Category Archives: Medical School

By msnbc.com staff and news services

CAMBRIDGE, Mass. -- A dehydrated squirrel monkey died at a Harvard Medical School research facility in December, the third monkey to die at the New England Primate Research Center in 19 months.

The Boston Globe reports  that the U.S. Department of Agriculture cited Harvard for failures to comply with federal animal welfare regulations, including injuries to monkeys.

William Chin, executive dean for research at Harvard Medical School, told the newspaper that the incidents are unacceptable. He said problems with management systems and implementing basic procedures were found in a review in 2010.

Chin says new leaders are addressing the issues.

Harvard and agriculture officials say the Dec. 27 death and non-fatal dehydration of a second monkey was caused by employees' failure to check a malfunctioning water dispensing system.

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Another squirrel monkey???s leg was fractured in January, when it was caught under a door, according to the Boston Globe. Also, the newspaper reported that a group of rhesus macaques escaped from their pen in December, resulting in an injury to one monkey???s foot.

???They???ve had a tough stretch, and it???s certainly something that???s gotten our attention and we look forward to them correcting the situation,?? David Sacks, a USDA spokesman, told the Boston Globe.

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US cites Harvard medical research facility

By Carolyn Y. Johnson, Globe Staff

A squirrel monkey died of dehydration at a Harvard Medical School research facility in December -- the third monkey to die at the New England Primate Research Center in 19 months -- and animals there also suffered a fracture and other injuries over the past three months, according to a federal inspection report released today.

The US Department of Agriculture cited Harvard for three serious incidents, which occurred after the medical school had responded to a series of other problems by replacing the center’s leadership. Harvard could face fines or receive a warning because of the failures to comply with federal animal welfare regulations.

Harvard officials and the Agriculture Department report, posted on the agency’s website, attributed the December 27 death and the non-fatal dehydration of a second monkey to employees’ failure to check a water dispensing system that had malfunctioned sometime after both monkeys arrived at the center Dec. 7.

Another squirrel monkey’s leg was fractured in January, when it was caught under a door. And a group of rhesus macaques escaped from their pen in December, resulting in an injury to one monkey’s foot.

The Agriculture Department considers all three incidents “direct noncompliance” issues, meaning there is a direct, adverse impact on the welfare of animals, or the high potential of such an effect. In fiscal year 2011, there were 25 direct noncompliance issues at research facilities nationwide.

“They’ve had a tough stretch, and it’s certainly something that’s gotten our attention and we look forward to them correcting the situation,” said David Sacks, a USDA spokesman.

William W. Chin, executive dean for research at Harvard Medical School, acknowledged in an interview that “there have been deficiencies in what we’ve been doing, leading to a number of incidents. These are regrettable. ... I would say they’re frankly unacceptable.”

Chin discussed the new issues and broader problems at the primate center during a 45-minute interview earlier this month, on the condition that the Globe would not report his comments until the Agriculture Department posted the latest findings. It was the first time a medical school official had agreed to discuss the situation at the Southborough research center in depth.

He said problems with management systems and the implementation of basic procedures were discovered through a review launched in the summer of 2010, after the first monkey died. Those issues are being addressed, Chin said, through the change in the leadership team last September, disciplinary actions, new policies and procedures, and the formation of a six-member team that will perform continual reviews, training, and testing of staff, and conduct random audits. Harvard Medical School released a lengthy statement, describing some of the problems at the center, and its response.

“We, as part of this public trust, even though we’re doing great science, we have to be sure that the animals are treated in the best way possible. And we just haven’t done it, and now we are working so hard to continue to do better in this,” Chin said. He added that the recent incidents occurred because it will take time for the ongoing improvements in training, procedures, and oversight “to take hold.”

Sacks said that the agency was still investigating the October death of a monkey. A common marmoset escaped while it was being transferred for an imaging procedure, was caught with a net, and was found dead after undergoing imaging. Sacks said that investigation could expand to include new problems. If an investigation finds a violation of the Animal Welfare Act, consequences could include an official warning letter or a fine -- a maximum of $10,000 per violation.

The New England Primate Research Center houses 2,058 monkeys and has a staff of 231, including veterinarians, technicians, and scientists. It receives about $25 million annually in federal funding to support its research activities, which include developing a vaccine for HIV.

Chin said Harvard officials first became aware of problems at the center in June 2010, after a cage went through a washer with a monkey in it. The cotton-top tamarin was found dead on the floor of the cage. An autopsy determined the animal died of natural causes prior to the cleaning, but the Agriculture Department issued a warning letter to Harvard.

Harvard initiated a comprehensive review, involving outside veterinary experts and consultants, which revealed a lack of oversight and disturbing series of breaks in following procedures that govern the research.

The review found that in more than one case, procedures were being done on animals without the required approval of an institutional committee. Chin said the lapses “almost certainly” did not affect the scientific integrity of the experiments, but were not acceptable.

That led the investigators to examine animals’ medical records and to discover troubling omissions, including incomplete records of tuberculosis tests, which are supposed to be performed regularly to ensure the health of the large monkey colony.

“It was kind of a messy situation in terms of being able to know exactly what happened to each of the animals,” Chin said.

New experiments were suspended in summer 2011 while the health of the colony was tested. There were no cases of tuberculosis. But it had become clear that the problems were deeper than initially thought, Chin said.

Senior medical school officials decided to replace the key leaders at the center last September, including the director, associate director for administration, and veterinary leadership. Dr. Fred Wang, the interim director, was not made available for an interview. Disciplinary actions were also taken, Chin said, but he could not be specific about what actions were taken or how many individuals were involved, citing employee privacy reasons.

In addition to the three deaths since 2010 at the primate center, a monkey died at a separate Harvard Medical School facility in Feburary 2011, due to an anesthesia error.

Carolyn Y. Johnson can be reached at cjohnson@globe.com. Follow her on Twitter @carolynyjohnson.

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A third monkey death reported at Harvard’s New England Primate Research Center

QUESTION: I am a 55-year-old woman who struggled with an eating disorder (anorexia) when I was a teen. As I get older, it's becoming harder to keep excess weight off, and I'm afraid I am slipping back into unhealthy behaviors. Are eating disorders common in older women? What can I do?

ANSWER: In a sense, it's good that you still take pride in your appearance. In fact, many baby boomers are experiencing a disconnect between how old they feel and their chronological age. In a 2009 Pew Research Center survey, half of people in their late 60s and early 70s said they felt at least 10 to 20 years younger than their actual age.

Feeling youthful inside is great, but a glance in the mirror may bring you up short. No matter how young you feel, you're likely to see wrinkles, sags, tummy fat and less firm muscles because of weakening elastic tissue and the muscle loss that comes with aging.

At the same time, we're surrounded by unrealistic images aimed squarely at mature women. You know that when you see a model or celebrity touted as looking "good for her age," it's the work of plastic surgeons, colorists, stylists and airbrushers, but your unretouched body image can't help but suffer by comparison.

If you feel you should look as good as celebrities your own age, even though their public images may be artificial, your self-esteem can suffer. And this can, in turn, lead to extreme eating habits aimed at weight loss, without regard for your own well-being. Because you have a past history of eating disorders, you're more susceptible than most.

Here are some questions to help you assess whether body image and food concerns are crowding out other important parts of your life:

• Do you worry about your body and your age more than your friends do? What efforts do you make to hide the effects of aging?

• If you had the choice between living an extra five years and attaining your perfect weight, would you pick attaining your perfect weight?

• Do you and your friends spend a lot of time discussing diets, weight, your looks, gym routines, etc.?

• Does the number on the scale determine your mood for the day?

• Do you spend an inordinate amount of time planning what to eat and not to eat and how to get enough exercise?

• Do you gravitate toward health regimens that involve purging or restricting food, going gluten- or yeast-free, becoming a vegan, fasting, or doing colonics or cleanses, for example?

If you answered yes to one or more of these questions, try to shift your conversations and mental energy away from food and body awareness. If this proves difficult, consider consulting a mental health professional.

Eating disorders are usually regarded as a problem of adolescents and young women; their prevalence among older women is less clear. Secrecy and shame often accompany these disorders, and women may not seek help -- particularly if they fear being forced to gain unwanted weight or stigmatized as having a "teenager's disease."

In a 2010 study at the Oregon Health & Science University, women ages 65 to 80 were just as likely as young adult women to feel fat or concerned about their body shape.

First, you need a thorough medical examination. Certain medical conditions that cause rapid weight loss, interfere with appetite, or make eating difficult can be confused with an eating disorder.

Tell your doctor about any experiences with weight loss or gain, eating disorder behaviors or use of drugs to control weight. Your doctor also needs to know about any emotional problems you're confronting, including depression and anxiety.

After taking a history and performing a physical, she or he may order certain tests, such as an electrocardiogram to check for arrhythmia, laboratory tests for metabolic imbalances, or a bone density scan. And if your doctor feels you could benefit from an expert in eating concerns, ask for a referral to a specialist.

A balanced diet is important for good health. With planning and perhaps some help, you can eat right and look good, too.

Have a question? Send it to harvard_adviser@hms.harvard.edu

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Harvard Medical School Adviser: Eating disorders affect older people, too

Dr. Frank M. Torti, who on Friday was named vice president for health affairs at the University of Connecticut Health Center, said he was drawn to UConn partly by the potential for Connecticut to become a bioscience leader.

"There's an excitement in focusing around this bioscience initiative, and it's the sort of challenge that we'll be a part of at the UConn Health Center," Torti said. He specifically cited Gov. Dannel P. Malloy's plan to boost bioscience and the university's partnership with Jackson Labs, a Maine-based mammalian genetic research lab.

Torti's appointment takes effect May 1.

"Frank Torti is a brilliant researcher, physician and teacher — a transformational leader who will make UConn one of the premier institutions of health care in the world," UConn President Susan Herbst said in a statement released by the university.

Torti currently works at the Wake Forest University School of Medicine, where he is vice president for strategic programs, director of the Comprehensive Cancer Center, and chairman of the Department of Cancer Biology. He has also served as a chief scientist and acting commissioner of theU.S. Food and Drug Administration.

Torti's base salary will be $780,000 with a possible $150,000 performance incentive at the end of his first year at UConn. His predecessor, Dr. Cato Laurencin, received similar compensation.

After Laurencin stepped down as vice president of health affairs and dean of the medical school, the university began a national search for his replacement in July.

If there was anything on his resume that helped him edge any other candidates for the position, Torti said, it might have been experience with the FDA. Many academics and scientists are good with the creation of new drugs, he said, but negotiating the often convoluted maze toward approval is another matter.

"A lot of people don't realize that many drugs fail not because they aren't good drugs, but because people don't understand the regulatory path," said Tort. "I can bring that to the table."

In the next few years, Torti said, the medical community will increasingly understand that "we ought not be satisfied with the same drugs and treatments of the 20th century." Instead, he said, as genetics technology advances, it will focus more on personalized medicine.

"I think [UConn] will be the national leaders in this area," he said.

Among the medical organizations that Torti serves on, or has served on, include the Cancer Biology Training Consortium, North Carolina's Drug Discovery Center of Innovation's Scientific Advisory Board, the Association of American Cancer Institutes and of the National Coalition for Cancer Research, the National Institutes of Health Council for the National Center for Complementary and Alternative Medicine, and the National Cancer Institute's Clinical Trial Advisory Committee and the Board of Scientific Advisors

Torti received his bachelor's and master's degrees from Johns Hopkins University in 1979, his doctor of medicine from Harvard Medical School in 1974, and his masters in public health in 1973 from the Harvard School of Public Health. In the mid-1970s, he was an intern and resident at the Beth Israel Hospital in Boston.

Torti's wife, Suzy V. Torti, is a cancer researcher and has been hired as a professor in the UConn School of Medicine. She currently teaches at the Department of Biochemistry at the Wake Forest University School of Medicine.

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UConn Appoints New Health Center Leader

A day after the UConn Health Center got its first researcher for a new genomic center, UConn President Susan Herbst announced that the school had hired a new leader for the health center and the UConn medical school.

Dr. Frank Torti, a vice president at Wake Forest University who runs the school's cancer biology center, will come to UConn as the eighth dean of the UConn medical school, and the school's vice president for health affairs.

The move comes two weeks after Herbst hired Warde Manuel to run the school's athletic department, and a day after a Maine genetics lab announced it had hired Yijun Ruan as the first researcher for the new genomic center.

Torti, who will also hold a Board of Trustees professorship in the Department of Medicine, will join the health center May 1, UConn announced in a press release.

"Frank Torti is a brilliant researcher, physician, and teacher -- a transformational leader who will make UConn one of the premier institutions of health care in the world," Herbst said in a statement. "It is a new day at UConn. As I have said since my appointment, we have the highest ambitions for excellence, so that we may take our place among the international pantheon of great institutions. Dr. Torti is a superb leader, and I want every citizen of this state to know that their Health Center simply could not be in better hands. With Dr. Torti's guidance, we will find new cures for disease, map the future political economy of health care, and most of all, ensure that every single patient we see receives the best possible care known to contemporary science."

Torti, a New Jersey native who has worked at Wake Forest since 1993, said in a statement that he's "honored to have the opportuinity to lead the UConn Health Center and the School of Medicine."

"Governor Malloy's Bioscience Connecticut program and the state's partnership with Jackson Laboratory are nothing less than transformational. Working together, Connecticut and the University will change the bioscience landscape and grow the region's economy. I look forward to working with everyone to ensure that this outstanding academic medical center reaches its full potential."

It's the second time this month that Herbst has hired a new campus leader.

On. Feb. 13, the school announced it had hired Manuel, the athletic director at the University at Buffalo, to be its new athletic director. He's the first African-American to hold the position, and will lead the athletic department at a time of transition and great uncertainty.

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UConn hires new medical school dean

DIARY OF SHORTCOMINGS: Margaret O'Connell has applied for a transfer. Source: The Courier-Mail

IN AN affront to free speech, Queensland Health has demanded all medical students sign a gag order or be turfed out of their courses.

Students are furious that the University of Queensland medical school has gone along with the ridiculous ban they fear will prevent them from speaking out against wrongdoing or mistreatment of patients.

The students fear they are being coerced into signing the seven-page student deed poll agreeing not to reveal anything.

The medical school's online forum has run hot with complaints.

"Of primary concern is the contents of the document which seems to provide disproportionately harsh penalties for students in relation to extremely vaguely worded 'breaches', most of which seem designed to protect Queensland Health, not patients," said one student.

"Also of concern is the manner in which students are being forced to sign these documents as a 'requirement' of their placement.

"If students choose not to sign this deed - a document which the students have had no role in writing or drafting and have not even been informed about - then Queensland Health will disallow the student to continue on a placement, effectively meaning their medical studies are over.

"This penalty is by virtue of paragraph 17 (which says): 'This Deed Poll will continue for the duration of the placement, subject to the student's right to withdraw this consent. The student acknowledges that they may withdraw this consent by providing written notice to Queensland Health and the education provider. A withdrawal of consent will affect the student's ability to continue with the placement'."

The unsigned deed warns that "Queensland Health may seek and obtain an ex parte interlocutory or final injunction to prohibit or restrain the student, from any breach or threatened breach of this Deed Poll".

The deed contains a direct threat of legal action. It says: "In the event of a breach or threatened breach of the terms of this Deed Poll, Queensland Health shall be entitled to seek the issue of an injunction restraining the student from committing any breach of this Deed Poll without the necessity of proving that any actual damage has been sustained or is likely to be sustained by Queensland Health."

Another student said there were already adequate privacy regulations.

She added: "It strikes me that this is Queensland Health out of control. With an election imminent, they are inappropriately trying to control all aspects of information about their organisation and inappropriately entitle themselves to take harsh punitive action against students.

"The document seems to have more to do with protection from comment or criticism about Queensland Health than patient privacy."

Matthew Ramsay, a student from the US, said the document appeared to be an attempt to shut down media scrutiny of Queensland Health and the university medical school.

"It's very disconcerting," he said. "It appears to be a cover-up. The medical profession is dangerously close to allowing the Hippocratic Oath to degenerate into the Hypocritical Oath."

He said the medical school was racked with discontent following the nepotism scandal that claimed the scalps of vice-chancellor Paul Greenfield and his deputy Michael Keniger.

Ramsay said he wondered whether it was linked to the controversy surrounding medical student Margaret O'Connell, who kept a diary of shortcomings at the school.

O'Connell said students were not properly supervised during a seven-week "rotation" at a Queensland private hospital catering chiefly for the mentally ill. She said doctors made fun of suicidal patients, including one who had threatened to jump into the Brisbane River.

O'Connell complained doctors would not let students attend consultations with them. And doctors made it clear to students they didn't care whether they turned up. The doctors didn't even know the students' names and didn't want to know.

"I suspect this gag order is directly or indirectly related to the case of Meg," said Ramsay.

O'Connell said she was asked to see a psychiatrist and failed on a rotation to far north Queensland.

But her case was strengthened when she won a glowing report card from Dr Peter Chilcott,

director of medical services at Gove District Hospital in the Northern Territory.

Chilcott went further, accusing the university of a witch-hunt.

In evidence tendered to the university, he said: "I applaud your courage in taking on the Queensland medical establishment. As you are aware, your time in Gove was cut short by similar slurs and innuendos concerning your mental state. I had no concerns about your time at Gove.

"I was contacted by the medical school to provide reports.

"There was no doubt in my mind that the medical school simply wanted me to falsify reports and would have been quite happy for the whole mess up here to simply go away. I told the medical school that I had many concerns about how your case was handled.

"If someone had concerns about your mental state at that time then who better to look into the matter than myself with 38 years of GP experience. I also had at that time a GP trainee who is very experienced in mental health because she was originally on a psychiatric training pathway before switching to general practice.

"From my perspective your case had all the signs of a witch-hunt."

Chilcott saw no signs of mental illness, adding: "I did see someone who is 'eccentric'. However, do not take offence at this because I am considered 'eccentric' as well."

He said he was happy to support O'Connell's complaints to the CMC and the Ombudsman.

O'Connell has applied for a transfer to other universities. Her complaint is being considered internally.

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Health chiefs gag medical students