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PubMed2002

The diagnosis of disorders caused by hand-transmitted vibration: Southampton Workshop 2000.

OBJECTIVES: To identify the current state of knowledge, current uncertainties and future needs related to the diagnosis of disorders associated with the use of vibratory hand-held tools. METHOD: An international workshop was convened with invited experts, medical doctors, scientists and engineers familiar with hand-transmitted vibration and the diagnosis of vascular, neurological and musculoskeletal disorders. This paper records the general conclusions from four panel discussions. RESULTS: For the most common vascular disorder (vibration-induced white finger), the principal symptom and sign involves attacks of well-demarcated finger blanching (Raynaud's phenomenon); low finger systolic blood pressure following cooling is indicative of vibration-induced white finger and zero finger systolic blood pressure can confirm an attack of Raynaud's phenomenon. For neurological disorders, some symptoms can exist without detectable signs and some signs can exist without symptoms; numbness and tingling are commonly reported but neurological changes may be present without these symptoms. The pathogenesis of musculoskeletal disorders in users of vibratory tools is not clear; symptoms may include pain that may not be associated with abnormal results in objective tests. For both neurological and musculoskeletal disorders, a thorough neuromuscular and skeletal examination is required; diagnosis must consider the work history and medical history, the results of physical examination and any objective tests in addition to other factors (e.g. age, smoking, alcohol, systemic disorders, medication and neurotoxic agents) that might have contributed to symptoms, signs and test results. CONCLUSIONS: While vibration-induced white finger is caused by vibration, some neurological and musculoskeletal disorders are the result of work with vibratory tools where the separate roles of vibration, repetitive movements, grip and push forces, non-neutral postures and any other ergonomic stressors are often unclear. Such disorders may be more easily identified as being caused by the work rather than by exposure to hand-transmitted vibration per se. A person found to have developed disorders induced by either vibration or the work situation should not be returned to the same vibration exposure or work without any changes expected to lessen the risks.

Education↗
PubMed2006

The relationship of nondirectiveness to genetic counseling: report of a workshop at the 2003 NSGC Annual Education Conference.

Nondirectiveness has been a guiding principle for genetic counseling since the founding of the profession. However, its efficacy and appropriateness in this role have been frequently questioned. A workshop at the 2003 Annual Education Conference of the National Society of Genetic Counselors provided audience participation in a discussion of these issues. Participants presented arguments for and against nondirectiveness as a central ethos. They described complex personal transitions in adapting what they had learned about nondirectiveness during training to the realities of the workplace. There was support for flexible approaches to genetic counseling, with varying adherence to nondirectiveness, based on client and family needs and values, clinical circumstances, and desired counseling outcomes. The discussion supports the use of clinical experience, outcomes research, and the experience of other professions to move beyond nondirectiveness and more accurately identify the theoretical bases that underlie genetic counseling in the variety of circumstances in which it is currently practiced.

Education↗
PubMed1992

Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a National Heart, Lung, and Blood Institute workshop.

Idiopathic dilated cardiomyopathy (IDC) is the primary indication for cardiac transplantation, with associated costs of approximately $177 million per year. Recognizing the economic implications of IDC, the increasing incidence, and the limited information on pathogenesis and prognosis, the National Heart, Lung, and Blood Institute convened a workshop on the Prevalence and Etiology of Idiopathic Dilated Cardiomyopathy on June 13 to 14, 1991. The difficulties of studying the disease were reviewed, including its relatively low prevalence, its potentially pluricausal nature, and the fact that it is often a diagnosis of exclusion. Still, it presents significant challenges to the cardiovascular scientific community, since the mechanism of myocardial damage and related etiologic and prognostic factors are virtually unknown. The development of more reliable measures of immune-mediated damage and noninvasive measures of impaired cardiac function present new research opportunities in this disorder. Standardized diagnostic criteria for use in observational and interventional trials were developed, and priorities for future research were proposed. Population-based registries and nested case-control studies, where feasible, are appropriate study designs for tracking incidence and prevalence, and for identifying risk factors, respectively. Interventional studies should focus on secondary prevention, through modifying immune-mediated damage in clinically evident dilated cardiomyopathy, and through prevention of sudden death in patients with the disorder. Primary prevention trials must await the identification of modifiable risk factors and of appropriate and effective interventions.

Cardiomyopathy, Dilated↗
PubMed1993

Identification and management of heterozygous familial hypercholesterolemia: summary and recommendations from an NHLBI workshop.

Heterozygous familial hypercholesterolemia (hFH) is one of the most common monogenic disorders with serious health consequences, affecting approximately 1 in 500 persons in the United States. Persons with hFH generally manifest elevations of low density lipoprotein (LDL) cholesterol throughout their lives and have a markedly increased risk of death from coronary artery disease. The hypercholesterolemia of hFH is responsive to medication and diet, and, if detected early, aggressive LDL cholesterol control may prevent or substantially delay cardiovascular disease. However, evidence suggests that many persons with hFH are undetected and inadequately treated. On July 20-21, 1992, the National Heart, Lung, and Blood Institute sponsored a workshop to assess the current understanding of the diagnosis and management of hFH, to emphasize recommendations for identification and management that are known to be effective, and to identify opportunities and needs for intervention and research.

Heterozygote↗
PubMed1991

Home monitoring of uterine contractility. Summary of a workshop sponsored by the National Institute of Child Health and Human Development and the Bureau of Maternal and Child Health and Resources Development, Bethesda, Maryland, March 29 and 30, 1989.

At an interdisciplinary workshop on home monitoring of uterine activity, participants reviewed the basis of this technology and its use in the identification of women at high risk of preterm delivery and in the prevention of preterm birth. Although the guard-ring devices in current use appear capable of detecting uterine activity, they do not clearly distinguish between Braxton Hicks contractions and the contractions of early labor. There was agreement that women destined for preterm delivery have more uterine activity on average than do other women of comparable gestational age but that there is substantial overlap between the two groups. Thus it is uncertain whether this difference can be used effectively for screening purposes. Conferees agreed that there is considerable evidence that twice-daily monitoring of very-high-risk women, in conjunction with daily nursing support and high-quality obstetric care, may prevent preterm births. Available evidence does not clearly distinguish the contribution of tocodynamometry from that of nursing support. A number of areas were identified in which further research is needed.

Cardiotocography↗
PubMed1991

The consensus workshops for the detection of autoantibodies to intracellular antigens in rheumatic diseases.

In 1988 and in 1989 consensus workshops were organized in order to define the interlaboratory concordance in detecting autoantibody specificities in selected sera from patients with rheumatoid disorders and to determine the possible causes of discrepancies. In total 20 sera were tested for the presence of antibodies against nRNP, Sm, Ro (SS-A), La (SS-B), Scl-70, centromeric antigens, ribosomal RNP and Jo-1. The methods used for detection by the 28 European laboratories who participated included immunofluorescence, counter-immunoelectrophoresis, immunodiffusion, immunoblotting and ELISA. The results showed that only a combination of two or more techniques was able to detect all specificities with an adequate efficiency. Recommendations to improve the efficiency of autoantibody detection and to standardize laboratory protocols are given.

Antibody Specificity↗
PubMed1981

Urinary undiversion in patients with myelodysplasia and neurogenic bladder dysfunction. Report of a workshop.

This workshop was conducted in an attempt to analyze critically the role of reconstruction of the myelodysplastic patient who had undergone urinary diversion and to develop guidelines for selecting those patients in whom urinary undiversion might be undertaken safely. The collective experience initially seems to be acceptable; however, the authors emphasize the gravity of the decision and the complexity of the evaluation which must be undertaken prior to embarking on such reconstructive surgery. Contrary to some reports, we believe that the defunctionalized bladder frequently can be evaluated. Further, many of the contraindications to urinary undiversion have been identified and several of the hazards involved therein can be avoided. We believe that the neurogenic bladder is no longer an absolute contraindication to undiversion. Our experience suggests that undiversion is a reasonable surgical treatment in select patient with neurogenic bladder dysfunction. But, the decision to remove a satisfactorily functioning conduit must not be undertaken lightly. Patients should be selected only after a thorough, detailed, and properly conducted evaluation. A protocol has been developed which will hopefully assist in this evaluation. Perhaps additional shared experience will further refine and delineate the circumstances appropriate for reconstruction of these patients.

Adolescent↗
PubMed1996

Very late antigen (VLA) expression by normal and neoplastic human plasma cells; including an assessment of antibodies submitted to the Vth International Workshop on Leucocyte Differentiation Antigens using human myeloma cell lines.

The biology of normal plasma cells and the pathophysiology of human multiple myeloma remain poorly understood. Functional assays are scarce and at present cell phenotyping is providing the most information about how human plasma cells may behave. Three different types of human plasma cells: normal, fresh neoplastic myeloma cells and plasma cell lines, have been studied for their reactivity with antibodies to the beta-1 integrins (Very Late Antigens; VLAs), including a panel obtained from the Vth International Workshop on Leucocyte Differentiation Antigens. Most plasma cell targets express VLA-4 (CD49d positive) and the common beta chain recognized by CD29. CD49e (VLA-5) was occasionally positive. Other VLAs were not usually expressed. These data suggest the wide use by plasma cells of VLA-4, possibly as a ligand with fibronectin and high endothelial venules (HEV). Of other adhesion structures expressed by plasma cells, only CD44 is seen as frequently, and this is also a HEV ligand.

Antibodies↗
PubMed1992

Model curriculum in Medical Crisis Counseling. Linda Pollin Foundation/NIMH Workshop.

This document describes a curriculum model for a year-long fellowship training program in Medical Crisis Counseling designed for health care professionals selected as Linda Pollin Fellows. The document was developed at the Second Annual Workshop, cosponsored in 1990 by the National Institute of Mental Health and the Linda Pollin Foundation. Conference participants included experts in the field of mental health--representing psychiatry, nursing, psychology, and social work--who were divided into task forces focusing on various content areas: clinical, sociocultural, managerial and administrative, liaison/educational, and research and evaluation. The document develops the content in these areas. Although designed for Pollin Fellows, the curriculum, once implemented and evaluated, may be modified for use in the basic education of a variety of health professionals. The philosophy upon which the curriculum is based incorporates the following core concepts: 1) each Fellow must have a skilled supervisor (Mentor), 2) the supervisor-trainee relationship should embody the essence of the future relationship between trainees and their patients, and 3) Medical Crisis Counseling is essentially a multidisciplinary enterprise.

Chronic Disease↗
PubMed1987

Monoclonal antibodies to human trophoblast and sperm antigens: report of two WHO-sponsored workshops, June 30, 1986--Toronto, Canada.

Two WHO-sponsored workshops were recently held to obtain a consensus view from researchers active in the field of reproductive immunology on the current status of the application of monoclonal antibodies to studies of molecular events underlying reproduction and to determine the feasibility of using this approach to identify trophoblast- or sperm-specific antigens that might represent suitable candidates for the development of antifertility vaccines. A total of 66 mouse monoclonal antibodies reacting with human sperm and 45 monoclonal antibodies reacting with human trophoblast membrane components were submitted by 29 laboratories. These were evaluated in coded form by 42 laboratories with the appropriate expertise in biochemistry, immunohistology and tests of reproductive cell function. The majority of both anti-sperm and anti-trophoblast monoclonal antibodies cross-reacted with cellular elements in non-reproductive tissues. However, at least five monoclonal antibodies (two anti-trophoblast and three anti-sperm) appeared to demonstrate sufficient specificity to warrant further investigation as reagents for the identification of antifertility vaccine candidates.

Antibodies, Monoclonal↗
PubMed1996

BSI workshop on cytokines in reproduction.

The British Society for Immunology Spring Meeting, held at the University of Bristol on April 17-19th, 1996, to mark the bicentenary of Edward Jenner's vaccination against smallpox, provided the setting for the recent meeting of the UK Materno-Fetal Immunobiology Group (MFIG). The them for the MFIG workshop was 'Cytokines in Reproduction' and it was attended by over 60 delegates.

Allergy and Immunology↗
PubMed1991

Reactivity of the workshop monoclonal antibodies with ovine bone marrow cells and bone marrow-derived monocyte/macrophage and mast cell lines.

The workshop monoclonal antibodies were tested by flow cytometry for reactivity against: (1) ovine bone marrow cells, (2) cultured bone marrow-derived monocyte/macrophage cell lines and (3) cultured bone marrow-derived mast cell lines. Both single and two-colour immunofluorescence tests were performed. The results of these analyses are presented and discussed.

Animals↗
PubMed1991

Biochemical analysis of bovine T cell antigens with workshop monoclonal antibodies.

The relative molecular weight (Mr) of the CD1, CD2, CD4, CD5, CD6, CD8 and additional molecules identified by monoclonal antibodies (mAb) submitted to the workshop was determined using 125I surface-labelled leukocytes. Of 37 mAb precipitating lymphocyte surface molecules, 33 had Mr correlating with their clusters of differentiation. Further, we were able to determine Mr for three "undefined T lymphocyte" antibodies. Of the 20 mAb that did not precipitate a molecule from the surface of leukocytes, one was non-reactive as determined by flow microfluorimetry. The inability to precipitate a molecule from the remaining cells was probably due to lower affinities of those antibodies and conformational changes in the antigen(s) following lysis of the leukocytes.

Animals↗
PubMed1993

Initial statistical clustering: definition of temporary clusters of monoclonal antibodies for the duration of the workshop.

Statistical clustering was performed on flow cytometry data generated from the reactivities of 189 mAbs with 56 cell preparations or cell lines (targets). Six targets were excluded from the statistical clustering because of non-reproducibility of data from the internal controls. Thirty-six temporary clusters (TC) were formed which were subjected to further examination in the second phase of the workshop.

Animals↗
PubMed1993

Reactivity of the CD11/CD18 workshop monoclonal antibodies in the sheep.

The anti-CD11/CD18 monoclonal antibodies (mAbs) submitted in the Second International Workshop on Ruminant Leukocyte Differentiation Antigens, were analysed for their reactivity with the ovine homologue of CD11/CD18. Their reactivity was tested on healthy sheep tissues, and alveolar macrophages, afferent dendritic cells, peripheral blood granulocytes and monocytes. The CD11a/CD18 mAbs found positive in the sheep were reactive with all the cell populations tested. The CD11b mAbs reacted with all the cells except afferent dendritic cells, whereas CD11c were non-reactive to blood granulocytes. This is in contrast to humans and cattle where blood granulocytes express CD11c. The mAbs 72-87, F10-150, MD2B7 and MUC76A were found to be homologous to CD11a whereas BAQ30A seemed to be homologous to CD18, instead of proposed initial specificity to CD11a. CC125 and IL-A15 mAbs were found to be homologous to CD11b. OM1, which clustered with a recognized CD1 mAb in the first cluster analysis, precipitated a heterodimer of molecular weight 95,000/150,000. We propose that OM1 reacts with sheep CD11c. The mAb MF14B4 was found to react with sheep CD18.

Animals↗
PubMed1993

Comparison of workshop CD45R monoclonal antibodies with OvCD45R monoclonal antibodies in sheep.

The reactivity of the antibovine monoclonal antibodies (mAbs) comprising temporary cluster TC1 was compared with that of two OvCD45R mAbs on sheep cells. Three of the mAbs--CC31, CC99 and CC103--did not cross-react with sheep cells. All the workshop mAbs precipitated two molecules of apparent molecular weight (MW) 200 kDa and 220 kDa while the antisheep CD45R mAb 20-96 precipitated a single band of 220 kDa. Cell surface expression was examined by single colour FACS (fluorescence activated cell sorting) analysis of efferent and afferent lymph cells and peripheral blood lymphocytes and the distribution of the antigens on CD4+, CD8+ and T19+ (WC1) and B cells was determined by two colour fluorescence staining. By cellular distribution and immunohistology the TC1 mAbs could be divided into four distinct groups which differed from a fifth group comprising the two OvCD45R antibodies.

Animals↗
PubMed1993

An investigation of temporary workshop clusters reacting with cells of the mononuclear phagocytic system.

Monoclonal antibodies (mAbs) within ten temporary workshop clusters (TC3, TC8, TC9, TC11, TC16, TC17, TC19, TC20, TC21 and TC31) which from preliminary evidence appeared to recognize molecules expressed by cells of the mononuclear phagocytic system were studied by immunohistology and flow cytometry. A number of mAbs were identified that were potentially useful for immunohistological studies of the mononuclear phagocytic system. The results confirmed the specificity of a number of CD11a, CD11b, CD11c and CD44 mAbs. The findings also indicated that for several TCs the mAbs could not be regarded as recognizing the same molecule.

Animals↗
PubMed1993

Cross-reactivity of workshop antibodies with cells from domestic and wild ruminants.

Reactivities of the monoclonal antibodies (mAbs) from the workshop panel with cells from cattle, sheep, goats, Cape buffalo (Syncerus caffer) and waterbuck (Kobus defassa) were tested. One hundred and sixty-nine mAbs reacted with bovine cells and 111 with sheep cells; 86 were shown to react with goat cells, 71 with buffalo cells and 70 with waterbuck cells. Some mAbs cross-reacted with all five ruminants tested, and are likely to react with epitopes that are conserved in other ruminant species. Such mAbs will obviate the need to produce mAbs panels to leukocyte antigens of other ruminants.

Animals↗