Faculty Bibliography

The new findings concern only the strain of influenza causing regular seasonal influenza, and not avian influenza or pandemic influenza, said the centers' director, Dr. Julie L. Gerberding. She said 91 percent of the human influenza A (H3N2) virus samples isolated in her agency's laboratories this flu season were resistant to both amantadine and rimantadine. A (H3N2) is this season's dominant strain. The agency's influenza surveillance program studies samples from state health departments. Influenza viruses constantly mutate. One theory is that the A (H3N2) influenza strain suddenly developed a mutation against amantadine and rimantadine. Another theory is that the resistance developed from inappropriate use of the two drugs, which are widely available over the counter in many countries. In the United States, all marketed antiviral drugs effective against influenza require a prescription

Over the last few days, the Israeli news media, along with a number of Israeli doctors, have raised questions about the treatment Mr. [Ariel Sharon] received after he had a mild stroke on Dec. 18, before he had a major one on Jan. 4. The condition, which is relatively common in elderly people, is marked by weakened blood vessels in the brain, and blood-thinning medicine can increase the risk of cerebral hemorrhage, according to doctors. Mr. Sharon suffered a hemorrhagic stroke on Jan. 4. If Mr. Sharon had not received such medicine, he could have suffered another clot in the brain instead of bleeding in the brain, Dr. Jose Cohen, one of his neurosurgeons, told Israeli television this week

[Rodier] said that transmission seemed to be occurring in families with children in an epidemiologic picture that closely resembled the one seen in East Asia. The recent cases identified in Turkey are the first outside of East Asia. The sudden appearance of a number of cases of avian influenza in different parts of Turkey is worrisome, Rodier said, but is probably linked to the complexities of bird migration

Dr. [Joseph Domenech] said there was now a risk that the virus had become so entrenched in Turkey that it would be impossible to eradicate it, meaning that a permanent reservoir of the dreaded virus would exist on the fringes of Europe and along bird migration routes to Africa. A senior United Nations official urged Turkey's neighbors to be ready to respond quickly and effectively to outbreaks of bird flu in their countries. The official, Dr. David Nabarro, the United Nations coordinator for avian and human influenza, urged countries to hold drills to confirm that their laboratories have all the necessary materials and competent staff. In many ways, the outbreak in Turkey is a cautionary tale about how rapidly avian influenza can become a widespread problem if it is not detected early and attacked aggressively. In the far eastern part of Turkey, where most of the human cases and deaths have occurred, officials waited for weeks to investigate widespread bird deaths that started in mid-December, villagers say, even after the deaths were reported to government veterinarians. In that time window, the virus spread from bird to bird and -- to a lesser extent -- from bird to man

In the process, which could last several days, the brain will 'show us what it has got' after the stroke and three operations, [Lee Schwamm] said. The operations were performed to reduce the pressure on [Ariel Sharon]'s brain and to remove blood clots and dead brain tissue. A possible failure to respond to commands on the first day would not necessarily be a bad sign, Schwamm said, 'in part because it may take a few days for Sharon's body to fully wash out the anesthetics.' Some stroke patients who have little response on the first day after a coma is lifted can often follow commands readily on the third day. Another concern is the heart. In Sharon's case, the stress of the stroke and three operations led to the release of high amounts of adrenaline and other hormones that could bring on a heart attack. Sharon also may have needed blood transfusions because of the amount of bleeding into his brain

The White House said the 3 a.m. trip to George Washington University Hospital was necessary because of fluid retention as a side effect of a drug Mr. [Dick Cheney], 64, had taken to treat chronic foot ailments. Last week, Mr. Cheney was seen using a cane, and the White House said he had a ''pre-existing condition'' in his foot, but the problem was not described with precision. Mr. Cheney's office said he had been using an anti-inflammatory drug that caused a buildup of fluid in his lungs, leading to shortness of breath. He began taking a diuretic to remove the fluid, his office said. His office said Monday that Mr. Cheney had long suffered periodic pain in his heel, which has been diagnosed as tendonitis, and in his big toe, which has led to a murkier diagnosis: gout or osteoarthritis. On Monday, Dr. Christopher P. Cannon, a cardiologist at Harvard Medical School, said the fluid retention possibly indicated Mr. Cheney's heart was decompensating and ''teetering on the edge of congestive heart failure.'' The fluid retention does not necessarily indicate a worsening of his heart condition

The doctors say they believe that Mr. Sharon can survive the extensive stroke and cerebral hemorrhage that he suffered Wednesday. But the assumption among Israelis is that Mr. Sharon, 77, will not be able to return to political life. Still, supporters hung a white sheet at the hospital entrance that read, ''[Ariel Sharon], there is more to do, please wake up.'' Ehud Olmert, a close ally of Mr. Sharon who has been elevated from deputy prime minister to acting prime minister, has pledged to follow Mr. Sharon's policies. He has not made any major decisions since Mr. Sharon was hospitalized. Later in the day, doctors administered pain-stimulus tests, and Mr. Sharon slightly moved his right arm and right leg, Dr. [Mor-Yosef] said. The movements ''grew more and more substantial as we reduced the medication,'' the doctor added. Mr. Sharon's blood pressure also rose in response to the tests, which the doctor said was a positive sign

'The Palestinian Authority should avoid making any connection between the health of [Ariel Sharon] and the election date,' he said in a statement published in Palestinian newspapers. 'The election is a national Palestinian issue and it must not be linked to any foreign concerns such as what is happening in Israel with Sharon.' Dr. Jose Cohen, one of the surgeons working on Sharon, told Channel 2 TV on Saturday that there was a 'very high' chance that Sharon would live. But he added: 'To say after such a severe trauma as this that there will be no cognitive problems is simply not to recognize the reality.' Cohen, who was born in Argentina, later told a group of Spanish reporters: 'He will not continue to be prime minister, but maybe he will be able to speak and to understand,' according to remarks printed in the Jerusalem Post. The risks to Sharon, which stem from his immobility since the stroke, include development of life-threatening infections like pneumonia plus urinary tract infections and bed sores. On Saturday, Cohen was quoted as saying, 'We are praying there won't be complications, like catching an infection.' It is standard care to move the arms and legs of stroke patients to prevent muscle atrophy and contractions. Hospital workers also move patients and use special mattresses to prevent bed sores

Dr. [Lee H. Schwamm] has followed Mr. [Ariel Sharon]'s case from news accounts. Although some of Mr. Sharon's treatment has been extraordinary, Dr. Schwamm said, in many ways it resembles that normally provided for ordinary stroke victims. As the coma eases, Mr. Sharon, who is connected to a mechanical ventilator that automatically breathes for him, will be expected to resume breathing on his own. But the doctors must make sure that the natural and mechanical breathing are synchronized and that Mr. Sharon does not become so agitated that he tries to spit out the breathing tube and act in other ways to increase the pressure in the brain to dangerous levels. Israeli doctors have taken aggressive measures that push the edge of medical knowledge in caring for Mr. Sharon. But, Dr. Schwamm said: ''A win here would be that he could speak, understand speech and move his right side purposely, even if he ended up in a wheelchair. Preserving such functions will have justified the efforts that Mr. Sharon's doctors have made trying to save his life, even his brain.''

Dr. Shlomo Mor-Yosef, the director of Hadassah Ein Kerem Hospital, said Saturday that [Ariel Sharon]'s blood pressure, heart rate and other 'vital signs were within normal limits.' Sharon is breathing with the aid of a mechanical respirator. Separately, the imprisoned Palestinian politician Marwan Barghouti warned against any move to use Sharon's illness as a reason to postpone Palestinian legislative elections scheduled for Jan. 25. 'The Palestinian Authority should avoid making any connection between the health of Sharon and the election date,' he said in a statement published in Palestinian newspapers. 'The election is a national Palestinian issue, and it must not be linked to any foreign concerns such as what is happening in Israel with Sharon.'