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June 08, 2007
Men who are at risk for a fatal heart attack should be evaluated by a cardiologist before beginning hormonal therapy to treat prostate cancer, researchers from Harvard Medical School report.
The article to appear Sunday in the Journal of Clinical Oncology follows a landmark paper by other Harvard doctors published last fall in the same journal (and reported in the Globe) that linked androgen suppression therapy to diabetes and heart disease.
Androgen suppression therapy is often prescribed for men with prostate cancer. Research has established that it improves survival rates in men with advanced stages of the disease when given with radiation therapy, but the benefits of the treatment are not as clear in men whose cancer is in earlier stages.
In the newer work, researchers led by Dr. Anthony V. D'Amico of Harvard and Brigham and Women's Hospital analyzed data from three randomized trials of 1,372 men in Australia and New Zealand, Canada and the United States. They report that nearly half of the men who were 65 and older and had heart disease risk factors suffered heart attacks sooner if they had received androgen suppression therapy for six months compared to men who had not been given the therapy.
Men who smoke or have diabetes, which put them at risk for heart attacks, should be referred for a cardiac evaluation before they start hormonal therapy to treat prostate cancer, D'Amico said in an interview.
"The study shows that a significant fraction of these men who are going to have heart attacks will have them on average 2 to 3 years sooner if the underlying heart disease is not addressed," he said.
D'Amico said his study's results "fit perfectly " with data produced by Dr. Nancy L. Keating of Brigham and Women's and Dr. Matthew R. Smith of Massachusetts General Hospital. They found that among 73,000 Medicare patients, men who received hormonal therapy significantly increased their risk of developing diabetes and also raised their risk of heart disease.
"The landmark study by Keating put on the map the issue of treatment-related diabetes and cardiovascular disease," Smith said. "Great care needs to be taken in interpreting the results of other trials because of the relatively small number of events and because the studies weren't designed to look at cardiovascular disease."
D'Amico said men can safely delay hormonal therapy to seek treatments for heart disease, which can range from taking aspirin to having stents placed to prop open clogged coronary arteries.
"Hormone therapy can cause a heart attack sooner than prostate cancer can progress," he said.
Posted by Elizabeth Cooney at 06:00 PM
June 08, 2007
By Stephen Smith, Globe Staff
Two nurses and an auditor in an outpatient cancer clinic at Cape Cod Hospital in Hyannis have been diagnosed with whooping cough, hospital and state public health authorities said today.
The hospital is contacting patients potentially exposed to the hospital workers and providing them with antibiotics, said Donna Rheaume, spokeswoman for the state Department of Public Health.
Whooping cough is a highly infectious bacterial disease transmitted by coughing and sneezing. Typically, the disease arrives with symptoms similar to those of the common cold, but then progresses to spasms of coughing.
At its worst, a rattling, rib-cracking cough can linger for months and cause patients to lose sleep and weight. Studies have shown that 62 percent of adults with pertussis are still coughing three months after symptoms appear.
While symptoms can be persistent, the disease rarely kills otherwise healthy adults. But like any infection, it can pose a more significant threat to patients with chronic illnesses and impaired immune systems -- such as those with cancer.
Children have been routinely vaccinated against whooping cough for decades, but specialists know that the effectiveness of the shot wanes over time, leaving adults and some teens vulnerable to the infection unless they get a booster shot.
Posted by Karen Weintraub at 01:23 PM
June 08, 2007
On Nature Network Boston, Deanne Taylor, research scientist and program chair in the bioinformatics graduate program at Brandeis University, calls for better science education, in light of recent debates in which Republican candidates for president have been bashing evolution.
"Maybe someone should mention that part of the US economy relies on the tools given by evolutionary theory," she writes. "Drug discovery, in many ways, depends on evolutionary theory to supply the logical framework and tools around molecule and sequence analysis, as one example. Evolution isnít 'just' an incredibly supported explanation for an extensive collection of facts. It also defines a mathematical tool that allows us to group sequences into a logical order."
Posted by Elizabeth Cooney at 12:54 PM
June 08, 2007
Massachusetts is beginning to develop a corps of certified peer specialists who have been through the depths of schizophrenia, bipolar disorder, or depression, and recovered enough that they can help others with mental illness.
The state Department of Public Health has launched a sweeping review of how it verifies the licenses of employees at public hospitals following the resignation of the director of social services at the state-operated Lemuel Shattuck Hospital in Jamaica Plain over allegations that she falsified her academic credentials and licenses.
Beth Israel Deaconess Hospital Needham says it will proceed with a $30 million expansion plan late this year to increase the hospital's capacity and improve its emergency and radiology departments. The project highlights a financial turnaround that has taken the suburban hospital from losses of $1.9 million in 2002 to an anticipated profit of $850,000 in the fiscal year that ends Sept. 30.
The Patrick administration forced the leader of the Massachusetts Life Sciences Center to resign from his post yesterday, just six months after his controversial appointment by a board controlled by appointees named by Governor Mitt Romney. Aaron D'Elia, a former state budget planner, was signed to a $125,000, one-year contract in December despite having no background in science.
Massachusetts health authorities said yesterday that they have no plans to require adolescent girls to receive the recently introduced vaccine against cervical cancer, a mandate that has generated controversy in other states.
Dr. Gilbert M. Cogan, a pediatrician for 53 years who treated everybody like family, died of congestive heart failure Wednesday in Saints Medical Center in Lowell, where he was a member of the staff for decades. He was 84.
The NFL continues to discredit data that suggests a link between multiple concussions and long-term health problems such as depression or early Alzheimer's, Globe Columnist Jackie MacMullan writes, recalling former linebacker Ted Johnson (left). His concussions have left him with debilitating headaches, dizziness, and bouts of depression during which he does not leave his darkened bedroom for days. There's little doubt the disparity between NFL research and independent research on concussions will come up during a league summit in Chicago June 19.
Posted by Elizabeth Cooney at 06:32 AM
June 07, 2007
A year after Harvard University scientists began trying to create cloned human embryonic stem cells, they have been stymied by their failure to persuade a single woman to donate her eggs for the groundbreaking but controversial research.
Speaking from his hospital room in Denver yesterday, Andrew Speaker (left, in June 1 photo), the lawyer who has extensively drug-resistant tuberculosis told a US Senate panel that no health official ever told him he would be a threat to anyone if he flew across the Atlantic and back.
Applying a new genomic technique to a large group of patients, researchers in Britain have detected DNA variations that underlie seven common diseases, discovering unexpected links among them.
President Bush's nominee for surgeon general, Kentucky cardiologist Dr. James Holsinger (left), has come under fire from gay rights groups for, among other things, voting to expel a lesbian pastor from the United Methodist Church and writing in 1991 that gay sex is unnatural and unhealthy.
An executive of the company that makes the diabetes drug Avandia said a researcher who was among the first to link it to heart problems would be held liable for the $4 billion GlaxoSmithKline PLC lost in stock value as a result of his findings, Dr. John B. Buse testified before congressional investigators yesterday.
Posted by Elizabeth Cooney at 06:31 AM
June 06, 2007
By Alice Dembner, Globe Staff
The state Board of Registration in Medicine today indefinitely suspended the medical license of Dr. Louis F. Alfano Jr., for negligent and substandard care of three patients.
The board found that Alfano, a surgeon who practiced in Melrose, performed unnecessary operations, botched one surgery and failed to treat post-surgical complications.
Alfano has been suspended from practicing since late January. He was affiliated with Whidden Memorial Hospital in Everett, Melrose-Wakefield Hospital in Melrose, and Lawrence Memorial Hospital in Medford, according to the board.
Through his attorney, Alfano agreed to the sanction. In the future, he can ask the board to practice again on a probationary basis.
During the probation, he must limit surgery to 40 hours a month and must allow all his cases to be monitored by another physician. In addition, he may not perform vasectomies and must take courses in breast cancer surgery and documenting medical procedures.
Posted by Gideon Gil at 08:25 PM
June 06, 2007
By Elizabeth Cooney, Globe Correspondent
Doctors in Massachusetts are disciplined at a rate just under the national average, according to rankings released today.
Roughly 3 Massachusetts physicians out of every 1,000 had their licenses revoked, surrendered, suspended or put on probation, or had their practice restricted between 2004 and 2006, the consumer advocacy group Public Citizen said.
Last year the state board imposed 100 disciplinary measures. In 2005, Massachusetts had 32,512 physicians, including osteopathic physicians, the group said.
That places Massachusetts 30th in the nation, down from 23rd in 2003 and 2004 and 28th in 2005. Alaska had the highest rate, with 7.30 citations per 1,000 physicians, and Mississippi had the lowest, with 1.41.
Their report is based on data from the Federation of State Medical Boards.
Posted by Elizabeth Cooney at 05:04 PM
June 06, 2007
By Colin Nickerson, Globe Staff
Scientists in Massachusetts and Japan say they have created embryonic stem cells using procedures that might overcome some of the ethical objections to the controversial research as well as a major scientific hurdle.
Most dramatically, three of the four research findings announced today used a highly experimental approach that avoids the destruction of embryos, which critics equate to taking a life. Instead, they used genes and retroviruses to coax adult cells back to an embryo-like state.
The other project, meanwhile, points to a new, readily available source of embryonic stem cells, which would allow researchers to bypass a bottleneck in current efforts at Harvard University to clone human stem cells genetically matched to a patient with a particular disease -- the inability to find women willing to donate unfertilized eggs for the research.
All of the research reported in today's Nature and Cell Stem Cell involved mice, but scientists say they believe the results could be replicated in humans.
"These new studies, done with mice cells, point the way to experiments that can be tried with human cells," said Douglas Melton, a Harvard stem cell scientist. "This represents some of the most exciting work in stem cell biology and genetic reprogramming."
In one of the papers, Melton's colleague at the Harvard Stem Cell Institute, Kevin Eggan, defied long-standing scientific dogma that fertilized eggs cannot be used to clone embryonic stem cell lines. Eggan carried out somatic cell nuclear transfer -- cloning -- by removing chromosomes from a one-cell fertilized egg and replacing it with DNA from another, mature cell. The modified cell began dividing, and he then harvested stem cells from the resultant embryo.
Although less razzle-dazzle than the techniques used in the other research, Eggan's work holds the best prospect of creating human embryonic stem cell lines in the near future.
The study by Eggan suggested that researchers could use the genetically-defective fertilized eggs discarded by the thousands daily at fertility clinics across the United States. Such one-cell embryos are treated as waste because they stand no chance of attaching to the womb and forming a healthy embryo.
"This represents a wonderful way of obtaining something good -- medical research that could lead to therapies for human disease -- out of something that would just be thrown away," Eggan said in an interview.
The findings by scientists from Harvard, the MIT-affiliated Whitehead Institute, Massachusetts General Hospital, and Japan's Kyoto University also represented the most successful attempts to date to find new ways to make embryonic stem cells that might overcome some of the ethical opposition from religious groups who oppose destruction of human embryos and from womens groups worried about the implications of female donors undergoing tricky hormonal therapy to produce eggs for research.
"All in all, this is encouraging, exciting progress that shows real willingness among scientists to weigh ethical concerns even as they pursue science objectives," said Dr. William Hurlbut, a neuroscientist and ethicist at Stanford University who serves on the President's Council on Bioethics. "The science is critical, of course. But so are many ethical concerns. We've got to calm down as a nation and stop the acrimony and misrepresentation flung by both sides."
Embryonic stem cells, considered crucial to medical science and eventual treatment for an array of terrible diseases, have the ability to form any of the 220 basic tissue types in the body -- from bone cells to brain cells.
But research on the cells has been slowed in the United States since President Bush, citing concerns about destruction of embryos, sharply limited federal funding of the science in 2001.
Work done by teams working independently of one another at Harvard, the Whitehead Institute, and Kyoto University involved the genetic manipulation of mouse skin cells back into an embryonic state. No eggs were used, no embryos destroyed -- a stunning advance, although perhaps difficult to replicate in humans.
"You can really turn back the clock from adult to embryonic stem cells," said Konrad Hochedlinger of the Harvard Stem Cell Institute and Massachusetts General Hospital's Center for Regenerative Medicine. "But success in humans might be much more difficult than in mice."
Posted by Gideon Gil at 01:37 PM
June 06, 2007
Less than a month before the deadline for all Massachusetts adults to have health insurance, it's still unclear who will be allowed to avoid the state requirement.
GlaxoSmithKline today trumpeted the preliminary results from a study it said found its embattled diabetes drug, Avandia, causes no more heart risks than medications that set the standard for diabetes care.
The 186 aging residents of the Fernald Development Center now receiving intensive treatment on the state-run campus deserve to live out their lives in familiar surroundings without fear of eviction, a Globe editorial says.
The risk of catching tuberculosis on a plane is extremely low, Dr. Marc Siegel, an associate professor of medicine at the NYU School of Medicine, writes in an opionion piece. He is author of "False Alarm; the Truth About the Epidemic of Fear."
Posted by Elizabeth Cooney at 06:20 AM
June 05, 2007
Lots of blog-linking to point to today.
Kevin, M.D., links to a blog by New York personal injury lawyer Eric Turkewitz that sheds more light on how Natick pediatrician Dr. Robert Lindeman (left) was revealed as the blogger Flea in his malpractice trial. Turkewitz called up Elizabeth Mulvey, the attorney for the plaintiffs, whose 12-year-old son died from complications of diabetes.
"She told me she was tipped off to his blog by another attorney. How did the other attorney know? Because Flea had blogged about a subject that Mulvey had spoken on some time back and the other attorney realized that she had the case," Turkewitz writes. "Flea had unwittingly given out the identifying information when he discussed her talk.
On A Healthy Blog, Health Care For All executive director John McDonough catches up to the conversation on Let's Talk Health Care, a blog written by Harvard Pilgrim Health Care chief Charlie Baker. The subject is hospital rate hikes and the role Partners HealthCare plays in the process.
McDonough sums up Paul Levy's point of view on the hospital marketplace as "Partners vs. everyone else," referring to the Beth Israel Deaconess CEO's blog, Running A Hospital, Then McDonough offers this observation on blogs:
"If anyone doubts the compelling relevance of the blogosphere to substantive health policy discussion, this conversation makes the case," he writes. "I canít recall a more substantive and real dialogue about the MA health market anywhere, anytime. Just wish our friends at Partners would get over their shyness and join the conversation."
Posted by Elizabeth Cooney at 10:57 AM
June 05, 2007
Dr. Kenneth C. Anderson (left) of Dana-Farber Cancer Institute has been named editor-in-chief of the journal Clinical Cancer Research, the American Association for Cancer Research said.
Anderson, who had been a senior editor of the oncology journal, is a professor of medicine at Harvard Medical School and chief of the division of hematologic neoplasia and director of the Jerome Lipper Multiple Myeloma Center at Dana-Farber.
Posted by Elizabeth Cooney at 09:34 AM
June 05, 2007
Tuberculosis specialists said yesterday that the real importance of the Andrew Speaker case is that it is a warning to all Americans: The United States should brace itself for many more cases of the drug-resistant airborne germ in the months and years ahead.
If members of the House Select Committee on Energy Independence and Global Warming invited by US Representative Edward J. Markey (left), could have peered through the storm clouds atop Cannon Mountain yesterday, they would have seen for themselves why the region's residents are so anxious about global warming. On a clear day, as far as the eye can see from the mountain, every business in this New Hampshire region depends on the climate, from its ski lifts to its hotels, from farms to snowmobile trails.
Incoming Harvard president Drew G. Faust has tapped a well-liked computer scientist to be dean of Harvard's largest school, the Faculty of Arts and Sciences. Michael D. Smith, 45, will oversee Harvard College and the PhD programs.
Leveraging his power as a federal adviser, tapping the reach of medical publications, and whispering in the ears of key members of Congress, Cleveland Clinic cardiologist Dr. Steven E. Nissen (left) has chipped away at the credibility of the Food and Drug Administration as the nation's top drug safety watchdog.
Posted by Elizabeth Cooney at 06:30 AM
June 04, 2007
A leading scientist who directed research programs at Harvard Medical School and at Brigham and Womenís Hospital is leaving Boston and taking about 20 researchers with him to develop a bioinformatics program in Houston.
Stephen Wong (left) is leaving his posts as director of the Center for Bioinformatics in the Harvard Center for Neurodegeneration and Repair at Harvard Medical School and executive director of the Functional and Molecular Imaging Center at Brigham and Womenís. He has been an associate professor of radiology at Harvard Medical School and part of the neuro-oncology and cancer imaging programs at Dana-Farber Cancer Institute.
On July 1 he will become chief of medical physics and vice chair of radiology at The Methodist Hospital and director of the bioinformatics program at The Methodist Hospital Research Institute. He will join the faculty at Weill Cornell Medical College, which became the hospitalís academic affiliate after it dissolved ties with Baylor University three years ago.
"This was not an easy decision to make. I think Harvard is wonderful," Wong said in an interview today. "I do think the opportunity in Houston is big. Itís a fantastic opportunity to be in on the infrastructure."
Wong said he was drawn to Methodist by Dr. King Li, with whom he had worked on molecular imaging. Li was the chief of diagnostic radiology at the National Institutes of Health Clinical Center before becoming chair of radiology at Methodist last year.
At Methodist, Wong will build a program to use information that comes from imaging and other biomedical technologies to devise diagnostic tests and treatments. He said he envisions a sort of human GPS system for interventional medicine, in which imaging guides individualized treatments.
Wong has a background in business that includes working for computer company HP and developing the online trading arm of stock broker Charles Schwab. He also worked on a digital image archive system at the University of California at San Francisco. He was recruited from industry three years ago to create the functional and molecular imaging center at the Brigham, Dr. Steven Seltzer, chair of radiology, said in an interview today.
"Steveís a very talented Ph.D. scientist," he said. "As disappointed as we are to lose him, itís a very exciting opportunity for Steve and for them."
Seltzer said the number of people transferring with Wong is "on the large side," calling it a testament to the resources Methodist has been able to put together. He said all but one of the Brigham people leaving with Wong are graduate students or postdoctoral fellows. Wong said the total number of people moving south with him is about 20. He will also take with him $4 million in NIH grants.
"Our backfill strategy is that talented folks are still here and some will be promoted into positions of new responsibility," Seltzer said. "We will in turn be looking at graduate students and postdoctoral fellows. We have the richness of the intellectual capital in the Boston area."
Wong said he will maintain the collaborations he has with 25 different labs in Boston.
"Science has no boundaries, so physical location doesnít matter," he said.
Posted by Elizabeth Cooney at 06:50 PM
June 04, 2007
By Alice Dembner, Globe Staff
Another 10,000 people enrolled in state-subsidized health insurance plans last month, the state announced yesterday, bringing the total to more than 79,000.
The plans, called Commonwealth Care, are open to adults without access to insurance at work who make up to $30,630 a year as individuals or $61,950 for a family of four.
Between 50,000 and 80,000 eligible individuals have yet to sign up, depending on who's counting.
For information on the plans, call 877-623-6765 or go to macommonwealthcare.com.
Posted by Karen Weintraub at 04:39 PM
June 04, 2007
A break in the protective barrier at Nauset
Beach is only getting deeper.
When an April northeaster punched a gap through the long, sandy spit that forms Nauset Beach in Chatham, local geologists and officials were not overly alarmed. But the break in the barrier beach, which protects much of mainland Chatham from the Atlantic, is only getting deeper and wider.
Frank L. Douglas, executive director of the MIT Center for Biomedical Innovation, has resigned in protest over the case of James L. Sherley, an MIT colleague who held a 12-day hunger strike in February after he did not receive tenure, faculty members and school officials said. Sherley is African-American, as is Douglas.
For the first time, doctors say they have found a pill that improves survival in liver cancer, a notoriously hard-to-treat disease diagnosed in more than half a million people globally each year.
A railway worker who emerged from a 19-year coma woke to a radically altered Poland and thinks "the world is prettier now" than it was under communism, his wife, Gertruda Grzebska, said about her husband, Jan, yesterday.
As antibiotics lose their punch, researchers are using an old idea and cutting-edge science to control bacteria. Scientists led by Rockefeller University researcher Vincent Fischetti are harnessing an enzyme found in viruses called phage as a way to eliminate lurking bacteria before they can do harm.
The number of graduates from US master's degree programs in international health has grown by 69 percent in the last decade as a part of an overall boom among students interested in saving lives in the poorest parts of the world. That's true among undergraduates and medical students as well, particularly at Boston's two major centers of public health teaching -- Boston University and Harvard University.
A new study by Boston doctors pitted metal detectors against patients with implants, testing to see what set the beepers off and what got through.
Also in Health/Science, retiring Harvard Medical School dean Dr. Joseph Martin talks about his plans and the challenges for the next dean.
Tom Mather (left), professor of Entomology at the University of Rhode Island and one of the country's foremost authorities, explains his career teaching people how to prevent tick bites, and, failing that, what to do if they get under their skin.
In Business, Harvard University, in one of its largest technology transfer deals ever, is set to disclose today that it has licensed a portfolio of more than 50 nanotechnology patents to a Cambridge start-up that is working with manufacturers and the Pentagon to commercialize the technology.
Patients should not haphazardly stop taking the controversial diabetes drug Avandia, even though it has been linked to heart risks, an early critic of the drug said yesterday.
Posted by Elizabeth Cooney at 06:26 AM
June 04, 2007
Massive litigation could force companies to leave the vaccine business, threatening the future of one of medicine's greatest achievements, Dr. Paul A. Offit writes in the Sunday Globe's Ideas section. He is the chief of infectious diseases at the Children's Hospital of Philadelphia and the co-inventor of the rotavirus vaccine currently licensed in the United States.
The bad news about our food seems to keep on coming, and it all points to the inevitable conclusion that the Food and Drug Administration cannot provide the protections for which it was created, William Hubbard, a former FDA associate commissioner, writes in an op-ed piece in Sunday's Globe.
Posted by Elizabeth Cooney at 06:25 AM