New AIDS test offers faster results
News from Boston's medical and scientific community
For years, doctors have faced a major obstacle in identifying and treating patients with HIV: One-third of those tested never claim their test results, which take up to two weeks. But physicians at Boston Medical Center believe they've found a solution in a rapid HIV test that shows results in 20 minutes.
Physicians there now knock on the door of every overnight patient to ask if they want to be tested, and hospital officials have asked all primary care-doctors in the Urgent Care Center and the Yawkey Ambulatory Care Center to refer patients for testing.
The test, called the OraQuick and made by Abbott Laboratories, requires medical staff to prick a patient's finger and squeeze a drop of blood into a special solution. A test strip detects antibodies to the human-immunodeficiency virus in 20 minutes. The one drawback is false positives, which is why any patient with a positive result is sent for the traditional blood test that takes two weeks.
"The real push is to make this test easy and convenient so people can start treatment sooner," said Dr. Jeffrey Greenwald, who's heading the effort.
LIZ KOWALCZYK
Remembering region's first heart transplant
Gerald Boucher was a 44-year-old pharmacist whose heart was so bad he no longer had the strength to wash his own hair. Matthew Shelales, 16, had wasted away to just 95 pounds on his 6-foot frame. Together, the pair made history at Brigham & Women's Hospital 20 years ago this month, becoming the first and second heart-transplant recipients in New England history.
Boston didn't exactly rush into heart-transplant surgery, waiting 16 years after South African surgeon Christian Barnard first accomplished the feat. But, by waiting until better drugs were available to prevent organ rejection, the Boston surgeons got much better results than the 18 days that Barnard's first patient survived. Boucher lived for 10 months with his new heart, and Shelales is still alive. Boucher's widow, Elaine, once said that the last months of his life were his best in a decade.
Dr. Gilbert Mudge, one of the surgeons on Boucher's transplant, said the team planned for a year before the Bouchard surgery, but now "such a procedure is considered routine." Brigham & Women's has done more than 500 heart transplants since Boucher's operation, for an average of two every month.
SCOTT ALLEN
The lasting effects of children's heart disease
Fifty years ago, babies born with a common heart defect that can make them blue from poor oxygen supply usually died before they reached adulthood. But advances in surgery now permit up to 90 percent of infants with the condition, called tetralogy of Fallot, to live at least 20 years, with more than 100,000 survivors in the United States today.
This month, Children's Hospital in Boston won a $20 million grant from the National Heart, Lung and Blood Institute in large measure to study the long-term health problems encountered by tetralogy of Fallot patients decades later.
People with tetralogy of Fallot (named for the French doctor who first described it in 1888) are born with a hole between the heart's two pumping chambers and an obstruction of blood to the lungs caused by a narrowing of the pulmonary valve. Years after corrective surgery, these patients often have irregular heartbeats, learning problems and a tendency toward depression.
The project's goal is to improve the long-term quality of life for victims of pediatric heart disease, said Dr. Jane W. Newburger of Children's, one of several researchers at Harvard-affiliated institutions involved with the five-year study, which will also look at the genetic roots of the condition. "Children who we repair have such a long life ahead that the burden . . . can be very heavy on families and on society."
SCOTT ALLEN
Neonatal intensive care moves to the suburbs
Premature or sick newborns who need advanced respiratory support routinely are transferred to teaching hospitals in Boston, Worcester or Springfield. Now, after two years of planning, state health officials last month allowed South Shore Hospital in Weymouth to open the first local neonatal intensive-care unit outside an academic medical center.
South Shore's unit is licensed for 10 babies. The state Department of Public Health allowed the license partly because the hospital has become one of the busiest maternity units in the state, with doctors delivering 4,114 babies last year. They said it was also important that specialists from Children's Hospital in Boston would help run the new unit.
LIZ KOWALCZYK
