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Dartmouth Medicine Fall 2006

Dear Reporter, Editor, or News Director:

In the Fall 2006 issue of Dartmouth Medicine, read about:

Bells and whistles prove their mettle: Sophisticated software that can convert 2-dimensional B&W vascular scans into 3D color images is more than a slick trick. Dartmouth surgeons were the first to make exclusive use of the new imaging system, developed at Dartmouth, and a study has shown it provides results at least as good as, and often better than, conventional arteriograms. See page 3.

Dollars and sense: Dartmouth-Hitchcock Medical Center has a new web-based tool that gives patients an estimate of their own out-of-pocket cost for many common diagnostic, surgical, and medical services-after factoring in their insurance coverage (or lack thereof). See page 17.

Is there solid evidence behind prescriptions?: Only 85% of them, according to a study of 725 million prescriptions written in 2001. That means 15% of drugs are prescribed without solid evidence of safety or effectiveness. A doctoral student at Dartmouth Medical School recently published a study of "off-label" prescriptions, and the results were disquieting. See page 4.

Battling biofilms: Biofilms-bacteria in communities rather than free-swimming or planktonic form-are more resistant to antibiotics. A casual chat led to a nephrologists's suspicion that infections in the catheters used for dialysis might be biofilm-related, and then to a study which showed that an anticoagulant used to keep the catheters clear was promoting the infections. See page 6.

No CLIPP off the old block: A pediatrics training program developed at Dartmouth is now used by more than half the nation's medical schools. The way the 31 virtual cases were created, rather than flashy technology, is the reason behind its success. See page 13.

A vein effort: A genetic defect that affects the growth of arteries but not veins was recently identified by Dartmouth's Angiogenesis Research Center. The finding may lead to ways to control angiogenesis, the creation of new blood vessels, which holds promise for treating conditions ranging from cancer to coronary artery disease. See page 5.

DES effects run deeper than feared: A drug banned for more than 30 years may be causing problems in a third generation. According to a recent study by a Dartmouth researcher, abnormalities are showing up in the children of the children of mothers who took diethylstilbestrol (DES), a synthetic estrogen prescribed to reduce the risk of miscarriage from about 1940 through the early 1970s. See page 5.

A better mousetrap: A Dartmouth surgeon has gotten a patent on a stencil designed to be a better way of making optimally sized incisions for laparoscopic surgery. See page 12.

Good night, sleep tight: Sleep evaluations are expensive, so patients with sleeping disorders but without insurance coverage have usually been out of luck. Recently, a pair of medical students set out to improve the options for uninsured patients in the Dartmouth region. See page 18.

To pursue any of these stories, contact the Dartmouth Medical School/Dartmouth-Hitchcock Medical Center Media Relations Office at 603-653-1969 or MedNews@Dartmouth.edu.

Dana Cook Grossman

Editor

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Geisel School of Medicine at DartmouthDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College