Faculty Bibliography

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Dr. Peter Piot, the director of the U.N. AIDS program. Earlier, five-year projections underestimated the extent of the spread of HIV, the AIDS virus, in Africa by one-third to one-half, Piot and Dr. Neff Walker, a U.N. epidemiologist, said in news conference conducted by telephone

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Peter Piot, the director of the U.N. AIDS program. Earlier five-year projections underestimated the extent of the spread of HIV, the AIDS virus, in Africa by one-third to one-half, Piot and Neff Walker, a U.N. epidemiologist, said

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-H.I.V. drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-H.I.V. treatment at the end of 2001. In Botswana, nearly 39 percent of adults are H.I.V.-infected, a rise of 3 percent since 2000. One-third of adults in two other African countries, Zimbabwe and Swaziland, were infected at the end of 2001, up from about 25 percent in 1999. In Cameroon, H.I.V. transmission is accelerating rapidly, rising to 12 percent now compared with a range of 4.5 to 9 percent from 1988 through 1996. In Indonesia, the world's fourth-most-populous country, infection rates are now rising rapidly following a decade of consistently low infections rates. New information suggests that there has been a surge in H.I.V. infections among prostitutes in some areas of Indonesia. The fastest growing epidemic is in Russia and Eastern Europe, where H.I.V. is now moving from injecting drug users into the wider population, Dr. [Peter Piot] said. In Ukraine, nearly one in four new infections now occurs through heterosexual sex

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Dr. Peter Piot, the director of the U.N. AIDS program. 'Nations with acceleration epidemics must move quickly to adapt proven responses from countries that have succeeded in turning the epidemic around,' Piot said. 'The essential elements of these are frank, widespread HIV prevention, including access to voluntary counseling and testing, leadership at the highest levels of government, and access to care for people infected and affected by AIDS.'

BARCELONA, Spain -- AIDS will claim an additional 65 million lives by 2020, more than triple the number who died in the first 20 years of the epidemic, unless more countries vastly expand their prevention programs, according to the first long-range forecast of the epidemic from the United Nations. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Dr. Peter Piot, the director of the U.N. AIDS program. 'Nations with acceleration epidemics must move quickly to adapt proven responses from countries that have succeeded in turning the epidemic around,' he said. 'The essential elements of these are frank, widespread HIV prevention, including access to voluntary counseling and testing, leadership at the highest levels of government, and access to care for people infected and affected by AIDS.'

BACKGROUND: Statins exert antiinflammatory and antiproliferative actions independent of cholesterol lowering. To determine whether these actions might affect neointimal formation, we investigated the effect of simvastatin on the response to experimental angioplasty in LDL receptor-deficient (LDLR-/-) mice, a model of hypercholesterolemia in which changes in plasma lipids are not observed in response to simvastatin. METHODS AND RESULTS: Carotid artery dilation (2.5 atm) and complete endothelial denudation were performed in male C57BL/6J LDLR-/- mice treated with low-dose (2 mg/kg) or high-dose (20 mg/kg) simvastatin or vehicle subcutaneously 72 hours before and then daily after injury. After 7 and 28 days, intimal and medial sizes were measured and the intima to media area ratio (I:M) was calculated. Total plasma cholesterol and triglyceride levels were similar in simvastatin- and vehicle-treated mice. Intimal thickening and I:M were reduced significantly by low- and high-dose simvastatin compared with vehicle alone. Simvastatin treatment was associated with reduced cellular proliferation (BrdU), leukocyte accumulation (CD45), and platelet-derived growth factor-induced phosphorylation of the survival factor Akt and increased apoptosis after injury. CONCLUSIONS: Simvastatin modulates vascular repair after injury in the absence of lipid-lowering effects. Although the mechanisms are not yet established, additional research may lead to new understanding of the actions of statins and novel therapeutic interventions for preventing restenosis.

In part it is the sleepless nights that form a doctor's mettle. Essential skills learned under military-type rigor are not soon forgotten and are essential to good doctoring. And many specialties require emergency middle-of-the-night calls throughout a doctor's career--it is the on-call shift that prepares a young doctor for the later demands of practice. A greater concern than hours is supervision. Eighteen years ago in New York a young woman named Libby Zion was diagnosed and treated improperly because of inadequately supervised--not sleep-deprived-- residents. She died. The result of this case was New York's laws to limit residency hours, yet adequate supervision, the real problem, was not ensured. This year, an undertrained doctor at a New York teaching hospital was left in charge of a ward of sick liver transplant donors and recipients, and a liver donor died

BACKGROUND: Hypercholesterolemia is a major cardiovascular risk factor, and cholesterol awareness is important in both clinical practice and in public health. We evaluated the validity of self-reported hypercholesterolemia and identified determinants of validity. METHODS: The study design was a cross-sectional survey, from 1988 to 1994, of adult participants (N=8236) from the Third National Health and Nutrition Examination Survey for whom self-report of hypercholesterolemia and serum measurement were available. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for self-reported hypercholesterolemia were calculated using total cholesterol > or =5.17 mmol/L (200 mg/dL) and/or taking cholesterol-lowering medication as the criterion standard. RESULTS: Overall test characteristics for self-report were sensitivity, 51%; specificity, 89%; PPV, 87%; and NPV, 55%. Sensitivity of self-report was higher among older subjects and non-Hispanic whites, specificity was higher among subjects with >12 years of education, PPV was higher in older subjects, and NPV was higher in younger subjects and in those with >12 years of education. Using higher cholesterol thresholds to define hypercholesterolemia led to higher sensitivity, lower specificity, lower PPV, and higher NPV. Sociodemographic and anthropometric predictors of validity were identified by logistic regression. CONCLUSIONS: Due to low sensitivity, self-reported hypercholesterolemia should be used with caution, both during the patient encounter and for surveillance of trends in hypercholesterolemia in the absence of measured cholesterol levels. Specificity is consistently much higher than sensitivity. The high PPV may be of use in certain clinical situations. Such validation studies should form the foundation for future research based on self-report

The origin of replication (oriC) region in some clinical strains of Mycobacterium tuberculosis is a hot spot for IS6110 elements. To understand how clinical strains with insertions in oriC can replicate their DNA, we characterized the oriC regions of some clinical strains. Using a plasmid-based oriC-dependent replication assay, we showed that IS6110 insertions that disrupted the DnaA box sequence CCGTTCACA abolished oriC activity in M. tuberculosis. Furthermore, by using a surface plasmon resonance technique we showed that purified M. tuberculosis DnaA protein binds native but not mutant DnaA box sequence, suggesting that stable interactions of the DnaA protein with the CCGTTCACA DnaA box are crucial for replication of oriC plasmids in vivo. Replacement by homologous recombination of the CCGTTCACA DnaA box sequence of the laboratory strain M. tuberculosis H37Ra with a mutant sequence did not result in nonviability. Together, these results suggest that M. tuberculosis strains have evolved mechanisms to tolerate mutations in the oriC region and that functional requirements for M. tuberculosis oriC replication are different for chromosomes and plasmids

WASHINGTON.- El Presidente estadounidense George W. Bush transfirio los poderes de la Presidencia al Vicepresidente Dick Cheney mientras se encontraba bajo un fuerte sedante durante una colonoscopia en Campo David, informo la Casa Blanca. Sin embargo, Alberto Gonzalez, asesor de la Casa Blanca, dijo que Bush no reanudo oficialmente sus poderes hasta las 8:24 horas, hora en que termino la transmision por fax de la carta destinada a Cheney, al Presidente de la Camara y al presidente temporal del Senado, como lo requiere la Constitucion