Complement: to be or not to be?
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Complement Activation↗
Biomedical subjects
P Letendre
Publications and source records attributed to P Letendre.
Reflections on ART certification.
Development of self-directed study skills and problem solving abilities is not nurtured in an environment in which every subject is specified and choices are few. The CSLT would do well to propose fewer requirements and to keep them process-related. It should have more faith in the universities and the candidates. A degree will develop the key skills to be life-long learners. The work environment and CE courses will help keep information current and relevant. The professional body, the CSLT, should produce an ART evaluation instrument that assesses both skills and knowledge at an appropriate level. Submission of a case study and an oral examination based on the case, if properly constituted, can fulfill this role. The Task Force On Future Trends and the ART Working Group are to be congratulated on developing a blueprint for future advanced certification. Their job has been enormous. They deserve our thanks for having the courage to propose major changes that, while not universally popular at the outset, should serve the membership well in the long term. As the new system evolves, it is important for all views to be heard. Members who have something to contribute, should speak up now. The ART process is still unfolding, and we may be able to influence its direction.
Canada↗
Heparin kinetics during hemodialysis: variation in sensitivity, distribution volume, and dosage.
A method to assess heparin kinetics and individualize dosages was examined in 27 patients during chronic hemodialysis. Pretreatment heparin sensitivities were determined to establish the relationship between heparin concentration and activated clotting times (ACTs). Distribution volume was calculated by dividing the heparin loading dose by the 5-min heparin concentration. Assessments were made during three different dialysis periods. There was a 10-fold range in pretreatment heparin sensitivities. Intrapatient heparin sensitivity remained relatively consistent between dialysis periods. The degree of heparin sensitivity was significantly correlated to baseline ACT. Patients post-splenectomy were more sensitive to heparin. Large intra- and interpatient variation in distribution volume was also observed. Men, patients less than 60 years old, and patients post-splenectomy represented variables that contributed to higher heparin dose requirements.
Adolescent↗