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Media Mentions: DMS & DHMC in the News

Among the people and programs coming in for prominent media coverage during recent months was Dr. Harold Sox, DMS's chair of medicine. He was quoted from the Washington Post to the San Francisco Chronicle, from National Public Radio to CNN, in connection with his role heading a panel of experts convened by the Institute of Medicine to investigate the cause of Gulf War syndrome. The panel's report concluded that there's not enough evidence to either confirm or deny a link between the syndrome and several suspected causative agents. "We'd like to give veterans and their families a definitive answer, but the evidence is simply not strong enough," Sox was quoted as saying in the Chicago Tribune.

A recent PBS special titled "Critical Condition" described a regional collaborative aimed at improving cardiovascular surgery outcomes in northern New England. Among those interviewed on the show was DMS's Dr. Gerald O'Connor, a key member of the collaborative. "We found that the mortality rates, that is the death rates across the region after heart surgery, varied substantially," said O'Connor. "In the lowest center, they were about 2%. That is, two out of a hundred patients dying. And in the highest, they were about six out of a hundred. We realized, right away, that it was not differences caused by differences in patients." The region has since then seen a 24% reduction in mortality after heart surgery. "There's very good evidence that northern New England is the best place to have chest pain in the country right now," O'Connor said on the show, emphasizing that the outcome is a result of "what we have done as a group, not just what we're doing as individual institutions."

A Dartmouth neuroscientist was quoted by UPI in a report that German scientists had taken "the first step toward unraveling the cellular 'wiring' of different parts of the brain." The finding "might ultimately help doctors determine what goes wrong in conditions such as autism and Alzheimer's disease, said neurology experts. According to Michael Gazzaniga, a professor of cognitive neuroscience at Dartmouth College, the painstaking discovery is the first evidence of cellular differences between corresponding structures on the right and left sides of the brain. . . 'This is a quantum jump forward,'" Gazzaniga said.

A three-part series in USA Today explored the variations in medical practice patterns uncovered by the Dartmouth Atlas of Health Care. "Operations often depend on where you live" was the headline on one piece in the series, which noted: "'Local medical opinions regularly differ to the point that four times more people in one region get a surgery' than do their neighbors, says John Wennberg of the Dartmouth Center for the Evaluative Clinical Sciences and head of the Atlas series." And in an article titled "Total trust in physicians is unwise," Wennberg was quoted as saying: "It's fair to say that we're trying to promote a new model of making surgical decisions that features open communication about what's known and not known about a procedure."

"Mommy, I have to throw up!" was the attention- getting headline on a feature in Parents Magazine that quoted a DMS infectious disease specialist, among other experts. Vomiting plus diarrhea and a mild fever, "in children over five, . . . particularly in the winter, could be caused by a group of bugs called caliciviruses," said the article. "'Symptoms tend to last 24 to 48 hours,' says John Modlin, M.D., acting chair of pediatrics at Dartmouth." After the child stops throwing up, Modlin advises offering a small amount of milk or juice. "If the fluid stays down and your child is willing, encourage him to eat whatever appeals to him, Dr. Modlin says."

The impact on teens of smoking on the silver screen was the topic of a recent Dartmouth study that's caught the attention of the media. Recently, both the Christian Science Monitor and Health magazine took note of it. "A new study finds that 95% of the most popular movies from 1988 to 1997 depict actors using tobacco," said the Monitor, "and of the films aimed at children, one in five featured smoking. Does all this have anything to do with the fact that 23% of high school seniors in the United States smoke daily? (And that figure was 17% eight years ago.)" And wrote Health, "James Sargent, a physician at Dartmouth Medical School, asked 632 teenagers to name their top film idols and then quizzed the kids on their own habits. Turns out, kids who picked a celeb who routinely lights up in flicks were three times more likely to take a drag themselves."

The dilemma of how, or even whether, to conduct controlled clinical trials of pharmaceuticals among children was the subject of a feature in the New York Times. "Researchers agree [that] where there is no effective treatment, placebos may be appropriate. 'There is still not an established standard of care for the treatment of child depression,' said Dr. Craig Donnelly, an assistant professor of psychiatry and of pediatrics at Dartmouth-Hitchcock Medical Center. Dr. Donnelly is now engaged in a large study of child depression, in which five antidepressants previously tested on adults only are being tested on children. Half will receive the drugs and half placebos."

The link between hospital volume and health outcomes was the subject of a recent Los Angeles Times feature. "'Surgeons are viewed as the captain of the ship, and patients are always concerned about their doctor's credentials,' says Dr. John Birkmeyer, a surgeon at Dartmouth Medical School. 'But the fact is that where your surgery is done or your disease is treated is even more crucial.'" Check the numbers at your hospital, advised the article. "'If they can't or won't give you the information,' says Dartmouth's Birkmeyer, 'that's a red flag.'"

Family Circle magazine recently reported that "left-handed women may have a higher risk of breast cancer than right-handed women, says a study led by Linda Titus-Ernstoff, Ph.D., at Dartmouth Medical School. Hormones in the womb, which may help determine a baby's dominant side, might also increase a woman's breast cancer risk. . . . Nevertheless, reassures Dr. Titus-Ernstoff, 'these findings indicate only a modest increase in risk.'"

"Exploring the enigma of prostate therapies" was the headline on a feature in the New York Times. "What makes . . . decisions about treatment [for prostate cancer] so difficult," said the article, "is that doctors do not know which one is most effective. . . . Dr. John Wasson, an expert on health-care delivery at Dartmouth, said there was no proof from scientifically controlled trials 'that any treatment is better than watchful waiting' and then, if the cancer spreads, prescribing drugs to lower male hormones to make the cancer shrink or grow more slowly. . . . Rigorously controlled trials for prostate cancer have been difficult to do 'because everyone felt they knew the answer,' said Dr. Wasson of Dartmouth."

When Miami Heat hoops star Alonzo Mourning was diagnosed with kidney disease, CNN turned for expert commentary to Dr. Brian Remillard, a nephrologist at Dartmouth- Hitchcock Medical Center. The CNN anchor asked Remillard to explain Mourning's condition, focal sclerosis. "That's a term that's used to describe a scarring process in the kidney," said Remillard, "which can occur for a variety of reasons. But probably the most common in African-Americans is hypertension. . . . In the age group that Alonzo is in, I think that this condition is much more common than recognized." Treatment options range from drug therapy to dialysis or a transplant, and Remillard said the choice depends on how advanced the disease is and how much kidney function remains.

In her "Personal Health" column in the New York Times, Jane Brody recently emphasized the importance of early detection of infant deafness. "Deafness is the most common disability present at birth," she wrote. "'A deaf newborn looks and acts like any other baby,' said Dr. Andrew Schuman, an adjunct professor of pediatrics at Dartmouth Medical School. There are rarely outward clues, and unless newborns are tested for hearing loss, it is often not detected until the child is two or three and fails to start talking. Such delays can permanently impair a child's ability to learn to speak intelligibly and can result in long-lasting social, emotional, and academic difficulties."

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