Faculty Bibliography

The mechanism of antimalarial action of the ruthenium-chloroquine complex [RuCl(2)(CQ)](2) (1), previously shown by us to be active in vitro against CQ-resistant strains of Plasmodium falciparum and in vivo against P. berghei, has been investigated. The complex is rapidly hydrolyzed in aqueous solution to [RuCl(OH(2))(3)(CQ)](2)[Cl](2), which is probably the active species. This compound binds to hematin in solution and inhibits aggregation to beta-hematin at pH approximately 5 to a slightly lower extent than chloroquine diphosphate; more importantly, the heme aggregation inhibition activity of complex 1 is significantly higher than that of CQ when measured at the interface of n-octanol-aqueous acetate buffer mixtures under acidic conditions modeling the food vacuole of the parasite. Partition coefficient measurements confirmed that complex 1 is considerably more lipophilic than CQ in n-octanol-water mixtures at pH approximately 5. This suggests that the principal target of complex 1 is the heme aggregation process, which has recently been reported to be fast and spontaneous at or near water-lipid interfaces. The enhanced antimalarial activity of complex 1 is thus probably due to a higher effective concentration of the drug at or near the interface compared with that of CQ, which accumulates strongly in the aqueous regions of the vacuole under those conditions. Furthermore, the activity of complex 1 against CQ-resistant strains of P. falciparum is probably related to its greater lipophilicity, in line with previous reports indicating a lowered ability of the mutated transmembrane transporter PfCRT to promote the efflux of highly lipophilic drugs. The metal complex also interacts with DNA by intercalation, to a comparable extent and in a similar manner to uncomplexed CQ and therefore DNA binding does not appear to be an important part of the mechanism of antimalarial action in this case.

BACKGROUND: Haitian immigrants, among the fastest growing immigrant communities in the United States, have low cancer screening rates. Several patient barriers have been identified and associated with low screening rates but little is known on provider barriers for cancer screening. To address this gap, we assessed the cancer screening practices, attitudes, and beliefs of primary care providers serving the Haitian community. METHODS: We surveyed a random sample of physicians serving first generation Haitian immigrants in New York City, identified through their zip codes of practice. Participants completed a questionnaire to assess their beliefs, attitudes and practices surrounding cancer screening, and their perceptions of patient barriers to screening. RESULTS: 50 of 87 physicians (58%) consented to participate in the study. Cancer site-specific and overall cancer screening scores were created for breast, cervical, and colorectal cancer screening. 75% of providers followed breast cancer screening guidelines, 16% for cervical cancer, and 30% for colorectal cancer. None of the providers in the sample were following guidelines for all three cancer sites. Additionally, 97% reported recommending digital rectal exam and PSA annually to patients 50 years or older with no family history, and 100% to patients over 50 years old with family history. CONCLUSIONS: The reported practices of providers serving the Haitian immigrant community in New York City are not fully consistent with practice guidelines. Efforts should be made to reinforce screening guideline knowledge in physicians serving the Haitian immigrant community, to increase the utilization of systems that increase cancer screening, and to implement strategies to overcome patient barriers

The undated letter was released less than a week after Senator John McCain of Arizona, the presumptive Republican nominee, released his medical records

'At the present time, Senator [McCain] enjoys excellent health and displays extraordinary energy,' McCain's primary care physician, Dr. John Eckstein, said Friday in a conference call arranged by McCain's campaign

The media organizations in the pool included ABC News, The Arizona Republic, Bloomberg, CBS News, CNN, Fox News, NBC News, Reuters and The Washington Post

Specifically, the Armed Forces Institute pathology report said that details about the lesion were 'highly suggestive of a metastasis of malignant melanoma and may represent a satellite metastasis,' with satellite meaning one melanoma had spread to create another

Campaign officials have nonetheless said that even if nothing in the records suggests a problem with his health, a rush of news media reports focusing on the cancer surgery was not politically helpful and that they wanted to play down the information as much as possible -- something that the timing of the release would seem to accomplish

Speaking of brain tumors in general and not of Mr. Kennedy's case, Dr. Steven S. Rosenfeld, who directs NewYork-Presbyterian/Columbia hospital's brain tumor center, said: I do not know what his surgeons are planning, but we certainly find ourselves with malignant gliomas on that side of the brain where we don't do surgery because of the possibility of damaging speech

House [Television Program] -- Dr. Bernard Feigenbaum, assistant professor of allergy and immunology at New York University School of Medicine, says that a person can become allergic to any drug at any time even without a typical rash, but he adds that, anaphylactic shock almost always occurs within the first few hours after an exposure