Faculty Bibliography

Reports that Canadian researcher Roger Poisson falsified data in a major breast cancer study coordinated by Bernard Fisher at the University of Pittsburg are raising questions about the quality of medical research, the honesty of medical researchers and the various ways studies are done. Leaders of the study and federal health officials reportedly delayed disclosing the situation

He described the pressures he felt in asking a patient to participate in the study. 'People who are not on the front line of the battle have no idea how frustrating it can be to prepare an eligible patient for the trial, with several pep talks and a great deal of discussion, explanation for the informed consent and to convince the patient to participate and -- at the last moment -- to realize that the patient' is ineligible for what he perceived to be a technicality, Dr. [Roger Poisson] said. 'It is a feeling of letdown and of frustration.' An official of the National Cancer Institute wrote to Dr. Fisher on Jan. 7, 1993, urging him to review the audit procedures and method of case selection for review. Among the cancer institute's concerns was that the data irregularities 'went undetected for more than a decade.' Another concern was the relatively small number of cases that Dr. [Bernard Fisher]'s team selected for re-audit, a factor that the cancer institute suggested had contributed to the study group's 'inability to detect problems.' Dr. Poisson wrote that he realized that 'there is no excuse to cut the corners' and that 'in the strict sense, I did bend the rules.' But he also said that he 'did not consider white lies for the purpose of practical logistics as a breach of my honor.'

The U.S. government has taken steps to be repaid $1 million from St. Luc's Hospital, a small community hospital in Montreal, where federal officials say the principal investigator, Dr. Roger Poisson, falsified data on more than 100 of the 1,511 patients he enrolled in his part of 22 studies from 1975 to 1991. Yet the reply that Poisson made to accusations from federal officials was rambling and disorganized. His reply creates the impression of an emotionally charged researcher who deliberately ignored what he saw as trivial rules. In a written reply to the U.S. Public Health Service's Office of Research Integrity, which spearheaded the federal investigation, Poisson stated: 'I always feel sorry for a nice case to be denied the right to enter a good protocol just on account of trivial details: a difference of a few days in the date of surgery because the patient took a long time to decide . .

In a development that reflects the changing demographic face ofthe AIDS epidemic in this country, heterosexual transmissionaccounted for the largest proportionate increase in AIDS cases reported last year, federal health officials said Thursday. Although the epidemic overall still mostly infects gay men, heterosexuals represented the largest proportionate increase in 1993, said Pat Flemming, chief of reporting and analysis in the CDC's AIDS division. Of the cases attributed to heterosexual transmission, almost half - or 49.7 percent - were attributed to a sex partner who had AIDS or was infected with HIV, the virus that causes the disease, the CDC said

Federal health officials said on Mar 10, 1994 that heterosexual transmission accounted for the largest proportionate increase in AIDS cases reported in 1993. However, heterosexual transmission still accounts for only 9% of the total 103,500 cases reported during 1993

In a development that reflects the changing demographic face of the AIDS epidemic in this country, heterosexual transmission accounted for the largest proportionate increase in AIDS cases reported last year, federal health officials said Thursday. In its first report on heterosexual transmission of AIDS in four years, the centers said that, in 1993, the cases of AIDS that could be attributed to heterosexual transmission were 6,056 for women and 3,232 for men. A disproportionate number were among blacks and Hispanics. A major challenge, the report said, is to help develop culturally and linguistically appropriate HIV-prevention messages for different racial and ethnic groups

In 1985, when the total number of AIDS cases was far smaller than now, heterosexual transmission accounted for 1.9 percent. From 1985 to 1993, the proportion of cases attributed to sex among gay men decreased from 66.5 percent to 46.6 percent. The Centers for Disease Control and Prevention, the federal agency in Atlanta that issues the reports and is responsible for tracking the AIDS epidemic, added that the 9 percent figure for heterosexuals for 1993 was a conservative estimate. In its first report on heterosexual transmission of AIDS in four years, the centers said that 1993 AIDS cases that could be attributed to heterosexual transmission were 6,056 for women and 3,232 for men. A disproportionate number were among black and Hispanic people. For a case of AIDS to be classified as due to heterosexual transmission, the federal centers require a history of heterosexual contact with a partner who has AIDS, is HIV-infected or has risk factors for HIV infection

So-called stomach ulcers appear in two places. Duodenal ulcers, which develop in the first part of the small intestine, are more common than gastric ulcers, which are in the stomach. Virtually all patients with duodenal ulcers have evidence of H. pylori infection, and about 80% of those with gastric ulcers harbor the organism. The most convincing evidence for a relationship between ulcers and H. pylori infection comes from significant differences in rates of recurrence among ulcer patients who did and did not receive antimicrobials. Among ulcer patients in whom H. pylori is eliminated and who do not take a drug that may cause gastrointestinal bleeding, such as ibuprofen, the recurrence rate is less than 5% after two years, [David Y. Graham] said. Few experts believe that H. pylori is the sole cause either of stomach ulcers or of cancer. The belief is that the two ailments result from a chain of events involving H. pylori at an early and crucial stage, but that other factors are necessary for their development. They hope elimination of H. pylori from the body might provide the knockout blow to stomach cancer

The ulcer link: 1. Decrease in mucus layer may allow acid to damage stomach. 2. H. Pylori may produce a toxin that harms stomach. 3. H. Pylori may elevate stomach acid. 4. Other factors like genetic tendencies and smoking may be involved. Possible cancer link: 1. Cell damage and death lead to increased cell division, raising risk of DNA damage. 2. Inflammation causes production of free radicals, highly reactive molecules that can damage DNA. 3