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PubMed2001

Parvovirus B19: implications for transfusion medicine. Summary of a workshop.

This 1-day workshop showed that the infectivity of B19 DNA in donor blood and the neutralizing action of different antibodies present in the donated blood are not yet fully understood. It is possible that B19-induced anemia and reticulocytopenia are not being recognized in transfused recipients other than those in specific risk groups. The testing of blood components for any infectious agent is usually clinically driven, and, if B19 NAT were recommended at the present time in other than plasma products, a CMV-like model might prove appropriate; that is, virus screening would be performed on blood components destined for high-risk groups only. Currently, there is insufficient evidence to recommend universal testing, especially for single units. Workshop participants recommended that basic research continue in the scientific areas addressed. If clinical trials were to be developed, participants recommended that they include special risk groups such as seronegative pregnant women and children with malignancies who are receiving chemotherapy.

Animals↗
PubMed2001

Establishment of complete and mixed donor chimerism after allogeneic lymphohematopoietic transplantation: recommendations from a workshop at the 2001 Tandem Meetings of the International Bone Marrow Transplant Registry and the American Society of Blood and Marrow Transplantation.

Approaches to the measurement of lymphohematopoietic chimerism have evolved from laboratory research to important clinical tools. However, there has been no logical, consistent, and uniform set of recommendations for the measurement of chimerism in clinical transplantation. The National Marrow Donor Program and the International Bone Marrow Transplant Registry (IBMTR) sponsored a workshop to discuss the use of chimerism analysis after allogeneic transplantation. The workshop was organized in an effort to make reasonable recommendations regarding laboratory techniques, the types of specimens to be studied, and the frequency of analysis. The panel recommended the following guidelines: 1. Chimerism analysis should use sensitive, informative techniques. At present, short tandem repeats (STR) or variable number tandem repeats (VNTR) analysis is the approach most likely to give reproducible informative data. 2. Peripheral blood cells are generally more useful than bone marrow cells for chimerism analysis. 3. Lineage-specific chimerism should be considered the assay of choice in the setting of nonmyeloablative and reduced-intensity conditioning. 4. The use of T-cell depletion, nonmyeloablative or reduced-intensity conditioning, or novel graft-versus-host disease (GVHD) prophylactic regimens warrants chimerism analysis at 1, 3, 6, and 12 months, because interventions such as donor lymphocyte infusions may depend on chimerism status. 5. In nonmyeloablative transplantation, the early patterns of chimerism may predict either GVHD or graft loss. Therefore, more frequent (every 2-4 weeks) peripheral blood analysis may be warranted. 6. For nonmalignant disorders, chimerism generally should be measured 1, 2, and 3 months after transplantation. Interventions to enhance donor engraftment must be considered on a disease-specific basis in relation to concurrent GVHD and, ultimately, clinical rationale.

Blood Cells↗
PubMed2000

Commentary on the workshop statement. Essentiality of and recommended dietary intakes for Omega-6 and Omega-3 fatty acids.

The Workshop document is welcome and important in its content and objectives. My comments deal with three topics, and are intended to set the historical perspective and take the discussion further as regards attitudes to infant nutrition. 1. ADVERSE ARACHIDONIC EFFECTS. I have some difficulty with the statement on the need to reduce LA (linoleic acid) content of the diet because 'This is necessary to reduce adverse effects of excesses of arachidonic acid and its eicosanoid products.'I have no problem with suggesting a reduction in the present level of LA in the USA but consider the expression 'adverse effects of arachidonic acid ...' to be misleading. Linking LA and AA in this way also implies a direct conversion of LA to AA, which is not the case. In fact, a very high dietary LA will reduce membrane AA. 2. EFA RATIOS. I suspect that their choice of omega 3/omega 6 ratio of 5.7 for early life may be high. Their recommendation for adults gives the much lower ratio of about 1.4. In view of the high requirement for DHA during neural development, I would have thought the ratios would have been the other way round or the same for infants as adults but with AA included in the omega 6. Also, I have some difficulty with the concept of a unitary ratio when there is clear disunity in the biological activities of the different parent and LCP EFAs. Hence the concept of omega 6/omega 3 ratio based on activity equality does not reflect the biological reality. 3. FDA RECOMMENDATIONS ON INFANT FORMULA. The Workshop essentially disagrees with the recent FDA recommendations on inclusion of LCPs in infant formula. There is, in addition, a need to re-think the requirements of the preterm infant beyond their recommendation.

Arachidonic Acid↗
PubMed1996

[Mini-probe ultrasound of the upper gastrointestinal tract--1995 state of the art and perspectives. Workshop on Mini-Probe Ultrasound in Gastroenterology, Münster, 28 October 1995].

Endoscopic ultrasound (EUS) allows for intraluminal sonographic imaging of the oesophagus, stomach, pancreatobiliary duct system, the papilla of Vater, as well as the colon and rectum. EUS has proved valuable for diagnosis and staging of tumours of the upper intestinal tract. EUS can also provide valuable additional information concerning lesions that cannot be immediately classified. As doing this involves, first, removal of the conventional endoscope and, second, insertion of the echo endoscope, EUS is not suitable for routine examinations. Therefore EUS has remained an independent endoscopic diagnostic modality. Moreover, due to their diameter conventional echoendoscopes cannot be inserted into the pancreatobiliary duct system. Fine calibre high frequency ultrasound probes promise a resolution of less than 2 mm in diameter. The following report is a summary of a one-day workshop which took place in Muenster, Germany on Oct. 28, 1995. Its goal was to define the current state of the art of miniaturised endoscopic ultrasound probes in the field of gastroenterology. During this workshop, possible clinical applications for diagnosis, therapy, as well as follow-up were described and discussed. The potential of miniaturised endoscopic ultrasound probes was explored in terms of possible future technical developments.

Endoscopy, Gastrointestinal↗
PubMed1996

Cadaveric Hands-on Workshop Using a Three-Dimensional High-Definition Television System.

We report the introduction of a three-dimensional high-definition television system in cadaveric microneurosurgical hands-on workshops on skull base technique. The system was found to be a useful means of exact communication between the instructor and the participants and avoided congestion around the instructor's table. The instructions could be refayed to the multiple participants at one time and thus avoided repetitions. More participants could be accommodated in the workshops. The entire proceeding could be recorded three-dimensionally for later use and educational purposes.

Journal Article↗
PubMed1990

Workshop on neurologic complications of pertussis and pertussis vaccination.

A multidisciplinary workshop held from September 29 to October 1, 1989, at Airlie House, Warrenton, Virginia, considered the neurologic complications of whooping cough and pertussis vaccine. Pertussis mortality in the U.S. in 2-3/1000 cases. Seizures occur in 1.9% of cases, and encephalopathy in 0.3%. Reviewing all data, it appears likely that a combination of one or more bacterial toxins, asphyxia, CO2 retention and loss of cerebral vascular autoregulation is responsible for neurologic symptoms. The timing of the encephalopathy suggests that it results from increased lysis of bacteria, and release of endotoxin. The encephalopathy is not confined to the paroxysmal phase. In evaluating side-reactions to the vaccine, the following must be kept in mind: 1. Vaccines are not standardized between manufacturers. 2. For a given manufacturer, vaccines are not standard from one batch to the next. 3. Unless the vaccine is properly prepared and refrigerated, its potency and reactivity varies with shelf life. In fact, the whole question of vaccine detoxification has never been systematically investigated. Listed in order of increasing severity, observed adverse reactions include irritability, persistent, unusually high pitched crying, somnolence, seizures, a shock-like "hypotensive, hyporesponsive" state, and an encephalopathy. Since the neurologic picture is not specific for pertussis vaccination, its temporal relationship to the vaccination is the critical variable for determining causation. Although the majority of seizures following pertussis vaccination are associated with fever, it was the consensus of the neurologists attending the workshop, that these do not represent febrile convulsions, but are non-benign convulsions. The incidence of post-vaccine encephalopathy is difficult to ascertain.(ABSTRACT TRUNCATED AT 250 WORDS)

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed1995

Workshop report: clinical CASA--the quest for consensus.

The goals of the Workshop were to establish the current state-of-the-art in the clinical use of computer-aided sperm analysis (CASA), to identify areas of contention or confusion in the use of CASA technology, and to reach consensus on these matters to facilitate the wider use, and usefulness, of these instruments in clinical and research applications. CASA assessments of sperm morphology were not considered as they were discussed in a separate Workshop (Advanced Techniques in Sperm Preparation and Imaging) on analytical techniques. Four topics were considered: (a) CASA and semen analysis; (b) the diagnostic value of sperm kinematics in semen; (c) human sperm hyperactivation; and (d) CASA and fertility prediction. In all, 17 specific consensus points were identified.

Biomechanical Phenomena↗
PubMed1997

Workshop on schizophrenia.

On November 29-30, 1995, the National Academy of Sciences and the Institute of Medicine brought together experts in schizophrenia and specialists in other areas of the biological sciences in a workshop aimed at promoting the application of the latest biological information to this clinical problem. The workshop paid particular attention to evidence of pathology in the brains of people with schizophrenia, and to the possibility that this reflects an abnormality in brain development that eventually leads to the appearance of symptoms. The participants were impressed with the complexity of the problem, and felt that multiple approaches would be required to understand this disease. They recommended that a major focus should be on the search for predisposing genes, but that there should be parallel research in many other areas.

Brain↗
PubMed2004

Emerging diet-related surrogate end points for colorectal cancer: UK Food Standards Agency diet and colonic health workshop report.

The UK Food Standards Agency convened a group of expert scientists to review current research investigating emerging diet-related surrogate end points for colorectal cancer (CRC). The workshop aimed to overview current research and establish priorities for future research. The workshop considered that the validation of current putative diet-related surrogate end points for CRC and the development of novel ones, particularly in the emerging fields of proteomics, genomics and epigenomics, should be a high priority for future research.

Biomarkers, Tumor↗
PubMed2003

Folate bioavailability: UK Food Standards Agency workshop report.

The UK Food Standards Agency convened a group of expert scientists to review current research investigating folate bioavailability. The workshop aimed to overview current research and establish priorities for future research. Discrepancies were observed in the evidence base for folate bioavailability, especially with regard to the relative bioavailability of natural folates compared with folic acid. A substantial body of evidence shows folic acid to have superior bioavailability relative to food folates; however, the exact relative bioavailability still needs to be determined, and in particular with regard to mixed diets. The bioavailability of folate in a mixed diet is probably not a weighted average of that in the various foods consumed; thus the workshop considered that assessment of folate bioavailability of whole diets should be a high priority for future research.

Biological Availability↗
PubMed1976

A short-term, intensive workshop approach for the treatment of human sexual inadequacy.

A rapid treatment approach to common sexual dysfunctions has been used in treating 59 couples, including 74 symptomatic individuals. Using a multidisciplinary team approach in an intensive 2 1/2 day workshop format, symptom improvement has been obtained in 86.5% of the dysfunctional individuals, with complete symptom reversal in 63.5%. The intensive workshop format has resulted in a saving of both patient and professional time and is seen as a viable and successful alternative to more time-consuming approaches of treating various sexual dysfunctions.

Adult↗
PubMed1979

The weekend workshop for dysfunctional couples: assets and limitations.

Two major new trends are emerging in the field of sexual counseling: the use of self-help programs and the increasing reliance on group therapy to overcome specific sexual complaints. The weekend sexual enhancement workshop represents a synthesis of both trends, but efficacy regarding outcome has not been well documented. In order to investigate specific changes in sexual and marital adjustment, two intensive weekend programs were conducted. Pre- and postmeasures were obtained for both groups. Based on the results of 15 couples who displayed a diversity of sexual dysfunctions, several conclusions can be drawn. The weekend workshop format appears effective in achieving three of its four major goals: (1) Couple communication improves via the stimulus of new information, group discussion, and permission to talk sexually. Marital satisfaction increases, particularly where the history of marital conflict is not chronic. (2) Attitude change occurs, and erroneous beliefs are relinquished in the face of new input. (3) The frequency of sexual interaction increases. (4) Long-standing sexual dysfunctions are not resolved as a result of group participation and information on self-help methods alone. Finally, the role of such weekend programs in sexual counseling in discussed.

Adult↗
PubMed1988

Brief sexual counseling for medical patients: a workshop for training professionals.

Most sexual concerns and dysfunctions in medical patients are unrecognized because neither patient nor health care team addresses the issue. A 5-day workshop is presented in detail so that clinicians specializing in treating sexual problems can educate primary care professionals in assessing sexual problems and providing brief sexual counseling. Suggestions for truncating the workshop or tailoring it to specific audiences are also included.

Curriculum↗
PubMed2002

Technical workshop on human milk surveillance and research on environmental chemicals in the United States: an overview.

Interest in human milk research and monitoring for environmental chemicals is growing, and as studies of chemicals in human milk are initiated, it is of the utmost importance that these studies be conducted using harmonized methods. Due to numerous limitations in previous studies and the fact that few studies on environmental chemicals in human milk have been conducted in the United States, there is a growing need for a human milk sampling and analysis protocol in this country. The Technical Workshop on Human Milk Surveillance and Research on Environmental Chemicals in the United States was organized to develop state-of-the-science protocols describing the various aspects of such a program. An expert panel, comprised of specialists in the fields of pediatrics, family medicine, nursing, lactation, human milk sampling, analytical chemistry, epidemiology, pharmacology, toxicology, nutrition, and risk evaluation and communication, was assembled to participate in a 2-day workshop at the Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine. The expert panel was tasked with carefully describing and defining the components of well-conducted human milk surveillance and research studies, including participant selection, sample collection and analysis techniques, questionnaire development, chemical selection, and data reporting and interpretation, especially for use in the United States. The articles that follow this overview describe the results of the expert panel's deliberations on the components of human milk surveillance and research programs.

Adult↗
PubMed2001

Assessments in evidence-based medicine workshops: loose connection between perception of knowledge and its objective assessment.

The outcome of continuing education programs is often based on self-assessment. We evaluated the relationship of self-assessment of knowledge based on rating scales with scores obtained on objective validated tests in evidence-based medicine workshops. In the West Midlands region (1998), 55 participants attended three workshops in critical appraisal of the medical literature.They completed two self-assessment questionnaires: one used a rating scale to subjectively examine the level of knowledge of six different literature appraisal issues; the other objectively assessed participants' literature appraisal knowledge in those issues using validated multiple true-false questions. Comparison of subjective scores reflecting understanding of specific literature appraisal issues with corresponding objective test scores revealed a poor correlation (r(s) ranged from -0.29 to 0.60 for the different knowledge issues assessed). Perception of ones level of knowledge did not always correlate with correctly possessed knowledge. In some instances, those who thought they were knowledgeable actually possessed incorrect knowledge. Therefore, continuing medical education programs should focus on objective, not subjective tests to assess outcome.

Journal Article↗
PubMed2005

International Workshop on the Design and Analysis of Experimental Studies using PM Concentrator Technologies, Boston, May 5, 2004.

A workshop that brought together representatives of most of the laboratories that have conducted animal and/or human inhalation exposure studies with concentrated ambient air particles (CAPs) was convened by the Health Effects Institute in Boston on May 5, 2004. Participants agreed that CAPs researchers need to make serious efforts to harmonize their experimental and analytical protocols to permit the sharing of lessons learned, questions raised, and opportunities for more definitive studies. Standardized outcome measures based on spirometry and response markers in lung bronchoalveolar lavage (BAL) cells and fluids exist, including the appropriate times after exposure to collect samples and measurements. However, for the emerging focus on cardiac system responses, there are many different electrocardiographic (ECG) endpoints being examined, and little standardization on markers that are most informative about adverse effects; on when the measurements need to be made; and on how to make comparable measurements. The workshop focused on two aspects of dealing with these complexities: sorting out influential particulate matter (PM) components responsible for observed effects, and searching for time-varying responses in continuous outcome data. The need for more complete analyses of PM samples from the CAPs studies was also emphasized, as was obtaining a consistent set of parameters characterizing exposure atmospheres and the ambient PM from which the CAPs are sampled. CAPs studies have already had a significant impact within the air pollution health effects community, especially in regard to cardiovascular system effects, and a follow-up meeting with a greater focus on means to harmonize data collection and analysis is needed.

Air Pollutants↗
PubMed1997

The neocortical local circuit--a research workshop held in Sde-Boker, Israel, May 4-8, 1997.

This report does not capture the raw vitality of the Sde-Boker workshop. We did not anticipate that so many presentations would focus on the importance of spike timing in the operations of cortical microcircuits and the profound effect of this on other cortical and subcortical networks. The roles of individual spikes, temporal firing patterns, neuronal synchronization, intrinsic neuronal and network oscillation, coincidence detection, integration by individual cells or even individual dendritic spines were also strong themes of nearly all presentations. The cortex could be viewed as a network, which, is similar to an orchestra, where each neuron (musician) generates particular timed spike patterns (notes) for which 'every spike counts' (the symphony). This assertion would have been the butt of considerable skepticism less than a decade ago. The conference led to a view that the cerebral cortex is a spatially distributed timing network. As such, the consensus reached provides a conceptual framework for exciting new discoveries in the next decade. One of the truly exciting outcomes of the workshop was the seamless integration of concepts derived from studies employing direct approaches such as brain slices to cell cultures and computer simulations to whole animal physiology. The availability of an ever expanding armamentarium of increasingly sophisticated techniques and cross-fertilization promises develop the field in a direction that is as flexible and as subtle as the cortical tissue it seeks to explain. It was perhaps symbolic that this meeting was held at a place in the desert where David Ben-Gurion, the first Prime Minister of the modern state of Israel, had a vision of pioneers settling the untamed Negev that had intrigued and intimidated mankind for so long. The hauntingly beautiful Negev, like the cerebral cortex, was an unyielding frontier. Now thanks to modern ingenuity and technology the Negev can, like the cerebral cortex, finally be conquered.

Animals↗
PubMed2001

Harmonization of future needs for dermal exposure assessment and modeling: a workshop report.

Dermal exposure assessment and modeling is still in early phases of development. This article presents the results of a workshop organized to harmonize the future needs in this field. Methods for dermal exposure assessment either assess the mass of contaminant that is transferred to the skin, or the transfer of contaminant through the skin. Models for dermal exposure are either knowledge-based or deterministic. Any method or model should be transparent, validated, and open to further development. Some (partly) validated and standardized methods are available for measuring or modeling permeation of the skin or of personal protective equipment (PPE). Further validation and standardization is necessary. More research is needed on permeation of dusts and aerosols and more realistic tests should be developed and used for PPE. Several methods have been developed to measure contamination of surfaces or skin, but they are not validated or standardized. A number of non-validated models exist to assess dermal exposure. A clear need exists for more studies of dermal exposure, regarding measurement methods, models and actual exposure levels. A running four-year European study will greatly expand the knowledge in this field. Simple tools to assess and control the risks of dermal exposure in small and medium sized enterprises are also needed. Increasing the general knowledge of practitioners (e.g., safety professionals, occupational hygienists and physicians) in the field of dermal exposure is a first requirement. Available data, for example, on the permeation of PPE, should be made more readily available, using modern information technology. When information on dermal exposure is gathered and stored, the core information needs are partly the same as those for inhalation exposure. Some elements of process and activity, substance and product or worker, specific for dermal exposure, have been suggested by the workshop.

Europe↗