Quality assurance from the viewpoint of the surgeon

The problem of global standardization, clinical documentation, and confidentiality of methods in quality control are discussed. It is concluded that conventional methods of quality assurance should be further developed in order to avoid investments into administration tools that have not yet proved any effectiveness worldwide. Future developments should be orientated to achieve benefits for the patient and to promote surgical excellence.     

Functional and DNA sequence divergence of the CYP71 gene family in higher plants

During ripening of avocado (Persea americana), the CYP71A1 mRNA and protein accumulate to relatively high levels. Although the CYP71A1 gene was the first plant P450 to be cloned and sequenced, the functional role of this P450 remains obscure. Substrate studies have shown that CYP71A1 will metabolize various monoterpenes (nerol and geraniol), although these have not been detected in ripening fruit. Using DNA from a conserved domain of the CYP71A1 gene, we have explored the scope of the CYP71 (or related) gene family in avocado using low stringency DNA hybridization. This analysis suggests that there are approximately 10-12 genes in the CYP71 family. An alternative approach using PCR gave essentially identical results.     

The automated prediction of hearing thresholds in sleeping subjects using auditory steady-state evoked potentials

OBJECTIVE: To examine the relationship between auditory steady-state evoked potentials (SSEPs) and behavioral thresholds in sleeping subjects. DESIGN: 60 adults and children with hearing thresholds ranging from normal to profound were selected on the basis of appropriate audiograms. Behavioral audiograms were determined at the octave frequencies 250-4000 Hz. These behavioral thresholds were then compared with the SSEP thresholds obtained during natural sleep for adults, or natural or sedated sleep for children. RESULTS: A strong relationship between behavioral and SSEP thresholds was observed. The strength of the relationship increased with increasing frequency and increasing degree of the loss. On the basis of these data, the prediction of behavioral thresholds from SSEP levels was determined. It was found that the standard deviation of the error in this prediction decreased with increasing frequency and increasing degree of the loss. There was no significant age effect in the results obtained at any of the frequencies. CONCLUSION: The results suggest the SSEP technique can be used as a predictor of behavioral threshold in adults and children at the frequencies 250-4000 Hz.     

Successful treatment of experimental murine Trypanosoma brucei infection with topical melarsoprol gel

Melarsoprol gel applied topically (0.1 mL for at least 2 d) can cure late-stage Trypanosoma brucei brucei and T. b. rhodesiense infections in mice. The best regimen was 3 applications at approximately 0, 6, and 24 h. The melarsoprol gel retained its activity at room temperature for at least 63 d. There was only minimal skin irritation and no sign of toxicity.     

On-line search strategies of third year medical students: perception vs fact

The curriculum at the University of New Mexico School of Medicine has evolved with a high priority on problem-based and life-long learning. As the information pool enlarges, a greater emphasis must be placed on the ability of physicians to access the biomedical literature following residency training. To foster information retrieval skills, our medical school has included on the ability of physicians to access the biomedical literature following residency training. To foster information retrieval skills, our medical school has included on-line searching instruction since 1987. On-line classes are taught by experienced medical librarians during the second month of the first year curriculum. After receiving training, students are assigned a code via Grateful Med software. The purpose of the study was to measure the long-term effectiveness of this training approach and to determine the students' ability to formulate a search strategy and run a search to answer clinical questions at the third year level. During the 1990-1991 school year, all third year students were asked to use Grateful Med to answer two questions related to surgical patient care and to complete a questionnaire showing how they use Grateful Med and how they view their training. The students' searches were compared to "gold standard" searches run by an experienced medical librarian. Nineteen percent of all searches resulted in zero retrieval, and the remainder missed 74-100% of the gold standard available citations. Additional instruction shortly after on-line training could identify problem areas (poor search behavior) and information retrieval skills should be integrated and encouraged in all levels of the curriculum.