Faculty Bibliography

Responding to a call to improve the quality of cancer care in the United States, a leading cancer organization said here yesterday that it was working with other groups to develop a national system to monitor how well each cancer patient is treated. The first phase will be conducted in Cleveland, Houston and Los Angeles and will involve 300 people with breast cancer and an additional 300 with cancer of the colon and rectum, the study's leaders said at the opening of a meeting here of the American Society of Clinical Oncologists, the leading group of cancer specialists in the United States

Responding to a call to improve the quality of cancer care in the United States, a leading cancer organization said yesterday that it was working with other groups to develop a national system to monitor how well each cancer patient is treated. The first phase will be conducted in Los Angeles, Cleveland and Houston and will involve 300 people with breast cancer and an additional 300 with cancer of the colon and rectum, the study's leaders said at a meeting of the American Society of Clinical Oncologists, the leading group of cancer specialists in the United States. The goal is to develop specific measures of quality spanning the course of care, from diagnosis to cure or death. Such measures could be used to hold health-care providers accountable for the quality of cancer care

BETHESDA, Md. -- A sound public health plan is in place nationally to combat further spread of the mosquito-borne West Nile virus, which caused an outbreak of encephalitis in New York City last year, U.S. health officials say. 'We may see some cases here and there this year,' but no one knows when and where the West Nile virus will strike, said Stephen Ostroff, who is coordinating the West Nile effort for the Department of Health and Human Services. When the West Nile virus was first detected in the New York City outbreak last fall, 'there were a variety of federal agencies that were very concerned about bioterrorism, and some conducted investigations at that time,' said Ostroff, an epidemiologist at the Centers for Disease Control and Prevention in Atlanta

Three large new studies are challenging the safety and benefits of clot-busting drugs for older people suffering heart attacks, particularly those 75 and older. The drugs fail to benefit many such heart-attack patients, and those 75 and older may be at higher risk of death from bleeding, strokes and ruptured hearts, two of the studies found. The American Heart Association and the American College of Cardiology recommend use of clot-busting drugs in heart-attack patients. But the two leading heart organizations caution that evidence for the drugs' effectiveness and safety in older people has been equivocal. TPA (tissue plasminogen activator) and streptokinase are the two main clot-busting drugs, also known as thrombolytics

Three large new studies are challenging the safety and benefits of clot-busting drugs for older people suffering heart attacks, particularly those 75 and older. The American Heart Association and the American College of Cardiology recommend use of clot-busting drugs in heart attack patients. But the two leading heart organizations caution that evidence for the drugs' effectiveness and safety in older people has been equivocal. The two main clot-busting drugs, also known as thrombolytics, are T.P.A. (tissue plasminogen activator) and streptokinase. Now an urgent need exists to reassess the recommendations for treating heart attacks in older people, particularly because the number of heart attacks in people over 75 is growing rapidly as the population ages, said the researchers from Harvard, Johns Hopkins and Yale who led the studies. The same point was stressed in an editorial in the journal Circulation, which is publishing the Johns Hopkins study today

Dr.Jeffrey M. Drazen, a leading asthma researcher at Harvard with strong ties to the drug industry, was named the editor of The New England Journal of Medicine here today. Pledging to protect the integrity of The Journal's information, Dr. Drazen, a professor of medicine at Harvard, said he would recuse himself from the editorial process for any papers submitted that relate to asthma or to nine major companies from which he has received research grants or consultation fees. Last February, after an internal investigation prompted by articles in The Los Angeles Times, The Journal found that it had violated its own rules in publishing 19 articles by Dr. Drazen and other authors with industry ties. The Journal said the articles should have been written by scientists without such connections, but its editors blamed themselves and said Dr. Drazen had disclosed his industry support

The National Institutes of Health is set to begin its first full-scale tests of a vaccine for people already infected with the AIDS virus, the vaccine's manufacturer said yesterday. In the tests, injections of the vaccine, Remune, will be added to standard combination drug therapy for H.I.V., the AIDS virus. Such drugs can halt reproduction of H.I.V. in infected cells but do not eradicate the virus from those who are infected. Remune is intended to be a therapeutic vaccine, to stimulate the immune system to destroy H.I.V.-infected cells. Vaccines are routinely given to prevent polio and many other infections. If the tests are successful, Remune would be the first therapeutic vaccine for any disease to work in those already infected. But the vaccine is not expected to cure AIDS

In the tests, injections of the vaccine, called Remune, will be added to standard combination drug therapy for HIV, the AIDS virus. Such drugs can halt reproduction of HIV in infected cells, but do not eradicate the virus from those who are infected. Remune is intended to be a therapeutic vaccine, to stimulate the immune system to destroy HIV-infected cells. The study aims at determining whether Remune will keep the levels of HIV in the blood suppressed longer than anti-HIV drug therapy alone, and thwart progression of infection to AIDS. Vaccines are routinely given to prevent polio and many other infections. If the tests are successful, Remune would be the first therapeutic vaccine for any disease to work in those already infected. But the vaccine is not expected to cure AIDS

In the tests, injections of the vaccine, called Remune, will be added to standard combination drug therapy for HIV, the AIDS virus. Such drugs can halt reproduction of HIV in infected cells, but they do not eradicate the virus from those who are infected. Remune is intended to be a therapeutic vaccine, to stimulate the immune system to destroy HIV-infected cells. The study aims at determining whether Remune will keep the levels of HIV in the blood suppressed longer than anti-HIV drug therapy alone, and thwart progression of infection to AIDS. Other therapeutic HIV vaccines have been tested and found to be ineffective. Before combination anti-HIV therapy was introduced, the U.S. military conducted a large full-scale test of another therapeutic vaccine. Prolonged administration of the vaccine was safe, but it did not benefit infected volunteers