Aug. 4, 1998
Mike OÃHara 507-284-9522 (days) 507-284-2511 (evenings) e-mail: [email protected]
For Immediate Release
Gallstones or Undissolved Pills? Study Finds That Most Pills Will Show Up on X-rays
ROCHESTER, MINN. ó The X-ray of the elderly patient showed a cluster of suspicious white blobs in the abdomen. Gallstones, thought the woman's doctor. But closer examination revealed them to be undigested iron pills. This incident spurred Dr. Jonathan Evans, an internist at Mayo Clinic to investigate common pills to see how well they show up on X-rays (their radiodensity). Dr. Evans and colleagues examined 50 medications, including painkillers, antibiotics, minerals and cardiovascular, endocrine, gastrointestinal, psychiatric and respiratory drugs. Researchers used standard methods to simulate pills in a patient's abdomen. Results were published in Mayo Clinic Proceedings. All 50 medications were found to be clearly visible to varying degrees on plain X-ray films. As a group, minerals were found to be the most visible with potassium chloride topping the list. Prednisone was the least visible. The authors cautioned doctors to be aware that virtually all undissolved medications can show up on X-rays and that their appearance on X-ray films could be confused with conditions such as gallstones or kidney stones. Dr. Evans said that the process of digestion breaks down pills and the study did not account for this effect. However, he said that many patients have conditions which impair digestion, so that real life conditions can frequently resemble those of the study.
Radiation for Brain Tumors Does Not Cause Cognitive Decline Radiation therapy helps patients with primary brain tumors survive significantly longer. But does this gain come at too high a cost in terms of loss of cognitive function? No, says a recent Mayo Clinic-led study of 701 patients with gliomas, a type of brain tumor. The patients, who were treated with radiation and chemotherapy, took a test measuring mental status every six months. Researchers found evidence of cognitive decline in only a small minority of survivors during the two years of the study. The study suggests that factors such as older age and tumor growth were more significant factors in patients whose cognitive functioning did decline. Researchers caution that decline may occur later than two years and more follow up is necessary. The study was published in the June issue of the Journal of Clinical Oncology.
Molecular Techniques Identify Dangerous Invasive Strep Bacteria Group A Strep is a common family of bacteria that causes countless sore throats. But this family also contains a dangerous relative ó a strain that rapidly invades deep tissues of the body, causing massive infection and, frequently, death. In the winter of 1995, Mayo Clinic found itself in the center of a rare outbreak of invasive Strep. Sixteen patients from the surrounding area were diagnosed with invasive Strep A infections between January and June of that year. One-half of those patients died. Mayo Clinic researchers studied that outbreak using new molecular techniques and reported their findings in a recent journal article. Some key points: ï All 16 patients were infected with invasive Strep A. But one strain (called PFGE-1) was particularly dangerous. Nine of the 16 patients had this strain and 7 died. ï Those affected tended to be older men with other underlying medical conditions, such as diabetes or alcoholism. A common feature was severe pain at the site of infection. ï Eight of the affected patients suffered massive infections which destroyed their soft tissues (necrotizing fasciitis); but in one-half of these cases, the infection was not evident on the surface of their skin. ï New molecular fingerprinting techniques can rapidly identify this strain and should be used over standard serological methods. "The old way takes days to make a diagnosis, which doesn't allow time to take preventive measures with others who may be exposed to this bacteria," says Dr. Franklin Cockerill, an infectious disease specialist at Mayo Clinic. The researchers studied samples from other Strep A outbreaks and found that the particular strain involved in the Minnesota outbreak was the same one involved in earlier outbreaks in Ohio, North Carolina and Japan. "Why it crops up in one location we don't know. It is probably everywhere in small numbers and when conditions are right, it can spread." Dr. Cockerill said the infection is treatable with penicillin. But in many cases, patients do not seek care until the infection is too far advanced to be stopped. "It's hard to issue a warning for this since it is so uncommon. But during Strep season, generally the winter months, if someone has a fever and severe pain in an arm or leg, particularly if they are older, it would be wise to see your doctor," says Dr. Cockerill.
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