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Dartmouth Medicine Summer 2007

Dear Reporter, Editor, or News Director:

In the Summer 2007 issue of Dartmouth Medicine, read about:

When less is more: A member of the Dartmouth faculty chairs a national committee that's found an association between a reduction in the number of "high-order" multiple births (triplets or more) at the nation's fertility clinics, and national guidelines on in vitro procedures. It's good news if such guidelines can keep babies out of neonatal intensive care units. See page 3.

An ever green institution: Dartmouth-Hitchcock Medical Center's commitment to environmentally conscious operations dates back nearly 20 years, and the institution is now poised to become the first hospital in the nation to calculate its carbon footprint. See page 26.

Findings cast iron as heart un-healthy: The first large randomized trial to look at the effects of high blood levels of iron on cardiovascular health found that middle-aged subjects (those aged 43 to 61) whose iron levels were kept low by regular blood drawings had 54% fewer deaths than similarly aged subjects in the control group. The study was led by a member of the Dartmouth faculty. See page 6.

A waitless environment: A new model for delivering mental-health care, within a primary-care setting, has reduced the average waiting time for patients from 33 days to 19 minutes, and also won two national awards. It was developed at the VA Medical Center affiliated with Dartmouth. See page 11.

Early warning about a viral threat: A member of the Dartmouth faculty who is an international expert on enteroviruses has sounded the alarm in a recent journal article about a virus that shows some worrisome similarities to polio-and some even more worrisome differences. See page 9.

Importing RICE to Vietnam: That's not as nonsensical as it sounds, for this RICE is an acronym for "remote interaction, consultation, and epidemiology"-a Dartmouth-led project that promises to foster some important improvements in the Vietnamese health system. See page 10.

The implications of CRP testing: A few years ago, testing for c-reactive protein (CRP), a marker for inflammation, was the hot new way to screen for cardiovascular problems. Now, Dartmouth researchers have shown that widespread CRP testing could lead to 25 million more people being prescribed lipid-lowering drugs-but the catch is that there's no solid evidence of benefit for that population. Worse, many people who are at high risk for cardiovascular problems are not taking the drugs. See page 7.

Haunted by their past: The problems suffered by people with schizophrenia, such as homelessness and substance abuse, are often attributed just to their mental illness. But a member of the Dartmouth psychiatry faculty has released a study showing that schizophrenia correlates with a high rate of adverse childhood events, including abuse. He calls such patients "a kind of perfect storm for trauma" and believes their past adversity needs to be factored into their treatment. See page 8.

Another use for the wonder drug?: Aspirin's pain-killing and cardiovascular effects are well known. The latest news about the do-it-all drug-based on a Dartmouth study-is that it may reduce deadly staph infections in catheter-dependent dialysis patients. See page 5.

To pursue any of these stories, contact the Dartmouth Medical School/Dartmouth-Hitchcock Medical Center Media Relations Office at 603-653-1913 or Jason.Aldous@Hitchcock.org.

Dana Cook Grossman

Editor

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