The retina is a thin layer of tissues, cells, and nerves that line the back wall inside the eye.  This layer has millions of light sensing cells that receive and organize visual information according to the Mayo Clinic.

On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Brittni Scruggs, an ophthalmologist at Mayo Clinic Children’s Center. Dr. Scruggs is a physician, surgeon, and scientist with a research laboratory at Mayo Clinic studying gene therapy and stem cell therapy for retinal degenerations, including for children. 

She treats all ages, ranging from newborns to adults. Dr. Scruggs is a member of the national workgroup developing ACMG evidence-based guidelines for diagnosis and clinical management of inherited retinal diseases.
Dr. Mattke and Dr. Scruggs explore retinal issues in children and discuss eye safety and health. 

Acute myeloid leukemia (AML), also called acute myelogenous leukemia, is a cancer of the blood and bone marrow, the spongy tissue inside bones where blood cells are made. The disease progresses rapidly, affecting a group of white blood cells called myeloid cells, which normally develop into mature red blood cells, white blood cells and platelets. 

"There are acute and chronic leukemias, explains Dr. James Foran, an oncologist at Mayo Clinic. "The chronic ones tend to happen slowly over many years. You can watch it for a period of time until it really becomes active. The acute leukemias come on more quickly and cause people to get sick more quickly. Hence, the word acute."

AML occurs when a bone marrow cell develops mutations in its DNA that cause the cell to continue growing and dividing. When this happens, blood cell production becomes out of control. The bone marrow produces immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.

Signs and symptoms of AML include:

• Fever
• Bone pain
• Lethargy and fatigue
• Shortness of breath
• Pale skin
• Frequent infections
• Easy bruising
• Unusual bleeding

Treatment of acute myeloid leukemia depends on several factors, including the subtype of the disease, and a person’s age and overall health. 

At the time of diagnosis, a bone marrow biopsy is performed, and testing is done to determine the subtype of AML. Genetic testing on leukemia cells helps oncologists plan treatment that will give patients the highest chance of remission.

"There have been massive advances in the last five or seven years," explains Dr. Foran. "We understand that almost everybody with acute myeloid leukemia will have some genetic abnormality in the leukemia cells. Some mutations predict for a lower remission rate with standard chemotherapies. Those are situations where we're looking for new therapies that would be more effective, new strategies — whether that's an immune treatment, a targeted therapy, a different type of chemotherapy. So those mutations really helped guide us on how to apply the new strategies." 

Dr. Foran says Mayo Clinic is a leader in ongoing research and clinical trials to refine and improve targeted and immune therapy treatments. New approaches include expanding the use of bone marrow transplants and using CAR-T cell therapy. 

"Mayo Clinic is in the front of the field, I believe. We're studying more targeted treatments to go after cells with mutations, to try to spare side effects, and get the most benefit in treating leukemia," he says. "We're continually and actively looking for new strategies to improve outcomes for patients."

On this Mayo Clinic Q&A podcast, Dr. Foran discusses acute myeloid leukemia, including the latest research and advances in treatments.

While we know that health affects longevity and quality of life, it can be difficult to change bad habits. People often try to make sweeping New Year's resolutions, only to fail.

In fact, Jan. 17 is the date that the average America breaks their New Year's resolution.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small, sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Healthy eating

Eating lots of fruits and vegetables provides antioxidants and anti-inflammatory nutrients that help the immune system fight infections. Dr. Kopecky recommends fruits, vegetables and healthy fats from olive oil and nuts, all found in the Mediterranean diet. 

Exercising

Regular moderate exercise increases the activity of virus-killing immune cells.

“Exercise has been shown to give the immune system a boost by maximizing the body's ability to take in and efficiently use oxygen, among other things,” says Dr. Kopecky. “Moderate exercise, where you can talk but not sing while exercising, is enough to increase the activity of virus-killing cells both in the short term and long term. Even 20 minutes daily can help quell inflammation and boost immunity, and exercise can be divided up during the day. The best part about exercise is that it can be done anywhere. Leg lunges, sit-ups, squats and stair-climbing are all easy exercises you can do at home."

Managing stress 

Calming activities and supportive relationships minimize stress, reduce cortisol production and enhance the immune system's function. "Concern about the health of our loved ones, our jobs, children's schooling and other stressors will cause an increased production of the hormone cortisol in the body, which in turn can suppress the immune system," says Dr. Kopecky. "Practicing mindfulness and stepping away from what's causing anxiety can help us stay grounded. Exercises that have calming or meditative qualities, such as qi gong and yoga, also are beneficial."

Getting enough sleep

Adequate sleep boosts the number of immune cells circulating in the body and improves infection outcomes. The interaction between the immune system and sleep is a two-way street. "When your immune system response kicks in, it changes your sleep,” explains Dr. Kopecky. “You may find yourself sleeping longer, for example, as your immune system stages an attack against a virus. When you're not sleeping well, you may notice that you get sick more easily. Getting adequate sleep can help support the way your immune system functions by increasing the number of immune cells circulating in your body." 

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging. We can slow aging," says Dr. Kopecky. "But we can prevent disease. It's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.