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DISCOVERIES
Research Briefs

Call me sometime
Improving cancer-screening rates among minority
and low-income women may be just a
phone call away. In a study led by DMS's
Allen Dietrich, M.D., researchers found that
minority and low-income women were more
likely to get screened for breast cancer,
cervical cancer, and colorectal
cancer if they received a
phone call encouraging them to do so. Published
in the Annals of Internal Medicine, the
study showed that phone calls boosted
screening rates 12 percentage points for
mammography, 7 points for Pap tests, and 13
points for colorectal screening.

Compound interest
A compound developed by DMS pharmacologists
proved extremely effective, even in
small doses, at preventing liver cancer in rats
during a recent study conducted at Johns
Hopkins. The compound—CDDO-Im—caused an 85% reduction in precancerous lesions
at the lowest dose and a 99% reduction
at the highest dose.
Dartmouth researcher Michael
Sporn, M.D., who has been leading the development
of CDDO-Im and related compounds
for over a decade, believes CDDOIm
may also be useful in inflammatory bowel
disease, hepatitis, and the prevention of
liver metastases from colon cancer.

Risk is revised
The risk after an initial melanoma diagnosis
of developing a second melanoma—the
deadliest form of skin cancer—may be higher
than had been previously thought, according
to a recent Dartmouth study. Of 354
individuals diagnosed with melanoma,
27 (8%) had a recurrence within two
years, and 20 of the 27 had a recurrence
within one year. The results "underscore
the importance of close surveillance
of patients with melanoma," wrote researcher
Linda Titus-Ernstoff, Ph.D., and her coauthors
in the Archives of Dermatology.

Stick 'em up
A typical dose of seasonal flu vaccine could
protect five people instead of just one, according
to preliminary results of a DHMC
study. Kathryn Kirkland, M.D., associate director
of infection control, presented the early
findings at a meeting of the Society of
Healthcare Epidemiology of America.
While stretching the supply of seasonal
influenza vaccine appears safe and effective,
a similar approach probably
could not be used in case of a bird-flu vaccine
shortage, Kirkland cautioned. To stretch
the seasonal supply, the vaccine was injected
into skin rather than muscle. A bird-flu
vaccine, if and when one is developed, would
probably require injection into muscle.

Is bypass better?
Heart-bypass surgery trumps catheter-based
procedures in patients over 80, concluded a
recent seven-center study. The DHMC-based
Northern New England Cardiovascular
Disease Study Group compared the
survival rates of nearly 1,700 patients
aged 80 to 89 who underwent either a
catheter-based coronary procedure—called percutaneous coronary intervention
(PCI)—or heart-bypass surgery. Short-term
survival was better among the PCI patients,
but after six months heart-bypass surgery
took the lead. DHMC surgeon Lawrence
Dacey, M.D., was the lead investigator.

Utility notice
Physicians order the test 100,000 times a
year, and with good cause it seems. Esophageal
manometry (EM)—in which a tube is
inserted into the esophagus to measure its
muscle action—provides new information
for diagnosis 86% to 100% of the time, according
to a survey by DHMC gastroenterologist
Brian Lacy, M.D., Ph.D. Presenting
his findings at an American College
of Gastroenterology meeting, Lacy
said that information gleaned from EM
led to a change in patient management in up
to 60% of the cases in his study. That's not
bad for a test whose clinical utility had never
before been formally evaluated.
DMS ranks 12th among the 126 U.S. medical
schools on the basis of research funding per
basic science faculty member, according to
the Association of American Medical Colleges.
A DMS research team has received a federal
grant of almost $400,000 to develop a simple
factual box, like the nutrition information panel
on packaged foods, for prescription drugs.
DMS doctoral student David Radley quantified
off-label prescription drug use in an Archives
of Internal Medicine paper that was deemed a
"must read" in the May 19 Medical Economics.
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