Faculty Bibliography

Swedish scientists reported a study supporting the link between the harmless virus, known as GBV-C, and HIV. But the Swedish and American authors disagreed at a meeting in Boston on Thursday about whether GBV-C could cause the apparent benefit or whether it was simply an indicator of something else as yet undetected that might account for the findings. By adding GBV-C to HIV in human blood cells in the laboratory, an American team led by Dr. Jack Stapleton of the University of Iowa found that GBV-C blocked the docking sites on the surface of the CD- 4 blood cell that HIV needs to enter to cause infection. It also found that adding GBV-C led to the production of natural substances called chemokines that are known to inhibit HIV

Swedish scientists reported a study supporting the link between the harmless virus, known as GBV-C, and H.I.V. But the Swedish and American authors disagreed about whether GBV-C could cause the apparent benefit or whether it was simply an indicator of something else -- as yet undetected -- that might account for the variability of H.I.V. infection. By adding GBV-C to H.I.V. in human blood cells in the laboratory, a team led by Dr. Jack T. Stapleton of the University of Iowa found that GBV-C blocked the docking sites on the CD-4 blood cell that H.I.V. needs to enter to cause infection. If further studies show that GBV-C significantly slows the progression of H.I.V., the researchers said a goal might be to identify a protein that could be used to mimic the GBV-C infection to aid H.I.V. patients

In the study, the rate of transmitting H.I.V. was 8.2 per thousand sexual acts in the first five months after a person became infected, and 1.5 per thousand sexual acts in the next year or two, Dr. [Maria J. Wawer] said. The risk then rose sharply, to 4.5 per thousand sexual acts, in the 15 months before death from AIDS. The findings are consistent with what was already understood to be a kind of AIDS cycle: a rise, a dip and then another rise in the amount of H.I.V. in the blood as the infection progresses. Other new data reported at the meeting added to earlier findings suggesting that H.I.V. infections might be on the rise. In part, the concerns reflect outbreaks of syphilis and other sexually transmitted diseases that can correlate with a risk of acquiring H.I.V. Such outbreaks have been reported in a number of cities. That as many as 20 percent of H.I.V.-infected people a year in this country spend time in a correctional facility underscores an urgent need for researchers to find ways to reduce the risk of H.I.V. transmission by departing inmates, Dr. [David A. Wohl] said

OBJECTIVES: To explore whether differences in disease prevalence, disease severity, or emergency department (ED) admission thresholds explain why black persons, Medicaid, and uninsured patients have higher hospitalization rates for ambulatory care sensitive (ACS) conditions. MATERIALS AND METHODS: The National Hospital Ambulatory Care Survey was used to analyze the ED utilization, disease severity (assessed by triage category), hospitalization rates, and follow-up plans for adults with five chronic ACS conditions (asthma, chronic obstructive lung disease, congestive heart failure, diabetes mellitus, and hypertension). The National Health Interview Survey was used to estimate the prevalence of these conditions in similarly aged US adults. RESULTS: Black persons, Medicaid, and uninsured patients make up a disproportionate share of ED visits for these chronic ACS conditions. Cumulative prevalence of these conditions was higher in black persons (33%) compared with white persons (27%) and Hispanic persons (22%), but did not differ among the payment groups. All race or payment groups were assigned to similar triage categories and similar percentages of their ED visits resulted in hospitalization. Black persons and Hispanic persons (odds ratios for both = 0.7), were less likely than white persons, whereas Medicaid and uninsured patients (odds ratios for both = 0.8), were less likely than private patients to have follow-up with the physician who referred them to the ED. CONCLUSIONS: The disproportionate ED utilization for chronic ACS conditions by black persons and Medicaid patients does not appear to be explained by either differences in disease prevalence or disease severity. Follow-up arrangements for black persons, Medicaid, and uninsured patients suggest that they are less likely to have ongoing primary care. Barriers to primary care appear to contribute to the higher ED and hospital utilization rates seen in these groups

Accurate information and an informed perspective could bring the public's fear of smallpox more in line with its real risk. Exaggerating the side effects of a largely safe vaccine is not the best way to treat the fear of the virus

[Jong Wook Lee] received his medical degree from Seoul National University. He received a master's degree in epidemiology and public health in 1981 from the University of Hawaii School of Public Health, where he focused on leprosy work. After he joined WHO in 1983, Lee investigated leprosy in the South Pacific and worked in the agency's regional office in Manila before moving to the Geneva headquarters in 1994 to direct both its vaccines program and its program to stop tuberculosis. Specialists credited Lee for success in further controlling tuberculosis, in part by forming an alliance among 250 countries and nongovernmental organizations. As director-general, Lee said, a major goal would be to develop programs with a greater scientific basis and more accountability

Dr. Jong Wook Lee, a South Korean expert on tuberculosis and vaccines who trained in the United States, was selected Tuesday to head the World Health Organization. Lee has a reputation for being a skilled administrator and a quick study who has learned the inner workings of WHO, a United Nations subagency in Geneva, in his 19 years there. He was nominated as the organization's new director- general by a vote of the 32 members of the organization that make up its executive board. Final election, which is considered a formality, is expected in May, when the entire membership meets. Lee, 57, is believed to be the first Korean to head an international agency. He was selected over Dr. Peter Piot, a Belgian, who is director of the United Nations AIDS program, on the seventh ballot

Dr. Jong Wook Lee, a South Korean epidemiologist and expert on vaccines, tuberculosis and diseases associated with poverty, was selected yesterday to head the World Health Organization. After he joined the W.H.O. in 1983, Dr. Lee investigated leprosy in the South Pacific and worked in the agency's regional office in Manila before moving to Geneva in 1994 to direct its vaccines program, including the effort to eliminate polio, and its program to stop tuberculosis. Dr. Jong Wook Lee, an expert on vaccines, tuberculosis and diseases associated with poverty, has worked for the W.H.O. for 19 years. (Agence France-Presse)

The Bill and Melinda Gates Foundation is giving $200 million to identify critical questions about the leading causes of death in developing countries and to create an international competition for scientists to solve them. The aim is to save many of the millions of lives lost each year to the world's most pressing health problems, like malaria, tuberculosis and nutritional deficiencies, [Gates] said in announcing the grant Sunday at the World Economic Forum meeting in Davos, Switzerland. In speaking there, Gates, founder of Microsoft, underscored the importance of poor health as a handicap to improving the economies of developing countries. In creating the grant, Gates said he was inspired by the success of a German, David Hilbert, who in 1900 challenged his fellow mathematicians to solve 23 problems over the following century