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PubMed2004

Maintenance of certification in the United States: a progress report.

The American Board of Medical Specialties (ABMS) is working closely with its 24 member boards to implement the four components of a Maintenance of Certification (MOC) program. Those components include evidence of professional standing, lifelong learning and self-assessment, cognitive expertise, and evaluation of performance in practice. The new MOC program of the ABMS represents a dramatic shift from how graduate medical education, initial certification in the medical specialties, and recertification in the medical specialties are being conducted. This article updates how specialty boards are implementing the four components.

Certification↗
PubMedDate not supplied

Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies.

Various different systems have been proposed to classify diabetic foot ulcers, but none has gained widespread acceptance. The International Working Group of the Diabetic Foot (IWGDF) developed a classification system for research purposes, which is described in this report. In this PEDIS system, all foot ulcers should be classified according to five categories: perfusion, extent/size, depth/tissue loss, infection and sensation. The methods to determine the presence and severity of these factors are described; each (sub)category is defined according to strict criteria, which are applicable worldwide. All experts involved and all members of the IWGDF reached consensus on this system, which will be validated first, before it can be formally introduced.

Diabetic Foot↗
PubMed1984

[Progress report. Possibilities and limitations of the in vitro technic for prenatal toxicologic studies].

Considering the variety of problems of the prenatal toxicity test the in vitro methods hitherto existing in this field are discussed according to their degree of complexity (cell culture, mass culture of dispersed cells, organ culture, whole embryo culture) within their limitations and possibilities. In this connection special attention is focussed to the use of human tissue for testing basic mechanisms of the developmental biology and for toxicity tests.

Animal Testing Alternatives↗
PubMed1990

[Progress report. Lipid peroxidation. 2. Secondary reactions].

Lipids and lipid containing foods are altered by autoxidative processes resulting in the formation of hydroperoxides which are considered as the actual primary autoxidation products. These hydroperoxides cause a variety of secondary reactions giving di- and trihydroperoxides, hydroperoxyepidioxides, endoperoxides and hydroperoxyepoxides, so called secondary autoxidation products at a primary level. Sometimes they are only minor substances. The formation of primary autoxidation products is accelerated by reaction conditions as increased temperature, oxygen, metal ions and sensibilizers but is inhibited by natural and synthetic antioxidants. The decomposition of hydroperoxides and secondary autoxidation products at the primary level results in volatile substances decreasing the flavour quality of lipid containing foods. Simultaneously there are other cleavage and decomposition products remaining in the lipid causing a reduction of its oxidative stability.

Chemical Phenomena↗
PubMed1990

[Progress report. Lipoxygenases--their significance in lipid chemistry].

Lipoxygenase catalysed reactions play an important role in the field of lipid peroxidation. The enzyme is characterized concerning its sources, biological importance, isolation, substrates, active centre and inhibition. Extensive explanations should show the complex mechanisms of enzyme catalyses divided into two major ways: dioxygenase and hydroperoxidase reactions. Food science specific importance and expected effects on food systems are discussed and related to reaction products generated during catalysis and enzymatic processes both preceding and following lipoxygenase reaction.

Animals↗
PubMed1990

[Progress report. What can one expect from a "functional prenatal toxicology?"].

In the strategy of investigation applied and demanded in prenatal toxicology partial aspects have been overstressed until now, although here as well as in postnatal toxicology the problems should be viewed in its complexity (in this case, F1-generation in its several pre- and postnatal stages of development). Therefore, there was the urgent need to summarize the existing methods of functional investigation in the field of prenatal toxicology and to compare them with conventional morphological methods as to their meaningfulness and sensitivity. As a result, the routine introduction of clinical-functional investigations is demanded.

Abnormalities, Drug-Induced↗
PubMed1987

Further experience with recombinant interferon alfa-2a with vinblastine in metastatic renal cell carcinoma: a progress report.

Thirty-three patients with measurable metastatic renal cell carcinoma were entered into 2 consecutive phase II protocols using interferon alfa-2a. In protocol I, 20 patients were treated with interferon alfa-2a at a dose of 36 X 10(6) IU i.m. t.i.w. Vinblastine was also given to 18 of these patients at a dose of 0.10-0.15 mg/kg i.v. every 2-3 weeks, depending on the blood cell count. In protocol 2, 13 patients received interferon alfa-2a at a dose of 18 X 10(6) i.m. t.i.w. with stepwise dose escalations of 3 X 10(6) IU being given every 2 weeks to 8 patients. Vinblastine, at a dose of 0.1 mg/kg every 3 weeks, was also given to 12 patients in protocol 2. Partial responses were seen in a total of 9 evaluable patients (lung, 5; lymph nodes, 2; liver, 1; and bone, 1), comprising 6 of 18 from protocol 1 and 3 of 13 from protocol 2. The median response duration was 89 days (range 91-540). No clinical parameter could be identified which was predictive for response. The subjective toxicity (flu-like symptoms and muscle pain) was considerable and necessitated dose reduction in 19 patients from protocol 1. The dose schedule of protocol 2 was tolerated better even after slight dose escalation. The considerable interpatient variation in toxicity, however, made any demonstration of a clear dose-toxicity relationship impossible. High dose interferon treatment of metastatic renal cell carcinoma combined with vinblastine results in a 33% response rate (95% confidence interval: 11-55%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaminophen↗
PubMed1998

Performance of human mass balance studies with stable isotope-labeled drug and continuous flow-isotope ratio mass spectrometry: a progress report.

We propose performing human mass balance studies by administering stable isotope labeled (13C or 15N) drug and quantitating excess (above background) 13C or 15N in urine, serum, and feces by continuous flow-isotope ratio mass spectrometry (CF-IRMS). Theoretical calculations and empirical data (dynamic range, linearity, sensitivity, precision, accuracy) are presented to establish that commercially available CF-IRMS instruments can quantitate stable isotope labeled (one or two 15N or 13C labels) drug concentrations of 1.0 microg/mL or greater in urine, serum (15N), or feces. More than two 13C labels may be necessary to quantitate 1.0 microg/mL of drug in serum. Three volunteers received 650 mg of 15N13C2-acetaminophen, and urine was collected for 72 hours. Percent of administered label recovered in urine from the three subjects was 97.4, 78.9, and 95.4 for 13C and 90.3, 77.0, and 90.6 for 15N. Fecal recovery of label for one subject was 0.9% (13C2) and 1.1% (15N). Serum pharmacokinetic values obtained by counting 13C or 15N in one subject were as expected for acetaminophen. This method appears to be promising, and further validation is ongoing.

Acetaminophen↗
PubMed1980

Progress report on extended clinical use of the argon laser for cutaneous lesions.

Since 1970 a variety of cutaneous lesions have been successfully treated with the argon laser and the histopathology carefully studied at the Palo Alto Medical Clinic. Patients with port wine hemangiomas, capillary/cavernous hemangiomas, and telangiectasia have achieved successful resolution in some cases, and subtotal blanching in other cases, with a low incidence of scarring or other complications. Recently, decorative tattoos as well as a variety of miscellaneous pigmented or vascular skin lesions, such as seborrheic keratoses, pyogenic granulomas, and senile angiomas, have also been successfully treated with the argon laser. Total clinical experience is updated in this report.

Adult↗
PubMed1999

Standardization: a progress report.

The introduction of nucleic acid amplification technology (NAT) assays for the detection of viral contamination of blood and blood products requires the availability of well-characterized reference reagents. Working reagents for hepatitis C virus RNA, hepatitis B virus DNA, HIV-1 RNA and human parvovirus B19 DNA have been established at NIBSC and at many other laboratories (both official medicinal control laboratories and commercial laboratories). However, as these reagents have been characterised independently, it is difficult to compare results from assays using different working reagents. Recently, a WHO International Standard was established for HCV RNA NAT assays. This standard has been calibrated in International Units (IU) and provides a common standard against which all working reagents can be calibrated. Collaborative studies to characterise two further candidate International Standards for HBV DNA and HIV-1 RNA NAT assays have been completed.

Blood Banks↗
PubMed1998

Chemotaxis receptors: a progress report on structure and function.

Recent biochemical and structural studies have provided many new insights into the structure and function of bacterial chemoreceptors. Aspects of their ligand binding, conformational changes, and interactions with other members of the signaling pathway are being defined at the structural level. It is anticipated that the combined effort will soon provide a detailed, unified view of an entire response system.

Bacterial Proteins↗
PubMed2003

Lung ischemia: endothelial cell signaling by reactive oxygen species. A progress report.

These studies using both intact lung and reconstituted cell systems have shown that pulmonary endothelial cells respond rapidly (within several seconds) to the acute cessation of perfusate flow, i.e., ischemia. These effects represent a response to the loss of shear stress and are unrelated to changes in cellular oxygenation. The immediate response is partial depolarization of the endothelial cell membrane followed by activation of endothelial NADPH oxidase and the extracellular generation of superoxide anion. Dismutation of superoxide to H2O2 generates a cell signaling molecule that results in the activation of protein kinases and transcription factors which in turn lead to NO generation and activation of endothelial cell division. The presumed physiological role of this signal cascade is the generation of a vasodilator (NO) and the formation of new capillaries in the effort to restore blood flow.

Animals↗