Boston researchers are launching a large, national trial of vitamin D and fish oil to see if the dietary supplements make a difference in developing cancer or cardiovascular disease. They are also testing the idea that lower levels of vitamin D might explain higher rates of these diseases among black people.

Dr. JoAnn Manson and Dr. Julie Buring, both of Harvard Medical School and Brigham and Women's Hospital, hope to enroll 20,000 healthy older people in the federally funded trial. One quarter of the participants will be black. The researchers believe higher rates of cancer, heart disease, and stroke among black people, compared with whites, might be related to dark skin's lower ability to make vitamin D from absorbing sunlight, and they hope to learn whether taking vitamin D supplements could reduce or eliminate these disparities.

"African-Americans have a higher risk of vitamin D deficiency and a greater frequency of certain types of cancer and diabetes and hypertension, so I think that it will be of great importance to look at whether something as simple as taking a vitamin D supplement can narrow these health gaps," said Manson, who believes the study is one the first large scale randomized trials to target a specific group at higher risk for a deficiency of nutrients. "It would be wonderful if something as simple as a vitamin D pill could narrow that health gap."

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An experimental device designed to help paralyzed people control computer cursors, robotic arms, or even wheelchairs just by thinking about moving them will be tested in a new hospital trial after its private-sector sponsor's withdrawal.

The pilot BrainGate 2 trial, funded by federal grants and led by doctors at Massachusetts General Hospital working with scientists at Brown University and the Providence VA Medical Center, is recruiting up to 15 participants who have become quadriplegics after a spinal cord injury, a brain stem stroke, or because of ALS, muscular dystrophy, or another neurological disorder, the collaborative said today.

The researchers hope to learn more about a system whose preliminary trial, supported by the former Cyberkinetics Inc. of Foxborough, showed promise in translating thoughts into movement. The system works by decoding brain signals detected by a sensor implanted in the motor cortex, the part of the brain that governs movement. Signals are then sent to an external device, such as a computer cursor, which then moves in response.

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The video is short, simple, and powerful.

A woman with advanced dementia -- wearing lipstick, beads and a white shawl -- stares blankly at the camera while her daughters ask her questions. A man's voice describes what she and others at this stage cannot do: communicate, walk or sit alone, feed themselves. She does not respond when her daughter asks her how many daughters she has, and she needs help to keep her spoonfuls of pureed food in her mouth.

Less than two minutes long, the video was shown to almost 100 elderly people taking part in a study comparing the effects of watching the narrated video of advanced dementia with listening to the verbal narration alone. Just over 100 other participants heard the narration. Both groups were then asked to choose what kind of end-of-life care they would want if they were in the same irreversible condition.

People who viewed the video were more likely to choose comfort care over life-extending measures than people who heard a verbal description alone, Dr. Angelo Volandes of Massachusetts General Hospital and his colleagues report in the British Medical Journal. Those who saw the video were also more knowledgeable about the disease, and more of them remained firm in their choice of end-of-life care six weeks after seeing the video.

"Most of our patients do not have experience with advanced stages of disease nor with the interventions such as CPR," Volandes said in an interview. "Video may be one way of better informing patients about decisions at the end of life. Video makes these conversations quite real."

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Boston surgeon and writer Dr. Atul Gawande unearths a medical mystery in Texas with reverberations for the nation's debate about revamping its healthcare system.

In an essay for the New Yorker, he visits McAllen, Texas, a town with unusually high healthcare costs. Not substantially different from El Paso, its residents accumulate $15,000 in Medicare costs per year, twice the levels of its neighbor 800 miles away on the Mexican border.

The difference is across-the-board overuse of medicine -- of tests, of referrals, of operations, of medical procedures -- he concludes. And more doesn't mean better, he writes.

"Health-care costs ultimately arise from the accumulation of individual decisions doctors make about which services and treatments to write an order for. The most expensive piece of medical equipment, as the saying goes, is a doctor’s pen," he writes. "If doctors wield the pen, why do they do it so differently from one place to another?"

In Boston, Beth Israel Deaconess CEO Paul Levy says McAllen is no exception, in a blog entry titled "McAllen, Texas = Boston, Massachusetts." On her blog, Alison Bass, author of "Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial," calls Gawande's piece "a scary article and a must read" for anyone considering how to control surging healthcare costs.

By James F. Smith, Globe Staff

Dr. Paul Farmer, a pioneer in improving health services in the Third World, has been named chairman of Harvard Medical School's Department of Global Health and Social Medicine but remains in the running for a senior role in the Obama Administration, the leader of the medical school said yesterday.

Dr. Jeffrey S. Flier, the medical school dean, told a meeting of global health specialists from Boston-area institutions that Farmer would succeed Dr. Jim Kim as chairman of the department as of July 1. Kim has been named president of Dartmouth College.

Andrew Marx, director of communications at Partners in Health, the Boston-based global health non-profit that Farmer founded with Kim in 1983, said Flier told the Harvard meeting that Farmer was still in discussions with Obama administration officials about an unspecified position.

Marx quoted Flier as saying that if Farmer did get a Washington position, he would take a leave of absence from the medical school, and that Flier hoped he would later return to the chairmanship.

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By Liz Kowalczyk, Globe Staff

James Maki, the nation's second face transplant recipient, said today that he hopes his story will encourage more families to donate the organs of their loved ones.

"My life has been a journey with many ups and downs. I hope this will be a chance to start fresh,'' he said during a brief press conference at Brigham and Women's Hospital.

Maki, 59, was disfigured in June 2005, when he fell onto the electrified third rail in the Ruggles subway station. His face and right arm were badly burned. He told the Globe in interviews earlier this week that since then he had endured ridicule and stares whenever he ventured outside.

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People hope technology will transform their healthcare the same way the Internet has changed other parts of their lives, by opening up information and personalizing their interactions, Boston researchers say in an article that adds patients' voices to the national debate about health information technology.

Jan Walker of Beth Israel Deaconess Medical Center and colleagues from Brigham and Women's Hospital, Harvard Medical School, and MIT asked focus groups in four American cities what they want from technology as it related to healthcare now and in the future. Their report is in the June issue of the Journal of General Internal Medicine. The study was funded by the Robert Wood Johnson Foundation.

The 82 participants -- frequent Internet users from Boston, Tampa, Denver, and Portland, Maine, divided into six patient and two doctor groups -- said they want access to their health records, ways to communicate with clinicians, and home monitoring to manage their illnesses. Patients were more willing to trade some privacy for having their health data available in case of emergency, compared to health professionals.

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Comparative effectiveness research has been painted as the road to rationing by some critics of the $1.1 billion federal effort to evaluate the relative benefits of different treatments for diseases.

Three articles in tomorrow's New England Journal of Medicine, including one by Dr. Jerry Avorn of Harvard and Brigham and Women's Hospital, make the case for the program, hoping it will find answers that will deliver on the promise of personalized medicine, improve the safety and affordability of healthcare, and make sure that patients receive the fruits of research.

Avorn, a critic of the pharmaceutical industry, welcomes a way to compare new drugs, devices, or procedures against one another, rather than placebo.

"It represents one of the best investments we can make to edge the health care system away from the fiscal catastrophe it faces, since such studies will help to reduce spending on poorer clinical decisions and to spare resources for expenditures that will help patients most (and most affordably)," he writes. "This research is a public good, like highways and clean air."

An experiment to make medication lists for hospital patients more accurate worked better than usual methods, potentially avoiding drug-related problems, a small study at two Boston hospitals shows.

Researchers led by Dr. Jeffrey L. Schnipper of Brigham and Women's Hospital tested a new process for reconciling the lists of drugs patients are taking when they arrive at the hospital with the medications they receive in the hospital or are sent home to take. About two out of three patients nationwide have at least one unexplained discrepancy in their medication lists when they are admitted, Schnipper and his co-authors note in tomorrow's Archives of Internal Medicine.

The researchers created a new process for checking drug lists, including a Web-based component that could draw electronic information from a variety of sources into a medication list. Physicians, nurses, and pharmacists changed the way they worked in order to generate the list.

The new process was compared to the usual method for 322 patients admitted and discharged over two months at the Brigham and at Massachusetts General Hospital. There were 170 medication discrepancies that could have caused harm among 162 patients assigned to the new process. That compares to 230 medication discrepancies among 160 receiving the usual care.

The authors call their intervention "far from perfect," but still successful because it combined information technology with a new process of cross-checking and communicating among doctors, nurses, and pharmacists to improve safety.

Getting exercise and eating a good diet can cut an older person's risk for developing type 2 diabetes nearly in half, a Boston study shows. When combined with moderate alcohol use and not smoking, the risk drops by 80 percent, making the low-risk lifestyles important tools in the battle against a difficult disease.

Healthy behaviors have been effective in other studies of diabetes. In a landmark trial called the Diabetes Prevention Program, improving diet and activity helped overweight people already showing the high blood-sugar levels that mark diabetes. The new study, in tomorrow's Archives of Internal Medicine, followed 4,883 men and women over 65, giving them physical exams and asking about their habits. After 10 years, the researchers compared those who developed type 2 diabetes to those who did not.

Each of five factors -- physical activity, diet, smoking, alcohol use, body mass index, and waist circumference -- was associated with a risk for diabetes. People who were active and ate a low-calorie diet had a 46 percent lower rate of diabetes than people who were inactive and had more more fats and sugars in their diets. If the low-risk people also didn't smoke and had no more than two drinks of alcohol a day, their risk was 80 percent lower than those who smoked or drank more. If their BMI and waist circumference also fell in the normal range, their risk was 89 percent lower than people who did not have any of these low-risk habits.

"Our results provide evidence for a tremendous combined impact of lifestyle on diabetes risk in older adults," the authors, led by Dr. Dariush Mozaffarian of Harvard and Brigham and Women's Hospital write. "Diabetes may be largely preventable among older adults through adherence to ... relatively modest lifestyle goals."

The longtime medical director of a major physicians' group at Brigham and Women's Hospital died Tuesday after she was involved in a head-on car crash near her home in Needham.

Police and relatives said it appears that the 2007 Toyota Prius driven by Dr. Phyllis Jen, an internist who for the last 27 years served as medical director of the Brigham Internal Medicine Associates, crossed into the oncoming lane of traffic on Greendale Avenue shortly before 6 p.m. as she was driving home from work.

A full story is here.

Universal health coverage in the form of Medicare eligibility narrowed the health gaps between Americans of different races, ethnicities, and education levels, a new study from Harvard shows. The results are seen as part of the national debate on revamping healthcare to cover uninsured Americans.

Disparities between people of different socioeconomic groups persist through middle age, with some groups healthier than others. Then, after age 65, when near-universal Medicare coverage kicks in, "we found a reduction in disparities," said Dr. J. Michael McWilliams, lead author of the study appearing in tomorrow's Annals of Internal Medicine.

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By Liz Kowalczyk, Globe Staff

The nation's second face transplant recipient saw his new face for the first time this week, according to a statement from Brigham and Women's Hospital.

Lead surgeon Dr. Bohdan Pomahac said the patient "recognized himself, and he really was very pleased. Both he and his family said his nose resembles his old nose."

The patient is in good condition, the hospital said. The man underwent a 17-hour operation last week to replace his nose, roof of his mouth, upper lip, facial skin, muscles, and the nerves that power them. The hospital has not released his name or any other details about him.

By Kay Lazar

Sometime in the next couple of days, the man who just became the nation's second face transplant patient will wake up and see his new face. When he does, the odds are better than even that he will recognize himself, the surgeon who preformed the transplant at Brigham and Women's Hospital said today.

"He's still waking up. He's not seen himself yet," said Dr. Bohdan Pomahac at a press conference this afternoon, a day after he led the surgery team that replaced the man's mid-face. The man's new identity will not, said Pomahac, reflect that of the face donor. And the odds are 60 percent that he will retain his original features, Pomahac said.

The first 24 hours are critical, said Pomahac, in determining whether the nerve and circulatory connections were successful. For the next week, the danger of infection looms.

At the press conference, officials released no further details about the recipient other than that he is a US citizen. He remains anonymous at his request. The only information about the donor came from a statement issued by the family. It read in part: "To go from being a recipient family to a donor family so suddenly has given us the opportunity to fully understand the power of organ transplants to give and transform lives. The fact that we were able to give this gift was a tremendous comfort in our time of grief."

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By Liz Kowalczyk, Globe Staff

Doctors at Partners HealthCare no longer will be allowed to accept gifts and meals from drug and device companies, or travel the country as paid members of company "speakers bureaus,'' as the state's largest hospital and physician network adopts tougher restrictions to counter industry's influence over the drugs and treatments doctors prescribe.

Partners, which includes the Harvard-affiliated Massachusetts General and Brigham and Women's hospitals in Boston, also is placing new limits on how physicians interact with company sales representatives and increasing oversight of these relationships. Overall, the changes, which also apply to senior Partners executives, go further than a new state law governing doctors' conflicts of interest and generally will bring the organization in line with other major US teaching hospitals that have adopted tougher standards.

Many Mass. General and Brigham physicians are top researchers, making drug and device companies eager to collaborate with them on developing new treatments for patients -- relationships Partners executives said they want to preserve. But because of their status as "thought leaders," these doctors also are attractive targets for helping companies spread their marketing messages through speakers bureaus and medical education.

"We don't want our faculty being on the road" as "hired guns," said Dr. Peter Slavin, president of Mass. General and a member of the commission that developed the new policy, referring to the decision to prohibit speakers bureaus. Slavin said the group decided to prohibit physicians from eating meals on a company's tab, including lunches bought for doctors-in-training in the hospital, because it "doesn't promote a positive image of physicians and increases health care costs."

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A former Harvard researcher falsified data and fabricated results in a 2003 sleep study, two news outlets report online today.

Dr. Robert B. Fogel, who taught at Harvard Medical School and practiced at Brigham and Women's Hospital until 2004, said he altered numbers and invented anatomic details reported in an article about obesity and sleep apnea. The journal Sleep retracted the article in February and the federal Office of Research Integrity concluded its investigation last month.

"What I did was obviously horrendously wrong," Fogel told The Scientist magazine. "I never really thought through the consequences, and once I did this I got myself into a loop that I found I couldn't get out of."

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Keeping a healthy weight means balancing how much food you take in with how much energy you put out. Eat too much and the excess is stored as fat. Exercise more and that fat melts away.

But what if fat itself could help burn calories?

New research reported in tomorrow's New England Journal of Medicine adds to growing knowledge about brown fat, the "good" fat that has been studied in mice for its connection to body weight and metabolism.

Babies are born with brown fat deposits that help keep them warm by burning calories instead of storing them, but scientists believed that brown fat disappeared or lay in dormant islands by adulthood. A team led by Dr. Aaron Cypess of the Joslin Diabetes Center has found that brown fat persists in adults and remains active. And in a correlation with potential implications for treating obesity, the researchers found that the more brown fat people had, the lower their body-mass index was, especially in older people.

"There really is a meaningful amount of brown fat in adult human beings and it is functional," Cypess said in an interview. While much remains to be learned, "this now is an entirely new approach to treating obesity."

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More than a third of Americans take aspirin every day to ward off heart disease and stroke, based on its power to prevent blood clots that can trigger heart attacks or strokes. But in some people aspirin can be harmful, too, if the same blood-thinning properties lead to bleeding in the stomach or intestines.

A team of researchers report in tomorrow's Annals of Internal Medicine that lower doses of aspirin appeared to be equally effective and safer compared with higher aspirin doses.

Updated guidelines from the US Preventive Services Task Force also appear in the journal, recommending that aspirin's risks be weighed against a patient's likelihood of developing cardiovascular disease. The advice also reflects aspirin's different effects in men and women.

"For many patients, probably just one baby aspirin a day is sufficient," co-author Dr. Deepak Bhatt, a cardiologist at VA Boston Healthcare System and Brigham and Women's Hospital, said in an interview. "It was just as effective as a higher dose and with perhaps less bleeding."

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By Tracy Jan, Globe Staff

Dartmouth College named Harvard medical anthropologist Dr. Jim Yong Kim as its 17th president today, making the Korean-born physician the first Asian-American to head an Ivy League school.

KIM

Kim, a 49-year-old expert in AIDS and tuberculosis, is internationally renowned for his ground-breaking work delivering health care to developing countries. He will replace James Wright, a historian and former US Marine, who will step down in June after 11 years at the helm to promote college opportunities for wounded veterans.

Members of Dartmouth's Board of Trustees said Kim is the ideal leader for the university at this time because of his lifelong commitment to teaching and mentoring young people in the field of global health.

They also praised his record in heading international agencies such as Partners in Health, a non-profit he co-founded with colleagues while students at Harvard Medical School, and ability to prod countries for funding while overseeing the World Health Organization's first major effort to promote AIDS treatment.

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Reminders mailed to patients who were overdue for colorectal cancer screening tests were more effective than sending alerts to their doctors during office visits, a Boston study has found.

Because only about 60 percent of patients nationwide say they are up to date on colorectal screening, researchers led by Dr. Thomas D. Sequist of Brigham and Women's Hospital tested ways to bring patients in for the tests. They report their results in this week's Archives of Internal Medicine.

National guidelines recommend people 50 and older be screened for colorectal cancer, which is the second leading cause of cancer deaths, after lung cancer. Colonoscopy can reduce colorectal cancer deaths by removing precancerous growths or detecting cancer at a more curable stage.

In the study, which was funded by the National Cancer Institute, more than 21,000 patients and 110 primary care physicians at Harvard Vanguard Medical Associates were randomly assigned to get notices saying the patients hadn't been screened for colorectal cancer. Some patients were also sent personalized reminders.

Patients who received the personalized mailings were significantly more likely -- 44 percent vs. 38 percent -- to get their screening tests done than similar patients who did not get the mailings. But patients whose doctors got electronic reminders during office visits were not more likely, statistically speaking -- 41.9 percent vs. 40.2 percent -- to get screened than patients whose doctors did not get the reminders.

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By Liz Kowalczyk, Globe Staff

A federal jury today awarded a Brigham and Women's Hospital neurosurgeon $1.6 million in her sex discrimination lawsuit against the hospital and against the chairman of her department, Dr. Arthur Day.

The jury of seven men and two women found that Dr. Sagun Tuli, who specializes in spine surgery, was subjected to a hostile work environment at the hospital where she has worked for more than six years. They jury also found that Day, a nationally-known brain surgeon who took over the department in 2007, slandered Tuli, and that the hospital retaliated against her for complaining about his behavior toward her and other employees.

The jury rejected claims by Tuli that the Brigham's decisions were motivated by ''discriminatory intent'' and that she was paid less than male colleagues because of her gender.

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Women who took a combination of folic acid and two B vitamins for several years had a lower chance of developing the most common cause of vision loss in older Americans, Harvard researchers report, the first rigorous trial to show a benefit from the supplements.

A team led by William G. Christen of Brigham and Women's Hospital and Harvard Medical School found that women who took a combination of folic acid and vitamins B6 and B12 had a 35 percent to 40 percent lower risk of developing age-related macular degeneration than the women who took a placebo. The results are reported in tomorrow's Archives of Internal Medicine.

"These are new findings and they need to be corroborated," Christen said in an interview. "If they are, they are potentially exciting and important."

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When 15 pilot programs tried to improve care and cut costs for chronically ill Medicare patients, the results were "underwhelming," according to a study published today in the Journal of the American Medical Association, summarized here.

None of the programs saved money, a critical concern as Medicare's expenditures swell to one-fifth of the nation's healthcare budget. But there are some insights to take away from the experiments in coordinating care of these older patients, Dr. John Z. Ayanian of Brigham and Women's Hospital and Harvard Medical School writes in an editorial that appears with the study.

First, face-to-face meetings between care coordinators and patients worked better than telephone counseling, an approach that was also successful in previous research on care management for people with congestive heart failure.

Second, care coordinators -- nurses in the Medicare pilot projects -- must work closely with patients' doctors in order to have a good chance of making a difference in care.

Coordinating care through a model called the medical home is a promising way to improve care, Ayanian writes. But it is unlikely to save money.

"Such an investment would be worthwhile if it improves the quality of care and health outcomes," he writes about funding medical homes. "Balancing the Medicare budget, however, will require much more difficult political decisions among less appealing choices -- raising payroll taxes to support Medicare, increasing beneficiary cost-sharing, reducing benefits, or cutting payments to physicians, hospitals, and health plans, particularly for services that are not clearly beneficial."

Multivitamins made no difference in the risk of cancer, cardiovascular disease, or death, a large national study of older women concludes, the latest clue in a confusing picture of nutritional supplements.

More than 161,000 postmenopausal women in the Women's Health Initiative were asked whether they took multivitamins when they entered the study between 1993 and 1998. Like Americans as a whole, about half of the women said they used multivitamins. Researchers tracked all the women and compared the incidence of several common cancers, heart attacks, stroke, and blood clots in women taking the vitamins to women who weren't.

After eight years, there was no significant link between multivitamin use and cancer, cardiovascular disease, or death.

"The study demonstrates that popping a multivitamin won't magically confer good health and is not a substitute for healthy balanced diet," Dr. JoAnn E. Manson, chief of preventive medicine at Brigham and Women's Hospital and a co-author of the study in the Archives of Internal Medicine, said in an interview. "However, I do think that multivitamins still have a role as a form of insurance for those with an inadequate or poorly balanced diet, and there are many Americans who fall into that category."

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When a patient near the end of life says "no more," sometimes that's not enough to end treatment.

Even when protocols are followed flawlessly, the patient's wishes can fall before their families' desires, the editor-in-chief of the New England Journal of Medicine writes.

Dr. Jeffrey M. Drazen and two colleagues recount in an essay in this week's journal what happened when an 83-year-old woman in intensive care at Brigham and Women's Hospital declared she wanted no more treatments.

She had survived multiple myeloma for seven years and she suffered from an array of other ailments, including kidney failure. Once she was mentally clear, she said she didn't want any more treatment.

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Paul Levy understands why Norwood Hospital is nervous.

On his blog Running a Hospital, the CEO of Beth Israel Deaconess Medical Center recounts his visit to Foxboro, where the Brigham and Women's/Mass General Health Care Center is being built at Patriot Place, a complex next to Gillette Stadium.

The newest satellite of the Partners Healthcare System offers many of the same medical services found about eight miles north at Norwood Hospital, which is part of the Caritas Christi hospital network. But doctors at the two hospitals are paid different amounts, despite no documented differences in quality of care they provide, Levy says, citing the recent Globe Spotlight series.

"Now, let's acknowledge that MGH and the Brigham are powerful brands," Levy writes. "To the extent patients are influenced by that reputation or other factors to migrate to the PHS facility from Norwood Hospital, the overall health care bill for the state will rise for no documented additional value to those patients or society."

A simple safety checklist before surgery saved lives in operating rooms around the world, this Globe story reported earlier this week. That spurred a simple question.

"What does it take?" Beth Israel Deaconess CEO Paul Levy asks on his blog Running a Hospital. Why aren't hospitals adopting the checklist Dr. Atul Gawande of Brigham and Women's Hospital has now shown cuts complications by a third?

About 30 commenters offer answers, from hospital politics to egos to time pressures. Dr. Don Berwick of the Institute for Healthcare Improvement says this:

"As 'duh' as the checklist looks (and it's really 'duh'), this is still a 'good people - bad system' thing, mostly," Berwick writes.

And Gawande himself joins the discussion:

"The intervention is simple. It is 'obvious,' " he writes. "And it is really really hard."

Levy calls the debate amazing.

"It is almost like a seminar on quality and safety improvement!" he said in an e-mail to the Globe.

The head of a Framingham hospital says plans by a Partners HealthCare affiliate to open an outpatient center in the town threaten his hospital and could duplicate services, according to the MetroWest Daily News.

MetroWest Medical Center CEO Andrei Soran told the paper that Newton-Wellesley Hospital's proposed clinic for routine orthopedic and gastrointestinal cases could take away patients and force him to reduce staff at Framingham Union hospital and its partner, Leonard Morse Hospital in Natick. Newton-Wellesley is part of Partners HealthCare, whose hospitals also include Brigham and Women's Hospital and Massachusetts General Hospital in Boston. A Globe Spotlight report examined Partners' push into the suburbs.

A Partners spokeswoman said the project will relieve crowding on the Newton-Wellesley campus.

"This is not about competing with MetroWest Medical Center," Rachel Kagno told the paper. "The people who will be treated in Framingham are people who would have come to (Newton-Wellesley) anyway."

Soran disagrees.

"It has very little to do with existing capacity," at Newton-Wellesley, Soran says in the story, citing Partners expansion projects on the North Shore and in Foxborough. "It has to do with a growth strategy in capturing new markets and accessing new patients."

Newton-Wellesley's proposal does not fall under new rules set last month by the state Public Health Council that require reviews of medical expansions to guard against duplicating services. The $17.5 million budgeted cost of the new center falls below the $25 million cap that would trigger the oversight, the story says.

By Liz Kowalczyk, Globe Staff

Deaths and complications dropped by an astounding 36 percent when operating room doctors and nurses completed a simple safety checklist before, during and after surgery, according to a study led by Harvard researchers.

The eight hospitals that participated in the study in eight countries collectively reduced complications during patients' hospital stays from 11 percent of patients before they began using the checklist to 7 percent of patients with the checklist.

The improvement means that 158 of 3,955 surgery patients whose cases included the checklist potentially avoided complications such as an infection, re-operation or death. Deaths alone dropped from 1.5 percent of patients to 0.8 percent.

"This was beyond anything we expected,'' said Dr. Atul Gawande, senior author of the Harvard School of Public Health paper and a surgeon at Brigham and Women's Hospital. "We had hoped to see a 10 percent reduction in complications.'' The impact of all the items on the checklist "put together seems to have produced these really remarkable results,'' he said.

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Newer medications designed to treat serious mental illnesses such as schizophrenia and bipolar disorder without troubling side effects pose the same risk of sudden cardiac death as older drugs, a new study shows.

The findings about the newer -- or "atypical" -- drugs spur a call for closer monitoring of the their use, especially when prescribed for other conditions.

People who took atypical antipsychotic drugs, including best-sellers Zyprexa (olanzapine), Risperdal (risperidone), and Seroquel (quetiapine) were at least as likely to suffer a fatal heart rhythm disturbance as people who took older, "typical" antipsychotics such as haloperidol (Haldol) and thioridazine (Mellaril), researchers from Vanderbilt University School of Medicine report in tomorrow's New England Journal of Medicine. A person's risk rose with the amount of the drug they were taking, the large study showed.

Drug specialists from Harvard Medical School urge a sharp reduction in the drug's "off-label" use, which means prescriptions for reasons other than for which the drug has been approved. That was seen as especially important for children and for the elderly with dementia. Screening is recommended for heart problems in patients who have no alternatives, according to an editorial also appearing in the journal.

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Getting a good night's sleep might not cure the common cold, but new research hints it could prevent one.

People who averaged less than seven hours of sleep a night were about three times more likely to develop cold symptoms than others who got eight or more hours of sleep, Pittsburgh researchers report in the Archives of Internal Medicine. Others who had a hard time falling asleep or woke up in the middle of the night fared even worse: Their chances of coming down with a cold were up to 5 and a half times higher than people who were sound asleep -- and stayed that way -- as soon as their heads hit the pillow.

"This is a huge effect," Dr. Charles Czeisler, chief of sleep medicine at Brigham and Women's Hospital, said in an interview. He was not involved in the study. "These results really fit in very well with what has been becoming increasingly clear, which is that sleep has major effects not only on the brain in terms of alertness and performance, but also on the health of the body."

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The Portland Trail Blazers call him "the sleep doctor."

Dr. Charles Czeisler of Brigham and Women's Hospital and Harvard Medical School is well known in local and international medical circles as a researcher specializing in the body's internal clocks. NASA has called on him to advise about the rigors of extended space missions. US Olympic athletes have learned how to stay well-rested and in top form.

According to a story in yesterday's Oregonian, Czeisler connected to the Trail Blazers through team doctor Don Roberts, a medical school classmate at Stanford.

After a consult in the fall, Czeisler has revamped the team's travel and practice schedules based on two simple ideas: stay on West Coast time and protect time for sleep.

"This is a relatively simple way to take advantage of their talent to the fullest," Czeisler told the Oregonian. "In the same way the team needs to stay in sync with each other on the court, they need to be in sync internally and physiologically, in order to perform."

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A pharmaceutical company has enlisted doctors at two Boston hospitals in a pilot project to spot drug risks sooner, according to today's Wall Street Journal.

Pfizer Inc. is funding a program at Brigham and Women's Hospital and Massachusetts General Hospital through which 30 doctors will note possible drug side effects and safety risks on patients' electronic charts rather than through separate reports. Data on serious adverse events (without personal patient information) will be sent automatically from the patients' electronic records to an outside company, and then on to the Food and Drug Administration, the Journal says.

The idea, also being tested by drug maker Eli Lilly in Indiana, is to make it simpler and quicker to detect possible hazards of new drugs.

Brigham and Women’s Hospital surgeon Dr. Atul Gawande questions how the nation's healthcare system pays the declining number of doctors trained to care for older people.

"There’s been a drastic decline in the number of geriatricians — and just 300 new ones are being trained each year — yet the number of people over 65 will double in the next 20 years," Gawande told the New York Times in a story posted today. "Those who work in geriatric care are among the worst paid in the health care system. Is the time I spend as a surgeon excising a patient’s cancer worth 10 times more than the time the primary care doctor spent finding the cancer in the first place?"

A Boston hospital poised to offer face transplants has enlarged the pool of patients it would consider for the life-changing surgery, the doctor leading the program said today after the first face transplant in the nation was reported.

Dr. Bohdan Pomahac, a plastic surgeon at Brigham and Women's Hospital, welcomed today's announcement by the Cleveland Clinic that its surgeons had replaced 80 percent of a woman's face with the face of a deceased female donor, making it the fourth face transplant in the world.

"I think it's very exciting," Pomahac said in an interview. "I hope it's going to open the door for many more patients and allow us to help them."

Three years ago the world's first face transplant gave a new face to a French woman who had been mauled by her dog. Since then a Chinese man who had been attacked by a bear and a French man with a disfiguring genetic condition have had face transplants. Like other transplant recipients, they have to take drugs to suppress their immune systems in order to prevent rejection of donor tissue. But because face transplants aren't life-saving surgeries, debate has arisen on whether it is ethically acceptable to put these patients on such powerful drugs for the rest of their lives.

The Brigham said last year it would offer face transplants only to people who were already taking the anti-rejection drugs. That limited the candidates to people who had already received transplants, such as a kidney or pancreas. Some of those patients develop cancers of the face that can be disfiguring, a possible side effect of the drugs that makes them more vulnerable to infections and cancer.

But in May the hospital expanded its protocol to anyone whose deformity involves 25 percent of the face or all of a major facial part such as the entire lip or entire nose. Burns, trauma, or benign tumors are common causes of this kind of disfiguring problem.

There are two reasons for the change, Pomohac said. Three years after the first transplant, the patient's function and sensation have been encouraging. At the same time, immune-suppressing drugs have been less problematic. In more than 100 patients who had limb transplants, which are similar to face transplants because they also involve a combination of skin, fat, muscle, and bone, no cases of skin cancer or kidney failure have been reported, Pomohac said.

"I still believe that a previously immune-suppressed organ transplant patient would be the ideal candidate, but there are just too few of them," he said.

Potential face transplant patients are being interviewed, he said. The New England Organ Bank, the region's organ-procurement organization, approved the Brigham's program earlier this year.

"It is an entirely new hope for these patients," Pomahac said. "We don't quite understand how bad life is for them."

Dr. Paul Farmer, known around the world for health initiatives modeled on his success in Haiti, returned to his hometown to accept an honor from the people who knew him way back when.

The Brigham and Women's physician and founder of Partners in Health, which has built health networks in Rwanda, Russia, and Peru as well as Haiti, went back to Florida to accept the 2008 Great Brooksvillian lifetime citizenship award, the St. Petersburg Times reports.

“You can only have one hometown,” Farmer told the paper.

Farmer, who has not been back to Brooksville since his father died in 1984, recalled how his family of eight lived first in a bus parked at a campground and then moved to a houseboat docked in the gulf, according to the story.

Compared to what he has seen in his work around the world, he thinks of his hometown as “beautiful, safe and wonderful Brooksville.”

Online second opinions get a second look in Newsweek.

Partners Online Specialty Consultations, which draws experts from Massachusetts General Hospital, Brigham & Women's Hospital, and Dana Farber/Partners Cancer Care, has done roughly 5,000 domestic consults since it began nine years ago, according to the story. The Cleveland Clinic launched its MyConsult program eight years ago and the Mayo Clinic is considering jumping into the market, too, the story says.

Not all insurers cover the service, which can cost up to $1,000, and some state regulations require a referral from a physician.

Online second opinions have their limits, Joseph Kvedar, founder and director of Partners Center for Connected Health, told Newsweek.

"We aren't providing the whole care package," he said. "An online second opinion doesn't replace the caring part of medicine; it's much more technical. That's why we are so keen on having a local partner."

Hopes that taking vitamins and other supplements might cut the risk of cancer took another blow in two new studies published today in the early online version of the Journal of the American Medical Association.

One large, randomized clinical trial led by Dr. J. Michael Graziano of Brigham and Women's Hospital found that middle-aged men who took vitamin E or vitamin C for about eight years did not have a lower risk of developing prostate cancer or other kinds of cancer compared to similar men who took placebos.

Another large trial from the University of Texas M.D. Anderson Cancer Center studying the effect of selenium and vitamin E on cancer risk was halted early when neither supplement showed any benefits to the men taking it. Final results told the same story: Selenium or vitamin E, taken alone or together, did not reduce the risk of prostate or other cancers in men at least 50 years old.

"It may be time to give up the idea that the protective influence of diet on prostate cancer risk — which is clearly observed in migrant studies and in populations transitioning to a Western diet — can be emulated by isolated dietary molecules given alone or in combination to middle-aged and older men," Dr. Peter H. Gann of the University of Illinois at Chicago writes in an editorial published with the two studies.

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Doctors using hand-held electronic devices to prescribe medications for their patients were more likely to make lower-cost choices than physicians using paper prescription pads, a study of two Massachusetts health plans found.

Researchers led by Dr. Michael A. Fischer of Brigham and Women's Hospital compared the prescribing habits of physicians before and after an e-prescribing system was rolled out in 2003 by Blue Cross Blue Shield of Massachusetts and Tufts Health Plan. The system color-coded medications in three tiers: green for tier 1 medications, which were all generic, cost the least, and carried the lowest co-payments; blue for tier 2 medications, which cost more and had higher co-pays; and red for tier 3 medications, which cost the most, were available in generic form, and had the highest co-pays.

Over the 18 months of the study, doctors using e-prescribing and its cues to cost savings were 3.3 percent more likely than other doctors to prescribe cheaper tier 1 medications. That translates into an annual savings of 70 cents per patient per month. During the study period, e-prescriptions accounted for 20 percent of prescriptions.

"Complete use of e-prescribing system ... could reduce prescription drug spending by up to $3.9 million per 100,000 patients per year," the authors write in the Archives of Internal Medicine. "Even in the context of pay-for-performance incentives, pharmacy regulations, and increasing overall use of generics, we still found a large potential savings from e-prescribing."

We all know driving is a complicated business, but that doesn't keep us from doing a lot of other things behind the wheel.

So when we siphon off some brainpower to talk on our cell phones, how much does it really matter?

A lot, say Boston researchers. As in, reducing emergency stopping distance by more than a car length if you are driving 60 miles an hour.

People tracking multiple objects on a screen -- a simulation analogous to the visual, physical and cognitive demands of driving -- took a little longer to react when they were just listening to someone talk, researchers reported. But listening and talking on a cell phone added significantly to their reaction times.

"If we assume that this result would generalise to driving, talking on a mobile phone would lead a driver going 60 mph to travel an additional 18.5 feet (more than the length of an average car) before braking," Todd Horowitz and Michael Cohen of the Brigham and Women's Hospital and co-authors write in the Psychonomic Bulletin and Review.

Don't think your hands-free phone gets you off the hook. The researchers say putting conversation on a speaker phone made little difference. It's the conversational give-and-take that drains some of the attention needed to drive, adding to competing demands on our visual and cognitive abilities.

By Elizabeth Cooney, Globe Correspondent

It's not just the marathon hours that doctors-in-training work but the lack of sleep they get between shifts that can impair their performance and potentially harm patients, says a national report recommending board changes by hospitals.

The Institute of Medicine, commissioned by Congress to study residents' hours five years after the first voluntary limits were put in place, suggests protected sleep" periods during lengthy shifts, closer supervision by senior physicians, and better communication during handovers of patients from one resident to another.

"Our overarching conclusion is that the science clearly shows that fatigue increases the chances of errors, and residents often work long hours without rest and regular time off," Dr. Michael M.E Johns, chancellor of Emory University and chair of the committee that prepared the report, said in a conference call with reporters today.

But the changes would be expensive, costing an estimated $1.7 billion to pay for others to fill in for residents who are off-duty. Boston teaching hospitals said it was too soon to say whether they would adopt any of the changes.

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CNN asked some celebrated health experts what kind of vitamins or other supplements they take to maintain good health.

The question is timely, given recent reports from Brigham and Women's researchers that vitamins C and E apparently don't protect men against heart disease. And scientists from the Los Angeles Biomedical Research Institute found that vitamin D and calcium didn't affect the development of breast cancer in women.

Dr. Walter Willett of the Harvard School of Public Health, Dr. Andrew Weil of the Arizona Center for Integrative Medicine, Dr. Christiane Northrup, author of "The Secret Pleasures of Menopause," and Dr. Melina Jampolis of Drmelina.com all shared their supplement habits.

Willett's list was the shortest: He takes a multivitamin and vitamin D.

What about vitamins C and E and heart health?

"I don't think we have the final answer," he told CNN, citing the Women's Health Study and a 24 percent reduction in total cardiovascular disease mortality among women in that study taking vitamin E.

By Stephen Smith
Globe Staff

Boston researchers reported this morning that they have developed a strategy that dramatically reduces the risk of heart attacks, strokes, and even death among older adults who don't have the traditional warning signs of perilously clogged arteries.

Using a test they pioneered, scientists from Brigham and Women's Hospital screened patients for evidence of cardiovascular disease missed by conventional cholesterol tests and then gave them preventive doses of a type of drug known as a statin.

The result: Heart attacks and strokes were cut by roughly 50 percent among patients who received the pill as part of a sprawling medical study that spanned 26 countries and included nearly 18,000 people. And the patients who received the medication rosuvastatin, marketed under the brand name Crestor, suffered only one side effect potentially linked to
the pill, according to the study, which was paid for by the drug's maker, AstraZeneca.

A half-dozen specialists not involved in the research predicted that the findings, presented in New Orleans at an American Heart Association convention that attracts thousands of cardiologists, will spawn a seismic shift in heart disease prevention. Describing the study as a landmark, the doctors said millions of patients who previously would not have been
considered candidates for statins now appear destined to receive some form of the medication widely used to lower cholesterol.

"The extent of reduction in death, heart attacks, and stroke is larger than we've seen in any trial I can remember," said Dr. Steven Nissen, a prominent Cleveland Clinic cardiologist. "I don't know how you get much bigger than that."

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Folic acid supplements that fortify our food, and two B vitamins many of us swallow in our daily multivitamins, are thought to play a role in preventing cancer, especially colorectal and breast cancer, but studies have shown mixed results.

A team led by researchers at Brigham and Women's Hospital weighed this question when they looked at cancer risk in more than 5,000 women who were enrolled in a large randomized clinical trial designed to test the supplements' role in preventing cardiovascular disease. The concern centers on folic acid, a synthetic form of folate added to the food supply since 1998 to reduce the risk of neural tube defects.

Folate may play a role in the progression of cancer. Early in the process, folic acid supplements appear to prevent tumors in people who have low folate levels, the authors say citing other research, but later on, folic acid may encourage tumors to develop in people with high folate levels.

The Boston researchers report in the Journal of the American Medical Association that daily supplements of folic acid and vitamins B6 and B12 had no significant effect on the risk of cancer among the women, who were followed for more than seven years.

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Cancer patients and their families traveling to Boston for treatment have a new place to stay.

The AstraZeneca Hope Lodge Center in Boston will officially open its doors at 125 South Huntington Ave. in the city's Jamaica Plain neighborhood next week and welcome patients the first week of November. The 28th Hope Lodge in the country established by the American Cancer Society, it offers a free, temporary home in the form of 40 suites and space for shared cooking and dining. Transportation to treatment is also free, as are counseling and other support services.

AstraZeneca, a drug manufacturer, contributed $7 million as a naming gift. A $27 million fund-raising campaign began with $2.5 million from the Dana-Farber Cancer Institute and $2 million each from Brigham and Women's Hospital and Massachusetts General Hospital. The hospitals' support allowed the Cancer Society to buy the property.

There are two other Hope Lodges in New England: Worcester Hope Lodge, which opened in 1986, and Hope Lodge in Burlington, Vt., which opened in 1985.

Six Boston-area experts in healthcare, medicine, and science have been elected to a national advisory group on human health.

The Institute of Medicine, created by the National Academy of Science as an independent source of scientific analysis, has named 65 new members chosen for their professional achievement and commitment to service. The Boston and Cambridge members are:

Maureen A. Bisognano, executive vice president and chief operating officer, Institute for Healthcare Improvement

Dr. Phyllis Jean Kanki, professor, department of immunology and infectious diseases, Harvard School of Public Health

Raju S. Kucherlapati, professor of genetics, Harvard Medical School, and scientific director, Harvard Medical School-Partners HealthCare Center for Genetics and Genomics, Brigham and Women's Hospital

Marsha A. Moses, professor of surgery, Harvard Medical School; and interim director, vascular biology program, Children's Hospital Boston

Dr. David C. Page, director, Whitehead Institute, and professor of biology, Massachusetts Institute for Technology

Louise M. Ryan, chair of the department of biostatistics, Harvard School of Public Health

Drug-coated stents get a vote of confidence from a Massachusetts study of heart attack patients appearing in tomorrow's New England Journal of Medicine.

Harvard researchers analyzed Massachusetts Data Analysis Center records of more than 7,000 heart attack patients whose coronary arteries were propped open with the tiny wire mesh tubes after blockages were cleared. About 4,000 had drug-coated stents and about 3,000 had bare metal stents. The drug is intended to reduce the chances of arteries closing up again. In a study funded by the state Department of Public Health, patients were matched according to their risk factors and then compared based on what kind of stent they received.

The patients, who had their heart attacks between April 2003 and September 2004, were followed for two years. The ones who had drug-coated stents fared better than the ones with bare metal stents, both in survival and in the need for repeat procedures to open up their coronary arteries.

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Women who do it all -- eat well, exercise daily, maintain a healthy weight, and never smoke -- are less likely to die from chronic diseases than their peers who don't keep such good habits. That may not be a shock, but the power of combining all four hallmarks of a healthy lifestyle turned out be greater than any one of those factors alone, including not smoking.

Harvard researchers followed 77,782 healthy women who were 34 to 59 years old for 24 years. Over that span, 8,882 women died. An estimated 55 percent of deaths from all causes could have been avoided if the women followed those four healthy behaviors, including 44 percent of cancer deaths and 72 percent of cardiovascular deaths, according to their analysis. The authors, who report their findings in the British Medical Journal, attribute 28 percent of deaths to smoking, 14 percent to being overweight, 17 percent to being physically inactive, and 13 percent to a poor diet.

The researchers reached their risk estimates by comparing women in the low-risk category for each risk factor with all other women.

"I think we all know that smoking has a major impact on health, so we were not surprised that smoking had a major impact on deaths," lead author Rob M. van Dam, assistant professor of medicine at the Harvard School of Public Health, said in an interview. "But it was a surprise that combined with a modest change in diet, physical activity, and a healthy weight, you could have avoided the estimated 55 percent of deaths, so almost double the deaths attributed to smoking."

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Vioxx, the painkiller pulled from the market in 2004 after it was shown to double the risk of heart attack and stroke, has become the poster child for reforming drug-safety oversight. The 2007 Food and Drug Administration Amendments Act is intended to give the agency more authority to gather information about problems caused by drugs, before and after approval.

But what if the only safety data available comes from company-sponsored trials or small studies comparing competing drugs? That can mean the FDA is issuing warnings about drug side effects based on sometimes incomplete or unreliable data, Dr. Jerry Avorn of Harvard Medical School and Brigham and Women's Hospital writes in the New England Journal of Medicine.

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IT leaders at three Boston-area healthcare providers have won laurels from a high-tech magazine.

Chief information officers at Brigham and Women's Hospital, Dana-Farber Cancer Institute, and the Massachusetts Developmental Disabilities Council have made the 2008 CIO 100, an honor roll for innovation through technology.

Sue Schade of the Brigham was singled out for implementing a system that uses data from patient encounters to set strategy for operations throughout the hospital, whether in patient care or in the business office, the magazine said.

Jeff Kessler of Dana-Farber was honored by the magazine for setting up a system to collect clinical research study data electronically rather than on paper reports.

Craig Hall of Mass. Developmental Disabilities won recognition from the magazine for creating a system that similar councils in 36 states use to provide performance data to states, federal agencies, and Congress, saving nearly $3.5 million in administrative costs.

Incorrect drug information is entered into patients' medical records an average of almost one and a half times per hospitalization, a study shows. Most of those discrepancies stem from errors in the medical history taken when patients are quizzed as they enter the hospital, but the potential for harm from these mistakes would be greatest after they left the hospital.

Researchers from Brigham and Women's Hospital and Massachusetts General Hospital followed 180 patients for two months at both hospitals to assess the accuracy of the information on the medications they were taking. They report in the Journal of General Internal Medicine that almost three-quarters of the mistakes were made when a list of drugs was being drawn up when the patients were being admitted. The remaining errors cropped up when discharge orders didn't match records from the patient's hospital stay.

Three-quarters of the problems from the wrong drug information had the potential to harm the patients after they left the hospital, which the authors said was not surprising. A mild overdose of the blood-thinner warfarin, for example, would be less dangerous while the patient was being closely monitored in the hospital than after being sent home.

"This information can help guide hospitals in determining where to focus their efforts for addressing this problem," lead author Dr. Jeffrey Schnipper of Brigham and Women's said in a statement.

Drug-resistant tuberculosis comes in two forms: bad and worse. New research from Harvard shows progress against the worst kind.

People with multidrug-resistant tuberculosis can't be helped by two first-line drugs, cutting down their chances of being cured. People whose disease does not respond to those two first-line drugs or to three classes of second-line drugs have what is called extensively drug-resistant tuberculosis, or XDR TB. Their chances of cure are even lower. First reported in 2006, the XDR TB strain has been found in 49 countries.

Writing in the New England Journal of Medicine, researchers from Harvard, working with colleagues in Peru, report good news in the battle against XDR TB. Their retrospective study found that an aggressive, comprehensive treatment program tailored to individual patients cured more than 60 percent of patients whose previous therapy had failed.

“It’s essential that the world know that XDR-TB is not a death sentence,” lead author Carole D. Mitnick of Harvard Medical School said in a statement.

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Before tonight's Red Sox-Yankees tilt, CVS/pharmacy will present $4.4 million from donations made in its stores to the Needham-based ALS Therapy Alliance. Scientists involved with the alliance work at Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Boston University, Harvard University, Massachusetts General Hospital, MIT, and the University of Massachusetts. Three researchers are on deck for tonight's first pitch ceremony: Dr. Robert H. Brown Jr. of Mass. General, Tom Maniatis of Harvard, and Craig Mello of UMass Medical School.

Researchers at Boston Medical Center have won a five-year, $5.4 million federal grant to test a program to detect and treat drug abuse in primary care visits. The project, funded by the National Institutes of Health, will compare standard screening and counseling for drug use with a more intensive model.

By Neil Munshi, Globe Correspondent

Low-carbohydrate and so-called Mediterranean diets may be more effective than low-fat diets, according to a major new study published in tomorrow’s New England Journal of Medicine.

Researchers studied 322 moderately obese employees of a research center in Israel, randomly assigning them to three diet groups, and providing them with encouragement and instruction over a two-year period.

Members of the low-fat group lost an average of 6.4 pounds, while those in the low-carb and Mediterranean groups lost about 10, said Dr. Meir Stampfer, associate director of the Channing Laboratory at Brigham and Women's Hospital, and the paper's senior author.

While there has been concern that low-carb diets can be harmful to cardiovascular health, Stampfer said that the participants who followed the low-carb and Mediterranean diets actually had better cardiovascular health than those in the low-fat group. (The study was funded in part by the Dr. Robert C. and Veronica Atkins Foundation, which supports independent scientific research. The late-Robert Atkins was known for promoting a low-carbohydrate diet.)

For people with cholesterol problems, the low-carb diet seemed best; for those at risk for diabetes, the Mediterranean diet provided more health benefits.

"The take-home message should be that we should abandon the idea that low fat diets are the number one way for people to lose weight –- it wasn’t the best diet, it can be helpful for some people, but overall I think the first choice should be the Mediterranean or the low carb," he said.

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Two Boston hospitals make US News & World Report's latest Best Hospitals rankings look a little like "Partners and Everyone Else," to borrow a phrase from former Globe business columnist Steve Bailey.

That's because Partners stalwarts Massachusetts General Hospital and Brigham and Women's Hospital are the only ones in the state to crack the magazine's 19-member Honor Roll. The distinction signifies hospitals that scored at or near the top in at least six of the list's 16 specialties. Pediatrics will have its own ranking in the fall.

Not that other hospitals didn't perform well. Our medical mecca's reputation is still intact with Beth Israel Deaconess Medical Center, Dana-Farber Cancer Institute, Massachusetts Eye and Ear Infirmary, McLean Hospital, and Spaulding Rehabilitation Hospital all finishing in the top 10 of various specialties.

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Two Boston researchers are among five young doctor-scientists receiving three-year, $450,000 grants to study cancer therapies. The Damon Runyon Cancer Research Foundation pairs clinical investigators with mentors to encourage physicians to translate scientific discoveries into treatments.

Dr. Andrew T. Chan of Massachusetts General Hospital is testing new ways to detect colorectal cancer through methods that may help in developing ways to treat and prevent the cancer. He will work with mentors Dr. Charles S. Fuchs and Dr. Ralph Weissleder at Mass. General.

Dr. Rachael A. Clark of Brigham and Women’s Hospital is studying how the immune system controls squamous cell carcinomas and how to develop new treatments for this form of skin cancer. Her mentor is Dr. Thomas S. Kupper of the Brigham.

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Imagine an itch so terrible it takes over your whole life. Or your brain.

Dr. Atul Gawande of Brigham and Women's Hospital ponders the mysteries of itch and other sensations, writing in the current New Yorker about pain, its perception, and what might be an entirely different order of sensation. He queries dermatologist Dr. Jeffrey Bernhard of University of Massachusetts Medical School and neurologist Dr. Anne Louise Oaklander of Massachusetts General Hospital about a puzzling case that nearly destroyed a woman's life.

"We now have the nerve map for itching, as we do for other sensations," Gawande writes. "But a deeper puzzle remains: how much of our sensations and experiences do nerves really explain?"

Risk factors for developing eating disorders are different for girls and boys, and a mother’s history may affect girls differently depending how old they are, a Boston study reports.

Alison E. Field of Children’s Hospital Boston and her colleagues report in the Archives of Pediatric and Adolescent Medicine on their study following more than 12,000 sons and daughters of participants in the Nurses Health Study II to see what influences might predict eating disorders. The girls and boys answered questionnaires every 12 or 18 months for seven years, starting when they were 9 to 15 years old. Their mothers were asked if they themselves had ever had an eating disorder.

After seven years, 10 percent of the girls and 3 percent of the boys said they were binge eating – overeating and feeling out of control -- or purging – vomiting or using laxatives to keep from gaining weight -- at least once a week. For girls, purging was more common than binge eating. For boys, the opposite was true. Few boys or girls did both, the study said.

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By Kay Lazar, Globe Staff

Boston's three leading medical schools are among 14 nationwide that will receive federal grants aimed at helping scientists more quickly turn their discoveries into treatments for patients.

Under the program, Harvard Medical School has been awarded $117.7 million over the next five years, while Boston University Medical School will receive $23 million and Tufts University School of Medicine $20 million over that time period, the National Institutes of Health announced today.

The awards reflect a sea change in federal funding for scientific research. Schools that have traditionally competed within their own institutions for federal dollars must now form one collaborative center at each medical school to pull together all of its researchers and departments.

The mission of the grant program, called the Clinical and Translational Science Award, is to create a network of medical research institutions across the country that will translate new knowledge into tangible benefits for patients. Launched in 2006, the initiative has awarded money to 24 other medical schools. Total funding for the 14 new recipients will be $533 million over the next five years, the NIH said.

"Everybody knows there is a lot of great research going on but it doesn’t get to public practice," said Dr. Harry Selker, director of Tufts' new Clinical and Translational Science Institute. "This (grant program) is a big deal for the nation."

Earlier this week we asked surgeons what they had on their iPods.

Plastic surgeon Dr. Bohdan Pomahac said he doesn't use one. Instead, he loads XM Radio over the Internet and listens to the top 100 mix when he operates at Brigham and Women's Hospital.

Vascular surgeon Dr. Marc Schermerhorn has lots of music on his iPod, as does the rest of the OR team. They equipped each of the three rooms they work in at Beth Israel Deaconess Medical Center with docking stations so they can bring in their own selections.

"It definitely makes everyone happier if they listen to music they like," he said.

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The federal government wants you to know how your local hospitals stack up, so today it is running newspaper ads in all 50 states -- including in the Boston Globe -- comparing local hospitals on two measures of quality and patient satisfaction.

In the Boston area, Beth Israel Deaconess Hospital -- Needham rated last in both categories. The hospital said today it has made improvements since the data were collected, from July 2006 through June 2007.

The numbers aren’t new, but the $1.9 million public push to get consumers onto the web site is.

“This is really trying to create a conversation over dinner tables in America and also in the community about how you choose a hospital,” Kerry Weems, acting administrator of the Centers for Medicare and Medicaid Services, said in a teleconference with reporters. “The goal is to drive the quality of healthcare up, drive costs down, and give consumers choice.”

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MIT biochemist Alexander Rich has won the Welch Award in Chemistry for his fundamental insights into the structure and function of RNA and DNA. He will receive the $300,000 prize in October.

Caritas Christi Health Care's senior vice president and chief information officer is leaving for Vermont. Charles H. Podesta, 50, will become chief information officer of Fletcher Allen Health Care in Burlington, Vt., in June. Last month Roger Deshaies, formerly senior vice president for finance at Brigham and Women’s Hospital, joined Fletcher Allen as its chief financial officer. The hospital is affiliated with the University of Vermont School of Medicine.

Clifford J. Tabin, a professor of genetics at Harvard Medical School, is one of two scientists to win the 2008 March of Dimes Prize in Developmental Biology. He will share the $250,000 award with Philip A. Beachy of Stanford. They are being honored for their work with "hedgehog" genes and how they affect the way embryos develop and form limbs, the brain, and other organs. Hedgehog genes got their name from the prickly appearance they gave fruit fly embryos.

Dr. Andy Whittemore, chief medical officer at Brigham and Women's Hospital, has been elected president of the American Surgical Association. Whittemore trained as a vascular surgeon, was a division chief at Brigham and Women's, and has been chief medical officer there since 1999.

Women who took folic acid and B vitamin supplements had the same rate of cardiovascular disease as women who didn't, a new study in the Journal of the American Medical Association reports, adding to the list of substances that showed promise in earlier observational studies but not in more rigorous trials.

Researchers led by Dr. JoAnn E. Manson of Harvard Medical School and Brigham and Women's Hospital studied 5,442 women in the health profession who were at least 42 years old and had a history of cardiovascular disease or three or more risk factors for it. For more than seven years, half were given a pill containing folic acid plus two B vitamins and half were given a matching placebo.

The supplements did lower the women's levels of homocysteine, an amino acid previously implicated in the risk of cardiovascular disease. But women randomly assigned to receive the vitamins had about the same number of heart attacks, strokes, coronary artery blockages, or deaths as the women who got dummy pills.

"This randomized trial casts further doubt on the role of folic acid and B vitamins in preventing cardiovascular disease, despite their effect in lowering homocysteine," Manson said in an interview. "It may take substantial lowering or it may be beneficial in people with extremely high levels of homocysteine, but this finding suggests folic acid and B vitamins should not be taken with the express intent of lowering cardiovascular disease."

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Doctors can make the biggest difference in bringing lessons learned from palliative care in cancer to other fatal conditions, according to a prominent scientific journal's poll.

Last month the British Medical Journal asked its readers to choose one of six topics where they thought the most improvement in patient care could be made. Two authors had written about each one, including Dr. Jerry Avorn and Dr. William Shrank of Harvard Medical School and Brigham and Women's Hospital. He discussed avoiding medication problems in older people.

More than 4,000 readers responded with these choices:

Palliative care for all at the end of life: 38 percent
Combating drug-resistant infections in the developing world: 22 percent
Better care for the elderly with multiple health problems: 17
Improving chronic pain management: 12 percent
Reducing excessive drinking in young women: 8 percent
Helping to reduce adverse drug reactions in the elderly: 3 percent

Women on hormone therapy had an increased risk of stroke whether they started taking the hormones close to menopause or at least 10 years later, a study reports, results that differ from the “timing hypothesis” suggested for estrogen and heart disease at different ages.

Harvard researchers led by Francine Grodstein write in the Archives of Internal Medicine that they found an overall increased risk for stroke of 39 percent for women taking estrogen and 27 percent for those taking estrogen plus progestin, compared to women who had never used hormones.

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Jack W. Szostak of Harvard Medical School and Massachusetts General Hospital has been honored by the Royal Netherlands Academy of Arts and Sciences with its 2008 Dr. H.P. Heineken Prize for Biochemistry and Biophysics. Szostak was recognized for his insights into the fundamental processes of life.

The Harvard School of Public Health's Nutrition Round Table bestowed its Healthy Cup Award on Dr. Kenneth Cooper, who introduced the word "aerobics" into Americans' vocabulary and helped spur a fitness movement.

Dr. Joseph Loscalzo of Harvard Medical School and Brigham and Women’s Hospital will accept the American Heart Association’s Paul Dudley White award at the Boston Heart Ball on May 10. He is being honored for his achievements in cardiovascular research.

Dr. JoAnn E. Manson of Harvard Medical School and Brigham and Women's Hospital has received the Premio Benessere Stresa International Prize for Research and Innovation Related to WellBeing for her research related to women's health. The prize is sponsored by the Centro Benessere Stresa and the Giovanni Lorenzini Medical Foundation in Milan, Italy.

In two separate reports yesterday, two international teams led by Ram Sasisekharan of the Harvard-MIT Division of Health Sciences and Technology offered insights into the contamination of the blood-thinner heparin that has been linked to 81 deaths since November.

How the contaminant entered the manufacturing process is still a mystery, but the researchers have confirmed the identity of the chemical culprit, and explained why it eluded detection, and how it caused serious reactions in so many people. Patients typically need the drug to prevent blood clots while they undergo kidney dialysis or cardiac surgery. The main ingredient for heparin, which is manufactured in China, is derived from pig intestines.

In one paper, Sasisekharan’s team confirmed that the contaminant is a complex sugar known as oversulfated chondroitin sulfate, and showed why its chemical structure made it particularly difficult to detect. The report appears in Nature Biotechnology.

The second team showed the biological link between the contaminant and the symptoms reported in patients who received it. They demonstrated in laboratory samples and in pigs how the contaminant triggered an allergic-like immune response and lowered blood pressure. Patients who suffered bad reactions after receiving the tainted heparin had extremely low blood pressure, shortness of breath, nausea, and swelling of the skin and mucous membranes. This work is described in the New England Journal of Medicine.

Both teams included researchers from Momenta Pharmaceuticals in Cambridge, which makes products that analyze complex mixtures. Sasisekharan receives consulting fees from Momenta.

Bar-coding surgical sponges makes them less likely to be lost, Boston researchers report.

Doctors from Brigham and Women’s Hospital found that a bar-code tracking system worked better than a simple count of sponges used during 300 operations, potentially reducing the risk of leaving a sponge inside a patient. The study, supported by SurgiCount Medical, the California maker of the systems, appears in the Annals of Surgery.

Bar-coding systems, using the black bars on stickers familiar from retail check-out counters, have become more common in healthcare. When added to medication labels, they have reduced the risk of harm from errors by 97 percent, according to research cited by Dr. Caprice C. Greenberg and co-authors. The same kind of system proved more accurate as a way to keep track of sponges than traditional counting methods, detecting 32 counting discrepancies (miscounted or misplaced sponges) compared with 13 found by simple counting.

Where can doctors make the biggest difference in patient care?

The British Medical Journal wants to know.

The journal culled six choices from a list of 200 topics and is publishing two articles about each issue, one stating the problem and another proposing how to solve it. Dr. Jerry Avorn and Dr. William Shrank of Harvard Medical School and Brigham and Women’s Hospital write about medication problems in older people.

The nominees are:

-- Drug-resistant infections in poor countries
-- Multiple health problems in elderly people
-- Excessive drinking in young women
-- Management of chronic pain
-- Adverse drug reactions in elderly people
-- Palliative care beyond cancer

Readers can vote until April 16; results will be revealed April 25.

Three Boston healthcare honchos made the Modern Physician list of the 50 most powerful physician executives.

Dr. James Mongan of Partners HealthCare System was the business publication's top doctor, followed by Dr. Donald Berwick of the Institute for Healthcare Improvement.

Dr. Gary Gottlieb of Brigham and Women's Hospital trailed his colleagues in 33rd place. But that wasn't far behind 29th place Dr. Elias Zerhouni, director of the National Institutes of Health. Dr. Julie Gerberding, director of the US Centers for Disease Control and Prevention, followed at 34th.

A prominent cardiologist is leaving the Cleveland Clinic to join Brigham and Women's Hospital and the VA Boston Healthcare System.

Dr. Deepak L. Bhatt (left), who had been associate director of the cardiovascular coordinating center at the Cleveland Clinic, will become director of the interventional cardiovascular program at the Brigham and chief of cardiology at VA Boston Healthcare. He will also become a senior investigator at the Thrombolysis in Myocardial Infarction Study Group at the Brigham. He was an undergraduate at MIT, earned his medical degree at Cornell, and is working on a master's degree at the Harvard School of Public Health.

Bhatt is the fifth cardiologist to leave the Cleveland Clinic over the last several months, according to the Cleveland Plain Dealer. The Brigham saw its own flurry of departures last year, some to competitors of the Cleveland Clinic, as this White Coat Notes story details.

“I had a wonderful time at the Cleveland Clinic, a fantastic place from which I would have been happy to retire," Bhatt said in a statement from the Brigham announcing his hiring. He called the opportunity at the Brigham and the VA Boston "too great an opportunity to pass up."

Drugs that were approved by government regulators just before their deadlines were much more likely to have later safety problems than medications approved at other times, Harvard researchers report.

Writing in tomorrow's New England Journal of Medicine, Daniel Carpenter and colleagues say congressional mandates to speed up the US Food and Drug Administration review process for new drugs have been followed by spikes in the number of new medications approved in the weeks before deadlines.

"The ones that are piled up before deadlines are significantly more likely to experience safety problems," Carpenter said in an interview.

The FDA disagrees with Carpenter's analysis of approvals after the Prescription Drug User Fee Act was enacted.

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Dr. Charles A. Czeisler, director of sleep medicine at Harvard Medical School and chief of sleep medicine at Brigham and Women's Hospital, has won a lifetime achievement award from the National Sleep Foundation.

Dr. Martin S. Hirsch of the Massachusetts General Hospital Infectious Disease Unit and the Partners AIDS Research Center was honored with the Maxwell Finland Award for Scientific Achievement from the National Foundation for Infectious Diseases.

Dr. John A. Parrish, director of the Center for Integration of Medicine and Innovative Technology, and Dr. R. Rox Anderson, director of the Wellman Center for Photomedicine at Massachusetts General Hospital, received the 2007 Discovery Award from the national Dermatology Foundation.

Dr. Nawal M. Nour of Brigham and Women's Hospital, founder of a center devoted to the medical needs of African women who have undergone female genital cutting, will receive an honorary degree June 1 from Williams College.

The chief financial officer at Brigham and Women’s Hospital is leaving Boston for an academic medical center in Vermont.

Roger Deshaies, senior vice president for finance at the Brigham, will leave April 11 to become CFO at Fletcher Allen Health Care in Burlington, Vt. The hospital is affiliated with the University of Vermont School of Medicine.

Brigham and Women’s spokesman Peter Brown said a search is under way to replace Deshaies, who was at the hospital for about 10 years.

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The New England Organ Bank has approved Brigham and Women's Hospital's plan to perform partial face transplants. Initial recipients will have to be kidney transplant patients with severe facial disfigurement, because they are already taking immunosuppressive drugs to prevent rejection. The Brigham is the first US hospital with clearance to perform the procedure.

Hospitals, faced with soaring bond interest rates because of the global credit crunch, are seeking permission from the Securities and Exchange Commission to bid on their own bonds.

Flat growths on the colon wall are more common in Americans than previously believed and are more likely to be cancerous than polyps, according to a study in today's Journal of the American Medical Association.

A slightly elevated risk of cancer persisted in older women for more than two years after they stopped taking hormone replacement therapy, including an unexpected higher risk of lung tumors, according to the latest results from the Women's Health Initiative. The increased risk of heart attacks, blood clots and strokes appeared to disappear after post-menopausal women stopped taking the drugs estrogen and progesterone.

The Government Accountability Office will study whether the FDA approved the diabetes drug Avandia and the cholesterol drug Vytorin without sufficient evidence of their safety or effectiveness.

A new study of the multiple sclerosis drug Tysabri, made by Biogen Idec Inc. and Elan Corp. PLC, showed that some patients carried the virus associated with a potentially fatal brain infection, though they did not have the infection itself.

Colleges and universities "are in a unique position to help, and become active partners in reversing the trend of unhealthy living," Simmons College President Susan C. Scrimshaw writes in an Op-Ed piece.

A prominent Harvard physician comes down hard on conflict-of-interest rules, comparing anti-business advocates who champion them to street evangelists preaching sermons against accepting gifts or payments from medical manufacturers.

Dr. Thomas P. Stossel, a Harvard Medical School professor and hematologist at Brigham and Women's Hospital, airs his views in answer to a question posed in the British Medical Journal: Has the hunt for conflicts of interest gone too far? Stossel gives a resounding yes while Kirby Lee of the University of California at San Francisco answers with a firm no in the head-to-head feature.

The conflict of interest movement demonizes company-sponsored education, maligns researchers who fail to honor "overblown journal disclosure requirements," and labels doctors mingling with corporations "ill advised, corrupt or both," Stossel writes.

"All of these charges obscure the fact that only private companies bring new products to patients and that medical care has improved steadily and spectacularly because of them," he writes. "Fraud and pathological bias could never have conferred these monumental achievements."

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The Center for Integration of Medicine and Innovative Technology has awarded a three-year, $2.1 million grant to a group of area doctors working on a new kind of minimally invasive surgery.

Called NOTES, short for natural orifice translumenal endoscopic surgery, the technique passes surgical tools through the mouth, anus, or vagina to reach organs in the abdomen, thorax, or pelvis. It leaves no scars, promises less pain, and offers a smaller chance of infection, its proponents say, according to this Globe story last month.

Dr. David Rattner of Massachusetts General Hospital will lead the NOTES team, which includes Dr. William Brugge, also of Mass. General, Dr. Christopher Thompson of Brigham and Women’s Hospital, and Dr. Richard Rothstein of Dartmouth Medical School.

The NOTES initiative is the largest grant ever made by CIMIT, a consortium of Boston-area teaching hospitals and engineering schools.

Dialysis patients shouldn’t panic over the recent voluntary recall of a drug used as part of their kidney-failure treatments, but there is concern about a possible shortage, a Boston kidney specialist said.

On Monday the US Food and Drug Administration announced that Baxter Healthcare Corp. had stopped making multi-dose vials of the blood-thinning drug heparin after reports of 350 serious allergic reactions, including four deaths, in patients who received the drug. It still makes single-dose vials.The exact cause has not been pinpointed, but most of the problems occurred in patients who were given large doses.

A plant in China that has not been inspected by the FDA makes the active ingredient in heparin for Baxter, according to a story in today’s New York Times. That plant and one in New Jersey where the drug is packaged will be inspected by the agency.

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To live until you’re 90, make sure to exercise and not smoke.

To make it to 100, it helps if you don't develop diseases linked to aging until after 85 – and to cope with them well if you do get them.

A pair of papers by two Boston research groups appearing in tomorrow’s Archives of Internal Medicine report on what factors -- other than good genes -- allow the oldest of old people to survive. A group from Harvard Medical School found that men who lived until 90 enhanced not only their lifespan but also improved their mental and physical function if they led a healthy lifestyle in “early old age.” Researchers at Boston University’s New England Centenarian Study said the timing of illness was important in reaching 100, but coping with illness well enough to stay independent was also key to reaching 100.

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By Stephen Smith, Globe staff

Even as he forges ahead with his battle to prevent CVS Corp. from opening in-store clinics, Boston Mayor Thomas M. Menino today quietly convened a summit of high-powered medical players to examine what ails primary care in the city.

The meeting at the city's Parkman House included a who's who from Boston's healthcare landscape, including the presidents of three of the city's biggest hospitals: Elaine Ullian from Boston Medical Center, Dr. Gary Gottlieb from Brigham and Women's, and Ellen Zane from Tufts-New England Medical Center. Leaders of community health centers were there, too, along with the in-coming president of the Massachusetts Medical Society and the dean of Boston University's medical school, Dr. Karen Antman.

"We came together not just to talk about a problem that we all know has existed for some time," Menino said in a written statement after the meeting, "we came together in the spirit of creating a thoughtful and coordinated action plan to reduce barriers that limit access to important medical services."

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Karleen Habin, clinical nurse supervisor of the breast oncology research program at Massachusetts General Hospital's cancer center, has won the American Cancer Society's Lane Adams Quality of Life Award. Habin is the author of many published articles on cancer survivorship and symptom management.

Dr. Peter Black, chair of neurosurgery at Brigham and Women's Hospital, has been named president-elect of the World Federation of Neurological Societies. The organization represents about 25,000 neurosurgeons worldwide.

Dr. Julian B. Marsh, a visiting scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and head of the Lipoprotein Metabolism Section of the Atherosclerosis Research Laboratory at Tufts, has won a lifetime achievement award. The Northeast Lipid Association is honoring him for his career in lipidology, which is the study of fats and cholesterol in human metabolism.

People who suffer from sinusitis list chronic fatigue as one of their most troubling symptoms, equal to facial pain and a blocked nose. Sometimes their exhaustion is explained as sick building syndrome, chronic fatigue syndrome or multiple chemical sensitivity.

But an analysis led by a group including a Boston researcher shows that surgery to clear clogged sinuses appears to substantially improve their energy too.

Senior author Dr. Neil Bhattacharyya of Brigham and Women’s Hospital, along with researchers from Georgetown University Medical Center, St. Louis University School of Medicine, and Oregon Health and Science University, looked at 28 studies of 3,427 patients who had endoscopic sinus surgery to remove blockages. All the studies showed that patients who reported fatigue before surgery said their energy had returned to normal levels an average of one year later, the authors report today in Laryngoscope.

“Finally we have good, scientifically consistent evidence that fatigue will very often improve significantly after surgery,” Bhattacharyya said in a statement released with the study.

Adding hormone treatment to radiation therapy does not improve survival chances for prostate cancer patients who already have other illnesses when their treatment begins, a new analysis by Boston researchers shows.

Dr. Anthony V. D'Amico of Brigham and Women's Hospital and his colleagues went back to a 2004 study of hormone treatment in prostate cancer patients to compare subgroups of men whose health was different before treatment. They report their findings in the current Journal of the American Medical Association.

“There is some clinical interaction, almost like a drug interaction, between the hormone therapy and the underlying illness, particularly cardiovascular disease,” D’Amico said in an interview. “This is the strongest piece of evidence to date for looking into hormone therapy and shorter survival time for men with cardiovascular disease.”

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A team of Boston investigators has received a federal grant to understand drug-resistant tuberculosis.

Researchers from Harvard, Brigham and Women’s Hospital, and Partners in Health will use a five-year, $14 million grant from the National Institutes of Health to study how multidrug-resistant and extensively drug-resistant strains of TB are developed and transmitted. The basic and drug-resistant forms of tuberculosis combine to kill 2 million people a year worldwide.

Dr. Megan Murray of the Harvard School of Public Health and the Brigham is the principal investigator. She will work with project co-leaders Mercedes Becerra, Partners in Health founder Dr. Paul Farmer, and Dr. Lucila Ohno-Machado, all of Harvard Medical School and the Brigham.

By Carey Goldberg, Globe Staff

In a key first step from theory to possible help for cancer patients, Boston-based scientists report today that they have managed to beat back a deadly human skin cancer in mice by targeting and destroying stem cells in the tumors.

The findings on malignant melanoma add weight to the growing belief among scientists that many types of cancer recur after treatment because of small, resilient groups of stem cells that survive and start multiplying all over again.

The research, published in tomorrow's Nature, shows that attacking melanoma stem cells is enough to halt a tumor's growth, said Dr. Markus Frank of Children's Hospital Boston, the paper's senior author. It thus offers new hope that this strategy will also work in humans -- perhaps, researchers say, within a few years.

"If this works with melanoma, this may also work with other tumors that are notoriously difficult to treat" once they have spread, said Dr. George Murphy, an author on the paper and chief of dermatopathology at Brigham and Women's Hospital.

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A new cancer center will open Monday in Milford that combines services from Boston hospitals with local oncology care.

The Dana Farber/Brigham & Women's Cancer Center at Milford Regional Medical Center, a two-floor, 54,000-square-foot structure built across the street from the Milford hospital, will offer radiation therapy, imaging, medical oncology, and support services.

Milford's two oncologists and their staff will become Dana-Farber employees and provide chemotherapy. Brigham and Women's cancer specialists will offer radiation therapy and Milford will perform imaging services in the town 30 miles southwest of Boston.

Two prominent Boston cardiologists are heading south to the University of Miami, theheart.org reports today.

Dr. Vivek Y. Reddy (left), director of the experimental electrophysiology program at Massachusetts General Hospital, will lead an expanded program at the University of Miami, according to the cardiology news site of WebMD and a university statement.

"I'm going from a great job to a great job, that's what it comes down to," Reddy told theheart.org.

Dr. Andre d'Avila, another specialist in abnormal heart rhythms, is also leaving Mass. General to become associate director of the electrophysiology section.

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Surgeons who perform laparoscopic surgery on patients at Beth Israel Deaconess Medical Center now have to prove they have the motor skills necessary to do the minimally invasive operations, in what appears to be the first policy of its kind.

Since 1989, when the first laparoscopic operations were done to remove gallbladders, many other operations from weight-loss surgery to colon surgery have been adapted to use the techniques. Instead of using large incisions to reach inside the body, surgeons insert long instruments and a camera through small openings and view the surgical site on a monitor.

Most surgeons who began practicing before 1990 have not had formal training in laparoscopy, according to Dr. Daniel B. Jones, the hospital's chief of minimally invasive surgery.

Under the new policy, as surgeons' credentials come up for renewal every two years, they will be tested in a simulation center to see how well they can suture, cut in a circle, and move objects using laparoscopy instruments. They also have to take a written exam.

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Once intensive care units in Michigan began using a five-step checklist to prevent hospital infections, the program saved more than 1,500 lives and nearly $200 million over 18 months.

A stunning success, you might say, but not as surprising as what happened next, Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston, writes in Sunday's New York Times.

The Office for Human Research Protections shut the program down. By introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations, Gawande explains.

"The need for safeguards in medical experimentation has been evident since before the Nazi physician trials at Nuremberg. Testing a checklist for infection prevention, however, is not the same as testing an experimental drug," he writes. "This work is different from drug testing not merely because it poses lower risks, but because a failure to carry it out poses a vastly greater risk to people’s lives."

Taking low-dose aspirin can cut short hormone therapy used to treat prostate cancer and lead to a lower chance of survival, Boston doctors warn.

In a letter appearing in tomorrow’s New England Journal of Medicine, authors Dr. Anthony V. D’Amico and Dr. Philip W. Kantoff of the Dana-Farber Cancer Institute and Ming-Hui Chen of the University of Connecticut report that the use of low-dose aspirin can cause abnormal liver function tests in men receiving hormones for prostate cancer. That meant an early end to part of their hormone therapy and more than triple the risk of death compared to men who completed full hormone therapy, the researchers' analysis showed.

"It is important for the public to be aware that commonly used medications can interfere with the delivery of full-dose cancer therapy that may compromise curability,” D'Amico said in a statement about the findings. “Therefore, patients should inform their doctors about all of the medications (including non-prescription over-the-counter drugs such as baby aspirin) that they are taking."

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A former Harvard professor was back in Boston today urging doctors to use a tool to identify and treat drug-abuse problems that has new recognition from federal and professional bodies.

Dr. Bertha K. Madras, a psychobiology professor and researcher at Harvard Medical School until joining the White House Office of National Drug Control Policy in 2006, described the screening and brief intervention procedures at Brigham and Women's Hospital this morning.

The screening and intervention, in use since the 1980s, are designed to identify drug users before they suffer harm and to help others who need treatment -- but are not seeking it -- get specialty services. On Jan. 1, the time doctors spend giving patients a questionnaire and referring them for further help will be recognized by new billing codes from the American Medical Association and the Centers for Medicare and Medicaid Services.

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By Liz Kowalczyk, Globe Staff

A Boston surgeon who plans to do partial face transplants said he is encouraged by a mostly positive report about the French woman who received the world's first face transplant two years ago.

Doctors of Isabelle Dinoire reported in today's New England Journal of Medicine that their patient is "doing well" and that the functional and aesthetic results of her transplant are "satisfactory."

Dr. Bohdan Pomahac, a plastic surgeon at Brigham and Women's Hospital, said Dinoire's face functions extremely well. "This demonstrates for the first time, that you can achieve good function. She can articulate well, she can eat, drink, smile and socialize. Overall, it's remarkable."

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Smokers should be screened for type 2 diabetes and encouraged to quit smoking to prevent it, two Boston researchers recommend based on a new review of studies linking smoking and diabetes.

Already the leading cause of preventable death around the world, smoking has now been tied to a 44 percent higher risk of developing type 2 diabetes, Swiss researchers report in a review of 25 studies of 1.2 million people, published in tomorrow’s Journal of the American Medical Association.

Two Harvard researchers, writing in an editorial that also appears in the journal, call on physicians to test smokers for diabetes and encourage them to quit. Current US Preventive Services Task Force guidelines suggest screening adults with high blood pressure and high cholesterol while the American Diabetes Association recommends testing adults 45 and older every three years.

“Given the increased incidence of type 2 diabetes associated with smoking, it is likely important and prudent for clinicians also to screen for and carefully monitor glucose levels among current and former smokers,” write Eric L. Ding and Dr. Frank B. Hu of the Harvard School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School. “Major population prevention of type 2 diabetes is achievable by avoidance of smoking and modification of lifestyle factors through a combination of healthy weight control, regular physical activity, moderate alcohol intake, and proper diet.”

Doctors are ordering tests to screen men for prostate cancer more often, even though there is no clear evidence that the blood tests reduce deaths related to the disease, according to a study by three Boston researchers. Younger men and African-American men had the biggest increases in testing, they found.

Prostate cancer is the most common cancer among men in the United States, with 200,000 new cases expected by the end of 2007. About 12 percent of these men will die of the disease, the authors write in the Archives of Internal Medicine.

There have been no randomized clinical trials showing that the prostate specific antigen, or PSA, test has been effective in reducing that death rate, Dr. Wildon R. Farwell of the Veterans Affairs Boston Healthcare System said in an interview. Yet primary care physicians were 50 percent more likely to order a PSA test during a clinical visit and three times more likely to order one during a preventive exam from 2000 to 2004 than during the previous five years, according to records of men 35 and older from the National Ambulatory Medical Care Survey.

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Medical pioneers Dr. Joseph Murray (left, in photo by Susan Symonds Mainframe Photographics) and Dr. Thomas Starzl (right) clapped each other on the back in a warm display of affection before Starzl gave a lecture last night in Boston as part of a visiting professorship named in honor of Murray.

Each thanked the other for his contributions to organ and cell transplantation that began in 1954 when Murray performed the first successful kidney transplant at the former Peter Bent Brigham Hospital. Nine years later, Starzl performed the first liver transplant.

“Joe Murray was the perfect leader because he possessed to an unusual degree skill, intelligence, genuine kindness and unfailing integrity,” Starzl, 81, said in a lecture that tracked progress since that milestone. He spoke to a few hundred people at a forum presented by Brigham and Women’s Hospital and Harvard Medical School. The program continued with grand rounds led by Starzl this morning.

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Regulations to protect patient privacy make it more difficult to conduct medical research, a national study reports, findings that don't surprise Boston researchers who say the rules slow the pace of their work, place a burden on the patients they seek to protect and may discourage them from participating in clinical trials.

Two-thirds of the scientists who answered a survey on privacy rules imposed under the Health Insurance Portability and Accountability Act said the law had a "substantial negative influence" on human health research, according to the article in tomorrow's Journal of the American Medical Association.

"HIPAA regulations have hindered more than they have helped," Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital, said in an interview. She was not involved in the study. "They have had a chilling effect on researchers and epidemiologists."

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By Elizabeth Cooney, Globe Correspondent

Older men in good health who took beta carotene for about 18 years had better memory skills than similar men who took a placebo for the same length of time, a Harvard study shows.

The antioxidant, found in carrots, showed no benefit when taken for only three years, pointing to long duration as a critical factor in possibly slowing cognitive decline, which is a strong predictor of dementia.

The improvement was modest: Brain aging was delayed by about a year in men who took beta carotene long-term, author Francine Grodstein of Brigham and Women’s Hospital said in an interview. The study appears in today’s Archives of Internal Medicine.

She cautioned that it was too soon to recommend that men take beta carotene supplements. Beta carotene also has risks: Previous research has connected beta carotene to increased rates of lung cancer in smokers.

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By Elizabeth Cooney, Globe Correspondent

Two Boston orthopedic surgeons each received $6.75 million this year from a maker of joint replacement implants, the largest among hundreds of payments revealed in a $311 million settlement of a federal criminal case that alleged five companies paid doctors to use their products.

Dr. Richard Scott and Dr. Thomas Thornhill of Brigham and Women's Hospital were paid royalties and consulting fees this year by the Johnson & Johnson subsidiary DePuy Orthopaedics, according to documents made public by the company last week. DePuy makes implants used in hip and knee replacements.

Four other companies -- Zimmer Inc., Biomet Orthopedics Inc., Smith & Nephew Inc. and Stryker Orthopaedics -- were also part of an agreement with the US Department of Justice. The five companies, which together share 95 percent of the market for hip and knee implants, were being investigated for using consulting agreements with orthopedic surgeons to influence their choice of implants. Making payments was a common practice from 2002 through 2006, according to the US Attorney's Office in New Jersey.

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Brigham and Women’s Hospital has won federal funding to study how health information technology can help medications be used more safely.

The Boston hospital is one of four new Centers for Education and Research on Therapeutics named today by the Agency for Healthcare Research and Quality. It will receive $4 million over four years.

Six previously funded research centers won renewals, including Harvard Pilgrim Health Care.

The Institute of Medicine today presented the 2007 Gustav O. Lienhard Award to Dr. Howard H. Hiatt, professor of medicine at Harvard Medical School, former dean of its School of Public Health and a senior physician at the Brigham and Women's Hospital.

The $25,000 award recognizes Hiatt's contributions to improving the performance of personal health services in the United States and around the world, the institute said in a news release.

"Throughout his professional life, Howard Hiatt brought compassionate and innovative approaches to health and medical care," said Harvey V. Fineberg, president of the Institute of Medicine. "He introduced fresh analytic methods to medical and public health education, fostered interdisciplinary approaches to complex health problems, cultivated a new generation of socially responsible physicians, illuminated key challenges to making the best use of limited health resources, pioneered in research on patient safety, and championed successful programs to reduce health disparities. Many of today's leaders in health can trace the roots of their accomplishments to the inspiration, example, and guidance of Howard Hiatt."

Hiatt was formerly chief of medicine at Beth Israel Hospital in Boston, led a pioneering study of medical malpractice, called the Harvard Medical Practice Study, and helped to create the Division of Social Medicine and Health Inequalities at the Brigham in 2001.

Girls competing in sports like soccer and basketball are more susceptible to concussions than boys are when playing the same sports, according to a story in today's New York Times.

Post-concussion syndrome — in which dizziness, lethargy and the inability to concentrate can cost teenagers weeks or months of school — is a growing concern, doctors said. Just as common among girls as boys, it is even more misunderstood among female athletes at this level, a Boston concussion expert said.

"Generally speaking, the medical profession does not do a very good job in recognizing that female athletes sustain concussions at an equal or even higher rate as males," Dr. Robert Cantu of Brigham and Women’s Hospital told the Times. "It’s flying under the radar. And as a result, looking for concussions in women is not pursued with the same diligence, and it’s setting girls up for a worse result."

A Boston doctor is fasting for three days as part of a national push to cancel Haiti's debt to the developed world.

Dr. Evan Lyon, a hospitalist at Brigham and Women's Hospital and a researcher in its division of social medicine and healthcare inequalities, has worked in Haiti for the past 10 years through Dr. Paul Farmer's organization, Partners in Health.

Because of his connection to Haiti, Lyon got involved with the Jubilee USA Network, a coalition of 80 religious denominations across the country that wants Congress to cancel the debt of 26 countries and make it easier for other nations to find financial relief.

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Annual physicals get a checkup in today's Archives of Internal Medicine.

Adult preventive health exams and women's gynecologic exams are among the most common reasons to see a doctor, but most preventive services other than Pap smears take place outside those visits, according to researchers from the University of Pittsburgh School of Medicine and Harvard Medical School.

"There's clearly a role for the type of preventive services we studied -- cancer screening, cholesterol testing and counseling about quitting smoking, losing weight and exercise," Dr. John Z. Ayanian of Harvard said in an interview. "It's a question of what's the best approach to get those provided."

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Texas scientists may have found an explanation for why estrogen failed to protect some older women from heart disease in the Women's Health Initiative, a finding a Boston researcher called "intriguing" in today's Wall Street Journal.

Researchers at the University of Texas Southwestern Medical Center in Dallas say a molecule created when the body processes cholesterol may block estrogen from helping blood vessels stay healthy, the story says. In women long past menopause, such as those who were in the Women's Health Initiative, these molecules may have taken over estrogen receptors and blocked the effects of the hormone they started taking, the theory goes.

Dr. JoAnn Manson of Brigham and Women's Hospital and a principal investigator for the WHI, told the Journal that the Texas work may explain why women with high cholesterol did worse on hormone therapy than those with low cholesterol.

"Their overall finding ties together very nicely with the clinical-trial results," Manson said in the story. "This could help fit pieces of the puzzle together."

By Elizabeth Cooney, Globe Correspondent

There were plenty of jokes about senior moments before a panel of neuroscientists began their discussion of how older people can stay sharp.

This was the AARP annual conference, after all, with oldies music piped through the Boston Convention & Exhibition Center and ads for bladder control drugs plastered in the restrooms. Gail Sheehy was competing for the crowd's attention, the doctors noted, with her session in another meeting room on "Sex and the Seasoned Woman."

But the four panelists, three from Brigham and Women's Hospital and one from the University of Massachusetts Medical School, were as serious as the crowd about how to identify, prevent and deal with cognitive decline and dementia.

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A single variant of a gene is linked to an increased risk for both rheumatoid arthritis and systemic lupus erythematosus, providing support for the idea that common risk genes and disease pathways are involved in many autoimmune disorders, authors including researchers at the Broad Institute, Brigham and Women's Hospital and Biogen Idec report.

Giving critically ill patients recombinant human erythropoetin did not reduce the need for red-blood-cell transfusions, but it may reduce deaths in trauma patients, according to an article by researchers including doctors from the Boston University School of Medicine and University of Massachusetts Medical School.

Seven Massachusetts researchers have won grants from a new government program to study how genes and the environment interact, the National Institutes of Health announced today.

Through the Genes, Environment and Health Initiative, researchers will study the genetics of such diseases as diabetes, cancer, heart disease and tooth decay. To learn about the environmental component, scientists will develop ways to monitor personal exposure, whether to toxins or to physical activity.

The Broad Institute of MIT and Harvard, led by Stacey Gabriel, will receive $3.8 million to become one of two genotyping centers for the initiative. The other is at Johns Hopkins University in Baltimore.

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Two studies reported yesterday bolster the case for a "timing hypothesis" in women taking estrogen after menopause.

The papers published in the journal Neurology suggest that estrogen may protect the brain if the hormone is taken within 10 years of menopause. Other observational studies have shown a 20 percent to 40 percent reduction in the risk of developing dementia if estrogen is started shortly after menopause, Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital, said in an interview today.

"There is mounting evidence that a woman's age and the time since onset of menopause influence her health outcomes on estrogen, including the risk of heart disease and cognitive decline," she said. "These (Neurology) studies do suggest that premature loss of estrogen tended to have an adverse effect on memory and cognitive function and that taking estrogen after menopause may counter those risks."

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Transplant pioneer Dr. Joseph E. Murray (left) is working on a second book about science and spiritual values, but he has a challenge for his former field.

In an interview in today's Vineyard Gazette, the 88-year-old Nobel laureate and author of "Surgery of the Soul" reflected on his long career, his love for Chappaquiddick and a current transplant question.

"We don't know why but when multiple tissues, say a limb with bone and muscle and tissue, are transplanted, each of the elements seem to aid in the healing rate of other elements at far greater rates than for skin transplant alone," he told the Gazette. "If I were a young doctor, that's where I'd concentrate. That work will be fruitful for 50 or 80 years," he said.

Murray performed the first successful kidney transplant in 1954 at the Peter Bent Brigham Hospital. A Globe retrospective describes the impact of that work.

Face transplants may be safer than previously thought, according to a new analysis of their risks, but the encouraging report will not change guidelines adopted by Brigham and Women's Hospital that limit who can have the rare procedure.

Researchers from the University of Cincinnati and the University of Louisville say in the journal Plastic and Reconstructive Surgery that an influential British report issued in 2004 overestimated the dangers by failing to take into account three important factors: newer drugs used to prevent rejection, the poorer health of kidney transplant recipients relative to face transplant patients and the different tissue composition of solid organs versus the skin.

The new analysis concludes that the risk of rejection for skin transplant patients, would be lower than predicted in 2004. Researchers based their conclusions on hand transplant patients, but said the results would be valid for both.

"I'm very encouraged that we see a lot less of rejection and even if it occurs, [doctors] were able to help them," Dr. Bohdan Pomahac, director of the Brigham program, said in an interview. "I think it's very interesting. In many ways it will correct the current estimate of morbidity associated with facial transplants."

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Dr. Robert A. Greenes says it's hard to leave Harvard and Brigham and Women's Hospital, after 40 years, but the chance to build a new biomedical informatics program in Arizona is too good to pass up.

"Harvard and the Brigham have provided a wonderful environment for my professional activity," he said in an e-mail message last night. "My decision to leave Boston after many years of working closely with so many wonderful colleagues was not easy but became irresistible as I learned more about what the opportunity could be."

Greenes, a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.

He is the second prominent biomedical informatics researcher to leave Harvard for a new program, following Stephen Wong, who took about 20 lab staffers with him to Methodist Hospital Research Institute in Houston.

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By Elizabeth Cooney, Globe Correspondent

Another biomedical informatics leader is leaving Harvard to head a new department in the Sun Belt.

Dr. Robert A. Greenes (left), a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.

He will chair the Phoenix-based department of biomedical informatics in ASU's School of Computing and Informatics, which was founded last year as part of the School of Engineering.

Greenes is leaving Brigham and Women's Hospital, where in 1980 he established the Decision Systems Group.

His departure follows the move in July by Stephen Wong, who took about 20 researchers with him when he left for The Methodist Hospital Research Institute in Houston to create a bioinformatics program there.

"Bob got a wonderful professional opportunity," Dr. Steven Seltzer, chief of radiology at the Brigham, said in an interview today. "They have money and they have space, so it's exciting."

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Seven Boston physicians who spent a year or more away from medical school doing research have won grants to continue their dual roles as scientists and clinicians.

The Howard Hughes Medical Institute has given Early Career Awards of $375,000 each over five years to 20 doctors to make sure they have the time and financial support for research early in their careers, it said in a statement. Their institutions agreed to allow these tenure-track physician-scientists to devote at least 70 percent of their time to research.

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The voices of independent scientists are more important than ever, according to a critic of drug-company influence on government regulation, and there are signs they are being heard more than before.

Writing in tomorrow's New England Journal of Medicine, Dr. Jerry Avorn of Brigham and Women's Hospital and Harvard Medical School warns that Congress's re-authorization of user-fee funding from pharmaceutical companies to support the Food and Drug Administration means unbiased outside experts are critical to proper drug evaluation. As an example, he compares the approval of Vioxx in 1999 to this year's rejection of Arcoxia. Renewed assertiveness by FDA's external advisers made the difference in reviews of the painkillers linked to cardiac risk, he writes.

"Though the quiet voice of science may often be no match for powerful vested interests or ideology, some encouraging signs may be in the air," he writes. "The same reauthorization bill, disappointing in so many respects, may tighten somewhat the conflict-of-interest rules for outside advisers."

Six Massachusetts hospitals have made a consulting company's list of 100 US hospitals that have improved their performance.

Beth Israel Deaconess Medical Center, Brigham and Women's Hospital and Caritas St. Elizabeth's Medical Center in Boston; UMass Memorial Medical Center in Worcester; NSMC Union Hospital in Lynn and Lowell General Hospital were recognized by Thomson Healthcare for better clinical outcomes, safety, financial stability and growth from 2001 to 2005.

The unranked 2006 list appeared in last week's Modern Healthcare magazine.

Three studies by Boston authors appear in this week's Journal of the American Medical Association.

A study from Dana-Farber Cancer Institute found that a diet high in meat, fat, sweets and refined grains may be associated with a higher risk of colon cancer recurrence and death in people who had surgery and chemotherapy to treat stage III colon cancer.

Researchers from Brigham and Women’s Hospital report that people with diabetes have an increased risk of death in the first month and first year after they have a heart attack or unstable angina compared with people who have these acute coronary syndromes but do not have diabetes.

A new measure of a lipid protein ratio is no better at predicting coronary heart disease than traditional methods of measuring cholesterol, Boston University School of Medicine investigators from the Framingham Study say.

Antioxidant pills do not protect high-risk women from cardiovascular disease, a Harvard study has found, adding to growing evidence that supplements can’t duplicate a healthy diet and lifestyle.

Taking vitamin C, vitamin E and beta carotene alone or together did not protect the women overall from heart attacks, coronary artery disease or stroke, Dr. JoAnne E. Manson of Harvard Medical School and colleagues report in today’s Archives of Internal Medicine.

"Antioxidants are clearly not the magic bullet for heart disease prevention," she said in an interview. "Supplements do not replace the more difficult lifestyle modifications that have been proven to lower the risk of cardiovascular disease, such as regular exercise, a heart-healthy diet, not smoking, and managing high blood pressure and high cholesterol."

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Cathy Moore is a midwife at Brigham and Women's Hospital and a belly dancer with Goddess Dancing. Now she is bringing those two skills together, gradually introducing belly-dance techniques to some patients and birth specialists, according to a story in the Wall Street Journal that says there may be an ancient connection between childbirth and the dance form.

At the Brigham, Moore says in the story, she has to tread carefully with expectant mothers, for whom belly-dancing remains outside the medical mainstream. She also warns against certain movements: sharp hip drops and pops, and anything up on the toes.

Dr. James Greenberg, the hospital's chairman of obstetrics, told the Journal he's not sure if belly-dancing offers proven benefits.

"But there's certainly no scientific reason to think it's bad, so if it makes you feel good, and it's safe -- do it," he said.

Hospice care for dying patients has entered mainstream medicine, but it is still misunderstood and underused, according to two opinion pieces in tomorrow’s New England Journal of Medicine. Attitudes and economic constraints are the reasons why, the authors say.

The median length of time a patient receives hospice care is 26 days; one-third of patients enter hospice in the week before they die. That means they have less time to have their unnecessary pain relieved or their families’ care-giving burden eased, both reviews said.

Physicians who equate death with professional failure or think hospice is appropriate only for people near death send patients to hospice too late, Dr. Gail Gazelle of Brigham and Women’s Hospital writes, citing previous research. And patients often think that hospice is only for people dying of cancer, although 40 percent of hospice admissions are for people with conditions such as advanced cardiac disease and dementia.

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Massachusetts General Hospital and Brigham and Women's Hospital held on to their honor roll positions in the annual rankings by U.S. News & World Report called "America's Best Hospitals." Nine Boston hospitals are featured in the guide.

Mass. General finished fifth in the standings, down one rung from last year, and the Brigham took tenth place, up one from last year. Once again, Johns Hopkins Hospital and the Mayo Clinic finished first and second. UCLA Medical Center moved up to third from fifth and the Cleveland Clinic slipped to fourth from third.

The magazine evaluated 5,462 hospitals in 16 specialties, excluding pediatrics, and came up with 173 hospitals that met standards in one or more specialties based on reputation, care-related factors such as nursing and patient services, and mortality rate. Eighteen hospitals scored at or near the top in at least six specialties to make the honor roll.

Other hospitals were ranked in the specialty areas, but not in a cumulative score. Beth Israel Deaconess Medical Center was in the top 50 for 10 categories: diabetes (in conjunction with the Joslin Clinic); digestive disorders; respiratory care; heart and heart surgery; cancer care; kidney diseases; geriatrics; gynecology, urology; and ear, nose and throat care.

Boston-area hospitals known for their specialties also made the top 50. Dana-Farber Cancer Institute placed fifth in the list for cancer care. Joslin Clinic, with its partner Beth Israel Deaconess, was ranked 12th for endocrinology. New England Baptist Hospital was 17th for orthopedics and Spaulding Rehabilitation Hospital ranked eighth for rehabilitation. Massachusetts Eye and Ear Infirmary placed fourth in ophthalmology and in the ear, nose and throat specialty.

Boston Medical Center was ranked 41st in geriatrics.

Mass. General's winning specialty areas were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; heart and heart surgery; gynecology; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; psychiatry; and rheumatology.

The Brigham's top specialties were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; and rheumatology.

Providing health care to uninsured adults before they qualify for Medicare coverage may not only improve their health but also reduce costs after they turn 65, a Harvard study says.

People who haven’t had insurance coverage are significantly more likely to report poor health before the age of 65, the authors report in tomorrow’s New England Journal of Medicine.

They looked at data from the national Health and Retirement Study to compare health care expenditures between insured and uninsured adults at age 59 and 60 and then again after 65. They concluded that expanding health insurance coverage for uninsured people before 65 might be offset by savings in health care costs that would come later, particularly for people who have cardiovascular disease or diabetes.

"It may be less costly than people thought," Dr. J. Michael McWilliams, a research associate at Harvard Medical School, said in an interview. "Earlier coverage improves health and reduces health care needs."

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Electronic health records, championed as a way to improve patient health and safety, don't by themselves lead to better care in doctors' offices, a study shows.

Researchers from Harvard and Stanford found that electronic records made no difference in 14 of 17 measures of quality for outpatient health care, according to today's Archives of Internal Medicine. They examined data from the National Ambulatory Medical Care Survey gathered from visits to doctors in 2003 and 2004.

Two categories showed better performance on recommended care in the 18 percent of visits in which electronic health records were used: not prescribing tranquilizers for depression and not ordering routine urinalysis in general medical exams. But in one area -- prescribing statins for patients with high cholesterol -- physicians using electronic health records performed worse than doctors who didn't have them.

The missing piece is information to guide clinical decisions, co-author Dr. David W. Bates of Harvard Medical School said in an interview last week. Prompts to order tests, prescribe medications or avoid harmful drug interactions can make the records more than just computerized charts, the study said.

"I was surprised," he said. "I expected we would find improvement with the use of electronic health records, especially because there's a lot of evidence that with good decision support, quality measures do improve."

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By Liz Kowalczyk, Globe Staff

A patient's chance of survival after suffering a heart attack or heart failure is better than average at four Massachusetts hospitals -- Cape Cod Hospital, Southcoast Hospital Group, Beth Israel Deaconess Medical Center and Brigham and Women’s Hospital -- according to newly-released data from the federal government.

Medicare, the national insurance program for the elderly, today added a new element to its website Consumers now can check the survival rate for a hospital's patients within 30 days of being treated for a heart attack or heart failure.

All other Massachusetts hospitals showed survival rates -- adjusted for how sick the patients were before they were hospitalized -- equal to the average US rates. No Massachusetts hospital scored worse than the national rates. But four did better -- Beth Israel Deaconess, the Brigham and Southcoast showed mortality rates better than the national average for heart failure; the US 30-day mortality rate for these patients is 11 percent.

Cape Cod Hospital had a better than average mortality rate for heart attack patients; the US 30-day mortality rate for these patients is 16 percent.

By Felicia Mello, Globe Correspondent

Relentless undertows, stinging jellyfish -- the beach can be a dangerous place. Now a Harvard medical resident wants sunbathers to pay attention to yet another threat: collapsing sand holes that he says have killed dozens of young people in the past two decades, several of them in New England.

While some might see them as freak accidents, Dr. Bradley Maron has spent years studying the phenomena, after twice seeing children almost suffocate to death on a Martha's Vineyard beach. In a letter in this week's New England Journal of Medicine, he warns that a pastime as innocent as building a sandcastle could lead to a family tragedy.

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Younger menopausal women who took estrogen reduced their risk of developing coronary artery calcium, a predictor of heart disease, by 40 percent, a study from the Women’s Health Initiative found.

Dr. JoAnn E. Manson, chief of preventive medicine at Brigham and Women’s Hospital, and colleagues report in tomorrow’s New England Journal of Medicine an even higher risk reduction of 60 percent in the women aged 50 to 59 years old who regularly took estrogen over an average of 7.4 years, compared with those who regularly took a placebo in the randomized clinical trial of more than 1,000 women.

"The findings provide additional reassurance for recently menopausal women who are considering hormone therapy for the short-term treatment of hot flashes, night sweats and other symptoms that disrupt quality of life," Manson said in an interview. "We do caution that this should not be interpreted to mean estrogen should be taken for the express purpose of preventing cardiovascular disease. There are risks."

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The results are in from the New England Journal of Medicine's first online poll of clinical decisions, and the winner was not a slam-dunk.

"What we learned from this is that evidence-based medicine is easy to talk about but hard to implement," editor-in-chief Dr. Jeffrey M. Drazen said in an interview.

Last month the journal asked readers to vote on how to handle the fictitious case of a woman who wanted to cut down on her medications for mild, persistent asthma. The vignette was created to accompany two articles on asthma treatment.

"People read those two papers and the vignette and came to very different conclusions," Drazen said.

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Four Boston-area scientists are among the newest class of 20 Pew Scholars in the Biomedical Sciences, the program announced today.

Funded by the Pew Charitable Trusts through a grant to the University of California at San Francisco, the awards give each scientist $240,000 over four years to support research.

Past winners have included Craig C. Mello of the University of Massachusetts Medical School, who shared the 2006 Nobel Prize in medicine or physiology for the discovery of the gene-silencing mechanism know as RNA interference.

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A Boston health educator is taking a page from the antismoking playbook.

Using money from a $430 million Pfizer Inc. settlement of illegal marketing charges, the MGH Institute of Health Professions is launching a program today to teach health care providers about drug industry influence. Just as tobacco company settlement dollars funded stop-smoking campaigns, a total of $21 million and 26 grants were earmarked nationwide to bring information about pharmaceutical marketing to prescribers and consumers.

Elissa Ladd (left), clinical assistant professor at the affiliate of Massachusetts General Hospital, won $399,400 to develop a documentary called "PERx: Prescribing Evidence-Based Therapies" and a companion website. Both are funded through fines paid by the drug giant Pfizer in 2004 when its Warner-Lambert subsidiary pleaded guilty to promoting unapproved uses for the anti-seizure drug Neurontin.

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Brigham and Women's Hospital is one of 14 research centers to receive a total of $20.65 million in High-End Instrumentation grants to buy advanced biomedical equipment.

The National Institutes of Health made the one-time awards through its National Center for Research Resources, which announced the round of funding today.

Brigham and Women's, the only research institution in Massachusetts to be named, received the maximum award of $2 million. It will purchase a 3 Tesla magnetic resonance imaging scanner to be used for navigation during open surgeries, minimally invasive treatments, vascular procedures and thermal ablation of tumors, the NIH statement said.

Previous winners since the program's inception in 2002 have included Beth Israel Deaconess Medical Center, Brandeis University, Harvard Medical School and Massachusetts General Hospital.

On Nature Network Boston, Anna Kushnir lets us in on a dirty little secret: Labs are an environmentalist's nightmare.

"The amount of waste that my lab generates every day makes paper mills look Earth-friendly," she writes reluctantly (while noting it's not her waste bucket at left). "There is nothing I can do about it. I am not willing to risk my samples being contaminated and my experiments failing to save a pair of gloves or spare a pipette."

A Healthy Blog's John McDonough of Health Care For All and Running a Hospital's Paul Levy of Beth Israel Deaconess Medical Center are engaged in a back-and-forth on hospital competition, cost and quality. This follows previous discussions about the power of Partners HealthCare to influence payment rates.

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Men who are at risk for a fatal heart attack should be evaluated by a cardiologist before beginning hormonal therapy to treat prostate cancer, researchers from Harvard Medical School report.

The article to appear Sunday in the Journal of Clinical Oncology follows a landmark paper by other Harvard doctors published last fall in the same journal (and reported in the Globe) that linked androgen suppression therapy to diabetes and heart disease.

Androgen suppression therapy is often prescribed for men with prostate cancer. Research has established that it improves survival rates in men with advanced stages of the disease when given with radiation therapy, but the benefits of the treatment are not as clear in men whose cancer is in earlier stages.

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A leading scientist who directed research programs at Harvard Medical School and at Brigham and Women’s Hospital is leaving Boston and taking about 20 researchers with him to develop a bioinformatics program in Houston.

Stephen Wong (left) is leaving his posts as director of the Center for Bioinformatics in the Harvard Center for Neurodegeneration and Repair at Harvard Medical School and executive director of the Functional and Molecular Imaging Center at Brigham and Women’s. He has been an associate professor of radiology at Harvard Medical School and part of the neuro-oncology and cancer imaging programs at Dana-Farber Cancer Institute.

On July 1 he will become chief of medical physics and vice chair of radiology at The Methodist Hospital and director of the bioinformatics program at The Methodist Hospital Research Institute. He will join the faculty at Weill Cornell Medical College, which became the hospital’s academic affiliate after it dissolved ties with Baylor University three years ago.

"This was not an easy decision to make. I think Harvard is wonderful," Wong said in an interview today. "I do think the opportunity in Houston is big. It’s a fantastic opportunity to be in on the infrastructure."

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By Liz Kowalczyk, Globe Staff

Harvard University's incoming president, Drew Gilpin Faust, is close to making a key hire, dean of Harvard Medical School, and the finalists include a nationally-known cardiologist and a leading Harvard diabetes researcher, according to several Harvard doctors and officials with knowledge of the search.

Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute, is a top finalist for the position, according to two of the sources.

Nabel and the agency's spokeswoman did not return calls asking for comment. While at the University of Michigan during the 1980s and 1990s, she rose to chief of the Division of Cardiology and became known for her research into the molecular genetics of cardiovascular diseases, according to the institute's website.

The sources said that Dr. Jeffrey Flier, chief academic officer at Beth Israel Deaconess Medical Center and a nationally-known researcher on diabetes and obesity, also is a serious contender for the job. He said through a spokeswoman that he would not comment on the search.

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Taking a page from an investors' club handbook, hedge fund managers and a Harvard scientist today introduced the Gotham Prize for Cancer Research, a $1 million annual award that will be given to a researcher who posts a promising idea on an online forum.

"As researchers who live and die by grant support, we want to hold on to our ideas," said prize co-founder Dr. Gary C. Curhan of Harvard Medical School and the School of Public Health. "But it's important to share the best ideas and also try to expedite their investigation."

To be considered, a scientist will have to send an essay of 500 to 1,000 words describing an idea for further research. If the idea is approved by a panel of cancer experts, the scientist will become a member of the online forum, where accepted ideas will be anonymously posted. Members will be asked to comment on these ideas in a spirit of collaboration the prize's founders hope will pave the way for progress in cancer research. Guests can also view the exchange.

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Even small amounts of physical activity can boost the fitness of postmenopausal women who are sedentary and overweight, an article in tomorrow's Journal of the American Medical Association says.

As little as 72 minutes of exercise a week showed benefits for women in a trial led by Dr. Timothy S. Church at Louisiana State University. More exercise -- up to about three hours a week -- meant higher fitness levels, as measured by the amount of oxygen they consumed while cycling or walking. But the exercise did not affect cardiovascular risk factors such as blood pressure or weight.

These findings answer a question researchers have had about what the minimum "dose" of exercise might be to deliver health benefits, I-Min Lee, an epidemiologist at Brigham and Women's Hospital, writes in a related editorial. Fitness levels are strong predictors of chronic disease and premature mortality, previous studies have shown.

Lee writes: "This might be succinctly summarized for patients and clinicians as 'Even a little is good; more may be better!'"

Two bursts of bright light in the evening help the brain's clock adapt to a longer day, sleep researchers at Brigham and Women's Hospital report, something important for astronauts traveling to Mars but also for earthbound travelers, shift workers or other people whose internal clocks are out of synch.

"Utilization of bright-light exposure could work whether you're going to Mars or Los Angeles," Dr. Charles Czeisler, chief of sleep medicine at Brigham and Women's Hospital, said in an interview.

Czeisler, Dr. Richard E. Kronauer of Harvard and colleagues from the University of Lyon and the University of Colorado conducted a study for NASA's National Space Biomedical Research Institute that appears in today's Proceedings of the National Academy of Sciences.

They set out to solve the problem of what could be perpetual jet lag-like fatigue on an eventual year-and-a-half-long mission to Mars, a plan announced by President Bush in 2004. The Martian day is 39 minutes and 35 seconds longer than a day on Earth -- which doesn't seem like much at first, but adds up to more than four hours in just one week.

The researchers sequestered 12 healthy people in rooms with no time cues for 65 days. First they observed their individual internal clocks, finding a range of differences in the timing of when their bodies released melatonin. Some people were releasing the sleep-promoting hormone as much as five hours before bedtime while for others it was an hour ahead.

"This may explain why some individuals feel so tired in the evening," Czeisler said. "It's as if people are in different time zones, like England and Boston. Their internal clocks are spread out over many time zones.

Over the next 30 days, the participants were exposed to a longer day under varying amounts of light. Those who got two 45-minute sessions of bright light in the evening were able to adapt their sleep/wake cycles to a longer-than-24-hour day.

"These results suggest that people could be treated for sleep disorders" in this way, Czeisler said.

Proposals to build new devices to help premature infants, to inject medicine without breaking the skin and to guide surgeons operating on the brain were among projects to win $5 million in grants from the Center for Integration of Medicine and Innovative Technology, the consortium announced today.

CIMIT, composed of Boston-area teaching hospitals and engineering schools, made 37 grants that range from $40,000 to $100,000. Twenty-two have military applications, acording to CIMIT, which receives support from the US Department of Defense as well as its members.

Dr. Riccardo Barbieri of Massachusetts General Hospital won a grant to develop a computational tool based on a premature infant's heartbeat to predict episodes when they stop breathing.

Mark Horenstein of Boston University will demonstate a way to inject medications through the skin using nanoparticles, leaving no wound behind.

Dr. Nobuyuki Nakajima of Brigham and Women's Hospital will work to improve how instruments can be navigated to diagnose and treat brain injury or disease.

"Our goal ... is to bring life-changing technology to patients as quickly as possible," Dr. John Parrish, CIMIT founder and director and Vietnam War battlefield surgeon, said in a statement. "We are especially aware of the needs of soldiers wounded on the battlefield."

Two papers in Science, including one by Harvard researchers, were among four published yesterday in Science and Nature Genetics on genetic risk factors for developing diabetes. Alice Dembner describes them in today's Globe.

Reseachers from Massachusetts General Hospital, Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital are part of an international team reporting on a new mechanism involved in resistance to "smart" cancer drugs Iressa and Tarceva that target lung cancer cell growth.

Scientists have identified a new gene that helps regulate the body's clock and Giulio F. Draetta of Merck
Research Laboratories in Boston and colleagues report on a molecular component of this clock involved in the
length of the circadian period.

A team that includes researchers from the CBR Institute for Biomedical Research and Harvard Medical School in Boston reveal how the influence of micro-RNAs, small RNA molecules that regulate gene expression, extends to the immune system.

The anti-angina medication ranolazine safely eased chest pain in a large clinical trial led by Brigham and Women's Hospital researchers, but the drug did not make a significant difference in whether people with coronary artery disease had another heart attack or died, according to a report in tomorrow's Journal of the American Medical Association.

"It does not prolong life, but it provides important relief of symptoms," lead author Dr. David A. Morrow said in an interview.

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This week's Science includes a special section on germ cells -- the reproductive cells of an organism.

George Q. Daley of Children's Hospital Boston, Brigham and Women's Hospital and the Harvard Stem Cell Institute asks whether the cup is half empty or half full for embryonic stem cells.

David C. Page of the Whitehead Institute and MIT considers the mysteries of sexual identity from the germ cell's perspective.

Alexander F. Schier of the Broad Institute of Harvard and MIT writes about the death and birth of RNAs during the maternal-zygotic transition.

Also in Science, Rachael L. Neve of Harvard and McLean Hospital is an author of a new study in mice about neurons competing to encode a memory in the brain.

Scientists from Harvard Medical School and Brigham and Women's Hospital have been honored with collaborators from the University of Michigan for their discoveries about the genetics of prostate cancer.

The American Association for Cancer Research chose the team from about 30 applicants, the organization said. The researchers will share a prize of $50,000.

The Harvard members are Dr. Mark A. Rubin, Charles Lee, Dr. Sven Perner and Francesca Demichelis.

Dr. Paula Johnson (left), executive director of the Connors Center for Women's Health and Gender Biology at Brigham and Women's Hospital, describes her career path and the center's goals in a Saturday New York Times feature called "The Boss."

"People think of women’s health as mammograms and Pap smears besides general health care, but it’s much more," said Johnson, who is a cardiologist. "It’s understanding the science of sex differences and how that science influences the way we deliver care, both in the office and by means of highly technical procedures."

Just as precious to Dr. Atul Gawande as his loupes — magnifying glasses he wears during surgery — is his iPod, which he carries with him into the operating room at Brigham and Women's Hospital and plugs into a little speaker there, a story in today's New York Times begins.

His second book, "Better: A Surgeon’s Notes on Performance" (Metropolitan Books), comes out this week. Like his first, "Complications," the story says, it consists mostly of essays he has published in The New Yorker — pieces whose common theme is both the complexity and the imperfection of modern medicine and the need for doctors to strive to do better.

Dr. William F. Owen Jr., formerly of Brigham and Women's Hospital, has been named president of the University of Medicine and Dentistry of New Jersey, the school said today.

Owen is the chancellor of the University of Tennessee Health Science Center in Memphis and vice president for health affairs at the University of Tennessee. Before that he had been chief scientist for Baxter Healthcare Corp.'s renal division while an adjunct professor at Duke University School of Medicine.

Owen graduated from Brown University and Tufts University School of Medicine. He completed his internship and residency in medicine as well as fellowships in nephrology, transplantation and immunology at Brigham and Women's.

By Stephen Smith and Liz Kowalczyk, Globe Staff

Patients with clogged arteries who have not yet had a heart attack benefit just as much from medications as angioplasty, according to a study released today.

Specialists representing different camps in cardiology have long argued about the best way to handle patients who have potentially life-threatening narrowing of arteries. Decisions about how to treat heart disease, the nation's number one killer, have significant ramifications, medically and economically.

A large team of researchers from across North America, who presented their findings today at the American College of Cardiology's annual meeting in New Orleans, studied nearly 2,300 patients suffering coronary artery disease.

"The results are very striking," said Dr. Steven Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic. "This is important for patients because it does now mean patients have choices. If your symptoms aren't so severe and aren't interfering with your lifestyle, you can afford to wait."

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Dr. Michael V. Seiden, a leading cancer clinician and researcher, is leaving Boston to become president and CEO of Fox Chase Cancer Center in Philadelphia, the center announced today.

Seiden, 48, is head of the gynecological cancer program at the Dana-Farber/Harvard Cancer Center and chief of clinical research in cancer medicine at Massachusetts General Hospital. An associate professor of medicine at Harvard, his research focuses on ovarian cancer tumor biology. He is the physician coordinator of the cancer stem cell project at the Dana-Farber/Harvard Cancer Center.

On June 1 he will succeed Dr. Robert C. Young, 67, who is retiring from Fox Chase, which treats about 6,500 new patients a year and employs about 2,500 people.

Seiden is a graduate of Oberlin College and earned his M.D. and Ph.D. at Washington University in St. Louis. He completed his internship and residency at Mass. General, was a fellow in medicine at Harvard, did a three-year clinical fellowship in medical oncology at Dana-Farber Cancer Institute and was a postdoctoral fellow in molecular pathology at Brigham and Women's Hospital.

Researchers from Brigham and Women's Hospital have won a five-year, $6 million grant from the National Institute of Arthritis, Musculoskeletal and Skin Disorders. The grant will allow them to study hip replacements in Medicare patients, to investigate the genetics of rheumatoid arthritis and to conduct a randomized trial of osteoporosis medication compliance, the hospital said.

Director Dr. Jeffrey N. Katz, associate professor of medicine and orthopedic surgery at Harvard, and associate director Dr. Elizabeth Karlson, associate professor of medicine at Harvard, will lead researchers from the division of rheumatology, immunology and allergy, the division of pharmacoepidemiology and the department of orthopedic surgery.

By Carey Goldberg, Globe Staff

Federal researchers announced early today that they’re launching a nationwide trial to see whether creatine, a supplement long favored by body-builders, can slow the effects of Parkinson’s Disease.

The National Institute of Neurological Disorders and Stroke is aiming to enroll more than 1,700 Parkinson’s patients at sites around the country, including two in Boston: one at Brigham and Women’s Hospital and one at Beth Israel Deaconess Medical Center.

Parkinson’s is a degenerative illness that affects more than a million Americans. Initial studies suggest that creatine may slow the degeneration. Some drugs can help relieve the tremors and other symptoms of Parkinson’s, but none seems able to stop the disease from progressively worsening.

Patients in the clinical trial will be expected to participate for from five to seven years.

More info: 1-800-352-9424; info@parkinsontrial.org.

Dr. Steve Colchamiro, dental director at Brookside Community Health Center, which is part of Brigham and Women's Hospital, has won this year's Founder's Award from the Massachusetts League of Community Health Centers.

The award honors a leader who protects and promotes healthcare access as a right for all, the community health center said in a statement. In 1971, Colchamiro established the School Dental Transportation Program, which has bused thousands of students from Boston public schools to Brookside for oral health services, often for their first visit to the dentist.

By John Donnelly, Globe Staff

Investor and philanthropist George Soros today announced a $3 million grant to Boston-based Partners in Health and Brigham and Women's Hospital in hopes of curbing the spread of extremely drug-resistant strains of tuberculosis in the small African nation of Lesotho.

Partners in Health, which has a decade of experience in treating drug-resistant TB in Haiti, Peru, and Russia, hopes that it can develop regimens to effectively battle these emerging strains of the disease. About five Brigham and Women's doctors will be involved in the project.

These new strains -- labelled XDR-TB -- have been found in 28 countries after an outbreak was reported last year in the Kwa-Zulu Natal province of South Africa. In that first documented outbreak, 52 of 53 patients identified with XDR-TB died. Since that outbreak, South Africa's death rate for those co-infected with HIV and the drug-resistant TB has been 85 percent.

"We were always afraid that multiple drug-resistant TB could meet HIV/AIDS and this is now happening," Soros said in a conference call with reporters. "It is not getting the attention it deserves."

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Nancy R. Kruger has been appointed senior vice president and chief nursing officer at UMass Memorial Medical Center in Worcester, the hospital said.

Kruger had been chief nursing officer and vice president of patient care services at Brigham and Women’s Hospital for five years. Before that she was chief nursing officer at Hershey Medical Center, the Pennsylvania State University College of Medicine’s academic medical center.

She received her bachelor’s degree in nursing from Skidmore College, completed a graduate degree in nursing from New York University and earned a doctorate in nursing science from the University of Pennsylvania.

Keeping drug safety data from clinical trials confidential to protect trade secrets can delay the discovery of dangerous side effects, two Boston researchers write in the current issue of Health Affairs.

Aaron S. Kesselheim, a clinical fellow in medicine in the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital, and Michelle M. Mello, associate professor of health policy and law at the Harvard School of Public Health, point to Vioxx and other cases of drugs with problems that came to light after their approval by the Food and Drug Administration.

The two urge the FDA to place a greater burden of proof on drug companies to show how they would be harmed by release of their data, they recommend more comprehensive public documents from drug companies on safety, and they ask Congress to act if the FDA doesn't.

"Disclosing safety data from clinical trials would allow protection of most commercially valuable information and better balance our interests in drug innovation and patient safety," they wrote.

Not a single institution on either side of the Charles cracked the Top 15 places to work in a survey of postdoctoral life scientists, the March issue of The Scientist magazine says.

Training and experience matter the most to these researchers, who have finished their Ph.D.s but don't have faculty positions, the survey reports. They ranked access to books and journals next, followed by affordable medical insurance and then equipment and supplies for research.

The closest Boston or Cambridge came was Beth Israel Deaconess Medical Center's 28th-place finish, shooting up from 97th last year.

Harvard Medical School, Brigham and Women's Hospital, Woods Hole Oceanographic Institute and Dana-Farber Cancer Institute also made the top 40. MIT dropped out of the top 40, placing 53rd.

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A new campaign called The Prescription Project seeks to end conflicts of interest that may arise from pharmaceutical company marketing aimed at physicians. It calls for academic medical centers to tighten their policies governing ties with industry.

"We are looking to see that payers, consumers and physicians work together to promote evidence-based medicine and to counter the bias of drug marketing," said Robert Restuccia, the project's Boston-based executive director.

The Prescription Project points to Stanford University Medical School, University of Pennsylvania Health System and Yale University School of Medicine as leaders. While their models vary, the institutions restrict gifts to doctors, drug samples and visits by industry sales representatives.

Boston hospitals surveyed by the Globe during the past week say they require drug company employees and other vendors to register with them before visiting, but other policies vary.

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Dr. Joseph V. Bonventre and Dr. Frederick J. Schoen have been named directors of the new Technology in Medicine Initiative at Brigham and Women's Hospital's Biomedical Research Institute, the hospital has announced.

They also will serve as liaisons between the hospital and the Center for Integration of Medicine and Innovative Technology, a consortium of area teaching hospitals, universities and research laboratories that develops medical devices.

Bonventre is a professor of medicine and health sciences and technology at Harvard Medical School, director of the renal division at Brigham and Women's and co-director of the BRI Stem Cell, Regenerative Medicine and Tissue Engineering Center.

Schoen is professor of pathology and health sciences and technology at Harvard Medical School, director of cardiac pathology and executive vice-chairman of the Brigham and Women's department of pathology.

Contrary to traditional notions of grief after the death of a loved one, a new study finds that yearning is felt more powerfully than depression.

Researchers from Harvard Medical School and Yale University School of Medicine found that yearning was the strongest negative emotion after loss, they report in tomorrow's Journal of the American Medical Association.

Negative emotions associated with grief peaked within six months, meaning people with more prolonged symptoms might need more help after that point. And the researchers recommend that the standard psychiatric reference, the Diagnostic and Statistical Manual of Mental Disorders, be revised to focus less on depression after the death of a loved one.

"Yearning is reacting to the loss of someone or something, and once that is gone, you miss it, you pine for it, you hunger for it, you crave it. That was the primary emotional experience after bereavement, rather than depression," Holly G. Prigerson, one of the authors, said in an interview. "This suggests that the DSM reconsider what the natural response to loss is, especially with respect to depression and yearning."

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By Stephen Smith, Globe staff

Boston Mayor Thomas M. Menino today appointed a specialist in women's medical issues and healthcare disparities to the city's health board.

Dr. Paula A. Johnson, chief of the women's health division at Brigham and Women's Hospital, will replace Dr. JudyAnn Bigby on the board of the Boston Public Health Commission. Bigby, who also was a top physician at the Brigham, is the new health secretary in the administration of Governor Deval Patrick.

Dr. Paula A. Johnson

The commission board approves major public health initiatives in the city, voting in the past, for example, to ban smoking in restaurants and bars. Boston has the nation's oldest public health agency.

Johnson is a participant in Menino's ongoing Disparities Project, which aims to bridge persistent gaps in health status that exist between racial and ethnic groups in the city. Menino has said that healthcare disparities are the city's most pressing medical issue.

After retired New England Patriots linebacker Ted Johnson told his story of depression and other mental impairments following a succession of on-field concussions, his neurosurgeon, Dr. Robert C. Cantu, thought he might hear from other retired professional football players.

He did. Some came to see him and others just talked to him on the phone about problems they trace to their playing days.

What surprised Cantu, who is chief of neurosurgery at Emerson Hospital in Concord and co-director of the Neurological Sports Injury Center at Brigham and Women's Hospital, was the handful of non-athletes he heard from.

"The scope of the problem goes beyond the athletic fields because people in certain lines of work sustain multiple concussions," he said.

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Michel Kazatchkine, France's AIDS ambassador and a Harvard-educated doctor specializing in infectious diseases, was selected today as the new head of the $7 billion Global Fund to Fight AIDS, Tuberculosis and Malaria.

Kazatchkine, 60, takes over an organization that in just over five years has provided grants to 450 programs in 136 countries, accounting for two-thirds of all international funding against TB and malaria, and 20 percent of global funding to fight AIDS.

From 1977 to 1981, Kazatchkine lived in Boston while doing post-doctoral work at Brigham and Women's Hospital as a member of Harvard's Immunology Department.

-- John Donnelly

Massachusetts General Hospital has no immediate plans to open a health-care facility in northern Palm Beach County, Florida, but the institution is still considering the idea, President Peter Slavin said yesterday, according to the Palm Beach Post.

Massachusetts General officials, in Palm Beach this week for their annual fund-raising trip, say several factors stand in their way of opening a satellite facility in Jupiter, including the large number of uninsured patients, the popularity of concierge practices and concern that it could not offer the same array and quality of services away from its Boston base.

"We're still interested in the opportunity," Slavin said Tuesday before a late afternoon health symposium and cocktails with donors at the Four Seasons Palm Beach. "But we have no specific plans yet."

Any plans would include Brigham and Women's Hospital, also owned by Partners HealthCare, the Post story said.

Stricter control of air pollution is needed to reduce the risk of heart disease in women, two Harvard researchers write in an editorial to be published in tomorrow’s New England Journal of Medicine.

Their comments accompany a study in the journal that shows long-term exposure to the fine particles in air pollution are more harmful to older women than previously known, raising their risk of heart disease and death.

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More Boston hospital workers may be getting flu shots this season than the national average, but beyond that it’s hard to figure out how they measure up.

Public health officials have been pushing for virtually all hospital workers to get flu shots because they can easily be exposed and infect vulnerable patients. But each of six hospitals that answered a White Coat Notes query today counts health care workers involved in direct patient care in its own way. And they don’t necessarily know who might have gotten a flu shot outside their hospitals' programs.

Here are the results:

Boston Medical Center: 71 percent
Dana-Farber Cancer Institute: 63 percent
Beth Israel Deaconess Medical Center: 60 percent
Massachusetts General Hospital: 59 percent
Brigham and Women’s Hospital: about 48 percent
Tufts-New England Medical Center: more than 50 percent, according to a preliminary count

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Brigham and Women's Hospital is trying to replenish its cardiology staff, after outside recruiters raided the department last year. The Brigham, which particularly needs a strong cardiology department as it prepares to open a $350 million cardiovascular wing next year, lost six, or 10 percent, of its 50 cardiologists last year.

They were lured away by private medical companies and by Case Western Reserve University Medical School and its affiliated University Hospitals of Cleveland, which are trying to compete with the Cleveland Clinic -- world renowned for its heart care and research.

In response, Brigham executives have gone on their own head-hunting spree, hiring three cardiologists who will start their new jobs in the next few months.

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Boston researchers have won two of 12 two-year contracts from the National Heart, Lung, and Blood Institute to study major diseases that affect post-menopausal women. The groups will use blood samples and data from the massive Women's Health Initiative to see what factors are important in predicting and preventing heart disease. The 12 grants will total $18.7 million.

Dr. I-Min Lee, Dr. JoAnn Manson and Dr. Howard D. Sesso of Brigham and Women's Hospital hope to tease out the biochemical mechanisms behind physical activity and lower body fat, looking for the way they reduce the risk of heart disease.

Dr. Alice Lichtenstein of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University wants to see how certain biomarkers compare with self-reports of food intake as predictors of heart disease.

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Longtime Boston television health reporter and producer Rhonda L. Mann is Beth Israel Deaconess Medical Center's new director of marketing communications.

Rhonda L. Mann

Mann previously managed the health news division at WCVB-Channel 5, doing on-air reporting and producing segments for medical editor Dr. Timothy Johnson.

The hospital said her appointment to fill an open position recognized her gifts as a storyteller. Another television figure turned hospital marketing professional is Peter R. Brown, vice president of public affairs and communications at Brigham and Women's Hospital, who two years ago left a 22-year career at WBZ-Channel 4.

Zineb Marchoudi, who was a writer and producer for Channel 5's 11 p.m. news, will join Mann's department at Beth Israel Deaconess as a media relations specialist. Senior editor Michael Keating is the third member of the department. He had been managing editor/features for Seacoast Media Group in Portsmouth, N.H., which publishes the Portsmouth Herald and Seacoastonline.com.