Faculty Bibliography

As H.I.V., the AIDS virus, spreads further, Africa will face ''an unprecedented crisis and a challenge never before seen since the advent of slavery,'' Dr. Peter Piot, the executive director of the Geneva-based United Nations AIDS program, said at a news conference in Addis Ababa, according to Reuters. The United Nations said the report was intended to improve decision-making and deepen public understanding of the possible course of the AIDS epidemic in Africa by 2025, when ''no one under the age of 50 in Africa will be able to remember a world without AIDS.'' By then, 89 million more people in Africa could be infected with H.I.V., under the worst circumstances, the United Nations said. An estimated 25.4 million people in Africa are infected now

In lifting on Wednesday their suspension of Chiron's manufacturing license, British regulators said the company had made 'satisfactory progress' in rectifying sanitary and quality control problems. British health authorities had suspended the license of the Liverpool plant on Oct. 5, depriving the United States of nearly 50 million doses, or about half the supply of vaccine expected for the current winter. The sudden and severe shortfall caused huge lines at flu clinics across the United States last fall and set off a wholesale examination of what many experts called the country's fragile vaccine supply system. It also brought new criticism of the Food and Drug Administration for not following up on safety problems at the factory and therefore being caught by surprise by the British government's action

The incidence of influenza steadily increased in January and February and has not clearly peaked, the Centers for Disease Control and Prevention said

In the third world, measles, which appears as a rash and fever, killed millions of children each year as recently as a decade ago. And many of the 30 million who survived were left blind or with complications that included brain damage and other disabilities. Measles also causes ear infections and pneumonia. Measles tends to be more severe among poorly nourished children, particularly those with low levels of vitamin A. Recommendations call for giving children with measles a dose of vitamin A supplement for two successive days to help prevent eye damage and blindness

The agency also says it is now in closer contact with its counterparts in Britain and other countries. Some members of Congress had criticized the agency for not following up on problems it had found in previous years at the Chiron plant and for therefore being caught by surprise when the British suspended the license. After the British action, the F.D.A. conducted its own inspection and agreed with the British decision that the vaccine's safety could not be guaranteed. It issued Chiron a warning letter. So the American flu vaccine business may not be the moneymaker Chiron envisioned when it entered that business in 2003 by paying $878 million to acquire PowderJect Pharmaceuticals, the British company that owned the Liverpool plant. After its license was suspended, Chiron assembled a team of 70 insiders and outside experts to fix the problem. Just last week, John Lambert, who had headed Chiron's overall vaccine business, resigned. The company is still facing investigations by the Justice Department and the Securities and Exchange Commission

Dr. Thomas R. Frieden, the commissioner of the New York City Department of Health and Mental Hygiene, has reported that the man has the first diagnosed strain of H.I.V. that shows both resistance to multiple classes of antiretroviral drugs and a rapid progression from infection to AIDS. Doctors have in the past reported each component separately, but not in combination. For one, Case B could have infected any number of other people, some never tested for H.I.V., and any of them may have infected Case A. Some contacts may not be openly gay. Also, the identification of anonymous sex contacts solicited through the Internet may come only from a patient's recalling a physical characteristic that the medical detectives must then track down. Many among the 3,900 AIDS experts who participated in the 12th Annual Retrovirus Conference in Boston last week praised Dr. Frieden for sending a warning to people to practice safer sex. As antiretroviral therapy becomes more widely available, drug resistant H.I.V. is likely to spread, speakers said

The article suggests that a baby whose mother is using SSRIs may suffer withdrawal symptoms including seizures when the child is born and abruptly stops getting the drug through the mother's bloodstream. But the study -- based on a survey of reports of adverse drug reactions -- contains no definitive evidence of this effect. There has been no clinical trial comparing infants whose moms did and didn't take Paxil during pregnancy. (Paxil is available to pregnant women by prescription, though manufacturer GlaxoSmithKline says on its Web site that some complications, including seizures, have been reported in babies whose mothers had used the drug during pregnancy.) More important, numerous studies have documented the adverse effects of maternal depression on fetal and infant well-being. Untreated depression during pregnancy has been associated in several studies with premature labor and low birth weight. A Danish study published in The Lancet in 2000 reported that maternal emotional distress led ultimately to congenital malformations. A study from Emory University in 2001 revealed that infants whose mothers had been depressed during pregnancy showed a higher than normal stress response at the age of 6 months. Depressed women are also at higher risk for using alcohol, drugs and tobacco, as well as for very poor diet and sleep habits, all of which have been shown to impair fetal development more than antidepressants do. [Shari Lusskin] has identified several risk factors for depression during pregnancy, including a history of depression, a family history of mental illness, a lack of social support from spouse and friends, and anxiety about the fetus, especially if the pregnancy is unplanned. Screening for such factors is vital, Lusskin said

We studied 6,141 consecutive, asymptomatic, nondiabetic patients who underwent electron beam tomography and explored the interaction between metabolic risk factors (RFs) and premature family history (FH) of coronary heart disease (CHD) in predicting the presence and severity of coronary arterial calcium (CAC). In the presence of >2 metabolic RFs, patients with a positive FH of premature CHD had a significantly higher prevalence of any CAC, CAC >/=100, and CAC >/=75th age-gender percentile than those without a FH of CHD. Our study demonstrated that a familial propensity to subclinical atherosclerosis interacts with the presence of >/=2 metabolic RFs, magnifying the risks for those exposed to both.

Rearrangements involving the MLL gene on chromosome band 11q23 are a hallmark of therapy-related acute myeloid leukemias following treatment with topoisomerase II poisons including etoposide. Therapy-related and de novo genomic translocation breakpoints cluster within a well-characterized 8.3-kb fragment of MLL. Repair of etoposide-stabilized DNA topoisomerase II covalent complexes may initiate MLL rearrangements observed in patients. We used a culture system of primary human hematopoietic CD34+ cells and inverse polymerase chain reaction to characterize the spectrum of stable genomic rearrangements promoted by etoposide exposure originating within an MLL translocation hotspot in therapy-related leukemia. Alterations to the region were observed at a readily detectable frequency in etoposide-treated cells. Illegitimate repair events after minimal repair included MLL tandem duplications and translocations, with minor populations of deletions or insertions. In stably repaired cells that proliferated for 10 to 14 days, the significant majority of illegitimate events were MLL tandem duplications, and several deletions, inversions, insertions, and translocations. Thus, etoposide promotes specific rearrangements of MLL consistent with the full spectrum of oncogenic events identified in leukemic samples. Although etoposide-initiated rearrangements are frequent, only a small subset of translocations occurs in cells that proliferate significantly.