Faculty Bibliography

A link between vitamin A deficiency and transmission of the AIDS virus from mother to infant has been found in a study in Africa, researchers from the Johns Hopkins School of Medicine in Baltimore and their colleagues in Malawi reported at a meeting here Thursday. The report is believed to be the first to show that maternal nutritional deficiencies can affect the transmission of HIV, the virus that causes AIDS, said Dr. Richard D. Semba of Johns Hopkins Hospital, the leader of the research team. He reported the findings at the closing session of a meeting sponsored by the American Society for Microbiology

A new combination of AIDS drugs, AZT and lamivudine, seems to suppress the AIDS virus more effectively and for longer than existing combinations of drugs, preliminary results of four American and European studies show

A new combination of AIDS drugs seems to suppress the AIDS virus more effectively and for longer than existing combinations of drugs, preliminary results of four American and European studies show. AZT, which was the first licensed drug against HIV, the virus that causes AIDS, when used in combination with an experimental drug known as 3TC or lamivudine also raises levels critical of immune cells in the blood, known as CD4, for six months or more. Both drugs work by interrupting a key step in the life cycle of HIV

At a meeting in Washington DC on Jan 31, 1995, Columbia University researchers said they had found strong new evidence that a recently discovered virus causes Kaposi's sarcoma, a cancer that frequently occurs among AIDS patients. The new agent belongs to the herpes group of viruses, which is different from the group that includes HIV

Bernard N. Fields, a leading microbiologist and virologist who strongly influenced the direction of viral research, died on Jan 31, 1995 of pancreatic cancer. He was 56

Columbia University researchers in Washington Tuesday said that they had found very strong new evidence that a recently discovered virus causes Kaposi's sarcoma, a cancer that frequently occurs among AIDS patients. The new Kaposi's sarcoma agent belongs to the herpes group of viruses, which is different from the group that includes HIV, the virus that causes AIDS. Dr. Patrick Moore and Dr. Yuan Chang, who headed the team that made the discovery, said they had tentatively named the agent Kaposi Sarcoma Associated Herpes Virus, or KSHV. The discovery was initially reported in preliminary form in December

BACKGROUND: Measuring critical-appraisal skills is a key step in assessing physicians' abilities to engage in self-directed learning. The authors developed an instrument to evaluate the abilities of residents to critically appraise a journal article. METHOD: In 1991, 62 residents in the categorical internal medicine program at the New England Medical Center were asked to respond to a questionnaire, evaluate a sample article, and complete a self-assessment of competence in evaluation of research. Critical-appraisal skill was determined by calculating the resident's deviations from a "gold standard" critique developed through a modified Delphi technique, using a panel of five physicians. Spearman correlation coefficients were used to compare the residents' actual and self-perceived abilities. RESULTS: Twenty-eight residents returned the questionnaire, for a response rate of 45%. The composite score for the residents' objective assessments was 63% of the gold standard, and was not significantly correlated with post-graduate year, prior journal club experience, or self-assessed critical-appraisal skill. CONCLUSION: After further validation in other settings, the assessment instrument in this study may be used to objectively assess critical-reading skills. It may also provide feedback and measure outcomes for interventions designed to improve critical reading.

Questions have arisen about the implications of notifying drug abusers of their HIV serostatus. One major concern is that awareness of HIV infection would have a negative impact on abstinence from drug abuse. In order to ascertain the effects of serostatus notification, the authors reviewed the clinical records of 73 methadone patients who learned of their serostatus within 20 weeks after enrolling in the clinic and thereafter remained in treatment for at least 1 year. They found that, at serostatus notification, seropositive patients were more likely to be socially disadvantaged and were younger than the seronegatives at first opiate use. After serostatus notification, seropositives had more 'fair hearings' for noncompliance with program norms and used more cocaine. Although the patients notified of HIV infection may have more behavioral problems, further research is needed to determine whether or not this reflects antecedent behavior patterns and drug use

After decades of decline, tuberculosis has emerged as a global health challenge. In the setting of HIV immunocompromise, TB occurs frequently, early, and often atypically. New infections can take an accelerated course. The usual tests for diagnosing Mycobacterium tuberculosis infection are less sensitive when CD4+ counts are low. Increased prevalence of treatment failure, drug-resistant strains, and nosocomial transmission of multidrug-resistant TB are discussed as are new diagnostic tests that will accelerate the time to diagnosis and allow better epidemiologic tracking. Early recognition, isolation, appropriate therapy, and environmental controls that will protect staff and patients from the risk of exposure are also described

WASHINGTON - AIDS has become the leading cause of death among all Americans ages 25 to 44, according to federal data released Monday. AIDS surpassed unintentional injury, the government's category for accidents, which dropped to second place in this age group, said Dr. Harold Jaffe, a top AIDS official at the Federal Centers for Disease Control and Prevention in Atlanta. Cancer and heart disease were third and fourth, followed by homicides and suicides. 'The dramatic rise is due to the accumulating toll from AIDS and is almost certain to continue because AIDS deaths reflect infections from HIV, the AIDS virus, that were acquired several years earlier,' Jaffe said