Faculty Bibliography

Louis Pasteur, one of the legendary figures in the history of science, lied about his research, stole ideas from a competitor and was deceitful in ways that would now be regarded as scientific misconduct if not fraud, according to a revisionist history published this month. The Private Science of Louis Pasteur, by Dr. Gerald L. Geison of Princeton University, is based on an examination of Pasteur's 102 laboratory notebooks, which have been well preserved for more than a century. In 1881, after having helped to establish the germ theory of fermentation and disease, Pasteur turned to veterinary and human medicine. He tried to reduce the virulence of microbes by exposing them to oxygen in order to make them suitable for vaccination. But in developing a vaccine against anthrax, a bacterial infection that was economically important because it was a major killer of sheep, Pasteur adapted a method he had used a year earlier to produce a vaccine against chicken cholera. To head off competitors, Pasteur had purposely withheld reporting the simple method he used to prepare the chicken cholera vaccine

Summary: A study at Johns Hopkins University finds that people with the enervating ailment have a kind of hypotension A small study published in The Journal of the American Medical Association strongly links chronic fatigue syndrome to a common abnormality in the way the body regulates blood pressure

Dr. Navarro-Valls's discussion about the Pope's health reflects a radical break in Vatican policy, which had maintained the strictest secrecy about the personal affairs of popes. 'Because of a long historical tradition,' Dr. Navarro-Valls said, 'anything concerning a pope's private life was private. It was a nonwritten rule, and that was it.' After the Pope's leg operation, for example, Dr. Navarro-Valls said he showed the Pontiff's X-rays to reporters to explain what the surgeons had done. 'Journalists were absolutely surprised,' Dr. Navarro-Valls said. Before Pope John Paul II went to a hospital in 1992 for the removal of a tumor from his colon, 'he himself announced publicly in St. Peter's, 'Pray for me, I am going to the hospital, they do not know exactly what it is,' ' Dr. Navarro-Valls said. 'That was a surprise.'

Twelve episodes of Staphylococcus epidermidis bacteraemia occurred within three months in a neonatal intensive care unit. Plasmid profiles and Southern blot hybridization with five different probes were used to determine whether an endemic strain of S. epidermidis could be identified among the contemporary isolates. It was concluded that this methodology was satisfactory for differentiation between isolates of coagulase-negative staphylococci: fifteen isolates were divided in eight groups indicating that there was no single endemic strain causing the outbreak

When new studies are released, patients should consider them as updates, not the final word on a therapy or an illness. Medicine is more of an art than a science, and it should be tailored to meet an individual patient's needs. Therefore, not every new breakthrough will apply to every patient

BACKGROUND AND OBJECTIVES: Frail older adults are especially vulnerable in a health system that is fragmented and fails to focus on preservation or restoration of function. The School of Nursing at the University of Pennsylvania, together with the School of Medicine and the Hospital of the University of Pennsylvania, established the Collaborative Assessment and Rehabilitation for Elders (CARE) Program to meet the needs of this population. We used the British Day Hospital as a model because it provides a comprehensive approach to care and a bridge between acute, home-based, and institutional long-term care. We have designed our program to provide innovative, interdisciplinary care as well as to be reimbursable under current and future payment structures. This nurse-managed, collaborative practice seeks to maximize independent functioning, promote health, and enhance quality of life for chronically ill, frail older adults living in the community whose needs are left unmet by existing services. The program was certified as a Comprehensive Outpatient Rehabilitation Facility (CORF) in December 1993 to maximize reimbursement of services through Medicare and other third party payers. With a Gerontological Nurse Practitioner as care manager, clients receive an intensive, individualized, time-limited program of nursing, rehabilitation, mental health, social, and medical services in one setting several days each week. Additional geriatric services, such as primary care, are available in the same location when needed. SETTING: The program is housed in renovated space devoted to the care of older people. The academic and clinical offices of the University of Pennsylvania's nursing and medical gerontologic and geriatric faculty are in the same building. PARTICIPANTS: We have targeted those persons older than age 65 who have complex health problems and are living at home. Individuals must need multiple services, including at least one rehabilitation therapy, and they must be unsuitable-for inpatient rehabilitation. DESCRIPTION OF THE POPULATION: In its first 8 months of operation, the program received 97 referrals and admitted 53 clients. Clients were, on average, 78 years of age. Over three-fourths (77%) were women and 58% were black. The average stay in the program was 6 weeks. FIM scores, which improved a mean of 2.4 points, were found to lack sensitivity to the functional improvements achieved by clients. CONCLUSION: Under existing Medicare and third party reimbursement policies, it is feasible to establish a nurse-managed comprehensive outpatient rehabilitation program designed to meet the needs of frail older persons. Preliminary data support the beneficial effects of the program as well as the economic feasibility of this approach.

A small study being published today in The Journal of the American Medical Association strongly links chronic fatigue syndrome to a common abnormality in the way the body regulates blood pressure. Many patients with the syndrome respond to treatment with increased salt and fluid intake in combination with standard drugs to regulate blood pressure, the researchers who carried out the study at Johns Hopkins Hospital in Baltimore said yesterday. But he cautioned that the treatment findings were preliminary and needed to be verified in a larger study conducted under more scientifically rigid criteria before they are widely applied among the estimated 1 million Americans who have chronic fatigue syndrome

Presumably, those with the abnormality of blood pressure regulation have had it all their lives. So the findings would not fully explain why some people with it suddenly develop chronic fatigue syndrome and others never do. A strong possibility, Dr. Calkins said, is that a virus infection or some other unidentified event sets off chronic fatigue syndrome, since so many people date an abrupt onset of the syndrome to a viral infection. 'To some degree, it is diet-related,' Dr. Calkins said. 'If you look at the differences in chronic fatigue syndrome between different countries, you don't see it in South America and Asia, where the diet is high in salt.' The 23 patients in the study were recruited from chronic fatigue syndrome support groups and met the criteria set by the Centers for Disease Control and Prevention for a diagnosis of chronic fatigue syndrome. They were compared with 14 people who responded to an advertisement placed by the researchers and who did not have the syndrome

Consider Dr. Barry J. Marshall, who was among the winners of this year's Albert Lasker Awards, which were announced yesterday. Dr. Marshall was honored for finding that a bacterium, not stress, causes inflammation of the stomach and ulcers. The research was partly based on experiments he did on himself in the early 1980's. Dr. Rosalyn S. Yalow won a Lasker Award in 1976 and a Nobel Prize in 1977, many years after she and Dr. Solomon A. Berson at the Bronx Veterans Administration Hospital developed the radioimmunoassay technique to detect tiny amounts of hormones and other substances. By 1976, Dr. Berson had died, an illustration that prize-worthy scientists need the good fortune to survive until their work is recognized. Posthumous Nobel Prizes and Lasker awards are not given. The Nobel awards were created by the will of Alfred Nobel, the Swedish chemist and inventor of dynamite. Yet the prizes almost did not come into being. The King of Sweden and the Prime Minister went to court to fight Nobel's will in part because they believed that his wealth would be scattered around the world, to Sweden's loss