2010-2011 Meetings and Conferences

Since meetings are our outlet as medical doctors and scientists to learn about the latest advances in our field, this issue highlights some worldwide meetings and conferences that may be of significant interest to put on your calendar during 2010 and 2011. These meetings are hosted by many of our affiliated societies throughout the world and have sessions dedicated to some form of pancreatic disease-related research. Many are annual meetings, so even if your travel calendar is booked for the year, utilizing their website to examine the program topics and abstracts for this year may prompt interest to attend one of the following year's meetings.     

Anti-HBs characteristics after hepatitis B immunisation with plasma-derived and recombinant DNA-derived vaccines

Hepatitis B surface antigen derived from chronic hepatitis B carriers has been replaced almost completely by recombinant DNA-derived HBsAg for use as hepatitis B vaccine. Similarly, recombinant DNA-derived HBsAg is replacing plasma-derived HBsAg in standard anti-HBs assays. We analysed the influence of a change from plasma-derived HBsAg to recombinant DNA-derived HBsAg on antigen presentation in immunoassays and the characteristics of the anti-HBs antibodies after immunisation. Antigens and/or antibodies were subjected to three types of experiments: (a) binding of 'a'-loop specific monoclonal (anti-S) antibody conjugates to immobilised vaccine-HBsAg; (b) binding of post-vaccination anti-HBs to immobilised (vaccine-)HBsAg and (c) inhibition of HBsAg binding to immobilised monoclonal anti-HBs after pre-incubation with post-vaccination antibodies. Our results show that, in both antigen presentation and anti-HBs binding properties, yeast recombinant HBsAg and related antibodies could be clearly distinguished from plasma-derived HBsAg and related antibodies. Divergent results were also obtained in the inhibition assay with recombinant DNA-derived HBsAg but not with serum HBsAg from the vaccine HBsAg subtype. It is concluded that both antigen presentation in vaccines and in anti-HBs assays can markedly influence the quantitation anti-HBs response. It is suggested that a challenge with an heterologous hepatitis B virus may encounter reduced efficacy of vaccine antibodies.     

Comparison of ticarcillin plus clavulanic acid with clindamycin and gentamicin in the treatment of postcesarean endomyometritis

The efficacy of a single antibiotic--Timentin (ticarcillin with clavulanic acid)--was compared with a standard two antibiotic regimen (clindamycin and gentamicin) for the treatment of endomyometritis after cesarean delivery. The regimens were 3 grams of ticarcillin plus 100 milligrams of clavulanic acid given intravenously every four hours, or 600 milligrams of clindamycin given intravenously every six hours plus 3 to 5 milligrams per kilogram per day of gentamicin given intramuscularly. The diagnosis of endomyometritis was based upon an oral temperature of 100.4 degrees F. or higher on any two occasions, excluding the first 24 hours post partum, uterine tenderness and the absence of another focus of infection. Ninety-one patients were treated. Treatment failure rates were three of 49 in the clindamycin and gentamicin group and four of 42 of the ticarcillin plus clavulanic acid group. Treatment failures did not appear to be different from successes demographically or in risk factors for endomyometritis. The results of this study suggest that ticarcillin with clavulanic acid is as effective in the treatment of postcesarean endomyometritis as the standard regimen of clindamycin and gentamicin.     

Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes

OBJECTIVES: Studies were conducted to: 1) assess physicians' attitudes and practices in managing cardiovascular disease (CVD) risks in diabetes; and 2) determine the awareness of CVD risks among diabetic patients. BACKGROUND: Cardiovascular disease is the leading cause of premature death among diabetic patients. As diabetes is often seen as a "glucose-centric" disease, it is unclear whether diabetic patients are talking with their doctors about CVD and other key clinical parameters of diabetes care such as blood pressure and cholesterol. METHODS: An online survey was completed by a nationally representative sample of 900 physicians. The 95% confidence interval is approximately +/-2.5%. Before this study, a telephone survey of 2,008 people with diabetes was conducted using random, direct-dial screenings of U.S. households. RESULTS: Ninety-one percent of physicians believe that their patients with diabetes are "very" or "extremely" likely to have a cardiovascular event. Although physicians report discussing CVD risk factors with 88% of their diabetic patients, they perceive their diabetic patients as being only moderately knowledgeable about their increased CVD risks. Sixty-eight percent of the people with diabetes do not consider CVD to be a serious complication of diabetes; they are more likely to be aware of complications such as blindness (65%) or amputation (36%) rather than heart disease (17%), heart attack (14%), or stroke (5%). Physicians perceive "poor compliance" with behavioral modifications and medication regimens as the greatest barriers to the management of CVD risks in diabetic patients. CONCLUSION: Materials should be made available to help facilitate communication about CVD risks, and strategies for improving compliance with life-style modifications and multiple drug therapies should be explored. Efforts should continue to promote a comprehensive approach to the management of diabetes to include aggressive control of blood glucose and other CVD risk factors.     

Connecting the disconnect between hospital and home

Mr. D, 76 years old, underwent a colostomy in a local hospital after several weeks of preoperative outpatient radiation therapy that caused severe diarrhea. The nurses at the hospital managed his colostomy and told him he probably "would not need to wear a pouch" after he was taught how to irrigate. They showed him how to empty a two-piece system before he was discharged 7 days after his surgery. Mr. D was able to manage emptying but did not pay much attention to the procedure because he viewed wearing the pouch as a temporary situation. After his discharge, the home care nurse informed him that due to the diarrhea he was experiencing, colostomy irrigation would not be an option and he would have to use a pouching system - one different from the one he had learned to use in the hospital. Mr. D was disappointed and bewildered.