Faculty Bibliography

We developed an approach for identifying groups or families of Staphylococcus aureus bacteria based on genotype data. With the emergence of drug resistant strains, S. aureus represents a significant human health threat. Identifying the family types efficiently and quickly is crucial in community settings. Here, we develop a hybrid sequence algorithm approach to type this bacterium using only its spa gene. Two of the sequence algorithms we used are well established, while the third, the Best Common Gap-Weighted Sequence (BCGS), is novel. We combined the sequence algorithms with a weighted match/mismatch algorithm for the spa sequence ends. Normalized similarity scores and distances between the sequences were derived and used within unsupervised clustering methods. The resulting spa groupings correlated strongly with the groups defined by the well-established Multi locus sequence typing (MLST) method. Spa typing is preferable to MLST typing which types seven genes instead of just one. Furthermore, our spa clustering methods can be fine-tuned to be more discriminative than MLST, identifying new strains that the MLST method may not. Finally, we performed a multidimensional scaling of our distance matrices to visualize the relationship between isolates. The proposed methodology provides a promising new approach to molecular epidemiology

The author never believed it was entirely fair that Eli Lilly was the target of vicious attacks regarding its anti-psychotic drug, Zyprexa. For one thing, many psychiatrists found, and still find, it to be effective. He was concerned that the fallout would stymie Lilly and keep it from innovation. So it is with much applause that he noticed the early success in trials of its new class of anti-psychotic drugs. Whether of not the new drug, LY2140023, becomes the next great anti-psychotic drug in clinical practice, Lilly deserves to be congratulated for developing it

America's medical schools have long used human cadavers to teach anatomy, but acquiring adequate numbers of bodies for dissection has always been a challenge. Physicians and medical students of the 18th and 19th centuries often resorted to robbing graves, and this history has been extensively examined. Less studied, however, is the history of body acquisition in the 20th century, and this article evaluates the factors that coalesced to transition American society from body theft to body donation. First, it describes the legislation that released the unclaimed bodies of those dying in public institutions to medical schools for dissection, thereby effectively ending grave robbery. Then it discusses midcentury journalistic exposes of excesses in the funeral industry-works that were instrumental in bringing alternatives, including the previously unpopular option of body donation, to public consciousness. Finally, it examines the rise of body transplantation, the Uniform Anatomical Gifts Act of 1968, and the subsequent state of willed-body programs at the turn of the 21st century. Body-donation programs have gradually stabilized since and currently provide most of the bodies used for dissection in American medical schools. Relying as they do on public trust, however, these programs remain potentially precarious and threatened by public scandals. Whether American medical schools will receive enough bodies to properly educate students in the future remains to be seen

Direct and indirect exposure to trauma is related to cardiovascular reactivity to stress, which is a marker for the future development of cardiovascular disease. The current study compared the effects of indirect exposure and no exposure (assessed via self-reports) to the 5/77 terrorist attacks on cardiovascular reactivity among a sample of 31 New Yorkers. Cardiovascular responses, measured every 2 minutes during baseline, a semistructured interview in which they relived a personally relevant aspect of the terrorist attack, and recovery periods revealed that the indirect exposure group had significantly higher diastolic blood pressure levels at baseline (p < .01), task (p < .05), and recovery (p < .05) than the no exposure group. No differences in trauma symptoms were observed between the two groups. Results suggest that indirect exposure to a traumatic event may have an impact on physiological responses to stress. (journal abstract)

BACKGROUND: To participate meaningfully in decisions regarding invasive procedure use, patients should understand the benefits and risks. Previous work has focused on risks; we assessed patient understanding of the benefits of coronary revascularization procedures. METHODS: We interviewed 1650 patients and their treating physicians after elective coronary angiography performed at 3 Veterans Health Administration hospitals and 1 university hospital. We excluded patients for whom the decision to undergo revascularization was made before admission. This report focuses on 633 patients who had been offered coronary artery bypass surgery (CABG, n = 324) or percutaneous coronary interventions (PCIs) and responded to questions about expected benefits. Both patient and physician were asked to report the benefits they expected from revascularization. Forty-nine physicians reported on 490 patients. RESULTS: Most patients were older (mean age 63.8 years), white (89.4%), and male (77.6%). Most patients expected improved symptoms (83%) and survival (83%). Physician-patient agreement regarding whether survival would improve was no better than chance (kappa = 0.02 for CABG, kappa = -0.01 for PCI, both P > .10). There was also poor agreement regarding whether symptoms were expected to improve, but this was better than chance (kappa = 0.09, P = .01 for CABG; kappa = 0.19, P = .02 for PCI). Physician-patient agreement was poor regardless of patient characteristics. CONCLUSIONS: Patients have more optimistic expectations about benefits of coronary revascularization than the cardiologist offering the procedure. Further research should confirm this finding and clarify how physician-patient disagreement regarding the benefits of coronary revascularization affects patient participation in decision making

Dr. Eugene Braunwald, an international leader in cardiology at Harvard, likened Sonnenblick's basic research work to 'what a brilliant mathematician or theoretical physicist does that ultimately allows you to go into space.' Sonnenblick's research began in the 1960s at Presbyterian Hospital in Manhattan. It continued at the National Heart, Lung and Blood Institute in Bethesda, Md.; Harvard; and the Albert Einstein College of Medicine of Yeshiva University in the Bronx, where he was a distinguished university professor of medicine. For providing a framework for understanding normal and abnormal heart function, 'Ed Sonnenblick occupies an honoured place in the pantheon of the greatest heart and blood vessel physiologists of the 20th century,' said Braunwald, who worked with Sonnenblick