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By Elaine Schattner, MD, on July 14th, 2011 This week the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills:
…It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the University of California, Los Angeles, and the University of Cincinnati — and 13 in Canada are using it.
At Virginia Tech Carilion, 26 candidates showed up on a Saturday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the applicants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the applicants charged into the small rooms and found an interviewer waiting. A
See more On Admitting Nice, Ethically-Minded People to Med School
By Elaine Schattner, MD, on May 17th, 2011 
The two-letter acronym specifies a molecule, or antigen, usually on a cell’s surface…
See more Defining a Cluster of Differentiation, or CD
By Elaine Schattner, MD, on May 13th, 2011 Yesterday I wrote on some tough decisions facing a TV show’s protagonist. She’s got metastatic melanoma and might participate in a clinical trial when the show resumes.
Now imagine you’re an oncologist, or a real patient with this killing disease — you really need to be on top of new developments, to understand the pros and cons, because someone’s life depends on it.
If you’re the doctor in the relationship, you need keep abreast of current information for all the other tumors types of patients in your care: what are the new findings, if any, what are the limitations of the data. You need to know how the advances apply to an individual person who, most likely, has another condition or two, like high blood pressure or, say, osteoporosis.
Oncologists ought to be familiar with new drugs, and how those compare to old ones, and the side effects, and the
See more TV Meets Real Life Oncology, and Anticipating the MCATs
By Elaine Schattner, MD, on March 29th, 2011 This clip has had me wondering:
The DNA Dance
The video shows kids dancing on a college campus. They’re wearing tee shirts in any of four colors (representing nucleotides?) and lining up and zip-splitting in a semi-coordinated fashion, and having fun.
That’s fine, but let’s face facts: the exercise has little to do with DNA or understanding genetics at a meaningful level. From the Times Learning Network:
The idea was to connect science with the arts and to facilitate student understanding of the role genetic information plays in our lives. It also works on a metaphorical level, as an allegory for the student-faculty relationship and the college experience.
My initial reaction was puzzlement, then concern about higher education in the U.S. mixed with fear for the next generation of scientists: Where are the nucleosomes? Is the bicyclist like a helicase? What happens if there’s a double-strand break? All these
See more Where Are the Nucleosomes?
By Elaine Schattner, MD, on March 10th, 2011 Lupus, an autoimmune disease, turned up on the front page, right side of today’s Wall Street Journal. It cropped up, also, on the first page of the New York Times business section, and elsewhere. Scientific American published a nice on-line review, just now. The reason is that yesterday the FDA approved a new, monoclonal antibody for treatment of this condition.
The drug, Benlysta (belimumab), targets a molecule called BlyS (B-lymphocyte Stimulator). The newspapers uniformly emphasize that this drug marks some sort of triumph for Human Genome Sciences, a biotech company that first reported on BlyS in the journal Science way back in 1999. BlyS triggers B cells to produce antibodies that, in patients with lupus tend to bind and destroy their own cells’ needed machinery, causing various joint, lung, liver, kidney, brain, blood vessel and other sometimes life-threatening problems. So if and when Benlysta works, it probably does so by
See more Benlysta, A New Treatment for Lupus
By Elaine Schattner, MD, on March 2nd, 2011 
A tweet from a former research colleague reminded me about the Cancer Genome Atlas, which I’d been meaning to check out. This website covers a project jointly funded by two NIH institutes: the NCI and the National Human Genome Research Institute (NHGRI). The project is about documenting cancer genetics for many, many human tumors.
Cancer Genome Atlas image
Some basics -
We all have genetic sequences we’re born with: our personal genomes. If you were to get your genome sequenced by a company, like 23andMe, they’d get some DNA from any of your cells or body fluid, and sequence your “somatic” or cellular genome. They would identify variants and mutations that you carry in the DNA of all or most of the cells in your body.
Cancer cells often contain genetic mutations that are not present in the patient’s healthy cells. So an individual’s breast cancer genome, for example,
See more Learning About the Cancer Genome Atlas
By Elaine Schattner, MD, on February 17th, 2011 
In today’s Times, Nicholas Wade reports on a potentially serious, besides costly, problem for biomedical researchers: Human DNA Contamination Seen in Genome Databases. He writes:
Nearly 20 percent of the nonhuman genomes held in computer databases are contaminated with human DNA, presumably from the researchers who prepared the samples, say scientists who chanced upon the finding while looking for a human virus…
The full report was published yesterday in PLoS One. The investigators, based at the University of Connecticut, screened for a common human sequence in 2,749 non-primate public databases — NCBI, Ensembl, JGI, and UCSC — and found 492 were contaminated with human DNA. Affected sequences included include bacterial, fish, plant and other genomes.
The implications are broad because if the findings in this report are true, scientists throughout the world have drawn inferences and conclusions and published papers based on incorrect DNA sequence information. As the PLoS authors
See more A New Source of Potential Error in Scientific Research
By Elaine Schattner, MD, on January 25th, 2011 Today’s Times reports on our nation’s students’ poor science test results. The results are bleak: only 34% of fourth graders scored at a “proficient” level or higher; just 30% of eight graders scored at a proficient level or higher; 21% of twelfth graders scored at a proficient or higher level in science.
The mega-analysis, prepared by the National Center for Education Statistics, derives from 2009 testing of 156,500 fourth-graders and 151,100 eighth-graders, with state-by-state and nationwide metrics of those, and of 11,100 twelfth-graders. Student scores were ranked at one of three science knowledge levels for each peer group: advanced, proficient and basic, as defined by the Department of Education. Only a tiny fraction — as few as 1 or 2% of students — attained “advanced” scores on the science exams.
The complete report card analyzes the data by race, sex, urban vs. rural districts, private vs. public schools and other
See more Sad Stats for Science Knowledge in U.S. Schools
By Elaine Schattner, MD, on January 11th, 2011 
There’s hematology news today, x 2 (at least):
flexible hydrogel particles resembling RBCs in size and shape (Credit: Timothy Merkel and Joseph DeSimone, University of North Carolina at Chapel Hill)
1. Progress in developing synthetic red blood cells -
A University of North Carolina, Chapel Hill-based research group has created hydrogel particles that mimic the size, shape and flexibility of red blood cells (RBCs). The researchers used PRINT® (Particle Replication in Non-wetting Templates) technology to generate the fake RBCs, which are said to have a relatively long half-life. The findings were reported on-line yesterday in PNAS (abstract available, subscription required for full text). According to a PR-ish but interesting post on Futurity, a website put forth by a consortium of major research universities, tests of the particles’ ability to perform functions such as transporting oxygen or carrying therapeutic drugs have not yet been conducted.
Developing competent, artificial RBCs is
See more Artificial Red Blood Cells and Platelets from Stem Cells!
By Elaine Schattner, MD, on January 6th, 2011 So many others have written on Wakefield’s fraud, and considered the role of the press in perpetuating the notion that vaccines cause autism, I wasn’t going to cover it here on ML. But I do think there are a few instructive points from this “lesson” about medical communication and news:
1. People aren’t always rational in their decisions about health care. (This is an understatement.)
See more Lessons from the Wakefield Case
By Elaine Schattner, MD, on January 3rd, 2011 
Three recent stories lead me to my opening topic for the year: the value of open-mindedness. This characteristic — a state of receptiveness to new ideas — affects how we perceive and process information. It’s a quality I look for in my doctors, and which I admire especially in older people.
Story #1 – on the questionable effects of echinacea
Echinacea Purpurea flower (Wikimedia Commons)
The first article, published in the Dec 21 Annals of Internal Medicine, considers the potential of echinacea in treating the common cold. The results of a 4-armed, randomized study involving 719 patients with symptoms of an acute respiratory infection (“a cold”) were inconclusive, at best. A skeptic might say of the trial, sponsored by the National Center for Complimentary and Alternative Medicine (NCCAM), that it proves once and for all that echinacea is therapeutically useless. Another reader, perhaps versed in the flower-derived substance’s purported
See more On the Value of Open-Mindedness
By Elaine Schattner, MD, on November 11th, 2010 
Franklin’s story starts like this: She was born in 1920 to a Jewish family in London. She excelled in math and science. She studied physical chemistry at Cambridge, where she received her undergraduate degree in 1941. After performing research in photochemistry in the following year on scholarship, she joined the British Coal Utilisation Research Association (BCURA) and carried out basic investigations on the micro-structure of coal and carbon compounds, and so earned a Ph.D. from Cambridge University. She was a polyglot, and next found herself in Paris at the Laboratoire Central des Services Chimique de l’Etat, where she picked up some fine skills in x-ray crystallography.
You get the picture: she was smart, well-educated and totally immersed in physical chemistry before, during and after WWII. Single-minded and focused, you might say –
See more A Play About the Life and Work of Dr. Rosalind Franklin
By Elaine Schattner, MD, on October 26th, 2010 
The cover of the November print edition of Wired features large, unnatural-appearing cleavage. Inside and toward the back of the issue, a curious article ties together stem cells and the future of breast reconstruction. It got my attention.
Wired, November 2010 issue
The detailed and admittedly interesting piece, by Sharon Begley, describes what’s science or science fiction: first humans, such as some plastic surgeons, remove adipose tissue, a.k.a. fat, by a well-established cosmetic surgery procedure called liposuction, from a body part where there’s a fat surplus — such as the belly or backside; next, laboratory workers purify and grow what are said to be stem cells from that that fat; finally, they use a nifty, calibrated and expensive device to inject those fatty stem cells where women want, such as in a hole or dimpled breast where a tumor’s been removed.
The story starts, unfortunately and distractingly, with a
See more Stem Cells, Breast Reconstruction and a Magazine Cover
By Elaine Schattner, MD, on October 12th, 2010 Last week, doctors injected embryonic stem cells into a human patient with an acute spinal cord injury. The procedure took place at Shepherd Center, a hospital and research center for spinal cord and brain injury in Atlanta, GA. The patient was the first to receive human stem cells derived from an embryo in an FDA-approved research protocol in the U.S.
See more Everybody’s Talking About Stem Cells
By Elaine Schattner, MD, on October 6th, 2010 Pajak, a graduate student at the University of Georgia, merges art and science in a novel way: she composed a new work, the Sounds of HIV, based on the virus’s genetic sequence.
See more The Music of H.I.V.
By Elaine Schattner M.D., on August 6th, 2010 A front-page story on the Humanities and Medicine Program at the Mount Sinai School of Medicine, here in Manhattan, recently added to the discussion on what it takes to become a doctor in 2010. The school runs a special track for non-science majors who apply relatively early in their undergraduate years. Mount Sinai doesn’t require that they take MCATs or the usual set of premedical science courses – some college math, physics, biology, chemistry and organic chemistry — before admission.
The idea of the program is two-fold: first, that the traditional med school requirements are a turn-off, or barrier, to some young people who might, otherwise, go on to become fine doctors; second, that a liberal arts education makes for better, communicative physicians and, based on the numbers published in a new article, a greater proportion who choose primary care.
Today Orac, a popular but anonymous physician-scientist blogger, considers the
See more Back to Basics – But Which Ones?
By Elaine Schattner M.D., on July 8th, 2010 …This goes well beyond a new approach to finding a cure for Parkinson’s disease. This story, largely based in genomics and computational advances, reflects the power of the human mind, how the gifted son of two mathematicians who fell into a particular medical situation, can use his brains, intellectual and financial resources, and creativity, to at least try to make a difference.
See more On Sergey’s Search (for a Cure for Parkinson’s Disease)
By Elaine Schattner M.D., on May 25th, 2010 
Earlier this month employees at most of 7500 Walgreens pharmacies geared up to stock a new item on their shelves: a saliva sampler for personal genetic testing. On May 11, officials at Pathway Genomics, a San Diego-based biotech firm, announced they’d sell over-the-counter spit kits for around $25 through an arrangement with the retailer. A curious consumer could follow the simple package instructions and send their stuff in a plastic tube, provided in a handy box with pre-paid postage, for DNA analysis.
See more DNA Comes Home, or Maybe Not
By Elaine Schattner M.D., on April 20th, 2010 
As pretty much anyone traveling in Europe this week can tell you, it’s sometimes hard to know what will happen next. Volcanologists – the people most expert in this sort of matter – simply can’t predict what the spitfire at Eyjafjallajokull will do next. It comes down to this: the volcano’s eruption could get better or it could get worse…
See more Uncertainty Rules (on Eyjafjallajokull, volatility and a patient’s prognosis)
By Elaine Schattner M.D., on April 12th, 2010 
if we want doctors who know what they’re doing, we should invest in their education and training, starting early on and pushing well past their graduation from med school. Sure, we like physicians who are kind and honest people and can talk to them in ways they understand. This is crucial, but only to a point — we still depend on doctors to know their stuff.
See more Nice Nerds Needed
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connections…