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NATIONAL
USA Today
Boston Globe
The Philadelphia Inquirer
Milwaukee Journal Sentine
Fox
MSNBC
WPVI-TV6
WCAU-TV10
WTXF-TV29
WNYW-TV5
KYW-AM1060
Planting the Seed
for Human Cloning
Chicago physicist and entrepreneur Richard Seed announced in January that, once he raised sufficient funds, he planned to establish a for-profit clinic that would clone humans in order to provide childless couples with infants. "God made man in his own image," Seed proclaimed. "God intended for man to become one with God. Cloning and the programming of DNA is the first serious step in becoming one with God."
Seed's announcement arrived less than a year after the news that a sheep in Scotland named Dolly had been cloned from an adult sheep. The prospect of using cloning technology in humans causes much concern among most experts. In fact, almost immediately after Dolly was introduced, President Clinton banned the use of federal money for human cloning. But currently there is no law to prevent private scientists from using cloning technology to reproduce a human.
"To just jump from sheep to people is the height of irresponsibility and it's actually silly and understood as such by mainstream science," commented Arthur L. Caplan, Ph.D., director of the Center for Bioethics, on the Fox News Channel. In a USA Today article, Caplan said that Seed is "Kevorkian-izing" cloning. "He is a person out on the fringe, seizing an issue and taking it up for his own purposes," he added.
Glenn McGee, Ph.D., assistant professor of bioethics for Penn's School of Medicine and senior fellow in health economics at Penn's Leonard Davis Institute, expressed his concern for future cloned generations. "Human cloning makes children who don't have their own identity," McGee told WPVI-TV6's Action News. "It makes children who are literally created to be copies of someone else."
Norman Hecht, M.D., professor of human reproduction, questioned Seed's credibility in an interview with The Philadelphia Inquirer. "[Seed] was a physicist and that doesn't prepare him for the type of biological work we are talking about," Hecht said. "I have been in reproduction since 1970, and I have not been aware of this man and what he has done."
A Philadelphia Inquirer column on the subject was penned by Paul Root Wolpe, Ph.D., senior faculty associate for Penn's Center for Bioethics. "It is true that human beings have always tried to envision ways to improve the species, and that biological constraints have limited the progress we could make," Wolpe wrote. "But those same constraints have limited the mistakes we could make as well. Our social, cultural, and even psychological nature have developed within those parameters, and we change them at our peril. There is just so much messing you can do with Mother Nature before she messes back with a vengeance."
In summation of all the various concerns this issue has
raised, Caplan told the Milwaukee Journal Sentinel, "This
field is screaming for regulatory control."
Reports began January 7.
WWOR-New York
WPHL-Philadelphia
KXAS-Dallas
WJBX-Detroit
KPRC-Houston
WFTS-Tampa
KWGN-Denver
KSDK-St. Louis
WMAR-Baltimore
KPTV-Portland
WKRC-Cincinnati
WITI-Milwaukee
WOTV-Grand Rapids
KRQE-Albuquerque
WBIR-Knoxville
KLAS-Las Vegas
WSJV-South Bend
KSFY-Sioux Falls
In mid-January, the Muscular Dystrophy Association announced that it would fund researchers at the University of Pennsylvania, Ohio State University, and the University of Michigan to explore initiatives that will lead to human trials of gene therapies to treat muscular dystrophy.
At Penn, research will be conducted through the Institute for Human Gene Therapy. The $3.2 million commitment to the Institute is the largest single grant in MDA's history.
According to James M. Wilson, M.D., Ph.D., director of the Institute, now is the time to focus on the discovery of promising gene therapies for human with inherited muscular dystrophies and their rapid evaluation in humans. The Institute is already testing several novel gene delivery systems in monkeys and mice. Human pilot trials of the most promising systems could begin as early as September.
"As a result of a series of positive developments," Wilson said, "it's become clear that muscle is a very receptive host for gene therapy, and that there's every reason to be optimistic about our aggressive program to make this therapy a reality."
National MDA chairman Jerry Lewis praised the collective
work of muscular dystrophy researchers. "Thanks to the
elegant work of hundreds of MDA-supported investigators
worldwide, muscular dystrophy tops the list of diseases
showing promise as targets for gene therapy. ... It's now
time to move from bench to bedside. We've done our homework,
and the Food and Drug Administration, in an unprecedented
move, has developed a working group to help keep our gene
therapy efforts on the fast track."
Reports began January 16.
Return to index
Philadelphia Tribune
Patriot-News
WPVI-TV6
Giving a Kidney --
With Less Pain
"With more than 36,000 people waiting for kidney transplants in the United States today, the availability of an easier donor removal technique is crucial," commented Kenneth Brayman, M.D., Ph.D., associate professor of surgery and director of the surgical team that performed the laparoscopic technique. "Relatives considering donation no longer have to worry about the painful operation associated with kidney removal."
Traditional surgery for kidney transplantation is said to be more difficult for the donor than for the transplant recipient. But the new technique uses just four half-inch incisions in the abdomen, along with one three-inch incision near the navel, rather than the conventional 12 - 14-inch incision.
Recent newspaper reports told the stories of families who were grateful to be given the option of the laparoscopic technique. In one couple, a 47-year-old pastor husband gave a kidney to his 50-year-old wife. They chose to have the surgery done at the Hospital of the University of Pennsylvania, and were told that doctors there had performed a total of 2,500 spousal transplants in the past 30 years. The wife, who suffers from polycystic kidney disease, is expected to do well, at least kidney-wise, for 20 years or more.
In addition to Brayman, the surgical team for Penn's
first laparoscopic kidney removal consisted of Jo Buyske,
M.D., assistant professor of surgery, and Noel N. Williams,
M.D., assistant professor of gastrointestinal surgery. The
donated kidney was immediately transplanted into a waiting
patient by Ali Naji, M.D., Ph.D., professor of surgery and
director of Penn's Renal Transplant Program.
Reports began November 10.
Return to index
Modern
Healthcare
Minorities at the
Top
Statistics on the matter are hard to find. The American Hospital Association does not collect such data. In 1991, the American College of Healthcare Executives and the National Association of Health Service Executives conducted a survey that showed a very low number of blacks in executive positions. A follow-up survey will be unveiled soon.
"I have no data," said Arthur L. Caplan, Ph.D., director of the Center for Bioethics, "but my eyeballs tell me. I see more minority faces at corporate meetings, whether it's the armed forces or at big pharmaceutical companies or Coca-Cola, than in healthcare."
Caplan said that he believes the lack of minorities in
high places is not overt racism. "I think what we see
instead is subtle factors about class, about opportunities
and market orientation that subtly shape who makes it to the
executive ranks."
The article appeared in the December 15 issue.
Science
Funding Oneself
One of the scientists profiled among one group, the "independently wealthy researchers," is Britton Chance, Ph.D., Sc.D., the Eldridge Reeves Johnson Emeritus Professor of Biophysics, Physical Chemistry, and Radiologic Physics at Penn. He is described as heir to the Chance Vought airplane company. Chance, says Science, "has liberally tapped his own funds when he believed his work was promising but too innovative to make it through the conservative peer-review process."
The example Chance cites is a cryogenic magnet used for
medical purposes, developed by Chance and George Radda of
Oxford University. Chance says he "plunked down 80
kilobucks" of his own money to help build the machine. Said
Chance, "If you really love research and have a societal
impulse and realize this technology could help people, you
go for it."
The article appeared in the January 9 issue.
The Wall Street Journal
Can Money Change
Opinions?
According to The Wall Street Journal, the NEJM looked at studies of calcium channel blockers and found that, in 70 published articles on this class of drug, 96 percent of the authors who supported calcium channel blockers had received some kind of financial support from the drugs' manufacturers. Among scientists who were critical of the drugs, only 37 percent had received financial support from the drugs' makers. And in only two of the 70 studies did the scientists reveal their financial ties to the companies.
The Wall Street Journal called the study "one of the first scientific reviews offering hard research into the nexus of scientists' financial backing and the views they hold." Allan S. Detsky, a University of Toronto professor and lead author of the study, said, "Our point in the paper is not to say that opinions were overtly influenced by relationships," but to assert that those relationships should be made public. "Bias can be a much more subtle thing," he said.
"Physicians and researchers are human beings, and human
beings respond to financial interests," Alan L. Hillman,
M.D., M.B.A., associate professor of medicine at Penn, told
The Wall Street Journal. Hillman, director of the Center for
Health Policy at Penn's Leonard Davis Institute of Health
Economics, said that simply disclosing the funding ties is
not sufficient. He believes that, as the Journal put it, "a
watchdog consortium of public and private interests should
be established to oversee and set rules for such funding
relationships."
The article appeared January 8.
The Philadelphia Inquirer
Philadelphia Daily News
CBS
WPVI-TV6
WPHL-TV17
WTXF-TV29
The Times (Reading, Pa.)
Getting a Clue About
Flu
Although many of the patients had flu-like symptoms, experts were hesitant to call the increase in illness a flu outbreak. Sometimes people with common respiratory illnesses assume that they are suffering from "the flu." But true influenza is a serious, dramatic illness, said Stephen Gluckman, M.D., associate professor of medicine, in an interview with CBS's Up to the Minute. "Flu starts suddenly, people have high fevers, bad muscle aches, bad headaches, actually--initially--very little respiratory symptoms. They may have real shaking chills."
Once flu season is in full swing, it is usually too late
to get a flu shot, Gluckman said, although it's not
"inappropriate." Gluckman added that although flu can be
cultured, most of the time it can be diagnosed based on
symptoms. Medication is available that can shorten the
duration of the flu, but it needs to be taken within the
first 24 to 48 hours of the illness.
Reports began January 7.
The New York Times
The Philadelphia Inquirer
WCAU-TV10
Senior Citizens in
Space
It has been reported that Glenn maintains a rigorous daily fitness routine that includes weight training, and that he plans to step up his activities in preparation. Doctors say he is excellent physical shape.
To report on what physical effects a space mission might have on a 76-year-old, WCAU-TV10's Arthur Fennell called upon the expertise of David Dinges, Ph.D., associate professor of psychology in psychiatry and director of the experimental psychiatry unit at the University of Pennsylvania School of Medicine. Last year, Dinges participated in a meeting of the National Institutes of Health and NASA to study data on aging on earth, aging in space, and the effects of microgravity.
"There are enormous similarities and the conclusion was we definitely need more information on the physiological effects of microgravity in older astronauts," Dinges said. "Senator Glenn was clearly someone who came to mind given his physical conditioning, his prior experience, and his interest."
Dinges explained that microgravity causes changes and problems with balance, loss of muscle and bone, and sleep disturbances. These same changes and problems also increase in incidence in advanced aging. "We would like to understand whether some of the mechanisms that produce these changes, like loss of growth hormone in space, are the same things that produce them on earth, and whether counter measures for microgravity will be useful down on earth. And, likewise, whether research on aging on earth will be useful in space."
Dinges said he doesn't believe that there is any
increased danger to the planned mission, but added that
there is always some risk to space flight. Dinges is one of
the scientists working to plan the Manned Mission to Mars,
set to launch in 2014.
The broadcast aired on January 16.
Perspectives
"It's cruel to say, 'We'll cover infertility diagnostic tests, but not the therapy.' ... Marriages have...broken up on the rocks of infertility."-- Stephen Corson, M.D., chief of reproductive endocrinology at Pennsylvania Hospital "Pioneer Insurer Cuts Infertility Benefits" The Philadelphia Inquirer, 1/9
"It is somewhere between the hilarious and the addled to say that we have privacy."--Arthur L. Caplan, Ph.D., director of Penn's Center for Bioethics "Proposed HIV List Raises Confidentiality Issues" Atlanta Constitution, 12/15
"If they want to endorse products, they should do it in the spirit of an educational agency, not as a paid shill."--Paul Root Wolpe, Ph.D., senior faculty associate for Penn's Center for Bioethics "Juicy Deals for ACS" [Subject: the American Cancer Society's agreement with the Florida Department of Citrus] Philadelphia Daily News, 12/24
"Conflict-of-interest standards are the thin blue line of morality."--Arthur L. Caplan, Ph.D., director of Penn's Center for Bioethics"Journal Fuels Conflict-of-Interest Debate" Boston Globe, 1/6
"It was through repeated experiences in the role of a [multiple sclerosis] patient, struggling to accept a body that seems to betray you, relinquishing control and having to ask for assistance with tasks that even a child can perform, having to redefine my role in a profession that I cherished, that I truly understood."--Alicia M. Conill, M.D., assistant professor of medicine "Living With Disabilities: A Proposal for Medical Education" Journal of the American Medical Association, 1/7
Snips & Clips
EMOTIONAL INTELLIGENCE. . . Women do not have a corner on the market when it comes to relating to others emotionally. Men simply relate differently, said Judith Coche, Ph.D., clinical associate professor of psychology in psychiatry, in an interview with Modern Bride magazine. "Men problem-solve by thinking things through themselves and then reporting it to someone," Coche said. "Whereas a woman will constantly report -- sometimes it feels like nagging or complaining to a man -- but really what she is doing is saying, 'Hi, here's the weather forecast for today. It's cloudy and a thunderstorm is coming any minute.'" A man, on the other hand, will not report the thunderstorm as it's approaching. But once it's over, he will report on the damage. Printed in the February/March 1998.
DROWSY MOTORISTS . . . According to a New York survey, 25 percent of drivers admit having fallen asleep at the wheel. Another 52 percent admitted driving while feeling drowsy. New Jersey state police estimate that 16 of the state's 800 annual traffic fatalities can be blamed on driver fatigue. "Being very drowsy is just as dangerous as drinking and driving," said Allan Pack, M.D., Ph.D., professor of medicine, in an article that appeared in the Asbury Park Press. Long distance travelers can take precautions against sleepiness behind-the-wheel, such as getting a good night's sleep, driving with a companion and switching drivers, stopping every two hours or 100 miles, and avoiding peak drowsiness periods (mid-afternoon and between midnight and 6 a.m.). Appeared December 2.
FOUR SQUARES A DAY. . . Many students change their eating habits when they get to college, adding a lot of late-night, high-fat eating to their usual diet. The obvious drawback is the famous "freshman 15," the typical amount of pounds that students add to their frames that first year away from home. At many campuses, students are able to conveniently purchase their late-night goodies at their dormitory dining hall. Gary Foster, Ph.D., clinical director of the weight and eating disorder program, summed up the bottom line in the Wilmington News Journal: "If you're used to eating 2,000 calories in three meals, and you're going to eat 2,500 calories with the fourth meal, you're going to gain weight." Printed December 26.
HMO CONFIDENTIALS. . . Traditionally, HMOs were able to withhold from employers data about the employees enrolled in a health plan, including how much the HMO paid out in claims to a company's insureds. "We see a small peep of light that that is starting to change," said David Shulkin, M.D., chief medical officer/chief quality officer of the Health System, in an article that appeared in US News and World Report. HMOs are learning that sharing information with employers and providers can work in everyone's best interest. And as an example of efforts being made, Aetna is developing a new company-wide computer system that will be able to easily track medical costs and treatment patterns. Appeared November 24.
HEAD OF THE CLASS. . . Jeffrey P. Carpenter, M.D., associate professor of surgery and director of HUP's vascular laboratory, was named to Main Line Today's "Class of '98." "In his position as director of the Vascular Surgery Program at Radnor, Carpenter brings the latest techniques to a state-of-the-art facility convenient for Main Line patients," the magazine reported. The article noted that Carpenter has pioneered endovascular surgery. Printed in the January issue.
ATHLETES AND HIV. . . A new state regulation requires boxers to test negative for HIV if they want to compete professionally in Pennsylvania. Athletes must provide negative HIV test results each time they apply for boxing licenses, which must be renewed annually. The regulation cannot prevent boxers from being infected with HIV, but it can reduce the risk of infection, Steven J. Gluckman, M.D., director of infectious diseases, told the Philadelphia Daily News. Printed January 14.
WOULD HELMETS HELP?. . . In response to the deaths of Michael Kennedy and Sonny Bono--both of whom died after skiing into trees and suffering severe head trauma--many are calling for the use of helmets by skiers. But could helmets really prevent, or lessen the severity of, injuries? Possibly, Mark Kotapka, M.D., vice chairman for the department of neurosurgery, told The Philadelphia Inquirer. There are two basic types of head injuries: impact injuries, caused by a blow to the head; and inertial injuries, caused when the body comes to a violent stop but the brain continues to travel forward. "You have a blend of those two extremes in skiing injuries," explained Kotapka. "You will probably hit your head, but you have also attained high speeds and you come to a rapid stop." Still, a "helmet would certainly provide some protection." Printed January 7.
WEIGHING THE BENEFITS. . . Obesity decreases life expectancy, according to a study published in a recent issue of The New England Journal of Medicine. But if you're only moderately overweight, will shedding pounds help you live longer? "I don't think there's good evidence that if you go from [weighing] 135 to 120 that you're going to increase your life expectancy," Psychiatry's Thomas A. Wadden, M.D., director of the Weight and Eating Disorders Program, told ABC's Good Morning America. "The issue here, really, is who needs to lose weight? And I think the persons who need to lose weight are those who are 20 percent or more above their ideal weight." Aired January 1.
PROMOTING ORGAN DONATION. . . In December, Vice President Gore unveiled an administration initiative designed to encourage organ donation and reduce the number of Americans who die while on organ waiting lists. "They're focusing a spotlight where it needs to be focused," said Arthur L. Caplan, Ph.D., director of the Penn Center for Bioethics, in USA Today. In his studies, Caplan said, those who are hesitant to donate the organs of a deceased loved one most often cite religious reasons, the feeling that the deceased has suffered enough, the fear it will damage the corpse, and the perception that the system of distributing organs isn't fair. Printed December 15.
FOR A PRICE. . . Aetna U.S. Healthcare recently said it would cover advanced fertility procedures such as in vitro fertilization through employers and groups that are willing to pay extra for it. The announcement partly reversed an earlier decision by Aetna to eliminate coverage for advanced procedures in most states for contracts signed after April 1, 1997. But many doctors are skeptical that the optional coverage will be affordably priced or widely available. "I don't think this is going to potentially help a lot of people," Stephen Corson, M.D., chief of reproductive endocrinology at Pennsylvania Hospital, told The Philadelphia Inquirer. "The cost will be so high because the base is low. They can bring it to the market at a cost that is prohibitory and then they can say they offered it but nobody took it." Printed January 15.
HOW TO BE HEALTHIER. . . The Philadelphia Forum turned to Mark A. Kelley, M.D., vice dean of clinical affairs, for simple steps the average person can take to live longer. The column included tips on preventing heart disease, cancer, infections, and accidents. A sample: "Even modest exercise reduces the risk of a heart attack. A reasonable exercise goal: a total of 30 minutes of exercise per day--and all exercise counts. If you can't jog, walk. If you can't hit the Stairmaster at your gym, climb your own stairs." Printed December 18.
TIPS FOR THE TIRED. . . Richard Schwab, M.D., of Penn's Sleep Center, offered viewers of WCAU-TV's News 10 Today advice on how to avoid sleeping problems. "You should not drink a lot of alcohol close to bedtime or any caffeine. Alcohol is extremely disruptive to sleep." He added: "You want to go to bed at the same time every night. Don't take a nap during the day unless you absolutely have to." And what if you find yourself lying in bed, wide-awake? "Get out of bed. Go do something. Read a book, watch television, watch the morning news, do something else until you're tired," he suggested. Aired December 16.
LIKE DOGS. . . One hundred years ago, Ivan Pavlov found that dogs will salivate and expect food in response to the sound of a bell if they are first conditioned to associate a feeding with bells ringing. Pavlov's work led to many accepted concepts, such as that some fears and aversions are conditioned responses. Charles O'Brien, M.D., Ph.D., chief of psychiatry at Philadelphia Veterans Medical Center and professor of psychiatry at the University of Pennsylvania Medical Center, talked about Pavlov and conditioning in the Boston Globe. "Our brains are wired to be conditioned, and conditioning is part of learning," he said. O'Brien uses conditioning in treating drug addiction. Conditioning "is automatic," he added. "It's not under our control. It happens whether we like it or not." Appeared December 22.
HUMAN GUINEA PIGS. . . Millions of Americans have participated in clinical trials of new drugs. While the process might earn them each a few hundred dollars and the possibility of facilitating the FDA approval of a drug that might help their own ailments, patients assume many risks when they participate in clinical trials. In an Atlanta Journal-Constitution article, a reporter wrote that the FDA does not oversee clinical trials, as one might expect. Instead, they are administered by the companies who will later seek approval for a new drug. "The entire enterprise is suffused with conflict of interest," commented Paul Root Wolpe, Ph.D., senior faculty associate for Penn's Center for Bioethics. "And the fact that we let the same people who have a deep, vested interest... also administer our ethical safeguards is a recipe for disaster." Printed November 16.
STRESS AND THE KIDNEY. . . A new study of 400 people has shown that patients with kidney stones are much more likely to have endured major stress in their lives. In an article that appeared in the Centre Daily Times, Alan Wasserstein, M.D., associate professor of medicine and director of Penn's stone evaluation center, acknowledged that the study provided valuable information. But, he said, stronger proof would come from studying thousands of healthy people, monitoring their stress levels, and seeing which ones develop kidney stones. He added that such an endeavor would be enormously expensive and complicated. Printed November 24.
EXERCISE DURING PREGNANCY. . . Healthy pregnant women can safely maintain their fitness routines throughout pregnancy, asserted an American College of Obstetricians and Gynecologists recommendation. There are certain conditions that may preclude safe exercise, ACOG acknowledged, including existing health conditions and pregnancy-induced hypertension. Mark A. Morgan, M.D., director of the maternal/fetal medicine division, added in Medical Tribune for the Family Physician that avoiding falls is very important during pregnancy. Runners may need to slow down to a jog, especially as they approach the later stages of pregnancy. Appeared December 18.
HOW MANAGED CARE FARES. . . Managed care has been around a long time. And now that legions of Americans have enrolled in managed care plans, insurers are trying to figure out how to hold medical costs down while improving care. In an article that appeared in American Medical News, Alan Hillman, M.D., M.B.A., associate professor of medicine and director of the Center for Health Policy at Penn's Leonard Davis Institute of Health Economics, commented that although managed care has kept costs down during the 1990s, the attention should turn now to what kind of managed care works best. Appeared January 12.
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March, 1998 Linda Bird Randolph, Editor Roshonda Jones, Colleen Hughes-Behler, Designer Administration: William N. Kelley, MD, CEO, University of Pennsylvania Medical Center and Health System, and Dean, School of Medicine Lori Doyle, Chief Public Affairs Officer Rebecca Harmon, Director of Media Relations
Media Review is published monthly by the University of Pennsylvania Medical Center's Office of Public Affairs to keep the faculty and administration aware of recent Penn-specific media highlights. To make comments, write to Editor, Media Review, 220 Blockley Hall, 3400Spruce Street, Philadelphia, PA 19104 |
