Faculty Bibliography

The new challenge for AIDS researchers and government officials is to preserve the benefit of drug therapy in pregnancy and find safe alternatives to breast-feeding. That is a formidable task in Africa where the overwhelming majority of women breast-feed their infants for long periods. Poverty limits the ability of women to buy formula and breast-milk substitutes. Widespread contamination of water supplies and poor sanitation make it dangerous to mix formula. Also, male domination leaves many women with little ability to choose an alternative to breast-feeding. And a woman who avoids breast-feeding her infant can be stigmatized as having AIDS. Further, the findings seem certain to renew the often bitter controversy over breast-feeding, which pits the new public health emergency of AIDS against a fundamental, even ideological, pediatric practice. Proponents say ''breast is best'' for infant nutrition and that the dangers of contaminated water make the use of formula too risky. But opponents contend that formula and other substitutes are needed in the face of a growing epidemic in which an estimated 570,000 children became H.I.V.-infected last year, mostly in Africa, where more than a third of pregnant women in some countries are infected. For about the last five years, doctors have been giving women in the United States and elsewhere infected with H.I.V., the virus that causes AIDS, one of two treatments during pregnancy to prevent the spread of the disease to their unborn children. The infants were treated in the first few days after birth, and an earlier study showed significant reductions in AIDS infections in the first six weeks of life. The success of that and similar studies had been hailed as one of the rare triumphs in the war against AIDS

When Columbia recruited Dr. Reemtsma to be its chief surgeon in 1971, 'he had no desire to leave Utah,' Dr. [Willem Kolff] said. He made demands that 'he never expected Columbia would accept,' and Columbia accepted, Dr. Kolff said

The Ebola virus, which has caused deaths from high fever and bleeding in African outbreaks, also can infect without producing illness, according to a new finding by African and European scientists. 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. Illness often begins abruptly, from five to 10 days after exposure to Ebola virus, with symptoms like fever, headache, vomiting and diarrhea. Then bleeding can occur internally or ooze from needle sites and through the nose and mouth. Death usually occurs from five to seven days after the onset of illness

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

Coagulase gene (coa) short sequence repeat region sequencing was used to measure relatedness among a collection of temporally and geographically diverse methicillin-resistant Staphylococcus aureus isolates. The results show that coa polymorphism is free of strong selective pressure and has a low index of variation that may be useful for long-term epidemiological investigations. coa typing is a useful addition to spa typing for analysis of S. aureus, including methicillin-resistant strains

Ethambutol (EMB) is a central component of drug regimens used worldwide for the treatment of tuberculosis. To gain insight into the molecular genetic basis of EMB resistance, approximately 2 Mb of five chromosomal regions with 12 genes in 75 epidemiologically unassociated EMB-resistant and 33 EMB-susceptible Mycobacterium tuberculosis strains isolated from human patients were sequenced. Seventy-six percent of EMB-resistant organisms had an amino acid replacement or other molecular change not found in EMB-susceptible strains. Thirty-eight (51%) EMB-resistant isolates had a resistance-associated mutation in only 1 of the 12 genes sequenced. Nineteen EMB-resistant isolates had resistance-associated nucleotide changes that conferred amino acid replacements or upstream potential regulatory region mutations in two or more genes. Most isolates (68%) with resistance-associated mutations in a single gene had nucleotide changes in embB, a gene encoding an arabinosyltransferase involved in cell wall biosynthesis. The majority of these mutations resulted in amino acid replacements at position 306 or 406 of EmbB. Resistance-associated mutations were also identified in several genes recently shown to be upregulated in response to exposure of M. tuberculosis to EMB in vitro, including genes in the iniA operon. Approximately one-fourth of the organisms studied lacked mutations inferred to participate in EMB resistance, a result indicating that one or more genes that mediate resistance to this drug remain to be discovered. Taken together, the results indicate that there are multiple molecular pathways to the EMB resistance phenotype