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Dartmouth Medicine Summer 2006

Dear Reporter, Editor, or News Director:

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

Putting prions in their place: Mad cow disease and its human variant are caused when brain proteins called prions misfold and infect normal prions. Dartmouth scientists have shown that copper ions may interrupt the conversion of normal prions to infectious ones; they don't yet know how the process works, but it's a promising finding about a devastating disease. See page 3.

Is there a fix for what ails American health care?: HMOs weren't the answer. Cost-cutting hasn't worked either. Technology, which reduces costs in most industries, raises them in health care. But a relatively simple concept called "microsystems" may be just what the doctor ordered. See page 28.

One of the "whys" of Vioxx: The news has been full of stories about Vioxx and other COX-2 inhibitors-a class of drugs that reduces pain but may elevate patients' risk of heart attacks and strokes. A Dartmouth lab recently identified one of the physiological mechanisms that may be causing the much-discussed side effects. See page 5.

Deep impact: Deep brain stimulation has become an effective and accepted treatment for the tremors caused by Parkinson's disease. But until a recent Dartmouth study proved that the technique increases dopamine levels in the brain, researchers could only guess at why it worked. See page 7.

A different kind of camp: Camp Dartmouth-Hitchcock has all the usual attractions of a summer camp-and then some. Established more than 20 years ago, it is one of the nation's oldest camps for children with chronic rheumatologic conditions. See page 14.

Details, details: Three infection-reduction initiatives at Dartmouth-Hitchcock have shown that paying attention to the tiniest details can be as important as sophisticated technology in improving outcomes. See page 18.

Is there a doctor in the house?: If you're asking internal medicine residents at Dartmouth-Hitchcock Medical Center, and are referring to the homes of elderly patients, the answer is yes. All residents in general internal medicine are now required to make house calls, and they gain useful insights from the visits. See page 23.

The metrics of polyps: The conventional wisdom has been that polyps, small growths on the lining of the colon that have the potential to become cancerous, are most worrisome when they're larger than 10mm. Now, a Dartmouth gastroenterologist has analyzed more than 3,000 colonoscopies and determined that even polyps between 5mm and 10mm should be removed. See page 4.

A new factor to consider in skin cancer: A Dartmouth epidemiologist recently confirmed an association between squamous cell carcinoma, a fairly common skin cancer, and human papillomavirus. Now the next step is to determine whether the relationship is causative. See page 6.

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