Faculty Bibliography

Focus groups conducted for a panel of scientists advising the government uncovered a catalog of misinformation about the smallpox vaccine -- the first vaccine to be developed (in 1796) and considered the most dangerous. Glen Nowak, from the Centers for Disease Control and Prevention, reported the findings to the panel, known as the Advisory Committee of Immunization Practices and the National Vaccine Advisory Committee. The government asked it to determine by June 20 whether to continue the policy of prohibiting vaccinations unless the disease returns in a bioterrorism attack or to allow the smallpox vaccine to be offered to everyone who wants it. Current guidelines, published in June 2001, do not recommend the smallpox vaccine for the public. Vaccination is limited chiefly to laboratory workers directly involved with the virus or its close virological cousins. The limits were based largely on the lack of enough vaccine. At the time, the government had only 15 million doses

Focus groups conducted for a panel of scientists advising the government uncovered a catalog of misinformation about the smallpox vaccine -- the first vaccine to be developed (in 1796) and considered to be the most dangerous. Unlike most other immunizations, smallpox vaccine can harm recipients and their contacts. Resumption of vaccination on a large scale would probably lead to thousands of serious complications and hundreds of deaths, as it did when millions of Americans were routinely vaccinated. Current guidelines, published in June 2001, do not recommend smallpox vaccine for the public. Vaccination is limited chiefly to laboratory workers directly involved with smallpox virus or its close virological cousins. The limits were based largely on the lack of enough vaccine. At the time, the government had only 15 million doses. In the wake of the anthrax attacks last fall, the government has expanded its stockpile of smallpox vaccine. Tests have shown that the 15 million doses can be diluted to 75 million. The drug company Aventis Pasteur has donated about 80 million doses that have been frozen since 1958 and that the government says would be used only in an emergency. The government is also buying 220 million doses made by a new laboratory technique. Delivery is expected by year's end

Focus groups conducted for a panel of scientists advising the government uncovered a catalog of misinformation about the smallpox vaccine -- the first vaccine to be developed (in 1796) and considered to be the most dangerous. Unlike most other immunizations, smallpox vaccine can harm recipients and their contacts

Instead of taking people who may have had heart attacks to the nearest hospital, as is now advised, the researchers said it may be better to send them farther, to a hospital where a trained team can perform angioplasty to open clogged coronary arteries

Costs of angioplasty and clot-dissolving drugs vary among hospitals and regions. The drugs cost about $2,200; an angioplasty, $2,000 to $4,000. But up to two-thirds of patients who receive the drug also then need angioplasty because their arteries are still clogged. All nine hospitals in Boston and the Boston Emergency Medical Services have started a program to monitor the quality of angioplasty performed in the seven hospitals offering it, Dr. [Christopher P. Cannon] said. The researchers want assurance that all seven hospitals that perform angioplasty can do so around-the-clock daily so that all patients will get angioplasty and not T.P.A. He said he expected that in six months patients with ST elevation heart attacks would be taken only to hospitals that did angioplasty. He cautioned that the approach might not be feasible everywhere. After six months, 6.2 percent in the angioplasty group died, compared with 7.1 percent in the drug therapy group. An additional heart attack occurred in 5.3 percent of the angioplasty patients, compared with 10.6 percent in the T.P.A. group. Stroke rates were 2.2 percent for the angioplasty group and 4 percent for the T.P.A. group. Length of stay was also shorter in the angioplasty group, 4.5 days compared with 6

Heart researchers, responding to new findings that a procedure to open clogged arteries is superior to clot-dissolving drugs for heart attacks, are urging the United States to change its system for emergency care of heart attacks

Heart researchers, responding to new findings that a procedure to open clogged arteries is superior to clot-dissolving drugs for heart attacks, are urging the United States to change its system for emergency care of heart attacks. Costs of angioplasty and clot-dissolving drugs vary among hospitals and regions. The drugs cost about $2,200; an angioplasty, $2,000 to $4,000. But up to two-thirds of patients who receive the drug also then need angioplasty because their arteries are still clogged. The researchers want assurance that all seven hospitals that perform angioplasties do so around-the-clock every day so that all patients will get angioplasties and not TPA. [Christopher Cannon] said he expected that in six months, patients with ST elevation heart attacks will be taken only to the hospitals that perform angioplasty. But he cautioned that the approach might not be feasible everywhere

About 670,000 Americans know they are infected; another 180,000 to 280,000 have the virus but do not know it, according to a study reported by Dr. Patricia Fleming's team at the disease centers

At a news conference yesterday, Hopkins officials said that they did not receive the Nov. 30 recall letter until late January, because instead of being sent to the department that used the bronchoscopes, it was addressed to a loading dock at another department across the street. The letter had a return receipt requested. No one had signed for it, and as far as they knew, Hopkins officials said, Olympus had not followed up. In the meantime, doctors at Hopkins, like those in Tennessee, had begun to notice an unusually high rate of pseudomonas infections among patients exposed to bronchoscopes. Hopkins began its own investigation and developed a culturing technique based on running fluid backward through the scope to detect the bacteria. Dr. [Paul Scheel] said doctors at Hopkins began calling other hospitals to warn them of the problem, to tell them how to culture the bacteria and to alert them to the recall. He said mention of the recall was usually greeted by a long silence and then the question, ''What recall?''

Her team used data from 25 states where H.I.V. infections are monitored to create a mathematical model to predict H.I.V. diagnosis in the remaining states. From the model, they also estimated that a quarter of infected people might not know they were infected. To improve care, the agency has begun public campaigns to increase the number of people who get H.I.V. tests. It is also urging wider use of a rapid H.I.V. test so individuals can get the results on the day they visit a clinic rather than waiting a week or longer, Dr. [Harold W. Jaffe] said. Also, the agency will urge hospitals to follow a guideline to make H.I.V. testing more of a routine part of health care. The recommendation, which was issued in 1993, calls on hospitals where at least 1 percent of the patient population has AIDS to consider offering H.I.V. testing to patients 15 to 54 years old