Faculty Bibliography

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. ''But no laboratory test for any disease is 100 percent,'' said one member of the panel, Dr. Karin Weyer of the South African Medical Research Council. ''Labs often have problems and can and do make mistakes,'' Dr. Weyer said. 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, Dr. Weyer said. Standard tests take weeks to complete because tuberculosis bacteria grow slowly

'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.'

The pneumococcal vaccine can prevent the pneumonia, meningitis and blood-system and other infections caused by the bacterium Streptococcus pneumoniae. These infections were long a major cause of illness and death among the elderly and the chronically ill throughout the world. Even healthy adults and infants suddenly died from them. After drug companies developed a vaccine that included 14 serotypes, Austrian proved its safety and effectiveness by supervising clinical trials among military trainees and gold miners in South Africa. They were at greater risk because they worked in crowded conditions. The vaccine was marketed in 1977, at a time when there were up to 750,000 cases of pneumococcal pneumonia in the United States each year

The findings also extend to an earlier study that found a reduced frequency of malaria among H.I.V.-infected adults in Uganda who took the antibiotic and slept under bed nets. Dr. Jonathan Mermin of the Centers for Disease Control and Prevention in Atlanta led the adult study, which was published in The Lancet last year. But Dr. [Anne Gasasira] said that because the adult and pediatric studies used different methodologies, the findings could not be directly compared. In the past, doctors assumed that a child who came to a clinic for fever in Uganda had malaria until it was proved otherwise. But because malaria was far less common among the participants who received the combination therapy, Dr. Gasasira said, doctors now assume that any fever in a young child must be investigated for a cause other than malaria. Dr. [Elaine Abrams], the Columbia expert, said in an interview that the Uganda findings had additional implications for treating H.I.V.-infected children in malarious areas. Because pediatricians are concerned that prolonged use of cotrimoxazole could lead to resistant malaria, they often stop the drug among AIDS patients when tests show significant improvement in the health of their immune system after antiretroviral therapy

''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

Richard J. Codey, the State Senate president and a Democrat like Mr. [Jon S. Corzine], stepped in as acting governor during the surgery, and is expected to remain in charge as long as Mr. Corzine is hospitalized. Governor Corzine was traveling, as he normally does, in a two-car caravan. Officials said the two troopers in the car following Mr. Corzine stopped to care for him rather than chase the red truck. A New Jersey state trooper at the scene of the crash on the Garden State Parkway in Galloway Township, where the governor was hurt when his car hit a guardrail. Two others in the car were also injured. (Photo by Colin Archer/Associated Press)(pg. B1); Jon S. Corzine (pg. B8)

The two drugs, which could be approved for marketing this year, would add two new classes of drugs to the four that are available to battle HIV, the virus that causes AIDS. That would be especially important to patients whose treatment is failing because their strain of virus has become resistant to drugs already in use. 'This is really a remarkable development in the field,' Dr. John Mellors of the University of Pittsburgh said at a news conference Tuesday at the 14th Annual Conference on Retroviruses and Opportunistic Infections in Los Angeles. Pfizer's drug works by blocking a portal on human immune system cells that HIV uses to enter and infect the cell. It would be the first AIDS drug that works by blocking a protein that is part of the human body rather than something in the virus. About 85 percent of newly infected patients have a virus that uses CCR5, while only about half of patients who have a resistant virus use CCR5. There has been some concern that blocking CCR5 would encourage the development of viruses that use the alternative portal

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

''The new analyses are both disappointing and puzzling'' because they offer no explanation for the vaccine's failure, said Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, a partner in the vaccine trial. The findings raise questions about whether adenovirus can ever be used as a crucial ingredient in an AIDS vaccine and whether new tacks will be needed. Use of a modified virus as a vector to deliver H.I.V. genes is a new and evolving way to make an AIDS vaccine. The Merck vaccine included three synthetic H.I.V. genes. ''We did a beautiful experiment, but it definitely was a disappointment,'' Dr. Larry Corey of the University of Washington, who led the investigators, said in an interview. ''One lesson is that scientists will have to look at vector-based immunity more thoroughly than we have in the past.''