Faculty Bibliography

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 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 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 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

[Michael Reardon], who performed the operation on Minnich at the Methodist- DeBakey Heart Center, learned bench heart surgery in 1983 while a resident under Dr. Denton Cooley, a pioneer heart surgeon in Houston. Cooley's patient, possibly the first to undergo the procedure for cancer, had a different kind of heart tumour than Minnich, and died. Reardon went on to do two more, both for Minnich's kind of cancer. The first of those patients survived the operation but died from spread of the cancer, and the second is alive and cancer-free 14 months after bench surgery. On Nov. 5, Minnich returned home to complete scheduled tests in preparation for previously planned chemotherapy and a heart transplant. But time was running out faster than everyone realized. 'When I walk up my stairs now, I'm starting to get short of wind,' Minnich told Reardon in a phone call. Reardon told her to return to Houston immediately. 'By the time she got down here on Nov. 12, she had to sit straight up at night to breathe,' Reardon said. The second cancer felt hard. To cut it out, Reardon removed much of the remaining portion of the left atrium and the wall separating it from the right atrium. He repaired Minnich's heart with tissue -- the pericardium or sac surrounding the heart -- from a cow. The bovine heart tissue had been chemically treated to prevent Minnich's body from rejecting it. After looking for spread of the cancer in Minnich's chest and finding none, Reardon began stitching her own heart in place

In such trials, participants agree to receive either a sirolimus-coated stent or a standard stent. The choice is made by the equivalent of a flip of a coin, and neither the doctor nor the recipient knows whether the implanted stent is coated or not. The trials are also designed to detect unexpected long-term complications from the drug. Since a stent was first implanted in a coronary artery in Europe in 1986, cardiologists have sought to improve them. The ideal healing would be limited growth -- a thin layer of cells to carpet the stent-injured area on the inside wall of the artery, rather than thicker scarring. Early attempts to coat stents with a drug to prevent scarring failed; some made the scarring worse. More recently, stents that have been coated with a drug, heparin, have been licensed for reducing the frequency of clot formation at or near the site of implantation. Other licensed stents use radiation and are implanted within stents that became blocked and need to be unclogged in a second go-round. Researchers are also testing stents coated with taxol, an anticancer drug, and other drugs to prevent excessive cell growth or scarring

Mr. Reagan's doctors declined to discuss the state of his Alzheimer's disease at a news conference on Saturday. His chief orthopedic surgeon, Dr. Kevin Ehrhart, said Mr. Reagan's hip fracture was ''fairly run-of-the-mill'' and his rehabilitation would be ''a long, uphill struggle.'' Mr. Reagan's Alzheimer's disease is a different matter. In 1994, Mr. Reagan disclosed that he had developed Alzheimer's, which affects an estimated four million Americans. That condition is likely to affect the physical therapy and rehabilitation that hip fracture patients need to regain the mobility they had before the accident. In Mr. Reagan's case, very little is publicly known about how advanced a case of Alzheimer's he has and the quality of his life before the broken hip. In trying to protect her husband's privacy, Nancy Reagan has said very little about what he can do

In 1957, he became chief virologist at the division of biological standards at the National Institutes of Health. Although [Joseph Louis Melnick] did not have a medical degree, he moved to Baylor in 1958 to become founding chairman of the medical school's department of virology and epidemiology. In 1960, Melnick showed that the weakened strains of polio virus used by Dr. Albert Sabin to make his oral vaccine produced less damage to the nervous system than the strains used in a competing vaccine. Melnick began his scientific career at Yale under Dr. John Paul, a renowned expert in polio. Until a vaccine was introduced in the 1960s, polio struck up to 57,000 people a year in the United States. His team showed that the polio virus was transmitted among people chiefly by fecal contamination, usually through soiled hands

Reardon, who performed the operation on [Joanne Minnich] at the Methodist- DeBakey Heart Center, learned bench heart surgery in 1983 while a resident under the legendary Dr. Denton Cooley. In describing the operation, Reardon said, he was 'bluntly honest' in explaining the risks. For anyone, a second heart operation is always more dangerous than a first. For Minnich, Reardon said that what he could do depended on what he saw when he opened her chest and then examined her heart in the bowl. He went on, 'It was very difficult to look Joanne in the eye and tell her she may die.' 2 PICS; 1. Dr. Michael J. Reardon moved Joanne Minnich's heart to a metal bowl, where he was able to remove five cancerous tumors. 2. Minnch, 57, following her risky 'bench surgery' for a rare heart cancer.; Credit: 1,2. New York Times photos