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department:Medicine. General Internal Medicine

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Lyme Disease Vaccine Gets Cautious Push [Newspaper Article]

Altman, Lawrence K
Lyme disease is the most common tick-borne illness in the United States, and its sometimes debilitating symptoms -- arthritis and damage to the nervous system and heart -- underscore the need for a vaccine
PROQUEST:29813511
ISSN: 0362-4331
CID: 84340

Treating Cancer in Elderly Baffles Experts [Newspaper Article]

Altman, Lawrence K
The problem has increased significantly in recent years following wider use of drugs for common cancers. A partial list includes tamoxifen and taxol for breast cancer, adriamycin for cancer of the lymph system and 5-fluorouracil for colon cancer. But with expanding use, there has been scarce discussion of the safety and effectiveness of such drugs in patients older than 65, who account for more than half the total number of cancer cases in this country each year, said Dr. Frank Haluska, a cancer expert at Massachusetts General Hospital in Boston. He moderated a news conference at the annual meeting of the American Society of Clinical Oncology, which ended here today. Now oncologists are belatedly recognizing that they have included too few older cancer patients in the clinical trials that they conduct to determine the most effective therapies for all cancer patients
PROQUEST:29578932
ISSN: 0362-4331
CID: 84348

Drug Is Found to Fight Return of Breast Cancer [Newspaper Article]

Altman, Lawrence K
Contrary to what many doctors had thought, tamoxifen benefits breast cancer patients of all ages, not just those who have gone through menopause, and is effective whether the cancer was confined to the breast or had spread to lymph nodes in the arm pit, the study found. Tamoxifen is also effective whether the cancer was removed surgically in a lumpectomy or mastectomy or treated with radiation or chemotherapy drugs. Tamoxifen also halves the incidence of new cancers in the other breast from the site of the first cancer. But too few women with breast cancer are taking tamoxifen, the Oxford team said. More widespread use of tamoxifen would save 20,000 lives a year, particularly among pre-menopausal women. That would double the 20,000 now saved among the one million women who take it for breast cancer worldwide, the authors said. The analysis focused only on tamoxifen use as a treatment among women who had developed breast cancer and did not concern its use to prevent development of breast cancer. A recently reported study found that tamoxifen reduced the incidence of breast cancer by 45 percent among women considered at high risk for the disease compared to those who took a placebo. Two additional studies suggest that a related drug, raloxifene, can also prevent breast cancer without raising the risk of uterine cancer, a side effect of tamoxifen
PROQUEST:29443764
ISSN: 0362-4331
CID: 84356

SECOND DRUG REPORTED TO FIGHT BREAST CANCER [Newspaper Article]

Altman, Lawrence K
Two new studies suggest that a second drug, raloxifene, apparently can prevent breast cancer. But raloxifene did not appear to raise the risk of uterine cancer, a side effect of tamoxifen, whose benefits were reported this month. Raloxifene halved the incidence of breast cancer, roughly the same proportion as in the earlier study of tamoxifen, according to information made public Monday by a national cancer organization. However, the raloxifene studies did not last as long as the tamoxifen study
PROQUEST:28893266
ISSN: 0745-4856
CID: 84363

Commonly used drug sold over-the-counter fatal to boy in surgery [Newspaper Article]

Altman, Lawrence K
State health officials began an investigation and eventually determined that the most probable cause of Harry's death was an adverse reaction to use of a nonprescription drug phenylephrine, the same medication that is sold over the counter as Neo-Synephrine, which is used to relieve nasal congestion related to allergies and ear infections. Doctors used phenylephrine to control bleeding during the removal of the boy's adenoids. The reaction may have been due to its use with a beta blocker drug, which is commonly used to lower high blood pressure. The surgeon instructed a nurse to instill phenylephrine drops in the nose to help stop bleeding. Three minutes later the surgeon began to operate on the left ear. But Harry's blood pressure shot up. Surgery stopped while an anesthesiologist injected a drug to reduce the pressure. In another seven minutes, the ear surgery resumed
PROQUEST:27646490
ISSN: 1074-7109
CID: 84371

Injectable Heart Drug Grows Blood Vessels [Newspaper Article]

Altman, Lawrence K
It is the first time that a drug has led to growth of new coronary blood vessels by mimicking the way collateral vessels naturally develop in some people with blocked arteries. The drug, a protein known as a growth factor, is called F.G.F.-1 (for fibroblast growth factor). The doctors made it with genetic engineering techniques in their laboratory in Fulda, Germany. F.G.F.-1 was injected into heart muscle near the grafts that surgeons made to create new channels around blocked coronary arteries during standard bypass operations at the Fulda Medical Center. For now, the drug could not replace bypass surgery, the German doctors said. Dr. Thomas-Joseph Stegmann, the head of the team, said the chief objective was to prove the concept that F.G.F.-1 could safely produce new blood vessels in the heart. Although other growth factors are now used safely in medical practice, some experts had warned of dangers with F.G.F.-1. One, Dr. Wolfgang Schaper of the Max Planck Institute in Bad Nauheim, Germany, wrote in 1993 that he doubted that the growth factor would have more than moderate benefit and said ''its pronounced toxicity would preclude its use in human patients.''
PROQUEST:26585817
ISSN: 0362-4331
CID: 84379

Study of H.I.V. Family Tree Pushes Back Origins [Newspaper Article]

Altman, Lawrence K
An analysis of a blood sample preserved since 1959 from the oldest documented case of infection with the AIDS virus called H.I.V.-1 shows that the first such infections probably occurred in people in the late 1940's or early 1950's, about a decade earlier than many estimates, scientists said today. The researchers compared that sample with others to build a family tree to trace changes in the fast-mutating AIDS virus. The family tree, or phylogenetic analysis, is in the shape of a starburst, with branches radiating from the center, and the 1959 virus is close to the center. The scientists used calculations to estimate the date when the virus first developed. The 1959 sample came from a Bantu man who lived in Leopoldville, Belgian Congo (now Kinshasa in the Democratic Republic of Congo). In 1986, scientists used what were then the latest laboratory techniques to show that he had been infected by H.I.V.-1. But only now could scientists, using the latest powerful tools of molecular biology, identify key fragments of the virus in the last few drops of the blood sample in a quest for the origins of the AIDS virus
PROQUEST:25843452
ISSN: 0362-4331
CID: 84387

Mass epidemic in 1918 and '19 behind flu fear [Newspaper Article]

Altman, Lawrence K
A 'bird flu' strain of influenza virus has caused only 20 confirmed or suspected cases of human illness in Hong Kong, all since May, and has not been found elsewhere. Yet Hong Kong health officials are so worried about the virus that last Monday they began slaughtering all 1.2 million chickens in the territory. And virologists around the world have been burning the midnight oil for several weeks, studying the strain and attempting to make a vaccine for it
PROQUEST:25176084
ISSN: 1074-7109
CID: 84395

Global prevalence and incidence estimates of selected curable STDs

Gerbase AC; Rowley JT; Heymann DH; Berkley SF; Piot P
OBJECTIVES: To update the WHO global and regional estimates of the prevalence and incidence of syphilis, gonorrhoea, chlamydia, and trichomoniasis. METHODS: Prevalence estimates for syphilis, gonorrhoea, chlamydia, and trichomoniasis were generated for each of the nine UN regions for males and females between the ages of 15 and 49 in 1995 based on an extensive review of the published and unpublished medical literature since 1985. Incidence estimates were based on the prevalence figures and adjusted to take into account the estimated average duration of infection for each disease in a particular region. The latter was assumed to depend upon a number of factors including the duration of infection in the absence of treatment, the proportion of individuals who develop symptoms, the proportion of individuals treated, and the appropriateness of treatment. RESULTS: In 1995 there were over 333 million cases of the four major curable STDs in adults between the ages of 15 and 49--12 million cases of syphilis, 62 million cases of gonorrhoea, 89 million cases of chlamydia, and 170 million cases of trichomoniasis. Geographically, the vast majority of these cases were in the developing world reflecting the global population distribution. CONCLUSIONS: STDs are among the most common causes of illness in the world. Estimates of the global prevalence and incidence of these infections are limited by quantity and quality of data available from the different regions of the world. Improving global STD estimates will require more well designed epidemiological studies on the prevalence and duration of infection.
PMID: 10023347
ISSN: 1368-4973
CID: 21080

"Applied quantitative methods for health services management" [Book Review]

Natarajan S
ORIGINAL:0004463
ISSN: 0272-989x
CID: 34118