DECEMBER 1998 -- News Tips from Harvard Medical School
These brief summaries of newsworthy features from Harvard Medical School are issued throughout the year. More information--and, in some cases, photos and other visual materials--can be obtained from Peta Gillyatt or Bill Schaller ([email protected]), Office of Public Affairs, 25 Shattuck Street, Rm 014, Boston, MA 02115; tel: 617-432-0442
Social Medicine Minorities, the Elderly and Children More Likely to Perish in Residential Fires Residential fires in the United States have claimed more than 38,000 lives during the past decade. In 1997, 395,000 residential fires--an average of one fire every 78 seconds--caused 3,360 deaths and 17,300 injuries. While residential fires affect all demographic groups, Ken Fox, MD, instructor in the HMS Department of Social Medicine, says that minorities, the elderly and children are more likely than others to be fire victims. Statistics show that age-adjusted fatality rates for blacks are more than twice those for whites," Fox explains. "In addition, children under the age of five and adults age 65 or older are more likely to die in residential fire than those in other age groups." Fox believes that educating the public about the importance of installing and maintaining smoke detectors outside every bedroom and on every floor of a residence could greatly reduce the number of fire deaths. "It is quite sad, but most residential fire-related deaths are preventable. Studies have ! found that residences with smoke detectors have almost half as many fire-related deaths compared with those that don't have them." Contact: Bill Schaller, 617-432-0441 ([email protected])
Dental Medicine Exploring the Pathways Linking Oral Health and Heart Disease Growing evidence suggests that periodontal disease--bacterial infection and inflammation in the pockets where the teeth meet the gums--can have a major impact on cardiovascular health. Several studies have shown that people with periodontal disease have a higher risk of coronary heart disease and stroke than those with healthy gums. Until now, researchers have not been able to determine how poor oral health might influence cardiovascular disease. Kaumudi Joshipura, assistant professor of oral health policy and epidemiology at Harvard School of Dental Medicine and School of Public Health, has just received a $1 million grant from the National Institute of Dental and Craniofacial Research. She will investigate whether the association between oral health and cardiovascular disease is independent of known cardiovascular risk factors, and evaluate the possible pathways by which periodontal disease, tooth loss, and dental caries may increase the risk of heart disease. Using longitudin! al data from the Nurses' Health Study and the Health Professionals Follow-Up Study, she will examine possible inflammatory mediators, which may be elevated when bacteria from periodontal pockets enter the bloodstream. In addition, Joshipura will track dietary changes brought about by tooth loss. Nearly 30 million Americans have serious periodontal disease. Contact: Peta Gillyatt, 617-432-0443 ([email protected])
Eating Disorders Many Doctors Overlook First Step in Diagnosing Eating Disorders Several studies suggest that eating disorders frequently go unrecognized in primary care settings, making early detection and treatment difficult. Moreover, in a 1996 educational and screening program for eating disorders held on college campuses across the United States, 85% of participants with clinically significant symptoms reported never having received care. In a follow-up telephone survey of almost 300 college students, Anne Becker, HMS assistant professor, and her colleagues found that of those had personal concerns about eating disorders or weight, only 25% had been asked about these issues by the doctor. Survey respondents reported a higher likelihood of both being asked about and sharing such information with friends or family than doctors, although they were asked about symptoms less frequently by teachers or coaches (11% and 9% respectively). Becker, director of research and training at the Harvard Eating Disorders Center, believes that training health care profes! sionals and educators to inquire about eating disorders symptoms in high risk populations is a necessary step to improving early detection and treatment of eating disorders. More than five million Americans suffer from eating disorders. Visit the Harvard Eating Disorders Center's Web site at http://www.hedc.org. Contact: Peta Gillyatt, 617-432-0443 ([email protected])
Neurobiology Lobster Neurons Display Puritan Work Ethic Resilience is a quality of active minds and it now appears of some active neurons. HMS professor of neurobiology Ed Kravitz has found that rapidly-firing serotonin-releasing neurons, when interrupted, spring back into action much more quickly than those firing at a lower rate. The findings, made in lobsters, suggest that these neurons have built into them a kind of safety feature which prevents them from becoming distracted from the task at hand. "It's like cells are either saying, 'I'm busy--don't bother me,' or 'I'm on vacation, I'm really not needed so, okay, I'll listen to what you're telling me,'" says Ed Kravitz, HMS professor of neurobiology. For this anti-distraction mechanism to work, neurons must have a capacity to remember what they were doing before the interruption. Serotoninergic cells fire continuously at a relatively slow rate in lobsters, and also in mammals. Researchers knew that stimulation via an electrode could cause the neurons to pause from their firing a! nd that this period of "autoinhibition" was directly proportional to the duration and intensity of stimulation. Some slow-firing neurons were known to pause for minutes at a time. Kravitz and his colleagues found that when they stimulated active neurons they did not pause at all. Kravitz speculates that serotonin-releasing cells may possess a special kind of ion channel that enables the cells, when active, to ignore distractions. Contact: Misia Landau, 617-432-2342 (l[email protected])
Medical Education Lessons In Diversity: Actions For The Future Harvard Medical School and the Harvard School of Dental Medicine are celebrating 30 years of affirmative action. A panel discussion on December 11--"Lessons In Diversity: Actions For The Future"--will address the continuing need for affirmative action, particularly in medicine where cultural competence directly impacts patient care. Presenters include Derek Bok, president emeritus, Harvard University; June Osborn, president, Josiah Macy, Jr. Foundation; Karen Davis, president, The Commonwealth Fund; and Richard Gavin, III, senior scientific officer, Howard Hughes Medical Institute and trustee, Robert Wood Johnson Foundation. (If you are interested in attending, please call for parking and directions.) Recent legal setbacks and national trends in applications of minorities to medical schools give cause for concern. Applications from minorities in 1997 declined by 11.1 percent from 1996 nation. The number of minority students entering medical school nationwide declined 8.4 percent!
in one year. At Harvard Medical School, the Class of 2002 comprises 200 medical and dental students, of which 18.7 percent are underrepresented minorities. Editors, please note: Interviews can be arranged with faculty involved in launching affirmative action at HMS 30 years ago, minority alumni, and students. Contact: Peta Gillyatt, 617-432-0443 ([email protected])
Women's Health New Center of Excellence in Women's Health Emphasizes Health of Minority Women Harvard Medical School has received a contract from the U.S. Department of Health and Human Services to establish a National Center of Excellence in Women's Health. Led by Andrea Dunaif, chief of the Division of Women's Health at Brigham and Women's Hospital and Benjamin Sachs, chair of the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center, the Center provides innovative, community-based health care for women--with a special emphasis on the health needs of minority women--as well as outreach, research, and education programs to further improve care. Women can call a toll-free number (800-713-1567) to obtain information or set up appointments for a wide variety of clinical services at a single site, what is known as "one-stop shopping." Minority women have unique health concerns. Black, Hispanic, and American Indian/Alaska Native women have shorter life expectancies and are less likely to receive adequate prenatal care than white women. Black women ! have the highest rates of death from cerebrovascular disease. While breast cancer death rates have declined among white women, they have increased for black women. American Indian, black, and Hispanic women have the highest rates of cervical cancer in the country. Contact: Peta Gillyatt, 617-432-0443 ([email protected])
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