Faculty Bibliography

Federal health officials reported a rare case last week of an individual with AIDS who persistently tested negative for the AIDS virus. The man, who lives in Utah, was a longtime blood plasma donor, but an investigation found no evidence that his plasma had infected anyone, the Centers for Disease Control and Prevention said in its weekly report. The report comes at a time when the Food and Drug Administration is about to license a new test for HIV, the virus that causes AIDS, that differs substantially from the standard one that has been used to screen all blood donations since 1985. If the new test had been available earlier, it probably would have detected the man's HIV infection, said officials with the centers. In August the FDA recommended that blood banks supplement the standard test with the new test within 90 days of its licensing. The new test detects the p24 antigen, or protein, in HIV. The standard test detects antibodies that the immune system produces in response to HIV infection, and has been enormously successful in preventing transfusion-associated AIDS

Memorial Sloan-Kettering Cancer Center in New York City has been fined $12,000, the maximum allowed by state law, in a case in which a surgeon operated on the wrong side of a patient's brain, officials of the State Health Department and the center said on Mar 8, 1996

In its weekly report on Mar 7, 1996, the CDC described a rare case of an individual with AIDS who persistently tested negative for HIV. The report comes at a time when the FDA is about to license a new HIV test that differs substantially from the standard one that has been used to screen blood donoations since 1985, and CDC officials say the new test would have detected the man's HIV infection

We investigated the relationship among chemosensitivity to drug-induced apoptosis in vitro, the presence of p53 gene mutations, and the expression of bcl-2 and bax proteins in B-cells from B-cell chronic lymphocytic leukemia (B-CLL) patients. Apoptosis was induced with a camptothecin analogue, 9-amino-20(s)-camptothecin, or a purine analogue, fludarabine. Cell death was monitored by propidium iodide staining and FACS analysis. Drug-induced apoptosis in B-CLL cells was p53-independent. Immunoblot analysis of bcl-2 and bax expression revealed a correlation between drug-induced apoptosis and the ratio of endogenous levels of bcl-2 to bax proteins. B-CLL cells with none to low bcl-2/bax ratios were drug-sensitive as compared to cells with intermediate to high ratios that were drug-resistant (P = 0.015). Prior to drug treatment, bax protein migrated as a single species of 21 kDa. Following drug-induced apoptosis, anti-bax specific protein complexes of 36-42 kDa were up-regulated. Using two-dimensional gel electrophoresis, bax complexes were disrupted under reducing conditions to reveal homo- and heterodimers of 18 and 21 kDa suggesting that disulfide interactions were required for complex formation. The de novo appearance of the 18 kDa anti-bax specific protein together with its increased expression in drug-sensitive B-CLL B-cells undergoing cell death suggests a role for this protein in the regulation of apoptosis

Scientists in California reported on Feb 29, 1996 that a virus that is believed to cause Kaposi's sarcoma, the most common cancer affecting gay men with AIDS, has been grown in the laboratory and photographed for the first time. The new research, which is being published in the March issue of the journal Nature Medicine, might lead to more effective therapies for Kaposi's sarcoma, which is often fatal, and to knowledge of how the virus is transmitted and the extent that the general population is infected

The findings significantly advance those that Columbia University researchers reported in December 1994, when they used a new technique to help detect molecular fragments from genes of what they believed was the Kaposi's sarcoma virus. The Columbia team did not actually identify the virus as the San Francisco team has done

The authors measured the rate and determinants of posttraumatic stress disorder (PTSD) in a group of cancer survivors. Patients who had a history of cancer diagnosis with at least 3 years since diagnosis, receiving no active treatment, such as chemotherapy or radiation, were interviewed (N = 27). Patients, who were part of the DSM-IV PTSD field trial, were compared with a community-based control group matched for age and socioeconomic status. One member of the survivor group (4%) and no members of the control group met criteria for current PTSD (NS). Six of the survivors (22%) and no control subjects met lifetime criteria (P < 0.02). Cancer patients have a higher rate of PTSD than found in the community. Symptoms closely resemble those of individuals who have experienced other traumatic events

There is a high prevalence of bacterial infections in long term care facilities (4.4 to 16.2%). This, together with the fact that antimicrobial resistance is a big concern in current medical practice, makes infection control so important in nursing home care. This article covers the mechanisms of antibacterial resistance and focuses on 4 major antibacterial-resistant bacteria. Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA). Colonisation with MRSA is not uncommon in nursing homes and eradication is probably not necessary. Any clinically important enterococcal infection should be tested for high-level resistance. An infectious disease consultation should be sought for vancomycin-resistant enterococcal infections. Gram-negative bacilli have developed multi-resistance. Susceptibility testing can identify the most appropriate therapy. Multiresistance should also be considered when treating Streptococcus pneumoniae. Overall, handwashing is highly recommended. Barrier precautions, minimising hospitalisations and avoiding unnecessary personnel rotation can reduce the chance of resistance spread.

The ideal vaccine would be safe, would produce no serious adverse reactions and would protect against chronic infection and disease after exposure to all HIV strains. An ideal vaccine would also eradicate AIDS, the way smallpox has been wiped out. Progress toward an ideal vaccine is likely to occur in incremental steps, says Dr. [Anthony S