Media Mentions: DMS & DHMC in the News
Among the people and programs coming in
for prominent media coverage during recent
months was Dr. Harold Sox, DMS's chair of medicine.
He was quoted from the Washington Post to the
San Francisco Chronicle, from National Public Radio
to CNN, in connection with
his role heading a panel of experts
convened by the Institute
of Medicine to investigate the
cause of Gulf War syndrome.
The panel's report concluded
that there's not enough evidence
to either confirm or deny
a link between the syndrome and several suspected
causative agents. "We'd like to give veterans
and their families a definitive answer, but the evidence
is simply not strong enough," Sox was
quoted as saying in the Chicago Tribune.
A recent PBS special titled "Critical Condition"
described a regional collaborative aimed at
improving cardiovascular surgery outcomes in
northern New England. Among those interviewed
on the show was DMS's Dr. Gerald O'Connor, a
key member of the collaborative. "We found that
the mortality rates, that is the
death rates across the region after
heart surgery, varied substantially,"
said O'Connor. "In
the lowest center, they were
about 2%. That is, two out of a
hundred patients dying. And in
the highest, they were about six
out of a hundred. We realized, right away, that it
was not differences caused by differences in patients."
The region has since then seen a 24% reduction
in mortality after heart surgery. "There's
very good evidence that northern New England is
the best place to have chest pain in the country
right now," O'Connor said on the show, emphasizing
that the outcome is a result of "what we
have done as a group, not just what we're doing as
individual institutions."
A Dartmouth neuroscientist was quoted by
UPI in a report that German scientists had taken
"the first step toward unraveling the cellular
'wiring' of different parts of the brain." The finding
"might ultimately help doctors determine
what goes wrong in conditions
such as autism and Alzheimer's
disease, said neurology experts.
According to Michael Gazzaniga, a
professor of cognitive neuroscience
at Dartmouth College,
the painstaking discovery is the
first evidence of cellular differences
between corresponding structures on the
right and left sides of the brain. . . 'This is a quantum
jump forward,'" Gazzaniga said.
A three-part series in USA Today explored the
variations in medical practice patterns uncovered
by the Dartmouth Atlas of Health Care. "Operations
often depend on where you
live" was the headline on one
piece in the series, which noted:
"'Local medical opinions regularly
differ to the point that four
times more people in one region
get a surgery' than do their
neighbors, says John Wennberg of the
Dartmouth Center for the Evaluative Clinical
Sciences and head of the Atlas series." And in an
article titled "Total trust in physicians is unwise,"
Wennberg was quoted as saying: "It's fair to say
that we're trying to promote a new model of making
surgical decisions that features open communication
about what's known and not known
about a procedure."
"Mommy, I have to throw up!" was the attention-
getting headline on a feature in Parents Magazine
that quoted a DMS infectious
disease specialist, among
other experts. Vomiting plus diarrhea
and a mild fever, "in children
over five, . . . particularly in
the winter, could be caused by a
group of bugs called caliciviruses,"
said the article. "'Symptoms
tend to last 24 to 48 hours,' says John Modlin, M.D.,
acting chair of pediatrics at Dartmouth." After
the child stops throwing up, Modlin advises offering
a small amount of milk or juice. "If
the fluid stays down and your child is willing,
encourage him to eat whatever appeals
to him, Dr. Modlin says."
The impact on teens of smoking on the
silver screen was the topic of a recent Dartmouth
study that's caught the attention of
the media. Recently, both the Christian Science
Monitor and Health magazine took note
of it. "A new study finds that 95% of the
most popular movies from 1988 to 1997 depict
actors using tobacco,"
said the Monitor, "and of
the films aimed at children,
one in five featured
smoking. Does all this
have anything to do with
the fact that 23% of high
school seniors in the United
States smoke daily? (And that figure was
17% eight years ago.)" And wrote Health,
"James Sargent, a physician at Dartmouth Medical
School, asked 632 teenagers to name
their top film idols and then quizzed the kids
on their own habits. Turns out, kids who
picked a celeb who routinely lights up in
flicks were three times more likely to take a
drag themselves."
The dilemma of how, or even whether, to
conduct controlled clinical trials of pharmaceuticals
among children
was the subject of a
feature in the New York
Times. "Researchers agree
[that] where there is no effective
treatment, placebos
may be appropriate.
'There is still not an established
standard of care for the treatment
of child depression,' said Dr. Craig Donnelly, an
assistant professor of psychiatry and of pediatrics
at Dartmouth-Hitchcock Medical
Center. Dr. Donnelly is now engaged in a
large study of child depression, in which five
antidepressants previously tested on adults
only are being tested on children. Half will
receive the drugs and half placebos."
The link between hospital volume and
health outcomes was the subject of a recent
Los Angeles Times feature. "'Surgeons are
viewed as the captain of
the ship, and patients are
always concerned about
their doctor's credentials,'
says Dr. John Birkmeyer, a surgeon
at Dartmouth Medical
School. 'But the fact is
that where your surgery is
done or your disease is treated is even more
crucial.'" Check the numbers at your hospital,
advised the article. "'If they can't or
won't give you the information,' says Dartmouth's
Birkmeyer, 'that's a red flag.'"
Family Circle magazine recently reported
that "left-handed women may have a higher
risk of breast cancer than right-handed
women, says a study led by Linda Titus-Ernstoff,
Ph.D., at Dartmouth Medical
School. Hormones in
the womb, which may help
determine a baby's dominant
side, might also increase
a woman's breast
cancer risk. . . . Nevertheless,
reassures Dr. Titus-Ernstoff,
'these findings indicate only a
modest increase in risk.'"
"Exploring the enigma of prostate therapies"
was the headline on a feature in the
New York Times. "What makes . . . decisions
about treatment [for prostate
cancer] so difficult,"
said the article, "is that
doctors do not know
which one is most effective.
. . . Dr. John Wasson, an
expert on health-care delivery
at Dartmouth, said
there was no proof from scientifically controlled
trials 'that any treatment is better
than watchful waiting' and then, if the cancer
spreads, prescribing drugs to lower male
hormones to make the cancer shrink or grow
more slowly. . . . Rigorously controlled trials
for prostate cancer have been difficult to do
'because everyone felt they knew the answer,'
said Dr. Wasson of Dartmouth."
When Miami Heat hoops star Alonzo
Mourning was diagnosed with kidney disease,
CNN turned for expert commentary
to Dr. Brian Remillard, a nephrologist at Dartmouth-
Hitchcock Medical Center. The
CNN anchor asked Remillard to explain
Mourning's condition, focal sclerosis.
"That's a term that's used to describe a scarring
process in the kidney," said Remillard,
"which can occur for a variety
of reasons. But probably
the most common in
African-Americans is hypertension.
. . . In the age
group that Alonzo is in, I
think that this condition is
much more common than
recognized." Treatment options range from
drug therapy to dialysis or a transplant, and
Remillard said the choice depends on how
advanced the disease is and how much kidney
function remains.
In her "Personal Health" column in the New York Times, Jane Brody recently emphasized the importance of early detection of infant deafness. "Deafness is the most common disability present at birth," she wrote. "'A deaf newborn looks and acts like any other baby,' said Dr. Andrew Schuman, an adjunct professor of pediatrics at Dartmouth Medical School. There are rarely outward clues, and unless newborns are tested for hearing loss, it is often not detected until the child is two or three and fails to start talking. Such delays can permanently impair a child's ability to learn to speak intelligibly and can result in long-lasting social, emotional, and academic difficulties."
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