Faculty Bibliography

As polio cases surge in Nigeria and the virus spreads to other countries, West and Central Africa are on the brink of the largest polio epidemic in recent years, alarmed officials of the World Health Organization and UNICEF said yesterday. Allegations about impurities in the vaccine have caused alarm and confusion among many people in Nigeria and elsewhere. Tests of the vaccine have refuted such claims, said Dr. David L. Heymann, the director of the World Health Organization's polio eradication program. The vaccine purchased by UNICEF meets the organization's standards and has been used safely to eliminate the disease in many other countries. In addition to Sudan, the virus has spread from Nigeria to the following nine countries since last August: Benin, Botswana, Burkina Faso, Cameroon, Central African Republic, Chad, Ghana, Ivory Coast and Togo

Cipla, an Indian company that has been in the forefront of getting generic drugs approved for use in poor countries, made the two generic drugs, lamivudine, which is also known as 3TC, and zidovudine, which is also known as AZT. The action followed the Bush administration's recent announcement of a significant shift in its AIDS policy to allow the purchase of cheaper generic drugs for Africa and the Caribbean. Cipla said the situation was 'on the mend' and that it expected its drugs to be back on the list within weeks. Reached by telephone in London, [Yusuf Hamied] said that lamivudine had been tested for bioequivalency in a laboratory in the United States and approved by the Food and Drug Administration, and that he would submit that data to the WHO. He said that the testing had been done for the U.S. drug agency because Cipla hoped to sell generic lamivudine when the U.S. patent expired in 2006

In 1980, despite his mother's history of senility, it was only a hypothetical possibility that Reagan would develop Alzheimer's. The disease's hereditary pattern was, and is, not precisely known. As it turned out, the disease is believed to have afflicted Reagan's brother, Neil, too. Whether their mother's dementia was from strokes or Alzheimer's, or both, is not known. No one can be absolutely certain when Reagan's Alzheimer's began. Then, as now, blood and other practical laboratory tests did not exist to detect the initial stages of Alzheimer's, which takes years to damage the brain, or to distinguish it from other forms of dementia. Lacking a test, Alzheimer's is estimated to account for half of all dementia cases. Strokes and other diseases cause the remainder. Doctors did not start giving Reagan psychological tests that can point to Alzheimer's until after he was thrown from a horse in Mexico in 1989, and suffered a subdural hematoma that was removed surgically. Initial tests did not show evidence of Alzheimer's, but subsequent ones, performed around 1993, did, his doctors have said

Cipla, an Indian company that has been in the forefront of getting generic drugs approved for use in poor countries, made the two generic drugs, lamivudine, which is also known as 3TC, and zidovudine, which is also known as AZT. The problem was detected during an inspection of an independent laboratory that Cipla had hired to conduct bioequivalence studies among volunteers whose blood had been tested after they took the generic drugs. The tests were devised to determine whether the concentration of the generic drug in the blood was the same as in its patented counterpart. Dr. [Lembit Rago] did not provide the name of the company that did the testing. Cipla's chairman, Dr. Yusuf K. Hamied, said the problem was due to inadequate record keeping in the testing laboratory in Bombay. Dr. Hamied, reached by telephone in London, said that Cipla's lamivudine has been tested for bioequivalency in a laboratory in the United States and approved by the Food and Drug Administration and that he would submit that data to the health agency

In 1980, despite his mother's history of senility, it was only a hypothetical possibility that Mr. Reagan would develop Alzheimer's. The disease's hereditary pattern was, and is, not precisely known. As it turned out, the disease is believed to have afflicted Mr. Reagan's brother, Neil, too. Whether their mother's dementia was from strokes or Alzheimer's, or both, is not known. No one can be absolutely certain when Mr. Reagan's Alzheimer's began. Then, as now, blood and other practical laboratory tests did not exist to detect the initial stages of Alzheimer's, which takes years to damage the brain, or to distinguish it from other forms of dementia. Lacking a test, Alzheimer's is estimated to account for half of all dementia cases. Strokes and other diseases cause the remainder. Doctors did not start giving Mr. Reagan psychological tests that can point to Alzheimer's until after he was thrown from a horse in Mexico in 1989, and suffered a subdural hematoma that was removed surgically. Initial tests did not show evidence of Alzheimer's, but subsequent ones, performed around 1993, did, his doctors have said

As HIV therapy becomes available to more people in poor countries, prevention may be neglected and even more cases may develop, a team of global leaders working to combat AIDS warned Thursday. The report says a shift in prevention strategies is needed to avoid repeating mistakes made in wealthy nations. After more potent combination anti-HIV drugs began to be used in rich countries in 1996, the same prevention messages were continued, even though the new therapies had made some obsolete

As H.I.V. therapy becomes available to more people in poor countries, prevention may be neglected and even more cases may develop, a team of AIDS experts working to combat the disease warned in a report issued yesterday. The report says a shift in prevention strategies is needed to avoid repeating mistakes made in wealthy nations. After more potent combination anti-H.I.V. drugs began to be used in rich countries in 1996, the same prevention messages were continued, even though the new therapies had made some obsolete. The team also urged more programs to change behavior that spreads H.I.V. Such programs, it said, should discourage sex at an early age; promote monogamy and sexual abstinence; and encourage safer behavior by those who inject drugs. Fewer than one in five people at high risk of becoming infected now have access to such interventions

It was about two years ago, Reagan's former doctor recalled. He had gone to visit the Reagan family at their house in Los Angeles. It was a typically glorious California day, and [John E. Hutton], a retired Army brigadier general who had been one of Reagan's White House physicians, was there with his daughter, Beth Shiau, a Navy neonatal nurse. As he recalled, the Rev. Billy Graham was there, too. [Nancy Reagan] was very protective of her husband's privacy during his final illness, and Hutton was one of the rare visitors to see Reagan in that period. Hutton said he had agreed to speak in a desire to inform the public about Alzheimer's disease and about 'the human side of Mr. Reagan.' He said Reagan's death on Saturday came on fairly quickly, in what had been a relatively stable course of chronic Alzheimer's disease, possibly after food inhaled into his lungs led to aspiration pneumonia. Though Hutton said he did not know for sure how Reagan had died because he had not yet talked to Nancy Reagan, he and experts on Alzheimer's disease not connected to Reagan's case said it was logical to assume that aspiration was involved because it is the way many Alzheimer's patients die, even with the best of nursing care

Dr. [John E. Hutton] stopped formally treating Mr. Reagan when he left the White House in 1989. But after the former president announced that he had Alzheimer's disease in 1994, Dr. Hutton stayed with him a number of times, each for a week or so, to give Mrs. Reagan some relief. He spoke with her often; the last time was just last month. Mrs. Reagan was very protective of her husband's privacy during his final illness, and Dr. Hutton was one of the rare visitors to see Mr. Reagan in that period. Dr.. Hutton said he had agreed to speak in a desire to inform the public about Alzheimer's disease and about ''the human side of Mr. Reagan.'' He said Mr. Reagan's death on Saturday came on fairly quickly, in what had been a relatively stable course of chronic Alzheimer's disease, possibly after food inhaled into his lungs led to aspiration pneumonia. Though Dr. Hutton said he did not know for sure how Mr. Reagan had died because he had not yet talked to Mrs. Reagan, he and experts on Alzheimer's disease not connected to Mr. Reagan's case said it was logical to assume that aspiration was involved because it is the way many Alzheimer's patients die, even with the best of nursing care