Faculty Bibliography

Bernard Fisher, the surgeon who was pivotal in changing the way breast cancer is treated, was ousted from his job at the University of Pittsburgh as head of a group of studies of breast and bowl cancer in a debacle over falsified data in tests. A Canadian researcher has admitted falsifying data submitted to Fisher, although Fisher himself is not under suspicion. Fisher, who will testify before Congress on the case in Apr 1994, is profiled

David M. Oshinsky reviews the book "Stories of Scottsboro" by James Goodman

Wound care in the elderly population requires careful attention to the medical status of the patient. The patient's underlying medical condition can often dictate what reconstructive options are appropriate. Many reconstructive techniques are available to repair a wide variety of wounds

In a retrospective review, a group of seven patients were found to have a sputum culture positive for Hafnia alvei. Hafnia alvei is a Gram-negative enteric and oropharyngeal bacillus and usually is nonpathogenic. All our patients had a chronic underlying illness and one of the patients was endotracheally intubated at the time of the isolation of this organism. Six of seven patients had other organisms isolated along with H alvei, and only one patient had a pure growth of H alvei confirmed by a culture obtained from a bronchoscopic protected brush specimen. All isolates displayed resistance to conventional antibiotics including cephalosporins and penicillins. Although rare, H alvei may be a potential pathogen in a patient with a chronic underlying illness

Automated DNA sequencing was used to characterize mutations associated with rifampin resistance in a 69-bp region of the gene, rpoB, encoding the beta subunit of RNA polymerase in Mycobacterium tuberculosis. The data confirmed that greater than 90% of rifampin-resistant strains have sequence alterations in this region and showed that most are missense mutations. The analysis also identified several mutant rpoB alleles not previously associated with resistant organisms and one short region of rpoB that had an unusually high frequency of insertions and deletions. Although many strains with an identical IS6110 restriction fragment length polymorphism pattern have the same variant rpoB allele, some do not, a result that suggests the occurrence of evolutionary divergence at the clone level

Collaborative efforts among health care professionals and institutions at all levels will be essential to the increased production of generalist physicians. There have been many successful collaborations in education and patient care among certifying boards, faculty, physicians in practice, specialists, generalists, and non-physician health professionals, as well as among the three generalist specialties. Recommended strategies to encourage collaboration in the preparation of generalist physicians include: creation of an institutional collaborative curriculum committee; design of a longitudinal curriculum on collaboration for physicians-in-training and other health professionals; implementation of collaborative patient care in ambulatory care teaching clinics; development of integrated systems of care that link inpatient, outpatient, and community-based health services; and education of physicians-in-training in these and other collaborative and co-practice models of patient care.

In an effort to assure the quality of crucial research projects, National Cancer Institute officials on Mar 29, 1994 took sweeping action intended to correct serious deficiencies of oversight in several large studies being coordinated by Dr Bernard Fisher at the University of Pittsburgh to determine new standards of care for cancer patients

The broad actions came a day after the cancer institute, citing a new discrepancy in a breast cancer study, asked the University of Pittsburgh to replace [Bernard Fisher] as principal investigator of an influential series of studies on breast and bowel cancer. The disciplinary action was demanded by cancer institute officials after their repeated criticism of Fisher for delays in detecting falsified data submitted by Dr. Roger Poisson at St. Luc Hospital in Montreal to the Pittsburgh center. The falsifications were first detected in 1990 and not reported to the cancer institute for several months. Although Fisher has submitted re-analyses of the findings excluding Poisson's data to the National Cancer Institute, officials there have criticized Fisher for not submitting a paper to The New England Journal of Medicine, which published the original reports in 1985 and 1989. Publication of the revised data is a standard way for correcting information in medicine

The National Cancer Institute, citing a new discrepancy in a breast cancer study, asked the University of Pittsburgh to replace Bernard Fisher as the principal investigator of an influential series of studies. A researcher from a Montreal hospital had submitted falsified data to the study