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August 31, 2007
Two studies reported yesterday bolster the case for a "timing hypothesis" in women taking estrogen after menopause.
The papers published in the journal Neurology suggest that estrogen may protect the brain if the hormone is taken within 10 years of menopause. Other observational studies have shown a 20 percent to 40 percent reduction in the risk of developing dementia if estrogen is started shortly after menopause, Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital, said in an interview today.
"There is mounting evidence that a woman's age and the time since onset of menopause influence her health outcomes on estrogen, including the risk of heart disease and cognitive decline," she said. "These (Neurology) studies do suggest that premature loss of estrogen tended to have an adverse effect on memory and cognitive function and that taking estrogen after menopause may counter those risks."
One Neurology paper said that women who had their ovaries removed before menopause had a higher risk of developing dementia or other cognitive impairment if they did not take estrogen until age 50. Another paper reported that the risk of Parkinson's disease and tremors was higher in women who had their ovaries removed, but those movement disorders were both less common than mental problems.
Manson was not involved in either study.
She said that because the studies were not randomized clinical trials, they do not provide conclusive evidence. She is working on her own large-scale randomized clinical trial of low-dose estrogen in preventing memory loss and cognitive decline. Called the KEEPS study, it is currently recruiting participants, and will look at recently menopausal women.
The findings reported in Neurology, while not conclusive, may offer reassurance to women considering the hormone for treatment of hot flashes and other symptoms, she said.
"The new research suggests more favorable benefits in younger women, providing reassurance for recently menopausal women who may be considering hormone therapy for the treatment of menopausal symptoms," she said.
Posted by Elizabeth Cooney at 01:48 PM
August 31, 2007
Transplant pioneer Dr. Joseph E. Murray (left) is working on a second book about science and spiritual values, but he has a challenge for his former field.
In an interview in today's Vineyard Gazette, the 88-year-old Nobel laureate and author of "Surgery of the Soul" reflected on his long career, his love for Chappaquiddick and a current transplant question.
"We don't know why but when multiple tissues, say a limb with bone and muscle and tissue, are transplanted, each of the elements seem to aid in the healing rate of other elements at far greater rates than for skin transplant alone," he told the Gazette. "If I were a young doctor, that's where I'd concentrate. That work will be fruitful for 50 or 80 years," he said.
Murray performed the first successful kidney transplant in 1954 at the Peter Bent Brigham Hospital. A Globe retrospective describes the impact of that work.
Posted by Elizabeth Cooney at 08:39 AM
August 31, 2007
The Archdiocese of Boston is in talks with Catholic Health Initiatives, a Catholic hospital chain based in Denver, to have it take over the church's ailing Caritas Christi Health Care system, according to three healthcare industry officials with knowledge of the discussions.
Massachusetts led all states, and Boston topped all major cities nationwide in the percentage of young children who received disease-fighting vaccinations last year, according to figures released yesterday by the Centers for Disease Control and Prevention.
Janet Marzilli (left) and her husband, recognizing a need for seminars to help people with multiple sclerosis accomplish daily tasks others take for granted, joined with others around 1970 to form the Association to Overcome Multiple Sclerosis. Mrs. Marzilli, who had lived in Arlington for decades, died Aug. 22 in Cape Cod Hospital of complications from multiple sclerosis. She was 74 and had lived the past several years in Marstons Mills.
Posted by Elizabeth Cooney at 06:47 AM
August 30, 2007
Industry R&D dollars have been leveling off at the same times as federal spending for biomedical research has flattened, says the advocacy group Research!America. Support from independent organizations, which account for 2 percent of the $116 billion spent on research in the United States last year, hasn't grown in five years.
The National Institutes of Health and other federal agencies have not seen their budgets grow since 2003, when medical inflation is taken into account. The total figure held steady at $37.7 million last year, including $28.5 billion for NIH. That has caused concern in Boston, whose teaching hospitals receive a total of about $1.4 billion a year in federal grants.
Nationally, the pharmaceutical, biotechnology and medical technology industries increased their research and development spending from $61 billion in 2005 to $64 billion in 2006, the report says. Industry budgets had been increasing along with government spending until three years ago, but have grown more slowly since. The report said there is a lag of about two years between what government and industry do.
In the independent category, made up of health associations, universities, private institutes, and state and local government funds, the total for 2006 came to $13.7 million, where it has been since 2001.
The investment in health research represents 5.5 cents of each dollar spent on health care, Research!America said. Other countries are stepping up their investments, Research!America president Mary Woolley told Science.
"The trends are not good," she said.
Posted by Elizabeth Cooney at 06:09 PM
August 30, 2007
The Massachusetts Child Psychiatry Access Project, the first of its kind in the nation, allows virtually any Massachusetts doctor who treats children to call for an immediate consultation about any patient's mental health -- for free.
Women who have their ovaries removed before menopause run a higher risk of developing dementia or other mental problems later in life -- unless they take estrogen until age 50, a study suggests.
Breathing easier without limiting activities is the goal of new government guidelines that urge more attention to asthma sufferers' day-to-day symptoms, not just their severe attacks.
After extending healthcare coverage to more than 150,000 previously uninsured residents over the past year, Massachusetts health reform took a turn for the worse this month with the Patrick administration's proposal to limit the state's Free Care Pool, Benjamin Day, executive director of Mass-Care: The Massachusetts Campaign for Single Payer Health Care, writes on the op-ed page.
Posted by Elizabeth Cooney at 06:46 AM
August 29, 2007
By Stephen Smith, Globe Staff
Who knew public health could be so hip?
State authorities tomorrow will unveil a glowing, gyrating website called the84.org that's targeted at adolescents, with film clips of antismoking ads made by kids, and an invitation to "peep" or see the winners. It's designed to dissuade youths from smoking -- and to encourage them to quit if they've already started.
The website is part of a broader campaign by the state Department of Public Health that also includes awarding about $200,000 to 18 organizations committed to the fight against teen smoking.
So why call the website the84.org?
"Because 84 percent of teenagers in school don't smoke," said John Auerbach, the state's public health commissioner. "This came from the young people themselves. The impression many young people have is that the majority of teenagers smoke.
"They felt it was important to have a name that suggested the vast majority of young people don't smoke -- that the norm is not smoking."
State statistics show that 7.1 percent of middle-school students and 20.7 percent of high-school students have smoked in the past month.
The effort to reduce youth smoking is the first initiative to benefit from increased funding the Legislature committed to tobacco control this year. The program's budget grew from $8.25 million in the last budget year to $12.75 million this year. Still, that's a small fraction of what the state spent in 2000, when the budget stood at a high of $54.3 million.
Posted by Karen Weintraub at 06:23 PM
August 29, 2007
Face transplants may be safer than previously thought, according to a new analysis of their risks, but the encouraging report will not change guidelines adopted by Brigham and Women's Hospital that limit who can have the rare procedure.
Researchers from the University of Cincinnati and the University of Louisville say in the journal Plastic and Reconstructive Surgery that an influential British report issued in 2004 overestimated the dangers by failing to take into account three important factors: newer drugs used to prevent rejection, the poorer health of kidney transplant recipients relative to face transplant patients and the different tissue composition of solid organs versus the skin.
The new analysis concludes that the risk of rejection for skin transplant patients, would be lower than predicted in 2004. Researchers based their conclusions on hand transplant patients, but said the results would be valid for both.
"I'm very encouraged that we see a lot less of rejection and even if it occurs, [doctors] were able to help them," Dr. Bohdan Pomahac, director of the Brigham program, said in an interview. "I think it's very interesting. In many ways it will correct the current estimate of morbidity associated with facial transplants."
The Brigham said last month it will perform partial face transplants only on patients already taking drugs to suppress their immune system because the drugs raise the risk of infection and cancer. That protocol will stay in place, said Pomahac, a plastic surgeon who is also the hospital's associate burn center director. He was not involved in the study by Cincinnati and Louisville researchers.
Pomahac cautioned that in the new study the number of hand transplants is small -- only 18 -- and the follow-up period may be too short for problems such as organ toxicity from taking even the newer immunosuppressant drugs to have shown up.
"I think every publication like this moves our knowledge a step forward and makes it more available ... as an option," he said.
Posted by Elizabeth Cooney at 05:40 PM
August 29, 2007
Dr. Robert A. Greenes says it's hard to leave Harvard and Brigham and Women's Hospital, after 40 years, but the chance to build a new biomedical informatics program in Arizona is too good to pass up.
"Harvard and the Brigham have provided a wonderful environment for my professional activity," he said in an e-mail message last night. "My decision to leave Boston after many years of working closely with so many wonderful colleagues was not easy but became irresistible as I learned more about what the opportunity could be."
Greenes, a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.
He is the second prominent biomedical informatics researcher to leave Harvard for a new program, following Stephen Wong, who took about 20 lab staffers with him to Methodist Hospital Research Institute in Houston.
"Besides the attractions of the new position in terms of the commitment of the participating institutions to it, and the generous budget, and space, ... I think the big attraction for me is the chance to raise the scale of informatics activity and commitment, " Greenes said.
Greenes singled out Dr. Steven Seltzer, chief of radiology at the Brigham, for his support of biomedical informatics as the field has matured. Yesterday Seltzer called the new opportunity for Greenes an exciting one.
The University of Arizona incorporated biomedical informatics into plans for its new medical school branch in Phoenix, Greenes said. Its 24 students have just begun classes, medical school spokesman Al Brava said yesterday.
Biomedical informatics includes the role of informatics not only in genomics and molecular science, but also in imaging, clinical medicine and public health, Greenes said.
"These are heady times for informatics, and Arizona recognizes and is poised to take advantage of its potential," he said.
His wife, Carole Greenes, is also joining Arizona State University. A professor of mathematics education at Boston University, she will become dean of the School of Educational Innovation and Teacher preparation at ASU's Polytechnic campus in Mesa.
Posted by Elizabeth Cooney at 09:27 AM
August 29, 2007
Patients seeking an appointment with a dermatologist to ask about a potentially cancerous mole have to wait substantially longer than those seeking Botox for wrinkles, says a study published online today by The Journal of the American Academy of Dermatology and described in today's New York Times.
In Boston, the median Botox wait was 13 days, versus 68 days for a mole examination, the Times story said. In Seattle, the median Botox wait was seven and a half days, compared to 35 days for a changing mole.
Dr. Alexa B. Kimball, an associate professor of dermatology at Harvard Medical School, told the Times one reason could be that the demand for medical dermatologists outstrips the supply. She was not involved in the study but her research has shown that dermatologists nationwide spent an average of three to four hours a week on cosmetic treatments.
More people are seeking medical appointments with dermatologists because of increased awareness about such skin diseases as melanoma and psoriasis, Kimball said. Meanwhile, a wider array of doctors, including plastic surgeons and even some internists, offer Botox shots, she said.
"The study shows that the Botox needs of the United States are being met," Dr. Kimball told the Times. "If dermatologists stopped providing cosmetic care, it would not necessarily have an impact on medical dermatology patients."
Posted by Elizabeth Cooney at 08:31 AM
August 29, 2007
Boston's emergency medical technicians, who often run red lights and speed through the opposite lane of traffic to save lives, are trained to confront broken bones and cardiac arrest. But EMTs, who are responding to more calls each year, often become victims themselves as they face Boston's rampant street violence without the guns, mace, and nightsticks that police officers carry.
A record 47 million Americans did not have health insurance last year, while the percentage of children without insurance rose for a second consecutive year, according to US Census Bureau data released yesterday, leading Democrats to charge that the Bush administration has ignored a growing, more vulnerable population.
Dr. Jack Mendelson (left), a noted psychiatrist at McLean Hospital and endocrinologist who promoted the concept that alcoholism is a medical disorder, died of cancer on Aug. 15 at the Kaplan Family Hospice in Danvers. He was 77.
Did someone kill Beethoven? A Viennese pathologist asserts that the composer's physician did -- inadvertently overdosing him with lead in a cure that went wrong. Other researchers are not convinced, but there is no controversy about one fact: The master had been a very sick man years before his death in 1827.
If feminism these days is all about sexiness as power -- vanquishing foes with a kiss -- then cancer might be the modern girl's ultimate challenge. Who better to conquer a dread disease than a hot chick with an attitude? That's who Kris Carr purports to be in "Crazy Sexy Cancer," an engaging documentary that airs tonight at 9 on TLC.
Posted by Elizabeth Cooney at 06:56 AM
August 28, 2007
By Elizabeth Cooney, Globe Correspondent
Another biomedical informatics leader is leaving Harvard to head a new department in the Sun Belt.
Dr. Robert A. Greenes (left), a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.
He will chair the Phoenix-based department of biomedical informatics in ASU's School of Computing and Informatics, which was founded last year as part of the School of Engineering.
Greenes is leaving Brigham and Women's Hospital, where in 1980 he established the Decision Systems Group.
His departure follows the move in July by Stephen Wong, who took about 20 researchers with him when he left for The Methodist Hospital Research Institute in Houston to create a bioinformatics program there.
"Bob got a wonderful professional opportunity," Dr. Steven Seltzer, chief of radiology at the Brigham, said in an interview today. "They have money and they have space, so it's exciting."
The departures by Greenes and Wong are "bittersweet" transitions that Harvard monitors, he said.
"Our institution is blessed with more than its fair share of resources and part of our mission in life is to help populate the world with folks who are leaders in American medicine," Seltzer said. "Having said that, we still need to retain our highly qualified faculty and when we lose any faculty member, even if for a unique opportunity, it is a bittersweet outcome for us. We monitor as carefully as we can with any faculty attrition we have, how much is for, a 'good' reason, like moving to a nice opportunity, and how much is for a bad reason, that we are not competitive [in] either compensation or other resources."
In a statement from ASU announcing his appointment, Greenes said he was influenced by "the substantial planning efforts and resources already devoted to ASU's biomedical informatics program."
"I'm impressed by the eagerness at all levels of the university, especially its leadership, and among its partners, the University of Arizona, and other Arizona health and biomedical science institutions, to create a top-notch biomedical informatics program," Greenes said. He was traveling today and did not immediately return calls or e-mails seeking comment.
Greenes is not taking members of the Decision Systems Group with him to Arizona, Seltzer said. Dr. Lucila Ohno-Machado will succeed him as director of the group.
Posted by Elizabeth Cooney at 02:44 PM
August 28, 2007
A new survey of Sept. 11-related illnesses has found an alarming increase in asthma -- 12 times higher than normal -- among those who toiled on the toxic debris piles of ground zero.
British heart doctors are fighting an effort to end government coverage for drug-coated heart stents.
We are all uninsured, when we face the risk that our employer will drop our plan, that Medicare will go bust, that our plan won't cover our needs, that premiums will eat us alive, that our doctor will stop taking our insurance, that long-term care will wipe us out, and that our uninsured friends and family members will need major financial help, Laurence J. Kotlikoff of Boston University writes on the op-ed page.
Benjamin Libet, a physiologist at the University of California at San Francisco whose studies of the brain led to a new understanding of consciousness and free will, died July 23 at his home in Davis. He was 91.
The Rev. James Putney, who used his experiences with pain to aid in his spiritual care to cancer patients, died Aug. 14 at Brotman Medical Center in Los Angeles He was 55.
Posted by Elizabeth Cooney at 06:44 AM
August 27, 2007
By Elizabeth Cooney, Globe Correspondent
A prominent Boston cancer researcher is encouraged that, for the first time in recent memory, cancer is taking center stage in a presidential campaign.
"It seems to me that it is a good thing for sure that this is part of the political debate," Dr. Eric Winer, director of the breast oncology center at Dana-Farber Cancer Institute, said in an interview. "We certainly want cancer to be in the forefront of what the candidates and what Americans are thinking about."
Today Democratic candidates Hillary Clinton and John Edwards presented their ideas at a forum in Cedar Rapids, Iowa, convened by cyclist and cancer survivor Lance Armstrong. His LIVESTRONG Foundation invited presidential hopefuls to explain what they would do to combat the disease that kills 600,000 Americans a year. New Mexico Governor Bill Richardson, Kansas Senator Sam Brownback and Arkansas Governor Mike Huckabee also agreed to speak at the two-day event.
Edwards's wife, Elizabeth, has breast cancer and has said she will probably die of the disease. Her illness has influenced his thinking, he told the Associated Press.
His plan promises more money for research and more support for cancer survivors and their caregivers, according to material supplied by his campaign. He also advocates monitoring chemical and environmental risks while promoting better diet, more exercise and smoking cessation.
Clinton's goals urge better access to health care, doubling the federal research budget, preventing disease through healthier lifestyles and increased screening, and reducing racial and ethnic disparities in care. Her plan would devote funds to comprehensive care for cancer patients and require insurance companies to pay for preventive measures such as mammograms, colorectal screening and HPV vaccination.
Without parsing each candidate's plan, Winer said the need for increased cancer research, some form of universal health coverage and a commitment to fight cancer are all critical.
"What we need is funding that has the potential to decrease the number of Americans and people around the world who die from cancer," he said. "We need a national commitment to fixing the cancer problem and this goes beyond just dollars for research and for care. My hope is that cancer would serve as a model for other diseases."
Posted by Elizabeth Cooney at 07:43 PM
August 27, 2007
By Liz Kowalczyk, Globe Staff
The number of Massachusetts residents without health insurance dropped to 355,000 this year, down from 395,000 last year, according to a newly-released state survey. The overall uninsured rate fell to 5.7 percent, from 6.4 percent.
Massachusetts officials said the drop indicates that the state's new mandatory insurance law is beginning to work.
"This is a clear indication that health reform is succeeding, '' said JudyAnn Bigby, state secretary of Health and Human Services. "Even in the early phase of the law's implementation, these findings confirm our success in reducing the number of uninsured people across the entire Commonwealth.''
The Center for Survey Research at UMass-Boston called 4,000 homes between January and June of this year.
Posted by Karen Weintraub at 04:49 PM
August 27, 2007
A Harvard Medical School physician-scientist has been named dean of the Duke University School of Medicine, the North Carolina school announced today.
Dr. Nancy C. Andrews (left), dean for basic sciences and graduate studies at Harvard Medical School, is the first woman to fill the position, Duke said. She will succeed Dr. R. Sanders Williams, who was promoted to senior vice chancellor for academic affairs at Duke.
Andrews, 48, is a pediatric hematologist/oncologist at Children's Hospital Boston and the Dana-Farber Cancer Institute. She previously directed the Harvard/MIT MD/PhD program. A member of the Institute of Medicine of the National Academy of Sciences, she was a Howard Hughes Investigator from 1993 to 2006.
Andrews earned bachelor's and master's degrees in molecular biophysics and biochemistry from Yale University, a Ph.D. in biology from MIT, and an MD from Harvard Medical School. She completed her residency at Children's and a fellowship in pediatric hematology/oncology at Children's and Dana-Farber.
Posted by Elizabeth Cooney at 02:51 PM
August 27, 2007
By Elizabeth Cooney, Globe Correspondent
Massachusetts adults are the second-leanest in the country, according to a report released today, but the state's younger residents rank in the middle on the overweight scale.
The adult obesity rate was 19.8 percent, placing the state higher than only Colorado. For children age 10 to 17, the rate of being overweight was 13.6 percent, or 27th highest on the national list in the fourth annual "F as in Fat: How Obesity Policies Are Failing in America, 2007" from the Trust for America's Health. Almost a third of American adults are obese, it said.
The report, funded by the Robert Wood Johnson Foundation, is based on data that the Centers for Disease Control and Prevention gathered from 2004 through 2006. Children are considered overweight if they are at or above the 95th percentile of body mass index for their age. Adults fall into the obese category if their BMI is 30 or above.
Adult obesity climbed in 31 states last year, including a gain of 1.2 percentage points in Massachusetts, which was also among 22 states that saw increases for two years in a row. In no state did obesity decline.
There's nothing surprising about the trends going upward, obesity specialist Dr. David Ludwig of Children's Hospital Boston said in an interview.
The difference between adults and youths may reflect the makeup of the population, with obesity being more prevalent among certain economic, social and ethnic groups, he said, but the rising trend among all segments is more important.
"The obesity epidemic continues to escalate," he said. "Even if we were to see a leveling off, especially with children, the full impact of the epidemic will not be felt for some time to come."
Type 2 diabetes, high blood pressure, high cholesterol and other serious complications are showing up in children now, which will translate into shorter life expectancy in the United States for the first time since the Civil War, he said, citing a paper he wrote two years ago. Ludwig was not involved in the report released today.
Mississippi's 30.6 percent adult obesity rate was the highest and Colorado's 17.6 percent was the lowest. For youths, the highest rate of 22.8 percent was found in Washington, D.C., and the lowest was 8.5 percent in Utah. For both children and adults, the highest rates of overweight were found in the South.
But Massachusetts isn't far behind, Ludwig said.
"Rather than focus on which state is winning the race, so to speak, the state-to-state variations are from my perspective less important than the overall more remarkable finding of this increase in obesity among adults and children everywhere," he said.
The report tracked policies in schools to encourage better nutrition and more physical activity. Massachusetts is not among the 17 states whose school lunches, breakfasts and snacks must meet higher standards than required by federal guidelines. The state is also not one of the 22 that have rules for other food sold in schools, from vending machines to bakes sales. But Massachusetts does send home fitness assessments about students, among 16 states to do so.
Posted by Elizabeth Cooney at 11:00 AM
August 27, 2007
Every year, 1.7 million people contract infections while hospitalized. Officials are fighting the problem, but there are things patients should know to avoid getting sicker.
Harvard archeologists have extracted usable DNA from long-dried spit on wads of prehistoric gum. Employing methods now common at modern-day crime scenes, they also managed to gather and analyze DNA from 2,000-year-old bloodstained garments, they report in next month's Journal of Field Archeology.
The southern Africa country of Botswana has reduced the HIV transmission rate from mother to child to less than 4 percent, providing fresh evidence that several hundred thousand babies in the developing world can be saved annually from acquiring the deadly virus.
Robert K. Coughlin (left), a top economic development aide to Governor Deval Patrick, waited six weeks before notifying the governor that he had talked to the Massachusetts Biotechnology Council about becoming its president, a period during which he continued to advance the administration's life science initiatives, according to e-mails and telephone records obtained by the Globe.
The day Dr. Leslie Halpern (right) discovered her calling was the day a woman walked into the emergency room at Lincoln Hospital in the Fort Apache section of the Bronx, her face slashed with a box blade.
Also in Health/Science, is it true that grapefruit juice has more nutrients than other fruit juices and do Storrow Drive lane closures add to greenhouse gas emissions?
Next month when the MIT Museum will complete a $3 million expansion, knocking out the ground-floor walls and replacing them with plate glass that will literally shine light on the latest research from the Massachusetts Institute of Technology brain trust.
California did not start the current wave of efforts to overhaul the American healthcare system, but what happens in Sacramento over the next few weeks could have a big impact on whether the drive gains momentum -- or peters out.
Posted by Elizabeth Cooney at 06:59 AM
August 27, 2007
A patron gave her car keys to a valet at Mistral last
month before entering the South End establishment.
(DINA RUDICK/GLOBE STAFF)
A surprising number of Boston's high-end dining rooms -- including such noted venues as Mistral in the South End and the Harvard Club on Commonwealth Avenue -- have been cited for serious health code violations of the sort that can cause food poisoning, according to a Globe review of city inspection reports for 2004, 2005, and 2006. Nearly half of the 50 restaurants whose records were examined had been flagged for major -- and sometimes chronic -- violations.
Jon Kingsdale (right), executive director of the Commonwealth Health Insurance Connector Authority, says "people like a plan better if they pick it themselves from a set of choices, rather than if they're just pushed into it -- even if they wind up in the same plan. People like having a sense that they are a little in control of their destiny."
As much a teacher as a physician, Dr. Peter Yurchak (left) received three awards for excellence in teaching from Harvard Medical School, where he was an assistant clinical professor of medicine. He died of pancreatic cancer July 30 in Massachusetts General Hospital, where until last year he was director of the training program in cardiology. Dr. Yurchak was 74 and had lived in Wellesley.
Posted by Elizabeth Cooney at 06:30 AM