Faculty Bibliography

The vaccine, sold as Menactra by Sanofi Pasteur, protects against infections caused by meningococcal bacteria. Such infections include a form of meningitis that can be rapidly fatal. In a third recommendation, the agency recommended that all college freshmen living in dormitories be immunized against meningococcal disease. The new recommendation strengthened an earlier one that said freshmen should consider such protection. Freshmen living in close quarters of dormitories are at a higher risk for meningococcal disease compared with peers the same age who are not at college

The study's authors, from Tufts University, said it was prudent for doctors to consider prescribing rival statins instead of Crestor as a first therapy to prevent heart attacks and stroke. They said Crestor could be useful for high-risk patients for whom rival statins did not lower cholesterol levels to recommended ranges

Dr. [Sandra J. Horning], who practices and does research on lymphomas at Stanford, wanted to be a doctor since she was 14. Her father died of cancer when she was 21 and a medical student. Her mother has survived two types of cancer. That family experience ''helped me in a way understand and perhaps be better prepared to deal with some of the emotional issues that are related to cancer diagnosis, treatment and survival,'' Dr. Horning said. ''But at the same time I thought about my career,'' Dr. Horning said. ''Medicine is more than a career. For me it is a passion.'' As an oncologist, she was better informed than other people. Still, she said, she sought opinions from breast cancer specialists elsewhere, and she avoided directing her care. So she bought a wig. Her patients, friends and family, said Dr. Horning, who is a blond, ''saw me as a redhead.'' Dr. Horning said that in caring for patients she placed communications at the top of the list. The reason, she said, is that while she was training to become an oncologist, a patient told her that whenever Dr. Saul A. Rosenberg, Dr. Horning's mentor, entered the room, his presence made that seriously ill patient feel better

The study's authors, from Tufts University, said it was prudent for doctors to consider prescribing rival statins instead of Crestor as a first therapy to prevent heart attacks and stroke. They and other experts like Dr. Valentin Fuster, chief of cardiology at Mount Sinai Medical Center, said Crestor could be useful for high-risk patients for whom rival statins did not lower cholesterol levels to recommended ranges. After an exhaustive review of the same information used by Dr. [Richard H. Karas]'s team and Public Citizen, the drug agency concluded that ''all of the available evidence'' showed that Crestor had no greater risk of muscle toxicity or serious kidney damage than the rival statins Lipitor, Pravachol and Zocor. Patients taking Crestor were eight times more likely to develop rhabdomyolysis, kidney failure or spillage of protein in the urine than patients taking Pravachol, 6.5 times more likely to develop such complications than patients taking Lipitor, and 2.2 times more likely than those taking Zocor

The governing body, the World Health Assembly, also said it favored the idea of sending small fragments of the smallpox virus to other laboratories to try to develop better diagnostic tests for the virus. But before any experiments proceed, the assembly said, researchers must provide details about the experiments and planned security precautions. The assembly, representing 192 countries, also approved the health agency's work to create a global reserve of 33.5 million doses of vaccine to prevent smallpox, which killed about a fourth of those infected, if the virus is somehow reintroduced

My wife was on the verge of delivering. With the nurses trying to stop me, I quickly wheeled her past the desk to a delivery room. My wife positioned herself on the table while I rushed to find an obstetrician -- any obstetrician. Fortunately, a nurse was helping my wife into a gown and getting her ready. Just then an older obstetrician whom I'd never seen before ran into the room, donned gloves and gown and, less than five minutes later, delivered a healthy child. For the first time -- this was our third child -- I wasn't asked to cut the newborn's umbilical cord. Our own obstetrician came 10 minutes later and delivered the afterbirth. I wondered if our difficulties were some kind of divine punishment for my own professional insensitivities. As a physician in a busy practice, had I really listened to my patients who complained that they weren't treated in a timely manner? That there were too many forms to fill out? That I had scared them unnecessarily about a possible illness? Patients had good reason to be frightened, and I was getting a glimpse of this now. But regular patients and their families can have it much worse than I did. Even though the chief resident had treated me disdainfully, she had been influenced enough by my rank to participate in our son's birth. And perhaps it had been professional courtesy that motivated this unknown doctor to rush in to save the day, before our regular obstetrician arrived

The W.H.O., a United Nations agency in Geneva, eradicated the disease in 1980. Since then two laboratories -- one at the Centers for Disease Control and Prevention in Atlanta and the other in Kostsovo, Russia -- have kept stocks of the virus frozen with the organization's permission. All research on the virus has been limited to the two laboratories, where scientists wear protective gowns and use the strictest precautions to prevent accidental infection and escape of the virus. The Bush administration and some health officials and smallpox experts have expressed fear that terrorists may have obtained smallpox virus from Russia or that scientists in some countries may have kept the virus without telling the W.H.O. On the advice of the agency's director general, Dr. Lee Jong Wook, the assembly told the advisory committee to reconsider its recommendation to allow scientists to insert a gene from the smallpox virus into closely related viruses like camelpox. Such experiments could theoretically help in finding ways to treat smallpox

The rate of cancer recurrence for women in the study who were assigned to follow a low-fat diet was reduced more than 20 percent over five years, the investigators found. Of 975 women assigned to a low-fat diet, 96, or 9.8 percent, had recurrences. But cancer returned for 181 of 1,462 women, or 12.4 percent, who were assigned to maintain their usual diet. Dr. Larry Norton, a breast cancer expert at Memorial Sloan- Kettering Cancer Center in New York City, one of the centers in the study, said the results had made him change his advice. 'Before this I was saying there's no reason not to eat a low-fat diet,' Norton said, adding, 'Now I am saying there is a reason to eat to low-fat diet.'

Women in the study who were assigned to follow a low-fat diet had more than a 20 percent reduction in their rate of recurrence over five years, the investigators found. Of 975 women assigned to a low-fat diet, 96, or 9.8 percent, had recurrences. But 181 of 1,462 women, or 12.4 percent, who were assigned to maintain their usual diet had their cancer return. The best way to find out whether fat in the diet makes a difference would be to randomly assign thousands of cancer patients to follow, or not follow, a low-fat diet. But many investigators questioned whether it would even be possible to do such a study. Would women really adhere to their assigned diet for years on end and, in particular, would they stay with a diet so low in fat? It enrolled 2,437 postmenopausal women with early stage breast cancer. Of them, 975 were assigned to a diet so low in fat that, Dr. [Rowan T. Chlebowski] said, it was about as low as possible without being a vegetarian diet. They consumed on average 33.3 grams of fat a day. The 1,462 women in the control group, who were instructed to follow their usual diet, consumed 51.3 grams of fat a day