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Discoveries
Research Briefs
For love of country
Primary-care physicians who live in rural areas
are likely to make less than their urban
counterparts. So stated two DMS researchers
in the Journal of Rural Health. They studied
data gathered by the American Medical Association
and concluded that primary-
care doctors in the country
work longer hours, see more patients,
and rely more heavily on
Medicaid reimbursements than do doctors in
cities. The authors recommended "increasing
incomes, reducing work hours, or some
combination of the two" to encourage doctors
to leave the pavement for the pasture.
Duck, dog, ditch, dig . . .
Given one minute, how many words could
you list that start with the letter "D"? That
word game is a test of verbal fluency—the
ability to name words in a limited category.
Members of the DMS Department of Psychiatry
used such tests to examine a possible
link between verbal fluency and mild cognitive
impairment (MCI), a condition
that often progresses to Alzheimer's
disease. They reported in Archives of
Clinical Neuropsychology that there was "an
overall decline in verbal fluency performance"
among patients with MCI. Their
work could help doctors spot the condition
earlier, making treatment more effective.
Paging Dr. C-3PO
Robotic-assisted prostate surgery can result
in less blood loss and a shorter hospital stay
than surgeries performed by sentient beings
alone, yet only 7% of hospitals own the necessary
equipment. According to DMS researchers,
that might be for the best. After
examining the costs associated with
purchasing a robot—about $1.5 million—and the time it takes to train a surgeon,
they concluded that it simply doesn't
make sense for many hospitals to own one.
They wrote in Urology that although there
are advantages to robotic-assisted procedures,
"expenditures on a robot are taken from other
portions of the health-care system."
Carpe medicamentum
There is no one-size-fits-all drug treatment
for epilepsy; some patients suffer serious side
effects, while others do not respond at all.
But researchers from the Neuroscience Center
at Dartmouth reported recently that
they had success using uridine—a
molecule involved in cell metabolism—to reduce the number and
severity of seizures in rats. Just as important
was the fact that they did not see any side effects.
"These properties," they concluded in
the journal Epilepsy and Behavior, "make uridine
a potentially promising agent for the
treatment or prevention of epilepsy."
Back and forth
Magnetic resonance imaging (MRI) is an important
tool for discovering the cause of lower
back pain. "Unfortunately," DMS researchers
wrote in Spine, "the relationship between
findings on MRI and clinical course
remains controversial." To test the consistency
ofMRI readings, they asked three radiologists
and one surgeon to examine images
of 50 patients suffering from a disc
herniation. The doctors agreed closely
on the severity of the herniations, but they
showed greater variability when it came to
measuring the length of disc fragmentations,
confirming the fact that reading an MRI can
be open to some interpretation.
Time-out for tumors
Lung cancer kills more Americans than any
other type of cancer,making better treatment
options imperative. According to findings
from the lab of DMS's Michael Sporn, Ph.D.,
erlotinib—a drug often used to treat lung
cancer—is less effective than two alternatives.
Sporn tested erlotinib against two
other types of drugs, a rexinoid and a
triterpenoid, and reported in Molecular
Cancer Therapeutics that the latter two "are
highly effective for preventing lung carcinogenesis
as measured by significant reductions
in the number, size, and severity of lung tumors"—more effective than erlotinib.
A DMS study found that people who drank two or more cups of green or black tea daily were 30% less likely to have squamous cell skin cancers than were non-teadrinkers.
Only 9% of U.S. physicians practice in rural communities, according to the AMA, but 20% of the population lives in rural areas and rural patients tend to be older and sicker.
The Office of Naval Research awarded DMS's Dr. Joseph Rosen and a colleague $600,000 to develop a computer to model surgeons' behavior in the OR, with the goal of preventing mishaps.
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