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Intense Scrutiny (intense + scrutiny)
Selected AbstractsNo Smoking Gun: Findings From a National Survey of Office-Based Cosmetic Surgery Adverse Event ReportingDERMATOLOGIC SURGERY, Issue 11 2003Rajesh Balkrishnan PhD Background. Because of recent press reports of adverse outcomes, office-based cosmetic surgery has come under intense scrutiny and associated legislative regulatory action. Objective. To assess the safety of office-based cosmetic surgery through a national survey of state agencies that collect information on adverse patient outcomes. Methods. Medical boards or other responsible authorities were contacted in 48 states to obtain records on adverse outcomes from cosmetic surgery procedures performed in an office-based setting. Results. Five states were able to provide complete information regarding 13 cases of adverse outcomes that resulted from office-based cosmetic surgery procedures. Thirteen states had incomplete information or were unable to provide information. The remaining states reported no adverse outcomes. Information collected by state agencies varies greatly and is inadequate to define the safety of office-based cosmetic surgery practice. Conclusions. The need to regulate physician office surgery on the basis of hospital privileges and office certification is not supported by current data. Mandatory reporting of adverse outcomes from office-based surgery is warranted to identify modifiable risk factors and to reduce the risk of adverse outcomes. [source] Control of IL-4 expression in T helper 1 and 2 cellsIMMUNOLOGY, Issue 4 2008Jane Gilmour Summary The mechanism of differentiation of naïve T cells to a variety of effector lineages, but particularly to T helper type 1 (Th1) and Th2 cells, has been the subject of intense scrutiny over the past two decades. Studies have revealed that the expression of cytokines, receptors, signalling molecules, transcription factors, DNA methylating enzymes and histone-modifying enzymes is altered during the process and has been shown to play a co-ordinated role to facilitate expression of the cytokines interleukin-4 (IL-4), IL-5 and IL-13 in Th2 cells, or interferon-, in Th1 cells. Regulation of IL-4 expression has been of particular interest for two main reasons: first because IL-4 acts as a growth factor for Th2 cells, and second because of its role in the induction of immunoglobulin class switching to immunoglobulin E, which plays a critical role in mediating allergic responses. Study of the pathways that promote this tissue-restricted expression of IL-4 may highlight potential areas for therapeutic intervention. [source] ATP-Sensitive K+ Channels of Vascular Smooth Muscle CellsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2003WILLIAM C. COLE Ph.D. ATP-sensitive potassium channels (KATP) of vascular smooth muscle cells represent potential therapeutic targets for control of abnormal vascular contractility. The biophysical properties, regulation and pharmacology of these channels have received intense scrutiny during the past twenty years, however, the molecular basis of vascular KATP channels remains ill-defined. This review summarizes the recent advancements made in our understanding of the molecular composition of vascular KATP channels with a focus on the evidence that hetero-octameric complexes of Kir6.1 and SUR2B subunits constitute the vascular KATP subtype responsible for control of arterial diameter by vasoactive agonists. [source] Pandemic influenza and the hospitalist: Apocalypse when?JOURNAL OF HOSPITAL MEDICINE, Issue 2 2006James C. Pile MD Abstract Beginning with a cluster of human cases in Hong Kong in 1997, avian influenza (H5N1) has spread progressively through, and beyond, Asia in poultry and other birds; and has resulted in sporadic cases of human disease associated with high mortality. The potential for H5N1 influenza to cause a pandemic of human disease continues to be the subject of intense scrutiny by both the media and the scientific community. While the likelihood of such a prospect is uncertain, the inevitability of future pandemics of influenza is clear. Planning for the eventuality of a virulent influenza pandemic at the local, national and global level is critical to limiting the mortality and morbidity of such an occurrence. Hospitalists have a key role to play in institutional efforts to prepare for a influenza pandemic, and should be aware of lessons that my be applied from both the response to Hurricane Katrina, as well as the severe acute respiratory syndrome (SARS) epidemic. Journal of Hospital Medicine 2006;1:118,123. © 2006 Society of Hospital Medicine [source] The Endocannabinoid System and Energy MetabolismJOURNAL OF NEUROENDOCRINOLOGY, Issue 6 2008L. Bellocchio Many different regulatory actions have been attributed to endocannabinoids, and their involvement in several pathophysiological conditions is under intense scrutiny. Cannabinoid receptors [cannabinoid receptor type 1 (CB1) and CB2] participate in the physiological modulation of many central and peripheral functions. The ability of the endocannabinoid system to control appetite, food intake and energy balance has recently received considerable attention, particularly in the light of the different modes of action underlying these functions. The endocannabinoid system modulates rewarding properties of food by acting at specific mesolimbic areas in the brain. In the hypothalamus, CB1 receptors and endocannabinoids are integrated components of the networks controlling appetite and food intake. Interestingly, the endocannabinoid system was recently shown to control several metabolic functions by acting on peripheral tissues such as adipocytes, hepatocytes, the gastrointestinal tract, the skeletal muscles and the endocrine pancreas. The relevance of the system is further strengthened by the notion that visceral obesity seems to be a condition in which an overactivation of the endocannabinoid system occurs, and therefore drugs interfering with this overactivation by blocking CB1 receptors are considered as potentially valuable candidates for the treatment of obesity and related cardiometabolic risk factors. [source] Reviewing child deaths,learning from the American experience,CHILD ABUSE REVIEW, Issue 2 2005Lisa Bunting Abstract Current systems for investigating child deaths in England, Wales and Northern Ireland have come under intense scrutiny in recent years and questions have been raised about the accuracy of child death investigations and resulting statistics. Research has highlighted the ways in which multidisciplinary input can contribute to investigative and review processes, a perspective which is further supported by recent UK policy developments. The experience of creating multidisciplinary child death review teams (CDRTs) in America highlights the potential benefits the introduction of a similar system might have. These benefits include improved multi-agency working and communication, more effective identification of suspicious cases, a decrease in inadequate death certification and a broader and more in-depth understanding of the causes of child deaths through the systematic collection and analysis of data. While a lack of funding, regional coordination and evaluation limit the impact of American CDRTs, the positive aspects of this process make it worthwhile, and timely, to consider how such a model might fit within our own context. Current policy developments such as the Home Office review of coroner services, the Children Bill and related Department for Education and Skills (DfES) work on developing screening groups demonstrate that strides have been made in respect of introducing a multidisciplinary process. Similarly, the development of local protocols for the investigation and[sol ]or review of child deaths in England, Wales and Northern Ireland highlights an increased focus on multidisciplinary processes. However, key issues from the American experience, such as the remit of CDRTs[sol ]screening panels, the need for national coordination and the importance of rigorous evaluation, can inform the development of a similar process in the UK. Copyright © 2005 John Wiley & Sons, Ltd. [source] Matching resources to treatment decisions for patients with acute coronary syndromesCLINICAL CARDIOLOGY, Issue S1 2002Robert M. Califf M.D. Abstract Multiple dynamic forces are having an impact on the way cardiovascular disease is treated today and will be in the future. These forces include extended life expectancy, decreased disability, and accelerated improvement in the effectiveness of medical technology. All of these forces will lead to a predictable increase in health care costs. Cardiologists must also be cognizant of the rise in health care consumerism; patients are assuming a larger role in decisions about their medical care and treatment. All of these factors are driving the climate of evidence-based medicine, particularly in the cardiovascular field. Payers and the government are beginning to require the clinical community to define quality. In turn, these third parties are beginning to measure quality as defined by the profession and to hold providers accountable for the quality of what they do. Although the frontier of genetic prediction in therapeutics will serve as an intellectual focus for bringing these issues closer to the forefront in cardiovascular medicine, the fundamental provision of value in health care (high quality at reasonable cost) cannot wait on genomics. Because the amount of evidence in acute coronary syndromes (ACS) exceeds other areas of medicine, therapies for ACS will undergo increasingly intense scrutiny. [source] | ||||||||||