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[Emergency preparedness based on coherent integration of crisis response resources: workshop on mass casualty management in Bethlehem in June 1999].

In June 1999, the Humanitarian Action Division of the Foreign Affairs Department organized a training course on the mass casualty management within the framework of religious festivities related to the Bethlehem 2000 project. This initiative was undertaken at the request of the Palestinian Authority and the General Consulate of France in Jerusalem. Palestinian and French specialists in the field worked together in three workshops devoted to rescue, search and first aid; medical outposts and triage; and emergency and surgical care in referring hospitals.

Disaster Planning↗

[Workshop of military reconstructive surgery in Conakry May 1999: example of civilian-military cooperation in responding to medical-surgical crisis emergencies].

During the period from 1998 to 1999, civil wars broke out in number of west African countries including Liberia, Sierra Leone, and Guinea Bissau. Due to the situation in surrounding countries, Guinea Conakry was forced to accept nearly 650000 refugees whose presence represented a major risk for the socio-political stability of the country. International organizations and NGOs condemned the atrocities inflicted on civilian populations by the children serving as soldiers in the RUF rebels organizations of Sierra Leone and Liberia. These attacks included murders, gang rapes, abduction of children and young people, and mutilation of extremities of people of all ages ranging from infants to elderly. Treatment of mutilation victims requires the availability of facilities for surgical treatment and prosthetic fitting in Guinea Conakry. The humanitarian action division of the French Foreign Affairs Department and the NGO Handicap International decided to provide specialized training in the management of mutilation injuries to surgical groups in hospitals of Guinea and Sierra Leone. The program consisted in a workshop on reconstructive surgery for war-related injuries to allow optimal prosthetic fitting for reinsertion of mutilation victims into society.

Adolescent↗

[Determination of the butyl 2,4-dichlorophenoxyacetate in the workshop by gas chromatography].

The new method for determining the content of 2,4-dichlorophenoxyacetic acid butyl ester in the workshop by using gas chromatography is presented. The experiments for precision and efficiency have been performed. The range of determination is 0.05-2.5 mg/m3. The minimum detectable mass concentration is 25 micrograms/m3. The method meets the requirement of the "monitoring and researching standard for toxic substances", and shows that it can be applied in routine analysis.

2,4-Dichlorophenoxyacetic Acid↗

Outcomes from the Patient Perspective Workshop at OMERACT 6.

The objective of the Patient Perspective Workshop at OMERACT 6 was to address the question of assessing the outcomes of intervention in rheumatoid arthritis (RA) from the perspective of those who experience the disease themselves. This was done by reviewing the current state of research in the area, identifying the requirements for the development of valid instruments, delineating a research agenda that can attain these requirements, and motivating participants to undertake the appropriate research. Through a series of meetings and discussion sessions a research agenda emerged that includes: exploring subjective experiences of RA identified by patients as important but not encompassed within the current "core set" of outcome measures (such as a sense of well being, fatigue, and disturbed sleep); clarifying terminology; and empowering patients to be more effective partners in outcomes research. These were supported by the OMERACT plenary session. Specific actions were required by both patient participants and organizers to ensure the nature of the conference, its focus and method of working were understood, and that the patient participants were sufficiently confident to make their contribution.

Arthritis, Rheumatoid↗

MCID/Low Disease Activity State Workshop: low disease activity state in rheumatoid arthritis.

The MCID (minimal clinically important difference) module of OMERACT 5 developed a research agenda that led to the conclusion that a state of low disease activity for rheumatoid arthritis (RA) would need to be defined. To develop such a definition the various concepts and terminologies, the process for developing an operational definition, and the availability and design of longitudinal datasets for validation needed to be considered. This article describes the process of the MCID/Low Disease Activity State Workshop at OMERACT 6 to develop such a definition.

Arthritis, Rheumatoid↗

Standard reference material for Her2 testing: report of a National Institute of Standards and Technology-sponsored Consensus Workshop.

A workshop was sponsored by the National Institute of Standards and Technology, the Cancer Diagnosis Program of the National Cancer Institute, the Food and Drug Administration, and the College of American Pathologists to address the need for a reference material for Her2 gene protein testing. It was agreed that such a standard was desirable and necessary to ensure the reliability of Her2 testing to qualify patients for trastuzumab therapy. Two standards consisting of well characterized cell lines will be produced, 1 that will be a National Institute of Standards and Technology-certifiable standard, and 1 that will be a commercially developed standard for use in all Her2 testing. It was also agreed that all Her2 testing must be performed on samples fixed only in 10% buffered formalin, as specified in the Food and Drug Administration-approved testing methods. Participants agreed to plan strategies to educate pathologists, clinicians, and laboratories about the need and use of such a standard. A National Committee for Clinical Laboratory Standards guideline for the use of the standard reference material will be created to facilitate this process.

Cell Line, Tumor↗

The Second International Symposium on Hodgkin's Disease. Workshop III: Recommendations for future clinical trials.

In the opinion of the participants of the workshop, the following problems should be addressed with high priority: 1st, a clear definition of the 10%-15% of patients who should receive radiotherapy only; 2nd, reduction of toxicity of combined modality approaches for patients in localized stages with risk factors; and 3rd, definition of a poor-prognosis subgroup of patients in stages IIIB/IV for whom more efficient treatment programs must be developed. Dose intensification in the form of ABMT as the prominent example of high dose intensity should be tested in these patients. If this approach proves its efficacy, the concept of dose intensification could be extended to other patients with advanced disease. Results of recent trials in Hodgkin's disease suggest that the cure rates which increased considerably between 1960 and 1980 have reached a plateau. Further improvements that can be realistically expected will be small and studies to prove such progress need large numbers of patients ('megatrials') to avoid 'false negative' results. Such megatrials could be performed as large international or even intercontinental trials. To some extent, overviews could substitute for megatrials, if sufficient high-quality randomized studies addressing a specific question are available for a meta-analysis. The installation of an international steering committee was recommended, which should stimulate and coordinate world-wide efforts for the solution of the remaining problems in the treatment of Hodgkin's disease.

Antineoplastic Combined Chemotherapy Protocols↗

Localization of proliferating cell nuclear antigen (PCNA/Cyclin) in workshop cases of Hodgkin's disease and non-Hodgkin's lymphoma.

Proliferating cell nuclear antigen (PCNA/Cyclin) is a 36-kD protein that is present in cycling cells but not in resting cells, and therefore represents a marker of tumor proliferation. Application of anti-PCNA/Cyclin monoclonal antibodies has shown that this protein is localized to the nucleus of cycling cells, with the exception of cells in mitosis, which demonstrate faint cytoplasmic reactivity. Recently, Benjamin and Gown found that Reed-Sternberg cells and variants show nuclear and cytoplasmic staining with anti-PCNA/Cyclin antibody 19A2, and suggested that this feature may be useful in distinguishing Hodgkin's disease from other tumors. This report describes the reactivity of 42 workshop cases that were stained with anti-PCNA/Cyclin antibodies 19A2 and/or PC10. Thirty-three (79%) of the 42 cases showed adequate reactivity to allow for interpretation of staining localization. In the group of reactive cases, 26 (79%) showed nuclear and cytoplasmic staining. The localization of PCNA/Cyclin was compared with the consensus diagnosis in each case. Eighty percent of cases classified as Hodgkin's disease, 67% of cases classified as non-Hodgkin's lymphoma, and 100% of unresolved cases showed both nuclear and cytoplasmic staining. The incidence of cytoplasmic PCNA/Cyclin was not different between Hodgkin's disease and non-Hodgkin's lymphoma in this study.

Hodgkin Disease↗

Report of a consensus workshop, Siena, Italy, January 17-18, 1992. Early diagnosis of HIV infection in infants.

To promote progress in the research and development of early diagnostic tests for HIV in young children an international workshop was held on January 17-18, 1992, in Siena, Italy. Experts on pediatric AIDS, diagnostic retrovirology, and immunodiagnosis discussed and summarized the state-of-the-art and made recommendations for general application of several tests and further evaluation and continued research for other candidate tests. From the discussions it was clear that the field has advanced beyond the time when it was necessary to wait until the infant reached 18 months of age before attempting the diagnosis with conventional serologic tests for HIV. About half of infected infants can now be identified at birth, approximately 90% by 3 months of age, and almost all by 6 months of age using HIV culture and polymerase chain reaction assays. IgA antibody tests and p24 antigen tests have also proved useful, although they are not as sensitive in newborn infants. The fact that HIV can be detected in only one-half of infected infants at the time of birth points to the need for further research on the timing of transmission and the natural history of perinatally acquired HIV infection to understand the limitations of current early diagnostic tests and to develop new approaches to overcome these problems.

DNA, Viral↗

[Evaluation of relaxation workshops in primary care].

After an extensive review which the author has presented in her previous articles on relaxation, in this article she tries to evaluate the workshops set up in Primary Health Care Centers. She evaluates relaxation exercises, those problems which may occur while performing these and possible exercises which may be carried out at home. Finally, the author comments on the need to establish a personal relaxation plan adjusted to the necessities of each individual.

Humans↗

Report of a Consensus Workshop, Siena, Italy, January 17-18, 1992. Maternal factors involved in mother-to-child transmission of HIV-1.

Although most children with AIDS have acquired HIV from their mothers, transmission from an HIV-infected mother to her infant is neither uniform nor currently predictable. With the rapid worldwide spread of HIV infection, particularly into women of child-bearing age, definition of the risk factors associated with maternal transmission is essential to develop and deliver intervention therapy that might impact on the devastating spread of AIDS. To promote research defining the risk factors of HIV transmission from mother to infant, an international workshop was held on January 17-18, 1992, in Siena, Italy. Epidemiology, immunology, virology, and health issues associated with maternal HIV transmission were actively discussed by participants. Current information from the literature and new data available from laboratories formed the basis for the consensus opinions developed at the meeting. Wide differences (10-39%) in HIV transmission seen at different geographic sites may be explained by multiple risk factors. The timing of transmission of HIV from mother to fetal, newborn, or breast-fed infants may be further complicated by viral burden and other cofactors. There are intriguing suggestions that the immunological status of the mother may be influential in preventing or reducing HIV transmission. But this appears to be interrelated with the HIV viral burden and health status of the mother and in turn her likelihood to transmit HIV to her offspring. The infecting "inoculum" may be low and/or selective because of biological barriers that favor reduced transmission with good health of the mother and the absence of other infectious diseases.

Acquired Immunodeficiency Syndrome↗

Antibacterial agents for wounds and burns in the developing world. Report on a workshop.

Publications on the use of antibacterial agents for wounds and burns in the developing world continue to emphasize the value of antiseptics such as Eusol and gentian violet. In the developed world these agents have been mostly discredited. A workshop organized by the European Society for Tissue Repair concluded that clearer instructions about the role of antibacterial agents in the management of wounds and burns could clarify appropriate usage. The report considers the factors contributing to infection and rationalizes the use of disinfectants, antiseptics and antibiotics, especially in the developing world.

Acute Disease↗

[Management of a focal hepatic mass: propositions of a workshop].

Focal hepatic masses are a common problem, due to the expansion of ultrasound. Individuals engaged in the four disciplines involved (hepatogastroenterology, digestive surgery, radiology and pathology) met to summarize the information available, to compare their experience and to make synthetic proposals. The method consisted of an expert report, discussion of the clinical cases, workshop discussion for each discipline around synthetic proposals, reporting of these proposals in full session and discussion. The results, i.e. the synthetic and consensual proposals concerned diagnosis, treatment and monitoring of focal hepatic masses are presented for each discipline.

Biopsy↗

Developing the public health workforce in Canada: a summary of regional workshops on workforce education and training.

The report of the National Advisory Committee on SARS and Public Health recommended the need for a national public health human resource strategy and the need to identify opportunities for improving training. The recent regional workshops reinforced both these recommendations, and the excellent suggestions made by the participants will be utilized by the many work groups that will endeavour to improve public health system infrastructure in this country.

Canada↗

Workshop 4 (synthesis): securing food production under climate variability--exploring the options.

Climate variabilities may result in different types of dry spells, droughts or flood situations, having harmful effects on agricultural productivity and food security. Long-term trends in climate variabilities and climate extremes may be a consequence of an on-going climate change and would thus result in a more permanent change in the pre-conditions for food production. The presentations and discussion during the workshop concentrated on some different measures to be taken in addressing these kind of situations and in particularly on the adverse effects of dry spells, droughts and to some extent also floods. The different areas presented were examples from Bangladesh, the indus river and delta region, examples from India (Tamil Nadu, Karnataka and Andhra Pradesh), Israel, Sri Lanka and Uzbekistan.

Bangladesh↗