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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. James Sargent, an associate professor of pediatrics, who "surveyed the 25 top-grossing movies each year from 1988 to 1997 and found that 95 percent contained scenes of tobacco use," according to ABCNews.com. The story said Sargent found 3,346 examples of tobacco use in the 250 films. "'You ask yourself, "Where do kids get the idea that smoking is going to calm them down or make it easier to socialize?"' asks Sargent. 'But just look at My Best Friend's Wedding. Every time Julia Roberts gets nervous, she lights up.'"

Columnist Matthew Miller wrote in the Baltimore Sun about the "nutty economics" of Medicare funding cuts, which mean "Medicare payments to HMOs vary widely across the country, ranging from $3,000 per beneficiary in some Midwestern towns to more than $9,000 in big cities. . . . Enter Dr. John Wennberg of Dartmouth, the nation's leading student of these variations. As he told me recently, only a tiny portion of these regional cost variations can be explained by cost-ofliving differences for supplies, wages, and the like. Instead, they're driven by local differences in the number of doctors and hospital beds . . . a self-interested case of supply driving demand."

Several recent studies have shown that survival rates after complex surgery are higher at hospitals that do a lot of the procedure. Nevertheless, "the importance of volume still isn't recognized," said U.S. News & World Report. "Busy hospitals aren't safer merely because surgeons there get lots of practice, contends John Birkmeyer, a surgeon at Dartmouth-Hitchcock Medical Center, who has published widely on the significance of volume. 'Hospital volume is a proxy for so many other things,' he says. 'Like a blood bank that can support major bleeding.' . . . Birkmeyer has concluded, in fact, that hospital volume is more important than are an individual surgeon's numbers." (See "Faculty Matters" in the Summer 2000 issue for more on Birkmeyer's research.)

Associated Press reported on a recent study examining "the five-year survival rate—the standard measurement of a cancer treatment's success." The study had concluded that such statistics can be misleading. "Dr. H. Gilbert Welch, lead author of the study and a professor at Dartmouth Medical School, said the increase in the survival rates is mostly influenced by earlier diagnoses of cancer, not advances in treatment. . . . 'We know that the five-year survival rate always goes up when we find cancer earlier in patients' lives. Whether or not these patients have their deaths postponed is a different matter altogether,' said Welch."

The Washington Post turned to another Dartmouth expert for commentary on a similar topic. "In cancer, early detection is a medical mantra," said the article. "Catching tumors before they have a chance to spread gives treatment the best chance of working. But that logical bedrock gets slippery when doctors ask a much-trickier question: Should people without symptoms be routinely screened for cancer? . . . William Black of Dartmouth Medical School said the Duke findings [which cast doubt on the value of such screenings] 'remind us that survival statistics can be misleading.'"

The Detroit Free Press turned to DHMC for advice in a story on bed-wetting. Dr. Marc Cendron, a pediatric urologist, is quoted as urging parents to explain the problem to children as "a medical condition that may be hereditary, and they are not to blame. 'Children deserve an explanation of what is happening to them,' he says."

A recent feature in Newsday explored the risks and benefits of hormone replacement therapy (HRT) for postmenopausal women. Among the effects cited was quality of life. "A recent study by researchers at Dartmouth Medical School asked 286 women, 116 of them current HRT users, to assess quality of life. Current HRT users had a 'higher health-related quality of life than past or never users,' according to the study. . . . But the authors said women's perceptions of potential side effects were 'highly variable.'" The lead author of the study was Dr. Anna Tosteson, an associate professor of medicine.

The shores of Cape Cod are the setting for "a conflict that reflects the precarious balance of ocean life," reported the Boston Globe. Increased demand for calamari is jeopardizing the supply of "the slim, translucent squid [that] give scientists insight into everything from the roots of Alzheimer's disease to the mechanics of vision. . . . George Langford, a biologist at Dartmouth College, has been studying the squid at Woods Hole since 1972. In three decades, he has seen the understanding of nerve functions grow exponentially."

A study by DMS's Tim Ahles continues to attract major media attention. Wrote Reader's Digest: "According to a Dartmouth Medical School study, chemotherapy may leave some patients with poor memories and concentration problems. Psychologist Tim Ahles found that people who got standard chemotherapy for breast cancer or lymphoma appeared to be twice as likely as those having surgery and/or local radiation to score poorly on memory and concentration tests. And the effects were present an average of 10 years after treatment." The Los Angeles Times also covered Ahles's work, saying he "estimates that 20% to 30% of cancer patients who have chemotherapy continue to have cognitive impairment more than two years after treatment."

Biography magazine asked Dartmouth's C. Everett Koop, "perhaps America's most recognizable doctor" for "25 ways to stay healthy." His tips included "don't smoke" (#1), "stay fit" (#7), "buckle up" (#15), and "get shots and vaccines" (#21).

The Learning Channel featured a patient of Dartmouth neurologist Richard Nordgren, M.D. (pictured at right), and neuropsychologist Andrew Saykin, Psy.D., (below) in a show on cold-water survival. Caleb Record, a high school senior, was driving home one snowy night in 1997 when his car slipped off an icy road and landed upside down in a river. He was trapped underwater for 20 minutes; although the extreme cold kept him alive, he didn't regain consciousness for five days. "When he arrived here he was still very sick [and] unresponsive," Nordgren said on the show. Record had to relearn everything, from walking to reading, but was able to finish high school. Two years after the accident, he underwent functional MRI testing at DHMC to determine how well the memory portions of his brain worked. "What we found is that performance was excellent," said Saykin. "We think that this probably bodes well for . . . further recovery of memory."

How to distinguish between a sprain and a strain, and what to do in each case, was the topic of an item in Walking Magazine. "'Although minor strains and sprains will heal on their own, you should seek medical attention immediately if there is acute swelling at a joint and/or persistent pain and tenderness to the touch,' says Ken Dolkart, M.D., an adjunct assistant professor of medicine at Dartmouth Medical School."

Another summer injury—bee stings— was covered in Child magazine. "If your child faints or has difficulty breathing, seek medical attention right away, because this may indicate a serious allergic reaction, says William Boyle, M.D., a pediatrician and professor of pediatrics at Dartmouth Medical School."

In a profile of a teenager with severe bulimia, the CBSNews.com Web site quoted Marcia Herrin, a nutritionist at Dartmouth College, on the role that perfectionism often plays in eating disorders. "'It's so prevalent in our society, this idea that one needs to be perfect to succeed,' she says. 'The perfect grades, the perfect family, why not add in the perfect body?'"

National Public Radio's Joanne Silberner reported on two recent studies that assessed screening for colon cancer. Some experts advocate screening everyone over age 50, said Silberner. But, she added, a national task force "found no evidence that colonoscopy should be routinely done on people with no special predisposition to cancer, though it is useful for people at high risk. Dr. Harold Sox of Dartmouth Medical School was on the task force, and the new studies haven't sold him on colonoscopy." Said Sox, "Is the standard going to be 'It looks like it might work, so let's do it' or is the standard going to be 'We've proven that it works'?" Silberner concluded by noting that "smokers routinely got x-rays to check for lung cancer, until someone proved that such screenings didn't extend their lives."

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