Khan M.L.,Mayo Clinic in Arizona |
Stewart A.K.,Mayo Clinic in Arizona
Future Oncology | Year: 2011
Carfilzomib (formerly PR-171) is a novel epoxyketone-based irreversible proteasome inhibitor. In preclinical studies, carfilzomib demonstrated irreversible binding to the proteasome and minimal off-target inhibition of other proteases. In clinical studies carfilzomib has demonstrated substantial antitumor activity in hematologic malignancies while exhibiting a well-tolerated side-effect profile. Painful neuropathy was minimally reported, suggesting a possible advantage over other proteasome inhibitors. With single-agent carfilzomib, dose-limiting toxicity was hematologic and included thrombocytopenia and neutropenia. In patients with relapsed or refractory multiple myeloma, twice-weekly consecutive-day single-agent carfilzomib 20 mg/m2 for 3 weeks every 28 days, escalating to 27 mg/m2 the second cycle was associated with a 54% overall response rate in bortezomib-naive patients and a 26% overall response rate in bortezomib and immunomodulatory drug refractory patients. © 2011 Future Medicine Ltd.
Bergsagel P.L.,Mayo Clinic in Arizona |
Mateos M.-V.,University of Salamanca |
Gutierrez N.C.,University of Salamanca |
Rajkumar S.V.,Mayo Medical School |
San Miguel J.F.,University of Salamanca
Blood | Year: 2013
Multiple myeloma (MM) is a heterogeneous disease with certain genetic features [eg, t(4;14), del17p] associated with worse outcome. The introduction of thalidomide, lenalidomide, and bortezomib has dramatically improved the outlook for patients with MM, but their relative benefit (or harm) for different genetic patient subgroups remains unclear. Unfortunately, the small number of patients in each subgroup frequently limits the analysis of high-risk patients enrolled in clinical trials. Strategies that result in survival of high-risk genetic subgroups approximating that of patients lacking high-risk features are said to overcome the poor prognostic impact of these high-risk features. This outcome has been difficult to achieve, and studies in this regard have so far been limited by inadequate sample size. In contrast, strategies that compare the survival of high-risk genetic subgroups randomized to different treatment arms can identify approaches that improve survival. This type of analysis is clinically useful, even if the absolute gains do not improve outcomes to levels seen in patients without high-risk cytogenetics. Reviewing available data in high-risk MM from this perspective, it appears that bortezomib has frequently been associated with improved survival, whereas thalidomide maintenance has sometimes been associated with a shorter survival. © 2013 by The American Society of Hematology.
Frey K.A.,Mayo Clinic in Arizona
Primary Care - Clinics in Office Practice | Year: 2010
Primary care physicians have an essential role and opportunity in positively impacting the reproductive health of men. Although men are less likely than women to consistently seek preventive services, an office visit for any reason should be seen as an opportunity to introduce the idea of reproductive health. Additionally, primary care physicians can and should initiate the diagnostic workup for infertile couples in their practices. The initial assessment for the male partner consists of a thorough history and physical examination and appropriate laboratory tests, including a semen analysis. © 2010 Elsevier Inc.
Foxx-Orenstein A.E.,Mayo Clinic in Arizona
Clinics in Geriatric Medicine | Year: 2014
Constipation is a frequently diagnosed gastrointestinal disorder. Symptoms of constipation are common, with the greatest prevalence in the elderly. Evaluation of constipation begins with a detailed medical history and a focused anorectal examination. Diagnostic testing for constipation is not routinely recommended in the initial evaluation in the absence of alarm signs. Key self-management strategies include increased exercise, a high-fiber diet, and toilet training. High-fiber diets can worsen symptoms in some patients who have chronic constipation. Biofeedback is an effective treatment option for patients who have constipation caused by outlet obstruction defecation. A variety of medications are available to remedy constipation. © 2014 .
Keith Stewart A.,Mayo Clinic in Arizona
Hematology | Year: 2012
Most myeloma patients still experience recurrent relapse and eventually become resistant and/or intolerant of effective agents such as corticosteroids, alkylating agents, immune modulators (lenalidomide and thalidomide) or proteasome inhibitors such as bortezomib. Once this happens average survivals are less than one year. Progress has been made for such patients, however, with the demonstration of clinical benefit of novel proteasome inhibitors (carfilzomib) and immune modulators (pomalidomide). Pomalidomide when used with dexamethasone has activity in 30-60% of patients depending on disease stage. Carfilzomib is an irreversible proteasome inhibitor with favorable toxicity profile (minimal neuropathy) and response rates of 17-54% depending on the disease stage treated. Novel targets are also being explored. Histone deacetylase inhibitors such as vorinostat and panobinostat are in phase II testing although results from a randomized trial combining vorinostat with bortezomib were disappointing. Other small molecules or monoclonal antibodies with novel targets such as kinase inhibitors(AKT, CDK5) and cell surface receptors (e.g. elotuzumab) are undergoing active investigation. © W. S. Maney & Son Ltd 2012.
Carey E.J.,Mayo Clinic in Arizona
Nutrition in Clinical Practice | Year: 2014
Sarcopenia is a relatively new concept in the medical literature, initially intended to describe the loss of lean body mass that occurs with aging. More recently, sarcopenia has been described in various forms of chronic disease, including patients with end-stage organ disease awaiting transplantation. The presence of sarcopenia is an important marker in transplant patients, since it has been linked to poorer pre- and posttransplant outcomes compared with patients with preserved muscle mass. The mechanisms and natural history of sarcopenia in transplant patients are incompletely understood, and there are currently no therapies proven to mitigate or reverse the process. This article reviews the current understanding of the prevalence and clinical significance of sarcopenia in transplant patients and highlights important areas of future research. © 2014 American Society for Parenteral and Enteral Nutrition.
News Article | February 23, 2017
LOS ANGELES--(BUSINESS WIRE)--Pepperdine Graziadio School of Business and Management will host its 3rd Annual Future of Healthcare Symposium on March 23, 2017 at the Marina del Rey Marriott. Ezekiel Emanuel, a key architect of the Affordable Care Act, will serve as the keynote speaker. The Future of Healthcare Symposium: Delivering Value-Based Healthcare, will explore the healthcare industry's transition from legacy fee-for-service and volume-based reimbursement models to value-based payments. The Pepperdine Graziadio event will bring together healthcare experts and professionals to share their personal insights, experiences and ideas in order to inspire larger conversations about the future of healthcare as a business. The 3rd Annual Future of Healthcare Symposium explores how rapid changes to healthcare reimbursements are impacting healthcare providers, consumers and insurance plans. Attendees will also enjoy opportunities to network and share best practices while discussing potential collaborations. Register and view the full agenda here. Pepperdine Graziadio School of Business and Management will host a daylong symposium featuring an impressive line-up of speakers addressing a broad range of issues related to value-based care. Speakers are affiliated with Harvard Medical School, Mayo Clinic, Cedars-Sinai Health System and other leading healthcare organizations. Ezekiel Emanuel, Joint Appointment: Wharton School, University of Pennsylvania; School of Medicine, University of Pennsylvania. Founding Chair, Clinical Center of the National Institutes of Health. Former Special Advisor on Health Policy, Office of Management and Budget. Ezekiel Emanuel is one of the leading practitioners shaping the future of healthcare, with a long record of experience at the top levels of policy. Trained both as an oncologist (MD, Harvard Medical School) and a political scientist, Dr. Emanuel offers a uniquely thoughtful perspective on the most difficult issues in medicine today. From 2009 to 2011, he served as a special advisor for health policy to the White House Office of Management and Budget. As one of the most prominent voices advising the White House about healthcare, he had a significant impact on federal healthcare budgets and the Affordable Care Act. Samir Malik is the Senior Vice President and General Manager of Genoa Telepsychiatry, part of Genoa, a QoL Healthcare company. Mr. Malik came into this role through the acquisition of his company, 1DocWay, a New York City-based telepsychiatry company, which he founded and served as CEO. The company expands access to mental healthcare in rural America. Mr. Malik and his team have built the technology-enabled services company from scratch, treating 50,000 patients across the country. Thomas M. Priselac is President and Chief Executive Officer of the Cedars-Sinai Health System and has held the position since January 1994. From 1988 to 1993, he served as Executive Vice President. An author and invited speaker on health policy issues, Mr. Priselac has served the healthcare field in various roles. He is past Chair of the American Hospital Association Board of Trustees and past Chair of the Association of American Medical Colleges. Barbara McNeil, Professor of Radiology and Former Acting Dean, Harvard Medical School Barbara J. McNeil, MD, PhD, is the Ridley Watts Professor and founding head of the Department of Health Care Policy at Harvard Medical School. She is also a professor of radiology at Harvard Medical School and at Brigham and Women’s Hospital. Dr. McNeil’s research focuses on several areas, most notably technology assessment and quality of care, as well as the effects of alternative payment arrangements and organizational characteristics on quality and costs of care. Wyatt W. Decker, MD, is Mayo Clinic Vice President and Chief Executive Officer of Mayo Clinic in Arizona. As a vice president of the largest not-for-profit integrated multi-specialty group practice in the nation, Dr. Decker helps direct Mayo Clinic’s research, education and clinical operations in Arizona, Florida and Minnesota. Dr. Decker is directly responsible for Mayo Clinic operations in Arizona. Lou Silverman has a 15-year track record of success as CEO in healthcare information technology and healthcare services companies, translating a passion for the transformative benefits of innovative healthcare solutions into successful clinical and commercial organizations. In addition to his leadership role at Advanced ICU Care, Mr. Silverman serves on the board of directors for a variety of healthcare-related companies, both public and private. Hill Ferguson is Chief Executive Officer at Doctor On Demand. With nearly two decades of experience in mobile technology, Mr. Ferguson has led companies at all stages of growth, from being a founder to serving as a senior executive at PayPal, a high-growth public company. He holds deep commitment to putting customers first by delivering the best possible products, a value that resonates with Doctor On Demand's commitment to its industry-leading clinical quality and best-in-class customer experience. About the Pepperdine Graziadio School of Business and Management A leader in cultivating entrepreneurship and digital innovation, the Pepperdine Graziadio School of Business and Management focuses on the real-world application of MBA-level business concepts. The Graziadio School provides student-focused, globally-oriented education through part-time, full-time, and executive MBA programs at our five Southern California locations, Silicon Valley and Santa Barbara campuses, as well as through online and hybrid formats. In addition, the Graziadio School offers a variety of master of science programs, a bachelor of science in management degree-completion program, and the Presidents and Key Executives MBA, as well as executive education certificate programs. Follow the Graziadio School on Facebook, Twitter at @GraziadioSchool, Instagram, and LinkedIn.
News Article | December 6, 2016
The International Association of HealthCare Professionals is pleased to welcome Alina M. Grigore, MD, MS, FAHA, FASE, Anesthesiologist, to their prestigious organization with her upcoming publication in The Leading Physicians of the World. She is a highly trained and qualified cardiac anesthesiologist with a vast expertise in all facets of her work. Dr. Grigore has been in practice for over 20 years and is currently serving patients in Las Vegas, Nevada. Dr. Grigore has extensive experience with intraoperative transesophageal echocardiographic, open heart surgery, aortic surgery, heart and lung transplant and ventricular assist devices. Dr. Grigore graduated with her Medical Degree from The Carol Davila University of Medicine and Pharmacy in Bucharest, Romania. Upon relocating to the United States, she completed her residency in Anesthesiology at St. Luke’s-Roosevelt Hospital Center, Columbia University, and underwent a two-year fellowship in Cardiothoracic and Vascular Anesthesia at Duke University, where she obtained a Master’s Degree in Health Sciences and Clinical Research in her second year. Dr. Grigore was honored with the American Patient’s Choice Award in 2010-2011, and the Consumers’ Research Council Award as America’s Top Anesthesiologist. Additionally, Dr. Grigore has received numerous awards attesting to her reputation of comprehensive, personalized, and compassionate care of cardiac patients. Dr. Grigore is certified by the American Board of Anesthesiology, National Board of Echocardiography, and has earned the coveted title of Fellow of American Heart Association, and Fellow American Society of Echocardiography. Dr. Grigore maintains professional memberships with the American Society of Anesthesiology, the Association of University Anesthesiologists, the Society of Cardiovascular Anesthesiology, the American Society of Echocardiography, the American Heart Association, and the American College of Physicians Executives. One of the highlights of her career is working for seven years at the Texas Heart Institute where she founded and lead the Cardiovascular Anesthesia Echocardiography Program. After Texas Heart Institute, she worked at the Mayo Clinic in Arizona where she served as Curriculum Director for residents on the cardiac anesthesia rotation. She provided perioperative care to the first total artificial heart patient at Mayo Clinic Arizona. Her success is attributed to her love and commitment to the field she has dedicated her life to, as well as loving what she does, and providing compassionate care to all patients. In her spare time, she enjoys reading and hiking. Learn more about Dr. Grigore here and be sure to read her upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics. Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews, and areas of expertise. A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life. For more information about FindaTopDoc, visit: http://www.findatopdoc.com.
News Article | December 13, 2016
The Journal of the American Osteopathic Association article analyzes a decade of research on popular diets like paleo, Atkins and South Beach CHICAGO--December 13, 2016--People deciding between low-carb and low-fat diets should know the research shows a slight advantage for low-carb diets when it comes to weight loss, according to an article published today in The Journal of the American Osteopathic Association. Physicians from the Mayo Clinic in Arizona found low-carb diets (LCDs), including Atkins, South Beach and Paleo, to be safe for up to six months. Depending on the diet, participants lost between two and a half to almost nine more pounds than those who followed a low fat diet. "The best conclusion to draw is that adhering to a short-term low-carb diet appears to be safe and may be associated with weight reduction," said Dr. Heather Fields, MD, an internal medicine physician at Mayo Clinic in Arizona and lead researcher on this study. "However, that weight loss is small and of questionable clinical significance in comparison to low-fat diets. We encourage patient to eat real food and avoid highly processed foods, especially processed meats, such as bacon, sausage, deli meats, hot dogs, and ham when following any particular diet." Analyzing research from January 2005 to April 2016, Dr. Fields reviewed articles that addressed potential adverse effects and overall safety of LCDs. Diets that heavily restrict carbohydrates often lead to greater consumption of meats--some of which have been implicated in worsened all-cause mortality and increased cancer risk. While available studies did not consistently address the source or quality of proteins and fats consumed in LCDs, they did show short-term efficacy in weight loss without negative effects on blood pressure, glucose, and cholesterol, compared with other diets. However, Fields says the findings come with a caveat. "Physicians must keep in mind that the literature is surprisingly limited, considering the popularity of these diets and the claims of health benefits in the public press. Our review found no safety issues identified in the current literature, but patients considering LCDs should be advised there is very little data on long-term safety and efficacy." Fields also notes that limitations in the previous research she reviewed made it difficult to draw broad conclusions. For example, studies did not address the type of weight lost, whether muscle, water, or fat; and studies primarily relied on dietary recall, which is highly susceptible to error. Fields' review found even the definition of LCD to be highly variable. While all were based on carbohydrate restriction, diets allowed carbs to account for anywhere between 4% and 46% of daily calories--which convolutes the evidence. "As an osteopathic physician, I tell patients there is no one size fits all approach for health," says Dr. Tiffany Lowe-Payne, DO, an osteopathic family physician. Factors like the patient's genetics and personal history should be considered, along with the diet programs they've tried before and, most importantly, their ability to stick to them." Dr. Lowe-Payne acknowledges that carbohydrates are a mainstay of most people's diets and, after six months, weight loss is virtually the same as for people on a low-fat diet. owever, she noted low-carb diets deliver early benefits for patients trying to lower their blood sugar levels or manage insulin resistance. "When you think of what dieters want--and what they need to stay motivated--it is the satisfaction of results. They want to see significant weight loss and fast. For many, a low-carb lifestyle provides the answer they are looking for," Dr. Lowe-Payne explained. About The Journal of the American Osteopathic Association The Journal of the American Osteopathic Association (JAOA) is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein, DO, it is the premier scholarly peer-reviewed publication of the osteopathic medical profession. The JAOA's mission is to advance medicine through the publication of peer-reviewed osteopathic research.
News Article | December 12, 2016
PHOENIX, Ariz. -- Dec. 12, 2016 -- The National Cancer Institute (NCI) has awarded a 5-year, $1.125 million grant to continue an innovative and unique oncology training program for newly minted physicians developed and overseen by Dr. Daniel Von Hoff, Distinguished Professor and Physician-In-Chief at the Translational Genomics Research Institute (TGen). Convened by the American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) -- the world's leading cancer professional organizations -- Dr. Von Hoff's Methods in Clinical Cancer Research Workshop is a one-week boot camp for new oncologists, which has been conducted each summer for the past 21 years. The program's nearly 2,100 graduates now populate leading cancer centers throughout the nation. The workshop draws on the expertise of 40 of the nation's leading oncologists, patient advocates and biostatisticians to provide intensive cancer care instruction each summer to 100 students -- 75 of whom are 2nd- and 3rd-year post-doctoral oncology fellows, and 25 are new faculty members at clinical centers. "Through a rigorous process, we select doctors who appear to have promise. It's a big deal. It's rough. It's one of the most effective courses ever," said Dr. Von Hoff, who also is Professor of Medicine at Mayo Clinic, Chief Scientific Officer for the HonorHealth Research Institute, and past director of the Arizona Cancer Center. He also is a past board member and president of AACR, a Fellow of the AACR, and recipient of the distinguished 1997 AACR Richard and Hinda Rosenthal Memorial Award. In addition, he is a past board member of ASCO and winner of its prestigious David A. Karnofsky Memorial Award for outstanding contributions to patient care and treatment. The course teaches the essentials of effective clinical trial design for therapeutic interventions in the treatment of all cancers. Working around the clock, each summer's class is divided into 12 groups. Each student must write a protocol for a new cancer clinical trial of sufficient quality to pass an Institutional Review Board, a critical step in receiving FDA approval to pursue such a study. Clinical trials are carefully controlled research studies that evaluate promising new drugs, while giving patients access to potentially lifesaving therapeutics. One of the first to take the Methods course when it began in 1996 is Dr. Ramesh K. Ramanathan, Professor of Medicine at Mayo Clinic with a joint appointment at TGen; he is now a gastrointestinal cancer specialist involved in early drug development at Mayo Clinic in Arizona: "This program helped me start a career in academic medicine and prepare me for the exacting work required to design and execute clinical trials that will make a substantial difference in the lives of our patients." Dr. Glen Weiss, a graduate of the 2006 Methods workshop and a Clinical Associate Professor at TGen, is now the Director of all Phase I and II clinical trials at Cancer Treatment Centers of America at Western Regional Medical Center near Phoenix: "This unique training course, under the meticulous watch of Dr. Von Hoff, helped me understand how to design top-flight cancer clinical trials, demanding enough to be approved by the nation's leading oncology experts. It was an invaluable experience." Poor design and conduct of a clinical trial can make it impossible for a study to provide definitive answers about the effectiveness of a new approach. They also can lead to the abandonment of promising avenues of research, even those based on sound basic scientific work, as well as to delays in the introduction of new treatments into the practice of oncology. "On behalf of the American Association for Cancer Research, I would like to thank Dr. Von Hoff for conceptualizing the idea for this course and for his tireless commitment to securing continued financial support for the Methods in Clinical Cancer Research Workshop," said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. "The Workshop has a proven track record of training early-career clinical researchers who have gone on to become world-renowned leaders in clinical trial design and conduct. We are thrilled to be able to continue this rich tradition, which will increase the number of therapeutic interventions that can be tested and made available in a timely manner to improve the care and treatment of cancer patients worldwide." AACR and ASCO have helped design the Methods workshop to increase the reliability and effectiveness of clinical trials by: Translational Genomics Research Institute (TGen) is a Phoenix, Arizona-based non-profit organization dedicated to conducting groundbreaking research with life changing results. TGen is focused on helping patients with neurological disorders, cancer, and diabetes, through cutting edge translational research (the process of rapidly moving research towards patient benefit). TGen physicians and scientists work to unravel the genetic components of both common and rare complex diseases in adults and children. Working with collaborators in the scientific and medical communities literally worldwide, TGen makes a substantial contribution to help our patients through efficiency and effectiveness of the translational process. TGen is allied with City of Hope, a world-renowned independent research and cancer and diabetes treatment center. This precision medicine alliance enables both institutes to complement each other in research and patient care, with City of Hope providing a significant clinical setting to advance scientific discoveries made by TGen. For more information, visit: http://www. . Follow TGen on Facebook, LinkedIn and Twitter @TGen.