Faculty Bibliography

On Friday, rumors of an imminent retirement announcement by Chief Justice [William H. Rehnquist] reached a frenzy of bizarre proportions. He was first said to have informed the White House that he would announce his retirement on Monday. The rescheduling from Monday until Tuesday of a meeting between the president and the Senate leadership was taken as proof of the chief justice's intention; in fact, the change was made to accommodate the schedule of Senator Bill Frist, Republican of Tennessee, the majority leader. Dr. Leonard Wartofsky, chairman of the department of medicine at Washington Hospital Center, said in an interview that he was ''surprised Mr. Rehnquist has done so well.'' Dr. Wartofsky, a thyroid cancer specialist, said the chief justice's case was ''a big topic'' among thyroid experts. ''It's on people's minds'' and ''we talk,'' he said. Another specialist, who had spoken to the chief justice's own doctors, said they were ''very, very pleased about his course and that he is so on the ball.'' Anaplastic thyroid cancer is rare, and Dr. Steven I. Sherman, chairman of the endocrine cancer department at the University of Texas M.D. Anderson Cancer Center in Houston, cautioned against jumping to the conclusion that this was the chief justice's diagnosis. ''More likely it was not anaplastic thyroid cancer, just by the relative frequency of the other'' types of the disease, Dr. Sherman said

Chief Justice [William Rehnquist] leaves his home in Arlington, Va., on Friday. Rehnquist remained at work in his chambers at the court Friday, as he has every day since the court finished its term and began its summer recess. J. SCOTT APPLEWHITE/THE ASSOCIATED PRESS

Dr. Leonard Wartofsky, chairman of the department of medicine at Washington Hospital Center, said that he was 'surprised Mr. [William Rehnquist] has done so well.' Wartofsky, a thyroid cancer specialist, said the chief justice's case was 'a big topic' among thyroid experts. 'It's on people's minds' and 'we talk,' he said

OBJECTIVES: The objective of this study was to perform a meta-analysis of the predictive value of microvolt T-wave alternans (MTWA) testing for arrhythmic events in a wide variety of populations. BACKGROUND: Previous studies describing the use of MTWA as a predictor of ventricular tachyarrhythmic events have been limited by small sample sizes and disparate populations. METHODS: Prospective studies of the predictive value of exercise-induced MTWA published between January 1990 and December 2004 were retrieved. Data from each article were abstracted independently by two authors using a standardized protocol. Summary estimates of the predictive value of MTWA were made using a random-effects model. RESULTS: Data were accumulated from 19 studies (2,608 subjects) across a wide range of populations. Overall, the positive predictive value of MTWA for arrhythmic events was 19.3% at an average of 21 months' follow-up (95% confidence interval [CI] 17.7% to 21.0%), the negative predictive value was 97.2% (95% CI 96.5% to 97.9%), and the univariate relative risk of an arrhythmic event was 3.77 (95% CI 2.39 to 5.95). There was no difference in predictive value between ischemic and nonischemic heart failure subgroups. The positive predictive value varied depending on the population of patients studied (p < 0.0001). CONCLUSIONS: Microvolt T-wave alternans testing has significant value for the prediction of ventricular tachyarrhythmic events; however, there are significant limitations to its use. The predictive value of MTWA varies significantly depending on the population studied. Careful standardization is needed for what constitutes abnormal MTWA. The incremental prognostic value of MTWA when used with other methods of risk stratification is unclear

[Jeanna Giese] told her pediatrician, Dr. Howard Dhonau, about the bat shortly before she left Fond du Lac, Dr. Willoughby said. Dr. Dhonau passed on the information to Children's Hospital, where Dr. Willoughby initially was skeptical about the possibility that she had rabies, largely because it is so rare. He learned that laboratory researchers at the Pasteur Institute in Paris had shown that an anesthetic, ketamine, was active against the rabies virus. So Dr. Willoughby proposed giving Jeanna ketamine to induce a deep coma and midazolam, a sedative, to prevent hallucinations. Colour Photo: Rick Wood, Milwaukee Journal Sentinel / Jeanna Giese greets Dr. Rodney Willoughby Jr. The two made medical history when Jeanna contracted rabies from ...; Colour Photo: ...a bat bite and survived -- the first time anyone has lived through the rare illness without vaccination -- thanks to Willoughby's radical treatment involving a drug regimen that put Jeanna into a coma for a week

The booster vaccine for whooping cough, or pertussis, is needed because immunity to it wanes 5 to 10 years after the initial vaccination. But an additional shot will not be needed because the new vaccine would be part of a booster routinely given for diphtheria and tetanus. Many hospitals stopped administering the vaccine because of a controversy over the use of thimerosal, which critics contend causes autism. Health officials say there is no evidence to support the contention. Thimerosal was eliminated from hepatitis B vaccines in 2000, but hospitals have been slow to reinstate orders to administer the vaccine to newborns, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University. The panel rejected adding a routine second dose of chickenpox vaccine for children 4 to 6 years old. The cost, the feasibility of delivering the vaccine to such a large population and the lack of persuasive data about how long immunity of a second dose lasts were cited as reasons

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging threat worldwide. CA-MRSA strains differ from hospital-acquired MRSA strains in their antibiotic susceptibilities and genetic backgrounds. Using several genotyping methods, we clearly define CA-MRSA at the genetic level and demonstrate that the prototypic CA-MRSA strain, MW2, has spread as a homogeneous clonal strain family that is distinct from other CA-MRSA strains. The Panton-Valentine leucocidin (PVL)-encoding genes, lukF and lukS, are prevalent among CA-MRSA strains and have previously been associated with CA-MRSA infections. To better elucidate the role of PVL in the pathogenesis of CA-MRSA, we first analyzed the distribution and expression of PVL among different CA-MRSA strains. Our data demonstrate that PVL genes are differentially distributed among CA-MRSA strains and, when they are present, are always transcribed, albeit with strain-to-strain variability of transcript levels. To directly test whether PVL is critical for the pathogenesis of CA-MRSA, we evaluated the lysis of human polymorphonuclear leukocytes (PMNs) during phagocytic interaction with PVL-positive and PVL-negative CA-MRSA strains. Unexpectedly, there was no correlation between PVL expression and PMN lysis, suggesting that additional virulence factors underlie leukotoxicity and, thus, the pathogenesis of CA-MRSA