In Print & On the Air

A TINY, EXPENSIVE DEVICE THAT CAN be tucked under the skin of the chest can sharply reduce the death rate in high-risk heart patients, according to a study published March 21 in the New England Journal of Medicine. The implantable defibrillators sense when the heart's rhythm is going awry and administer an electric shock to bring the rhythm back to normal. Although the device is effective, it costs $20,000 and the operation to insert it costs another $10,000. The device raises questions about the cost of medicine in society. "This is only one example of many that we will be seeing in the coming years where there are very, very effective and very, very expensive new treatments," ALAN GARBER, an internist and economist who holds the Henry J. Kaiser Jr. Professorship, told the New York Times. "Does that mean we should put the breaks on this procedure? The broader question is, Can we as a society afford to pay?" In this case, much of the cost would fall on Medicare, but that adds an enormous burden to a publicly financed program with a fixed budget.

RESEARCHERS AT THE STANFORD SLEEP Disorders Clinic have learned how to treat a rare medical disorder that causes patients to commit sexual acts while asleep, according to research by CHRISTIAN GUILLEMINAULT, professor of psychiatry and behavioral sciences. Research on 11 cases of "sleep sex" are documented in the current issue of the journal Psychosomatic Medicine. The San Francisco Chronicle reported March 27 that some patients may cry out in excitement while others assault their bedmates. "We can't really know how many people have this medical disorder, because people feel so ashamed of their behavior, and the patients and their spouses have great difficulty in describing it," Guilleminault said. "Often the patients are in internal denial that the events occur, and it's the spouses who insist on the consultation." The major issue is to identify what type of sleep disorder is at the root of the problem, Guilleminault said. These may include epileptic seizures, chronic sleepwalking and activity during the period called REM sleep, he said.

THE NEW YORK TIMES REPORTED ON March 28 that a new software program being developed at Columbia University will make it easier for intelligence analysts to browse for information. Newsblaster currently trawls 17 websites, gathers articles and sorts them by topic, and then searches for shared terms and common phrases to create a summary. CHRISTOPHER MANNING, assistant professor of computer science and of linguistics, said Newsblaster's performance was "in some sense quite crude and quite imperfect compared to what a reporter might be doing if they were summarizing a news article." But Manning predicted that perfection of the program ultimately will hand human editing over to a machine.

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