Faculty Bibliography

Within 10 years, tests for genetic predisposition to 25 major causes of illness and death in this country will be widely available if predictions of Dr. Francis S. Collins, head of the Human Genome Project of the National Institutes of Health, prove correct. Using genetics to tailor and improve health care will be the genome project's main legacy if effective laws are passed to protect privacy, prevent use of genetic information to deprive an individual of health insurance or a job, and prohibit other forms of genetic discrimination, Dr. Collins said. A disorder of iron metabolism is likely to become the model for such screening. The condition, hemachromatosis, affects 1 in 300 people and in the early stages often goes undetected, which is unfortunate because simple treatments, like periodic blood-letting to remove excess iron, can prevent complications like cirrhosis. By 2010, studies will have found the most effective combination of biochemical and genetic tests to detect people who are susceptible.In cancer, genetic tests will identify those at highest risk for lung cancer from smoking. Genetic tests for colon cancer will narrow colonoscopy screening to people who need it most. A genetic test for prostate cancer could lead to more precise use of the prostate specific antigen, or P.S.A., test by identifying those men in whom the cancer is most likely to progress fastest. Additional genetic tests would guide treatment of breast and ovarian cancer

The possibility of asymptomatic infection was only suggested in earlier studies, they said in last week's issue of The Lancet, a medical journal published in London. Now they said they had documented such infections for the first time. They found that the Ebola virus could persist in the blood of asymptomatic infected individuals for two weeks after they were first exposed to an infected individual. How much longer the virus can persist is unknown. One concern is transmitting Ebola through blood transfusions. Dr. Thomas G. Ksiazek, an expert in Ebola at the Centers for Disease Control and Prevention, a federal agency in Atlanta, said that such concern would be much greater in Africa than in the United States, where blood banks usually ask people who have been in Africa in recent months not to donate because of the threat of transmitting malaria. Dr. [E. M. Leroy]'s team said another public health concern was transmission of Ebola virus from healthy carriers through sex. Other scientists have detected Ebola in semen

* By 2010, the genome will help identify people at highest risk of particular diseases. In cancer, for example, genetic tests will identify those at highest risk for lung cancer from smoking. Genetic tests for colon cancer will narrow colonoscopy screening to people who need it most. Additional genetic tests would guide treatment of breast and ovarian cancer

In disclosing the surprising development, the officials told clinics, hospitals and other providers of health care to delay mass influenza immunization campaigns for at least a month later than planned and to make provisions to immunize people at highest risk first. Preparations are now under way for the immunizations, which are usually conducted from October through mid-November. The delay was attributed in part to difficulty in growing in the laboratory two new influenza strains in this year's vaccine. Studies have shown influenza vaccine to be 70 percent to 90 percent effective in preventing illness among healthy young men, and less effective among older people and those with chronic ailments. But the vaccine is effective in reducing influenza-related hospitalizations and deaths among older adults. Because the influenza virus mutates, the vaccine is altered each year to account for the strains expected to circulate during the season. This year, as usual, the vaccine protects against three strains. The two new ones are A/Panama and A/New Caledonia; the third, B/Yamanashi, was in last year's vaccine

Mycobacterium tuberculosis, which causes tuberculosis, is the greatest single infectious cause of mortality worldwide, killing roughly two million people annually. Estimates indicate that one-third of the world population is infected with latent M. tuberculosis. The synergy between tuberculosis and the AIDS epidemic, and the surge of multidrug-resistant clinical isolates of M. tuberculosis have reaffirmed tuberculosis as a primary public health threat. However, new antitubercular drugs with new mechanisms of action have not been developed in over thirty years. Here we report a series of compounds containing a nitroimidazopyran nucleus that possess antitubercular activity. After activation by a mechanism dependent on M. tuberculosis F420 cofactor, nitroimidazopyrans inhibited the synthesis of protein and cell wall lipid. In contrast to current antitubercular drugs, nitroimidazopyrans exhibited bactericidal activity against both replicating and static M. tuberculosis. Lead compound PA-824 showed potent bactericidal activity against multidrugresistant M. tuberculosis and promising oral activity in animal infection models. We conclude that nitroimidazopyrans offer the practical qualities of a small molecule with the potential for the treatment of tuberculosis

When [Eva Peron], the first lady of Argentina, underwent a hysterectomy in November 1951, she did not know that her husband, [Juan Peron], had summoned a Manhattan cancer surgeon to perform the procedure. The surgeon, Dr. George Pack, flew to Buenos Aires, entered the operating room after Eva was anesthetized and left before she awoke. The Argentine and the U.S. governments apparently have not officially confirmed that Eva Peron had cervical cancer or that Pack performed the operation without her knowledge. State Department officials and the Argentine Embassy in Washington said they had no knowledge about Eva's case because it occurred so long ago. [Barron Lerner] said he did not try to examine Eva's medical records or government records. At the time, the Argentine government declined to disclose the nature of Eva's illness. Press reports gave conflicting views as to whether she had cancer. Peron was re-elected while Eva recuperated from surgery. Later, she resumed limited political activities. But when the abdominal pain returned in February 1952, Argentine doctors confirmed, again without telling Eva, that the cancer had recurred with striking rapidity

When [EVA PERON], the first lady of Argentina, underwent a hysterectomy in November 1951, she did not know that her husband, [Juan Peron], had summoned a Manhattan cancer surgeon to perform the procedure. The surgeon, Dr. George Pack, flew to Buenos Aires, entered the operating room after Eva was anesthetized, and left before she awoke. Eva's medical ordeal began in January 1950 when she was 30. She fainted and underwent an appendectomy. Despite persistent weakness and anemia from vaginal bleeding, she delayed further tests. In August 1951, Eva, much weaker, developed increasingly severe abdominal pain and fainted again. A physical showed she had advanced cancer of the cervix, and Argentine doctors treated her with radium, then a standard therapy. At the time, the Argentine government declined to disclose the nature of Eva's illness. Press reports gave conflicting views as to whether she had cancer. Peron was re-elected while Eva recuperated from surgery. Later, she resumed limited political activities. But when the abdominal pain returned in February 1952, Argentine doctors confirmed, again without telling Eva, that the cancer had recurred with striking rapidity

Peron was re-elected while Eva recuperated. Later, she resumed limited political activities. But when the abdominal pain returned in February, 1952, Argentine doctors confirmed, again without telling Eva, that the cancer had recurred very quickly. In lifting Eva's medical story from obscurity and reporting it in the June 3 issue of The Lancet, Barron Lerner, a medical historian and ethicist at Columbia University, has added new information to an earlier biography of Eva and a small number of articles about her illness in Argentine newspapers and medical journals

The Argentine and the United States governments apparently have not officially confirmed that [Eva Peron] had cervical cancer or that Dr. Pack performed the operation without her knowledge. State Department officials and the Argentine Embassy in Washington said they had no knowledge about Eva's case because it occurred so long ago. Dr. [Barron H. Lerner] said he did not try to examine Eva's medical records or government records. Eva's medical ordeal began in January 1950 when she was 30. She fainted and underwent an appendectomy. Despite persistent weakness and anemia from vaginal bleeding, she delayed further tests. In August 1951, Eva, much weaker, developed increasingly severe abdominal pain and fainted again. A physical showed she had advanced cancer of the cervix, and Argentine doctors treated her with radium, then a standard therapy. At the time, the Argentine government declined to disclose the nature of Eva's illness. Press reports gave conflicting views as to whether she had cancer. President Peron was re-elected while Eva recuperated from surgery. Later, she resumed limited political activities. But when the abdominal pain returned in February 1952, Argentine doctors confirmed, again without telling Eva, that the cancer had recurred with striking rapidity

I knocked on the door, entered and found Tito Puente alone. He seemed comfortable, but nervous. I told him that I had been sent to see him by his manager, who was a patient of mine. Tito nodded. He'd been expecting me, he said. He looked healthy; sometimes it was a matter of subtle perception to differentiate who needed an operation from who didn't. I went downstairs to speak with his relatives. They were holding a vigil near the elevators where families traditionally waited for the surgeon to bring them the news. In Tito's case, the surgeon was still in there with him, trying to treat the unforeseeable bleeding disorder. For almost 10 hours he'd been there with his patient, unwilling to take a break. I arrived there at the same time as the pizza man, bringing the family more sustenance than I could. 'It doesn't look good,' I said, something they already knew. I recognized Tito's daughter from the TV and, as she jounced up to pay the pizza man, I could again see her father's energy. I drew a picture of the heart and showed Tito where the valve was that was damaged. It was a straightforward operation to repair it and, if the vessels that fed the heart its blood and oxygen were blocked, a bypass operation would be performed at the same time. Tito was nervous about the operation. He was used to exerting maximal control over his life, his music. Now he would be handing all this over to a stranger, a man who, in a different world, was also a control artist, working long hours with maximal attention and focus, a man who was also known for his great hands