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Identifying drugflation
The economy is not the only thing that's inflated. People with inflammatory bowel disease (IBD) overestimate the effectiveness—and underestimate the dangers—of the commonly used drug infliximab (sold as Remicade). So found a team of Dartmouth and Harvard researchers in a survey of 165 patients or parents of patients. When asked about a hypothetical drug that mirrored the benefits and risks of infliximab, a majority of respondents said they would not take the drug. "It is likely that marketing plays some role in both patients' and physicians' beliefs," the authors wrote in the journal Inflammatory Bowel Diseases.

An expressive manner
A member of a common molecular family is one of the culprits behind the growth and metastasis of pancreatic cancer, according to a Dartmouth-led study in the Journal of Clinical Investigation. GPC1, as it is known, is overexpressed in pancreatic cancer, reported a team led by Murray Korc, M.D., "and attenuation of GPC1 expression dampens [the response to growth factors] and slows pancreatic tumor growth. . . . Taken together, the present findings suggest that targeting GPC1 may ultimately yield novel therapeutic options" for treating pancreatic cancer and its metastases.

Staying abreast of the news
Magnetic resonance imaging (MRI) just isn't worth it as a breast-cancer screening tool for women who have already had a lumpectomy and radiation therapy. That's the conclusion of Dartmouth researchers from the Departments of Surgery and Radiology. After analyzing the records of 471 women who received standard care, they estimated that the total cost of using annual MRIs to detect recurrences would have been more than $7 million. "A total of 2,570MRIs would have been performed," they wrote in the Annals of Surgical Oncology, "but these would have been unlikely to change the therapy or survival of any of our patients."

A big-hearted mouse
When the Grinch's heart grew three sizes in one day, he must have grown a lot of new blood vessels, too—at least according to a recent finding made by the lab of DMS's Michael Simons,M.D. By manipulating a gene in a mouse, the researchers discovered that vessel density controls organ size. "An increase in the size of the vascular bed in the normal heart," wrote Simons and his coauthors in the Journal of Clinical Investigation, "leads to increased cardiac mass and . . . increased cardiac performance." In other words, more blood vessels result in a larger—and more powerful—heart.

Air line guide
An increasingly popular way to deliver oxygen to infants with respiratory problems may be easier but should not replace the standard method, DMS researchers recently reported in Pediatrics. The team measured the pressure inside the mouths of 27 infants as they received oxygen through heated, humidified, high-flow nasal cannula therapy. "Only in the smallest infants with the highest flow rates, with the mouth fully closed, can clinically significant but unpredictable levels of continuous positive airway pressure be achieved," wrote Zuzanna Kubicka, M.D., and her coauthors. "Our results and those of others also raise important safety and monitoring issues."

Air line guide
Despite efforts to ensure equal access to organs, country-dwellers are up to 20% less likely than their urban counterparts to get a heart, liver, or kidney transplant, concluded a study led by DMS surgeon David Axelrod, M.D. Patients in "rural regions and small towns face multiple barriers to health-care access," wrote Axelrod and his coauthors in the Journal of the American Medical Association, "including the need to travel long distances, the lack of locally available specialty services, and difficulty in receiving follow-up care."

Depression is prevalent among teens seeking care in the ER, but they're rarely screened for it. A DMS study showed a two-question screen is nearly as sensitive as a 20-question tool.

Another study from SPORT found that patients who had a diskectomy saw an improvement not only in back pain, but also in leg pain; in fact, their leg pain declined more.

DMS's David Goodman, M.D., found a 200% difference in physician supply across the U.S. For every physician who has moved to a lowsupply area, four moved to a high-supply area.

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