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Monday, November 12, 2007
Long-term beta carotene use may help aging brains, study suggests
By Elizabeth Cooney, Globe Correspondent
Older men in good health who took beta carotene for about 18 years had better memory skills than similar men who took a placebo for the same length of time, a Harvard study shows.
The antioxidant, found in carrots, showed no benefit when taken for only three years, pointing to long duration as a critical factor in possibly slowing cognitive decline, which is a strong predictor of dementia.
The improvement was modest: Brain aging was delayed by about a year in men who took beta carotene long-term, author Francine Grodstein of Brigham and Women’s Hospital said in an interview. The study appears in today’s Archives of Internal Medicine.
She cautioned that it was too soon to recommend that men take beta carotene supplements. Beta carotene also has risks: Previous research has connected beta carotene to increased rates of lung cancer in smokers.
“Even though the changes that we saw are relatively modest, it is known that even modest changes in your memory can have a pretty big impact on the risk of dementia over the long term,” Grodstein, an associate professor of medicine at Harvard Medical School, said. It's the first study, she added, to find something that may help healthy people's memory.
The study followed about 6,000 men enrolled in the Physicians’ Health Study II over two time periods. They were given either 50 milligram pills of beta carotene or a placebo every other day. The first group participated for an average of 18 years and the second group for up to three years. They took tests of memory over the phone.
There was no improvement in the men who took beta carotene for the shorter time. The men who were on long-term beta carotene treatment did better, showing delays in cognitive aging of one to one and a half years, the study says.
In an accompanying editorial, Dr. Kristine Yaffe of the University of California, San Francisco, says it's plausible that long-term treatment may be necessary to have an effect on a disease that takes a long time to develop. But she also suggests there may be other interpretations of the results. In particular, she notes that the study doesn’t consider whether the men who took beta carotene for 18 years, staying in the study until it's completion, might be somehow different from men who did not continue to participate in the trial.
“For the clinician, there is no convincing justification to recommend the use of antioxidant dietary supplements to maintain cognitive performance in cognitively normal adults or in those with mild cognitive impairment,” she writes.
Grodstein said being conservative is appropriate.
“We don’t want to tell people to run out and start taking it immediately,” she said. “If we keep doing the research and keep working at it, it should give people hope we are going to be able to find something to help them keep their memory.”
Friday, November 9, 2007
Open access, open debate
Making scientific articles free and available to all is only fair to the taxpayers who support research and the developing countries who need it, a Nobel laureate at the forefront of the open-access movement said at a forum today, but the editor of a prestigious journal likened that approach to vanity publishing.
Dr. Harold Varmus, head of Memorial Sloan-Kettering Cancer Center and former director of the National Institutes of Health, and Emilie Marcus, executive editor of Cell Press, took opposing positions at a conference on scientific publishing organized by graduate students at Harvard Medical School.
"The public pays a lot for the research that's published in this country," said Varmus, the keynote speaker. He shared the 1989 Nobel in medicine for his work with genes that cause cancer. "Why should they have to pay for it twice to see the results?"
During a later panel discussion, Marcus countered that having scientists pay journals to publish their work, which is the way open-access journals offset costs traditionally borne by subscribers, ignores the value that journals and editors bring.
"When journals derive money from readership, the pressure is on the journal to provide value important to the people who read it. I as editor focus on creating a journal you as readers want to read," she said. "The philosophy of publishing with the author paying can turn publishing into a vanity publishing model."
In opening remarks, Dr. Steven Hyman, provost of Harvard University, reminded the mostly young crowd of about 120 that when he was a student, he had to scramble to feed nickels into Xerox machines to copy papers from bound volumes of journals in the stacks of Countway Library.
Now scientists have the opportunity to make their work freely and immediately available online, with the same peer-review process in place, Varmus said. They pay a fee of up to $3,000 for publication in journals of the Public Library of Science.
Varmus also hopes for an encyclopedic and timely repository of all research, whatever journal publishes it originally, so people can search for all sorts of information without having to pay for it -- a concern for poorer nations around the world. PubMed Central was formed in 1999 with that idea in mind when Varmus was near the end of his tenure at NIH, but with only 5 percent of NIH-funded researchers contributing to it, and only several months after publication, the repository falls short of that goal, he said.
Marcus said articles published by Cell's parent company, Elsevier, are deposited on behalf of all NIH-funded authors into PubMed Central 12 months after publication at no charge.
Wednesday, November 7, 2007
Women at the top, families in training
Dr. Nancy Andrews, who earlier this year left Harvard Medical School to become the first female dean of the Duke University School of Medicine, asks why it’s still big news when a woman takes the top post in academic medicine.
Writing in tomorrow’s New England Journal of Medicine, she answers her own question. Only 14 of 124 US medical school deans are women, and the pipeline for leadership at the department chair level is almost empty, despite similar numbers of men and women graduating from medical school.
“If institutions are to accelerate the emergence of more female deans, then they will need to consider women who have not stepped on every rung of the traditional academic career ladder,” she writes.
The article that follows Andrews’ essay takes a look earlier in medical careers, focusing on family leave policies for male and female doctors during their residency programs.
Dr. Reshma Jagsi of the University of Michigan and Dr. Nancy J. Tarbell and Dr. Debra F. Weinstein, both of Harvard Medical School, say while federal law allows family leave, policies set by graduate programs and medical-specialty boards can make that unworkable if they require training to be completed within a fixed time frame.
“It is unrealistic and inappropriate to expect trainees to delay childbearing or to forgo spending critical time with their infants,” they write. “We therefore need new solutions.”
Wednesday, October 24, 2007
Patients and doctors struggle separately with medical errors, Journal authors say
Doctors aren’t the only ones who can become paralyzed by guilt, fear and isolation after medical errors occur.
Patients and families also struggle with these emotions, Dr. Tom Delbanco and Dr. Sigall K. Bell discovered when they made a documentary about the impact of medical errors. They write about the parallel experiences in tomorrow’s New England Journal of Medicine.
“I had no idea, frankly, and I’ve been a primary care provider for 36 years,” Delbanco said in an interview. He and Bell are both from Harvard Medical School and Beth Israel Deaconess Medical Center. “It had never entered my mind that family members could feel the same kind of guilt that we as doctors feel. It had never entered my mind they would say, ‘If only I’d been more assertive with the doctor before this happened’ or ‘If only I’d listened to my instincts.’ ”
Another surprise, Delbanco said, was how reluctant people are to speak up, afraid that they will get worse care, particularly if they are from disadvantaged immigrant groups.
Doctors don’t talk for three different reasons, he said.
Building bridges to injured patients would be a first step, after the taboo of mentioning mistakes is dispelled, the authors write. They also suggest teaching healthcare providers about preventing errors and how to respond when they do happen. Their 2006 documentary has been shown to third-year medical students at Harvard.
"Everyone involved needs an organized structure that restores communication and supports emotional needs," they write. "The yield from working in partnership could be enormous, both improving people's experience with medical errors and preventing harm from occurring in the future."
Boston group to share genetic data on autism
A Boston group is sharing genetic information from families affected by autism with other researchers to promote understanding of the developmental disorder.
The Autism Consortium, whose members include hospitals, medical schools and universities in the Boston area, will transfer profiles of 500,000 genetic variations found across the genomes of 700 families with two or more children who have autism. The data will be held by the Autism Genetic Resource Exchange, a program of the advocacy organization Autism Speaks. Scientists can apply to the exchange, which gathered DNA from the families. The samples have been scanned for sequences where there are deletions or extra copies of DNA segments. The consortium is sharing the genetic variations it found.
"We returned all of the raw data to AGRE so they can distribute it to any other investigtors who want to begin exploring what may be the genetic underpinnings of autism," Mark Daly, a consortium member from Massachusetts General Hospital and the Broad Institute of MIT and Harvard, said in an interview. "Understanding the genetics underlying a complex disease is not an easy problem to solve. So there's no excuse for hoarding your data when much more can be learned by sharing."
Only a small percentage of autism arises from a recognizable genetic cause, such as Fragile X syndrome, Daly said. Recent research suggests that some families with autism might have higher rates of genomic abnormalities, but very few of these abnormalities have been conclusively identified.
"There's very strong heritability to autism but very little of the heritability has been explained by specific mutations of specific genes," he said. "What we hope is that this data is a starting point. We need to perform collaborative research in the spirit of the Human Genome Project to deliver on the trust the public has placed in us."
Members of the Autism Consortium are Beth Israel Deaconess Medical Center, Boston Medical Center, Boston University, Boston University School of Medicine, the Broad Institute of MIT and Harvard, Cambridge Health Alliance, Children’s Hospital Boston, Harvard University, Harvard Medical School, Massachusetts General Hospital, Massachusetts Institute of Technology, McLean Hospital and Tufts-New England Medical Center.
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Tuesday, October 23, 2007
Who needs sleep?
Just as weary but exhilarated Red Sox fans head into the World Series on two days' rest, the New York Times devotes its Science section to the subject of sleep.
“To do science you have to have an idea, and for years no one had one; they saw sleep as nothing but an annihilation of consciousness,” Dr. J. Allan Hobson, a professor of psychiatry at Harvard, told the Times. “Now we know different, and we’ve got some very good ideas about what’s going on."
Boston researchers are prominent in the story, beginning with cognitive neuroscientist Robert Stickgold of Harvard and Beth Israel Deaconess Medical Center. He and postdoctoral student Matthew Tucker are studying the effect of naps on memorized words. Matthew Wilson of MIT is investigating what happens to mice cells when they record memories. Subimal Datta of Boston University School of Medicine is looking at the chemicals that bathe the brain while we sleep.
“During waking we have a thousand things happening at once, the library is filling up, and we can’t possibly process it all,” Datta says in the Times story. “It’s during sleep that we have this special condition to clear away this overload."
Something to sleep on before tomorrow night's Game 1.
Wednesday, October 17, 2007
Mayor Bloomberg to receive Harvard public health award
By Stephen Smith, Globe Staff
New York Mayor Michael R. Bloomberg, who has championed bans on cigarette smoking in restaurants and bars and banished trans fats from restaurant menus, is receiving the highest award bestowed by the Harvard School of Public Health.
Bloomberg, a native of Medford, will receive the Richmond Award in a ceremony Oct. 29 at Harvard. The award is named for Dr. Julius Richmond, an emeritus professor at Harvard who served as US surgeon general from 1977 to 1981 and was the first national director of the Head Start program.
Along with his campaigns against smoking and fatty foods, Bloomberg has been lauded -- and, in some camps, vilified -- for his efforts to keep illegal guns off the street, a passion shared by Boston Mayor Thomas M. Menino. Most recently, the New York mayor has embraced aggressive measures to curtail pollution in the city, raising the specter of charging drivers who venture onto Manhattan's traffic-clogged streets.
Bloomberg is no stranger to schools of public health: He has one named for him. His financial backing led Johns Hopkins University in Baltimore to call its school the Bloomberg School of Public Health.
Harvard launches new website
Harvard Wednesday launched a new website – HarvardScience – to feature the scientific, medical, and engineering work done at the university’s schools and related hospitals.
The site has a snappy design, and includes profiles, breaking news and stories about topics from agriculture to zoology. Today’s headlines include Harvard chemists’ construction of nanowires that can carry and create electricity, as well as a study led by Massachusetts General Hospital researchers finding that the drug companies have increasingly cozy relationships with medical schools and teaching hospitals.
Tuesday, October 16, 2007
Community partnerships needed to recruit minority patients to cancer clinical trials
Higher cancer rates among ethnic and racial minority groups cannot be attacked without increasing their representation in clinical trials, community health workers and health care providers heard today.
"The solution is to build community-academic partnerships," Dr. Claudia Baquet, director of the University of Maryland Comprehensive Center for Health Disparities, told about 100 people at a conference at the University of Massachusetts - Boston also sponsored by the Harvard School of Public Health and community outreach organizations. "Notice I said 'community' first."
About 3 percent to 5 percent of all cancer patients participate in clinical trials that study ways to prevent, diagnose and treat cancer. Fewer than 1 percent of African-American patients do.
Historic barriers, including lack of trust or limited access to health care, aren't the only reasons, Baquet said. Patients need to hear from their health care providers that they might have the option of joining the studies, which are typically run by researchers at academic medical centers.
"It's a total myth that underserved communities have no interest in research," she said. "It's just that it has not been presented in a way that they can consider the benefits."
Groups like the Cherishing Our Hearts and Souls Coalition, which works to improve health among African-Americans in Roxbury, is an example of efforts to make research better reflect different populations, she said. The group is one of three pilot programs in the US funded by the Lance Armstrong Foundation with the goal of including more minorities in research.
Trust is still an issue, Tarma Johnson, director of clinical health services at Mattapan Community Health Center, said at a separate session for primary care practitioners. She was involved in recruiting patients for a clinical trial about vitamin D led by Boston University School of Medicine researcher Dr. Michael Holick. The patients were interested in what she told them, which could apply to cancer studies, too.
"The information came from the health center, not the hospital, because they trust us," she said.
Thursday, October 11, 2007
Second Harvard team heading to Congo to help women injured by rape
Physicians and public health specialists from Harvard will join their colleagues in Congo to care for women who have suffered rape-related injuries.
The Harvard Humanitarian Initiative has been working since May with Panzi Hospital in the eastern part of the Democratic Republic of Congo, where up to 70 percent of girls and women have been raped or sexually mutilated, the group said in a statement today. Their medical problems include pregnancy, sexually transmitted disease (including HIV), and traumatic fistula – a condition that leaves women incontinent. A story in Sunday's New York Times describes the brutal violence that brings about 10 women to the Panzi Hospital each day.
The Harvard surgeons and researchers will perform gynecologic surgery, begin training programs, and initiate research into the causes of the violence. Their efforts will be coordinated with Doctors Without Borders, United Nations Office for the Coordination of Humanitarian Affairs, the International Urogynecological Association, V-Day, Brigham & Women’s Hospital, and University of Illinois.
Boston-Denver team to lead study of COPD
A team of researchers from Boston and Denver will lead a large study of genetic factors and biological mechanisms involved in progressive lung diseases.
Brigham and Women's Hospital in Boston and National Jewish Medical and Research Center in Denver are the lead sites for the five-year, 16-center study of chronic obstructive pulmonary disease, which includes emphysema and chronic bronchitis. The two hospitals have received $37 million from the National Heart, Lung, and Blood Institute.
The researchers hope to enroll 10,500 participants, including 3,500 African-Americans. COPD is rising among African-Americans but risk factors in this population have not been adequately studied, according to the two hospitals' news release.
The Harvard School of Public Health, working with Johns Hopkins University, Brigham and Women's and the University of Colorado, will provide statistical analysis.
Wednesday, October 10, 2007
Children get recommended care less than half the time
Children get recommended care from their doctors less than half the time, leaving them even worse off than adults, concludes an analysis of medical care in 12 cities including Boston.
Researchers from the University of Washington, RAND and UCLA reviewed the medical records of more than 1,500 children and evaluated the quality of care they got as outpatients. They chose 175 quality indicators, from prescribing asthma medications to immunizing against childhood diseases to screening for sexually transmitted diseases.
To measure quailty, they divided the number of times the children's charts showed that recommended care was ordered or given by the number of times the care was warranted, based on national guidelines for screening, diagnosis, treatment and follow-up.
Overall, children received recommended care 46.5 percent of the time, they write in tomorrow's New England Journal of Medicine. That compares with a rate of 54.9 percent for adults.
When children had acute medical problems, they got the right services 67.6 percent of the time. For chronic conditions, they were given the indicated care 53.4 percent of the time. That falls to 40.7 percent for preventive care.
The authors note that research and policy devoted to children have concentrated more on expanding access to healthcare for children than on providing the right care.
"Deficits in the delivery of care must be identified if appropriate strategies to close the gaps are to be developed and implemented," they write.
Dr. James M. Perrin and Dr. Charles J. Homer of Harvard Medical School called the findings "shocking," while pointing out the study's limitations. Some of the data are 10 years old and failures in keeping accurate medical records may be a factor in the "dismal story," they write in an accompanying editorial.
"Services are not delivered when they should be, or they are delivered when they should not be," Perrin and Homer say in their editorial, also in tomorrow's journal. "Although one could challenge the precise 46.5 percent value for the percentage of overall care delivered, one cannot avoid the main observation that there exists a yawning chasm in the quality of health care provided to children."
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WSJ blog: Harvard scientist devises way to bring vaccines to the poor, via China
Harvard scientist John Mekalanos (left) came up with a way to make vaccines much more cheaply, but to actually produce them, he had to fly to China, the Wall Street Journal's Health Blog reports.
Mekalanos struck a deal with Gerald Chan, a venture capitalist who is opening a vaccine factory on a tropical island called Hainan, one of the regions China has targeted for foreign investment, the blog says. Harvard will license Mekalanos’s method to Chan’s Morningside Group. The result will be a company with scientists working in Boston and on Hainan to develop a commercial vaccine.
The deal allows Harvard to license any vaccines the company creates to governments and humanitarian groups in the developing world, Isaac Kohlberg, the chief of Harvard’s technology development office, told the WSJ blog. Morningside would be able to sell the vaccine in the developed world.
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Tuesday, October 9, 2007
Breast-feeding medical student to take licensing test tomorrow
By Elizabeth Cooney, Globe Correspondent
A Harvard medical student who went to court to get extra time to pump breast milk during a licensing exam will start taking the test tomorrow.
Sophie Currier, who is breast-feeding her 5-month-old daughter, sued the National Board of Medical Examiners on Sept. 5 when it refused to give her more than the usual 45-minute break allowed to students taking the nine-hour exam. Since then the case has gone through seven rulings.
Today the Supreme Judicial Court denied a request from the board for an expedited review of the case after a state Appeals Court ruling on Friday cleared the way for Currier to have the extra time. The examination board had also asked for a single justice to hear an appeal, but the court did not rule on that petition, board spokeswoman Carol Thomson said in an interview.
"Sophie Currier is scheduled to take the test tomorrow and the following day," Thomson said. "The board certainly will comply with the court's requirements and she will take the test with extra time."
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. She will get an hour of extra break time each day.
The 33-year-old Brookline resident had argued that it would be uncomfortable and possibly harmful to her health if she could pump breast milk only during standard breaks.
Currier was unavailable to comment today, her spokeswoman Alex Zaroulis said.
"Sophie is looking forward to taking the test tomorrow. She's focused, she's prepared," Zaroulis said. "This has all been about Sophie being able to take this test and be able to express milk while she takes the test in a humane and sanitary way."
One of her lawyers said she found it troubling that the organization responsible for licensing doctors continues to take such an "anti-female approach."
"We took this case pro bono because we believed strongly in the legal positions that were set forth regarding a nursing mother's right in the workplace and by extension, a nursing mother's right to be able to become a doctor and take the medical exam without being at risk for physical harm," said Lauren Stiller Rikleen, who worked on the case with Christine Smith Collins of the law firm Bowditch & Dewey.
Monday, October 8, 2007
Howard Hiatt honored by Institute of Medicine
The Institute of Medicine today presented the 2007 Gustav O. Lienhard Award to Dr. Howard H. Hiatt, professor of medicine at Harvard Medical School, former dean of its School of Public Health and a senior physician at the Brigham and Women's Hospital.
The $25,000 award recognizes Hiatt's contributions to improving the performance of personal health services in the United States and around the world, the institute said in a news release.
Hiatt was formerly chief of medicine at Beth Israel Hospital in Boston, led a pioneering study of medical malpractice, called the Harvard Medical Practice Study, and helped to create the Division of Social Medicine and Health Inequalities at the Brigham in 2001.
Five Boston researchers named to Institute of Medicine
Five Boston researchers have been elected to membership in the Institute of Medicine, a prestigious group established by the National Academies of Science to analyze health issues and make recommendations on policy.
Among the 65 new US members, five are from Massachusetts (four from Harvard, one from MIT), three are from Connecticut (all from Yale) and one is from New Hampshire (Dartmouth). The current 1,538 active members chose new members from candidates nominated for achievement and commitment to service, the IOM said in its announcement of new members today.
The Massachusetts members are:
Dr. Emery N. Brown, professor of anesthesia, department of anesthesia and critical care, Massachusetts General Hospital; and professor of computational neuroscience, health sciences, and technology, Massachusetts Institute of Technology
Dr. William G. Kaelin Jr., investigator, Howard Hughes Medical Institute, and professor, Harvard Medical School, Dana-Farber Cancer Institute
Dr. David T. Scadden, professor of medicine and co-chair, department of stem cell and regenerative biology, and co-director, Harvard Stem Cell Institute; and director, Center for Regenerative Medicine, Massachusetts General Hospital
Jonathan G. Seidman, professor of genetics, Harvard Medical School
B. Katherine Swartz, professor of health economics and policy, department of health policy and management, Harvard School of Public Health
The three new members from Connecticut are:
Dr. Robert J. Alpern, dean, Yale University School of Medicine
Dr. Harlan M. Krumholz, professor of medicine and epidemiology and public health, and professor of internal medicine, Yale University School of Medicine
Dr. Mary E. Tinetti, professor of medicine, epidemiology and public health, and director, Yale Program on Aging, Yale University School of Medicine
New Hampshire has one new member:
Jonathan S. Skinner, professor of economics, Dartmouth College, and professor of community and family medicine, Dartmouth Medical School
Nobel for medicine honors gene targeting in mice
Three scientists who modified genes in mice using embryonic stem cells have won this year's Nobel Prize in physiology or medicine, the Swedish Academy announced this morning.
Capecchi, born in Verona, Italy, in 1937, earned a doctorate in biophysics at Harvard in 1967 and is now a US citizen. Evans was born in Great Britain in 1941. Smithies was born in Great Britain in 1925 and is now a US citizen.
At Harvard, Capecchi's Ph.D. advisor was James D. Watson, a previous Nobel winner for his co-discovery of the DNA double helix. Capecchi, a Howard Hughes Medical Institute investigator, credits Watson for inspiring his development as a scientist and his pursuit of big questions, according to the institute's website.
"He taught me not so much about how to do science but rather provided me with the confidence to tackle any scientific question that fascinated me, regardless of its complexity," Capecchi is quoted on the site. "He also taught me the importance of communicating your science clearly and to pursue important scientific questions."
Capecchi told the journal Nature in 2004 that his relationship with Watson was not always smooth. He recounted a disagreement they had about the results of an experiment. Capecchi was unconvinced by the data and wanted to repeat the experiment while Watson wanted to publish the results. Capecchi then threw away glass plates containing crucial bits of data, ensuring that the results could not be published and prompting Watson to explode in anger. Capecchi recalled: "I came that close to being thrown out of the lab."
Capecchi's childhood was disrupted by World War II in Italy, according to the Nature article and the Hughes website. When he was 4 years old, his mother, a poet, was taken by the Gestapo to a concentration camp, and he lived on the streets, begging and stealing, until they were reunited five years later. After the war, they emigrated to the United States, where Capecchi began school at age 9, knowing no English and unable to read or write.
"It is not clear whether those early childhood experiences contributed to whatever successes I have enjoyed or whether those achievements were attained in spite of those experiences," he said.
Friday, 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.
Ig Noblesse oblige
Nobel laureates (seated, from left) William Lipscomb,
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.
Thursday, 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:
Breast-feeding student to reschedule exam, wait for court ruling
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.
Wednesday, 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.
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."
Tuesday, 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
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.
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.
Monday, 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.
Thursday, September 27, 2007
Researchers from Boston and Cambridge have won two of three prizes for young cancer investigators.
Angelika Amon (left) of MIT and Dr. Todd R. Golub of Dana-Farber Cancer Institute and the Broad Institute of Harvard and MIT will receive the 2007 Paul Marks Prize for Cancer Research from Memorial Sloan-Kettering Cancer Center. The prize recognizes contributions to understanding the treatment of cancer made by scientists under the age of 45.
Amon studies how chromosomes segregate during cell division and Golub uses genomic approaches to classify subtypes of cancer. They will share a $150,000 prize with the third winner, Gregory J. Hannon of Cold Spring Harbor Laboratory, who studies the biology and biochemistry of RNA interference. All three winners are also Howard Hughes Medical Institute investigators.
Wednesday, September 26, 2007
Journal asks: After a patient dies, how do doctors deal with their emotions?
It was more than 30 years ago, but Dr. Katharine Treadway (left) vividly remembers answering her first "code" call to revive a hospital patient.
The resuscitation attempt failed, and in this week’s New England Journal of Medicine she recalls what it felt like, as a freshly minted intern, to simply walk away from a life that had just ended.
“Someone had just died. But we all behaved as though that was not at all what had happened,” she writes. “We learned to bury our fear of death in an avalanche of knowledge. … And for good reason. We could not do what we do – take responsibility for the lives of our patients – if we were aware, minute to minute, of the true significance of what we were actually doing.”
The journal is publishing Treadway's essay to spark an online discussion, which the Boston-based publication calls Perspective Forum. Its physician readers are invited to write about how they cope with the emotions they put away while meeting clinical challenges.
Treadway, a Harvard Medical School faculty member and primary care doctor at Massachusetts General Hospital, writes that many doctors have private rituals they observe whenever a patient dies -- she says aloud, "May choirs of angels greet thee at they coming" -- but they rarely share them.
White Coat Notes asked Treadway what she would like to hear from readers, why she chose this topic, and what she teaches medical students about it.
What do you hope to hear in the forum?
What do you teach medical students about emotions?
What about situations like the code call?
There’s this tremendously fine line that we have to walk in terms of dealing with acute life-threatening situations in which you absolutely have to stifle your emotions. You can’t fling your hands into the air and say, 'Oh my god.' That wouldn’t help anyone.
How do you find that middle ground?
How about your own work?
Being a primary care doctor, I take care of my patients’ children, or their children’s children, or in one case, the great-granddaughter of my original patient. In addition to teaching medical students who are so eager and idealistic, it’s just so renewing. I feel very lucky.
Judge orders extra break time for breastfeeding medical student
By Felicia Mello, Globe Correspondent
A Harvard medical student and nursing mother won an appeal today in her lawsuit for extra break time to pump breast milk during her doctor-licensing exam. A state appeals court judge ruled that the National Board of Medical Examiners must grant Sophie Currier of Brookline an additional 60 minutes of rest periods on each day of the exam, which Currier must pass to graduate and begin her residency at Massachusetts General Hospital.
Currier sued the board September 6, arguing that it violated her constitutional rights by denying her more than the 45 minutes of rest periods allotted to all test takers. She also accused the board of gender discrimination.
Last week, a state superior court judge denied her claim, saying Currier could still find a way to expel her milk during the test or on regularly scheduled breaks.
But Appeals Court Judge Gary Katzmann overturned that decision. “In order to put the petitioner on equal footing as the male and non-lactating female examinees, she must be provided with sufficient time to pump breast milk and to address the same physiological and other functions to which those examinees are able to attend,” he wrote.
Currier, who has a 4-month-old daughter, originally planned to take the exam this week, but postponed it until October 4 in hopes of winning her appeal. She already has received permission from the board to take the test over two days instead of one, because she has dyslexia and attention deficit hyperactivity disorder. The board also offered to allow her to bring a breast pump into the exam room and to provide her with a private room in which to express milk during breaks.
Lactating women can experience pain and risk developing infections of their breasts if they don't express milk at least once every three hours, breastfeeding experts say.
Mass. General scores on two workplace lists
Massachusetts General Hospital has landed on two lists of best places to work.
One is the Working Mother magazine's 100 Best Companies, which considers compensation, child-care and flexibility programs, and leave policies. Harvard University also made the non-ranked list, along with Arnold Worldwide, The Boston Consulting Group and Massachusetts Mutual Life Insurance.
The other list is AARP's ranking of Best Employers for Workers Over 50, where it came in 10th. No other Massachusetts-based company made the list of 50 workplaces. The AARP considered recruiting practices; opportunities for development; and work options, such as flexible scheduling, job sharing, and phased retirement, in addition to health and retiree benefits.
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Monday, September 24, 2007
Value of annual physicals debatable, study says
Annual physicals get a checkup in today's Archives of Internal Medicine.
Adult preventive health exams and women's gynecologic exams are among the most common reasons to see a doctor, but most preventive services other than Pap smears take place outside those visits, according to researchers from the University of Pittsburgh School of Medicine and Harvard Medical School.
"There's clearly a role for the type of preventive services we studied -- cancer screening, cholesterol testing and counseling about quitting smoking, losing weight and exercise," Dr. John Z. Ayanian of Harvard said in an interview. "It's a question of what's the best approach to get those provided."
Looking closely at the exams, the authors found that checkups including gynecological exams accounted for 1 in 12 adult visits to doctors. Annual exams are more common in the Northeast than in the West, according to previous research. Physicians in Boston, for example, are more likely to say they perform the annual exams than their counterparts in San Diego. People with insurance are more likely to go for physicals than people without coverage.
Annual physical exams "fill a very important role in the US healthcare system," but it wouldn't be feasible to recommend that all adults have annual physicals because there aren't enough primary care physicians or gynecologists, said Ayanian, who practices at Brigham and Women's Hospital. People get most of their preventive services when they come for an acute problem or receive care for chronic conditions, according to the authors' analysis of data from national surveys done from 2002 to 2004.
The study may help guide policy about who should be having preventive exams and what they should include, Ayanian said. People's expectations for blood tests or EKGs during checkups may increase healthcare costs without adding value, the authors found.
"We need to be very selective about what tests we recommend on a routine basis and limit them to those that are likely to have value in affecting people's health rather than reflexively ordering tests out of some sense of tradition," he said.
Friday, September 21, 2007
Appeals judge will hear nursing med student's plea for more break time
By Felicia Mello, Globe Correspondent
A nursing mother will take her request for extra break time on a medical licensing exam to a state appeals court judge Tuesday, after a lower court denied her claim.
Sophie Currier, 33, says she needs more than the standard 45 minutes of rest periods in order to pump breast milk for her four-month-old daughter.
Currier has finished an MD-PhD program at Harvard but must pass the test in order to graduate and begin her residency at Massachusetts General Hospital.
Last week, Norfolk Superior Court Judge Patrick Brady dismissed Currier’s lawsuit against the National Board of Medical Examiners, saying the board’s offer to let Currier express milk while taking the test and in a separate room during scheduled breaks was sufficient.
The appeal will be heard at 9 a.m. in Boston’s John Adams Courthouse.
Wednesday, September 19, 2007
Judge rules against breastfeeding medical student
By Felicia Mello, Globe Correspondent
A Harvard medical student and new mother will not be permitted to take extra break time to pump breast milk during her exam to become a doctor, a judge ruled today.
Sophie Currier of Brookline sued the National Board of Medical Examiners Sept. 6, arguing the board violated her constitutional right to breastfeed by denying her more than the 45 minutes of rest periods allotted to all test takers.
Currier, who has a four-month-old daughter, must pass the exam before she can graduate and begin a residency program at Massachusetts General Hospital later this fall.
In a three-page opinion, Norfolk Superior Court Judge Patrick Brady said Currier could still find a way to expel her milk during the test or on regularly scheduled breaks.
"The plaintiff may take the test and pass, notwithstanding what she considers to be unfavorable conditions," Brady wrote. "The plaintiff may delay the test, which is offered numerous times during the year, until she has finished her breast-feeding and the need to express milk."
Currier’s lawyer, Christine Smith Collins, said she will appeal the decision to a state court of appeals judge, who could still issue a ruling before Currier takes the exam next Monday.
"Basically the judge decided it’s okay to tell women to wait until they are done being moms to become professionals, which as far as I’m concerned is not acceptable in this day and age,” Collins said.
The board has offered to allow Currier to bring her breast pump into the exam room, and to provide her with an extra room in which to expel milk during her breaks. Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day. Currier wants an additional hour of break time each day.
But the board argued that it would be unfair to other test takers to allow Currier more time for a condition not recognized as a disability under the Americans with Disabilities Act.
"The national board thinks that breastfeeding is a fine thing to do but it also thinks that having a standardized examination for licensure is also really important," said board spokesperson Ken Cotton.
He said the board periodically reviews its testing policies and will consider increasing break time for all examinees, a solution he said would be more consistent than making an exception for Currier.
Monday, September 17, 2007
Breastfeeding medical student gets day in court
By Felicia Mello, Globe Correspondent
A state judge heard arguments today in the case of a Harvard medical student who is suing for extra break time to pump breast milk during her exam to become a doctor, but postponed a ruling until later this week.
The hearing set the stage for a last-minute decision in the suit filed by Sophie Currier of Brookline, who plans to take the clinical knowledge exam -- the last hurdle she must clear before she can begin her residency program at Massachusetts General Hospital -- next Monday and Tuesday.
Currier's lawyer today asked Judge Patrick Brady of Norfolk Superior Court to issue an injunction forcing the National Board of Medical Examiners to grant Currier, who has a four-month-old daughter, two hours of extra rest periods over the course of the exam. The lawyer accused the board of violating Currier's rights under the state constitution and discriminating against her based on her gender.
"What you're doing is screening out women because they are unable to take care of their dual roles as mothers and professionals," Currier's lawyer, Christine Smith Collins, told the court. "It's unfair, it's unjust, and it's not in the public's interest."
But a lawyer for the board said that making Currier follow the same rules as other test-takers didn't prevent her from breastfeeding, but just made it less convenient.
"One thing we cannot do is change the format for the test, because then we've failed all 50 medical boards that are relying on this and we've failed every other student who takes this test," said board lawyer Joseph Savage.
The board has offered to allow Currier to bring her breast pump into the exam room, and to provide her with an extra room in which to expel milk during her breaks -- though it's unclear whether that room would be monitored. Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day -- the daily amount granted all test-takers.
Holding her baby outside the Dedham courthouse after the hearing, Currier, who has started a blog to reach out to mothers in similar situations, said she hoped her case would help them, too.
"It's really about whether women should be protected under the law to breastfeed their children," she said.
Children's group building online medical records for major employer group
A group from Children's Hospital Boston has been hired by a corporate consortium to develop online medical records for their employees.
Dossia, a group of eight major employers including Wal-Mart and Intel, chose the Children's Hospital Informatics Program to adapt its own program called Indivo to provide secure health records for 5 million employees and their dependents and retirees.
The Children's program, which also has ties to Harvard and MIT, has been working for 10 years to create Web-based records for patients that include a lifetime of health information across different doctors and care sites. The Dossia goal is to allow its workers to have access to their medical records, to communicate with their doctors, and to pull together information from different sources, the group said.
Dossia does not disclose details of its contracts, Colette Cote, a spokeswoman for member Pitney-Bowes and Dossia, said when asked about the financial terms of the agreement with Children's. The other companies in Dossia are AT&T, Sanofi-aventis, Applied Materials, BP America Inc. and Cardinal Health.
Indivo will be introduced at Children's this fall and Dossia plans to roll out its version to some members by the end of the year, its statement said.
Wednesday, September 12, 2007
Hearing put off in nursing mother's suit against medical exam board
By Felicia Mello, Globe Correspondent
The case of a Brookline woman who is suing for extra break time to pump breast milk during the licensing exam to become a doctor has been removed to federal court, meaning a previously scheduled state court hearing this afternoon will not take place.
A hearing has been set for tomorrow at 2 p.m. to decide whether the federal court will hear the case before Sophie Currier, 33, is scheduled to take the test September 24 and 25.
Currier, a Harvard Medical School student who is breastfeeding her 4-month-old daughter, filed suit against the National Board of Medical Examiners in state court last week, saying the 45 minutes of free time allowed over the course of the nine-hour exam was not enough for her to expel milk in addition to eating and using the restroom.
The board has refused to grant Currier the extra time but has offered to supply her with a private room in which to pump the milk during scheduled breaks.
The case was transferred to the US District Court at the request of lawyers for the medical board.
Christine Smith Collins, Currier’s attorney, said the removal "could be viewed as a delay tactic by the board trying to push off a decision until after she's taken the exam, so she can’t get the relief that she’s seeking."
But medical board attorney Joseph Savage said he made the request because Currier’s major argument was that her civil rights had been violated, a claim more appropriately heard by a federal judge.
Currier, a Brookline resident, has started a blog, called Support Nursing Moms, in hopes of reaching other women in similar circumstances.
"I am fighting because I don't have a choice," she said today, "but I feel passionate about it because I feel I could influence how other nursing mothers are treated as well."
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Berwick and Herr win Heinz awards
Two Cambridge innovators are among five winners of $250,000 awards from the Heinz Family Foundation for their achievements in medicine and science, the foundation said today.
Dr. Donald Berwick (left), co-founder of the Institute for Healthcare Improvement and a professor of pediatrics at Harvard Medical School, won in the public policy arena. His organization has been central in the movement to increase patient safety through efforts to make healthcare systems work better. The 100,000 Lives campaign, followed by the 5 Million Lives effort, set goals to improve care in hospitals.
Hugh Herr (left), MIT professor and director of biomechatronics at the MIT Media Lab, won in the technology, the economy and employment category. He studies human movement, how it is controlled and how to engineer human-like structures, including prostheses for amputees and wrap-around devices for people who have suffered strokes.
"My philosophy is that there are no disabled people in the world. There are only technologies that haven't been invented yet or technologies that don't work," Herr said in an interview yesterday. He calls himself an end-user because both his legs were amputated. "We should not accept disability and society should always continue to work toward technological interventions that bring us closer to being sure no one has to live with a disability, whether cognitive or physical."
Yesterday Berwick said he might use his grant to advance IHI's work in developing countries, where the organization has been applying the same principles that work to reduce infections in hospital ICUs to ways that keep women from dying in childbirth in remote villages in Malawi.
"We take very good science around public health and then empower local groups to implement that science," he said. "The same improvement methods that are getting traction in wealthy countries can have tremendous effects in developing countries."
The other winners of the Heinz awards, named for Senator John Heinz of Pennsylvania and selected by the foundation chaired by his widow, Teresa Heinz, are:
Dr. David L. Heymann of Geneva, assistant director general of the World Health Organization, in the human condition category
Dave Eggers, San Francisco author and founder of the 826 Valencia writing laboratories, in the arts and humanities category
Bernard Amadei of Boulder, Colo., founder of Engineers Without Borders -- USA and -- International, and Susan Seacrest of Lincoln, Neb., founder of the Groundwater Foundation. They are co-recipients in the environment category
Monday, September 10, 2007
Nursing mother files suit against medical exam board
By Carey Goldberg, Globe Staff
Sophie Currier, the Harvard MD-PhD and nursing mother who was denied extra time to pump her breasts during an all-day exam of medical knowledge, has filed suit against the board that administers the exam.
Her case is currently scheduled to be heard this Wednesday at 2 p.m. in Norfolk Superior Court in Dedham, said her lawyer, Christine Collins, but that timing is still under negotiation.
Collins is asking the judge for an immediate order requiring the National Board of Medical Examiners to provide extra time and an appropriate place for pumping. Currier plans to take the clinical knowledge exam on Sept. 24 and 25th.
Currier, 33, is not claiming that breastfeeding is a disability. But it is a demanding biological reality, she argues, and one that -- medical authorities agree -- is important for the health of her 4-month-old daughter, who is still exclusively breastfeeding.
Nursing mothers who go for hours without breastfeeding or pumping risk painfully hard breasts, plugged milk ducts and possible infection, as well as a possible reduction in milk supply.
Collins argues that it is a woman's constitutional right to breastfeed, and that denying Currier extra time to pump amounts to discrimination on the basis of sex. A member of the firm Bowditch & Dewey of Boston, Worcester and Framingham, Collins has taken Currier's case pro bono.
"We try to do the best job we can do to balance those priorities," she said.
Given the questions raised about breastfeeding, she said, she expects the board to re-examine its policy on lactation within the next year.
Wednesday, September 5, 2007
UMass Medical School recruits two RNA stars
University of Massachusetts Medical School has hired two leading RNA researchers to join a group best known for Nobel Prize winner Craig C. Mello.
Victor R. Ambros (far left), who discovered molecules called microRNAs that are important in gene regulation, is leaving Dartmouth Medical School for UMass, and Melissa J. Moore, noted for her work with gene splicing and messenger RNA, is coming from Brandeis University.
"Wow, they got the A Team," Phillip A. Sharp, an MIT Nobel laureate, said in an interview today. Moore previously worked in his lab and Ambros worked in the lab next door.
Ambros, 53, earned undergraduate and graduate degrees at MIT, where he also did postdoctoral work. While at MIT he worked with two other Nobel winners: David Baltimore on the poliovirus genome, and H. Robert Horvitz on the genetic regulation of organ development and programmed cell death.
When Ambros joined the faculty of Harvard, Mello was a graduate student in his lab. Mello won the 2006 Nobel Prize in medicine or physiology with Stanford's Andrew Z. Fire for discovering RNA interference, a natural mechanism that silences genes.
It was Mello who called Ambros about coming to UMass, Ambros said in an interview.
"There's really a great convergence of bright people and exciting problems" at UMass, he said. "When I heard Melissa Moore was planing to move there, that was sort of the clincher."
Moore, 45, is a Howard Hughes Investigator who has made major contributions to understanding how RNA is edited by the cell to make sure it is intact, Sharp of MIT said.
Moore said she was recruited by UMass professor and RNA scientist Phillip D. Zamore, who also worked in the Sharp lab at MIT.
"I think UMass is just really at an exciting stage of its growth and there is a tremendous community already there for the kind of research I do in RNA and what Victor does as well," she said in an interview.
Tuesday, September 4, 2007
NIH grants focus on genes and the environment
Seven Massachusetts researchers have won grants from a new government program to study how genes and the environment interact, the National Institutes of Health announced today.
Through the Genes, Environment and Health Initiative, researchers will study the genetics of such diseases as diabetes, cancer, heart disease and tooth decay. To learn about the environmental component, scientists will develop ways to monitor personal exposure, whether to toxins or to physical activity.
The Broad Institute of MIT and Harvard, led by Stacey Gabriel, will receive $3.8 million to become one of two genotyping centers for the initiative. The other is at Johns Hopkins University in Baltimore.
Individual investigators and their projects are:
Dr. Frank Hu, Harvard School of Public Health, genes and environment initiatives in type 2 diabetes, $622,000;
Patty Freedson, University of Massachusetts, Amherst, development of an integrated measurement system to assess physical activity, $411,000;
Stephen Intille, MIT, enabling population-scale physical activity measurement on common mobile phones, $681,000;
Bevin Engelward, MIT, comet-chip high-throughput DNA damage sensor, $429,000;
Bruce Kristal, Brigham and Womenâ€™s Hospital, mitochondrial, metabolite and protein biomarkers of effects of diet, $454,000;
Dr. Avrum Spira, Boston University, a non-invasive gene expression biomarker of airway response to tobacco smoke, $643,000.
Wednesday, August 29, 2007
Update on Harvard physician-scientist's move to Arizona
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.
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.
Wait for Botox shorter than for mole check, study says
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."
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Tuesday, August 28, 2007
Another Harvard bioinformatics leader leaving
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.
Monday, August 27, 2007
Harvard leader named dean of Duke medical school
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.
Wednesday, August 22, 2007
A Brown University neuroscientist has won Germany's top honor for basic neurological research for creating a device that translates thought into action.
John P. Donoghue, who developed a brain implant called BrainGate that allows paralyzed people to use their thoughts to move a computer cursor, control a wheelchair or operate a robotic arm, will receive one of two K.J. Zulch prizes next week. The other goes to University of Melbourne professor emeritus Graeme Clark, who invented the cochlear implant.
Each year MIT's Technology Review names 35 innovators under 35 for its TR35. This year eight technologists and scientists from New England make the list.
David Berry, 29, Flagship Ventures, Cambridge: renewable petroleum from microbes
Monday, August 20, 2007
Patient safety leader applauds Medicare policy to not pay for hospital errors
By Elizabeth Cooney, Globe Correspondent
A leader of the patient safety movement supports Medicare’s decision to not cover hospitals' costs of treating preventable errors, saying it’s time to go beyond altruistic efforts at improving outcomes.
"I would have preferred it to have been positive rather than punitive, but the time has passed for that, I’m afraid," Dr. Lucian Leape of the Harvard School of Public Health said in an interview. "We’ve got a lot of solutions out there and the thing that is so frustrating is they haven’t been implemented."
Under the new regulations, Medicare will not pay the costs of treating patients harmed by errors, injuries and infections that occur in hospitals.
The list of conditions includes pressure ulcers (bedsores), injuries from falls, and infections, most commonly from the use of catheters in the bladder or lines inserted into blood vessels. Hospital-acquired infections lead to 99,000 deaths a year, according to an estimate by the US Centers for Disease Control and Prevention.
Leape was an author of the landmark Institute of Medicine report "To Err is Human" in 1998 that said as many as 98,000 people die each year from hospital medical errors. Since that time, the picture has improved, he said -- citing the Cambridge-based Institute for Healthcare Improvement's "100,000 Lives Saved" campaign -- but not enough.
"That progress has been made in the absence of any financial incentives or penalties," he said. "It has been done because a lot of good people –- doctors, nurses, administrators and others -– have wanted to do the right thing and reduce injuries. That just hasn’t been enough, so people are beginning to pull the other lever, pulling the financial incentives in."
The Medicare move wasn’t a surprise to hospitals, Karen Nelson, vice president of clinical affairs at the Massachusetts Hospital Association, said in an interview, calling it consistent with a trend toward pay for performance and public reporting of patient outcomes.
That might mean getting urine samples before a patient is admitted to determine whether a patient already has a urinary tract infection, she said, a practice in place now but not used for every patient.
John Auerbach, commissioner of the state Department of Public Health, applauded the Medicare policy, but said it was only one part of a solution that will also involve the state and individual hospitals.
"I think it's an excellent policy and we need a range of different approaches in terms of eliminating these infections and injuries," he said in an interview. "Reimbursement is one of them, providing technical assistance and education is another one, and requiring public reporting of these infections and injuries is a third. If we employ them all, it will end up being the best thing for the patient."
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Friday, August 17, 2007
On the blogs: faculty diversity in science
On Nature Network Boston, scientist Deanne Taylor offers her take on why women and members of minority groups are underrepresented in academic science.
The main obstacle to increasing faculty diversity could be the habit of self-identification, says Taylor, who does research at the Harvard School of Public Health and chairs the bioinformatics graduate program at Brandeis University. By that she means feeling more comfortable with someone who seems the same and then using that familiarity as a shortcut to social interaction.
"Although there are exceptions, in my experience, we scientists are not always known for deft socialization skills, which would allow for that kind of facility in finding common ground among diverse people," she writes, stressing that this is her opinion, not the result of data analysis. "Since scientists make decisions on everything from grants to departmental resources and tenure awards on ‘best fit,’ you can imagine the consequences of self-identification could be quite predictable."
Thursday, August 16, 2007
New physician-scientists win Howard Hughes awards
Seven Boston physicians who spent a year or more away from medical school doing research have won grants to continue their dual roles as scientists and clinicians.
The Howard Hughes Medical Institute has given Early Career Awards of $375,000 each over five years to 20 doctors to make sure they have the time and financial support for research early in their careers, it said in a statement. Their institutions agreed to allow these tenure-track physician-scientists to devote at least 70 percent of their time to research.
The winners are alumni of either HHMI's research scholars or training fellowship programs, which bring students to the National Institutes of Health or other institutions. They are:
Dr. Sarah Fortune, Harvard University School of Public Health
What Canada can learn from US about health care
Discussions about healthcare often look north to the single-payer model in Canada. But the tables are turned, now that the Canadian Medical Association has recommended allowing private competition to enter its national healthcare system.
That way lies disaster, Dr. Arnold S. Relman contends. The Harvard emeritus professor and former editor of the New England Journal of Medicine warns of a US-style system failure in a commentary that appears on globeandmail.com, the online partner of The Globe and Mail in Toronto.
"If Canada were so unwise as to allow privatization to grow in its health-care system, it would sooner or later experience all of the problems driving the U.S. system toward collapse," he writes. "One thing is certain: When medical care and health insurance are allowed to become private businesses, costs go up and patients with little or no resources do not get the care they need. That is the lesson Canadians should learn from the United States."
Wednesday, August 15, 2007
Encouraging signs on drug reviews, critic says
The voices of independent scientists are more important than ever, according to a critic of drug-company influence on government regulation, and there are signs they are being heard more than before.
Writing in tomorrow's New England Journal of Medicine, Dr. Jerry Avorn of Brigham and Women's Hospital and Harvard Medical School warns that Congress's re-authorization of user-fee funding from pharmaceutical companies to support the Food and Drug Administration means unbiased outside experts are critical to proper drug evaluation. As an example, he compares the approval of Vioxx in 1999 to this year's rejection of Arcoxia. Renewed assertiveness by FDA's external advisers made the difference in reviews of the painkillers linked to cardiac risk, he writes.
"Though the quiet voice of science may often be no match for powerful vested interests or ideology, some encouraging signs may be in the air," he writes. "The same reauthorization bill, disappointing in so many respects, may tighten somewhat the conflict-of-interest rules for outside advisers."
Tuesday, August 14, 2007
This week in JAMA
Three studies by Boston authors appear in this week's Journal of the American Medical Association.
A study from Dana-Farber Cancer Institute found that a diet high in meat, fat, sweets and refined grains may be associated with a higher risk of colon cancer recurrence and death in people who had surgery and chemotherapy to treat stage III colon cancer.
Researchers from Brigham and Women’s Hospital report that people with diabetes have an increased risk of death in the first month and first year after they have a heart attack or unstable angina compared with people who have these acute coronary syndromes but do not have diabetes.
Monday, August 13, 2007
Antioxidants no magic bullet for heart disease, study says
Antioxidant pills do not protect high-risk women from cardiovascular disease, a Harvard study has found, adding to growing evidence that supplements can’t duplicate a healthy diet and lifestyle.
Taking vitamin C, vitamin E and beta carotene alone or together did not protect the women overall from heart attacks, coronary artery disease or stroke, Dr. JoAnne E. Manson of Harvard Medical School and colleagues report in today’s Archives of Internal Medicine.
The study of 8,171 women was the first large-scale randomized trial to look at the impact of vitamin C on the risk of cardiovascular events, and it was also the first to examine vitamin C, vitamin E and beta carotene individually and in combination, Manson said.
Previous randomized trials of antioxidants have been disappointing, failing to duplicate the promising results found in observational studies following people who ate high amounts of antioxidants in their food. Antioxidants have been the subject of much research because of the hope that they could limit the harm caused by compounds called free radicals.
They shouldn’t throw away their multivitamins, either, if they take them to make up for not eating a balanced diet, she said. The trial used doses much higher than can be found in multivitamins.
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Wong's Texas state of mind
Stephen Wong (left), the bioinformatics leader who left Harvard for Houston and took nearly two dozen lab colleagues with him, talks about his new role in a Houston Chronicle story.
"Texas is a whole change in mind-set," Wong, 49, told the Chronicle. "We want to do something new. The whole idea is, we don't want to do something small. And this is the place to come and do that."
The exact place, as in lab space, is significant, too, according to the story:
"For decades, Houston has been known for its leading-edge heart research. Yet, it is a clear sign of the times that Wong, a star recruited by The Methodist Hospital from Harvard University earlier this summer, will claim a large chunk of the hospital's two floors of lab space formerly used by legendary heart surgeon Dr. Michael DeBakey."
Friday, August 10, 2007
Update on Harvard stem cell scientist
Here's an update from Harvard stem cell scientist Kevin C. Eggan on a report in today's New York Times –- denied earlier today by a Harvard spokesman -- that he is delaying a move to Kansas City because of political opposition in Missouri to human embryonic stem cell research.
"Our contracts say that advancement in the institute would be tied to moving to Kansas City if the political situation improved," Eggan said. "It was always very much on the table."
Even though Missouri voters approved a constitutional amendment in November to allow stem cell research, state legislators have proposed many bills that would limit any research on human embryonic stem cells.
"The political situation is anything but clear," Eggan said.
Jim and Virginia Stowers of Kansas City, who have delayed a $300 million expansion of their Stowers Institute for Medical Research there, started supporting Eggan and Cowan because they thought Missouri would ban stem cell research.
If the climate for stem cell research changes in Missouri, Eggan and his lab colleagues will have a decision to make.
"It's certainly something we would have to seriously consider," he said.
Stem cell scientist never planned to leave, Harvard says
Harvard Stem Cell Institute scientist Kevin C. Eggan (left) has no plans to move to a Kansas City, Mo., research center, a Harvard spokesman said today, despite a report in today's New York Times saying he has delayed leaving because of political opposition in Missouri to working with embryonic stem cells.
Eggan, whose Harvard lab is supported by the same Kansas City donors that built the Missouri research center, did not immediately return a phone call seeking comment, but a Harvard Stem Cell Institute spokesman said Eggan isn't going anywhere.
"There are not and there have not been any plans for Kevin Eggan to leave the Harvard Stem Cell Institute," B.D. Colen said in an interview. "He was making a general comment about anyone who was considering going to Missouri to do stem cell research."
The Times quoted Eggan in a front-page story about political and financial roadblocks to a $300 million expansion of the Stowers Institute for Medical Research, funded by Kansas City philanthropists Jim and Virginia Stowers. Even though Missouri voters approved a constitutional amendment in November that allows embryonic stem cell research, many new bills to limit research have been proposed in the state legislature, stalling the recruitment of scientists, the story said.
Eggan is a founding member and assistant investigator of the separate Stowers Medical Institute based in Cambridge, which supports researchers in an arrangement that follows the Howard Hughes Medical Institute model of funding scientists' work at their home institutions. Stowers is providing $5.9 million over five years to Eggan's lab, according to a 2005 Harvard statement.
The Stowers Medical Institute also supports Chad Cowan at the Center for Regenerative Medicine at Massachusetts General Hospital and the Harvard Stem Cell Institute.
Jim Stowers said in 2005 that he and his wife were supporting research at Harvard rather than in Missouri because of fears that the Missouri legislature would ban stem cell research, according to that Harvard statement.
Tuesday, August 7, 2007
Underinsured children fall into vaccine gap
By Elizabeth Cooney, Globe Correspondent
Children whose private health insurance does not pay for new recommended vaccines may not be eligible to receive them in public programs, leaving them more vulnerable than if they had no insurance, according to a Harvard study.
These gaps are occurring as the number and cost of new vaccines have escalated. New vaccines recommended for children have doubled in the past five years and the cost to fully vaccinate a child -- about $1,170 -- is 7.5 times higher in 2007 than it was in 1995, Dr. Grace M. Lee of Harvard Medical School and colleagues write in tomorrow’s Journal of the American Medical Association. They surveyed state immunization program managers in 48 states from January to June 2006.
Those children were referred to public health clinics, but they were still unable to receive vaccine because funding to pay for it was not available, the researchers found. The work was funded by the US Centers for Disease Control and Prevention.
"To us that was alarming because we had always seen the public sector as a safety net for vulnerable children," said Lee, also of Children’s Hospital Boston and Harvard Pilgrim Health Care. "Now we find that with the newer, more expensive vaccines, a lot of states are unable to provide these vaccines to kids who can’t afford them."
The JAMA study did not attempt to find out how many families might pay out of pocket for vaccines. The HPV vaccine costs about $120 for each of three doses, the meningitis vaccine costs about $80, and the rotavirus vaccine costs about $60.
"I imagine that if a family can’t afford health insurance that covers vaccines, they probably wouldn’t be able to afford to pay for that," Lee said.
In an accompanying editorial, Dr. Matthew M. Davis of the University of Michigan suggests a tiered approach to financing newly recommended vaccines for underinsured children where funding is not available.
"Vaccines that benefit more of the population per individual immunized would receive higher priority," he writes.
Lee and her co-authors suggest working with insurance plans to include coverage.
"Until those enhancements can be made to health insurance plans, I think we need to support our public sector safety net," she said. "We need to come up with funding for these kids who are falling through the cracks to bridge the gap until we can have all health insurance plans covering vaccines."
Thursday, August 2, 2007
Partners executive to lead New York foundation
By Elizabeth Cooney, Globe Correspondent
Dr. George E. Thibault (left), a leader at Partners HealthCare hospitals and Harvard Medical School, is leaving Boston to become president of a New York foundation devoted to improving health care.
"It’s a very exciting opportunity to influence medical education nationally," Thibault said in an interview. "These are things that I’ve been interested in all my career, but now I can do them on a national scale."
Thibault, 63, had previously been chief medical officer at Brigham and Women's Hospital and chief of medical services at Brockton/West Roxbury VA Medical Center. Earlier in his career he was the first director of the Medical Practices Evaluation Unit at Massachusetts General Hospital and director of the medical intensive care unit and coronary care unit at MGH.
"The integrity, wisdom, and experience that George has brought to this position have allowed him to play a very important 'honest broker' role in working with physicians across the Partners system," Partners president and CEO Dr. James J. Mongan said in a message to staff today. "During George's tenure as Vice President of Clinical Affairs, he has improved physician relationships and cooperation across Partners."
Korean cloning fraud covered an accidental stem cell first, Harvard paper says
Harvard scientists have answered a question that lingered after Korean scientists retracted their fraudulent claim
Kitai Kim, Dr. George Q. Daley (left) and their colleagues at Children's Hospital Boston and the Harvard Stem Cell Institute report today in Cell Stem Cell that the embryonic stem cells created by the Korean lab resulted not from somatic cell nuclear transfer, a technique in which a person's DNA is injected into a donor egg cell that has had its own DNA removed, but from parthenogenesis, the process of making an embryo from the donor egg alone.
Cells derived from parthenogenesis carry a distinct genetic fingerprint because they have a duplicate set of chromosomes from the egg. Most of the genetic sequences are identical, but some show differences from the donor egg. Investigators looking into the Korean claims last year said parthenogenesis could not explain these different patterns, the paper said.
Kim and Daley's group analyzed the cells further and found that the DNA differences were clustered at certain points, just as they are in experiments on parthenogenesis in mice.
The Koreans appear to have created the first human embryonic stem cells from a woman's egg alone, the paper says.
Daley's lab is studying parthenogenetic cells as another possible source of embryonic stem cells to treat disease.
A Children's Hospital interview with Daley is here.
Wednesday, August 1, 2007
Harvard-educated doctor named Joint Commission chief
Dr. Mark R. Chassin (left) of Mount Sinai Medical Center in New York, a Harvard-educated doctor and former commissioner of the New York State Department of Health, has been named president of The Joint Commission, a body that accredits US healthcare organizations.
Chassin graduated from Harvard College and Harvard Medical School and received a master's degree in public policy from the Kennedy School of Government at Harvard. He also holds a master's degree in public health from the University of California at Los Angeles.
Chassin succeeds Dr. Dennis S. O'Leary, who will conclude 21 years as president of the commission at the end of the year. O'Leary earned his bachelor's degree at Harvard.
Tuesday, July 31, 2007
Harvard researchers identify treatment target in Hodgkin lymphoma
By Elizabeth Cooney, Globe Correspondent
Hodgkin lymphoma tumors are a paradox. In tumors that can grow as large as baseballs, only a small fraction of the tumor is made up of cancer cells – about 5 percent – but they are surrounded by the patient’s normal immune cells. Something keeps the immune cells from attacking the cancer cells they vastly outnumber.
Harvard researchers will report later this week in the online Proceedings of the National Academy of Sciences that they have identified a protein that acts like the tumor’s bodyguard. Called galectin-1, it disables the immune cells, a discovery they believe will lead to better diagnosis and treatment of the blood cancer that usually strikes young adults.
"The reason we think this may turn out to be very important from a clinical perspective is it suggests if you could neutralize the galectin-1 that is being secreted by the Hodgkin lymphoma cells, then you would have a very good chance at re-regulating or reinstalling an effective immune response in Hodgkin lymphoma," Dr. Margaret A. Shipp of Harvard Medical School and the Dana-Farber Cancer Institute said in an interview. "We think this may have relevance in other tumors."
The protein is already showing promise as a way to identify tumors as Hodgkin lymphomas as opposed to other types of lymphoma, the paper suggests. Previous work in mice has shown that galectin-1 can also be produced by tumors in melanoma.
"This is a fascinating paper from a big-picture perspective because we are increasingly learning that the immune system is often involved in cancer formation and it can be stimulated to be part of cancer treatment," said Deborah Banker of the Leukemia and Lymphoma Society, which is funding the research going forward. "It seems that in general none of us might ever get cancer if the immune system were better at finding the very first cancer cells and eradicated them before they had a chance to multiply."
Two Mass. scientists win Keck awards
Two Massachusetts scientists are in the 2007 class of the W.M. Keck Foundation's Distinguished Young Scholars in Medical Research.
The Los Angeles philanthropy awards grants of up to $1 million each to five junior faculty members in the United States. Institutions make nominations by invitation only.
Amy Wagers (right) of the Harvard Stem Cell Institute, Joslin Diabetes Center and Harvard Medical School will study how to slow down or reverse the natural process of aging, which has potential implications for treating such age-related diseases as diabetes, immune deficiencies, muscle weakness and cancer, the foundation said.
Job Dekker (left) of University of Massachusetts Medical School will study how chromosomes are regulated by comparing cancer cells to normal cells, which may uncover defects that cause malignancy, potentially leading to advances in treating cancer, the foundation said.
The three other winners are Wallace Marshall of the University of California, San Francisco, who will study blue-green algae to gain insights into human ciliary disorders such as polycystic kidney disease and retinal degeneration; Dr. Xander Wehrens of Baylor College of Medicine, who will investigate the mechanisms of specialized protein complexes in excitable cells, such as heart muscle; and Jennifer Zallen of Memorial Sloan-Kettering Cancer Center, who will focus on a fruit fly’s cell structure to develop approaches to analyze cell behavior and structure in living embryos, the foundation said.
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Monday, July 30, 2007
Harvard leader named president of Texas Tech Health Sciences Center
Dr. John C. Baldwin (left), a Harvard professor of surgery and head of the CBR Biomedical Institute affiliated with Harvard Medical School, has been named president of the Texas Tech University Health Sciences Center in Lubbock, the university's chancellor announced today.
A fifth-generation Texan, Baldwin graduated from Harvard College and Stanford University School of Medicine and completed his internship and residency at Massachusetts General Hospital. He was chief of cardiovascular surgery at Yale University, head of surgical programs at Baylor College of Medicine, dean of Dartmouth Medical School and associate provost of Dartmouth College before returning to Harvard to become president and CEO of the CBR Institute for Biomedical Research, which is in the process of changing its name to the Immune Disease Institute.
Wednesday, July 25, 2007
Friendships may contribute to obesity epidemic
By Alice Dembner, Globe Staff
A study released today suggests that obesity spreads through social connections, particularly via close friendships.
This doesn’t replace the effects of genetics, failing to exercise or supersizing food. But researchers writing in the New England Journal of Medicine say it provides a possible explanation for the rapid increase in obesity over the last few decades. Nationally surveys show that nearly one-third of US adults are now obese.
Studying more than 12,000 people linked to a long-running study of heart disease based in Framingham, the researchers found that an individual's chances of becoming obese increased by 57 percent if someone they consider a friend grew obese.
If the friendship was close and mutual and one person became obese, the other's risk soared by 171 percent. The study found similar, but smaller influences between siblings and spouses, but neighbors who aren't friends had no effect.
Surprisingly, obesity seemed to spread even if friends were geographically distant.
"We were stunned to find that friends who are hundreds of miles away have just as much impact on a person's weight as those who are geographically close," said James Fowler, the paper's other author, who is an associate professor of political science at the University of California San Diego. This led researchers to suggest that the effect wasn't only due to sharing behaviors -- such as eating together -- but to sharing ideas about what constitutes an appropriate weight.
Because the study looked at relationships over time, the researchers were able to exclude cases in which obese people chose overweight friends, and therefore were able to make a stronger case for a causal effect.
Researchers have developed an illustration showing how relationships impact obesity.
HBS professor takes AMA to task
The American Medical Association, which received $286 million in revenue last year to protect the profession, has served physicians poorly, a Harvard Business School professor writes in today's Washington Post.
Regina E. Herzlinger (left), who is also a senior fellow of the Manhattan Institute, says doctors' professionalism and incomes have taken a terrible beating recently. Some physicians are switching occupations and showing up in her classes seeking MBAs, saying they can no longer practice medicine, she writes.
"You might expect that the AMA would fight the insurers, hospitals, government bureaucrats and ivory tower academics who have diminished physicians' incomes, besmirched their ethical reputations and compromised their professionalism -- but you would be wrong," she writes. "No, instead, at its annual meeting last month, the AMA declared war on retail medical clinics, located in places such as CVS and Wal-Mart."
"We and doctors deserve better advocates."
Telling all, genetically speaking
Technology consultant Esther Dyson writes about being one of 10 members of Harvard geneticist George Church's Personal Genome project in today's Wall Street Journal.
The project's goal is to recruit 100,000 volunteers whose information will be public for anyone to use, whether for research, their own healthcare or commerce, she says.
She worries about the thousands that will follow the first group willing to post not only their genomes, but also their medical records and answers to extensive questionnaires on the Internet for all to see.
"The 10 of us are fairly well informed, and we know whom to turn to for help if we get an anomalous result," she writes. "But what if the 99,999th person has something alarming in his medical records? This is a research project: We will be careful not to give clinical advice or diagnoses, which could subject us to additional regulation."
Despite that concern, she has faith in the project's goals.
"No one said it would be easy, but the knowledge from our project, and with luck from many others, will ultimately lead to better information that will be there for anyone to use," she concludes.
Tuesday, July 24, 2007
After Katrina, coastal residents reluctant to evacuate, Harvard survey finds
Almost two years after Hurricane Katrina, nearly a third of the people who live along the coastline from North Carolina to Texas say they would not evacuate if ordered to do so, according to a Harvard survey, up from almost a quarter of people who told researchers last year they would stay in their homes.
The latest survey, conducted last month, asked 5,406 people who lived in counties within 20 miles of the Atlantic Ocean or the Gulf of Mexico how prepared they were for a hurricane. Almost half of them had lived in places that had already been hit by damaging hurricanes.
Three-quarters of residents who said they wouldn’t leave thought their homes would be safe during a hurricane. More than half were afraid that evacuation routes would be too crowded; about a third worried that leaving would be dangerous; and a third also were concerned about theft or damage to their homes. About a quarter didn’t want to leave their pets.
If they did have to leave their homes, about two-thirds said they were most concerned that shelters would be dirty, lack clean water and be too crowded. Almost two-thirds of respondents thought they would be exposed to sick people and have no medical care.
Friday, July 13, 2007
Harvard doctors will blog on Gather.com
By Liz Kowalczyk, Globe Staff
Harvard Medical School physicians will begin blogging under a new agreement with Gather.com, a social networking site for adults. Harvard Health Publications, which provides content from the medical school, announced this week that it is launching 35 online communities focusing on different chronic conditions, including depression, diabetes and insomnia.
LifeMasters Supported SelfCare Inc., a leading provider of disease management programs, also is part of the venture.
Wednesday, July 11, 2007
Covering people before 65 reduces health care costs later
Providing health care to uninsured adults before they qualify for Medicare coverage may not only improve their health but also reduce costs after they turn 65, a Harvard study says.
People who haven’t had insurance coverage are significantly more likely to report poor health before the age of 65, the authors report in tomorrow’s New England Journal of Medicine.
They looked at data from the national Health and Retirement Study to compare health care expenditures between insured and uninsured adults at age 59 and 60 and then again after 65. They concluded that expanding health insurance coverage for uninsured people before 65 might be offset by savings in health care costs that would come later, particularly for people who have cardiovascular disease or diabetes.
"It may be less costly than people thought," Dr. J. Michael McWilliams, a research associate at Harvard Medical School, said in an interview. "Earlier coverage improves health and reduces health care needs."
These findings are especially important as baby boomers reach 65, he said. The current generation of adults has higher rates of obesity and hypertension than their parents', pointing to more chronic disease and a greater need for preventive care, said McWilliams, who also practices general internal medicine at Brigham and Women’s Hospital.
"Not only does providing coverage to these adults substantially reduce their health care needs after 65, but it also protects them financially," McWilliams said.
It's official: Flier is new Harvard medical dean
By Liz Kowalczyk, Globe Staff
Harvard just announced that Dr. Jeffrey S. Flier, a prominent diabetes and obesity researcher at Beth Israel Deaconess Medical Center, has been named dean of Harvard Medical School.
Harvard University President Drew Gilpin Faust said in a telephone interview that Flier has wide ranging experience across the university, developed during his nearly 30 years there. She said she was impressed that Harvard leaders and faculty in vastly different roles -- basic science researchers, academic leaders, and physicians -- all spoke highly of him.
"All brought the same sense of deep respect," she said this afternoon.
Flier succeeds Dr. Joseph Martin, who stepped down as dean last month.
Flier was selected after the head of the National Heart Lung and Blood Institute, Dr. Elizabeth Nabel, a cardiologist, withdrew as a finalist, two Harvard officials said, citing a desire to stay in Washington where her husband works. Just as Faust is the first female president of Harvard, Nabel could have been the first female dean of the medical school.
"The timing was not right for her family, but Dr. Nabel congratulates Dr. Flier and wishes him great success in his new position as dean," said NHLBI spokeswoman Susan Dambrauskas.
Flier, 59, lives in Newton; his wife, Dr. Eleftheria Maratos-Flier, also is a leading diabetes researcher at Beth Israel Deaconess.
"It's pretty clear we're starting from a very high base line," said Flier, who begins as dean Sept. 1. "The challenge is finding areas where this incredible institution can be strengthened," he said in an interview.
He said that his areas of focus will include implementing Harvard Medical School's new curriculum, which pushes students to better understand patients' experiences in the health care system; helping plan the university's new Allston campus and the future of science at Harvard; and increasing collaboration among researchers across the system, particularly in the area of translating basic research into treatments for patients.
Asked how he pitched himself for the job, considering the dozens of candidates, Flier recounted, "I said that I've been in this system my whole career. I've seen the system on the patient care end, the researcher end, the teaching and the academic leadership end. I know I've been successful in those areas."
Dr. James Thrall, head of radiology at Massachusetts General Hospital and a member of the search committee, said "it was very clear in the proceedings that all of the people in the Harvard community who had worked with him (Flier) held him in very high regard. Given the nature of the academic world that is refreshing. People are pretty tough and judgmental. Having the right personality is important; trust and respect become very important when (people) have legitimate disagreements."
Dr. Jeffrey Flier to be named Harvard medical dean
By Liz Kowalczyk, Globe Staff
Word is that Dr. Jeffrey Flier (left), chief academic officer at Beth Israel Deaconess Medical Center and a nationally known researcher on diabetes and obesity, will be named the new dean of Harvard Medical School, as early as today.
Two Harvard officials with knowledge of the search said today that Harvard University president Drew Gilpin Faust is close to making an announcement about Flier's appointment.
Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute in Washington, D.C., dropped out of contention, the officials said. Just as Faust is the first female president of Harvard, Nabel would have been the first female dean of the medical school.
But Nabel did not want the job for family reasons; her husband, Dr. Gary Nabel, is heading the National Institutes of Health's search for an AIDS vaccine, also in Washington.
A search committee evaluated an initial list of several hundred candidates. Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.
Tuesday, July 10, 2007
A century's worth of sky
More than half a million images constituting humanity’s only record of a century’s worth of sky exist on glass plates at the Harvard College Observatory, a story in today's New York Times notes.
"Besides being 25 percent of the world’s total of astronomical photographic plates, this is the only collection that covers both hemispheres," Alison Doane (left) told the Times. She is curator of the glass database, which weighs 165 tons and contains more than a petabyte of data, the story says. There is no backup.
For the last few months, Doane and a few colleagues, along with volunteers from the Amateur Telescope Makers of Boston, have been setting the stage for a mammoth attempt to convert the entire collection into a searchable online atlas, the story says.
Monday, July 9, 2007
Electronic records alone don't improve outpatient care, study says
Electronic health records, championed as a way to improve patient health and safety, don't by themselves lead to better care in doctors' offices, a study shows.
Researchers from Harvard and Stanford found that electronic records made no difference in 14 of 17 measures of quality for outpatient health care, according to today's Archives of Internal Medicine. They examined data from the National Ambulatory Medical Care Survey gathered from visits to doctors in 2003 and 2004.
Two categories showed better performance on recommended care in the 18 percent of visits in which electronic health records were used: not prescribing tranquilizers for depression and not ordering routine urinalysis in general medical exams. But in one area -- prescribing statins for patients with high cholesterol -- physicians using electronic health records performed worse than doctors who didn't have them.
The missing piece is information to guide clinical decisions, co-author Dr. David W. Bates of Harvard Medical School said in an interview last week. Prompts to order tests, prescribe medications or avoid harmful drug interactions can make the records more than just computerized charts, the study said.
"I was surprised," he said. "I expected we would find improvement with the use of electronic health records, especially because there's a lot of evidence that with good decision support, quality measures do improve."
The survey did not ask if doctors were using electronic records with decision support tools, said Bates, who is chief of general internal medicine at Brigham and Women's Hospital. But previous research has shown quality goes up when a physician is reminded to order a lab test to monitor a patient's diabetes, for example. Decision support is most helpful with preventive care and chronic disease management, he said.
"I hope this will emphasize the importance of including good decision support in electronic health records," he said.
Wednesday, July 4, 2007
Doctor advises how to resolve family-hospital disputes over ending life support
They’re called "medical futility" cases, when family members and hospitals disagree on whether to continue life support for very sick patients. Although rare, they raise questions about respect for others’ viewpoints, a Children’s Hospital Boston doctor says.
Writing in tomorrow’s New England Journal of Medicine, Dr. Robert D. Truog warns against laws that allow a hospital ethics committee to be "surrogate judge and jury."
He considers the recent case of 19-month-old Emilio Gonzales, whose mother went to court to prevent Austin Children’s Hospital from turning off his respirator. Emilio had a rare, fatal genetic disorder called Leigh’s disease that meant he was in intensive care for five months with declining neurological function. Under the Texas Advance Directives Act, the hospital’s ethics committee decided to withdraw life support despite the objections of his mother, Caterina Gonzales.
"I’m concerned that legislation like that in Texas makes it just too easy for people in the medical profession to override the desires of those who have unpopular views," Truog said in an interview. "We’ve got a beautiful system of laws designed to protect people from the tyranny of the majority. The Texas law just bypasses it."
Massachusetts has no law governing cases like these, Truog said. Director of medical ethics at Harvard Medical School, he wrote a policy for Children’s about medically futile care. Under that policy, if a hospital ethics committee were to conclude that medical treatment should be stopped and the family disagreed, it would assist the family in finding and sometimes paying for a lawyer to take the hospital to court so a judge would decide.
In Emilio’s case, his mother found legal help through right-to-life groups, Truog said, but the process should have included safeguards to make that recourse standard. Those safeguards also have the benefit of allowing time for more discussion between the family and the hospital, he said, rather than ending the argument with a unilateral decision. Emilio died before the judge ruled, an outcome that is common in cases like these, Truog said.
"The claim that continued life support for Emilio was morally objectionable was nothing more than an assertion that the values of the clinicians were correct while those of Ms. Gonzales were wrong," Truog wrote. "I believe that in cases like that of Emilio Gonzales, we should seek to enhance our capacity to tolerate the choices of others, even when we believe they are wrong."
Monday, July 2, 2007
Scientists report win against bacterial biofilms
Two scientists from Boston University and a Harvard-MIT program have engineered an organism to fight bacterial biofilms.
Writing in the online Proceedings of the National Academy of Sciences, Timothy K. Lu and James J. Collins report that they created a bacteriophage -- a virus that infects bacterial cells -- that releases an enzyme to attack both the bacterial cells in the biofilm and to disperse the biofilm itself.
Bacteria commonly live in biofilms. They can be found in dental plaque or water pipes or on medical devices. A source of infection and contamination, biofilms pose a particular problem when they are resistant to antibiotics.
Bacteriophages work in a different way than antibiotics when they infect bacterial cells. The authors say that adding enzymes makes the bacteriophages much more effective than previous efforts that didn't incorporate enzymes.
Lu is from the Harvard-MIT Division of Health Sciences and Technology and Collins is from BU's Center for BioDynamics.
Thursday, June 28, 2007
Cambridge Health Alliance will accept an award today from the National Association of Public Hospitals and Health Systems for its role in medical school curriculum change.
CHA developed a program for third-year Harvard Medical School students to follow patients for a year at one hospital instead of traditional rotations in different settings. The hospital was chosen for the 2007 Chair Award from 64 submissions, NAPH said in a statement.
Dr. Samantha L. Rosman, a third-year resident in pediatrics in Boston, has been re-elected to the American Medical Association's board of trustees. She is a 2004 graduate of Columbia University College of Physicians and Surgeons. After completing her residency, she will begin a fellowship in pediatric emergency medicine at Boston Medical Center.
Dr. Karen Shedlack (left), medical adviser for the mental retardation division of Vinfen, has won a 2007 Distinguished Fellowship from the American Psychiatric Association.
Before joining Vinfen, a private, nonprofit human services organization based in Cambridge, Shedlack was medical director for the adult developmental disabilities program at McLean Hospital and worked in the department of psychology and brain science at the Massachusetts Institute of Technology.
Virgin Life Care has named three Boston academics to its science advisory board.
A subsidiary of the Virgin group headed by Sir Richard Branson, the Boston company develops activity-based health rewards programs.
The board members are Dr. I-Min Lee of Harvard Medical School and the Harvard School of Public Health, Kyle McInnis of UMass-Boston and Jessica Whitely of UMass-Boston and Brown Medical School.
They are Dr. Anthony Compagnone of Hyde Park Pediatrics, Dr. Debra Ann Gfeller of Holliston Pediatrics, Dr. David Holder of the Martha Eliot Health Center, Dr. Richard Marshall of Harvard Vanguard Associates at Copley and Dr. Robert Michaels of Longwood Pediatrics.
Tuesday, June 26, 2007
Kitty Dukakis (left), wife of former Governor Michael Dukakis and author of books about her battles with addiction and depression, was honored by the National Alliance on Mental Illness at its conference in San Diego last week. Author of last year's "Shock: The Healing Power of Electroconvulsive Therapy" with former Globe medical reporter Larry Tye and the 1990 book "Now You Know" about addiction to alcohol and diet pills, she was recognized for sharing her struggles and reducing the stigma associated with mental illness.
Dr. Donald M. Berwick (left), a Harvard Medical School professor who heads the Institute for Healthcare Improvement in Cambridge, is among 15 finalists for an award honoring innovators over 60 for their work on social problems.
Five Purpose Prize winners will each receive $100,000 from the San Francisco think tank Civic Ventures in September. Berwick, 60, was nominated for his work to help hospitals improve care through the "100,000 Lives" patient safety campaign. Each finalist is awarded at least $10,000.
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Friday, June 22, 2007
Harvard researcher wins MERIT Award from NIH
Xihong Lin (left), professor of biostatistics at the Harvard School of Public Health, has won a MERIT Award from the National Institutes of Health.
Lin will develop statistical methods for analyzing cancer research data, including long-term and family data as well as genomic and proteomic information in epidemiological studies and population sciences, NIH said in a statement.
Fewer than 5 percent of NIH-funded investigators are selected to receive the awards.
Current MERIT recipients in Massachusetts and their instituions are:
Beth Israel Deaconess Medical Center: Benjamin G. Neel
Tuesday, June 19, 2007
Boston scientists named Pew biomedical scholars
Four Boston-area scientists are among the newest class of 20 Pew Scholars in the Biomedical Sciences, the program announced today.
Funded by the Pew Charitable Trusts through a grant to the University of California at San Francisco, the awards give each scientist $240,000 over four years to support research.
Past winners have included Craig C. Mello of the University of Massachusetts Medical School, who shared the 2006 Nobel Prize in medicine or physiology for the discovery of the gene-silencing mechanism know as RNA interference.
This year's Boston-area winners are:
Ekaterina Heldwein (left), an assistant professor at Tufts University, will study how herpes viruses enter human cells. A graduate of Oregon Health and Science University, she trained at Children’s Hospital Boston and Harvard Medical School.
Dr. Deborah T. Hung (right), an assistant professor at Harvard Medical School and an assistant molecular biologist at Massachusetts General Hospital, will search for ways to fight the infectiousness of Pseudomonas aeruginosa, a bacterium that harms people with compromised immune systems because they have such conditions as cystic fibrosis, HIV or traumatic burns. She earned a doctorate in chemistry and a medical degree from Harvard and did additional training at Brigham and Women’s Hospital and Mass. General.
Thomas U. Schwartz (left), an assistant professor at MIT, will study the three-dimensional structure of the nuclear pore complex that regulates molecular traffic into and out of the cell nucleus, which could lead to antiviral therapies. He earned a doctorate in biochemistry from the Free University of Berlin and did postdoctoral research at Rockefeller University.
Thursday, June 14, 2007
Houston $3b, Boston $1b
Last week Houston won Harvard's Stephen Wong and his bioinformatics team of 20 when they said they were wooed to Methodist Hospital. Yesterday Texas Gov. Rick Perry (at left with cancer survivor and lobbyist Andrea McWilliams) signed a bill that will put on the November ballot a $3 billion bond issue to fund research in the fight against cancer, today's Houston Chronicle reports.
The initiative, modeled after a 2004 California measure in which voters approved $3 billion for stem-cell research, seeks to compensate for the federal government's declining funding for scientific research in recent years, the story says.
"There is no piece of legislation that could mean more to the future of this state than this cancer-research bill," Perry said at the University of Texas M.D. Anderson Cancer Center in Houston, where he was joined by Lance Armstrong, a cancer survivor and seven-time Tour de France winner.
Officials at the ceremony, the story said, expect no area to receive a bigger share than Houston's Texas Medical Center, which is home to M.D. Anderson Cancer Center and Baylor College of Medicine, two of the state's three federally designated cancer centers. The third is at the University of Texas Health Science Center at San Antonio.
Last month Massachusetts Governor Deval Patrick announced a plan to invest $1 billion in life sciences, including a new stem-cell bank, job training, biomedical research, and tax breaks for companies hiring new workers.
Tuesday, June 12, 2007
She calls it 'phenomena,' not art
First an artist in residence and now a research scientist at MIT and also a senior research fellow at the Institute for Innovative Computing at Harvard, Felice Frankel (left) helps researchers use cameras, microscopes and other tools to display the beauty of science, a story in today's New York Times says.
But she doesn't call it art.
"My stuff is about phenomena," she says in the story, referring to magnetism or the behavior of water molecules or how colonies of bacteria grow — phenomena of nature. "When it’s art, it’s more about the creator, not necessarily the concept in the image."
Frankel and George M. Whitesides, a Harvard chemist and her longtime collaborator, are finishing a book about "small things," Whitesides told the Times, things at the limit of what can be seen with light, even through the microscope.
"She has transformed the visual face of science," he said.
New Florida school's dean remembers Harvard scholarship
Dr. Deborah German (left) won a full scholarship to Harvard Medical School. Now the 1976 graduate wants to offer the same free ride to students at the new medical school where she is dean, according to a story in today's St. Petersburg Times.
The University of Central Florida's medical school isn't even built yet, but it plans to pay the full ride for its entire inaugural class of 40 medical students admitted in 2009, the story says. The four-year scholarship of more than $160,000 would cover tuition and living expenses, under a money-raising campaign to be announced at UCF's main campus in Orlando today.
German's full scholarship to Harvard "made all the difference," she told the Times. Before becoming dean, she held positions at Vanderbilt and Duke.
"I want to offer the same gift that others offered to me."
Monday, June 11, 2007
Harvard names acting medical school dean
Harvard has named an acting dean for the medical school in a move that means a permanent appointment will not be made before the current dean leaves.
Dr. Barbara J. McNeil (left), chair of health care policy and professor of radiology, will assume the interim position after retiring dean Dr. Joseph B. Martin steps down June 30. A 1966 graduate of Harvard Medical School, McNeil has been a member of the faculty since 1983.
In a statement from Harvard last week, incoming President Drew Gilpin Faust said it did not seem feasible for a permanent dean to be appointed or to start as dean by July 1.
"We have made good progress in the search for a new dean and identified some very promising candidates," Faust said in the statement.
The Globe reported on May 24 that nationally known cardiologist Dr. Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute, and leading Harvard diabetes researcher Dr. Jeffrey Flier were among the finalists, according to several Harvard doctors and officials with knowledge of the search.
The cost of health
People do put a price tag on their existence, a story in a special section on the business of health says in today's New York Times.
Studies of real-world situations produce relatively consistent results, suggesting that average Americans value a year of life at $100,000 to $300,000, Peter J. Neumann, director of a program at Tufts-New England Medical Center that measures the cost-effectiveness of new treatments, told the Times.
The story also quotes David Cutler, a professor of economics at Harvard and author of "Your Money or Your Life: Strong Medicine for America’s Health-Care System." He says such estimates have value, at least as guides to the diseases and conditions that people will spend the most to avoid.
Also in the Times section, Jon Kingsdale (left) of the Commonwealth Health Care Connector and John McDonough of Health Care For All describe the challenges of implementing Massachusetts' new healthcare law.
"We’ll try to be the test laboratory for the rest of the country," Kingsdale said.
Friday, June 8, 2007
Study suggests men at risk for heart attack should be evaluated before starting hormones for prostate cancer
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.
Wednesday, June 6, 2007
Harvard, Whitehead scientists report embryonic stem cell advances
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."
Monday, June 4, 2007
Harvard bioinformatics team leaving for Houston
A leading scientist who directed research programs at Harvard Medical School and at Brigham and Women’s 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 Women’s. 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.
"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. It’s 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.
"Steve’s a very talented Ph.D. scientist," he said. "As disappointed as we are to lose him, it’s 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 doesn’t matter," he said.
Friday, June 1, 2007
Harvard's Herzlinger a 'healthcare heretic'
Harvard Business School professor Regina Herzlinger (left) is trying to transform America's health-care system through her advocacy of consumer choice, an article in The Economist headlined 'health-care heretic' says.
Calling her America's leading advocate of market-driven, consumer-orientated health reform, the article quotes Ray Gilmartin, a former chairman of drug giant Merck, on her efforts in the 1980s: "She argued for a greater role for competition and choice when market forces and productivity were foreign concepts in this sector."
In the 1990s, when managed care was all the rage, the story says, she predicted correctly that such a cost-obsessed approach would alienate consumers while it failed to rein in cost inflation ("I said, ‘this fish stinks’," she recalls in the article).
Today, "the US health-care system is in the midst of a ferocious war. Four armies are battling to gain control: the health insurers, hospitals, government and doctors," the article quotes from her new book, "Who Killed Health Care?"
Then she moves in for the kill, the story continues: "Yet you and I, the people who use the health system and who pay for all of it, are not even combatants."
Wednesday, May 23, 2007
Harvard close to hiring medical school dean
By Liz Kowalczyk, Globe Staff
Harvard University's incoming president, Drew Gilpin Faust, is close to making a key hire, dean of Harvard Medical School, and the finalists include a nationally-known cardiologist and a leading Harvard diabetes researcher, according to several Harvard doctors and officials with knowledge of the search.
Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute, is a top finalist for the position, according to two of the sources.
Nabel and the agency's spokeswoman did not return calls asking for comment. While at the University of Michigan during the 1980s and 1990s, she rose to chief of the Division of Cardiology and became known for her research into the molecular genetics of cardiovascular diseases, according to the institute's website.
The sources said that Dr. Jeffrey Flier, chief academic officer at Beth Israel Deaconess Medical Center and a nationally-known researcher on diabetes and obesity, also is a serious contender for the job. He said through a spokeswoman that he would not comment on the search.
Harvard University spokesman John Longbrake said the university would not comment on the search until it is completed.
The next dean of Harvard Medical School will replace Dr. Joseph Martin, who steps down next month, ending a 10-year tenure during which he oversaw dramatic changes to the school's curriculum. Martin, a neurologist, plans to take a sabbatical for one year and then increase his work with the Harvard Center for Neurodegeneration & Repair, a group that is trying to develop new drugs for Parkinson's and Alzheimer's disease and other neurological disorders.
Interim Harvard University president Derek Bok convened a faculty search committee to recommend potential replacements for Martin. But he left the final decision to Faust, partly because of the medical school's importance -- it has 11,000 faculty members and $1.2 billion in National Institutes of Health research grants awarded to the medical school and its affiliated hospitals. The medical school dean also will have a key role in the development of Harvard's new Allston campus, where a major stem cell research institute and other scientific laboratories will be located.
The search committee evaluated an initial list of several hundred candidates, the sources said, but the committee is advisory; Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.
Harvard study explains how aspirin might prevent some colon cancers
Taking aspirin regularly has long been known to prevent colorectal cancer in some people, but why that’s true has been unclear.
Researchers have suspected that blocking the enzyme COX-2 might be the mechanism involved. Dr. Andrew T. Chan and his Harvard Medical School colleagues confirm a connection to COX-2 in an article to appear in tomorrow’s New England Journal of Medicine.
"That’s a pretty striking difference," Chan said in an interview.
It’s too soon to suggest taking aspirin to prevent colorectal cancer, he said. At this point no one knows how to predict who will develop COX-2 negative or COX-2 positive forms of the cancer. Further studies are needed to see if people who develop polyps that are COX-2 positive, or people who had COX-2 positive tumors and are concerned about recurrence, might benefit from aspirin.
"We need to ask whether there are alternative strategies for targeting the COX pathway that have better efficacy or lower rates of adverse effects," Markowitz writes.
$1m cancer prize promotes sharing of ideas
Taking a page from an investors' club handbook, hedge fund managers and a Harvard scientist today introduced the Gotham Prize for Cancer Research, a $1 million annual award that will be given to a researcher who posts a promising idea on an online forum.
"As researchers who live and die by grant support, we want to hold on to our ideas," said prize co-founder Dr. Gary C. Curhan of Harvard Medical School and the School of Public Health. "But it's important to share the best ideas and also try to expedite their investigation."
The prize was created by New York hedge fund managers Joel Greenblatt and Robert Goldstein of the investment firm Gotham Capital and Curhan, a kidney specialist at Brigham and Women's Hospital. For the website, they took as their model the Value Investors Club, an online group where members share investment ideas.
The winner will be selected based on the quality of the idea, the feasibility of studying it, and on the comments it generates on the forum. The prize will be awarded in February. An additional $250,000 Ira Sohn Conference Foundation Prize in pediatric oncology will also be offered.
The scientific advisory board for the prizes includes Dr. Meir J. Stampfer of Harvard's medical and public health schools.
Joan S. Brugge, a cancer researcher at Harvard Medical School who is not involved in the prize, applauded the marketplace of ideas approach that the website will take.
"Since research money is really tight, any influx of support for cancer research is a good thing in general," she wrote in an e-mail. "'Experimentation' to evaluate new strategies to stimulate novel ideas and new approaches can't hurt cancer research and could indeed lead to important new breakthroughs."
Federal funding for cancer research has been flat in recent years, but still provides the foundation for basic knowledge, she said.
"These kinds of creative approaches ... should not be viewed as substitutes for continued robust/large scale support of investigator-initiated programs at NIH," Brugge wrote.
Tuesday, May 22, 2007
Eric Winer adds role at Susan G. Komen for the Cure
Dr. Eric P. Winer (left) today was named chief scientific adviser to Susan G. Komen for the Cure, the breast cancer advocacy group.
He will remain director of breast oncology at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School while taking on the new role at Komen. He explained in an interview why he is excited about the opportunity and about the future of breast cancer research.
Why did you agree to join Komen?
What are some of the questions that need answers?
What’s important on the research agenda?
How will you influence the research that gets done?
What are the significant advances in breast cancer research over your 20-year career?
What do you see for the future?
How old are you?
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Monday, May 21, 2007
On the blogs: Swiss healthcare parallels, latest hospital infection rates
On WBUR's CommonHealth, Béatrice Schaad Noble, a Swiss journalist who is getting her master’s in public health at the Harvard School of Public Health, explains how Switzerland approached universal health insurance coverage.
"Switzerland has gone through the same problems Massachusetts is facing now. Eleven years ago, pockets of resistance were strong. Some people deeply disliked being forced to buy coverage," she writes. "Today resistance has completely disappeared. Last March Swiss have even refused in a vote to shift to a single payer system."
On Running a Hospital, Beth Israel Deaconess CEO Paul Levy posts the latest report on central line infection rates. In the past he has challenged other hospitals to do the same.
"The overall quarterly trend is in the right direction, but as you can see ..., there is troublesome variation from time to time," he writes. "The up's and down's, I guess, are normal, but we all wish they stay down."
Friday, May 18, 2007
Holzman to lead state psychiatry group
Dr. Todd F. Holzman (left), a pediatric psychiatrist at Harvard Vanguard Medical Associates, has been named president-elect of the Massachusetts Psychiatric Society. He is also an instructor in psychiatry at Harvard Medical School.
Thursday, May 17, 2007
Surgery with a 90-day warranty
Geisinger Health System in central Pennsylvania is offering what amounts to a 90-day warranty on elective bypass surgery, according to a story in today's New York Times.
That makes Geisinger stand out as a group that has transformed the way it delivers care, Dr. Donald M. Berwick told the Times. A professor of pediatrics and healthcare policy at Harvard Medical School, he is the chief executive of the Institute for Healthcare Improvement in Cambridge, a national nonprofit organization whose goal is better patient care.
In almost no other field would consumers tolerate the frequency of error that is common in medicine, Berwick said, and Geisinger has managed to reduce the rate significantly. "Getting everything right is really, really hard," Berwick said.
Wednesday, May 16, 2007
Finding a quicker route to vaccines
Harvard microbiologist Dr. Darren E. Higgins (left) wants to help your immune system in a hurry and on the cheap, a story in today's New York Times says.
The 40-year-old associate professor of microbiology and molecular genetics at Harvard Medical School is a co-founder of Genocea, a Cambridge start-up working on a novel method of vaccine development. His goal is to find the quickest way to make inexpensive vaccines that fight numerous complex and aggressive viruses and bacteria, the story says.
Students in his lab are trying to determine which proteins stimulate an immune system response, the story says. The idea is to administer these proteins, or combinations of proteins, to people in order to prepare their immune systems to resist attacks by the likes of tuberculosis, HIV or malaria.
"We are mimicking the human body immune response," he told the Times.
Tuesday, May 15, 2007
Harvard scientists to discuss stem cell research with Charlie Rose
Harvard scientists Dr. George Daley (at left in photo) and Doug Melton (center) will discuss embryonic and adult stem cell research on the fifth installment of the Charlie Rose Science Series on PBS. It airs at 11 p.m. tomorrow on Channel 2.
The other guests are Larry Goldstein of the University of California at San Diego and Story Landis of the National Institute for Neurological Disorders and Stroke. Sir Paul Nurse, president of Rockefeller University, will be the co-host.
Doctors flocking to books, blogs, columns
Dr. Jerome Groopman (far left) and Dr. Atul Gawande are Harvard clinicians who also write for The New Yorker. Each doctor has a well-received new book. But they are only two of many doctors telling their stories or sharing their views on the pages of books, on blogs or in newspaper columns, a story in today's New York Times says.
The last six months alone have seen the publication of a half-dozen volumes of memoir and opinion by doctors at every stage of professional life, the story says, from newbie ("M.D.: A Four-Year Journey Through Medical School" by Shani Stein-Ratzker) to emeritus ("Galileo’s Gout: Science in an Age of Endarkenment" by Gerald Weissmann).
Friday, May 11, 2007
Hollywood smoking rating scripted by Harvard
Smoking will be weighed in movie ratings along with sex, violence and drug use, according to a new policy from a film industry panel influenced by the Harvard School of Public Health.
Before yesterday's announcement by the Motion Picture Association of America, only teenage smoking scenes were taken into account when its ratings board reviewed movies. Now all tobacco use will be evaluated, the MPAA said, taking into consideration whether the portrayals are historically accurate or otherwise appropriate to the film.
Smoking won't mean an automatic "R" rating, but new labels such as "glamorized smoking" or "pervasive smoking" will appear.
"The addition of tobacco smoking as a factor in determining a movie's rating marks an historic and important step by the film industry to protect children and adolescents from one of the most significant health concerns our nation and our children face today," HSPH dean Barry R. Bloom said in a statement.
Bloom, his Harvard colleague Jay Winsten, and Jonathan Samet of Johns Hopkins worked with the MPAA for more than a year to reduce the depiction of smoking in movies, bringing scientists to make presentions to the group.
"By placing smoking on a par with considerations of violence and sex, the Rating Board has acknowledged the public health dangers to children associated with glamorized images of a toxic and lethal addiction to tobacco," Bloom's statement said.
Thursday, May 10, 2007
Brandeis-led project targets lack of women leaders in medical schools
Relatively few women are department heads or full professors at the four medical schools in Massachusetts. And Dr. Karen Antman of the Boston University School of Medicine is the only female dean.
This lack of women in leadership roles in academic medicine is no longer a pipeline problem, now that medical schools admit equal numbers of men and women, says Dr. Linda Pololi of Brandeis University, who is leading a study of the issue.
The answer to women's persistent under-representation must lie elsewhere, she said in a recent interview. "Something in the system impedes their progress toward taking leadership positions."
Here are the percentages of women in leadership positions at Massachusetts medical schools and how they compare with all 125 medical schools nationwide, according to 2005 data from the Association of American Medical Colleges provided by Pololi:
Chairs of clinical science departments
Pololi, principal investigator of the National Initiative on Gender, Culture and Leadership in Medicine, brought deans from five US medical schools to a two-day retreat at Brandeis last week. The medical schools, which are demonstration sites for the project, are Tufts University, Duke University, George Washington University, the University of Minnesota and the University of New Mexico.
Project members are still trying to diagnose the problem before coming up with solutions, Dr. Michael Rosenblatt, dean of the Tufts school of medicine, said in an interview. The project will run five years and is supported by a $1.4 million grant from the Josiah Macy Jr. Foundation of New York.
"People might reflexively think that it's discrimination or a glass ceiling, and there may well be an element of that," he said. "It may be in some cases that women choose not even to apply for these positions or don't aspire to them because they are not appealing to women at that stage in life."
"It's an important problem," Rosenblatt said. "I hate to see that potential not being realized."
The five medical schools in the project will experiment with programs to deal with the issue. Those programs have not been defined yet, Rosenblatt said, but each school will report on its results and share what works with others.
Certain minority groups -- African-Americans, Hispanics, Native Americans, Pacific Islanders -- are also under-represented in academic medicine, but that does seem to reflect a pipeline problem at entry to medical school, Pololi and Rosenblatt said.
Psychiatrists, children and drug industry's role
Doctors maintain that payments from drug companies do not influence what they prescribe for patients, according to a story in today's New York Times.
But the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care, the story says. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.
Dr. Steven E. Hyman (left), the provost of Harvard University and former director of the National Institute of Mental Health, told the Times the growing use of atypicals in children is the most troubling example of this. The Times story was based on an analysis of records in Minnesota, which tracks drug company payments to doctors.
"There’s an irony that psychiatrists ask patients to have insights into themselves, but we don’t connect the wires in our own lives about how money is affecting our profession and putting our patients at risk," he said.
Tuesday, May 8, 2007
Cataloguing every species on earth
By Colin Nickerson, Globe Staff
Spurred by fears that thousands of animals, plants, and microbes will disappear from the planet before scientists can properly study them, a consortium of world-famous research institutions and funding foundations tomorrow will launch an effort to compile an enormous, computer-based "Encyclopedia of Life" to catalog every species known or found.
"For biologists, this is equivalent to the moon shot or mapping the human genome in terms of complexity and scope," said Gary Borisy, director of the Marine Biological Laboratory in Woods Hole, which along with Harvard University is among the top players in a project that will be overseen by biologists but undertaken mainly by software designers and computer engineers.
The aim of a project expected to take a decade at a cost of $100 million is to create a gigantic computer data base containing detailed descriptions of each of 1.8 million "named" species -- that is, forms of life that have been identified by scientists.
Some species, like Elephas maximus (the Asian elephant) or Lumbricus terrestris (a common earthworm), are familiar to everybody and well-studied by biologists. But hundreds of thousands of species -- from microscopic fungi, to bottom dwellers from the deepest seas, to obscure desert beetles -- have simply been preserved on slides or specimen pins, given a Latin name, and assigned a tentative place on the tree of life, then stashed in a sample drawer and all but forgotten.
In addition, biologists believe that untold millions of species -- mainly microorganisms, but also insects, flowers, trees, and even a few reptiles and mammals -- have never been noticed by humans, much less scientifically recorded.
The Encyclopedia of Life -- to be formally launched tomorrow in Washington, where it will be headquartered -- is envisioned as a computer-based, ever-expanding roster of all life forms that will give scientists an unprecedented means to help decide when they've encountered a new species. It should also provide an invaluable, publicly-accessible trove for everyone from bio-entrepreneurs to birdwatchers.
Sample demonstration pages of the polar bear show what the scientists hope to do. It offers pictures, maps, research and data on the molecular biology, genetics, reproduction diet of the polar bear.
The information can be accessed at the "novice" level, which says: "Polar bears inhabit Arctic sea ice, water, islands and continental coastlines." At "expert" level, it says: Polar bears occur in low numbers throughout their range and are most abundant in shallow water areas near shore or where current or upwellings increase biological productivity near ice areas associated with open water, polynyas or lead systems."
"It's really more of a communications project than a discovery project," said Edwards. "It's integrating information so that anyone and everyone can access it, from a frontline scientist to a high school teacher to a farmer trying to figure whether a certain worm in the soil is friend or foe."
And that's just fine with Wilson.
Material from the Associated Press was used in this report.
Monday, May 7, 2007
Mass. doctors favorable toward pay for performance
Leaders of Massachusetts primary care physician groups look favorably on pay-for-performance incentives, and practices that have the programs also adopt quality improvement plans, a survey by Harvard researchers shows.
Skepticism has greeted these programs because of concerns that they undermine professionalism, Dr. Eric C. Schneider of the Harvard School of Public Health said in an interview. He is a co-author of the Robert Wood Johnson Foundation-funded study in this month’s American Journal of Managed Care.
In pay-for-performance programs, a portion of insurers' payments to doctors is based on how well they meet national standards for care, such as managing diabetes or encouraging mammograms. Schneider and his co-authors wondered what physicians thought about performance pay as a way to improve quality.
"The financial situation for primary care physicians is pretty challenging right now and these incentives are coming at a time when they’ve been given other incentives that relate directly to having them reduce access to care, such as imaging, formularies for medications, and some other things," Schneider said. "I do think the clinical view is those are related not directly to quality but more to cost control, so these other incentives directed at improving quality align well with their mission."
Another reason pay-for-performance initiatives might be well received is that they pay bonuses rather than take away compensation, Schneider said.
The researchers surveyed leaders of 100 primary care group practices in Massachusetts in 2005. Pay-for-performance accounted for an average of 2.2 percent of a practice’s total revenue, the article said, which one-third of the practice leaders thought was financially important. Eighty-nine percent of the leaders said their groups had pay-for-performance incentives in at least one of their health plan contracts.
Dr. Kenneth Peelle, president of the Massachusetts Medical Society, said that since the survey was done, health plans have increased the amount of pay tied to performance. Blue Cross Blue Shield of Massachusetts, for example, said last year its performance bonus would be 10 to 13 percent.
"The problem we see is each of the health plans seems to come up with a different payment plan," said Peelle. "We look to government to put out some overall guidelines for this to work together."
CIMIT awards $5m to medical device researchers
Proposals to build new devices to help premature infants, to inject medicine without breaking the skin and to guide surgeons operating on the brain were among projects to win $5 million in grants from the Center for Integration of Medicine and Innovative Technology, the consortium announced today.
CIMIT, composed of Boston-area teaching hospitals and engineering schools, made 37 grants that range from $40,000 to $100,000. Twenty-two have military applications, acording to CIMIT, which receives support from the US Department of Defense as well as its members.
Dr. Riccardo Barbieri of Massachusetts General Hospital won a grant to develop a computational tool based on a premature infant's heartbeat to predict episodes when they stop breathing.
Mark Horenstein of Boston University will demonstate a way to inject medications through the skin using nanoparticles, leaving no wound behind.
Dr. Nobuyuki Nakajima of Brigham and Women's Hospital will work to improve how instruments can be navigated to diagnose and treat brain injury or disease.
"Our goal ... is to bring life-changing technology to patients as quickly as possible," Dr. John Parrish, CIMIT founder and director and Vietnam War battlefield surgeon, said in a statement. "We are especially aware of the needs of soldiers wounded on the battlefield."
Wednesday, May 2, 2007
Neurologists here for conference
Boston researchers are among neurologists and neuroscientists delivering more than 1,000 presentations and poster sessions at the annual meeting of the American Academy of Neurology at the Hynes Convention Center in Boston. The weeklong conference has drawn more than 10,000 people, the group said.
Local presenters include Dr. Miguel Hernan of the Harvard School of Public Health, who is presenting his study showing that depression may be an early symptom of Parkinson's disease.
Evan L. Thacker, also of the Harvard School of Public Health, was scheduled to describe research exploring how moderate to vigorous exercise might be associated with the risk of developing Parkinson's disease.
Dr. Jeffrey Ellenbogen of Harvard Medical School was slated to talk about his study's conclusion that sleep not only protects memories from outside interferences, but also helps strengthen them.
Tuesday, May 1, 2007
11 from area named to National Academy of Sciences
Eleven researchers from the Boston area are among 72 new members named today to the prestigious National Academy of Sciences, a private organization established by Congress in 1863 to advise the federal government.
Five are from MIT, four from Harvard and two from Brandeis. They are:
Tania A. Baker, Howard Hughes Medical Institute investigator and professor of biology, MIT
Friday, April 27, 2007
This week in Science
Two papers in Science, including one by Harvard researchers, were among four published yesterday in Science and Nature Genetics on genetic risk factors for developing diabetes. Alice Dembner describes them in today's Globe.
Reseachers from Massachusetts General Hospital, Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital are part of an international team reporting on a new mechanism involved in resistance to "smart" cancer drugs Iressa and Tarceva that target lung cancer cell growth.
Scientists have identified a new gene that helps regulate the body's clock and Giulio F. Draetta of Merck
A team that includes researchers from the CBR Institute for Biomedical Research and Harvard Medical School in Boston reveal how the influence of micro-RNAs, small RNA molecules that regulate gene expression, extends to the immune system.
On the blogs: high deductibles and hospitals
On WBUR's CommonHealth, Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program, asks if high-deductible insurance coverage is worse than being uninsured for patients but better for hospitals seeking payment for services.
"Forcing modest-income families to buy insurance policies with huge deductibles, co-payments and co-insurance may help hospitals, but leave patients even worse off than when they were uninsured," he writes.
Thursday, April 26, 2007
Genetic understanding of diabetes deepens
By Alice Dembner, Globe Staff
Four separate scientific teams, including one led by Harvard researchers, are today reporting progress toward unraveling the genetic basis of the most common form of diabetes.
They have identified three new genetic risk factors and confirmed five others that were discovered over the last few years. An additional risk factor identified by one group has not yet been confirmed by others.
Together, the genetic defects account for about 5 percent of the risk of getting the illness, said David Altshuler, associate professor of genetics and medicine at Harvard Medical School and a leader of one of the four teams that included the Broad Institute of Harvard and MIT.
"The picture that is emerging is of multiple genes, each with a modest effect" on diabetes, he said.
Overall, genetics account for about half the risk of getting type 2 diabetes, according to Altshuler. Environment and such behaviors as obesity and lack of exercise account for the remaining risk.
More than 20 million Americans now have type 2 diabetes and scientists estimate that about 54 million more are at risk of getting the illness. The disease harms the body's ability to control blood sugar and can lead to heart disease, blindness and early death.
"The pharmaceutical industry is absolutely salivating at all of these studies because they represent the best validation of a new drug target," said Dr. Francis Collins, director of the National Human Genome Research Institute and a leader of another of the teams. But Collins cautioned that it could be a decade before patients see any new drugs from the research.
The results were published today in the online editions of the journals Science and Nature Genetics.
They are all based on a new research technique called genome-wide association studies, in which scientists compare genetic samples from thousands of individuals with a specific illness to those without it. Differences between the two are examined as possible genetic causes of the disease.
Aronson, Rosenbaum honored for career achievements
Dr. Mark D. Aronson of Beth Israel Deaconess Medical Center and Dr. Jerrold F. Rosenbaum of Massachusetts General Hospital are being honored for liftime contributions to their fields.
Aronson has won the Society of General Internal Medicine's Career Achievement in Medical Education Award. He founded Beth Israel's hospital medicine program, incorporating it into the residency curriculum and into continuing education and graduate medical education at Harvard Medical School.
Rosenbaum, chief of psychiatry at MGH, has won the C. Charles Burlingame Award from the Institute of Living in Hartford. He specializes in treatment-resistant mood and anxiety disorders, focusing on drug treatments for those conditions.
Wednesday, April 25, 2007
More than a quarter of doctors paid by industry, survey shows
Lunch in the doctor's office courtesy of pharmaceutical company reps and payments to physicians who speak at conferences aren't new, but the proportion of physicians reporting that they get money from industry and how that varies by specialty may be important for efforts to control these relationships, according to an article in tomorrow's New England Journal of Medicine.
Researchers at the Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School conducted a national survey of 3,167 physicians and found that 94 percent had some kind of relationship with the pharmaceutical or medical device industries. The respondents reported receiving drug samples (78 percent), gifts of food (83 percent) and sports or cultural event tickets (7 percent). More than a third (35 percent) received reimbursement for continuing medical education or meeting expenses.
More than a quarter (28 percent) got paid for consulting, serving on an advisory board or speakers bureau, or enrolling patients in clinical trials. This surprised the authors more than the 94 percent of doctors with some sort of tie, which could have been as little as a mug or pen, Dr. David Blumenthal said.
"I figured that direct payments went pretty much to people who were academic or opinion leaders, but it seemed to be far more common," he said in an interview. "The fact that more than a quarter of physicians are actually getting direct monetary payments tells me this remains an important phenomenon in American medicine and that the rules and regulations put into effect have not eliminated it."
In 2002, the Pharmaceutical Research and Manufacturers of America, the industry's trade group, put in place voluntary guidelines limiting certain gifts. Leading physician groups have also adopted similar rules.
Pediatricians were less likely than internists to receive payments or reimbursements. Anesthesiologists didn't get samples, reimbursements or payments as often as family practitioners, internists or cardiologists.
Cardiologists were more than twice as likely to be paid by industry as family practitioners were, perhaps because they are recognized as the ones who set standards for prescribing widely used heart drugs, the authors suggested.
Where the physician practiced also made a difference, they found. Group practice doctors were six times as likely to get samples, three times as likely to receive gifts, and almost four times as likely to receive payments for professional services such as consulting than doctors in hospitals, clinics or staff-model HMOS. Male doctors and those with fewer Medicaid or uninsured patients also were more likely to receive payments.
"Specialties, organizations and practice leaders with an interest in reporting and managing physician-industry relationships may need to develop guidelines and recommendations that are specific to the context of each specialty and setting," the authors wrote.
Tuesday, April 24, 2007
Gene variants tied to progression of eye disease
Age-related macular degeneration is the most common cause of vision loss in people over 60, but only some of the people who have the early or intermediate stages of the eye disease develop its more serious form, losing so much of their central vision that they can no longer drive or read.
Researchers led by Dr. Johanna M. Seddon of Tufts-New England Medical Center report in tomorrow’s Journal of the American Medical Association that people with variations in two common genes have a two- to four-times higher risk of developing advanced AMD. When combined with smoking and obesity, already known risk factors for advanced AMD, the gene variations pushed the risk of advanced AMD 19 times higher.
"We have shown how genetic variations do add to progression," Seddon said in an interview about the clinical trial, which followed 1,466 people for about six years. "Genetic factors, smoking and obesity are all independent factors related to progression of AMD and they seem to be additive."
But Seddon and her co-authors, who include Sarah George and Bernard Rosner of Harvard, say it's too early to call for genetic screening. Many, but not all, people with the gene variations progress to advanced AMD, but so do some people without the gene variation.
They do recommend that people exercise, eat a healthy diet and not smoke, based on previous work implicating the same risk factors for cardiovascular disease in AMD. Seddon showed in 1994 that diet is linked to AMD, and in 1996 that smoking is related.
Dr. Bruce P. Rosenthal of Lighthouse International, a non-profit organization established to help people with vision loss, said the study will be valuable as researchers continue to seek the root causes of the disease.
"While we have known for many years that smoking and being overweight contributes to the risk of macular degeneration, the findings of a genetic link for the progression of macular degeneration from early or intermediate stages to advanced disease are indeed significant and will have a major impact on future study and possible treatment of AMD," he said in a statement.
Rosenthal was not involved in the study, which was funded by the National Eye Institute and other grants.
Angina drug helps with symptoms but doesn't reduce risk of further heart problems, study says
The anti-angina medication ranolazine safely eased chest pain in a large clinical trial led by Brigham and Women's Hospital researchers, but the drug did not make a significant difference in whether people with coronary artery disease had another heart attack or died, according to a report in tomorrow's Journal of the American Medical Association.
"It does not prolong life, but it provides important relief of symptoms," lead author Dr. David A. Morrow said in an interview.
One of the purposes of the randomized trial, which followed 6,560 patients for almost a year, was to answer questions about whether ranolazine could lead to heart problems, based on differences in heart rhythm noted in the electrocardiograms of people who took it.
The researchers found no difference in the number of heart arrhythmias reported in people who took ranolazine compared to people who took placebos.
In an editorial, Dr. L. Kristin Newby and Dr. Eric D. Peterson of Duke University Medical Center said beta-blockers and nitrates should still be the first drugs to turn to because ranolazine does not improve a patient's prognosis.
"Ranolazine may offer a back-up option for intensification of antianginal treatment if these first-line agents fail," they wrote.
Ranolazine, approved for marketing by the Food and Drug Administration in 2006, is sold as Ranexa by CV Therapeutics, which funded the trial.
Friday, April 20, 2007
This week in Science
This week's Science includes a special section on germ cells -- the reproductive cells of an organism.
George Q. Daley of Children's Hospital Boston, Brigham and Women's Hospital and the Harvard Stem Cell Institute asks whether the cup is half empty or half full for embryonic stem cells.
David C. Page of the Whitehead Institute and MIT considers the mysteries of sexual identity from the germ cell's perspective.
Alexander F. Schier of the Broad Institute of Harvard and MIT writes about the death and birth of RNAs during the maternal-zygotic transition.
Wednesday, April 18, 2007
Medical PR move
John Lacey leaves his post as associate director of public affairs for media relations at Harvard Medical School today to become director of communications at the Massachusetts Biotechnology Council on April 30. No replacement has been named for Lacey, who held the Harvard job for 7 years.
Tuesday, April 17, 2007
On the blogs: life-threatening or not, vaccine costs, calling RNA labs
But that doesn't mean they aren't.
"In the real world, evidence-based medicine often doesn't make a dime's worth of difference," he writes. "It doesn't matter to parents and it doesn't even matter to some of Flea's colleagues. This is especially true in the current climate of over-test, over-diagnose, over-treat, and over-admit."
On Kevin, M.D., Nashua pediatrician Dr. Kevin Pho posts a link to the American Academy of Pediatrics' concern about the cost of new vaccines Gardasil, against cervical cancer vaccine ($360), and RotaTeq, against diarrhea-causing rotavirus ($190).
Via Nature Network Boston, Alex Palazzo of Harvard Medical School and the Daily Transcript is putting out the word to 29 RNA labs in the Boston area to meet for a monthly informal data seminar to be called the Boston RNA Data Club. Something like the Boston Area Yeast Meeting at the Whitehead, Nature Network's Corie Lok notes.
Teaching doctors to teach patients about lifestyle
Two years ago, a group of doctors founded an organization with the goal of making lifestyle medicine -- how daily habits affect health -- a credentialed clinical specialty and a part of basic medical training, according to a story in today's New York Times. Now the group, the American College of Lifestyle Medicine, has a new publication, The American Journal of Lifestyle Medicine.
"We know lifestyle interventions can be very powerful," often more effective than drugs or surgery, said Dr. JoAnn Manson, a professor of epidemiology at Harvard’s School of Public Health and a member of the editorial board of the new journal. "But we need to provide the scientific evidence on how to incorporate that knowledge into practice."
Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a member of the lifestyle medicine college’s board of advisers, said primary caregivers should be trained in lifestyle medicine.
Teaching doctors to teach patients about lifestyle
Two years ago, a group of doctors founded an organization with the goal of making lifestyle medicine -- how daily habits affect health -- a credentialed clinical specialty and a part of basic medical training, according to a story in today's New York Times. Now the group, the American College of Lifestyle Medicine, has a new publication, The American Journal of Lifestyle Medicine.
"We know lifestyle interventions can be very powerful," often more effective than drugs or surgery, said Dr. JoAnn Manson, a professor of epidemiology at Harvard’s School of Public Health and a member of the editorial board of the new journal. "But we need to provide the scientific evidence on how to incorporate that knowledge into practice."
Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a member of the lifestyle medicine college’s board of advisers, said primary caregivers should be trained in lifestyle medicine.
Most doctors see religion as beneficial, study says
Most physicians in the United States believe that religion and spirituality have a positive effect on patients’ health, according to a survey published last week in The Archives of Internal Medicine, and that God at least occasionally intervenes on their behalf, a story in today's New York Times says.
Dr. Jerome E. Groopman, a professor of medicine at Harvard who was not involved in the study, told the Times he was surprised by how many doctors believe in divine intervention.
"The most striking finding is the perception that God is micromanaging clinical outcomes at the bedside," said Groopman, the author of the new book "How Doctors Think" (Houghton Mifflin).
Monday, April 16, 2007
Harvard, Michigan team share cancer research honor
Scientists from Harvard Medical School and Brigham and Women's Hospital have been honored with collaborators from the University of Michigan for their discoveries about the genetics of prostate cancer.
The American Association for Cancer Research chose the team from about 30 applicants, the organization said. The researchers will share a prize of $50,000.
The Harvard members are Dr. Mark A. Rubin, Charles Lee, Dr. Sven Perner and Francesca Demichelis.
New genetic risk factors for Crohn's disease identified
Researchers from Massachusetts General Hospital and the Broad Institute of Harvard and MIT are part of a team that has discovered new genetic risk factors for Crohn's disease.
Reporting in the online Nature Genetics, they identify new genes that are involved in the immune system's response to bacteria. Crohn's disease, which affects about half a million Americans, is a chronic inflammatory bowel disease.
The authors include John D. Rioux, who has moved from the Broad to the Universite de Montreal, Ramnik J. Xavier, Alan Huett and Petric Kuballa of MGH, Todd Green of the Broad, and Mark J. Daly of the Broad and MGH.
Eric Lander honored for work in genomics
Eric S. Lander (left), founding director of the Broad Institute of Harvard and MIT and a leader of the Human Genome Project, has won the 2007 Society for Biomolecular Sciences Achievement Award for his study of genes and how they function in health and disease.
He will receive the award, which carries a $5,000 honorarium, and present a talk called "Beyond the Human Genome" at this week's SBS meeting in Montreal. Past recipients have included Stuart L. Schreiber, also of the Broad, in 2004.
On the blogs: dogs and handwashing, dumb movie science
On Running a Hospital, Paul Levy says Beth Israel Deaconess Medical Center has joined Boston Children’s Hospital, Tufts-New England Medical Center and MGH in offering a pet therapy program. Trained dogs and volunteers visit patients who give written consent. A dozen comments include praise as well as concern about allergies, infection and fears, plus Levy's replies with hospital policies on screening for the therapy dogs.
In the next post down, Levy vents frustration over hand hygiene stats at the hospital that show some improvement but not enough.
"Trust me, the irony of putting these two posts next to each other was not lost on me," he writes.
On Nature Network Boston, Harvard virology graduate student Anna Kushnir lists her favorite dumb movie science moments and invites more.
"When I think about the fact that I have spent 23/28ths of my life in school, I have difficulty controlling my gag reflex," she writes. "However, the (exceedingly) rare swells of intellectual superiority I experience when watching really (really) dumb movies make those 23 years worth it."
Friday, April 13, 2007
This week in PLoS and JCI
Harvard researchers including Dr. Todd R. Golub report in PLoS Medicine, the online Public Library of Science journal, that, using a molecular biology technique called microarray expression profiling (an example of a detail is at left), they were able to identify compounds that could target genes involved in Ewing sarcoma, the second most common childhood cancer of bone and soft tissue.
In the Journal of Clinical Investigation, Dr. Alan D'Andrea and colleagues at Dana-Farber Cancer Institute show a new therapeutic target for the treatment of Fanconi anemia, which carries the risk of cancer and bone-marrow failure.
Also in the Journal of Clinical Investigation, Dr. Rong Tian and colleagues from Brigham and Women's Hospital report that in mice, mutations in a protein that triggers cells to generate more energy are associated with heart failure.
Thursday, April 12, 2007
Harvard team identifies protein from a dinosaur
By Colin Nickerson, Globe Staff
Scientists at Harvard Medical School have for the first time isolated and identified protein from a dinosaur -- a Tyrannosaurus rex that perished in Montana 68 million years ago and was partly preserved under tons of sandstone. Some of the protein identified in the Cretaceous era predator match that of modern-day chickens, the research revealed.
The findings, being published tomorrow in the journal Science, upset the long-held assumption that protein and other basic materials of life could not possibly survive in detectable amounts for more than a few hundred thousand years. They also raise the possibility that scientists might eventually recover DNA from prehistoric beasts, allowing for even more sophisticated analyses of ancient organisms and the processes of evolution.
"People are going to be looking differently at prehistoric bones because now we see they may carry tissue and information that nobody believed could still exist," said Mary H. Schweitzer, a paleontologist at North Carolina State University and a coauthor of both articles.
In all, scientists at Harvard were able to isolate seven tiny strips of collagen protein from soft tissue found in the thigh bone of a Tyrannosaurus rex recovered earlier in the decade from beneath 60 feet of sandstone ledge in Montana's Hell Creek formation.
"At the very least, this breakthrough shows we can look at [protein] sequences that are many, many millions of years old," said John M. Asara, director of the mass spectrometry core facility at Beth Israel Deaconess Medical Center and one of the authors. "That's a first."
Paleontologists not involved in the the T.rex protein research said it represented an astonishing piece of scientific sleuthwork.
"This research might be creating a whole new field of molecular paleontology," said Lawrence M. Witmer, a paleontologist at Ohio University. "This research has opened a door we didn't even suspect was there."
But some scientists doubted whether the experiment will have much practical effect on the study of prehistoric life. Many seemed to believe that the surviving soft tissue found in the Montana T. rex was a fluke -- and that there will never be enough material for the sort of fullbore scientific scrutiny that would allow large conclusions to be drawn about the animals.
"If there were regular opportunities for this kind of matching and comparison, [these] techniques might add important evidence to genuine conundrums -- outstanding questions about the origin and relationships of various vertebrate groups," said Farish A. Jenkins Jr., a Harvard professor of zoology and internationally-recognized expert in vertebrate paleontology. "But the reality remains that finding soft tissues preserved with actual soft tissue structure intact is outside the realm of common expectation, so the applicability of their techniques is very limited."
Similar skepticism was expressed by Mark A. Norell, a paleontologist with the American Museum of Natural History: "This is a very cool experiment. But I don't think curators are going to start grinding up their fossil bones to obtain the really minuscule bits of protein that might be available. There probably just isn't going to be enough of this material" to conduct major research.
"Science requires replication," he said. "You need thousands of comparisons. Not dozens."
Still, buzz surrounded the the mind-boggling findings that protein dating back tens of millions of years can be identified at all. Until now, the oldest positively-identified proteins were recovered from the bones of a wooly mammoth reckoned to be a couple hundred thousand years old, according to Schweitzer. DNA has been taken from the 38,000 year-old bones of a Neanderthal, believed to be a prehistoric relative of modern humans.
Several of the T. rex protein snippets captured at Harvard matched sequences in modern chickens, which the authors of the Science articles say lends more credence to the increasingly accepted view among paleontologists that birds are descended from dinosaurs. "We've added molecular evidence to evidence based on the architecture of bones," said Asara.
The research marked an unusual collaboration between field paleontologists -- famous for rough expeditions to remote places in search of rare fossils -- and medical researchers more familiar with finicky lab equipment and computer readouts than sharp pickaxes, smelly sleeping bags, and battered sifting trays.
Lewis Cantley, professor of systems biology at Harvard Medical School and one of the authors, said the techniques used in sequencing the dinosaur protein from minuscule amounts of material could be useful for researchers who need to find the tiny molecular changes that lead to cancer. "We're creating a cross-discipline of biomedical researchers and paleontologists."
The T. rex femur at the center of the research was found in 2003 by John Horner, a paleontologist with Montana's Museum of the Rockies and reknowned fossil hunter. Schweitzer, analyzing the bone, found evidence that the big bone still contained actual bone and vascular tissue. In most preserved dinosaur remains, minerals have replaced all organic matter, the process known as fossilization.
Scientists were quick to discount any suggestion that the sequencing of protein from a T. rex might represent a toddling first step toward cloning dinousaurs, as in Michael Crichton's novel Jurassic Park and the movies that followed. Cloning would require DNA, which deteriorates more rapidly than protein. Collagen, the sort isolated from the t. rex, is a notably durable protein.
"The idea of cloning prehistoric animals from genetic materials remains science fiction," said Ohio University's Witmer. "But keep in mind, until very, very recently, just the idea of obtaining any genetic material at all from animals so old was dismissed as pure science fiction."
HHMI opens competition for 50 scientists and $600m
At at time when federal funding for scientific research is harder to come by, the Howard Hughes Medical Institute is opening up a competition today to select 50 new investigators who will share $600 million for biomedical research.
For the first time scientists can apply directly to become HHMI investigators rather than needing their institutions to nominate them.
The researchers must belong to eligible institutions. In Massachusetts, 10 qualify: Boston Biomedical Research Institute, Boston College, Boston University, Brandeis University, Harvard Medical School and associated hospitals, Harvard University, the Marine Biological Laboratory, MIT, Tufts University School of Medicine, and the University of Massachusetts Medical School.
The competition comes at a time when funding from the National Institutes of Health, which is based on individual grant proposals, is declining, when inflation is taken into account. Established researchers worry about sustaining their work while younger investigators are taking longer to win approval for their first grant applications.
HHMI, which has spent $8.3 billion over 20 years on biomedical research and science education, won’t be filling that gap, senior scientific officer Dr. Josephine Briggs said in an interview yesterday.
"Our resources are very sizable, but they do not in any way compensate for the problem of the shrinking NIH budget," she said. "The support that Hughes is able to offer is something that the scientific community will of course welcome with delight, but at the same time all of us hope we can see a reversal in the decline in federal funding."
HHMI holds competitions every three or four years. This time, it's looking for people in the earlier stages of their careers, Briggs said.
HHMI investigators receive initial five-year appointments that come with support for their own salaries as well as flexible budgets they can use to pay for personnel and some equipment. Appointments can be renewed.
To be eligible to apply, a candidate must hold a Ph.D., M.D. or equivalent degree; have a tenured or tenure-track position as assistant professor or higher at one of about 200 eligible host institutions; and be the principal investigator on one or more active, national, peer-reviewed research grants at least three years long, such as an NIH R01 award.
The deadline for applications is June 13; expert panels will convene to review them in January, and decisions will be made in March.
"We expect a very hefty Boston response."
Wednesday, April 11, 2007
How two doctors think
Slate's Book Club features a conversation between Dr. Jerome Groopman, professor of medicine at Harvard Medical School and author of "How Doctors Think," and Dr. Darshak Sanghavi, an assistant professor of pediatrics at the University of Massachusetts Medical School who met Groopman when he was a fellow at Children's Hospital Boston.
"Algorithms and treatment guidelines are based on prototypes," Groopman writes. "They are not substitutes for individual thinking. And they break down when cases are atypical or complex."
Sanghavi, an occasional contributor to the Globe, summarizes their different points of view:
"This ultimately returns to our disagreement about standardizing medical care," he writes. "You feel it often constricts good medical practice; I think we don't have enough of it."
Tuesday, April 10, 2007
Canadian medical grads lured to US
When Montrealer Dr. Glenn Saxe first got to Boston to begin his residency in psychiatry at Harvard Medical School, he thought he'd return home when his training was over, a story in today's Toronto Star says. But like so many of his Canadian counterparts – 12,040 Canadian-educated physicians live in the US – Saxe decided to stay once his training was complete.
"As I spent time in Boston and Harvard, there were more and more opportunities. More interesting and important research to get involved in," said Saxe, who is a specialist in post-traumatic stress disorder in children. "I met an American woman, married her and decided this was a place where I could really contribute."
One in nine Canadian-educated doctors who graduated last year is taking care of American patients, according to a new study in the Canadian Medical Association Journal.
Friday, April 6, 2007
This week in Science
This week in Science Express, researchers Gohta Goshima, Roy Wollman,
In Science, Young-Sam Lee and Erin K. O'Shea of Harvard take a closer look at inositol pyrophosphates, signaling molecules involved in a number of cellular processes, from gene expression to stress responses.
Tuesday, April 3, 2007
Harvard creates Developmental and Regenerative Biology Department
By Gareth Cook, Globe Staff
Harvard University's governing body has approved a new Department of Developmental and Regenerative Biology, the first academic department in the university’s 371-year history to be based in more than one of the university’s schools.
The new department will bring together 13 to 16 researchers from the Faculty of Arts and Sciences and Harvard Medical School. It will be co-chaired by biologist Doug Melton, the Cabot Professor of the Natural Sciences, and David Scadden, Gerald and Darlene Jordan Professor of Medicine at Harvard Medical School and Massachusetts General Hospital. Melton and Scadden are also the co-directors of the Harvard Stem Cell Institute, which was founded in 2004.
The decision by the Harvard Corporation is a response to a critical university report that called for better coordination of interdisciplinary research.
HSPH takes anti-smoking campaign to Hollywood
The Harvard School of Public Health is urging the Motion Picture Association of America to eliminate the depiction of tobacco smoking from films seen by children and youths.
HSPH dean Barry R. Bloom, Dr. Jonathan M. Samet of Johns Hopkins, and HSPH associate dean Jay A. Winsten delivered a scientific briefing in February.
"We know movies are only one of the determinants of smoking in youths, and I don’t want to hang the whole problem on the motion picture industry. But we know you can make a real difference," Bloom told the MPAA. "The glamorization of smoking in films, even when the bad guys smoke, has impact. And even normalization of smoking in films has impact."
Feldman leaving as leader of Worcester health center
Zoila Torres Feldman, an ardent advocate for expanding access to high-quality health care, is leaving as chief executive officer of Great Brook Valley Health Center in Worcester after 26 years.
Feldman, 62, said her Oct. 1 departure is "absolutely not" a retirement. She has accepted no specific position but said she is passionate about addressing the ethnic and racial disparities that persist in health care.
"There are too many challenges in health care I’d like to participate in," she said in an interview. "I’d like to do some new things."
Her influence has been felt beyond Worcester, where the health center grew from an apartment in a housing complex to a free-standing clinic with an annual budget of $23 million and 140,000 patients a year. Another health center opened in Framingham last year, despite anti-immigrant opposition.
Feldman, who lives in Newton, is a native of Ecuador and a graduate of Boston University and the Harvard School of Public Health. She worked as a nurse for 12 years at Tufts-New England Medical Center.
"I think there is no more talented and respected community health leader in the commonwealth than Zoila," Andrew Dreyfus, executive vice president of health care services at Blue Cross Blue Shield of Massachusetts, said in an interview. "Her center was a kind of magnet for innovation in community health delivery. She was always a thought leader in the kind of public policy issues that surround the community health movement."
Monday, April 2, 2007
Public health measures slowed 1918 flu pandemic, study finds
Quickly closing schools, theaters and churches reduced deaths early in the deadly 1918 flu pandemic, researchers report in today's online Proceedings of the National Academy of Sciences.
Measures taken by different American cities were compared to see whether they were associated with reduced transmission of the flu virus, which is spread by coughing or sneezing. The first US cases of flu were reported in Philadelphia on Sept. 17, 1918, but city officials still allowed a a parade on Sept. 28 and public gatherings were not banned until Oct. 3, when cases were overwhelming the health system.
In St. Louis, public health authorities closed schools, theaters and churches two days after their first cases on Oct. 5, and that city experienced a smaller epidemic, with half the number of deaths at its peak.
"Looking back at the comparison between cities in 1918, there were enormous variations in the severity of the pandemic in different cities and those variations seem to be closely tied to the aggressiveness and promptness with which different cities put in place a set of interventions to try to block transmission," co-author Marc Lipsitch, professor of epidemiology at the Harvard School of Public Health, said in an interview.
Once those interventions were relaxed, the death rates among different cites became the same. Temporary measures were still valuable, Lipsitch said, because they reduced the stress on society and on the healthcare system by buying time at the peak of the epidemic.
"This gives support to the notion, which is now federal policy, that when facing the next pandemic communities should try as early as possible to implement a set of measures similar to this if the pandemic is severe," Lipsitch said.
Friday, March 30, 2007
Harvard leads U.S. News medical school rankings
Harvard Medical School, is again the top medical school in the United States, according to the annual rankings compiled by U.S. News & World Report. Harvard has led the rankings since 1990, when they began.
Johns Hopkins, University of Pennsylvania, Washington University in St. Louis and University of California -- San Francisco followed in the top five.
Boston University ranked 34th, Tufts University was 47th and the University of Massachusetts came in 49th out of 125 U.S. medical schools.
The standings were based on eight measures, including surveys of medical school deans and residency program directors, as well as 2006 research funding from the National Institutes of Health. Harvard received $1.17 billion from NIH that year, BU pulled in $170 million, UMass had $118 million and Tufts drew $61 million, according to U.S. News.
UMass Medical School's primary care education program ranked 11th. The University of Washington led that category.
Thursday, March 29, 2007
On the blogs: healthcare haiku, CRNA salaries
On WBUR's CommonHealth, Nancy Turnbull of the Harvard School of Public Health tries her hand at haiku to muse about the state's new healthcare law.
Here's how she starts:
Health reform is hard.
So far one response is also in verse. It might be a haiku, too, but it's been a long time since White Coat Notes was in poetry class.
Kevin, M.D.'s link to a Student Doctor Network item about certified registered nurse anesthetists sparked a bit of a spat about training requirements for registered nurses. The SDN post said CRNAs make 224 percent as much as RNs and 156 percent as much as advance practice nurses.
Wednesday, March 28, 2007
Egg donation debate should move from payment to safety, HBS author writes
By Elizabeth Cooney, Globe Correspondent
Women who donate eggs for use in stem cell research become part of two debates: One concerns the use of embryos restricted by federal rules and rejected by some on religious grounds; and the other centers on whether women should be paid, as they are when they provide eggs for use in in vitro fertilization.
Debora Spar, a professor of business administration at Harvard Business School, contends that the debate shouldn't be about paying women for egg donation -- sometimes up to $50,000 -- but rather should focus on the health risks for the women.
Writing in tomorrow's New England Journal of Medicine, she asks whether women can give fully informed consent when there are few long-term studies of the drugs they are given to stimulate egg production and no federal guidelines governing egg donation, or collecting data about it, as there are for organ donation and other medical procedures.
"Certainly, egg donors deserve at least the same levels of information and protection," she writes. "We need to consider the health risks and ways of identifying and mitigating them."
On the question of payment, Spar said in an interview that she applies market principles to egg donation, as she did for reproductive medicine in her book "The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception."
That's more useful than making policies based on emotional, ideological or religious grounds, she said.
"Paying women money to give eggs for one purpose and not the other when the processes are absolutely identical is bad public policy," she said. "I don't have a personal agenda or any skin in the game. The practical side of me is saying this is nuts. This is not a policy that makes sense."
In the NEJM perspective piece she says the issue of payment will have to be resolved to ensure a supply of eggs for stem cell research, based on what has happened in countries that restrict payment for eggs.
"At a minimum we have to clarify the situation," she said. "We need a fresh debate on egg donation and a new set of policies."
Judy Norsigian, executive director of Our Bodies Ourselves and a women's health advocate, said in an interview that the benefits to science are too few and premature to be justified by risks known and unknown to women donating eggs.
"Hopefully, this new attention to the risks of egg extraction will result in research that should have been done long ago and that will enable women to provide true informed consent regardless of the reason they will be providing eggs," she said.
Treatment in doctors' offices works for opioid addiction, CHA study finds
People addicted to opioids such as methadone or oxycodone can be treated in their primary care doctor's office as safely and effectively as at specialized clinics, authors from Cambridge Health Alliance and Harvard Medical School report in the Annals of Family Medicine.
Dr. Ira L. Mintzer and his colleagues studied 99 patients who received the drug buprenorphine-naloxone to treat their opioid dependence at two urban primary care practices: one in a hospital clinic and the other in a neighborhood health center. After six months 54 percent of patients were sober.
Where the patients received their treatment made no significant difference in sobriety, the authors said.
"We hope that our findings will encourage other primary care physicians to consider providing this efficacious form of care," they wrote.
Himmelstein's healthcare law winners and losers
On WBUR's CommonHealth, Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program, lists winners and losers in the first year of the state's new healthcare law.
His winners: health insurance firms, very poor citizens, hospitals that serve few of the uninsured and "politicians who are posing as innovative leaders."
His losers: uninsured immigrants, safety net hospitals and clinics, low-income patients, and "the American public who are once again being taken down a health reform blind alley."
Monday, March 26, 2007
Aspirin linked to lower risk of death in women, but study authors urge caution
Women who regularly took low doses of aspirin had a lower risk of death from all causes, but particularly heart disease and cancer, Harvard researchers report in today's Archives of Internal Medicine.
But it's still too soon to recommend aspirin for the general prevention of disease, the lead author said.
"Women should not take this study, or any study, thus far as a license to take aspirin without any supervision," Dr. Andrew T. Chan of Massachusetts General Hospital said in an interview. "Women need to discuss with their physicians whether it makes sense for them, get a sense of what their risk is for cancer or cardiovascular disease, and strategize with them how to prevent the risk of disease through other means."
Chan and his colleagues looked at 24 years of data from nearly 80,000 healthy women enrolled in the observational Nurses Health Study. Women who said they used aspirin had a 38 percent lower risk of dying from cardiovascular disease and a 12 percent lower risk of dying from cancer. Their overall risk of death was 25 percent lower than women who never took aspirin regularly.
The reduction in cardiovascular disease became apparent after five years and in cancer after 10 years.
The findings conflict with another large study of women and aspirin use called the Women's Health Study. That clinical trial, in which 40,000 women randomly received aspirin or placebo, concluded that aspirin had no effect on mortality, from cardiovascular disease or other causes.
In an editorial, Dr. John A. Baron of Dartmouth Medical School says the nurses study may not have been able to account for the differences between aspirin users and non-users, suggesting women who decide to take aspirin may have better health in the first place.
"These new findings by Chan et al cannot overcome the accumulated evidence that aspirin is not particularly effective for the primary prevention of death from cardiovascular disease in women," he wrote.
Chan responded that he and his co-authors were able to account for health differences among the women in the nurses study because they had detailed information on risk factors. They found that women who were older and had more risk factors for cardiovascular disease were the ones who benefited the most from low to moderate aspirin use, defined as 1 to 14 325-milligram tablets per week.
Higher doses of aspirin have been linked in many studies to gastrointestinal bleeding, the authors noted.
The authors say their study confirms the importance of common mechanisms in both cancer and heart disease, such as inflammation. Aspirin is an anti-inflammatory and inflammation has been implicated in the formation of plaque that blocks arteries as well as in the transformation of normal tissue into cancer.
Proven ways to lower risk of disease are eating a healthy diet, maintaining a good body weight and exercising, Chan said.
"We know those modifications don't have risks," he said.
Contrast agent may shed light on breast cancer diagnosis
Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School are reporting preliminary success with a new way to screen for breast cancer that one day might supplement mammography, according to the American Chemical Society.
Dr. John Frangioni and researchers in his lab have developed a way to make a contrast agent that after being injected into the bloodstream binds to a particular calcium salt called hydroxyapatite.
That salt is found in malignant micro-calcifications in the breast, but not in benign ones, according to an ACS statement. The contrast agents are designed to be used with optical tomography, an imaging method that sends near-infrared light through the body. Frangioni said it would likely be a few years before the compound is tested in human trials.
Kumar R. Bhushan, a postdoctoral fellow in Frangioni's lab, is scheduled to present the details today at the ACS meeting in Chicago.
Friday, March 23, 2007
Top scientists gather for metastasis meeting
Cancer researchers from Boston and around the world have gathered in Houston for a symposium today and tomorrow to talk about metastasis -- how cancer spreads -- and to honor Dr. Isaiah J. Fidler, the scientist who confirmed a 100-year-old theory of how cancer kills.
Speakers at the symposium include Dr. M. Judah Folkman of Children's Hospital Boston and Harvard Medical School, Robert Weinberg of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology, Dr. Harold Dvorak of Beth Israel Deaconess Medical Center and Harvard, and Richard Hynes of Howard Hughes Medical Institute and MIT.
Fidler, whose recent research focuses on prostate and pancreatic cancer, is stepping down as chair of cancer biology at The University of Texas M. D. Anderson Cancer Center in September.
Stem cell summit planned for the fall
The Harvard Stem Cell Institute, along with two other groups, just announced that it will put on a “Stem Cell Summit” in the fall to bring together leaders from the worlds of science, business, public policy, ethics, and patient advocacy. The summit is scheduled for October 2-3, and will be held in Boston.
Collaborating on the summit with Harvard will be the Genetics Policy Institute, a stem cell research advocacy organization, and the Burrill Life Sciences Media Group, which organizes life science conferences.
For more information, contact Bernard Siegel, firstname.lastname@example.org.
- GARETH COOK
Harvard scientist to lead Stanford's Bio-X program
Harvard neurobiologist Carla Shatz will move to Stanford this summer to lead the university's Bio-X program, a bioscience effort that promotes collaborations between wide-ranging fields of scientists, the San Jose Mercury News reported this week.
The Stanford Report, quoting a Harvard alumni publication, said that in 1976 Shatz became the first woman to receive a doctorate in neurobiology from Harvard, and in 2000, the first woman to chair Harvard's neurobiology department and the second woman in the history of Harvard Medical School to chair a basic science department.
Thursday, March 22, 2007
Boston oncologist picked to lead Fox Chase
Dr. Michael V. Seiden, a leading cancer clinician and researcher, is leaving Boston to become president and CEO of Fox Chase Cancer Center in Philadelphia, the center announced today.
Seiden, 48, is head of the gynecological cancer program at the Dana-Farber/Harvard Cancer Center and chief of clinical research in cancer medicine at Massachusetts General Hospital. An associate professor of medicine at Harvard, his research focuses on ovarian cancer tumor biology. He is the physician coordinator of the cancer stem cell project at the Dana-Farber/Harvard Cancer Center.
On June 1 he will succeed Dr. Robert C. Young, 67, who is retiring from Fox Chase, which treats about 6,500 new patients a year and employs about 2,500 people.
Seiden is a graduate of Oberlin College and earned his M.D. and Ph.D. at Washington University in St. Louis. He completed his internship and residency at Mass. General, was a fellow in medicine at Harvard, did a three-year clinical fellowship in medical oncology at Dana-Farber Cancer Institute and was a postdoctoral fellow in molecular pathology at Brigham and Women's Hospital.
Wednesday, March 21, 2007
Firefighters' heart attack risk rises sharply on calls
By Elizabeth Cooney, Globe Correspondent
Heart disease has long been known to be the leading cause of death among firefighters, but a new study in tomorrow's New England Journal of Medicine reports that putting out fires raises a firefighter's risk of having a heart attack up to 100 times more than doing other, non-emergency duties.
Dr. Stefanos N. Kales of Cambridge Health Alliance and Harvard School of Public Healthled the study that looked at the types of tasks firefighters did -- responding to a fire, putting it out, returning from a call, training, etc. -- to see how these tasks were associated with death. They reviewed data on deaths from 1994 through 2004, excluding the 344 firefighters who died from the Sept. 11 terrorist attacks.
"This provides the strongest evidence to date that specific firefighting duties can precipitate coronary events," Kales said.
Firefighters don't have a higher risk of heart disease compared to the general population, but the sudden exertion of their work can trigger a heart attack in the same way shoveling snow can lead to a heart attack in someone else.
Firefighters may begin their careers in better shape than others, but as they grow older they may acquire risk factors, such as high blood pressure and cholesterol as well as weight gain.
"The implications of this study are clear," Dr. Linda Rosenstock and Dr. Jorn Olsen of UCLA write in an editorial. "Modifiable risk factors, whether or not they are related to occupation, should be aggressively addressed."
About 70 percent of fire departments don't have programs to promote fitness, according to the National Fire Protection Association.
"One of the issues for fire services is coming up with the funding to have medical evaluations" and fitness programs, said Rita Fahy, manager of fire databases and systems for the NFPA.
"It's the job, but the job's interaction with a person's underlying status," Kales said. "We have to make sure we are doing everything we can so risk factors are addressed sooner. Because the job is so dangerous, it needs to be career-long."
Tuesday, March 20, 2007
Biomedical research crisis questioned
Research scientists are feeling financial pain that is largely self-inflicted, a BusinessWeek story says.
The National Institutes of Health budget doubled over a five-year period ending in 2003, leading to new projects, lab buildings and equipment. That was followed by years of flat funding that couldn't sustain the larger scientific enterprise, the story says.
Kevin Casey senior director of federal and state relations at Harvard suggests that a steady 10 percent growth might have been better, the story says.
How cigarettes' image changed from sexy to deadly
Allan M. Brandt, a medical historian at Harvard, contends that recognizing the dangers of cigarettes resulted from an intellectual process that took the better part of the 20th century. His book, "The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America," is described in today's New York Times.
Monday, March 19, 2007
Shrinking NIH budget hurts cancer research, Harvard scientist tells Congress
It's dangerous to cut funds for basic research into new cancer therapies just as a tsunami of baby boomers in their cancer-prone years is about to hit, Harvard scientist Joan Brugge told a US Senate appropriations committee today.
She spoke as part of a consortium of nine academic institutions fighting for more funding.
"There's going to be a huge impact in terms of human suffering," she said in an interview. "It's taken a while to understand this complex disease, but now we have a blueprint for how to develop therapies. Now is not the time to retreat."
Every basic science department at Harvard Medical School had at least two or three faculty members whose grants were not funded, she said. Nationwide all grant amounts were cut by 24 percent to 29 percent in 2006.
Read Brugge's testimony below.
First, let me thank Chairman Harkin, ranking member Specter, and members of the committee for this opportunity to report to you some remarkable advances that have occurred in biomedical research because of your strong support for NIH. I hope that I can convey as well my personal excitement for the incredible potential still to be realized in my own field of cancer research. Unfortunately, this enthusiasm is dampened by profound concerns that the four years of flat funding has compromised significantly our ability to fully realize this potential.
When I was a sophomore math major at Northwestern University, my sister was diagnosed with a malignant brain tumor. This event and her subsequent death redirected me towards a career in cancer research. Most of my career has been spent in universities and medical schools. However, for five years before I came to Harvard Medical School, I served as the Scientific Director of a biotechnology company focused on cancer and other diseases. My industry experience significantly shaped my understanding of issues critical to the translation of scientific discoveries into therapies for patients. It taught me among other things, that though the path to treatment can be arduous, today the path between basic discovery and successful drugs also can be remarkably short.
The early 70’s, when I entered cancer research, was a heady time in science. Many of us expected, based in part on the success of the polio vaccine and the Congressionally mandated War on Cancer, that we would soon have a cure for this horrible disease. However, it soon became evident that cancer, unlike polio, is not a single disease with a single cause. There are hundreds of different forms and, indeed, tumors from individual cancer patients carry unique sets of genetic changes. This unexpected complexity – unique to cancer - precluded rapid development of a single vaccine or simple cure.
Though we certainly underestimated the complexity of cancer, the Congressional investment in cancer research is now beginning to pay off. We have made enormous progress in understanding the cause of this disease and its molecular underpinnings. This fundamental information has led to revolutionary approaches to treatment, aimed specifically at the unique vulnerabilities of specific tumors; we now know how to target a tumor’s genetic or molecular Achilles’ heel. In addition, new imaging modalities and biomarkers provide the potential to identify tumors at early stages when treatments are most effective.
Today, I feel a new confidence that we are poised to make more rapid progress in developing effective and less toxic treatments for the myriad different cancers. This confidence is based on initial evidence of success. We now have multiple examples of effective treatments that target the molecular alterations of specific subsets of tumors (such as Tarceva for a subset of lung tumors, Gleevec for chronic myelogenous leukemia, and Tykerb, approved just a week ago for treatment of certain breast cancers). These successes provide a blueprint for the development of treatments for many more types of cancer.
Cancer treatment in the future will involve a molecular diagnosis of each tumor, followed by customized therapies. Already this is being done for breast cancer, in which tumor tissues are probed for several markers that predict which tumors will respond to specific drugs (like Tykerb, Herceptin, or estrogen antagonists) and which will not. The results are dramatic, adding years to the lives of many patients with the most aggressive forms of breast cancer, and sparing patients of treatments that offer no promise of efficacy. For the first time, we are seeing a decrease in deaths associated with cancer. The tip of the iceberg is visible, underneath lies the foundation for a rapid pace of breakthroughs in cancer detection and treatment based on the research investment in the past.
We cannot afford to stand still—the demographics are against us. There is an impending increase in cancer due to the baby boomers aging into their cancer-prone years, which has been referred to as an impending tsunami. You are all keenly aware of the ramifications for government of Medicare entitlements associated with this surge in cancer. But unlike a real tsunami, which comes unexpectedly with no time for preparation, we are well aware of this impending crisis. And We know that the Congressional investment in basic and cancer-focused research has positioned the cancer research community to make more rapid progress in translating basic discoveries into the diagnosis, treatment, and eventually, prevention of cancer. We owe it to the public to capitalize on these investments; failure to maintain the pace of advancement towards reducing the suffering of cancer is not an option the American people should support or will support. We are all in this together.
This brings me to my profound concerns regarding the state of NIH funding today. Four years of flat funding have had a devastating impact on the trajectory of cancer research. We are losing the momentum and the dedicated careers that were fueled by the previous federal investments. We are now damaging the research infrastructure, and this will certainly delay relief from the cancer burden.
While you have seen the statistics regarding grant awards presented by Dr. Zerhouni and others at NIH and are aware of the inflationary erosion of our buying power, the mere numbers mask the profound effects on the research community. I would like to give you an appreciation for what these numbers mean to the cancer research community, which is emblematic of the whole research enterprise. While the eventual success rate of grants is 20%, this number reflects success of either the first, second, or third submission of a grant. The success rate of the first submissions is now about half of this; thus the vast majority of scientists are subjected to a lapse in funding and the negative consequences of this. Not only can a lapse in funding force labs to cut back, let staff go, and redirect efforts to finding alternative funding and resubmission, it creates an environment of insecurity and anxiety that is anathema to the conduct of creative, innovative exploration. Recovery after a 6-12 month funding gap requires retrenching and retraining of new staff. Many leads will never be followed up. Loss of continuity is one of the most serious problems for a scientist. For new investigators, repeated failure to launch their research program is also demoralizing, and discourages taking original and risky paths.
Researchers at all levels are affected —those beginning their careers and senior investigators with long and sustained track records of major discoveries. For example, multiple colleagues at Harvard Medical School who are leaders in their field with outstanding accomplishments, are suffering lapses in funding or losing grants that received priority scores in the 10-20 percentile range. Peer review is too imprecise to distinguish differences in the quality of the grants in this tight range.
Secondly, in order for the success rate of grants to hit the mandated target number of grants, NIH has resorted to cutting grant size dramatically—at NCI, 24-29% (2006). Aggravating this situation are reductions in buying power due to inflation and the 30 percent increase in mandated stipends for graduate students and postdoctoral fellows over the past seven years (an increase that we applaud). Lab directors are faced with carrying their labs at funding levels equivalent to those 7-10 year years ago, at a time when there is a significant increase in cost of the new technologies required for state-of-the-art research. As a result, almost every grant is severely under-funded for achieving the approved goals, and scientists are starving for resources.
The frustration and anxiety of lab directors is not going unnoticed by trainees, and many young scientists are looking for other venues to exercise their talents, ones where their long training investment will not be jeopardized by this lottery in NIH grant review. This has major implications for the science of tomorrow, since we will not be able to fill in the gaps of this lost generation.
I would like to reiterate the long-term implications of the current research budget shortfall on the economy. Cancer incidence for those 65 and older is 10 times greater than for those under 65, and the death rate is 16 times higher. By 2003, 20% of the U.S. population will be over age 65 compared with 12% in 2004. The cost consequences of this tsunami of baby boomers hitting their cancer-prone years could devastate our economy.
A one percent decrease in cancer mortality is reported to be worth $500 billion to our economy according to an NCI report. Getting these potential new therapies I have outlined to patients will take a significant new investment in translational and clinical research, the cost of which can dwarf the cost of basic research. But without the most promising basic discoveries, we will not be able to improve early stage therapies and more and more translational and clinical endeavors will result in dead ends. We can’t be shortsighted.
We recognize the challenges each member of Congress faces in balancing worthy priorities, but I can assure you that from a scientific perspective there is justification for fully supporting basic, translational, and clinical pursuits. Basic science now more than ever fuels the success of effective disease diagnosis, treatment, and prevention in the future.
Through the foresight of the members of this committee and others, the public has generously provided a start toward eradicating one of the scourges of human health. We are in fact in a better place to detect, treat, and potentially, prevent cancer. But just as new therapies based on our cellular and molecular understanding are emerging from our labs, the opportunity to expand them to other types of cancer, to build on them, and to provide for a future of more discoveries has idled. We can’t retreat now that the infrastructure is in place and we are mobilized to launch a full force attack on a disease that we now understand. For the sake of the American people, please find a political route to keep progress against cancer at a sustainable pace. The research findings are clear. There is a path to major advances in cancer detection, diagnosis, therapy, and prevention. Help us get those advances to the public and fulfill the promises of the best in scientific research.
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New trend in organ donation raises questions
A new approach to organ donation is saving the lives of more waiting patients but, some say, it risks sacrificing the interests of the donors, according to a story in Sunday's Washington Post.
In "donation after cardiac death," surgeons remove organs within minutes after the heart stops beating and doctors declare a patient dead, the story says. Most organs are removed only after doctors have declared a patient brain dead.
Two Boston doctors and a woman whose son became a donor at Massachusetts General Hospital voice their opinions.
"People are dying on the waiting list," said Francis L. Delmonico, a transplant surgeon at Harvard Medical School, speaking on behalf of the United Network for Organ Sharing. More than 95,000 Americans are waiting for organs. "This is vital as an untapped source of organ donors."
Nancy Erhard's 25-year-old son, Bo, became a DCD donor at Mass. General in November 2005 after a burst artery caused devastating brain damage, the story said.
"There was no hope. He would never regain conscious thought," Erhard said. "This gave his life so much more meaning in the end because he was able to help so many others."
Michael A. Grodin, director of Boston University's Bioethics and Human Rights Program, said the practice is troubling.
"The image this creates is people hovering over the body trying to get organs any way they can," he said. "There's a kind of macabre flavor to it."
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Thursday, March 15, 2007
Medical students meet their match
Now they know.
Graduating medical students ripped open envelopes at noon today that contained their futures. Known as "Match Day," today was the day 15,206 medical school seniors across the country learned where they will be going and what specialty they'll embark on once they get there.
Nationally, 94 percent of students trained in the United States got their first choices, according to the National Resident Matching Program, which has coordinated the preferences of medical students with residency programs since 1952.
Massachusetts' four medical schools -- Boston University School of Medicine, Harvard Medical School, Tufts University School of Medicine and University of Massachusetts Medical School -- took part in the ritual. They did not all have data today on who's going where.
At Harvard, 44 percent of its 180 graduates will be going into primary care, which includes family practice, internal medicine, pediatrics, and obstetrics and gynecology. A third of all students will be training in internal medicine. The next closest specialty was emergency medicine, where 8 percent of students are headed. These percentages are in line with what they've been over the last several years, according to Harvard data.
At Tufts, primary care was the choice of 49 percent of graduating students, while 18 percent are going into surgical specialties. Five percent of the students will go into military residencies.
At UMass, there was no crush at the mailboxes. Students were randomly called by name in a conference room to get their envelopes. They were reminded to bring $1 to put in a pot. Daniel Egan, the last one called, picked up $79 for his patience.
Wednesday, March 14, 2007
Lander wins honor from biomolecular group
Eric Lander, founding director of the Broad Institute of MIT and Harvard, will receive the 2007 Society for Biomolecular Achievement Award for Innovation, the organization said.
Also a member of the Whitehead Institute for Biomedical Research and a leader of the Human Genome Project, Lander will receive the award and make a presentation called "Beyond the Human Genome Project" at the group's conference in Montreal next month.
Tuesday, March 13, 2007
High-deductible plan cuts ER use, study finds
People who changed their health insurance to a high-deductible plan went to emergency rooms 10 percent less often in the first year than people covered by traditional insurance, cutting down on their visits for such illnesses as colds, headaches and nausea, a study by Harvard Medical School and Harvard Pilgrim Health Care researchers shows.
High-deductible health plans are an important part of discussions in Massachusetts about how to make health insurance affordable as the state implements its new law mandating coverage for all citizens.
Previous studies, including the landmark RAND Health Insurance Experiment conducted almost 30 years ago, showed that making health care more expensive drives down the use of hospitals, medications and prevention services, whether needed or not.
The new study, which appears in tomorrow's Journal of the American Medical Association, came to a different conclusion: "Most HDHP (high-deductible health plan) members did not forgo high-severity emergency department visits and seemed able to distinguish low-severity conditions not requiring emergency department care." Dr. J. Frank. Wharam of Harvard and Harvard Pilgrim is the lead author.
The researchers also wanted to see if the drop in emergency department visits was followed by any change in hospitalizations that might suggest harm from a delay in seeking care. They didn't find such a link, but warn that their study was not designed to pick up this kind of association.
In an editorial commenting on the study, Dr. Corita R. Grudzen of the University of California at Los Angeles and RAND, and Dr. Robert H. Brook of UCLA make the point that a patient can't tell if a headache is serious or not.
"It is inconceivable that high-deductible health plans will not affect the health of some patients," they wrote. "If costs are to be constrained by less generous health insurance, some patients will be harmed."
The study analyzed emergency department visits and hospitalizations afterward among 8,724 people for one year before and after their employers switched from a traditional health-maintenance organization insurance plan to one that had a high deductible. They were compared to 59,557 people who stayed in the traditional HMO plan.
In high-deductible plans, monthly premiums are lower but patients must pay for most medical services, including emergency department visits and hospitalizations, up to a set level. The deductibles for people in the study ranged from $2,985 to $4,008 per year for family plans.
The rate of first visits that patients with high deductibles made to emergency departments wasn't different from those with traditional HMO coverage, but the number of second visits in that year fell 25 percent compared to the control group. That implies that once people get billed for an emergency visit, they are less likely to return, the authors said.
Patients still sought help in the emergency department for severe illness, the study found. But the authors warn that longer follow-up is needed to see if patients who defer care have worse health, particularly if they have low income.
"Our findings imply that, at least in the short term, HDHPs may be associated with reduced overall emergency department utilization without significantly affecting the highest-severity visits," they concluded. "Although we did not detect adverse outcomes, broad decreases in emergency department and hospital utilization raise concerns about long-term effects on health."
Responding to concerns raised in the editorial about harm to patients, Wharam said in an interview that high-deductible insurance plans might be offered by employers who would otherwise offer no coverage at all.
"It's possible that if the employer didn't purchase health insurance, the outcomes could be even worse," he said.
Massachusetts' new healthcare law presents a different case because it targets the uninsured population, he said, making it difficult to extend the study's results to it.
"The attempt to cover all Massachusetts residents is a noble one," he said. "I think the bottom line is that we need more research about how the high-deductible plans affect the behavior and outcomes of patients before making conclusive statements."
The study was funded by the Harvard Pilgrim Health Care Foundation and researchers were supported by federal and medical school grants and fellowships.
Monday, March 12, 2007
At the end of life, a racial divide
An ongoing Harvard project funded by the National Cancer Institute that will involve about 800 terminally ill cancer patients in Massachusetts, Texas, Connecticut, New Hampshire and New York -- is finding that African Americans are two to three times as likely as whites to want everything possible done to keep them alive, to get life-prolonging care and to die in intensive care. A Washington Post story reports on the debate about what is a "good death."
Friday, March 9, 2007
On the blogs: philanthropy and science, hospital quality measures, health care law, paying doctors more to teach
Corie Lok connects the $100 million windfall for the Broad Institute's new psychiatric research center with other grants to the Harvard-MIT venture, suggesting they account for the dominance of the Broad in papers published in Nature journals. But the effect of philanthropy doesn't stop there.
"To me, this is more evidence that Boston research is greatly benefiting from philanthropic sources of funding," she writes. "I find it interesting that people who became millionaires through businesses that have nothing to do with science are quickly becoming the benefactors of science."
Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, repeats his call for hospitals to make public their rates of central line infections, which can occur after tubes are inserted into patients. An anonymous poster asked about another safety issue:
"What about the NY Times story just the other day on how rapidly the various hospitals react when someone enters the emergency room with what looks like a heart attack?" the writer says. "Boston Medical Center (is) way ahead of the BID (and all others in the Boston area). Are we working on this (and other things we are low on on the HHS measures)?"
John McDonough of Health Care For All reports on yesterday's Commonwealth Health Insurance Connector board meeting that celebrated meeting milestones, having enrolled more than 52,000 people and approving seven health plans to sell Commonwealth Choice coverage to people who don't qualify for subsidized plans.
"Working nurse" sounds a note of caution, however, saying 48,000 of those people were automatically given insurance paid for through the state budget, and the other 4,000 had state subsidies for their coverage.
"More folks having true affordable quality coverage is a very good thing," the post says. "It should be pointed out that in the big picture what’s been accomplished thus far has been the easy part."
On WBUR's CommonHealth, Jonathan Gruber, professor of economics at MIT and member of the Connector Board, asks whether health insurance can be compared with food.
"Most Americans think of health insurance as medical prepayment: you buy an up-front premium and in return all of your medical expenses are covered," he writes. "But such a system has an inherent flaw: any time something is free, it will be overused. This should not be a controversial statement to anyone who has ever gone to an all-you-can-eat buffet. Having paid at the door, you always end up eating more than if you were paying for each item your ordered."
Based on research of how insurance is used, he argues that individuals should pay for some of their health care costs, according to their income.
"Coming back to the buffet analogy, it is clearly harmful to not allow individuals to eat –- but less critical that you allow them to eat as much as they want."
"Great, so now my tuition goes up $10,000."
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Thursday, March 8, 2007
Beth Israel Deaconess hires new COO
Beth Israel Deaconess Medical Center has named Eric Buehrens its new chief operating officer, the hospital said today.
Buehrens has been the deputy provost for administration at Harvard University. Before that he was executive dean for administration at Harvard Medical School, and associate dean for planning and facilities at HMS.
He will succeed Dr. Michael F. Epstein, who said last month he would be leaving May 1.
CHA gets grant to study depression treatment for minority patients
Cambridge Health Alliance has received a two-year, $599,999 grant from the Robert Wood Johnson Foundation to study the quality of depression treatment for ethnic and racial minorities, the hospital said today.
Margarita Alegría, director of the Center for Multicultural Mental Health Research at CHA and a professor of psychiatry at Harvard Medical School, will lead the study.
Wednesday, March 7, 2007
Soliciting organ donations undermines fairness of waiting list, surgeon writes
Soliciting organ donations, whether on billboards or on the Internet, raises ethical questions and threatens the fairness of how organs are allocated, Dr. Douglas W. Hanto writes in tomorrow's New England Journal of Medicine.
Organs from deceased donors go to the people at the top of the waiting list maintained by the United Network for Organ Sharing, which is regulated by the federal government. The only exception is made for family members of deceased donors.
But when it comes to living donors who may come forward to give a kidney or part of a liver, there are no policies regulating directed donations, writes Hanto, chief of transplantation at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School.
"We don't have enough organs for everybody," he said in an interview. "I would like to see the system change so those donations are directed to the top of the waiting lists, after family, friends and pre-existing relationships."
Most organs from living donors go to friends or family members, according to UNOS figures, but there are increasing numbers of prospective donors with no relationship to the potential recipient. Between 1996 and 2006, the percentage of living donors without close ties rose from 6.5 percent to 23 percent.
Websites such as Canton-based matchingdonors.com were created to connect people who need transplants with live organ donors. Phone messages seeking comment today were not returned, but on its website, matchingdonors.com says "there are thousands of wonderful, altruistic and compassionate people willing to help a fellow human being. It is our belief that many of the potential donors would have never considered live organ donation if it wasn’t for the increased awareness due to our site."
Hanto urges development of rules to guard against unfair allocation of organs from living donors that will protect donors and recipients alike. He points to a study in Minnesota of altruistic donors, whose desire to donate was unaffected by knowing who would receive their gift compared with their organ going to the person at the top of a waiting list.
Hanto also cites concerns that organs will go to people with more advantages (as shown by their access to the Internet), that the potential for illegal payment is greater without previous close ties, and that recipients might be vulnerable to later demands from donors.
Dr. Francis L. Delmonico, a transplant surgeon at Massachusetts General Hospital, medical director of the New England Organ Bank and past president of UNOS, agrees that solicitation of living donors raises concerns, but he thinks that there is no legal basis to regulate how people find or identify a donor, through matchingdonors.com or other groups.
"It is not for us to tell people how they can make relationships," he said in an interview. "But it is for UNOS and for the transplant centers to exercise some caution."
Transplant centers perform a psychosocial as well as a medical evaluation of any potential donor.
"I would say this has to be done in a more heightened way," Delmonico said about screening. "The risks that are associated with donors that come along under the circumstances of solicitation are greater in having misunderstanding by the donor and misunderstanding as to what is being derived for the recipient."
Hanto does endorse the New England Kidney Exchange, an effort to pair living donations in cases where one potential donor might not be a match for the loved one they hope to help, but that organ can be exchanged for a match with another pair in the same situation who can provide a compatible organ.
"I think that's a terrific idea," he said. "It's not going to solve the whole problem, but it's a great solution."
$100 million to be spent unlocking the genetic mysteries of mental illness
By Carey Goldberg, Globe Staff
It looks to be the largest single gift ever for research into mental illness: The Broad Institute, the genomics powerhouse in Cambridge, announced this evening that it will receive $100 million to figure out the genetics of schizophrenia and bipolar disorder.
It will go mainly to gather and analyze thousands of DNA samples from people with schizophrenia and bipolar disorder, in hopes of finally figuring out the complex genetics behind the diseases.
That is no easy task. The diseases afflict more than 6 million Americans, and clearly run in families. But the specific genes at work have proven largely elusive. Multiple genes are believed to be involved, and they could vary from patient to patient. Environment, too, plays a role.
But in the last year or so, gene-scanning technology has reached the point that scientists believe they can run studies on a scale large enough to detect the genetic culprits, said Dr. Edward Scolnick, who oversees the Broad's psychiatric research. He wants to gather DNA samples from as many as 10,000 people with each disease, plus 10,000 without.
That DNA then needs to be scanned in its entirety for genes correlated to the disease, and that is where the Broad's expertise comes in.
Its genomic tools have been getting ever faster and cheaper, so that it can now scan a patient's sample for half a million genetic variations at once. In a couple of months, said Eric Lander, the Broad's director, that will be up to a full million.
"If you're looking for a needle in a haystack, and you can sift the whole haystack, you'll find the needle," Lander said.
The Broad is a joint institute of Harvard University and the Massachusetts Institute of Technology.
Hot stuff: Three local researchers rank high
When you're hot, you're hot.
Three researchers from Boston and Cambridge ranked among the world's most highly cited scientific authors in 2005 and 2006, according to the March/April issue of Thomson Scientific’s Science Watch newsletter. Its Web of Science database identifies a paper as "hot" if it is cited in scientific journals at a much higher rate than similar papers over a two-year period.
Richard D. Gelber of Dana-Farber Cancer Institute had six hot papers in biostatistics and oncology; Max Tegmark of MIT had six in space science; and Mark J. Daly of Harvard Medical School had five in genetics.
They finished behind Shizuo Akira of Osaka University, who had 7 hot papers in immunology. Akira and Tegmark are the only two researchers who stayed hot for the second list in a row.
Here is the complete list of the hottest researchers:
Shizuo Akira, Osaka University, Immunology, 7
Tuesday, March 6, 2007
On the blogs
Corie Lok offers her take on life for postdocs in and around Boston and Cambridge, in light of a weak showing in a Scientist survey.
She talked to a number of postdocs last year about the situation, and one common complaint "was that offices, services and policies for postdocs across the Harvard campuses and affiliated hospitals were not consistent," she writes. "While the hospitals govern themselves, at least the medical school, the school of public health, and the main campus should be more coordinated in these affairs."
Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, writes about saying you're sorry for medical errors and Mt. Auburn Hospital's creation of an on-call team to help doctors and nurses figure out when they need to apologize, and what to say to a patient and family members.
Researchers urge drug companies to make safety data public
Keeping drug safety data from clinical trials confidential to protect trade secrets can delay the discovery of dangerous side effects, two Boston researchers write in the current issue of Health Affairs.
Aaron S. Kesselheim, a clinical fellow in medicine in the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital, and Michelle M. Mello, associate professor of health policy and law at the Harvard School of Public Health, point to Vioxx and other cases of drugs with problems that came to light after their approval by the Food and Drug Administration.
The two urge the FDA to place a greater burden of proof on drug companies to show how they would be harmed by release of their data, they recommend more comprehensive public documents from drug companies on safety, and they ask Congress to act if the FDA doesn't.
"Disclosing safety data from clinical trials would allow protection of most commercially valuable information and better balance our interests in drug innovation and patient safety," they wrote.
Monday, March 5, 2007
Depression often disabling and untreated among blacks
Lifetime rates of major depression are higher among whites, but depression is more likely to be severe and disabling among African-Americans and Caribbean blacks, according to a study in the March issue of the Archives of General Psychiatry. Fewer than half of African-Americans and fewer than a quarter of Caribbean blacks got any kind of therapy for their major depression.
Data on treatment was not collected for whites, the article said, but the national average for treatment of major depression among adults is 57 percent.
"These data suggest that when blacks develop major depressive disorder, it is likely debilitating in impact and persistent in its course," wrote lead author David R. Williams of the Harvard School of Public Health. "These findings underscore the pressing need to understand the factors underlying racial differences in access and quality of mental health care and the urgency of implementing interventions to eliminate these disparities."
The researchers studied major depression among 6,082 people in the National Survey of American Life, the largest study of mental health in the U.S. black population. They looked at results from face-to-face interviews followed by telephone calls with 3,570 African-Americans, 1,621 Caribbean blacks and 891 non-Hispanic whites from 2001 through 2003.
More whites (17.9 percent) than African-Americans (10.4 percent) and Caribbean blacks (12.9 percent) said they had experienced major depression over their lifetimes, but among those who had, more African-Americans (56.5 percent) and Caribbean blacks (56 percent) reported episodes in the past 12 months compared with whites (38.6 percent.)
This is the first psychiatric epidemiologic study of blacks in the United States to include a large national sample of Caribbean-origin blacks, the authors said.
Kristin N. Javaras, a biostatistician who studies mental health data at the Harvard School of Public Health and McLean Hospital, said the study's findings are valuable because they confirm in a larger population work that had been done in smaller groups. Studying African-Americans and Caribbean blacks as separate groups was also important.
Study co-author Harold W. Neighbors said in an e-mail interview, "The most important next step is to figure out ways to get more black Americans (both African-Americans and Caribbean blacks) with depression into professional care."
Responsibility rests on both the consumer and professional side for decreasing barriers to care for depression, wrote Neighbors, director and research professor in the Program for Research on Black Americans at the University of Michigan's Institute for Social Research.
"More open and honest discussion among black Americans within smaller friendship networks about their struggles with depression should lift some of the social stigma associated with depression," he said. "But we also need more effective educational programs that will help mental health clinicians establish rapport with black patients and others from cultural backgrounds that differ from the prototypical patient who too often is a white American."
The article said more research needs to be done on the social support systems, including religious activities, and individual strengths, such as self-esteem, that may account for lower levels of lifetime major depression. Further work is also needed to understand why, when severe depression occurs, it is more persistent and disruptive among both African-Americans and Caribbean blacks, the authors said.
Dr. Timothy G. Benson, a psychiatrist at McLean Hospital who lectures on African-American health disparities, said he was excited to see the report put the issue back in the forefront. He was not involved in the study.
"This gives us a gauge to see that what we are doing right now is not sufficient. There is a significant gap in access to care," he said. "What I hope to see are more papers on strategies on how to eliminate these disparities."
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Home and school drug testing flawed, pediatricians say
Drug testing of adolescents at home or in school is unreliable and lacks scientific proof of effectiveness, the American Academy of Pediatrics says in its journal Pediatrics today. Simple conversations with a school counselor are more effective and cost far less, according to the study.
In 1996 the AAP published a policy statement opposing testing adolescents for drugs without their consent. Since then two US Supreme Court decisions have upheld random testing, first for student athletes and then for any student participating in extracurricular activities. At the same time, drug-testing companies have begun marketing kits to parents for use at home. The current policy addendum was written in response to these two trends.
"Testing can be a very powerful tool when it is used properly in a clinical population," Dr. John R. Knight, associate professor of pediatrics at Harvard Medical School and director of the Center for Adolescent Substance Abuse Research at Children's Hospital Boston, said in an interview. He is the lead author of the article. "It's just a really bad screening test."
There is little proof that drug testing in schools works, he said, citing two studies whose results conflict. Testing is complicated, it produces errors, its results can be hard to interpret and the Internet is awash in ways to defeat it.
"It's almost like an arms race," Knight said. "We think up new tests and kids who are using drugs think up new ways to beat the new tests."
The tests also miss ecstasy, inhalants such as glue and paint thinners and prescription drugs such as oxycodone, as well as alcohol, he said.
Where drug tests do work is in programs where young people are committed to recovering from drug abuse and agree to monitoring, he said. For the larger population of students, talking to a doctor or school nurse works better, published data has shown, he said.
"I am in favor of screening teens for drug and alcohol abuse and I know how it can be done cheaper and more effectively," he said. "Have a health care provider ask the young person, with a confidential questionnaire or a simple oral test, and most of the time they give you an honest answer."
Schools can do the same kind of screening, instead of taking samples for lab tests, Knight said he told the president's Office of National Drug Control policy in November. Using charges for tests by Quest Laboratories, he calculated that a school with 1,000 students that tested half of them once each year, yielding 30 percent positive results, would spend $142,000 on tests and $58,000 to administer the program.
Screening all the students with confidential questionnaires and follow-up counseling would cost about $50,000 per year for one school-based counselor, he estimated. The government could better spend its money on treatment or prevention programs, he said.
"We should be taking the money they're dangling in front of the schools willing to do the testing and we should be putting it into treatment for young people," he said.
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Friday, March 2, 2007
Beth Israel hires new emergency radiology chief
Dr. Marc A. Camacho, instructor in radiology at Harvard Medical School, has been named chief of the newly established section of emergency radiology in the department of radiology at Beth Israel Deaconess Medical Center.
Camacho received his medical degree from the University of South Florida College of Medicine and a masters of science degree in biomedical engineering from Boston University. He comes to Beth Israel from Virginia Commonwealth University Health System/Medical College of Virginia Hospital in Richmond, Va., where he was chief of the emergency radiology section and an assistant professor at Virginia Commonwealth University.
Thursday, March 1, 2007
Snub of the universe? Postdocs pick elsewhere
Not a single institution on either side of the Charles cracked the Top 15 places to work in a survey of postdoctoral life scientists, the March issue of The Scientist magazine says.
Training and experience matter the most to these researchers, who have finished their Ph.D.s but don't have faculty positions, the survey reports. They ranked access to books and journals next, followed by affordable medical insurance and then equipment and supplies for research.
The closest Boston or Cambridge came was Beth Israel Deaconess Medical Center's 28th-place finish, shooting up from 97th last year.
Harvard Medical School, Brigham and Women's Hospital, Woods Hole Oceanographic Institute and Dana-Farber Cancer Institute also made the top 40. MIT dropped out of the top 40, placing 53rd.
M.D. Anderson Cancer Center in Houston topped the list, zooming up from 29th last year. The J. Gladstone Institutes in San Francisco slid to second place from first. The U.S. Environmental Protection Agency in Research Triangle Park, N.C., stayed in third.
Here's how postdocs ranked area institutions, with the 2006 ranking in parentheses:
Beth Israel Deaconess: 28 (97)
A total of 96 institutions in North America were ranked this year. Research centers with too few responses were not listed, including some in the Boston area.
For its "Best Places to Work 2007: Postdocs," the magazine polled its readers about conditions in their research facilities. The Web-based questionnaire pulled in 2,555 usable responses from people who identified themselves as non-tenured scientists working in academia or other non-commercial research organizations.
So, postdocs, White Coat Notes wonders what you think about where you work. Send us your thoughts at email@example.com.
Wednesday, February 28, 2007
Weighing the risks and benefits of Caesareans
Caesarean deliveries continue to climb, two Massachusetts General Hospital obstetricians write in a perspective piece appearing in tomorrow's New England Journal of Medicine. The rising number suggests that doctors need to do more to educate their patients about the trade-offs and to ensure that their choices fit their own philosophy, plans, and risk tolerance. Clinical trials should be launched to produce the data needed for counseling patients, Dr. Jeffrey L. Ecker and Dr. Fredric D. Frigoletto Jr. write.
Managing chronic disease at community health centers
Researchers from Harvard Medical School assessed the effectiveness of the Health Disparities Collaboratives, a group set up to help community health centers improve the quality of their care. The collaboratives improved care for patients with diabetes and asthma but not for those with hypertension, Dr. Bruce E. Landon and colleagues report in tomorrow's New England Journal of Medicine.
Paul Farmer wins $100,000 Austin College award
Harvard professor and international health advocate Dr. Paul Farmer has won the 2007 Austin College Leadership Award, whose $100,000 prize he plans to give to Partners In Health, the college said.
"Dr. Farmer’s life really exemplifies service," college president Oscar C. Page said in an interview. "We felt his life in Haiti and other parts of the world would certainly be a great role model for our students."
Farmer will accept the award tomorrow at the Belo Mansion in Dallas.
"I am so grateful to receive this award," Farmer said in a statement. "I want to use these resources to further our goal of promoting health and human rights and to ensure that Partners In Health's work is able to continue for years to come."
Farmer is a founding director of Partners In Health, which builds hospitals and provides health services in parts of the world affected by poverty, violence, and disease. His work in Haiti was described in the best-selling book, "Mountains Beyond Mountains," by Tracy Kidder. Austin College will distribute the book to its incoming freshmen, who will hear Farmer at their convocation in September.
Farmer's other honors include a "genius" grant from the MacArthur Foundation, the Conrad N. Hilton Humanitarian Prize of $1.5 million, which he also gave to PIH, and the American Medical Association’s International Physician Award.
Tuesday, February 27, 2007
High-fat dairy foods may help some women get pregnant
Women having trouble getting pregnant because they aren't ovulating regularly may want to drink a daily glass of whole milk and skip the skim, according to a Harvard study appearing in tomorrow's issue of the journal Human Reproduction.
Dr. Jorge E. Chavarro and his colleagues at the Harvard School of Public Health followed 18,555 women in the Nurses Health Study II for eight years. They found that eating low-fat dairy foods may increase the risk of infertility from a lack of ovulation by 85 percent while eating high-fat dairy foods may decrease the risk by 27 percent.
The findings are important in light of government recommendations to consume three or more daily servings of low-fat milk or other dairy products, the article says, calling it a "strategy that may be deleterious for women planning to become pregnant."
For both high-fat and low-fat foods, the effects showed up with only one or two servings per day, Chavarro said.
"The women in the study really did not consume that much high-fat dairy food, but the level they did had some protective effect at about one serving a day, especially for whole milk and to a lesser extent for ice cream," Chavarro said in an interview. "It was not really high, not going crazy with buckets of ice cream after every meal."
Lack of ovulation is a significant cause of infertility, affecting as many as 1 in 3 women who have difficulty conceiving, said Dr. Alan Penzias, director of the reproductive endocrinology fellowship at Beth Israel Deaconess Medical Center and a professor of obstetrics and gynecology at Harvard Medical School. He was not involved in the study.
A number of conditions, including big swings in weight, can shut down ovulation. If a woman has gained weight recently, she is typically told to go on a diet, he said. But now that advice may be adjusted when it comes to dairy foods.
"Instead of just telling them, lose weight, we may then modify some of our advice," he said. "We may say, 'While trying to have a well-balanced healthy diet, you may want to avoid an excess of low-fat dairy foods.' "
Should doctors order ice cream for their patients?
"Ice cream may be great for sensational headlines, but it's not the best dietary advice," Penzias said.
Friday, February 23, 2007
Three CHA physicians promoted at Harvard
Three Cambridge Health Alliance physicians have earned academic promotions from Harvard Medical School.
Dr. Jean A. Frazier, director of the Child and Adolescent Neuropsychiatric Research Program at CHA and co-director of CHA’s Center for Child and Adolescent Development, has been named associate professor of psychiatry at the medical school.
Dr. Elizabeth H. Gaufberg, an internist and a psychiatrist at CHA, has been named assistant professor of medicine and assistant professor of psychiatry.
Dr. Cynthia J. Telingator, training director of CHA’s Division of Child and Adolescent Psychiatry, has been named assistant professor of psychiatry.
Thursday, February 22, 2007
HMS Follies puts retiring dean in the spotlight
Retiring Harvard Medical School Dean Joseph B. Martin will get an early musical send-off tonight when second-year students present "Joseph Martin and the Amazing Technicolor White Coat."
The centennial show runs through Saturday at the Media/Arts Center at Roxbury Community College. (Tickets are available at the door.)
"It's our gift to the first-year students," said Heather Gunn, director of the show, a tradition since 1907. "We make fun of all the professors we had last year and they have now."
Gunn said the time devoted to the show has meant a lot of nights when the 190 full-time medical and dental students involved get only about two hours of sleep a night. That makes it good training for their third year, when they will be working on hospital wards, she said.
Her training to direct the HMS Follies comes from 13 years as an actor in Los Angeles.
"I got into Harvard Medical School because they needed me to direct the second-year show," she joked.
Wednesday, February 21, 2007
New way of training med students touted in NEJM
By Liz Kowalczyk, Globe staff
Doctors from Cambridge Health Alliance, which includes Cambridge Hospital, and Harvard Medical School tout a new way of training medical students in tomorrow's New England Journal of Medicine.
Third-year medical students who spend the entire year following the same patients as they are treated by various doctors throughout the health care system see patients more frequently and are supervised more often by experienced faculty, than students trained the traditional way, write Dr. David Hirsh and Dr. Barbara Ogur, both physicians at the hospital; and HMS professors Dr. George Thibault, an executive with Partners HealthCare, and Dr. Malcolm Cox of the federal Veteran's Health Administration. Students normally go from hospital to hospital for one- to three-month stints in specific specialties.
Students in the Cambridge pilot program, which began in July 2004, also score as well or better on tests of clinical skill and knowledge than their peers, the authors report, although results are preliminary.
Cox, who helped Hirsh and Ogur develop the program, gets revenge of sorts in the article. Many doctors at Harvard's other teaching hospitals considered the Cambridge approach too radical, and felt Cox was not building a consensus as leader of a curriculum reform initiative at Harvard Medical School. He resigned after 18 months, saying in an interview with the Globe last year that he had "deep philosophical differences" with many Harvard faculty who believed that students learn better the traditional way.
Joslin doctor joins state's new Asian American Commission
Dr. George L. King, director of research at Joslin Diabetes Center and co-director of Joslin's Asian American Diabetes Initiative, was sworn in today as a member of the state's new Asian American Commission in a State House ceremony.
King also heads vascular cell biology at Joslin and is a professor of medicine at Harvard Medical School.
Tuesday, February 20, 2007
Yearning is primary emotion after death of a loved one
Contrary to traditional notions of grief after the death of a loved one, a new study finds that yearning is felt more powerfully than depression.
Researchers from Harvard Medical School and Yale University School of Medicine found that yearning was the strongest negative emotion after loss, they report in tomorrow's Journal of the American Medical Association.
Negative emotions associated with grief peaked within six months, meaning people with more prolonged symptoms might need more help after that point. And the researchers recommend that the standard psychiatric reference, the Diagnostic and Statistical Manual of Mental Disorders, be revised to focus less on depression after the death of a loved one.
"Yearning is reacting to the loss of someone or something, and once that is gone, you miss it, you pine for it, you hunger for it, you crave it. That was the primary emotional experience after bereavement, rather than depression," Holly G. Prigerson, one of the authors, said in an interview. "This suggests that the DSM reconsider what the natural response to loss is, especially with respect to depression and yearning."
Prigerson is an associate professor of psychiatry at Harvard and director of the Center for Psycho-Oncology and Palliative Care Research at the Dana-Farber Cancer Institute.
The participants in the study, mostly widows, did experience the five stages of grief in the sequence popularized by Elisabeth Kubler-Ross's description of terminally ill patients, but yearning was the most powerful negative emotion and, on average, participants' worst feelings peaked within six months. The level of acceptance -- the strongest emotion of all -- rose steadily over six months.
In contrast, the DSM focuses exclusively on depressive symptoms, saying they should be expected two months after a loss, Prigerson said.
Prigerson emphasized that the people in the study had lost loved ones to natural causes, reflecting 94 percent of deaths in the United States. People who had lost a child or a loved one after a traumatic death, such as a car crash or suicide, were excluded from the study.
The ones who knew for six months or more that their loved ones had a terminal illness reached acceptance sooner than those who had less time to prepare for the death, the study found.
"People never get over a loss, they just get used to it," Prigerson said. "Even years after someone dies, they get pangs of grief, they need to think about the person, and they miss them with heartache," she said. "That's normal. But intense levels beyond that become problematic."
Friday, February 16, 2007
Beth Israel Deaconess lures hot-shot cancer geneticist
By Scott Allen, Globe Staff
Beth Israel Deaconess Medical Center has successfully lured one of the most promising young cancer geneticists away from Memorial Sloan-Kettering Cancer Center in New York City, making Dr. Pier Paolo Pandolfi the director of its newly created cancer genetics program.
The Italian-born Pandolfi, 43, already has won a slew of awards for his research into the molecular and genetic causes of leukemia, lymphoma and other cancers. His work has led to new treatments for a form of blood cancer, acute promyelocytic leukemia.
As both a professor at Cornell University's Weill Medical College and a researcher at the world's largest cancer center, Pandolfi was positioned for a long run in New York. But Beth Israel Deaconess, eager to play a bigger role in the most dynamic area of cancer research, attracted Pandolfi to Boston with the promise of a new program where he will attempt to develop individualized treatments for cancer patients. Pandolfi also will become a professor at Harvard Medical School, for which Beth Israel Deaconess is a major teaching hospital.
In an interview, Pandolfi said he was attracted by the idea of working in Boston's storied Longwood Medical Area, adding that he dreamed of becoming a Harvard professor when he was a boy growing up in Rome. "I have a very good job. Sloan-Kettering is a top institution, but I'm sure we can do as well or better here," he said.
Senior Beth Israel Deaconess officials were full of praise for their new rising star, and one official couldn't resist a little Boston-bests-New York ribbing. "Now they can keep Johnny Damon," he joked.
Wednesday, February 14, 2007
Children's study: Steroids no help for Kawasaki disease
Children with Kawasaki disease are at risk for developing
Tuesday, February 13, 2007
Three-quarters of impaired doctors recover, study says
Three-quarters of Massachusetts physicians being monitored for substance abuse or mental and behavioral health problems successfully completed their programs while continuing to practice, a study by the Massachusetts Medical Society's Physician Health Services program found.
The success rate was nearly identical for both types of disorders, showing that techniques developed for helping physicians with substance abuse can be applied to other problems, the authors reported in the Journal of Psychiatric Practice. But they also found that women fared worse than men.
"We thought men and women would do equally well," said Dr. John R. Knight of Harvard Medical School and Children's Hospital Boston. "We don't know the exact reasons the women did so poorly. It's really going to require a new look at our program, and I think we've got to consider offering new services for women physicians."
Overall results showed that 75 percent of doctors with substance abuse disorders and 74 percent with mental and behavior problems met all the requirements of the medical society's monitoring program. But women relapsed significantly sooner than men and only 62 percent of women physicians were successful, compared with 78 percent of male physicians.
Five members of the Physician Health Services program, including Knight, looked at 10 years of records for 58 physicians with mental and behavioral problems, such as depression or bipolar illness, and 120 with substance abuse disorders who agreed to monitoring by the program. They were followed for at least three years.
Monitoring included oversight by other physicians they worked with, meetings with supervisors, and drug tests for those with substance abuse problems. Physicians who also had dealings with the state licensing board had a higher success rate than others, especially when substance abuse was involved.
Nancy Achin Audesse, executive director of the state Board of Registration in Medicine, was encouraged by the report.
"I think it is very good news that we have a system in place to identify physicians who are in trouble, to handle them, and to help them back to recovery," she said. "When we have these experienced and capable doctors and they end up with health problems, we don't want to lose them from practice. We want to get them back into healthy practice."
Farmers become health care monitors in China
In China, an experimental program developed by a Harvard professor stresses monitoring of doctors and enlists local residents to monitor health care, and publicize what they find out, a Wall Street Journal story says.
Monday, February 12, 2007
Beth Israel Deaconess radiology chief to edit journal
Dr. Herbert Y. Kressel, radiologist-in-chief at Beth Israel Deaconess Medical Center, will step down at the end of the year to become editor-in-chief for the journal Radiology, the hospital said today.
Kressel will stay on staff one day a week in the radiology department and he will keep his appointment as a professor of radiology at Harvard Medical School. Dr. Vassilios Raptopoulos, who was recently named vice chair of clinical services in radiology, will serve as interim chief if needed. A search committee is being formed to appoint a new chief.
Kressel joined Beth Israel Hospital as radiologist-in-chief in 1993. He was chief medical officer and president for BIDMC until 2000.
The lifesaving potential of an afternoon nap
By Stephen Smith, Globe Staff
Could midday napping save your life?
The study, published in the Archives of Internal Medicine, concluded that napping was more likely than diet, physical activity or smoking to lower the incidence of heart attacks and other life-ending heart ailments.
Still, the authors cautioned that further research is needed to confirm their findings.
Specialists not involved with the study said there are sound biochemical reasons to believe that a nap may help protect against heart disease.
The researchers quizzed study participants about their siesta habits, defining regular nappers as those who took a midday break at least three times a week, with the nap lasting a minimum of 30 minutes. It was that group that derived the greatest benefit, with a 37 percent drop in deaths attributable to heart disease. The effect was far more modest among those who napped only occasionally, and was not considered statistically meaningful.
There's a well-recognized biological impetus for the desire to take a break mid-way through the waking hours: Our bodies tell us to, said Michael Twery, director of the federal government's National Center on Sleep Disorders Research. It happens again right before bedtime.
"It leads to improved safety," said marketing director Susan Kozikowski.
"The take-home message is we do need a good night's sleep, we do need to look at how much sleep we get and optimize that," Irwin said. "We need to recognize that sleep is a behavior we can control as humans, and if we do that, our overall health will improve in this country."
A web site run by the American Academy of Sleep Medicine, an organization of specialists, provides information about sleep and sleeping disorders. The site is underwritten by physicians and does not take funding from pharmaceutical companies or medical device makers.
MIT research IDs tumor defense mechanism
MIT scientists have identified a new defense mechanism that tumor cells use to survive chemotherapy, a discovery that could lead to drugs that make existing cancer drugs work better at lower doses.
Writing in the cover story of today's Cancer Cell, Dr. Michael B. Yaffe and his biomedical engineering colleagues explain that once tumors lose their ability to repair DNA that has been damaged by drugs or radiation, they turn to a signaling pathway involved in inflammation in order to survive.
"The exciting thing is we can now target this pathway," said Yaffe, who is also a surgeon at Beth Israel Deaconess Medical Center and affiliated with the Broad Institute of Harvard and MIT. "It won't make normal cells any more susceptible to chemo but it will make cancer cells much more sensitive."
The scientists tested their idea by turning off the inflammation pathway in mouse tumors. After they gave low doses of the common cancer drug cisplatin to the mice, their tumors melted away, Yaffe said.
A drug that works against a molecule important in inflammation called MK2 is already being tested. Originally conceived as a treatment for arthritis, it may be modified to thwart just the inflammatory pathway that cancer cells use to survive.
"Our results suggest it might have a second life in helping to treat cancer patients," Yaffe said. "It could mean standard chemotherapy would suddenly become much more effective."
Narrowing the search for cancer genes
The road to personalized medicine is a bumpy one, but researchers at the Dana-Farber Cancer Institute and the Broad Institute have found a method that might smooth the way.
Writing in yesterday's Nature Genetics, they report on a faster, cheaper method of screening for multiple mutations that turn on cancer genes.
Taking advantage of mass spectrometry, a tool researchers use to detect variations in genes, they were able to narrow down their search for relevant mutations in 1,000 samples of tumor tissue by examining only regions of genes where most troublesome mutations occur.
"You don't have to sequence the entire cancer genome," said Dr. Levi A. Garraway, a medical oncologist at Dana-Farber and an associate member of the Broad, a joint MIT-Harvard institute. "All you need to do is look in specific locations."
The researchers discovered that some tumor samples showed mutations not normally expected for the kind of cancer the patient had been diagnosed with. If a patient with pancreatic cancer showed a mutation more commonly found in lung cancer, for example, there might be a treatment to use that would not otherwise have been considered, Garraway said.
The screening method could be used along with the Cancer Genome Atlas, a large, complex project to sequence cancer genes.
There are two barriers to making individualized cancer medicine a reality, the paper says. One is to identify all the genes involved in the spectrum of cancers, and the other is to translate that knowledge into therapies for patients.
Thursday, February 8, 2007
Harvard-trained doctor to lead Global Fund
Michel Kazatchkine, France's AIDS ambassador and a Harvard-educated doctor specializing in infectious diseases, was selected today as the new head of the $7 billion Global Fund to Fight AIDS, Tuberculosis and Malaria.
Kazatchkine, 60, takes over an organization that in just over five years has provided grants to 450 programs in 136 countries, accounting for two-thirds of all international funding against TB and malaria, and 20 percent of global funding to fight AIDS.
From 1977 to 1981, Kazatchkine lived in Boston while doing post-doctoral work at Brigham and Women's Hospital as a member of Harvard's Immunology Department.
-- John Donnelly
Wednesday, February 7, 2007
Horse genome sequenced by Broad team
The first draft of the horse genome sequence has been completed by scientists at the Broad Institute in Cambridge, work that has implications for the study of human disease, the National Human Genome Research Institute announced today.
A team led by Kerstin Lindblad-Toh at the joint MIT-Harvard institute began sequencing the domestic horse genome in 2006, culminating a 10-year effort by international scientists called the Horse Genome Project.
The horse whose DNA was used is a Thoroughbred named Twilight from Cornell University. Research done there by Doug Antczak has implications for research on reproduction, clinical organ transplantation and immune regulation, according to the NHGRI.
Tuesday, February 6, 2007
Nominee for 'paper of the year'
An article by Dr. Thomas A. Gaziano of Brigham and Women's Hospital and Harvard Medical School, Lionel H. Opie of the University of Cape Town, and Milton C. Weinstein of the Harvard School of Public Health was among 23 original research articles nominated for "Paper of the Year 2006." Editors of the Lancet for the past three years have winnowed biomedical papers -- 700,000 in last year's case -- to pick the best medical research of the year.
The winners for 2006 were trials of two rotavirus vaccines, published in the New England Journal of Medicine.
Monday, February 5, 2007
Turning off the TV won't make kids more active
Cutting down on how much television adolescents watch doesn't necessarily translate into more physical activity, Harvard researchers report in today's issue of Pediatrics.
"Kids have other activities that they do if they turn off the TV," said Dr. Matthew W. Gillman, a professor at Harvard Medical School and director of an obesity prevention program at Harvard Pilgrim Health Care. "They don't necessarily go out and play or join a sports team."
Researchers tracked 10,000 10- to 15-year-old boys and girls for four years, asking them to report their TV habits and physical activity levels. The results ruled out any major association between the two.
Programs that work on sedentary behaviors like TV watching and physical activity as separate, independent elements hold more promise for helping children avoid excess weight during adolescence, the authors concluded.
They noted that adolescents may gain weight if they watch a lot of television because of what they also do in front of the TV set. There's some evidence that kids who watch TV ads for unhealthy foods wind up eating more of them. Or they just snack while they watch.
"If we want to get the greatest bang for our buck in terms of interventions to prevent obesity, we're going to have to work on both TV and physical activity independently," Gillman said.
Thursday, February 1, 2007
Binge eating is the most common eating disorder, McLean study shows
Binge eating disorder affects more American adults than anorexia and bulimia combined, a study from McLean Hospital and Harvard Medical School finds, making it a "major public health problem."
Binge eating behavior also tends to last longer, spanning about eight years compared with an average of 1.7 years for anorexia, the Harvard authors write in Biological Psychiatry.
About 5.9 million people in the United States could have a binge eating disorder at some point in their life, Dr. James I. Hudson and his co-authors say. That compares with 1.3 million cases of anorexia and 2.1 million cases of bulimia, based on data from the National Comorbidity Survey Replication. The survey asked 9,000 people across the United Sates about their mental health.
Binge eating, defined as repeated bouts of uncontrolled eating, appears to be a cause for severe obesity. People with anorexia fear being overweight so much that they eat very little. Bulimics overeat but vomit after to avoid weight gain.
Binge eaters continue to gain weight, becoming morbidly obese, with a body mass index of 40 or greater. For a 5-foot-6-inch woman, that BMI would mean 248 pounds; for a 5-foot-9-inch man, 270 pounds.
"If we can identify and treat the underlying cause of this behavioral disturbance, we may be able to make an impact on the obesity epidemic," Hudson said. "This is a major public health problem."
Hudson reported receiving funding for the eating disorders analysis from OrthoMcNeil Neurologics, which has tested its antiepilepsy drug, topiramate, for effectiveness in binge eating disorder.
The national survey's funders included Eli Lilly and Co.
Wednesday, January 31, 2007
Air pollution raises women's heart disease risk, says study
Stricter control of air pollution is needed to reduce the risk of heart disease in women, two Harvard researchers write in an editorial to be published in tomorrow’s New England Journal of Medicine.
Their comments accompany a study in the journal that shows long-term exposure to the fine particles in air pollution are more harmful to older women than previously known, raising their risk of heart disease and death.
Researchers from the University of Washington reviewed medical records from more than 65,000 postmenopausal women with no previous history of heart disease who participated in a long-running, federally funded study called the Women’s Health Initiative.
Other studies have shown a connection between fine particles in air pollution and death. But the pairing of the detailed medical records with data from air monitors in the 36 US cities where the women lived, revealed that women who breathed in more fine particles over a period averaging six years increased their chances of having heart attacks, strokes, blocked arteries and other illnesses. And the risk depended on the level of fine-particulate pollution in the area of the city where they lived.
"The findings of the WHI study strongly support the recommendations for tighter standards for long-term fine particulate air pollution," said Douglas W. Dockery of the Harvard School of Public Health and Peter H. Stone of Brighams and Women's Hospital and Harvard Medical School, writing in the editorial.
They noted that the US Environmental Protection Agency had recently lowered the standard for exposure to fine particles in the air over a 24-hour period but had declined to reduce the standard for longer-term exposure. Dockery and Stone called on the EPA to adopt a tighter standard, which has also been recommended by the agency's science advisers.
Friday, January 26, 2007
Statins over-prescribed, Harvard doctor says
Dr. John Abramson argued in his 2004 book "Overdosed America" that pharmaceutical companies are distorting medical knowledge. Now he writes in a medical journal that too many people -- healthy women of any age and men over 65 -- are taking statins without proof they need them.
A clinical instructor at Harvard Medical School and former chair of family practice at Lahey Clinic, he questions National Cholesterol Education Program guidelines recommending the blockbuster drugs for people who may have high cholesterol but don't have clogged arteries.
Commenting with Dr. Jim Wright of the University of British Columbia in the Jan. 20 Lancet, he says there's no proof that statins prevent heart attacks or strokes in healthy people, yet high cholesterol numbers are enough to prompt a prescription. We called him, and here's some of what he said:
Q. Where did the NCEP recommendations come from?
A: The full report is 284 pages. Near the back, talking about women, it says "the rationale for therapy is based on extrapolation of benefit from men of similar risk." We know you cannot extrapolate from men to women. ... And there are no gold-standard clinical trials that show benefit for older men without a history of heart disease.
Q. What about people who do have heart disease?
A. There is good evidence that statins are beneficial for secondary prevention but there's even better evidence that living a healthy lifestyle is even more effective than taking a statin, though they are not mutually exclusive. Don't think that by taking your statin you are doing everything you can do to reduce your risk of heart disease.
Everyone is focused on cholesterol, not on real epidemiological facts of what the risks are.
A. The guidelines that create the clinical imperative for physicians are done by experts who have financial ties to drug companies that make the drugs being considered in the process. Fifty-nine percent of the experts who formulate the guidelines have financial ties.
In a meta-analysis of statins in the October Lancet, 13 out of 14 studies were commercially sponsored. The one that was not commercially sponsored showed distinctly less benefit from statins.
Q. What about you? The Lancet says you are an expert consultant to plaintiff's attorneys on litigation involving the drug industry, including Pfizer for its marketing of atorvastatin.
A. That's right.
Do Nobel laureates live longer? Harvard winner doubtful
Winning the Nobel Prize can add almost a year and a half to a laureate's life, two British economists say. But though he's 81,
"It strikes me as remarkably doubtful," he said.
The University of Warwick researchers, testing the idea that social status can influence quality of life and longevity, looked at nominees for the Nobel Prize in chemistry and physics from 1901 to 1950. They thought sudden success would tell them the effect of social status on the winners when compared to their nominated peers.
Winners lived to an average age of 77.2 years, 1.4 years longer than those who were simply nominated for the prize, who died at an average age of 75.8 years old. Varying amounts of prize money over the years didn't budge those averages, the researchers said.
But Glauber said the study might have been biased by the fact that many laureates aren't selected until they're quite old. Glauber won his Nobel 40 years after publishing his work on how light behaves.
"Needless to say, if you wait a long time in selecting any group of people, you've eliminated the people who have a short lifespan," he said in an interview. "That does load the dice in favor of longevity."
We won't know about Glauber's class of laureates for about another 50 years, when nominees' names are unsealed.
"You never know," he said. "Maybe a Nobel winner will live to be 150."
-- Elizabeth Cooney