Medicine/Science

The latest cool stuff out of some of the nation's best labs; news on medical research and what it may mean for patients.

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Financial Relief Finally On Its Way For Meningitis Outbreak Victims

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

Lyn Laperriere, a retired automobile industry worker living in Michigan, was having back pain in the fall of 2012 when he received a dose of steroids produced at the former New England Compounding Center in Framingham.

Lapperiere was a drag racer and was looking forward to the winter bowling season. But a week after receiving the shot he checked into a hospital. Forty-two days later, his wife Penny Laperriere agreed to take him off life support. He was 61.

“We did everything together,” Penny Laperriere recalled. “So when he passed away, life for me came to a screeching halt too.”

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

More than two and a half years after NECC recalled all of its products after steroids the compounding pharmacy produced were linked to a nationwide meningitis outbreak, some financial relief may finally be on its way for the relatives of the 64 who died and the 750 who were sickened as a result of receiving injections of the tainted drugs.

A federal bankruptcy judge on Tuesday indicated he would approve a $200 million settlement to compensate NECC’s creditors, including victims of the outbreak.

‘There’s Been No Financial Help’

Penny Laperriere, who’s now 58, couldn’t afford to keep the house she’d shared with her husband. She had an auction to sell off the couple’s things and moved close to her sister. She’s received lots of bills, but no money to help with what became the deadliest case of contaminated medicine in the country’s history.

“That’s the hard part, there’s been no financial help for me or any of the patients who are still living with this,” she said.

Laperriere started a support group for victims of fungal meningitis who’ve had to cash in retirement funds, file bankruptcy and still face mounting medical bills. Patients and those who lost loved ones will file claims for a share of the $200 million settlement beginning next month.

Laperriere has no idea what to expect. “Anything I get will be a gift,” she said. “I’m not expecting much because there are so many hands in the pot.” Continue reading

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Cancer Haves And Have-Nots: Care And Treatment In 2 Different Worlds

By Michael J. Misialek, M.D.
Guest Contributor

Imagine feeling a lump on your body, visiting a doctor, and then waiting seven months (if you’re lucky) to find out whether it is cancer.

This has been the reality for the vast majority of patients in two of the world’s most impoverished nations, Rwanda and Haiti — both emerging from different but unthinkably grim histories of structural violence.

But since 2012, more patients are getting the care that everyone deserves, no matter what country they live in. A medical partnership between several Boston-based hospitals has radically reduced turnaround time for cancer diagnosis, and shrunk the number of people who fall through the cracks.

It is difficult to quantify the exact numbers here, since record keeping in the past has been poor. One data point: In Rwanda, where these interventions are in place, far fewer patients are lost to follow-up after they’ve been treated compared to patients in other poor countries, according to Dr. Larry Shulman, senior vice president for medical affairs at Dana-Farber Cancer Institute, and leader of the medical partnership.

As a pathologist at of one of these partner institutions — Newton-Wellesley Hospital — I can’t help but think about the patient behind the slides under the microscope. Here’s one: Tushime, an 11-year-old Rwandan girl, who had a large tumor protruding from her jaw.

The tissue sample from Tushime’s tumor arrived in Boston in a suitcase carried by an employee of Partners in Health, the global nonprofit. Like all other specimens, hers was processed into a slide by the pathology department of Brigham and Women’s Hospital and read by Harvard faculty.

Tushime’s tumor turned out to be a rhabdomyosarcoma, a common childhood sarcoma. After 48 weeks of chemotherapy and surgery in Rwanda, she is now healthy and free of disease. Doctors there used standard chemotherapy for a cost of about $300 (which was covered by Partners in Health, Dana Farber and the Rwandan government). They relied on age-old, tried and true chemotherapy drugs; in comparison, the newer chemotherapy agents in the U.S. often cost several thousands of dollars.

Even though access to care has improved dramatically in the developing world there is so much work to be done. There are patients who still present with tumors at an advanced stage, many being neglected for months or even years because of barriers to care. There’s often a lack of access to facilities for both diagnosis and treatment, and funding for cancer care is limited. As a result, ordinary diagnoses become extraordinary.

This is an image of a less aggressive (low grade) breast cancer, something that is fairly common among patients in the U.S. You can see the well formed tubules and glands of cancer, but fewer tumor cells growing in a more organized fashion -- only about 30 percent of the image is tumor. (Courtesy of Michael J. Misialek)

This is an image of a less aggressive (low grade) breast cancer, something that is fairly common among patients in the U.S. You can see the well formed tubules and glands of cancer, but fewer tumor cells growing in a more organized fashion — only about 30 percent of the image is tumor. (Courtesy of Michael J. Misialek)

This is an image of an aggressive (high grade) breast cancer not uncommonly diagnosed among patients in countries where access to medical care is limited, such as Haiti. You can see a solid mass of cancer -- the photo is 100 percent tumor. (Courtesy of Michael J. Misialek)

This is an image of an aggressive (high grade) breast cancer not uncommonly diagnosed among patients in countries where access to medical care is limited, such as Haiti. You can see a solid mass of cancer — the photo is 100 percent tumor. (Courtesy of Michael J. Misialek)

Under my microscope, I’ve seen some of the most aggressive appearing tumors from patients in these countries. What are typically rare cancers here in the U.S., such as sarcomas or unusual variants of breast cancers, are all too common in developing nations. Continue reading

Boston Medical Center And Tufts Medical Center End Merger Talks

(Kalman Zabarsky/BU)

(Kalman Zabarsky/BU)

Boston Medical Center and Tufts Medical Center announced Wednesday that they are ending merger talks.

The two nonprofit hospitals, which had been in talks since last year, said in a statement that both sides “determined that at this time it is best for our medical centers to remain separate.”

Here’s the full statement from BMC President Kate Walsh and Tufts President Michael Wagner:

Over the last several months, Tufts Medical Center and Boston Medical Center have carefully considered how we might combine our two organizations. We have had thoughtful conversations and considered different options for tackling the complex task of integrating two vital, but different, academic medical centers. After much consideration, we have determined that at this time it is best for our medical centers to remain separate. We conclude these discussions with great respect for each organization’s mission and remain open to future opportunities for collaboration as neighboring institutions.

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A Life Filled With Promise Is Overpowered By A Complex Web Of Pain And Trauma

Jamie Neal's family -- her father Bob, mother Debbie and brother Abe -- at their church in Duxbury (Jesse Costa/WBUR)

Jamie Neal’s family — her father Bob, mother Debbie and brother Abe — at their church in Duxbury (Jesse Costa/WBUR)

When Jamie Neal was home on medical leave from Williams College in early 2010, her parents were going to great lengths to try to protect her.

“I knew she was suicidal,” says Jamie’s mother, Debbie Neal. “My husband and I decided we would do everything to keep her alive.”

Several months earlier, in August 2009, the Duxbury resident had made a suicide attempt that left her in a coma for several days.

“The last few months before she died, I had her sleep in my bed next to me,” Debbie Neal explains. “And every single day, I asked her on a [scale of] 1 to 10 how she felt and was she suicidal. And she would tell me that she was a 5 and that she wasn’t suicidal.”

In March of 2010, the 21-year-old killed herself in the family’s home. Suicide had become her desperate attempt to escape a complex web of pain and trauma: not only mental illness, but sexual assault and drug addiction — a dark journey in a life filled with so much promise.

CAPTION

Jamie Neal was a member of three varsity sports teams beginning her freshman year at Duxbury High School. She was recruited to play basketball at Williams College. (Courtesy the Neal family)

Like many other survivors of suicide, the Neals recall a loved one who was outwardly happy — even, in Jamie’s case, “outrageously fun.” She had a ready smile.

“Jamie was always, always smiling,” Debbie Neal says. “It kind of defined who she was. She loved other people who were struggling. And she was very kind, and she had a beautiful heart.”

There were some signs early on that Jamie might have mental health issues. A nursery school teacher noticed the normally cheerful, outgoing girl would sometimes withdraw into a sad state. And the straight-A student was a perfectionist in everything she did.

“That perfectionism drove her and motivated her,” says Jamie’s brother, Abe Neal. “On the other hand, I don’t want to say it necessarily did her in. But it was very difficult for her. You would find her at four in the morning editing some minor paper for an English class. And she was also very hard on herself as things started going downhill with herself.” Continue reading

After Cluster Of Suicides, MIT Works To Relieve Student Pressure, Raise Awareness

Student climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

Students climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

On a recent sunny spring day, MIT students were lined up at a table grabbing ice cream sundaes, milk and cookies, and, if they were interested, an embrace.

“Yes, giving away ice cream and now hugs,” explained MIT parent Sonal Patel, of Cambridge, as she embraced Miguel Mendez, a native of Mexico who is doing post-doctoral research at MIT.

“It’s always good to know that people around the campus actually care about you as a person,” Mendez said. “This being an institution that expects a lot from you, it can really pass a toll on you sometimes.”

The event was billed as “Stress Less Day,” a chance for people at the university that churns out many of the world’s top engineers and scientists to take a break from problem sets, exams and research.

The snack break was sponsored by the student group Active Minds, which promotes mental health awareness. Volunteers handed out flyers with facts on depression and anxiety, as well mental health resources at MIT.

Active Minds raised awareness about their group during MIT's campus preview weekend for incoming freshman. (Robin Lubbock/WBUR)

Active Minds raised awareness about their group during MIT’s campus preview weekend for incoming freshman last month. (Robin Lubbock/WBUR)

Following six student suicides since March 2014, Active Minds and other student groups have seen increased interest in their events designed to reduce stress, promote a sense of community and reduce stigma.

MIT is not the only higher education institution to struggle with suicide clusters. But the school and its students, widely considered among the world’s most elite, are taking some very open steps to confront the problem. Continue reading

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Ringing In Your Ears? Finally, Researchers Finding New Clues About Tinnitus

Alan Starr, an audio engineer, has tinnitus as a result of the Boston Marathon bombing. (Courtesy of Alan Starr)

Alan Starr, an audio engineer, has tinnitus as a result of the Boston Marathon bombing. (Courtesy of Alan Starr)

By Richard Knox

Alan Starr remembers being blown back by the bomb’s force. He had come to watch a friend cross the Boston Marathon finish line on that fateful April day.

Starr, a 52-year-old audio engineer who makes his living by his ears, suffered no visible injury. But, like at least 70 other marathon bombing victims, he’s left with a never-ending reminder of that moment — a death knell that never stops ringing in his head.

“It’s a very high pitch like a whistle,” he says. “It doesn’t waver. It’s just constant, 24/7.”

It’s called tinnitus, and it’s beginning to get the attention it deserves.

Nearly a million veterans suffer from tinnitus. 

This is partly due to the Boston Marathon bombings. Starr and a few dozen other bombing victims are participating in studies supported by the One Fund, created to help bombing victims, that are aimed at devising an effective treatment.

An even more powerful driver of tinnitus research is the enormous incidence of the problem among Iraq and Afghanistan war veterans who’ve suffered blast damage. Nearly a million veterans suffer from tinnitus. That makes it the leading service-related disability — far outstripping PTSD.

And tinnitus — most often pronounced TIN-uh-tiss — is surprisingly common in the general population. At least one in every six Americans suffers from tinnitus — around 50 million people. Of these, the condition is “burdensome” for 20 million, according to the American Tinnitus Foundation. Two million of them have severe, disabling tinnitus, often accompanied by depression.

The problem has no cure and no very effective treatment. But after decades of dead-end research, scientists are beginning to figure out what causes the constant ringing, whistling, whooshing or hissing that makes sufferers feel trapped inside their own heads.

New research is providing some surprising clues. Continue reading

Team Of MGH Doctors And Nurses Headed To Nepal To Treat Earthquake Victims

Members of the MGH medical team headed to Nepal to help care for the more than 10,000 people injured in last weekend's earthquake attend a last-minute briefing Thursday morning at MGH's Center for Global Health. (Courtesy MGH)

Members of the MGH medical team headed to Nepal to help care for the more than 10,000 people injured in last weekend’s earthquake attend a last-minute briefing Thursday morning at MGH’s Center for Global Health. (Courtesy MGH)

As the death toll following a massive earthquake last Saturday in Nepal continues to rise, and more than 10,000 injured men, women and children await treatment, a group of nurses and physicians from Massachusetts General Hospital will join those working to keep survivors alive.

They plan to arrive in Kathmandu on Saturday, with all the basic equipment. Each person will carry their own tent, sleeping bag, mosquito net and basic medical supplies, hopefully in a carry-on so they’ll have a place to sleep if luggage is lost in the chaos.

At a last-minute training Thursday morning, members of the team acknowledged that they can’t prepare for the emotional impact of arriving in a city where rain and a shortage of wood is making it difficult to dispose of the nearly 6,000 bodies recovered so far.

“We cremate our dead,” said Dr. Bijay Acharya, who is from Nepal, explaining that the country follows Hindu customs. “They’ve run out of wood, so bodies are piling up in hospitals.”

Most of the doctors and nurses on this trip have either been to Nepal or traveled to other medical disaster zones. But Dr. Hilarie Cranmer, director of disaster response for MGH’s Center for Global Health, says the devastation in Nepal may still be shocking.

Continue reading

Beth Israel Doctors Travel To Nepal To Aid Relief Efforts

Villagers wait in the rain as an aid relief helicopter lands at their remote mountain village of Gumda, near the epicenter of Saturday's massive earthquake in the Gorkha District of Nepal on Wednesday. (Wally Santana/AP)

Villagers wait in the rain Wednesday as an aid relief helicopter lands at their remote mountain village of Gumda, near the epicenter of Saturday’s massive earthquake in the Gorkha District of Nepal. (Wally Santana/AP)

A team of doctors from Boston’s Beth Israel Deaconess Medical Center is heading to Nepal Wednesday to aid with earthquake relief efforts.

As of Tuesday, more than 5,000 people were confirmed dead and nearly 11,000 injured from Saturday’s 7.8-magnitude earthquake that hit just outside the capital city of Kathmandu.

Beth Israel Disaster Medicine Fellowship Director Greg Ciottone says the team will set up a base at a hospital 30 kilometers southeast of Kathmandu. He said the doctors will essentially function as “a mobile emergency department,” but will not be performing complex surgeries.

According to Ciottone, the group is planning to work in areas with little to no drinking water, power or communication infrastructure.

“We have to take all of that into account,” he told WBUR’s newscast unit. “So we take our redundant communication systems with us. We take all the personal items and necessities for water, food, shelter.”

He said the doctors are also preparing to face wet and somewhat cold conditions.

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Seeking Patients’ Stories, Ann Romney Launches #50MillionFaces Campaign

Ann Romney in 2013. (AP)

Ann Romney in 2013. (AP)

Ann Romney would see them at almost every rally along the campaign trail when her husband was running for president: a few men and women who arrived hours in advance to secure a spot up front, against the police barricade.

“When I would get there, there would be people at the front of the lines hanging on,” Romney recalled, “and I knew who they were, they were people with MS. They’d been there for hours and hours, waiting just to say thank you to me for being an example for them.”

Romney recalls men and women collapsing after they saw her, exhausted from the wait.

“And it’s now time for me to be a strength for them,” Romney said Tuesday as she launched a social media campaign to capture and share the stories of 50 million patients around the world, and their families, who have multiple sclerosis or other neurological diseases.

Romney told an audience at a Partners HealthCare forum that she does not want patients to repeat the experience of her diagnosis, when 16 years ago a doctor told Romney she had MS and to come back when she got more sick.

“That was shocking to me,” Romney said with a laugh. “I thought, wait a minute, someone’s got to give me a pill here? I can’t just walk out because I’m so sick.”

Romney found a physician at Brigham and Women’s Hospital who offered hope. The treatment — intravenous steroids — stopped the progression of MS for Romney. But she wanted a better long-term plan.

Continue reading

Report Finds Stark Gaps In Mass. Addiction Care

The math is simple and starkly clear.

There are 868 detox beds in Massachusetts, where patients go to break the cycle of addiction. They stay on average one week. Coming out, they hit one of the many hurdles explained in a report out this week from the Center for Health Information and Analysis on access to substance abuse treatment in the state.

There are only 297 beds in facilities where patients can have two weeks to become stable. There are 331 beds in four-week programs.

As the table below shows, there are almost four times as many men and women coming out of detox, with its one-week average, as there are from a two- or four-week program.

From the CHIA report on Access to Substance Use Disorder Treatment in Massachusetts

From the CHIA report on Access to Substance Use Disorder Treatment in Massachusetts

Patients who can’t get into a residential program right away describe a spin cycle, where they detox and relapse, detox and relapse. Some seek programs in other states with shorter wait times.

Continue reading