January 27, 1997
Study looks at Drug to Prevent Colon Cancer
ROCHESTER, MINN. ã Can colon cancer be prevented with a medication? Mayo gastroenterologists have just begun testing this idea with a drug called urso (ursodeoxycholate). The trial is based on the hypothesis that most colon cancers arise from adenomatous polyps in the colon and the growth of these polyps is stimulated by high levels of certain bile acids. Bile acids are produced in the liver and excreted into the intestines. Urso has been shown in animal trials to modify the types of bile acids that reach the colon, replacing more harmful bile acids with ≥safer≤ bile acids. The study will look at the effect of urso on 600 patients who have had polyps removed and are at increased risk for the development of new polyps. ≥Our hope is that urso will prevent recurrent polyps from forming,≤ says Dr. Mark Larson, principal investigator of the study. ≥If this effect occurs, we may be able to prevent the development of colon cancer in patients who are at risk for this malignancy.≤ The M For more information or copies of the article, contact: Michael OπHara, Mayo Clinic News Bureau, 507-284-9522 (days), 507-284-2511 (evenings), or e-mail: [email protected].
Different Heart Treatment for Women than Men? Heart valves, yes, Angioplasty, no
Sometimes women with heart disease need therapy different from men, and sometimes they donπt, according to two recent Mayo Clinic studies. New research indicates that some women who need heart valve surgery should have it performed sooner than men with a comparable problem, according to a report by Mayo researchers in the journal Circulation. Previously, decisions to replace a leaky aortic valve, a condition called aortic regurgitation, were based on studies in which most of the patients were men (relatively few women develop severe forms of the condition). When researchers studied a large group of women, they found that the male-based criteria were irrelevant. ≥We found that in women with aortic regurgitation, surgical correction should be considered at an earlier stage before severe symptoms develop,≤ says Dr. Maurice Enriquez-Sarano, a Mayo cardiologist. In a second study on women and heart disease, Mayo Clinic researchers report that women with unstable angina and rest pain ã that is, chest pain from poor blood supply to the heart muscle, even when resting ã survived aggressive therapy as well as men. Aggressive therapy includes advancing a tiny balloon into a narrowed artery and inflating it to widen the artery (angioplasty).
≥The results of several studies, for reasons not well explained, have suggested that the risks of more aggressive treatment strategy are much higher for women than for men,≤ says Dr. Malcolm Bell, a Mayo cardiologist and the primary author of the study that appeared in the January issue of Mayo Clinic Proceedings. ≥Our study shows that survival rates were excellent in both women and men after angioplasty. Gender considerations should not influence the management strategy for these patients.≤ For more information or copies of the article, contact: Randall Fritz, Mayo Clinic News Bureau, 507-284-2483 (days), or 507-284-2511 (evenings).
Program Successfully Weans Patients from Mechanical Ventilation
Many patients hospitalized in intensive care units need mechanical ventilators to help them breathe, especially after surgery. All too often older patients become dependent on the ventilators, with detrimental consequences to their health and independence. In 1990 Mayo set up a special hospital unit to help wean people on ventilators, an effort which has produced excellent results, according to a recent report on the unitπs first five years. Of 206 patients admitted to the unit, who had been on ventilator assistance for an average of 58 days:
Ä 80 percent of patients were liberated completely from mechanical ventilation
Ä 77 percent were able to return to their homes
Ä Hospital mortality rates were 8 percent, compared to 28 percent for a similar group of patients treated in the ICU environment
≥Patients with prolonged stays in the ICU are frequently sleep-deprived, are often overmedicated, and usually have central venous catheters, urinary catheters and various other appliances, which have been left in place for prolonged periods,≤ the authors of the report wrote. ≥We believe that removing all unnecessary appliances and mobilizing these patients are critical factors in the successful liberation from mechanical ventilation.≤ They called exercise and nutritional support the ≥cornerstones of our program.≤ The report was published in the January issue of Mayo Clinic Proceedings. For more information or copies of the article, contact: Michael OπHara, Mayo Clinic News Bureau, 507-284-9522 (days), 507-284-2511 (evenings), or e-mail: [email protected].
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