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Vital Signs
Media Mentions: DMS and DHMC in the News
Among the people and programs coming in for
prominent media coverage in recent months
was a DMS orthopaedic surgeon who is leading a
multisite back-surgery study known as SPORT
(Spine Patient Outcomes Research Trial). In November,
results comparing surgical and nonsurgical
treatment of herniated disks were available.
"We basically found that [for] people who had
very significant symptoms, that
surgery, in fact was better," Dr.
James Weinstein told Katie Couric
on CBS's Evening News. "However,
what was really interesting
is that patients who decided not
to have surgery, who could wait,
also did really well." Dozens of
other media outlets featured the study results, including
CNN, National Public Radio's All Things
Considered, the International Herald Tribune, the
New York Times, and USA Today. "Trying to find
an answer to the surgery vs. nonsurgery question
for herniated discs is important, Weinstein said,"
in the Chicago Tribune, "because the number of
spinal operations has been increasing and the rate
of these surgeries can vary greatly in different regions."
(For more on this study, see here.)
The press also tapped another DHMC physician
for comment on the SPORT results. "By the twoyear
mark, the researchers
found, the nonoperative group
had improved considerably,
even though surgery patients
still maintained a slight edge,"
U.S. News & World Report explained.
"Still, 'this study supports
nonoperative treatment
for patients who can manage their pain,' [said] Dr.
William Abdu, medical director of the Spine Center at
Dartmouth-Hitchcock Medical Center and one
of the authors" of the study.
In November, a U.S. Food and Drug Administration advisory panel recommended the approval of a new test that detects whether breast cancer has spread to the lymph nodes or not. But, as the Reuters wire service noted, the panelists—including a Dartmouth physician—"questioned how well the test would help determine the best care for patients." Panelist "Marc Ernstoff, a cancer immunologist at Dartmouth-Hitchcock Medical Center in New Hampshire" explained, "I think what you're hearing from the panel is 'Yes, let's proceed forward but cautiously.'"
Susan Dentzer, a Dartmouth alumna and correspondent
for PBS's NewsHour, recently profiled a
soldier whose face had been destroyed in an explosion
in Iraq. One of the clinicians whom the
soldier's wife "considers an angel," reported
Dentzer, "is [the soldier's] plastic
surgeon, Dr. Joe Rosen. He normally
practices at Dartmouth-Hitchcock Medical Center in
New Hampshire but was called
in by Walter Reed [Army Medical
Center] as a consultant" for
this case and others. "We can
only do so much at each stage," Rosen told the
soldier. "But if we're willing to be patient . . . each
three months we can do another stage and make
it better until you're satisfied."
A sugar found in crabs and shrimp "seems to protect against the build-up of nasty bacteria and yeast colonies called biofilms," the Atlanta Journal-Constitution
reported in an article
about some recent research.
"George O'Toole, an associate professor
of microbiology and immunology
at Dartmouth Medical
School, expressed some
reservation" about the research,
however. "'This would be a terrific
advance if this proved to be true, particularly
because there is an advantage in using a nonantibiotic
coating that can't be understated,'
O'Toole said. 'Antibiotic coatings in catheters,
for example, are a terrible idea because they will
likely contribute to the development of [drug] resistance
in the long run. . . . However . . . many
people have worked on this for many years without—
to my knowledge—many effective results.
So, I would have to see more research.'"
V8 juice, Campbell's Healthy Request tomato
soup, and nearly all yogurt with fruit didn't make
the cut in Hannaford Brothers' new Guiding Stars nutritional rating system, noted a recent
New York Times article. Why? "Many products
that are marketed as healthy received
zero stars from Hannaford because they contain
too much salt or sugar
or not enough nutrients,
said Lisa Sutherland, a research
assistant professor
of pediatrics and a nutrition
scientist at Dartmouth
who was part of the
advisory panel that developed
Hannaford's formula." V8, for example,
is "like drinking a vitamin with a lot of
salt on it," Sutherland told the Times.
"Black, Latino, and Asian patients are more
likely than whites to have high-risk surgeries
at California hospitals that have less experience
doing the procedures," read a Los Angeles
Times article about a study that appeared
in the Journal of the American Medical
Association. "In an editorial
accompanying the report,"
the Times noted,
"Dr. Samuel Finlayson of Dartmouth
Medical School examined
some of the reasons
for the disparities.
'The easiest explanations
for why ethnic minority and poorly insured
patients are less likely to use high-volume
hospitals are that they cannot [because of
barriers to access] or that they may not be
aware of other options,'" Finlayson wrote.
South Carolina's largest newspaper called on
"pain expert Joyce DeLeo of Dartmouth Medical
School" twice last fall.
"Each year, sickle cell patients
experience two
bouts, on average, of severe
pain," the State reported
in an article about
a University of South Carolina
study on "why pain
early in life can heighten pain later" in such
patients. "There hasn't been a lot of research
focusing on early development of pain,"
DeLeo pointed out. In the other article,
"DeLeo, a professor of anesthesiology, and
of pharmacology and toxicology" weighed
in on a pain assessment scale that uses photographs
of babies in varying states of discomfort
and of varying races. "'You want the
[child] to associate the picture with what he
or she looks like and what the family looks
like,' she said."
"Babies who die of SIDS [Sudden Infant
Death Syndrome] apparently have not developed
a sort of 'alarm system' that would
make them respond to rising carbon dioxide
levels by turning their
heads and breathing harder,"
the author of a recent
study told the Boston
Globe. "Dr. Gene Nattie, a
Dartmouth physiology
professor who researches
SIDS but was not involved"
in the study, explained to the Globe
that "to have these kinds of clues . . . gives
investigators who want to find ways that biology
could go awry, and cause death, a
much better handle on where to start."
A recent study done at another institution
concluded that "performing annual CT
scans on smokers and others at risk for lung
cancer could prevent 'some 80 percent of
deaths from lung cancer,'"
Slate magazine reported.
To explain why "many radiologists
and cancer specialists
. . . are unconvinced"
by the study, as
the San Francisco Chronicle
explained it, both publications
turned to a Dartmouth radiologist.
"Dr. William Black of Dartmouth-Hitchcock
Medical Center, and a principal investigator
in the National Lung Screening Trial," told
the Chronicle that the study "ran the risk of
being skewed by scans that detected small
tumors that would never have developed
into life-threatening cancers. He said he is
also concerned that, as the resolution of CT
scans improves,
tests will show
increasing numbers
of tiny nodules in
the lungs of patients that
will set off alarms but are not cancerous."
Plunging necklines and bare midriffs—on
young doctors and medical students—were
the subject of an essay in the New York
Times. Lamenting "less-than-professional attire"
among many of her
younger colleagues, the
author consulted "a behavioral
scientist and director
of the office of professional
development at
Dartmouth. 'Poor choice is
not regional—I've seen it
everywhere,' said Dr. Pamela Rowland, . . . who
has studied the impact of physician clothing
on patient confidence. . . . 'Patients
don't have your CV in front of them, and
appearance is all they have to go by,' Dr.
Rowland said. 'If you don't meet their expectations,
their anxiety level increases.'"
"Research by a professor at Dartmouth Medical
School aims to help physicians in Missouri
lower their overhead and help their patients
take more active roles in improving
their health." So began an article in the St.
Louis Post-Dispatch about a project that
"teams researchers at Dartmouth" with a local
coalition and state
health-care improvement
officials. "The project is
based on a concept called
'micro practice.' The idea
is to set up a low-overhead,
efficient, and patient-centered
practice. . . . 'High
overhead is toxic,' said Dr. John Wasson, a professor
of community and family medicine at
Dartmouth and lead investigator on this
project. 'It passes on to the patients in the
form of minimal time . . . to the payor in the
form of higher cost, and . . . to the clinician
in the form of dissatisfaction.'"
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