Faculty Bibliography

The study's authors, from Tufts University, said it was prudent for doctors to consider prescribing rival statins instead of Crestor as a first therapy to prevent heart attacks and stroke. They said Crestor could be useful for high-risk patients for whom rival statins did not lower cholesterol levels to recommended ranges

The W.H.O., a United Nations agency in Geneva, eradicated the disease in 1980. Since then two laboratories -- one at the Centers for Disease Control and Prevention in Atlanta and the other in Kostsovo, Russia -- have kept stocks of the virus frozen with the organization's permission. All research on the virus has been limited to the two laboratories, where scientists wear protective gowns and use the strictest precautions to prevent accidental infection and escape of the virus. The Bush administration and some health officials and smallpox experts have expressed fear that terrorists may have obtained smallpox virus from Russia or that scientists in some countries may have kept the virus without telling the W.H.O. On the advice of the agency's director general, Dr. Lee Jong Wook, the assembly told the advisory committee to reconsider its recommendation to allow scientists to insert a gene from the smallpox virus into closely related viruses like camelpox. Such experiments could theoretically help in finding ways to treat smallpox

The rate of cancer recurrence for women in the study who were assigned to follow a low-fat diet was reduced more than 20 percent over five years, the investigators found. Of 975 women assigned to a low-fat diet, 96, or 9.8 percent, had recurrences. But cancer returned for 181 of 1,462 women, or 12.4 percent, who were assigned to maintain their usual diet. Dr. Larry Norton, a breast cancer expert at Memorial Sloan- Kettering Cancer Center in New York City, one of the centers in the study, said the results had made him change his advice. 'Before this I was saying there's no reason not to eat a low-fat diet,' Norton said, adding, 'Now I am saying there is a reason to eat to low-fat diet.'

Women in the study who were assigned to follow a low-fat diet had more than a 20 percent reduction in their rate of recurrence over five years, the investigators found. Of 975 women assigned to a low-fat diet, 96, or 9.8 percent, had recurrences. But 181 of 1,462 women, or 12.4 percent, who were assigned to maintain their usual diet had their cancer return. The best way to find out whether fat in the diet makes a difference would be to randomly assign thousands of cancer patients to follow, or not follow, a low-fat diet. But many investigators questioned whether it would even be possible to do such a study. Would women really adhere to their assigned diet for years on end and, in particular, would they stay with a diet so low in fat? It enrolled 2,437 postmenopausal women with early stage breast cancer. Of them, 975 were assigned to a diet so low in fat that, Dr. [Rowan T. Chlebowski] said, it was about as low as possible without being a vegetarian diet. They consumed on average 33.3 grams of fat a day. The 1,462 women in the control group, who were instructed to follow their usual diet, consumed 51.3 grams of fat a day

The governing body, the World Health Assembly, also said it favored the idea of sending small fragments of the smallpox virus to other laboratories to try to develop better diagnostic tests for the virus. But before any experiments proceed, the assembly said, researchers must provide details about the experiments and planned security precautions. The assembly, representing 192 countries, also approved the health agency's work to create a global reserve of 33.5 million doses of vaccine to prevent smallpox, which killed about a fourth of those infected, if the virus is somehow reintroduced

The study's authors, from Tufts University, said it was prudent for doctors to consider prescribing rival statins instead of Crestor as a first therapy to prevent heart attacks and stroke. They and other experts like Dr. Valentin Fuster, chief of cardiology at Mount Sinai Medical Center, said Crestor could be useful for high-risk patients for whom rival statins did not lower cholesterol levels to recommended ranges. After an exhaustive review of the same information used by Dr. [Richard H. Karas]'s team and Public Citizen, the drug agency concluded that ''all of the available evidence'' showed that Crestor had no greater risk of muscle toxicity or serious kidney damage than the rival statins Lipitor, Pravachol and Zocor. Patients taking Crestor were eight times more likely to develop rhabdomyolysis, kidney failure or spillage of protein in the urine than patients taking Pravachol, 6.5 times more likely to develop such complications than patients taking Lipitor, and 2.2 times more likely than those taking Zocor

Of 975 women assigned to a low-fat diet, 96, or 9.8 per cent, had recurrences. But 181 of 1,462 women, or 12.4 per cent, who were assigned to maintain their usual diet had their cancer return. Although the treatments varied, the two groups were equivalent because the women were assigned at random to follow a low-fat diet. The additional benefit from diet, [Rowan T. Chlebowski] said, was equivalent to adding a new drug to their regimen. The study began in 1994 and enrolled 2,437 postmenopausal women with early-stage breast cancer. Of them, 975 were assigned to a diet so low in fat that, Chlebowski said, it was about as low as possible without being a vegetarian diet. They consumed on average 33.3 grams of fat a day

Dr. [Sandra J. Horning], who practices and does research on lymphomas at Stanford, wanted to be a doctor since she was 14. Her father died of cancer when she was 21 and a medical student. Her mother has survived two types of cancer. That family experience ''helped me in a way understand and perhaps be better prepared to deal with some of the emotional issues that are related to cancer diagnosis, treatment and survival,'' Dr. Horning said. ''But at the same time I thought about my career,'' Dr. Horning said. ''Medicine is more than a career. For me it is a passion.'' As an oncologist, she was better informed than other people. Still, she said, she sought opinions from breast cancer specialists elsewhere, and she avoided directing her care. So she bought a wig. Her patients, friends and family, said Dr. Horning, who is a blond, ''saw me as a redhead.'' Dr. Horning said that in caring for patients she placed communications at the top of the list. The reason, she said, is that while she was training to become an oncologist, a patient told her that whenever Dr. Saul A. Rosenberg, Dr. Horning's mentor, entered the room, his presence made that seriously ill patient feel better

The scientists analyzed the genetic makeup of patients taking warfarin in clinics at the University of Washington in Seattle and Washington University in St. Louis and found that they fell into three dosing groups -- low, intermediate and high. The genetic variations identified in the study correlated with the grouping, suggesting the findings hold promise for simplifying warfarin therapy, the scientists reported in The New England Journal of Medicine. The scientists identified genetic variations, matched them to the doses warfarin patients were taking, and found that patients with a particular variation of the gene usually took similar doses of warfarin. The VKORC1 gene accounted for 25 percent of the overall variation in warfarin doses in the studies -- what Dr. [Mark J. Rieder] said he believes is the largest genetic variation affecting warfarin

Surgeons can generally learn the on-pump operation faster than the off-pump technique because it is technically less demanding. Also, the report said, surgeons can generally perform more grafts, if necessary, in an on-pump bypass, and the grafts may stay open longer. A controversy has developed over some evidence that a small but significant number of on-pump bypass patients suffer a degree of cognitive impairment like memory and attention deficits and language problems. Such problems tended to occur less among patients whose bypasses were performed with the beating-heart technique compared with the stopped-heart technique, the team said. The extent of the decrease was not detailed. The most conclusive benefit of off-pump over on-pump operations was for patients who had deposits of calcium in their aortas, the body's main artery. When surgeons clamp the aorta in the on-pump technique, small pieces can break off to cause disabling and fatal strokes