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."
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.
If you'd like to offer feedback about this article, we'd welcome getting your comments at DartMed@Dartmouth.edu.
This article may not be reproduced or reposted without permission. To inquire about permission, contact DartMed@Dartmouth.edu.