Faculty Bibliography

A study reported in the New England Journal of Medicine on Aug 12, 1993 offers an explanation for the fact that symptoms of rheumatoid arthritis usually abate during pregnancy. Researchers say that genetic differences between the fetus and the woman may set off maternal immune responses that ameliorate the arthritis

Dr. Ponsonby's study was conducted in Hobart, Tasmania, an island state of Australia, where crib death was twice as common as in other areas of the country. After a campaign warning against putting infants to sleep in the prone position, the rate of crib death dropped to 1.7 per 1,000 live births in 1991 from 3.6 recorded 10 years earlier. About the same time, a survey found that the number of Tasmanian babies sleeping face down had dropped to fewer than 8 per cent from 33, Dr. Ponsonby said

Mounting evidence has indicated that babies who sleep face down are at greater risk of SIDS than those who sleep on their backs or sides. In addition, in several areas where health officials have urged parents to avoid putting babies face down, the incidence of the syndrome has dropped

Two teams of eminent doctors in Boston came to diametrically opposite conclusions after Lewis collapsed during a playoff game on April 29. A third team in California reached a third conclusion. Lewis died July 27 while shooting baskets at Brandeis University. His funeral was held here Monday. Preliminary autopsy results showed Lewis's heart was abnormal and badly scarred. A second, equally distinguished team, at Brigham and Women's Hospital, disputed the first team's findings, saying that Lewis had a normal athlete's heart and a nonfatal condition called neurocardiogenic syncope, or vasovagal fainting. That team said it was optimistic that Lewis would return to professional basketball without any limitations. Its assessment has now arguably become one of the most widely publicized and second-guessed consultation in the annals of medicine. [Nicholas Diaco]'s team, individually and separately, examined Lewis. Each of the examining doctors detected an abnormality in Lewis' heart when they put their hands on his chest to examine the strength of the heartbeat. That was a critical clue to heart damage. But the data sent to Diaco showed that none of the experts in Boston had detected the abnormality in a physical examination, even those who did a hands-on examination. The New England Baptist Dream Team identified the abnormality only on laboratory tests

[Nicholas Diaco] said in an interview that his team had examined Lewis and had studied data sent by both Boston teams. He concluded that Lewis had both an abnormal heart and the benign fainting condition. Special studies, known as electrophysiological tests, performed in Boston showed that when doctors applied a large stimulus, but not smaller ones, to Lewis's heart, it could be provoked to produce several beats of a potentially fatal rhythm known as ventricular tachycardia. Doctors disagree about the significance of such a finding. And because they did not find the abnormal rhythm when Lewis exercised vigorously on a treadmill, Diaco said, there was no evidence that a heart-rhythm problem had caused his collapse. Diaco's team, individually and separately, examined Lewis. Each of the examining doctors detected an abnormality in Lewis' heart when they put their hands on his chest to examine the strength of the heartbeat. That was a critical clue to heart damage

It was the first statement from Lewis's doctor, Gilbert H. Mudge, since Lewis collapsed and died while shooting baskets on July 27. The statement came a day following a preliminary report from the Chief Medical Examiner of Massachusetts, who said that an autopsy showed that Lewis's heart 'was abnormal, enlarged and was extensively scarred.' Lewis 'was followed closely' and 'his complete evaluation was reviewed by' unnamed national experts as well as the California team, Mudge said. He added that he 'sought the advice of colleagues from around the country' and shared all information with Lewis. In a separate statement, H. Richard Nesson, the president and chief executive officer of Brigham and Women's Hospital, said Mudge had been 'deeply shaken and saddened by' Lewis's death and praised Mudge's commitment to his patients and the hospital

The medical examiner's preliminary findings of extensive scarring appear to contradict the public statements by Dr. Gilbert H. Mudge, [Reggie Lewis]'s personal doctor, who said that he had 'a normal athlete's heart with normal function.' Mudge said he was optimistic that under medical supervision Lewis could 'return to professional basketball without limitation.' Still Some Confusion It is possible, however, for a heart to become scarred from previous use of drugs even if usage has been stopped. The 12 experts -- called 'the Dream Team' -- who consulted in Lewis's case at New England Baptist Hospital after he collapsed in a playoff game on April 29 -- have not said whether Lewis's blood and urine were tested for drugs at that time and, if so, what the results were. A second opinion team headed by Mudge at Brigham and Women's Hospital, a Harvard teaching institution, disputed the first team's findings. Mudge told Lewis that he had 'a normal athlete's heart' and a non-fatal fainting condition known as neurocardiogenic syncope, or vasovagal fainting. Such a condition does not scar the heart

The medical examiner's preliminary findings of extensive scarring appear to contradict the public statements by Dr. Gilbert H. Mudge, [Reggie Lewis]' personal doctor, who said that Lewis had 'a normal athlete's heart with normal function.' Mudge said he was optimistic that under medical supervision Lewis could 'return to professional basketball without limitation.'

An autopsy has shown that the heart of Reggie Lewis, the late Boston Celtics captain, 'was abnormal, enlarged and was extensively scarred,' the Massachusetts Chief Medical Examiner said in a statement issued in Boston yesterday

A second opinion team, at Brigham and Women's Hospital, a Harvard teaching hospital, headed by Dr. Gilbert H. Mudge, disputed the first team's findings. It told [Reggie Lewis] that he had a normal athlete's heart and a benign fainting condition known as neurocardiogenic syncope, or vasovagal fainting. The results of an autopsy, expected to shed some light on the case, have yet to be announced. According to the person familiar with the case, [Roman W. DeSanctis] told Mudge privately that while he agreed that Lewis suffered from a benign fainting condition, he also felt that Mudge had not fully proven his case that the fainting condition had caused Lewis's collapse. At this news conference, DeSanctis said that he concurred with Mudge's conclusion that 'Reggie's cardiovascular condition seemed less serious than was originally thought' and that he was 'personally cautiously optimistic that Reggie will play again.'