Faculty Bibliography

One heart surgeon not associated with the case, Dr. Konstadinos Plestis of Montefiore Medical Center in the Bronx, said that irritation from even a small amount of fluid collecting in the chest after bypass surgery could lead to the formation of a layer of tissue that can cover the left lower lobe of the lung like a thick sock. When asked to specify the risk on a scale of 1 to 10, Dr. Joshua Sonnet, a chest surgeon who will perform Mr. [Bill Clinton]'s operation, did not give an answer. To free the lung, surgeons must peel off the thickened tissue in an operation that takes about two hours, Dr. Plestis said. One of the first steps in the surgery, to give doctors room in which to work, is to collapse the lung, which is done with a special breathing tube that blocks air supply to one lung. Dr. Plestis said that to remove the thickened tissue, doctors normally try the least invasive method first, inserting a miniature video camera and surgical tools between the ribs through three small punctures in the chest

The possible case of the nurse in Hanoi takes on particular potential importance because of his occupation. Bloomberg News reported that he had carried the avian influenza patient on a stretcher and provided direct care at a hospital. If tests identify the A(H5N1) strain as the cause of his illness, and other sources of exposure are ruled out, he could become the first health worker to have contracted avian influenza

The new cases bring to at least 42 the number of human cases of A(H5N1) avian influenza that Vietnam has reported to the W.H.O. Of those, at least 31 have been fatal. Thailand has reported 17 human cases of avian influenza, of which 12 were fatal. Cambodia has reported one fatal case. At the same time, infectious disease and laboratory workers from W.H.O., Japan and the United States have been working with Vietnamese officials to improve the accuracy of influenza testing in Vietnam. Scientists in Tokyo are testing specimens from seven people who actually may have been positive for the avian A(H5N1) strain in Vietnam but were classified as negative

As H.I.V., the AIDS virus, spreads further, Africa will face ''an unprecedented crisis and a challenge never before seen since the advent of slavery,'' Dr. Peter Piot, the executive director of the Geneva-based United Nations AIDS program, said at a news conference in Addis Ababa, according to Reuters. The United Nations said the report was intended to improve decision-making and deepen public understanding of the possible course of the AIDS epidemic in Africa by 2025, when ''no one under the age of 50 in Africa will be able to remember a world without AIDS.'' By then, 89 million more people in Africa could be infected with H.I.V., under the worst circumstances, the United Nations said. An estimated 25.4 million people in Africa are infected now

In the third world, measles, which appears as a rash and fever, killed millions of children each year as recently as a decade ago. And many of the 30 million who survived were left blind or with complications that included brain damage and other disabilities. Measles also causes ear infections and pneumonia. Measles tends to be more severe among poorly nourished children, particularly those with low levels of vitamin A. Recommendations call for giving children with measles a dose of vitamin A supplement for two successive days to help prevent eye damage and blindness

The incidence of influenza steadily increased in January and February and has not clearly peaked, the Centers for Disease Control and Prevention said

In lifting on Wednesday their suspension of Chiron's manufacturing license, British regulators said the company had made 'satisfactory progress' in rectifying sanitary and quality control problems. British health authorities had suspended the license of the Liverpool plant on Oct. 5, depriving the United States of nearly 50 million doses, or about half the supply of vaccine expected for the current winter. The sudden and severe shortfall caused huge lines at flu clinics across the United States last fall and set off a wholesale examination of what many experts called the country's fragile vaccine supply system. It also brought new criticism of the Food and Drug Administration for not following up on safety problems at the factory and therefore being caught by surprise by the British government's action

The agency also says it is now in closer contact with its counterparts in Britain and other countries. Some members of Congress had criticized the agency for not following up on problems it had found in previous years at the Chiron plant and for therefore being caught by surprise when the British suspended the license. After the British action, the F.D.A. conducted its own inspection and agreed with the British decision that the vaccine's safety could not be guaranteed. It issued Chiron a warning letter. So the American flu vaccine business may not be the moneymaker Chiron envisioned when it entered that business in 2003 by paying $878 million to acquire PowderJect Pharmaceuticals, the British company that owned the Liverpool plant. After its license was suspended, Chiron assembled a team of 70 insiders and outside experts to fix the problem. Just last week, John Lambert, who had headed Chiron's overall vaccine business, resigned. The company is still facing investigations by the Justice Department and the Securities and Exchange Commission

Dr. Thomas R. Frieden, the commissioner of the New York City Department of Health and Mental Hygiene, has reported that the man has the first diagnosed strain of H.I.V. that shows both resistance to multiple classes of antiretroviral drugs and a rapid progression from infection to AIDS. Doctors have in the past reported each component separately, but not in combination. For one, Case B could have infected any number of other people, some never tested for H.I.V., and any of them may have infected Case A. Some contacts may not be openly gay. Also, the identification of anonymous sex contacts solicited through the Internet may come only from a patient's recalling a physical characteristic that the medical detectives must then track down. Many among the 3,900 AIDS experts who participated in the 12th Annual Retrovirus Conference in Boston last week praised Dr. Frieden for sending a warning to people to practice safer sex. As antiretroviral therapy becomes more widely available, drug resistant H.I.V. is likely to spread, speakers said

The discoveries arose from studies undertaken out of concern that another retrovirus could emerge to mushroom into another global pandemic like AIDS. Many scientists say they believe that H.I.V., the AIDS virus, mutated from a simian virus that was transmitted from nonhuman primates to hunters and then spread widely through sex and contaminated needles. The retroviruses, named H.T.L.V.-3 and H.T.L.V.-4, for human T-lymphotropic virus, are the newest members of a class that can cause a wide spectrum of illnesses. The retrovirus numbered 1 is a cause of leukemia and inflammatory diseases, and it and H.T.L.V.-2 can lead to neurological disease, Dr. [Walid Heneine] said. Although the ultimate aim is to prevent another virus from causing an AIDS-like pandemic, Dr. Heneine said, one concern is the potential spread of the new viruses through blood transfusions. Blood banks in Africa do not test for H.T.L.V. viruses before blood and blood products are transfused, he said