Faculty Bibliography

In 1980, despite his mother's history of senility, it was only a hypothetical possibility that Reagan would develop Alzheimer's. The disease's hereditary pattern was, and is, not precisely known. As it turned out, the disease is believed to have afflicted Reagan's brother, Neil, too. Whether their mother's dementia was from strokes or Alzheimer's, or both, is not known. No one can be absolutely certain when Reagan's Alzheimer's began. Then, as now, blood and other practical laboratory tests did not exist to detect the initial stages of Alzheimer's, which takes years to damage the brain, or to distinguish it from other forms of dementia. Lacking a test, Alzheimer's is estimated to account for half of all dementia cases. Strokes and other diseases cause the remainder. Doctors did not start giving Reagan psychological tests that can point to Alzheimer's until after he was thrown from a horse in Mexico in 1989, and suffered a subdural hematoma that was removed surgically. Initial tests did not show evidence of Alzheimer's, but subsequent ones, performed around 1993, did, his doctors have said

Cipla, an Indian company that has been in the forefront of getting generic drugs approved for use in poor countries, made the two generic drugs, lamivudine, which is also known as 3TC, and zidovudine, which is also known as AZT. The problem was detected during an inspection of an independent laboratory that Cipla had hired to conduct bioequivalence studies among volunteers whose blood had been tested after they took the generic drugs. The tests were devised to determine whether the concentration of the generic drug in the blood was the same as in its patented counterpart. Dr. [Lembit Rago] did not provide the name of the company that did the testing. Cipla's chairman, Dr. Yusuf K. Hamied, said the problem was due to inadequate record keeping in the testing laboratory in Bombay. Dr. Hamied, reached by telephone in London, said that Cipla's lamivudine has been tested for bioequivalency in a laboratory in the United States and approved by the Food and Drug Administration and that he would submit that data to the health agency

In 1980, despite his mother's history of senility, it was only a hypothetical possibility that Mr. Reagan would develop Alzheimer's. The disease's hereditary pattern was, and is, not precisely known. As it turned out, the disease is believed to have afflicted Mr. Reagan's brother, Neil, too. Whether their mother's dementia was from strokes or Alzheimer's, or both, is not known. No one can be absolutely certain when Mr. Reagan's Alzheimer's began. Then, as now, blood and other practical laboratory tests did not exist to detect the initial stages of Alzheimer's, which takes years to damage the brain, or to distinguish it from other forms of dementia. Lacking a test, Alzheimer's is estimated to account for half of all dementia cases. Strokes and other diseases cause the remainder. Doctors did not start giving Mr. Reagan psychological tests that can point to Alzheimer's until after he was thrown from a horse in Mexico in 1989, and suffered a subdural hematoma that was removed surgically. Initial tests did not show evidence of Alzheimer's, but subsequent ones, performed around 1993, did, his doctors have said

As HIV therapy becomes available to more people in poor countries, prevention may be neglected and even more cases may develop, a team of global leaders working to combat AIDS warned Thursday. The report says a shift in prevention strategies is needed to avoid repeating mistakes made in wealthy nations. After more potent combination anti-HIV drugs began to be used in rich countries in 1996, the same prevention messages were continued, even though the new therapies had made some obsolete

As H.I.V. therapy becomes available to more people in poor countries, prevention may be neglected and even more cases may develop, a team of AIDS experts working to combat the disease warned in a report issued yesterday. The report says a shift in prevention strategies is needed to avoid repeating mistakes made in wealthy nations. After more potent combination anti-H.I.V. drugs began to be used in rich countries in 1996, the same prevention messages were continued, even though the new therapies had made some obsolete. The team also urged more programs to change behavior that spreads H.I.V. Such programs, it said, should discourage sex at an early age; promote monogamy and sexual abstinence; and encourage safer behavior by those who inject drugs. Fewer than one in five people at high risk of becoming infected now have access to such interventions

It was about two years ago, Reagan's former doctor recalled. He had gone to visit the Reagan family at their house in Los Angeles. It was a typically glorious California day, and [John E. Hutton], a retired Army brigadier general who had been one of Reagan's White House physicians, was there with his daughter, Beth Shiau, a Navy neonatal nurse. As he recalled, the Rev. Billy Graham was there, too. [Nancy Reagan] was very protective of her husband's privacy during his final illness, and Hutton was one of the rare visitors to see Reagan in that period. Hutton said he had agreed to speak in a desire to inform the public about Alzheimer's disease and about 'the human side of Mr. Reagan.' He said Reagan's death on Saturday came on fairly quickly, in what had been a relatively stable course of chronic Alzheimer's disease, possibly after food inhaled into his lungs led to aspiration pneumonia. Though Hutton said he did not know for sure how Reagan had died because he had not yet talked to Nancy Reagan, he and experts on Alzheimer's disease not connected to Reagan's case said it was logical to assume that aspiration was involved because it is the way many Alzheimer's patients die, even with the best of nursing care

Dr. [John E. Hutton] stopped formally treating Mr. Reagan when he left the White House in 1989. But after the former president announced that he had Alzheimer's disease in 1994, Dr. Hutton stayed with him a number of times, each for a week or so, to give Mrs. Reagan some relief. He spoke with her often; the last time was just last month. Mrs. Reagan was very protective of her husband's privacy during his final illness, and Dr. Hutton was one of the rare visitors to see Mr. Reagan in that period. Dr.. Hutton said he had agreed to speak in a desire to inform the public about Alzheimer's disease and about ''the human side of Mr. Reagan.'' He said Mr. Reagan's death on Saturday came on fairly quickly, in what had been a relatively stable course of chronic Alzheimer's disease, possibly after food inhaled into his lungs led to aspiration pneumonia. Though Dr. Hutton said he did not know for sure how Mr. Reagan had died because he had not yet talked to Mrs. Reagan, he and experts on Alzheimer's disease not connected to Mr. Reagan's case said it was logical to assume that aspiration was involved because it is the way many Alzheimer's patients die, even with the best of nursing care

Ibrahim Shekarau, the Kano state governor whose eight-month moratorium on polio vaccinations has been blamed for the spread of polio widely across Africa, said in an interview on Tuesday that he was ready to resume immunizations. Dr. David L. Heymann, director of W.H.O.'s polio program, said Wednesday that his agency ''welcomes any decision to resume polio vaccinations in [Kano].'' After a formal decision is announced, he said, W.H.O. and its partners, Rotary International and the United Nations children's fund, Unicef, would help conduct a large-scale program from June to August to immunize all children 5 years and younger in Nigeria. A Nigerian child receives a dose of the polio vaccine. The governor of the northern Nigerian state of Kano had opted out of a polio immunization drive, prompted by claims of a link between the vaccine and infertility. (Photo by European Pressphoto Agency)

When the SARS epidemic ended last July, experts were concerned that it would come back from wherever it hid in nature. But officials of the World Health Organization were just as worried about a new epidemic emerging from a SARS sample that escaped from one of the many laboratories working with it. The outbreak began March 25 after a graduate student became infected in China's main SARS laboratory in Beijing. Her case led to two more waves of transmission involving seven people including her mother, who died before her illness was recognized as SARS, or severe acute respiratory syndrome, on April 22. One problem is what happens when you have BL3 and BL4 laboratories in old buildings in developing countries, he went on, adding: What struck me as quite bizarre is, here is a student working in a laboratory that handles SARS, and when she gets a respiratory disease and pneumonia, it takes three weeks before they even tested for SARS. That is a long period of time. In that period, for example, she could have infected fellow passengers on trains

Recent reports about avian influenza in Asia have come almost daily, creating an impression that the viral disease is spreading among countries as fast as birds fly. Indeed, avian influenza has moved rapidly. The simultaneous appearance of avian influenza in eight countries, particularly in one region, is ''unprecedented,'' the World Health Organization says. The A(H5N1) strain of current concern is a mutation of the same bird flu virus that caused outbreaks among chickens in Hong Kong in 1997 and 2003, when the virus infected 20 people, 7 fatally. Now the mutated strain has caused 14 human cases, of which 11 were fatal, and led to the slaughter of 25 million birds. The human cases were believed to have resulted from direct contact with infected chickens, except for possibly two cases in Vietnam. Avian influenza was first described in Italy a century ago, but health officials have lacked the monitoring systems to track small outbreaks in birds or humans over time. Another unknown is what allowed A(H5N1) to mutate to become virulent among ducks and other migratory aquatic birds when the older strain was less harmful. The virus has been isolated recently from various species of ducks, geese, swans and flamingos, Dr. [Klaus Stohr] said