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May 25, 2007
Louis Kunkel, director of the program in genomics at Children's Hospital Boston, has won a one-year $100,000 distinguished investigator award from the Mental Health Research Association to study gene expression in autistic children.
Dr. Mary Jane England, president of Regis College, has been honored as this year's outstanding psychiatrist for lifetime achievement by the Massachusetts Psychiatric Society.
Dr. Suzanne A. Bird, medical director of Cambridge Health Alliance's psychiatric emergency service, has received the annual Irma Bland Award for Excellence in Teaching Residents from the American Psychiatric Association.
Maureen Walsh, a nurse and health teacher at St. Francis Xavier School in South Weymouth, was one of 13 people to receive national recognition from the Food Allergy & Anaphylaxis Network for service to children with food allergies.
US Representative Patrick Kennedy of Rhode Island will be honored with fellow Congressman Jim Ramstad of Minnesota for their Campaign to Insure Mental Health and Addiction Equity at Mental Health America's annual meeting June 6 through 9 in Washington.
Posted by Elizabeth Cooney at 11:34 AM
May 25, 2007
After gloriously soaring to freedom over Falmouth on Sunday, a rare yellow-nosed albatross is back in captivity, thousands of miles from its South Atlantic range.
Congress should give the Food and Drug Administration new powers to regulate tobacco products -- including a plan to reduce nicotine levels -- to help slash smoking rates, an Institute of Medicine committee said yesterday.
Smoking is forbidden in nearly 75 percent of US households, a dramatic increase from the 43 percent of homes that prohibited smoking a decade ago, the federal government reported yesterday.
Chemicals like those in marijuana help shape the way brain cells form connections, scientists said, suggesting why pregnant women who smoke pot may harm fetuses.
Posted by Elizabeth Cooney at 06:20 AM
May 24, 2007
Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at email@example.com.
In Patient Doctor I -- the art of taking a medical history -- several classmates and I intrude weekly into the lives of Beth Israel Deaconess Medical Center patients to practice our interviewing skills and bedside manner.
Last week, these skills were captured in all their glory on videotape as we interviewed "patients," portrayed by actors, about stomach pain and bisexual curiosity. I bumbled my way through the interview, armed with a yearís worth of reading about how far to sit from a patient, what tone to adopt, how to listen attentively, and when to stay silent -- more the stuff of a Miss Manners column than a class textbook.
Though we often joke about such inorganic means of teaching and implementing kindness -- "That must be tough for you" is one empathic statement that we deliberately overuse to the point of absurdity -óIíve found that learning the vocabulary of human connection can be just as critical as the language of human anatomy and disease.
Take "concern" -- Iím concerned about how your six-pack a day might be affecting your health; do you have any concerns about controlling your asthma?; it sounds like youíre concerned that this might be cancer. Equipped with this word alone, we can convey caring, encourage positive life changes, uncover diagnoses and treatment strategies, and elicit patientsí fears or the real reasons behind their visit.
When I was first robed in a white coat and thrust in front of a patient last fall, I felt uneasy adopting such vocabulary because it implied that I had some clinical expertise to offer. Over dozens of interviews and scores of awkward moments, Iíve come to realize that talking the talk without walking the walk, so to speak, can be valuable in its own right -- as long as you use the right words.
Thinking back on my first year, I wonder whether this language has been the most lasting lesson in some ways, a piece of medical school that has readily seeped into my relationships with friends and family in ways that endear rather than alienate. As our Patient-Doctor preceptors reminded us yesterday in our closing session, even a seasoned doctorís most critical skill is making conversation. Itís not a bad skill for life, either.
Posted by Ishani Ganguli at 03:49 PM
May 24, 2007
By Stephen Smith, Globe Staff
With apologies to Hillary Rodham Clinton: When it comes to public health, it takes a village.
That's the question the state's new public health commissioner, John Auerbach, is asking. Massachusetts now has a crazy quilt of 351 public health boards -- one for every city and town. Some are so small that on certain afternoons, especially Fridays, they simple close down.
Auerbach told the state's Public Health Council today that he intends to explore the feasibility of creating regional public health networks to maximize expertise and assure responsiveness.
"There has to be a solution other than the current way of functioning," Auerbach said in an interview. "Most other states have already figured this out. We're the exception."
Florida, for example, which has three times the population of Massachusetts and considerably more land mass, has 67 county health departments.
Posted by Karen Weintraub at 01:53 PM
May 24, 2007
By Stephen Smith, Globe Staff
The state's Public Health Council today unanimously approved a major expansion at Massachusetts General Hospital that will increase the number of operating suites, add more private rooms, and allow ambulances to arrive protected from the weather and prying eyes.
The heart of the nearly $500 million expansion is a new 10-story building that will rise in the shadow of the hospital's iconic entrance on Fruit Street. The total number of beds at Mass. General will increase from 902 to 1,052, while the roster of operating rooms will grow from 52 to 71.
The project is expected to be completed by October 2011, and hospital administrators pledged that the new tower will be built to high environmental standards.
Regular crowding in the emergency room was cited as a prime reason for the expansion. Patients wait on average 7 to 8 hours in the hospital's bustling room because there aren't beds available elsewhere in the hospital to accept cases.
"If you ask me what keeps me awake at night, it's the fact that we have overcrowding in our emergency department," said Dr. Alasdair Conn, chief of emergency medicine at Mass. General. "Frankly, it gets very cramped. But emergency department overcrowding is not an emergency problem -- it's a hospital overcrowding problem."
As part of its deal with the state to win approval for the expansion, Mass. General is pledging to spend $18.6 million on community initiatives to address substance abuse, violence and healthcare disparities.
Posted by Karen Weintraub at 11:27 AM
May 24, 2007
Harry Spence, replaced yesterday as commissioner of the state Department of Social Services, wanted more time leading DSS and submitted a written application to Governor Deval Patrick earlier this month.
Thousands of sickly newborns could be saved each year if officials closed some of the nation's smaller neonatal intensive care units, according to a new study that suggests larger hospitals are better able to treat the infants.
A professor at the University of Massachusetts at Amherst who has waged a nearly six-year fight to persuade the government to let him grow marijuana for medical research pressed his case yesterday outside the offices of the US Drug Enforcement Administration. Horticulturist Lyle Craker said he wants to boost research into potential medicinal benefits of marijuana.
If mammography is going to continue to save lives, researchers must find out why fewer women, especially those in the critical 50 to 64 age group, are turning away from it, a Globe editorial says.
Posted by Elizabeth Cooney at 06:21 AM
May 23, 2007
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.
Harvard University spokesman John Longbrake said the university would not comment on the search until it is completed.
The next dean of Harvard Medical School will replace Dr. Joseph Martin, who steps down next month, ending a 10-year tenure during which he oversaw dramatic changes to the school's curriculum. Martin, a neurologist, plans to take a sabbatical for one year and then increase his work with the Harvard Center for Neurodegeneration & Repair, a group that is trying to develop new drugs for Parkinson's and Alzheimer's disease and other neurological disorders.
Interim Harvard University president Derek Bok convened a faculty search committee to recommend potential replacements for Martin. But he left the final decision to Faust, partly because of the medical school's importance -- it has 11,000 faculty members and $1.2 billion in National Institutes of Health research grants awarded to the medical school and its affiliated hospitals. The medical school dean also will have a key role in the development of Harvard's new Allston campus, where a major stem cell research institute and other scientific laboratories will be located.
The search committee evaluated an initial list of several hundred candidates, the sources said, but the committee is advisory; Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.
Posted by Gideon Gil at 06:50 PM
May 23, 2007
Taking aspirin regularly has long been known to prevent colorectal cancer in some people, but why thatís true has been unclear.
Researchers have suspected that blocking the enzyme COX-2 might be the mechanism involved. Dr. Andrew T. Chan and his Harvard Medical School colleagues confirm a connection to COX-2 in an article to appear in tomorrowís New England Journal of Medicine.
Analyzing data from two large observational studies, they found that regular aspirin use ó two or more tablets a week for more than 10 years ó reduced the risk of developing colorectal tumors with high levels of COX-2 by 40 percent but did not have any effect on tumors without COX-2.
"Thatís a pretty striking difference," Chan said in an interview.
Itís too soon to suggest taking aspirin to prevent colorectal cancer, he said. At this point no one knows how to predict who will develop COX-2 negative or COX-2 positive forms of the cancer. Further studies are needed to see if people who develop polyps that are COX-2 positive, or people who had COX-2 positive tumors and are concerned about recurrence, might benefit from aspirin.
"Weíre on the right track," Chan said. "Ultimately, we may reach a point of making clinical recommendations for some subset of the population to improve the methods we already have to prevent colorectal cancer," such as screening, eating a balanced diet low in red meat and maintaining a low body weight, he said. "People can do that now."
In an editorial accompanying Chanís article, Dr. Sanford D. Markowitz of Case Western Reserve University School of Medicine echoed the articleís call for more research into other ways to inhibit production of COX-2, noting that only one-third of the COX-2 positive colorectal cancers were prevented by regular aspirin use.
"We need to ask whether there are alternative strategies for targeting the COX pathway that have better efficacy or lower rates of adverse effects," Markowitz writes.
Posted by Elizabeth Cooney at 05:12 PM
May 23, 2007
By Alice Dembner, Globe Staff
A 63-year-old Bedford couple are the first purchasers of the new non-subsidized insurance plans offered through the Commonwealth Health Insurance Connector.
Parimal Patel drove all the way to the processing center in Worcester a few weeks ago to present his check for the first month's premium, even though the insurance doesn't kick in until July 1.
In his first interview with the media, he said today that he wanted to be sure the check didn't get lost in the mail or in a crush of other people applying for coverage.
He is paying $1,350 a month total for himself and his wife, Ruth, both of whom have diabetes. He purchased a comprehensive, but not top-of-the-line plan offered by Blue Cross Blue Shield as part of the Commonwealth Choice products.
"It's not exactly cheap, but it's about 30 percent cheaper than the market rate," said Patel, who retired early from management at Thermo Electron Corp. in Waltham and whose work-based insurance will end June 30.
The new insurance, he said, will tide the couple over until they qualify for Medicare in a few years.
Posted by Karen Weintraub at 04:33 PM
May 23, 2007
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.
The prize was created by New York hedge fund managers Joel Greenblatt and Robert Goldstein of the investment firm Gotham Capital and Curhan, a kidney specialist at Brigham and Women's Hospital. For the website, they took as their model the Value Investors Club, an online group where members share investment ideas.
The winner will be selected based on the quality of the idea, the feasibility of studying it, and on the comments it generates on the forum. The prize will be awarded in February. An additional $250,000 Ira Sohn Conference Foundation Prize in pediatric oncology will also be offered.
The scientific advisory board for the prizes includes Dr. Meir J. Stampfer of Harvard's medical and public health schools.
Joan S. Brugge, a cancer researcher at Harvard Medical School who is not involved in the prize, applauded the marketplace of ideas approach that the website will take.
"Since research money is really tight, any influx of support for cancer research is a good thing in general," she wrote in an e-mail. "'Experimentation' to evaluate new strategies to stimulate novel ideas and new approaches can't hurt cancer research and could indeed lead to important new breakthroughs."
Federal funding for cancer research has been flat in recent years, but still provides the foundation for basic knowledge, she said.
"These kinds of creative approaches ... should not be viewed as substitutes for continued robust/large scale support of investigator-initiated programs at NIH," Brugge wrote.
Posted by Elizabeth Cooney at 03:36 PM
May 23, 2007
Governor Deval Patrick is poised to announce today the fate of several key commissioners remaining from the previous administration, including Harry Spence (left), the embattled leader of the Department of Social Services, who is expected to be replaced by the head of a New Jersey children's welfare group.
Wyeth won US approval for its contraceptive Lybrel, the first birth control pill designed to completely eliminate monthly periods.
Posted by Elizabeth Cooney at 06:31 AM
May 22, 2007
Dr. Eric P. Winer (left) today was named chief scientific adviser to Susan G. Komen for the Cure, the breast cancer advocacy group.
He will remain director of breast oncology at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School while taking on the new role at Komen. He explained in an interview why he is excited about the opportunity and about the future of breast cancer research.
Why did you agree to join Komen?
Itís a way of helping an organization that I view as a very strong organization to do even better in the future. Komen is about raising money for research and increasing those funds to answer the most appropriate questions as quickly as possible. This is now a way for me to have a slightly larger influence beyond the exam room, beyond my own institution and to work in an organization that is really trying to do good.
What are some of the questions that need answers?
We have new treatments that are better treatments, but one of the issues that arises is, the better the treatments get, the more important access to care gets. When you have a disease that is very poorly treated, it almost doesnít matter whether people have access if theyíre not going to get well. When you have a disease that can be more effectively treated, access to care ó and this applies in the United States and worldwide ó becomes increasingly important. Among the various goals that Komen has is trying to improve access to care.
Whatís important on the research agenda?
This is a time when there really have been advances in our understanding of breast cancer biology that we need to translate into treatments in the clinic that will actually help patients with breast cancer and cure women with breast cancer. This is occurring at a time when federal funding for research has gone down, so organizations like Komen become even more important in terms of their ability to support research.
How will you influence the research that gets done?
Research funds will still be given out to investigators based on the peer review system. However, we can put out requests for applications in specific areas, as has always occurred with federal funds. Itís an important way to ask for proposals in areas where we think there can be the biggest bang for the buck.
What are the significant advances in breast cancer research over your 20-year career?
There are really two major areas: One is that we have finally understood that breast cancer isnít one disease but a family of fairly distinct diseases that each requires different treatments. One-size-fits-all doesnít work. And our understanding of that is paired with the increasing ability to identify treatments for each of those different subtypes. An example is the drug Herceptin for HER-2 positive breast cancer. HER-2 positive breast cancer is a distinct entity and we have treatments that work based on that.
What do you see for the future?
One of the exciting things about the work Iíve been able to do, by no means by myself but with hundreds of others, is that there really will have been a dramatic change in breast cancer. For a disease that was terrifying to women and that took many lives, I think that it will be a disease that takes very few womenís lives by the time Iím at the end of my career.
How old are you?
Iím 50. I donít view this as preparation for retirement.
Posted by Elizabeth Cooney at 05:38 PM
May 22, 2007
By Stephen Smith, Globe Staff
A plastic container in a laboratory at Boston Medical Center caught fire late this morning, resulting in smoke but no injuries or damage, according to a hospital spokeswoman.
The container, carrying a salt solution, was being used by researchers in an endocrinology lab on the second floor of the building at 670 Albany St., said Maria Pantages, a Boston Medical spokeswoman. The researchers said they believed they had put the container into a machine that would spin its contents, Pantages said. Instead, the device was both a spinner and a hot plate, and about 11:45 a.m., researchers smelled smoke.
The building was evacuated as a precaution and emergency units summoned. Within 45 minutes, she said, the building's occupants were allowed to return.
In March, smoldering medical waste caught fire in a sterilizing machine in a lab at the Boston University School of Medicine. The BU medical school and Boston Medical Center are affiliated institutions.
Posted by Karen Weintraub at 04:13 PM
May 22, 2007
Senator Jarrett Barrios, a Cambridge Democrat who has been an outspoken advocate for minorities and gay marriage, confirmed today that he will leave office in early July to become the president of the Blue Cross Blue Shield of Massachusetts Foundation. He will replace Nancy Turnbull, now an associate dean at the Harvard School of Public Health.
Posted by Gideon Gil at 03:43 PM
May 22, 2007
By Carey Goldberg, Globe Staff
Late last month, Journal Watch, a publication for doctors seeking quick highlights of recent research, published an overview of an important question: whether pregnant women should take antidepressants.
Headlined "Antidepressants during Pregnancy: Treating the
Condition While Acknowledging the Risks," it was written by Dr. Claudio N. Soares.
Today, Dr. Adam Urato, a Tufts assistant professor and obstetrician at New England Medical Center, sent The Globe a copy of a complaint he has just filed with the journal's editors, saying that the piece downplayed the potential dangers of antidepressants during pregnancy, and failed to adequately disclose that Soares had received payments from at least six drugmakers.
Journal Watch is published by the Massachusetts Medical Society, which also publishes the New England Journal of Medicine.
In an e-mail to the Globe, Urato said that Journal Watch "shouldn't be running one-sided editorials on antidepressants in pregnancy without notifying readers that the author is paid by the antidepressant manufacturers."
Dr. Sandra Ann Carson, Editor-in-Chief of Journal Watch, Women's Health, responded to a Globe query:
"Dr. Urato has mistakenly overlooked the disclosures by Dr. Soares at
Journal Watch's conflict-of-interest policy is publicly available at
Sandra Jacobs, spokeswoman for the publishing division of the Massachusetts Medical Society, said that the site is in the process of being restructured to make financial disclosures more obvious.
Posted by Karen Weintraub at 03:34 PM
May 22, 2007
Childrenís Hospital Boston has named James Cote (left) executive director of the Martha Eliot Health Center, a community health center in Jamaica Plain that is licensed and operated by Childrenís.
Cote, who had been the health center's interim leader for the past year, has also worked at Childrenís and Boston Medical Center. He holds an MBA with a specialty in health care administration and marketing from UMass-Boston and a bachelor's degree in biology from Saint Josephís College in North Windam, Maine.
Posted by Elizabeth Cooney at 10:03 AM
May 22, 2007
Avandia, the world's top-selling oral diabetes drug, significantly increases the risk of heart attacks, a prominent cardiologist said in an article that the New England Journal of Medicine deemed important enough to post on its website yesterday, weeks before the scheduled print publication date. Patients taking Avandia should not abruptly stop the drug, the FDA said. Instead, they should meet with their doctors to discuss their risk of a heart attack and how well their diabetes is controlled, according to Dr. Larry C. Deeb, president of medicine and science for the American Diabetes Association.
Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority, which is overseeing implementation of the state's healthcare revamp, will gather with state political leaders and Red Sox executives today at Fenway Park to unveil a $3 million advertising campaign (above) that is heavily tied to the Red Sox and will be featured on the team's cable television outlet, New England Sports Network.
Medtronic Inc. will report today that its stent for preventing heart attacks didn't cause blood clots in tests, increasing the company's chances of expanding its share of the $5.4 billion-a-year worldwide market. The results, to be presented at a scientific meeting in Barcelona, suggest that experimental devices may be safer than those sold by Johnson & Johnson and Boston Scientific Corp.
Posted by Elizabeth Cooney at 06:28 AM
May 21, 2007
On WBUR's CommonHealth, Bťatrice Schaad Noble, a Swiss journalist who is getting her masterís in public health at the Harvard School of Public Health, explains how Switzerland approached universal health insurance coverage.
"Switzerland has gone through the same problems Massachusetts is facing now. Eleven years ago, pockets of resistance were strong. Some people deeply disliked being forced to buy coverage," she writes. "Today resistance has completely disappeared. Last March Swiss have even refused in a vote to shift to a single payer system."
On Running a Hospital, Beth Israel Deaconess CEO Paul Levy posts the latest report on central line infection rates. In the past he has challenged other hospitals to do the same.
"The overall quarterly trend is in the right direction, but as you can see ..., there is troublesome variation from time to time," he writes. "The up's and down's, I guess, are normal, but we all wish they stay down."
Posted by Elizabeth Cooney at 11:22 AM
May 21, 2007
Skeptics wonder whether a third failure to eradicate polio would doom the ambitious two-decade effort, which has cost $5.3 billion so far and is appealing to donor nations for funds at a time when other diseases such as AIDS and malaria are consuming global health resources.
After weeks of care at the Tufts School of Veterinary Medicine -- and then a long, bumpy ride in the back of a van driven by wildlife doctor Flo Tseng -- the yellow-nosed albatross, thousands of miles from its true home, waddled warily yesterday from a dog carrier box onto the rain-spattered sands of Old Silver Beach. Then it spread its 6 1/2-foot span of wings to achieve "lift" from the wind. It was airborne in an instant, veering sharply down coast, harried by seagulls and scolding crows.
Medical research is undergoing a sea change in its approach to linking genes to disease. Instead of hunting individual mutant genes -- a painstaking, expensive process -- researchers are more often turning to genome-wide association, a bold, computer-driven technique that allows for fast, cheap scanning of vast regions of DNA for anomalies that can make people more susceptible to a disease or even directly trigger illness.
Laura, a computer-generated character, raises and knits her eyebrows, nods her head ever so gently, and almost seems to sigh as she commiserates with a patient over how challenging it is to remember to take pills or get out for a walk. A virtual health coach, she asks questions of patients and responds empathetically and encouragingly to their answers.
A doctorate in genetic toxicology doesn't have to mean a life squirreled away among test tubes. That's the lesson in the career of Brindha Muniappan (left), a health science educator at Boston's Museum of Science. "I'm a scientist," says Muniappan, 34, who taught environmental toxicology at the University of Guam. "Working on specific mutations was great," she says. "But I realized I wanted to talk about a lot of other topics."
You don't have to propose a 130-turbine wind farm in the middle of Nantucket Sound to cause a controversy. In Fairhaven, two proposed turbines behind the town's wastewater treatment plant have earned the wrath of a vocal group of residents who say the whirring blades will be too noisy and cast flickering shadows on homes during sunsets.
Two medical device companies, Hologic Inc. and Cytyc Corp., have agreed to a $6.2 billion deal that will create a women's healthcare powerhouse in Boston's suburbs, they said yesterday.
Posted by Elizabeth Cooney at 06:27 AM
May 21, 2007
Jonathan and Robert Kraft are hoping to attract
40,000 visitors daily to Patriot Place.
(Globe Staff Photo /Barry Chin)
The same doctors who treat Tom Brady, Tedy Bruschi and other New England Patriots players will soon be available to examine the knee your kid sprained at soccer practice, Christopher Rowland reports in Sunday's Globe.
Dr. Bertram Zarins and Dr. Thomas J. Gill, Massachusetts General Hospital orthopedic surgeons who serve as Patriots team doctors, will be among the marquee physicians who will work next year at a new sports medicine center and outpatient surgical clinic in Foxborough, part of the Patriot Place commercial complex the Kraft family is building around Gillette Stadium.
Posted by Elizabeth Cooney at 06:25 AM