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Endoscopic surgery for Crohn's disease improves outcomes and reduces costs

Mayo Clinic

A Mayo Clinic study is the first to show that laparoscopic colon and rectal surgery for Crohn's disease both improves outcomes and reduces costs.

In the study, 33 laparoscopic patients were matched for five confounding factors (age, gender, diagnosis, type of resection, and date of operation) to control patients undergoing the equivalent open procedure. Patients in the study underwent an ileocolic resection.

Published in the May issue of Surgical Endoscopy, it found that patients were able to resume a regular diet three days earlier than those having open procedures. Narcotics were removed four days earlier than the open procedure patients. The laparoscopic patients were discharged from the hospital in four days compared with seven days for those with the open procedure.

Overall, Tonia Young-Fadok, M.D., a Mayo Clinic colon and rectal surgeon, the study's primary author, found that cost savings were nearly $3,400 less for the laparoscopic patients compared with the costs for open procedure patients.

Contact: Lee Aase @ 507-266-2442 (days)

Vaccination is an effective method to prevent Lyme disease, Mayo Review says awareness also helps people avoid contact with Tick-Borne Disease

A review of medical literature published in the July edition of Mayo Clinic Proceedings reports that vaccination is an effective and demonstrated method to prevent Lyme disease and the best evidence supports prevention efforts focused on practices that encourage immunization, Lyme disease awareness and possibly treatment of deer. Lyme disease is the most commonly reported tick-borne illness in the United States and an emerging infectious disease of world-wide importance.

Healthy People 2010, an initiative designating the nation's public health goals, established prevention of Lyme disease a priority. Its goal is that by 2010 the cases in endemic states will be reduced by 44 percent.

To do so, Gregory Poland, M.D., a Mayo Clinic vaccine specialist, reviewed a wide range of clinical trials, epidemiological and experimental studies and predictive models.

Some of Dr. Poland's findings included:

Outdoor activities appear to be linked to the risk of Lyme disease, but the behaviors do not account for all risk. Most infections are likely to occur in residential areas during routine activities.

Approaches to Lyme disease prevention, such as the removal of deer or the removal of vegetation can effectively control ticks. However, the effect of these strategies on the incidence of Lyme disease in humans is unknown.

Only 40 to 50 percent of adults take precautions against tick bites even when they are aware of Lyme disease.

Contact: John Murphy @ 507-538-1385 (days)

Genetics may cause abdominal fat in postmenopausal women family history reveals important link

A team of researchers at Mayo Clinic has found that genetics often determine the amount and location of abdominal fat in postmenopausal women. Abdominal fat is a proven risk factor for diabetes, heart disease, breast cancer and many other chronic conditions.

"We have gathered additional evidence showing a major gene influence on the distribution of abdominal fat in postmenopausal women," says Mayo Clinic researcher, Janet Olson, Ph.D., whose findings were recently published in the May 2001 edition of Genetic Epidemiology. "With this information, we can conduct further studies to try to locate the gene that influences how and where excess weight is carried in our bodies."

Dr. Olson and colleagues drew their conclusions from a method called segregation analysis, which looks at how a trait moves across generations in a family. Women from the Family Studies of Cancer were investigated for this analysis. This study started about 50 years ago, when a doctor at the University of Minnesota collected pedigrees from more than 500 women. Today, information from this group of women and their families continue to be collected and studied by Mayo Clinic researchers.

There are different ways to measure the amount of abdominal fat in a person's body. Dr. Olson and colleagues used the measurement called the "waist-to-hip ratio," which is the measurement of a woman's waist circumference divided by her hip circumference (WHR). This measurement method is commonly used in large-scale studies. "In general, lower levels of abdominal fat are better, and a low waist-to-hip ratio is healthier," Dr. Olson says.

Researchers looked at the group of women in three ways: premenopausal women alone, postmenopausal women alone, and all women combined. "Abdominal fat distribution did not appear to be influenced by a major gene in premenopausal women, as opposed to what was found in postmenopausal women," Olson explains. She adds that women tend to carry their fat differently after menopause, meaning that "there may be a difference in how genes are expressed after menopause."

With this evidence, researchers have decided to continue their study. "Since we have evidence that a gene influences abdominal fat distribution, we're going to do a 'linkage analysis' to locate the major gene influencing fat distribution," Olson said. This involves obtaining blood samples from family members to directly examine their genes.

This group of women and their families will continue to be studied, as the researchers collect additional information and expand their study to include future generations and more distant relatives.

Contact: Tom Huyck @ 507-284-0003

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