Faculty Bibliography

The discovery of protease inhibitors was a revolutionary accomplishment in the world of virology that has changed the course of clinical disease for HIV patients. Here is how these drugs work: When the protease enzymes is blocked, HIV makes copies of itself that can no longer infect new cells. Studies have shown that these drugs reduce the amount of circulating virus in the blood and improve the body's immunological response to viruses. At a time when drug companies are routinely criticized for drug safety violations, it is good to recall the life-saving effects of the HIV drugs

CSI: Miami [Television Program] -- Victims suffocate from respiratory depression or sustain lethal heart arrhythmias as the cyanide interferes with hemoglobin metabolism (depriving the body's tissues of oxygen). The initial treatment is to administer pure oxygen. Common cyanide antidotes are nitrites and sodium thiosulfate, which work together to restore the hemoglobin. These aren't often completely effective, however, in part because the cyanide may have already done a lot of damage by the time the antidotes are administered

The 80-year-old was in the hospital after a failed balloon attempt to open the main artery that supplied blood and oxygen to his right kidney. His kidney function was deteriorating, and dialysis seemed likely, but he was now refusing all treatment and had fired his kidney doctor. My friend had contacted a new kidney expert, but he too was suggesting dialysis, and the father-in-law was on the verge of firing him as well. The father-in-law was a thin, tall man with a quick handshake, and his wife -- who immediately smiled when she saw me -- was sitting faithfully by his side. 'We've heard so much about you,' she said. 'We're so glad you're here.' The father-in-law smiled too. I knew better than to discuss dialysis, but in looking over the medical record, I saw that he had a fever and that his white blood count was elevated. My friend had warned me not to offer new treatments, but I feared a kidney infection and -- gambling on our seeming instant rapport -- suggested an antibiotic. The couple nodded and told me they would consider it. Just this month he has finally agreed -- in a state of near delirium from his kidney poisons -- to dialysis. When I had tried to break through his well-established macho structure to help him before he reached such a desperate point, it only created more anxiety and distance. He was afraid of becoming frail and dependent because this would negate his established role as his family's protector. In the end, there was little I could do beyond remaining cordial. This kind of pride and so-called male strength, when a man sets himself up as a quiet unemotional rock who doesn't need anyone's help and can't admit weakness, can be very destructive when it comes to his health

One million newcomers arrive in the United States every year; 11.7% of the total U.S. population is foreign-born. Immigrants face cancer care and research access barriers, including economic, immigration status, cultural, and linguistic. In 2000, the Center for Immigrant Health, NYU School of Medicine, launched the Cancer Awareness Network for Immigrant Minority Populations (CANIMP), a network comprising community- and faith-based organizations, local and national government health institutions, clinical service providers, researchers, and immigrant-service and advocacy organizations. This community-based participatory program chose as its priorities high- incidence cancer sites in the overall immigrant community (colorectal, lung, breast, cervical, prostate), as well as sites with strikingly high incidence in specific immigrant groups (gastric, liver, oral). CANIMP has developed successful outreach, education, screening, survivorship, training, and research programs to decrease cancer disparities. Over 2500 at-risk community members have been reached, 25 junior minority researchers trained, 60 minority interns mentored, numerous cancer disparities research projects funded and conducted, and vital partnerships to improve cancer data developed. These initiatives serve as models to address community, systems, physician, and cancer research gaps in immigrant communities. Cancer 2006. (c) 2006 American Cancer Society

AIM: To evaluate the prevalence of abnormalities of the uterine cervix in women with inflammatory bowel disease (IBD) when compared to healthy controls. METHODS: One hundred and sixteen patients with IBD [64 with Crohn's disease (CD) and 52 with ulcerative colitis (UC)] were matched to 116 healthy controls by age (+/- 2 years) at the time of most recent papanicolaou (Pap) smear. Data collected consisted of age, race, marital status, number of pregnancies, abortions/miscarriages, duration and severity of IBD, Pap smear results within five years of enrollment, and treatment with immunosuppressive drugs. Pap smear results were categorized as normal or abnormal including atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL), and high-grade squamous intraepithelial lesion (HGSIL). RESULTS: The median age at the time of Pap smear was 46 (range: 17-74) years for the IBD group and matched controls (range: 19-72 years). There were more Caucasian subjects than other ethnicities in the IBD patient group (P = 0.025), as well as fewer abortions (P = 0.008), but there was no significant difference regarding marital status. Eighteen percent of IBD patients had abnormal Pap smears compared to 5% of controls (P = 0.004). Subgroup analysis of the IBD patients revealed no significant differences between CD and UC patients in age, ethnicity, marital status, number of abortions, disease severity, family history of IBD, or disease duration. No significant difference was observed in the number of abnormal Pap smears or the use of immunosuppressive medications between CD and UC patients (P = 0.793). No definitive observation could be made regarding HPV status, as this was not routinely investigated during the timeframe of our study. CONCLUSION: Diagnosis of IBD in women is related to an increased risk of abnormal Pap smear, while type of IBD and exposure to immunosuppressive medications are not. This has significant implications for women with IBD in that Pap smear screening protocols should be conscientiously followed, with appropriate investigation of abnormal results

'It's the first formal way to track HIV/AIDS treatments and outcomes on a broad, comprehensive scale and in real time,' said Dr. Michael Saag, the principal investigator of the project, which is based at the University of Alabama at Birmingham. Extrapolating findings from clinical trials to individual patients can be difficult. One reason is that there are restrictions on the kinds of other ailments that participants in the trials can have. A second is that such trials usually are conducted on a short- term basis -- weeks or months. Doctors say that while short-term information is crucial for starting therapy, they need more data about the long-term benefits and dangers of such treatments. The seven current centers had pre-existing databases that tracked the clinical outcomes of their individual patients but lacked a collaborative, interactive information-sharing network. The centers were selected in part because they had shown the reliability of their data. be06 0078 061011 N S 0000000000 00002863

''It's the first formal way to track H.I.V./AIDS treatments and outcomes on a broad, comprehensive scale and in real time,'' said Dr. Michael Saag, the principal investigator of the project, which is based at the University of Alabama at Birmingham. A chief aim of the network is to determine the effectiveness of therapies for the thousands of patients in everyday practice compared with a hundred or so selected for clinical trials. The network will track patients who receive various treatments for such ailments to determine if and how they adversely interact with those for H.I.V./AIDS. Steps will be taken to keep the identities of the 15,000 patients in the project confidential. Dr. Saag said he hoped that the H.I.V./AIDS project would be a successful pilot to develop similar networks for other diseases

Grey's Anatomy [Television Program] -- As [Benjamin O'Leary] is being readied for brain surgery, 14-year-old Harly Hernandez is brought to the emergency room impaled on a large tree branch. Harly has sustained major damage to his kidney and intestines, and his father is told that his son has only a 60% chance of survival. After Harly's organs are repaired, the large tree branch is removed in sections, and he lives. Benjamin, however, dies when his brain hemorrhages and swells during surgery. Impalement injuries, especially with sharp objects, carry a high risk of major-organ damage, as the abdominal cavity is tightly packed with organs. Although beginning a surgical procedure with the object protruding from the body may seem counterintuitive, it can make sense -- if the object is in a stable position. This allows doctors to immediately stop the bleeding and begin to suture the damaged organs before removing the object. Removing the object prematurely or all at once can risk further bleeding and organ damage

Dr. [Robert G. Petersdorf], who was known affectionately to his colleagues as the Dorf, usually swam at lunchtime. As a teacher, he emphasized the practical and demanded that his students be prepared, and if they were not, he occasionally terrified them during rounds, said Dr. Paul G. Ramsey, the dean and vice president of the University of Washington. Dr. Roger J. Bulger, who retired last year as president of the Association of Academic Health Centers, based in Washington D.C., and who trained with Dr. Petersdorf, said that 'the knowledge he could spew extemporaneously on rounds was pretty amazing.' Dr. Petersdorf became famous in medicine for a classic study of prolonged fevers of unknown origin, which he carried out with Dr. Paul Beeson at Yale. Doctors still cite the study, published in 1961, although CT, MRI and other scans have made some of its findings less relevant to practice today