Faculty Bibliography

In a draft of proposed new federal guidelines, the Centers for Disease Control says doctors and dentists infected with the AIDS virus should get permission from local panels of experts before continuing to perform certain operations and invasive procedures. The meeting in Atlanta was called after an investigation by epidemiologists at the centers found that a Florida dentist had probably transmitted the AIDS virus to three patients. The dentist, Dr. David J. Acer of Stuart, has since died of AIDS. Those are the only known incidents of an apparent transmission from a health care worker to a patient among the more than 170,000 AIDS cases reported since the disease was discovered in 1981

In a draft of proposed new federal guidelines, the Centers for Disease Control says doctors and dentists infected with the AIDS virus should get permission from local panels of experts before continuing to perform certain operations and invasive procedures. The meeting in Atlanta was called after an investigation by epidemiologists at the centers found that a Florida dentist had probably transmitted the AIDS virus to three patients. The dentist, Dr. David J. Acer of Stuart, has since died of AIDS. Those are the only known incidents of an apparent transmission from a health care worker to a patient among the more than 170,000 AIDS cases reported since the disease was discovered in 1981

There is little doubt that some of the reported increase in fatal and nonfatal cases results from improved ability to distinguish asthma from ailments like bronchitis and recurrent croup that can also produce wheezing. And doctors have learned to identify subtypes of asthma. For instance, individuals who have polyps in their nose can die suddenly from an asthmatic attack if they take aspirin. Beta-agonist drugs are a mainstay in the treatment of asthma. But an important unresolved question is whether beta-agonists should be used to prevent asthma attacks or only when symptoms flare. Another unresolved question is whether regular use of them makes asthma worse. The need for imaginative thinking is greatest when research is stymied. One area that seems to have escaped attention are the foods and drugs that women take during pregnancy and the pollutants to which they are exposed. About 20 years ago, scientists were surprised to learn that a drug, DES, could cause vaginal cancer among daughters born to women who took it in pregnancy. Perhaps a similar factor might explain part of the paradox of asthma. The Management Of Asthma Breathlessness is caused by inflammation and constriction of the small airways in the lungs. As lungs collapse to expel air, these bronchioles are further narrowed. When an attack occurs, drugs can help open the airways, but the goal of treatment is also to head off further attacks. Self-Monitoring To avoid hospitalization, patients are advised to monitor their breathing with flow meters and to use drugs like inhaled steroids to stop the escalation of inflammation. Source: 'American Medical Association Encyclopedia of Medicine' (Random House)

Experts in orthopedic surgery and sports medicine are divided in their opinion about whether the hip injury sustained by Bo Jackson, a star in professional baseball and football, is one that will end his career as a professional athlete. The Kansas City Royals released Jackson Mar 18, 1991

Other orthopedic experts expressed serious doubt that [Bo Jackson] could return to professional competition from their reading of the Kansas City Royals' medical report on Jackson's hip injury. Dr. James R. Andrews, the orthopedic surgeon who has treated Jackson in Birmingham, Ala., said he had would wait to see how well Jackson's injuries healed over the next several months before determining whether Jackson could play again. Dr. James Garrick, an orthopedist and sports medicine specialist in San Francisco, were pessimistic because even if the blood supply is restored and the bone heals without collapsing, Jackson will still be left with a bad joint from cartilage damage. The bones in Jackson's hip would meet face-to-face without cartilage, and that could be painful

Earlier this month a Rochester, N.Y., doctor described in The New England Journal of Medicine how he had prescribed barbiturates to help a patient kill herself. The doctor, Timothy E. Quill, said in an interview that he was trying to open up discussion to overcome the secrecy that has shrouded such acts. Quill, many ethicists and experts suggest, has significantly advanced the debates over doctor-assisted suicide. Black & White Photo; AP; Dr. Timothy Quill discusses his involvement in a patient's suicide in a recent issue of the New England Journal of Medicine. Dr. [Jack Kevorkian] with his suicide device that [Janet Adkins] used to take her life last year

A new study reported in the New England Journal of Medicine found that combined chemotherapy and radiation treatments have significantly lowered the recurrence of rectal cancer after surgery and have improved survival

In particular, [Timothy E. Quill] said he had cared for the woman, whom he identified only as ``Diane,'' for many years. He said he knew she was mentally alert and making her decision calmly. Diane said tearful goodbyes to her closest friends and to Quill. Two days later her husband called Quill to say that Diane said her final goodbyes to him and their college-age son that morning and died peacefully after asking them to leave her alone for an hour. Quill said he decided to publish his account of Diane's story, with her family's permission, in part because of his mixed reaction to [Jack Kevorkian]'s case. ``It focused on machines, and making it a mechanized, sterilized process was not right,'' Quill said. ``He did not know the person well; that was so far away from anything I could do.''