School Notes: School of Medicine
January/February 2008

New cancer hospital named for alumnus

The new 14-story cancer hospital, currently under construction, will be called the Smilow Cancer Hospital in appreciation of the generous support offered by Joel E. Smilow ’54 and his wife Joan. Smilow, the former chair, chief executive officer, and president of Playtex Products, Inc., is one of the university's most generous benefactors. The Smilow Cancer Hospital will gather all oncology patient services at Yale-New Haven Hospital and the School of Medicine into one building designed to deliver multidisciplinary cancer care. The new facility will cost an estimated $467 million and is expected to open in 2009.

Student-run clinic receives award

HAVEN Free Clinic, the two-year-old clinic run by students in public health, nursing, medicine, and the physician associate program, won an Elm-Ivy Award for helping further the partnership between New Haven and Yale.

HAVEN (Health Care, Advocacy, Volunteerism, Education, and Neighborhood) offers primary care, social services, and specialty referrals to city residents, many of whom are undocumented workers with no health insurance. Based at the Fair Haven Community Health Center, the clinic is supervised by attending physicians from the medical school and the community. Since it opened, it has provided medical care to more than 200 patients.

Weighing the benefits against the risks

Computed tomography (CT) scans are an invaluable diagnostic tool, but too much exposure to the radiation they use could increase a patient's risk of cancer, according to a Yale physician. James A. Brink, professor and chair of diagnostic radiology, says doctors need to be more aware of the risks posed by CT and other imaging devices that rely on radiation. The number of CT scans administered annually in the United States has grown from 3 million in 1981 to 63 million in 2005. In terms of radiation exposure, one CT scan is equal to between 100 and 250 chest X-rays. Brink would like to see physicians order fewer scans, particularly when another imaging technique would be adequate. "CT is a phenomenal technique," Brink says. "I'm not saying it shouldn't be used. I'm just saying we need to use it judiciously."

"Chronic Lyme disease" may not be real

There is no evidence that "chronic Lyme disease" exists, and if it does, the risks of prolonged antibiotic treatment outweigh any benefits, according to researchers at Yale and other institutions. In a review article in the New England Journal of Medicine, Eugene D. Shapiro of Yale and colleagues focused on the "imprecisely defined" condition "chronic Lyme disease." They maintain that the term is a misnomer and that prolonged use of dangerous and expensive antibiotics is not warranted.

Lyme disease is the most common tick-borne infection in the northern hemisphere. The disease is caused by the bacteria Borrelia burgdorferi, and typically manifests as a rash. Patients usually respond well to conventional antibiotics, but a minority later complain of fatigue, musculoskeletal pain, and difficulty with concentration or short-term memory. If these symptoms last longer than six months, they are called "post-Lyme disease syndrome."

Chronic Lyme disease encompasses this condition, but it also includes symptoms unrelated to B. burgdorferi infection, according to Shapiro, a professor of pediatrics, epidemiology, and public and investigative medicine. He recommends patients with these symptoms be thoroughly evaluated for other medical conditions that could explain them.