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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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 Short White Coat blogger Jennifer Srygley
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« June 10, 2007 - June 16, 2007 | Main | June 24, 2007 - June 30, 2007 »

June 22, 2007

Soaring costs threaten universal coverage in Switzerland

By Alice Dembner, Globe Staff

While Massachusetts is the first state to require every adult to have health insurance, Switzerland led the way internationally, imposing a similar mandate on its 7.4 million residents in 1996.

Like the Massachusetts law, the Swiss initiative did not include any significant cost containment measures and that is one of Switzerland’s biggest mistakes, according to Ruth Dreifuss, who was a top official in the Swiss government.

Speaking today at a forum about the Swiss plan and its lessons for Massachusetts, Dreifuss said the cost of healthcare has soared, and with it, the price of premiums and the cost to taxpayers of insurance subsidies for low-income people.

About one-third of the Swiss people get subsidies. And some of those who don’t are paying as much as 16 percent of their income for healthcare, according to Beatrice Schaad Nobel, a Swiss journalist who also spoke and who just completed a report on the Swiss program for the Massachusetts Health Policy Forum, a nonprofit group that aims to improve healthcare here. The Forum and Health Care for All sponsored the talk.

The Swiss initiative has brought universal coverage and continues to have broad support, Dreifuss said. But "a system with no cost containment is not a sustainable one," she added. "I am worried about the future."

What can be done? The Swiss are still trying to figure that out. But Dreifuss said more managed care is one possibility, as well as setting up a government system to pay for the largest healthcare costs. The latter suggestion, called reinsurance, has also been floated here, but rejected so far on both sides of the ocean.

Nobel also suggests that unfettered competition among insurers might help, as well as larger copayments for patients who opt out of managed care programs that control access to specialists and hospitals.

In Massachusetts, the issue of cost control has been left to a newly appointed Quality and Cost Council, which has just set goals for this year that include finding ways to prevent unnecessary hospital stays and providing consumers with comparative cost data on hospitals.

June 22, 2007

Harvard researcher wins MERIT Award from NIH

Lin100.bmpXihong Lin (left), professor of biostatistics at the Harvard School of Public Health, has won a MERIT Award from the National Institutes of Health.

Lin will develop statistical methods for analyzing cancer research data, including long-term and family data as well as genomic and proteomic information in epidemiological studies and population sciences, NIH said in a statement.

Fewer than 5 percent of NIH-funded investigators are selected to receive the awards.

Current MERIT recipients in Massachusetts and their instituions are:

Beth Israel Deaconess Medical Center: Benjamin G. Neel
CBR Institute for Biomedical Research: Timothy R. Springer
Children's Hospital Boston: Michael Klagsbrun and Bruce R. Zetter
Dana-Farber Cancer Institute: Stanley Korsmeyer and David M. Livingston
Harvard: John Blenis, Stephen C. Harrison, Peter M. Howley and Andrew G. Myers
Massachusetts General Hospital: Daniel Haber
MIT: Michael R. Lieber, Stephen J. Lippard and Alexander Rich
Tufts: John M. Coffin
Whitehead Institute for Biomedical Research: Rudolph Jaenisch

Posted by Elizabeth Cooney at 11:05 AM
June 22, 2007

Today's Globe: eldest know best, Arctic Ocean explorers, pathologist off duty, Parkinson's gene therapy, follow-on biologics, biotech strategy, Bulger for Carney, drug pricing

A large study by Norwegian scientists appearing in today's edition of Science concludes that a child raised as the eldest has a higher intelligence quotient, on average, than younger siblings.

camper150.bmpAn international team of scientists is embarking on a search for life on the floor of the Arctic Ocean, the smallest but least known of the world's oceans. Led by researchers from the Woods Hole Oceanographic Institution, deep-sea specialists will be equipped with unique robotic vehicles (including the Camper, left) designed to explore mountain ranges miles beneath the polar ice cap.

State pathologist Dr. William M. Zane, whose autopsy error forced prosecutors to downgrade murder charges against twin brothers from Ayer, will not be allowed to examine any potential homicide victims until the Patrick administration completes a review of the state medical examiner's office.

An experimental treatment for Parkinson's disease seemed to improve symptoms -- dramatically so, for one 59-year-old man -- without causing side effects in an early study of a dozen patients.

Good patient care demands that manufacturers show that their products are safe and effective before they are allowed on the market, Dr. James A. Bianco, president and CEO of Cell Therapeutics Inc. in Seattle, writes on the op-ed page. For biologics, including the follow-on type , the only way to demonstrate this is through clinical trials -- though follow-on biologics should be on an expedited track.

Governor Deval Patrick told a group of business and science leaders yesterday that he will introduce legislation next month detailing his $1 billion biotechnology proposal.

bulger100.bmpCaritas Carney Hospital in Dorchester, part of the six-hospital Caritas Christi Health Care system being sold by the Archdiocese of Boston, has tapped William Bulger (left), former president of the state Senate and the University of Massachusetts, to help it raise money.

US District Judge Patti B. Saris ruled against pharmaceutical companies AstraZeneca PLC, Schering-Plough Corp., and Bristol-Myers Squibb Co. in Boston yesterday, finding them guilty of engaging in unfair and deceptive trade practices for their medication prices, according to the law firm of Hagens Berman Sobol Shapiro LLP.

Posted by Elizabeth Cooney at 06:30 AM
June 21, 2007

Heart care beats US average at four Mass. hospitals, new Medicare rankings say

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.

Posted by Elizabeth Cooney at 05:32 PM
June 21, 2007

Doctor denies painkiller allegations, lawyer says

By Liz Kowalczyk, Globe Staff

Dr. Joseph Zolot, whose license was suspended yesterday for prescribing too many painkillers to patients -- some of whom suffered fatal overdoses -- is innocent, his attorney said today. Jeffrey Catalano of Boston said that his client "vehemently denies all allegations" and "is looking forward to vigorously defending himself" during an appeal. Zolot is entitled to a
hearing before the state Division of Administrative Law Appeals within seven days.

The Board of Registration in Medicine, which licenses doctors in Massachusetts, pulled Zolot's license yesterday, saying that he is an immediate threat to the public. The board released a document briefly outlining poor care to 30 patients, including eight who died, most from overdoses on drugs Zolot had prescribed or from chronic drug abuse.

Catalano said he could not comment on the details of the allegations. But he said Zolot cares about his patients, and that his office is open for patients who want to see other health care providers in the practice.

Posted by Elizabeth Cooney at 05:02 PM
June 21, 2007

NCI cancels breast cancer prevention study

By Elizabeth Cooney, Globe Correspondent

In an unusual step, the National Cancer Institute has canceled a $130 million clinical trial to compare how well two drugs prevent breast cancer.

Called the P-4 trial because it is the fourth such prevention study undertaken by the federal agency, it would have enrolled more than 12,000 women at high risk for breast cancer at 500 sites and followed them for years. The termination of the study before it began recruiting patients comes at a time when NCI is straining under four years of tight budgets.

The women would have received either raloxifene, an estrogen-blocking drug approved to treat osteoporosis but now prescribed to stop breast cancer, or letrozole, a compound from a newer class of drugs called aromatase inhibitors that deplete the production of estrogen. Both target estrogen because it promotes the growth of cancer cells.

Dr. Bruce Chabner, clinical director of the Massachusetts General Hospital Cancer Center, was on a scientific panel that last week advised NCI director Dr. John E. Niederhuber to pull back the P-4 trial. Niederhuber, who called for a review of the trial in January, visited Mass. General Monday and discussed the trial in previously scheduled sessions with Boston researchers and clinicians.

Chabner said the trial's cost was considered along with scientific concerns, including the desire to better match powerful drugs with the individuals who can be helped by them.

"I think in times when the budgets were really generous the NCI would probably have gone ahead with the study. It's not so much a criticism of the trial as it's expensive when there are other priorities that are very important," he said. "It is an unusual step. But these are unusual times."

The NCI's June 19 letter to the study's principal investigators at the University of Pittsburgh cited troubling complications caused by the two cancer prevention drugs and the relatively small number of women -- 3 or 4 out of 100 -- who benefit from them. The decision not to go forward with the study was first reported in Wednesday's Washington Post.

"While the P-4 study may provide another possible option for women at risk for breast cancer, the dangers of introducing these drugs, with their many known side effects, outweighs their potential until we are better able to determine who will benefit from these interventions and what the longer-term effect may be," the letter said.

Tamoxifen -- studied in 20,000 women in the P-1 trial of the early 1990s -- is currently the only drug approved for the prevention of breast cancer. Doctors prescribe it to treat women with breast cancer, to avoid a recurrence or in some cases to prevent it in the first place. Tamoxifen and raloxifene were compared in a large trial that last year reported they had just about the same effectiveness in preventing cancer, but raloxifene had fewer side effects.

Tamoxifen is linked to uterine cancer, blood clots and cataracts. Raloxifene was associated with a lower risk of these complications. Aromatase inhibitors are known to cause brittle bones, a particular worry for older women who might be taking them.

Chabner said the advisory panel's consensus was that this expensive trial was "not going to change the practice of medicine."

"Everybody agrees that the number-one priority is not to compare drug X to drug Y," he said. "It's to really define who is at highest risk for breast cancer so we don't have to treat 100 patients to prevent three or four or five cancers. If we can treat 10 patients and prevent 5 cancers, then it's going to be more reasonable."

NCI holds out hope for personalized medicine to better fit treatments to patients.

"Targeted chemoprevention must rely on individual genomic and proteomic signatures to identify those patients for whom the risk-benefit ratio justifies using a chemopreventive drug," its letter said. "NCI will continue to have a strong commitment to cancer prevention and search for ways in which such patients can be provided highly personalized approaches to prevention."

Other ongoing studies are examining how well other aromatase inhibitors protect women against breast cancer compared with placebos. One trial, funded by the National Cancer Institute of Canada and looking at exemestane, is led by Dr. Paul E. Goss, also of Mass. General.

"I feel strongly that aromatase inhibitors should be tested in prevention but always believed that the trial should be against a placebo," he said in an e-mail. "I am not privy to all the forces that fed into the NCI director's decision but I have no doubt that competing priorities were a big part of it. It is true that our trial would have reported before (P-4) and I agree that (P-4) may therefore not have changed practice."

Chabner said another weakness of the P-4 trial was that letrozole, the aromatase inhibitor being compared with raloxifene, will no longer be protected by its patent in 2011, meaning its manufacturer will have no incentive to seek FDA approval if it is shown to be effective.

Dr. Harold J. Burstein, a breast cancer specialist at the Dana-Farber Cancer Institute, said oncologists will have to infer from other studies in other countries how the different kinds of chemoprevention drugs compare. Dana-Farber would likely have been one of the many sites for the P-4 trial, he said.

"There's no doubt we need more studies in breast cancer prevention and the study being proposed was a very practical strategy to compare two likely effective strategies," he said. "There will be a void when a patient comes to see a doctor eight years from now and says, 'Which one should I take?'"

Posted by Elizabeth Cooney at 10:27 AM
June 21, 2007

Today's Globe: wounded vets, hospital breakup in court, another Bush stem cell veto, Needham doctor suspended

veterans.jpg
Dan Nevins (left) and Sean Lewis, each
of whom lost a limb while serving in Iraq, hit
practice shots at Nashawtuc Country Club in
Concord. (Barry Chin/Globe Staff)

Soldiers and Marines were part of a golf clinic, held during the annual Bank of America Championship, that promoted the sport as a rehabilitative tool for wounded veterans. It was a partnership between the Wounded Warrior Project and Disabled Sports USA and was sponsored by the bank.

The squabble between Tufts-New England Medical Center and Lifespan Corp., the Rhode Island hospital group that owned Tufts-New England from 1997 to 2002, over who owes what to whom in the wake of their failed merger has spilled into court.

bush150.bmpVetoing a stem cell bill for the second time, President Bush yesterday sought to placate those who disagree with him by signing an executive order urging scientists toward what he termed "ethically responsible" research in the field.

State officials yesterday ordered Dr. Joseph Z. Zolot, 56, of Needham to stop practicing medicine, charging that he provided poor care to at least 30 patients, including improperly prescribing strong painkillers to some who later died of overdoses.

Posted by Elizabeth Cooney at 06:29 AM
June 20, 2007

Brigham resident uncovers new beach threat

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.

Maron was a 23-year-old lab technician with dreams of a medical career when he came across a scene of "total chaos" during an afternoon walk on Edgartown's South Beach in 1998, he said in an interview. Kids at a birthday party had dug a seven-foot-deep cavity in the sand and were trying to jump over it when one fell in. The walls of the hole caved, obliterating any sign of the 8-year-old girl.

Digging frantically, a lifeguard located the child's mouth and cupped his hand over it, creating an air pocket. She survived, but the accident made an impression on the young Maron, who had witnessed a similar incident as a student lifeguard three years earlier. "I was probably at that moment of the opinion that most people are, that this must be an isolated, extremely uncommon problem," he said. "In medicine we call it a case report -- something you might see once in your whole life."

But as Maron began to investigate, urged on by his father, a cardiologist who researches sudden death in athletes, he quickly uncovered similar sand cave-ins around the country. Though the accidents are rare -- you're about as likely to die from a shark attack in the United States as from falling into a beach hole -- they fit a tragic pattern, according to Maron's research: A buildup of pressure causes the sides of a hole to crumble suddenly, burying alive a child or teenager playing inside. The victim, usually a boy, remains submerged for several minutes as bystanders panic and rescuers, afraid to use a shovel because they might hit the person, struggle to reach them by hand.

"Granulated sand runs just like when you open your sugar bowl, it just slides right in and fills up awful quick," said Dennis Arnold, director of beach patrol for South Beach, where it's illegal to dig a hole deeper than waist-height of the smallest nearby person.

Combing through media accounts and interviewing witnesses, Maron; his father, Barry; and a nurse at the Minneapolis Heart Institute, Tammy Haas, have documented 52 sand immersions in the United States, Britain, Australia and New Zealand since 1985. Six took place in New England. Thirty-one of the victims died.

One of those was Matthew Gauruder, a 17-year-old playing football at a post-prom party on a Westerly, Rhode Island, beach in 2001. Running backward to catch a pass, Gauruder fell into a hole dug by friends. As his stunned buddies tried to walk towards him, the hole caved in. He was revived briefly before later dying at a local hospital. His mother, Mavis Gauruder, said she grew up playing on New England beaches and never could have anticipated what happened to her son.

"As a parent of a teenager, the first thing you think of is has there been a car accident," said Gauruder. "This was a total shock."

Her son's death was so unusual, said Gauruder, that it's difficult to explain to others. Even Maron, a resident at Brigham and Women's Hospital, admits that the mishaps he's spent years studying pose a very small risk to most people. Still, he cringes when he sees Youtube videos of people posing in massive trenches they've excavated, or sunscreen advertisements featuring children up to their necks in sand.

He and his wife, Jill, a pediatrician, often approach families digging holes on the shore of Lake Massapoag near their Sharon home and tell them to be careful. Some shrug them off, said Maron, but others listen. "I don't want to be a vigilante about this," he said. "Kids dig in sand, that's what they do. But parents are probably unaware of the risk associated with collapse and the extent to which [it] could jeopardize their son or daughter's life."

Maron, who has two children still too young to dig, recommends that parents not allow their kids to carve out holes deeper than their knees. He continues to collect data on sand submersions and hopes to create an official national registry of the accidents.

Gauruder said she's thankful for Maron's obsession. "If one person thinks twice about digging a hole on the beach, that would be well worth it," she said. "I would not want any other family to go through what we've experienced."

June 20, 2007

Arteries clearer in younger menopausal women taking estrogen

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."

The risks of taking estrogen pills for more than four to five years include blood clots that can travel to the lungs, and an increased risk of stroke and breast cancer, Manson said.

Women who are more than a decade past menopause did not benefit from taking estrogen, previous studies have shown. Dr. Michael E Mendelsohn and Dr. Richard H. Karas of Tufts University School of Medicine say in an accompanying editorial that the "timing hypothesis" of estrogen therapy may explain why the larger WHI trial showed that hormone therapy did not cut the incidence of heart disease. Older women who already have hardening of the arteries don’t benefit from estrogen.

Younger women struggling to decide whether to start hormone therapy to ease menopausal symptoms should consider taking estrogen in the lowest doses for the shortest possible time, Manson said.

"The pendulum has swung from one extreme to the other," she said. "We now have a more refined understanding of the benefits and risks of hormone therapy and how age and time since menopause influence heart health outcomes."

Posted by Elizabeth Cooney at 05:20 PM
June 20, 2007

Journal voters stray from the evidence

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.

Readers were given three choices to vote on. When the 6,085 votes from 113 countries were counted, two of the three choices were almost a tie, with only eight votes separating them. But the winner, with 37.5 percent of the votes, was not the choice consistent with what the two studies concluded, Drazen said.

"It appears that although we as physicians use new data, we do not slavishly follow them," Dr. Laura Fredenburgh of Brigham and Women's Hospital writes in tomorrow's journal.

That fits with the more than 340 comments the journal received, Drazen and Fredenburgh said. The doctors said they picked out different parts of the fictitious patient's story to guide their decisions.

Drazen said he was encouraged by the number of votes and the thoughtful nature of the comments.

"I was amazed," he said. "We'll probably do it again in the fall."

Posted by Elizabeth Cooney at 05:00 PM
June 20, 2007

Friday nights

Weather permitting, the Museum of Science's rooftop observatory is open for free on Friday evenings from 8:30 to 10 p.m. for stargazing. The 12-inch Meade LX200 telescope is available and museum staff are hand to answer questions. Call 617-589-0267 or go to mos.org/events_activities/social_events&d=1212.

Posted by Karen Weintraub at 09:59 AM
June 20, 2007

Today's Globe: billion-dollar biotech question, "After the Fall" award, fathers and breast cancer gene

patrick at BIO100.bmpSix weeks after Governor Deval L. Patrick captured national attention with a proposal to spend $1 billion on biomedical research, one sticky question still hangs over the plan: Who will actually get the money? Tomorrow morning Patrick (left, at the BIO International Convention) will bring together a group of about 70 state life-science leaders to help start writing the rules for how the state's $1 billion would be spent.

afterthefall150.bmpBoston Globe reporter Alice Dembner is among the recipients of the 2007 National Press Club Awards, the Washington-based organization announced yesterday. Dembner won the Joseph D. Ryle Award for Excellence in Writing on the Problems of Geriatrics for her three-day series "After the Fall," which was published in December. The series examined the deadly and disabling outcomes of hip fractures in the elderly.

A deadly gene's path can hide in a family tree when a woman has few aunts and older sisters, making it appear that her breast cancer struck out of nowhere when it really came from her father.

Posted by Elizabeth Cooney at 06:21 AM
June 19, 2007

Short White Coat: Behind the blue curtain

Short White Coat is a blog written by third-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

srygley- -short white coat106.bmp

As a student in the operating room, there is ample opportunity to look around. And there is a lot to see: Inside each and every patient is a uniquely beautiful anatomy that tells stories of previous operations or illness; there is the long table with rows and rows of shiny instruments (often named after famous surgeons); there are the clear blue lines of demarcation between sterile and contaminated.

What you don’t see very much is the patient's exterior. Except for exposed skin where the incision will be made, most of the patient is covered up. A big blue drape creates a curtain that hides the patient’s head and the team of anesthesiologists who quietly toil to keep the patient comfortable and asleep.

Last week, I had a chance to venture behind the blue curtain as part of a one-week anesthesiology rotation. While surgeons cut a swath through disease, it is the anesthesiologist’s job to make sure the patient stays alive during the operation. The airway, the heart, the lungs, the eyes, and the skin are all carefully monitored for signs of discomfort or distress. Not unlike air traffic controllers, an anesthesiologist avidly and continuously surveys the patient for the first sign of something abnormal. There is a true art to staring at the EKG stream of a thousand normal heartbeats and then noticing the slight variation that portends of arrhythmia.

In the midst of watching all the monitors, on the anesthesia side of the curtain, I could also look upon the sleeping face of the patient I was helping. For some reason the patient’s face, more than the knee or liver or aorta that I could see and touch on the surgical side of the curtain, reminded me of why we were in the operating room in the first place.

Posted by Jennifer Srygley at 06:58 PM
June 19, 2007

Most want free care pool to remain unchanged

By Alice Dembner, Globe Staff

The more things change…

As part of the state's health insurance initiative, the "free care pool," which pays for treatment for the uninsured, is supposed to be revamped.

But at a session this afternoon to gather suggestions about changes to the pool, speaker after speaker told state officials that the pool needs to remain pretty much unchanged.

For low- and moderate-income people who remain uninsured, the pool should continue to cover all medically necessary services, including preventive care, substance abuse treatment, prescription drugs and hospital treatment, speakers from various hospital organizations, community health centers and advocacy groups said.

And it should help those with low incomes whose insurance has gaps, and cover bills that hospitals can’t collect from low-income patients, the speakers said.

"It’s functioned well," said Pat Edraos, policy director for the Massachusetts League of Community Health Centers. "Don’t make it any worse until the glitches are worked out" of the health insurance initiative.

The lone dissenter was the Massachusetts Association of Health Plans, which suggested limiting the coverage to a smaller group: those people not eligible for Medicaid or subsidized insurance; those who get waivers from the state’s new insurance requirement; and those with medical hardships.

The state Division of Health Care Finance and Policy is working on new regulations –- expected in mid-July -- to define who will be eligible and what services will be covered under the pool’s successor, to be called the Health Safety Net Trust Fund.

The assumption is that the fund won’t be needed as much, since more people will be insured. And the state is counting on using a big chunk of the $600 million that now goes to the pool to pay for insurance subsidies for low-income patients.

As of March, according to the Massachusetts Hospital Association, pool costs are down about 11 percent, compared with last year. The state’s own accounting is expected next month.

June 19, 2007

Boston scientists named Pew biomedical scholars

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.

This year's Boston-area winners are:

heldwein90.bmpEkaterina Heldwein (left), an assistant professor at Tufts University, will study how herpes viruses enter human cells. A graduate of Oregon Health and Science University, she trained at Children’s Hospital Boston and Harvard Medical School.

hung90.bmpDr. Deborah T. Hung (right), an assistant professor at Harvard Medical School and an assistant molecular biologist at Massachusetts General Hospital, will search for ways to fight the infectiousness of Pseudomonas aeruginosa, a bacterium that harms people with compromised immune systems because they have such conditions as cystic fibrosis, HIV or traumatic burns. She earned a doctorate in chemistry and a medical degree from Harvard and did additional training at Brigham and Women’s Hospital and Mass. General.

nicastro90.bmpDaniela Nicastro (left), an assistant professor at Brandeis University, will investigate the molecular interactions involved in the beating of flagella in sea urchin sperm, which are important to understanding defects that underlie such human disorders as polycystic kidney disease, chronic respiratory disease and infertility. She received a doctorate in biology from the Ludwig Maximilians University in Munich and did postdoctoral research at the Max Planck Institute for Biochemistry and the University of Colorado.

schwartz90.bmpThomas U. Schwartz (left), an assistant professor at MIT, will study the three-dimensional structure of the nuclear pore complex that regulates molecular traffic into and out of the cell nucleus, which could lead to antiviral therapies. He earned a doctorate in biochemistry from the Free University of Berlin and did postdoctoral research at Rockefeller University.

Posted by Elizabeth Cooney at 04:28 PM
June 19, 2007

Today's Globe: health program for poor, campus hunger strikes, diabetes deaths, bipolar diagnosis in children

santiago and abreu300.bmp
Iris M. Santiago and Robert Abreu looked over
snack food content ingredients at the Holyoke
Health Center, part of the CenterCare program.
(Nancy Palmieri for the Boston Globe)

CenterCare, a program that has improved the health of low-income patients with chronic illnesses, faces deep funding cuts in the pending state budget, even though top state officials touted similar disease management strategies just a month ago as a crucial way to improve healthcare quality and cut costs.

hunger strikrs150.bmpStudents on at least five campuses went on hunger strikes this year, most of them protesting what they saw as their university's involvement in unfair treatment of workers. In most of the protests, the hunger strikers claimed to have won concessions at the end (including Harvard, left). But they have also alarmed university leaders and, on some campuses, triggered a backlash from fellow students.

The death rate for men with diabetes has fallen sharply in the United States since the early 1970s even as more people develop the disease, but women are not making the same progress, researchers said yesterday.

Dr. Joseph Biederman and his colleagues at Harvard are the professionals most responsible for developing and promoting the standards of care in the Rebecca Riley case -- which include diagnosing preschool children as young as 2 with bipolar disorder and treating them with multiple medications, Dr. Lawrence Diller writes on the op-ed page. He practices behavioral/developmental pediatrics in Walnut Creek, Calif., and is the author of "The Last Normal Child: Essays on the Intersection of Kids, Culture and Psychiatric Drugs."

Posted by Elizabeth Cooney at 06:27 AM
June 18, 2007

Sherley protests pending MIT closure of his lab

sherley150.bmpJames L. Sherley (in file photo, left), an African-American stem cell scientist who went on a hunger strike in February to protest what he called racism in MIT's decision to deny him tenure, has begun another protest.

About 10 to 15 people joined him in front of MIT's domed building opposite the student center on Massachusetts Avenue at noon today, he said in an e-mail message. The group, which included colleagues from other universities and MIT staff, students, alumni and faculty, passed out about 75 fliers, he said. In a weekend e-mail, he called on supporters to lock arms with him for an hour each weekday in opposition to the administration's plan to close his lab June 30.

MIT was aware of Sherley's planned protest, spokeswoman Patti Richards said in an e-mail today. The university has no further comment, she said, citing an earlier statement that said the tenure decision is final.

"Both before and since his hunger strike, MIT has been committed to resolving its differences with Professor Sherley and has offered repeatedly to engage in professional mediation to facilitate an amicable agreement," the statement said. "With June 30 fast approaching, MIT has continued to urge Professor Sherley to work with the Administration to make appropriate transition plans for his departure from MIT."

Posted by Elizabeth Cooney at 06:55 PM
June 18, 2007

NCI director discusses budget realities

niederhuber.jpgThe director of the National Cancer Institute said today that researchers around the country are telling him their labs are cutting staff and trimming some goals of their research while they turn to philanthropic support to make up the shortfall in government grants.

"There is real pain in individual labs," Dr. John E. Niederhuber (left) told a group of cancer and stem cell specialists gathered in the Ether Dome at Massachusetts General Hospital. "They are dangerously close to the point that the amount of dollars doesn’t allow the job to be done."

He hears from individual investigators worried that "big science" –- which he prefers to call "team science" -- will divert funding from small projects in favor of broader efforts. He said there's room for both, even in an era of stiffer competition for initial awards and of grant renewals with their value eroded by inflation.

"The world has changed. The technology available to researchers today has changed. It couldn’t go forward unless we invest in teams," he said, pointing to last week’s reports of stem cell scientists turning back the developmental clock in mature mouse cells so that they behaved like embryonic stem cells, regaining the potential to become any kind of cells.

The researchers gathered in the historic surgical amphitheater may have wanted to turn the clock back to 1998 through 2003, a period during which the NIH budget doubled. The budget for the cancer institute, like that of the rest of the National Institutes of Health, will fall next year once inflation is factored into the 1.5 percent increase over 2007 levels that a House subcommittee is considering, Niederhuber said. This follows four years of flat budgets.

Dr. David M. Livingston of Dana-Farber/Harvard Cancer Center pressed Niederhuber on how well he was communicating to Congress and to concerned scientists the need to sustain work that was launched during the doubling era.

"The degree of success in discovery has jumped geometrically," he said. "The budget was always a way of letting Congress know just how urgent the need was for funds" to shorten the time to translate research into patient care.

Niederhuber, defending his efforts, said he tells Congress science has never moved more rapidly than today.

"I remind them we simply can't lose this opportunity to invest in biomedical science," while still being realistic, he said.

The result is "more a reflection of where we are in society and the demands on our budget," he said.

Posted by Elizabeth Cooney at 06:09 PM
June 18, 2007

Daley named president of stem cell group

george daley.jpgDr. George Q. Daley, associate director of the stem cell program at Children's Hospital Boston, has been named president of the International Institute for Stem Cell Research, the hospital said today.

An associate professor at Harvard Medical School, he is also affiliated with Dana-Farber Cancer Institute and Brigham and Women's Hospital.

The nonprofit stem cell organization, which is meeting in Australia this week, was formed in 2002 to foster the exchange of information on stem cell research. In February the group established ethical guidelines for stem cell research.

"I hope to make these guidelines more relevant to practitioners and stem cell oversight committees worldwide," Daley said in a statement. "As countries debate what sorts of regulations to put in place, we want to take a leadership role, acknowledging the social context of the work while removing unnecessary barriers to scientific progress."

Posted by Elizabeth Cooney at 04:46 PM
June 18, 2007

New Hampshire heart patients may come south

Boston hospitals may see an influx of New Hampshire heart patients while Concord Hospital's 10-year-old cardiac surgery practice is shut down this summer, the Concord Monitor reports today.

The hospitals' two surgeons, who took jobs elsewhere, performed about 175 open-heart operations a year, the story says.

Possible contenders to help run Concord Hospital's heart surgery program in a future partnership include Massachusetts General Hospital, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center, the story said.

Posted by Elizabeth Cooney at 01:36 PM
June 18, 2007

Neurontin fine funds program on drug industry influence

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.

ladd100.bmp 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.

"As a practicing nurse practitioner, I was struck with the fact that pharmaceutical promotional activity was ubiquitous in our world, both as providers and consumers," Ladd said in an e-mail interview. "I felt that this promotional activity was driving the appetite in our culture for medications."

The documentary, produced by filmmaker and former pharmaceutical sales rep Kathleen Slattery-Moschkau, includes interviews with Dr. Jerry Avorn of Brigham and Women's Hospital, Dr. David Blumenthal of Mass. General, Susan M. Reverby of Wellesley College and Kenneth Kaitin of the Tufts Center for the Study of Drug Development.

While the materials were crafted as continuing medical education, the website and film are available to the public, Ladd said.

"The important outcome of this project is that prescribers of all health care professions develop an appreciation that the overuse and sometimes unnecessary prescription of expensive brand-name medications can negatively impact our overburdened health care system," she said. "Ultimately it is our patients who will suffer from the undue burden that these costs are generating."

Posted by Elizabeth Cooney at 06:46 AM
June 18, 2007

Today's Globe: coverage countdown, virtual explorers, sustainable toys, prostate therapy, autism split, Swiss healthcare, Umass biotech

On July 1, state law requires every adult to have health insurance if affordable plans are available. There are many options, as explained in this interactive guide.

Virtual explorers travel through time and space via an online, interactive collection of one of the most famous archaeological sites in the world -- the Old Kingdom Giza Necropolis, with its royal tombs, pyramids, temples, and other Egyptian monuments circa 2500 BC -- through the Giza Archives Project, established by Boston's Museum of Fine Arts in January 2005.

Toys, according to Sally Edwards, a researcher at the Lowell Center for Sustainable Production at UMass-Lowell, are the next frontier in environmentalism.

Also in Health/Science, batteryless flashlights and fertility monitors.

Fissures in the autism community -- where some are convinced the disorder is genetic and others blame preservatives in vaccinations -- have spread into the Wright family, founders of Autism Speaks.

When federal regulators delayed approving a promising new prostate cancer therapy, patients and the drug’s advocates took to the streets and to the Internet, mounting an unusually intense lobbying campaign to pressure the Food and Drug Administration to reverse its stance on Provenge.

Massachusetts isn't the first place to mandate that everyone buy insurance as a way to achieve universal health coverage, and it isn't the first to get queasy about seeing through that solution. Béatrice Schaad Noble, a Swiss journalist who this month got her master's in public health at the Harvard School of Public Health, relates the Swiss experience.

UMass is at the center of Governor Deval Patrick's plan to invest $1 billion in the Massachusetts biotech industry over the next decade. Success will require a single point within the university that is accountable for mobilizing campuses and departments to work with both each other and the outside world to leverage the system's impact, William H. Guenther, president of Mass Insight Corporation, writes on the op-ed page.

Posted by Elizabeth Cooney at 06:39 AM
June 18, 2007

In case you missed it: bipolar diagnosis backlash, trimming trans fat, Dr. Tucker Collins, ether pilgrimage

Joseph Biederman 100.bmpNo one has done more to convince Americans that even small children can suffer the dangerous mood swings of bipolar disorder than Dr. Joseph Biederman (left) of Massachusetts General Hospital. But the death in December of a 4-year-old Hull girl from an overdose of drugs prescribed to treat bipolar disorder and attention deficit hyperactivity disorder has triggered a growing backlash against Biederman and his followers, Scott Allen reports in Sunday's Globe.

trans fat 150.bmpNowhere is there more chatter about Brookline's trans-fat ban and its consequences than along a bustling swath of Harvard Street in the heart of Coolidge Corner. Pizza makers and bagel bakers, crepe chefs and sports-bar owners are scouring their kitchens for evidence of the bad boy of the fat world, Stephen Smith writes in the Sunday Globe.

tucker collins 100.bmpDr. Tucker Collins (left), chief pathologist at Children's Hospital and a respected researcher in the field of vascular biology, collapsed and died June 8 while mowing a field behind his house in Cohasset. He was 54 and had been diagnosed in January with an aggressive brain tumor.

The scrubs and beepers revealed their profession. Few onlookers, though, would have guessed the intention and specialization of the two dozen medical residents and their families gathered at the gates of Mount Auburn Cemetery on a recent Thursday evening. The neophyte anesthesiologists, most of them from Massachusetts General Hospital, had come to celebrate their forebears, a group of Bostonians whose experiments with ether in the mid-19th century revolutionized surgery, City Weekly reports.

Posted by Elizabeth Cooney at 06:01 AM
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