Discoveries
Research Briefs
Making the cut
Surgery trumps physical therapy, steroid injections,
and drugs in relieving pain from a
slipped vertebra and a narrowing spinal
canal, according to the latest paper from the
seven-year, $21-million Spine Patient Outcomes
Research Trial. "We suspected
surgery produced better results, but we
had little objective data to support that,"
said James Weinstein, D.O., M.S., chair
of orthopaedics at Dartmouth and lead
author of the study, published in the
New England Journal of Medicine. "We can
now discuss much more fully the surgical and
non-surgical options available to our patients
so that they can make an informed choice."
Function junction
Hunting for better ways to combat cancer, a
DMS team examined the expression patterns
of 241 microRNAs (miRNAs) in 59 cancer
cell lines. Since miRNAs regulate gene expression
and protein production, knowing
how they function is "essential . . .
for designing effective strategies
for cancer prevention and treatment,"
note Arti Gaur, Ph.D., and her
coauthors in Cancer Research. Understanding
miRNAs may also offer insight into how
a "limited number of genetic alterations . . .
result in the profound physiologic changes
that characterize all malignant tissues."
Aging well
A new fountain of youth for yeast was reported
by DMS biochemists in the journal
Cell. Previously, the best known way to prolong
life in yeast, as well as more complex organisms,
was by calorie restriction. But
Charles Brenner, Ph.D., and colleagues
have found a new vitamin
that prolongs life in yeast. "If we could do
this in humans," he says, "we would be able
to provide some of the benefits of calorie restriction,
which are pretty striking in model
organisms." The findings may one day help
people with neurodegenerative diseases and
other conditions associated with aging.
Needlepoint
Administering vaccinations against measles,
mumps, rubella, and chicken pox may soon
be easier in developed and developing nations
alike. Pediatric researchers at Dartmouth
recently evaluated a combination
vaccine that only needs to be refrigerated,
not frozen, and found it to be
just as good as its frozen counterparts.
Adopting the refrigerator-stable formulation
"will lessen the burden of distribution
and storage on pediatric practices, increase
the ease of vaccine administration, and allow
additional global expansion of current
recommendations throughout the world,"
the authors wrote in the journal Pediatrics.
Walkabout
Elderly men, but not women, who live in
pedestrian-friendly neighborhoods have lower
rates of depression, found a study led by a
new DMS faculty member. Even after taking
into account factors such as income, education,
age, ethnicity, smoking status, and
chronic diseases, the association persisted.
"One consequence of a poorly walkable
neighborhood may be more depressive
symptoms, particularly in
older men," wrote Ethan Berke, M.D.,
M.P.H., in the Journal of the American Geriatrics
Society. So, the authors wondered,
should clinicians suggest that "older patients
. . . live, if possible, in more-walkable areas?"
High sign
Higher malpractice awards and premiums go
hand in hand with higher Medicare spending,
note DMS health-policy analysts. In a
state-by-state comparison of Medicare data
from 2000 to 2003, they found that rising liability
costs were associated with increases
in physician services. "Our estimates
do not imply that [the association
is due to] 'defensive medicine,'"
the authors wrote in Health Affairs. But they
identified an especially strong link between
higher liability costs and more imaging procedures,
which are "often believed to be driven
by physicians' fears of malpractice."
Using national data from 10,061 people patchtested
for allergens, a DHMC resident found
that children and adults show allergic reactions
at similar rates—but to different substances.
Who decides where elective surgery is
performed? A recent Dartmouth study of 500
Medicare patients found that in 31% of cases,
the doctor was the primary decision-maker.
DMS geneticists explained in the journal Science
how cells' circadian clocks sense light and thus
pace their daily cycle. It's a mechanism that
has implications for mental illness and cancer.
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