Faculty Bibliography

Federal health officials recommended Thursday that doctors immediately stop using a vaccine recently recommended for all infants to protect against rotavirus, the most common cause of severe diarrhea in infants and children. The federal Centers for Disease Control and Prevention said it took the extraordinary action because a program that monitors vaccine side-effects suggested a link between the drug, licensed last year, and 20 cases of a painful blockage of the bowel called intussusception. The disease, which can in rare cases be fatal, affects an estimated 3.5 million children in the United States a year. Although there is no conclusive evidence that the vaccine causes the bowel condition, CDC officials said the data are so strongly suggestive of a link that they considered it prudent to advise halting rotavirus vaccinations at least until November, by which time a new study of the vaccine will be done

In an advance that promises to significantly reduce the incidence of AIDS among children in developing countries, American and Ugandan scientists have found a simple way to help prevent mother-to-child transmission of the AIDS virus that is less costly and markedly more effective than the standard therapy in the Third World. The new and more practical therapy comes from substituting one marketed drug, nevirapine, for the standard drug, AZT. The cost for the two doses of nevirapine was $4, compared with $268 for the AZT regimen used in developing countries and $815 for the much longer and more complicated course used in the United States and other developed countries. By the time a child is 3 months, nevirapine had reduced the risk of mother-to-child transmission of HIV to 13 percent from the 25 percent for the standard course of AZT in developing countries, or a reduction of 47 percent, the researchers said

In an advancement that promises to significantly reduce the incidence of AIDS in children in developing countries, American and Ugandan scientists have found a simple new way to prevent mother-to-child transmission of the AIDS virus that also is less costly and markedly more effective than the standard therapy in the third world. The more practical therapy comes from substituting one marketed drug, nevirapine, for the standard drug, AZT. The cost for the two doses of nevirapine was $4, compared with $268 for the AZT regimen now used in developing countries and $815 for the much longer and more complicated course used in the United States and other developed countries, Federal health officials said in releasing the findings yesterday. Nevirapine, a drug used in combination ''cocktail'' treatments, has been marketed since 1996 in the United States for treatment of H.I.V., the AIDS virus, and it was remarkably safe in the study that was conducted by American and Ugandan researchers. As babies reached 3 months of age, nevirapine had cut the risk of mother-to-child transmission of H.I.V. to 13 percent from the 25 percent for the standard course of AZT in developing countries, or a reduction of 47 percent, United States and Ugandan health officials said

In an advance that promises to significantly reduce the incidence of AIDS among children in developing countries, American and Ugandan scientists have found a simple new way to help prevent mother-to- child transmission of the AIDS virus that is less costly and markedly more effective than the standard therapy in the Third World. The new and more practical therapy comes from substituting one marketed drug, nevirapine, for the standard drug, AZT. The total cost for the two doses of nevirapine was $4, compared with $268 for the AZT regimen now used in developing countries and $815 for the much longer and more complicated course used in the United States and other developed countries, federal health officials said in releasing the findings yesterday. Nevirapine has been marketed since 1996 in the United States for treatment of HIV, the virus that causes AIDS, and it was remarkably safe in the study by American and Ugandan researchers

In an advance that promises to significantly reduce the incidence of AIDS among children in developing countries, American and Ugandan scientists have found a simple new way to help prevent mother-to- child transmission of HIV that is less costly and markedly more effective than the standard therapy in the Third World. The new and more practical therapy comes from substituting one marketed drug, nevirapine, for the standard drug, AZT. The total cost for the two doses of nevirapine is $4, compared to $268 for the AZT regimen now used in developing countries and $815 for the much longer and more complicated course used in the United States and other developed countries, federal health officials said Wednesday. By age 3 months, nevirapine had reduced the risk of mother-to- child transmission of HIV to 13 percent from the 25 percent for the standard course of AZT in developing countries, or a reduction of 47 percent, the researchers said

Now, as the epidemic in Africa becomes an even greater catastrophe, Dr. Peter Piot, Assistant Secretary General of the United Nations and head of its AIDS programs, says he sees signs of momentum among African leaders to fight the disease. The momentum promises to slow the relentless transmission of H.I.V., conveyed on the continent primarily through heterosexual sex, Dr. Piot said in an interview. The United Nations General Assembly recently called for a 25 percent reduction in new H.I.V. infections among young people over the next five years in the countries most affected by AIDS. And the Clinton Administration, appalled by the staggering dimensions of the African AIDS epidemic, is planning an initiative to help, Dr. Piot said. ''It is such a big change,'' Dr. Piot, a 50-year-old Belgian and a pioneer in AIDS research in Africa, said in a brief visit to New York. In years past, Dr. Piot said, even meeting with an African head of state was difficult

Summary: The disease has been declared eradicated, yet the United States will keep samples in hopes of warding off use of the virus as a potential weapon 'It's disturbing, extremely disturbing. I thought the door had closed on smallpox. I had happily put it away.' -- DR. DONALD A. HENDERSON, WHO LED THE GLOBAL CAMPAIGN THAT ERADICATED SMALLPOX Today, the high fevers, deep rashes and oozing pustules that characterize smallpox are gone -- a feat of disease eradication so far unequaled in the history of public health. This banishment is so complete that recent medical textbooks often skip the disease or give few details of its wrath

[Lyn Hester] oversees the MIRTH (Medical Institute for Recovery Through Humor) wing of Integris Health, a hospital in Oklahoma City, where patients receive a written joke with every meal and doctors and staff are encouraged to trade humorous stories with patients. "Laughter is good medicine," says Hester. "It makes people feel good and sometimes they get better quicker, using laughter as part of the healing process." Whoever thought the antics of the Three Stooges or the Marx Brothers could be good for your health? Well, the ancient Greeks built their hospitals next to amphitheaters so the infirm could be entertained, and researchers now understand that laughter can have a powerful effect on health. Scientists at the Loma Linda School of Medicine have discovered that the simple act of laughing stimulatesthe immune system, decreases stress-producing hormones and raises the number and increases the activity of naturalkiller cells in the body, which attack and kill viruses and tumor cells

BACKGROUND:Despite major changes in health care, the prevalence and predictors of career satisfaction have not recently been comprehensively studied in either women or men physicians. METHODS:The Women Physicians' Health Study surveyed a nationally representative random sample (n = 4501 respondents; response rate, 59%) of US women physicians. Using univariate and logistic regression analyses, we examined personal and professional characteristics that were correlated with 3 major outcomes: career satisfaction, desire to become a physician again, and desire to change one's specialty. RESULTS:Women physicians were generally satisfied with their careers (84% usually, almost always, or always satisfied). However, 31% would maybe, probably, or definitely not choose to be a physician again, and 38% would maybe, probably, or definitely prefer to change their specialty. Physician's age, control of the work environment, work stress, and a history of harassment were independent predictors of all 3 outcomes, with younger physicians and those having least work control, most work stress, or having experienced severe harassment reporting the most dissatisfaction. The strongest association (odds ratio, 11.3; 95% confidence interval, 7.3-17.5; P<.001) was between work control and career satisfaction. Other significant predictors (P<.01) of outcomes included birthplace, ethnicity, sexual orientation, having children, stress at home, religious fervor, mental health, specialty, practice type, and workload. CONCLUSIONS:Women physicians generally report career satisfaction, but many, if given the choice, would not become a physician again or would choose a different specialty. Correctable factors such as work stress, harassment, and poor control over work environment should be addressed to improve the recruitment and retention of women physicians.