Faculty Bibliography

The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. Dr. Thomas R. Frieden, the New York City health commissioner, said he expected the impact to be severe. ''While we appreciate the federal government's support for bioterrorism preparedness, the vaccination drive will be extraordinarily disruptive to our day-to-day work of protecting the public's health,'' Dr. Frieden said. ''This is the unfortunate price we are paying for the level of preparedness it appears we need.'' The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health- care and emergency workers will be vaccinated. In the second, up to 10 million health-care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine

Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President Bush's federal smallpox vaccination program. The Bush administration requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving the vaccinations in two stages. In the first, expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police, firefighters and emergency medical technicians will be offered the vaccine. Dr. Thomas R. Frieden, the New York City health commissioner, said he expected the impact to be severe. 'While we appreciate the federal government's support for bioterrorism preparedness, the vaccination drive will be extraordinarily disruptive to our day-to- day work of protecting the public's health,' Frieden said

Many health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President Bush's federal smallpox vaccination program. The Bush administration has requested that health departments administer smallpox vaccine to health-care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health-care and emergency workers will be vaccinated. In the second, up to 10 million health-care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine

Dr. James Crucetti, Albany County public health commissioner, said he is concerned to hear other health departments are considering cutting programs to cover smallpox vaccination costs. The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

BACKGROUND & AIMS/OBJECTIVE:A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list. METHODS:The MELD model predicts liver disease severity based on serum creatinine, serum total bilirubin, and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis. In this study, we prospectively applied the MELD score to estimate 3-month mortality to 3437 adult liver transplant candidates with chronic liver disease who were added to the OPTN waiting list at 2A or 2B status between November, 1999, and December, 2001. RESULTS:In this study cohort with chronic liver disease, 412 (12%) died during the 3-month follow-up period. Waiting list mortality increased directly in proportion to the listing MELD score. Patients having a MELD score <9 experienced a 1.9% mortality, whereas patients having a MELD score > or =40 had a mortality rate of 71.3%. Using the c-statistic with 3-month mortality as the end point, the area under the receiver operating characteristic (ROC) curve for the MELD score was 0.83 compared with 0.76 for the Child-Turcotte-Pugh (CTP) score (P < 0.001). CONCLUSIONS:These data suggest that the MELD score is able to accurately predict 3-month mortality among patients with chronic liver disease on the liver waiting list and can be applied for allocation of donor livers.

5-Fluorouracil (5-FU) is the most routinely administered drug in the treatment of colon cancer. The main mechanism of the drug is not completely understood and its method of administration has been strongly disputed. A 24-hour infusion of 5-FU has clinically yielded better response rates and lower toxicities in comparison to bolus administration, but an exploration into possible mechanisms needs to be performed. Experiments were conducted with two 5-FU resistant cell lines where cytotoxicity, thymidylate synthase (T.S.) activity, thymidine kinase (T.K.) activity, DNA and RNA incorporation, and T.S. expression were contrasted between a 10 microM/24 hour administration of 5-FU (simulating continuous exposure) and a 100 microM/1 hour schedule (simulating bolus administration). After 6 days from the initial exposure, the 10 microM/24 hour schedule (schedule A) inhibited more cell growth than the 100 microM/1 hour regimen (schedule B) by more than 38% and 17% in the two cell lines. After the 6-day observation, schedule A inhibited twice as much T.S. activity as schedule B. Incorporation of [14C]-5-FU into DNA and total RNA was higher in cells exposed to schedule A in comparison to schedule B over the 6 days. T.S. expression and T.K. activity patterns were variable over time. Thus, the exposure of 10 microM/24 hour 5-FU results in superior cytotoxicity when compared to a 100 microM/1 hour regimen and its effectiveness may be explained mechanistically by T.S. activity and DNA and RNA incorporation

PCR-based assays were used to evaluate agr locus nucleotide polymorphism for the identification of agr autoinducer receptor specificity groups within a population of Staphylococcus aureus isolates colonizing children and their guardians. All isolates could be assigned to one of three major agr groups that had similar prevalences, regardless of whether isolates were implicated in transmission of S. aureus within families. Among healthy carriers, agr groups I to III appear to be equally fit, which may reflect selection for the coexistence of S. aureus strains in a population

Staphylococcus aureus produces a wide array of cell surface and extracellular proteins involved in virulence. Expression of these virulence factors is tightly controlled by numerous regulatory loci, including agr, sar, sigB, sae, and arl, as well as by a number of proteins with homology to SarA. Rot (repressor of toxins), a SarA homologue, was previously identified in a library of transposon-induced mutants created in an agr-negative strain by screening for restored protease and alpha-toxin. To date, all of the SarA homologues have been shown to act as global regulators of virulence genes. Therefore, we investigated the extent of transcriptional regulation of staphylococcal genes by Rot. We compared the transcriptional profile of a rot agr double mutant to that of its agr parental strain by using custom-made Affymetrix GeneChips. Our findings indicate that Rot is not only a repressor but a global regulator with both positive and negative effects on the expression of S. aureus genes. Our data also indicate that Rot and agr have opposing effects on select target genes. These results provide further insight into the role of Rot in the regulatory cascade of S. aureus virulence gene expression