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At least 721 records · Page 40Linked to original sources
PubMed2001

Mitogen-activated protein kinase pathway is involved in alpha6 integrin gene expression in androgen-independent prostate cancer cells: role of proximal Sp1 consensus sequence.

Metastatic diseases of prostate cancer reveal high expression of alpha6 integrin and the activation of mitogen-activated protein kinases (MAP kinase). Therefore, the present study was conducted to examine whether MAP kinase pathway is involved in the alpha6 integrin gene expression in androgen-independent prostate cancer cell lines. alpha6 integrin mRNA expression, the alpha6 integrin promoter-induced luciferase activities and MAP kinase enzyme activities in androgen-independent LNCaP and PC-3 cell lines were higher than those in androgen-dependent LNCaP. Deletion and mutation analysis showed that Sp1 consensus sequence at -48 to -43 bp from the transcription start site was necessary for basal promoter activity. Binding of Sp1 to its consensus sequence in three cell lines was confirmed by electrophoretic mobility shift assays. Sp1 binding to its consensus sequence, as well as promoter activity and mRNA expression, were found to be inhibited by an inhibitor of MAP kinase kinase 1 and 2, U0126, in the androgen-independent cell lines. Our results indicate that the proximal Sp1 is necessary for basal promoter activity of the alpha6 integrin, suggesting that signal transduction from MAP kinases to activation of Sp1 might be involved in alpha6 integrin gene expression in androgen-independent prostate cancer cell lines.

Consensus Sequence↗
PubMedDate not supplied

Assessment of dementia in elderly outpatients: a comparative study of European centers and consensus statement.

Large numbers of elderly patients, suspected of having dementia, need medical evaluation, often in early phases of their illness. A complete outpatient assessment clearly could be advantageous. Thirty-five centers from 15 European countries, known to their scientific gerontological and geriatric societies to have experience in outpatient care for elderly patients with dementia, participated in an effort to develop a consensus statement for the assessment needs of these patients. The comparison of the centers showed that a wide variety of approaches was currently in practice. Differences appeared to be mainly based on local facilities and organization. A consensus for diagnostic outpatient assessment was easily reached. Diagnosis should be based on DSM-IV criteria, which requires a standardized assessment (including neuropsychological, functional and technical evaluation) and should be multidisciplinary. An assessment of dementia of elderly outpatients appears to be very feasible - a consensus approach with minimum diagnostic requirements is presented.

Journal Article↗
PubMed1997

Proceedings of the International Consensus Conference on Cutaneous T-cell Lymphoma (CTCL) Treatment Recommendations. Boston, Massachusetts, Oct. 1 and 2, 1994.

At the International Consensus Conference for Cutaneous T-Cell Lymphoma (CTCL) Treatment Recommendations (held in Boston, Massachusetts, Oct. 1 and 2, 1994), international experts were asked to assess where consensus existed and to identify areas that required clinical research. We review the epidemiology, pathology, and immunology of CTCL, summarize the important areas in which consensus exists, and discuss newer targeted therapies.

Humans↗
PubMed1999

Priorities for research in emergency medical services for children: results of a consensus conference.

STUDY OBJECTIVE: To arrive at a consensus on the priorities for future research in emergency medical services for children. METHODS: A consensus group was convened using the Rand-UCLA Consensus Process. The group took part in a 3-phase process. Round 1 involved reviewing a compendium of relevant research articles and answering a mailed questionnaire. Panel members were asked to prioritize topics on the basis of the 1993 Institute of Medicine Report on Emergency Medical Services for Children. Participants were asked to rate each topic based on the significance of the research, and whether the topic would (1) improve general knowledge, (2) change behavior, (3) improve health, (4) decrease the cost of care, or (5) change public policy. A 4-point Likert scale was used. Participants were also asked if the research would require a multicenter study and if the research were feasible. Round 2 of the study involved a meeting of the panel, where the results of Round 1 were discussed and the topics were reprioritized. The topics were given a rank order and a final ranking was done in Round 3. RESULTS: The panel considered a list of 32 topics; these were combined and reworded to give them more precise meaning. Several new topics were also added. Fifteen topics were given a rank order and placed within the 7 broad categories of the Institute of Medicine report. Clinical aspects of emergency care, systems organization, configuration, and operation and injury prevention were given high priority rankings. The first 5 topics were very close in point-rank order. CONCLUSION: The panel was able to develop a list of important topics for future research in emergency medical services for children that can be used by foundations, governmental agencies, and others in setting a research agenda for such services.

Child↗
PubMed1998

Requirements for infrastructure and essential activities of infection control and epidemiology in hospitals: A consensus panel report. Society for Healthcare Epidemiology of America.

The scientific basis for claims of efficacy of nosocomial infection surveillance and control programs was established by the Study on the Efficacy of Nosocomial Infection Control project. Subsequent analyses have demonstrated nosocomial infection prevention and control programs to be not only clinically effective but also cost-effective. Although governmental and professional organizations have developed a wide variety of useful recommendations and guidelines for infection control, and apart from general guidance provided by the Joint Commission on Accreditation of Healthcare Organizations, there are surprisingly few recommendations on infrastructure and essential activities for infection control and epidemiology programs. In April 1996, the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in hospitals. The following report represents the consensus panel's best assessment of needs for a healthy and effective hospital-based infection control and epidemiology program. The recommendations fall into eight categories: managing critical data and information; setting and recommending policies and procedures; compliance with regulations, guidelines, and accreditation requirements; employee health; direct intervention to prevent transmission of infectious diseases; education and training of healthcare workers; personnel resources; and nonpersonnel resources. The consensus panel used an evidence-based approach and categorized recommendations according to modifications of the scheme developed by the Clinical Affairs Committee of the Infectious Diseases Society of America and the Centers for Disease Control and Prevention's Hospital Infection Control Practices Advisory Committee.

Accreditation↗
PubMed1999

Requirements for infrastructure and essential activities of infection control and epidemiology in out-of-hospital settings: a Consensus Panel report.

In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings. The following report represents the Consensus Panel's best assessment of requirements for a healthy and effective out-of-hospital-based infection control and epidemiology program. The recommendations fall into 5 categories: managing critical data and information; developing and recommending policies and procedures; intervening directly to prevent infections; educating and training of health care workers, patients, and nonmedical caregivers; and resources. The Consensus Panel used an evidence-based approach and categorized recommendations according to modifications of the scheme developed by the Clinical Affairs Committee of the Infectious Diseases Society of America and the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee.

Allied Health Personnel↗
PubMed1998

Consensus phosphorylation sites of human GABA(c)/GABArho receptors are not critical for inhibition by protein kinase C activation.

The mechanism of inhibition of human GABA(C)/GABArho receptors by protein kinase C (PKC) activation was investigated in Xenopus oocytes. Phorbol 12-myristate 13 acetate (PMA), a potent PKC activator, at 25 nM inhibited the currents through GABArho2 receptors, which have one consensus phosphorylation site by PKC in the predicted intracellular loops. The time-courses and amplitudes of inhibition were not significantly different from those occurring through GABArho1 receptors, which have six such sites. The inhibitory effect of PMA was also observed after removing each consensus phosphorylation site in both GABArho1 and rho2 receptors by site-directed mutagenesis. These results suggest that phosphorylation of consensus sites in the intracellular loops is not involved in the inhibition of human GABA(C)/GABArho receptors by PKC activation.

Animals↗
PubMed2003

Interdisciplinary consensus on the use and technique of vacuum-assisted stereotactic breast biopsy.

PURPOSE: Quality assurance of stereotactic vacuum-assisted breast biopsy (VB). METHOD: A consensus was achieved based on the existing literature and the experience of VB users (Ethicon Endosurgery, Norderstedt). RESULTS: The imaging work-up must be completed according to existing standards before an indication for stereotactic VB is established. Indications include microcalcifications and small non-palpable masses; for the time being lesions very close to the skin and architectural distortions (radial scar) are considered less suitable. Acquisition of >20 cores (11 Gauge) should be routinely attempted (goals: as complete a removal of small lesions as possible, thereby increasing diagnostic confidence and reducing so-called 'underestimates'). The pre/post-fire and post-biopsy stereotactic images and a post-biopsy orthogonal mammogram must be documented. All cases with no or uncertain histopathological correlation require discussion in a regular interdisciplinary conference and a documented consensus concerning further work-up or therapy. Standardised documentation of the primary findings and follow-up mammography after approximately 6 months is requested. CONCLUSION: This consensus includes protocols for the establishment of an indication, performance indicators, interdisciplinary interpretation and therapeutic recommendation, documentation and follow-up. It does not replace official recommendations for percutaneous biopsy.

Biopsy, Needle↗
PubMed1997

Guidelines for management of left-sided prosthetic valve thrombosis: a role for thrombolytic therapy. Consensus Conference on Prosthetic Valve Thrombosis.

OBJECTIVES: We sought to form a consensus recommendation for management of prosthetic valve thrombosis (PVT) from previous case and uncontrolled reports from a consensus of international specialists. BACKGROUND: PVT and thromboembolism relate to inadequate anticoagulation and valve type and location. PVT is suspected by history (dyspnea) and auscultation (muffled valve sounds or new murmurs) and confirmed by Doppler echocardiography showing a marked valve gradient. METHODS: A consensus conference was held to recommend management of left-sided PVT. RESULTS: Transesophageal Doppler echocardiography is used to visualize abnormal leaflet motion and the size, location and mobility of thrombus. Thrombolysis is used for high risk surgical candidates with left-sided PVT (New York Heart Association functional class III or IV) because cerebral thromboembolism may occur in 12% of patients. Duration of thrombolysis depends on resolution of pressure gradients and valve areas to near normal by Doppler echocardiography performed every few hours. Lysis is stopped after 72 or 24 h if there is no hemodynamic improvement (operation indicated). Heparin infusion with frequent measurement of activated partial thromboplastin time (aPTT) begins when aPTT is more than twice control levels and can be converted to warfarin (international normalized ratio [INR] 2.5 to 3.5) plus aspirin (81 to 100 mg/day). Patients in functional class I or II have lower surgical mortality, and those with large immobile thrombi on the prosthetic valve or left atrium have responded to endogenous lysis with combined subcutaneous heparin every 12 h (aPTT 55 to 80 s) plus warfarin (INR 2.5 to 3.5) for 1 to 6 months. Operation is advised for nonresponders or patients with mobile thrombi. CONCLUSIONS: Thrombolysis, followed by heparin, warfarin and aspirin, is advised for high risk surgical candidates with left-sided PVT.

Aortic Valve↗
PubMed2005

[Impact of the consensus conference on the ambulatory treatment of bronchiolitis in infants].

OBJECTIVE: To assess the impact of guidelines of the consensus conference in September 2000 on the ambulatory management of acute bronchiolitis in infants. METHODS: Prospective multicenter study, in four hospitals in the North department in France, during three epidemic periods: the winter preceding the consensus conference and the two following winters. All the infants between 30 days and 2 years of age, admitted to an emergency care unit for a first or second episode of bronchiolitis were included. The infants' characteristics and ambulatory treatments prescribed were collected. RESULTS: Six hundred thirty-eight infants were included: 169 before the conference and 469 after. Seventy-seven percent had consulted previously and a prescription had been drawn-up for 77%. There was no difference in the frequency of drug prescriptions or physiotherapy between the three periods. After the conferences, inhaled beta(2) agonists were still prescribed in 21% of cases, inhaled corticosteroids in 15%, oral corticosteroids in 34%, antibiotics in 53% and mucolytics in 54%. Physiotherapy was prescribed for 58% of the infants. CONCLUSION: Two years after the consensus conference, the ambulatory treatment of bronchiolitis has no changed, corticosteroids, beta(2) agonists, antibiotics and mucolytics are still prescribed in excess. Further studies, within a few years, are required to reassess the application of the guidelines, not only in outpatient but also in inpatient management.

Acute Disease↗
PubMed2003

Clinically important differences in health-related quality of life for patients with asthma: an expert consensus panel report.

BACKGROUND: Standards for change in health-related quality of life (HRQoL) measures used among asthmatic patients have been established by considering only patient preferences to determine important differences and may not reflect an informed clinical evaluation of change. OBJECTIVE: To establish clinically important difference (CID) standards through the consensus of an expert physician panel for the Juniper Asthma Quality of Life Questionnaire (AQLQ) and Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36, version 2) when used to measure HRQoL among asthmatic patients. METHODS: We organized an 8-person panel of physicians familiar with measuring HRQoL among asthmatic patients with the AQLQ and the SF-36. This expert panel participated in 2 rounds of a modified Delphi process before attending an in-person consensus meeting to establish the CID standards for small, moderate, and large changes in the AQLQ and the SF-36. After the consensus meeting, the panel used an iterative improvement process to cooperatively complete their final report. RESULTS: The expert panel's thresholds for detecting CIDs in the domains of the AQLQ were much higher than previously established levels using patient-perceived changes. CIDs for asthma were also ascertained on the scales of the SF-36, version 2, which were markedly greater than previously cited cross-sectional differences between patient groups. CONCLUSIONS: The CID standards established by this expert panel elucidate a potential distinction between patient and physician perspectives of important HRQoL changes. The many stakeholders of HRQoL difference standards should consider this distinction when adopting standards to evaluate patient change.

Asthma↗
PubMedDate not supplied

Surgeon perceptions of the complications and value of threaded fusion cages as a spine fusion technique: results of a consensus survey.

BACKGROUND CONTEXT: Threaded cage technology has had a meteoric rise in usage. It has been touted as a procedure with low risk and minimal complications. PURPOSE: To gauge the spine surgical community's general consensus regarding cage usage and its complications. STUDY DESIGN/SETTING: A canvassing questionnaire regarding threaded cage usage and complications was sent to members of the North American Spine Society. PATIENT SAMPLE: A total of 665 doctors reported on their perception of 22,585 cages placed by the second year after pre-market approval from the Food and Drug Administration approval. OUTCOME MEASURES: A nonscientific canvassing questionnaire was thought to give a consensus of surgical outcome perception in a large number of caregivers with hopes of understanding general trends. METHODS: Simple statistical measurements were used to report perceived complications by surgeons involved in performing threaded cage surgical procedures. RESULTS: Sixty-nine percent of doctors reported at least one complication with threaded cages, but the complication incidence was low. Visceral injuries were reported in 0.1%; vascular injuries, 1.0%; cage displacement and dislodgement, 1.4%; temporary and permanent neurologic injuries, 2.25% and 0.56%, respectively; infection 0.34%; retrograde ejaculation 1.2% and revision surgery recorded for 2.7%. Those rating cages as fair to poor (16.5%) were those physicians reporting the longest experience with this technology. CONCLUSIONS: The general consensus is that threaded cages have low complication rates and high satisfaction rates, 83.5%. The data represent a convenience sampling and is not scientific.

Attitude of Health Personnel↗
PubMed1988

Consensus development conferences in Sweden. Effects on health policy and administration.

Seven consensus development conferences have been held in Sweden since 1982. The conferences, sponsored by the Swedish Medical Research Council and Spri, typically examine social, organizational, and economic aspects of technology, and therefore, generate consensus statements of interest not only to physicians but also to politicians and health administrators. The study presented here examines the influence of the first five consensus development conferences on politicians and health administrators. Data was obtained via a mail questionnaire and personal interviews with leading individuals in these groups. More than half of the respondents indicated that they had found the statements from one or more conferences to be of practical value as a basis for discussing specific technologies with medical staffs. In some cases the statements directly influenced political decisions.

Consensus Statements as Topic↗
PubMed1991

Physicians' perceptions of consensus reports.

In a pretest-posttest panel survey of 595 eligible Maryland physicians practicing family or general medicine, internal medicine, cardiology, or nephrology, perceptions of consensus reports designed to alter medical practice are examined. On a 7-point scale, physicians reported positive or neutral views of descriptors, most favorably rating credible (mean = 2.25) and reliable (mean = 2.41), and least favorably rating biased (mean = 3.79). In a regression analysis of factors influencing changes in practice behavior congruent with consensus recommendations before and 1 year after the release of a consensus report on hypertension (8), these perceptions were not significant determinants. The strongest predictor of congruent practice behavior a year after the report was published was congruent practice behavior just prior to the report's release, and the second strongest predictor was perceived influence of the report's sources/sponsors.

Attitude of Health Personnel↗
PubMed1998

Consensus among experts and research synthesis. A comparison of methods.

A comparison of two assessment methods, consensus among experts and research synthesis of the scientific literature, was performed using a surgical procedure, carotid endarterectomy (CE), as an example. These two methods have been widely advocated as being scientifically valid. While the comparison revealed a number of areas of general agreement, important differences between the two methods emerged. For example, 30-day mortality for asymptomatic patients was considered an effective outcome (ranked first) by the synthesis, but only "equivocal" (ranked third) of six major indicators reported by the consensus method. The synthesis results are also consistent with other literature reviews as well as with recent large-scale randomized trial results. A number of factors that could account for differences between the two methods were examined. Overall, use of consensus panels may be appropriate early in the development of an intervention where the evidence is sparse, while quantitative research synthesis is preferable when a number of high-quality studies have been performed.

Consensus Statements as Topic↗
PubMed2001

Secretion of mouse ZP3, the sperm receptor, requires cleavage of its polypeptide at a consensus furin cleavage-site.

The mouse egg extracellular coat, or zona pellucida, consists of three glycoproteins, called mZP1-3. Each glycoprotein possesses a consensus sequence recognized by the furin family of proprotein convertases. Previously, it was reported that mZP2 and mZP3 are cleaved at their consensus furin cleavage-sites located near the C-terminus of the polypeptides [Litscher, E. S., Qi, H., and Wassarman, P. M. (1999) Biochemistry 38, 12280-12287]. Here, use of site-directed mutagenesis of the mZP3 gene and a specific inhibitor of furin-like enzymes revealed that secretion of nascent mZP3 from transfected cells is dependent on cleavage of mZP3 at its consensus furin cleavage-site. The dependence of secretion on cleavage represents a novel function for furin family enzymes.

Amidohydrolases↗
PubMed1998

Estrogen receptor alpha requires no accessory factors for high-affinity binding to a consensus response element.

Estrogen receptor (ER) alpha is commonly thought to bind to a consensus estrogen response element (ERE) as a homodimer, but previous experiments have not ruled out the presence of other proteins in the ERalpha/ERE complex. To characterize this interaction in more detail, we overexpressed mouse (m) ERalpha in a baculovirus system, using the selective advantage of the apoptosis inhibitor p35. Recombinant mERalpha possesses the predicted molecular weight and binds 17beta-estradiol and an oligonucleotide containing a consensus vitellogenin ERE with high affinity. Over a wide concentration range of mERalpha protein (0.1-50 nM), only one complex was detected between mERalpha and vitellogenin ERE in gel shift assays. The ratio of E2:vitellogenin ERE bound by mERalpha was close to 2:1, and each complex contained only one ERE. The molecular weight of the complex was determined to be 160 000, very close to that predicted for two mERalpha proteins and one ERE oligonucleotide, therefore providing strong evidence that no other proteins were present. Recombinant mERalpha was purified such that it was the only protein observable by silver stain. Purified mERalpha and mERalpha in a nuclear extract behaved identically in Ferguson analysis, providing more evidence that only mERalpha was binding to the ERE. Purified mERalpha bound vitellogenin ERE with high affinity (Kd = 0. 92 +/- 0.20 nM), indicating that no other proteins are necessary for high-affinity mERalpha interaction with a consensus ERE. To determine whether ERalpha in an estrogen-responsive mammalian tissue behaves the same as the overexpressed mERalpha, we tested rat uterine cytosol by Ferguson analysis. ERalpha in rat uterine cytosol behaved identically to overexpressed mERalpha, suggesting that ERalpha in the uterine extract also binds to DNA predominantly as a homodimer with no additional proteins.

Animals↗
PubMed2003

Statistical and consensus-based strategies for grouping consumers in mental health level-of-care schemes.

Mental health Level-of-Care schemes differ in the emphasis placed on statistically based versus consensus-based strategies for delineating consumer groups. Statistical strategies define groups on the basis of empirical distinctions within the caseload. Consensus strategies group consumers according to an a priori framework of consumer characteristics determined by experts to differentiate the appropriate types and intensities of service. This article compares the performance of two grouping strategies-one statistical and one consensus-on three criteria: programmatic relevance, measurement adequacy, and homogeneity of consumer groups. It explores the advantages of integrating elements of each strategy.

Consensus↗