade target chamber. The program goal is to design, construct, and test the entire target delivery system by June 1996. When completed (including an operational demonstration), the system will be shipped to Rochester for reassembly and commissioning in time for the Omega Upgrade cryogenic campaign, scheduled to start in 1998. General Atomics has been assigned the task of developing the conceptual design for the cryogenic target delivery system. Design and fabrication activities will be closely coordinated with the University of Rochester, Lawrence Livermore National laboratory (LLNL) and Los Alamos National Laboratory (LANL), drawing upon their knowledge base in fuel layering and cryogenic characterization. The development of a target delivery system for Omega could also benefit experiments at Lawrence Livermore National Laboratory and the other ICF Laboratories in that the same technologies could be applied to NOVA, the National Ignition Facility or the future Laboratory Microfusion Facility.

  11. Randomized Trials of the Teen Outreach Program in Louisiana and Rochester, New York

    PubMed Central

    Seibold-Simpson, Susan M.; Crean, Hugh F.; Spruille-White, Briana

    2016-01-01

    Objectives. To evaluate the Teen Outreach Program, a pregnancy prevention program, in 2 community-based settings. Methods. We evaluated the Teen Outreach Program, a 9-month positive youth development program, in 3 cohorts of youths from 2012 to 2015 in 2 states. In Louisiana, 7 agencies participated in an individualized randomized controlled trial, with youths randomly assigned to a treatment or control condition. Fourteen agencies in Rochester, New York, participated in a cluster randomized controlled trial. Results. We found no differences between the intervention and control youths on delay of sexual onset in Louisiana (adjusted odds ratio [AOR] = 0.80; 95% confidence interval [CI] = 0.62, 1.03) or in Rochester, New York (AOR = 0.89; 95% CI = 0.45, 1.77), or for sex with no effective means of birth control (Louisiana, AOR = 1.18; 95% CI = 0.78, 1.78; Rochester, AOR = 0.41; 95% CI = 0.13, 1.27) after controlling for relevant covariates. Conclusions. We found no short-term effects for the offer of the intervention. Research might be needed for the long-term and intermediate impacts of youth development programs on these and other adolescent risk behaviors. PMID:27689491

  12. Randomized Trials of the Teen Outreach Program in Louisiana and Rochester, New York.

    PubMed

    Robinson, William T; Seibold-Simpson, Susan M; Crean, Hugh F; Spruille-White, Briana

    2016-09-01

    To evaluate the Teen Outreach Program, a pregnancy prevention program, in 2 community-based settings. We evaluated the Teen Outreach Program, a 9-month positive youth development program, in 3 cohorts of youths from 2012 to 2015 in 2 states. In Louisiana, 7 agencies participated in an individualized randomized controlled trial, with youths randomly assigned to a treatment or control condition. Fourteen agencies in Rochester, New York, participated in a cluster randomized controlled trial. We found no differences between the intervention and control youths on delay of sexual onset in Louisiana (adjusted odds ratio [AOR] = 0.80; 95% confidence interval [CI] = 0.62, 1.03) or in Rochester, New York (AOR = 0.89; 95% CI = 0.45, 1.77), or for sex with no effective means of birth control (Louisiana, AOR = 1.18; 95% CI = 0.78, 1.78; Rochester, AOR = 0.41; 95% CI = 0.13, 1.27) after controlling for relevant covariates. We found no short-term effects for the offer of the intervention. Research might be needed for the long-term and intermediate impacts of youth development programs on these and other adolescent risk behaviors.

  13. Validation of the Mayo Sleep Questionnaire to Screen for REM Sleep Behavior Disorder in a Community-Based Sample

    PubMed Central

    Boeve, Bradley F.; Molano, Jennifer R.; Ferman, Tanis J.; Lin, Siong-Chi; Bieniek, Kevin; Tippmann-Peikert, Maja; Boot, Brendon; St. Louis, Erik K.; Knopman, David S.; Petersen, Ronald C.; Silber, Michael H.

    2013-01-01

    Objective: To validate a questionnaire focused on REM sleep behavior disorder (RBD) in a community-based sample. Background: RBD is a parasomnia manifested by recurrent dream enactment behavior during REM sleep. While confirmation of RBD requires the presence of REM sleep without atonia on polysomnography (PSG), a screening measure for RBD validated in older adults would be desirable for clinical and research purposes. Methods: We had previously developed the Mayo Sleep Questionnaire (MSQ) to screen for the presence of RBD and other sleep disorders. We assessed the validity of the MSQ by comparing the responses of subjects' bed partners with the findings on PSG. All subjects recruited from 10/04 to 12/08 in the Mayo Clinic Study of Aging—a population-based study of aging in Olmsted County, Minnesota—who had also undergone a previous PSG were the focus of this analysis. Results: The study sample included 128 subjects (104 male; median age 77 years [range 67-90]), with the following clinical diagnoses at baseline assessment: normal (n = 95), mild cognitive impairment (n = 30), and mild Alzheimer disease (n = 3). Nine (5%) subjects had RBD based on history and PSG evidence of REM sleep without atonia. The core question on recurrent dream enactment behavior yielded sensitivity (SN) of 100% and specificity (SP) of 95% for the diagnosis of RBD. The profile of responses on four additional subquestions on RBD improved specificity. Conclusions: These data suggest that the MSQ has adequate SN and SP for the diagnosis of RBD among elderly subjects in a community-based sample. Citation: Boeve BF; Molano JR; Ferman TJ; Lin Siong-Chi; Bieniek K; Tippmann-Peikert M; Boot B; St. Louis EK; Knopman DS; Petersen RC; Silber MH. Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in a community-based sample. J Clin Sleep Med 2013;9(5):475-480. PMID:23674939

  14. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    PubMed

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P < 0.0001), lower time to positivity (P < 0.0001), immunosuppression (P = 0.03), and recommendation made by an infectious disease consultant (P = 0.0005). On multivariable analysis, infectious diseases consultation (P = 0.03), higher number of positive blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs

  15. Assessing clinical significance in measuring oncology patient quality of life: introduction to the symposium, content overview, and definition of terms.

    PubMed

    Sloan, Jeff A; Cella, David; Frost, Marlene; Guyatt, Gordon H; Sprangers, Mirjam; Symonds, Tara

    2002-04-01

    The Clinical Significance Consensus Meeting Group of the Symposium on the Clinical Significance of Quality-of-Life Measures in Cancer Patients produced 6 articles regarding the clinical significance of quality of life (QOL) assessments in oncology. The 6 articles deal with the methods used to date: group-vs-individual clinical significance; single items vs summated scores; patient, clinician, and population perspectives; assessment of changes over time; and communication of results. The articles were produced by a team of 30 QOL research experts assembled in a consensus writing meeting held at the Mayo Clinic, Rochester, Minn, October 6 and 7, 2000. This introduction describes the need for the articles, definitions of key terms, and plans for the future. It is hoped that this series of articles will serve as a resource for individuals conducting cancer QOL research and for clinicians considering incorporation of QOL assessment in the treatment of patients with neoplastic diseases. A secondary goal is to stimulate further discussion and research in the interpretation of QOL assessments.

  16. Impact of Clinical Pharmacist on the Pediatric Intensive Care Practice: An 11-Year Tertiary Center Experience.

    PubMed

    Tripathi, Sandeep; Crabtree, Heidi M; Fryer, Karen R; Graner, Kevin K; Arteaga, Grace M

    2015-01-01

    With increasing complexity of critical care medicine comes an increasing need for multidisciplinary involvement in care. In many institutions, pharmacists are an integral part of this team, but long-term data on the interventions performed by pharmacists and their effects on patient care and outcomes are limited. We aimed to describe the role of pediatric clinical pharmacists in pediatric intensive care unit (PICU) practice. We retrospectively reviewed the records of pharmacy interventions in the PICU at the Mayo Clinic in Rochester, Minnesota, from 2003-2013, with a distinct period of increased pharmacist presence in the PICU from 2008 onward. We compared demographic and outcome data on patients who did and who did not have pharmacy interventions during 2 periods (2003-2007 and 2008-2013). We identified 27,773 total interventions by pharmacists during the 11-year period, of which 79.8% were accepted by the clinical team. These interventions were made on 10,963 unique PICU admissions and prevented 5867 order entry errors. Pharmacists' interventions increased year over year, including a significant change in 2008. Patients who required pharmacy involvement were younger, sicker, and had longer intensive care unit, hospital, and ventilator duration. Average central line infections and central line entry rates decreased significantly over the study period. Increased pharmacist presence in the PICU is associated with increased interventions and prevention of adverse drug events. Pharmacist participation during rounds and order entry substantially improved the care of critically sick children and should be encouraged.

  17. Rochester's lead law: evaluation of a local environmental health policy innovation.

    PubMed

    Korfmacher, Katrina Smith; Ayoob, Maria; Morley, Rebecca

    2012-02-01

    Significant progress has been made in reducing the incidence of childhood lead poisoning in the United States in the past three decades. However, the prevalence of elevated blood lead in children (≥ 10 μg/dL) remains high in some communities, particularly those with high proportions of pre-1978 housing in poor condition. Increasingly, municipalities are using local policy tools to reduce lead poisoning in high-risk areas, but little is known about the effectiveness of such policies. In this article, we evaluated the effectiveness of a comprehensive rental housing-based lead law adopted in Rochester, New York, in 2005. This policy evaluation integrates analyses of city inspections data, a survey of landlords, landlord focus groups, and health department data on children's blood lead levels from the first 4 years of implementation of the 2005 law. Implementation has proceeded consistent with projected numbers of inspections with nearly all target units inspected in the first 4 years. Higher than expected inspection passage rates suggest that landlords have reduced lead hazards in rental housing affected by the law. Implementation of the lead law does not appear to have had a significant impact on the housing market. Although many uncertainties remain, our analysis suggests that the lead law has had a positive impact on children's health. Strong enforcement, support for community-based lead programs, and ongoing intergovernmental coordination will be necessary to maintain lead-safe housing in Rochester. Lessons learned from the Rochester experience may inform future local lead poisoning prevention policies in other communities.

  18. The Rochester Epidemiology Project: exploiting the capabilities for population-based research in rheumatic diseases

    PubMed Central

    Kremers, Hilal Maradit; Myasoedova, Elena; Crowson, Cynthia S.; Savova, Guergana; Gabriel, Sherine E.

    2011-01-01

    The Rochester Epidemiology Project (REP) is a patient record-based database based upon a medical records-linkage system for all residents of the Olmsted County, MN, USA. This comprehensive system includes all health-care providers of patients resident in this geographically defined region. It uniquely enables long-term population-based studies of all medical conditions occurring in this population; their incidence and prevalence; permits examination of disease risk and protective factors, health resource utilization and cost as well as translational studies in rheumatic diseases. PMID:20627969

  19. Runoff of deicing salt: effect on irondequoit bay, Rochester, new york.

    PubMed

    Bubeck, R C; Diment, W H; Deck, B L; Baldwin, A L; Lipton, S D

    1971-06-11

    Salt used for deicing the streets near Rochester, New York, has increased the chloride concentration in Irondequoit Bay at least fivefold during the past two decades. During the winter of 1969-70 the quantity and salinity of the dense runoff that accumulated on the bottom of the bay was sufficient to prevent complete vertical mixing of the bay during the spring. Comparison with 1939 conditions indicates that the period of summer stratification has been prolonged a month by the density gradient imposed by the salt runoff.

  20. Diabetes and Menopause: A Twin Challenge

    MedlinePlus

    ... overview/managing-diabetes/4-steps. Accessed Jan. 11, 2017. Diabetes, heart disease, and stroke. National Institute of Diabetes ... Diseases. ... 11, 2017. Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. ...

  1. “We feel deep compassion for patients...” | NIH MedlinePlus the Magazine

    MedlinePlus

    ... a potentially fatal protein buildup in the skeletal muscles. Once that was made—and it was made solely because of this program—she got a stem-cell transplant at the Mayo Clinic in Rochester, Minn., ...

  2. Bags Under Eyes

    MedlinePlus

    ... 7, 2014. Yanoff M, ed., et al. Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier; 2014. https:// ... Bradley EA (expert opinion). Mayo Clinic, Rochester, Minn., July 22, 2014. Sept. 26, 2014 Original article: http:// ...

  3. Carotid Artery Disease

    MedlinePlus

    ... brain cells begin to die. Stroke is the fourth most common cause of death and the leading ... System. Mayo Clinic, Rochester, Minn. March 28, 2014. July 19, 2014 Original article: http://www.mayoclinic.org/ ...

  4. Over-the-Counter Acne Products: What Works and Why

    MedlinePlus

    ... In: Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. Eichenfield LF, ... opinion). Mayo Clinic, Rochester, Minn. June 29, 2015. July 09, 2015 Original article: http://www.mayoclinic.org/ ...

  5. Busy Minds May Be Better At Fighting Dementia

    MedlinePlus

    ... this, but it's not an unreasonable connection." Dr. Paul Wright is chair of neurology for North Shore ... Mayo Clinic Alzheimer's Disease Research Center, Rochester, Minn.; Paul Wright, M.D., chair of neurology, North Shore ...

  6. Psychometric properties of the Mayo Elbow Performance Score.

    PubMed

    Celik, Derya

    2015-06-01

    To translate and culturally adapt the Mayo Elbow Performance Score (MEPS), a widely used instrument for evaluating disability associated with elbow injuries, into Turkish (MEPS-T) and to determine psychometric properties of the translated version. The MEPS was translated into Turkish using published methodological guidelines. The measurement properties of the MEPS-T (construct validity and floor and ceiling effects) were tested in 91 patients with elbow pathology. The reproducibility of the MEPS-T was tested in 59 patients over 7-14 days. The responsiveness of the MEPS-T was tested in a subgroup of 46 patients diagnosed with lateral epicondylitis and who received conservative treatment for 6 weeks. The interclass correlation coefficient (ICC) was used to estimate the test-retest reliability. The construct validity was analyzed with the disabilities of the arm, shoulder and hand (DASH), Visual Analog Scale (VAS) and the Short Form 36 (SF-36). Effect size (ES) was used to assess the responsiveness. The distribution of floor and ceiling effects was determined. The MEPS-T showed very good test-retest reliability (ICC 0.89). The correlation coefficients between the MEPS-T and DASH and VAS were -0.61 and -0.53, respectively (p < 0.001). The highest correlations were between the MEPS-T and the mental component summary (r = 0.47, p = 0.001) and role emotional (r = 0.45, p = 0.001). The MEPS-T ES, 0.50, was moderate (95% CI 0.33-0.62). We observed no ceiling or floor effects. The MEPS-T represents a valid, reliable and moderately responsive instrument for evaluating patients with elbow disease.

  7. Cytokines and clinical predictors in distinguishing pulmonary transfusion reactions.

    PubMed

    Roubinian, Nareg H; Looney, Mark R; Kor, Daryl J; Lowell, Clifford A; Gajic, Ognjen; Hubmayr, Rolf D; Gropper, Michael A; Koenigsberg, Monique; Wilson, Gregory A; Matthay, Michael A; Toy, Pearl; Murphy, Edward L

    2015-08-01

    Pulmonary transfusion reactions are important complications of blood transfusion, yet differentiating these clinical syndromes is diagnostically challenging. We hypothesized that biologic markers of inflammation could be used in conjunction with clinical predictors to distinguish transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), and possible TRALI. In a nested case-control study performed at the University of California at San Francisco and Mayo Clinic, Rochester, we evaluated clinical data and blood samples drawn before and after transfusion in patients with TRALI (n = 70), possible TRALI (n = 48), TACO (n = 29), and controls (n = 147). Cytokines measured included granulocyte-macrophage-colony-stimulating factor, interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-α. Logistic regression and receiver operating characteristics curve analyses were used to determine the accuracy of clinical predictors and laboratory markers in differentiating TACO, TRALI, and possible TRALI. Before and after transfusion, IL-6 and IL-8 were elevated in patients with TRALI and possible TRALI relative to controls, and IL-10 was elevated in patients with TACO and possible TRALI relative to that of TRALI and controls. For all pulmonary transfusion reactions, the combination of clinical variables and cytokine measurements displayed optimal diagnostic performance, and the model comparing TACO and TRALI correctly classified 92% of cases relative to expert panel diagnoses. Before transfusion, there is evidence of systemic inflammation in patients who develop TRALI and possible TRALI but not TACO. A predictive model incorporating readily available clinical and cytokine data effectively differentiated transfusion-related respiratory complications such as TRALI and TACO. © 2015 AABB.

  8. Modeling source contributions to submicron particle number concentrations measured in Rochester, New York

    SciTech Connect

    Ogulei, D.; Hopke, P.K.; Chalupa, D.C.; Utell, M.J.

    2007-02-15

    An advanced receptor model was used to elicit source information based on ambient submicron (0.01-0.47 {mu}m) particle number concentrations, gaseous species, and meteorological variables measured at the New York State Department of Environmental Conservation central monitoring site in Rochester, NY. Four seasonal data sets (winter, spring, summer, and fall) were independently investigated. A total of ten different sources were identified, including two traffic factors, two nucleation factors, industrial emissions, residential/commercial heating, secondary nitrate, secondary sulfate, ozone-rich secondary aerosol, and regionally transported aerosol. The resolved sources were generally characterized by similar number modes for either winter, spring, summer or fall. The size distributions for nucleation were dominated by the smallest particles ({lt}10-30 nm) that gradually grew to larger sizes as could be seen by observing the volume profiles. In addition, the nucleation factors were closely linked to traffic rush hours suggesting that cooling of tail-pipe emissions may have induced nucleation activity in the vicinity of the highways. Industrial emissions were dominated by emissions from coal-fired power plants that were located to the northwest of the sampling site. These facilities represent the largest point emission sources of SO{sub 2}, and probably ultrafine ({lt}0.1 {mu}m) or submicron particles, in Rochester. Regionally transported material was characterized by accumulation mode particles. Air parcel back-trajectories showed transport of air masses from the industrial midwest.

  9. Boundary networks and Rochester's "smart" lead law: the use of multidisciplinary information in a collaborative policy process.

    PubMed

    Korfmacher, Katrina Smith

    2010-01-01

    The Rochester, New York, Coalition to Prevent Lead Poisoning formed in 2001 with the goal of eliminating childhood lead poisoning by 2010. The Coalition recruited diverse community stakeholders into a collaborative process committed to using the best available science. The Coalition successfully infused the debate about a new lead poisoning law with local data, national analyses, and the latest medical research. We argue that this was facilitated by a boundary network of individuals who provided technical input throughout the process. As a result of the Coalition's advocacy, in 2005 the Rochester City Council unanimously passed an ordinance that has been hailed as one of the nation's "smartest" lead laws. Many communities are looking to Rochester's new lead ordinance as a model. Both the process and outcome of this case provide valuable lessons for collaborative efforts to promote scientifically sound local environmental health policy.

  10. Therapy for Relapsed Multiple Myeloma: Guidelines From the Mayo Stratification for Myeloma and Risk-Adapted Therapy.

    PubMed

    Dingli, David; Ailawadhi, Sikander; Bergsagel, P Leif; Buadi, Francis K; Dispenzieri, Angela; Fonseca, Rafael; Gertz, Morie A; Gonsalves, Wilson I; Hayman, Susan R; Kapoor, Prashant; Kourelis, Taxiarchis; Kumar, Shaji K; Kyle, Robert A; Lacy, Martha Q; Leung, Nelson; Lin, Yi; Lust, John A; Mikhael, Joseph R; Reeder, Craig B; Roy, Vivek; Russell, Stephen J; Sher, Taimur; Stewart, A Keith; Warsame, Rahma; Zeldenrust, Stephen R; Rajkumar, S Vincent; Chanan Khan, Asher A

    2017-04-01

    Life expectancy in patients with multiple myeloma is increasing because of the availability of an increasing number of novel agents with various mechanisms of action against the disease. However, the disease remains incurable in most patients because of the emergence of resistant clones, leading to repeated relapses of the disease. In 2015, 5 novel agents were approved for therapy for relapsed multiple myeloma. This surfeit of novel agents renders management of relapsed multiple myeloma more complex because of the occurrence of multiple relapses, the risk of cumulative and emergent toxicity from previous therapies, as well as evolution of the disease during therapy. A group of physicians at Mayo Clinic with expertise in the care of patients with multiple myeloma regularly evaluates the evolving literature on the biology and therapy for multiple myeloma and issues guidelines on the optimal care of patients with this disease. In this article, the latest recommendations on the diagnostic evaluation of relapsed multiple myeloma and decision trees on how to treat patients at various stages of their relapse (off study) are provided together with the evidence to support them. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. The absence of longitudinal data limits the accuracy of high-throughput clinical phenotyping for identifying type 2 diabetes mellitus subjects.

    PubMed

    Wei, Wei-Qi; Leibson, Cynthia L; Ransom, Jeanine E; Kho, Abel N; Chute, Christopher G

    2013-04-01

    To evaluate the impact of insufficient longitudinal data on the accuracy of a high-throughput clinical phenotyping (HTCP) algorithm for identifying (1) patients with type 2 diabetes mellitus (T2DM) and (2) patients with no diabetes. Retrospective study conducted at Mayo Clinic in Rochester, Minnesota. Eligible subjects were Olmsted County residents with ≥1 Mayo Clinic encounter in each of three time periods: (1) 2007, (2) from 1997 through 2006, and (3) before 1997 (N = 54,283). Diabetes relevant electronic medical record (EMR) data about diagnoses, laboratories, and medications were used. We employed the HTCP algorithm to categorize individuals as T2DM cases and non-diabetes controls. Considering the full 11 years (1997-2007) as the gold standard, we compared gold-standard categorizations with those using data for 10 subsequent intervals, ranging from 1998-2007 (10-year data) to 2007 (1-year data). Positive predictive values (PPVs) and false-negative rates (FNRs) were calculated. McNemar tests were used to determine whether categorizations using shorter time periods differed from the gold standard. Statistical significance was defined as P < 0.05. We identified 2770 T2DM cases and 21,005 controls when the algorithm was applied using 11-year data. Using 2007 data alone, PPVs and FNRs, respectively, were 70% and 25% for case identification and 59% and 67% for control identification. All time frames differed significantly from the gold standard, except for the 10-year period. The accuracy of the algorithm reduced remarkably as data were limited to shorter observation periods. This impact should be considered carefully when designing/executing HTCP algorithms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Atorvastatin does not improve liver biochemistries or Mayo Risk Score in primary biliary cirrhosis.

    PubMed

    Stanca, Carmen M; Bach, Nancy; Allina, Jorge; Bodian, Carol; Bodenheimer, Henry; Odin, Joseph A

    2008-07-01

    Statin treatment reduces hypercholesterolemia and may be anti-inflammatory. Case reports noted decreased alkaline phosphatase and histological improvement following statin treatment in primary biliary cirrhosis. The objective of this study was to assess the long-term effects of statin treatment in primary biliary cirrhosis. A retrospective analysis compared clinical and biochemical data from 15 hypercholesterolemic individuals with primary biliary cirrhosis who were treated long-term with atorvastatin with an age and gender matched, primary biliary cirrhosis control group. A significant decrease in total cholesterol and low-density lipoprotein (LDL)-cholesterol (p < or = 0.002) was observed throughout atorvastatin treatment (median time 2.5 years). LDL-cholesterol levels in the control group were not significantly changed after 2 years (p > 0.050). No significant changes were noted in alanine aminotransferase (ALT), alkaline phosphatase, total bilirubin and Mayo Risk Score in either group (p > 0.05). Long-term atorvastatin treatment reduced LDL-cholesterol in primary biliary cirrhosis, but there was no evidence of any anti-inflammatory effect.

  13. 78 FR 9358 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse 345-kV Transmission Line Proposal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse 345-kV... site at http://www.rurdev.usda.gov/UWP-CapX2020-Hampton-Rochester-LaCrosse.html . SUPPLEMENTARY...

  14. PROJECT HEAD START AND THE CULTURALLY DEPRIVED IN ROCHESTER, NEW YORK, A STUDY OF PARTICIPATING AND NON-PARTICIPATING FAMILIES IN AREAS SERVED BY PROJECT HEAD START IN ROCHESTER, FINAL REPORT.

    ERIC Educational Resources Information Center

    CHANDLER, MARVIN; AND OTHERS

    A COMMUNITY PROFILE OF ROCHESTER, N.Y. CITES HISTORY, PRESENT COMMUNITY CHARACTERISTICS, AND CURRENT IMPROVEMENT PROGRAMS AS THEY RELATE TO CULTURAL DEPRIVATION AND AN ANTI-POVERTY PROGRAM. TO DETERMINE WHAT EFFECTS HISTORICAL, ECONOMIC, POLITICAL, ECOLOGICAL, AND SOCIAL FORCES HAVE UPON HEAD START CHILDREN, MATCHED GROUPS OF EIGHT HEAD START…

  15. Pooling annotated corpora for clinical concept extraction

    PubMed Central

    2013-01-01

    Background The availability of annotated corpora has facilitated the application of machine learning algorithms to concept extraction from clinical notes. However, high expenditure and labor are required for creating the annotations. A potential alternative is to reuse existing corpora from other institutions by pooling with local corpora, for training machine taggers. In this paper we have investigated the latter approach by pooling corpora from 2010 i2b2/VA NLP challenge and Mayo Clinic Rochester, to evaluate taggers for recognition of medical problems. The corpora were annotated for medical problems, but with different guidelines. The taggers were constructed using an existing tagging system MedTagger that consisted of dictionary lookup, part of speech (POS) tagging and machine learning for named entity prediction and concept extraction. We hope that our current work will be a useful case study for facilitating reuse of annotated corpora across institutions. Results We found that pooling was effective when the size of the local corpus was small and after some of the guideline differences were reconciled. The benefits of pooling, however, diminished as more locally annotated documents were included in the training data. We examined the annotation guidelines to identify factors that determine the effect of pooling. Conclusions The effectiveness of pooling corpora, is dependent on several factors, which include compatibility of annotation guidelines, distribution of report types and size of local and foreign corpora. Simple methods to rectify some of the guideline differences can facilitate pooling. Our findings need to be confirmed with further studies on different corpora. To facilitate the pooling and reuse of annotated corpora, we suggest that – i) the NLP community should develop a standard annotation guideline that addresses the potential areas of guideline differences that are partly identified in this paper; ii) corpora should be annotated with a two

  16. Matters of priority: Herbert Mayo, Charles Bell and discoveries in the nervous system.

    PubMed

    Bradley, James

    2014-10-01

    Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell's death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell's case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo's public performances elided with Bell's descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner.

  17. Prevalence of Fibromyalgia: A Population-Based Study in Olmsted County, Minnesota, Utilizing the Rochester Epidemiology Project

    PubMed Central

    Vincent, Ann; Lahr, Brian D; Wolfe, Frederick; Clauw, Daniel J; Whipple, Mary O; Oh, Terry H; Barton, Debra L; St Sauver, Jennifer

    2014-01-01

    Objective Our objective was to estimate and compare the prevalence of fibromyalgia by two different methods, in Olmsted County, Minnesota. Methods The first method was a retrospective review of medical records of potential cases of fibromyalgia in Olmsted County using Rochester Epidemiology Project (from January 1, 2005, to December 31, 2009) to estimate the prevalence of diagnosed fibromyalgia in clinical practice. The second method was a random survey of adults in Olmsted County using the fibromyalgia research survey criteria to estimate the percentage of responders who met fibromyalgia research survey criteria. Results Of the 3,410 potential patients identified by the first method, 1,115 had a fibromyalgia diagnosis documented in the medical record by a health care provider. The age- and sex-adjusted prevalence of diagnosed fibromyalgia by this method was 1.1%. By the second method, of the 2,994 people who received the survey by mail, 830 (27.6%) responded and 44 (5.3%) met fibromyalgia research survey criteria. The age- and sex-adjusted prevalence of fibromyalgia in the general population of Olmsted County by this method was estimated at 6.4%. Conclusion To the best of our knowledge, this is the first report of the rate at which fibromyalgia is being diagnosed in a community. This is also the first report of prevalence as assessed by the fibromyalgia research survey criteria. Our results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia. PMID:23203795

  18. The Rochester OSA Optics Suitcase: 13 years of middle school outreach

    NASA Astrophysics Data System (ADS)

    Canavesi, Cristina; Donlon, Theresa M.; Jacobs, Stephen D.

    2012-10-01

    The Rochester Section of the Optical Society of America (ROSA) developed a youth outreach program in 1999 to be presented in middle schools by scientists, engineers and engineering students. The objective was to kindle interest in technology careers, especially those related to optics, photonics, and optical engineering. Three in-class experiments using individual take-home theme packets that explore color in white light were devised early in the program, and these have proven to be the key to its success. Over the past 13 years, with financial support from a variety of organizations and individuals, ROSA has manufactured and delivered over 450 Optics Suitcases to groups in 34 US states and 54 countries. The presentation guide is now available in 4 languages besides English. In this paper, the elements of an Optics Suitcase presentation are reviewed, and examples of outreach events are used to document its success.

  19. Aeroallergens in dairy barns near Cooperstown, New York and Rochester, Minnesota.

    PubMed

    Campbell, A R; Swanson, M C; Fernandez-Caldas, E; Reed, C E; May, J J; Pratt, D S

    1989-08-01

    We sampled atmospheric barn air using a volumetric air sampler in ten barns near Cooperstown, NY and six barns near Rochester, MN, and, with radioimmunoassays, measured allergens of Aspergillus fumigatus, Thermoactinomyces vulgaris, Micropolyspori faeni, short ragweed, rye grass group I pollen, Alternaria (Alt-1), Dermatophagoides sp. Lepidoglyphus destructor, common insect allergen, mouse urine, rat urine, and cattle epithelium. The most abundant allergen present was A. fumigatus followed by L. destructor. This study provides initial data on barn aerobiology and demonstrates for the first time the abundance of L. destructor allergens in North American dairy barns. More comprehensive study of barns, poultry houses, confinement houses for swine, and other agricultural environments from various geographic locations is needed to define the allergen levels to which millions of farm workers are exposed each day. While most of the allergens were expected, the presence of airborne allergens reactive with antisera to Dermatophagoides suggests indirectly that substantial amounts of pyroglyphid mites are present in some barns.

  20. Bakhtinian grotesque realism and the subversion of biblical authority in Rochester's sodom.

    PubMed

    Frontain, R J

    1997-01-01

    Rather than signalling Rochester's agreement with the presumptive biblical imprecation against sodomy and consequent divine vengeance, the apocalyptic denouement of The Farce of Sodom bespeaks defiance of divine judgement and a willingness to persevere in the pleasure of homosexual anal sex despite what might seem certain divine retribution. A Bakhtinian reading of the play's carnivalesque features concludes that it is the failure of all sexual endeavor, rather than of sodomy per se, that is dramatized in the farce's concluding scene. Sodom anticipates both the modern attitude towards the open male body that has come to dominate contemporary gay discourse, and the transgressive uses to which modern writers have put the Bible by which they undercut its authority and the presumptive morality that it is otherwise used to sanction.

  1. Flood of July 5-7, 1978, on the South Fork Zumbro River at Rochester, Minnesota

    USGS Publications Warehouse

    Latkovich, V.J.

    1979-01-01

    The intense thunderstorm of July 5-6, 1978, caused record flooding on the South Fork Zumbro River at Rochester, Minnesota. The peak discharge on July 6 was 30,500 cubic feet per second compared with 19,600 cubic feet per second for the flood of March 1965, which was the largest previously known. The 1965 flood had a recurrence interval of about 30 years, whereas the 1978 flood had a recurrence interval exceeding 100 years. The flood waters claimed at least 5 lives and 5,000 people were forced to leave their homes. Millions of dollars in flood damage was reported, and this report summarizes some of the flood data and a photomosaic map shows the inundated area.

  2. High-Energy Petawatt Project at the University of Rochester's Laboratory for Laser Energetics

    SciTech Connect

    Stoeckl, C.; Delettrez, J.A.; Kelly, J.H.; Kessler, T.J.; Kruschwitz, B.E.; Loucks, S.J.; McCrory, R.L.; Meyerhofer, D.D.; Maywar, D.N.; Morse, S.F.B.; Myatt, J.; Rigatti, A.L.; Waxer, L.J.; Zuegel, J.D.; Stephens, R.B.

    2006-04-12

    A high-energy petawatt laser, OMEGA EP, is currently under construction at the University of Rochester's Laboratory for Laser Energetics. Integrated into the existing OMEGA laser, it will support three major areas of research: (a) backlighting of high-energy-density plasmas, (b) integrated fast ignition experiments, and (c) high-intensity physics. The laser will provide two beams combined collinearly and coaxially with short pulses (~1 to 100 ps) and high energy (2.6 kJ at 10 ps). Cone-in-shell fuel-assembly experiments and simulations of short-pulse heated cryogenic targets are being performed in preparation for cryogenic integrated fast ignitor experiments on OMEGA EP.

  3. Aeroallergens in dairy barns near Cooperstown, New York and Rochester, Minnesota

    SciTech Connect

    Campbell, A.R.; Swanson, M.C.; Fernandez-Caldas, E.; Reed, C.E.; May, J.J.; Pratt, D.S. )

    1989-08-01

    We sampled atmospheric barn air using a volumetric air sampler in ten barns near Cooperstown, NY and six barns near Rochester, MN, and, with radioimmunoassays, measured allergens of Aspergillus fumigatus, Thermoactinomyces vulgaris, Micropolyspori faeni, short ragweed, rye grass group I pollen, Alternaria (Alt-1), Dermatophagoides sp. Lepidoglyphus destructor, common insect allergen, mouse urine, rat urine, and cattle epithelium. The most abundant allergen present was A. fumigatus followed by L. destructor. This study provides initial data on barn aerobiology and demonstrates for the first time the abundance of L. destructor allergens in North American dairy barns. More comprehensive study of barns, poultry houses, confinement houses for swine, and other agricultural environments from various geographic locations is needed to define the allergen levels to which millions of farm workers are exposed each day. While most of the allergens were expected, the presence of airborne allergens reactive with antisera to Dermatophagoides suggests indirectly that substantial amounts of pyroglyphid mites are present in some barns.

  4. 77 FR 2268 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission... of the Draft EIS may be viewed online at the following Web site: http://www.rurdev.usda.gov/UWP-Cap...

  5. Investigation of Gene Expression Correlating With Centrosome Amplification in Development and Progression of Breast Cancer

    DTIC Science & Technology

    2004-09-01

    Breast Cancer PRINCIPAL INVESTIGATOR: Wilma L. Lingle, Ph.D. CONTRACTING ORGANIZATION: Mayo Clinic and Foundation, Rochester Rochester, MN 55905...Progression of Breast Cancer 6. AUTHOR(S) Wilma L. Lingle, Ph.D. 7. PERFORMING ORGANIZA TION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZA TION Mayo...tumors. The goal of this research is to identify genes important in breast cancer due to their association with amplified centrosomes. We determined that

  6. Database of Autotransplants for Breast Cancer.

    DTIC Science & Technology

    1997-12-01

    California San Diego Mayo Clinic-Rochester La Jolla, CA Rochester, MN Dillon, Catherine RN, BSN Jenson, Michelle BS Riverview Medical Center Georgetown...Westlake Village CA 91361 Houston TX 77060 PHONE: 818 865 4445 PHONE: 713 775 0186 FAX: 818 865 4413 FAX: 713 775 0386 Vachon , Marie-France RN CRA

  7. Benign Prostatic Hyperplasia (BPH)

    MedlinePlus

    ... Pizzorno JE, et al. Textbook of Natural Medicine. 4th ed. St. Louis, Mo.: Churchill Livingstone Elsevier; 2013. https://www.clinicalkey.com. Accessed Aug. 27, 2014. Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. July 14, 2014. Castle EP (expert opinion). Mayo Clinic, ...

  8. 'A certain instability of mind': Herbert Mayo, 1796-1852, Surgeon and Physiologist.

    PubMed

    Bradley, James

    2015-05-29

    Herbert Mayo was a significant physiologist and an important figure in the London medical world of the 1820s and 1830s. And yet, a combination of poor decision-making and dabbling in heterodox medicine damaged his reputation. The life of Herbert Mayo illustrates that during the critical period before the 1858 Medical Act the boundary between orthodox and alternative medicine was porous. It also gives important insights into the politics of medicine at this time, particularly the significance of character to becoming a successful medical practitioner.

  9. 78 FR 14528 - Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... Energy Regulatory Commission Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On November 20, 2012, Mayo Hydropower, LLC (transferor) and Avalon Hydropower, LLC (transferee) filed an application for transfer of...

  10. Is there an increased stem migration or compromised osteointegration of the Mayo short-stemmed prosthesis following cerclage wiring of an intrasurgical periprosthetic fracture?

    PubMed

    Zeh, Alexander; Radetzki, Florian; Diers, Verena; Bach, Dirk; Röllinghoff, Marc; Delank, Karl Stefan

    2011-12-01

    Short-stemmed prostheses are increasingly regarded as implants of first choice in primary THA. As a result of the press-fit fixation in the femoral metaphysis, the occurrence of intraoperative fractures were reported. The aim of this study was to analyze the postoperative results of the Mayo short-stem prosthesis following treatment of an intrasurgical femur fracture with cerclage wiring. From 1999 to 2005, in 38 patients (18 females, 20 males; mean age 56 years; mean BMI = 27) with the diagnosis of coxarthrosis in whom a Mayo short-stemmed prosthesis has been implanted, an intraoperative fracture was observed. The fractures were treated with cerclage wiring (1 cerclage, n = 32; 2 cerclages, n = 5; 3 cerclages, n = 1). Postoperatively, all patients were prescribed mobilization without weight-bearing (floor contact) on the treated leg for 6 weeks. Using the Wristing software, longitudinal stem migration and varus-valgus femoral stem alignment were examined digitally in anteroposterior X-rays taken immediately after surgery, after 6 weeks and on average after 5.7 years (Zeh et al., Z Orthop Unfall 149:200-205, 2011). Additionally, the incidence of periprosthetic radiolucent lines was captured in the anteroposterior X-rays and assigned to the Gruen zones. Additionally, a DEXA scan was performed. The X-rays of a matched control group after the implantation of a Mayo prosthesis without femur fracture were analyzed by the same method. There was no significant migration of the Mayo prosthesis in the study or control groups during postoperative follow-up (t test, P > 0.05). The cerclage group compared with the control group showed a statistically significant valgus tilt of 1.5° on average during the follow-up, which is regarded to be clinically not relevant. The frequency of occurrence of radiolucent lines was not statistically different (chi-square test, χ = 0.42, P = 0.51). DEXA scans showed no differences of the bone mineral density in the Gruen zones compared with a

  11. Matters of Priority: Herbert Mayo, Charles Bell and Discoveries in the Nervous System

    PubMed Central

    Bradley, James

    2014-01-01

    Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell’s death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell’s case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo’s public performances elided with Bell’s descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner. PMID:25284895

  12. Comparison of EO1 Landsat-7 ETM+ and EO-1 ALI images over Rochester, New York

    NASA Astrophysics Data System (ADS)

    Pedelty, Jeffrey A.; Morisette, Jeffrey T.; Smith, James A.

    2002-08-01

    We present a comparison of images from the ETM+ sensor on Landsat-7 and the ALI instrument on EO-1 over a test site in Rochester, NY. The site contains a variety of features, ranging from water of varying depths, deciduous/coniferous forest, grass fields, to urban areas. The nearly coincident cloud-free images were collected just one minute apart on 25 August, 2001. We atmospherically corrected each image with the 6S atmosphere model, using aerosol optical thickness and water vapor column density measured by a Cimel sun photometer within the Aerosol Robotic Network (Aeronet), along with ozone density derived from NCEP data. We present three-color composites from each instrument that show excellent qualitative agreement. We present ETM+ and ALI reflectance spectra for water, grass, and urban targets. We make a more detailed comparison for our forest site, where we use measured geometric and optical properties as input to the SAIL canopy reflectance model, which we compare to the ETM+, ALI, and EO-1 Hyperion reflectance spectra.

  13. Secular trends and birth cohort effects in unprovoked seizures: Rochester, Minnesota 1935-1984.

    PubMed

    Annegers, J F; Hauser, W A; Lee, J R; Rocca, W A

    1995-06-01

    The incidence of idiopathic/cryptogenic epilepsy and isolated unprovoked seizures has been relatively stable in the population of Rochester, Minnesota, for the 50-year period 1935 through 1984. In each decade, the age-specific rates exhibited a consistent U-shaped pattern of decreasing rates from infancy to age 40-49 and a progressive increase thereafter to a second peak at age 70 years. Males had a 15% higher incidence of cryptogenic unprovoked seizures than females. The most pronounced secular trend was a decrease in the incidence in children aged < 10 years for the first 4 decades of the study; however, this trend was interrupted by a slight rebound in the decade 1975-1984. There has been a progressive decrease in the incidence of cryptogenic unprovoked seizures in individuals aged > or = 50 from 1965 through 1984. This decrease paralleled the decrease in cerebrovascular disease in the community. The decrease in idiopathic unprovoked seizures may be related to a concurrent trend in "silent stroke." Plots and Poisson regression analysis did not show patterns in the incidence of idiopathic unprovoked seizures related to successive birth cohorts. However, significantly lower incidence rates were observed for the 1930-1934 birth cohort, about half that of all others, between the ages of 5 and 54 years.

  14. Rudolf Kingslake: accomplishments before joining the University of Rochester's Institute of Optics

    NASA Astrophysics Data System (ADS)

    Johnson, R. Barry

    2011-12-01

    Rudolf Kingslake (1903 to 2003) is perhaps the most widely-known name in lens design and is arguably recognized as the father of lens design in the United States. Although his contributions in optical design, engineering, and education after he moved to the United States in 1929 are generally well-known, little has been written about his technical activities beforehand. In the early summer of 1929, the president of the University of Rochester, Rush Rhees, visited England to recruit faculty members for the new Institute of (Applied) Optics and hired 26-year-old Rudolf Kingslake as its first faculty member, and appointed him as assistant professor of geometrical optics and optical design. The following review of Kingslake's nine published papers while at the Imperial College illustrates his early and already remarkable talents in the field of optical engineering and justifies Dr. Rhees' insightful decision. Kingslake made significant contributions in the area of optical testing. In particular, he expanded the utility of the Hartmann test to measure oblique aberrations and improved the metrology for large optics, and was the first to mathematically analyze interferograms to obtain the primary aberration coefficients.

  15. Math learning disorder: incidence in a population-based birth cohort, 1976-82, Rochester, Minn.

    PubMed

    Barbaresi, William J; Katusic, Slavica K; Colligan, Robert C; Weaver, Amy L; Jacobsen, Steven J

    2005-01-01

    To report the incidence of math learning disorder (Math LD) among school-aged children, overall and by gender. To compare incidence estimates obtained by using three different methods to identify Math LD cases. To assess the extent to which children manifest Math LD alone, versus Math LD with comorbid reading disorder. This is a population-based, retrospective, birth cohort study. Subjects included all children born 1976-82 who remained in Rochester, Minn after age 5 (N = 5718). Using records from all public and private schools, medical facilities, and private tutorial services, all individually administered intelligence quotient and achievement tests and extensive medical, educational, and socioeconomic information were abstracted. Math LD was established using research criteria based on 3 formulas (regression-based discrepancy, nonregression-based discrepancy, low achievement). Cumulative incidence rates of Math LD by age 19 years varied from 5.9% to 13.8% according to the formula used. Boys were more likely to be affected than girls, with relative risk ratios from 1.6 to 2.2 depending on the formula applied. Many children with Math LD (35% to 56.7%, depending on the formula used to define Math LD) did not have a comorbid reading disorder. These results, from a community-based birth cohort, suggest that Math LD is common among schoolchildren, and is significantly more frequent among boys than girls, regardless of definition. Many children with Math LD do not have an associated reading disorder.

  16. Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system.

    PubMed

    St Sauver, Jennifer L; Grossardt, Brandon R; Yawn, Barbara P; Melton, L Joseph; Pankratz, Joshua J; Brue, Scott M; Rocca, Walter A

    2012-12-01

    The Rochester Epidemiology Project (REP) medical records-linkage system was established in 1966 to capture health care information for the entire population of Olmsted County, MN, USA. The REP includes a dynamic cohort of 502 820 unique individuals who resided in Olmsted County at some point between 1966 and 2010, and received health care for any reason at a health care provider within the system. The data available electronically (electronic REP indexes) include demographic characteristics, medical diagnostic codes, surgical procedure codes and death information (including causes of death). In addition, for each resident, the system keeps a complete list of all paper records, electronic records and scanned documents that are available in full text for in-depth review and abstraction. The REP serves as the research infrastructure for studies of virtually all diseases that come to medical attention, and has supported over 2000 peer-reviewed publications since 1966. The system covers residents of all ages and both sexes, regardless of socio-economic status, ethnicity or insurance status. For further information regarding the use of the REP for a specific study, please visit our website at www.rochesterproject.org or contact us at info@rochesterproject.org. Our website also provides access to an introductory video in English and Spanish.

  17. Air pollution at Rochester, NY: Long-term trends and multivariate analysis of upwind SO2 source impacts.

    PubMed

    Emami, Fereshteh; Masiol, Mauro; Hopke, Philip K

    2017-09-11

    There have been many changes in the air pollutant sources in the northeastern United States since 2001. To assess the effect of these changes, trend analyses of the monthly average values were performed on PM2.5 and its components including major ions, elemental carbon (EC), organic carbon (OC), and gaseous pollutant concentrations measured between 2001 (in some cases 1999) and 2015 at the NYS Department of Environmental Conservation sites in Rochester, NY. Mann-Kendall regression with Sen's slope was applied to estimate the trends and seasonality. Using piecewise regression, significant reductions in the air pollution of Rochester area were observed between 2008 and 2010 when a 260MW coal-fired power plant was decommissioned, new heavy-duty diesel trucks had to be equipped with catalytic regenerator traps, and the economic recession that began in 2008 reduced traffic and other activities. The monthly average PM2.5 mass showed a downward trend (-5μg/m(3); -41%) in Rochester between 2001 and 2015. This change is largely due to reductions in particulate sulfate that showed a 65% decrease. The sulfate concentrations were compared to changes in SO2 emissions in seventeen upwind source domains, and other systematic changes by multivariate linear regression. Selectivity ratio obtained from target projection discriminated the most important source domains that are SO2 emissions from Georgia for winter, North Carolina for transition (spring and fall) and Ohio along with other influences for summer. North Carolina and Michigan were identified as the main sources for entire period. These observations suggest that any further reductions in the specified regional SO2 emissions would result in a proportional decrease in sulfate in Rochester. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Utility of the Mayo-Portland adaptability inventory-4 for self-reported outcomes in a military sample with traumatic brain injury.

    PubMed

    Kean, Jacob; Malec, James F; Cooper, Douglas B; Bowles, Amy O

    2013-12-01

    To investigate the psychometric properties of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) obtained by self-report in a large sample of active duty military personnel with traumatic brain injury (TBI). Consecutive cohort who completed the MPAI-4 as a part of a larger battery of clinical outcome measures at the time of intake to an outpatient brain injury clinic. Medical center. Consecutively referred sample of active duty military personnel (N=404) who suffered predominantly mild (n=355), but also moderate (n=37) and severe (n=12), TBI. Not applicable. MPAI-4 RESULTS: Initial factor analysis suggested 2 salient dimensions. In subsequent analysis, the ratio of the first and second eigenvalues (6.84:1) and parallel analysis indicated sufficient unidimensionality in 26 retained items. Iterative Rasch analysis resulted in the rescaling of the measure and the removal of 5 additional items for poor fit. The items of the final 21-item Mayo-Portland Adaptability Inventory-military were locally independent, demonstrated monotonically increasing responses, adequately fit the item response model, and permitted the identification of nearly 5 statistically distinct levels of disability in the study population. Slight mistargeting of the population resulted in the global outcome, as measured by the Mayo-Portland Adaptability Inventory-military, tending to be less reflective of very mild levels of disability. These data collected in a relatively large sample of active duty service members with TBI provide insight into the ability of patients to self-report functional impairment and the distinct effects of military deployment on outcome, providing important guidance for the meaningful measurement of outcome in this population. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Shorter Anogenital Distance Predicts Poorer Semen Quality in Young Men in Rochester, New York

    PubMed Central

    Mendiola, Jaime; Stahlhut, Richard W.; Jørgensen, Niels; Liu, Fan

    2011-01-01

    Background: In male rodents, anogenital distance (AGD) provides a sensitive and continuous correlate of androgen exposure in the intrauterine environment and predicts later reproductive success. Some endocrine-disrupting chemicals can alter male reproductive tract development, including shortening AGD, in both rodents and humans. Whether AGD is related to semen quality in human is unknown. Objective: We examined associations between AGD and semen parameters in adult males. Methods: We used multiple regression analyses to model the relationships between sperm parameters and two alternative measures of AGD [from the anus to the posterior base of the scrotum (AGDAS) and to the cephalad insertion of the penis (AGDAP)] in 126 volunteers in Rochester, New York. Results: AGDAS, but not AGDAP, was associated with sperm concentration, motility, morphology, total sperm count, and total motile count (p-values, 0.002–0.048). Men with AGDAS below (vs. above) the median were 7.3 times more likely (95% confidence interval, 2.5–21.6) to have a low sperm concentration (< 20 × 106/mL). For a typical study participant, sperm concentrations were 34.7 × 106/mL and 51.6 × 106/mL at the 25th and 75th percentiles of (adjusted) AGDAS. Conclusions: In our population, AGDAS was a strong correlate of all semen parameters and a predictor of low sperm concentration. In animals, male AGD at birth reflects androgen levels during the masculinization programming window and predicts adult AGD and reproductive function. Our results suggest, therefore, that the androgenic environment during early fetal life exerts a fundamental influence on both AGD and adult sperm counts in humans, as demonstrated in rodents. PMID:21377950

  20. Linking medical and dental health record data: a partnership with the Rochester Epidemiology Project

    PubMed Central

    St. Sauver, Jennifer L; Carr, Alan B; Yawn, Barbara P; Grossardt, Brandon R; Bock-Goodner, Cynthia M; Klein, Lori L; Pankratz, Joshua J; Finney Rutten, Lila J

    2017-01-01

    Purpose The purpose of this project was to expand the Rochester Epidemiology Project (REP) medical records linkage infrastructure to include data from oral healthcare providers. The goal of this linkage is to facilitate research studies examining the role of oral health in overall health and quality of life. Participants Eight dental practices joined the REP between 2011 and 2015. The REP study team has linked oral healthcare information with medical record information from local healthcare providers for 31 750 participants who have resided in Olmsted County, Minnesota. Overall, 17 718 (56%) participants are women, 14 318 (45%) are 40 years of age or older and 26 090 (82%) are white. Findings to date A first study using this new information was recently completed. This resource was used to determine whether the 2007 guidelines from the American Heart Association affected prescription rates of antibiotics to patients with moderate-risk cardiac conditions prior to dental procedures. The REP infrastructure was used to identify a series of patients diagnosed with moderate-risk cardiac conditions by the local healthcare providers (n=1351), and to abstract antibiotic prescriptions from dental records both pre-2007 and post-2007. Antibiotic prescriptions prior to dental procedures declined from 62% to 7% following the change in guidelines. Future plans Dental data from participating practitioners will be updated on an annual basis, and new dental data will be linked to patient medical records. In addition, we will continue to invite new dental practices to participate in the REP. Finally, we will continue to use this research infrastructure to investigate associations between oral and medical health, and will present findings at conferences and in the scientific literature. PMID:28360234

  1. A Randomized Controlled Trial of the Rochester Forensic Assertive Community Treatment Model.

    PubMed

    Lamberti, J Steven; Weisman, Robert L; Cerulli, Catherine; Williams, Geoffrey C; Jacobowitz, David B; Mueser, Kim T; Marks, Patricia D; Strawderman, Robert L; Harrington, Donald; Lamberti, Tara A; Caine, Eric D

    2017-10-01

    Forensic assertive community treatment (FACT) is an adaptation of the assertive community treatment model and is designed to serve justice-involved adults with serious mental illness. This study compared the effectiveness of a standardized FACT model and enhanced treatment as usual in reducing jail and hospital use and in promoting engagement in outpatient mental health services. Seventy adults with psychotic disorders who were arrested for misdemeanor crimes and who were eligible for conditional discharge were recruited from the Monroe County, New York, court system. Participants were randomly assigned to receive either FACT (N=35) or enhanced treatment as usual (N=35) for one year. Criminal justice and mental health service utilization outcomes were measured by using state and county databases. Forty-nine participants (70%) completed the full one-year intervention period. Nineteen (27%) were removed early by judicial order, one was removed by county health authorities, and one died of a medical illness. Intent-to-treat analysis for all 70 participants showed that those receiving the FACT intervention had fewer mean±SD convictions (.4±.7 versus .9±1.3, p=.023), fewer mean days in jail (21.5±25.9 versus 43.5±59.2, p=.025), fewer mean days in the hospital (4.4±15.1 versus 23.8±64.2, p=.025), and more mean days in outpatient mental health treatment (305.5±92.1 versus 169.4±139.6, p<.001) compared with participants who received treatment as usual. The Rochester FACT model was associated with fewer convictions for new crimes, less time in jail and hospitals, and more time in outpatient treatment among justice-involved adults with psychotic disorders compared with treatment as usual.

  2. Part-of-speech tagging for clinical text: wall or bridge between institutions?

    PubMed

    Fan, Jung-wei; Prasad, Rashmi; Yabut, Rommel M; Loomis, Richard M; Zisook, Daniel S; Mattison, John E; Huang, Yang

    2011-01-01

    Part-of-speech (POS) tagging is a fundamental step required by various NLP systems. The training of a POS tagger relies on sufficient quality annotations. However, the annotation process is both knowledge-intensive and time-consuming in the clinical domain. A promising solution appears to be for institutions to share their annotation efforts, and yet there is little research on associated issues. We performed experiments to understand how POS tagging performance would be affected by using a pre-trained tagger versus raw training data across different institutions. We manually annotated a set of clinical notes at Kaiser Permanente Southern California (KPSC) and a set from the University of Pittsburg Medical Center (UPMC), and trained/tested POS taggers with intra- and inter-institution settings. The cTAKES POS tagger was also included in the comparison to represent a tagger partially trained from the notes of a third institution, Mayo Clinic at Rochester. Intra-institution 5-fold cross-validation estimated an accuracy of 0.953 and 0.945 on the KPSC and UPMC notes respectively. Trained purely on KPSC notes, the accuracy was 0.897 when tested on UPMC notes. Trained purely on UPMC notes, the accuracy was 0.904 when tested on KPSC notes. Applying the cTAKES tagger pre-trained with Mayo Clinic's notes, the accuracy was 0.881 on KPSC notes and 0.883 on UPMC notes. After adding UPMC annotations to KPSC training data, the average accuracy on tested KPSC notes increased to 0.965. After adding KPSC annotations to UPMC training data, the average accuracy on tested UPMC notes increased to 0.953. The results indicated: first, the performance of pre-trained POS taggers dropped about 5% when applied directly across the institutions; second, mixing annotations from another institution following the same guideline increased tagging accuracy for about 1%. Our findings suggest that institutions can benefit more from sharing raw annotations but less from sharing pre-trained models for

  3. The influence of mammogram acquisition on the mammographic density and breast cancer association in the mayo mammography health study cohort

    PubMed Central

    2012-01-01

    Introduction Mammographic density is a strong risk factor for breast cancer. Image acquisition technique varies across mammograms to limit radiation and produce a clinically useful image. We examined whether acquisition technique parameters at the time of mammography were associated with mammographic density and whether the acquisition parameters confounded the density and breast cancer association. Methods We examined this question within the Mayo Mammography Health Study (MMHS) cohort, comprised of 19,924 women (51.2% of eligible) seen in the Mayo Clinic mammography screening practice from 2003 to 2006. A case-cohort design, comprising 318 incident breast cancers diagnosed through December 2009 and a random subcohort of 2,259, was used to examine potential confounding of mammogram acquisition technique parameters (x-ray tube voltage peak (kVp), milliampere-seconds (mAs), thickness and compression force) on the density and breast cancer association. The Breast Imaging Reporting and Data System four-category tissue composition measure (BI-RADS) and percent density (PD) (Cumulus program) were estimated from screen-film mammograms at time of enrollment. Spearman correlation coefficients (r) and means (standard deviations) were used to examine the relationship of density measures with acquisition parameters. Hazard ratios (HR) and C-statistics were estimated using Cox proportional hazards regression, adjusting for age, menopausal status, body mass index and postmenopausal hormones. A change in the HR of at least 15% indicated confounding. Results Adjusted PD and BI-RADS density were associated with breast cancer (p-trends < 0.001), with a 3 to 4-fold increased risk in the extremely dense vs. fatty BI-RADS categories (HR: 3.0, 95% CI, 1.7 - 5.1) and the ≥ 25% vs. ≤ 5% PD categories (HR: 3.8, 95% CI, 2.5 - 5.9). Of the acquisition parameters, kVp was not correlated with PD (r = 0.04, p = 0.07). Although thickness (r = -0.27, p < 0.001), compression force (r = -0

  4. Part-of-speech tagging for clinical text: wall or bridge between institutions?

    PubMed Central

    Fan, Jung-wei; Prasad, Rashmi; Yabut, Rommel M.; Loomis, Richard M.; Zisook, Daniel S.; Mattison, John E.; Huang, Yang

    2011-01-01

    Part-of-speech (POS) tagging is a fundamental step required by various NLP systems. The training of a POS tagger relies on sufficient quality annotations. However, the annotation process is both knowledge-intensive and time-consuming in the clinical domain. A promising solution appears to be for institutions to share their annotation efforts, and yet there is little research on associated issues. We performed experiments to understand how POS tagging performance would be affected by using a pre-trained tagger versus raw training data across different institutions. We manually annotated a set of clinical notes at Kaiser Permanente Southern California (KPSC) and a set from the University of Pittsburg Medical Center (UPMC), and trained/tested POS taggers with intra- and inter-institution settings. The cTAKES POS tagger was also included in the comparison to represent a tagger partially trained from the notes of a third institution, Mayo Clinic at Rochester. Intra-institution 5-fold cross-validation estimated an accuracy of 0.953 and 0.945 on the KPSC and UPMC notes respectively. Trained purely on KPSC notes, the accuracy was 0.897 when tested on UPMC notes. Trained purely on UPMC notes, the accuracy was 0.904 when tested on KPSC notes. Applying the cTAKES tagger pre-trained with Mayo Clinic’s notes, the accuracy was 0.881 on KPSC notes and 0.883 on UPMC notes. After adding UPMC annotations to KPSC training data, the average accuracy on tested KPSC notes increased to 0.965. After adding KPSC annotations to UPMC training data, the average accuracy on tested UPMC notes increased to 0.953. The results indicated: first, the performance of pre-trained POS taggers dropped about 5% when applied directly across the institutions; second, mixing annotations from another institution following the same guideline increased tagging accuracy for about 1%. Our findings suggest that institutions can benefit more from sharing raw annotations but less from sharing pre-trained models

  5. Impact of Clinical Pharmacist on the Pediatric Intensive Care Practice: An 11-Year Tertiary Center Experience

    PubMed Central

    Crabtree, Heidi M.; Fryer, Karen R.; Graner, Kevin K.; Arteaga, Grace M.

    2015-01-01

    OBJECTIVES: With increasing complexity of critical care medicine comes an increasing need for multidisciplinary involvement in care. In many institutions, pharmacists are an integral part of this team, but long-term data on the interventions performed by pharmacists and their effects on patient care and outcomes are limited. We aimed to describe the role of pediatric clinical pharmacists in pediatric intensive care unit (PICU) practice. METHODS: We retrospectively reviewed the records of pharmacy interventions in the PICU at the Mayo Clinic in Rochester, Minnesota, from 2003-2013, with a distinct period of increased pharmacist presence in the PICU from 2008 onward. We compared demographic and outcome data on patients who did and who did not have pharmacy interventions during 2 periods (2003–2007 and 2008–2013). RESULTS: We identified 27,773 total interventions by pharmacists during the 11-year period, of which 79.8% were accepted by the clinical team. These interventions were made on 10,963 unique PICU admissions and prevented 5867 order entry errors. Pharmacists' interventions increased year over year, including a significant change in 2008. Patients who required pharmacy involvement were younger, sicker, and had longer intensive care unit, hospital, and ventilator duration. Average central line infections and central line entry rates decreased significantly over the study period. CONCLUSIONS: Increased pharmacist presence in the PICU is associated with increased interventions and prevention of adverse drug events. Pharmacist participation during rounds and order entry substantially improved the care of critically sick children and should be encouraged. PMID:26380569

  6. Therapy for Relapsed Multiple Myeloma: Guidelines From the Mayo Stratification for Myeloma and Risk-Adapted Therapy

    PubMed Central

    Dingli, David; Ailawadhi, Sikander; Bergsagel, P. Leif; Buadi, Francis K.; Dispenzieri, Angela; Fonseca, Rafael; Gertz, Morie A.; Gonsalves, Wilson I.; Hayman, Susan R.; Kapoor, Prashant; Kourelis, Taxiarchis; Kumar, Shaji K.; Kyle, Robert A.; Lacy, Martha Q.; Leung, Nelson; Lin, Yi; Lust, John A.; Mikhael, Joseph R.; Reeder, Craig B.; Roy, Vivek; Russell, Stephen J.; Sher, Taimur; Stewart, A. Keith; Warsame, Rahma; Zeldenrust, Stephen R.; Rajkumar, S. Vincent; Chanan Khan, Asher A.

    2017-01-01

    Life expectancy in patients with multiple myeloma is increasing because of the availability of an increasing number of novel agents with various mechanisms of action against the disease. However, the disease remains incurable in most patients because of the emergence of resistant clones, leading to repeated relapses of the disease. In 2015, 5 novel agents were approved for therapy for relapsed multiple myeloma. This surfeit of novel agents renders management of relapsed multiple myeloma more complex because of the occurrence of multiple relapses, the risk of cumulative and emergent toxicity from previous therapies, as well as evolution of the disease during therapy. A group of physicians at Mayo Clinic with expertise in the care of patients with multiple myeloma regularly evaluates the evolving literature on the biology and therapy for multiple myeloma and issues guidelines on the optimal care of patients with this disease. In this article, the latest recommendations on the diagnostic evaluation of relapsed multiple myeloma and decision trees on how to treat patients at various stages of their relapse (off study) are provided together with the evidence to support them. PMID:28291589

  7. Impact of the Development of a Light Microscopy Shared Resource for the University of Rochester Medical Center: A Quantitative Assessment

    PubMed Central

    Jepson, M.; Jordan, P.; Kasischke, K.; Brown, E.; Reed, A.; Lentine, M.; Bushnell, T.; Puzas, E.; Callahan, L.M.

    2014-01-01

    The University of Rochester Medical Center (URMC) determined the need for a shared Light Microscopy facility to support researchers requiring high-end light microscopy for their research programs. URMC Shared Resource Laboratories (SRLs) represent a strategic investment in technology, targeted expertise, and space administration to systematically support and advance the research mission of the institution. Recognizing the need for centralized light microscopy resources to support the University of Rochester Medical Center, a task force of senior researchers, investigators, and administration developed a plan to create a light microscopy resource. Through strategic investment for instrument upgrades and acquisition as well as hiring of additional staff, the LM resource has grown since its inception in 2008 with expanded capacity and capabilities to support the diverse needs and studies of the URMC researchers. The data presented here address the impact of the LM Shared Resource on the URMC research community in quantitative areas such as publications, new grant funding, and training as well as addressing qualitative measures of success including impact on graduate education and new research avenues.

  8. Assessing condition of macroinvertebrate communities and bed sediment toxicity in the Rochester Embayment Area of Concern, New York, USA

    USGS Publications Warehouse

    Duffy, Brian; George, Scott D.; Baldigo, Barry P.; Smith, Alexander J.

    2017-01-01

    The United States and Canada agreed to restore the chemical, physical, and biological integrity of the Great Lakes ecosystem under the first Great Lakes Water Quality Agreement in 1972. The lowest reach of the Genesee River and the Rochester Embayment on Lake Ontario between Bogus Point and Nine Mile Point, including Braddock Bay, were designated as an Area of Concern (AOC) due to effects of contaminated sediments and physical disturbance on several beneficial uses. Following sediment remedial efforts and with conditions improving in the AOC, the present study was conducted to reevaluate the status of the benthic macroinvertebrate (benthos) beneficial use impairment (BUI). Benthic macroinvertebrate community assessments and 10-day Chironomus dilutus bioassays were used to test the hypotheses that sediments within the AOC were no more toxic than sediments from surrounding reference areas. The study was separated into three discrete systems (Genesee River, Lake Ontario, and Braddock Bay) and non-parametric analyses determined that a multimetric index of benthic macroinvertebrate community integrity was significantly higher at AOC sites compared to reference sites on the Genesee River and in Braddock Bay while AOC and reference sites on Lake Ontario did not differ significantly. Survival and growth of C. dilutus were also similar between AOC and reference sites for each system with the exception of significantly higher growth at reference sites on Lake Ontario. Results generally indicated that the condition of benthos and toxicity of sediment of the Rochester Embayment AOC are similar to or better than that in the surrounding area.

  9. Dysphagia in inflammatory myopathy: clinical characteristics, treatment strategies, and outcome in 62 patients.

    PubMed

    Oh, Terry H; Brumfield, Kathlyn A; Hoskin, Tanya L; Stolp, Kathryn A; Murray, Joseph A; Bassford, Jeffrey R

    2007-04-01

    To assess the clinical characteristics, treatment, and outcome of patients with inflammatory myopathy-associated dysphagia. We retrospectively reviewed the medical records of all patients with inflammatory myopathy-associated dysphagia seen at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. A total of 783 patients were diagnosed as having inflammatory myopathy during the 5-year study period. Of these, 62 patients (41 women and 21 men; mean age, 68.6 years) had inflammatory myopathy-associated dysphagia: 26 with inclusion body myositis (IBM), 18 with dermatomyositis, 9 with polymyositis, and 9 with overlap syndrome. Dysphagia was a presenting symptom in 13 patients (21%), with the highest incidence in the IBM group. Videofluoroscopic examinations revealed pharyngeal pooling and impaired oropharyngeal and cricopharyngeal function. The benefits of swallowing compensation techniques and exercises were difficult to establish. Interventional procedures were performed in 24 patients (39%) and most frequently (62%) in patients with IBM, with cricopharyngeal myotomy being most beneficial. Patients with IBM had the least symptomatic improvement. Overall, 11 patients died during the median follow-up of 38 months, with respiratory failure due to aspiration pneumonia as the most common cause. Mortality was high in patients who required percutaneous endoscopic gastrostomy (7/11, 64%), and 1- year mortality was highest (31%) in those with dermatomyositis. Dysphagia is a serious and at times presenting problem in patients with inflammatory myopathy. It occurs most frequently and appears to be most refractory in patients with IBM. The mortality rate was high in patients who required percutaneous endoscopic gastrostomy, and the 1-year mortality rate was the highest in patients with dermatomyositis.

  10. Influence of atmospheric dispersion and new particle formation events on ambient particle number concentration in Rochester, United States, and Toronto, Canada.

    PubMed

    Jeong, Cheol-Heon; Evans, Greg J; Hopke, Philip K; Chalupa, David; Utell, Mark J

    2006-04-01

    Continuous measurements of particle number concentrations were performed in Rochester, NY, and Toronto, Ontario, Canada during the 2003 calendar year. Strong seasonal dependency in particle number concentration was observed at two sites. The average number concentration of ambient particles was 9670 +/- 6960 cm(-3) in Rochester, whereas in Toronto the average number of particles was 28,010 +/- 13,350 cm(-3). The particle number concentrations were higher in winter months than in summer months by a factor of 1.5 in Rochester and 1.6 in Toronto. In general, there were also distinct diurnal variations of aerosol number concentration. The highest weekdays/weekends ratio of number concentration was typically observed during the rush-hour period in winter months with a ratio of 2.1 in Rochester and 2.0 in Toronto. The correlation in the total particle number concentrations between the two urban sites was stronger in winter because of the common urban traffic patterns, but weaker in summer because of local sulfur dioxide (SO2)-related particle formation events in Rochester in the summer. Strong morning particle formation events were frequently observed during colder winter months. Good correlations between particle number and carbon monoxide (CO) as well as temperature suggested that motorvehicle emissions lead to the formation of new particles as the exhaust mixes with the cold air. Regional nucleation and growth events frequently occurred in April. Local SO2-related particle formation events most frequently occurred in August. SO2 and UV-B were highly correlated with particle concentration, suggesting a high association of photochemical processes with these local events. A high directionality in a northerly direction was observed for particle number and SO2, indicating the influence of point sources located north of Rochester.

  11. Physical and chemical limnology of Ides Cove near Rochester, New York, 1970-1982

    USGS Publications Warehouse

    Bubeck, R.C.; Staubitz, W.W.; Weidemann, A.D.; Spittal, L.P.

    1995-01-01

    Ides Cove is a small embayment on the western shore of Irondequoit Bay near Rochester, N.Y. In 1982, alum was applied to the cove to seal the bottom sediments and thereby decrease nutrient fluxes in an effort to assess the applicability of this technique to Irondequoit Bay. Published data were used to develop a baseline analysis of the chemical and physical limnology of Ides Cove prior to the alum treatment and to provide a basis for comparison and evaluation of post-treatment data. The baseline analysis also enables evaluation of trends in the nutrient status and mixing patterns in Ides Cove since the decrease of sewage inflows and use of road salt in the Irondequoit Bay and Ides Cove drainage basins during 1970-82. Data from 1970-72 and 1979-82 were used to construct partial and full-year depth profiles of several physical properties and chemical constituents of water in the cove; comparison of these profiles indicates a significant improvement in water quality between 1970 and 1982. The diversion of sewage out of the Irondequoit Creek drainage basin in the late 1970's resulted in an 80-percent decrease in total phosphate concentration and a 50- to 60-percent decrease in nitrogen (nitrate and ammonia) concentration in the cove. Indications of decreased primary productivity are associated with these lowered nutrient concentrations. Summer Secchi-disk transparency increased from 0.6 m (meters) in 1970-72 to 1.2 m in 1980-82; peak epilimnetic dissolved oxygen levels decreased from a range of 22 to 28 mg/L (milligrams per liter) to a range of 16 to 20 mg/L; and peak epilimnetic pH decreased from greater than 9.4 to between 8.8 and 9.0. The decrease in the use of road salt in the Irondequoit basin beginning in 1974 resulted in a decrease in chloride concentration and gradient (difference between the surface and bottom con- centration). The maximum annual chloride concentration in the epilimnion decreased from the 210-to-225-mg/L range in the spring of 1971-72 to the

  12. Pediatric hospital dermatology: experience with inpatient and consult services at the Mayo Clinic.

    PubMed

    Storan, Eoin R; McEvoy, Marian T; Wetter, David A; el-Azhary, Rokea A; Hand, Jennifer L; Davis, Dawn M R; Bridges, Alina G; Camilleri, Michael J; Davis, Mark D P

    2013-01-01

    Data describing the management of pediatric patients admitted to a hospital under the care of a dermatologist and dermatology hospital consults for pediatric inpatients are limited. We aim to describe the role of an inpatient hospital service jointly run by dermatology and pediatrics and the activities of a pediatric dermatology hospital consult service. We retrospectively identified pediatric (age < 18 yrs) dermatology inpatients and hospital consult patients from January 1, 2009, through December 31, 2010. We examined patient demographics, indications for admission, length of stay, treatment provided, consult-requesting service, and consult diagnosis. One hundred eight admissions were by a dermatologist. The mean age was 5.8 years; the median length of stay was 3 days. Indications for admission included atopic dermatitis (86.1%), psoriasis (3.7%), and eczema herpeticum (2.8%). The main treatment provided was wet dressings (97.2%). Eighty-three dermatology hospital consults were requested. The mean age was 7.4 years. The main indications for dermatology consultation included drug rash (12.1%), cutaneous infections (12.1%), contact dermatitis (9.6%), psoriasis (8.4%), atopic dermatitis (6.0%), and hemangiomas (6.0%). This study describes the utility of the hospital pediatric dermatology inpatient and consult services in treating patients with severe skin disease.

  13. Systemic Lupus Erythematosus, Radiotherapy, and the Risk of Acute and Chronic Toxicity: The Mayo Clinic Experience

    SciTech Connect

    Pinn, Melva E.; Gold, Douglas G. M.; Petersen, Ivy A.; Osborn, Thomas G.; Brown, Paul D.; Miller, Robert C.

    2008-06-01

    Purpose: To determine the acute and chronic toxic effects of radiotherapy in patients with systemic lupus erythematosus (SLE). Methods and Materials: Medical records of 21 consecutive patients with SLE, who had received 34 courses of external beam radiotherapy and one low-dose-rate prostate implant, were retrospectively reviewed. Patients with discoid lupus erythematosus were excluded. Results: Median survival was 2.3 years and median follow-up 5.6 years. Eight (42%) of 19 patients evaluable for acute toxicity during radiotherapy experienced acute toxicity of Grade 1 or greater, and 4 (21%) had acute toxicity of Grade 3 or greater. The 5- and 10-year incidence of chronic toxicity of Grade 1 or greater was 45% (95% confidence interval [CI], 22-72%) and 56% (95% CI, 28-81%), respectively. The 5- and 10-year incidence of chronic toxicity of Grade 3 or greater was 28% (95% CI, 18-60%) and 40% (95% CI, 16-72%), respectively. Univariate analysis showed that chronic toxicity of Grade 1 or greater correlated with SLE renal involvement (p < 0.006) and possibly with the presence of five or more American Rheumatism Association criteria (p < 0.053). Chronic toxicity of Grade 3 or greater correlated with an absence of photosensitivity (p < 0.02), absence of arthritis (p < 0.03), and presence of a malar rash (p < 0.04). Conclusions: The risk of acute and chronic toxicity in patients with SLE who received radiotherapy was moderate but was not prohibitive of the use of radiotherapy. Patients with more advanced SLE may be at increased risk for chronic toxicity.

  14. Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN.

    PubMed

    Sethi, Sanjeev; Haas, Mark; Markowitz, Glen S; D'Agati, Vivette D; Rennke, Helmut G; Jennette, J Charles; Bajema, Ingeborg M; Alpers, Charles E; Chang, Anthony; Cornell, Lynn D; Cosio, Fernando G; Fogo, Agnes B; Glassock, Richard J; Hariharan, Sundaram; Kambham, Neeraja; Lager, Donna J; Leung, Nelson; Mengel, Michael; Nath, Karl A; Roberts, Ian S; Rovin, Brad H; Seshan, Surya V; Smith, Richard J H; Walker, Patrick D; Winearls, Christopher G; Appel, Gerald B; Alexander, Mariam P; Cattran, Daniel C; Casado, Carmen Avila; Cook, H Terence; De Vriese, An S; Radhakrishnan, Jai; Racusen, Lorraine C; Ronco, Pierre; Fervenza, Fernando C

    2016-05-01

    Renal pathologists and nephrologists met on February 20, 2015 to establish an etiology/pathogenesis-based system for classification and diagnosis of GN, with a major aim of standardizing the kidney biopsy report of GN. On the basis of etiology/pathogenesis, GN is classified into the following five pathogenic types, each with specific disease entities: immune-complex GN, pauci-immune GN, antiglomerular basement membrane GN, monoclonal Ig GN, and C3 glomerulopathy. The pathogenesis-based classification forms the basis of the kidney biopsy report. To standardize the report, the diagnosis consists of a primary diagnosis and a secondary diagnosis. The primary diagnosis should include the disease entity/pathogenic type (if disease entity is not known) followed in order by pattern of injury (mixed patterns may be present); score/grade/class for disease entities, such as IgA nephropathy, lupus nephritis, and ANCA GN; and additional features as detailed herein. A pattern diagnosis as the sole primary diagnosis is not recommended. Secondary diagnoses should be reported separately and include coexisting lesions that do not form the primary diagnosis. Guidelines for the report format, light microscopy, immunofluorescence microscopy, electron microscopy, and ancillary studies are also provided. In summary, this consensus report emphasizes a pathogenesis-based classification of GN and provides guidelines for the standardized reporting of GN.

  15. The state of the science of whole blood: lessons learned at Mayo Clinic

    PubMed Central

    Stubbs, James R.; Zielinski, Martin D.; Jenkins, Donald

    2016-01-01

    AABB Standards specify that ABO group-specific whole blood is the only acceptable choice for whole blood transfusions. Although universal donor group O stored whole blood (SWB) was used extensively by the military during the wars of the mid-twentieth century, its use has fallen out of favor and has never been used to great extent in the civilian trauma population. Interest in the use of whole blood has been renewed, particularly in light of its potential value in far-forward military and other austere environments. Evidence of preserved platelet function in SWB has heightened enthusiasm for a “one stop shop” resuscitation product providing volume, oxygen carrying capacity, and hemostatic effects. Experience with universal donor group O SWB is required to ascertain whether its use will be an advance in trauma care. Described here is the process of establishing a universal donor group O SWB at a civilian trauma center in the United States. PMID:27100754

  16. Culture-Proven Thorn-Associated Infections in Arizona: 10-Year Experience at Mayo Clinic.

    PubMed

    Simmons, Sierra C; Budavari, Adriane I; Kusne, Shimon; Zhang, Nan; Vikram, Holenarasipur R; Blair, Janis E

    2017-01-01

    Thorn injuries are common in the desert Southwest; however, the frequency and microbiology of thorn-associated infections have not been systematically described. Most information comes from case reports describing infections from atypical or environmental microorganisms. Our aim was to summarize the spectrum of thorn-associated infections. We conducted a retrospective review of electronic health records for patients presenting to our institution from January 1, 2005 to December 31, 2014 for treatment of thorn-associated injuries and then focused on the patients with cultures. Of 2758 records reviewed, 1327 patients had thorn-associated injuries; however, only 58 (4.4%) had cultures. Of these patients, 37 (64%) had positive findings; 5 had polymicrobial infection. The most commonly identified organisms were Staphylococcus aureus (n = 22, 59.0%) and coagulase-negative Staphylococcus species (n = 8, 21.6%). Other pathogens included Nocardia species (n = 3, 8.1%), Streptococcus species (n = 2, 5.4%), Gram-negative bacteria (n = 2, 5.4%), Aspergillus species (n = 2, 5.4%), Paecilomyces lilacinus (n = 1, 2.7%), and Candida species (n = 1, 2.7%). There were no infections caused by Pantoea agglomerans, Sporothrix schenckii, or Coccidioides spp. In contrast to most published case reports, we found that typical cutaneous microorganisms, such as Staphylococcus species, caused the majority of culture-positive, thorn-related infections.

  17. Radiotherapy for malignancy in patients with scleroderma: The Mayo Clinic experience

    SciTech Connect

    Gold, Douglas G.; Miller, Robert C.; Petersen, Ivy A.; Osborn, Thomas G.

    2007-02-01

    Purpose: To determine the frequency of acute and chronic adverse effects in patients with scleroderma who receive radiotherapy for treatment of cancer. Methods and Materials: Records were reviewed of 20 patients with scleroderma who received radiotherapy. Acute and chronic toxic effects attributable to radiotherapy were analyzed, and freedom from radiation-related toxicity was calculated. Results: Of the 20 patients, 15 had acute toxic effects, with Grade 3 or higher toxicity for 3 patients. Seven patients had self-limited Grade 1 or 2 radiation dermatitis, and no patient had Grade 3 or higher radiation dermatitis. Thirteen patients had chronic toxic effects, with Grade 3 or higher chronic toxicity for 3 patients. The median estimated time to any grade chronic toxicity was 0.4 years, and the median estimated time to Grade 3 or higher chronic toxicity has not been reached. Conclusions: The results suggest that although some patients with scleroderma treated with radiation experience considerable toxic effects, the occurrence of Grade 3 or higher toxicity may be less than previously anticipated.

  18. Animal-assisted therapy at Mayo Clinic: The time is now.

    PubMed

    Creagan, Edward T; Bauer, Brent A; Thomley, Barbara S; Borg, Jessica M

    2015-05-01

    The animal-human bond refers to an emotional, almost existential, relationship between animals and people. From the time of antiquity, domestic animals were an important source of economic vitality, but with the changing cultural landscape, the companion animal has become a faithful friend. Overwhelming anecdotal evidence supports the healing power of this relationship. We summarize the emerging literature on the neurobiochemical and cardiovascular benefits of companion pet ownership. We address the peer-reviewed data from myriad journal articles assessing the impact of the companion animal on the quality and often the length of life of select patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Medulloblastoma--prognostic factors and outcome of treatment: Review of the Mayo Clinic experience

    SciTech Connect

    Garton, G.R.; Schomberg, P.J.; Scheithauer, B.W.; Shaw, E.G.; Ilstrup, D.M.; Blackwell, C.R.; Laws, E.R. Jr.; Earle, J.D. )

    1990-08-01

    From March 1965 through December 1984, 58 patients (35 male and 23 female patients; median age, 17 years) with posterior fossa (PF) medulloblastoma underwent surgical treatment and postoperative radiation therapy at our institution. Radiation fields were the craniospinal axis in 39 patients, PF plus spinal axis in 12, PF in 6, and whole brain in 1. Median radiation doses were 43 Gy (22 to 60 Gy) to the PF and 34 Gy (6.2 to 50 Gy) to the spinal axis. Overall 5- and 10-year survivals were 50% and 33%, respectively; 5- and 10-year relapse-free survivals were 46% and 32%. Treatment failed in 34 patients (59%): in 18 who had irradiation to the craniospinal axis (13 had received 50 Gy or less to the PF) and in 16 who had a radiation field of less than the craniospinal axis. A statistically significant (P less than 0.05) improvement in 10-year survival was associated with the following prognostic variables: PF dose of 50 Gy or more, whole-brain irradiation, and spinal axis irradiation. In comparison with subtotal resection, total resection was correlated with better 10-year relapse-free survival but not overall survival. All five patients with initial treatment failure only in the spine had received a radiation dose of 30 Gy or less to the spinal axis. The 2-year survival after relapse was 46% with salvage chemotherapy or irradiation in 23 patients and 0% in the 11 patients who received no further treatment (P less than 0.01).

  20. Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: The Mayo Clinic experience

    SciTech Connect

    Miller, Robert C. . E-mail: miller.robert@mayo.edu; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses

    2006-11-15

    Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy.

  1. Prediction of IQ in the Mayo Older Adult Normative sample using multiple methods.

    PubMed

    McCarthy, Frances M; Sellers, Alfred H; Burns, William J; Smith, Glenn; Ivnik, R J; Malec, J F

    2003-04-01

    Using the Mayo Older Adult Normative sample (Ivnik et al., 1992) as our database, we developed regression models for estimating premorbid Full Scale (FSIQs), Verbal (VIQs), and Performance (PIQs) IQs for elderly adults. Age, years of education, and sex were the only demographic variables that showed sufficient variability; therefore, they were used as predictor variables in three stepwise procedures. The Mayo Normative FSIQs, VIQs, and PIQs served as the dependent variables. Both education and sex added significantly to the accounting of variance of both FSIQ and VIQ ( p < .001), whereas education ( p < .001) and age ( p < .05) were significant predictors of PIQ. These models produced statistically significant multiple Rs of .54, .58, and .35 ( p < .0001), with standard errors of estimate of 9.02, 8.28, and 10.77 for FSIQ, VIQ, and PIQ, respectively. Estimated FSIQs generated with the present model and the model developed by Barona and colleagues (Barona, Reynolds, & Chastain, 1984) were compared. The correlation between estimated IQs was large, the mean difference between IQs was very small, the standard deviations were nearly equal, and the categorical distributions of the two were similar. Because the Barona model is likely to be familiar to most clinicians, these findings argue in favor of the continued use of the Barona model, even when assessing people older than the WAIS-R normative sample. Extensions of these models to the WAIS-III also are discussed. Copyright 2003 Wiley Periodicals, Inc. J Clin Psychol 59: 457-463, 2003.

  2. Matrix-assisted laser desorption ionization time of flight mass spectrometry and diagnostic testing for prosthetic joint infection in the clinical microbiology laboratory.

    PubMed

    Peel, Trisha N; Cole, Nicolynn C; Dylla, Brenda L; Patel, Robin

    2015-03-01

    Identification of pathogen(s) associated with prosthetic joint infection (PJI) is critical for patient management. Historically, many laboratories have not routinely identified organisms such as coagulase-negative staphylococci to the species level. The advent of matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) has enhanced clinical laboratory capacity for accurate species-level identification. The aim of this study was to describe the species-level identification of microorganisms isolated from periprosthetic tissue and fluid specimens using MALDI-TOF MS alongside other rapid identification tests in a clinical microbiology laboratory. Results of rapid identification of bacteria isolated from periprosthetic joint fluid and/or tissue specimens were correlated with clinical findings at Mayo Clinic, Rochester, Minnesota, between May 2012 and May 2013. There were 178 PJI and 82 aseptic failure (AF) cases analyzed, yielding 770 organisms (median, 3/subject; range, 1-19/subject). MALDI-TOF MS was employed for the identification of 455 organisms (59%) in 197 subjects (123 PJIs and 74 AFs), with 89% identified to the species level using this technique. Gram-positive bacteria accounted for 68% and 93% of isolates in PJI and AF, respectively. However, the profile of species associated with infection compared to specimen contamination differed. Staphylococcus aureus and Staphylococcus caprae were always associated with infection, Staphylococcus epidermidis and Staphylococcus lugdunensis were equally likely to be a pathogen or a contaminant, whereas the other coagulase-negative staphylococci were more frequently contaminants. Most streptococcal and Corynebacterium isolates were pathogens. The likelihood that an organism was a pathogen or contaminant differed with the prosthetic joint location, particularly in the case of Propionibacterium acnes. MALDI-TOF MS is a valuable tool for the identification of bacteria isolated from patients

  3. Computer-aided design and modeling of nickel dithiolene near-infrared dyes. 1998 summer research program for high school juniors at the University of Rochester`s Laboratory for Laser Energetics: Student research reports

    SciTech Connect

    Corsello, S.

    1999-03-01

    Recent advances in computational chemistry have made it feasible to design many types of molecules and predict their properties theoretically. The author applied these techniques to the design of organometallic transition-metal dyes absorbing in the near-infrared region of the spectrum which possess the combination of a large molar extinction coefficient, good chemical and thermal stability, and a high solubility in liquid crystal (LC) hosts. These properties are required for the dye to function as a near-infrared (IR) attenuator in a liquid crystal point diffraction interferometer (LCPDI) device that will be used as a beam diagnostic on the 60-beam OMEGA solid-state Nd:glass laser system at the University of Rochester`s Laboratory for Laser Energetics. Using commercially available software, both the absorption spectra and solubility characteristics of bis[1,2-di-(p-n alkoxyphenyl)ethane-1,2-dithione] nickel dye complexes were modeled in an isotropic host (cyclohexane) and, in most cases, excellent agreement was found with experimental data. Two additional compounds utilizing the same nickel dithiolene core but with alkylthio and phenylalkylthio terminal groups have been designed and show excellent potential to produce dramatic improvements in both solubility and optical density (absorbance) in liquid crystalline hosts. Based upon my work, a new dye not previously reported, 2(C{sub 4}S)2(C{sub 4}SPh)DTNi, has been proposed to satisfy the LCPDI device requirements. The nickel dithiolene dyes may also find important applications in other technology areas such as near-IR photography and laser-based near-IR communications.

  4. Direct-Drive Inertial Fusion Research at the University of Rochester's Laboratory for Laser Energetics: A Review

    SciTech Connect

    McCrory, R.L.; Meyerhofer, D.D.; Loucks, S.J.; Skupsky, S.; Bahr, R.E.; Betti, R.; Boehly, T.R.; Craxton, R.S.; Collins, T.J.B.; Delettrez, J.A.; Donaldson, W.R.; Epstein, R.; Fletcher, K.A.; Freeman, C.; Frenje, J.A.; Glebov, V.Yu.; Goncharov, V.N.; Harding, D.R.; Jaanimagi, P.A.; Keck, R.L.; Kelly, J.H.; Kessler, T.J.; Kilkenny, J.D.; Knauer, J.P.; Li, C.K.; Lund, L.D.; Marozas, J.A.; McKenty, P.W.; Marshall, F.J.; Morse, S.F.B.; Padalino, S.; Petrasso, R.D.; Radha, P.B.; Regan, S.P.; Roberts, S.; Sangster, T.C.; Seguin, F.H.; Seka, W.; Smalyuk, V.A.; Soures, J.M.; Stoeckl, C.; Thorp, K.A.; Yaakobi, B.; Zuegel, J.D.

    2010-04-16

    This paper reviews the status of direct-drive inertial confinement fusion (ICF) research at the University of Rochester's Laboratory for Laser Energetics (LLE). LLE's goal is to demonstrate direct-drive ignition on the National Ignition Facility (NIF) by 2014. Baseline "all-DT" NIF direct-drive ignition target designs have been developed that have a predicted gain of 45 (1-D) at a NIF drive energy of ~1.6 MJ. Significantly higher gains are calculated for targets that include a DT-wicked foam ablator. This paper also reviews the results of both warm fuel and initial cryogenic-fuel spherical target implosion experiments carried out on the OMEGA UV laser. The results of these experiments and design calculations increase confidence that the NIF direct-drive ICF ignition goal will be achieved.

  5. Determination of CA-41, I-129 and OS-187 in the Rochester tandem accelerator and some applications of these isotopes

    NASA Technical Reports Server (NTRS)

    Fehn, U.; Elmore, D.; Gove, H. E.; Kubik, P.; Teng, R.; Tubbs, L.

    1986-01-01

    The measurement of Ca-41 and I-129 utilizing the Rochester Tanden Accelerator Mass Spectrometer (TAMS) is discussed. Ca-41, having a half-life of 100,000 yrs., is of potential use for the dating of ground water as well as of bones in the age range between 50,000 and 1 million yrs. A major problem for the measurement of Ca-41 with TAMS is the fact that calcium does not readily form negative atomic ions. It does, however, form negative molecular ions. The production of CaO ions from compounds such as CaO and CaCO3 and from free Ca molecules sprayed with oxygen gas was studied. A project to utilize I-129 as a tracer for hydrothermal convection in sediment-covered oceanic crust is also briefly described. Finally, plans to use the Os-187/Os-186 ratio for the determination of extraterrestrial material in the Ries crater in Germany are summarized.

  6. Improving Special Education in the Rochester City Schools: Report of the Strategic Support Team of the Council of the Great City Schools, Winter 2008-09

    ERIC Educational Resources Information Center

    Council of the Great City Schools, 2009

    2009-01-01

    This report by the Council of the Great City Schools to the Rochester City School District presents the organization's findings and recommendations for improving the special education program in the school system, placing special emphasis on the organizational structure of the program, accountability, and how the instructional program generally…

  7. Rochester: can't we just get along? City that spurned healthcare consensus for conflict now looks to reverse the current.

    PubMed

    Saphir, A

    1999-10-25

    A sharp rise in competition--and insurance premiums--has threatened the reputation of Rochester, N.Y., as a leader in low-cost, high-quality healthcare. Tired of beating one another up, healthcare leaders there are trying to bring collaboration back from the dead.

  8. Know Your Students: Rochester's Two-Year Ethnographic Study Reveals What Students Do on Campus and How the Library Fits In

    ERIC Educational Resources Information Center

    Marshall, Ann; Burns, Vicki; Briden, Judi

    2007-01-01

    In this article, the authors discuss how the University of Rochester's two-year ethnographic study reveals what students do on campus and how the library fits in. Under Nancy Fried Foster's guidance, teams of librarians and staff conducted a two-year investigation. The goal: to improve the libraries' reference services, facilities, and web pages…

  9. Know Your Students: Rochester's Two-Year Ethnographic Study Reveals What Students Do on Campus and How the Library Fits In

    ERIC Educational Resources Information Center

    Marshall, Ann; Burns, Vicki; Briden, Judi

    2007-01-01

    In this article, the authors discuss how the University of Rochester's two-year ethnographic study reveals what students do on campus and how the library fits in. Under Nancy Fried Foster's guidance, teams of librarians and staff conducted a two-year investigation. The goal: to improve the libraries' reference services, facilities, and web pages…

  10. Seeking Pathways to a Coordinated System of Health and Human Services for High-risk Urban Children and Families: The Rochester, New York Experience.

    PubMed

    Weitzman, M; Doniger, A S; Partner, S F

    1994-01-01

    The Rochester, New York community has undergone major changes over the past 20 years. Like many other industrial areas, it has seen an erosion of its manufacturing base and a flight of employment opportunities and population from the city to the suburbs. While commonly misperceived as an affluent, white-collar community, in reality there are many families, particularly within the city of Rochester, that are afflicted by some of the most devastating health and social problems facing the United States today.(1) It was against this backdrop that, in 1991, an ongoing effort was begun to develop a system of coordinated health and human services to more effectively address the needs of Rochester's children and families. As a first step, a study was conducted to obtain a detailed picture of the current service system in Rochester; lay out a series of recommendations to improve collaboration and communication; and foster coordinated and integrated services for high-risk youth and families in the community. Key indicators of child and family health were collected, collated, and analyzed, and extensive interviews were conducted with humanservice and medical providers, government officials, education professionals, and parents. This paper describes the process that was used in the study and the recommendations that were included in the final report, which is intended to create a framework for the creation of a comprehensive, needs-based health care system for impoverished and at-risk children and families, including the effective integration of health services into the human service network.

  11. An assessment of management history of damaged and undamaged trees 8 years after the ice storm in Rochester, New York, U.S.

    Treesearch

    Wayne C. Zipperer; Susan M. Sisinni; Jerry Bond; Chris Luley; Andrew G. Pleninger

    2004-01-01

    Rochester, New York, U.S., were reviewed to evaluate the city's storm related removal protocol and how maintenance varied by damage classes. Maintenance codes assigned in 1991 were used to identify ice-storm damage classes based on percentage of crown loss. We evaluated seven species Noway maple (Acer platanoides), silver maple (A. saccharinum), sugar maple (A....

  12. Clinician time used for decision making: a best case workflow study using cardiovascular risk assessments and Ask Mayo Expert algorithmic care process models.

    PubMed

    North, Frederick; Fox, Samuel; Chaudhry, Rajeev

    2016-07-20

    Risk calculation is increasingly used in lipid management, congestive heart failure, and atrial fibrillation. The risk scores are then used for decisions about statin use, anticoagulation, and implantable defibrillator use. Calculating risks for patients and making decisions based on these risks is often done at the point of care and is an additional time burden for clinicians that can be decreased by automating the tasks and using clinical decision-making support. Using Morae Recorder software, we timed 30 healthcare providers tasked with calculating the overall risk of cardiovascular events, sudden death in heart failure, and thrombotic event risk in atrial fibrillation. Risk calculators used were the American College of Cardiology Atherosclerotic Cardiovascular Disease risk calculator (AHA-ASCVD risk), Seattle Heart Failure Model (SHFM risk), and CHA2DS2VASc. We also timed the 30 providers using Ask Mayo Expert care process models for lipid management, heart failure management, and atrial fibrillation management based on the calculated risk scores. We used the Mayo Clinic primary care panel to estimate time for calculating an entire panel risk. Mean provider times to complete the CHA2DS2VASc, AHA-ASCVD risk, and SHFM were 36, 45, and 171 s respectively. For decision making about atrial fibrillation, lipids, and heart failure, the mean times (including risk calculations) were 85, 110, and 347 s respectively. Even under best case circumstances, providers take a significant amount of time to complete risk assessments. For a complete panel of patients this can lead to hours of time required to make decisions about prescribing statins, use of anticoagulation, and medications for heart failure. Informatics solutions are needed to capture data in the medical record and serve up automatically calculated risk assessments to physicians and other providers at the point of care.

  13. Toxicity of waters from the Rochester Embayment Area of Concern to the plankton species Pseudokirchneriella subcapitata and Ceriodaphnia dubia

    USGS Publications Warehouse

    Baldigo, Barry P.; Duffy, Brian T.; Smith, Alexander J; George, Scott D.

    2016-01-01

    The lower Genesee River and Rochester Embayment of Lake Ontario are a designated Area of Concern (AOC) under the binational Great Lakes Water Quality Agreement. The “degradation of phytoplankton and zooplankton populations” or plankton Beneficial Use Impairment (BUI) was classified as unknown and in need of further assessment in this AOC because water quality data suggested plankton communities could be effected and community data were either unavailable or indicated impacts. The plankton BUI may now be obsolete because local contaminant sources have been largely eliminated. The present study was conducted between July 2013 and August 2014 to assess the BUI-removal criteria: “AOC plankton bioassays confirm that toxicity in ambient waters (i.e., no growth inhibition) is not significantly higher than comparable non-AOC controls”. Acute and chronic toxicity of waters from 13 sites were quantified seasonally using standardized bioassays with the green alga Pseudokirchneriella subcapitata and water flea Ceriodaphnia dubia to test the hypothesis that toxicity of waters from AOC sites was not higher than that of waters from comparable non-AOC reference sites. Survival and reproduction of C. dubia did not differ significantly between site types, systems, or months. The growth of P. subcapitata did not differ between site types, but differed among systems and months. All results indicate that waters from AOC sites were no more toxic to both plankton species than waters from reference sites. Assuming test species represent natural plankton assemblages, water quality should not negatively affect survival and growth of resident plankton populations in the Rochester Embayment AOC.

  14. Mayo Adhesive Probability Score Is an Independent Computed Tomography Scan Predictor of Adherent Perinephric Fat in Open Partial Nephrectomy.

    PubMed

    Martin, Logan; Rouviere, Olivier; Bezza, Riadh; Bailleux, Jérôme; Abbas, Fatima; Schott-Pethelaz, Anne-Marie; Ruffion, Alain; Paparel, Philippe

    2017-05-01

    To evaluate predictive radiological elements for adherent perinephric fat (APF) and the Mayo adhesive probability (MAP) score in the setting of open partial nephrectomy, and to assess their reproducibility. We performed a retrospective case-control study involving 86 patients who had open partial nephrectomies performed by a single surgeon between January 1, 2009 and April 1, 2015. Radiological elements were assessed by 4 readers blinded to patient APF status. Univariate and multivariate analyses were performed for all radiological and clinical factors. Reproducibility was analyzed using agreement coefficients. On univariate analysis for radiological findings, lateral and posterior fat thickness (odds ratio [OR]: 1.084 [1.033, 1.138], P < .001), stranding (OR: 2.179 [1.431, 3.318], P < .001), -80 HU fat area, and the MAP score (OR: 1.797 [1.332, 2.424], P < .001) were predictive of APF. On multivariate analysis, only age and the MAP score remained statistically significant (OR: 1.060 [1.005, 1.118], P = .03; and OR: 1.560 [1.137, 2.139], P = .0058, respectively). The reproducibility of the MAP score was fair (AC1 = 0.367 and kappa F = 0.353), as was that of stranding (AC1 = 0.499, kappa F = 0.376). The agreement was important if we defined a "low" (0 to 3) or "high" (4 or 5) score (AC1 = 0.706 and kappa F = 0.681). The MAP score was the element that best predicted APF in our study, although its reproducibility among our readers was only fair. The agreement becomes important if we defined "low or high" score. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. An Assessment of the Biological Fixation of a Retrieved Mayo Femoral Component

    PubMed Central

    Meldrum, Russell D; Willie, Bettina M; Bloebaum, Roy D

    2003-01-01

    Implant analysis was conducted on a retrieved Mayo femoral prosthesis that has a non-anatomic design with two distinct surfaces intended for osseous fixation. The prosthesis itself has a circumferential grit-blasted region interposed with the porous surfaces and involving the entire proximal stem. In addition, there are pads of mesh porous coating on the anterior, posterior, and medial surfaces proximally. A single, radiographically stable stem retrieved after 18 months secondary to recurrent dislocations was examined for osseous fixation by measurement of trabecular bone into the porous-coated and onto the grit-blasted surfaces of the stem. Results showed 17% ± 7% bone ingrowth into the porous coated areas and 20% ± 16% osseointegration onto the grit-blasted surfaces. These results are similar to percentages of ingrowth seen with more conventional, anatomic design prostheses. PMID:14575260

  16. Mayo, Myriad, America Invents Act and BPCIA: how has the United States biopharmaceutical market been affected?

    PubMed

    Finston, Susan K; Davey, Neil S; Davé, Elina; Ravichandran, Varsha; Davey, Sonya R; Davé, Raj S

    2016-05-01

    This paper discusses how the United States biopharmaceutical market has been affected by recent changes in patent law resulting from United States legislations (Biologics Price Competition and Innovation Act and the Leahy-Smith America Invents Act) and Supreme Court precedents (Mayo Collaborative Services v. Prometheus Laboratories, Inc. and Molecular Pathology v. Myriad Genetics). The authors interviewed eight key opinion leaders from the United States knowledgeable in biopharmaceuticals, including industry veterans, patent counsel, senior scientists and jurists. This paper summarizes the opinions of the key opinion leaders. This paper explains the impact of these Supreme Court decisions - i.e., broadening the exceptions to patent eligibility for law of nature and natural phenomenon - on biopharmaceutical innovations and provides future perspectives.

  17. Elemental composition of Usnea sp lichen from Potter Peninsula, 25 de Mayo (King George) Island, Antarctica.

    PubMed

    Bubach, Débora; Catán, Soledad Perez; Di Fonzo, Carla; Dopchiz, Laura; Arribére, Maria; Ansaldo, Martin

    2016-03-01

    Several pollutants, which include metals, are present in the Antarctic atmosphere, snow, marine and terrestrial organisms. This work reports the elements incorporated by Usnea sp thalli in Potter Peninsula, 25 de Mayo (King George) Island, South Shetlands, Antarctica. Geological origin was analyzed as possible sources of elements. For this purpose, correlations were done using a geochemical tracer, principal component analysis and enrichment factors were computed. Lithophile elements from particulate matter were present in most of the sampling sites. Bromine, Se and Hg showed the highest enrichment factors suggesting other sources than the particulate matter. Mercury values found in Usnea sp were in the same range as those reported for Deception Island (South Shetlands) and remote areas from the Patagonia Andes.

  18. Integration and standardization within the Mayo Foundation Laboratories: the centralized laboratory purchasing group.

    PubMed

    Hernandez, James S; Newton, Nancy C; O'Hara, Susan K

    2005-11-29

    Integration and standardization of laboratories throughout a medical system can increase the efficiency and effectiveness of laboratory operations. This task is challenging in most health-care systems, as no central governance exists to compel laboratories to standardize and integrate. We describe the initial collaborative efforts to integrate and standardize the laboratories of the Mayo Foundation, which includes more than 60 laboratories of different sizes in diverse locations. The goals and objectives of the group formed to develop this initiative--the Centralized Laboratory Purchasing Group--its origin, and lessons learned are described. Similar initiatives by other academic medical centers and community health-care systems to integrate and standardize their laboratories are discussed. Successful standardization and integration increases the value of the laboratory to the larger health-care system by demonstrating accountability, efficiency, and effectiveness, and can result in considerable cost savings to the entire health-care system.

  19. "Where Brains Had a Chance": William Mayo and Rhetorical Instruction at East Texas Normal College, 1889-1917

    ERIC Educational Resources Information Center

    Gold, David

    2005-01-01

    The rhetorical training of students at East Texas Normal College is examined with reference to the rhetorical practices and educational ideologies of William Mayo, the experiences of his students and the features of his teaching. Examination of the history of schools like East Texas Normal College helps in dealing with concerns regarding…

  20. The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester.

    PubMed

    Baker, Clayton J; Shaw, Margie Hodges; Mooney, Christopher J; Daiss, Susan Dodge-Peters; Clark, Stephanie Brown

    2017-06-07

    Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.

  1. Ambient mercury sources in Rochester, NY: results from Principle Components Analysis (PCA) of Mercury Monitoring Network Data.

    PubMed

    Huang, Jiaoyan; Choi, Hyun-Deok; Hopke, Philip K; Holsen, Thomas M

    2010-11-15

    Continuous atmospheric measurements of speciated mercury (Hg) (elemental mercury (Hg⁰), reactive gaseous mercury (RGM), and particulate mercury (Hgp)) were made in Rochester, NY from Dec 2007 to May 2009. Continuous measurements of ozone (O₃), sulfur dioxide (SO₂), carbonmonoxide (CO), particulate matter (PM₂.₅), and meteorological data were also available. A principle components analysis (PCA) of 3886 observations of 13 variables for the period identified six major factors. Melting snow was observed to be a source of Hg⁰in winters. Positive correlations between RGM and O₃ in the spring and summer may be indicative of Hg⁰ oxidation. RGM concentrations increased simultaneously with SO₂ suggesting the influence of coal fired power plants (CFPP). The fifth factor (F5) containing O₃ (high negative loading), CO (positive loading), Hg⁰ and Hg(p) (positive), and/or RGM (negative) was identified as a mobile source which was usually observed during morning rush hours (6:00-9:00 a.m.). The concentrations of the three mercury species from the direction of the CFPP were significantly reduced following the shutdown of this source.

  2. Creating community collaboration to improve the care of patients with high blood pressure: lessons from Rochester, New York.

    PubMed

    Bisognano, John D; Speranza, Paul S; Becker, Lawrence M; Norwood, Wade S; Bradley, Al; Nazar, Michael D; Beckman, Howard B

    2012-03-01

    Over the past two years, the business community of Monroe County, which includes Rochester, New York, has been engaging in a collaborative to improve outcomes for people with high blood pressure. As the employers examined the costs of care in the community, they recognized two important factors. First, the costs of care for the uninsured, the underinsured, and the Medicare population influence the business community's cost of care. Second, trying to redesign care just for their employees alone was not effective. This project is unique in that the stimulus and funding for community-wide action comes from the business community. They saw beyond the often unsuccessful short-term cost reduction programs and joined with a community-focused organization, the Finger Lakes Health Systems Agency, to construct a multi-year, multi-faceted intervention designed to encourage practice redesign and an invigorated community commitment to partnership and accountability. This report describes the process to date and hopefully will stimulate conversations about mechanisms to encourage similar collaboration within other communities. © 2012 Wiley Periodicals, Inc.

  3. 1991 Summer research program for high school juniors at the University of Rochester's Laboratory for Laser Energetics

    SciTech Connect

    Meyerhofer, David D.

    1991-09-01

    Ten students participated in the 1991 summer high school student research program at the University of Rochester's Laboratory for Laser Energetics (LLE). The participants spent 8 weeks working and learning at LLE. They spent most of their time working on individual research projects. Each student was assigned a project, upon which he/she worked under the direct supervision of one of the staff members of the laboratory. The students, their high schools, and their projects are listed in Table 1. The program culminated in oral and written reports describing their work. The oral reports were presented at a symposium on 23 August 1991, at which the student's parents and teachers and members of the LLE staff were present. The written reports are collected in this volume. The titles of the works are UV alignment table; neutron yields can be measured by using the relative gain of a photomultiplier tube; scattering in isotropic and anisotropic media; a better approximation of the diffusion equation; use of the SLAC code to produce a photoemissive electrostatic electron gun; spatial resolution deteriorates with increasing film exposure; analysis of refractive image distortion; making of pinholes for x-ray pinhole cameras; does perturbation theory accurately describe multiphoton ionization and wave front analysis using shearing interferometry.

  4. Polyphenolic substrates and dyes degradation by yeasts from 25 de Mayo/King George Island (Antarctica).

    PubMed

    Rovati, José I; Pajot, Hipólito F; Ruberto, Lucas; Mac Cormack, Walter; Figueroa, Lucía I C

    2013-11-01

    Antarctica offers a range of extreme climatic conditions, such as low temperatures, high solar radiation and low nutrient availability, and constitutes one of the harshest environments on Earth. Despite that, it has been successfully colonized by ’cold-loving’ fungi, which play a key role in decomposition cycles in cold ecosystems. However, knowledge about the ecological role of yeasts in nutrient or organic matter recycling/mineralization remains highly fragmentary. The aim of this work was to study the yeast microbiota in samples collected on 25 de Mayo/King George Island regarding the scope of their ability to degrade polyphenolic substrates such as lignin and azo dyes. Sixty-one yeast isolates were obtained from 37 samples, including soil, rocks, wood and bones. Molecular analyses based on rDNA sequences revealed that 35 yeasts could be identified at the species level and could be classified in the genera Leucosporidiella, Rhodotorula, Cryptococcus, Bullera and Candida. Cryptococcus victoriae was by far the most ubiquitous species. In total, 33% of the yeast isolates examined showed significant activity for dye decolorization, 25% for laccase activity and 38% for ligninolytic activity. Eleven yeasts did not show positive activity in any of the assays performed and no isolates showed positive activity across all tested substrates. A high diversity of yeasts were isolated in this work, possibly including undescribed species and conspicuous Antarctic yeasts, most of them belonging to oligotrophic, slow-growing and metabolically diverse basidiomycetous genera.

  5. The Mayo Lung Project for early detection and localization of bronchogenic carcinoma: a status report.

    PubMed

    Fontana, R S; Sanderson, D R; Woolner, L B; Miller, W E; Bernatz, P E; Payne, W S; Taylor, W F

    1975-05-01

    The Mayo Lung Project (MLP) is a screening program designed to detect bronchogenic carcinoma at a curable stage. Screening tests include chest roentgenograms, three-day "pooled" sputum cytology studies, and lung-health questionnaires. These are being applied every four months to a study population of outpatients who have a high probability of developing lung cancer. Initial patient acceptance of the screening program has been excellent. Small asymptomatic lung cancers have been detected both roentgenographically and cytologically. The two procedures have complemented each other with little overlap. Chest roentgenography has proved most useful in diagnosing peripherally situated cancers, whereas sputum cytology studies have been most effective in identifying early squamous cancer involving major airways. At present, more cancers have been detected roentgenographically than cytologically, but the cytologically detected cases appear to have a better prognosis. Roentgenographically occult cancers have been localized with regularity, although the localization process is complicated. Theoretically, vigorous application of radiologic and cytologic screening, combined with optimum use of localizing procedures and treatment, could increase the five-year survival rate among lung cancer patients to nearly 50 percent. However, the actual survivorship attained will ultimately be determined by currently imponderable factors such as patient acceptance of longterm screening, frequency of multicentric respiratory cancers, and incidence of noncancerous smoking-related diseases, especially chronic obstructive pulmonary disease and ischemic heart disease.

  6. The December 2012 Mayo River debris flow triggered by Super Typhoon Bopha in Mindanao, Philippines: lessons learned and questions raised

    NASA Astrophysics Data System (ADS)

    Rodolfo, Kelvin S.; Lagmay, A. Mahar F.; Eco, Rodrigo C.; Herrero, Tatum Miko L.; Mendoza, Jerico E.; Minimo, Likha G.; Santiago, Joy T.

    2016-12-01

    Category 5 Super Typhoon Bopha, the world's worst storm of 2012, formed abnormally close to the Equator, and its landfall on Mindanao set the record proximity to the Equator for its category. Its torrential rains generated an enormous debris flow in the Mayo River watershed that swept away much of the village Andap in the New Bataan municipality, burying areas under rubble as thick as 9 m and killing 566 people. Established in 1968, New Bataan had never experienced super typhoons and debris flows. This unfamiliarity compounded the death and damage. We describe Bopha's history, debris flows and the Mayo River disaster, and then we discuss how population growth contributed to the catastrophe, as well as the possibility that climate change may render other near-Equatorial areas vulnerable to hazards brought on by similar typhoons. Finally, we recommend measures to minimize the loss of life and damage to property from similar future events.

  7. Development of the Mayo Investigational Neuromodulation Control System: toward a closed-loop electrochemical feedback system for deep brain stimulation

    PubMed Central

    Chang, Su-Youne; Kimble, Christopher J.; Kim, Inyong; Paek, Seungleal B.; Kressin, Kenneth R.; Boesche, Joshua B.; Whitlock, Sidney V.; Eaker, Diane R.; Kasasbeh, Aimen; Horne, April E.; Blaha, Charles D.; Bennet, Kevin E.; Lee, Kendall H.

    2014-01-01

    Object Conventional deep brain stimulation (DBS) devices continue to rely on an open-loop system in which stimulation is independent of functional neural feedback. The authors previously proposed that as the foundation of a DBS “smart” device, a closed-loop system based on neurochemical feedback, may have the potential to improve therapeutic outcomes. Alterations in neurochemical release are thought to be linked to the clinical benefit of DBS, and fast-scan cyclic voltammetry (FSCV) has been shown to be effective for recording these evoked neurochemical changes. However, the combination of FSCV with conventional DBS devices interferes with the recording and identification of the evoked analytes. To integrate neurochemical recording with neurostimulation, the authors developed the Mayo Investigational Neuromodulation Control System (MINCS), a novel, wirelessly controlled stimulation device designed to interface with FSCV performed by their previously described Wireless Instantaneous Neurochemical Concentration Sensing System (WINCS). Methods To test the functionality of these integrated devices, various frequencies of electrical stimulation were applied by MINCS to the medial forebrain bundle of the anesthetized rat, and striatal dopamine release was recorded by WINCS. The parameters for FSCV in the present study consisted of a pyramidal voltage waveform applied to the carbon-fiber microelectrode every 100 msec, ramping between −0.4 V and +1.5 V with respect to an Ag/AgCl reference electrode at a scan rate of either 400 V/sec or 1000 V/sec. The carbon-fiber microelectrode was held at the baseline potential of −0.4 V between scans. Results By using MINCS in conjunction with WINCS coordinated through an optic fiber, the authors interleaved intervals of electrical stimulation with FSCV scans and thus obtained artifact-free wireless FSCV recordings. Electrical stimulation of the medial forebrain bundle in the anesthetized rat by MINCS elicited striatal dopamine

  8. Development of the Mayo Investigational Neuromodulation Control System: toward a closed-loop electrochemical feedback system for deep brain stimulation.

    PubMed

    Chang, Su-Youne; Kimble, Christopher J; Kim, Inyong; Paek, Seungleal B; Kressin, Kenneth R; Boesche, Joshua B; Whitlock, Sidney V; Eaker, Diane R; Kasasbeh, Aimen; Horne, April E; Blaha, Charles D; Bennet, Kevin E; Lee, Kendall H

    2013-12-01

    Conventional deep brain stimulation (DBS) devices continue to rely on an open-loop system in which stimulation is independent of functional neural feedback. The authors previously proposed that as the foundation of a DBS "smart" device, a closed-loop system based on neurochemical feedback, may have the potential to improve therapeutic outcomes. Alterations in neurochemical release are thought to be linked to the clinical benefit of DBS, and fast-scan cyclic voltammetry (FSCV) has been shown to be effective for recording these evoked neurochemical changes. However, the combination of FSCV with conventional DBS devices interferes with the recording and identification of the evoked analytes. To integrate neurochemical recording with neurostimulation, the authors developed the Mayo Investigational Neuromodulation Control System (MINCS), a novel, wirelessly controlled stimulation device designed to interface with FSCV performed by their previously described Wireless Instantaneous Neurochemical Concentration Sensing System (WINCS). To test the functionality of these integrated devices, various frequencies of electrical stimulation were applied by MINCS to the medial forebrain bundle of the anesthetized rat, and striatal dopamine release was recorded by WINCS. The parameters for FSCV in the present study consisted of a pyramidal voltage waveform applied to the carbon-fiber microelectrode every 100 msec, ramping between -0.4 V and +1.5 V with respect to an Ag/AgCl reference electrode at a scan rate of either 400 V/sec or 1000 V/sec. The carbon-fiber microelectrode was held at the baseline potential of -0.4 V between scans. By using MINCS in conjunction with WINCS coordinated through an optic fiber, the authors interleaved intervals of electrical stimulation with FSCV scans and thus obtained artifact-free wireless FSCV recordings. Electrical stimulation of the medial forebrain bundle in the anesthetized rat by MINCS elicited striatal dopamine release that was time-locked to

  9. Seroprevalence and correlates of Toxoplasma gondii infection in Yoremes (Mayos) in Mexico: a cross-sectional study

    PubMed Central

    Alvarado-Esquivel, Cosme; Rascón-Careaga, Antonio; Hernández-Tinoco, Jesús; Corella-Madueño, María Alba Guadalupe; Sánchez-Anguiano, Luis Francisco; Aldana-Madrid, María Lourdes; Almada-Balderrama, Gerardo Javier; Nuñez-Aguirre, Alan Daniel; Liesenfeld, Oliver

    2016-01-01

    Objectives We sought to determine the prevalence of anti-Toxoplasma gondii antibodies in Yoremes and to identify associations of T. gondii exposure with sociodemographic, clinical and behavioural characteristics of Yoremes. Design A cross-sectional survey. Setting Yoremes were enrolled in the locality of Tierra Blanca in the municipality of Navojoa in Sonora State, Mexico. Participants We studied 200 Yoremes (Mayos); they are an indigenous ethnic group living in a coastal region in northwestern Mexico. Primary and secondary outcome measures We assessed the prevalence of anti-Toxoplasma IgG and IgM antibodies in participants using enzyme-linked immunoassays. We used a standardised questionnaire to obtain the characteristics of Yoremes. The association of T. gondii exposure and Yoremes’ characteristics was assessed by bivariate and multivariate analyses. Results Of the 200 Yoremes studied (mean age: 31.50±18.43 years), 26 (13.0%) were positive for anti-T. gondii IgG antibodies and 19 (73.1%) of them were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection did not vary with sex, educational level, occupation or socioeconomic status. In contrast, multivariate analysis of sociodemographic and behavioural characteristics showed that T. gondii exposure was associated with increasing age (OR=1.02; 95% CI 1.00 to 1.04; p=0.03) and consumption of squirrel meat (OR=4.99; 95% CI 1.07 to 23.31; p=0.04). Furthermore, seroprevalence of T. gondii infection was significantly higher in Yoremes with a history of lymphadenopathy (p=0.03) and those suffering from frequent abdominal pain (p=0.03). In women, T. gondii exposure was associated with a history of caesarean sections (p=0.03) and miscarriages (p=0.02). Conclusions We demonstrate, for the first time, serological evidence of T. gondii exposure among Yoremes in Mexico. Results suggest that infection with T. gondii might be affecting the health of Yoremes. Results may be useful for an

  10. Enhancing Therapeutic Cellular Prostate Cancer Vaccines

    DTIC Science & Technology

    2011-06-01

    Butterworth, K. T., McCarthy, H. O., Devlin , A., Ming, L., Robson, T., McKeown, S. R. and Wo rthington, J., Hypoxia selects for androgen in dependent...55905 Office: 507-284-4008, Laboratory: 507-284-1744, FAX: 507-284-8566 Education 1988 - 1995 B.S. and M.S. in Biochemistry , School of Chemical and...Department of Oncology, Mayo Clinic Cancer Center, Rochester, MN 2009 - Date Assistant Professor of Biochemistry /Molecular Biology, Mayo

  11. Metronidazole- and carbapenem-resistant bacteroides thetaiotaomicron isolated in Rochester, Minnesota, in 2014.

    PubMed

    Sadarangani, Sapna P; Cunningham, Scott A; Jeraldo, Patricio R; Wilson, John W; Khare, Reeti; Patel, Robin

    2015-07-01

    Emerging antimicrobial resistance in members of the Bacteroides fragilis group is a concern in clinical medicine. Although metronidazole and carbapenem resistance have been reported in Bacteroides thetaiotaomicron, a member of the B. fragilis group, they have not, to the best of our knowledge, been reported together in the same B. thetaiotaomicron isolate. Herein, we report isolation of piperacillin-tazobactam-, metronidazole-, clindamycin-, ertapenem-, and meropenem-resistant B. thetaiotaomicron from a patient with postoperative intra-abdominal abscess and empyema. Whole-genome sequencing demonstrated the presence of nimD with at least a portion of IS1169 upstream, a second putative nim gene, two β-lactamase genes (one of which has not been previously reported), two tetX genes, tetQ, ermF, two cat genes, and a number of efflux pumps. This report highlights emerging antimicrobial resistance in B. thetaiotaomicron and the importance of identification and antimicrobial susceptibility testing of selected anaerobic bacteria. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  12. The Mayo Dysphagia Questionnaire-30: documentation of reliability and validity of a tool for interventional trials in adults with esophageal disease.

    PubMed

    McElhiney, Judith; Lohse, Matthew R; Arora, Amindra S; Peloquin, Joanna M; Geno, Debra M; Kuntz, Melissa M; Enders, Felicity B; Fredericksen, Mary; Abdalla, Adil A; Khan, Yulia; Talley, Nicholas J; Diehl, Nancy N; Beebe, Timothy J; Harris, Ann M; Farrugia, Gianrico; Graner, Darlene E; Murray, Joseph A; Locke, G Richard; Grothe, Rayna M; Crowell, Michael D; Francis, Dawn L; Grudell, April M B; Dabade, Tushar; Ramirez, Angelica; Alkhatib, MhdMaan; Alexander, Jeffrey A; Kimber, Jessica; Prasad, Ganapathy; Zinsmeister, Alan R; Romero, Yvonne

    2010-09-01

    The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test-retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients' written responses. The MDQ-30, a 28-item instrument, took 10 min (range = 5-30 min) to complete. Four hundred thirty-one outpatients [210 (49%) men; mean age = 61 years] participated. Overall, most concurrent validity kappa values for dysphagia were very good to excellent with a median of 0.78 (min 0.28, max 0.95). The majority of reproducibility kappa values for dysphagia were moderate to excellent with a median kappa value of 0.66 (min 0.07, max 1.0). Overall, concurrent validity and reproducibility kappa values for gastroesophageal reflux disease (GERD) symptoms were 0.81 (95% CI = 0.72, 0.91) and 0.66 (95% CI = 0.55, 0.77), respectively. Individual item percent agreement was generally very good to excellent. Internal consistency was excellent. We conclude that the MDQ-30 is an easy-to-complete tool to evaluate reliably dysphagia symptoms over the last 30 days.

  13. 1999 Summer Research Program for High School Juniors at the University of Rochester's Laboratory for Laser Energetics

    SciTech Connect

    2002-10-09

    oak-B202--During the summer of 1999, 12 students from Rochester-area high schools participated in the Laboratory for Laser Energetics' Summer High School Research Program. The goal of this program is to excite a group of high school students about careers in the areas of science and technology by exposing them to research in a state-of-the-art environment. Too often, students are exposed to ''research'' only through classroom laboratories that have prescribed procedures and predictable results. In LLE's summer program, the students experience all of the trials, tribulations, and rewards of scientific research. By participating in research in a real environment, the students often become more enthusiastic about careers in science and technology. In addition, LLE gains from the contributions of the many highly talented students who are attracted to the program. The students spent most of their time working on their individual research projects with members of LLE's technical staff. The projects were related to current research activities at LLE and covered a broad range of areas of interest including laser modeling, diagnostic development, chemistry, liquid crystal devices, and opacity data visualization. The students, their high schools, their LLE supervisors and their project titles are listed in the table. Their written reports are collected in this volume. The students attended weekly seminars on technical topics associated with LLE's research. Topics this year included lasers, fusion, holography, optical materials, global warming, measurement errors, and scientific ethics. The students also received safety training, learned how to give scientific presentations, and were introduced to LLE's resources, especially the computational facilities. The program culminated with the High School Student Summer Research Symposium on 25 August at which the students presented the results of their research to an audience that included parents, teachers, and members of LIX. Each

  14. Multiple-year black carbon measurements and source apportionment using delta-C in Rochester, New York.

    PubMed

    Wang, Yungang; Hopke, Philip K; Rattigan, Oliver V; Chalupa, David C; Utell, Mark J

    2012-08-01

    Black carbon (BC), an important component ofthe atmospheric aerosol, has climatic, environmental, and human health significance. In this study, BC was continuously measured using a two-wavelength aethalometer (370 nm and 880 nm) in Rochester; New York, from January 2007 to December 2010. The monitoring site is adjacent to two major urban highways (I-490 and I-590), where 14% to 21% of the total traffic was heavy-duty diesel vehicles. The annual average BC concentrations were 0.76 microg/m3, 0.67 microg/m3, 0.60 microg/m3, and 0.52 microg/m3 in 2007, 2008, 2009, and 2010, respectively. Positive matrix factorization (PMF) modeling was performed using PM2.5 elements, sulfate, nitrate, ammonia, elemental carbon (EC), and organic carbon (OC) data from the US. Environmental Protection Agency (EPA) speciation network and Delta-C (UVBC370nm-BC880nm) data. Delta-C has been previously shown to be a tracer of wood combustion factor It was used as an input variable in source apportionment models for the first time in this study and was found to play an important role in separating traffic (especially diesel) emissions from wood combustion emissions. The result showed the annual average PM2.5 concentrations apportioned to diesel emissions in 2007, 2008, 2009, and 2010 were 1.34 microg/m3, 1.25 microg/m3, 1.13 microg/m3, and 0.97 microg/m3, respectively. The BC conditional probability function (CPF) plots show a large contribution from the highway diesel traffic to elevated BC concentrations. The measurements and modeling results suggest an impact of the US Environmental Protection Agency (EPA) 2007 Heavy-Duty Highway Rule on the decrease ofBC and PM2.5 concentrations during the study period.

  15. Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings.

    PubMed

    Iacucci, Marietta; Fort Gasia, Miriam; Hassan, Cesare; Panaccione, Remo; Kaplan, Gilaad G; Ghosh, Subrata; Gui, Xianyong

    2015-08-01

    A novel high definition colonoscopy imaging technique (i-Scan) can characterize, in detail, colonic mucosa in patients with ulcerative colitis, and may provide additional information about mucosal healing. The aim of this study was to create a more refined histological and endoscopic criteria based on this novel technique in order to redefine inflammatory activity and mucosal healing. A total of 78 patients with ulcerative colitis were assessed by high definition colonoscopy as well as by white light endoscopy (WLE). Mayo endoscopic subscores were assigned to patients according to WLE findings. Mucosal and vascular patterns on high definition colonoscopy were each graded from 1 - 4. A histological scoring system (ECAP system) was designed to reflect all histological changes in ulcerative colitis. The overall high definition imaging scores (mucosal and vascular patterns) were significantly correlated with Mayo endoscopic subscores (rs = 0.86, 95 % confidence interval [CI] 0.79 - 0.91; P < 0.0001). Of those with Mayo endoscopic subscore of 0, 30.4 % had an abnormal mucosal pattern and 73.9 % of them had an abnormal vascular pattern on high definition colonoscopy; a score of 6 or less had a sensitivity of 95.8 % (95 %CI 85.7 % - 99.3 %) and specificity of 75.9 % (95 %CI 56.5 % - 90.0 %) to detect mucosal healing as defined by Mayo endoscopy subscore of 0 or 1. Furthermore, mucosal and vascular pattern scores were also significantly correlated with most parameters of the proposed ECAP score. The subtle histological abnormalities underlying the apparently healed mucosa in ulcerative colitis could be detected using high definition colonoscopy and the refined ECAP histology scoring system. These techniques detect residual abnormalities in the majority of patients with seemingly complete mucosal healing by conventional Mayo criteria. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Ambulatory cardiovascular monitoring of healthy adults in Rochester, Minnesota: chronobiologic assessment.

    PubMed

    Zachariah, P K; Cornélissen, G; Halberg, F

    1990-01-01

    To serve as a tentative reference group for clinical health, 107 adults measured their systolic (S) and diastolic (D) blood pressure (BP) with an ambulatory Del Mar Avionics monitor (Irvine, California). Data were collected over approximately 24 hours at 7.5-minute intervals during waking and at 15-minute intervals during sleep. An echocardiogram served to determine the left ventricular mass (LVM), septal wall thickness (SWT), posterior wall thickness (PWT), ejection fraction (EjFr), and left atrial size (LAS). Each data series was analyzed by single cosinor. A statistically significant circadian rhythm (P less than 0.05) was found in 96 subjects (89.7 percent) for SBP and in 86 subjects (80.4 percent) for DBP. A population-mean cosinor reveals a highly significant circadian rhythm (P less than 0.001) for both variables in men (n = 44) as well as in women (n = 63), with an acrophase around 14:15. The double circadian amplitude, a measure of the total predictable change within a day, averages 10 (women) and 11 (men) mm Hg for DBP and 14 (women) and 17 (men) mm Hg for SBP. The midline-estimating statistic of rhythm (MESOR) of SBP is found to be higher for men (125 mm Hg) than for women (120 mm Hg), P = 0.018, whereas no difference in MESOR is found for DBP (71 mm Hg). A statistically significant correlation with age is found for the MESOR of SBP in both men (r = 0.352; P = 0.018) and women (r = 0.336; P = 0.007). The MESOR of SBP is also found to correlate with LVM in men (r = 0.300; P = 0.046), but not in women (r = 0.181; P = 0.153), whereas the MESOR of DBP correlates with LVM in women (R = 0.316; P = 0.011) but not in men (r = 0.117; P = 0.543). A positive correlation is also found between the MESOR of SBP and SWT as well as with EjFr, which is more prominent in women; between the MESOR of DBP and LAS, which is more prominent in men; and a negative correlation is found for women but not men between the circadian amplitude of both SBP and DBP and EjFr. Blood

  17. Accurate prediction of death by serial determination of galactose elimination capacity in primary biliary cirrhosis: a comparison with the Mayo model.

    PubMed

    Reichen, J; Widmer, T; Cotting, J

    1991-09-01

    We retrospectively analyzed the predictive accuracy of serial determinations of galactose elimination capacity in 61 patients with primary biliary cirrhosis. Death was predicted from the time that the regression line describing the decline in galactose elimination capacity vs. time intersected a value of 4 mg.min-1.kg-1. Thirty-one patients exhibited decreasing galactose elimination capacity; in 11 patients it remained stable and in 19 patients only one value was available. Among those patients with decreasing galactose elimination capacity, 10 died and three underwent liver transplantation; prediction of death was accurate to 7 +/- 19 mo. This criterion incorrectly predicted death in two patients with portal-vein thrombosis; otherwise, it did better than or as well as the Mayo clinic score. The latter was also tested on our patients and was found to adequately describe risk in yet another independent population of patients with primary biliary cirrhosis. Cox regression analysis selected only bilirubin and galactose elimination capacity, however, as independent predictors of death. We submit that serial determination of galactose elimination capacity in patients with primary biliary cirrhosis may be a useful adjunct to optimize the timing of liver transplantation and to evaluate new pharmacological treatment modalities of this disease.

  18. Refertilization process in the Patagonian subcontinental lithospheric mantle of Estancia Sol de Mayo (Argentina)

    NASA Astrophysics Data System (ADS)

    Melchiorre, Massimiliano; Coltorti, Massimo; Gregoire, Michel; Benoit, Mathieu

    2015-05-01

    Anhydrous mantle xenoliths equilibrated at 1003-1040 °C from Estancia Sol de Mayo (ESM, Central Patagonia, Argentina) and entrained in post-plateau alkaline lavas belonging to Meseta Lago Buenos Aires have been investigated aiming at reconstructing the depletion and enrichment processes that affected this portion of the Patagonia lithospheric mantle. Xenoliths are characterized by a coarse-grained protogranular texture and are devoid of evident modal metasomatism. They show two texturally different clinopyroxenes: protogranular (cpx1) and texturally related to spinel (cpx2). Three different types of orthopyroxenes are also recognized: large protogranular crystals with exsolution lamellae (opx1); small clean and undeformed grains without exsolution lamellae (opx2) and small grains arranged in a vein (opx3). Major element composition of clinopyroxenes and orthopyroxenes highlights two different trends characterized by i) a high Al2O3 content at almost constant mg# and ii) a slight increase in Al2O3 content with decreasing mg#. Clinopyroxenes are enriched in LREE and are characterized by prominent to slightly negative Nb, Zr and Ti anomalies. No geochemical differences are observed between cpx1 and cpx2, while a discrimination can be observed between opx1 and opx2 (LREE-depleted; prominent to slightly negative Ti and Zr anomalies) and opx3 (prominent positive Zr anomaly). Partial melting modeling using both major and trace elements indicates a melting degree between ~ 5% and ~ 13% (up to ~ 23% according to major element modeling) for lherzolites and between ~ 20% and ~ 30% for harzburgites (down to ~ 5% according to trace element modeling). La/Yb and Al2O3, as well as Sr and Al2O3 negative correlations in clinopyroxenes point to a refertilization event affecting this lithospheric mantle. The agent was most probably a transitional alkaline/subalkaline melt, as indicated by the presence of orthopyroxene in the vein and the similar geochemical features of ESM

  19. The Rochester Robot

    DTIC Science & Technology

    1988-08-01

    board can program the other boards in the same manner as the host. The MaxVideo device can operate either in continuous mode or interrupt mode . We have...not so far successfully used interrupt mode . The 16-node Floating-Point Platform Butterfly Parallel Processorg (FPP-BPP) has a VMEbus connection that...serves to implement commonly useful relatively complex actions that arise in response to the environment, or can be initiated and then automatically

  20. Prospective study on the clinical course and outcomes in transfusion-related acute lung injury*.

    PubMed

    Looney, Mark R; Roubinian, Nareg; Gajic, Ognjen; Gropper, Michael A; Hubmayr, Rolf D; Lowell, Clifford A; Bacchetti, Peter; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C; Wu, Ping; Grimes, Barbara; Norris, Philip J; Murphy, Edward L; Gandhi, Manish J; Winters, Jeffrey L; Mair, David C; Schuller, Randy M; Hirschler, Nora V; Rosen, Rosa Sanchez; Matthay, Michael A; Toy, Pearl

    2014-07-01

    Transfusion-related acute lung injury is the leading cause of transfusion-related mortality. A prospective study using electronic surveillance was conducted at two academic medical centers in the United States with the objective to define the clinical course and outcomes in transfusion-related acute lung injury cases. Prospective case study with controls. University of California, San Francisco and Mayo Clinic, Rochester. We prospectively enrolled 89 patients with transfusion-related acute lung injury, 164 transfused controls, and 145 patients with possible transfusion-related acute lung injury. None. Patients with transfusion-related acute lung injury had fever, tachycardia, tachypnea, hypotension, and prolonged hypoxemia compared with controls. Of the patients with transfusion-related acute lung injury, 29 of 37 patients (78%) required initiation of mechanical ventilation and 13 of 53 (25%) required initiation of vasopressors. Patients with transfusion-related acute lung injury and possible transfusion-related acute lung injury had an increased duration of mechanical ventilation and increased days in the ICU and hospital compared with controls. There were 15 of 89 patients with transfusion-related acute lung injury (17%) who died, whereas 61 of 145 patients with possible transfusion-related acute lung injury (42%) died and 7 of 164 of controls (4%) died. Patients with transfusion-related acute lung injury had evidence of more systemic inflammation with increases in circulating neutrophils and a decrease in platelets compared with controls. Patients with transfusion-related acute lung injury and possible transfusion-related acute lung injury also had a statistically significant increase in plasma interleukin-8, interleukin-10, and interleukin-1 receptor antagonist posttransfusion compared with controls. In conclusion, transfusion-related acute lung injury produced a condition resembling the systemic inflammatory response syndrome and was associated with

  1. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.

    PubMed

    West, Colin P; Dyrbye, Liselotte N; Rabatin, Jeff T; Call, Tim G; Davidson, John H; Multari, Adamarie; Romanski, Susan A; Hellyer, Joan M Henriksen; Sloan, Jeff A; Shanafelt, Tait D

    2014-04-01

    IMPORTANCE Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem. OBJECTIVE To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 74 practicing physicians in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, conducted between September 2010 and June 2012. Additional data were collected on 350 nontrial participants responding to annual surveys timed to coincide with the trial surveys. INTERVENTIONS The intervention involved 19 biweekly facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning for 9 months. Protected time (1 hour of paid time every other week) for participants was provided by the institution. MAIN OUTCOMES AND MEASURES Meaning in work, empowerment and engagement in work, burnout, symptoms of depression, quality of life, and job satisfaction assessed using validated metrics. RESULTS Empowerment and engagement at work increased by 5.3 points in the intervention arm vs a 0.5-point decline in the control arm by 3 months after the study (P = .04), an improvement sustained at 12 months (+5.5 vs +1.3 points; P = .03). Rates of high depersonalization at 3 months had decreased by 15.5% in the intervention arm vs a 0.8% increase in the control arm (P = .004). This difference was also sustained at 12 months (9.6% vs 1.5% decrease; P = .02). No statistically significant differences in stress, symptoms of depression, overall quality of life, or job satisfaction were seen. In additional comparisons including the nontrial physician cohort, the proportion of participants strongly agreeing that their work was meaningful increased 6.3% in the study intervention arm but decreased 6.3% in the study control arm

  2. Are Cancer Survivors/Patients Knowledgeable about Osteoporosis? Results from a Survey of 285 Chemotherapy-Treated Cancer Patients and Their Companions

    ERIC Educational Resources Information Center

    McKean, Heidi; Looker, Sherry; Hartmann, Lynn C.; Hayman, Suzanne R.; Kaur, Judith S.; McWilliams, Robert R.; Peethambaram, Prema P.; Stahl, Jean F.; Jatoi, Aminah

    2008-01-01

    Objective: This study assessed osteoporosis knowledge deficits among cancer patients and their spouses/partners. Design: Single-institution survey (modified version of the Osteoporosis Knowledge Assessment Tool). Setting: The Mayo Clinic in Rochester, Minnesota. Participants: Consecutive chemotherapy-treated cancer patients (n = 285) with their…

  3. Are Cancer Survivors/Patients Knowledgeable about Osteoporosis? Results from a Survey of 285 Chemotherapy-Treated Cancer Patients and Their Companions

    ERIC Educational Resources Information Center

    McKean, Heidi; Looker, Sherry; Hartmann, Lynn C.; Hayman, Suzanne R.; Kaur, Judith S.; McWilliams, Robert R.; Peethambaram, Prema P.; Stahl, Jean F.; Jatoi, Aminah

    2008-01-01

    Objective: This study assessed osteoporosis knowledge deficits among cancer patients and their spouses/partners. Design: Single-institution survey (modified version of the Osteoporosis Knowledge Assessment Tool). Setting: The Mayo Clinic in Rochester, Minnesota. Participants: Consecutive chemotherapy-treated cancer patients (n = 285) with their…

  4. Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

    PubMed

    Turner, Leigh

    2012-05-01

    When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.

  5. Deletion 5q is frequent in myelodysplastic syndrome (MDS) patients diagnosed with interstitial lung diseases (ILD): Mayo Clinic experience.

    PubMed

    Nanah, Rama; Zblewski, Darci; Patnaik, Mrinal S; Begna, Kebede; Ketterling, Rhett; Iyer, Vivek N; Hogan, William J; Litzow, Mark R; Al-Kali, Aref

    2016-11-01

    A variety of interstitial Lung Diseases (ILD) have been described in patients with myelodysplastic syndromes (MDS) with possible etiologies including autoimmunity, drug related toxicity, and recurrent infections. A comprehensive study of ILD in MDS patients has not been previously performed. Out of 827 consecutive biopsy proven MDS patients seen at our institution from June 1970-May 2010, 18 (2%) were found to have ILD. There was no statistical significance in baseline characteristics between patients with ILD (ILD +) vs those without ILD (ILD-). Cytogenetic studies were reported in 14 ILD+patients out of whom 43% had 5q- abnormalities (21% isolated and 22% part of complex karyotype). Prevalence of high risk MDS was similar between both groups (22% vs 29% in ILD-) with similar overall survival. ILD was diagnosed prior to MDS in the majority of cases (72%) with a median time to MDS diagnosis of 22.3 months. Our study suggests that ILD are present in a higher percentage than anticipated in the MDS population. Deletion 5q was frequent in ILD+ cases and this requires further study. Prior MDS treatment and autoimmunity seemed to play no significant role in ILD development.

  6. Mayo Clinic approaches to meet United States Pharmacopeia <797> requirements for facility design and environmental controls of nuclear pharmacy.

    PubMed

    Hung, Joseph C; Anderson, Michelle M

    2009-01-01

    According to the United States Pharmacopeia (USP) General Chapter <797> (USP <797>), "Pharmaceutical Compounding-Sterile Preparations," the compounding facility must be physically designed and environmentally controlled to minimize airborne contamination from contacting critical sites. The goal of the project was to evaluate the appropriateness and effectiveness of our approaches in meeting <797> requirements. USP <797> standards, radiation safety concerns, and work-flow patterns were the focal points in our assessment of 4 laboratories: 2 nuclear pharmacy laboratories that engage in preparing sterile (low-, medium-, and high-risk levels), nonsterile, or possible hazardous radioactive drugs and 2 other laboratories in which only low-risk-level preparations are involved. Each laboratory was constructed with a physically separated International Organization for Standardization Class 7 anteroom and clean room to allow us to maintain an appropriate air quality, a consistent operation, and a desirable flexibility. An isolated area within the laboratory was designated for preparing nonsterile products. Higher air change per hour was used in the areas with higher traffic or smaller space. Lead-lined biological safety cabinets (BSCs) were segregated and used depending on the risk category of the preparations. In 1 laboratory, the exhaust flow for the BSC was too great, and a lead-lined compounding aseptic containment isolator (CACI) was installed. Air in the BSC and CACI was 100% exhausted to the atmosphere. 99Mo/99mTc generators were placed in the negative-pressure clean room to ensure a more efficient operation and cleaner air environment. Clean-room equipment (i.e., keyboards, printers, and telephones) was installed, and refrigerators or freezers and the central-processing unit of each computer were placed outside clean room. Our wide-range preparations of sterile, nonsterile, or potential hazardous radiopharmaceuticals, coupled with the limited space of each laboratory and existing antiquated mechanical systems, presented a challenge. Nevertheless, we successfully remodeled each nuclear pharmacy laboratory to meet USP <797> requirements for facility design and environmental controls.

  7. Topical amitriptyline combined with ketamine for the treatment of erythromelalgia: a retrospective study of 36 patients at Mayo Clinic.

    PubMed

    Poterucha, Timothy J; Weiss, William T; Warndahl, Roger A; Rho, Richard H; Sandroni, Paola; Davis, Mark D P; Murphy, Sinead L

    2013-03-01

    Erythromelalgia is an uncommon neurovascular disorder characterized by redness, increased skin temperature, and pain that usually occurs in the extremities. Treatment remains challenging because of its varying response to medical therapy. The objective of this study was to assess the response of erythromelalgia to compounded topical amitriptyline-ketamine. We retrospectively evaluated 36 patients with erythromelalgia who were treated with compounded topical amitriptyline-ketamine from January 1, 2004, through January 31, 2011. Thirty-two patients (89%) were female. Mean (standard deviation) age was 44.7 (15.8) years (range, 5-74 years). Patients applied the medication 1 to 6 times per day (median, 5 times). One patient (3%) had complete relief from symptoms, 14 (39%) had substantial relief, 12 (33%) had some relief, 7 (19%) had no relief, and 2 (6%) had local worsening of symptoms. No patients had systemic adverse effects. A majority of patients with erythromelalgia (75%) reported improvement in pain with topical application of a compounded amitriptyline-ketamine formulation. The medication was well tolerated.

  8. Gastrointestinal helminths of Gentoo penguins (Pygoscelis papua) from Stranger Point, 25 de Mayo/King George Island, Antarctica.

    PubMed

    Diaz, Julia Inés; Fusaro, Bruno; Longarzo, Lucrecia; Coria, Néstor Rubén; Vidal, Virginia; Jerez, Silvia; Ortiz, Juana; Barbosa, Andrés

    2013-05-01

    The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Gentoo penguin (Pygoscelis papua) from 25 de Mayo/King George Island (South Shetlands, Antarctica). Gastrointestinal tracts of 37 fresh dead individuals (21 chicks, 10 juveniles, and 6 adults) were collected from December 2006 to February 2012 and examined for macroparasites. Four adult parasite species were found: one Cestoda species (Parorchites zederi), two Nematoda species (Stegophorus macronectes and Tetrameres wetzeli), and one Acanthocephalan (Corynosoma shackletoni). Two species of immature acanthocephalans, Corynosoma hamanni and Corynosoma bullosum, were found in a single host. This is the first record of Tetrameres wetzeli in Gentoo penguins. The low parasite richness observed could be related to the stenophagic and pelagic diet of this host species which feeds almost exclusively on krill.

  9. A brief report on WAIS-R normative data collection in Mayo's Older African Americans Normative Studies.

    PubMed

    Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

    2005-06-01

    Historically, neuropsychological measures such as the Wechsler Adult Intelligence Scale-Revised (WAIS-R) have yielded unacceptably high rates of misdiagnosis of impairment among cognitively normal African Americans, primarily due to poor test specificity and inadequate representation of ethnic minorities in the normative sample. In this report, we briefly review these issues and describe efforts by investigators in Mayo's Older African Americans Normative Studies (MOAANS) to develop more appropriate norms for African American elders on the WAIS-R. During MOAANS data collection, the third edition of the WAIS (WAIS-III) was introduced with updated representation of ethnic minorities in the normative database. More recently, specific demographic corrections for African Americans have been derived for WAIS-III subtest scores and indices. As such, WAIS-R normative estimates are not presented here. Interested readers who wish to obtain a full set of MOAANS WAIS-R norms, however, are invited to contact the authors for these data.

  10. Level II scour analysis for Bridge 25 (ROCHTH00400025) on Town Highway 40, crossing Corporation Brook, Rochester, Vermont

    USGS Publications Warehouse

    Wild, Emily C.; Weber, Matthew A.

    1998-01-01

    This report provides the results of a detailed Level II analysis of scour potential at structure ROCHTH00400025 on Town Highway 40 crossing Corporation Brook, Rochester, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (FHWA, 1993). Results of a Level I scour investigation also are included in appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, from Vermont Agency of Transportation files, was compiled prior to conducting Level I and Level II analyses and is found in appendix D. The site is in the Green Mountain section of the New England physiographic province in central Vermont. The 4.97-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is forest on the upstream left and right overbanks, and the downstream left overbank. On the downstream right overbank, the surface cover is predominately brushland. In the study area, Corporation Brook has an incised, sinuous channel with a slope of approximately 0.04 ft/ft, an average channel top width of 37 ft and an average bank height of 6 ft. The channel bed material ranges from gravel to boulders with a median grain size (D50) of 101 mm (0.332 ft). The geomorphic assessment at the time of the Level I site visit on April 12, 1995 and Level I and II site visit on July 8, 1996, indicated that the reach was stable. The Town Highway 40 crossing of Corporation Brook is a 31-ft-long, one-lane bridge consisting of a 26-foot steel stringer span (Vermont Agency of Transportation, written communication, March 22, 1995). The opening length of the structure parallel to the bridge face is 24 ft. The bridge is supported by vertical, concrete abutments. The channel is skewed approximately 15 degrees to the opening while the opening-skew-to-roadway is 15 degrees. A scour hole 1

  11. Level II scour analysis for Bridge 28 (ROCHTH00370028) on Town Highway 37, crossing Brandon Brook, Rochester, Vermont

    USGS Publications Warehouse

    Wild, Emily C.; Weber, Matthew A.

    1998-01-01

    This report provides the results of a detailed Level II analysis of scour potential at structure ROCHTH00370028 on Town Highway 37 crossing Brandon Brook, Rochester, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (FHWA, 1993). Results of a Level I scour investigation also are included in appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, gleaned from VTAOT files, was compiled prior to conducting Level I and Level II analyses and is found in appendix D. The site is in the Green Mountain section of the New England physiographic province in central Vermont. The 8.0-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is pasture on the upstream left overbank although the immediate banks have dense woody vegetation. The upstream right overbank and downstream left and right overbanks are forested. In the study area, the Brandon Brook has an incised, sinuous channel with a slope of approximately 0.01 ft/ft, an average channel top width of 44 ft and an average bank height of 7 ft. The channel bed material ranges from gravel to cobbles with a median grain size (D50) of 84.2 mm (0.276 ft). The geomorphic assessment at the time of the Level I site visit on April 12, 1995 and Level II site visit on July 8, 1996, indicated that the reach was stable. The Town Highway 37 crossing of the Brandon Brook is a 33-ft-long, one-lane bridge consisting of a 31-foot timber-stringer span (Vermont Agency of Transportation, written communication, March 22, 1995). The opening length of the structure parallel to the bridge face is 29.6 ft. The bridge is supported by vertical, timber log cribbing abutments with wingwalls. The channel is skewed approximately 5 degrees to the opening while the computed opening-skew-to-roadway is zero

  12. Level II scour analysis for Bridge 144 (ROCHVT01000144) on State Route 100, crossing the White River, Rochester, Vermont

    USGS Publications Warehouse

    Boehmler, Erick M.; Wild, Emily C.

    1997-01-01

    This report provides the results of a detailed Level II analysis of scour potential at structure ROCHVT01000144 on State Route 100 crossing the White River, Rochester, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (U.S. Department of Transportation, 1993). Results of a Level I scour investigation also are included in Appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, gleaned from Vermont Agency of Transportation (VTAOT) files, was compiled prior to conducting Level I and Level II analyses and is found in Appendix D. The site is in the Green Mountain section of the New England physiographic province in central Vermont. The 68.9-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is pasture with forest on the valley walls. In the study area, the White River has a meandering channel with a slope of approximately 0.003 ft/ft, an average channel top width of 119 ft and an average channel depth of 4 ft. The predominant channel bed material is gravel and cobbles with a median grain size (D50) of 72.5 mm (0.238 ft). The geomorphic assessment at the time of the Level I and Level II site visit on July 22, 1996, indicated that the reach was laterally unstable due to a cut-bank present on the upstream left bank and wide point bars upstream and downstream in the vicinity of this site. The State Route 100 crossing of the White Riveris a 103-ft-long, two-lane bridge consisting of one 101-foot steel-beam span (Vermont Agency of Transportation, written communication, March 8, 1995). The bridge is supported by vertical, concrete abutment walls with spill-through embankments in front of each abutment wall and no wingwalls. The channel is skewed approximately 10 degrees to the opening while the opening-skew-toroadway is

  13. Level II scour analysis for Bridge 34 (ROCHTH00210034) on Town Highway 21, crossing the White River, Rochester, Vermont

    USGS Publications Warehouse

    Wild, Emily C.; Degnan, James

    1997-01-01

    This report provides the results of a detailed Level II analysis of scour potential at structure ROCHTH00210034 on Town Highway 21 crossing the White River, Rochester, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (U.S. Department of Transportation, 1993). Results of a Level I scour investigation also are included in Appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, obtained from Vermont Agency of Transportation (VTAOT) files, was compiled prior to conducting Level I and Level II analyses and is found in Appendix D.The site is in the Green Mountain section of the New England physiographic province in central Vermont. The 74.8-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is suburban on the upstream and downstream left overbanks, though brush prevails along the immediate banks. On the upstream and downstream right overbanks, the surface cover is pasture with brush and trees along the immediate banks.In the study area, the White River has an incised, straight channel with a slope of approximately 0.002 ft/ft, an average channel top width of 102 ft and an average bank height of 5 ft. The channel bed material ranges from sand to cobble with a median grain size (D50) of 74.4 mm (0.244 ft). The geomorphic assessment at the time of the Level I and Level II site visit on July 23, 1996, indicated that the reach was stable.The Town Highway 21 crossing of the White River is a 72-ft-long, two-lane bridge consisting of 70-foot steel stringer span (Vermont Agency of Transportation, written communication, March 22, 1995). The opening length of the structure parallel to the bridge face is 67.0 ft. The bridge is supported by vertical, concrete abutments with wingwalls. The channel is skewed approximately 15

  14. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery

    PubMed Central

    2011-01-01

    Introduction The RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) classification for acute kidney injury (AKI) was recently modified by the Acute Kidney Injury Network (AKIN). The two definition systems differ in several aspects, and it is not clearly determined which has the better clinical accuracy. Methods In a retrospective observational study we investigated 4,836 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass from 2005 to 2007 at Mayo Clinic, Rochester, MN, USA. AKI was defined by RIFLE and AKIN criteria. Results Significantly more patients were diagnosed as AKI by AKIN (26.3%) than by RIFLE (18.9%) criteria (P < 0.0001). Both definitions showed excellent association to outcome variables with worse outcome by increased severity of AKI (P < 0.001, all variables). Mortality was increased with an odds ratio (OR) of 4.5 (95% CI 3.6 to 5.6) for one class increase by RIFLE and an OR of 5.3 (95% CI 4.3 to 6.6) for one stage increase by AKIN. The multivariate model showed lower predictive ability of RIFLE for mortality. Patients classified as AKI in one but not in the other definition set were predominantly staged in the lowest AKI severity class (9.6% of patients in AKIN stage 1, 2.3% of patients in RIFLE class R). Potential misclassification of AKI is higher in AKIN, which is related to moving the 48-hour diagnostic window applied in AKIN criteria only. The greatest disagreement between both definition sets could be detected in patients with initial postoperative decrease of serum creatinine. Conclusions Modification of RIFLE by staging of all patients with acute renal replacement therapy (RRT) in the failure class F may improve predictive value. AKIN applied in patients undergoing cardiac surgery without correction of serum creatinine for fluid balance may lead to over-diagnosis of AKI (poor positive predictive value). Balancing limitations of both definition sets of AKI, we suggest application of the

  15. Obtaining oblique technique source-to-skin distances for irregular field (Clarkson) calculations: The Mayo Off-axis Distance Indicator

    SciTech Connect

    Lajoie, W.N. )

    1988-09-01

    Significant dose inhomogeneities may exist between the supraclavicular fossa (SCF) and the internal mammary chain (IMC) regions in the irregular L-shaped (hockey stick) field associated with breast cancer treatments. This dose inhomogeneity exists, in part, because of a positive air gap in the SCF and a negative air gap in the IMC locations. Independent of treatment technique, (i.e., whether anterior-posterior (AP) or oblique fields are used), accurate source-to-skin distance (SSD) values for the SCF, IMC, and axilla are necessary when doing an irregular field (Clarkson) dose calculation. However, when an oblique technique is used to treat the hockey stick field, obtaining non-central-axis SSDs is not as straightforward as when an AP technique is employed. The Mayo Off-axis Distance Indicator was constructed to slide into the blocking tray slot of the simulator or treatment machine. This mechanical measuring device provides quick and accurate SSD measurements for non-central-axis points under either AP or, more importantly, oblique treatment conditions.

  16. What Is the Difference between Pseudoclaudication and Claudication?

    MedlinePlus

    ... D. References Wheeler SG, et al. Evaluation of low back pain in adults. http://www.uptodate.com/home. Accessed Dec. 17, 2016. AskMayoExpert. Lumbar spinal stenosis. Rochester, Minn.: Mayo Foundation for Medical ...

  17. Hydrocele

    MedlinePlus

    ... 7, 2014. AskMayoExpert. What are possible causes of pediatric testicular pain? Rochester, Minn.: Mayo Foundation for Medical ... 1725. Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http:// ...

  18. Using RxNorm and NDF-RT to Classify Medication Data Extracted from Electronic Health Records: Experiences from the Rochester Epidemiology Project

    PubMed Central

    Pathak, Jyotishman; Murphy, Sean P.; Willaert, Brian N.; Kremers, Hilal M.; Yawn, Barbara P.; Rocca, Walter A.; Chute, Christopher G.

    2011-01-01

    RxNorm and NDF-RT published by the National Library of Medicine (NLM) and Veterans Affairs (VA), respectively, are two publicly available federal medication terminologies. In this study, we evaluate the applicability of RxNorm and National Drug File-Reference Terminology (NDF-RT) for extraction and classification of medication data retrieved using structured querying and natural language processing techniques from electronic health records at two different medical centers within the Rochester Epidemiology Project (REP). Specifically, we explore how mappings between RxNorm concept codes and NDF-RT drug classes can be leveraged for hierarchical organization and grouping of REP medication data, identify gaps and coverage issues, and analyze the recently released NLM’s NDF-RT Web service API. Our study concludes that RxNorm and NDF-RT can be applied together for classification of medication extracted from multiple EHR systems, although several issues and challenges remain to be addressed. We further conclude that the Web service APIs developed by the NLM provide useful functionalities for such activities. PMID:22195170

  19. Increased Incidence and Recurrence Rates of Nonmelanoma Skin Cancer in Patients With Non-Hodgkin Lymphoma: A Rochester, MN Epidemiology Project Population-Based Study

    PubMed Central

    Brewer, Jerry D.; Shanafelt, Tait D.; Khezri, Farzaneh; Sosa Seda, Ivette M.; Zubair, Adeel S.; Baum, Christian L.; Arpey, Christopher J.; Cerhan, James R.; Call, Timothy G.; Roenigk, Randall K.; Smith, Carin Y.; Weaver, Amy L.; Otley, Clark C.

    2015-01-01

    Background Cutaneous malignancy is associated with worse outcomes in patients with chronic lymphocytic leukemia (CLL). Objective To identify the incidence and recurrence rate of nonmelanoma skin cancer (NMSC) in patients with non-Hodgkin lymphoma (NHL). Methods NMSC incidence was calculated and Cox proportional hazard models were used to evaluate associations with risk of recurrence for patients with NHL between 1976 and 2005 who were in the Rochester Epidemiology Project research infrastructure. Results We identified 282 patients with CLL or small lymphocytic lymphoma and 435 with non-CLL NHL. The incidence of BCC and SCC was 1,829.3 (95% CI, 1,306.7-2,491.1) and 2,224.9 (95% CI, 1,645.9-2,941.6), respectively, in patients with CLL. The cumulative recurrence rate at 8 years after treatment with Mohs micrographic surgery was 8.3% (95% CI, 0.0%-22.7%) for BCC and 13.4% (95% CI, 0.0%-25.5%) for SCC in patients with CLL. Limitations This was a retrospective cohort study. Conclusions After Mohs micrographic surgery and standard excision of NMSC, patients with NHL had a skin cancer recurrence rate that was higher than expected. Careful treatment and monitoring of patients with NHL and NMSC are warranted. PMID:25479909

  20. Survey of Lake Ontario bottom sediment off Rochester, New York, to define the extent of jettisoned World War II material and its potential for sediment contamination

    USGS Publications Warehouse

    Kennedy, Gregory; Kappel, William M.

    2000-01-01

    Military-type mat??riel was recovered from the bottom of Lake Ontario near Rochester, N.Y., during bottom-trawl, fish-stock surveys at depths of 75 to 180 feet each year from 1978 through 1996. The recovered mat??riel included many shell-detonator nose cones (2 inches in diameter by about 3.5 inches long); several electronic components; one corroded box of detonators; a corrugated container of mercury-filled capsules; and corroded batteries. Most of the recovered mat??riel has been identified as defective components of shell detonators (proximity-fuze assemblies) that were jettisoned in the lake to protect them from discovery during World War II. Side-scan SONAR, metal-detector, and ROV (remotely-operated-vehicle) surveys found no evidence of any large piles of mat??riel containing potentially hazardous, toxic, or polluting materials within the 17-square-mile study site. Many scattered magnetic anomalies were detected in this area, but chemical analysis of bottom sediment and of zebra- and quagga-mussel (Dreissena spp.) tissue indicate that the concentrations of mercury and other heavy metals are within the previously documented ranges for Lake Ontario sediment. The failure of ROV videos and of SCUBA-diver surveys and probes of the lake bottom to locate any debris indicates that most, if not all, of the debris is scattered and buried under a layer of fine-grained sediment and, possibly, mussels.

  1. Variation at the M235T locus of the angiotensinogen gene and essential hypertension: a population-based case-control study from Rochester, Minnesota.

    PubMed

    Fornage, M; Turner, S T; Sing, C F; Boerwinkle, E

    1995-09-01

    A variant of the angiotensinogen gene, M235T, has been associated with essential hypertension in selected subjects from Paris, France and Salt Lake City, Utah. In the present report, we studied a population-based sample consisting of 104 subjects diagnosed with hypertension before age 60 and 195 matched normotensive individuals from Rochester, Minnesota. We determined whether there was a relationship between the M235T polymorphism of the angiotensinogen gene and the occurrence of essential hypertension using two methods. First, a contingency chi-square analysis was carried out to test for an association between the M235T polymorphism and hypertension status. Second, multivariable conditional logistic regression was used to determine whether variation at the M235T polymorphism was a significant predictor of the probability of having essential hypertension. We detected no statistically significant association between the M235T polymorphism and the occurrence of essential hypertension. In particular, the association was not significant in either gender or in a subset of severely hypertensive subjects requiring two or more anti-hypertensive medications. Furthermore, variation in the number of M235T alleles did not make a significant contribution to predicting the probability of having essential hypertension, either alone or in conjunction with other predictor variables. These results suggest that the contribution of variation in the angiotensinogen gene to the occurrence of essential hypertension is less than initially suspected, or may not be constant across populations.

  2. Using RxNorm and NDF-RT to classify medication data extracted from electronic health records: experiences from the Rochester Epidemiology Project.

    PubMed

    Pathak, Jyotishman; Murphy, Sean P; Willaert, Brian N; Kremers, Hilal M; Yawn, Barbara P; Rocca, Walter A; Chute, Christopher G

    2011-01-01

    RxNorm and NDF-RT published by the National Library of Medicine (NLM) and Veterans Affairs (VA), respectively, are two publicly available federal medication terminologies. In this study, we evaluate the applicability of RxNorm and National Drug File-Reference Terminology (NDF-RT) for extraction and classification of medication data retrieved using structured querying and natural language processing techniques from electronic health records at two different medical centers within the Rochester Epidemiology Project (REP). Specifically, we explore how mappings between RxNorm concept codes and NDF-RT drug classes can be leveraged for hierarchical organization and grouping of REP medication data, identify gaps and coverage issues, and analyze the recently released NLM's NDF-RT Web service API. Our study concludes that RxNorm and NDF-RT can be applied together for classification of medication extracted from multiple EHR systems, although several issues and challenges remain to be addressed. We further conclude that the Web service APIs developed by the NLM provide useful functionalities for such activities.

  3. The transition from an analog to a digital echocardiography laboratory: the Mayo experience.

    PubMed

    Hansen, William H; Gilman, Gregory; Finnesgard, Scott J; Wellik, Trudy J; Nelson, Tishri A; Johnson, Margaret F; Schwenk, Nina M; Seward, James B; Khandheria, Bijoy K

    2004-11-01

    Our echocardiography laboratory has completed the transition from an analog to a digital imaging laboratory. The process involved a thorough analysis of the practice and design of a complete digital solution. After an effective implementation of a robust reporting solution, the transition to digital imaging ensued. The implementation plan for digital imaging enabled the transition to be made without adversely affecting the practice, which has an average daily examination load of more than 200 patients. Full-load testing simulations were required on high-end image processing review workstations, high-speed local area network connections to each imaging suite, and new clustered imaging servers. We had to test the ability of approximately 100 ultrasound machines with 3 idiosyncratic ultrasound platforms to allow digital image transfer to the new imaging servers over the local area network. Our sonographer, allied health, and physician staff of more than 250 persons had to be trained to adapt to important changes that the digital echocardiographic image acquisition and review platform would have on their specific roles in the laboratory. The efficiency of the implementation, reporting, and imaging resulted in improved staff resource allocation. The lessons learned may benefit laboratories with a similar interest in making the transition to a digital imaging laboratory with minimal effect on patient scheduling and staff satisfaction. The effect of the transition to a completely digital laboratory on operating expenses, imaging, and reviewing systems and the impact on the clinical practice of echocardiography at our institution are presented, with emphasis on the particular aspects of transitioning to digital imaging.

  4. Spirometry

    MedlinePlus

    ... lung condition such as: Asthma COPD Chronic bronchitis Emphysema Pulmonary fibrosis If you've already been diagnosed ... Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are ...

  5. Impact of paroxetine on sleep problems in 426 cancer patients receiving chemotherapy: A trial from the University of Rochester Cancer Center Community Clinical Oncology Program

    PubMed Central

    Palesh, Oxana G.; Mustian, Karen M.; Peppone, Luke J.; Janelsins, Michelle; Sprod, Lisa K.; Kesler, Shelli; Innominato, Pasquale F.; Roth, Thomas; Manber, Rachel; Heckler, Charles; Fiscella, Kevin; Morrow, Gary R.

    2013-01-01

    Background Sleep problems are a frequent distressing symptom in cancer patients, yet little is known about their treatment. Sleep problems and depression frequently co-occur, leading healthcare professionals to treat depression with the expectation that sleep problems will also improve. The purpose of this study was to compare the effect of paroxetine to placebo on sleep problems via a secondary data analysis of a RCT designed to compare the effects of paroxetine to placebo on fatigue in cancer patients undergoing chemotherapy. A previously published report found a significant effect of paroxetine on depression in this cohort. Methods A total of 426 patients were randomized following Cycle 2 of chemotherapy to receive either 20 mg of paroxetine or placebo. Sleep problems were assessed using questions from the Hamilton Depression Inventory three times during chemotherapy. Results A total of 217 patients received paroxetine and 209 received placebo. Significantly fewer patients taking paroxetine reported sleep problems compared to patients on placebo (Paroxetine 79% versus Placebo 88%; p < 0.05). These differences remained significant even after controlling for baseline sleep problems and depression (p < 0.05). Conclusion Paroxetine had a significant benefit on sleep problems in both depressed and non-depressed cancer patients. However, rates of sleep problems remained high even among those effectively treated for depression with paroxetine. There is a need to develop and deliver sleep-specific interventions to effectively treat sleep-related side effects of cancer treatments. These findings suggest that sleep problems and depression are prevalent and co-morbid. Cancer progression, its response to treatment, and overall patient survival are intricately linked to host factors, such as inflammatory response and circadian rhythms, including sleep/wake cycles. Sleep problems and depression are modifiable host factors that can influence inflammation and impact cancer progression and quality of life. Future research should focus on discovering the pathogenesis of sleep dysregulation and depression in cancer so that better treatment approaches can be developed to ameliorate these symptoms. PMID:22858235

  6. Exercise and side effects among 749 patients during and after treatment for cancer: a University of Rochester Cancer Center Community Clinical Oncology Program Study.

    PubMed

    Mustian, Karen M; Griggs, Jennifer J; Morrow, Gary R; McTiernan, Anne; Roscoe, Joseph A; Bole, Christopher W; Atkins, James N; Issell, Brian F

    2006-07-01

    Despite advances in cancer treatment and symptom management, many patients experience side effects from cancer treatments that cause suffering and impair quality of life (QOL). Exercise is a method for enhancing QOL among cancer patients that shows promise in reducing side effects. However, patient participation in exercise is not well defined. We report on exercise participation during and within 6 months after chemotherapy and radiation therapy, the association of exercise with treatment side effects, and the communication between physicians and patients about exercise in a large (N = 749) nationwide sample of cancer patients. Participants completed measures that included questions concerning exercise during and after treatment, treatment side effects, and communication with physicians regarding exercise. Questionnaires were administered 2 weeks and 6 months after completion of therapy. Almost half of the 749 participating patients reported exercising while undergoing chemotherapy and/or radiation, and more than half reported exercising during the 6 months after treatment. Exercise was associated with less severe side effects during and after treatment (p < or = 0.050). More than 30% of patients reporting exercise did not discuss exercise with a physician; however, those who did were more likely to talk with their oncologist than with their primary care provider. Cancer patients report exercising and appear amenable to attempting exercise during and within 6 months after treatment. Research is needed to assess (1) the frequency, intensity, duration, and mode of exercise; (2) randomized controlled trials with exercise and its influence on treatments and side effects; and (3) physician-patient communication regarding exercise during cancer treatment.

  7. Improving patient access in nuclear medicine: a case study of PET scanner scheduling.

    PubMed

    Marmor, Yariv N; Kemp, Bradley J; Huschka, Todd R; Ruter, Royce L; McConnell, Daniel M; Rohleder, Thomas R

    2013-01-01

    We used the systems engineering technique of discrete event simulation modeling to assist in increasing patient access to positron emission tomographic examinations in the Department of Nuclear Medicine at Mayo Clinic, Rochester. The model was used to determine the best universal slot length to address the specific access challenges of a destination medical center such as Mayo Clinic. On the basis of the modeling, a new schedule was implemented in April 2012 and our before and after data analysis shows an increase of 2.4 scans per day. This was achieved without requiring additional resources or negatively affecting patient waiting, staff satisfaction (as evaluated by day length), or examination quality.

  8. Improved modeling of multiple scattering in hyperspectral BRDF of coastal sediments observed using the Goniometer of the Rochester Institute of Technology (GRIT)

    NASA Astrophysics Data System (ADS)

    Bachmann, Charles M.; Peck, Douglas S.; Ambeau, Brittany; Harms, Justin; Schultz, Malachi

    2015-09-01

    Approximate solutions to the Radiative transfer equation for granular media have been previously developed1. To apply these models to coastal sediments, modifications are needed to account for observed phenomenology. This study uses a new hyperspectral goniometer system, the Goniometer of the Rochester Institute of Technology (GRIT), designed for both field and laboratory settings, to compare observed bidirectional reflectance distribution function (BRDF) measurements with outcomes predicted by the approximate radiative transfer solutions. In previous laboratory studies,2 using a more limited hyperspectral goniometer observing in the principle plane, we had seen that the degree of optical contrast between coastal sand constituents was indicative of whether these models accurately predict the observed BRDF dependence on sediment density. Our earlier measurements using another field hyperspectral goniometer also demonstrated results consistent with the laboratory measurements as well as with CASI- 1500 airborne hyperspectral measurements3,4. In our earlier work,2 the presence of highly contrasting constituents (translucent quartz and more opaque fractions composed of minerals such as magnetite) led to greater reflectance as density decreased, exactly the opposite of what was anticipated from radiative transfer models for a more uniform sand. The present study shows that the illumination zenith angle also plays a significant role in whether or not BRDF dependency exhibits behavior predicted by current radiative transfer theory, and this distinction is directly related to the degree of multiple scattering, which depends on the illumination zenith angle. We also investigate a novel sampling paradigm that constrains the measurements to constant phase angle and reveals when the multiple scattering component of models departs from the assumptions of current theory. For the multiple scattering term, we also propose and analyze a simple modification which removes the

  9. The success story of an intermediate care area nurse internship program.

    PubMed

    McGohan, Ladonna D; Twedell, Diane M; Fahje, Carol J; Sanchez, Anna L R; Bohn, Lisa C; Carr, Christy J

    2005-01-01

    Mayo Clinic Rochester Hospitals have experienced significant growth in the number of patients requiring the specialized nursing care offered in intermediate care areas (ICAs). To ensure quality nursing care for ICA level patients, a standardized educational program was developed. The Mayo Intermediate Care Area Nurse Internship Program was a tuition-free education program that provided additional knowledge, insights, and skills needed to develop a highly competent ICA nurse. This article will describe how the concept of an ICA nurse internship program was taken from birth of an idea to fruition.

  10. Commensal Gut-Derived Anaerobes as Novel Therapy for Inflammatory Autoimmune Diseases

    DTIC Science & Technology

    2011-05-01

    have shown that it possesses anti-inflammatory activity. We propose that gut microbiota can influence peripheral immune response and may modulate... Gut -Derived Anaerobes as Novel Therapy for Inflammatory Autoimmune Diseases Ashutosh Mangalam Mayo Clinic Rochester, MN 55905...human gut have the potential to be used as a therapeutic agent. We have used collagen induced arthritis (CIA) in HLA-DR4DQ8 mice and PLP91-110 induced

  11. The impact of Myriad and Mayo: will advancements in the biological sciences be spurred or disincentivized? (Or was biotech patenting not complicated enough?).

    PubMed

    Gordon, Jennifer

    2014-12-11

    For years, purified and isolated naturally occurring biological substances of great medical importance--including genes--have been the subject of U.S. patents. Similarly, methods in which the detection of a biological substance (e.g., in a blood sample) dictates subsequent actions, as in disease diagnostics and treatment, have long enjoyed patent protection. However, two recent Supreme Court cases, Association for Molecular Pathology v. Myriad Genetics, Inc. (133 S. Ct. 2107) (2013) and Mayo Collaborative Services v. Prometheus Laboratories, Inc. (132 S. Ct. 1289) (2012), have shaken up the status quo of biotech patenting. The highest court in our land unanimously agreed with patent challengers that much of what we took for granted as patentable subject matter is not, as a matter of law, eligible for patenting after all. This review discusses the Myriad and Mayo cases, their impact on which biology-based innovations we may or may not continue to patent, and whether the altered status quo is benignly corrective or gravely disruptive. Is what happened here a good thing or not?

  12. Unified Medical Language System term occurrences in clinical notes: a large-scale corpus analysis

    PubMed Central

    Liu, Hongfang; Li, Dingcheng; Tao, Cui; Musen, Mark A; Chute, Christopher G; Shah, Nigam H

    2012-01-01

    Objective To characterise empirical instances of Unified Medical Language System (UMLS) Metathesaurus term strings in a large clinical corpus, and to illustrate what types of term characteristics are generalisable across data sources. Design Based on the occurrences of UMLS terms in a 51 million document corpus of Mayo Clinic clinical notes, this study computes statistics about the terms' string attributes, source terminologies, semantic types and syntactic categories. Term occurrences in 2010 i2b2/VA text were also mapped; eight example filters were designed from the Mayo-based statistics and applied to i2b2/VA data. Results For the corpus analysis, negligible numbers of mapped terms in the Mayo corpus had over six words or 55 characters. Of source terminologies in the UMLS, the Consumer Health Vocabulary and Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) had the best coverage in Mayo clinical notes at 106 426 and 94 788 unique terms, respectively. Of 15 semantic groups in the UMLS, seven groups accounted for 92.08% of term occurrences in Mayo data. Syntactically, over 90% of matched terms were in noun phrases. For the cross-institutional analysis, using five example filters on i2b2/VA data reduces the actual lexicon to 19.13% of the size of the UMLS and only sees a 2% reduction in matched terms. Conclusion The corpus statistics presented here are instructive for building lexicons from the UMLS. Features intrinsic to Metathesaurus terms (well formedness, length and language) generalise easily across clinical institutions, but term frequencies should be adapted with caution. The semantic groups of mapped terms may differ slightly from institution to institution, but they differ greatly when moving to the biomedical literature domain. PMID:22493050

  13. 13C-methacetin breath test correlates with clinical indices of liver disease severity in patients with primary biliary cirrhosis.

    PubMed

    Kochel-Jankowska, A; Hartleb, M; Jonderko, K; Kaminska, M; Kasicka-Jonderko, A

    2013-02-01

    This prospective study intended to ascertain if cytochrome P450 dependent liver function is affected in early and late histological stages of primary biliary cirrhosis (PBC). The study included 32 female PBC patients (mean age 55.4 years, range 33-70) and 16 aged-matched healthy women (mean age 52.6 years, range 38-65). In every subject a 13(C)-methacetin breath test (13(C)-MBT) was applied, and the results were related to histological Ludwig's staging system and several indices of liver disease severity comprising the MAYO-1, MAYO-2, MELD, and Child-Pugh score. The 13(C)-MBT differentiated healthy controls from the patients with Ludwig IV and Ludwig III histopathological stages of PBC. The most significant relationships (i.e. explaining >50% of the variance) were found between measurements of the momentary breath 13(C) elimination from 6 to 18 minutes as well as the 15-min or 30-min cumulative elimination and the MAYO-1 or MAYO-2 scores. The breath test poorly correlated with histopathological features of PBC, however, it accurately discriminated cirrhotic from non-cirrhotic patients (momentary breath 13(C) elimination at 40 min, AUROC 0,958). In conclusion, 13(C)-MBT correlates with clinical scoring systems, especially those specifically designed for PBC (Mayo model) and accurately recognizes the disease at the stage of cirrhosis up to 40 minutes of the test duration.

  14. SU-E-J-171: Evaluation of Cervical Spine and Mandible Reproducibility of the CDR Mayo Mold and Civco Type-S Head and Neck Immobilization Systems.

    PubMed

    Chungbin, S

    2012-06-01

    To evaluate the cervical spine (c-spine) and mandible reproducibility of the CDR Mayo Mold and Civco Type-S head and neck immobilization system using Mosaiq Setup Intelligence Curve Image Registration Methods: Patients were immobilized with either the Mayo Mold or Civco Type-S head and neck immobilization systems. Using curve image registration tools in Mosaiq, the c-spine and mandible were outlined. For each lateral image, two separate image registrations were performed using an initial kV image as reference - 1) c-spine only 2) mandible only. To evaluate the relative difference between the c-spine and mandible position, the mandible image registration results were subtracted from the c-spine image registration results. To evaluate whether the initial difference between the planning CT and the first kV setup image is larger than subsequent daily imaging variations, the difference in the image registration of the DRR was compared to the variation in subsequent image registrations. The degree of neck flexion was determined by observing the amount of mismatch between the upper and lower cervical spine after the pitch correction. During the first weeks of treatment, there was minimal difference in the image registration results for both the c-spine and mandible individually, and in the relative difference between them. For neck flexion, the Mayo Mold system demonstrated 82.6% minimal difference and 3.8% significant difference between the alignment of upper and lower c spine, vs. 84% and 5.2% for the S frame. For some patients, there is a greater difference between the DRR and the initial kV image registration than the variation in registrations for subsequent daily imaging. Preliminary results indicate minimal difference in the c-spine and mandible reproducibility between the two immobilization systems during the first weeks of treatment. Further analysis of whether this minimal difference remains consistent throughout the entire course and treatment and with greater

  15. Chemistry and origin of the Mayo Kila sapphires, NW region Cameroon (Central Africa): Their possible relationship with the Cameroon volcanic line

    NASA Astrophysics Data System (ADS)

    Paul Mbih, Kemeng; Meffre, Sebastien; Yongue, Rose Fouateu; Kanouo, Nguo Sylvestre; Jay, Thomson

    2016-06-01

    Mineralogical, chemical and geochronological studies constrained the origin of sapphires from Mayo Kila, Northwest Cameroon. The sapphires are mostly blue, with sizes ranging from 2 to 5 mm. The pale blue grains are transparent, whereas, other corundums are transparent to translucent and/or opaque. The sapphires are dominantly euhedral to sub-hedral with few polished lustrous grains, acquired features during moderate to short distance transport from a proximal source rock. Solid inclusions are limited to rutile and zircon. Trace element analysis of sapphires shows significant concentration (in ppm) in some elements: Fe (2208-14,473), Ti (82-1783), Ga (77-512), Mg (0.9-264.9), Cr (b.d.l -168) and V (1.3-82). The other elements (e.g. Sn, Nb, Ta, Th, Zr, Ni, Ce) are generally below 10 ppm. The calculated ratios for some of the selected elements show an extreme variation: Fe/Mg (43-3043), Fe/Ti (2-76), Ti/Mg (1-328), and Ga/Mg (0.4-363). They are dominantly corundum crystallized in alkaline magma (s) with few from metamorphic source (s). Trace elemental features with Hf (13,354-26,238 ppm), Th (4018-45,584 ppm) and U (7825-17,175 ppm), and Th/U (0.39-2.65) found in zircon inclusions are compatible with quantified values in magmatic crystallized zircons. The Cenozoic age (mean of 30.78 ± 0.28 Ma) obtained for zircon inclusions is close to the age of some igneous rocks found within the Cameroon Volcanic Line (e.g. rocks of the Mount Oku: 31-22 Ma), showing the same period of formation. The most probable source of the zircon host sapphires is the Oku Mountain located SW of Mayo Kila.

  16. Stroke Team Remote Evaluation Using a Digital Observation Camera in Arizona (STRokE DOC AZ) - The Initial Mayo Clinic Experience (TIME) Trial

    PubMed Central

    Demaerschalk, Bart M.; Bobrow, Bentley J.; Raman, Rema; Kiernan, Terri-Ellen J.; Aguilar, Maria I.; Ingall, Timothy J.; Dodick, David W.; Ward, Michael P.; Richemont, Phillip C.; Brazdys, Karina; Koch, Tiffany C.; Miley, Madeline L.; Hoffman Snyder, Charlene R.; Corday, Doren A.; Meyer, Brett C.

    2010-01-01

    Background and Purpose Telemedicine techniques can be employed to address the rural-metropolitan disparity in acute stroke care. The STRokE DOC trial reported more accurate decision making for telemedicine consultations compared with telephone-only, and that the California based research network facilitated a high rate of thrombolysis use, improved data collection, low risk of complications, low technical complications, and favorable assessment times. The main objective of the STRokE DOC AZ TIME trial was to determine the feasibility of establishing, de novo, a single-hub, multi-rural spoke hospital telestroke research network across a large geographical area in Arizona by replicating the STRokE DOC protocol. Methods Prospective, single hub, two spoke, randomized, blinded, controlled trial of a 2-way, site independent, audiovisual telemedicine system designed for remote examination of adult patients with acute stroke versus telephone consultation to assess eligibility for treatment with intravenous thrombolysis. The primary outcome measure was whether the decision to give thrombolysis was correct. Secondary outcomes were rate of thrombolytic use, 90-day functional outcomes, incidence of intracerebral hemorrhages, and technical observations. Results From December 2007 to October 2008, 54 patients were assessed; 27 randomized to each arm. Mean National Institutes of Health stroke scale score at presentation was 7.3 (SD 6.2) points. No consultations were aborted, however technical problems (74%) were prevalent in the telemedicine arm. Overall, the correct treatment decision was established in 87% of the consultations. Both modalities, telephone (89% correct) and telemedicine (85% correct) performed well. Intravenous thrombolytic treatment was used in 30% of the telemedicine and telephone consultations. Good functional outcomes at 90 days were not significantly different. There were no statistically significant differences in mortality (4% in telemedicine and 11% in telephone) or rates of intracerebral hemorrhage (4% in telemedicine and 0% in telephone). Conclusions It is feasible to extend the original STRokE DOC trial protocol to a new state and establish an operational single hub, multi-spoke rural hospital telestroke research network in Arizona. The trial was not designed to have sufficient power to detect a difference between the two consultative modes, telemedicine and telephone-only. Whether by telemedicine or telephone consultative modalities, there were appropriate treatment decisions, high rates of thrombolysis use, improved data collection, low rates of intracerebral hemorrhage, and equally favorable time requirements. The learning curve was steep for the hub and spoke personnel of the new telestroke network as reflected by the frequent technical problems. Overall, the results support the effectiveness of highly organized and structured stroke telemedicine networks for extending expert stroke care into rural remote communities lacking sufficient neurological expertise. PMID:20431081

  17. Association of Plasma Total Tau Level With Cognitive Decline and Risk of Mild Cognitive Impairment or Dementia in the Mayo Clinic Study on Aging.

    PubMed

    Mielke, Michelle M; Hagen, Clinton E; Wennberg, Alexandra M V; Airey, David C; Savica, Rodolfo; Knopman, David S; Machulda, Mary M; Roberts, Rosebud O; Jack, Clifford R; Petersen, Ronald C; Dage, Jeffrey L

    2017-09-01

    The utility of plasma total tau level as a prognostic marker for cognitive decline and dementia is not well understood. To determine (1) the association between plasma total tau level, cognitive decline, and risk of mild cognitive impairment (MCI) and dementia; (2) whether this association differs by the presence of elevated brain amyloid β (Aβ); and (3) whether plasma total tau level is associated with cognitive decline over a short interval of 15 months. The present analyses included 458 participants who were enrolled in a population-based cohort study between October 2008 and June 2013. All included participants had available plasma total tau levels, Aβ positron emission tomography imaging, and a complete neuropsychological examine at the same visit, as well as at least 1 follow-up visit. Concentration of plasma total tau. Risk of MCI and dementia; global and domain-specific cognitive decline. Of the 458 participants, 287 (62.7%) were men; mean (SD) age was 80.6 (5.6) years. Among cognitively normal (CN) participants oversampled for elevated brain Aβ, both the middle (hazard ratio [HR], 2.43; 95% CI, 1.25-4.72) and highest (HR, 2.02; 95% CI, 1.01-4.06) tertiles of plasma total tau level, compared with the lowest, were associated with an increased risk of MCI. Among participants with MCI, higher plasma total tau levels were not significantly associated with risk of dementia (all-cause dementia or Alzheimer disease). Among all participants, higher levels of plasma total tau, examined as a continuous variable, were associated with significant (P < .05) declines in global cognition, memory, attention, and visuospatial ability over a median follow-up of 3.0 years (range, 1.1-4.9 years). In additional analyses restricting the follow-up to 15 months, plasma total tau did not predict decline among CN participants. However, among participants with MCI, higher plasma total tau levels were associated with greater decline in both visuospatial ability (regression coefficient [b] = -0.50 [0.15], P < .001) and global cognition (b = -0.27 [0.10], P = .009) at 15 months. Adjusting for elevated brain Aβ did not attenuate any association. There was no interaction between plasma total tau level and brain Aβ for prognosis with any outcome. These results suggest that elevated plasma total tau levels are associated with cognitive decline, but the results differ based on cognitive status and the duration of follow-up. The association between plasma total tau levels and cognition is independent of elevated brain Aβ.

  18. Patch testing with a large series of metal allergens: findings from more than 1,000 patients in one decade at Mayo Clinic.

    PubMed

    Davis, Mark D P; Wang, Michael Z; Yiannias, James A; Keeling, James H; Connolly, Suzanne M; Richardson, Donna M; Farmer, Sara A

    2011-01-01

    The standard allergen series used in patch testing contains metals that most commonly cause allergic contact dermatitis, but testing with additional metal allergens is warranted for select patients. To report our experience with patch testing of metals. We retrospectively analyzed outcomes of 1,112 patients suspected of having metal allergies. Patients were seen from January 1, 2000, through December 31, 2009. Patch testing was performed with 42 metal preparations (6 in the standard series, 36 in the metal series). Patch testing most commonly was performed for patients with oral disease (almost half the patients), hand dermatitis, generalized dermatitis, and dermatitis affecting the lips, legs, arms, trunk, or face. At least one positive reaction was reported for 633 patients (57%). Metals with the highest allergic patch-test reaction rates were nickel, gold, manganese, palladium, cobalt, Ticonium, mercury, beryllium, chromium, and silver. Metals causing no allergic patch-test reactions were titanium, Vitallium, and aluminum powder. Metals with extremely low rates of allergic patch-test reactions included zinc, ferric chloride, and tin. Reaction rates varied depending on metal salt, concentration, and timing of readings. Many metals not in the standard series were associated with allergic patch-test reactions. The many questions raised by these findings, concerning patch testing with individual metals, will be the subject of future studies.

  19. Aortic Calcification: An Early Sign of Heart Valve Problems?

    MedlinePlus

    ... Rekha Mankad, M.D. References AskMayoExpert. Valvular disease – aortic stenosis. Rochester, Minn.: Mayo Foundation for Medical Education and ... Original article: http://www.mayoclinic.org/diseases-conditions/aortic-stenosis/expert-answers/aortic-valve-calcification/FAQ-20058525 . Mayo ...

  20. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    PubMed

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Breast Lumps

    MedlinePlus

    ... You might notice: A distinct lump with definite borders A firm, hard area within your breast A ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  2. Mayo Registry for Telemetry Efficacy in Arrest (MR TEA) study: An analysis of code status change following cardiopulmonary arrest.

    PubMed

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Chirila, Razvan; Maniaci, Michael; Bosworth, Veronica; Whitman, Anastasia; Lewis, Patricia; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2015-07-01

    Code status discussions are important during a hospitalization, yet variation in its practice exists. No data have assessed the likelihood of patients to change code status following a cardiopulmonary arrest. A retrospective review of all patients that experienced a cardiopulmonary arrest between May 1, 2008 and June 30, 2014 at an academic medical center was performed. The proportion of code status modifications to do not resuscitate (DNR) from full code was assessed. Baseline clinical characteristics, resuscitation factors, and 24-h post-resuscitation, hospital, and overall survival rates were compared between the two subsets. A total of 157 patients survived the index event and were included. One hundred and fifteen (73.2%) patients did not have a change in code status following the index event, while 42 (26.8%) changed code status to DNR. Clinical characteristics were similar between subsets, although patients in the change to DNR subset were older (average age 67.7 years) compared to the full code subset (average age 59.2 years; p = 0.005). Patients in the DNR subset had longer overall resuscitation efforts with less attempts at defibrillation. Compared to the DNR subset, patients that remained full code demonstrated higher 24-h post-resuscitation (n = 108, 93.9% versus n = 32, 76.2%; p = 0.001) and hospital (n = 50, 43.5% versus n = 6, 14.3%; p = 0.001) survival rates. Patients in the DNR subset were more likely to have neurologic deficits on discharge and shorter overall survival. Patient code status wishes do tend to change during critical periods within a hospitalization, adding emphasis for continued code status evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Geochemical provenance and spatial distribution of fluoride in groundwater of Mayo Tsanaga River Basin, Far North Region, Cameroon: implications for incidence of fluorosis and optimal consumption dose.

    PubMed

    Fantong, Wilson Y; Satake, Hiroshi; Ayonghe, Samuel N; Suh, Emmanuel C; Adelana, Segun M A; Fantong, Emilia Bi S; Banseka, Hycinth S; Gwanfogbe, Cletus D; Woincham, Leonard N; Uehara, Yoshitoshi; Zhang, Jing

    2010-04-01

    The 500,000 inhabitants of Mayo Tsanaga River Basin are vulnerable to a "silent" fluorosis from groundwater consumption. For the first time, the groundwater is investigated for the purpose of identifying the provenance of fluoride and estimating an optimal dose of fluoride in the study area. Based on the fluoride content of groundwater, fluorine and major oxides abundances in rocks from the study area, mean annual atmospheric temperature, and on-site diagnosis of fluorosis in children, the following results and conclusions are obtained: Fluoride concentration in groundwater ranges from 0.19 to 15.2 mg/l. Samples with fluoride content of <1.5 mg/l show Ca-HCO(3) signatures, while those with fluoride >1.5 mg/l show a tendency towards Na-HCO(3) type. Fluor-apatite and micas in the granites were identified as the main provenance of fluoride in the groundwater through water-rock interactions in an alkaline medium. The optimal fluoride dose in drinking water of the study area should be 0.7 mg/l, and could be adjusted downward to a level of 0.6 mg/l due to the high consumption rate of groundwater, especially during drier periods.

  4. Development of a Multidisciplinary, Multicampus Subspecialty Practice in Endocrine Cancers

    PubMed Central

    Bible, Keith C.; Smallridge, Robert C.; Morris, John C.; Molina, Julian R.; Suman, Vera J.; Copland, John A.; Rubin, Joseph; Menefee, Michael E.; Sideras, Kostandinos; Maples, William J.; McIver, Bryan; Fatourechi, Vahab; Hay, Ian; Foote, Robert L.; Garces, Yolanda I.; Kasperbauer, Jan L.; Thompson, Geoffrey B.; Grant, Clive S.; Richards, Melanie L.; Sebo, Thomas; Lloyd, Ricardo; Eberhardt, Norman L.; Reddi, Honey V.; Casler, John D.; Karlin, Nina J.; Westphal, Sydney A.; Richardson, Ronald L.; Buckner, Jan C.; Erlichman, Charles

    2012-01-01

    Purpose: Relative to more abundant neoplasms, endocrine cancers have been historically neglected, yet their incidence is increasing. We therefore sought to build interest in endocrine cancers, improve physician experience, and develop innovative approaches to treating patients with these neoplasms. Methods: Between 2005 and 2010, we developed a multidisciplinary Endocrine Malignancies Disease Oriented Group involving all three Mayo Clinic campuses (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ). In response to higher demand at the Rochester campus, we sought to develop a Subspecialty Tumor Group and an Endocrine Malignancies Tumor Clinic within the Division of Medical Oncology. Results: The intended groups were successfully formed. We experienced difficulty in integration of the Mayo Scottsdale campus resulting from local uncertainty as to whether patient volumes would be sufficient to sustain the effort at that campus and difficulty in developing enthusiasm among clinicians otherwise engaged in a busy clinical practice. But these obstacles were ultimately overcome. In addition, with respect to the newly formed medical oncology subspecialty endocrine malignancies group, appointment volumes quadrupled within the first year and increased seven times within two years. The number of active therapeutic endocrine malignancies clinical trials also increased from one in 2005 to five in 2009, with all three Mayo campuses participating. Conclusion: The development of subspecialty tumor groups for uncommon malignancies represents an effective approach to building experience, increasing patient volumes and referrals, and fostering development of increased therapeutic options and clinical trials for patients afflicted with otherwise historically neglected cancers. PMID:22942830

  5. Magmatismes tholéiitique et alcalin des demi-grabens crétacés de Mayo Oulo Léré et de Babouri Figuil (Nord du Cameroun Sud du Tchad) en domaine d'extension continentaleTholeiitic and alkaline magmatisms of the Early-Cretaceous half-grabens of Mayo Oulo Léré and Babouri Figuil (Northern Cameroon Southern Chad) in extensional structural settings

    NASA Astrophysics Data System (ADS)

    Ngounouno, Ismaı̈la; Déruelle, Bernard; Guiraud, René; Vicat, Jean-Paul

    2001-08-01

    Two major dykes of basalts, microgabbros, olivine dolerites (continental tholeiites), and of camptonites and benmoreites (alkaline rocks) are respectively exposed in the Mayo Oulo-Léré and Babouri-Figuil Early Cretaceous half-grabens (Northern Cameroon-Southern Chad). The tholeiites were probably derived from an asthenospheric source in connection with a lithospheric thinning occurring between Santonian and Eocene times. In contrast, the alkaline rocks may be derived from a deeper metasomatized mantle source.

  6. Microbial synthesis of gold nanoparticles using the fungus Penicillium brevicompactum and their cytotoxic effects against mouse mayo blast cancer C 2 C 12 cells.

    PubMed

    Mishra, Amrita; Tripathy, Suraj Kumar; Wahab, Rizwan; Jeong, Song-Hoon; Hwang, Inho; Yang, You-Bing; Kim, Young-Soon; Shin, Hyung-Shik; Yun, Soon-Il

    2011-11-01

    Microorganisms, their cell filtrates, and live biomass have been utilized for synthesizing various gold nanoparticles. The shape, size, stability as well as the purity of the bio synthesized nanoparticles become very essential for application purpose. In the present study, gold nanoparticles have been synthesized from the supernatant, live cell filtrate, and biomass of the fungus Penicillium brevicompactum. The fungus has been grown in potato dextrose broth which is also found to synthesize gold nanoparticles. The size of the particles has been investigated by Bio-TEM before purification, following purification and after storing the particles for 3 months under refrigerated condition. Different characterization techniques like X-ray diffraction, Fourier transform infrared spectroscopy, and UV-visible spectroscopy have been used for analysis of the particles. The effect of reaction parameters such as pH and concentration of gold salt have also been monitored to optimize the morphology and dispersity of the synthesized gold nanoparticles. A pH range of 5 to 8 has favored the synthesis process whereas increasing concentration of gold salt (beyond 2 mM) has resulted in the formation of bigger sized and aggregated nanoparticles. Additionally, the cytotoxic nature of prepared nanoparticles has been analyzed using mouse mayo blast cancer C(2)C(12) cells at different time intervals (24, 48, and 72 h) of incubation period. The cells are cultivated in Dulbecco's modified Eagle's medium supplemented with fetal bovine serum with antibiotics (streptopenicillin) at 37°C in a 5% humidified environment of CO(2). The medium has been replenished every other day, and the cells are subcultured after reaching the confluence. The viability of the cells is analyzed with 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide method.

  7. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

    PubMed

    Paim, Crislaine Pires Padilha; Goldmeier, Silvia

    2017-01-10

    Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

  8. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology

    PubMed Central

    2017-01-01

    Background Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. Objective To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. Methods The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom’s taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. Results The development of the game called “Playing with Tweezers” was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. Conclusions The “digital” nursing student needs engagement, stimulation, reality, and entertainment, not just readings. “Playing with Tweezers” is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we

  9. [The umbilical metastasis. Sister Mary Joseph and her time].

    PubMed

    Trebing, D; Göring, H-D

    2004-02-01

    Although Baluff in 1854 and Nelaton in 1860 had already described umbilical metastases, the best known description of the metastasis of carcinomas to this site as "trouser button navel" was published in 1928 by William James Mayo (1861-1939), son of William Worrall Mayo (1815-1911), the founder of the Mayo Clinic in Rochester, Minnesota, This phenomenon is supposed to have been pointed out to Mayo by his long-serving head surgical nurse Sister Mary Joseph (1856-1939). The English surgeon Hamilton Bailey, in his famous textbook "Physical Signs in Clinical Surgery" in 1949, coined the term "Sister Joseph's nodule" for an umbilical metastasis. The expression has become widely accepted and used. Sister Mary Joseph, daughter of Irish immigrants, belonged to the 3rd order of the Holy Francis, was distinguished for her skills, intelligence and devotion to nursing which was also her calling. She worked for many decades at the world-famous Mayo Clinic and taught generations of young nurses. In recent years, the original surgical building at Saint Mary's Hospital has been named "Joseph Building" in her memory. Among the numerous eponyms occurring in the dermatology and the medicine, the association with the name of a nurse represents beyond doubt a special feature.

  10. Modeling progression risk for smoldering multiple myeloma: results from a prospective clinical study.

    PubMed

    Cherry, Benjamin M; Korde, Neha; Kwok, Mary; Manasanch, Elisabet E; Bhutani, Manisha; Mulquin, Marcia; Zuchlinski, Diamond; Yancey, Mary Ann; Maric, Irina; Calvo, Katherine R; Braylan, Raul; Stetler-Stevenson, Maryalice; Yuan, Constance; Tembhare, Prashant; Zingone, Adriana; Costello, Rene; Roschewski, Mark J; Landgren, Ola

    2013-10-01

    The risk of progression to multiple myeloma (MM) from the precursor condition smoldering MM (SMM) varies considerably among individual patients. Reliable markers for progression to MM are vital to advance the understanding of myeloma precursor disease and for the development of intervention trials designed to delay/prevent MM. The Mayo Clinic and Spanish PETHEMA have proposed models to stratify patient risk based on clinical parameters. The aim of our study was to define the degree of concordance between these two models by comparing the distribution of patients with SMM classified as low, medium and high risk for progression. A total of 77 patients with SMM were enrolled in our prospective natural history study. Per study protocol, each patient was assigned risk scores based on both the Mayo and the Spanish models. The Mayo Clinic model identified 38, 35 and four patients as low, medium and high risk, respectively. The Spanish PETHEMA model classified 17, 22 and 38 patients as low, medium and high risk, respectively. There was significant discordance in overall patient risk classification (28.6% concordance) and in classifying patients as low versus high (p < 0.0001), low versus non-low (p = 0.0007) and high versus non-high (p < 0.0001) risk. There is a need for prospectively validated models to characterize individual patient risk of transformation to MM.

  11. Eventos de Mayo (May Events).

    ERIC Educational Resources Information Center

    Toro, Leonor; Pla, Myrna

    Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…

  12. Eventos de Mayo (May Events).

    ERIC Educational Resources Information Center

    Toro, Leonor; Pla, Myrna

    Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…

  13. Pygoscelis antarcticus feathers as bioindicator of trace element risk in marine environments from Barton Peninsula, 25 de Mayo (King George) Island, Antarctica.

    PubMed

    Catán, Soledad Perez; Bubach, Debora; Di Fonzo, Carla; Dopchiz, Laura; Arribére, Maria; Ansaldo, Martin

    2017-04-01

    We report the contents of elements in feathers of Chinstrap penguin (Pygoscelis antarcticus), which had not been informed up to now, such as silver and bromine and others listed as hazardous by the United States Environmental Protection Agency as arsenic, cobalt, chromium, and mercury. Analyses of the element concentrations in feathers, adult and chicken, from Barton Peninsulas at 25 de Mayo (King George) Island, South Shetlands, were made by Instrumental Neutron Activation Analysis. Samarium, lanthanum a, thorium, and uranium concentrations in Chinstrap penguin feathers were below 0.1 mg/kg. This suggests that the elements in feather do not come from atmospheric particles surface deposition. Arsenic (0.120 ± 0.050 mg/kg) and cobalt (0.030 ± 0.020 mg/kg) concentrations were lower than the reports for other colony of Chinstrap penguins, and essential elements as iron (26 ± 12 mg/kg), zinc (78.0 ± 5.3 mg/kg), and chromium (0.51 ± 0.27 mg/kg) were in the same range while Se (2.90 ± 0.65 mg/kg) content were the lowest reported. Mercury (0.43 ± 0.21 mg/kg), chromium (0.210 ± 0.060 mg/kg), and silver (0.083 ± 0.003 mg/kg) in chicks tended to be lower than in adults. Iron, cobalt, and arsenic concentrations in feathers found in this study were the lowest compared to measurements were in several penguin species in Antarctica. These results confirm to feathers like effective indicators for the trace elements incorporated in the penguins and it provide a data set which can adds to the baseline for bioindication studies using feathers.

  14. Abbreviation and Acronym Disambiguation in Clinical Discourse

    PubMed Central

    Pakhomov, Serguei; Pedersen, Ted; Chute, Christopher G.

    2005-01-01

    Use of abbreviations and acronyms is pervasive in clinical reports despite many efforts to limit the use of ambiguous and unsanctioned abbreviations and acronyms. Due to the fact that many abbreviations and acronyms are ambiguous with respect to their sense, complete and accurate text analysis is impossible without identification of the sense that was intended for a given abbreviation or acronym. We present the results of an experiment where we used the contexts harvested from the Internet through Google API to collect contextual data for a set of 8 acronyms found in clinical notes at the Mayo Clinic. We then used the contexts to disambiguate the sense of abbreviations in a manually annotated corpus. PMID:16779108

  15. Abbreviation and acronym disambiguation in clinical discourse.

    PubMed

    Pakhomov, Sergeui; Pedersen, Ted; Chute, Christopher G

    2005-01-01

    Use of abbreviations and acronyms is pervasive in clinical reports despite many efforts to limit the use of ambiguous and unsanctioned abbreviations and acronyms. Due to the fact that many abbreviations and acronyms are ambiguous with respect to their sense, complete and accurate text analysis is impossible without identification of the sense that was intended for a given abbreviation or acronym. We present the results of an experiment where we used the contexts harvested from the Internet through Google API to collect contextual data for a set of 8 acronyms found in clinical notes at the Mayo Clinic. We then used the contexts to disambiguate the sense of abbreviations in a manually annotated corpus.

  16. Racial Differences in Information Needs During and After Cancer Treatment: a Nationwide, Longitudinal Survey by the University of Rochester Cancer Center National Cancer Institute Community Oncology Research Program.

    PubMed

    Asare, Matthew; Peppone, Luke J; Roscoe, Joseph A; Kleckner, Ian R; Mustian, Karen M; Heckler, Charles E; Guido, Joseph J; Sborov, Mark; Bushunow, Peter; Onitilo, Adedayo; Kamen, Charles

    2016-04-21

    Before treatment, cancer patients need information about side effects and prognosis, while after treatment they need information to transition to survivorship. Research documenting these needs is limited, especially among racial and ethnic minorities. This study evaluated cancer patients' needs according to race both before and after treatment. We compared white (n = 904) to black (n = 52) patients receiving treatment at 17 National Cancer Institute Community Oncology Research Program (NCORP) sites on their cancer-related concerns and need for information before and after cancer treatment. Two-sample t test and chi-squared analyses were used to assess group differences. Compared to white patients, black patients reported significantly higher concerns about diet (44.3 vs. 25.4 %,) and exercise (40.4 vs. 19.7 %,) during the course of treatment. Compared to whites, blacks also had significantly higher concern about treatment-related issues (white vs. black mean, 25.52 vs. 31.78), self-image issues (7.03 vs. 8.60), family-related issues (10.44 vs. 12.84), and financial concerns (6.42 vs. 8.90, all p < 0.05). Blacks, compared to whites, also had significantly greater post-treatment information needs regarding follow-up tests (8.17 vs. 9.44), stress management (4.12 vs. 4.89), and handling stigma after cancer treatment (4.21 vs. 4.89) [all p < 0.05]. Pre-treatment concerns and post-treatment information needs differed by race, with black patients reporting greater information needs and concerns. In clinical practice, tailored approaches may work particularly well in addressing the needs and concerns of black patients.

  17. "Yes board" facilitates rapid sharing of key data, trims LOS in the ED by 40 minutes.

    PubMed

    2012-11-01

    A practicing emergency medicine physician who is also a computer engineer has helped Mayo Clinic sites in Rochester, MN, and Phoenix, AZ, develop a web-based ED monitoring system that is responsive to the needs of clinicians. Data suggest that the innovation, called a Yes Board, has sliced LOS by as much as 40 minutes, and it is constantly being tweaked with changes and new functionality. Data flows automatically into the Yes Board from as many as 15 different data systems the hospital is already using. The Yes Board conveys the status of tests and procedures, clinical results, vital sign information, and where patients are in the admissions or discharge process.

  18. Orchitis

    MedlinePlus

    ... normal, which helps confirm the diagnosis of orchitis. Nuclear scan of the testicles. A radioactive tracer is ... scrotal masses? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013. Wein AJ, et al. Campbell- ...

  19. Stress Management: When and How to Say No

    MedlinePlus

    Healthy Lifestyle Stress management Sure it's easier to say yes, but at what price to your peace of mind? Here's why saying no ... 2016. Barbara Woodward Lips Patient Education Center. Stress management. Rochester, Minn.: Mayo Foundation for Medical Education and ...

  20. When Might Sunburn Require Medical Attention?

    MedlinePlus

    ... When might sunburn require medical attention? Answers from Lawrence E. Gibson, M.D. Consult a doctor for ... not required unless you develop an infection. With Lawrence E. Gibson, M.D. References AskMayoExpert. Sunburn. Rochester, ...

  1. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows.

    PubMed

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M

    2011-02-01

    Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

  2. Rochester Connectionist Papers. 1979-1985

    DTIC Science & Technology

    1985-12-01

    updated and improved version of the thesis account of recent neurolinguistic data. Fanty, M., "Context-free parsing in connectionist networks." TR 174...April 1982. Our first large program in the connectionist paradigm. It simulates a multi- layer network for recognizing line drawings of Origami figures...The program successfully deals with noise and simple occlusion and the thesis incorporates many key ideas on designing and running large models. Small

  3. Carotid Artery Intima-Media Thickness and Subclinical Atherosclerosis in Women With Remote Histories of Preeclampsia: Results From a Rochester Epidemiology Project-Based Study and Meta-analysis.

    PubMed

    Garovic, Vesna D; Milic, Natasa M; Weissgerber, Tracey L; Mielke, Michelle M; Bailey, Kent R; Lahr, Brian; Jayachandran, Muthuvel; White, Wendy M; Hodis, Howard N; Miller, Virginia M

    2017-09-01

    To measure carotid artery intima-media thickness (CIMT), a marker of subclinical atherosclerosis, in postmenopausal women with and without histories of preeclampsia and to synthesize these results with those from prior studies of CIMT performed 10 or more years after preeclamptic pregnancies. Forty women (median age, 59 years) with histories of preeclampsia and 40 with histories of normotensive pregnancy (confirmed by medical record review) were selected from women who resided and gave birth in Olmsted County, Minnesota, between January 1, 1976, and December 31, 1982. The participants were identified and recruited in 2014-2015, and CIMT was measured by B-mode ultrasonography. Meta-analysis included CIMT studies that were performed 10 or more years after preeclamptic pregnancies and which were identified through PubMed, EMBASE, and Web of Science. Heterogeneity was assessed using the I(2) statistic. Standardized mean difference was used as a measure of effect size. Carotid artery intima-media thickness, expressed as a median (interquartile range), was greater in the preeclamptic than in the normotensive group (0.80 mm [0.75-0.85 mm] vs 0.73 mm [0.70-0.78]; P=.004); the odds of having CIMT higher than threshold (0.77 mm) was statistically significant after adjusting for confounding factors (odds ratio, 3.17; 95% CI, 1.10-9.14). A meta-analysis of 10 studies conducted 10 or more years post partum included 813 women with and 2874 without histories of preeclampsia. Carotid artery intima-media thickness was greater among women with histories of preeclampsia, with a standardized mean difference of 0.18 and 95% CI of 0.05 to 0.30 mm (P=.004). Among women with histories of preeclampsia, CIMT may identify those with subclinical atherosclerosis, thus offering an opportunity for early intervention. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. The case for implementing activity based costing.

    PubMed

    Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

    2012-01-01

    ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level.

  5. Biochemical testing of thyroid function.

    PubMed

    Klee, G G; Hay, I D

    1997-12-01

    Various published guidelines recommending serum thyrotropin (TSH)-first thyroid testing are outlined. The entities called "subclinical hypothyroidism" and "subclinical hyperthyroidism" are defined on the basis of abnormal TSH concentrations and normal values of other biochemical thyroid tests. The controversies about follow-up and treatment of these disorders are discussed. The laboratory experience of Mayo Clinic Rochester in using TSH-first thyroid testing and the subsequent implementation of a thyroid test ordering cascade are presented. Finally, recommendations are given for further optimizing laboratory testing for thyroid disorders.

  6. 210Pb-dating of a lake sediment core from Lough Carra (Co. Mayo, western Ireland): use of paleolimnological data for chronology validation below the 210Pb dating horizon.

    PubMed

    O'Reilly, J; Vintró, L León; Mitchell, P I; Donohue, I; Leira, M; Hobbs, W; Irvine, K

    2011-05-01

    The chronologies and sediment accumulation rates for a lake sediment sequence from Lough Carra (Co. Mayo, western Ireland) were established by applying the constant initial concentration (CIC) and constant rate of supply (CRS) hypotheses to the measured (210)Pb(excess) profile. The resulting chronologies were validated using the artificial fallout radionuclides (137)Cs and (241)Am, which provide independent chronostratigraphic markers for the second half of the 20th century. The validity of extrapolating the derived CIC and CRS dates below the (210)Pb dating horizon using average sedimentation rates was investigated using supplementary paleolimnological information and historical data. Our data confirm that such an extrapolation is well justified at sites characterised by relatively stable sedimentation conditions.

  7. Kidney Transplant

    MedlinePlus

    Kidney transplant Overview By Mayo Clinic Staff A kidney transplant is a surgical procedure to place a healthy kidney ... bloodstream via a machine (dialysis) or a kidney transplant to stay alive. Mayo Clinic's approach . Mayo Clinic ...

  8. Multiple System Atrophy (MSA)

    MedlinePlus

    Multiple system atrophy (MSA) Overview By Mayo Clinic Staff Multiple system atrophy (MSA) is a rare, degenerative neurological disorder ... progresses gradually and eventually leads to death. Multiple system atrophy care at Mayo Clinic . Mayo Clinic Footer ...

  9. Clinical application of a modern high-definition head-mounted display in sonography.

    PubMed

    Takeshita, Hideki; Kihara, Kazunori; Yoshida, Soichiro; Higuchi, Saori; Ito, Masaya; Nakanishi, Yasukazu; Kijima, Toshiki; Ishioka, Junichiro; Matsuoka, Yoh; Numao, Noboru; Saito, Kazutaka; Fujii, Yasuhisa

    2014-08-01

    Because of the remarkably improved image quality and wearability of modern head-mounted displays, a monitoring system using a head-mounted display rather than a fixed-site monitor for sonographic scanning has the potential to improve the diagnostic performance and lessen the examiner's physical burden during a sonographic examination. In a preclinical setting, 2 head-mounted displays, the HMZ-T2 (Sony Corporation, Tokyo, Japan) and the Wrap1200 (Vuzix Corporation, Rochester, NY), were found to be applicable to sonography. In a clinical setting, the feasibility of the HMZ-T2 was shown by its good image quality and acceptable wearability. This modern device is appropriate for clinical use in sonography.

  10. AQP4 autoantibody assay performance in clinical laboratory service

    PubMed Central

    Fryer, J.P.; Lennon, V.A.; Pittock, S.J.; Jenkins, S.M.; Fallier-Becker, P.; Clardy, S.L.; Horta, E.; Jedynak, E.A.; Lucchinetti, C.F.; Shuster, E.A.; Weinshenker, B.G.; Wingerchuk, D.M.

    2014-01-01

    Objective: To compare performance of contemporary aquaporin-4–immunoglobulin (Ig) G assays in clinical service. Methods: Sera from neurologic patients (4 groups) and controls were tested initially by service ELISA (recombinant human aquaporin-4, M1 isoform) and then by cell-based fluorescence assays: fixed (CBA, M1-aquaporin-4, observer-scored) and live (fluorescence-activated cell sorting [FACS], M1 and M23 aquaporin-4 isoforms). Group 1: all Mayo Clinic patients tested from January to May 2012; group 2: consecutive aquaporin-4-IgG–positive patients from September 2011 (Mayo and non-Mayo); group 3: suspected ELISA false-negatives from 2011 to 2013 (physician-reported, high likelihood of neuromyelitis optica spectrum disorders [NMOSDs] clinically); group 4: suspected ELISA false-positives (physician-reported, not NMOSD clinically). Results: Group 1 (n = 388): M1-FACS assay performed optimally (areas under the curves: M1 = 0.64; M23 = 0.57 [p = 0.02]). Group 2 (n = 30): NMOSD clinical diagnosis was confirmed by: M23-FACS, 24; M1-FACS, 23; M1-CBA, 20; and M1-ELISA, 18. Six results were suspected false-positive: M23-FACS, 2; M1-ELISA, 2; and M23-FACS, M1-FACS, and M1-CBA, 2. Group 3 (n = 31, suspected M1-ELISA false-negatives): results were positive for 5 sera: M1-FACS, 5; M23-FACS, 3; and M1-CBA, 2. Group 4 (n = 41, suspected M1-ELISA false-positives): all negative except 1 (positive only by M1-CBA). M1/M23-cotransfected cells expressing smaller membrane arrays of aquaporin-4 yielded fewer false- positive FACS results than M23-transfected cells. Conclusion: Aquaporin-4-transfected CBAs, particularly M1-FACS, perform optimally in aiding NMOSD serologic diagnosis. High-order arrays of M23-aquaporin-4 may yield false-positive results by binding IgG nonspecifically. PMID:25340055

  11. 75 FR 25289 - Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... these medicine faces as being needed for the practice of traditional Native American religions by... American religious leaders for the practice of traditional Native American religions by their present-day...

  12. 76 FR 34865 - Safety Zone; Rochester Harbor Festival, Genesee River, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... MST3 Rory Boyle, Marine Events Coordinator, U.S. Coast Guard Sector Buffalo; telephone 716-843-9343, e... the Captain of the Port (COTP) Buffalo from protecting the public and vessels from the hazards... Buffalo has determined that waterborne fireworks displays present significant hazards to vessels...

  13. 75 FR 36666 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... (AE5126/ 36.378.4) is made of cucumber wood and measures 10'' x 6 1/2''. The fifth (AE 4859/36.378.5...) is made of willow wood. The third (AE 4814/35.271.22) is made of cucumber wood. The fourth (AE 4815....379.18) is made of basswood. The seventh face (AE 5128/36.379.17) is made of cucumber wood...

  14. 75 FR 25290 - Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... practice of traditional Native American religions by present-day adherents. During consultation, it was... Native American religious leaders for the practice of traditional Native American religions by...

  15. Chronic Myelomonocytic Leukemia: Focus on Clinical Practice.

    PubMed

    Patnaik, Mrinal M; Tefferi, Ayalew

    2016-02-01

    Chronic myelomonocytic leukemia (CMML) is a clonal stem cell disorder with features that overlap those of myelodysplastic syndromes (MDSs) and myeloproliferative neoplasms (MPNs). Chronic myelomonocytic leukemia often results in peripheral blood monocytosis and has an inherent tendency to transform to acute myeloid leukemia. Clonal cytogenetic changes are seen in approximately 30% of patients, and molecular abnormalities are seen in more than 90%. Gene mutations involving TET2 (∼60%), SRSF2 (∼50%), ASXL1 (∼40%), and RAS (∼30%) are frequent, with nonsense and frameshift ASXL1 mutations being the only mutations identified thus far to have an independent negative prognostic effect on overall survival. Contemporary molecularly integrated prognostic models (inclusive of ASXL1 mutations) include the Molecular Mayo Model and the Groupe Français des Myélodysplasies model. Given the lack of formal treatment and response criteria, management of CMML is often extrapolated from MDS and MPN, with allogeneic stem cell transplant being the only curative option. Hydroxyurea and other cytoreductive agents have been used to control MPN-like features, while epigenetic modifiers such as hypomethylating agents have been used for MDS-like features. Given the relatively poor response to these agents and the inherent risks associated with hematopoietic stem cell transplant, newer drugs exploiting molecular and epigenetic abnormalities in CMML are being developed. The creation of CMML-specific response criteria is a much needed step in order to improve clinical outcomes. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  16. Identifying therapeutic targets for Alzheimer's disease with big data.

    PubMed

    Ertekin-Taner, Nilüfer

    2017-04-01

    Nilüfer Ertekin-Taner is a Professor of Neuroscience and Neurology at the Mayo Clinic, Jacksonville, FL, USA. A neurogeneticist and board-certified behavioral neurologist, she received her medical degree from Hacettepe University Medical School in Ankara, Turkey and her doctorate degree in Molecular Neuroscience from Mayo Graduate School. She completed her residency training in the Department of Neurology at Mayo Clinic in Rochester (MN, USA) and fellowship in Behavioral Neurology at Mayo Clinic in Jacksonville. Her laboratory aims to discover and characterize genetic factors underlying the complex genetics of Alzheimer's disease (AD) and related neurodegenerative conditions. Her earlier work contributed to the establishment of the endophenotype approach in genetic studies of AD and pioneered the use of amyloid β peptide levels as an endophenotype in AD genetic research. Her laboratory currently uses biological traits such as gene expression levels and cognitive scores and leverages combined genome, transcriptome and epigenetic data to uncover genetic risk factors for neurodegenerative conditions. She is the principal investigator of numerous NIH and foundation grants. She leads multiple collaborative projects aimed at gene and pathway discoveries in AD and other neurodegenerative diseases, as a part of the NIH initiatives Accelerating Medicines Partnership AD (AMP-AD) and Molecular Mechanisms of the Vascular Etiology of AD (M(2)OVE-AD) consortia. She is the Principal Investigator of the Florida Consortium for African-American AD Studies (FCA(3)DS). As a neurologist in the Memory Disorders Clinic at Mayo Clinic in Jacksonville, Florida, she continues to evaluate and manage patients with AD and other dementias and aspires to improve the quality of care that we provide to our patients and their families.

  17. Cancer Treatment for Women: Possible Sexual Side Effects

    MedlinePlus

    ... effects among women include: Difficulty reaching climax Less energy for sexual activity Loss of desire for sex ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

  18. Lichen Nitidus

    MedlinePlus

    ... References Chu J, et al. Lichen nitidus. CMAJ: Canadian Medical Association Journal. 2014;186:E688. Tilly JJ, ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

  19. Over the Counter Laxatives for Constipation: Use with Caution

    MedlinePlus

    ... et al. Mothrerisk update: Treating constipation during pregnancy. Canadian Family Physician. 2012;58:836. Laxative (Oral route). ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

  20. CD1a immunopositivity in perivascular epithelioid cell neoplasms: true expression or technical artifact? A streptavidin-biotin and polymer-based detection system immunohistochemical study of perivascular epithelioid cell neoplasms and their morphologic mimics.

    PubMed

    Ahrens, William A; Folpe, Andrew L

    2011-03-01

    Perivascular epithelioid cell neoplasms comprise a family of rare neoplasms composed of morphologically distinctive perivascular epithelioid cells exhibiting a "myomelanocytic" immunophenotype. The distinction of perivascular epithelioid cell neoplasms from other tumors with melanocytic and smooth muscle differentiation can be difficult. A recent study has suggested that perivascular epithelioid cell neoplasms routinely express CD1a, a Langerhans cell-associated transmembrane glycoprotein involved in antigen presentation and that expression of this marker may be helpful in the distinction of perivascular epithelioid cell neoplasms from various mimics. We evaluated a series of perivascular epithelioid cell neoplasms and potential mimics for CD1a expression. A total of 54 cases (27 perivascular epithelioid cell neoplasms, 11 leiomyosarcomas, 10 melanomas, 6 clear cell sarcomas) were evaluated in 2 laboratories (Mayo Clinic Rochester: 31 cases, Carolinas Medical Center: 23 cases). Selected positive cases were retested at Carolinas Medical Center (11 cases) and Mayo Clinic Rochester (10 cases). Mayo Clinic Rochester methods were as follows: MTB1 clone (1:20, Novocastra, Newcastle-upon-Tyne, UK), heat-induced epitope retrieval in EDTA (pH 8.0), and Dako Advance detection system (Dako Corp, Carpinteria, CA) with background-reducing diluent. Carolinas Medical Center methods were as follows: MTB1 clone (1:30; CellMarque, Rocklin, CA), heat-induced epitope retrieval in Medium Cell Conditioner #1 (pH 8.0-9.0), and streptavidin-biotin detection system with diaminobenzidine chromogen, with and without biotin blocking. Scores were as follows: 1+, 5% to 25%; 2+, 26% to 50%; and 3+, more than 51%. Langerhans cells served as a positive internal control in all tested cases. All Mayo Clinic Rochester cases were negative. Sixteen Carolinas Medical Center perivascular epithelioid cell neoplasms (14 renal angiomyolipomas, 1 soft tissue perivascular epithelioid cell neoplasm, 1

  1. Phase II Evaluation of Gefitinib in Patients With Newly Diagnosed Grade 4 Astrocytoma: Mayo/North Central Cancer Treatment Group Study N0074

    SciTech Connect

    Uhm, Joon H.; Ballman, Karla V.; Wu Wenting; Giannini, Caterina; Krauss, J.C.; Buckner, Jan C.; James, C.D.; Scheithauer, Bernd W.; Behrens, Robert J.; Flynn, Patrick J.; Schaefer, Paul L.; Dakhill, Shaker R.; Jaeckle, Kurt A.

    2011-06-01

    Purpose: Amplification of the epidermal growth factor receptor (EGFR) gene represents one of the most frequent gene alterations in glioblastoma (GBM). In the current study, we evaluated gefitinib, a potent EGFR inhibitor, in the treatment of adults with newly diagnosed GBM. Methods and Materials: Ninety-eight patients (96 evaluable) were accrued between May 18, 2001, and August 2, 2002. All were newly diagnosed GBM patients who were clinically and radiographically stable/improved after radiation treatment (enrollment within 5 weeks of radiation completion). No prior chemotherapy was permitted. EGFR amplification/mutation, as assessed by fluorescence in situ hybridization and immunohistochemistry, was not required for treatment with gefitinib but was studied when tissues were available. Gefitinib was administered at 500 mg each day; for patients receiving dexamethasone or enzyme-inducing (CYP3A4) agents, dose was escalated to a maximum of 1,000 mg QD. Treatment cycles were repeated at 4-week intervals with brain magnetic resonance imaging at 8-week intervals. Results: Overall survival (OS; calculated from time of initial surgery) at 1 year (primary end point) with gefitinib was 54.2%, which was not statistically different compared with that of historical control population (48.9%, data from three previous Phase III North Central Cancer Treatment Group studies of newly diagnosed GBM patients). Progression-free survival (PFS) at 1 year post-RT (16.7%) was also not significantly different to that of historical controls (30.3%). Clinical outcome was not affected by EGFR status (amplification or vIII mutation). Fatigue (41%), rash (62%), and loose stools (58%) constituted the most frequent adverse events, the majority of these being limited to Grade 1/2. Of note, the occurrence of drug-related adverse effects, such as loose stools was associated with improved OS. Conclusions: In our evaluation of nearly 100 patients with newly diagnosed GBM, treatment with adjuvant

  2. Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

    PubMed Central

    Raeissadat, Seyed Ahmad; Sedighipour, Leyla; Rayegani, Seyed Mansoor; Bahrami, Mohammad Hasan; Bayat, Masume; Rahimi, Rosa

    2014-01-01

    Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P > 0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P < 0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion. PMID:24579044

  3. Ovarian remnant syndrome: comparison of laparotomy, laparoscopy and robotic surgery.

    PubMed

    Zapardiel, Ignacio; Zanagnolo, Vanna; Kho, Rosanne M; Magrina, Javier F; Magtibay, Paul M

    2012-08-01

    To compare laparotomy, laparoscopy and robotic surgery in the management of ovarian remnant syndrome. Retrospective comparative study. Mayo Clinic Arizona and Mayo Clinic Rochester, USA. Women who underwent surgical treatment for ovarian remnant syndrome. The clinical records of 223 patients with histologically documented residual cortical ovarian tissue excised at Mayo Clinic by laparotomy, laparoscopy or a robotic approach, from January 1985 through February 2009, were reviewed. Data collected included the patient's age, body mass index, previous medical and surgical history, symptoms, prior management of ovarian remnant syndrome, preoperative imaging study, intraoperative details, postoperative course, complications and follow-up data. Intraoperative and postoperative outcomes. One hundred and eighty-seven patients (83.9%) were operated by laparotomy, 19 (8.5%) by laparoscopy and 17 (7.6%) by a robotic approach. Estimated blood loss and length of stay were significantly lower in the robotic and laparoscopic groups compared with laparotomy (p < 0.01). After a mean follow-up of 21.1 ± 32.4 months, the rate of pain improvement was 93.1, 94.4 and 71.4% for the laparotomy, laparoscopy and robotic surgery group, respectively. Robotic and laparoscopic surgery for the treatment of ovarian remnant syndrome offer advantages over laparotomy in terms of reduced blood loss, lower postoperative complications and shorter length of stay. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Severe symptomatic acute hyponatremia in traumatic brain injury responded very rapidly to a single 15 mg dose of oral tolvaptan; a Mayo Clinic Health System hospital experience - need for caution with tolvaptan in younger patients with preserved renal function.

    PubMed

    Onuigbo, Macaulay Amechi Chukwukadibia; Agbasi, Nneoma

    2017-01-01

    Tolvaptan is now well established as a potent pharmaceutical agent for symptomatic hyponatremia from syndrome of inappropriate antidiuretic hormone secretion (SIADH), congestive heart failure and liver cirrhosis. Previous studies had recruited older (63-65 years) patients with mild renal impairment (serum creatinine, 1.3-1.4 mg/dl). A 2012 report in the Journal of Neurology, Neurosurgery & Psychiatry described tolvaptan as a "lifesaving drug". A major outcome concern in the treatment of chronic hyponatremia is potentially fatal pontine demyelination from over-rapid correction of serum sodium >0.5 mEq/dL/h. The maximum reported correction of serum sodium within 24 hours was 13 mEq/L in a case of SIADH. We recently experienced the dramatic correction of hyponatremia at 1 mEq/dL/h over 18 hours, following 15 mg of oral tolvaptan in a 32-year old male patient with normal kidney function (serum creatinine 0.76 mg/dL), following traumatic brain injury (TBI). Tolvaptan is indeed an effective and life-saving drug for post-TBI hyponatremia. However, we strongly recommend the use of lower doses of tolvaptan (≤15 mg/d) in younger patients with more preserved renal function to avoid the development of life-threatening pontine demyelination.

  5. Representing Mutually Exclusive Knowledge in a Property Hierarchy for a Reasoning System in Clinical Gynecology

    PubMed Central

    Small, Steven L.; Muechler, Eberhard K.

    1985-01-01

    The education and practice of clinical medicine can benefit significantly from the use of computational assistants. This article describes the development of a prototype system called SURGES (Strong/University of Rochester Gynecological Expert System) for representing medical knowledge and then applying this knowledge to suggest diagnostic procedures in medical gynecology. The paper focuses on the representation technique of property inheritance, which facilitates the simple common sense reasoning required to enable execution of the more complex medical inferences. Such common sense can be viewed as a collection mundane inferences, which are the simple conclusions drawn from knowledge that an exclusive or (XOR) relation (i.e., mutual exclusion) holds among a number of facts. The paper discusses the use of a property hierarchy for this purpose and shows how it simplifies knowledge representation in medical artificial intelligence (AIM) computer systems.

  6. Temporal trends of single-photon emission computed tomography myocardial perfusion imaging in patients without prior coronary artery disease: A 22-year experience at a tertiary academic medical center.

    PubMed

    Jouni, Hayan; Askew, J Wells; Crusan, Daniel J; Miller, Todd D; Gibbons, Raymond J

    2016-06-01

    Between 1990 and 2006, there was a large national increase in utilization of single-photon emission computed tomography myocardial perfusion imaging (SPECT) for assessment of coronary artery disease (CAD). We aim to examine the trends of SPECT test results and patients' characteristics at Mayo Clinic Rochester. Using the Mayo Clinic nuclear cardiology database, we examined all SPECT tests performed between January 1, 1991, and December 31, 2012, in patients without prior CAD. The study cohort was divided into 5 time periods: 1991-1995, 1996-2000, 2001-2005, 2006-2010, and 2011-2012. There were 35,894 eligible SPECT tests (mean age 62.5 ± 12 years, 54% men). Annual utilization of SPECT increased significantly in 1992-2002 but then decreased without evidence of test substitution with stress echocardiography. There were modest changes in CAD risk factors over time. Testing of asymptomatic patients doubled (21.9% in 1991-1995 to 40% in 2006-2010) but later decreased to 33.6% in 2011-2012. Tests on patients with typical angina decreased dramatically (18.3% in 1991-1995 to 6.7% in 2011-2012). Summed stress score, summed difference score, and high-risk SPECT tests all decreased over time in both symptomatic and asymptomatic patients regardless of stress modality (exercise vs pharmacologic). In Mayo Clinic Rochester, annual SPECT utilization in patients without prior CAD increased in 1992-2002 but then decreased. Despite similar CAD risk factors and decreased utilization after 2003, more tests were low risk; summed stress score, summed difference score, and high-risk tests all decreased. Our findings confirm previous observations that SPECT was increasingly used in patients with a lower prevalence of CAD. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Anaphoric relations in the clinical narrative: corpus creation

    PubMed Central

    Chapman, Wendy W; Zheng, Jiaping; Crowley, Rebecca S

    2011-01-01

    Objective The long-term goal of this work is the automated discovery of anaphoric relations from the clinical narrative. The creation of a gold standard set from a cross-institutional corpus of clinical notes and high-level characteristics of that gold standard are described. Methods A standard methodology for annotation guideline development, gold standard annotations, and inter-annotator agreement (IAA) was used. Results The gold standard annotations resulted in 7214 markables, 5992 pairs, and 1304 chains. Each report averaged 40 anaphoric markables, 33 pairs, and seven chains. The overall IAA is high on the Mayo dataset (0.6607), and moderate on the University of Pittsburgh Medical Center (UPMC) dataset (0.4072). The IAA between each annotator and the gold standard is high (Mayo: 0.7669, 0.7697, and 0.9021; UPMC: 0.6753 and 0.7138). These results imply a quality corpus feasible for system development. They also suggest the complementary nature of the annotations performed by the experts and the importance of an annotator team with diverse knowledge backgrounds. Limitations Only one of the annotators had the linguistic background necessary for annotation of the linguistic attributes. The overall generalizability of the guidelines will be further strengthened by annotations of data from additional sites. This will increase the overall corpus size and the representation of each relation type. Conclusion The first step toward the development of an anaphoric relation resolver as part of a comprehensive natural language processing system geared specifically for the clinical narrative in the electronic medical record is described. The deidentified annotated corpus will be available to researchers. PMID:21459927

  8. Evaluation of the modified API 20C system for identification of clinically important yeasts.

    PubMed Central

    Buesching, W J; Kurek, K; Roberts, G D

    1979-01-01

    The modified API 20C system (Analytab Products, Inc.) containing 19 carbohydrate assimilation tests was used to identify stock cultures of clinical isolates and routine clinical isolates from the Mayo Clinic mycology laboratory. The system provided correct identifications for 96% of the 505 organisms tested. The API 20C represents a commercial system useful for the identification of yeasts from clinical specimens. Although reliable, it is not a complete system and must be used in conjunction with microscopic morphological features for definitive identification. Since the system requires 72 h for identification, it is not designed for the rapid presumptive identification of such organisms as Cryptococcus neoformans; other biochemical tests must be used for this purpose. PMID:383742

  9. Integration of e-consultations into the outpatient care process at a tertiary medical centre.

    PubMed

    North, Frederick; Uthke, Lorraine D; Tulledge-Scheitel, Sidna M

    2014-06-01

    An e-consultation is an asynchronous consultation performed by a specialist without a face-to-face patient visit. E-consultations have been available to primary care providers at the Mayo Clinic for several years. We reviewed e-consultations performed by specialists at the Mayo Clinic for the first six months of 2013. We included only "internal" e-consultations, originating from within the Rochester practice. During the study period a total of 3242 e-consultations were completed at the Mayo Clinic. After excluding those relating to patients who did not give research consent, 3008 e-consultations remained. We categorized our internal e-consultations into eight types. The most frequently used types were the first e-consultation processes to be implemented: the primary care to specialist e-consultation and the specialist to specialist e-consultation, accounting for 74% of the total. As these two types of e-consultation became widely used, the staff discovered that the e-consultation process could be adapted to meet specific practice needs and six more e-consultation types emerged. For example, intra-specialty e-consultations and surgical e-consultations accounted for 16% of the total. E-consultations appear to have improved access to specialists, and they are integrated into care processes when timely expert opinions are needed. As e-consultations evolve, it will be important to develop a standard, well-defined terminology to compare outcomes of these processes across practices.

  10. [Primary biliary cirrhosis complicated by pulmonary arterial hypertension: a clinical analysis].

    PubMed

    Shen, Min; Zhang, Xuan; Zhang, Feng-chun

    2005-04-13

    To analyze the clinical features and prognosis of patients with primary biliary cirrhosis (PBC) complicated by pulmonary arterial hypertension (PAH). The medical records of 80 PBC inpatients, 8 of which were complicated by pulmonary arterial hypertension (PAH) were retrospectively analyzed to compare the differences in clinical features, biochemical parameters, positive rates of autoantibodies and Mayo risk score between the 2 groups with or without PAH. The prevalence of portal hypertension was 7/8, in the PAH group, significantly higher than that in the non-PAHG group [(44.4%, 32/72), P < 0.05]. The Mayo score of the PAH group was 7.0 +/- 1.2, significantly higher than that in the non-PAH group (5.6 +/- 1.5, P < 0.05). The IgA level of the PAH group was (4.4 +/- 1.9) g/L, significantly higher than that in the non-PAH group [(3.0 +/- 1.8) g/L, P < 0.05]. The serum level of alkaline phophatase of the noon-PAH group was 293 +/- 218 U/L, significantly higher than that of the PAH group [(150 +/- 53) U/L, P < 0.05]. Closely associated with portal hypertension and indicating poor prognosis, moderate to severe PAH is not a rare complication of PBC.

  11. External Compression Headaches

    MedlinePlus

    ... If protective headwear, such as a sports or construction helmet, is necessary, make sure it fits properly ... shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo ...

  12. Correlating Lab Test Results in Clinical Notes with Structured Lab Data: A Case Study in HbA1c and Glucose.

    PubMed

    Liu, Sijia; Wang, Liwei; Ihrke, Donna; Chaudhary, Vipin; Tao, Cui; Weng, Chunhua; Liu, Hongfang

    2017-01-01

    It is widely acknowledged that information extraction of unstructured clinical notes using natural language processing (NLP) and text mining is essential for secondary use of clinical data for clinical research and practice. Lab test results are currently structured in most of the electronic health record (EHR) systems. However, for referral patients or lab tests that can be done in non-clinical setting, the results can be captured in unstructured clinical notes. In this study, we proposed a rule-based information extraction system to extract the lab test results with temporal information from clinical notes. The lab test results of glucose and HbA1c from 104 randomly sampled diabetes patients selected from 1996 to 2015 are extracted and further correlated with structured lab test information in the Mayo Clinic EHRs. The system has high F1-scores of 0.964, 0.967 and 0.966 in glucose, HbA1c and overall extraction, respectively.

  13. Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis: A Population-Based Study in Olmsted County, Minnesota

    PubMed Central

    Reeder, Margo J.; Wetter, David A.; Li, Xujian; Davis, Mark D. P.

    2010-01-01

    Objective To identify new and existing cases of dermatomyositis and its subtypes in Olmsted County, Minnesota, from 1976 through 2007, and to establish a population-based estimate of the incidence and prevalence of dermatomyositis and amyopathic dermatomyositis. Design Retrospective population-based study. Setting Community-based epidemiology project. Patients Using the Rochester Epidemiology Project, patients with a diagnosis of dermatomyositis were identified. Main Outcome Measures Incidence of dermatomyositis and clinically amyopathic dermatomyositis; risk of malignancy in clinically amyopathic dermatomyositis. Results Of the 29 patients identified, 6 (21%) of these had the clinically amyopathic subtype of dermatomyositis, and 22 (76%) were female. Overall age- and sex-adjusted incidence (95% confidence interval) of dermatomyositis including all subtypes was 9.63 (6.09-13.17) per 1,000,000 and was 2.08 (0.39-3.77) per 1,000,000 for clinically amyopathic dermatomyositis. Age- and sex-adjusted prevalence was 21.42 (13.07-29.77) per 100,000. Eight patients (28%) had a malignancy during the study period; risk of malignancy (odds ratio) for classic dermatomyositis compared with clinically amyopathic dermatomyositis was 4.61 but was not statistically significant (0.22-96.09) (P=.44). Conclusions Dermatomyositis is a rare disease, and clinically amyopathic dermatomyositis represents an estimated 20% of all dermatomyositis cases. Larger population-based studies are needed to estimate the risk of malignancy associated with subtypes of dermatomyositis, particularly clinically amyopathic dermatomyositis. PMID:20083689

  14. Acute histological inflammatory activity is associated with clinical relapse in patients with ulcerative colitis in clinical and endoscopic remission.

    PubMed

    Calafat, Margalida; Lobatón, Triana; Hernández-Gallego, Alba; Mañosa, Míriam; Torres, Paola; Cañete, Fiorella; Cabré, Eduard; Ojanguren, Isabel; Domènech, Eugeni

    2017-09-08

    It has been suggested that acute histological activity has a prognostic value in the outcome of ulcerative colitis (UC) patients in clinical and endoscopic remission. Our aim was to assess the role of histology as a risk factor for clinical relapse (CR) in patients in both clinical and endoscopic remission. Patients with left-sided or extensive UC in clinical and endoscopic remission (Mayo endoscopic subscore ≤1) undergoing colonoscopy for dysplasia surveillance with random colonic biopsies between 2005-2015 were included. Basal plasmacytosis, acute (AHA), and the chronic (CHA) histological inflammatory activity of all biopsy sets were evaluated. One hundred and thirteen patients were included. Median time in clinical remission at inclusion was 27 months (IQR 15-56). Eight percent of patients relapsed within the first year and 33% during the whole follow-up period. In the univariate analysis, the presence of AHA, alone (P=0.048) or together with a past flare within the previous 12 months (P=0.01), was associated with CR within the first year of follow-up. In the multivariate analysis, AHA, together with a flare within the previous 12 months, remained the only risk factor for relapse (RR=7.5; IC95%; 1.8-29.9; P=0.005). In UC patients in clinical and endoscopic remission, the presence of AHA is a risk factor for clinical relapse. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Mayo AVC Registry and BioBank

    ClinicalTrials.gov

    2017-09-11

    Arrhythmogenic Right Ventricular Cardiomyopathy; Cardiomyopathies; Heart Diseases; Cardiovascular Diseases; Sudden Cardiac Arrest; Sudden Cardiac Death; Arrhythmogenic Right Ventricular Dysplasia; Arrhythmogenic Ventricular Cardiomyopathy; Familial Dilated Cardiomyopathy; Cardiovascular Abnormalities

  16. Effect of a Novel Clinical Decision Support Tool on the Efficiency and Accuracy of Treatment Recommendations for Cholesterol Management.

    PubMed

    Scheitel, Marianne R; Kessler, Maya E; Shellum, Jane L; Peters, Steve G; Milliner, Dawn S; Liu, Hongfang; Komandur Elayavilli, Ravikumar; Poterack, Karl A; Miksch, Timothy A; Boysen, Jennifer; Hankey, Ron A; Chaudhry, Rajeev

    2017-02-08

    The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record. To assess the impact of our clinical decision support tool on the efficiency and accuracy of clinician calculation of cardiovascular risk and its effect on the delivery of guideline-consistent treatment recommendations. Clinicians were asked to review the EHR records of selected patients. We evaluated the amount of time and the number of clicks and keystrokes needed to calculate cardiovascular risk and provide a treatment recommendation with and without our clinical decision support tool. We also compared the treatment recommendation arrived at by clinicians with and without the use of our tool to those recommended by the guidelines. Clinicians saved 3 minutes and 38 seconds in completing both tasks with MayoExpertAdvisor, used 94 fewer clicks and 23 fewer key strokes, and improved accuracy from the baseline of 60.61% to 100% for both the risk score calculation and guideline-consistent treatment recommendation. Informatics solution can greatly improve the efficiency and accuracy of individualized treatment recommendations and have the potential to increase guideline compliance.

  17. Sedna - Artist Unknown.

    PubMed

    Wentz, Margaret R

    2016-05-01

    Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as interpreted by the author.

  18. Comment on “The role of interbasin groundwater transfers in geologically complex terranes, demonstrated by the Great Basin in the western United States”: report published in Hydrogeology Journal (2014) 22:807–828, by Stephen T. Nelson and Alan L. Mayo

    USGS Publications Warehouse

    Masbruch, Melissa D.; Brooks, Lynette E.; Heilweil, Victor M.; Sweetkind, Donald S.

    2015-01-01

    The subject article (Nelson and Mayo 2014) presents an overview of previous reports of interbasin flow in the Great Basin of the western United States. This Comment is presented by authors of a cited study (comprising chapters in one large report) on the Great Basin carbonate and alluvial aquifer system (GBCAAS; Heilweil and Brooks 2011; Masbruch et al. 2011; Sweetkind et al. 2011a, b), who agree that water budget imbalances alone are not enough to accurately quantify interbasin flow; however, it is proposed that statements made in the subject article about the GBCAAS report are inaccurate. The Comment authors appreciate the opportunity to clarify some statements made about the work.

  19. Clinical Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck's Disease.

    PubMed

    Dehghani, Mohammad; Moshgelani, Mohammad Ali; Nouraei, Mohammad Hadi; Dehghani, Shaghayegh; Gholshahi, Maryam

    2014-01-01

    The aim of this study was to compare two surgery methods including radial shortening and radial shortening combined with vascularized bone graft for treatment of stage II or IIIa of Kienböck's disease. It is a randomized, controlled clinical trial, which was carried out in 2011-2013. Twenty-four patients were assigned equally to radial shortening group (A) or radial shortening combined with vascularized bone graft group (B). The outcome was assessed by Mayo Wrist score before and 9 months after surgery. The mean Mayo Wrist score (SD) was 27.1 (15.4) and 32.5 (18.3) before surgery and 74.6 (5.4) and 85.8 (5.1) after surgery for groups A and B, respectively. The mean score increased in both groups, and it was higher in group B significantly. Radial shortening combined with vascularized bone graft is a valuable method which can be more effective than radial shortening alone, in early stages of Kienböck's disease. This trial is registered with IRCT201404127841N5.

  20. Clinical Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck's Disease

    PubMed Central

    Dehghani, Mohammad; Nouraei, Mohammad Hadi; Dehghani, Shaghayegh; Gholshahi, Maryam

    2014-01-01

    The aim of this study was to compare two surgery methods including radial shortening and radial shortening combined with vascularized bone graft for treatment of stage II or IIIa of Kienböck's disease. It is a randomized, controlled clinical trial, which was carried out in 2011–2013. Twenty-four patients were assigned equally to radial shortening group (A) or radial shortening combined with vascularized bone graft group (B). The outcome was assessed by Mayo Wrist score before and 9 months after surgery. The mean Mayo Wrist score (SD) was 27.1 (15.4) and 32.5 (18.3) before surgery and 74.6 (5.4) and 85.8 (5.1) after surgery for groups A and B, respectively. The mean score increased in both groups, and it was higher in group B significantly. Radial shortening combined with vascularized bone graft is a valuable method which can be more effective than radial shortening alone, in early stages of Kienböck's disease. This trial is registered with IRCT201404127841N5. PMID:27382615

  1. Clinical monitoring: infliximab biosimilar CT-P13 in the treatment of Crohn’s disease and ulcerative colitis

    PubMed Central

    Keil, Radan; Wasserbauer, Martin; Zádorová, Zdena; Hajer, Jan; Drastich, Pavel; Wohl, Pavel; Beneš, Marek; Bojková, Martina; Svoboda, Pavel; Konečný, Michal; Falt, Přemysl; Vaňásek, Tomáš; Pešta, Martin; Pešek, František; Bouchner, Luděk; Koželuhová, Jana; Novotný, Aleš; Bartůsková, Lucie; Špičák, Julius

    2016-01-01

    Abstract Objective: The infliximab biosimilar CT-P13 (Remsima®, Inflectra®) was approved in Europe for the treatment of inflammatory bowel disease (IBD) based on extrapolation of data from patients with rheumatic disease. Because there are limited published reports on clinical outcomes for IBD patients treated with CT-P13, we monitored responses to induction treatment with this biosimilar in patients with Crohn’s disease (CD) or ulcerative colitis (UC) in centres across the Czech Republic. Material and methods: Fifty-two patients with CD (n = 30) or UC (n = 22) were treated with 5 mg/kg CT-P13 for up to 14 weeks. Effectiveness of therapy was evaluated with the Crohn’s Disease Activity Index (CDAI) or the Mayo Scoring System (MSS) in patients with CD or UC, respectively, before and after 14 weeks. Additional goals were to evaluate weight changes, serum C-reactive protein (CRP) levels, and complications/adverse events. Results: In patients with CD, remission (CDAI <150) was achieved in 50.0% of cases, and partial response (≥70-point decrease in CDAI score from baseline) in the remaining 50.0%. In patients with UC, remission (total score on partial Mayo index ≤2 points) was achieved in 40.9% of cases, partial response (≥2-point decrease in partial Mayo score from baseline) in 54.5%, and no response in 4.5%. There were statistically significant improvements in CDAI, MSS and CRP serum levels after 14 weeks of therapy, and body weight increased. Four adverse events were identified (n = 1 each): lower-extremity phlebothrombosis, herpes labialis, pneumonia and allergic reaction. Conclusions: This prospective observational study provides evidence of the effectiveness of CT-P13 in IBD. PMID:27002981

  2. Impact of Telemedicine Monitoring of Community ICUs on Interhospital Transfers.

    PubMed

    Pannu, Jasleen; Sanghavi, Devang; Sheley, Todd; Schroeder, Darrell R; Kashyap, Rahul; Marquez, Alberto; Daniels, Craig E; Brown, Daniel R; Caples, Sean M

    2017-08-01

    To study the effects of tele-ICU monitoring on interhospital transfers from community-based ICUs to the quaternary care hospital at Mayo Clinic, Rochester, MN. This is a retrospective review of data on interhospital transfers comparing trends prior to tele-ICU implementation to those following implementation. Tele-ICU programs are increasingly utilized to fill resource gaps in caring for critically ill patients. How such programs impact population and bed management within a healthcare system are not known. Mayo Clinic serves as quaternary referral care center for hospitals in the region within the Mayo Clinic Health System. In August 2013, we implemented tele-ICU monitoring at six Mayo Clinic Health System hospital ICUs. All adult ICU admissions during the study period (preimplementation phase: January 1, 2012, to December 31, 2012; and postimplementation phase: January 1, 2014, to December 31, 2014) in any of the six specified community ICUs were included in the study. Interhospital transfers significantly increased post institution of tele-ICU (p = 0.040) and was attributed primarily to transfer from less specialized ICUs (p = 0.037) as compared with more resource-intensive ICUs (p = 0.88). However, for such patient transfers, there were no significant differences before and after severity of illness scores, ICU mortality, or inhospital mortality. In a regional healthcare system, implementation of a tele-ICU program is associated with an increase in interhospital transfers from less resourced ICUs to the referral center, a trend that is not readily explained by increased severity of illness.

  3. The TU-025 keishibukuryogan clinical trial for hot flash management in postmenopausal women: results and lessons for future research.

    PubMed

    Plotnikoff, Gregory A; Watanabe, Kenji; Torkelson, Carolyn; La Valleur, June; Radosevich, David M

    2011-08-01

    The aim of this study was to assess the efficacy of TU-025, keishibukuryogan, a Japanese prescription herbal medicine used for hot flash management, in American women. This randomized, double-blind, placebo-controlled, phase II trial enrolled 178 postmenopausal women aged 45 to 58 years with a Mayo hot flash score greater than 28 per week who met other inclusion criteria. After a 1-week placebo run-in period, participants were randomly assigned placebo, or 7.5 g/day, or 12.5 g/day groups, for 12 weeks. Primary and secondary outcomes were measured using the Mayo Clinic Hot Flash Diary, the Greene Climacteric Index, and the Pittsburgh Sleep Quality Index. At 3 months, hot flash scores, climacteric symptoms, and sleep quality improved by 34% in the placebo group, 40% in the 7.5 g/day group, and 38% in the 12.5 g/day group. (P < 0.001). However, the differences in changes between groups were not statistically significant (P = 0.990). Diarrhea unexpectedly developed in 20% of participants receiving active medication. For American women, unlike the clinical experience for Japanese women, TU-025 did not significantly reduce the frequency and severity of hot flash symptoms, improve climacteric symptoms, or benefit sleep quality. This study identified several potentially significant methodological factors to be considered in future scientific assessments of traditional Asian medicines.

  4. Solomon's Seal, Flamingo Flower, Kousa Dogwood, and Kousa Dogwood by Harold Feinstein.

    PubMed

    Wentz, Margaret R

    2014-05-01

    In recognition of the important part that art has had in the Mayo Clinic environment since the original Mayo Building was finished in 1914, Mayo Clinic Proceedings will feature some of the numerous works of art displayed throughout the buildings and grounds on the Mayo Clinic campuses.

  5. Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy.

    PubMed

    Ono, Ryohei; Falcão, L Menezes

    2016-04-15

    Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning with the absence of coronary occlusion, which typically occurs in older women after emotional or physical stress. The pathophysiology of TTC is not well established, though several possible causes such as catecholamine cardiotoxicity, metabolic disturbance, coronary microvascular impairment and multivessel epicardial coronary artery spasm have been proposed. A number of diagnostic criteria have been suggested in the world and not unified as single, but the most common accepted one is Mayo Clinic proposed criteria. Since the clinical presentation of TTC is usually similar to acute coronary syndrome, differential diagnosis is essential to exclude other diseases and also for its treatment. Imaging modality including echocardiogram, angio CT and cardiac MRI, and lab tests for catecholamine, troponin T, creatine kinase MB and B-type natriuretic peptide can be useful to differentiate TTC from other diseases. Prognosis is generally favorable and in-hospital mortality is from 0% to within 10%.

  6. [Evaluation of the concordance between biological markers and clinical activity in inflammatory bowel disease].

    PubMed

    Miranda García, Pablo; Chaparro, María; Gisbert, Javier P

    2015-01-06

    Endoscopy is the gold standard to assess disease severity in inflammatory bowel disease, although it is an invasive procedure. Clinical activity and biological markers have been routinely used to determine disease activity in a non-invasive manner. The aim of this study was to determine concordance between common biological markers (C reactive protein, orosomucoid, erythrocyte sedimentation rate, fibrinogen, platelets, leukocytes, neutrophils and haemoglobin) and clinical activity in inflammatory bowel disease. Consecutive patients with inflammatory bowel disease were included. Clinical activity was evaluated according to the Harvey-Bradshaw index in Crohn's disease and to the partial Mayo score in ulcerative colitis. Serum concentrations of the different biomarkers were analysed. Concordance between clinical activity and elevation of the serological biomarkers was determined using the kappa statistic. In total, 350 patients were included (median age 46 years, Crohn's disease 59%). Eleven percent of patients had clinical activity. Crohn's disease patients had mild clinical activity in 44% of cases, moderate disease in 44% and only 12% of patients had severe clinical activity. In ulcerative colitis, patients had mild, moderate and severe clinical activity in 50, 42 and 8% of cases, respectively. None of the biomarkers included had an acceptable concordance with clinical activity (kappa statistic ≤ 0.30). Concordance between serological biomarkers and clinical activity in inflammatory bowel disease is remarkably low. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  7. Clinical Trials

    MedlinePlus

    ... Sponsors Why Are They Important How Do They Work Who Can Participate What To Expect During Benefits and Risks How They Protect Participants Finding Clinical Trials Links Children & Clinical Studies NHLBI Trials Clinical Trial Websites What Are Clinical ...

  8. Soluble ST2 is a sensitive clinical marker of ulcerative colitis evolution.

    PubMed

    Díaz-Jiménez, David; De la Fuente, Marjorie; Dubois-Camacho, Karen; Landskron, Glauben; Fuentes, Janitza; Pérez, Tamara; González, María Julieta; Simian, Daniela; Hermoso, Marcela A; Quera, Rodrigo

    2016-08-26

    The ST2/IL-33 pathway has been related to ulcerative colitis (UC), and soluble ST2 (sST2), to disease severity. We tested the potential usefulness of sST2 as a predictive marker of treatment response and patients' outcome. Twenty-six patients with active UC were prospectively recruited and grouped according to an endoscopic score and therapy response. Colonoscopic biopsies were collected at baseline and 6 months or when patients showed clinical activity. The protocol was reinitiated in patients requiring rescue therapy. Blood and stool were collected at baseline, 1, 3, 6 and 12 months. Serum and mucosal ST2, and fecal calprotectin (FC) content were determined by ELISA and correlated to Mayo clinical and endoscopic subscore. Intestinal ST2 was evaluated by immunofluorescence. Wilcoxon signed rank test and Spearman correlations (Rs) were applied (p <0.05). Follow-up was completed in 24 patients. sST2 levels (median and range) varied from 173.5 [136.6-274.0] to 86.5 [54.6-133.2] in responders (p < 0.05), and 336.3 [211.0-403.2] to 385.3 pg/mL [283.4-517.3] in non-responders at baseline and 6 months, respectively. sST2 levels correlated with Mayo clinical and endoscopic subscore, mucosal ST2 and FC (Rs = 0.57, 0.66, 0.74 and 0.42, respectively; p < 0.0001) and showed a trend similar to that of FC in responders. Non-responders revealed an increased ST2 content, restricted to the lamina propria's cellular infiltrate. Consecutive sST2 measurement to follow changes in inflammatory activity of UC patients who respond or not to treatment identifies sST2, like FC, as a useful biomarker in predicting clinical outcome of UC patients.

  9. [Clinical outcome after discontinuation of infliximab in patients with ulcerative colitis in deep remission].

    PubMed

    Muñoz Villafranca, Carmen; Bravo Rodríguez, Maria Teresa; Ortiz de Zárate, Jone; Arreba González, Paz; García Kamiruaga, Iñigo; Heras Martín, Juan Ignacio; Cabezudo Gil, Pilar; Orive Cura, Víctor

    2016-01-01

    Infliximab (IFX) is effective in treating ulcerative colitis (UC) and in achieving mucosal healing (MH). Little is known about the role of mucosal healing (MH) in the subsequent evolution of the disease and the consequences of discontinuing treatment. To evaluate the characteristics and evolution of patients with UC treated with IFX who discontinued treatment after disease remission. Observational, prospective study of patients with moderate to severe UC, corticosteroid-resistant/corticosteroid-dependent, naïve to anti-TNF. IFX administration regimen: 5 mg/kg at 0-2-6 weeks and every 8 weeks thereafter until week 54. In patients achieving MH, IFX was discontinued and the patients were followed-up for at least 20 months. Clinical remission (CR): mayo score <2; Clinical response: decrease in mayo score of 3 points; MH: mayo score 0-1; Deep remission: patient with CR and MH. Of the 21 patients enrolled, 19 completed the study (colectomy, n = 1; non-responder, n = 1). Mean age: 47.8 years. UC: severe (n = 13) and moderate (n = 6); most patients (n = 11) were steroid-resistant; 57.8% received combined treatment with immunosuppressants, and 31.5% intensified treatment. Week 54: 16 patients (84.2%) showed clinical response, 13 (68.4%) showed CR, and 12 (63.2%) deep remission. Of these, 6 (25%) presented a new episode of UC, and in 3 (25%) IFX was restarted within 12 weeks of discontinuation, with all patients responding. Of the total sample, 91.7% remained IFX-free at week 8, and 75% at week 12, with no remission during follow-up. None of the patients required hospitalization or surgery. Half of patients with deep remission of UC with IFX therapy presented a new episode after treatment discontinuation, and in 25% IFX therapy was restarted. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  10. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  11. Word sense disambiguation in the clinical domain: a comparison of knowledge-rich and knowledge-poor unsupervised methods

    PubMed Central

    Chasin, Rachel; Rumshisky, Anna; Uzuner, Ozlem; Szolovits, Peter

    2014-01-01

    Objective To evaluate state-of-the-art unsupervised methods on the word sense disambiguation (WSD) task in the clinical domain. In particular, to compare graph-based approaches relying on a clinical knowledge base with bottom-up topic-modeling-based approaches. We investigate several enhancements to the topic-modeling techniques that use domain-specific knowledge sources. Materials and methods The graph-based methods use variations of PageRank and distance-based similarity metrics, operating over the Unified Medical Language System (UMLS). Topic-modeling methods use unlabeled data from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC II) database to derive models for each ambiguous word. We investigate the impact of using different linguistic features for topic models, including UMLS-based and syntactic features. We use a sense-tagged clinical dataset from the Mayo Clinic for evaluation. Results The topic-modeling methods achieve 66.9% accuracy on a subset of the Mayo Clinic's data, while the graph-based methods only reach the 40–50% range, with a most-frequent-sense baseline of 56.5%. Features derived from the UMLS semantic type and concept hierarchies do not produce a gain over bag-of-words features in the topic models, but identifying phrases from UMLS and using syntax does help. Discussion Although topic models outperform graph-based methods, semantic features derived from the UMLS prove too noisy to improve performance beyond bag-of-words. Conclusions Topic modeling for WSD provides superior results in the clinical domain; however, integration of knowledge remains to be effectively exploited. PMID:24441986

  12. Fecal level of calprotectin identifies histologic inflammation in patients with ulcerative colitis in clinical and endoscopic remission.

    PubMed

    Guardiola, Jordi; Lobatón, Triana; Rodríguez-Alonso, Lorena; Ruiz-Cerulla, Alexandra; Arajol, Claudia; Loayza, Carolina; Sanjuan, Xavier; Sánchez, Elena; Rodríguez-Moranta, Francisco

    2014-11-01

    Histologic recovery of patients with ulcerative colitis (UC) often is incomplete, even among those in clinical and endoscopic remission. Persistent active microscopic inflammation is associated with an increased risk of relapse and colorectal neoplasia. A high level of fecal calprotectin (FC) is a reliable marker of endoscopic lesions in patients with UC. We evaluated the accuracy of FC in identifying patients with UC in clinical and endoscopic remission who still have histologic features of inflammation. We performed a prospective observational study of 59 patients with UC in clinical and endoscopic remission undergoing colonoscopy. Several biopsy specimens were collected from each colonic segment. Endoscopic remission was defined as a Mayo endoscopic subscore with a grade of 0 or 1. Active histologic inflammation was defined by the presence of neutrophils infiltrating crypt epithelial cells. FC was determined by enzyme-linked immunosorbent assay analysis. Eighteen patients (30.5%) showed evidence of active histologic inflammation. Patients with active histologic inflammation had a significantly higher median level of FC (278 μg/g; interquartile range, 136-696 μg/g) than those without active histologic inflammation (68 μg/g; interquartile range, 30-172 μg/g) (P = .002). In multivariate analysis, the FC and Mayo endoscopic subscore (0 or 1) were each independent predictors of histologic inflammation. The level of FC identified active histologic inflammation in patients in clinical and endoscopic remission, with an area under the receiver operator characteristic curve value of 0.754. Histologic inflammation is common among patients with UC in clinical and endoscopic remission. Patients with histologic features of inflammation can be identified reliably based on their fecal level of calprotectin. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  13. Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn's Disease Phenotypes.

    PubMed

    Taleban, Sasha; Stewart, Kathleen O; Li, Darrick K; Singh, Prashant; Pardi, Darrell S; Sturgeon, Holly C; Yajnik, Vijay; Xavier, Ramnik J; Ananthakrishnan, Ashwin N; Khalili, Hamed

    2016-09-01

    Clinical activity and quality of life (QOL) indices assess disease activity in Crohn's disease (CD) and ulcerative colitis (UC). However, a paucity of data exists on the validity of these indices according to disease characteristics. To examine the correlation between QOL and clinical activity indices and endoscopic disease activity according to disease characteristics. We used a prospective registry to identify CD and UC patients ≥18 years old with available information on Short Inflammatory Bowel Disease Questionnaire scores (SIBDQ), Harvey-Bradshaw Index (HBI) and simple endoscopic scores for CD (SES-CD), and Simple Clinical Colitis Activity Index (SCCAI) and Mayo endoscopic score for UC. We used Spearman rank correlations to calculate correlations between indices and Fisher transformation to compare correlations across disease characteristics. Among 282 CD patients, we observed poor correlation between clinical activity and QOL indices to SES-CD with no differences in correlation according to disease characteristics. Conversely, among 226 UC patients, clinical activity and QOL had good correlation to Mayo endoscopic score (r = 0.55 and -0.56, respectively) with better correlations observed with left-sided versus extensive colitis (r = 0.73 vs. 0.45, p = 0.005) and shorter duration of disease (r = 0.61 vs. 0.37, p = 0.04). Our data suggest good correlation between SCCAI and endoscopic disease activity in UC, particularly in left-sided disease. Poor correlations between HBI or SIBDQ and SES-CD appear to be consistent across different disease phenotypes.

  14. Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial

    PubMed Central

    2014-01-01

    Background Lateral humeral epicondylitis, or ‘tennis elbow’, is a common condition with a variety of treatment options. Platelet-rich plasma (PRP) and Autologous Whole Blood (AWB) represent new therapeutic options for chronic tendinopathies including tennis elbow. The aim of the present study was to compare the long term effects of PRP versus autologous whole blood local injection in patients with chronic tennis elbow. Methods Seventy six patients with chronic lateral humeral epicondylitis with duration of symptoms more than 3 months were included in this study and randomized into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous leukocyte rich PRP (4.8 times of plasma) and group 2 with 2 mL of AWB. Tennis elbow strap, stretching and strengthening exercises were administered for both groups. Pain and functional improvements were assessed using visual analogue scale (VAS), Mayo score (modified Mayo Clinic performance index for the elbow) and pressure pain threshold (PPT) at 0, 4, 8 weeks and 6 and 12 months. Results All pain variables including VAS, PPT and Mayo scores improved significantly in both groups at each follow up intervals compared to baseline. No statistically significant difference was noted between groups regarding pain, functional scores and treatment success rates in all follow up examinations (P >0/05). Conclusion PRP and autologous whole blood injections are both effective methods to treat chronic lateral epicondylitis and their efficacy persisted during long term follow up. PRP was not superior to AWB in long term follow up. PMID:24635909

  15. Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments.

    PubMed

    Zhang, Xiao C; Bermudez, Ana M; Reddy, Pranav M; Sarpatwari, Ravi R; Chheng, Darin B; Mezoian, Taylor J; Schwartz, Victoria R; Simmons, Quinneil J; Jay, Gregory D; Kobayashi, Leo

    2017-03-01

    A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care. We designed and built a novel, open-source, portable, bedside procedural surface through an iterative development process with use testing in simulated and live clinical environments. The procedural surface development project was conducted between October 2014 and June 2016 at an academic referral hospital and its affiliated simulation facility. An interdisciplinary team of emergency physicians, mechanical engineers, medical students, and design students sought to construct a prototype bedside procedural surface out of off-the-shelf hardware during a collaborative university course on health care design. After determination of end-user needs and core design requirements, multiple prototypes were fabricated and iteratively modified, with early variants featuring undermattress stabilizing supports or ratcheting clamp mechanisms. Versions 1 through 4 underwent 2 hands-on usability-testing simulation sessions; version 5 was presented at a design critique held jointly by a panel of clinical and industrial design faculty for expert feedback. Responding to select feedback elements over several surface versions, investigators arrived at a near-final prototype design for fabrication and use testing in a live clinical setting. This experimental procedural surface (version 8) was constructed and then deployed for controlled usability testing against the standard Mayo stands in use at the study site ED. Clinical providers working in the ED who opted to participate in the study were provided with the prototype

  16. The Sixth Rochester Conference on Coherence and Quantum Optics

    DTIC Science & Technology

    1990-11-01

    60201 USA OZIZFIR ERCURENT COLLEGE OF STATEN IS .AN 44 PAlI PLCE STATEN ISLAM), NT 10301 t3A PALMA MASSIMO 6 IMPERIAL COLLEGE LASER OPTICS, ILACIETT LON...SOTH STREET NORRISTOWN, WJ 07960 USA SAN A1GUEL A UNIV IS LAS IALEARS IPTO E FISICA PALMA MALLORCA 07071 SPAIN SANCHEZ-1ONDRA&N JAVIER...ALEKANIRIA, VA 2232 US" VHITTAIER ER ARI STEIENS INST OF TECH IPAMRIREI If PHYSICS HOOIEN, NJ 0703G USA WINFUL HERIERT NIVERSIT OF NICHIAN EEC DEPT AMl ARO

  17. 78 FR 72023 - Drawbridge Operation Regulation; Genessee River, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-02

    ... Genessee River. D. Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses based on these statutes or executive... the Instruction, an environmental analysis checklist and a categorical exclusion determination are...

  18. Difficulty and Discrimination Parameters of Boston Naming Test Items in a Consecutive Clinical Series

    PubMed Central

    Pedraza, Otto; Sachs, Bonnie C.; Ferman, Tanis J.; Rush, Beth K.; Lucas, John A.

    2011-01-01

    The Boston Naming Test is one of the most widely used neuropsychological instruments; yet, there has been limited use of modern psychometric methods to investigate its properties at the item level. The current study used Item response theory to examine each item's difficulty and discrimination properties, as well as the test's measurement precision across the range of naming ability. Participants included 300 consecutive referrals to the outpatient neuropsychology service at Mayo Clinic in Florida. Results showed that successive items do not necessarily reflect a monotonic increase in psychometric difficulty, some items are inadequate to distinguish individuals at various levels of naming ability, multiple items provide redundant psychometric information, and measurement precision is greatest for persons within a low-average range of ability. These findings may be used to develop short forms, improve reliability in future test versions by replacing psychometrically poor items, and analyze profiles of intra-individual variability. PMID:21593059

  19. Difficulty and discrimination parameters of Boston naming test items in a consecutive clinical series.

    PubMed

    Pedraza, Otto; Sachs, Bonnie C; Ferman, Tanis J; Rush, Beth K; Lucas, John A

    2011-08-01

    The Boston Naming Test is one of the most widely used neuropsychological instruments; yet, there has been limited use of modern psychometric methods to investigate its properties at the item level. The current study used Item response theory to examine each item's difficulty and discrimination properties, as well as the test's measurement precision across the range of naming ability. Participants included 300 consecutive referrals to the outpatient neuropsychology service at Mayo Clinic in Florida. Results showed that successive items do not necessarily reflect a monotonic increase in psychometric difficulty, some items are inadequate to distinguish individuals at various levels of naming ability, multiple items provide redundant psychometric information, and measurement precision is greatest for persons within a low-average range of ability. These findings may be used to develop short forms, improve reliability in future test versions by replacing psychometrically poor items, and analyze profiles of intra-individual variability.

  20. Skin cancer in patients with psoriasis treated with coal tar. A 25-year follow-up study

    SciTech Connect

    Pittelkow, M.R.; Perry, H.O.; Muller, S.A.; Maughan, W.Z.; O'Brien, P.C.

    1981-08-01

    For many years, crude coal tar has been used for the treatment of psoriasis. The possible carcinogenic effect of crude coal tar and ultraviolet (UV) radiation (Goeckerman regimen), considered individually or in combination, has been of some concern to physicians. A 25-year follow-up study was completed on 280 patients with psoriasis who were hospitalized and treated with crude coal tar and UV radiation at the Mayo Clinic, Rochester, Minn, during the years 1950 through 1954. The results of this study suggest that the incidence of skin cancer is not appreciably increased above the expected incidence for the general population when patients are treated with coal tar ointments. It seems that the Goeckerman regimen (topical crude coal tar combined with UV radiation) can be used with minimal risk for skin cancer in the treatment of psoriasis.

  1. Safety of electroconvulsive therapy in patients receiving long-term warfarin therapy.

    PubMed

    Mehta, Vinay; Mueller, Paul S; Gonzalez-Arriaza, Heydy L; Pankratz, V Shane; Rummans, Teresa A

    2004-11-01

    To investigate the safety of electroconvulsive therapy (ECT) in patients receiving long-term warfarin therapy. Retrospective data were reviewed for 35 consecutively hospitalized patients who received long-term warfarin therapy and ECT at the Mayo Clinic in Rochester, Minn, between January 1, 1994, and December 31, 2001. A total of 300 ECT treatments were administered to the 35 patients. Of 284 ECT treatments for which data were available, no ECT-related complications due to anticoagulation occurred despite increases in blood pressure and pulse rate. One patient experienced ventricular tachycardia, resulting in transfer to a cardiology service for temporary monitoring. No other serious ECT-related adverse effects were noted. The rate of intertreatment delirium was similar to that reported in other studies. Electroconvulsive therapy in patients receiving long-term warfarin therapy appears to be safe. Although no major adverse effects were identified in our case series, additional prospective evaluation is warranted.

  2. Dermatologic relationships between the United States and German-speaking countries: part 3--the Europeans come to the United States.

    PubMed

    Burgdorf, Walter H C; Bickers, David R

    2013-10-01

    Following World War II, dermatology in German-speaking Europe faced enormous challenges, including the need to rebuild damaged or destroyed facilities, the replacement of the loss of many prewar leaders, and a raging venereal disease epidemic. Restoration of academic excellence and leadership required that young German-speaking dermatologists had to seek additional training in the United States, thereby reversing the historical trends of the 19th and early 20th centuries. Some of the initial visitors included Herbert Goldschmidt, Egon Macher, Gerd Steigleder, and Klaus Wolff. By the 1970s, there were numerous German-speaking scholars coming to the University of Pennsylvania, Philadelphia, with Albert Kligman and then to the Dermatology Branch at the National Institutes of Health and the Mayo Clinic, Rochester, Minnesota, and subsequently many other centers. Today, most of the leaders of German-speaking departments of dermatology have had some training in the United States.

  3. Allergic contact dermatitis from exotic woods: importance of patch-testing with patient-provided samples.

    PubMed

    Podjasek, Joshua O; Cook-Norris, Robert H; Richardson, Donna M; Drage, Lisa A; Davis, Mark D P

    2011-01-01

    Exotic woods from tropical and subtropical regions (eg, from South America, south Asia, and Africa) frequently are used occupationally and recreationally by woodworkers and hobbyists. These exotic woods more commonly provoke irritant contact dermatitis reactions, but they also can provoke allergic contact dermatitis reactions. We report three patients seen at Mayo Clinic (Rochester, MN) with allergic contact dermatitis reactions to exotic woods. Patch testing was performed and included patient-provided wood samples. Avoidance of identified allergens was recommended. For all patients, the dermatitis cleared or improved after avoidance of the identified allergens. Clinicians must be aware of the potential for allergic contact dermatitis reactions to compounds in exotic woods. Patch testing should be performed with suspected woods for diagnostic confirmation and allowance of subsequent avoidance of the allergens.

  4. Alternate endpoints and clinical outcome assessments in pediatric ulcerative colitis registration trials.

    PubMed

    Sun, Haihao; Lee, Jessica J; Papadopoulos, Elektra J; Lee, Catherine S; Nelson, Robert M; Sachs, Hari C; Rodriguez, William J; Mulberg, Andrew E

    2014-01-01

    Presently, there is no consensus on endpoint measures to assess clinical outcomes for pediatric ulcerative colitis (UC). This study reviewed the endpoints used in the registration trials of approved drugs for pediatric UC. The primary efficacy endpoints of all registration trials completed from 1950 to 2008 that led to Food and Drug Administration approval for indications in pediatric and adult UC were reviewed. Colazal and Remicade have been approved for pediatric UC indication, and clinical response was used as a primary endpoint in these registration trials. The clinical response in the adult Colazal trials was defined as a reduction of rectal bleeding and improvement in at least one of the other assessed symptoms (stool frequency, patient functional assessment, abdominal pain, sigmoidoscopic grade, and physician's global assessment) assessed by the Sutherland UC Activity Index. The pediatric Colazal trial defined clinical response using the Modified Sutherland UC Activity Index, which excluded abdominal pain and functional assessment. Both adult and pediatric Remicade trials used clinical response defined by the Mayo score as the primary endpoint. The Pediatric Ulcerative Colitis Activity Index was used to measure various secondary endpoints in the pediatric Remicade trial. Pediatric-specific endpoints were used, but outcome measures and definition of clinical response were not consistent in pediatric UC trials. Consensus on the definition of successful treatment outcome (clinical response and/or remission) and collaboration in the development of well-defined and reliable measures of signs and symptoms for use in conjunction with endoscopic parameters of mucosal healing will facilitate pediatric drug development.

  5. Radiological and Clinical Evaluation of the Transosseous Cortical Button Technique in Distal Biceps Tendon Repair.

    PubMed

    Caekebeke, Pieter; Vermeersch, Nicolas; Duerinckx, Joris; van Riet, Roger

    2016-12-01

    One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome and radiological outcome of this technique. The main goal of this study was to evaluate the radiographic evolution of the bone tunnel in the radius. Patients with an acute distal biceps tendon rupture treated with a transosseous cortical button were invited to take part in the study. Fourteen patients were included in the final analysis. All patients were evaluated both clinically and by computed tomography scanning of the proximal radius after a minimum follow-up of 2 years. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Bone tunnel volume was measured with semiautomated computed tomography segmentation using image-processing software. There were no failures of fixation in the patient group examined. Elbow mobility, arm, and forearm circumference were symmetric for all patients. Average visual analog scale for pain was less than 2. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score were 2.3 and 97.6, respectively. Computed tomography images showed an average closure of the radial bony tunnel of 64% of the initial volume. Biceps tendon repair with cortical button fixation only shows partial tunnel closure. This could reduce the risk of potential complications due to osteolysis, such as radius fracture or hardware failure. Functional results were excellent and comparable to other fixation methods. The role of interference screws in transosseous cortical button techniques to strengthen the repair and to avoid osteolysis may therefore be questioned. Therapeutic IV. Copyright © 2016

  6. Long-term clinical results in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft.

    PubMed

    Kastenskov, Christian; Rasmussen, Jeppe Vejlgaard; Ovesen, Janne; Olsen, Bo Sanderhoff

    2017-06-01

    The aim was to report the long-term functional and radiologic outcomes in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft. We included 18 patients previously treated for posterolateral elbow joint instability and evaluated for clinical results in 2003. Fifteen patients were examined with a mean follow-up period of 19 years (range, 17-22 years). We performed the clinical follow-up with clinical examination of stability, range of motion, pain score on a visual analog scale, Mayo Elbow Performance Score, and Danish version of Oxford Elbow Score. Furthermore, conventional anteroposterior and side-view radiographs of the elbow were obtained to evaluate osteoarthritis, calcifications in the ligaments, and joint subluxation. We evaluated the radiographs by the size of osteophytes, joint space narrowing, and subchondral sclerosis and classified the findings into 3 categories: no osteoarthritis, osteoarthritis, and severe osteoarthritis. All patients had a clinically stable elbow. None had pain while inactive or locking of the joint, and 4 had decreased range of motion. Two patients had a positive pivot-shift stress test, indicating laxity. The mean Mayo Elbow Performance Score was 93 (range, 70-100). The mean Oxford Elbow Score was 45. We observed 5 patients with osteoarthritis and 1 patient with severe osteoarthritis. The technique reported by Olsen and Søjbjerg in 2003 gives good long-term results in the treatment of symptomatic posterolateral elbow joint instability, though the development of elbow joint osteoarthritis may decrease the surgical result in the coming years. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. Radiological assessment report for the University of Rochester Annex, 400 Elmwood Avenue, Rochester, New York, April-May 1984

    SciTech Connect

    Wynveen, R.A.; Smith, W.H.; Sholeen, C.M.; Flynn, K.F.

    1984-12-01

    In light of the results of the comprehensive radiological assessment of the annex and auxiliary facilities, the following conclusions can be made: There is no immediate hazard from the elevated levels of radioactivity detected; however, some of these levels are above criteria. The radon, thoron, actinon, long-lived particulates, and tritium in the air are all below criteria for unrestricted use. Some ductwork has been identified as being contaminated. All ductwork must, therefore, be considered potentially contaminated. Since several floor drains were found to exhibit elevated readings, and the samples had elevated concentrations of radionuclides, it must be concluded that the drain and sewer systems of the Annex are contaminated with radioactive material. Since the samples collected from the storm and sewer systems outside the building also had elevated concentrations of radionuclides, these systems are also considered contaminated with radioactive material. The grounds around the Annex have exhibited background concentrations of radionuclides. Two rooms, B-330 and B-332, were inaccessible for survey due to the presence of stored furniture and equipment. Therefore, no comment about their radiological status can be made. At the common baseboard for Room C-12 and C-16 and on the floor below the tile in Room C-40, contamination appeared to be masked by construction modifications. Other areas of the Annex must also be considered potentially contaminated where modifications may have masked the contamination.

  8. 1989 Rochester FORTH Conference on Industrial Automation, University of Rochester, NY, June 20-24, 1989, Proceedings

    SciTech Connect

    Hess, T.

    1989-01-01

    Abstracts and papers are presented from a conference on the FORTH programming language and industrial automation, covering topics such as the use of FORTH in the Soviet Union and Germany, a FORTH-based development and simulation environment for industrial embedded controllers, FORTH-based control of an ion implanter, the Cellmate/TOOLBOX system for automotive and aerospace testing, industrial control by hierarchial decompositiion, machine vision, cross compiling, remote instrumentation in stellar horizon atmospheric dispersion measurements, and menu control. Additional topics include object oriented programming (OOP) systems, minimal OOP notation for FORTH, a vacuum-system controller, implementing record structures in FORTH, the Harris RTX 2000 C compiler, microballoon selection for laser fusion targets, engine development environments for industrial control, and hierarchial representation of binary image attributes. In addition, papers are presented on extending the FORTH environment to single chip microprocessors, easy Monte Carlo error analysis, a real-time visual langauge based on the FORTH stack concept, a two-color refractometry program, a FORTH-based man/maching interface for environmental control and monitoring, and fast time-resolved fluorescence data.

  9. Repeat retail clinic visits: impact of insurance coverage and age of patient.

    PubMed

    Angstman, Kurt B; Bernard, Matthew E; Rohrer, James E; Garrison, Gregory M; Maclaughlin, Kathy L

    2012-12-01

    As retail clinics provide a less costly alternative for health care, it would be reasonable to expect an increase in multiple (repeat) retail visits by those patients who may have expenses for receiving primary care. If costs were not a significant factor, then repeat visits should not be significantly different between these patients and those with coverage for primary care visits. The hypothesis for this study was that patients with the potential for out-of-pocket expenses would have a higher frequency of repeat retail clinic visits within 180 days compared to those with primary care coverage. A retrospective chart review was conducted of 5703 patients utilizing a retail clinic in Rochester, Minnesota from January 1, 2009 through June 30, 2009. The first visit to the retail clinic was considered the index visit and the chart was reviewed for repeat retail clinic visits within the next 180 days. Using a multiple logistic regression model, the odds of a pediatric patient (N=2344) having a repeat retail visit within 180 days of the index visit were not significantly impacted by insurance coverage (P=0.4209). Of the 3359 adult patients, those with unknown coverage had a 25.6% higher odds ratio of repeat retail clinic visits than those with insurance coverage (odds ratio 1.2557, confidence interval 1.0421-1.5131). This study suggested that when cost is an issue, the adult patient may favor retail clinics for episodic, low-acuity health care. In contrast, the pediatric population did not, suggesting that other factors, such as convenience, may play more of a role in the choice of episodic health care for this age group.

  10. Schnitzler syndrome: an under-diagnosed clinical entity

    PubMed Central

    Jain, Tania; Offord, Chetan P.; Kyle, Robert A.; Dingli, David

    2013-01-01

    Schnitzler syndrome is considered to be a rare disorder characterized by a monoclonal IgM protein and chronic urticaria that is associated with considerable morbidity. We hypothesized that the syndrome may be under-recognized and patients may be deprived of highly effective therapy in the form of anakinra. We performed a retrospective search of the dysproteinemia database at Mayo Clinic as well as the medical records of all patients with chronic urticaria to determine the true incidence of the disease. We compared patients with the diagnosis of Schnitzler syndrome and those who met the criteria but in whom the syndrome was not recognized. Comparisons between groups were performed and survival curves determined. We identified 16 patients with diagnosed Schnitzler syndrome and an additional 46 patients who met diagnostic criteria. The monoclonal protein was IgMκ in 94% of patients. Therapy with anakinra in 4 patients led to rapid and complete resolution of symptoms. The median overall survival for this syndrome is over 12.8 years. Progression to lymphoma was only observed in 8% of patients; this is lower than previous reports. Schnitzler syndrome may be present in up to 1.5% of patients with a monoclonal IgM in their serum and likely under-recognized as a clinical syndrome. PMID:23812931

  11. Diagnostic Yield and Safety of Cerebellar and Brainstem Parenchymal Biopsy.

    PubMed

    Tobin, W Oliver; Meyer, Fredric B; Keegan, B Mark

    2015-12-01

    We aimed to determine the diagnostic yield and safety of posterior fossa parenchymal biopsy. One-hundred-thirty-six patients who underwent 137 posterior fossa (brainstem or cerebellar) parenchymal biopsies at Mayo Clinic (Rochester, Minnesota, USA) between 1996 and 2009 were identified by chart review. Case histories; radiologic, surgical, and pathologic reports; and safety outcomes were assessed. Posterior fossa parenchymal biopsies were performed on 78 male and 58 female patients of median age 47 years (interquartile range 28-61). Preoperative clinical diagnosis in the majority of cases was of a malignant neoplasm. Glial neoplasm (51%) was the most common finding followed by lymphoma (7%) and neurosarcoidosis (7%). Normal tissue or nonspecific changes were observed in 28 cases (20%). Three deaths occurred: 2 at the time of biopsy (1%) and 1 due to underlying disease. All deaths occurred in patients who had a cerebellar biopsy. Transient neurologic deficits occurred in 15 patients (11%): worsening of presenting symptoms (4), cardiac arrhythmia (3), vertigo (2), diplopia (2), ataxia (3), seizure (1), decreased consciousness (1), and limb numbness (3). Sustained neurologic deficits occurred in 3 patients: fourth nerve palsy (1), hemiparesis (1), and facial numbness (1). The diagnostic yield of posterior fossa parenchymal biopsy in Mayo Clinic patients with diverse pathologies was 80%. The complication rate was 11% with the majority being transient, but 2 deaths were attributed to biopsy. Evaluation of the diagnostic yield and complication rate at individual neurosurgical centers is needed to determine generalizability of these results. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Detection of Keratoconus in Clinically and Algorithmically Topographically Normal Fellow Eyes Using Epithelial Thickness Analysis

    PubMed Central

    Reinstein, Dan Z.; Archer, Timothy J.; Urs, Raksha; Gobbe, Marine; RoyChoudhury, Arindam; Silverman, Ronald H.

    2017-01-01

    PURPOSE To assess the effectiveness of a keratoconus-detection algorithm derived from Artemis very high-frequency (VHF) digital ultrasound (ArcScan Inc., Morrison, CO) epithelial thickness maps in the fellow eye from a series of patients with unilateral keratoconus. METHODS The study included 10 patients with moderate to advanced keratoconus in one eye but a clinically and algorithmically topographically normal fellow eye. VHF digital ultrasound epithelial thickness data were acquired and a previously developed classification model was applied for identification of keratoconus to the clinically normal fellow eyes. Pentacam (Oculus Optikgeräte, Wetzlar, Germany) Belin-Ambrósio Display (BAD) data (5 of 10 eyes), and Orbscan (Bausch & Lomb, Rochester, NY) SCORE data (9 of 10 eyes) were also evaluated. RESULTS Five of the 10 fellow eyes were classified as keratoconic by the VHF digital ultrasound epithelium model. Five of 9 fellow eyes were classified as keratoconic by the SCORE model. For the 5 fellow eyes with Pentacam and VHF digital ultrasound data, one was classified as keratoconic by the VHF digital ultrasound model, one (different) eye by a combined VHF digital ultrasound and Pentacam model, and none by BAD-D alone. CONCLUSIONS Under the assumption that keratoconus is a bilateral but asymmetric disease, half of the ‘normal’ fellow eyes could be found to have keratoconus using epithelial thickness maps. The Orbscan SCORE or the combination of topographic BAD criteria with epithelial maps did not perform better. PMID:26544561

  13. The Developmental Brain Disorders Database (DBDB): a curated neurogenetics knowledge base with clinical and research applications.

    PubMed

    Mirzaa, Ghayda M; Millen, Kathleen J; Barkovich, A James; Dobyns, William B; Paciorkowski, Alex R

    2014-06-01

    The number of single genes associated with neurodevelopmental disorders has increased dramatically over the past decade. The identification of causative genes for these disorders is important to clinical outcome as it allows for accurate assessment of prognosis, genetic counseling, delineation of natural history, inclusion in clinical trials, and in some cases determines therapy. Clinicians face the challenge of correctly identifying neurodevelopmental phenotypes, recognizing syndromes, and prioritizing the best candidate genes for testing. However, there is no central repository of definitions for many phenotypes, leading to errors of diagnosis. Additionally, there is no system of levels of evidence linking genes to phenotypes, making it difficult for clinicians to know which genes are most strongly associated with a given condition. We have developed the Developmental Brain Disorders Database (DBDB: https://www.dbdb.urmc.rochester.edu/home), a publicly available, online-curated repository of genes, phenotypes, and syndromes associated with neurodevelopmental disorders. DBDB contains the first referenced ontology of developmental brain phenotypes, and uses a novel system of levels of evidence for gene-phenotype associations. It is intended to assist clinicians in arriving at the correct diagnosis, select the most appropriate genetic test for that phenotype, and improve the care of patients with developmental brain disorders. For researchers interested in the discovery of novel genes for developmental brain disorders, DBDB provides a well-curated source of important genes against which research sequencing results can be compared. Finally, DBDB allows novel observations about the landscape of the neurogenetics knowledge base. © 2014 Wiley Periodicals, Inc.

  14. Incidence of a clinical diagnosis of the irritable bowel syndrome in a United States population.

    PubMed

    Locke, G R; Yawn, B P; Wollan, P C; Melton, L J; Lydick, E; Talley, N J

    2004-05-01

    The incidence of irritable bowel syndrome is uncertain. We aimed to determine the incidence of clinically diagnosed irritable bowel syndrome in the community. Using the Rochester Epidemiology Project, all diagnoses of irritable bowel syndrome made among adult residents of Olmsted County, Minnesota, over a 3-year period were identified. The complete medical records of a random sample of the potential subjects were reviewed for the 10 years prior to the irritable bowel syndrome diagnosis and any patient who had received a previous diagnosis of irritable bowel syndrome was excluded (prevalent cases). The diagnostic index listed 1245 possible irritable bowel syndrome patients; 416 patient charts were reviewed and, of these, 149 were physician diagnosed incident cases of irritable bowel syndrome. The age- and sex-adjusted incidence rate was 196 per 100,000 person-years and increased with age (P = 0.006). The age-adjusted annual incidence per 100,000 in women was higher than in men: 238 vs. 141 (ratio 3:2; P = 0.005). The overall symptom frequency at the time of diagnosis was abdominal pain (73%), diarrhoea (41%) and constipation (16%). The incidence of a clinical diagnosis of irritable bowel syndrome in adults was estimated to be two per 1000 per year, increased with age and was higher in women than men. As many people with irritable bowel syndrome do not seek care, the true incidence of irritable bowel syndrome is likely to be higher.

  15. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers scientific ... screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  16. Volar Plate Fixation in Patients Older Than 70 Years with AO Type C Distal Radial Fractures: Clinical and Radiologic Outcomes.

    PubMed

    Piuzzi, Nicolas S; Zaidenberg, Ezequiel E; Duarte, Matias Pereira; Boretto, Jorge G; Donndorff, Agustin; Gallucci, Gerardo; De Carli, Pablo

    2017-08-01

    Introduction  Treatment of unstable distal radial fractures (DRFs) in elderly patients is controversial, and considering the increasing life expectancy, their appropriate treatment is of growing importance. Our aim was to analyze the clinical and radiologic outcomes in the elderly patients with AO type C DRF treated with volar locking plate (VLP). Materials and Methods  Between 2007 and 2011, 572 DRFs were operated on in our hospital with open reduction and internal fixation with VLP. Of these, only 64 patients (66 DRFs) met the selection criteria (AO type C DRF, age > 70 years, minimum 12-month follow-up). Mean follow-up was 28 months. Outcome assessment included range of motion, grip strength, VAS pain, Mayo Clinic Score, and DASH score. Analysis of pre- and postoperative radiographs was performed. Complications were recorded. Statistical analysis was performed comparing the results with the contralateral side. Results  Mean postoperative range of motion of the injured wrist compared with the control contralateral side was 86% for flexion ( p  < 0.001), 92% for extension ( p  < 0.001). The average DASH was 12. Mayo Clinic Wrist Score showed 43 excellent results, 15 good, 4 satisfactory, and 4 poor. Articular step-offs were reduced in 34 of 38 wrists. Five (7%) patients required plate removal. Conclusion  The treatment of articular DRF (AO type C) with VLP in the elderly patients achieved greater than 90% of the wrist range of motion and grip strength with no residual pain in greater than 90% of the patients. Level of Evidence  Therapeutic IV, case series.

  17. Spot scanning proton therapy plan assessment: design and development of a dose verification application for use in routine clinical practice

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Walsh, Timothy J.; Beltran, Chris J.; Stoker, Joshua B.; Mundy, Daniel W.; Parry, Mark D.; Bues, Martin; Fatyga, Mirek

    2016-04-01

    The use of radiation therapy for the treatment of cancer has been carried out clinically since the late 1800's. Early on however, it was discovered that a radiation dose sufficient to destroy cancer cells can also cause severe injury to surrounding healthy tissue. Radiation oncologists continually strive to find the perfect balance between a dose high enough to destroy the cancer and one that avoids damage to healthy organs. Spot scanning or "pencil beam" proton radiotherapy offers another option to improve on this. Unlike traditional photon therapy, proton beams stop in the target tissue, thus better sparing all organs beyond the targeted tumor. In addition, the beams are far narrower and thus can be more precisely "painted" onto the tumor, avoiding exposure to surrounding healthy tissue. To safely treat patients with proton beam radiotherapy, dose verification should be carried out for each plan prior to treatment. Proton dose verification systems are not currently commercially available so the Department of Radiation Oncology at the Mayo Clinic developed its own, called DOSeCHECK, which offers two distinct dose simulation methods: GPU-based Monte Carlo and CPU-based analytical. The three major components of the system include the web-based user interface, the Linux-based dose verification simulation engines, and the supporting services and components. The architecture integrates multiple applications, libraries, platforms, programming languages, and communication protocols and was successfully deployed in time for Mayo Clinic's first proton beam therapy patient. Having a simple, efficient application for dose verification greatly reduces staff workload and provides additional quality assurance, ultimately improving patient safety.

  18. Imaging Classification of Autosomal Dominant Polycystic Kidney Disease: A Simple Model for Selecting Patients for Clinical Trials

    PubMed Central

    Irazabal, María V.; Rangel, Laureano J.; Bergstralh, Eric J.; Osborn, Sara L.; Harmon, Amber J.; Sundsbak, Jamie L.; Bae, Kyongtae T.; Chapman, Arlene B.; Grantham, Jared J.; Mrug, Michal; Hogan, Marie C.; El-Zoghby, Ziad M.; Harris, Peter C.; Erickson, Bradley J.; King, Bernard F.

    2015-01-01

    The rate of renal disease progression varies widely among patients with autosomal dominant polycystic kidney disease (ADPKD), necessitating optimal patient selection for enrollment into clinical trials. Patients from the Mayo Clinic Translational PKD Center with ADPKD (n=590) with computed tomography/magnetic resonance images and three or more eGFR measurements over ≥6 months were classified radiologically as typical (n=538) or atypical (n=52). Total kidney volume (TKV) was measured using stereology (TKVs) and ellipsoid equation (TKVe). Typical patients were randomly partitioned into development and internal validation sets and subclassified according to height-adjusted TKV (HtTKV) ranges for age (1A–1E, in increasing order). Consortium for Radiologic Imaging Study of PKD (CRISP) participants (n=173) were used for external validation. TKVe correlated strongly with TKVs, without systematic underestimation or overestimation. A longitudinal mixed regression model to predict eGFR decline showed that log2HtTKV and age significantly interacted with time in typical patients, but not in atypical patients. When 1A–1E classifications were used instead of log2HtTKV, eGFR slopes were significantly different among subclasses and, except for 1A, different from those in healthy kidney donors. The equation derived from the development set predicted eGFR in both validation sets. The frequency of ESRD at 10 years increased from subclass 1A (2.4%) to 1E (66.9%) in the Mayo cohort and from 1C (2.2%) to 1E (22.3%) in the younger CRISP cohort. Class and subclass designations were stable. An easily applied classification of ADPKD based on HtTKV and age should optimize patient selection for enrollment into clinical trials and for treatment when one becomes available. PMID:24904092

  19. Effect of a Novel Clinical Decision Support Tool on the Efficiency and Accuracy of Treatment Recommendations for Cholesterol Management

    PubMed Central

    Scheitel, Marianne R.; Kessler, Maya E.; Shellum, Jane L.; Peters, Steve G.; Milliner, Dawn S.; Liu, Hongfang; Elayavilli, Ravikumar Komandur; Poterack, Karl A.; Miksch, Timothy A.; Boysen, Jennifer J.; Hankey, Ron A.

    2017-01-01

    Summary Background The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record. Objective To assess the impact of our clinical decision support tool on the efficiency and accuracy of clinician calculation of cardiovascular risk and its effect on the delivery of guideline-consistent treatment recommendations. Methods Clinicians were asked to review the EHR records of selected patients. We evaluated the amount of time and the number of clicks and keystrokes needed to calculate cardiovascular risk and provide a treatment recommendation with and without our clinical decision support tool. We also compared the treatment recommendation arrived at by clinicians with and without the use of our tool to those recommended by the guidelines. Results Clinicians saved 3 minutes and 38 seconds in completing both tasks with MayoExpertAdvisor, used 94 fewer clicks and 23 fewer key strokes, and improved accuracy from the baseline of 60.61% to 100% for both the risk score calculation and guideline-consistent treatment recommendation. Conclusion Informatics solution can greatly improve the efficiency and accuracy of individualized treatment recommendations and have the potential to increase guideline compliance. PMID:28174820

  20. Clinical Efficacy of Beclomethasone Dipropionate in Korean Patients with Ulcerative Colitis

    PubMed Central

    Lee, Yoon Jee; Kim, Jae Hyun; Yoo, SunHo; Lee, Hyun Jung; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho

    2017-01-01

    Purpose Our aim was to evaluate the efficacy and safety of oral beclomethasone dipropionate (BDP) in Korean patients with ulcerative colitis (UC). Materials and Methods The medical records of patients with active UC who were treated with BDP were retrospectively reviewed. Partial Mayo Clinic score (pMS) was calculated to determine disease activity. After 4 weeks of therapy, clinical remission, clinical response, and response failure rates were evaluated. Clinical remission was defined as a post-treatment pMS of 0 or 1, clinical response as a decrease of two of three points in pMS and >30% from baseline, and response failure as a lack of clinical response. Also, we considered that clinical remission was included in clinical response. Results Between July 2013 and April 2015, 95 patients with UC received BDP therapy at our institution (median age, 44 years; range, 12–81 years). After 4 weeks of therapy, clinical remission and clinical response rates were 50.5% and 73.7%, respectively. Mean change of pMS before and after BDP therapy was 2.4. There was no significant side effect reported. In multivariate analysis, disease activity was the only factor associated with a favorable response. Clinical remission rate was significantly higher in the mild disease activity group (66.7%) than that in the moderate or severe disease activity group (41.9%) (p=0.024). Conclusion BDP is efficacious in inducing a clinical response or remission in Korean patients with UC. Patients with mild UC were more likely to be in remission than those with moderate or severe UC after receiving BDP for 4 weeks. BDP exhibited a good safety profile. PMID:27873507

  1. The incidence of primary angle-closure glaucoma in Olmsted County, Minnesota.

    PubMed

    Erie, J C; Hodge, D O; Gray, D T

    1997-02-01

    To determine the incidence of primary angle-closure glaucoma (PACG) and to assess the visual outcomes of patients treated for PACG. Population-based retrospective incidence study. Residents of Olmsted County, Minnesota, aged 40 years and older and diagnosed with PACG in the 13-year period between January 1, 1980, and December 31, 1992. Incident cases of PACG identified through the Medical Diagnostic Index of Mayo Clinic, Rochester, Minn, and the Rochester Epidemiology Project. Thirty-six incident cases were identified. The mean annual age-and sex-adjusted incidence per 100000 people aged 40 years and older was 8.3 (95% confidence interval, 5.6-11.0). The probability of monocular blindness associated with PACG at the time of diagnosis was 14%. Among patients not monocularly blind at diagnosis, the 5-year probability of developing monocular blindness associated with PACG was 4%. Primary angle-closure glaucoma is an uncommon disease in our community. Most of the patients blinded by PACG were blind at the time the condition was diagnosed.

  2. Flipping the Quality Improvement Classroom in Residency Education.

    PubMed

    Bonnes, Sara L; Ratelle, John T; Halvorsen, Andrew J; Carter, Kimberly J; Hafdahl, Luke T; Wang, Amy T; Mandrekar, Jayawant N; Oxentenko, Amy S; Beckman, Thomas J; Wittich, Christopher M

    2017-01-01

    The flipped classroom (FC), in which instructional content is delivered before class with class time devoted to knowledge application, has the potential to engage residents. A Mayo Clinic Internal Medicine Residency Program study was conducted to validate an FC perception instrument (FCPI); determine whether participation improved FC perceptions; and determine associations between resident characteristics, change in quality improvement (QI) knowledge, and FC perception scores. All 143 internal medicine residents at Mayo Clinic, Rochester participated from 2014 to 2015; some experienced a flipped QI curriculum and others completed the traditional nonflipped course. The FCPI was developed, and factor analysis revealed an intuitive two-factor structure: preclass activity and in-class application. Residents were surveyed before and after the monthlong curriculum to measure changes in perception, and the QI Knowledge Assessment Tool was employed to measure knowledge improvement. Postcourse FCPI scores significantly increased for three of the eight items. QI knowledge increased significantly among residents who experienced the FC compared with residents who completed the non-FC curriculum. Those without prior FC exposure demonstrated a significant increase in QI knowledge compared with those with previous FC experience. The FCPI had compelling validity evidence with improved scores after curriculum exposure and associations with greater engagement in online modules. Residents who participated in the FC demonstrated improved QI knowledge compared with the control group. Residents valued the in-class application sessions more than the online component. These findings have important implications for graduate medical education as residency training programs increasingly use FC models.

  3. Apple HealthKit and Health App: Patient Uptake and Barriers in Primary Care.

    PubMed

    North, Frederick; Chaudhry, Rajeev

    2016-07-01

    The Apple (Cupertino, CA) HealthKit is a new telemonitoring platform that promises to make it easier for patients and healthcare institutions to collect, transmit, and store data from devices that monitor common conditions such as diabetes, hypertension, and asthma. To assess the potential use for this platform in primary care, we need to know how many Apple Healthkit users there are and if they have conditions that could benefit from telemonitoring. We examined patients in the Mayo Clinic primary care practice in Rochester, MN, who registered to connect to their Mayo Clinic medical record with Apple HealthKit. We used the primary care registry to identify users with chronic conditions of diabetes, hypertension, asthma, and depression. We also examined users for recent measurements of blood pressure, glucose, hemoglobin A1C, and cholesterol. Of 98,151 patients there were 503 registrants of HealthKit. There were 95 (19%) who had hypertension, 37 (7.4%) who had diabetes, 125 (25%) who had depression, and 56 (11%) who had asthma. Overall, there were 245 (49%) who had readily telemonitorable conditions. Almost half of primary care Apple HealthKit registrants have conditions that could benefit from telemonitoring. This pre-installed telemonitoring platform, available on every new iPhone(®) (Apple), can be used to monitor a significant number of primary care patients. However, it also has continued provider and informatics barriers that need to be addressed.

  4. Radiation safety role in institutional disaster planning.

    PubMed

    Classic, K L; Knutson, A H; Smith, G D

    2000-05-01

    United States Nuclear Regulatory Commission (NRC) materials license applicants (non-nuclear power) must submit spill procedures with their application. While our counterparts in the nuclear power industry historically have concerned themselves with disaster drills and evacuation plans as a result of fire, explosion, or an act of terrorism, other licensees are looking only at minor spills of unsealed radioactive material and only at tile radiation hazard. Beyond NRC regulations, various oversight and accrediting organizations require, or at a minimum encourage, a written disaster plan outlining actions to be taken for events likely to occur in the region of the institution. Some of these organizations require drills to practice implementation of the written plan. On 5 May 1999, Mayo Clinic performed a wide-scale disaster drill involving Rochester City and Olmsted County response organizations, and several Mayo Clinic departments. Planning took several months; the drill took approximately three hours. Participants gathered at several meetings post-drill for "debriefing" sessions to discuss successes, areas for improvement, and lessons learned. There were three overriding lessons learned: critical responders need special identification to allow access to the disaster site; initial victim surveys are for gross contamination only; and access to the potentially contaminated disaster site might take weeks or months following a real event.

  5. Resident duty-hour restrictions and their effect on operative experience in obstetrics and gynecology.

    PubMed

    Occhino, John A; Hannigan, Tiffany L; Baggish, Michael S; Gebhart, John B

    2011-01-01

    To determine the effect of duty-hour restrictions on the operative experience of obstetrics and gynecology residents. Operative numbers were obtained from graduates of Mayo Clinic (Rochester, Minn., USA) and Good Samaritan Hospital (Cincinnati, Ohio, USA). Mean operative numbers between graduates in 2007 and 2003 were compared. The following procedures were evaluated: spontaneous vaginal delivery, forceps-assisted vaginal delivery, vacuum-assisted vaginal delivery, cesarean delivery, surgery on antenatal patients, amniocentesis, total abdominal hysterectomy, total vaginal hysterectomy, laparotomy, incontinence or pelvic floor surgery, operative laparoscopy, hysteroscopy, cervical conization, and surgical sterilization. The number of procedures performed (total and as the primary surgeon) were evaluated. We analyzed each institution's residents separately. At Mayo Clinic, the 2007 graduates performed significantly fewer conizations than the 2003 graduates (p = 0.006). At Good Samaritan Hospital, the 2007 graduates performed significantly more vacuum-assisted vaginal deliveries (p = 0.002), cesarean deliveries (p = 0.002), and sterilizations (p < 0.001) than the 2003 graduates. The above findings were unchanged when evaluating procedures for which the resident was the primary surgeon. Duty-hour restrictions have not adversely affected the operative experience of obstetrics and gynecology residents. No significant differences in the number of the spontaneous vaginal deliveries, abdominal hysterectomies, or vaginal hysterectomies performed were observed. Copyright © 2011 S. Karger AG, Basel.

  6. A comparison of general medical and clinical ethics consultations: what can we learn from each other?

    PubMed

    Geppert, Cynthia M A; Shelton, Wayne N

    2012-04-01

    Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important to help the medical community appreciate ethics consultation as a vital service in today's health care setting. Therefore, this Special Article presents a comparison of medical and clinical ethics consultations in terms of fundamental goals of consultation, roles of consultants, and methodologic approaches to consultation, concluding with reflections on important lessons about the physician-patient relationship and medical education that may benefit practicing internists. Our aim is to examine ethics consultation as a clinical service integral to the medical care of patients. Studies for this analysis were obtained through the PubMed database using the keywords ethics consultation, medical consultation, ethics consults, medical consults, ethics consultants, and medical consultants. All English-language articles published from 1970 through August 2011 that pertained to the structure and process of medical and ethics consultation were reviewed. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. [Clinical characteristics of triceps brachii tendon rupture at olecranon ending].

    PubMed

    Ma, Jiang-Tao; Mao, Yu-Jiang; Yu, Min; Yu, Gao-Feng; Zhu, Cong-Qing; Zhang, Meng-Chao

    2014-11-01

    To observe the clinical characteristics of triceps brachii tendon rupture at olecranon ending. From June 2005 to November 2011,19 patients with triceps brachii tendon rupture at olecranon ending were treated with surgical technique. Among the 19 patients, 7 patients were male, with an average age of 24.1 years old (ranged, 15 to 41 years old); 12 patients were female, with an average age of 51.4 years old (ranged, 16 to 73 years old). Eight patients had injuries in the left elbows, and 11 patients had injuries in right elbows. Seventeen patients had injuries induced by walking fall and 2 patients had injuries induced by falling down. Thirteen patients were simple triceps brachii tendon rupture at olecranon ending, 6 patients were associated with other elbow injuries. Five patients were associated with radial fracture; 1 patient with capitellum fracture; 1 patient with coronoid process fracture; 1 patient with epitrochlear. All the lateral radiographs of the injuried elbow demenstrated the flecks of avulsed osseous material from the olecranon (flake sign). The associated injuries had the homologus presence. All the patients were treated with surgical techniques:15 patients were treated with figure-of-eight tension-band wire; figure-of-eight tension band wire and Kirschner wire in 1 patient; wire cerclage in 1 patient; nonabsorbable suture in 2 patients. The associated injuries were treated simultaneously. Plaster was applied after operation in 2 patients with heavier elbow associated injuries, other patients without any external fixation. The Mayo elbow score were observed to determinate the function of the elbow. All the patients were followed up, 1 patient died of other disease at one year after operation, the other 18 patients were followed up with an average of 47.9 months (ranged from 14 to 91 months). According to the Mayo elbow score, 16 patients got an excellent result and 2 good. Traumatic rupture of triceps brachii tendon at olecranon ending is not a rare

  8. Clinical Challenge.

    PubMed

    2017-09-01

    Questions for this month's clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated four Category 2 points (Activity ID: 109894). Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2017-19 triennium; therefore, the previous months' answers are not published. Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the most appropriate statement as your answer.

  9. Clinical Challenge.

    PubMed

    2016-12-01

    Questions for this month's clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated four Category 2 points (Activity ID: 69787). Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2014-16 triennium; therefore, the previous months' answers are not published. Each of the questions or incomplete statements below is followed by four or five suggested answers or completions. Select the most appropriate statement as your answer.

  10. Application of a Natural Language Processing Algorithm to Asthma Ascertainment. An Automated Chart Review.

    PubMed

    Wi, Chung-Il; Sohn, Sunghwan; Rolfes, Mary C; Seabright, Alicia; Ryu, Euijung; Voge, Gretchen; Bachman, Kay A; Park, Miguel A; Kita, Hirohito; Croghan, Ivana T; Liu, Hongfang; Juhn, Young J

    2017-08-15

    Difficulty of asthma ascertainment and its associated methodologic heterogeneity have created significant barriers to asthma care and research. We evaluated the validity of an existing natural language processing (NLP) algorithm for asthma criteria to enable an automated chart review using electronic medical records (EMRs). The study was designed as a retrospective birth cohort study using a random sample of 500 subjects from the 1997-2007 Mayo Birth Cohort who were born at Mayo Clinic and enrolled in primary pediatric care at Mayo Clinic Rochester. Performance of NLP-based asthma ascertainment using predetermined asthma criteria was assessed by determining both criterion validity (chart review of EMRs by abstractor as a gold standard) and construct validity (association with known risk factors for asthma, such as allergic rhinitis). After excluding three subjects whose respiratory symptoms could be attributed to other conditions (e.g., tracheomalacia), among the remaining eligible 497 subjects, 51% were male, 77% white persons, and the median age at last follow-up date was 11.5 years. The asthma prevalence was 31% in the study cohort. Sensitivity, specificity, positive predictive value, and negative predictive value for NLP algorithm in predicting asthma status were 97%, 95%, 90%, and 98%, respectively. The risk factors for asthma (e.g., allergic rhinitis) that were identified either by NLP or the abstractor were the same. Asthma ascertainment through NLP should be considered in the era of EMRs because it can enable large-scale clinical studies in a more time-efficient manner and improve the recognition and care of childhood asthma in practice.

  11. Using Clinical Risk Models for Lung Nodule Classification.

    PubMed

    Deppen, Stephen A; Grogan, Eric L

    2015-01-01

    Evaluation and diagnosis of indeterminate pulmonary nodules is a significant and increasing burden on our health care system. The advent of lung cancer screening with low-dose computed tomography only exacerbates this problem, and more surgeons will be evaluating smaller and screening discovered nodules. Multiple calculators exist that can help the clinician diagnose lung cancer at the bedside. The Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) model helps to determine who needs lung cancer screening, and the McWilliams and Mayo models help to guide the primary care clinician or pulmonologist with diagnosis by estimating the probability of cancer in patients with indeterminate pulmonary nodules. The Thoracic Research Evaluation And Treatment (TREAT) model assists surgeons to determine who needs a surgical biopsy among patients referred for suspicious lesions. Additional work is needed to develop decision support tools that will facilitate the use of these models in clinical practice, to complement the clinician's judgment and enhance shared decision making with the patient at the bedside.

  12. The clinical performance of a silicone hydrogel lens for daily wear in an Asian population.

    PubMed

    Long, Bill; McNally, John

    2006-03-01

    To evaluate slitlamp findings, frequency and severity of symptoms, and wearing time with a silicone hydrogel contact lens when used for daily wear by patients of Asian ethnicity. This was a five-site, 88-patient, prospective, open-label study involving 1 month of daily wear of lotrafilcon A lenses (Focus NIGHT & DAY, CIBA Vision, Duluth, GA) among adapted soft lens wearers previously wearing etafilcon A (ACUVUE 2, Johnson & Johnson Vision Care, Jacksonville, FL) or polymacon (Optima FW, Bausch & Lomb, Rochester, NY) lenses. Statistically significant improvements in conjunctival redness, limbal redness, and corneal neovascularization were reported after 1 week and 1 month of wear. Patients reported statistically significant improvements in subjective symptoms of redness, dryness during the day, and dryness at the end of the day. More patients reported increased than reduced average daily wear time and average daily comfortable wear time with the silicone hydrogel lens. Significant improvements in clinical signs and subjective symptoms may occur when some patients of Asian ethnicity wearing conventional hydrogel lenses for daily wear are refitted with silicone hydrogel lenses for daily wear.

  13. Rehabilitation and multiple limb amputations: A clinical report of patients injured in combat.

    PubMed

    Melcer, Ted; Pyo, Jay; Walker, Jay; Quinn, Kimberly; Lebedda, Martin; Neises, Kamaran; Nguyen, Christina; Galarneau, Michael

    2016-01-01

    This clinical report describes the outpatient rehabilitation program for patients with multiple limb amputations enrolled in the Comprehensive Combat and Complex Casualty Care facility at the Naval Medical Center San Diego. Injury-specific data for 29 of these patients wounded by blast weaponry in Afghanistan in 2010 or 2011 were captured by the Expeditionary Medical Encounter Database at the Naval Health Research Center and were reviewed for this report. Their median Injury Severity Score was 27 (N = 29; range, 11-54). Patients averaged seven moderate to serious injuries (Abbreviated Injury Scale scores ≥2), including multiple injuries to lower limbs and injuries to the torso and/or upper limbs. All patients received care from numerous clinics, particularly physical therapy during the first 6 mo postinjury. Clinic use generally declined after the first 6 mo with the exception of prosthetic devices and repairs. The clinical team implemented the Mayo-Portland Adaptability Inventory, 4th Revision (MPAI-4) to assess functioning at outpatient program initiation and discharge (n = 23). At program discharge, most patients had improved scores for the MPAI-4 items assessing mobility, pain, and transportation, but not employment. Case reports described rehabilitation for two patients with triple amputations and illustrated multispecialty care and contrasting solutions for limb prostheses.

  14. Comparison of three prognostic scoring systems in a series of 146 cases of chronic myelomonocytic leukemia (CMML): MD Anderson prognostic score (MDAPS), CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model. A detailed review of prognostic factors in CMML.

    PubMed

    Calvo, Xavier; Nomdedeu, Meritxell; Santacruz, Rodrigo; Martínez, Núria; Costa, Dolors; Pereira, Arturo; Estrada, Natalia; Xicoy, Blanca; Esteve, Jordi; Nomdedeu, Benet

    2015-07-23

    Although specific prognostic models for chronic myelomonocytic leukemia (CMML) exist, few are based on large series of patients. MD Anderson prognostic score (MDAPS) has been the most useful for CMML risk assessment. Due to recent emergence of CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model, we compared the three scores. One hundred forty-six CMML patients diagnosed between 1998 and 2014 were retrospectively analyzed. Univariate analysis was performed to assess prognostic impact on overall survival (OS) and leukemia-free survival (LFS) of the variables composing the scores and all items showed prognostic value on OS with the exception of the presence of circulating immature myeloid cells. Regarding LFS, only CPSS variables, bone marrow blast ≥10% and an absolute monocyte count >10×10(9)/L had an impact. When the scores were applied, all showed an impact on OS and retained their significance in multivariate analysis. By using ROC curves and C-index, CPSS showed a slightly better predictive value for mortality and leukemia transformation. Variables composing the three indexes were compared in multivariate analysis and only CPSS parameters and platelets<100×10(9)/L retained their significance. Based on these findings, by adding platelet count to CPSS, a new score was implemented (CPSS-P) showing the best risk prediction capability in our series. This study reinforces the validity of the tested scores.

  15. Pericardial Effusion

    MedlinePlus

    ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...

  16. Vasovagal Syncope

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  17. Fractures (Broken Bones): First Aid

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  18. Double Uterus

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  19. Frequent Urination

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  20. Can Lung Nodules Be Cancerous?

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  1. Endometriosis

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    ... of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors ... women who have had endometriosis. By Mayo Clinic Staff . Mayo Clinic Footer Legal Conditions and Terms Any ...

  2. Is Acute Bronchitis Contagious?

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  3. Aspirin Allergy: What Are the Symptoms?

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  4. When to Have an Eye Exam

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  5. Fuchs' Dystrophy

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  6. Multiple Myeloma

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  7. Limited Scleroderma (CREST Syndrome)

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  8. Testicular Cancer

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  9. Wheezing

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  10. Prenatal Testing: MedlinePlus Health Topic

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    ... Reliable Is Laboratory Testing? (American Association for Clinical Chemistry) Prenatal Testing: Is It Right for You? (Mayo ... Spanish Amniotic Fluid Analysis (American Association for Clinical Chemistry) Biophysical Profile (Mayo Foundation for Medical Education and ...

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  12. Ovarian Cysts and Fertility: Is There a Connection?

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  13. Elbow Pain

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  14. Sinus Infection and Toothache: Any Connection?

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  16. Chlamydia

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  18. Diet After Gallbladder Removal

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