Faculty Bibliography

A second, equally distinguished team, at Brigham and Women's Hospital, disputed the first team's findings, saying that Mr. Lewis had a normal athlete's heart and a nonfatal condition called neurocardiogenic syncope, or vasovagal fainting. That team said it was optimistic that Mr. 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. Dr. [Nicholas Diaco]'s team, individually and separately, examined Mr. Lewis. Each of the examining doctors detected an abnormality in Mr. Lewis's 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 Dr. 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. Newspaper reports discussed the possibility of implanting a defibrillator in Mr. Lewis so a shock could be administered to the heart if necessary to stop a potentially fatal heart rhythm. But Dr. Diaco said the evidence did not warrant such treatment. Implanting the device would have not only ended Mr. Lewis's basketball career, Dr. Diaco said, but also would have interfered with his daily activities and prevented him from getting a driver's license

[Reggie Lewis] sought a second opinion at the Brigham and Women's Hospital, a Harvard teaching hospital, from a team headed by Dr. Gilbert H. Mudge, the hospital's head of clinical cardiology. The team also included Dr. Eugene Braunwald, the hospital's chief of medicine. The Brigham and Women's team disputed the findings at Baptist hospital and concluded that Lewis had a benign neurological condition, known as neurocardiogenic syncope. The condition causes fainting, is sometimes called a vaso-vagal reaction, and rarely is fatal. Dr. Roman DeSanctis, a cardiologist at the Massachusetts General Hospital and a member of the first team to examine Lewis, told the Boston Globe in May that he initially agreed with a preliminary diagnosis that Lewis had a serious heart condition based upon what he was told by the panel of doctors. But, he said, he changed his opinion after reviewing 'new important information' collected after Lewis sought a second opinion. Dr. DeSanctis did not say whether he agreed with Dr. Mudge's diagnosis. 'I concurred with Dr. Mudge's conclusions with respect to the fact that Reggie's cardiovascular condition seemed less serious than was originally thought,' Dr. DeSanctis said in a statement in May. The statement came three days after Dr. Mudge held a news conference at which he predicted Lewis would be able to play basketball 'without limitation' and that he was convinced that Lewis has a normal athlete's heart.

The error, in a theory justifying a novel drug therapy for H.I.V., the virus that causes AIDS, illustrates the enormous pressures on AIDS scientists to publish quickly while maintaining traditional scientific standards. And it points up the risks run by scientists and Federal health officials when they rush into clinical trials on the ground that a lethal disease justifies greater speed. In the Harvard case, a national trial began without independent confirmation of preliminary research findings, illustrating the risks in taking such short cuts. The Harvard error was made in carrying out test-tube experiments involving H.I.V. Recognition of that mistake has demolished the scientific evidence supporting the Harvard team's theory that using a combination of three drugs against one genetic region in H.I.V. could stop its replication. Dr. [Martin S. Hirsch]'s team has studied combination drug therapy against H.I.V. since 1986. But Dr. Hirsch said he never dreamed of using several drugs aimed at the same target until Mr. Chow came up with the theory. When he did, Dr. Hirsch allowed Mr. Chow to take the credit. It was an unusual step for a senior scientist because many others would have denied a junior associate that honor. Mr. Chow spoke excitedly about the moment he got the idea while working at the dinner table, telling reporters, 'It was an inspiration, almost like: 'Eureka!' '

In reporting their findings in February in Nature, a British scientific journal, the Harvard researchers said they may have found the Achilles' heel of H.I.V., the virus that causes AIDS. Federal health officials then rushed to test the theory on H.I.V.-infected volunteers.

The CDC reported on Jul 22, 1993 that, for the first time, more women have developed AIDS as a result of heterosexual intercourse than from intravenous drug use. Nearly 60% of those women had been sex partners of men who were intravenous drug users. Statistics regarding AIDS in the US are given

The number of men and women who have become infected with AIDS through heterosexual intercourse and who have no risk factors for AIDS 'is very low, but not zero,' said Dr. John Ward, an AIDS official at the Centers for Disease Control and Prevention in Atlanta. He said the CDC does not have any numbers for such transmission, but he added that there was no evidence that the numbers are large

As the AIDS epidemic continues into its 13th year, women continue to constitute a growing proportion of people with AIDS in this country. The number of AIDS cases among women jumped 9.8 percent in 1992; the number of cases involving men rose 2.5 percent. The spread of AIDS among women varied by region. In the Northeast, more women became infected with AIDS as a result of intravenous drug use. But transmission through heterosexual intercourse was more frequent among women with AIDS in the South, Midwest, West and U.S. territories, the agency said. [John Ward] said that because women who become infected with HIV can pass the virus to their babies, the increase in AIDS cases involving women is even more significant. Transmission of HIV to infants during pregnancy ranked second, after heterosexual transmission, as the largest proportionate increase in AIDS cases last year

'We are embarrassed by the unrecognized error,' Dr. [Martin Hirsch] said. 'I wish we had never used the term 'Achilles' heel.' ' Dr. Deborah Cotton, an AIDS researcher at the Beth Israel Hospital, a Harvard teaching hospital in Boston, said the hope that the combination drug trial 'will represent a major leap in therapy is now dimmed.'

The number of men and women who have become infected with AIDS through heterosexual intercourse and who have no risk factors for AIDS 'is very low, but not zero,' said Dr. John Ward, an AIDS official at the Centers for Disease Control and Prevention in Atlanta. He said the CDC did not have any numbers for such transmission, but he added that there was no evidence that the numbers were large. As the AIDS epidemic continues into its 13th year, women continue to constitute a growing proportion of people with AIDS in this country. The number of AIDS cases among women jumped 9.8 percent in 1992, while the number of cases involving men rose 2.5 percent. The pattern of how AIDS was spread among women varied with the region of the country. In the Northeast, more women became infected with AIDS as a result of intravenous drug use. But transmission through heterosexual intercourse was more frequent among women with AIDS in the South, Midwest, West and the United States' territories, the federal agency reported

In February, the Massachusetts General Hospital in Boston said scientists there and at Harvard Medical School had found what 'may be the Achilles heel of HIV,' the virus that causes AIDS. The findings were made by a Harvard medical student, Yung-Kang Chow, working in the laboratory of Dr. Martin S. Hirsch, the principal investigator for the study. In an interview Wednesday, Hirsch said that the new reports had prompted his team to repeat its original studies, which led to the finding of an error in one part of the paper. The error was a misidentification of a part of a mutant form of HIV used in the experiments, Hirsch said. Hirsch said his Harvard team planned to send a letter Thursday to Nature reporting its error