Faculty Bibliography

An ethical issue in the debates over benefits and hazards of adding iron to foods is where to draw the line between helping one group with iron deficiency and harming another with hemochromatosis. Experts still do not have definitive data to answer key questions like how many people would benefit and how many would be harmed if foods were not fortified with iron. The focus on hemochromatosis could renew the debates. Key Chemical Gone Awry Iron enters the body in foods that are broken down for absorption in the duodenum. An inherited disease, hemochromatosis, may let too much iron be absorbed. Iron One of iron's vital roles is as the constituent of hemoglobin that lets red blood cells carry oxygen through the body. Oxygen Inhaled oxygen binds to the iron at the center of the hemoglobin molecule. Widely dispersed in tissue, iron can flood organs like the liver, heart, pancreas and tested, and cause severe damage, like cirrhosis, cancer and diabetes. Source: 'The Physical World', Oxford University Press

Dr. Isaac Schiff, an expert in reproductive problems of Massachusetts General Hospital in Boston, said that even if the findings were confirmed, high amounts of LH 'will not explain the entire problem of infertility.' Also, he said, the high amounts of LH may not be the primary problem, but a symptom of another abnormality. Dr. [Howard S. Jacobs] said that he was led to do the tests for LH by earlier studies in which he found 'stunningly high miscarriage rates' among women who had many cysts in their ovaries and high amounts of LH. Dr. Jacobs and other experts said that current methods of testing for LH often vary widely among laboratories and they recommended caution in evaluating the results. Also the British findings were based on a population of women and might not apply to a particular individual . Brain Hormone's Role In Timing of Ovulation A hormone from the pituitary gland in the brain called luteinizing hormone stumulates a ripened egg follicle to burst through the surface of the ovary into the pelvic cavity. The egg eventually enters the fallopian tube for fertilization. Normally, the hormone surges about the 14th day of the menstrual cycle. In a study, large amounts of the hormone on the eighth day were linked with a higher rate of miscarriage. (source: 'Mayo Clinic Family Health Book' (Morrow)

Specialists from pediatricians to pathologists have mistaken the sores of syphilis for cancers, abscesses, hemorrhoids, hernias and other conditions. Pediatricians have mistaken the sniffles than can result at birth from congenital syphilis for the flu. Other doctors have also mistaken different forms of syphilis for dizziness from Meniere's disease and multiple sclerosis. In New York State, 'a booming syphilis epidemic' is occurring, says Dr. David Axelrod, the Health Commissioner. Testing for syphilis of all patients 15 to 45 years old who are admitted to hospitals and treated in emergency rooms is the current standard of medical care, Dr. Axelrod said. This practice was dropped in the years when the number of syphilis cases reached record lows. No other state has adopted a similar measure, though pregnant women are often tested in other states. Until the recent resurgence, syphilis was not a research priority, said Dr. Edward W. Hook 3d, an expert in sexually transmitted diseases at Johns Hopkins University in Baltimore. 'It was a hard organism to work with, time consuming, expensive, and people viewed it as a minor and declining problem,' Dr. Hook said. 'Now we find ourselves knowing so little about it.'

Normally, the production of LH surges on about the 14th day, in mid-cycle when ovulation occurs. What the British team found were large amounts of LH at an inappropriate time, on the eighth day of the menstrual cycle, before ovulation. In the women who had high amounts of LH, 20, or 65 per cent, of the pregnancies ended in miscarriage, as against 15, or 12 per cent, of the pregnancies in women with normal amounts of LH

The decision, announced last week, comes after Blue Cross-Blue Shield said it had been sued by more than a dozen people and consumer groups seeking the experimental therapy, which costs up to $125,000 per patient. Blue Cross-Blue Shield lost more than half the suits and had to pay for the treatment. In the past, the costs for experimental procedures have been borne largely by the government, research-oriented hospitals, private foundations and patients. Insurance companies have refused to pay the costs of experimental care, although many have paid indirect costs such as for hospital stays when infections and other serious complications result from experimental procedures and therapies. Paying for experimental treatments ``is a role health insurers have never seen themselves playing before,'' said Cheryl van Tilburg, a spokeswoman for Blue Cross-Blue Shield. She said the decision reflected an evolution in Blue Cross-Blue Shield's process of evaluating new technologies

Paying for experimental treatments 'is a role health insurers have never seen themselves playing before,' said Cheryl van Tilburg, a spokeswoman for Blue Cross-Blue Shield. She said the decision reflected an evolution in Blue Cross-Blue Shield's process of evaluating new technologies. Defining the Issues The autologous transplants differ from standard bone marrow transplants, which are generally limited to people 50 and younger and in which the patient receives bone marrow from another person. In autologous bone marrow transplants, the patient's own marrow is returned after the chemotherapy treatment. Douglas Peters said Blue Cross-Blue Shield, of which he is a senior vice president, concluded that clinical studies were needed for the experimental therapy for breast cancer after Dr. David Eddy, a specialist in health policy at Duke University, made a special study for Blue Cross-Blue Shield. The decision also reflected the opinions of a number of leading medical researchers who reported the results to a meeting of the medical directors of Blue Cross-Blue Shield plans throughout the country

The decision, announced last week, comes after Blue Cross-Blue Shield said it had been sued by more than a dozen people and consumer groups seeking the experimental therapy, which costs up to $125,000 per patient. Blue Cross-Blue Shield lost more than half the suits and had to pay for the treatment. In the past, the costs for experimental procedures have been borne largely by the government, research-oriented hospitals, private foundations and patients. Insurance companies have refused to pay the costs of experimental care, although many have paid indirect costs such as for hospital stays when infections and other serious complications result from experimental procedures and therapies. Paying for experimental treatments ''is a role health insurers have never seen themselves playing before,' said Cheryl van Tilburg, a spokeswoman for Blue Cross-Blue Shield. She said the decision reflected an evolution in Blue Cross-Blue Shield's process of evaluating new technologies

Experts in high blood pressure say that millions of Americans are being overtreated for the mildest form of high blood pressure, and they blame a government health strategy that they call wasteful, expensive and possibly dangerous

The authors of the report, headed by Dr. Robert Berg of Strong Memorial Hospital in Rochester, N.Y., and Dr. Joseph Cassells of the Institute of Medicine, studied 13 risk factors such as misuse of medications, falls and social isolation, which affect large numbers of elderly people and for which remedial interventions are available. o Osteoporosis, loss of bone substance. Research is needed to improve fracture rehabilitation programs and to evaluate estrogen replacement therapy, calcium supplements and exercise. o Falls. A hip fracture is the most devastating hazard of a fall. About 50 percent of elderly people who were able to walk before suffering a hip fracture were unable to walk independently afterward