Faculty Bibliography

His team's findings support the growing view that oncologists continue to prescribe chemotherapy for too many cancer patients when clinical evidence indicates they are in the terminal stages of the disease. There are no guidelines for the appropriate use of chemotherapy at the end of life based on scientifically controlled trials or consensus statements, [Ezekiel Emanuel] said. The researchers used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. This summer, [Michael Glantz] will start work at the Barrow Institute in Phoenix, and he said his team would begin studies to determine whether marriage counseling or other types of counseling can help patients with brain tumors and their spouses cope with the disease. Depression and fatigue are frequent problems of patients undergoing chemotherapy, and a common notion among cancer doctors is that they are linked. But in a study by Dr. Gary Morrow's team from the University of Rochester Cancer Center, they were found not to be linked

The researchers used standard textbooks to classify whether different cancers were generally responsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. Additional studies are needed to confirm such findings nationally and to develop guidelines for when chemotherapy should be stopped in terminal cases, [Ezekiel Emanuel] said. He also urged studies to determine how much managed care and traditional fee-for-service practices influenced the timing of chemotherapy. [Gary Morrow]'s team found that although a drug on the market, Paxil, could relieve depression among cancer patients receiving chemotherapy, it failed to relieve symptoms of fatigue. 'While the study does not totally disprove the theory, it certainly casts doubt on it,' Morrow said

[Ezekiel J. Emanuel]'s team from Boston University and Stanford University used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gall bladder, kidney, liver, pancreatic and melanoma

Bioterrorism was a main reason that Dr. Katherine A. Feldman's team from the C.D.C. was summoned to investigate five cases of rabbit fever pneumonia on Martha's Vineyard last summer. One man had died. Rabbit fever, or tularemia, is caused by a bacterium that usually is transmitted by ticks and by handling animal carcasses. But the bacterium is ranked high on the list of biological warfare agents in part because inhaling the microbe is particularly dangerous and the death rate is high if antibiotics are not started early. Health officials were puzzled when four men who developed typhoid fever in Cincinnati reported no foreign travel or common meals. Through interviews Dr. [Megan E. Reller]'s team learned that the men were gay. By reviewing hospital records and alerting health officials in other states, the epidemiologists identified a total of nine cases in Cincinnati and Indianapolis. They found that one man was a typhoid carrier and that seven of the other eight patients said they had sexual relations with him before becoming ill. Dr. Reller's team concluded that the men acquired typhoid through fecal-oral transmission during sex. The allergist then looked up articles that pointed Dr. [John T. Redd]'s team to exposure to caterpillars of the Douglas fir tussock moth (Orgyia pseudotsugata) that are widely distributed through the western United States. Dr. Redd's investigation showed that the allergic reactions occurred more commonly at certain camp sites, affecting as many as 55 percent of the scouts. For a number of reasons, Dr. Redd's team is advising the scouts not to play a game in which they they put caterpillars on the forearm, allow them to crawl on to the index finger, then flick the insects into a fire

Dr. [Kevin L. Winthrop] said spot checks of other nail salons elsewhere in California showed that the microbe was present in the vast majority of footbaths. Although only one nail salon customer outside Watsonville, a San Diego woman, is known to have been infected with the microbe, Dr. Winthrop and Dr. Ben Werner of the California health department said they strongly suspected that other outbreaks would occur. Dr. Winthrop said his team discovered whirlpool footbaths used in pedicures were teeming with M. fortuitum. By summer, Dr. Winthrop said, California officials are expected to issue regulations for rigorous cleaning and disinfection of footbaths in nail salons. M. fortuitum and its bacteriological cousins are often found in potable water and are ubiquitous elsewhere in the environment. Although the microbe has occasionally caused infections among patients with traumatic injuries, the Watsonville outbreak was the first spread in a community, Dr. Winthrop told the 50th annual meeting of the Epidemic Intelligence Service at the centers

The new guidelines, written by a federal panel and due to be announced tomorrow, represent a major philosophical shift in treating HIV, the AIDS virus. These drug cocktails, which suppress the amount of HIV in the blood beyond levels that tests could detect, led to substantial responses, with many AIDS patients getting off their deathbeds or going back to work. And many experts advocated early treatment for healthy infected people to prevent damage to the immune system. Studies show that the drug cocktails do not cure HIV. When infected people stop therapy, the virus rebounds, making lifetime therapy necessary

The panel, convened by the Department of Health and Human Services and the Henry J. Kaiser Family Foundation, still recommends therapy for anyone who develops symptoms of AIDS. Therapy should also be given to people whose blood tests show they have been infected for less than six months, in the belief that early treatment might strengthen the immune system's ability to fight the virus, the panel says. The aggressive approach to treating HIV was adopted shortly after protease inhibitor drugs were marketed and then combined with older drugs in 1996. These drug 'cocktails,' which suppress the amount of HIV in the blood beyond levels that tests could detect, led to substantial responses, with many AIDS patients getting off their deathbeds or going back to work. And many experts advocated early treatment for healthy infected people to prevent damage to the immune system. A second change relates to the HIV blood level as measured by two tests. The panel urged delaying therapy until the HIV level exceeds 30,000 per milliliter in the so-called branched DNA test (instead of the previously recommended 10,000) and 55,000 in the so-called polymerase-chain-reaction test (instead of 20,000)

The new guidelines, written by a federal panel and due to be announced on Monday, represent a major philosophical shift in treating HIV, the AIDS virus

The new guidelines, written by a federal panel and due to be announced on Monday, represent a major philosophical shift in treating H.I.V., the AIDS virus. The aggressive approach to treating H.I.V. was adopted shortly after protease inhibitor drugs were marketed and then combined with older drugs in 1996. These drug cocktails, which suppress the amount of H.I.V. in the blood beyond levels that tests could detect, led to substantial responses, with many AIDS patients getting off their deathbeds or going back to work. And many experts advocated early treatment for healthy infected people to prevent damage to the immune system. A second change relates to the H.I.V. blood level as measured by two tests. The panel urged delaying therapy until the H.I.V. level exceeds 30,000 per milliliter in the so-called branched DNA test (instead of the previously recommended 10,000) and 55,000 in the so-called Polymerase Chain Reaction test (instead of 20,000)

The panel, convened by the Department of Health and Human Services and the Henry J. Kaiser Family Foundation, still recommends therapy for anyone who develops symptoms of AIDS. Therapy also should be given to people whose blood tests show they have been infected for less than six months, in the belief that early treatment might strengthen the immune system's ability to fight the virus, the panel says. The aggressive approach to treating HIV was adopted shortly after protease inhibitor drugs were marketed and then combined with older drugs in 1996. These drug cocktails, which suppress the amount of HIV in the blood beyond levels that tests could detect, led to substantial responses, with many AIDS patients getting off their deathbeds or going back to work. And many experts advocated early treatment for healthy infected people to prevent damage to the immune system