Faculty Bibliography

The European study challenged the validity of using the CD-4 count as a surrogate marker for AZT among symptomless individuals infected with H.I.V., the virus that causes AIDS. The human immunodeficiency virus destroys the specialized immune cells known as CD-4 cells, and a fall in the count may signal a worsening of the condition. CD-4 failed as a surrogate marker in the Concorde study, said the scientists who conducted it. Although the CD-4 count increased by 30 cells among the symptomless H.I.V.-infected participants who were given AZT in the study, the rise did not signal any apparent clinical benefit. The Concorde findings are 'a needed challenge to those of us who conduct trials,' said Dr. Iain Chalmers, an expert in clinical trials at Oxford University. He added, 'There is so much money to be made in approving new drugs, the pressure to get approval is great' and what needs to be determined is 'whether people conducting trials are actually measuring things that matter.'

A new European study found that there was no evident benefit in giving the drug AZT to people infected with the AIDS virus before they develop full-fledged AIDS. Early treatment with AZT is standard in the US for HIV-positive patients. The results of the Concorde study, which were released on Apr 1, 1993, differ significantly from those in four smaller studies in the US that found early treatment with AZT to be beneficial

The treatment, recommended by the U.S. government and widely followed in many countries, is to prescribe the drug AZT to people infected with the virus long before they develop the symptoms of full-fledged AIDS. But the Concorde study found there was no evident benefit in taking AZT early. Several experts interviewed said they doubt that many patients who are taking AZT but have no AIDS symptoms will be advised to stop the therapy. More likely, they said, is that the Concorde study will discourage doctors from recommending AZT therapy in many new HIV cases until more studies resolve the issue. The Concorde study is the largest of any aimed at evaluating the treatment of early HIV infection; it followed patients for an average of three years, much longer than other studies. But it was not designed to determine the effectiveness of AZT in full-fledged AIDS and thus has no bearing on such treatment

Three American studies have failed to confirm the findings of a Finnish study that suggested that a high level of iron more than doubles the risk for heart attacks in men, leaving the issue of iron as a risk factor for heart attacks far from settled

'Whenever we see somebody with hypertrophic cardiomyopathy, the first thing we have to ask is, Is there anything like light-headed spells or fainting that might suggest that this person might have an arrhythmia that could lead to sudden death,' Dr. [Stephen E. Epstein] said. 'If so,' he said, 'we would go ahead and do an electro-physiologic study that takes a few hours in a laboratory to determine whether the patient has one of the abnormalities that could predispose them to sudden death. And then we treat them, which can mean implanting a defibrillator in some patients.' Defibrillators, which differ from pacemakers, shock the heart when life-threatening abnormal heart rhythms begin. For example, Mr. [Les Aspin], 54, first learned he had the condition after he became short of breath while skiing in Colorado two years ago. Mr. Aspin told his doctors that his grandfather, a kayak champion, had died at an early age of 'an athlete's heart.' It may very well have been hypertrophic cardiomyopathy

After isolating squalamine from the stomachs of the dogfish shark, the scientists reported this month in the Proceedings of the National Academy of Sciences that they had purified it and in recent weeks have found a way to synthesize it. The ability to make squalamine makes it unnecessary to kill sharks. Squalamine has not been tested in humans. But Michael Zasloff, who headed the research team from Magainin Pharmaceuticals in Plymouth Meeting, Pa., that discovered squalamine, said he and his colleagues have begun experiments to determine which infections in humans will respond to squalamine

Researchers reported last week that men who were bald at the top were, inexplicably, somewhat more likely to suffer heart attacks than those with full heads of hair. The more extensive the 'vertex baldness' -- hair loss on the top or crown of the head -- the higher the risk, the report in the Journal of the American Medical Association said

Defense Secretary Les Aspin returned to work on Feb 25, 1993 after being treated for a serious heart condition. Aspin has been advised to have a pacemaker implanted in the next two weeks

A study being reported on Feb 23, 1993 in the Journal of the AMA found that a bald spot on the top of the head of men under the age of 55 was associated with a small but significant increase in the risk of heart attack. No biological explanation has yet been found for the correlation

In a study of men under 55, a bald patch in that position, a condition known as vertex baldness, was found to be correlated with a slight but definite increase in the risk of heart attack, according to a study being reported on Wednesday in the Journal of the American Medical Association. The risk did not hold for frontal baldness or loss of hair from other areas of scalp. The more extensive the vertex baldness, the higher the risk. For men with mild or moderate vertex baldness, the risk was about 40% greater than that for men with a full head of hair, rising to 340% for those with severe vertex baldness, the authors of the Boston University study said