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Category Archives: Neurology

Mayo Clinic Offers Dietary Supplements, Stress Management, Massage and Acupuncture in the Mall of America

Cleveland Clinic has a Wellness Institute. In another push to the realm of wellness, Mayo Clinic now offers one-on-one consults with Complementary and Integrative Medicine physicians on campus and where the customers are - right in the Mall of the America. See this 3-part video series below:

Brent A. Bauer, M.D. Dr. Bauer is a physician in the Department of General Internal Medicine and supervisor of the Complementary and Integrative Medicine Research program at Mayo Clinic.

Nancy Drackley, a physical therapist, massage therapist, and supervisor of massage therapy at Mayo Clinic.

Tony Chon, M.D, a physician in the Department of General Internal Medicine and a member of the Complementary and Integrative Medicine team at Mayo Clinic, discusses acupuncture.

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The 21 genetic conditions that should be reported by patients if found incidentally during whole-genome sequencing


Illustration: DNA associates with histone proteins to form chromatin. Image source: Wikipedia.

There are no established guidelines on which genetic variants should be presented to physicians as incidental findings from whole-genome sequencing. A recent study showed that genetic specialists agreed that pathogenic mutations for 21 common genetic conditions should be disclosed by patients.

For adult patients

APC-associated polyposis
Fabry disease
Familial hypercholesterolemia
Galactosemia
Gaucher disease
Glycogen storage disease type IA
Hereditary breast and ovarian cancer
Homocystinuria
Li-Fraumeni syndrome
Lynch syndrome
Multiple endocrine neoplasia type 1
Multiple endocrine neoplasia type 2
MYH-associated polyposis
Phenylketonuria
Pompe disease
PTEN hamartoma tumor syndrome
Retinoblastoma
Romano-Ward (long QT syndrome)
Tyrosinemia type 1
Von Hippel-Lindau disease
Wilson disease

For pediatric patients (child)

PTEN hamartoma tumor syndrome
Retinoblastoma
Romano-Ward (long QT syndrome)
Von Hippel-Lindau disease

Collecting family history predicts cancer risk better than 23andMe genetic testing, according to a recent study from the Cleveland Clinic:

References

Exploring concordance and discordance for return of incidental findings from clinical sequencing. Green RC, Berg JS, Berry GT, Biesecker LG, Dimmock DP, Evans JP, Grody WW, Hegde MR, Kalia S, Korf BR, Krantz I, McGuire AL, Miller DT, Murray MF, Nussbaum RL, Plon SE, Rehm HL, Jacob HJ. Genet Med. 2012 Apr;14(4):405-10. doi: 10.1038/gim.2012.21. Epub 2012 Mar 15.

Genome sequencing to add new twist to doctor-patient talks. American Medical Association, 2012.

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Understanding Healthcare Power of Attorney – Cleveland Clinic video

This is very important: Advance directives are legal documents that provide instructions about who should oversee your medical treatment and what your end-of-life wishes are, in case you are unable to speak for yourself.

Advance directives include:

- Health Care Power of Attorney
- Living Will

Everyone over the age of 18 should consider assigning Health Care Power of Attorney to someone.

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Top articles in medicine in April 2012

Here are my suggestions for some of the top articles in medicine in April 2012 so far:

Dr. Breslow, Who Tied Good Habits to Longevity, Dies at 97 - NYTimes http://goo.gl/ftRDR - It certainly worked for him. His recommendations: do not smoke; drink in moderation; sleep seven to eight hours; exercise at least moderately; eat regular meals; maintain a moderate weight; eat breakfast. Dr. Breslow found that a 60-year-old who followed the seven recommended behaviors would be as healthy as a 30-year-old who followed fewer than three.

Activation of free fatty acid receptor 1 (FFAR1) by experimental drug TAK-875 offers hope as new diabetes therapy j.mp/IQTDnd

Vitamin D Doesn't Improve Academic Performance in Children (study) http://j.mp/ICZpyu - It also doesn't help patients with pneumonia

Phthalates May Double Diabetes Risk - Phthalates are chemicals found in cosmetics, scented candles, plastics http://j.mp/ICZ5j7

Endangered species found in Chinese herbal medications... http://j.mp/HF001J

Google starts ranking journals http://j.mp/HBGIez -- using Google Scholar Metrics for Publications http://j.mp/HBGK6f. Google ranks the top 100 journals and NEJM is no more the "top dog" http://j.mp/HBGYKB according to G Scholar Metrics for Publications. The most cited NEJM article is "Vitamin D Deficiency" followed by "CT - An Increasing Source of Radiation Exposure" http://j.mp/HBHsAi

NEJM now has 17 Interactive Medical Cases - free full text online http://j.mp/Hw5F59

12-Word Social Media Policy by Mayo Clinic: Don’t Lie, Don’t Pry, Don’t Cheat, Can’t Delete, Don’t Steal, Don’t Reveal http://bit.ly/Hr8c1E

Chinese herbal medicines made from Aristolochia plants might be responsible for urinary tract cancer - BMJ http://j.mp/I1pCD5

5 Futures for Academic Medicine. "Drivers of Change in Academic Medicine: “Big hungry buyers” demanding more from health care" - PLoS Medicine http://j.mp/Hw07t4

FDA Approves "Alzheimer's PET scan" by Eli Lilly - radioactive agent florbetapir tags clumps of sticky amyloid in brain http://goo.gl/VbQi7

The articles were selected from my Twitter and Google Reader streams.

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Battling depression with "battery-powered brains" – CNN report on deep brain stimulation (DBS)

CNN reports on treating severe depression with electrodes inside the brain:

The procedure -- called deep brain stimulation, or DBS -- targets a small brain structure known as Area 25, the "ringleader" for the brain circuits that control our moods.

Area 25 is relatively overactive in depressed patients. One hypothesis is that in patients who do not improve with treatments for depression, Area 25 is somehow stuck in overdrive.

DBS had been used since 1997 as a treatment for movement disorders, including essential tremor, Parkinson's disease and dystonia.

References:

Treating depression with electrodes inside the brain. CNN, 2012.

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Clinical Trial at Evergreen Healthcare Shows Intestinal Gel Reduces Symptoms of Advanced Parkinson's Disease

KIRKLAND, Wash., April 20, 2012 /PRNewswire/ -- A recent clinical trial conducted at Evergreen Healthcare shows that a new form of a common drug used to treat Parkinson's Disease greatly improves the quality of life for patients and reduces the affects of symptoms such as tremors, slowness, stiffness and difficulty walking.

Evergreen was the only site in the Pacific Northwest to hold the trial, which was led by Dr. C. Warren Olanow, a Fellow of the American Academy of Neurology and Professor of Neurology and Neuroscience at the Mount Sinai School of Medicine in New York.

The trial tested standard oral dosages of a Parkinson's drug against the newer levodopa-carbidopa intestinal gel (LCIG) and found that the intestinal treatments gave patients an average of two extra hours per day of reduced symptoms and improved movement.

"We have been involved in the trials since 2008," said Dr. Alida Griffith, principal investigator for the trial at Evergreen's Booth Gardner Parkinson's Care Center. "Levodopa is the 'gold standard' treatment for Parkinson's disease."

The intestinal gel contains levodopa and carbidopa, two drugs commonly prescribed for Parkinson's, and is infused through a portable pump connected to a tube implanted in the intestine.

In the three-month, double-blind trial, 71 participants were randomized to receive either the continuous infusion of LCIG and dummy pills or a dummy intestinal gel and pills that contained levodopa and carbidopa. At the start of the study, the average person had Parkinson's disease for about 11 years and experienced 6.6 hours of symptomatic behavior per day. A total of 93 percent of participants completed the study.

The results of the study are set to be presented as part of the Emerging Science program (formerly known as Late-Breaking Science) at the American Academy of Neurology's 64th Annual Meeting in New Orleans from April 21 to April 28, 2012.

The study was supported by Abbott.

Learn more about Parkinson's disease at http://www.aan.com/patients.

To learn more about the Evergreen Neuroscience Institute, visit http://www.evergreenhealthcare.org/parkinsons or call the Evergreen Healthline 425.899.3000.

Read more:
Clinical Trial at Evergreen Healthcare Shows Intestinal Gel Reduces Symptoms of Advanced Parkinson's Disease

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