Faculty Bibliography

At times the president took as many as eight medications a day, says the historian, Robert Dallek. A committee of three longtime [John F. Kennedy] family associates, who for decades refused all requests to look at the records, granted Dallek's request, in part because of his 'tremendous reputation,' said one of them, Theodore C. Sorensen, who was the president's special counsel. In The Atlantic, Dallek writes that while Kennedy's secrecy can be taken as 'another stain on his oft-criticized character,' the records also reveal the 'quiet stoicism of a man struggling to endure extraordinary pain and distress.'

The first thorough examination of President John F. Kennedy's medical records, conducted by an independent presidential historian with a medical consultant, has found that Kennedy suffered from more ailments, was in far greater pain and was taking many more medications than the public knew at the time or biographers have since described. At times the president took as many as eight medications a day, says the historian, Robert Dallek. A committee of three longtime Kennedy family associates, who for decades refused all requests to look at the records, granted Dallek's request, in part because of his 'tremendous reputation,' said one of them, Theodore C. Sorensen, who was the president's special counsel

Cangene, by contrast, has a bigger contract but a less urgent time frame. It is to produce up to 100,000 doses for the United States civilian population over five years. Lacking a pool of frozen plasma, it is seeking about 10,000 volunteers like Mr. [Michael Kuring] to be inoculated for smallpox and then bled twice a week for two months. Plasma is spun off their blood and their red cells are returned to them. Each is paid $100 a week, but four donors interviewed in Marietta said money was not a factor. Mr. Kuring, Ralph McKinstry, Albert Casanova, all veterans, and Kathy Eagye, who has a master's degree in public health, said they wanted to help protect others. Ms. Eagye, however, did confess that she so feared a smallpox attack that she volunteered partly to get revaccinated. Ralph McKinstry, recently immunized for smallpox, gives blood to help create a treatment for people who have serious reactions to the vaccine. (Photographs by Erik S. Lesser for The New York Times)(pg. F1); Jacke Grayson, left, gives a smallpox vaccine to Karl Fivecoat, who has provided blood to help create an antidote to the vaccine's side effects. (Erik S. Lesser for The New York Times)(pg. F2)

''We'd have no difficulty recognizing'' the chemical and providing the appropriate care, Dr. [Lewis R. Goldfrank] said. But the Moscow disaster and a theoretical attack on this country differ in crucial ways. If the agent is a narcotic like fentanyl or heroin, victims will probably be calm, their pupils pinpoint size, their breathing and heart rates slow and their blood pressures low. Other types of drugs could produce opposite symptoms. If it is scopolamine, an anti-motion sickness drug that robbers have used to incapacitate victims, people may be delirious. While treatment progresses, toxicologists will use laboratory tests to try to quickly identify the chemical used in the attack. All major cities have equipment to identify or rule out certain classes of chemicals. Many hazardous materials teams carry mass spectrometers and other analytical tools that can screen a large number of chemicals and provide specific identification of an agent, said Jerome M. Hauer, who directs the Office of Public Health Preparedness in the Department of Health and Human Services

The sheer number of medical errors, whether due to poor clinical judgment, laziness, arrogance, false leads, or just plain bad luck, is enough to make any clinician shudder, and none of the errors, of course, manage to enter the official H&P. But the starkest conclusion that materializes when these two recountings of the same events are exhibited side by side is that the standard H&P is inherently, and disastrously, ill equipped to convey the interconnecting and conflicting layers of a patient's experience

We present a short summary of recent observations on the global distribution of the major clades of the Mycobacterium tuberculosis complex, the causative agent of tuberculosis. This global distribution was defined by data-mining of an international spoligotyping database, SpolDB3. This database contains 11708 patterns from as many clinical isolates originating from more than 90 countries. The 11708 spoligotypes were clustered into 813 shared types. A total of 1300 orphan patterns (clinical isolates showing a unique spoligotype) were also detected

Spacer oligonucleotide (spoligotyping) analysis is a rapid polymerase chain reaction-based method of DNA fingerprinting the Mycobacterium tuberculosis complex. We examined spoligotype data using a bioinformatic tool (sequence logo analysis) to elucidate undisclosed phylogenetic relationships and gain insights into the global dissemination of strains of tuberculosis. Logo analysis of spoligotyping data provides a simple way to describe a fingerprint signature and may be useful in categorizing unique spoligotypes patterns as they are discovered. Large databases of DNA fingerprint information, such as those from the U.S. National Tuberculosis Genotyping and Surveillance Network and the European Concerted Action on Tuberculosis, contain information on thousands of strains from diverse regions. The description of related spoligotypes has depended on exhaustive listings of the individual spoligotyping patterns. Logo analysis may become another useful graphic method of visualizing and presenting spoligotyping clusters from these databases

In 1998-1999, the Baltimore TB control program detected a cluster of 21 tuberculosis (TB) cases. Patients reported frequent travel to various East Coast cities. An investigation was conducted to determine whether transmission of the same Mycobacterium tuberculosis strain was occurring in these other localities. A collaborative investigation among federal, state, and local TB controllers included TB record reviews, interviews of patients, and restriction fragment length polymorphism (RFLP) analysis of selected M. tuberculosis isolates from diagnosed TB patients in several cities in 1996-2001. A national TB genotyping database was searched for RFLP patterns that matched the outbreak pattern. Eighteen additional outbreak-related cases were detected outside of Baltimore-the earliest diagnosed in New Jersey in 1996, and the most recent in New York City in late 2001. The outbreak demonstrates the need for strategies to detect links among patients diagnosed with TB across multiple TB control jurisdictions