Faculty Bibliography

With the agreement of Mr. Tools's wife, Carol, and a retired anesthesiologist who had been appointed as an advocate for Mr. Tools, Dr. [Robert D. Dowling] instructed engineers to override safety commands in a computer to stop the AbioCor mechanical heart. Until then, the device had beat flawlessly more than 20 million times inside Mr. Tools. Before receiving the implant, Mr. Tools was nearly bedridden from end-stage heart failure. He had lost more than 50 pounds, mostly muscle, and had difficulty even raising his head. Heart attacks had left such extensive scarring that the two main pumping chambers of his heart were failing badly, and his lungs were full of fluid. A formula used to predict survival in heart failure patients showed that statistically, Mr. Tools had an 80 percent chance of dying within 30 days. On Nov. 11, Mr. Tools suffered a major stroke that paralyzed the right side of his body and impaired his speech. The stroke was due to a blood clot that may have come from the AbioCor heart. The AbioCor was removed in an autopsy yesterday, and a detailed examination may provide clues to the origin of the stroke

Controversy has surrounded the death of Eleanor Roosevelt in 1962. There has been a persistent sense that doctors missed the diagnosis of miliary tuberculosis, thereby jeopardizing her life. This article, using Roosevelt's medical chart and other previously unreviewed documents, revisits her illness and death. What disease actually killed Eleanor Roosevelt? Did her physicians miss the diagnosis? These questions are of particular importance in light of the recent Institute of Medicine report estimating that almost 100,000 Americans die each year from medical mistakes. Why has the possibility of error clouded the care of Roosevelt for almost 40 years? What can Roosevelt's case reveal about ongoing efforts to reduce mistakes in clinical practice?

This paper attempts to answer a series of questions regarding the interaction of income and birth weight across generations. First, does the effect of the income of a mother during her pregnancy on her infant's birth weight depend on the family's birth weight history (genetic predisposition)? Second, does the effect of low birth weight status on adult life chances depend on income during early childhood? These questions have implications for the way we envision the biological and social worlds as interacting across generations. To address these issues, this study uses intergenerational data from the Panel Study of Income Dynamics, survey years 1968 through 1992. Results of sibling comparisons (family-fixed-effects models) demonstrate that maternal income has a significant impact on birth weight for those infants who are already at high risk hereditarily (i.e., who have a low birth weight parent). However, it is not clear whether income acts as a developmental buffer for low birth weight infants as their lives progress. These findings suggest the existence of biosocial interactions between hereditary predisposition and socio-economic environment.

OBJECTIVES: This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. METHODS: Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. RESULTS: The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gunshot wounds, and sexual assault. CONCLUSIONS: The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians

The Sept. 11 attacks dealt ''a major blow to the global AIDS agenda'' because fears of terrorism displaced AIDS in the political dialogue in countries affected by H.I.V. and made it harder to get contributions to a fund that the United Nations has created for AIDS, tuberculosis and malaria, Dr. [Peter Piot] said. Disparities in H.I.V. rates are striking. Sixteen African countries have rates exceeding 10 percent among adults. But 119 countries have rates of less than 1 percent. Although H.I.V. came to Asia in the 1990's, it has infected 7.1 million people. This year, for the first time, new infections in Asia exceeded one million. Prevalence rates exceed 1 percent in Cambodia, Myanmar and Thailand. ''Few countries are acting vigorously enough to protect sex workers and clients'' from H.I.V., Dr. Piot said. ''Yet, it is from the comparatively small pool of sex workers first infected by their clients that H.I.V. steadily enters the larger pool of still-uninfected clients who eventually transmit the virus.''

''Any vaccination strategy for containing a smallpox outbreak should utilize the ring vaccination concept,'' the guidelines said. ''This includes isolation of confirmed and suspected smallpox cases with tracing, vaccination and close surveillance of contacts in these cases as well as vaccination of the household contacts of the contacts.'' Such vaccination involves detecting infected people and then finding everyone they had contact with when they could have transmitted the smallpox virus. The program would focus on vaccinating contacts in outward rings to create a buffer of immune people. Although smallpox vaccine is considered safe, it can lead to serious adverse effects among those receiving it for the first time. The plan mentions that patients who develop serious reactions can be helped by injections of vaccinia immune globulin, which is derived from the blood of people who have recently received smallpox vaccinations. The globulin is in short supply, with enough to treat only about 600 people, but plans are being made to increase the supply, Dr. [Lisa Rotz] said