Faculty Bibliography

Mr. [Bill Clinton] was immediately transferred to Columbia-Presbyterian, where, in a four-hour procedure Monday, a team of surgeons led by Dr. Craig R. Smith, the hospital's chief of cardiothoracic surgery, took blood vessels from his chest and left leg and sewed them to arteries feeding his heart. Dr. Smith said that to make three of the grafts, the surgical team had taken blood vessels known as internal mammary arteries from beneath the left and right sides of Mr. Clinton's sternum, or breastbone. For the fourth graft, the team took a vessel from his left leg. The arteries that received the grafts were the left anterior descending, the first diagonal, the obtuse marginal and the posterior descending, Dr. Smith said. In performing coronary bypass operations of the type Mr. Clinton underwent, surgeons cut through the sternum to open the chest. The pain from the incision and the broken bone is usually intense for the first 24 hours after the operation, requiring strong medications like morphine, said doctors not connected with Mr. Clinton's case. But then the pain generally eases, and patients need only milder medications

The strain of the avian influenza virus, known as A(H5N1), is gaining a stronger foothold in Asia, health officials said on Friday at the end of a three-day meeting on the disease. The United Nations has called the scope of the spread of avian influenza in Asia and its effect on the livelihood and nutrition of people there 'unprecedented.' UN officials have also called continued presence of A(H5N1) a threat to human health because it has become increasingly virulent and because it could combine with a human influenza virus to create a new one that could cause a worldwide influenza epidemic. 'The epidemiology of avian influenza is very complex' in part because of the differences in geography, culture and farming systems, [Joseph Domenech] said. 'This makes it very difficult to obtain a precise understanding of the crisis and definition of required control plans.' Theories include biological changes in the virus; premature restocking of poultry farms, and improved surveillance and awareness with earlier detection and more prompt reporting of cases

Guinea's last polio case was in October of 1999; Mali's was in January 1999. Before the latest cases were confirmed, the World Health Organization had planned additional synchronized vaccination programs in 22 countries, including Guinea and Mali, in October and November. The program aims to immunize 74 million children younger than 5 years old. The outbreak originated in northern Nigeria, where the government of the Kano state had banned polio immunizations, the health organization said. Religious and political leaders there opposed polio immunization, contending that the vaccine made girls sterile and could spread the AIDS virus. As of Aug. 24, there were 602 polio cases worldwide. Of them, 476, or 80 percent, were in Nigeria. Ninety percent were in Africa, where all but two countries Nigeria and Niger had been freed of polio

Guinea and Mali are outside a ring of countries that had conducted synchronized polio vaccination programs last winter in an attempt to limit the spread of the disease from Nigeria and Niger. Polio was last reported from Guinea in October 1999 and from Mali in January 1999. In addition to Guinea and Mali, the countries to which polio has spread from Nigeria are: Benin, Botswana, Burkina Faso, Cameroon, Central African Republic, Chad, Ghana, Ivory Coast, Sudan and Togo. Map of Africa highlighting polio-endemic countries (Niger and Nigeria) and countries reporting new cases (Guinea, Ivory Coast, Ghana, Togo, Benin, Cameroon, Mali, Burkina Faso, Chad, Sudan, Central African Rep. and Botswana)

The spread of polio to Guinea and Mali brings to 12 the number of previously polio-free African countries that have experienced an outbreak of the disease since January 2003. The spread also deals another serious setback to the agency's efforts to eradicate the disease by year's end, a goal that is hampered by a funding gap of $100 million. Guinea and Mali are outside a ring of countries that conducted synchronized polio vaccination programs last winter in an attempt to create an immunologic firewall to limit the spread of the disease from Nigeria and Niger. Polio was last reported from Guinea in October 1999 and from Mali in January 1999. In addition to Guinea and Mali, the countries to which polio has spread from Nigeria are: Benin, Botswana, Burkina Faso, Cameroon, Central African Republic, Chad, Ghana, Ivory Coast, Sudan and Togo

The ostrich outbreak was detected on Aug. 2 in Eastern Cape Province, but infection probably began on July 21. Of 9,000 susceptible ostriches on the two farms, 1,500 became ill and 1,000 died, said Dr. Emily Mmamakgaba Mogajane, assistant director general in National Regulatory Services of the National Department of Agriculture. United Nations officials have warned that the strain found in Southeast Asia is a potential threat to human health. In a worst-case situation, if an individual became infected with both the A(H5N1) avian virus and a human influenza virus, the viruses could swap genes to create a new virus and cause a global epidemic

A deadly strain of avian influenza virus has killed more than 1,500 ostriches on two farms in South Africa in recent days and health officials are preparing to kill 30,000 ostriches to stop transmission elsewhere, South African and United Nations health officials said yesterday. The strain affecting ostriches has never been known to infect humans, Dr. Klaus Stohr, the World Health Organization's chief influenza specialist, said by telephone from its headquarters in Geneva. Nevertheless, United Nations officials are urging South Africa to impose strict biosafety measures to prevent spread of the virus and to closely monitor people for possible A(H5N2) infections. The A(H5N2) strain was detected at the Onderstepoort Veterinary Institute in South Africa by identifying certain amino acids in the virus that characterize it as highly pathogenic, or deadly strain, Dr. Stohr said. The findings were confirmed at the Veterinary Public Health Laboratory in Weybridge, England, which is part of an international network

Scientists have recently found that the strain of the avian influenza virus, known as A(H5N1), seems firmly rooted among domesticated ducks and wildlife and so cannot be wiped out by culling, quarantines and other standard measures alone, [Joseph Domenech] said. He spoke at a meeting attended by health officials from 10 Asian countries that the FAO convened in part to deal with a resurgence of avian influenza in China, Thailand and Vietnam and the virus' continuing spread in Indonesia. At the same time, many influenza experts and public health officials fear a scenario in which an individual becomes infected with both the A(H5N1) avian virus and a human influenza virus. Under such circumstances, the viruses could swap genes to create a new virus to cause a global epidemic that would be difficult to control. In the A(H5N1) epidemic in Southeast Asia, health workers are dealing with a situation that differs significantly from outbreaks of other strains of avian influenza. Those outbreaks, in developed countries in temperate regions, have been stopped by using vaccines as a short-term emergency measure in tandem with culling and other standard measures, said Mike Nunn, who manages Australia's Animal Health Science department, and Sarah Kahn, an Australian veterinary consultant to the Food and Agricultural Organization

The Bangkok AIDS conference, the largest so far, drew more than 17,000 delegates. Science took a back seat to the concurrent sessions on social, economic, legal, policy-making and other aspects of AIDS. At the time of the Atlanta conference the AIDS virus had yet to be named HIV. There were no effective antiretroviral drugs. Leading AIDS scientists and top government officials had promised that a vaccine was months away. It has yet to come. The United States contributes more money for AIDS than any other country. Yet participants in Bangkok harshly criticized the Bush administration for doing too little, emphasizing a policy of abstinence, and severely restricting the number of government scientists allowed to attend the conference. Two U.S. agencies, the Centers for Disease Control and Prevention and the National Institutes of Health, have been strong forces in earlier conferences. Yet the Bush administration did not allow some scientists from these agencies to travel to Bangkok to discuss their papers that had been accepted for presentation

The Bangkok AIDS conference, the largest so far, drew more than 17,000 delegates. Science took a back seat to the concurrent sessions on social, economic, legal, policy-making and other aspects of AIDS. In a jocular yet serious AIDS prevention effort on the eve of the conference, [Peter Piot] went to a Bangkok tollbooth to hand to drivers the condoms that are the main weapon in controlling the spread of HIV. The tollbooth scene was a variant on a Thai police program, known as cops and rubbers. 'No one was embarrassed, and some asked for more condoms,' Piot told me of the experience that he shared with Mechai Viravaidya, a Thai senator whose efforts to promote condom use helped prevent millions of Thais from getting infected over the past decade. The transformation of the AIDS conferences from austere scientific meetings to mammoth jamborees results from two main factors. One is that AIDS has become one of the worst epidemics in history, killing more than 20 million people, mostly in Africa. Second, the themes of the meetings and the thrust of the demonstrations have evolved from a failure to cure the disease to a failure to deliver the treatments now available