Faculty Bibliography

The trials, in Africa and India, involved a chemical, cellulose sulfate or Ushercell, and were the second failure of a potential microbicide in a full-scale trial in recent years. In one of the latest trials, a standard check by an independent scientific committee found an increased risk of H.I.V. infection among women who used cellulose sulfate compared with those who used a placebo gel. An ideal microbicide would work in three ways. First, it would kill H.I.V. in the vagina and cervix. Second, the microbicide would prevent any virus that escaped from attaching to a woman's cells, the way the virus starts to infect. Third, for any virus that did enter cells, the microbicide would block an enzyme, reverse transcriptase, that the virus needs to replicate. The new findings were surprising, researchers said, because 11 smaller trials of more than 500 women conducted since 1999 showed that cellulose sulfate was safe. The chemical, which was developed as Ushercell by Polydex Pharmaceuticals in Toronto, was active against H.I.V. in laboratory tests

Reviews the book, Speed>Ecstasy>Ritalin: The science of amphetamines by Leslie Iverson (2006). The readership targeted for the book is hard to plumb. Is it a text for professionals, or are parts added for interested voyeurs? There are spicy interludes of celebrity difficulties with these highly reinforcing drugs of potential misuse. This is a must-read for addiction medicine specialists. General internists, family physicians, and general pediatricians would find it valuable as well. Often they are the ports of first call for troubled users.

Although a subjective component of trauma is commonly recognized in diagnosing posttraumatic stress disorder (PTSD), there are few studies that specifically address Criterion A2, and none addressing this issue among undocumented immigrants. We assessed 212 arriving undocumented immigrants with diverse trauma histories to investigate concordance between objective and subjective factors of trauma (Criteria A1 and A2) and across different types of trauma and PTSD. Concordance between Criteria A1 and A2 varied, with highest rates found for political violence. Interpersonal violence in general was associated with higher rates of PTSD. We identified a dose-response effect for PTSD, but this was not dependent on other events (i.e., other doses) meeting Criterion A2. Discussion focuses on Criterion A within the phenomenology of PTSD and the need to gauge subjective interpretations of trauma events among this population

Pediatric overweight challenges us as health care providers to utilize the best strategies we have available to help prevent and treat this nationwide epidemic. Comprehensive behavioral treatment is an effective approach for promoting weight loss and health benefits in children and is a promising approach for adolescents. Pediatricians can play an important role in curbing the rise of overweight through early detection and monitoring, and by using a variety of comprehensive behavioral treatment strategies to help manage overweight in their patients.

As soon as the Journal of the American Medical Association's study from Britain which showed an almost 50% increase in hip fractures in elderly patients taking stomach drugs Nexium, Prevacid and Prisolec was published, many patients were frightened to continue taking drugs which only a day before had helped them live pain-free, reflux-free lives. Over interpretation of a perfectly good study and fear leads to good drugs becoming instant bad guys. Many doctors are sure to continue using proton-pump inhibitors because people do not have good alternatives to these drugs

Reviews the book, Freedom and neurobiology by John R. Searle (2007). This book deals with the monumental problems of free will, personal agency and the workings of the brain. The author's attention to the workings of the mind within the brain will provide students of the addictions with a plate full of digestible ideas. This book explores the behavioral realities, that is the decision making in the real world allowing us to get through each day. The reviewer recommends this book to anyone who wants to peer deeply into the human condition through the lens of the neurobiology of the addictions.

BACKGROUND: Mycobacterium tuberculosis strains belonging to the W-Beijing family have received broad clinical and public health attention because of their rapid worldwide spread and their frequent association with outbreaks, multidrug resistance, and treatment failures and relapses. METHODS: The present study examined a large number of multidrug-resistant strain-W isolates (isolates of 29 patients) by susceptibility testing for pyrazinamide (PZA) using the reference BACTEC 460TB method (Becton Dickinson Diagnostic Instrument Systems; Sparks, MD) and also by DNA sequencing of the pncA gene. RESULTS: We found that despite of the presence of a strain W-specific Thr47Ala in the pncA gene, all strains showed susceptibility to PZA in the reference BACTEC 460TB system due to their higher minimum inhibitory concentrations (relative to BACTEC 460TB PZA-susceptible strains). CONCLUSIONS: Our results suggest that the current radiometric reference method cannot reproducibly detect PZA resistance in patients infected with W-Beijing strains. Therefore, PZA susceptibility testing should instead be based on analysis of the pncA gene for resistance-associated mutations

The most common mechanism by which Staphylococcus aureus gains resistance to vancomycin is by adapting its physiology and metabolism to permit growth in the presence of vancomycin. Several studies have examined the adaptive changes occurring during the transition to vancomycin-intermediate resistance, leading to a model of vancomycin resistance in which decreased cell wall turnover and autolysis result in increased cell wall thickness and resistance to vancomycin. In the present study, we identified metabolic changes common to vancomycin-intermediate S. aureus (VISA) strains by assessing the metabolic and growth characteristics of two VISA strains (vancomycin MICs of 8 microg/ml) and two isogenic derivative strains with vancomycin MICs of 32 microg/ml. Interestingly, we observed the parental strains had impaired catabolism of nonpreferred carbon sources (i.e., acetate), and this impairment became more pronounced as vancomycin resistance increased. To determine if acetate catabolism impairment is common to VISA strains, we assessed the ability of VISA and vancomycin-sensitive S. aureus (VSSA) clinical isolates to catabolize acetate. As expected, a significantly greater percentage of VISA strains (71%) had impaired acetate catabolism relative to VSSA (8%). This is an important observation because staphylococcal acetate catabolism is implicated in growth yield and antibiotic tolerance and in regulating cell death and polysaccharide intercellular adhesin synthesis

Grey's Anatomy [Television Program] -- The premise: Intern George O'Malley (T.R. Knight) is worried because his father, [Harold O'Malley], having recently undergone a heart operation (aortic valve replacement), is now having an operation for esophageal cancer. The doctors don't know if the cancer has spread. Harold is told that the tumor won't be removed if it is too extensive. Harold tells the surgeon, Dr. Richard Webber (James Pickens Jr.), that he wants the cancer removed no matter what. The operation reveals metastases to the stomach, lymph nodes and liver. Webber follows the patient's wishes and performs an extensive operation. Postoperatively, Harold does poorly, requiring an emergency reintubation (insertion of a breathing tube), before going into kidney failure and dying. George wrestles with the fact that his father might have lived longer without surgery