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Among the people and programs coming in for prominent media coverage in recent months was epidemiologist John Baron. From the Washington Post to the Los Angeles Times and CNN to NPR, the media covered a study he led about aspirin's effect on colon cancer. Noted Newsweek: "Now, scientists say, [aspirin] may also help ward off colon cancer, at least in high-risk populations." The San Francisco Chronicle reported that "Dr. John Baron of Dartmouth Medical School said aspirin's benefits are real but modest." And Reader's Digest issued a caution: "Though aspirin is great, says Dartmouth's John Baron, it has risks. Talk to your doctor first." See page 10 for more on the study.

A Newsweek cover story on pain quoted a DHMC expert for insights into "small patients, big pain." Doctors are "rethinking the treatment of acute pain for children who go to emergency rooms for more common injuries like broken limbs or cuts that need stitches. In the past 'you brought your kid to the hospital. They held them down and did something that hurt, and you brought them home,' says Joe Cravero, a pediatrician and anesthesiologist who is cowriting an American Academy of Pediatrics policy statement on pain relief in the ER."

"The perils of prevention" was the headline on a New York Times feature about some downsides of aggressive screening practices. "'Imaging has improved so much, we can find things we really don't know enough about,' says Dr. William Black, a radiologist at Dartmouth. In the face of this uncertainty, doctors say they must err on the side of caution and treat practically every tiny tumor as if it were potentially deadly. . . . But that means that widespread screening for prostate and breast cancer has resulted in huge numbers of patients suffering the side effects of unnecessary medicine." See page 14 for a recent study on a related topic.

From Better Homes & Gardens, to the New York Times, to the San Diego Union-Tribune, the word is out that the advice to drink eight 8-ounce glasses of water a day is all wet. A review article on the subject last year by DMS physiologist Heinz Valtin is still getting wide coverage. BH&G wrote that "according to a study at Dartmouth, the '8-by-8 rule,' as it's known among nutritionists, doesn't appear to have any real scientific basis." The New York Times said many marathoners are "overhydrated, having fallen for what Dr. Heinz Valtin of Dartmouth deems a medical myth: that dehydration is always lurking." And in the San Diego newspaper, "Heinz Valtin, a noted kidney expert from Dartmouth, [warned that] water intoxication and even death can result from drinking more water than your kidneys can process."

Debate in the scientific community regarding the rigor of space-shuttle science was fodder for a recent article in the Houston Chronicle. One of the experts who defended such work was "Jay Buckey, a Dartmouth medical professor who flew on Neurolab. . . . Buckey said NASA did several things right for Neurolab, such as tailoring the flight to fit the science and not the science to fit the flight."

"Take two recent medical anecdotes," wrote a reporter for the Milwaukee Journal-Sentinel. "I had two surgeries, one on a knee and another on a wrist, and nobody asked me in a systematic way how they came out. My doctors know and I know, but no one else knows. In the same time frame, my son had a back operation at Dartmouth-Hitchcock Medical Center, a longtime leader in systematic medicine. . . . His results, like mine, were excellent, but his were fed into a real-time database, while mine went into the ether." The director of DHMC's Spine Center is James Weinstein.

Ruing "a medical arms race that is spreading openheart surgery across southeastern Pennsylvania but is draining the number of patients at many programs, threatening patient safety," the Philadelphia Inquirer turned to a Dartmouth expert on the effect of volume on surgery risk. "In the largest surgical volume study ever done, John Birkmeyer, chief of general surgery at Dartmouth, found that 4.8% of Medicare patients died soon after bypasses in high volume hospitals. But the death rate jumped to 6.1% for bypass patients in the lowest-volume hospitals."

The Wall Street Journal reported that ruptured aneurysms, "a ballooned section of a blood vessel, . . . kill an estimated 18,000 Americans a year—more than AIDS or brain cancer." They can be diagnosed with "a simple test," but it's not covered by most insurers or recommended by most doctors. Now, however, "a large new study is being organized by the medical schools at Dartmouth, the University of Pennsylvania, and the University of Pittsburgh. Initially it will measure the prevalence of aneurysms; a later phase will check for a mortality benefit from screening. 'There is reasonable emerging evidence suggesting it's reasonable to screen men over 60' for abdominal aneurysm, 'particularly if they have a history of smoking, and anyone with a first-degree relative with an aneurysm,' says Jack Cronenwett, a study organizer and chief of vascular surgery at Dartmouth."

Noted the Miami Herald: "Blood banks are starting to adopt new anti-germ technology. 'Although the public is worried about HIV or West Nile virus, we may have to occasionally stand up and say in public or to a newspaper reporter, "That's not what we should be worrying about,"' blood safety expert James AuBuchon of Dartmouth told a recent meeting of the government's top blood advisors. 'Share with the public what the real risks are.' Topping that list: germs." AuBuchon's work was the subject of the cover feature in the Spring issue of the magazine.

Though bioterrorism remains a subject of concern, "vaccinating the entire U.S. population for smallpox in the 21st century, without signs of an attack, is a step vaccine experts call extreme," reported Newsday. "'We need a policy, but that doesn't mean that we have a general policy to immunize large numbers of people,' said Dr. John Modlin," who chairs the federal Advisory Committee on Immunization Practices. "Modlin, a professor at Dartmouth Medical School, said the vaccine is based on a live virus, and therefore a policy must be carefully crafted."

The Baltimore Sun wrote about a problem that "cancer patients [call] chemo brain or chemo curse . . . a sense that their brains are in a fog. In one study of breast cancer and lymphoma patients at Dartmouth- Hitchcock Medical Center, more than twice as many chemotherapy patients scored in the lower impaired range than did patients who had radiation or surgery. Dr. Tim Ahles, who directs psychooncology research at Dartmouth, found deficits even after accounting for education differences and screening out survivors with problems such as depression and anxiety."

Newsday reported on "arsenic's reputation for toxic nastiness," saying a Dartmouth study shows "that even minuscule doses disrupt the way hormones work. . . . 'Arsenic is an agent of considerable public health concern in the United States and worldwide,' said toxicologist Joshua Hamilton of Dartmouth. The elemental metal is already known to be outright poisonous. . . . Now, Hamilton said, 'it's very clear that arsenic is a potent endocrine disrupter.'"

The London Daily Telegraph carried word of a recent "finding that some sufferers from temporal lobe epilepsy . . . seem to experience devout hallucinations that bear striking resemblances to the mystical experiences of holy figures such as St. Paul or Moses. This theory received a boost from Gregory Holmes, a pediatric neurologist at Dartmouth, who says one of the principal founders of the Seventh-Day Adventist movement, Ellen White, in fact suffered from temporal lobe epilepsy."

The myriad benefits of a good night's sleep were recently touted in the pages of Reader's Digest. "The solutions to sleeplessness are better than ever, but it helps to understand the nature of your problem, says Michael Sateia, who directs the Dartmouth- Hitchcock Sleep Disorders Center. 'Virtually everyone has at least a transient period of insomnia that lasts a night or a few nights.' It could be triggered by grief, hardship, jet lag, divorce, or pressures at work. But most people get over it quickly."

The connection between sleep disturbances and traumatic events was the subject of a piece on ABCNews.com. Another Dartmouth sleep medicine expert, Thomas Mellman, was quoted as saying that a traumatic event can disturb sleep in several ways. "A person might feel the need to be alert or on guard. And being alert is basically incompatible with being asleep," he said. "Also, worry and intrusive thoughts, such as disturbing images of what happened, might interfere with sleep. . . . Similarly, there are certain startle mechanisms that can actually operate within sleep. . . . Finally, particularly intense, life-threatening experiences can affect what one dreams about."

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