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PubMed1998

Retinal gene therapy 1998: summary of a workshop.

The 1998 Workshop on Retinal Gene Therapy evaluated the potential of gene therapy in treatment of retinal disease. Academic, industry, and private foundation representatives attended. Topics included: determing which retinal diseases are likely candidates for gene therapy, specific retinal degenerations and nonspecific neuronal survival mechanisms, design and use of viral and retroviral vectors in achieving regulated gene expression, animal models of retinal degeneration and associated therapies, human trials, and alternatives to gene therapy. The discussion of human trials explored the justification for moving from animal models to human testing, patient population concerns, lessons learned from previous human gene therapy trials, and the role of industry in support of basic and clinical research.

Adenoviridae↗
PubMedDate not supplied

[Optimizing the response to epidemics of meningococcal meningitis: report of a workshop of experts at CERMES (Niamey, Niger, 12th to 14th January 1998)].

Recent meningitis epidemics in West Africa have drawn attention to shortcomings in the response of the health services. The health ministries of the countries involved have identified particular requirements. Following WHO recommendations, OCCGE organized a meeting of experts at CERMES, Niamey, in January 1998. The aim of this workshop was to consider the problems common to these countries, identify their needs and to produce concrete recommendations defining the roles of OCCGE and CERMES. Difficulties in mobilization, as no procedure had been established, and a lack of resources limited the efficiency of the response to epidemics. There was also insufficient training of personnel and laboratory facilities were often inadequate. OCCGE could draft a procedure manual specifying tasks and responsibilities for the control of an epidemic. It was suggested that a sub-regional stock of drugs, vaccines and injection equipment should be set up at CERMES. This should improve the speed of the response and complement national and international distribution systems. The group stressed the importance of improving the surveillance of meningitis epidemics. This approach depends on a structured network based around a reference laboratory. CERMES plans to support government initiatives by training and by maintaining the network. Efforts will be made to report and make best use of epidemiological information at all levels of the "health pyramid". Some OCCGE institutes (e.g. IPR and CERMES) have computer tools such as the Geographical Information System, which can be made available to governments. Analysis of sub-regional epidemics demonstrated the limitations of an alert threshold of 15 cases per 100,000 people. The sensitivity and specificity of this threshold differs between climatic zones OCCGE recommends that each country carry out its own research to determine the most appropriate alert threshold for each zone. Epidemics are currently managed by treatment with short courses of chloramphenicol in oil (injected into muscle). This approach may change as ceftriaxone becomes more affordable. The systematic use of ceftriaxone in infants under the age of 1 year presenting with meningitis is justified by the frequency of non-meningococcal bacterial causes. A consensus was reached on the most appropriate vaccination strategies: Emergency vaccination implemented rapidly in response to an epidemic. The entire population of a district between the age of 6 months and 30 years are vaccinated. Prophylactic vaccination in high-risk zones. This is carried out in the zone itself or in neighboring regions where there was an epidemic the preceding year. There is evidence that those not infected during an epidemic are at high risk the following year. These vaccinations should be carried out as soon as possible, at least before the start of the next epidemic season. Systematic vaccination is currently limited to special groups (e.g. school children, military personnel and pilgrims). It is hoped that the conjugated vaccine will become available for integration into the infant vaccination program.

Africa, Western↗
PubMed1998

Seventh International Workshop on Ataxia-Telangiectasia.

Ataxia-telangiectasia (A-T) is a rare hereditary syndrome involving cerebellar degeneration, immunodeficiency, cancer risk, and radiosensitivity. Since the cloning of the A-T gene, ATM, in 1995, research on this pleiotropic disease and its molecular basis has expanded tremendously. ATM is a large protein kinase that appears to be one of the primary sensors of DNA strand-break damage. The vast majority of mutations in ATM result in truncation and destabilization of the protein, but certain missense and splicing errors have been shown to result in a less severe phenotype. A-T heterozygotes have been shown to have a slightly increased risk of cancer, but their increased in vitro radiosensitivity does not seem to result in any in vivo sensitivity. ATM does seem to act as a classic tumor suppressor gene in T-prolymphocytic leukemia, and LOH at the ATM locus is a common event in some tumor types, suggesting a general role for ATM in cancer. Recent work has shown the interaction of ATM with proteins involved in cell cycle control, and the direct phosphorylation of some of these interactors by ATM. ATM knockout mice have been created by several groups, and recapitulate the immunodeficiency, radiosensitivity, cancer risk, and fertility defects of A-T, although the effect on the cerebellum is slight. These diverse topics, and their integration into a global understanding of A-T, were the basis of the 7th International A-T Workshop.

Animals↗
PubMed1998

American Diabetes Association's Fourth International Workshop-Conference on Gestational Diabetes Mellitus: summary and discussion. Therapeutic interventions.

This review summarizes Session IV: Therapeutic Interventions of the Fourth International Gestational Diabetes Workshop and suggests intervention protocols based on the presentations at this meeting and the literature. The opinions of the six presenters and their interpretation of the review of the literature in their specific areas, the synthesis of the 30 abstracts presented at this symposium on therapeutic interventions, and my interpretations of the literature to date on these strategies are discussed. Also, the suggested intervention protocols are outlined as to medical nutritional therapy, weight gain, insulin prescriptions, and the utility of an exercise program for gestational diabetes mellitus. The goals of an intervention protocol for the gestational diabetic women are to achieve and maintain normoglycemia and thus to minimize the risk of maternal or fetal morbidity.

Blood Glucose↗
PubMed1998

The immunological properties of cord blood: overview of current research presented at the 2nd EUROCORD workshop.

It is generally agreed that cord blood (CB) transplantation represents an encouraging alternative to bone marrow (BM) transplantation. There are a variety of reasons for this, the two most controversial being (1) whether there is less graft-versus-host disease with CB compared to BM transplantation and (2) whether we can use more HLA mismatches with CB transplantation? If these are true then CB may generate a lower 'immunological response' compared to transplantation with adult cells. Why this may be is unknown, however, recently there has been much work which compared the immunological function of CB and adult monocytes. Here, we highlight the major contributions from 'The Immunological Properties of CB' session at the 2nd EUROCORD workshop which tried to determine why the immunological response in CB may be lower than that of the adult.

Adult↗
PubMed1995

Tumor receptor imaging: proceedings of the National Cancer Institute workshop, review of current work, and prospective for further investigations.

In February 1994, the National Cancer Institute held a workshop to evaluate the current and future role of emission tomographic imaging methods, positron emission tomography and single-photon emission computed tomography, in improving the accuracy of cancer diagnosis and the effectiveness of treatment and in elucidating basic aspects of human cancer biology. Reviews covered many of the receptor and transport systems for hormones and growth factors, as well as metabolic changes important in human cancer, and topical presentations reviewed the current status of receptor-based imaging in the most well-characterized systems: somatostatin receptor imaging of neuroendocrine tumors, estrogen receptor imaging of breast cancer, and epidermal growth factor receptor and tumor metabolic imaging. A critical analysis was made of the current research and of new directions for the future development and use of receptor-imaging methods in oncology. In each area, recommendations were made for further investigation, where emerging understanding of tumor cell biology and defined molecular targets might be combined with the methods of radiopharmaceutical design and evaluation, to develop new approaches to critical issues in the diagnosis, staging, and treatment of cancer through tumor receptor imaging.

Humans↗
PubMed1998

Eradication therapy of Helicobacter pylori. A review. Report from a workshop organized by the Swedish and Norwegian Medical Products Agencies, September 1995.

An expert meeting was organized by the Swedish and Norwegian Medical Products Agencies in September 1995 in order to review the current literature and opinions on detection and treatment of Helicobacter pylori. Ten people from these Agencies and 23 experts participated in the workshop and all were involved in the final manuscript, summarizing the background data and the conclusions (Info Läkemedelsverket 1:96). This report is limited to the therapeutic issues. Therapeutic effect on H. pylori is shown for tetracyclines, nitroimidazoles, clarithromycin, and amoxicillin. Acid inhibitory drugs or bismuth salts increase the antibacterial activity. In vitro resistance to metronidazole is reported in cultures of 10%-40% of H. pylori-infected patients in Scandinavia. Primary resistance to clarithromycin and tetracyclines is rare and no resistance to amoxicillin is confirmed. The clinical significance of resistance is unclear when effective triple combinations are used in previously untreated patients, but should be considered in treatment failures. Recommended therapeutic regimens should achieve a more than 90% cure rate. Important factors when choosing therapy are efficacy, side-effects, ecological factors, duration of therapy, and cost-benefit. Four triple regimens are effective and relatively well documented: omeprazole/amoxicillin/metronidazole for 1 week, omeprazole/clarithromycin/metronidazole for 1 week, omeprazole/clarithromycin/amoxicillin for 1 week, or bismuth subnitrate or bismuth citrate/tetracycline/metronidazole for 10 days. Side-effects are less pronounced in the combinations without bismuth. Dual therapy is not recommended. Eradication therapy should be considered for patients with peptic ulcer disease, MALT-lymphoma and Menetriéré's disease. Triple combinations, including two antimicrobials and a potent acid inhibitory drug or bismuth, are recommended.

Antacids↗
PubMedDate not supplied

Implementing a bicycle safety workshop.

Each year almost 400,000 children ages 14 and younger are treated in emergency rooms for bicycle-related injuries. An additional 500,000 young riders are treated in other settings (private pediatrician's office, urgent care centers) (American Academy of Pediatrics, 1991). An awareness has been raised this past decade toward programs that target injury prevention and promote safety and health in children. The implementation of bicycle safety workshops and "bicycle rodeos" are just one of many programs that educate young children on the techniques of safe, yet fun, bicycling.

Accident Prevention↗