Immunology:
Mobilizing Cytokine Receptor Key Step in Defense Coordination

Psychiatry:
Studies Give Boost to Therapies for Depression

Cell Biology:
Chemical Genetics Identifies New Way of Disrupting Cell's Protein Recycling System

Awards
Systems Bio Recruit Takes MacArthur Award

New Books:
The Fall Bookshelf

Structure Reveals Binding of Platelet Integrin

Eosinophils Play Role in Chronic Allergic Asthma

Complement Linked to Tissue Damage in Diabetes

Cell Death Proteins Counter Chemo Resistance

Commission Reports Racial and Ethnic Disparities in Health Professions

Applications Requested for 2005 Alzheimer's Research Pilot Grants

Science in the News Opens Fall Series

Fourth Annual Albright Symposium

Appointments to Full and Named Professorships

Honors and Advances

In Memoriam:
George Thorn
John Badwey
Howard Frank
Margaret Brenman-Gibson
Kenneth Herman
John Richard Gaintner

HMI and International Partners Combat HIV/AIDS Through Education

Front Page

The Fall Bookshelf

John Abramson
Overdosed America: The Broken Promise of American Medicine
HarperCollins

Marcia Angell
The Truth About the Drug Companies: How They Deceive Us and What to Do About It
Random House

Jerry Avorn
Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs
Alfred A. Knopf
Researchers hope their discoveries will alleviate suffering or lead to new cures for disease. And doctors want to prescribe the new medications developed by researchers to heal their patients or extend their lives.

Standing in the way is profiteering by drug companies, suppression or subversion of evidence about effectiveness and safety, collusion by government regulators, and the complicity of doctors and medical educators. So say three new books by HMS faculty members that probe the rich vein of dissatisfaction with the marketing practices, rising costs, and perceived lack of innovation in the American pharmaceutical industry.

John Abramson, HMS clinical instructor in ambulatory care and prevention at Harvard Pilgrim Health Care, focuses on "the virtual takeover of medical knowledge in the U.S." He writes that "much of the Œscientific evidence' which guides our clinical decisions is commercially spun or worse, and many of the articles published in even the most respected medical journals seem more like infomercials whose purpose is to promote their sponsors' products rather than to search for the best ways to improve people's health." The integrity of medical science has been transformed from "a public good whose purpose is to improve health into a commodity whose primary function is to maximize financial returns." In his premise, patients and doctors alike are duped.

Marcia Angell, HMS senior lecturer on social medicine and former editor-in-chief of The New England Journal of Medicine, agrees that the pharmaceutical industry is "primarily a marketing machine to sell drugs of dubious benefit." Rather than "investing more in innovative drugs and moderating prices, drug companies are pouring money into marketing, legal maneuvers to extend patent rights, and government lobbying to prevent any form of price regulation." Instead, the public would be better served if the industry changed in order to translate the unparalleled wealth of publicly sponsored research advances into drugs available at reasonable prices.

Taking a slightly different perspective, Jerry Avorn, HMS associate professor of medicine at Brigham and Women's Hospital, asks "why there is such a contrast between the robust success of biomedical science and the lame disarray with which we sometimes deploy that science." Taking a cue from the emerging field of medical errors research, Avorn blames a faulty system. "We waste billions of dollars a year on prescription drugs that are excessively priced, poorly prescribed, or improperly taken," he writes. "We need a better grip on how to maximize the potentially awesome good of medicines, contain their often preventable harm, and manage their increasingly burdensome expense."

Evangelos S. Gragoudas, Joan W. Miller, and Leonidas Zografos, Editors
Photodynamic Therapy of Ocular Disease
Lippincott Williams & Wilkins
The most effective treatment for subfoveal neovascular age-related macular degeneration (AMD) is photodynamic therapy, an evolving intervention for AMD that reduces visual loss in patients with this central vision-destroying disorder. The editors, Evangelos Gragoudas, a professor of ophthalmology; Joan Miller, the Henry Willard Williams professor of ophthalmology; both at the Massachusetts Eye and Ear Infirmary; and Leonidas Zografos, an ophthalmology professor at the Jules Gonin Eye Hospital in Lausanne, Switzerland, describe the history and principles of photodynamic therapy, covering preclinical animal studies of photosensitizing dyes and current applications of the technique. Written primarily for vitreoretinal specialists, the book includes contributions from 40 authors, including the editors, and provides dozens of clinical images, in color and black and white.

John Loewenstein and Scott Lee, Editors
Ophthalmology: Just the Facts
McGraw-Hill
Though medical students are no longer required to take a rotation in ophthalmology, many will encounter visual problems such as glaucoma, conjunctivitis, retinal disease, cancer, diabetic retinopathy, and other eye problems in their patients. Few books are designed to prepare medical students in the basics of ophthalmology. Recognizing the need for "a concise, yet complete text," John Loewenstein, HMS assistant professor of ophthalmology, and his University of California-San Francisco colleague Scott Lee, have produced a well-organized, richly illustrated text. Chapters by Loewenstein, who is at the Massachusetts Eye and Ear Infirmary, Lee, and other experts in the field introduce the reader to the clinical presentation, pathophysiology, diagnosis, and treatment of a full range of eye diseases.

Theodore A. Stern, Gregory L. Fricchione, Ned H. Cassem, Michael S. Jellinek, and Jerrold F. Rosenbaum, Editors
Massachusetts General Hospital Handbook of General Hospital Psychiatry
Mosby
The editors of this handbook, all HMS professors from Massachusetts General Hospital's Department of Psychiatry, expanded the fifth edition of this text by more than 20 chapters and nearly doubled its length. Aimed at practitioners on medical and surgical wards, the book offers guidance on how to diagnose and treat specific psychiatric problems of medically ill adults and children. This edition adds content on many topics, including psychopharmacology, care of the geriatric patient, diagnostic rating scales and laboratory tests, collaborative care, complementary medicine, and natural medications. Seventy-nine authors penned chapters on a range of topics and provided treatment strategies that are both cognitive and behavioral.

Garrett M. Fitzmaurice, Nan M. Laird, and James H. Ware
Applied Longitudinal Analysis
Wiley-Interscience
The authors' goal in writing this text is to bring recent advances in longitudinal analysis into the mainstream of applied statistics. Geared toward a readership of researchers and graduate students in the health and medical sciences, the book takes a comprehensive and systematic approach to the subject. Content is organized into four main parts, an overview, analysis methods for longitudinal data involving certain continuous response variables, analysis methods for data with outcomes that are not continuous, and advanced topics like study design and dealing with missing data. To apply the methods described in the text, readers will need a commercially available software package such as SAS, which the authors use. All from the Department of Biostatistics at HSPH, the authors are associate professor Garrett Fitzmaurice; professor Nan Laird; and James Ware, the Frederick Mosteller professor.

Darshak Sanghavi
A Map of the Child: A Pediatrician's Tour of the Body
A John Macrae Book/Henry Holt and Co.
With a storyteller's gift and a pediatrician's training, Darshak Sanghavi takes the reader on a journey through eight organ systems of a child's body. Sanghavi, an HMS clinical fellow in pediatrics at Children's Hospital Boston, weaves together medical facts, patient stories, and personal reflections about the lungs, heart, blood, bones, brain, skin, gonads, and gut. A glance at the table of contents reveals his entertaining and intimate style. Chapter one on the lungs is subtitled, "From Bombay to Boston, stories of people and lungs seeking freedom." The last chapter is "Guts: On remedying various kinds of emptiness, and a concluding confession." Sanghavi's explorations will engage not just parents but all readers.

Andrea Farkas Patenaude
Genetic Testing for Cancer: Psychological Approaches for Helping Patients and Families
American Psychological Association
Genetic testing can be a psychological double-edged sword when people learn they carry a genetic mutation for a disease that has no cure. Even those who carry genes for treatable diseases, such as some forms of cancer, may find that such information brings emotional distress. Andrea Farkas Patenaude, HMS assistant professor of psychology in the Department of Psychiatry, identifies the psychological reactions and dilemmas of patients concerned about hereditary cancer. She explores patients' reactions to receiving genetic test results, the impact on their families, and the challenge of making decisions about prophylactic surgery. Patenaude, who is at Dana-Farber Cancer Institute and Children's Hospital Boston, concludes by discussing the complex social and ethical issues surrounding genetic testing.

Allan M. Josephson and John R. Peteet, Editors
Handbook of Spirituality and Worldview in Clinical Practice
American Psychiatric Publishing
Editors Allan Josephson of the University of Louisville and John Peteet, HMS associate professor of psychiatry at Brigham and Women's Hospital, were confronted with questions of how and to what extent to incorporate religion and spiritual factors in mental health treatment. They set out to create a basic text for mental health professionals with a framework for understanding the diagnosis and therapeutic implications of different systems of belief, both formal and informal. Chapters examine Christians, Jews, Muslims, Hindus, Buddhists, atheists, and agnostics, providing variations of therapeutic encounters specific to each system of belief. The cognitive aspects of belief, or worldview, must be considered in all individuals, both patients and clinicians, write the editors.