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Biomedical subjects

J C C Borleffs

Publications and source records attributed to J C C Borleffs.

3 recordsLinked to original sources

[Pro and contra discussion about medical education].

Since the end of the last century, medical education is being renewed in many countries. There is a tendency toward integration of clinical and preclinical knowledge, presentation of basic science topics as themes of organ systems in conjunction with clinical cases, emphasis on professional attitude, context-related and small-scale learning and the own responsibility of the student. As a contribution to the discussion, the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) and the Tijdschrift voor Medisch Onderwijs (Dutch Journal of Medical Education) have decided to publish articles in a pro and contra format.

Clinical Competence↗

Competency-based training for internal medicine.

The Central College of Medical Specialities has presented guidelines for modernisation of all postgraduate speciality training programmes. These guidelines include the definition of seven general competency fields, each of them described in more detail with four key competencies. By 2006, all postgraduate speciality training programmes will be based on these competency fields. Furthermore, by then assessment of residents will be focused on the achievement of competence, rather than only on fulfilment of length of specified rotations, numbers of clinical experiences and numbers of performed skills. The application of this competency model emphasises the fact that the education of medical doctors entails more than providing them with the required theoretical and clinical knowledge and skills.

Competency-Based Education↗

Comparison of two once-daily regimens with a regimen consisting of nelfinavir, didanosine, and stavudine in antiretroviral therapy-naïve adults: 48-week results from the Antiretroviral Regimen Evaluation Study (ARES).

BACKGROUND: To improve the dosing frequency and pill burden of antiretroviral therapy, we compared two once-daily dosed regimens to a twice-daily dosed regimen. METHOD: HIV-1-infected, antiretroviral drug-naïve adults were randomized to either twice-daily nelfinavir and stavudine and once-daily didanosine (regimen A) or simplified once-daily dosed antiretroviral regimens consisting of nevirapine, didanosine, and lamivudine (regimen B) or saquinavir, ritonavir, didanosine, and lamivudine (regimen C). RESULTS: At 48 weeks of therapy, the proportion of patients with a blood plasma HIV-1 RNA concentration (pVL) <50 copies/mL by intention-to treat analysis was 42.3%, 50.0%, and 56.5% for regimens A (n = 26), B (n = 22), and C (n = 23), respectively. The time to a pVL <50 copies/mL for the first time was significantly shorter in regimen C, and there was significantly more progression to CDC events in regimen B. These differences are possibly due to differences in baseline characteristics. Adverse events were lowest for regimen C; more signs associated with mitochondrial toxicity occurred in regimen A. Increase in CD4 count was comparable between arms. CONCLUSION: No statistically significant difference in efficacy was found between the two investigated once-daily dosed treatment regimens (B and C) and the reference (A). Regimen C possibly had a better virological response and less toxicity than regimens A and B.

Adult↗