Faculty Bibliography

OBJECTIVE: Brief interventions for hazardous and low-dependent drinkers in the primary care setting have considerable empirical support. The purpose of this study was to (1) evaluate the effects of brief advice (BA) and motivational enhancement (ME) interventions on alcohol consumption. In addition, a hindsight matching design was used to (2) study the moderator effects of patient readiness to change (alcohol use) on alcohol consumption. METHOD: The subjects (N = 301, 70% men) were patients 21 years of age or older who presented for treatment at one of 12 primary care clinics. After screening for eligibility and providing consent to participate in the study, the patients completed a baseline assessment and were randomly assigned to the BA, ME or standard care (SC) interventions condition. Follow-up assessments were completed at 1-, 3-, 6-, 9- and 12-months postbaseline assessment. RESULTS: Evaluation of the first hypothesis (n = 232 for these analyses) showed that all participants tended to reduce their alcohol use considerably between the baseline and 12-month assessments. In addition, evaluation of the second hypothesis showed a moderator effect of readiness to change in predicting the number of drinks at 12 months, such that the BA intervention seemed more effective for patients relatively low in readiness to change compared to those higher in readiness. Readiness to change did not seem to be related to changes in drinking of participants in the SC or ME conditions. CONCLUSIONS: The results confirm that, among primary care patients, substantial changes in alcohol consumption are possible. They further suggest that matching studies of patient readiness to change their alcohol use, as well as other variables, are warranted.

MPT53 is a secreted protein of Mycobacterium tuberculosis. Southern transfer and hybridization showed mpt53 to be conserved in the M. tuberculosis complex and to have homology with DNA from Mycobacterium avium and other nontuberculous mycobacteria. However, anti-MPT53 polyclonal antibodies detected no antigen in the culture filtrates of M. avium and other nontuberculous mycobacteria. MPT53 of M. tuberculosis induced strong, tuberculosis-specific antibody responses in guinea pigs but induced no delayed-type hypersensitivity. Involvement in immune responses during human tuberculosis was very modest

Lamm discusses the fact that many seemingly-obvious medical diagnoses may turn out to be something quite different. He shares various stories from his experiences as a physician and urges other physicians to fully examine all diagnostic avenues

Breaking the secrecy over his identity as the first recipient of a self-contained artificial heart, Robert Tools, 59, of Franklin, Ky., said from his hospital room that he felt fine but that living with the constant whirring and..

Before speaking, Mr. Tools put a finger over a hole in his neck, an opening known as a tracheotomy that allowed him to be more comfortable when he had been attached to a mechanical ventilator. Dr. Laman A. Gray Jr., one of the surgeons, said that his team closed the tracheotomy today but that until it completely healed in a few days, Mr. Tools would have some difficulty in speaking and being understood by others. Mr. Tools repeated the point later after he walked with his doctors into Dr. Gray's office to speak in a news conference. Mr. Tools was dressed in a blue shirt, red tie and wearing sneakers, as he said: ''Jewish did not seek me out. I came to Jewish because I was dying. I was in the last few days of life and my cardiologist informed me about the trial here.'' Mr. Tools lost vast amounts of weight and muscle mass during the months he suffered from heart failure and had a poor appetite and could not digest food properly. In the weeks ahead, Dr. [Robert D. Dowling] said, Mr. Tools needs to regain 30 or so pounds and muscle mass. ''If I could fix one thing, it would be his nutritional status,'' Dr. Dowling said. ''He would be a month or two ahead.''

Robert Tools was identified as the first recipient of a self-contained artificial heart, an official at Jewish Hospital in Louisville said. Mr

His urologist and surgeon, Dr. Peter R. Carroll, discussed Mr. [Robert S. Mueller III]'s cancer, his operation and his prognosis in a detailed interview with a reporter for The New York Times, who is also a physician. Dr. Carroll said Mr. Mueller has a ''very high likelihood of cancer cure,'' is in excellent physical and mental health, and is fit to serve the 10-year term as F.B.I. director. Mr. Mueller disclosed his cancer to administration officials before he was selected for the F.B.I. post. The Senate Judiciary Committee received a letter dated June 20 from Dr. Carroll affirming the diagnosis and giving a favorable prognosis. But in the letter Dr. Carroll did not provide the details that he did in recent interviews. Mr. Mueller declined to be interviewed about his health, but Dr. Carroll spoke with his permission. Mr. Mueller's prostate felt normal to all physicians who have examined him in Washington and California since last September, Dr. Carroll said. But at that time his P.S.A. was slightly elevated at 5.5 nanograms per milliliter. The number is usually less than 4, although it can vary according to age, the laboratory performing the test, and other conditions like prostate inflammation

[Peter R. Carroll] said [Robert S. Mueller III], 56, has a 'very high likelihood of cancer cure,' is in excellent physical and mental health, and is fit to serve the 10-year term as FBI director. The timing of the 2 1/2-hour operation and the confirmation vote Aug. 2 was a coincidence. Mueller, who learned that he had prostate cancer last fall and was told he could wait for treatment, had scheduled the surgery this summer, said Carroll, who is the chief of urology at the University of California at San Francisco