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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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
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« April 22, 2007 - April 28, 2007 | Main | May 06, 2007 - May 12, 2007 »

May 04, 2007

New site for health insurance information

By Alice Dembner, Globe Staff

Looking for information on the new health insurance plans offered by the state?

There's a new website to guide people through the complex maze of choices -

The site is the work of the Commonwealth Health Insurance Connector, the state agency overseeing implementation of the new health insurance law that requires all adults to have coverage by July 1.

The site focuses on the plans without state subsidies. It also includes information on how businesses can sign up to offer their employees these new plans.

Posted by Karen Weintraub at 05:56 PM
May 04, 2007

Children's author takes kid-sized approach to weight loss

ludwigbook.jpgThere's no shortage of weight loss books, but few are designed for children, Dr. David M. Ludwig thought. So he set out to condense lessons learned from the Optimal Weight for Life program at Children's Hospital Boston and put them between the covers of a new book.

"What works for adults won't necessarily work for kids, especially when there's conflict about food at home," he said in an interview. "We start with the right eating program, bring in the right amount of physical activity, and then we need the right parenting program."

"Ending the Food Fight" (Houghton Mifflin, $26), with recipes by dietitian Suzanne Rostler, spells out a nine-week program that favors a low-glycemic diet emphasizing high-quality food. Even young children can understand the difference between "fake" foods that are heavily processed and real foods without excess sugar and fat, Ludwig says.

Children's minds and bodies aren't designed for treadmill-like exercise, he said, but they will be active if they are encouraged to play outside or try dance or yoga.

As for parents, they need to shift from coercion to cooperation with their kids, modeling good food and activity choices in a fast-food, sedentary world.

"All too often parents try to take control of the situation, excessively restricting some foods or pushing kids to have other foods," he said. "Criticism, nagging, even punishment seem like they work in the short term, but they really don't over the long term."

Posted by Elizabeth Cooney at 01:26 PM
May 04, 2007

Global warming panel says everyone must pitch in

By Beth Daley, Globe Staff

The world already has the technical tools to make significant reductions in greenhouse gas emissions and must immediately put them in place to avert the worst impacts of global warming, the leading scientific authority on climate change said this morning.

The United Nation’s Intergovernmental Panel on Climate Change said temperatures could stabilize after an increase of around 3.6 degrees Fahrenheit -- but only if greenhouse gas emissions peak in the next decade and then decline between 50 and 80 percent by 2050.

Humans have the ability to do this by adopting a suite of policies and methods that include energy efficiency, renewable energy, better agricultural and forestry practices and sequestering of carbon dioxide, the chief global warming gas. The cost of doing this could total 3 percent of the world’s gross domestic product by 2030.

“The time for making excuses is over…the time to act is now,’’ said Adil Najam, a lead author of the IPCC report and associate professor of International Negotiation & Diplomacy at Tufts' Fletcher School, who is in Bangkok for the release of the report. “We can do something about climate change. We now have the technologies and enough known policy measures that we know work.”

For the first time, the IPCC assessment, issued about once every five years, said individuals could make a significant difference in emissions by changing their lifestyle and consumption patterns.

Through relatively simple efforts from carpooling to reducing air conditioning usage, people could collectively make large changes with little economic harm, the report's authors said in a press conference.

Still, lasting long-term reductions will almost definitely cost consumers money.

Today’s report follows on the heels of two grim analyses issued earlier this year by the scientific panel that concluded humans were largely responsible for the rising temperatures in the world and climatic changes are already underway as a result.

The panel projects that the world’s temperature could rise 3.2 to 7.2 degrees by the end of this century if emissions aren't curbed. That temperature rise could cause widespread havoc, because of rising sea levels, more powerful storms and increased droughts.

Climate change analysts at the conference and elsewhere say they want governments to use the report as an arsenal of ideas to start enacting policy changes. But they admitted it would not be easy. In many countries, few incentives exist to spark renewable energy or energy efficiency investment.

Posted by Karen Weintraub at 10:59 AM
May 04, 2007

Today's Globe: biotech party tips, Serono acquittal, tainted food, Tysabri, breast cancer drop, diabetes and sperm

bio.bmpWhere does a biotechie go for a good time in Boston? As more than 20,000 biotech industry executives, researchers, and salespeople flock to town this weekend for the BIO International Convention, Biogen Idec is offering them some unique answers.

A jury yesterday acquitted four former Massachusetts executives of drug maker Serono SA of charges they bribed doctors to prescribe an AIDS drug, a major setback for local Justice Department prosecutors who have focused on the pharmaceutical industry.

Pets in the United States could have eaten food laced with industrial chemicals for years, the Food and Drug Administration said yesterday, but so far there is no indication that such tainted Chinese imports went directly into human food.

Ten months and 10,000 patients after the multiple sclerosis drug Tysabri returned to the market, there have been no new cases of the potentially fatal brain infection that led to the treatment's temporary withdrawal in February 2005, its makers said yesterday.

The recent drop in breast cancer cases started in the late 1990s, before the plunge in hormone use that has been credited with the decline, researchers said. The drop in cancer rates dovetails with a leveling off in the number of mammograms done on women age 40 and older since 1999, the study from the American Cancer Society found.

Diabetes is linked to a higher level of damaged sperm and may affect fertility, a study found.

Posted by Elizabeth Cooney at 06:27 AM
May 03, 2007

Pancreatic surgery up close

The program promised high-definition images of pancreatic surgery. What it delivered was part of the organ itself.

About 40 doctors crowded into a conference room at Massachusetts General Hospital today to watch a live broadcast of surgery to remove a growth from a patient's pancreas, to see whether it was malignant or benign. They were there to learn about finding early forms of pancreatic cancer as the hospital introduced its new pancreatic-biliary program.

During the operation, surgeon Dr. Carlos Fernandez-del Castillo asked Dr. Gregory Lauwers, a pathologist who had gone to the conference room, to return to the operating room to examine part of the pancreas he had just cut out and solve the mystery.

A few minutes later, Lauwers, director of gastrointestinal pathology at MGH, appeared back in the conference room with the answer -- and the reddish tissue in a metal tray. Wearing gloves, he turned the tissue with a metal instrument to show the group.

The doctors rose from their chairs to crowd around and peer at the piece of pancreas, about the size of a child's fist. It turned out to be benign, in the judgement of Lauwers and another pathologist who later examined a frozen section under a microscope.

Then the doctors, including the one who had sent the patient for surgery, discussed how hard it is to know in advance who needs to have such growths removed.

Pancreatic cancer is the fourth leading cause of cancer death, in part because it is so difficult to detect before it has grown and spread. A small subset of tumors are benign growths, some of which later become malignant. The challenge is to know which ones, they said.

Posted by Elizabeth Cooney at 07:40 PM
May 03, 2007

Genetic link to heart disease found

By Colin Nickerson, Globe Staff

Scientists using powerful new genetics research methods have for the first time identified a snippet of DNA common to many people that dramatically increases the chances of developing heart disease.

The discovery, revealed in two large and independent studies in North America and Europe, indicates that 75 percent of Caucasians possess a previously unknown genetic defect that puts them at elevated risk of a heart attack regardless of bad habits -- smoking, for example -- or bad health, such as hypertension or high cholesterol levels. The increased risk is most substantial for the 25 percent of Caucasians who have two copies of this defective DNA, one on each set of chromosomes.

"This is one of the most significant genetic risk factors found to date for heart attack," said Dr. Kari Stefansson, chief executive of DeCode Genetics, an Iceland-based company famous for its gene-hunting prowess.

"The variant may account for one-fifth of heart attacks" among white Europeans and North Americans, he said in a telephone interview.

Heart disease is the deadliest affliction in the western world. In the United States alone, some 1.2 million people suffer a heart attack every year and at least 452,000 die from it, according to the American Heart Association.

Human DNA is mostly the same, with less than 1 percent of the "letters" that make up the genetic code varying among individuals. Those differences, called gene variants, can account for such distinguishing traits as green eyes or blonde hair. But gene variants can also translate into susceptibility to diseases.

The newly-identified genetic variant appears unrelated to other risk factors for heart attack, according to the studies, which were published online today by the journal Science.

"This is a very common genetic variant, which has a very strong effect on heart disease risk, that isn't related to any of the other factors we know of," said Dr. Ruth McPherson, an endocrinologist at Canada's University of Ottawa Heart Institute, leader of the other research team.

Scientists believe that they will ultimately find many genes that can contribute to heart disease, just as there might be genes that protect the heart. They also stress that environmental and lifestyle factors can cause heart disease in individuals without a genetic predisposition.

Intense medical interest was stirred by the genetic location of the heart disease variant. Both studies showed the morsel of DNA appears to be encoded on the same chromosome in almost exactly the same "neighborhood" as genes identified in papers published only last week as connected to the most common form of diabetes.

At the very least, that's extraordinary coincidence. It also raises the possibility of a lethal bunching of DNA responsible for multiple ailments.

"It's a stunner," said Dr. Francis S. Collins, director of the National Human Genome Research Institute, who was not involved in either heart study. "It seems like this place [possibly] carries all of that weight for two very common and very dangerous diseases."

No one knows why DNA variants associated with the two diseases might lie in such close genetic proximity.

"This may suggest a causal link between these two disorders that is much deeper than previously suspected," Dr. David Altshuler, director of medical and population genetics at the Broad Institute, a Cambridge research center affiliated with Harvard and the Massachusetts Institute of Technology, wrote in an e-mail.

"It is too early to say anything with certainty," he said, "but very exciting days, to be sure."

Altshuler led one of the diabetes research teams but was not involved with the hunt for the heart disease genes. Of the overall heart variant discovery, he said: "It is an extremely convincing and exciting finding, with great potential to influence our understanding of coronary artery disease."

The Canadian and Icelandic researchers compared people who had heart disease with healthy individuals, looking for common genetic variants that were far more prevalent among the heart patients. They found that an individual who possesses two copies of the newly-identified genetic variant has a 30- to 40 percent higher risk of suffering a heart attack than an individual of comparable age and health who does not. A person carrying a single copy of the defect has a 15- to 20 percent increase in risk.

Discovery of the genetic variant represents a potentially important tool for diagnosing people at risk of heart disease, one which might become available to hospitals and clinics as early as this year, according to DeCode's Stefansson. But researchers admit that the genetic research is still a long way from yielding new treatments.

"The hope is that by discovering genetic predisposition to heart attack, we can identify people who are at greater risk for genetic reasons alone," said McPherson, "and in the long run can develop custom-tailored treatments."

Other studies have linked heredity to heart disease, but previously identified "bad" genes have tended to be either rare or linked to other illnesses that cause or exacerbate coronary ailments.

May 03, 2007

Today's Globe: drug suicide warning, biotech protest prep, ex-stripper trial, post-menopausal fracture drug, FDA on pet food, MGH real estate

The Food and Drug Administration ordered drug makers yesterday to add warnings to antidepressant medications, saying the drugs increase the risk of suicidal thinking or behavior in some young adults.

When 20,000 delegates descend on Boston for an international biotechnology conference starting Sunday, they will be met by dozens if not hundreds of protesters and by police bracing for what could be the biggest demonstrations in the city since the 2004 Democratic National Convention.

On the last day of testimony in her trial in Suffolk Superior Court, 47-year-old Louise Wightman, known 25 years ago in Boston's Combat Zone as the stripper Princess Cheyenne, testified that she never said she was a licensed psychologist while treating hundreds of patients, many of them adolescents with eating disorders and other serious problems, at a practice called South Shore Psychology Associates.

A yearly 15-minute infusion of a new drug substantially reduces bone fractures in post menopausal women, offering a new treatment for women who have trouble taking existing bone-strengthening drugs, researchers reported yesterday.

A Chinese company accused of selling contaminated wheat gluten to American pet food suppliers avoided inspections partly because it did not correctly disclose its shipping contents to Chinese export authorities, according to the US Food and Drug Administration.

Massachusetts General Hospital, a major tenant at Charles River Plaza, a recently modernized office and retail complex on Cambridge Street in Boston, is buying part of the property, a hospital spokeswoman said last night.

Posted by Elizabeth Cooney at 05:50 AM
May 02, 2007

Tight diabetes control doesn't harm cognitive function, study finds

Researchers led by a team at the Joslin Diabetes Center report in tomorrow's New England Journal of Medicine that tightly controlling blood sugar levels does not impair long-term cognitive function for people with type 1 diabetes.

Type 1 diabetics, whose immune systems destroy cells in the pancreas that make insulin, must monitor the level of sugar in their blood and inject insulin or use an insulin pump to keep down blood sugar. High levels can lead to such complications as blindness, heart disease and kidney failure.

Tight control of blood sugar, however, can unintentionally result in episodes of hypoglycemia, or low blood sugar levels. Hypoglycemia can lead to confusion, coma and convulsions. That has raised concerns that over time, hypoglycemia could cause long-term cognitive problems.

The Joslin study followed 1,441 type 1 diabetics for 12 years, following up on an earlier study of the same participants that showed that after 6 years, diabetics with tightly controlled blood sugar showed the same cognitive function as diabetics on less intensive therapy. The results after 18 years confirmed the earlier findings.

"While acute episodes of hypoglycemia can impair thinking and can even be life-threatening, type 1 diabetes patients do not have to worry that such episodes will impair their long-term abilities to perceive, reason and remember," Dr. Alan M. Jacobson, head of Joslin's behavioral and mental health research section and lead author of the study, said in a statement.

Posted by Elizabeth Cooney at 06:51 PM
May 02, 2007

Nobelist takes funding plea to Washington

mello150.bmpNobel laureate Craig C. Mello of University of Massachusetts Medical School (left) is taking his plea for more science funding to Capitol Hill, along with four other Americans who swept the 2006 science Nobel prizes.

Mello, who won the 2006 prize in medicine or physiology with Stanford’s Andrew Z. Fire for their discovery of gene silencing known as RNA interference, was invited to speak this afternoon at a hearing of the Senate subcommittee on science, technology and innovation. Roger D. Kornberg (chemistry) and John C. Mather and George F. Smoot (joint winners in physics) were also on the agenda.

"We need a call to arms, a call to fund science broadly in this country," a transcript of Mello’s prepared testimony said. "This isn’t science for the sake of science, but science for the sake of medical advances and lives to be saved."

Mello has deplored the decline in federal funding for research since the October day his prize was announced, insisting that the type of work he and Fire did 10 years ago would not win grants in today’s climate. They weren’t looking for RNAi when they found it, he said, but in eight years it went from being a puzzle to being the subject of a 1998 Nature paper to being applied as a tool for treating disease.

"This could happen only because we are in an era unprecedented for scientific discovery," he said, citing the sequencing of the human genome made possible by government investment that is now not keeping pace with inflation. "What other discoveries, what work like RNAi ... will be missed?"

Posted by Elizabeth Cooney at 06:05 PM
May 02, 2007

Neurologists here for conference

Boston researchers are among neurologists and neuroscientists delivering more than 1,000 presentations and poster sessions at the annual meeting of the American Academy of Neurology at the Hynes Convention Center in Boston. The weeklong conference has drawn more than 10,000 people, the group said.

Local presenters include Dr. Miguel Hernan of the Harvard School of Public Health, who is presenting his study showing that depression may be an early symptom of Parkinson's disease.

Evan L. Thacker, also of the Harvard School of Public Health, was scheduled to describe research exploring how moderate to vigorous exercise might be associated with the risk of developing Parkinson's disease.

Dr. Jeffrey Ellenbogen of Harvard Medical School was slated to talk about his study's conclusion that sleep not only protects memories from outside interferences, but also helps strengthen them.

Posted by Elizabeth Cooney at 03:02 PM
May 02, 2007

Report details broad sweep of norovirus in Boston

By Stephen Smith, Globe Staff

The wave of gastrointesinal illness that swept Boston in recent months spawned 18 outbreaks in colleges, day care centers, and healthcare facilities, ranging from eight cases to 438, according to a report released today by the Boston Public Health Commission.

Disease trackers from the city confirmed that the illnesses were caused by norovirus, the same germ that ignited outbreaks across the nation this past winter.

Boston's sophisticated disease tracking system found that the number of patients showing up at emergency rooms complaining of gastrointestinal ailments was significantly higher from December 2006 through April 2007 than the comparable period a year earlier. Over a 19-week period, an average of 95 patients a day flocked to ERs with norovirus symptoms, compared with 78 a day the year before.

May 02, 2007

Today's Globe: CVS clinics, prison mental health, heart attack deaths, pancreatic cancer clues, MS empathy, food safety, Kerry on health insurance

CVS Corp. has asked Massachusetts health officials for approval to open the first of 20 to 30 planned "MinuteClinics" in Boston-area stores that executives said will offer patients fast, inexpensive care in a region struggling with packed emergency rooms and closed doctors' practices.

State legislators, reacting to the recent spate of suicides in Massachusetts prisons, sought assurances from prison officials yesterday that they were taking greater precautions with mentally ill inmates to prevent further deaths.

Increased use of angioplasty and the introduction of new drugs over the past six years have nearly halved the number of hospitalized heart attack victims who die or suffer severe heart failure, an international team of researchers including Dr. Joel M. Gore of the University of Massachusetts Medical School reported today.

Scientists have identified a molecule that could eventually help determine how to better treat highly lethal pancreatic cancer, according to a study published yesterday.

A machine, commissioned for this week's American Academy of Neurology meeting by Cambridge drug maker Biogen Idec Inc. and Elan Pharmaceuticals Inc., puts doctors in the shoes of a typical multiple sclerosis patient, a 30-something woman struggling to keep her life together as her body slips from her control.

Regulators don't have the money, equipment, and staff to keep industrial chemicals, salmonella, and E. coli from contaminating the US food supply, former commissioners of the Food and Drug Administration said.

On the op-ed page, Senator John F. Kerry writes that this week he will introduce the Healthy Businesses, Healthy Workers Reinsurance Act, "a bill that will make government a partner in helping businesses with the heavy financial burden of those catastrophic cases: those that use over $50,000 in a single year in healthcare costs."

Posted by Elizabeth Cooney at 06:30 AM
May 01, 2007

Children's rolls out computerized drug ordering

Doctors at Children's Hospital Boston began this weekend prescribing medications by computer, and nurses are entering into the system when they give the drugs to patients, replacing paper records.

Lab results and pharmacy information were computerized in an earlier effort, along with other documentation from doctors and nurses.

nigrin100.bmp"The whole project is centered around creating an integrated electronic clinical information system, but this is probably the biggest in terms of how our clinicians act in the hospital," Dr. Daniel Nigrin (left), the hospital's chief information officer, said yesterday.

Nigrin, who conceded he hasn't gotten a lot of sleep since Saturday, said the transition has been smooth after months of training on CHAMPS, which stands for Children's Hospital Applications Maximizing Patient Safety. Thirty hours into the process, there were a peak of 1,300 staffers connected and working through the system.

On patient units, nurses can enter information at the nursing station or on bedside computers on wheels (known by the acronym COWs). Information on patients will be available to providers wherever they are, instead of just on the unit where the patient is.

Trained "superusers," dressed in blue shirts, will be available on units for the next couple of weeks to lend support, he said.

Nigrin said such a program is hardly unique to Children's, but the young patients they care for have more complex needs than adults when it comes to safety checks for administering drugs, an important part of order-entry systems.

"Medication dosing in children can be a very exact science," he said. "We deal with teeny 1-pound babies as well as hulking 18-year-old football players, so for that range of patient population we need to be very precise."

Posted by Elizabeth Cooney at 04:46 PM
May 01, 2007

State health insurance plans hit the market today

By Alice Dembner, Globe Staff

A state agency today began selling new unsubsidized health insurance policies, some with premiums significantly lower than market prices.

The policies are aimed at about 200,000 people who don't have insurance, who don't qualify for state subsidies, and who are required by state law to buy coverage this year.

Coverage ranges from basic to comprehensive in the four tiers of policies offered. The basic policies have lower premiums but require higher out-of-pocket payments for care. The more comprehensive policies have higher premiums that cover most health costs without additional fees.

Special stripped-down policies are available for young adults, ages 19 to 26.

The coverage, called Commonwealth Choice, is provided by Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan and Tufts Health Plan.

For information, contact the Commonwealth Health Insurance Connector or telephone the call center between 8 a.m. and 6 p.m. Monday through Friday at 1-877-623-6765.

Posted by Karen Weintraub at 01:05 PM
May 01, 2007

11 from area named to National Academy of Sciences

Eleven researchers from the Boston area are among 72 new members named today to the prestigious National Academy of Sciences, a private organization established by Congress in 1863 to advise the federal government.

Five are from MIT, four from Harvard and two from Brandeis. They are:

Tania A. Baker, Howard Hughes Medical Institute investigator and professor of biology, MIT
Moungi G. Bawendi, professor of chemistry and professor of energy, MIT
Michael B. Brenner, professor of medicine, Harvard Medical School
Kerry A. Emanuel, professor, program in atmospheres, oceans, and climate, MIT
Gerald Gabrielse, professor of physics, Harvard University
Eve E. Marder, professor of neuroscience, Brandeis University
Curtis T. McMullen, professor of mathematics, Harvard University
Silvio Micali, professor of computer science, MIT
Christopher Miller, Howard Hughes Medical Institute investigator and professor of biochemistry, Brandeis University
Peter H. Schiller, professor of medical engineering and medical physics, MIT
Jonathan G. Seidman, professor of cardiovascular genetics, Harvard Medical School

Posted by Elizabeth Cooney at 12:37 PM
May 01, 2007

MGH leads drug maker Lilly's list of grants

Massachusetts General Hospital's psychiatry department got the largest single grant -- $825,000 -- from drug maker Eli Lilly & Co. in the first quarter of 2007, according to today's Wall Street Journal.

The Indianapolis pharmaceutical company will release a report today that for the first time details how much it gives to nonprofit groups and educational institutions, the story said. In the first quarter the grants totaled $11.8 million.

"We issued a challenge to the pharmaceutical industry: You say you believe in [continuing medical education], then give to academic institutions without any direct knowledge of what the curriculum will be," Dr. Jerrold Rosenbaum, psychiatrist-in-chief at Massachusetts General Hospital, told the Journal. Lilly isn't the only drug company to fund his program, but that support does not affect the content, he said.

Lilly's move comes amid criticism that money from drug companies is exerting an unhealthy influence on medicine, the story said.

Posted by Elizabeth Cooney at 08:14 AM
May 01, 2007

Today's Globe: FDA woes, cardiac device failures

Rogue food exporters have had little trouble shipping suspect products into the United States because the chances of being caught by an underfunded and understaffed Food and Drug Administration are slim.

One in five devices used to shock hearts back into a normal rhythm fail to work properly after 10 years, a study found. Electrical wires that connect cardiac defibrillators to the heart were at fault, according to the research.

Posted by Elizabeth Cooney at 06:22 AM
April 30, 2007

Tufts Health Plan loosens restrictions on obesity surgery

By Elizabeth Cooney, Globe Correspondent

Tufts Health Plan has quietly loosened its restrictions on weight-loss surgery, expanding who can get insurance coverage for the operations and shrinking how much time patients must first spend in a counseling program.

The restrictions were criticized by the state Department of Public Health, patients and surgeons even before they went into effect in March.

In a statement issued yesterday in response to questions about its new policy, Tufts said it was committed to offering its members the best chance for long-term success.

"Working most closely with bariatric surgeons at Tufts-New England Medical Center, we jointly agreed to guidelines for the coverage of bariatric surgery," the statement said.

Tufts spokeswoman Catherine Grant said the plan would not elaborate on the reasons for the change.

The revised rules, effective as of April 16, appear to address some of the concerns raised by Nancy Ridley, associate public health commissioner, who in February sent a letter to Tufts president and CEO James Roosevelt Jr. saying the restrictions were "contrary to evidence-based guidelines" that the department had crafted for obesity surgery. She warned him that the agency could review denials of coverage.

Under the revised rules, Tufts will pay for obesity surgery for members with a body mass index above 35 if they also have diabetes, hypertension or sleep apnea that requires medical treatment. Under the original rules, the minimum BMI for such patients was 40.

The health plan also dropped limits on the types of obesity surgery patients could qualify for. Now patients eligible for coverage can undergo either laparoscopic gastric banding or gastric bypass surgery.

Before surgery, members now must join the health plan's lifestyle modification program, called iCanChange, for six months, down from 12 months under the original rules. They can continue the behavioral program for 12 months if they wish, rather than go on to surgery, the plan said.

April 30, 2007

Short White Coat: Medical School-house Rock

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

Now that lectures are videotaped, Harvard medical professors seem to be hamming it up for the camera, using song and dance to entice students to watch and learn.

Earlier this month, Shiv Pillai tried genres as diverse as the ode, the mantra, and hip hop to summarize and attach some sort of teleology to complicated immunology pathways while lightening up otherwise tedious lecture-packed days. His melancholy take on T cells: "Looking for antigen below and above, Many will die of unrequited love."

"Thread that peptide into TAP," he added with an enthusiastic shimmy, encouraging us to join in. "Everybody do the lymphocyte rap!"

Unshockingly, the approach isn’t limited to graduate education. Some of my friends from college are turning hip hop into an educational tool for middle schoolers, mixing catchy beats on topics including the circulatory system and fractions. In a family opera production at the Cambridge Science Festival last week, evolution was festively summed up in a 23-part oratorio.

Singing and rapping educators are on to something. Analogy and anthropomorphosis are potent means of understanding concepts (for example, I like to think of the way your immune system learns what to attack as a slightly morbid version of speed-dating for white blood cells). If there’s a tune or a beat attached, one that you can hum under your breath or tap on your desk while taking an exam, even better (never mind the annoyance of neighboring students).

We learned last Thursday that the music need only be inferred to be an effective learning tool: In a microbiology lecture on sexually transmitted infections already enhanced by stick figure drawings, Michael Starnbach used the immortal lyrics of Frank Zappa to illustrate the clinical manifestations and social implications of gonorrheal infection.

"Why does it hurt when I pee?," Zappa heart-wrenchingly inquires. In Starnbach’s impressively straight-faced dramatic reading, complemented with medical references, he answered this question (for one thing, Zappa was wrong to blame the toilet seat) and so much more.

Posted by Ishani Ganguli at 04:10 PM
April 30, 2007

On the blogs: patients Googling doctors, doctors Googling lawyers, healthcare law through teen eyes

On Kevin, M.D., Dr. Kevin Pho offers a primer on protecting one's Google reputation.

"There is no doubt that patients and potential employers will Google you as an initial screen. It is to your benefit to ensure that favorable stories come up when your name is entered as a search term."

On Flea, the Boston-area pediatrician shares a thing or two he has learned by Googling the plaintiff's attorney in the malpractice trial in which he will be testifying. (Doesn't he think they read blogs?)

"What patients hope for and expect from malpractice litigation is 'compensation, explanation, and a safer healthcare system,'" he quotes from a presentation by the lawyer he found. "Flea's adversary could have stopped with compensation. As we said before, if a patient wants an explanation, he can acquire it much less expensively than a lawsuit: He can ask the doctor."

On WBUR's CommonHealth, Nancy Turnbull of the Harvard School of Public Health answers her teen-age nephew's objections to the Massachusetts healthcare law, from the name "Commonwealth Choice," when individuals are required to get coverage, to vegans paying for the ills of meat-eaters.

"I know you think it’s an infringement on individual rights that the state is telling people that they have to buy health insurance," writes Turnbull, who also is president of the Blue Cross Blue Shield of Massachusetts Foundation.. "That type of attitude comes from your father’s side of the family —- he hates wearing his seatbelt too."

Posted by Elizabeth Cooney at 11:15 AM
April 30, 2007

University of Miami luring top researchers

The University of Miami medical school has embarked on a billion-dollar campaign to become a top research center and create the conditions for biotech success seen in places like Boston and Cambridge and Research Triangle Park in North Carolina, a story in today's Miami Herald says.

The school, led by university president and Clinton administration Health and Human Services Secretary Donna Shalala, has hired away 51 of the 180 researchers at the Duke University Center for Human Genetics over the past year, the story says. Miami is pouring money into new research centers, but it's also helping with housing costs, the school told the paper.

Within the past six months, the story says, Miami's medical school has brought these researchers on board, along with about $70 million in multiyear grants from the National Institutes of Health:

Dr. Joshua M. Hare, a cardiologist at Johns Hopkins in Baltimore, and seven colleagues.

Dr. Marc Estes Lippman, a breast-cancer researcher at the University of Michigan, and 30 colleagues.

Dr. Ralph Sacco, a Columbia University stroke expert, and 10 colleagues.

Dr. Julio Licinio, professor of psychiatry and biobehavioral sciences at UCLA's David Geffen School of Medicine, and 20 colleagues.

Miami spokesman Omar Montejo told the Globe today that no Boston researchers are among the scientists recently recruited to the medical school.

Posted by Elizabeth Cooney at 10:48 AM
April 30, 2007

Today's Globe: genetics of life on Mars, undersea life, lessons out of med school, chocolate dream, Botox, full moon, Joslin halt

If there is life on Mars, a Harvard geneticist Gary Ruvkun thinks it resembles something we already know. Now, he's trying to prove it.

Laura Preston, a ninth-grade earth sciences teacher at Salem High School in New Hampshire, shares her blog about spending the last four weeks aboard a research vessel in the Pacific Ocean studying undersea volcanoes.

Some situations are not rehearsed in medical school, where we focused on the details of diseases, not on what to advise families struggling with problems like childhood obesity, parental smoking, overdose, television abuse, Internet pornography, and anxiety, writes Dr. Victoria Rogers McEvoy, chief of pediatrics and the medical director of the Mass. General West Medical Group and assistant professor of pediatrics at Harvard Medical School.

Also in Health/Science, meet Dr. Norman Hollenberg, who is raising hopes that the secret elixir of life may have less to do with wheat germ and more with cocoa. And does Botox help with migraines and do people behave oddly when the when the moon is full?

In Business, just four months into his job as head of the Joslin Diabetes Center, Ranch Kimball has pulled the plug on the center's ambitious plan to build a new laboratory building and 29-story residential tower at its Longwood home.

Posted by Elizabeth Cooney at 06:25 AM
April 30, 2007

In case you missed it: veterans in rural areas, mosquitoes and climate change

The Department of Veterans Affairs is struggling and often failing to do right by the many veterans with serious combat injuries who need closely supervised care but live in remote areas, a Globe review has found, Charles Sennott writes in Sunday's Globe. Realigned in the 1990s to concentrate specialized care in urban areas, the system now finds itself overwhelmed by the wounded from wars in Iraq and Afghanistan -- engagements that have, even more than other modern-day conflicts, been fought by soldiers from rural America.

Along with Canadian red squirrels and European blackcap birds, the mosquito -- a non biting variety found from Florida to Canada -- is one of only five known species that scientists say have already evolved because of global warming, Beth Daley writes in the Sunday Globe, the fourth in a series of occasional articles examining climate change, its effects, and possible solutions.

Posted by Elizabeth Cooney at 06:24 AM
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