Faculty Bibliography

That chilling forecast is based in part on analyses by the organization that show that, on average, a patient infected with drug-resistant tuberculosis in 2004 was resistant to more drugs than a similar patient with that diagnosis in 1994, Dr. Paul Nunn, a TB expert for the organization, said Tuesday. About 420,000, or 5 percent, of the estimated 8.8 million new cases of tuberculosis in the world are resistant to many standard anti-tuberculosis drugs, Dr. Mario Raviglione, who directs the WHO's tuberculosis department, said in an interview. 'It is possible that in some settings drug-resistant tuberculosis could completely replace standard tuberculosis,' Raviglione said

''It was not watered down in terms of its science,'' Ms. [Dana Perino] said. ''It wasn't watered down in terms of the concerns that climate change raises for public health.'' The testimony that remained said, ''Climate change is anticipated to have a broad range of impacts on the health of Americans and the nation's public health infrastructure.'' But a line saying ''the public health effects of climate change remain largely unaddressed'' was gone, and the testimony focused on the ways health agencies were already prepared to tackle any problems

''This technique has a big potential in the vascular surgical field,'' said Dr. Toshiharu Shinoka, who directs pediatric cardiovascular surgery at Yale and who plans to conduct studies with Cytograft on the new vessel. He called the technique an advance over one he used in operations on children in Japan, in which vessels were grown from cells on a scaffold that then degraded and was absorbed into the body. Doctors not connected with the company agreed on the importance of the new technique. ''A potential benefit may be for infants and children with congenital heart defects,'' said Dr. Deepak Srivastava, director of the Gladstone Institute of Cardiovascular Disease at the University of California, San Francisco. Unlike grafts from cadavers, he added, ''the Cytograft vessels should be able to grow as the child does.'' Dr. Sergio A. Garrido, a vascular surgeon in Buenos Aires, said he implanted the Cytograft vessels in the forearm or upper arm under general anesthesia, in a different area from the malfunctioning shunt. The procedure took 60 to 90 minutes. Through surgical gloves, the Cytograft vessel, 5 1/2 to 11 * inches long, felt a little more delicate than a regular vein, he said

The outbreak resembles one last year that was linked to a different manufacturer's lens solution and a different microbe. In both instances, the cornea, the eye's transparent outer covering, is at risk. But why two different microbes caused the outbreaks is not known. ''It is beyond comprehension,'' said Dr. Dan B. Jones, the chairman of ophthalmology at Baylor College of Medicine in Houston, who detected a case of acanthamoeba keratitis, which is behind the current outbreak, on Friday. Acanthamoeba infections have been reported in many countries. Dr. Jones's team is credited for first identifying a corneal infection from acanthamoeba in the United States, in a rancher who was injured in an accident in Texas in 1973. That case did not involve contact lenses: while the rancher was working in a field, a piece of wire and hay hit his eye

Still, the effort is ''a remarkable success'' considering that only 2 percent of infected patients needing antiretroviral therapy were receiving it three years ago, said Dr. Kevin De Cock, the H.I.V./AIDS director at the World Health Organization, a United Nations agency in Geneva. Many numbers were discouraging. In 2006, about six times as many people became infected with H.I.V. as started treatment, meaning prevention efforts are faltering or not in place, Dr. De Cock told reporters by telephone. The Bush administration's emergency plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria were paying for care of about 1.27 million of the two million total, the United Nations said

Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, used to clean and store soft contact lenses

The overwhelming majority of tuberculosis cases are caused by bacterial strains that yield to the standard, or first-line, anti- TB drugs. Newer, second-line drugs are used if a strain of tuberculosis is MDR or XDR, which are resistant to the first-line drugs. If tuberculosis strains are not tested for drug resistance as soon as they are found in a patient, the problem may be detected too late to permit a cure. The panel also recommended using molecular tests to detect rifampicin resistance as a proxy for MDR tuberculosis. Use of such tests could reliably determine XDR in less than two months, compared with the several months that are often needed now, [Karin Weyer] said. Standard tests take weeks to complete because TB bacteria grow slowly. The panel emphasized that laboratory workers needed more experience in interpreting results of the tests. As new laboratories are created in the many countries where drug-resistant tuberculosis exists but testing facilities do not, technicians will need to learn how to do the testing. Refresher training is also needed even in the best laboratories because they are mainly in countries with a low incidence of resistant tuberculosis

'Calling in Dr. [Michael DeBakey] was very important, a signal that he was in very serious condition, and consulting with a world leader in surgery this way was almost unthinkable in the Soviet period,' said Marshall Goldman, a Russian expert and senior scholar at Harvard. 'It was a measure of Dr. DeBakey's stature in Russia.' As a patient, [Boris Yeltsin] 'was not as bossy with me as he was with some of his Russian doctors,' DeBakey said, adding: 'He didn't get along with some of the doctors there. But he took a liking to me, listened, and that made things much better.' My requests for interviews with Yeltsin were always denied, so I was never able to ask him about DeBakey. But in a foreword to the Russian edition of DeBakey's book The New Living Heart (Adams, 1997), written with Antonio Gotto Jr., Yeltsin described DeBakey as 'a magician of the heart' and 'a man with a gift for performing miracles.'

That was the case in Tugela Ferry, a rural town in KwaZulu-Natal province in South Africa, when an outbreak of extremely drug- resistant tuberculosis -- XDR-TB for short -- killed 52 of its 53 victims, all of whom were also infected with HIV. The outbreak was detected in 2005, but it did not receive international attention until it was reported at the international AIDS meeting in Toronto last August. Using statistics from recent years, [Karin Weyer] said her team estimated that 6,000 new cases of multi-drug-resistant tuberculosis occurred in South Africa each year and that the rate of treatment failure was about 10 per cent. Assuming that most failures were due to the extremely drug-resistant form, a conservative estimate is 600 cases of XDR-TB in her country each year, Weyer said. The outbreak is not limited to Africa. Dr. Paul Nunn, a tuberculosis expert at the World Health Organization, told the meeting here that one or more cases of XDR-TB had been found in at least 28 countries. Extrapolating from data about the multi-drug- resistant form of tuberculosis, Nunn estimated that two-thirds of the XDR-TB cases were from China, India and Russia

The combination - taking one inexpensive antibiotic pill each day and sleeping under an insecticide-treated mosquito net - reduced the incidence of malaria by 97 percent compared with a control group, Dr. Anne Gasasira, an AIDS researcher at Makerere University in Kampala, Uganda, said Wednesday at a medical conference in Los Angeles. She said the findings had already changed medical practice in Uganda. But scientists said they had not yet determined whether the treatment would be as effective in HIV-negative children with malaria