HICN609 Medical News Part 3/4 
Author Message
 HICN609 Medical News Part 3/4

------------- cut here -----------------
     "The data from these two preliminary studies are going to be extremely
useful to us and others who are designing trials to test this theory," he
says.
     Reaven and Witztum's coauthors include Andrew Khouw, M.D.; William F.
Beltz, Ph.D.; and Sampath Parthasarathy, Ph.D., all of the Department of
Medicine at the University of California, San Diego.

Health InfoCom Network News                                            Page 28
Volume  6, Number  9                                            April 10, 1993

                    "TUMOR SUPPRESSOR" GENE ASSOCIATED WITH
                   NEUROFIBROMATOSIS TYPE 2 (NF2) IDENTIFIED
                The National Neurofibromatosis Foundation Inc.
                         Press Release, March 11, 1993

     Researchers funded by the National Neurofibromatosis Foundation and
working at the Massachusetts General Hospital in Boston, in collaboration with
scientists at the Bristol-Myers Squibb Pharmaceutical Research Institute in
Princeton, NJ, the National Cancer Institute in Bethesda, MD, the University
of Cincinnati in Cincinnati, OH, and Georgetown University Medical Center in
Washington, DC, have cloned the "tumor suppressor" gene associated with
neurofibromatosis type 2 (NF2).  Aberrations in this gene are thought to be
responsible for the development of a large percentage of human brain tumors,
particularly of acoustic neuromas and meningiomas.  Surprisingly the NF2 gene
belongs to a family of genes which have not yet been suspected to play a role
in cancer development and/or tumor suppression.  The proteins belonging to
this gene family, whose members include moesin, ezrin, and radixin, are
thought to be involved in anchoring the cell membrane what the cell's
cytoskeleton.

     Hence, in addition to providing a major breakthrough toward understanding
and eventually correcting the defect causing the hereditary tumor syndrome
NF2, the cloning of the NF2 gene which is being reported in the March 12 issue
of the journal, CELL, has opened an entirely new avenue for cancer research in
general, by directing our attention to a new class of proteins which appear to
link the cell membrane with components of the intracellular matrix.

     The name Neurofibromatosis (NF) is associated with two distinct, as yet
incurable hereditary diseases: NF1 (formally called "von Recklinghausen's
neurofibromatosis" and NF2, previously termed "Bilateral Acoustic
Neurofibromatosis." One of the hallmarks of NF2 -- whose clinical
manifestations are usually more severe than those in NF1 -- is the bilateral
and multifocal occurrence of acoustic neuromas, i.e., Schwann cell-derived
tumors of the eighth cranial nerve.  Although histologically benign, these
tumors wrapping around the eighth cranial nerve frequently led to deafness.

     Furthermore, many NF2 patients suffer from multiple meningiomas, brain
tumors which may lead to serious neurological complications or even death.  
NF2 is also associated with a higher incidence of glial brain tumors.  In
addition, approximately 50% of NF2 patients suffer from lens opacities.  The
connection between this symptom and the typical tumor formation in NF2 is not
as yet understood.  There is currently no cure available for this disorder.  
Once the tumors are identified, neurosurgical removal is usually the treatment
of choice.  However, the multifocal nature of many of these tumors often
complicates surgery, increasing the risk of hearing loss.  Furthermore, tumor

Health InfoCom Network News                                            Page 29
Volume  6, Number  9                                            April 10, 1993

recurrences and the formation of new tumors are common.

     NF2 is a relatively rare hereditary tumor syndrome, with approximately
1:50,000 live births.  However, its hallmark tumors, acoustic neuromas and
meningiomas, are known to occur much more frequently in the general population
without a family history of NF2.  Hence, they represent two of the most common
brain tumors in humans.  Indeed, many human tumors such as acoustic neuromas
may occur in two distinct forms: As sporadic tumors in the general population
(the majority of cases), and as hereditary tumors where the same tumor type is
transmitted form generation to generation in families.  There is increasing
evidence that both the hereditary and sporadic form of one and the same tumor
type is associated with very similar pathogenetic events affecting the same
gene defect.  Indeed, previous tumor studies by Seizinger et al. (Nature 1986;
Science 1987) have strongly suggested that the same gene which causes NF2 may
also cause the much more common sporadic acoustic neuromas and (at least some
of the) sporadic meningiomas.  Thus, importance of the cloning of the NF2 gene
should reach well beyond neurofibromatosis.  Future studies will undoubtedly
address this issue.

     Neurofibromatosis research, a "cinderella" of the scientific community as
recently as in the early and mid-1980's, has undergone a remarkable
metamorphosis. the cloning of the NF1 gene in 1990 has firmly established NF
research in the forefront of modern cancer research, and has elevated NF to
model status for the successful application of the so-called "positional
cloning" or if reversed genetics" approach.  This strategy, although
technically demanding and labor intensive, provides a rational approach
towards the identification of the defective gene associated with a hereditary
disorder in which nothing is known about the defective protein or disease
mechanism (unfortunately, this situation has been characteristic for the vast
majority of the 4,000 or so hereditary disorders known in humans).

     Although the identification of the NF2 gene represents another triumph of
the "positional cloning" approach, it should be noted, however, that there
have been several characteristic differences between the NF1 and NF2 cloning
strategies.  In contrast to NF1 whose defective gene was first mapped to
chromosome 17q using classical linkage studies (Barker et al., SCIENCE 1987;
Seizinger et al., CELL 1987), the first major clue about the location of the
NF2 gene on chromosome 22 actually came from molecular tumor deletion studies
rather than from linkage analysis (Seizinger et al., NATURE 1986; SCIENCE
1987).

     The final phase of the NF2 cloning -- like that of the NF1 cloning -- may
well be described as a "tour de force," involving the generation of many
hundreds of genetic markers around the NF2 locus, as well as the construction
of high resolution genetic and physical maps, including YAC contigs covering

Health InfoCom Network News                                            Page 30
Volume  6, Number  9                                            April 10, 1993

the entire NF2 region.  Only at a relatively late stage, small germline
mutations (however, cytogenetically invisible!) were discovered.  These
deletions were crucial for homing in on the disease gene.  The elegant
technique of exon trapping was similarly important for the identification of
expressed sequences in the deleted region.  The NF2 gene itself was ultimately
identified by non-overlapping deletions affecting different portions of the
same chromosome 22 gene in two independent NF2 families.  In addition, two
meningiomas from another set of NF2 patients showed a single base pair and a
4-base pair deletion, respectively, further confirming the identify of the NF2
gene.

     It should be noted that in almost all successful applications of the
"positional cloning" approach the respective disease gene was isolated with
the additional aid of cytogenetically visible chromosomal aberrations in one
or several patients.  For example, the identification of cytogenetically
detected translocations in two NF1 patients was instrumental in cloning the
NF1 gene.  In contrast, the NF2 community was not blessed with such a
convenient short-cut.  In fact, the cloning of the NF2 gene may represent one
of the very few examples of successfully applying the "pure" positional
cloning approach (cystic fibrosis is another'pure" example).

     The NF2 gene encodes for a relatively small protein of 587 amino acids
(in comparison, the NF1 protein is several times larger).  As mentioned above,
NF2 shows striking similarity to the moesin-ezrin-radixin-protein family,
which is thought to link proteins of the cell membrane to the cytoskeleton of
the cell.  Thus, the NF2 gene has been termed "merlin" ("Moesin-ezrin-radixin-
like protein").  The cytoskeleton of mammalian cells is a very complex network
of interconnected filaments which are thought to participate in a variety of
important cellular activities, including movement, cell division, cell-cell
communication, intracellular communication, cell anchorage, and intracellular
milieu.  Hence, aberrations in this network including aberrations in
interacting proteins may pertrub any of these functions.  The possible role of
the normal and aberrant NF2 protein in any of these functions remains to be
determined.

     Surprisingly, the NF2 gene appears to be widely expressed in multiple
tissues in and outside the nervous system, although the tumors in NF2 are
typically (although not exclusively) Schwann cell-derived.  However, in
analogy to other tumor suppressor genes -- e.g., the NF1 gene, the Rb gene,
and p53 -- it is conceivable that aberrations in the NF2 gene are not
restricted to NF2-derived tumor types, but may contribute to the development
of a variety of seemingly unrelated cancers.

     The "Boston-team" which has now succeeded in cloning the NF2 gene has
been working on this disorder since 1984.  The same group was previously

Health InfoCom Network News                                            Page 31
Volume  6, Number  9                                            April 10, 1993

instrumental in finding the chromosomal location of the NF2 gene and providing
evidence for a recessive mechanism of tumorigenesis in NF2, similar to that in
the retinoblastoma "tumor suppressor" model (Seizinger et al., NATURE 1986;
SCIENCE 1987; PROC.  NATL.  ACAD.  SCI.  USA 1987; Rouleau et al., NATURE
1987).

     Led by James F. Gusella, Ph.D., Director of the Molecular Neurogenetics
Laboratory at Massachusetts General Hospital, and a Professor of Genetics at
Harvard Medical School, who is a also senior author on the CELL paper, this
team contains several previous recipients of the competitive Junior
Investigator Award from the National Neurofibromatosis Foundation, NNFF,
including Bernd R. Seizinger, M.D., Ph.D., who is now Vice President, Oncology
Drug Discovery, at Bristol-Myers Squibb Pharmaceutical Research Institute in
Princeton, NJ, (Dr.  Seizinger also retains his academic appointments as
Associated Geneticist and Associate Professor at Massachusetts General
Hospital and Harvard Medical School), Dr. Nikolai Kley, currently a Senior
Research Scientist a the Bristol-Myers Squibb Pharmaceutical Research
Institute, and Dr. Anil Menon, who recently accepted an Assistant
Professorship at the University of Cincinnati in Cincinnati, OH.

     Furthermore, it should be pointed out that this recent success in cloning
the NF2 gene is also another highlight of the accomplishments of the "NNFF
International Consortium on Gene Cloning and Gene Function for NF1 AND NF2."
This Consortium is sponsored by the National Neurofibromatosis Foundation and
meets approximately twice a year.  It is organized by Drs.  Francis Collins,
Bernd Seizinger, Nancy Ratner, and  Bruce Ponder, in close collaboration with
Peter Bellermann, President of the NNFF.  The Consortium, originally founded
in 1987 to aid linkage studies in NF1 has meanwhile grown into an
international enterprise of more than 100 scientists working on the genetics,
cell biology, pharmacology, and clinical aspects of both NF1 and NF2.  The
intensive exchange of information and reagents between the Consortium members
has been of crucial importance not only for the previous identification of the
NF1 gene, but also for the cloning of the NF2 gene.  Among various important
contributors to this Consortium, Dr. Guy Rouleau from McGill University in
Montreal, Canada, and Dr. Gilles Thomas from the Curie Institute in Pads,
France, deserve to be particularly mentioned for their invaluable and
outstanding work on NF2.

     The cloning of the NF2 gene, although a milestone in NF and cancer
research, is only the beginning of a new enterprise with the goal to better
understand the normal and abnormal biological function(s) of this cancer-
related gene.  Insights into the cell biology of the NF2 should eventually
provide us with a basis for the development of new rational therapeutic
approaches which may ultimately benefit not only NF2 patients but patients
suffering from cancer in general.

Health InfoCom Network News                                            Page 32
Volume  6, Number  9                                            April 10, 1993

     One of the immediate implications of the cloning of the NF2 gene,
however, will be in the diagnostic area for prenatal and presymptomatic
testing in NF2 patients.  Since markers from within the gene can now be
identified, the diagnostic accuracy should be close to 100%.  Moreover, by
sequencing the gene, one should be able to extend diagnostic testing to those
(relatively frequent) cases where no other affected family member is
available, and to new NF2 mutations without previous NF2 family histories.  
The relatively small size of the NF2 coding region will make this approach
relatively straightforward.  As a result, the National Neurofibromatosis
Foundation has already announced that it will fund a pilot project to
demonstrate the feasibility of diagnostic testing in NF2.

     Moreover, careful correlations may now be attempted between certain
genetic aberration patterns and distinct clinical phenotypes in NF2.

     It should be kept in mind, however, that NF2 is not only a tumor
syndrome, but also a developmental disorder.  Thus, the elucidation of the NF2
gene functions should ultimately provide new insights not only into cancer-
related questions, but also into fundamental mechanisms regulating the
development of the human nervous system, one of the remaining mysteries of
modern biology.

Health InfoCom Network News                                            Page 33
Volume  6, Number  9                                            April 10, 1993

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
                       Announcements of Studies/Research
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

                           PAIN MANAGEMENT RESEARCH

Prof. Walter W. Hudson and Prof. Jackie Sieppert announce the beginning of a
major research project to investigate the frequency and severity of acute and
chronic pain and the impact of pain on the capacity for personal and social
functioning. This research will consist of two major components although both
will be conducted through a single data collection effort.

The first component of this research will focus on examination of the
psychometric characteristics of a new Pain Management Inventory (PMI) that was
developed by Prof. Hudson.  This portion of the study will examine the
reliability and several types of validity for each of the 15 subscales of the
PMI.

The second component of this research will focus on a more substantively
oriented examination of the way the 15 PMI subscales relate to the 27 personal
and social functioning subscales of the Multi-Problem Screening Inventory or
MPSI (Hudson, 1990).  The aim is not to produce definitive research findings
about specific populations but to obtain initial evidence about relationships
between pain and several areas of personal and social functioning.  Findings
are intended only for use in designing more refined subsequent research using
specific and well defined populations of interest.

There are two ways to participate in this research for those who may be
interested.  The first is to administer the Pain Management Questionnaire
Package (PMQP) to students in your courses or to other groups with whom you
have regular contact. Such respondents will be placed in a normative sample.  
The second way to participate is to administer the PMQP to clients or patients
whom you know to be experiencing acute or chronic pain. Those clients will be
placed in a clinical sample.

In return for your participation and assistance with this research, the
authors will send you (1) an extensive bibliography that reflects the extant
knowledge base in the area of pain management in social work with key
references to the knowledge base in other professions or disciplines, (2) the
results of the pain management study when it has been completed, and (3)
information that will assist those who are interested in developing a sub-
specialty in pain management within the broader arena of medical social work
education and practice.

If you are interested in assisting with the data gathering phase of this

Health InfoCom Network News                                            Page 34
Volume  6, Number  9                                            April 10, 1993

research, please contact the authors, indicate the number of copies of the
PMQP that you can distribute and return, and provide them with a surface
mailing address.  The authors will cover all materials and shipping costs.

Prof. Walter W. Hudson              Prof. Jackie Sieppert
School of Social Work               Faculty of Social Work
Arizona State University            University of Calgary
Tempe, AZ, USA 85287                Calgary, ALB, CANADA T2N 1N4

Health InfoCom Network News                                            Page 35
Volume  6, Number  9                                            April 10, 1993

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
                      Meeting & Conference Announcements
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

       Advanced ToolBook for Health Science Educators: New Techniques in
                             Multimedia and Video

                        Center for Continuing Education
                     University of Nebraska Medical Center
                                Omaha, Nebraska
                            Thursday, May 27, 1993

                                 Sponsored by
                   The University of Nebraska Medical Center

                ADVANCED TOOLBOOK FOR HEALTH SCIENCE EDUCATORS
                    NEW TECHNIQUES IN MULTIMEDIA AND VIDEO

     Advanced ToolBook for Health Science Educators: New Techniques
     in Multimedia and Video will be held Thursday, May 27, 1993 at the
     Center for Continuing Education on the campus of the University of
     Nebraska Medical Center, Omaha.

               WHAT TOOLBOOK CAN DO FOR HEALTH SCIENCE EDUCATORS

     This program is designed to teach health science educators advanced
     applications for the production of computer based instruction. The
     program will concentrate on new techniques in multimedia and video.
     Health Science educators now are using technology in exciting new
     ways to make positive, fundamental changes in the way they teach.
     These technologies can be used to:

     -- explain complex concepts more easily
     -- spark the discussion of more challenging topics
     -- increase student motivation and productivity
     -- offer a surrogate "tutor" when the instructor is unavailable
     -- give the instructor feedback on students' performance
     -- create scholarly papers, proposals and reports
     -- facilitate all academic work, from research to correspondence to
         gradebooks

                                  INSTRUCTOR

     F.S. (Key) Lawson is Senior Industry Administrator at the IBM
     Headquarters Staff in Santa Monica, CA.

Health InfoCom Network News                                            Page 36
Volume  6, Number  9                                            April 10, 1993

     Mr. Lawson is a member of the IBM ACIS (Academic Information
     System) staff and has been since 1985.  He is currently responsible for
     technical and education support of the IBM Advanced Academic
     System (AAcS), specializing in ToolBook and Multimedia.

     He joined IBM before the announcement of the IBM System/360 as
     a System Engineer in Los Angeles, CA, and moved his way up the
     ranks of SE and Marketing Rep until joining the regional staff in 1978.
     On the regional staff he held technical support and customer education
     positions until being promoted to SE Manager in the Los Angeles
     area.  He was a SEM and later a technical manager for seven years
     before moving to an ACIS headquarters staff role in ACIS in 1985.

     His first job in ACIS was supporting the IBM Advanced Education
     program grants to UCLA, USC and Caltech.  Then as ACIS began
     developing its own products to support higher education, namely the
     student bundles and the AAcS, he moved into direct customer support
     for these products.  He continues in that capacity while assisting IBM
     with its planning, development, and testing of future academic
     products.

                                 AGENDA TOPICS

      8:30 A.M.     Course Registration
      9:00          Introduction
      9:15          Toolbook's Object Hierarchy
      9:30          Radio Buttons
     10:00          Lively map of the U.S.A.
     10:45          Break
     11:00          Creating and using user-defined messages
     12:00          Working Lunch and Toolbook Demonstrations
                    Applications in Medical Education and Patient Care
                    Robert S. Wigton, MD
                    Thomas Tape, MD
      1:00 P.M.     Object animation with simple and list variables
      1:45          Object animation with local and system variables
      2:30          Break
      2:45          Writing Scripts to Track Students' Selections of Options
                       and Pathways
      3:00          Overview of AAcS multimedia architecture
      3:15          Adding digitized sound to a ToolBook book
      4:00          Demonstration of adding full-motion video to a book
      4:30          Demonstration of adding CD audio to a book
      4:45          Adjourn

Health InfoCom Network News                                            Page 37
Volume  6, Number  9                                            April 10, 1993

                     GET HANDS-ON EXPERIENCE AND TRAINING

     Each student will be provided access to a 386 or higher PC and learn
     through hands-on exercises how to develop ToolBook and Multimedia
     ToolBook applications.

                                 PREREQUISITES

     This class is recommended for faculty who have had hands-on
     experience with Asymetrix ToolBook.  The student should be
     comfortable using Windows and a PC-based word processor and should
     be able to perform the following tasks in ToolBook.

     - Create and manipulate ToolBook objects like buttons, fields, ellipses,
         etc.
     - Create and modify ToolBook pages and backgrounds
     - Access and use ToolBook clipart

     Any programming experience is helpful, but not required.

     REGISTRATION FEE: The registration fee which includes breaks and
     lunch as well as handout material and other amenities to make this an
     enjoyable and productive meeting is $125.  Fees will be refunded,
     except for a $25 processing fee, only if you notify us one week prior to
     the symposium.  No refunds will be made after the meeting begins.
     Students and residents can attend at a reduced fee.

     EXHIBITS:  We welcome Academic exhibits pertaining to ToolBook
     or similar programs. Academic exhibits are open throughout the day
     and during special exhibit sessions.  There is no charge for academic
     exhibits in addition to the $125 registration fee.  If you have questions
     about exhibits or about the symposium, call James Van Arsdall EdD,
     (402) 559-4152.

     PLANNING COMMITTEE: Robert S. Wigton, MD; Thomas G. Tape,
     MD; Daniel L. Moser, Ph.D; Vickie S. Freeman, MS., University of
     Nebraska Medical Center.

     CREDIT: The University of Nebraska College of Medicine designates
     this continuing medical education activity for 7 hours in Category I of
     the Physician's Recognition Award of the American Medical
     Association, and is, therefore, approved for 7 hours of Category I
     credit by the American Academy of Physician Assistants.

Health InfoCom Network News                                            Page 38
Volume  6, Number  9                                            April 10, 1993

     FACILITY AND PARKING: The Center for Continuing Education is
     located at 45th and Emile Streets on the University of Nebraska
     Medical Center Campus in Omaha. The facility provides a tranquil
     environment conducive to an undisturbed meeting.  For off campus
     visitors, the Center is conveniently located across the street from the
     main University of Nebraska Medical Center parking structure which
     provides parking at no charge.

     LODGING:  We have reserved a block of rooms at the New Tower
     Inn located at 78th and Dodge Streets in Omaha.  The New Tower is
     located mid-city with comfortable rooms and a solar dome all-season
     swimming pool.  It is near fine restaurants, fast cooking.net">food facilities, movie
     theaters and many major shopping centers.  A special room rate is
     available for $42 per night for a single room and $45 for a double
     room.  When making reservations, please call (402) 393-5500.  You
     must tell them you are attending this program to receive the special
     room rate.

     TRANSPORTATION:  The New Tower Inn provides a shuttle bus from
     Omaha's Eppley Airport.  Parking at the hotel is free for guests.
     Transportation to the meeting at the Medical Center will leave the
     hotel at 7:45 A.M. and return at the conclusion of the program.

     For registration information, contact:
        Center for Continuing Education, University of Nebraska Medical
        Center, 600 South 42nd Street, Omaha, Nebraska 68198-5651

     TO REGISTER BY PHONE, CALL (402) 559-4523 OR FAX (402)
     559-5915.

Health InfoCom Network News                                            Page 39
Volume  6, Number  9                                            April 10, 1993

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
                              AIDS News Summaries
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

                AIDS Daily Summary for April 6 to April 9, 1993

  The Centers for Disease Control and Prevention (CDC) National AIDS  
Clearinghouse makes available the following information as a public  service
only. Providing this information does not constitute endor{*filter*}t  by the CDC,
the CDC Clearinghouse, or any other organization. Reproduction  of this text
is encouraged; however, copies may not be sold.  Copyright 1993, Information,
Inc., Bethesda, MD

     ====================================================================  
                                 April 6, 1993
     ====================================================================  

"AIDS Study Casts Doubt on Value of Hastened Drug Approval in  U.S." New York
Times (04/06/93), P. C3  (Altman, Lawrence K.)

     The recent summary of a European study that revealed no benefit  from
early treatment with AZT in HIV infection has also raised  questions about the
validity of certain tests that the U.S.  government has used to hasten the
drug approval process.  The  tests are known as surrogate markers, and are
designed to be  quick substitutes for the standard, time-consuming approaches  
traditionally used in predicting the benefit of a treatment.  The "Concorde"
study challenged the efficacy of using the CD-4 count  as a surrogate marker
for AZT among asymptomatic HIV-positive  people.  The cooking.net">food and Drug
Administration relied heavily on  studies that found an improvement in CD-4
counts when it licensed AZT for early treatment of HIV.  It also used the same
markers in approving DDI and DDC, two other anti-AIDS {*filter*}.  However, the  
British government rejected applications to approve DDI based on  a decline in
CD-4 cell counts that the United States observed.   Tim Peto, an AIDS expert
at Oxford University, said the primary  reason it was rejected in England was
widespread doubts among  European experts, including himself, about the
validity of CD-4  counts as a surrogate marker for the clinical benefit of an
AIDS  drug.  Dr. David A. Kessler, Commissioner of the FDA, revealed  his
faith in the validity of the CD-4 count.  "It is a reliable  predictor," he
said, adding that his agency would examine the  complete data from the
Concorde study when it is published in a  few months.  The researchers in the
Concorde study said CD-4  failed as a surrogate marker because although the
CD-4 count  increased by 30 cells among the asymptomatic HIV-positive  
patients who were given AZT, the rise did not indicate any  medical benefit.
====================================================================  
"Major Study of People With HIV, TB is Set" Philadelphia Inquirer (04/06/93),

Health InfoCom Network News                                            Page 40
Volume  6, Number  9                                            April 10, 1993

P. A8  (Dixon, Jennifer)

     The federal government yesterday revealed that it will launch the first
major American study of drug treatment approaches for  people infected with
tuberculosis and HIV.  Nearly 650  HIV-infected people with active TB will be
involved in the  clinical trials.  Dr. Anthony S. Fauci, director of the
National  Institute of Allergy and Infectious Diseases, said a substantial  
proportion of the subjects would probably be from New York City,  where TB,
particularly drug-resistant TB, is an increasing  problem.  In addition, the
U.S. Department of Health and Human  Services announced plans for a $2.1-
million, five-year grant to  Johns Hopkins University to examine the efficacy
and appropriate  use of AZT, DDI, and other anti-AIDS {*filter*}.  This move is a  
result of preliminary findings of the European Concorde study,  which found
that AZT is not effective when used in the early  course of HIV infection.  
HHS Secretary Donna Shalala said,  "While {*filter*} have been reviewed for basic
safety and  effectiveness before they go on the market, these further studies
should help physicians make the best treatment choices."  The  government will
evaluate the clinical drug trials involving  HIV-positive patients with TB for
the benefit of adding a new  drug for TB treatment, levofloxacin, to the usual
four-drug  therapy used in areas where TB organisms are commonly resistant  to
one or more anti-TB {*filter*}.  People who live in areas where  drug-resistant TB
is rare can also enroll in the trial and will  receive the four-drug regimen
without levofloxacin.
====================================================================  
"Britain Announces New Guidelines for Health Workers With AIDS" United Press
International (04/05/93)

     London--The British government issued new guidelines for  HIV-positive
health-care workers Monday, but decided against  mandatory HIV testing for
National Health Service employees.  The new guidelines simply encourage
physicians, dentists, nurses, and other health-care workers who believe they
may have been exposed  to HIV to seek medical advice and undergo HIV testing
where  appropriate.  The government has called for health officials to  inform
every patient who may have been put at risk by a  health-care worker found to
have AIDS.  The revised guidelines  require that HIV-positive health-care
workers be taken off  high-risk duties, such as invasive surgery, where there
may be a  possibility of transmitting the disease.  Dr. Kenneth Calman, the
government's chief medical officer, opposes mandatory HIV tests  and says that
public safety will be ensured if health workers  promise to voluntarily seek
medical advice and undergo HIV  testing where appropriate.  The review of the
guidelines was  prompted by an influx of recent cases in which thousands of  
patients were tested for HIV after they learned they had been  treated by HIV-
positive physicians.
====================================================================    
"Hysteria Over Doctors With HIV" Lancet (03/20/93) Vol. 341, No. 8847, P. 764  

Health InfoCom Network News                                            Page 41
Volume  6, Number  9                                            April 10, 1993

(Ellis, Simon J.)

     HIV-related policies among health-care workers should be based on medical
facts of transmission and not media-induced hysteria,  writes Simon J. Ellis
of Green College in Oxford, U.K.  The media reaction in the United Kingdom to
the discovery of health-care  workers infected with HIV has been spurred by
response from the  Department of Health or the health officials concerned.  
The risk of HIV infection to patients is infinitesimal and theoretical  since
there have been no reported cases of surgeons infecting  patients and only one
case of a dentist who allegedly infected a  patient.  The latest commotion
involved the media naming the  unfortunate gynecologist and reporting his
lifestyle and {*filter*}  orientation.  This is a severe invasion of privacy.  
There is no  legal basis for informing the patients treated by this person  
other than political expediency.  Physicians are much more likely to contract
--------- end of part 3 ------------

---





Thu, 28 Sep 1995 04:34:08 GMT
 
 [ 1 post ] 

 Relevant Pages 

1. HICN609 Medical News Part 1/4

2. HICN609 Medical News Part 2/4

3. HICN609 Medical News Part 4/4

4. HICN608 Medical News Part 1/4

5. HICN608 Medical News Part 2/4

6. HICN608 Medical News Part 3/4

7. HICN608 Medical News Part 4/4

8. HICN610 Medical News Part 3/4

9. HICN610 Medical News Part 4/4

10. HICN611 Medical News Part 1/4

11. HICN611 Medical News Part 2/4

12. HICN611 Medical News Part 3/4


 
Powered by phpBB® Forum Software