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April 06, 2007
 On Nurse at small, Betsy Baumgartner, who works at a Boston teaching hospital, relates how patients react when she suggests they take Oxycodone (left) for pain.
"I'm still amazed at how many people are afraid to take this painkiller because of the media hype" about Oxycontin, she writes. "The funny part is that if you offer them Percocet they will gobble it right up without any questions!"
On Healthy Children, Dr. Stephen Parker of Boston Medical Center talks about methods for pain-free pediatrics - from skin-to-skin contact for newborns during procedures, to pet therapy for older hospitalized children, as well as anesthesia.
"Using some well-established (and some not-so-well-established) techniques to diminish the experience of pain, the screaming of kids in our emergency room and offices has markedly decreased," he writes.
Posted by Elizabeth Cooney at 10:25 AM
April 06, 2007
 This week in Science Express, researchers Gohta Goshima, Roy Wollman,
Ronald D. Vale and Nico Stuurman at the Marine Biological Laboratory at Woods Hole report on a genome screen that revealed about 200 genes -- 150 of them previously unknown or unexpected -- that are involved in assembling the mitotic spindle (left), the structure that separates chromosomes during cell division and plays a role in human diseases, including cancer.
In Science, Young-Sam Lee and Erin K. O'Shea of Harvard take a closer look at inositol pyrophosphates, signaling molecules involved in a number of cellular processes, from gene expression to stress responses.
Posted by Elizabeth Cooney at 08:37 AM
April 06, 2007
An experiment to test just how loud is loud during lunch hour at Smith Leadership Academy in Dorchester surprised even Sharon G. Kujawa, the director of audiology at Massachusetts Eye and Ear Infirmary.
Children who eat lots of grapes, oranges, and tomatoes are less likely to have hay fever, researchers found, suggesting that a Mediterranean diet may have health benefits for youngsters as well as adults.
A little exercise, even just a long walk, may go a long way toward helping women feel better while going through menopause, according a Penn State University study.
High-deductible health insurance plans favored by many employers often wind up being an unfair burden to women, a Harvard Medical School study says, largely because women need many routine medical exams that quickly add up.
Posted by Elizabeth Cooney at 06:15 AM
April 05, 2007
If fairly conservative climate projections hold true for Boston, global warming will raise sea levels enough by the end of the century that Boston Harbor will flood parts of East Boston and the downtown Financial District during a typical winter northeaster. South Boston, Back Bay, and Cambridge would also probably flood during a category 2 hurricane, according to simulations produced for the Globe by a computer modeling consultant. Yet, the region has no plan to deal with flooding of that magnitude.
The latest United Nations assessment of the role of humans in global warming has found with "high confidence" that greenhouse gas emissions are at least partly responsible for a host of changes already underway, including longer growing seasons and shrinking glaciers.
Hundreds of reunions have taken place in El Salvador over the past decade, aided by advances in DNA matching through a Physicians for Human Rights forensics program, and an intensifying campaign to bring closure to victimized families, if not justice to those who violated them long ago.
Posted by Elizabeth Cooney at 06:09 AM
April 04, 2007
Computer-aided detection systems not only failed to detect more breast cancer in women who had screening mammograms, researchers report in tomorrow's New England Journal of Medicine, but it also may have harmed them by generating a higher number of false-positive readings, resulting in significantly more call-backs for repeat mammograms and biopsies.
Dr. Joshua J. Fenton of the University of California, Davis, and his co-authors studied CAD in 429,345 mammograms, the largest trial to date since it was approved by the Food and Drug Administration in 1998. They found that about 157 women would be called back for another mammogram and 15 women would undergo biopsies in order to detect one additional case of cancer, possibly a ductal carcinoma in situ, which is noninvasive and highly treatable.
Fenton's results "constitute a substantial hit to this technology," Dr. Ferris M. Hall of Beth Israel Deaconess Medical Center writes in an editorial in the same issue. Early studies had said CAD helped detect 10 to 15 percent more cases of breast cancers.
CAD programs analyze digitized mammograms and mark suspicious areas for review by radiologists.
CAD picks up a disproportionate number of clustered microcalcifications, which are the sign of ductal carcinoma in situ. DCIS makes up 25 percent of breast cancers diagnosed in the United States, Hall writes, but DCIS may never progress to cancer in a woman's lifetime.
"CAD does find a few more cancers in DCIS, so it's got some usefulness, but in all likelihood it's not going to save many lives," he said in an interview.
A study of CAD and mortality will take more time, Hall said, as it did for screening mammography.
"Mortality is the gold standard," he said. "Finding extra cancers does not prove that you have affected anything. You may have found a cancer that you would find next year anyway."
MRI screenings do a better job, Hall said, but cost and the need for interpretive expertise are delaying its adoption, as they did for mammography before it was accepted, he said.
Posted by Elizabeth Cooney at 05:00 PM
April 04, 2007
Stem cell researchers should consider whether a woman has been pregnant when they interpret results of stem cell transplantation trials, Dr. Diana Bianchi writes in a commentary in today's Journal of the American Medical Association.
Bianchi, who is chair of research in the department of pediatrics at the Floating Hospital for Children at Tufts-New England Medical Center, showed in 1996 that fetal cells persist in the blood of women who have been pregnant. In 2004 she reported that these cells appear to act like stem cells, traveling to injured organs in the mother and repairing them.
Fetal cells are "betwixt and between" adult and embryonic cells, she said in an interview. Embryonic stem cells are prized for their ability to become any kind of cell in the body. Adult stem cells are less capable of this kind of differentiation.
"It's not all adult versus embryonic stem cells," she said. "Fetal cells may have qualties that are intermediate between embryonic and adult cells. We are still testing the hypothesis that they have capabilities that may be closer to embryonic stem cells than adult stem cells."
Recent discoveries of stem cells in amniotic fluid-- another "bewtixt and between" situation -- fit in with her findings, she said.
Bianchi and her co-author, Nicholas M. Fisk of Imperial College London, reviewed 58 articles on the long-term fate of stem cells transplanted into sex-mismatched recipients. None of them reported whether the women who donated or received these bone marrow transplants had been pregnant, they write in their commentary.
Without knowing the pregnancy history of women involved in trials using bone marrow stem cells to treat disease, researchers cannot know whether fetal cells or adult cells are responsible for the results they are seeing, Bianchi said.
"It's important because it's a mixed population of the woman's bone marrow stem cells as well as cells from all the pregnancies she has had, including ones she might have terminated," she said. "It's just remarkable to me that this is not part of the paradigm."
Posted by Elizabeth Cooney at 02:01 PM
April 04, 2007
By Scott Allen, Globe Staff
Officials at the Dana-Farber Cancer Institute today announced the second largest gift in the hospital's history: $30 million from a philanthropy dedicated to the memory of the longtime owners of the Boston Red Sox, Tom and Jean Yawkey.
The gift from the Yawkey Foundation will help pay for the first new patient care building in more than 30 years at Dana-Farber, the Yawkey Center for Cancer Care, which is scheduled to open in 2011.
The Yawkey Foundation's endowment skyrocketed in value after the family sold the Red Sox in 2002, enabling the board to give away more than $150 million in the past five years, including $15 million for improved cancer care at Boston Medical Center and $25 million for Massachusetts General Hospital's Yawkey Center for Outpatient Care.
But Dana-Farber always had a special relationship with the late Tom and Jean Yawkey, who made the hospital's Jimmy Fund the official charity of the Red Sox back in 1953, and today's gift is the largest in foundation history.
"More than 50 years ago, Tom and Jean Yawkey and our founder Dr. Sidney Farber shared a vision of one day conquering cancer," said Dr. Edward J. Benz, Jr., president of Dana-Farber, in announcing the donation. "The Yawkey's longstanding support of Dana-Farber and the Jimmy Fund has enabled us to move much, much closer to this goal and has helped save countless lives along the way."
The new 275,000 square foot outpatient treatment center to be constructed near the intersection of Brookline Ave and Jimmy Fund Way, will house 100 examination rooms, 150 beds for cancer treatment and a new front entrance for the entire Dana-Farber campus, located in the Longwood Medical Area.
Posted by Karen Weintraub at 10:49 AM
April 04, 2007
A 2002 study that led millions of women to throw out their hormone pills may have overestimated the dangers of that medication to women in their 50s, new research suggests. Study co-author Dr. JoAnn E. Manson will chat live with Globe readers about the report at noon at boston.com.
Paul Zani, chief executive officer of Pembroke Hospital, has resigned, and the hospital has agreed to cap its admissions amid several state investigations into the private psychiatric facility.
A strain of flu has shown hints of resistance to two flu drugs among patients in a small study in Japan, a country known for prescribing the drugs more frequently than anywhere else in the world.
The Nevada firm that imported tainted wheat gluten that triggered a massive, nationwide recall of pet food said it shipped the product only to pet food manufacturers.
Merck & Co.'s arthritis drug Arcoxia, the planned successor to its withdrawn Vioxx painkiller, probably won't win US clearance because studies suggest the product raises the risks of heart attacks.
Posted by Elizabeth Cooney at 06:20 AM
April 03, 2007
By Liz Kowalczyk, Globe Staff
People are enrolling faster than expected in health insurance plans under a new state law that eventually will require most Massachusetts residents to have coverage.
Nearly 63,000 people who earn less than 300 percent of the federal poverty level -- about $30,000 annually for an individual -- had signed up for state subsidized plans as of April 1, said officials overseeing implementation of the law. State officials had projected that it would take until July 1 to enroll 70,000 residents, out of the estimated 140,000 eligible for subsidized coverage.
Thousands of other residents who earn more than 300 percent of the poverty level will be required to enroll in non-subsidized programs this year. For individuals earning less than $10,210 per year, there are no monthly premiums. For those earning above that and up to $30,630, the average premium is $45 per month.
Information is available by calling 1-877-623-6765, weekdays between 8 a.m. and 5 p.m., or online at the Commonwealth Care website.
Posted by Gideon Gil at 07:21 PM
April 03, 2007
By Gareth Cook, Globe Staff
Harvard University's governing body has approved a new Department of Developmental and Regenerative Biology, the first academic department in the university’s 371-year history to be based in more than one of the university’s schools.
The new department will bring together 13 to 16 researchers from the Faculty of Arts and Sciences and Harvard Medical School. It will be co-chaired by biologist Doug Melton, the Cabot Professor of the Natural Sciences, and David Scadden, Gerald and Darlene Jordan Professor of Medicine at Harvard Medical School and Massachusetts General Hospital. Melton and Scadden are also the co-directors of the Harvard Stem Cell Institute, which was founded in 2004.
The decision by the Harvard Corporation is a response to a critical university report that called for better coordination of interdisciplinary research.
Posted by Gideon Gil at 06:05 PM
April 03, 2007
The Harvard School of Public Health is urging the Motion Picture Association of America to eliminate the depiction of tobacco smoking from films seen by children and youths.
HSPH dean Barry R. Bloom, Dr. Jonathan M. Samet of Johns Hopkins, and HSPH associate dean Jay A. Winsten delivered a scientific briefing in February.
"We know movies are only one of the determinants of smoking in youths, and I don’t want to hang the whole problem on the motion picture industry. But we know you can make a real difference," Bloom told the MPAA. "The glamorization of smoking in films, even when the bad guys smoke, has impact. And even normalization of smoking in films has impact."
Posted by Elizabeth Cooney at 05:29 PM
April 03, 2007
Zoila Torres Feldman, an ardent advocate for expanding access to high-quality health care, is leaving as chief executive officer of Great Brook Valley Health Center in Worcester after 26 years.
Zoila Torres Feldman
Feldman, 62, said her Oct. 1 departure is "absolutely not" a retirement. She has accepted no specific position but said she is passionate about addressing the ethnic and racial disparities that persist in health care.
"There are too many challenges in health care I’d like to participate in," she said in an interview. "I’d like to do some new things."
Her influence has been felt beyond Worcester, where the health center grew from an apartment in a housing complex to a free-standing clinic with an annual budget of $23 million and 140,000 patients a year. Another health center opened in Framingham last year, despite anti-immigrant opposition.
Feldman, who lives in Newton, is a native of Ecuador and a graduate of Boston University and the Harvard School of Public Health. She worked as a nurse for 12 years at Tufts-New England Medical Center.
"I think there is no more talented and respected community health leader in the commonwealth than Zoila," Andrew Dreyfus, executive vice president of health care services at Blue Cross Blue Shield of Massachusetts, said in an interview. "Her center was a kind of magnet for innovation in community health delivery. She was always a thought leader in the kind of public policy issues that surround the community health movement."
Posted by Elizabeth Cooney at 01:37 PM
April 03, 2007
Dr. Terence R. Flotte, a pediatrician and gene therapy researcher from the University of Florida, has been named the new dean and deputy executive chancellor of the University of Massachusetts Medical School.
Dr. Terence R. Flotte
Currently the chair of pediatrics at the University of Florida School of Medicine in Gainesville, Flotte, 45, will succeed Dr. Aaron Lazare, 71, on May 15. Last year Lazare stepped back from the dual role of dean and chancellor of UMass Medical School, remaining chancellor until last month, when for health reasons he began a one-year sabbatical. He will then return to teaching psychology.
Flotte focuses his research on genetic therapies and cystic fibrosis in particular. He plans to continue to conduct research, see patients and teach.
"It is a very special time right now for UMass Medical School," Flotte said in an interview. "The new dean will have the great privilege of helping to lead the process whereby scientific knowledge will be translated into benefits for patients, first through clinical trials and, we hope, to usable treatments for patients with diseases ranging from Huntington’s disease to cancer to you name it."
Flotte was one of four finalists to become the dean of the UF medical school, a position that last month went to Dr. Bruce C. Kone, chairman of the department of internal medicine at the University of Texas Medical School in Houston. Flotte said he applied for both positions because he wanted to do more than a department head can.
In a memo to members of the medical school, UMass President Jack M. Wilson said the search committee looked at department chairs because medical school departments can be incubators for leadership and vision.
"In this regard, Dr. Flotte has a superb record: Under his leadership the department of pediatrics has grown in size, funding, prestige and opportunities for clinical and education service initiatives," Wilson wrote.
Flotte is a graduate of the University of New Orleans and Louisiana State University School of Medicine. He completed a residency in pediatrics, a pediatric pulmonary fellowship and postdoctoral training in molecular virology at Johns Hopkins University.
Posted by Elizabeth Cooney at 12:05 PM
April 03, 2007
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.
Posted by Elizabeth Cooney at 09:01 AM
April 03, 2007
In a defeat for the Bush administration, the US Supreme Court ruled yesterday that greenhouse gases are pollutants and ordered federal environmental officials to reconsider their refusal to limit emissions from new cars and trucks.
About 1 in 4 people who appear to be depressed are in fact struggling with the normal mental fallout from a recent emotional blow, like a ruptured marriage, the loss of a job, or the collapse of an investment, a new study led by Jerome C. Wakefield of New York University suggests. To avoid unnecessary diagnoses and stigma, the standard definition of depression should be redrawn to specifically exclude such cases, the authors argue.
The the American College of Physicians is challenging the widely accepted recommendation that women should routinely undergo mammograms in their 40s, saying the risks of the breast exams may outweigh the benefit for many.
Tainted wheat gluten that triggered a massive nationwide pet food recall also ended up in processing plants that prepare food consumed by people, the Food and Drug Administration said yesterday.
Two subsidiaries of Pfizer Inc. have agreed to pay fines totaling $34.7 million for offering a kickback to recommend company drugs and for illegally promoting the human growth hormone product Genotropin for nonapproved uses, federal prosecutors said yesterday.
Posted by Elizabeth Cooney at 06:22 AM
April 02, 2007
By Stephen Smith, Globe Staff
A proposal to spend $36.5 million to prepare the state for a long-feared global epidemic of influenza is back before Massachusetts lawmakers, three months after they failed to act on the measure.
The money would be used in large part to buy breathing machines, hospital beds, and caches of flu medication. The legislation, sponsored by Senator Richard T. Moore, resembles a pandemic plan originally championed in February 2006 by then-Governor Mitt Romney.
Moore, an Uxbridge Democrat who is chairman of the Joint Committee on Health Care Financing, also calls in his legislation for spending money to improve the state laboratory, enhance disease tracking systems, and strengthen the ability of local health departments to deal with major health emergencies.
A hearing on the proposal is expected this week.
Posted by Gideon Gil at 07:53 PM
April 02, 2007
Quickly closing schools, theaters and churches reduced deaths early in the deadly 1918 flu pandemic, researchers report in today's online Proceedings of the National Academy of Sciences.
Measures taken by different American cities were compared to see whether they were associated with reduced transmission of the flu virus, which is spread by coughing or sneezing. The first US cases of flu were reported in Philadelphia on Sept. 17, 1918, but city officials still allowed a a parade on Sept. 28 and public gatherings were not banned until Oct. 3, when cases were overwhelming the health system.
In St. Louis, public health authorities closed schools, theaters and churches two days after their first cases on Oct. 5, and that city experienced a smaller epidemic, with half the number of deaths at its peak.
"Looking back at the comparison between cities in 1918, there were enormous variations in the severity of the pandemic in different cities and those variations seem to be closely tied to the aggressiveness and promptness with which different cities put in place a set of interventions to try to block transmission," co-author Marc Lipsitch, professor of epidemiology at the Harvard School of Public Health, said in an interview.
Once those interventions were relaxed, the death rates among different cites became the same. Temporary measures were still valuable, Lipsitch said, because they reduced the stress on society and on the healthcare system by buying time at the peak of the epidemic.
"This gives support to the notion, which is now federal policy, that when facing the next pandemic communities should try as early as possible to implement a set of measures similar to this if the pandemic is severe," Lipsitch said.
Posted by Elizabeth Cooney at 05:00 PM
April 02, 2007
Sixty families in Massachusetts were among 750 who tested a pilot version of the Interactive Autism Network, a website designed to accelerate research by connecting families with scientists who study the disorder. The site goes live today.
Julie Riley of Whitman, whose 7-year-old son is autistic, was among the testers during the pilot phase. She urged other parents to join the new network, both to learn from one another's experiences and to find answers for a future in which trial and error aren't the only way to discover what works.
"The more parents we get to participate, the more results we can get," she said in an interview. "I think it's a way to get closer to a cure."
The goal is to have families enter information about their children into a secure database that could be explored by researchers. The site is also designed to help researchers recruit participants for studies that have been approved by their institutional review boards.
There will be a forum for parents as well as information reviewed by doctors for scientific validity, founders Dr. Paul Law and Dr. Kiely Law of the Kennedy Krieger Institute in Baltimore said in an interview. They have a 13-year-old son with autism.
Dr. Margaret Bauman, associate professor of neurology at Harvard and head of the LADDERS program for developmental disorders at Massachusetts General Hospital, was on a committee that worked on the site.
"The hope is this mechanism will match families with researchers and vice versa," she said. "Parents who have been in the world of autism for a couple of years are asking questions."
The IAN project is supported by a $6.5 million grant from the non-profit Autism Speaks.
Posted by Elizabeth Cooney at 08:32 AM
April 02, 2007
Random urine tests for drug use have a high error rate even when performed in adolescent substance abuse programs, researchers from Children's Hospital Boston report in the April issue of Pediatrics.
Dr. Sharon Levy and her colleagues at the hospital's Center for Adolescent Substance Abuse Research took 710 random urine tests from 110 patients who were 13 to 21 years old and enrolled in a drug program. Comparing the results with those obtained from confirmed laboratory tests, they found that 12 percent of the random tests had results that could be misinterpreted.
Some of the samples were too diluted to interpret reliably. Of the samples confirmed to show Oxycontin use, two-thirds had tested negative at first.
Drug-testing programs demand rigorous procedures and well-trained people to obtain accurate results, the authors conclude.
"'Quick and dirty' drug-testing programs that use procedures of convenience are likely to result in unintended consequences, such as misidentifying some students as using illicit drugs when they are not and enabling others to continue illicit drug use by allowing them to evade detection easily," the Children's authors wrote.
In last month's issue the American Academy of Pediatrics said drug testing of adolescents at home or in school was unreliable and lacked scientific proof of effectiveness.
Posted by Elizabeth Cooney at 06:28 AM
April 02, 2007
A team led by Harvard researchers has found dramatic genetic links to prostate cancer that appear to underlie many of the cases and help explain the higher occurrence of the disease among African-American men.
Boston's hospitals are going green: The city's next wave of medical buildings will feature earth-friendly construction materials. Sunlight will bathe patient rooms, and some roofs will sprout grass or "healing gardens" that use recycled water and provide insulation.
People who hoard bear the weight of their mess plus a mental disorder only now being understood. Treatment programs are just beginning.
In choosing a doctor, people surveyed for Blue Cross and Blue Shield of Massachusetts said the most important information is the doctor's experience treating a specific medical condition, the average amount of time the doctor spends with each patient, and patient satisfaction ratings.
His career, her health. Not an easy balancing act, Judy Foreman writes about John and Elizabeth Edwards -- and her own 11 years grappling with that dilemma while her husband Tom had lymphoma and prostate cancer.
Also in Health/Science, meet environmental epidemiologist Phillippe Grandjean, who studies the relationship between chemicals and children's diseases.
In Business, Boston Scientific Corp. plans to spend up to $40 million on a campaign to educate patients who receive the company's heart stents about the importance of sticking with the blood-thinning drugs they are prescribed after surgery.
In Living/Arts, a new book by Harriet A. Washington called "Medical Apartheid" puts clinical testing of minorities on trial.
Posted by Elizabeth Cooney at 06:27 AM
April 02, 2007
The flu spawned significantly fewer fevers and coughs than usual this winter in Massachusetts and much of the nation, the second straight year that the season of misery passed without widespread suffering.
"It's a very, very slow this season," said Dr. Alfred DeMaria, the director of communicable disease control in Massachusetts, said in Saturday's Globe.
Posted by Elizabeth Cooney at 06:24 AM
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