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Discoveries
Research Briefs

Viewer beware
Most of the 220,000 men diagnosed with
prostate cancer each year look for information
about the condition online. But, according
to DHMC surgeon Peter Steinberg,
M.D., what they find might not be very balanced.
Steinberg and other researchers
studied YouTube videos that discuss
treatments for prostate cancer and the
controversial prostate-specific antigen
(PSA) test. They found that 69% of the
videos expressed a bias in favor of screening
or treatment, but none expressed a bias for
less aggressive approaches. "YouTube is not a
reliable source of information for individual
patients seeking to better understand the
screening for, and management of, prostate
cancer," Steinberg wrote in Urology.

Doctor disparities
"We need to create incentives for surgeons
to practice in rural areas," explained DMS
surgeon Ian Paquette, M.D., at a recent gathering
of the American College of Surgeons.
Paquette made the suggestion in
the context of presenting research showing
that people living in the country are
more likely to suffer a perforated appendix
than are people living in the
city. One reason for the regional difference,
according to Paquette, is that there are more
general surgeons in urban than rural areas.
DMS's Ann Gormley, M.D., chairs the Urinary Incontinence Treatment Network, a nine-site research group funded by the National Institute of Diabetes and Digestive and Kidney Disease.

Bubble trouble
Exercising right before undergoing a rapid
change in air pressure may raise the risk of
acquiring decompression sickness. Exercise
causes tiny bubbles called micronuclei to
form, but they had never been conclusively
detected—until recently. DMS researchers
had subjects exercise strenuously
for 30 minutes. They then used a
form of ultrasound to spot bubbles in
subjects' legs. "The ability to measure micronuclei
could offer a way to examine how
and where they form, and their relationship
to decompression sickness risk," they wrote
in the Journal of Applied Physiology.

Benefits of breast-feeding
A team of DMS and DHMC researchers
have made an intriguing finding with regard
to breast-feeding and ovarian cancer. They
studied hundreds of women with and without
ovarian cancer and concluded that breastfeeding
offers some protection against ovarian
cancer—but only if the woman breastfed
her youngest child. There was no protective
effect if a woman breast-fed some
of her children but not her final child.
"These findings," the authors wrote in the
journal Cancer Causes Control, "which require
confirmation by future studies, imply
that breast-feeding resets pregnancy-related
states that mediate ovarian cancer risk."
At the International Conference on Alzheimer's and Parkinson's Diseases, DMS's Tracie Caller, M.D., made a presentation about selecting the optimal site of deep brain stimulation to treat Parkinson's.

Octogenarian outcomes
The number of U.S. octogenarians is predicted
to double between 2000 and 2050.
Many people in this demographic eventually
develop heart disease, raising the question
of whether the benefits of surgery to treat it
outweigh the age-related risks. In a large
study, Donald Likosky, Ph.D., and colleagues
found that patients over 80 who
underwent aortic valve surgery did, on average,
benefit, with over half surviving more
than six years. "This study presents the
largest experience to date of octogenarians
undergoing surgical treatment of aortic stenosis," the authors wrote in Circulation.

Counting all costs
According to DMS researchers, changes in
surgical technologies may have hidden costs.
They compared open colectomies—an older
approach—to laparoscopic colectomies—a
newer, minimally invasive technique. There
is little difference in the dollar cost of
performing the two procedures, but the
laparoscopic approach takes about 27
minutes longer. The lost time, say the researchers,
adds up to between $240 and $700
more in opportunity cost per procedure. "Although
frequently overlooked, opportunity
cost is a potentially very important element
in assessing the true costs of surgical innovation,"
they wrote in Surgical Endoscopy.
Dartmouth's Norris Cotton Cancer Center ranked among the top 5% of institutions nationwide in total research dollars from the National Cancer Institute in FY09—earning over $34 million.
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