Medical Research Archive

An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.

A test used to give doctors a close-up view of the pancreas, called endoscopic retrograde cholangiopancreatography (ERCP), often cause a painful inflammation of the pancreas (pancreatitis). According to report in the New England Journal of Medicine, a single dose of indomethacin, a powerful nonsteroidal anti-inflammatory drug, can help prevent this post-procedure problem. About half a million Americans have ERCP each year. As many as one in six develop pancreatitis afterward. In a randomized controlled trial that included men and women who had just undergone ERCP, administration of an indomethacin suppository right after the procedure cut the rate of post-ERCP pancreatitis almost in half. Once a person has pancreatitis, the chances he or she will have it again go up. That’s why the New England Journal report is good news for anyone who needs to undergo ERCP.

The term “personalized medicine” is still something of an abstract idea. In an audacious experiment, Stanford molecular geneticist Michael Snyder gave it a face—his own—and showed what it can do. Snyder and a large team of colleagues first sequenced his DNA, revealing his complete genetic library. Then they analyzed blood samples he gave every few weeks for two years. This was akin to taking a 3-D movie of his inner workings to observe how genes, the molecules that read and decode them (RNA), the proteins they make, and other substances interact during health and illness. The team saw how Snyder’s body responded to a cold at the very beginning of the study. Midway through, they watched as molecular changes wrought by a respiratory infection tipped him into full-blown diabetes.

Games are meant to be fun and exciting. Some involve the body, some the mind. Others do both. Researchers are tapping into this engagement to use games to heal an ailing mind or body. Researchers are testing virtual reality to help people with mental and physical problems ranging from post-traumatic stress disorder and stroke rehabilitation to smoking cessation and stuttering. Exergames may also help people become more physically active. Although they won’t help you lose weight or train for a marathon, many meet the American Heart Association’s criteria for “moderate-intensity daily activity,” meaning they could stand in for taking a walk.

An epileptic seizure is a frightening thing to experience, and almost as frightening to watch. Fortunately, most seizures stop on their own after a couple minutes. Any that last longer than five to 10 minutes (doctors call a long-lasting seizure status epilepticus) are a medical emergency and must be halted with medication. A new study shows that delivering anti-seizure medication with a hand-held auto-injector—much like the epi pens used by people with life-threatening allergies—is better than delivering them intravenously. This study could pave the way for home treatment of epileptic seizures.

As paper medical records give way to electronic health records, it is becoming increasingly possible to view your medical history. Yet experts are debating whether the electronic health record should include the notes that doctors make in them. The Open Notes project is designed to test the consequences of giving patients access to doctors’ notes. Results of a survey of the expectations that doctors and patients have for note sharing, reported in the Annals of Internal Medicine, suggest that while physicians are generally optimistic about doing this, many believe it could cause patients to worry or generate unnecessary questions. Patients who filled out the survey thought that seeing their doctor’s notes would provide a clearer understanding of their medical condition, improve self-care, and give them a greater sense of control.

On the 13th annual World AIDS Day, there’s cause for hope. The epidemic seems to have peaked. Drug therapy has turned HIV/AIDS into a manageable chronic disease. Drug therapy appears to prevent transmission of HIV from infected to uninfected individuals. And HIV cures are under investigation. Yet there is also cause for continued alarm. The AIDS epidemic is far from over, and the downward trends in infection rates could plateau or head up if prevention and treatment efforts slack off. The overalI trends don’t apply to everybody. In the United States, new HIV infections are still increasing among young black men, both gay and bisexual. And despite all the research into HIV and over two dozen ongoing trials of candidate agents, there’s still no HIV/AIDS vaccine.

Today, the only reliable way to check blood sugar is by pricking a finger, squeezing out a drop of blood, and placing it on a small test strip attached to a meter. For some people, this means five to ten finger sticks a day. Researchers across the country are exploring pain-free ways to measure blood sugar. University of California, San Diego researchers have developed a titanium sensor the diameter of a quarter that would be implanted under the skin and wirelessly send blood sugar readings to an external monitor. At Northeastern University in Boston, researchers are working on a blood sugar “tattoo” by injecting glucose-detecting nanosensors under the skin. Arizona State University researchers are working to perfect a device that measures blood sugar using tears instead of blood.

The new fields of pharmacoepidemiology and pharmacoeconomics aim to understand how people use medications and how effective—or ineffective—medications are. A leader in this area is Dr. Jerry Avorn, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School. In a recent issue of the Harvard Health Letter, editor Peter Wehrwein spoke with Avorn about generic drugs, the pharmaceutical industry, the high cost of cancer drugs, and more.

When it comes to lowering cholesterol, a “portfolio” diet that includes cholesterol-lowering foods is better. In a head-to-head trial, the portfolio approach lowered harmful LDL by 13%, compared to a 3% reduction for a traditional low-fat diet. Elements of the portfolio diet included a daily handful of nuts; two teaspoons of margarine enriched with plant sterols; two servings of foods rich in soluble fiber, such as oatmeal, psyllium-enriched cereals, barley, and vegetables such as okra and eggplant; and two servings of soy-based foods, such as a glass of soy milk or a soy burger.