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Practical procedures in internal medicine: a workshop for fourth-year medical students.

A series of workshops demonstrating technical skills and practical procedures in internal medicine was conducted for fourth-year medical students. With the chance to observe and in some situations to perform the technical procedures under supervision, the students could become familiar with these techniques before beginning their residencies. Students from 13 medical schools participated. The consensus of the students was that this aspect of their training was neglected in medical school, that the experience was very valuable, and that additional procedure-oriented opportunities were necessary.

Clinical Competence↗

The clinical utility of the dexamethasone suppression test in psychiatry. Summary of a National Institute of Mental Health workshop.

The dexamethasone suppression test (DST) is being increasingly used in psychiatry, especially in the differential diagnosis of affective disorders. In light of this, the National Institute of Mental Health convened a workshop of clinical scientists drawn from neuroendocrinology, psychopathology, and general clinical psychiatry to review the evidence for the efficacy of the use of the DST in psychiatry. Specifically considered were DST's relevance to differential diagnosis, its use as a predictor of response to treatment, its relationship with other biologic variables, and technical issues. The panelists concluded that at this time there are no clear indications for routine use of the DST in diagnosis or clinical management of depression, although it is a useful research tool. Areas of potential utility include prediction of suicidal activity, prediction of relapse, and differential diagnosis.

Depressive Disorder↗

Creatine kinase variants. Report on the workshop conference of the German Society for Clinical Chemistry held on September 19 to 21, 1982 in Tübingen, FRG.

It was the aim of the workshop to summarize present knowledge of the variant creatine kinases in human blood. Discussion was centered on the nature, measurement, and clinical significance of these variants. On the basis of the presented results, the different creatine kinase variants can be classified as follows: Normal size variants (80000 Daltons). These originate from postsynthetic modifications of the three dimeric isoenzymes creatine kinase-MM, MB or BB. The M subunit can be transformed by a serum constituent and these modifications result in at least three different creatine kinase-MM and two creatine kinase-MB variants, which still show catalytic activity. The mechanism of the postsynthetic alterations of creatine kinase-BB seems to be more complex: In vitro incubation of this isoenzyme even in a non-serum matrix changes its electrophoretic mobility and decreases activity. In vivo there is evidence that on the one hand intact creatine kinase-BB molecules are directly removed from the circulation. On the other hand, however, inactive creatine kinase-BB-protein is reported to occur in serum. Variants with higher molecular weights (greater than 200000 Daltons). These are termed macro creatine kinases. Macro creatine kinase type 1 comprises the immunoglobulin-bound creatine kinase isoenzymes. Of these immune complexes, IgG-linked creatine kinase-BB is well known and has been described in detail, whereas the occurrence of creatine kinase-MM-containing macro creatine kinases is still questionable. Macro creatine kinase type 1 is found in the blood of about 2% of all hospitalized patients. It occurs mainly in elderly women, but it is not known whether it has any special clinical significance. Macro creatine kinase type 2 is the term for an oligomeric form of mitochondrial creatine kinase released after breakdown of mitochondria in liver, heart and some tumours. After treatment with urea this oligomeric form is converted into a normal sized, dimeric creatine kinase-MiMi. Macro creatine kinase type 2 is found exclusively in seriously ill patients, and may occur in more than 3% of all hospitalized patients. This classification of the creatine kinase variants seems logical, since it takes into account the nature of the creatine kinase variants, and it permits the classification of all atypical creatine kinases described in the literature. As quantification and differentiation now become possible, further experimental and clinical investigations should provide the information necessary for a better understanding of the physiology and pathobiochemistry of these multiple forms of creatine kinase.

Creatine Kinase↗

Workshop on allergic responses and hypersensitivities induced by chemicals; Frankfurt, 12-15 October 1982. World Health Organization/Commission of European Communities.

There is a significant health problem associated with allergy and intolerance to man-made chemicals, both in terms of the severity of the clinical condition and the seriousness of interference with life quality and in terms of the number of exposed people. Recognizing the growing importance of the problem, the World Health Organization Regional Office for Europe and the Commission of European Communities (Health and Safety Directorate) jointly organized a Workshop on Allergic Responses and Hypersensitivities Induced by Chemicals, which was held in Frankfurt/on Main, Federal Republic of Germany, from 12 to 15 October 1982.

Animals↗

Joint report of the first workshop of the LD typing study group.

In the first workshop of the American LD Typing Study Group, six exchanged typing cells were used by all participants. Several other homozygous typing cells were included in individual experiments by the participating laboratories. The data obtained from LD typing of 142 individuals, among whom were members of 33 families, were submitted for joint analysis by computer. Several typing cells appeared to recognize new HLA-D specificities. Their typing reactions were clearly discernible in the computer analysis of the results using the 25th percentile stabilization method. The next phase of this work will consist of an expanded study of the families included in the present report.

Epitopes↗

UDP-glucuronyltransferase. Report on the workshop conference of the German Society for Clinical Chemistry held on September 27-28, 1977 in Schloss Auel.

A Workshop Conference on UDP-glucuronyltransferase was held in order to bring together different investigators specialising in a particular aspect of the enzyme. The intention was to find a basis for a closer cooperation between the different groups and to exchange ideas and methods making it possible to cross the hurdles facing those who work in the field of glucuronidation of endogenous and exogenous substances. The topics which were chosen for the meeting covered the following aspects: methods of determination of UDP-glucuronyltransferase activity; problems relating to the origin of the enzyme and the nature of the substrate; application of assays of UDP-glucuronyltransferase in clinical chemistry; enzyme-substrate interactions and factors influencing the enzymic reaction; the role of UDP-glucuronyltransferase in the entero-hepatic circulation of glucuronides, regulation and induction of UDP-glucuronyltransferase, with a subsection on solubilisation and purification.

Animals↗

Is glucose a reliable index of carbohydrate metabolism? Report on the joint workshop conference "Glucose" of the German Society for Clinical Chemistry and the German Diabetes Society held on May 15-16, 1981 in Stuttgart, Germany.

The determination of glucose concentration is the most frequently used clinical laboratory test. It was the current vehemence in discussions about the judgement criteria for the diagnosis and monitoring of diabetes that motivated this discussion of pathobiochemical and analytical aspects in a circle of 38 experts. The composition of the working group made it possible to compare the needs of clinical diabetologists and diabetics with the analytical possibilities. Pathobiochemistry, sampling problems, diabetic self control, analytical methods and their standardisation, glucose monitoring, glucose sensors and glycosylated proteins were the topics of this glucose workshop.

Blood Glucose↗

[The traits theory in longitudinal life span research. Partial report of a workshop].

During the international Workshop on 'Life Span and Change in a Gerontological Perspective' (9-12 July, 1981) at the University of Nijmegen, the Netherlands, research data from the Oakland Growth Study and the Guidance Study have been discussed. The second major contribution came from the longitudinal studies at the Bonn University. These groups of researchers cover different periods in the life span, but both contribute to prediction and understanding of periods not under investigation. Each of these longitudinal studies can contribute to the total understanding of the psychology of the life span. In this contribution we describe the trait-centered approach. The older research is mostly done with this theoretical approach in mind. We summarize the Californian studies and the Manhattan study on mental health. We close with some general critical remarks and we try to define the limitations of the trait-theoretical approach.

Adolescent↗

Report of a workshop on urothelial lesions in mice.

Thirteen pathologists with a variety of backgrounds met at the National Center for Toxicological Research in Jefferson, Arkansas, to discuss and exchange views on urothelial lesions in mice. Fifteen slides of urothelial lesions from mice were distributed to the participants prior to the meeting. A consensus was reached on 11 of the lesions, 8 of which were neoplastic and 3 of which were non-neoplastic. The author encourages such workshops and feels that they are meaningful and beneficial in understanding the significance of such lesions.

Animals↗

Model workshop on nutrition counseling for dietitians.

The purpose of the workshop on nutrition counseling was twofold: (a) to enhance nutritionists' and dietitians' knowledge of counseling and basic interviewing skills, behavioral weight control counseling skills, and adherence counseling skills and (b) to quantitatively evaluate improvement and maintenance of the newly acquired skills. Changes in these areas indicated that it is possible to improve certain skills and to maintain those improvements over time.

Counseling↗

[Statistical problems in the comparison of methods of clinical chemical analysis. Report on the workshop conference of the German Society for Clinical Chemistry held on June 28 and 29, 1979 in Hannover (Author's transl)].

Despite published recommendations and experimental protocols for the evaluation of clinical chemical analytical methods, the statistical evaluation of results still leaves many questions unanswered. The purpose of the workshop conference was to produce, and submit to discussion, recommendations for suitable statistical procedures, in particular for the comparison of different analytical methods.

Chemistry, Clinical↗

Strategies for prevention of perinatal transmission of HIV infection. Siena Consensus Workshop II.

Worldwide clinical trials are in progress or are being planned to evaluate different interventions aimed at reducing transmission of human immunodeficiency virus (HIV) from mother to infant. Several new therapeutic agents will soon be the focus of clinical trials to evaluate their safety for pregnant women and their infants and to test their efficacy in preventing perinatal transmission. Identification of the factors that influence the timing and mechanism of perinatal HIV transmission is essential to the assessment of interventions to reduce transmission. An international workshop was held on June 3-6, 1993, in Siena, Italy, to review what is known about the risk factors, timing, and mechanisms of HIV type 1 (HIV-1) transmission from mother to infant during gestation, birth, and lactation. Several possible interventions were compared with respect to their mechanism of action, their dependence upon the mode and timing of perinatal HIV transmission, and their suitability for incorporation into trials, alone or in combination, in various parts of the world. Obstetrical interventions such as caesarian section or use of a virucidal vaginal lavage during labor, administration of antiretroviral drugs to mother and/or infant, as well as active and/or passive immunization were discussed. The role of breast-feeding in perinatal HIV infection and in the trials was also evaluated. Because the ability to enroll pregnant, HIV-infected women in trials is limited, it is essential that proposed trials be carefully evaluated for adequacy of the sample size, appropriateness of the type of intervention to the particular population of women to be enrolled, and feasibility of the intervention. Worldwide coordination of perinatal intervention trials is essential to prevent duplication, allow the optimal use of human and financial resources, and ensure the most rapid possible evaluation and implementation of means to prevent pediatric HIV infection.

AIDS Vaccines↗

Sialylated Lewis(x) and Lewis(a) determinants expression on human neoplastic cell lines: immunocytometric study with the 5th workshop monoclonal antibodies.

The reactivity of monoclonal antibodies from the 5th workshop Selectins/Selectin Ligands panel, directed to the sialylated Lewis(x) and sialylated Lewis(a) determinants, with the human breast carcinoma (BT-20, ZR-75-1 and MDA-MB-468) cell lines, human ovarian carcinoma cell line A2780, fibrosarcoma (HT-1080, B-6FS) and hematopoietic neoplastic (U-937, HL-60, K-562) cell lines were determined with the aid of flow immunocytofluorometry. The examined monoclonal antibodies to sialylated Lewis determinants reacted with examined breast carcinoma, but not with the examined ovarian carcinoma and fibrosarcoma cell lines.

Antibodies, Monoclonal↗

Anovulatory infertility. The ESHRE Capri Workshop Group.

The ESHRE Capri Workshop group first arrived at a working definition of anovulatory infertility, then discussed the diagnoses, the advantages and disadvantages of the available treatments for the various categories of infertility, namely hyperprolactinaemic anovulation, hypogonadotrophic hypogonadism and normogonadotrophic anovulation including polycystic ovary syndrome.

Anovulation↗

[Gallbladder polyps. 2d Consensus Workshop of the Chilean Hepatology Association].

During a workshop, hepatologists analyzed and gave recommendations about gallbladder polyps. They arrived to the following agreements: gallbladder polyps of less than 10 mm should be followed with ultrasonography at 3, 6 and 12 months if there is no enlargement. If there is enlargement, a cholecystectomy should be performed. Polyps larger than 10 mm should be subjected to cholecystectomy.

Female↗

[Radioimmunologic diagnosis and pathobiochemistry of the renin-angiotension-aldosterone system. Report of the workshop conference of the German Society for clinical chemistry on January 31 and February 1, 1975 in Bonn (author's transl)].

Studies on the individual components of the renin-angiotensin-aldosterone system are of crucial importance for the investigation of hypertension. The purpose of the workship conference was to give occasion for discussion amongst German speaking research groups on the determination of the individual components of this system, and for the consideration of new results and their pathophysiological significance, as well as possibilities for the evaluation of radioimmunological data with the aid of electronic data processing. The following report is a summary of the contributions to the discussion by those taking part in the workshop conference.

Aging↗

Quality in the dermatological contract. A report from the Workshop on Quality Issues in Dermatological contracting of the British Association of Dermatologists.

This document is a summary of the most important points from a meeting convened by the audit sub-committee of the British Association of Dermatologists (BAD) and the research unit of the Royal College of Physicians on 16 May 1994. Participants represented the views of district general and teaching hospital dermatologists, a fundholding general practitioner, a health commissioning agent and patient support groups. The meeting was preceded by a workshop on 6 April 1994, involving 16 patient support groups chaired by Consumers Association from which a discussion paper was presented by two representatives. This report is intended for dermatologists, contract managers and purchasers.

Dermatology↗

Indoor air quality a major public-health issue, workshop told.

Indoor pollution is a major public-health issue, say representatives from government and the medical profession who participated in a recent workshop in Ottawa. Researchers are certain that indoor pollution causes many of the allergy-related problems and asthma, bronchitis, rhinitis, coughing and others respiratory problems experienced by North Americans. They urge physicians to learn about indoor air quality and to educate patients to improve their environment, particularly with respect to second-hand smoke, dust mites and mould.

Air Pollution, Indoor↗