Faculty Bibliography

''Women are really much better off now,'' Dr. Peter M. Layde, one of the authors, said in an interview. ''There are a lot fewer reproductive deaths than there were 25 years ago.'' ''A number of studies conducted over the last five to 10 years,'' Dr. Layde said, ''show that that risk is concentrated in a very small subgroup of women on the pill - those 35 and older, particularly those who smoke.'' He said that ''for the vast majority of younger women who do not smoke, the pill is very safe.'' For most women, he continued, ''The risks of contraconception are lower than the risks of childbearing. The exception appears to be the risk of oral contraceptives in women 35 and older who smoke. For them, that risk probably is greater than the risk of childbearing.''

Nevertheless, Dr. [William J. Fouty] said, the surgical team took ''due care getting to and removing the bullet.'' They avoided any heat or shock that might have set it off. They did not use electrocautery, a widely used technique that uses heat to stop bleeding. They located the bullet precisely by placing needles in the area and taking X-rays at different angles. The operation went off without a hitch. The bullets in Mr. [Reagan] or Officer [Thomas K. Delahanty] ''might have been detonated if ultrasound or microwave techniques had been used for diagnosis,'' Dr. Bernard Knight, a professor of forensic pathology at the Welsh National School of Medicine in Cardiff, said in the March 13 issue of the British Medical Journal. His article reviewed the findings of medical examiners in Maryland, Minnesota, Texas and Florida who had reported their experiences with exploding bullets. Dr. Knight said that since the publication of his article, a physicist had called to agree that microwaves, heat or slight percussion could trigger the explosion of a Devastator or similar bullet. But the physicist and others challenged the thesis that ultrasound could set the bullet off. However, Dr. Knight said, chuckling, that he ''wouldn't like to be the guinea pig they try it on.''

Federal prosecutors had objected to such testimony on the ground that CAT scans had not been shown to have any relevance to human behavior and might mislead the jury into thinking Dr. [David M. Bear]'s analysis had some ''mystic infallibility.'' - Although schizophrenic patients, as a group, have larger cerebral ventricles and more cortical atrophy than do normal individuals, there is a great deal of overlap between the two groups. In other words, there are many schizophrenics who do not show those things. ''In fact, the majority of schizophrenics don't show that,'' Dr. [Daniel R. Weinberger] said. ''Some normals have ventricles that are as large or larger than those of many schizophrenics.'' ''A CAT scan is not diagnostic of schizophrenia in any way. There are a few normals walking around with very large ventricles and cortical atrophy,'' Dr. Weinberger said. He added that ''the crux of the issue is that from an individual CAT scan one cannot draw any clinical conclusions, either diagnostic or otherwise, for an individual case because all the reported findings have involved large groups and are statistical findings. There are too many exceptions to these rules for it to be diagnostic of anything.''

The researchers did caution, however, that for people who already had heart problems, there was an additional risk in jogging. ''This rate is seven times the estimated death rate from coronary heart disease during more sedentary activities in Rhode Island,'' they said, ''and suggests that exercise contributes to sudden death in susceptible persons.'' ''Our results suggest that at least 2,000 exercise stress tests and possibly as many as 13,000 tests would have to be done to identify one potential victim of an exercise-related death,'' said the authors of the study, Dr. [Paul D. Thompson], Dr. Erik J. Funk, Dr. Richard A. Carleton and Dr. William Q. Sturner. Dr. Sturner is the Rhode Island Medical Examiner and the study had its origins in his interest in deaths among joggers. Drs. Funk and Carleton are affiliated with Memorial Hospital in Pawtucket, R.I., and Dr. Thompson is based at the Miriam Hospital in Providence. Exercise 'With Little Concern'

When the retina is detached, there are varyng consequences. Some detached retinas present more serious problems than others especially if the small area known as the macula, which is crucial to central vision, is damaged. A spokesman for the Wilmer Eye Institute at Johns Hopkins Hospital in Baltimore, where [Leonard] underwent surgery, would not comment on whether hismacula was involved. Retinal detachments are often repaired in a three-step procedure. In the first, the tear is closed by producing inflammation, such as by cryotherapy, to bind the detached retina to the back of the eye. In cryotherapy, intense cold is applied to the outside of the eye. In the second stage, fluid accumulating behind the retina may be removed. The third step involves implanting a substance, such as silicon, to bring the detached area in contact with the wall of the eye to help the healing process. The eye institute said that this procedure was often used there, but it would not comment on whether it was used in Leonard's case. In addition to injuries, other causes of detached retinas include complications of cataract surgery; high myopia, or nearsightedness, in which the retina is easily detached because the eyeball is too long and the retina taut; end-stage diabetes in which scar tissue forms as a result of years of damage, and hereditary problems, which are not common

According to both the Centers for Disease Control and the National Cancer Institute in Bethesda, Md., GRID has reached epidemic proportions and the current totals probably represent ''just the tip of the iceberg.'' Preliminary results of immunological tests have led some Federal health officials to fear that tens of thousands of homosexual men may have the acquired immune dysfunction and be at risk for developing complications such as Kaposi's cancer, infections and other disorders at some future date. GRID is ''a matter of urgent public health and scientific importance,'' Dr. James W. Curran, a Federal epidemiologist who coordinates the Centers for Disease Control's task force on Kaposi's sarcoma and opportunistic infections, told the Congressional hearing. Opportunistic infections are those that rarely cause illness except in those whose immunological resistance has been lowered by drugs or disease. The urgent need to discover the cause of the immune system disorder and to prevent the problems it creates has been underscored by Dr. Linda Laubenstein of New York University Medical Center. Dr. Laubenstein, who said she has treated 62 such patients in the last year and who is a leading investigator of the syndrome, summarized it by saying: ''This problem certainly is not going away.''

Such a diagnosis would be a damning indictment of [Nancy]'s mental stability, and proof that she was faking would require special radioimmunological tests. Such tests can determine, for example, whether all the insulin present in her blood was of human origin. Nancy's doctors sent blood samples to Dr. Rosalyn S. Yalow and Dr. William A. Bauman at Montefiore Hospital in the Bronx, and the results showed that some of the insulin in her blood had come from a cow. Nancy had been giving herself insulin in order to have another operation. Her diagnosis: another case of Munchausen's syndrome. [Munchausen] patients tend to seek emergency medical care and demand hospitalization by relating harrowing stories that are plausible at first. Somehow, they derive some personal ''pleasure'' from lying to doctors, apparently exhibiting a pathological need for attention. Generally, their deceptions and lies become apparent only long after they consult a doctor, and then only after extensive discussion and costly tests. Although doctors report cases in medical journals to alert colleagues, and hospitals develop lists, the true nature of a Munchausen's syndrome patient is often discovered at odd times and in strange places. In a hospital dining room, for example, an older physician may hear a brief case report, laugh and exclaim: ''Oh, for heaven's sake, don't you know who he is?''

Atrial fibrillation is characterized by an erratic disturbance of the electrical impulses from the atria, or upper chambers of the heart, to the ventricles, or the bottom chambers. A result is a rapid and irregular heart beat. Because the irregular heart beat can lead to formation of clots in the atrium that then travel in the blood to lodge in the brain to cause strokes, doctors have long regarded atrial fibrillation as a serious problem

Plasmapheresis is still not a proven cure for any disorder, though by treating the complications it has lessened suffering and helped prolong lives. Generally, it is used to alleviate symptoms, reduce the potential for deleterious complications, and enhance drug therapy. Medical journals are filled with anecdotal reports of physicians trying plasmapheresis as a last resort, saying, in effect, ''Let's try it and see what happens. What have we to lose?'' ''This implies a cost of up to $28 billion in the first year,'' the National Center for Health Care Technology reported in the Journal of the American Medical Association. ''If 5 percent to 10 percent of the nearly 1 million Medicare-eligible patients with rheumatoid arthritis were to be given apheresis, it would cost between $2 and $4 billion. While these are gross-cost projections, they should be modified by projected savings from reduced expenditures for hospitalized bed rest, medication and joint surgery. Additionally, maintenance of, or return to, a productive life style should also be considered if apheresis is shown to be effective.'' ''Ideally, criteria should exist for the selection of patients, the intensity, frequency and duration of the procedure, the choice of replacement fluids, the serological parameters to be followed, and the clinical evaluation of the procedure's effects,'' Dr. Barry Wenz and Dr. Peter Barland of the Albert Einstein College of Medicine and Montefiore Hospital and Medical Center in the Bronx reported in the journal Seminars in Hematology

The potency of 41 million doses of swine flu vaccine stored in a warehouse in Georgia is to be tested later this year, according to Don Berreth, a spokesman for the Centers for Disease Control. He said that the vaccine could not be used without authorization from Congress and that there were no plans to ask for such authorization. 48 Million Doses Destroyed The newest case represented a continuing ''pattern of occasional human infections with swine influenza virus currently circulating in pigs,'' the disease centers said in their Morbidity and Mortality Weekly Report