Most of the 220,000 men diagnosed with prostate cancer each year look for information about the condition online. But, according to DHMC surgeon Peter Steinberg, M.D., what they find might not be very balanced. Steinberg and other researchers studied YouTube videos that discuss treatments for prostate cancer and the controversial prostate-specific antigen (PSA) test. They found that 69% of the videos expressed a bias in favor of screening or treatment, but none expressed a bias for less aggressive approaches. "YouTube is not a reliable source of information for individual patients seeking to better understand the screening for, and management of, prostate cancer," Steinberg wrote in Urology.
"We need to create incentives for surgeons to practice in rural areas," explained DMS surgeon Ian Paquette, M.D., at a recent gathering of the American College of Surgeons. Paquette made the suggestion in the context of presenting research showing that people living in the country are more likely to suffer a perforated appendix than are people living in the city. One reason for the regional difference, according to Paquette, is that there are more general surgeons in urban than rural areas.
DMS's Ann Gormley, M.D., chairs the Urinary Incontinence Treatment Network, a nine-site research group funded by the National Institute of Diabetes and Digestive and Kidney Disease.
Exercising right before undergoing a rapid change in air pressure may raise the risk of acquiring decompression sickness. Exercise causes tiny bubbles called micronuclei to form, but they had never been conclusively detected—until recently. DMS researchers had subjects exercise strenuously for 30 minutes. They then used a form of ultrasound to spot bubbles in subjects' legs. "The ability to measure micronuclei could offer a way to examine how and where they form, and their relationship to decompression sickness risk," they wrote in the Journal of Applied Physiology.
Benefits of breast-feeding
A team of DMS and DHMC researchers have made an intriguing finding with regard to breast-feeding and ovarian cancer. They studied hundreds of women with and without ovarian cancer and concluded that breastfeeding offers some protection against ovarian cancer—but only if the woman breastfed her youngest child. There was no protective effect if a woman breast-fed some of her children but not her final child. "These findings," the authors wrote in the journal Cancer Causes Control, "which require confirmation by future studies, imply that breast-feeding resets pregnancy-related states that mediate ovarian cancer risk."
At the International Conference on Alzheimer's and Parkinson's Diseases, DMS's Tracie Caller, M.D., made a presentation about selecting the optimal site of deep brain stimulation to treat Parkinson's.
The number of U.S. octogenarians is predicted to double between 2000 and 2050. Many people in this demographic eventually develop heart disease, raising the question of whether the benefits of surgery to treat it outweigh the age-related risks. In a large study, Donald Likosky, Ph.D., and colleagues found that patients over 80 who underwent aortic valve surgery did, on average, benefit, with over half surviving more than six years. "This study presents the largest experience to date of octogenarians undergoing surgical treatment of aortic stenosis," the authors wrote in Circulation.
Counting all costs
According to DMS researchers, changes in surgical technologies may have hidden costs. They compared open colectomies—an older approach—to laparoscopic colectomies—a newer, minimally invasive technique. There is little difference in the dollar cost of performing the two procedures, but the laparoscopic approach takes about 27 minutes longer. The lost time, say the researchers, adds up to between $240 and $700 more in opportunity cost per procedure. "Although frequently overlooked, opportunity cost is a potentially very important element in assessing the true costs of surgical innovation," they wrote in Surgical Endoscopy.
Dartmouth's Norris Cotton Cancer Center ranked among the top 5% of institutions nationwide in total research dollars from the National Cancer Institute in FY09—earning over $34 million.
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