Your Life your connection to The Boston Globe
White Coat Notes: News from the Boston-area medical community
Send your comments and tips to

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
 Short White Coat blogger Jennifer Srygley
Week of: October 7
Week of: September 9
Week of: September 2

« September 23, 2007 - September 29, 2007 | Main | October 7, 2007 - October 13, 2007 »

October 5, 2007

Who’s not offering health insurance?

By Alice Dembner, Globe Staff

In the first week of a 6-week filing period, only four Massachusetts companies fessed up to not providing health insurance for their full-time workers, according to figures from the administration of Governor Deval Patrick.

The state’s universal health insurance law requires companies with 11 or more employees to offer insurance or pay a fee of up to $295 per employee per year. To enforce this provision, companies must report by Nov. 15 whether they paid for insurance for at least one-quarter of their full-time workers or offered to pay at least one-third of an individual’s premium in the last year. Firms that don’t meet either of these tests must pay the fee.

From Monday through the end of business Thursday, about 860 companies with 11 or more employees filed. But only four said they would be subject to the fee. At least partial payment of the fee is due by Nov. 15.

State officials said they had no idea how many companies are required to file. But US Census figures from 2005 suggest there may be as many as 40,000 Massachusetts companies with 11 or more workers.

Posted by Karen Weintraub at 06:01 PM
October 5, 2007

Breast-feeding medical student wins break time

A Harvard medical student battling for extra time to pump breast milk during a licensing exam plans to take the test as soon as she can after a court ruling in her favor today.

The state Appeals Court declined to reverse a ruling made by a single justice last week that cleared the way for Sophie Currier to have extra time.

"I'm going to take the test as soon as possible," Currier said in a phone interview before referring other questions to a spokeswoman so she could return to studying.

The 33-year-old Brookline mother of a five-month-old girl sued the National Board of Medical Examiners when it refused to give her more than the standard 45-minute break allowed to students taking the nine-hour exam. Currier, who must pass the test before beginning her residency at Massachusetts General Hospital, has been granted permission to take the test over two days because of her dyslexia and attention deficit hyperactivity disorder.

Joseph Savage, the board's attorney, argued that granting Currier extra time would not be fair to other test-takers. Savage did not immediately return phone calls seeking comment.

Today's ruling did not consider the merits of the case. Instead it was based on whether the single justice whose decision overturned a superior court's denial of Currier's claim showed abuse of discretion or a clear error of law. The court found neither.

Posted by Elizabeth Cooney at 01:53 PM
October 5, 2007

Ig Noblesse oblige


Nobel laureates (seated, from left) William Lipscomb,
Robert Laughlin, Craig Mello, Roy Glauber and Dudley
Herschbach taste Ig Nobel-prize winning ice cream
flavored by vanillin derived from cow dung.

(Kees Moeliker / Annals of Improbable Research)

You had to be there.

At last night's Ig Nobel prize ceremony, paper airplanes, pointless chicken references and acceptance speech poems sailed through Harvard's Sanders Theatre. The mood was part Mardi Gras, part Marx Brothers as the Annals of Improbable Research induced real Nobel laureates to play along with real scientists whose published work first made people laugh, and then think, journal editor and master of ceremonies Marc Abrahams said.

There was sword-swallowing, natch, from the Tennessee winner Dan Meyer, who studied sword swallowing's side effects. There was ice cream from Toscanini's made, so the real laureates were told, using Japanese Ig Nobel winner Mayu Yamamoto's formula for deriving vanillin from cow dung. Craig Mello, last year's Nobel winner in medicine, was the first to dip his spoon into his dish as the crowd chanted "Eat it!"

There was 2005 physics Nobelist Roy Glauber, wearing a Chinese straw hat and wielding a twig broom, sweeping paper airplanes off the crowded stage as he has done for 10 years of Ig Nobel celebrations.

And there were chicken and/or egg costumes made out of black garbage bags that Mello, Glauber, and their good-natured peers Dudley Herschbach (chemistry 1986), William Lipscomb (chemistry 1976) and Robert Laughlin (physics 1998) climbed into and burst through on cue.

You had to be there.

But there's another chance to enjoy the merriment: At 1 p.m. tomorrow, the Ig Nobel winners will make presentations in MIT Building 10, Room 250. Check out their prizes and real references.

Posted by Elizabeth Cooney at 11:46 AM
October 5, 2007

Today's Globe: biolab scrutiny, pregnant women and fish, OxyContin suit, health records site, Dr. Marvin Krims

The US government does not conduct surprise inspections of laboratories handling the world's most dangerous organisms and poisons, but regulators said yesterday that that could change.

Women who are pregnant or breast-feeding should eat at least 12 ounces of fish and other seafood a week because the benefits for infant brain development outweigh any worries about mercury contamination, a group of US specialists said yesterday.

Kentucky officials yesterday sued the manufacturer of OxyContin, the prescription painkiller dubbed "hillbilly heroin," because of widespread abuse in Appalachia.

Microsoft Corp.
launched a website yesterday for managing personal health and medical information, but privacy advocates worry that neither the technology nor US law will protect patients' most confidential details.

Dr. Marvin B. Krims, a Newton psychiatrist for almost 50 years who was a specialist in the psychoanalytic interpretations of Shakespeare, died Monday in his home of complications from lung cancer. He was 79.

Posted by Elizabeth Cooney at 06:55 AM
October 4, 2007

Ig Nobels pop tonight

By Elizabeth Cooney, Globe Correspondent

Bottomless soup bowls, vanilla made from cow dung, a net that drops on bank robbers and "gay bombs." And don't forget discriminating rats listening to Japanese and Dutch. Backwards.

Must be time for the Ig Nobel Prizes again, when the science humor magazine Annals of Improbable Research recognizes scientists with a sense of humor from around the world for achievements that made the judges laugh and think.

Harvard's Lakshminarayanan Mahadevan is the only local laureate this year. He took the prize in physics for studying how sheets become wrinkled. Seems a little mild, next to the soup bowl that refilled itself in an experiment measuring people's appetites. But that sounds more appetizing than the vanillin, which really did come from livestock excrement.

The robber-nabbing net? Its Taiwanese inventor seems to have vanished, the Ig Nobel organizers report.

Gay bombs, however, were found at an Air Force research lab in Ohio that developed a chemical weapon to make enemy soldiers sexually irresistible to each other. The technical term is "Harassing, Annoying and 'Bad Guy' Identifying Chemicals."

And those rats? Turns out, sometimes they can't tell the difference between Japanese and Dutch spoken backwards. Huh.

This year's ceremony, at which real live Nobel laureates give out prizes to the winners -- 7 of the 10 were expected to show up at their own expense -- was webcast tonight from Harvard's Sanders Theatre.

Here's the list of winners:

Brian Witcombe of Gloucester, UK, and Dan Meyer of Antioch, Tenn., for their penetrating medical report "Sword Swallowing and Its Side Effects."
REFERENCE: "Sword Swallowing and Its Side Effects," Brian Witcombe and Dan Meyer, British Medical Journal, December 23, 2006, vol. 333, pp. 1285-7.

L. Mahadevan of Harvard University, and Enrique Cerda Villablanca of Universidad de Santiago de Chile, for studying how sheets become wrinkled.
"Wrinkling of an Elastic Sheet Under Tension," E. Cerda, K. Ravi-Chandar, L. Mahadevan, Nature, vol. 419, October 10, 2002, pp. 579-80.
"Geometry and Physics of Wrinkling," E. Cerda and L. Mahadevan, Physical Review Letters, fol. 90, no. 7, February 21, 2003, pp. 074302/1-4.
"Elements of Draping," E. Cerda, L. Mahadevan and J. Passini, Proceedings of the National Academy of Sciences, vol. 101, no. 7, 2004, pp. 1806-10.

Johanna E.M.H. van Bronswijk of Eindhoven University of Technology, The Netherlands, for doing a census of all the mites, insects, spiders, pseudoscorpions, crustaceans, bacteria, algae, ferns and fungi with whom we share our beds each night.
"Huis, Bed en Beestjes" [House, Bed and Bugs], J.E.M.H. van Bronswijk, Nederlands Tijdschrift voor Geneeskunde, vol. 116, no. 20, May 13, 1972, pp. 825-31.
"Het Stof, de Mijten en het Bed" [Dust, Mites and Bedding]. J.E.M.H. van Bronswijk Vakblad voor Biologen, vol. 53, no. 2, 1973, pp. 22-5.
"Autotrophic Organisms in Mattress Dust in the Netherlands," B. van de Lustgraaf, J.H.H.M. Klerkx, J.E.M.H. van Bronswijk, Acta Botanica Neerlandica, vol. 27, no. 2, 1978, pp 125-8.
"A Bed Ecosystem," J.E.M.H. van Bronswijk, Lecture Abstracts -- 1st Benelux Congress of Zoology, Leuven, November 4-5, 1994, p. 36.

Mayu Yamamoto of the International Medical Center of Japan, for developing a way to extract vanillin -- vanilla fragrance and flavoring -- from cow dung.
REFERENCE: "Novel Production Method for Plant Polyphenol from Livestock Excrement Using Subcritical Water Reaction," Mayu Yamamoto, International Medical Center of Japan.

Juan Manuel Toro, Josep B. Trobalon and Núria Sebastián-Gallés, of Universitat de Barcelona, for showing that rats sometimes cannot tell the difference between a person speaking Japanese backwards and a person speaking Dutch backwards.
REFERENCE: "Effects of Backward Speech and Speaker Variability in Language Discrimination by Rats," Juan M. Toro, Josep B. Trobalon and Núria Sebastián-Gallés, Journal of Experimental Psychology: Animal Behavior Processes, vol. 31, no. 1, January 2005, pp 95-100.

Glenda Browne of Blaxland, Blue Mountains, Australia, for her study of the word "the" -- and of the many ways it causes problems for anyone who tries to put things into alphabetical order.
REFERENCE: "The Definite Article: Acknowledging 'The' in Index Entries," Glenda Browne, The Indexer, vol. 22, no. 3 April 2001, pp. 119-22.

The Air Force Wright Laboratory, Dayton, Ohio, USA, for instigating research & development on a chemical weapon -- the so-called "gay bomb" -- that will make enemy soldiers become sexually irresistible to each other.
REFERENCE: "Harassing, Annoying, and 'Bad Guy' Identifying Chemicals," Wright Laboratory, WL/FIVR, Wright Patterson Air Force Base, Ohio, June 1, 1994.

Brian Wansink of Cornell University, for exploring the seemingly boundless appetites of human beings, by feeding them with a self-refilling, bottomless bowl of soup.
REFERENCE: "Bottomless Bowls: Why Visual Cues of Portion Size May Influence Intake," Brian Wansink, James E. Painter and Jill North, Obesity Research, vol. 13, no. 1, January 2005, pp. 93-100.
REFERENCE: Mindless Eating: Why We Eat More Than We Think, Brian Wansink, Bantom Books, 2006, ISBN 0553804340.

Kuo Cheng Hsieh, of Taichung, Taiwan, for patenting a device, in the year 2001, that catches bank robbers by dropping a net over them.
REFERENCE: U.S. patent #6,219,959, granted on April 24, 2001, for a "net trapping system for capturing a robber immediately."

Patricia V. Agostino, Santiago A. Plano and Diego A. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that Viagra aids jetlag recovery in hamsters.
REFERENCE: "Sildenafil Accelerates Reentrainment of Circadian Rhythms After Advancing Light Schedules," Patricia V. Agostino, Santiago A. Plano and Diego A. Golombek, Proceedings of the National Academy of Sciences, vol. 104, no. 23, June 5 2007, pp. 9834-9.

Posted by Elizabeth Cooney at 10:30 PM
October 4, 2007

Short White Coat: Race for the Snacks

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at

ishani 2.JPG

For the past few weeks, I’ve been living off the bounty of my "altruism": Coffee, yogurt, energy bars, and soymilk from Boston’s Race for the Cure, t-shirts and fruit roll-ups from the Harvard University-wide Day of Service, and a little musical and comedic nourishment for the soul at the Boston 826 community writing center fund-raiser.

In Boston, there’s no dearth of do-good opportunities -- medical or otherwise -- and they come with more than a fair share of Free Stuff.

The Office cleverly and hilariously addressed the pageantry of charity events in its season premiere last Thursday, which featured the Michael Scott Dunder Mifflin Scranton Meredith Palmer Memorial Celebrity Rabies Awareness Fun Run Race for the Cure. Michael Scott, the ever-fumbling head honcho, urges his workers to support the rabid in a convoluted attempt to allay his guilt for hitting an employee with his car. The $700 the office raises for the spurious cause is quickly eaten up by the cost of creating a giant check (made out to “Science”) and hiring a stripper nurse to accept this check (because rabies doctors are unwilling to travel to Scranton, PA, as well as nonexistent). The perks of racing for an already existent cure? T-shirts, water, and of course, an overwhelming sense of moral contentment.

I’m getting better at rationalizing the guilt that comes with the glee of collecting charity booty. There’s good reason for the perks -- pre-race bagels at Race for the Cure made the 5K run just a bit smoother, while spray-on pink ribbon tattoos raised awareness for the cause (at least the ones placed visibly). As for the companies donating the goods or musical acts the talent, they get good publicity out of the deal.

I’ve also been thinking more carefully about how I choose my causes. I’m happy to say that the goody bag factor is low on the list. But as a debt-ridden medical student, I’m happy to take my snacks where I can get them.

Posted by Ishani Ganguli at 03:36 PM
October 4, 2007

Breast-feeding student to reschedule exam, wait for court ruling

(Michele McDonald/Globe Staff)

Sophie Currier with her white coat and her baby.

By Globe Staff

Sophie Currier, the Harvard medical student who sued because she wanted time to pump breast milk during a licensing exam, will postpone taking the exam, her lawyer said Wednesday.

Currier had planned to take the exam this week after Massachusetts Appeals Court Judge Gary Katzmann ordered that she should get the extra time. But a three-judge panel of the court on Tuesday stayed Katzmann's order, promising a ruling by next Wednesday.

Carol Thomson, a spokeswoman for the National Board of Medical Examiners, said, "The next step for us is to await their conclusion."

She noted that Currier could take the exam under normal conditions or reschedule.

Christine Collins, Currier's lawyer, said Currier planned to reschedule so she could see how the court ruled.

"We're fairly confident that the judges are going to affirm Judge Katzmann's decision and order," she said.

Posted by Karen Weintraub at 11:06 AM
October 4, 2007

UMass participating in long-term study of child health

By Scott Allen, Globe Staff

The babies will be studied from the time they are in their mothers' wombs through their 21st birthdays in hopes of discovering the earliest signs of diseases that disable and kill Americans by the million. The air they breath, the grass they play on, the water they drink -- all of it will be carefully measured for signs of contamination, and their family histories and genetic composition mined for the smallest defects.

The National Children's Study, the most ambitious study of children's health ever undertaken, took a big step toward reality today with the naming of 22 centers, including the University of Massachusetts Medical School in Worcester, that will carry out the decades of meticulous research.

Under an initial $16.24 million, five-year federal grant, the state medical school will recruit 1,000 Worcester County women willing to let their children's growth and development be tracked as part of the 100,000-child national study that aims to do for children's health what the famous Framingham Heart Study did for the understanding of heart disease.

"This is transformational ... We are talking about 30 years of studies," said Dr. Marianne Felice, chair of pediatrics at UMass, who spearheaded efforts to win the right to run the central Massachusetts branch of the study. "This is like the Framingham Heart Study for children, but better, longer and in more detail."

In the planning stages since 2000, the National Children's Study is intended to improve both prevention and treatment of major conditions such as birth defects, autism, diabetes, heart disease, and obesity.

Children's study officials had previously named seven institutions nationally to lead the project, but it nearly stalled at the starting gates in 2006 when the Bush administration tried to eliminate its funding. Congress ultimately put up $69 million for this year that allowed the study to name 22 more academic centers, including Yale and Brown universities in New England, to carry out the work. Ultimately, study officials expect a total of 30 to 40 centers will carry out the research in 105 locations around the United States.

Already, Felice said UMass is gearing up to hire many of the 100 or more employees they will need to recruit families and then track the children. UMass officials also are poring over a three-inch-thick briefing book that spells out the study procedures right down to details such as collecting a sample of infants' cord blood in the delivery room for analysis. Felice said the study will be a major boost for pediatrics research at the university, giving local researchers a platform to investigate both national and local concerns, such as the unusually high infant mortality rate in Worcester County.

"I consider this a legacy that I will leave to my young faculty," she said.

October 4, 2007

Today's Globe: children's health bill veto, surgeon in VA probe, virtual colonoscopy, drug-coated stents

The bill that President Bush vetoed would have
expanded the State Children's Health Insurance
program by $35 billion. Above, Christina
Brownlee got a checkup in Miami yesterday.
(Joe Raedle/Getty Images)

President Bush yesterday vetoed a bill to add $35 billion to a program providing health insurance coverage to children from lower-income families, portraying the State Children's Health Insurance Program as a costly entitlement program that has increasingly come to benefit middle-class families.

A surgeon with a history of malpractice complaints in Massachusetts was involved in "aggressive, complex surgeries" at a Veterans Affairs medical center in southern Illinois that went beyond what that site could handle, resulting in a spike in deaths there, US Senator Richard Durbin said yesterday.

Having an X-ray to look for signs of colon cancer may soon be an option for those who dread the traditional scope exam.

Patients given drug-coated stents to prop open clogged heart arteries were less likely to die or need repeat procedures than those with older, bare-metal devices, according to a study that may help revive sales of the newer models.

Posted by Elizabeth Cooney at 06:55 AM
October 3, 2007

'Brain-eating amoeba' unlikely here, experts say

By Elizabeth Cooney, Globe Correspondent

Sunday’s "brain-eating amoeba" story has been among’s most e-mailed stories all week, but that’s about as close as the parasite may come to us, state and national health experts said.

Six people have died this year after an amoeba called Naegleria fowleri infected them while swimming in Florida, Texas and Arizona. That’s a spike compared to the 23 deaths from 1995 to 2004, a trend that may continue with rising temperatures, epidemiologist Michael Beach of the US Centers for Disease Control and Prevention said in an interview.

The microscopic parasite, which lives in the bottom of warm, freshwater pools, can crawl into the brain via the olfactory nerve, the pathway from the nose to the brain that is crucial for our sense of smell. Once there, it can cause inflammation that destroys brain tissue. Symptoms typically start with a stiff neck, headache and fever, and death usually follows after three to seven days.

"This is a heat-loving bug that you really find only in hot springs or in southern tier states," Beach said. "We know we tend to see an increase in cases after an extended heat wave, and that's what we think happened this year."

A similar burst occurred in 1980, when eight people died, he said.

"It’s a very rare disease," Dr. Alfred DeMaria, the Massachusetts director of communicable disease control, said in an interview. “We’ve never had a case in Massachusetts. We don’t have that kind of environment."

People shouldn’t be swimming in the kind of water where this parasite lives, DeMaria said, making it a good idea to stick to clean beaches, salt water and chlorinated pools.

"We wouldn’t expect to see it here," DeMaria said.

Beach said there has not been an overall increase in the number of cases, despite the spikes that follow heat waves in states in the swath from Florida to California. But as temperatures rise because of global warming, so does concern.

"These are extremely tragic deaths," Beach said. "One has to consider with temperatures going up, the organism will compete better and we may see more cases. We want to track this."

Posted by Elizabeth Cooney at 07:42 PM
October 3, 2007

Harvard's Allston science complex approved

Harvard University won final approval today from the Boston Redevelopment Authority for a four-building science complex that will be the first major project in the university's new Allston campus.

The complex, with an estimated cost of $1 billion, will house Harvard's Stem Cell Institute and the Department of Stem Cell and Regenerative Biology. The project will face Western Avenue, across the street from the old WGBH-TV studios.

October 3, 2007

Medford man diagnosed with West Nile

By Stephen Smith, Globe Staff

A 49-year-old Medford man is hospitalized with West Nile virus, the third person to contract the mosquito-borne illness this year in Massachusetts, state public health authorities reported today.

The man, who was not identified because of patient confidentiality laws, became ill at the end of September.

So far, more than 2,500 cases of West Nile have been confirmed this year in the United States, with most of the infections contracted west of the Mississippi River. In the most severe cases, West Nile virus can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

Separately, New Hampshire health authorities announced today that they have detected fresh evidence that another disease spread by mosquitoes, Eastern equine encephalitis, is still circulating. Infected mosquitoes were found in four towns, Brentwood, Fremont, Kingston, and Newton.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 04:14 PM
October 3, 2007

Researchers gain access to Framingham Heart Study data

Three generations of Framingham Heart Study participants have shared their medical information with researchers learning about cardiovascular disease. Now the landmark study's files will be opened to scientists around the world so they can explore the links between genes and disease.

Framingham is the first study in an open-access project launched by the National Heart, Lung, and Blood Institute. The data come from more than 9,300 Framingham participants who had their DNA tested for 550,000 genetic variations. Researchers will have free access to that genetic information as well as clinical and laboratory test results. Names of the study subjects have been removed.

The Framingham study, sponsored by Boston University School of Medicine, Boston University School of Public Health and the NHLBI, will continue to add information from ongoing research. NHLBI will also add data from other large studies to the new program called SHARe, short for SNP Health Association Resource. SNP stands for single nucleotide polymorphism, which is a kind of genetic variation. Researchers can find out about access to SHARe data at the NIH database of Genotypes and Phenotypes.

Posted by Elizabeth Cooney at 04:08 PM
October 3, 2007

New anesthesia method blocks pain without numbness or paralysis

By Colin Nickerson, Globe Staff

The world's hottest work in anesthesiology is being done at Harvard, where researchers are pouring pepper on pain.

Scientists at Harvard Medical School and Massachusetts General Hospital today described a new "targeted" approach to anesthesia that uses the active ingredient in chili peppers as part of an ingenious recipe for blocking pain neurons. Most critically, the technique doesn't cause the numbness or partial paralysis that is the unwelcome side effect of anesthesia used for surgery performed on conscious patients.

If approved for use in humans, the method could dramatically ease the trial of giving birth -- by sparing women pain while allowing them to physically participate in labor. It could also diminish the trauma of knee surgery, for instance, or the discomfort of getting one's molars drilled. Not only would there be no "ouch," there would be none of the sickening wooziness or loss of motor control that comes from standard forms of "local" anesthesia.

In time, the process might even be employed for major surgery on the heart and other organs, the researchers said. More prosaically, the work might also represent a breakthrough cure for the common itch.

The work on lab rats, described in the scientific journal Nature, breaks from the standard approach to local anesthesia, which usually involves anesthetics delivered by catheter tubes or injections that silence all neurons in a given region of the body, not just those that sense pain. Shutting down just the pain neurons means that patients could still feel a light touch and other non-hurtful sensations.

"This could really change the experience of, for example, knee surgery, tooth extractions, or childbirth," said Dr. Clifford Woolf, senior author of the study and a researcher in anesthesia and pain management at Mass. General. "The possibilities are almost endless."

Woolf collaborated with Bruce Bean, professor of neurobiology at Harvard Medical School, in research that employed surprisingly basic scientific principles as well as some unlikely ingredients -- capsaicin, the stuff that imparts "hot" to chili peppers, as well as an all-but-forgotten variation of a standard anesthesia, long dismissed as clinically useless.

"We plucked a little of this and little of that off the shelves," Bean said. "The project is really a great illustration of how basic biological principles can have very practical applications."

Indeed, scientists with no involvement in the Harvard study were most surprised by its simplicity.

"It's a really clever piece of work, based on one of those 'I wish I'd thought of that' ideas," said Dr. Stephen G. Waxman, head of the department of neurology at Yale University's School of Medicine. "This is an important piece of research."

There's also sweet historic symmetry to the discovery.

Boston, after all, is the city that invented feeling no pain -- at least in surgery.

Modern anesthesia was first successfully employed in surgery in October 1846, one of the greatest moments in medicine. In Boston's Public Garden, the second-largest statue -- after that of George Washington on his horse -- is a soaring pillar, adorned with roaring lions and bas-relief depictions of 19th Century surgeons, that celebrates the "discovery that the inhaling of ether causes insensibility to pain. First proved to the world at the Massachusetts General Hospital."

Not far away, modern Mass. General's original "ether dome" still stands, a national landmark and popular pilgrimage point for anesthesiologists from around the world.

The work undertaken by Woolf, Bean and post-doctoral researcher Alexander Binshtok exploits well-known concepts of how electrical signals in the nervous system depend on ion channels -- proteins that make passageways through the membranes of nerve cells. Pain-sensing neurons possess a unique channel protein, TRPV1, but one that is usually blocked by a molecular "gate."

Medicine for more than 150 years has relied on general and standard anesthetics that penetrate and suppress sensation in all neurons, not just those nerve cells dedicated to sensing pain. That's why an epidural or a simple shot of Novocain leaves a whole region of the body numb or paralyzed, because all nerves cells are affected.

Enter the hot chili pepper, in the form of capsaicin.

Enter, too, a failed derivative of the common anesthetic lidocaine, invented in the 1940s. The derivative, known as QX-314, was deemed useless because it couldn't penetrate cell membranes to block sensation. In non-pharmaceutical terms, that's a bit like having a power shovel that can't cut earth.

In experiments, the Harvard researchers found that the chili pepper ingredient generated heat that opened the gate to pain neurons, but had no similar effect on other nerve cells. Then, when they introduced the lidocaine derivative, it charged through the open channels to block pain in those neurons, but was still unable to enter other nerve cells, such as "motor" neurons that control coordination and mobility.

Thus, in rat experiments, there appeared to be a total shutdown of pain, with no apparent numbness or paralysis.

The rats received injections near nerves leading to their hind feet, and lost the ability to feel pain in their paws. But they continued to scamper about their cages normally and showed sensitivity to touch and other stimulation.

"We introduced a local anesthetic selectively into specific populations of neurons," said Bean. "Now we can block the activity of pain sensing neurons without disrupting other kinds of neurons that control movements or non-painful sensations."

Experimentation will likely move on to to sheep, then humans. One problem that needs to be addressed is whether the capsaicin might cause such a burning sensation when first injected -- before the lidocaine derivitive shuts down the pain -- that it may be too uncomfortable for use as an anesthetic. But the researchers are confident they can find a more practical "warming" chemical to open the gateways to the pain neurons.

"This method could really transform surgical and post-surgical analgesia. Patients could remain alert without suffering pain. But they also wouldn't have to cope with numbness or paralysis," Woolf said.

Noting that itch-sensitive neurons are similar to nerves that sense pain, he added: "We may have even found a good treatment for the common itch."

October 3, 2007

Today's Globe: senior group homes, disparities grant, lab accidents, essential medicines

Home health aide Edith Kabugo gave Thomas Patrick
Donagher orange juice as he relaxed at a group home
in Peabody, where he lives with three other frail seniors.
(Yoon S. Byun/ Globe Staff)

Nestled in a neighborhood of neatly kept houses, four frail seniors in Peabody are pioneering an alternative to nursing homes. Similar to group homes for the mentally ill and mentally retarded that helped thousands move out of institutions, the model is designed to serve seniors too frail or disabled to live safely on their own or in assisted living, but who don't need - or want - the round-the-clock nursing of a large facility.

The federal government is promising to give Boston more than $4 million during the next five years to further address healthcare disparities and to export what has worked here to other cities across New England.

American laboratories handling deadly germs and toxins have experienced more than 100 accidents and missing shipments since 2003, and the number is increasing as more labs do the work.

Universities must honor their social role by joining the movement to ensure that patients worldwide have access to life-saving drugs that have been funded by the American public and discovered by American scientists working in American universities, Rachel Kiddell-Monroe and Ethan Guillen of Universities Allied for Essential Medicines write on the op-ed page, urging Harvard and MIT to turn promises of their commitment from words into action.

Posted by Elizabeth Cooney at 06:57 AM
October 2, 2007

Residents stand up for SCHIP

By Elizabeth Cooney, Globe Correspondent

Pediatric residents in Massachusetts and around the country gathered at noon today to push for expansion of a children's insurance plan that President Bush has threatened to veto.

At Boston Medical Center, about 50 residents, pediatricians, nurses and social workers paused in the hospital's main lobby as part of "Stand Up for SCHIP," the insurance program that covers children who don't qualify for Medicaid. There would have been one more, but that resident stayed behind in the intensive care unit with a child in respiratory distress, chief resident Marie Clark told the group. The child's father couldn't afford the asthma medication prescribed during an office visit on Friday, Dr. Suzanne Steinbach added, as an example of how lack of insurance hurts children.

"All of us here have had the same story," Dr. Barry Zuckerman, chief of pediatrics, said. "All of us are asking the president to do the right thing for children."

The State Children's Health Insurance Program is a federal program that covers 6.6 million children. It was set to expire after 10 years but Congress and the Bush administration are at odds over its funding and expansion. It is temporarily funded through mid-November.

Congress passed a bill that would expand the program by $35 billion over five years, to be paid for with new tobacco taxes.The number of uninsured children who could participate nationwide would grow to 10 million. Bush, who wants to increase funding by $5 billion over five years, has promised to veto the bill.

"Congressional leaders have put forward an irresponsible plan that would dramatically expand this program beyond its original intent," the president said in his radio address Saturday. "And they know I will veto it."

In Massachusetts, families earning three times the federal poverty level can obtain insurance through SCHIP for their children. The plan covers 90,500 children in the state.

Last week residents at Stanford's Lucile Packard Children's Hosptial in California planned a demonstration for today that spread to more than 30 hospitals around the country.

At Children's Hospital Boston, about 40 residents stood outside on Longwood Avenue to hear chief resident Carl Eriksson and second-year resident Michelle Niescierenko .

"We need to come together in solidarity with pediatric residents around the country to make a stand for children's health," Eriksson said.

At UMass Medical School in Worcester, about 40 medical students, interns, residents, staffers and administrators stood outside to voice their support for an expanded SCHIP program.

"It's not socialized medicine," UMass professor Dr. David Keller said in a statement. "It is good for our children."

Posted by Elizabeth Cooney at 04:58 PM
October 2, 2007

Mass. law slows stem cell research, Harvard scientist says

By Colin Nickerson, Globe Staff

One of Harvard’s best and brashest used a major conference on stem cells to lambaste the policies of a commonwealth that takes huge pride in medical research

"In Massachusetts, we have a law meant to support stem cell research, but it creates restrictions that are more onerous than in states" where religious fundamentalists, conservative legislators and other opponents actively fight medical research involving human embryos, Kevin Eggan said today at the Stem Cell Summit, a two-day conference that brought some of the world’s top stem cell researchers to Boston.

Eggan, a Harvard molecular biologist and leading stem cell scientist, was voicing deepening frustration that the Harvard University Stem Cell Institute's research into one of medicine’s most promising, if controversial fields, has been slowed by lack of raw materials – human eggs. More than a year after Harvard vowed to create cloned human embryonic stem cells for research, the institute has not been able to persuade a single eligible woman to donate a single egg.

Eggan blames a Massachusetts law that forbids researchers from paying women to donate eggs. The law is meant to prevent researchers from exploiting poor women who might be willing to undergo the lengthy and occasionally painful procedures for a cash pay-off. Eggan considers it hypocritical that women can be paid to "donate" eggs for use in fertility treatments, but not for stem cell research that, many scientists believe, holds enormous promise for combating degenerative diseases, cancer, and spinal injuries.

"Despite an advertising campaign to find donors, we have yet to have a woman donate an egg to our cause," Eggan said. Only women age 25 to 35 are eligible as donors.

"We’ve had hundreds of calls" from women expressing interest, Eggan said. But none, so far, is willing to take the time, effort, and slight medical risk purely for altruism.

The question of paying individuals to donate tissue -- whether a kidney or an egg -- is complex and bitterly controversial. And while most stem cell scientists share Eggan’s frustration with the pace of research, not all agree with his notion that money is the answer.

"This is a tremendously contentious issue," said George Q. Daley, a blood specialist at Children's Hospital Boston and president of the International Society for Stem Cell Research.

Many stem cell researchers, Daley told the same panel discussion at the conference, believe that paying "market rates" for donated eggs is morally unacceptable. But he indicated that there is more support for the idea that women should be paid something in compensation for undergoing a process that typically takes two months.

The Stem Cell Summit, at the Hynes Convention Center, attracted almost everyone who is anyone in the stem cell world, including researchers from Australia, South Korea, Japan, Great Britain, Canada, Italy and the Netherlands. The conference, sponsored by Harvard, the Genetics Policy Institute, and Burrill Life Sciences Media Group, ends Wednesday.

Along with physicians, scientists, and eager venture capitalists, the conference attracted people suffering from conditions that might eventually be cured by stem cell advances.

Among them was Brooke Ellison, author of the book "Miracles Happen," based on her struggles after a 1990 accident left her paralyzed from the neck down and dependent on a ventilator for breathing.

"The potential of cures that may arrive out of stem cells represent the most powerful manifestation of hope in the world today," said Ellison, a Harvard graduate who raises money for stem cell research.

October 2, 2007

Boston wins federal grant to address gaps in healthcare

By Stephen Smith, Globe Staff

Boston will receive more than $4 million in federal money over the next five years to address gaps in healthcare and to export the advances it has already made to other New England cities, Mayor Thomas M. Menino announced today.

The US Centers for Disease Control and Prevention has designated the city as a Center of Excellence in the Elimination of Disparities, with an emphasis on investigating the health status and medical treatment received by black residents who suffer from cardiovascular disease and breast and cervical cancer. African-American women in Boston are more likely to die from breast cancer than women of any other race or ethnicity.

Two years ago, Menino declared that the most pressing medical issue confronting the city was the persistent gap in health status and treatment that exists among racial and ethnic groups. At that time, the Boston Public Health Commission released a sweeping study on the subject and, later, ordered hospitals to begin collecting detailed information about all patients to better determine why disparities remain.

"We have a pretty good record on this," Menino said in an interview. "But we have to do more."

Posted by Karen Weintraub at 02:55 PM
October 2, 2007

Residents to take a stand on SCHIP

At noon today, pediatric residents across the country will join a 15-minute Stand up for SCHIP to urge President Bush not to veto an expansion of coverage for uninsured children who don't qualify for Medicaid.

The action started at Stanford's Lucile Packard Children's Hosptial in California but soon spread to dozens of hospitals, including Boston Medical Center, Children's Hospital Boston and UMass Memorial Medical Center in Massachusetts. The House and Senate have voted to reauthorize and expand the State Children's Health Insurance Plan, but the president has said he would veto it.

"It means children who could be covered won't be and the possibility that some children already covered may lose their insurance," Dr. Barry Zuckerman of Boston Medical Center said in an interview yesterday. "We see the consequences when patients don't get care when they don't have insurance."

Posted by Elizabeth Cooney at 10:51 AM
October 2, 2007

Girls' concussion risk overlooked, Times says

girls%20soccer150.bmpGirls competing in sports like soccer and basketball are more susceptible to concussions than boys are when playing the same sports, according to a story in today's New York Times.

Post-concussion syndrome — in which dizziness, lethargy and the inability to concentrate can cost teenagers weeks or months of school — is a growing concern, doctors said. Just as common among girls as boys, it is even more misunderstood among female athletes at this level, a Boston concussion expert said.

"Generally speaking, the medical profession does not do a very good job in recognizing that female athletes sustain concussions at an equal or even higher rate as males," Dr. Robert Cantu of Brigham and Women’s Hospital told the Times. "It’s flying under the radar. And as a result, looking for concussions in women is not pursued with the same diligence, and it’s setting girls up for a worse result."

Posted by Elizabeth Cooney at 07:37 AM
October 2, 2007

Today's Globe: ViaCell sale, supermarket beef, children's health care, detecting doping in sports

PerkinElmer Inc., a Waltham company that sells an array of life sciences instruments and services, unveiled plans late yesterday to buy ViaCell Inc. of Cambridge for $300 million to bolster its genetics-screening business for pregnant women and newborn children. Although ViaCell is probably best known for developing new drug therapies from stem cells, PerkinElmer said it was attracted by ViaCell's growing business to help families preserve newborn babies' umbilical cord blood for possible medical use.

Shaw's Supermarkets Inc. and Stop & Shop Supermarket Cos. said they have removed Topps Meat Co. beef from their shelves over the weekend, and state officials said there have been no reports of tainted hamburger following a nationwide recall of 21.7 million pounds of meat potentially contaminated by a dangerous strain of E. coli bacteria.

Eight states are suing the Bush administration over new rules that block expansion of a health insurance program for children from low-income families.

There's a better way to detect doping that relies on a more advanced detection system: the human body, Dr. Darshak Sanghavi, a pediatric cardiologist at UMass Medical School, writes on the op-ed page.

Posted by Elizabeth Cooney at 06:56 AM
October 1, 2007

Back and neck pain, depression take toll in 'lost days'

Mental and physical illnesses have "staggering" costs that are measured not only directly in health care dollars but also indirectly, in days lost when people are unable to carry out their usual activities, a new study reports.

More than half of American adults suffered from one or more of 30 conditions that kept them from their typical functions at work or at home for an average of 32.1 days a year, according to a survey analyzed by researchers including Ronald C. Kessler and Minnie Ames of Harvard Medical School. That translates into a total of 3.6 billion days a year, with mental disorders accounting for 1.3 billion days lost.

Chronic back and neck pain led to the most days of disability (1.2 billion), followed by major depression (387 million), the researchers found. The national survey’s results, funded by the National Institute of Mental Health, appear in the October issue of the Archives of General Psychiatry.

"The staggering amount of health-related disability associated with mental and physical conditions should be considered in establishing priorities for the allocation of health care and research resources," the authors conclude.

Posted by Elizabeth Cooney at 04:00 PM
October 1, 2007

Beth Israel Deaconess, Red Sox sign new deal

Here's one contract the American League East champions have all wrapped up for next year.

BIDMC%20First%20Aid%20Team%20150.bmpThe Boston Red Sox and Beth Israel Deaconess Medical Center have agreed to a second five-year relationship, the hospital said. Under the arrangement, Beth Israel Deaconess pays the team an undisclosed annual fee to remain the "official hospital of the Boston Red Sox." It also staffs the first aid station at Fenway Park with the team at left and sponsors 25 students annually as Red Sox Scholars.

Posted by Elizabeth Cooney at 11:47 AM
October 1, 2007

Today's Globe: fading frosts, combatting climate change, the post-diet era, math pirate

Valerie Maltais (right), 14, and her sister, Myriam,
16, harvested blueberries in St.-Jean Lake,
(Dina Rudick/Globe Staff)

Temperatures are rising in Canada, and so too are the annual blueberry harvests - giving a whiff of how global warming could shift economic fortunes.

It reads more like science fiction than any real solution to global warming: Fertilizing the sea to create plankton blooms that suck heat-trapping carbon dioxide out of the air.

help%20scale100.bmpIf you're among the two-thirds of adult Americans who are overweight or obese, permanent, substantial weight loss appears to be almost impossible by diet and exercise alone.

paul%20sally100%202.bmpPerhaps the most repeated story in the legend of Paul Sally - the mathematician and 74-year-old Roslindale native who is known around the University of Chicago as "Professor Pirate" (with MIT professor Sigurdur Helgson at right) - involves a man dangling from the top floor balcony of a large atrium hotel at a mathematics conference many years ago.

Also in Health|Science, why is electricity transferred at high voltages when we use 120 volts and what exactly is the condition normal-pressure hydrocephalus?

Posted by Elizabeth Cooney at 06:56 AM
October 1, 2007

In case you missed it: cancer scares, drug company settlement, VA Boston review, Danvers rivals

Cancer specialists are proud that the United States is home to more cancer survivors than any other nation, 10.5 million people. But for every cancer survivor, there are several "cancer scare survivors" who have been told, based on imperfect tests, that they may have cancer when they do not, Scott Allen writes in Sunday's Globe.

Bristol-Myers Squibb and a subsidiary have agreed to pay more than $515 million to settle civil suits over fraudulent drug marketing and pricing schemes, including illegally promoting an anti-psychotic drug to children and the elderly, US Attorney Michael J. Sullivan said Friday, Jonathan Saltzman and Liz Kowalczyk report in Saturday's Globe.

The US Department of Veterans Affairs is considering closing a VA clinic on Causeway Street and merging the Jamaica Plain and West Roxbury campuses into one facility, Emily Sweeney writes in City Weekly.

North Shore Medical Center in Salem and Beverly Hospital have long battled for profits and position across the North Shore. Now they're cross-town rivals in Danvers, where each is spending millions of dollars to build outpatient-care facilities on major roadways, Kathy McCabe reports in Globe North.

Posted by Elizabeth Cooney at 06:50 AM
Sponsored Links