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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
 Short White Coat blogger Ishani Ganguli
 Short White Coat blogger Jennifer Srygley
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« June 24, 2007 - June 30, 2007 | Main | July 08, 2007 - July 14, 2007 »

July 06, 2007

Mosquitoes found with Triple-E

By Stephen Smith, Globe Staff

For the first time this summer, mosquitoes infected with Eastern equine encephalitis have been detected in Massachusetts.

The state Department of Public Health announced today that the disease-carrying insects were found Wednesday in Raynham, in Bristol County. No human cases of the viral illness have been reported so far this summer.

Last year, five people contracted Eastern equine encephalitis, two of whom died.

The virus kills one-third of its victims and half of those who survive suffer permanent neurological damage. There is no cure; survivors often require lengthy hospitalization.

The department has put together videos about the dangers of EEE and ways to prevent it.

Posted by Karen Weintraub at 02:44 PM
July 05, 2007

Short White Coat: Lessons from a little one

Short White Coat is a blog written by fourth-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

When is a wave not a wave? One of the first patients I saw on the pediatric neurology service at Children's Hospital Boston was a 12-month-old baby who had recently started raising her right arm when she became agitated. Her arm seemed to take on a life of its own, so sudden and repetitive were its movements.

While she had been developing normally -- she could pull herself up and was already saying a few words -- there was concern that her arm-raising might be the sign of something more sinister: partial seizures. When we examined her, she seemed perfectly normal. But a baby's brain can be hard to examine. A more conclusive test would be to monitor the electrical activity of her brain while she was waving her arm.

While the baby didn't seem to enjoy the sticky electrodes placed on her scalp, the electroencephalogram was much more physically taxing on the parents. They stayed up all night to monitor when she was having episodes of arm raising, so that the brain-wave recording could be correlated with the episodes. Even if her parents didn't have to remain wakeful and vigilant all night, I doubt they would have been able to sleep. The hours waiting for a test result to come back can stretch as long as the corridors of the hospital.

For my patient, the results were good. This baby did not have seizures -- just a quirky arm-raising habit when she got upset, perhaps the earliest signs of her personality emerging.

Though her neurologic work-up wasn't complicated, my experience with this patient and her parents reminded me that too often on the wards, we forget that every patient fits into a network of family and friends who worry and wait for every test result.

Posted by Jennifer Srygley at 05:20 PM
July 05, 2007

Potentially tainted toothpaste found on Massachusetts shelves

By Stephen Smith, Globe Staff

Massachusetts public-health authorities announced today that they have discovered tubes of toothpaste that may contain a dangerous chemical on store shelves in Boston and 11 other cities and towns.

The discovery comes as federal regulators report that some toothpaste made in China and elsewhere abroad contains diethylene glycol, a substance used in antifreeze. Long-term exposure to the chemical can cause kidney and liver problems.

The state Department of Public Health urged consumers not to use toothpaste falling into these categories:
-- If it is labeled "Made in China." The US Food and Drug Administration has identified a variety of brands made in China, including Cooldent, Dr. Cool, Everfresh Toothpaste, Superdent, and Oral Bright.
-- If is labeled as "Colgate" that is made in South Africa. Colgate officials have said their company does not import toothpaste from South Africa. The warning from health authorities does not apply to Colgate toothpaste made in the United States.
-- If the labeling is not in English.

Investigators from local health departments found about 160 tubes of toothpaste fitting those descriptions in shops in Amherst, Arlington, Boston, Cambridge, Dedham, Lawrence, Lowell, Malden, Somerville, Sturbridge, Wellesley, and West Springfield. It is not known whether any of the tubes contains diethylene glycol, a spokesman for the state Department of Public Health said.

The state agency has asked local health authorities to inspect stores to determine if they carry the potentially contaminated toothpaste and to ask shop owners to discard it.

Consumers with questions or concerns should contact their local board of health or the Food Protection Program at the state Department of Public Health, at 617-983-6712.

Posted by Karen Weintraub at 03:26 PM
July 05, 2007

Today's Globe: Rising autism cases, IVF, nutrition education, snapping turtles

The number of Massachusetts schoolchildren diagnosed with autism has nearly doubled over the last five years, to 7,521, according to new data from the state Department of Education, and the increase is leading to delays in services.

A popular procedure touted as a way to boost birth rates for older women undergoing in vitro fertilization actually reduces births by one-third, according to Dutch research published today in the New England Journal of Medicine.

Nutrition education programs funded by the federal government have mostly failed to change children's eating habits, according to a review of scientific studies by the Associated Press.

University of Massachusetts scientists are attaching solar-powered computers to the shells of snapping turtles to track their travels as part of research intended to aid survival of a species they fear is threatened by encroaching development.

July 04, 2007

Doctor advises how to resolve family-hospital disputes over ending life support

They’re called "medical futility" cases, when family members and hospitals disagree on whether to continue life support for very sick patients. Although rare, they raise questions about respect for others’ viewpoints, a Children’s Hospital Boston doctor says.

Writing in tomorrow’s New England Journal of Medicine, Dr. Robert D. Truog warns against laws that allow a hospital ethics committee to be "surrogate judge and jury."

He considers the recent case of 19-month-old Emilio Gonzales, whose mother went to court to prevent Austin Children’s Hospital from turning off his respirator. Emilio had a rare, fatal genetic disorder called Leigh’s disease that meant he was in intensive care for five months with declining neurological function. Under the Texas Advance Directives Act, the hospital’s ethics committee decided to withdraw life support despite the objections of his mother, Caterina Gonzales.

"I’m concerned that legislation like that in Texas makes it just too easy for people in the medical profession to override the desires of those who have unpopular views," Truog said in an interview. "We’ve got a beautiful system of laws designed to protect people from the tyranny of the majority. The Texas law just bypasses it."

Massachusetts has no law governing cases like these, Truog said. Director of medical ethics at Harvard Medical School, he wrote a policy for Children’s about medically futile care. Under that policy, if a hospital ethics committee were to conclude that medical treatment should be stopped and the family disagreed, it would assist the family in finding and sometimes paying for a lawyer to take the hospital to court so a judge would decide.

In Emilio’s case, his mother found legal help through right-to-life groups, Truog said, but the process should have included safeguards to make that recourse standard. Those safeguards also have the benefit of allowing time for more discussion between the family and the hospital, he said, rather than ending the argument with a unilateral decision. Emilio died before the judge ruled, an outcome that is common in cases like these, Truog said.

The beliefs of people providing care in cases like these should not be ignored, he said. Clinicians should be supported in the difficult job of giving care that they don’t agree is the right thing to do. But their concerns do not automatically win the day, he wrote.

"The claim that continued life support for Emilio was morally objectionable was nothing more than an assertion that the values of the clinicians were correct while those of Ms. Gonzales were wrong," Truog wrote. "I believe that in cases like that of Emilio Gonzales, we should seek to enhance our capacity to tolerate the choices of others, even when we believe they are wrong."

Posted by Elizabeth Cooney at 05:00 PM
July 04, 2007

Today's Globe: TB scare, chocolate, wounded soldier hot line, doctors in terrorist role

andrew speaker100.bmpNew tests show that American lawyer Andrew Speaker (left), who caused an international health scare by traveling with a dangerous form of tuberculosis, has a less severe form of the disease, doctors said yesterday. The Centers for Disease Control and Prevention stood by its earlier test and its action to isolate Speaker. And both Speaker's doctor in Denver and an official with the CDC who appeared at a news conference here said the public health response should be the same to both forms of drug-resistant TB.

hersheys kisses50.bmpHere's some good and bad news for chocoholics: Dark chocolate seems to lower blood pressure, but it requires an amount less than two Hershey's Kisses to do it, a small study suggests.

The Army's new Wounded Soldier and Family Hotline has logged more than 3,500 calls since it was set up three months ago following revelations that Walter Reed Army Medical Center outpatients were languishing in shoddy housing and suffering bureaucratic delays in getting additional care, evaluations, and compensation for wounds, mental problems, and other health issues.

The general public often is shocked to see that doctors -- the world's healers -- can become militants or even terrorist killers. But some experts believe it is part of a socioeconomic trend in which wealthy families highly educate their sons, who sometimes become radical and have the education they need to become leaders.

Posted by Elizabeth Cooney at 06:53 AM
July 03, 2007

Some funding restored for chronic illness management

By Alice Dembner, Globe Staff

A program that helps low-income patients manage chronic illnesses will receive $1 million in state funding this fiscal year, under the compromise budget approved by the Legislature on Monday.

The funding for CenterCare is a big drop from the $2.7 million allocation last year, but it is not as deep as Governor Deval Patrick and the House of Representatives had proposed. Patrick is reviewing the entire state budget and could veto money for the program, which is run through 30 community health centers statewide.

But CenterCare supporters said they were lobbying hard to ensure that doesn't happen, and plan to seek more money in a supplemental budget later in the year.

"It's still at less than half strength," said Patricia Edraos, policy director of the Massachusetts League of Community Health Centers. "But it gives us something to build on."

Even if the governor approves spending the money, it's unclear how much would go to a branch of the program at Holyoke Health Center, the subject of a Globe story on June 19. The center has helped hundreds of patients with diabetes adopt healthier lifestyles and reduce their blood sugar levels.

Posted by Karen Weintraub at 04:36 PM
July 03, 2007

Former MIT trustee withdraws support over Sherley case

bernard loyd.jpgMIT graduate and former trustee Bernard Loyd (left) has withdrawn from activities supporting the university because of how it has handled the tenure case of James L. Sherley, he said in a letter to the university yesterday.

"I write with a heavy heart," his letter says. "I will not support an MIT that, through disregard for fair process in the recent Sherley case, through repeated rebuffs of well-meaning attempts to engage on issues of black talent and scholarship, and through an apparent unwillingness to speak forcefully on issues of race suggests that it lacks genuine commitment to merit and diversity."

Sherley, an African-American stem cell scientist and professor in the bioengineering department, went on a 12-day hunger strike in February to protest a tenure decision process that he said was racist. His faculty appointment ended June 30 and his laboratory was closed and his staff was laid off.

MIT, which has previously said its tenure decision is final, released a statement this afternoon:

"We value Dr. Loyd's many significant contributions as an active MIT alumnus. He has raised important issues regarding diversity at MIT and we are working hard to accelerate our progress in recruiting and retaining underrepresented minority faculty."

Last month, Frank L. Douglas, executive director of the MIT Center for Biomedical Innovation, said he would leave the university because of MIT's refusal to reconsider its decision not to grant Sherley tenure.

Loyd earned bachelor's, master's and doctoral degrees in aeronautics and astronautics and was the chairman of the Black Graduate Student Association at MIT. The 1983 alumnus raised funds for MIT and served on visiting committees for those two departments after his five-year term as a member of the MIT Corporation, the university's name for its board of trustees. He also identified and recruited minority students for MIT in the Chicago area.

He is the president of Urban Juncture Inc., a Chicago company that develops commercial real estate and other businesses that contribute to revitalizing cities, according to its web site.

"It has been an honor to serve the Institute," his letter said, describing the visiting committees that gathered professionals to drive progress at MIT. "However, in my view, the notion of meritocracy and its implications for an openness to and, indeed, sponsorship of diverse students, staff, and faculty must be central to the Institute."

Posted by Elizabeth Cooney at 03:53 PM
July 03, 2007

Kennedy bill seeks to blunt HIPAA side effects

kennedy100.bmpDismayed by the "bizarre hodgepodge" of regulations layered onto the Health Insurance Portability and Accountability Act, Senator Edward M. Kennedy (left) plans to introduce legislation to create an office within the Department of Health and Human Services dedicated to interpreting and enforcing medical privacy, according to a story in today's New York Times.

HIPAA was designed to allow Americans to take their health insurance coverage with them when they changed jobs, with provisions to keep medical information confidential. But new studies have found that some health care providers apply HIPAA regulations overzealously, the Times story says, leaving family members, caretakers, public health and law enforcement authorities stymied in their efforts to get information.

Kennedy, a sponsor of the original bill, is bothered by the department’s failure to provide "adequate guidance on what is and is not barred by the law," several staff members told the Times. Senator Patrick M. Leahy of Vermont is a co-sponsor of the new bill.

"In this electronic era it is essential to safeguard the privacy of medical records while insuring our privacy laws do not stifle the flow of information fundamental to effective health care," Kennedy said.

Posted by Elizabeth Cooney at 08:02 AM
July 03, 2007

Today's Globe: Genzyme defeat, helping a father die

Genzyme Corp. suffered an unaccustomed defeat yesterday when shareholders in Bioenvision Inc., a small New York cancer-drug developer, blocked a $350 million takeover bid by refusing to sell their stock to the Cambridge biotechnology giant.

What seem like comfort measures to one doctor would be certain euthanasia to another, Dr. Darshak Sanghavi, an assistant professor of pediatrics at the University of Massachusetts Medical School, writes on the op-ed page. This argument recently occurred over his father in a hospital intensive care unit.

Posted by Elizabeth Cooney at 06:36 AM
July 02, 2007

Sherley locked out of MIT

sherley150.bmpJames L. Sherley (at right in February photo), the 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 been locked out of his laboratory, he said today.

In an e-mail to MIT president Susan Hockfield, he said his staff had been laid off, the locks to the doors of his lab changed and campus police officers stationed in the hallway outside. The university had set a June 30 deadline for his departure, which he disputed.

"I maintain that the forced closure of my laboratory is an illegitimate injustice by your office," he wrote. "MIT is in active violation of the agreement it made with me on February 16 to develop a fair external resolution process without a deadline."

MIT has said previously that its tenure decision is final and that the agreement reached when he ended his hunger strike did not reopen that process.

"His appointment did end June 30," MIT spokeswoman Patti Richards said tonight. "It had already been extended and he did have full access to his lab and office for the duration of his faculty appointment."

Claude Canizares, vice president for research and associate provost at MIT, responded to Sherley's letter to Hockfield.

"As I have stated, as recently as last week, we are deeply disappointed that you have repeatedly declined for several months to develop a transition plan that would have allowed you and your staff to continue your research outside of MIT and for you to participate in the orderly closure of your lab," Canizares's e-mail says. "You chose not to communicate and not to participate in the necessary decommissioning of your lab and relocation of the research by June 30. As supervisor for your staff until June 30, you bore primary responsibility for them and should have taken steps to assist them in their transition."

In his reply, Sherley placed the blame on MIT.

"The responsibility for the present act is MIT's alone," he wrote. "The members of my research group understand this issue fully, as do many in the MIT community."

Posted by Elizabeth Cooney at 08:54 PM
July 02, 2007

Two Mass. doctors elected to AMA posts

Two Massachusetts doctors have been elected to leadership posts in the American Medical Association.

rockett85.bmpDr. Barbara P. Rockett (left), a surgeon at Newton-Wellesley Hospital, has been elected president of the American Medical Association Foundation.

heyman85.bmpDr. Joseph M. Heyman (right), an obstetrician in private practice in Amesbury, was elected chair-elect of the AMA Board of Trustees.

Both are past presidents of the Massachusetts Medical Society.

Posted by Elizabeth Cooney at 04:02 PM
July 02, 2007

Mental health provider group names CEO

vicker digravio iii.jpgVicker DiGravio III (left) has been named president and CEO of Mental Health and Substance Abuse Corporations of Massachusetts Inc.

DiGravio had been chief of staff to state Senate majority leader Frederick E. Berry before joining the trade association in October. The statewide association of community-based mental health and substance abuse service provider organizations is based in Natick.

Posted by Elizabeth Cooney at 03:53 PM
July 02, 2007

Hungry for information

By Alice Dembner, Globe Staff

The state has been flooded with inquiries about the requirement that every adult obtain health insurance this year if it is affordable.

Calls, e-mails and visits to the Commonwealth Health Insurance Connector soared over the last month, reaching 70,000 last week, according to a connector spokesman. That's up from 25,000 inquiries in mid-May, before advertising campaigns began.

The official deadline for getting coverage was yesterday, but there is a grace period until just before the end of the year.

The connector, the new state agency overseeing implementation of the requirement, doesn't yet have an updated tally on how many are newly buying insurance. As of last month, about 135,000 of the approximately 400,000 to 500,000 uninsured had obtained coverage, either through new subsidized state plans or through Medicaid.

Other people are buying unsubsidized coverage through the connector or from insurers, and still others are newly insured through work-based plans.

Information on the law and new coverage options is available via the connector and boston.com.

Posted by Karen Weintraub at 03:04 PM
July 02, 2007

Scientists report win against bacterial biofilms

Two scientists from Boston University and a Harvard-MIT program have engineered an organism to fight bacterial biofilms.

Writing in the online Proceedings of the National Academy of Sciences, Timothy K. Lu and James J. Collins report that they created a bacteriophage -- a virus that infects bacterial cells -- that releases an enzyme to attack both the bacterial cells in the biofilm and to disperse the biofilm itself.

Bacteria commonly live in biofilms. They can be found in dental plaque or water pipes or on medical devices. A source of infection and contamination, biofilms pose a particular problem when they are resistant to antibiotics.

Bacteriophages work in a different way than antibiotics when they infect bacterial cells. The authors say that adding enzymes makes the bacteriophages much more effective than previous efforts that didn't incorporate enzymes.

Lu is from the Harvard-MIT Division of Health Sciences and Technology and Collins is from BU's Center for BioDynamics.

Posted by Elizabeth Cooney at 02:29 PM
July 02, 2007

On the blogs: Concern for Caritas, medicine and motherhood

On A Healthy Blog, Rachel Siemons and James Madden of Health Care For All, and Mary Cyriac, of Health Law Advocates, lament the collapse of the deal for Ascension Health to take over the six Caritas Christi hospitals. Both Health Care for All and Health Law Advocates worked with people in each of the six hospital communities: Holy Family in Methuen, St. Elizabeth’s in Brighton, Caritas Carney in Dorchester, Norwood Hospital, Good Samaritan in Brockton and St. Anne’s in Fall River.

"We were surprised by the news and disappointed. Ascension Health, with its reputation for financial stability and quality care, could have done great things for all six hospitals," they write. "These six hospitals are important institutions that provide critical services to their communities. They are in trouble. We are worried for the communities that rely on them."

On Dr. Gwenn Is In, Boston-area pediatrician Dr. Gwenn O'Keeffe reacts to Carey Goldberg's recent story in the Globe about medical resident Sophie Currier. The group administering a day of medical boards testing would not allow her breaks to breast-feed her daughter.

"I wasn't surprised because I lived it," writes O'Keeffe, who was taken to task for seeking assistance when pregnant. "I recall being called to my residency director's office as a junior resident and 7 months pregnant for asking for a stool at 3 a.m. to sit down during a procedure in the neonatal ICU."

Posted by Elizabeth Cooney at 11:18 AM
July 02, 2007

Today's Globe: trauma care, life in the pits, frog mystery, stress-obesity link, the right mouse

richard mollica150.bmpOver 25 years of caring for survivors of extreme violence and torture, Dr. Richard F. Mollica (right) and his colleagues at Harvard and Massachusetts General Hospital have found that most trauma victims can transcend the most horrific events imaginable and go on to lead rich and meaningful lives. Ultimately, traumatized people heal themselves -- and what's more, their experience can teach the rest of us how to deal with the tragedies of everyday life, he writes in Health/Science.

jacobo corbo150.bmpSuccess in the world's most popular, high-tech and, some might say, glamorous form of auto racing -- Formula One -- can often come down to one decision: when to stop and pit for fuel and tires, which sounds easy enough, but is a terribly complex decision. Jacomo Corbo (above) analyzed it for the Renault F1 team that came to Harvard in search of help.

frogs missing limbs85.bmpWhen schoolchildren on a field trip found frogs with missing legs in a Minnesota pond 12 years ago, the mystery captured the imagination of biologists and the public. Research published this month in the journal EcoHealth is part of a growing consensus among amphibian biologists that the mutant-frog conundrum is too complex to be pegged to a single cause.

Also in Health/Science, a way to protect against pelvic muscle injury during childbirth and the ingredients in salt substitutes.

Scientists reported yesterday that they have uncovered a biological switch with which stress can promote obesity, a discovery that could help explain the world's growing weight problem and lead to new ways to melt fat and manipulate it for cosmetic purposes.

Aveo Pharmaceuticals Inc. of Cambridge, a five-year-old company that says it has a better way to induce cancer in laboratory mice. As a result, research conducted on those mice is a better indicator of how humans will respond to experimental drugs.

Posted by Elizabeth Cooney at 06:51 AM
July 02, 2007

In case you missed it

The long-term success of the state's insurance initiative rests in large measure on the response of healthy young people. Without them, the total cost of the program could soar, because those with coverage would be older, sicker, and more likely to require costly services. But many young people partying and working near the Faneuil Hall Marketplace on a recent night were not sold on getting insurance, Alice Dembner reports in Sunday's Globe.

faint dog150.bmpAs Marty Harris walked into the South End building where she keeps her car, her dog, Adele (left), began to act funny. She sniffed and nuzzled Harris's knees, then sat down and refused to budge. That was Harris's alert that she was in danger of fainting. Harris suffers from a chronic fainting disorder caused by an irregular heartbeat. Adele, a black Labrador retriever, is her heart service dog, trained to alert its owner about an impending problem, Bella English writes in the Sunday Globe.

There is a growing push in medical, legislative, and legal circles -- both liberal and conservative -- to recognize an expansive new right that some are describing as "medical self-defense." The movement is rooted in a desire to help patients who have run out of options, Christopher Shea writes in the Sunday Ideas section.

Dr. Jeffrey Bass, 50, of Brigham and Women's Hospital, and Dr. Ronald Katz, 51, of Beth Israel Deaconess Medical Center, are the latest physicians to give up large traditional medical practices, in which doctors see a patient every 15 to 30 minutes, in favor of a slower pace and potentially higher income in a small concierge practice, Liz Kowalczyk reports in Saturday's Globe.

A month after a Gloucester man challenged a state regulation that bars anyone wearing an insulin pump from being hired as a full-time police officer, state officials have moved to lift the ban, Shelley Murphy writes in Saturday' Globe.

Posted by Elizabeth Cooney at 06:20 AM
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