Archive: March, 2010
A Danish scientist involved in two major studies that debunked any linkage of vaccines to autism is suspected of misappropriating $2 million in U.S. grants at his university in Denmark.
Poul Thorsen, a medical doctor and Ph.D., was an adjunct professor at the Drexel University School of Public Health for several months before resigning Tuesday.
On Jan. 22, Aarhus University said that it had uncovered a “considerable shortfall” in grant money from the U.S. Centers for Disease Control and Prevention for a research program that Thorsen had directed. The university referred the matter to police, who are conducting an investigation.
Anti-vaccine groups have seized on the allegations to contend that scientific studies disproving the vaccine link to autism are wrong. Those groups have long argued that thimerosal, a preservative in some vaccines, can cause autism, as can the MMR vaccine for measles, mumps, and rubella.
Six years ago\my colleague Julie Stoiber wrote about her decision to donate a kidney to her sister in-law. The entire episode left me awed by her generosity and bravery. Julie is no longer at the paper, but an study published in the Journal of the American Medical Association has reminded me again of how impressed I was and am by her willingness to give of herself to help another.
In Monday's Health & Science section my colleague Marie McCullough writes about the study that could encourage more people to become living kidney donors. Here is an early look at that item:
Donating one of your kidneys can save a life, without shortening your own lifespan.
Johns Hopkins University researchers reached that heartening conclusion by analyzing how 80,347 live kidney donors were doing 15 years after their selfless acts. Although they had a small risk - 3 per 10,000 - of dying within 90 days of surgery, their long-term survival rates were the same as a matched group of healthy individuals who were not kidney donors, according to the study in the March 10 issue of the Journal of the American Medical Association.
You can only imagine my dread when I saw the bright yellow note posted on the door of my daughters’ daycare center: HEAD LICE OUTBREAK.
While my six-month-old doesn’t have much hair yet and isn’t likely to get lice, my older daughter has nearly waist-long curly hair and only recently began to allow us to wash it without suffering through a massive fit.
So any prospect of needing to wash her hair twice a day with lice-killing shampoo produced tsunami-sized waves of fear in me. It would surely result in eardrum-splitting tantrums that would likely having my neighbors wondering whether they needed to call child protective services.
But an article in today’s New England Journal of Medicine could promise relief to parents who, like me, live in terror of a lice outbreak. European researchers tried oral ivermectin (a drug used to treat worm infections and sold by Merck & Co. in the U.S. as Stromectol) on 398 children with lice and compared the results with 414 kids who got a topical treatment.
Men diagnosed with prostate cancer have many treatment options – surgery, radiation (beam or seed implants), hormone therapy, or watchful waiting. And according to a study in the current issue of the Archives of Internal Medicine the treatment they choose has a lot to do with the type of specialist they consult.
Researchers analyzed the records of 85,000 Medicare beneficiaries and found that those who saw a urologist – a surgical specialist – chose surgery 40 percent of the time and hormone therapy 27 percent of the time. Only 5 percent of this group of men got radiation and 34 percent chose watchful waiting. On the other hand, 83 percent of the men who went to both a urologist and a radiation oncologist chose radiation compared with 8 percent who had an operation.
The men who returned to consult with their primary care physician were more likely to forego aggressive treatment in favor of watchful waiting. In fact, 58 percent of the youngest and healthiest of the men – those considered prime candidates for surgery or radiation – who returned to see their family doctor decided against aggressive treatment in favor of watchful waiting.
The researchers speculated that primary care doctors might be more willing than specialists to consider watchful waiting. Alternatively, they suggested those men who were not good candidates for aggressive treatment may have been more likely to be referred back to their primary care doctors.
Are you ready for an evening among some freakish and gruesome artifacts of 19th century American medicine? For $50 tickets you can attend the Mütter Ball on Friday, the second annual fundraising ball put on by the College of Physicians of Philadelphia at its Center City headquarters – the very place that houses the famous museum of strange and fascinating medical memorabilia.
The Mütter museum is renowned for its 20,000-piece collection of oddities such as a preserved cancer tumor removed from President Grover Cleveland, a collection of more than 2,000 objects removed from people’s throats, the plaster cast of Chang & Eng, the Siamese twins joined at their livers, and its large collection of skulls – the Hyrtl skulls.
The ball will feature tours of the museum as well as a DJ dance party, hors d’hoeuvres and 19th century punch. The college was founded in 1787 and touts itself as the oldest doctor’s group in the nation. The group conducts research and works to improve public health through education and communications such as its www.phillyhealthinfo.org website.
Tickets to the ball can be purchased from the college and online here.
Research led by Kevin Volpp of the Leonard Davis Institute of Health Economics at the University Pennsylvania showed that financial incentives can help people quit smoking. The Penn team’s work with General Electric to implement a smoking cessation program using financial incentives was recognized today with an award from BMJ Group, the publisher of prominent British medical journals.
In February 2009, Volpp and his team published a study in the New England Journal of Medicine of 878 smokers that showed the 436 participants who took part in smoking cessation programs were significantly more likely to quit than the 442 people who participated in the same programs but did not get financial incentives. The participants were paid $100 for joining a smoking cessation program, $250 more if they quit within six months, and $400 more if they stayed smoke-free for another six months.
General Electric and the Leonard Davis Institute have implemented the financial incentive approach to quit smoking for the company's employees. For implementing that program for all 152,000 GE workers in the US, the researchers won the Getting Research into Practice, or GRiP award, from BMJ.
“In health care settings people have the same foibles and lapses as they do in other parts of their everyday lives,” Volpp said in a statement. “By understanding these, sometimes we can help overcome them and help people do things they want to do but have difficulty doing, like lose weight, exercise more, and quit smoking.”
President Obama has proposed raising $184 billion over ten years to help pay for his $950 billion health plan by imposing new taxes on the investment income of individuals making more than $200,000 a year and couples earning more than $250,000 a year. In addition to paying 2.9 percent on interest and investment income above those amounts, the President’s health bill would impose a 2.35 percent Medicare payroll tax on all earnings above those levels.
Christopher Weaver of Kaiser Health News lays out the proposal here and touches on what proponents and opponents say about the President’s proposed Medicare taxes.
When a stroke strikes, quick access to emergency care is critical. Getting to a hospital designated as a primary stroke center is even better.
But according to researchers from the University of Pennsylvania and elsewhere, only 55 percent of Americans have access to a primary stroke center within 60 minutes and less then 25 percent have access in 30 minutes.
The time it takes to get patients to care impacts their chances for survival. And the more time it takes to get care the less opportunity there is for doctors to minimize damage to parts of the brain starved of blood by the clots that often cause strokes. About 2 million neurons die every minute a stroke is left untreated.
“Our findings show that many people do not have timely access to the type of care that they would need to save their life or minimize damage from a stroke,” said Brendan G. Carr, the study’s senior author and an emergency medicine doctor at the Hospital of the University of Pennsylvania. Carr and his coauthors suggested that using helicopters to transport patients who live far from primary stroke hospitals would improve their outcomes.
A new report from the New Jersey Council of Teaching Hospitals shows that many young doctors leave the garden state after completing their post medical school training. The apparently aptly named 2009 New Jersey Resident Exit Survey Final Report found that fewer than one in three residents intend to remain in New Jersey after completing their residency.
“This year’s exit survey is alarming,” said J. Richard Goldstein, president of the council, in a statement. “The primary driving force responsible for the dramatic decline in New Jersey is that other states are now stepping up their recruitment efforts to deal with their own shortages. To put it simply: Their offers are better then ours.”
And as a result the council estimates that there will be a 3,250 shortfall of physicians in New Jersey.
In recent years, similar predictions of doctor shortfalls have been made by professional groups in Pennsylvania, particularly in the context of medical malpractice insurance costs, which many claim drives doctors to leave high cost areas, such as Philadelphia and its suburbs.
When you are having a heart attack, the hospital you go to can make the difference between living and dying.
Researchers at Yale, Harvard, Mount Sinai in New York and the University of Michigan studied the outcomes of 718,028 Medicare beneficiaries hospitalized for heart attacks from 2004 through 2006. And those patients who went to hospitals with the capability to open clogged heart arteries with stents – so-called PCI hospitals – were less likely to die as those who went to hospitals without that ability.
The researchers noted that the degree of patient benefit varied based on the region where they got care. Still patients who first went to a non-PCI hospital were much more often transferred (31.4 percent versus 3.3 percent) and also less likely to undergo heart surgery or get a stent than those taken to a PCI hospital. The study was published in the current issue of the Archives of Internal Medicine.
An interactive database on heart care available here shows that in New Jersey and Pennsylvania eight of 12 hospitals that had death rates that were “better than the national rate” were PCI hospitals. Those included Doylestown Hospital in Bucks County and Virtua West Jersey Hospital – Marlton. At the same time that data shows that two of the three hospitals that had worse results than the national rate were PCI hospitals. The vast majority of hospitals in Pennsylvania had rates that fell into the normal range.