Risk of Dementia Higher in Adult Diabetics
ROCHESTER, MINN. ã People with adult-onset diabetes mellitus (AODM) have a higher risk of developing dementia later in life, a Mayo epidemiologic study reports. Researchers examined medical records of all adults in Olmsted County with AODM over a 14 year-period. They identified 101 cases of dementia (77 meeting the criteria for Alzheimerπs) among the 1,455 people followed. Comparing this with known rates of dementia among the general population in the county, they found that people with AODM had a 1.66 times greater risk of developing dementia than people without AODM. They also found that men with diabetes had a higher risk of Ahlzheimerπs than men in the general population. Researchers report that these higher risks could be caused by diabetes or could be the result of shared risk factors, including common genetic factors. Results were reported in The American Journal of Epidemiology. It is the first population-based estimate of the incidence of dementia among persons with AOD
Surgery for Severe Constipation Highly Effective Study Shows
Surgery to relieve chronic constipation can be highly effective if the cause of the problem is properly identified, say Mayo colorectal surgeons. In the journal Diseases of the Colon and Rectum, they report on results of 74 surgeries to relieve chronic, life-altering constipation. After five years, all patients were able to defecate normally without the aid of laxatives or enemas. Ninety-seven percent report satisfaction with the results and 90 percent report good or improved quality of life.
The key to success, says Dr. John Pemberton, is reserving surgery only for problems of slowed movement of food through the colon. Of over 1,000 patients evaluated at Mayo for severe constipation, only 15 percent fit the category of movement problems and only half of those had surgery. About 60 percent of patients were found to have irritable bowel syndrome, for which surgery is not effective. An additional 25 percent of patients had dysfunctional pelvic floor muscles and most were treated effectively with a program of pelvic floor retraining.
Floating Patients and Organs: The Challenges of Doing Physical Exams in Space
Doing physical exams in space takes some adjustments, reports a NASA team in the March issue of the Mayo Clinic Proceedings. For one, foot loops, handrails and Velcro are vital to keep patients, doctors and equipment from floating away. Heart and bowel sounds can be hard to hear in the noisy (65 decibels) cabin of the space shuttle. Organs are not always where you expect them to be. Large organs like the liver, spleen and diaphragm, unconstrained by gravity, shift from their normal position in the abdomen. So does the heart, making it hard to find the point of maximal impulse where the doctor listens on the chest wall. Nevertheless, the authors conclude that changes in the body in space can be measured, based on experiments with a microgravity examination technique on seven astronauts on two space shuttle missions. Use of this technique and the insight it will give, they say, ≥will prove essential in recognizing and treating medical conditions of the astronauts and space travel
For copies of the article, contact: Mayo Clinic News Bureau at 507-284-5580 (days), 507-284-2511 (evenings). For interviews, contact Johnson Space Center Public Affairs, Houston, Texas, 713-483-8693.
Angioplasty, Stenting are Preferred Methods to Open Clogged Arteries
Although new devices to open blocked coronary arteries have grown in number, balloon angioplasty is still the overwhelming choice, according to a Mayo study in a recent issue of Archives of Internal Medicine. Angioplasties were used in more than 90 percent of all coronary interventions at Mayo in 1995. ≥Angioplasty is considered at least as effective as any new device, even when the patientπs case is complex,≤ says Mayo cardiologist Dr. David Holmes. ≥Newer devices may be more effective than conventional angioplasty only in very specialized cases.≤
Devices invented since 1988 include athrectomies (≥roto-rooter≤ devices), lasers that ≥sweep out≤ the plaque in arteries, and various types of stents (devices inserted into arteries to support the vesselπs structure). Stents were used in about 48 percent of all coronary interventions at Mayo in 1995, while other new devices were used in less than 10 percent of all procedures. (Note: Since more than one approach may be used in any procedure, the sum of all procedure types is greater than the total number of procedures.)
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