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HICNet Medical News Digest Mon, 08 Aug 1994 Volume 07 : Issue 34 Today's Topics: [MMWR] Occupational Homicide [MMWR] Results National Breast & and Cervical Cancer Early Detection International Symposium on Brain-Death [FDA] Breast Implant Update National Institute of Cancer CancerNet Update WHO Global Program for Vaccines and Immunizations Articles on Investigating the HantaVirus Pediatric Pathology Course Armed Forces Institute of Pathology Postgraduate Short Courses InterPsych Mailing List Announcement +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Mosaic WWW: http://biomed.nus.sg/MEDNEWS/welcome.html Compilation Copyright 1994 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Jack E. Cross, B.S Health Care Admin, 882 Medical Trng Grp, USAF Albert Shar, Ph.D. CIO, Associate Prof, Univ of Penn School of Medicine Martin I. Herman, M.D., LeBonheur Children's Medical Center, Memphis TN Stephen Cristol, M.D., Dept of Ophthalmology, Emory Univ, Atlanta, GA Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- Date: Sun, 07 Aug 94 23:21:19 MST From: mednews (HICNet Medical News) To: hicnews Subject: [MMWR] Occupational Homicide Message-ID: <9H8Pqc10w165w@stat.com> Occupational Homicide -- Alaska, 1993 During 1980-1992, approximately two homicides occurred at work each year in Alaska; however, in 1993, homicide was the third most frequent cause of occupational fatality (n=11), following aircraft crash (n=23) and drowning (n=20). This report summarizes the 10 incidents resulting in these 11 occupational deaths in 1993. Occupational homicide is defined as a fatality resulting from intentional nonself-inflicted injury (International Classification of Diseases, Ninth Revision [ICD-9], external cause-of-death codes E960-E969) that occurred in a work setting (as defined by standard guidelines [1]). Since 1991, the Alaska Occupational Injury Surveillance System (AOISS)* has received reports of fatal occupational injuries from the Alaska Department of Health and Social Services, Occupational Safety and Health Administration, the Alaska Department of Labor, the National Transportation Safety Board, and the U.S. Coast Guard. Fatal events that occur outside the primary jurisdictions of these agencies may not be reported. To identify additional occupational homicides, newspaper reports were screened daily, and death certificates were reviewed routinely. As of March 9, 1994, death certificates were available for 10 of the homicide victims, and reports from medical examiners were available for five. Law enforcement agencies provided information for one homicide event; reports on other events were withheld because of ongoing investigations and litigation. All 11 occupational homicides occurred during May-October 1993; all victims were men, with a median age of 40 years (range: 22-50 years). Seven occurred on Saturdays, and four were in urban areas. Eight incidents involved firearms; a homemade bomb was used in one; and a knife was used in one. Two victims (in one incident) were maintenance personnel on a moored vessel; two were on-duty taxicab drivers, and one was an on-duty pilot for an air-taxi service. Other victims were a shopkeeper, a forester inspecting a logging camp, a painter driving a company truck from a remote worksite, an Army National Guardsman driving through an armory gate, a health aide attending a patient, and a security guard attempting to break up a fight. In six of the 11 deaths (five of 10 incidents), the alleged assailants knew the victims, and in two others, they did not know the victims; this information was unavailable for three incidents. Three incidents occurred during a known or suspected robbery. Five events did not occur during any other crime, and adequate information to determine whether another crime was involved was unavailable for two incidents. Reported by: GL Bledsoe, Occupational Injury Prevention Manager, JP Middaugh, MD, State Epidemiologist, Alaska Dept of Health and Social Svcs. Alaska Activity, Div of Safety Research, National Institute for Occupational Safety and Health, CDC. Editorial Note: In 1993, the occupational homicide rate in Alaska was 4.1 per 100,000 workers; for 1980-1989, when an average of 2.2 occupational homicides (range: 0-5) occurred each year in Alaska, the annual rate was 1.1 per 100,000 workers in Alaska, compared with 0.7 per 100,000 for U.S. workers. Why the number and rate of occupational homicides in Alaska increased in 1993 is unclear; because the events in this report occurred during a single year, future surveillance for occupational homicide in Alaska is needed to characterize any trends. The higher occupational homicide rate determined by AOISS may be, in part, the result of more complete ascertainment of incidents in Alaska than in the remainder of the United States. Newspaper reports can be used to identify homicide incidents rapidly. Death certificates have been used for homicide surveillance (2) but may not always be timely and must be supplemented with information from other official sources. For the cases in this report, legal authorities did not provide information on the accused assailants (e.g., psychiatric history or prior criminal records) that would permit further characterization of these homicide incidents. Most occupational homicides in this report did not involve victims in known high-risk occupations (e.g., taxicab driver, late-night retail worker, and security guard [3,4]). In addition, only three of the events involved robberies, and the victims knew their assailants in most instances; these findings contrast with national data on occupational homicides, which more frequently involve robberies committed by strangers (3). Four of the events reported here ensued when arguments escalated to violence; two others (the air-taxi pilot and forester) involved impulsive attacks. The availability of deadly force (a firearm in eight incidents) probably contributed to these deaths. A previous study has shown positive correlations between rates of household gun ownership and homicide rates (5). Reducing access to firearms may be particularly difficult to accomplish in Alaska, where gun dealership rates are the highest in the United States (6) and where a recent law (Chapter 67, SLA 94) provides a mechanism for Alaskans to obtain concealed weapons permits--with a local (municipal) option to prohibit such permits. Interposing physical barriers between customers and service personnel may be considered for settings where workers must serve customers at late hours or in relative isolation. However, the effectiveness of such measures has not been determined (7). Because most of the 1993 homicides in Alaska occurred on Saturdays, Alaskan workers, especially those who deal with customers or the public, should be alerted to the potentially heightened risk of homicide on weekends. U.S. homicides on weekends have been partly attributable to greater consumption of alcohol on weekends (8), but insufficient information was available to assess the impact of alcohol consumption on the events in this report. All workers should be trained in conflict-resolution and nonviolent responses to potentially hazardous or threatening situations in the workplace (9). Preventable risk factors and practical preventive strategies for occupational homicide need to be evaluated in Alaska and other states. Expanded surveillance for violence-related injuries and fatalities has been proposed, as has a multifaceted prevention strategy incorporating education, legislation, and technology approaches (2). Expanded collaboration with timely sharing of information between public health and law enforcement agencies may facilitate development of strategies and interventions that address this public health problem (10). References 1. Association for Vital Records and Health Statistics. Operational guidelines for determination of injury at work. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, NIOSH, NCHS, National Center for Environmental Health and Injury Control, March 30, 1992. 2. Hammett M, Powell KE, O'Carroll PW, Clanton S. Homicide surveillance--United States, 1979-1988. In: CDC surveillance summaries (May). MMWR 1992;41(no. SS-3):1-32. 3. Castillo D, Jenkins L. Industries and occupations at high risk for work-related homicide. J Occup Med 1994;36:125-32. 4. Kraus JF. Homicide while at work: persons, industries, and occupations at high risk. Am J Public Health 1987;77:1285-9. 5. Killias M. International correlations between gun ownership and victims of homicide and suicide. Can Med Assoc J 1993;148:1721-5. 6. Bureau of Alcohol, Tobacco, and Firearms. Federal firearms license holders. Washington, DC: US Department of the Treasury, Bureau of Alcohol, Tobacco, and Firearms, Office of Compliance Operations, May 1994. 7. Manitoba Taxicab Board. Taxi driver safety. Manitoba, Canada: Manitoba Taxicab Board, January 1992. 8. Baker SP, O'Neill B, Ginsburg MJ, Guohua L. The injury fact book. New York: Oxford University Press, 1992. 9. NIOSH. Preventing homicide in the workplace. Cincinnati: US Department of Health and Human Services, Public Health Service, CDC, NIOSH, 1993; DHHS publication no. (NIOSH)93-109. 10. Bell CA, Jenkins EL. Homicide in U.S. workplaces: a strategy for prevention and research. Morgantown, West Virginia: US Department of Health and Human Services, Public Health Service, CDC, NIOSH, 1992; DHHS publication no. (NIOSH)92-103. *Maintained by CDC's National Institute for Occupational Safety and Health, Division of Safety Research, Alaska Activity. ------------------------------ Date: Sun, 07 Aug 94 23:23:12 MST From: mednews (HICNet Medical News) To: hicnews Subject: [MMWR] Results National Breast & and Cervical Cancer Early Detection Message-ID: <DL8Pqc11w165w@stat.com> Progress in Chronic Disease Prevention Results from the National Breast and Cervical Cancer Early Detection Program, October 31, 1991-September 30, 1993 To reduce the burden of morbidity and mortality from breast and cervical cancers among U.S. women, Congress enacted the Breast and Cervical Cancer Mortality Prevention Act* in August 1990. This legislation authorized CDC to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides state health agencies with grants to increase breast and cervical cancer screening among women (1). Most funds pay for screening and follow-up services for underserved women, particularly women who are elderly, have low incomes, are underinsured or uninsured, or are members of racial/ethnic minority groups (2). This report presents age- and race-specific cancer screening (i.e., mammography and Papanicolaou [Pap] smear) results for women who received these services through the NBCCEDP from October 1, 1991, to September 30, 1993. During this period, eleven states** with NBCCEDP-funded cancer screening programs reported data to CDC. For each woman who received a cancer screening examination, data were obtained about demographics, screening location and results, diagnostic procedures and outcomes, and treatment information. The forms used for data collection varied among local sites and states; state program officials standardized data formats before transmitting files electronically to CDC. CDC requests that radiologists report mammography results using categories specified in the Breast Imaging Reporting and Data System (BIRADS) of the American College of Radiology (3) and that laboratories report Pap smear results using categories from the Bethesda System (4). This analysis presents results from initial mammography screening examinations and excludes results from women who may have undergone subsequent screening examinations. Results were adjusted for state and age using all women undergoing screening through the NBCCEDP as the standard population. From October 1, 1991, through September 30, 1993, approximately 67,000 women aged greater than or equal to 40 years had a mammogram through the NBCCEDP; of these women, 7.2% had abnormal results (i.e., suspicious abnormality, highly suggestive of malignancy, or assessment incomplete***) (Table 1). Overall, the proportion of women who had abnormal results declined with increasing age, from 7.8% for women aged 40-49 years to 5.3% for women aged greater than or equal to 70 years. However, for results highly suggestive of malignancy (the most serious result) the opposite trend was observed. The proportion of abnormal mammography results was highest for non-Hispanic whites (7.9%) and non-Hispanic blacks (7.8%) and lowest for Asians/Pacific Islanders (4.1%). During the same period, approximately 100,500 women had Pap smears; of these, 5.1% had abnormal results (i.e., low-grade squamous intraepithelial lesion [SIL], high-grade SIL, or squamous cell carcinoma) (Table 2). The proportion of women with abnormal results declined sharply with increasing age, from 11.5% for women aged less than 30 years to 1.9% for women aged greater than or equal to 70 years. The proportion of abnormal Pap smear results varied slightly among racial/ethnic groups (except Asians/Pacific Islanders) ranging from 4.2% for Hispanics to 4.7% for American Indians/Alaskan Natives; the proportion was lowest for Asians/Pacific Islanders (2.0%). Reported by: Epidemiology and Statistics Br and Office of the Director, Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC. Editorial Note: Despite the proven effectiveness of mammography and Pap smears in detecting breast and cervical cancers in early, more treatable stages, not all women have access to necessary screening and follow-up services. The NBCCEDP is mandated to detect cancer and precancerous lesions in women who are at high risk for not being screened and therefore at higher risk for having cancer diagnosed at a later stage. This report represents one of the largest case studies on screening services targeting underserved women. The overall proportion of abnormal mammograms reported by NBCCEDP during 1991-1993 is consistent with findings in a previous study (5), although these two studies used different result categories. The overall decline with increasing age in the proportion of abnormal mammography results is attributable primarily to results categorized as assessment incomplete--an outcome more common among younger women, whose dense breast tissue make radiologic assessment more difficult. The percentage of findings categorized as highly suggestive of malignancy increases with age, reflecting the increasing incidence of breast cancer with increasing age (6). The higher proportion of abnormal results among white and black women reflects the higher reported incidence of breast cancer in these groups than in other racial/ethnic groups. Reasons for these differences in incidence are unclear. Most of the Pap smear results reported by NBCCEDP during 1991- 1993 are similar to findings in previous studies (7,8). The steady decline with increasing age in the proportion of abnormal Pap smear results is attributable primarily to the increase in results categorized as low-grade SIL. The findings in this report are subject to at least two limitations. First, NBCCEDP results are derived from screening tests and therefore do not represent the final diagnoses. Some abnormal results classified as cancer may not be confirmed as such on biopsy, and some results classified as noncancerous may be found to be cancer. Because states have had difficulty tracking the diagnostic results of women with abnormal screening examinations, complete information is not yet available to analyze diagnostic outcomes. Second, because use of the BIRADS reporting categories was initiated in NBCCEDP in 1991 (before BIRADS was officially disseminated to U.S. radiologists by the American College of Radiologists), the categories for reporting results of mammography screening probably have not been used uniformly among the participating states, particularly during the first year of the program. However, as radiologists become more familiar with BIRADS, its use in different program sites probably will become more uniform. CDC's NBCCEDP increases cancer screening among women by increasing access to screening and follow-up services, increasing education programs for women and health-care providers, and improving measures to assure quality of mammography and Pap smear testing. These activities are implemented through partnerships with state health agencies; 45 states are participating in NBCCEDP at different levels. These efforts should increase detection and treatment of precancerous cervical lesions and early-stage breast cancer and ultimately reduce the incidence of cervical cancer and morbidity and mortality from breast cancer among underserved women. References 1. CDC. Implementation of the Breast and Cervical Cancer Mortality Prevention Act: 1992 progress report to Congress. Atlanta: US Department of Health and Human Services, Public Health Service, 1993 (in press). 2. CDC. Update: National Breast and Cervical Cancer Early Detection Program, July 1991-July 1992. MMWR 1992;41:739-43. 3. Kopans DB, D'Orsi CJ, Adler DD, et al. Breast Imaging Reporting and Data System. Reston, Virginia: American College of Radiology, 1993. 4. Broder S. Rapid communication: the Bethesda System for reporting cervical/vaginal cytologic diagnoses--report of the 1991 Bethesda Workshop. JAMA 1992;267:1892. 5. Sickles EA, Ominsky SH, Sollitto RA, Galvin HB, Monticciolo DL. Medical audit of a rapid-throughput mammography screening practice: methodology and results of 27,114 examinations. Radiology 1990;175:323-7. 6. Hankey BF, Brinton LA, Kessler LG, Abrams J. Section IV: breast. In: Miller BA, Reis LAG, Hankey BF, et al, eds. SEER cancer statistics review, 1973-1990. Bethesda, Maryland: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute, 1993:IV.1-IV.24; DHHS publication no. (NIH)93-2789. 7. Bottles K, Reiter RC, Steiner AL, Zaleski S, Bedrossian CW, Johnson SR. Problems encountered with the Bethesda System: the University of Iowa experience. Obstet Gynecol 1991;78:410-4. 8. Sadeghi SB, Hsieh EW, Gunn SW. Prevalence of cervical intraepithelial neoplasia in sexually active teenagers and adults. Am J Obstet Gynecol 1984;148:726-9. *Public Law 101-354. **California, Colorado, Maryland, Michigan, Minnesota, Missouri, Nebraska, New Mexico, North Carolina, South Carolina, and Texas. ***A mammography finding that requires additional radiologic evaluation (3). ------------------------------ Date: Mon, 08 Aug 94 06:41:49 MST From: mednews (HICNet Medical News) To: hicnews Subject: International Symposium on Brain-Death Message-ID: <ewRqqc1w165w@stat.com> "II INTERNATIONAL SYMPOSIUM ON BRAIN DEATH-CONTINUING HAVANA" Santa Fe, Argentina. September 18-22, 1995 Havana, 07-06-94 Dear colleague: From September 22 to 25, 1992, the "FIRST INTERNATIONAL SYMPOSIUM ON BRAIN DEATH" was held at the International Conference Center of Havana. This Conference was certainly a success, because of two main reasons. First, a large number of the most outstanding personalities in this field presented striking and controversial lectures: A. Earl Walker (USA), Christopher Pallis (UK), Gaetano Molinari (USA), Daniel Wikler (USA), Stuart Youngner (USA), R. Dierkens (Belgium), R. Firshing (Germany), Hilmar Prange (Germany), Arnold Starr (USA), Moshe Tendler (USA.), Douglas Lynn (Canada), Nelly Chiofalo, (Chile), and many others. Second, scientific discussions were enriched by a multi-disciplinary approach. It was clear that this is still a polemic field and a lot of controversies arose among specialists. Thus, the delegates of that Conference proposed to hold periodical meetings on this issue. As Argentina became the leading delegation with 22 attendees, this country was proposed to host the next event. Thus, Dr. Pedro Zukas and the Medical Association of Santa Fe, are pleased to announce the holding of the "SECOND INTERNATIONAL SYMPOSIUM ON BRAIN DEATH-CONTINUING HAVANA", on September 18-22, 1995, in the city of Santa FE, Argentina. Main topics: - Concepts of death on neurological grounds. - Brain death criteria in different countries and states. - Confirmatory tests in brain death. - Brain death in childhood. - End-of-life dilemmas: persistent vegetative state, euthanasia, anencephalics, terminal patient, etc. - Legal considerations on brain death and related states. - Bioethical considerations on brain death and related states. - Philosophical, theological, sociological, historical and cultural considerations on death. As we are now in the first organization steps, we would like to know your opinions, suggestions, and in general we would be very grateful for your collaboration. Inform us your topics of interest. We look forward to welcome you in the "Country of Tangos". Please, contact me at the following address, as soon as possible. Sincerely yours, Prof. Calixto Machado, M. D., Ph. D. Past-President in Havana Vice-president of the Organizing Committee 29 y D, Vedado Ciudad de La Habana 10400 Apartado Postal 4268 Fax: 53-7-331657 53-7-228382 Telef.: 53-7-327825 E.mail: braind@infomed.sld.cu ------------------------------ Date: Mon, 08 Aug 94 06:42:38 MST From: mednews (HICNet Medical News) To: hicnews Subject: [FDA] Breast Implant Update Message-ID: <RXRqqc2w165w@stat.com> BREAST IMPLANT UPDATE FDA has been receiving inquiries in advance of its June 2 public hearing on a proposal to require manufacturers of saline- filled breast implants to submit data showing safety and effectiveness before the products can continue to be marketed. The hearing will focus on the status of the manufacturers' studies, reports of independent research, consumer and professional concerns, and the timing of the requirement for submission of the data. FDA has also received inquiries on the status of silicone gel-filled breast implants. The following is a summary of the main issues and may be useful in responding to inquiries. Saline-filled and silicone gel-filled breast implants were already on the market when FDA began regulating medical devices in l976. Like other devices that were grandfathered under the Medical Device Amendments of l976, breast implants were allowed to remain in use with the understanding that FDA would later require manufacturers to submit evidence of product safety and effectiveness. Saline-filled breast implants are silicone envelopes filled with salt water. Currently, only saline-filled breast implants are commercially available for both breast augmentation and reconstruction. The short and long-term safety of saline implants has not been established. It is known that the implants can leak or rupture, requiring further surgery for replacement. Other known risks include infection, capsular contracture, interference with mammography, and altered breast sensation. In addition, because the envelope is made of a silicone elastomer, there is concern about any systemic problems that may be related to exposure to silicone. In a January l993 proposed rule, FDA notified manufacturers of saline-filled implants that the agency intended to require submission of data demonstrating product safety and effectiveness, and that each company's products would have to receive agency approval to allow continued marketing. At its June 2 public hearing, FDA will solicit public comment on the timing of this requirement, which could affect availability of the products. The agency will consider this testimony in determining when to promulgate the final rule. FDA also has asked the manufacturers to present testimony on the status of their clinical studies on saline implants, including patient enrollment. In regard to silicone gel-filled implants, none are available commercially. This type of implant is available only as part of a clinical study, and currently only for breast reconstruction. Mentor Corp. of Santa Barbara, Calif., is at this time the only manufacturer allowed to conduct clinical studies of silicone gel- filled implants. Manufacturers currently are gathering data on women who already have breast implants in order to provide important information about long-term effects of the implants. The agency advises potential implant recipients to discuss risks with their doctors before undergoing implant surgery, and to read carefully the patient information that accompanies the products. The record of hearing will remain open until July 5, l994. Written comments may be submitted to the Dockets Management Branch (HFA-305), Food and Drug Administration, Room. 1-23, 12420 Parklawn Drive, Rockville, MD 20857. ------------------------------ Date: Mon, 08 Aug 94 06:43:38 MST From: mednews (HICNet Medical News) To: hicnews Subject: National Institute of Cancer CancerNet Update Message-ID: <FZRqqc3w165w@stat.com> +----------------------------------------------+ | NATIONAL INSTITUTE | | C A N C E R | | INTERNATIONAL INFORMATION | | C E N T E R | +----------------------------------------------+ | CancerNet@icicb.nci.nih.gov | +-------------------------------+ CancerNet has been updated for August. The following statements were modified. For a description of the changes, request Monthly PDQ Statement Changes ( cn-405001). Changed physician (state-of-the-art) statements: ID Adult Brain Cancer cn-101143 Adult Hodgkin's Disease cn-100003 Bladder Cancer cn-101206 Breast Cancer cn-100013 Chronic Myelogenous Leukemia cn-101031 Colon Cancer cn-100008 Extragonadal Germ Cell Tumor cn-103773 Gastrointestinal Carcinoid T cn-101064 Hodgkin's Disease During Precy cn-105289 Islet Cell Cancer cn-100790 Nonsmall Cell Lung Cancer cn-100039 Pheochromocytoma cn-102494 Prostate Cancer cn-101229 Rectal Cancer cn-100076 Small Cell Lung Cancer cn-100040 Changed patient information statements: Adult Brain Cancer cn-201143 Adult Hodgkin's Disease cn-200003 Bladder Cancer cn-201206 Breast Cancer cn-200013 Chronic Myelogenous Leukemia cn-201031 Colon Cancer cn-200008 Gastrointestinal Carcinoid Tr cn-201064 Islet Cell Cancer cn-200790 Nonsmall Cell Lung Cancer cn-200039 Pheochromocytoma cn-202494 Prostate Cancer cn-201229 Rectal Cancer cn-200076 Small Cell Lung Cancer cn-200040 Changed cancer screening and prevention statements: Prevention of Colorectal Canr cn-304731 Screening for Breast Cancer cn-304723 Screening for Colorectal Canr cn-304726 Screening for Prostate Cance cn-304727 Screening for Skin Cancer cn-304724 Changed supportive care statements: The following item was deleted: Pain cn-304470 Changed drug information statements: Paclitaxel (Taxol) cn-802424 Changed other PDQ Information No changes. Changed CancerNet News and NCI Publication Information: The following news items were added: Two NSABP Trials Reopened cn-400060 *Investigator Letter: Secondary AML After Dose-Intensive Therapy cn-400061 Secondary Leukemia Risk Examined in breast Cancer Treatment Study cn-400063 Taking Time ( full text) cn-400062 Chemotherapy and You (full text) cn-400064 *Note: This news items was added to CancerNet on July 29 in advance of the August Update. The following news items were deleted: Board of Scientific Counselors Recommendations on BCPT cn-400047 Letter Sent to Participants of the BCPT cn-400046 ORI Directs U of Pittsburgh to Investigate NSABP cn-400042 ORI: Alleged Falsified NSABP Data, St. Mary's Hospital, Montreal cn-400040 The following news items were changed: Measures of Progress Against Cancer cn-400058 NCI High Priority Clinical Trials cn-400007 How to Access NCI Information Resources - U.S. Residents cn-400035 How to Access NCI Information Resources - International cn-400036 NCI Fact Sheets: ---------------- The following fact sheet was added: NCI Questions Substitution of Smokeless Tobacco for Cigarettes cn-600339 The following fact sheets were changed: Community Clinical Oncology Program cn-600013 Referral Information for the Prostate Cancer Prevention Trial cn-400090 through 400095 CANCERLIT Citations and Abstracts: ---------------------------------- The following CANCERLIT citations and abstracts were added: Mesothelioma cn-7__600 Screening and prevention of breast cancer cn-7__015 Screening and prevention of digestive cancers cn-7__025 Screening and prevention of gynecologic cancers cn-7__185 Small cell lung cancer cn-7__590 Soft tissue sarcoma/rhabdomyosarcoma cn-7__520 Therapy of melanoma cn-7__570 Thymoma cn-7__605 The CANCERLIT citations and abstracts for August will be available on August 9, 1994. Instructions: To request the CancerNet Instructions and Contents List, send a mail message, leaving the subject line of the message blank, and in the body of the message, enter HELP. Address the mail message to: cancernet@icicb.nci.nih.gov To request the modified statements, follow the above directions, and in the body of the mail message, enter the statement code. When requesting more than one statement, enter each code on a separate line. CancerNet statements are now available in Spanish. To request the Instructions and Contents List in Spanish, enter SPANISH in the body of the mail message. If you would like to request the statements in Spanish, substitute the prefix "cs-" in front of the number e.g., cs-100022 to receive the statement on anal cancer in Spanish). All of the physician and patient statements are available in Spanish. Supportive care statements are now available in Spanish. News items that are available in Spanish have a # next to the statement title. Although both the English and Spanish are updated at the same time each month, the Spanish statements do not reflect the changes made in the English statements until the following month to allow time for translation). If you are interested in requesting CancerNet statements or news articles in Spanish, it is suggested that you request an updated Contents List. If you are redistributing the PDQ information you retrieve from CancerNet to others at your location, or are interested in redistributing the information from CancerNet, request the news article, Redistribution of Cancernet (cn-400030), to find out about conditions that apply when redistributing the information. This article also has information on other sites providing access to CancerNet information. Please send comments or questions to: Cheryl Burg NCI International Cancer Information Center Internet: cheryl@icicb.nci.nih.gov ------------------------------ Date: Mon, 08 Aug 94 06:44:35 MST From: mednews (HICNet Medical News) To: hicnews Subject: WHO Global Program for Vaccines and Immunizations Message-ID: <11Rqqc4w165w@stat.com> The Global Programme for Vaccines and Immunization (GPV) of the World Health Organization now posts immunization coverage and disease incidence data, newsletters, and bibliographies of publications and articles on Internet. We are using this medium to expand and accelerate exchange and dissemination of information on the Programme. WHO/GPV supports and coordinates both research and development on new vaccines and the implementation of immunization programmes in developed and developing nations. The programme welcomes Internet users who are involved in research or production of vaccines or who have an interest or involvement in immunization services. In addition, a specific document has been posted to open a discussion forum. This document concerns worldwide efforts to eliminate Neonatal Tetanus by the 1995 through immunization of women with Tetanus Toxoid vaccine. Immunization is an extraordinarily effective, and cost effective technology for the prevention, and even eradication, of disease. But aside from the technical and managerial aspects of conducting effective immunization services, social factors strongly affect the acceptance of immunization by families and they affect the level of political commitment needed to mobilize support for immunization services. Use of our information and discussion on both the technical, the managerial and social aspects of immunization are encouraged. All these are under the "Global Programme for Vaccines and Immunization", "Major Programmes of WHO" of the WHO Gopher menu. The WHO gopher server is gopher.who.ch For inquiries, you may send a message to internet address GPV@who.ch ------------------------------ Date: Mon, 08 Aug 94 06:46:20 MST From: mednews (HICNet Medical News) To: hicnews Subject: Articles on Investigating the HantaVirus Message-ID: <X4Rqqc5w165w@stat.com> - Stalking The Deadly Hantavirus: A Study In Teamwork Karen Young Kreeger URL=ftp://ds.internic.net/pub/the-scientist/the-scientist-940711 This is the first part of a two-part series on hantavirus, the mysterious and lethal microorganism whose sudden appearance in the southwestern United States last year led to the deaths of more than a dozen people and sparked a flurry of activity in the research community. The following article recounts the swift and effective response to the frightening microbe by scientists of various disciplines. The second part of the series, to appear in the July 25 issue, discusses researchers' ongoing efforts to forestall further outbreaks of hantavirus-related infections. - One Year Later, The Hantavirus Investigation Continues Karen Young Kreeger URL=ftp://ds.internic.net/pub/the-scientist/the-scientist-940725 This is the second part of a two-part series on the hantavirus--a mysterious microbe that last year caused the sudden deaths of more than a dozen men and women in the southwest United States. Part 1, presented in the July 11, 1994, edition of The Scientist (page 14), described the effective cooperation among scientists to identify the microorganism. This article provides an account of how the research community is following up on hantavirus studies and what the prospects are for future paths of investigation. ------------------------------ Date: Mon, 08 Aug 94 06:47:40 MST From: mednews (HICNet Medical News) To: hicnews Subject: Pediatric Pathology Course Message-ID: <66Rqqc6w165w@stat.com> PEDIATRIC PATHOLOGY will be presented 19-22 February 1995 at the Grosvenor Hotel Resort, Lake Buena Vista, Florida, USA. SPONSORS: The Armed Forces Institute of Pathology and the American Registry of Pathology. GENERAL INFORMATION: AFIP/ARP Education Div.,14th & Alaska Ave, N.W., Washington, DC 20306-6000 USA; (301) 427-5231; FAX (301) 427-5001; INTERNET: LOWTHER@email.afip.osd.mil CONTENT: The fetus, infant, and child are subject to pathologic states unique to their age groups. Pediatric surgical and autopsy cases, however, constitute only a small percentage of pathology practices and resident training programs. This course, primarily designed for general pathologists, pathology residents, neonatologists, pediatricians, obstetricians, and other clinicians interested in perinatal and pediatric pathology, will familiarize the participants with some of the most frequent pathologic conditions seen in the pediatric age group. The course will offer an opportunity for the participant to discuss with pediatric pathologists specific problems encountered in the handling and diagnosis of pediatric material. This course will emphasize tumors, infections, and metabolic diseases unique to childhood. Topics include: * Common malformation syndromes * Congenital anomalies * Cytogenetic disease * The sudden infant death syndrome * Placental examination and pathology * Neoplasia * Infectious diseases COURSE DIRECTORS: J. Thomas Stocker, MD TUITION: $475 if you register by 27 January 1995 and $525 if you register after 27 January 1995. Active duty military, DoD civilians, full-time permanent Department of Veterans Affairs employees (not residents or fellows), and commissioned officers of the Public Health Service with authorized approval have a registration fee of $235. ------------------------------ Date: Mon, 08 Aug 94 06:49:05 MST From: mednews (HICNet Medical News) To: hicnews Subject: Armed Forces Institute of Pathology Postgraduate Short Courses Message-ID: <i9Rqqc7w165w@stat.com> ARMED FORCES INSTITUTE OF PATHOLOGY POSTGRADUATE SHORT COURSES ON CONTINUING EDUCATION FALL 1994 8-12 Aug Pathology of Laboratory USUHS Animals Bethesda, MD 19-21 Aug Environmental Pathology AFIP Washington, DC 27-28 Aug Anatomy, Histology & Electron Georgetown University Microscopy of the Eye, Orbit Conference Center and Ocular Adnexa Washington, DC Aug29-2Sep Ophthalmic Pathology`for Georgetown University Ophthalmologists Conference Center Washington, DC 12-16 Sep Pathology of Congenital Heart AFIP Washington, DC 17-18 Sep Pulmonary & Mediastinal Menger Hotel Radiology San Antonio, TX 19-22 Sep Morphologic Findings in Ramada Inn Renal Disease Bethesda, MD 26-30 Sep Advances in Diagnostic Doubletree Hotel Pathology of Infectious Park Terrace Diseases Washington, DC 3- 7 Oct Basic Forensic Pathology Holiday Inn Crowne Plaza Rockville, MD 10-14 Oct 4th Annual Radiologic Disney Contemporary Hotel Pathologic Correlation Lake Buena Vista, FL 4- 5 Nov DNA Databanks & Repositories Sheraton Midway St. Paul, MN 19-20 Nov Interpretation of Prostatic AFIP Biopsy Washington, DC SPRING 1995 4-8 Jan 95 Telemedicine I Disney Contemporary Hotel Lake Buena Vista, FL 8-11 Jan 95 Telemedicine II Disney Contemporary Hotel Lake Buena Vista, FL 9-13 Jan 95 Oral Pathology Disney Contemporary Hotel Lake Buena Vista, FL 22-27 Jan 95 Neuropathology Review Hyatt Regency New Orleans, LA 22-27 Jan 95 Uropathology Holiday Inn Crowne Plaza Rockville, MD 13-17 Feb Controversies & Recent Contemporary Hotel Advances in Surgical Lake Buena Vista, FL Pathology 17-19 Feb Respiratory Tract & Marriott Rivercenter Mediastinum San Antonio, TX 19-22 Feb Pediatric Pathology Grosvenor Resort Lake Buena Vista, FL 25-26 Feb Neuroradiology Review Hyatt Regency Bethesda, MD 6-31 Mar Otolaryngology: Head & Neck AFIP Washington, DC 13-17 Mar Forensic Dentistry Holiday Inn Crowne Plaza Rockville, MD 1-2 Apr Abdominal & Gastrointestinal AFIP Imaging Washington, DC 3-15 Apr Update & Review of AFIP Anatomic Pathology Washington, DC 22-23 Apr Uroradiology AFIP Washington, DC 19-21 May Musculoskeletal Imaging AFIP Washington, DC May 31- Controversias y Adelantos Caribe Hilton & Casino 3 Jun Nuevos en Patholgia San Juan, PR Quirurgica 5- 9 Jun Comparative Pathology of Woods Hole, MA Aquatic Animals 5- 9 Jun Diagnostic Exfoliative & Fine Marriott Hotel Needle Aspiration Cytology Washington, DC Jun 27- Forensic Anthropology University of Bradford 1 Jul Bradford, England 2- 5 Jul Controversies & Recent Snowmass Lodge & Club Advances in Surgical Pathology Snowmass, CO Schedules are published monthly. Press announcements will be published as information becomes available. For additional information or clarification you may write: AFIP/ARP, Educ. Div.(INT), Washington, DC 20306-6000; Telephone 301/427-5231; Fax 301/427-5001; or INTERNET: LOWTHER@email.afip.osd.mil ------------------------------ Date: Mon, 08 Aug 94 06:50:25 MST From: mednews (HICNet Medical News) To: hicnews Subject: InterPsych Mailing List Announcement Message-ID: <qasqqc8w165w@stat.com> ------------------------------ Why you should join InterPsych ------------------------------ ---------------------------------------------------------------------- InterPsych is an international, multidisciplinary organization having members drawn from anthropology, computer science, neuroscience, pharmacology, philosophy, psychiatry, psychology, and sociology. ---------------------------------------------------------------------- InterPsych has two main aims: 1. To foster interdisciplinary debate and empirical collaboration on all aspects of psychopathology in the belief that an eclectic approach will produce refinements in theoretical conceptualization and advancements in clinical practice in both psychiatry and psychology. 2. To encourage and promote the use of the vast resources of the Internet amongst both academics and clinical practitioners, and to ensure rapid progress by disseminating research findings, discussion, etc via this remarkable network. ---------------------------------------------------------------------- The Internet and InterPsych --------------------------- InterPsych operates on the Internet, a worldwide network of over 2 million computers and 40 million users, expected to rise to 200 million by the end of 1995. There is no charge for access to InterPsych. You can access the Internet in several ways (some of them free). Many colleges, universities, and other agencies have access to the Internet. Check with your supervisor or your computer department to see if you qualify for access. Some computer on-line services (such as Delphi) offer direct Internet access. Others (such as CompuServe) allow you to exchange electronic mail with the Internet. To access these on-line services, all you need is a computer, a modem, and readily available communications software. Mailbase is an electronic information service which allows groups to manage their own discussion topics (Mailbase lists) and associated files. The Mailbase service is run as part of the JANET (Joint Academic NETwork) Networked Information Services Project (NISP) based at the University of Newcastle-upon-Tyne in the United Kingdom. InterPsych is a non-profit making, voluntary organization, established on Mailbase with the aim of promoting international scholarly collaboration on inter-disciplinary research efforts in the field of psychopathology. The network has over 2500 members throughout the world, including many leading academics, research scientists, and clinical practitioners. ---------------------------------------------------------------------- InterPsych has the following structure: ---------------------------------------------------------------------- psychiatry-superlist (Superlist) [CLOSED] -------------------- This list exists to co-ordinate sub-lists dealing with psychiatry and abnormal psychology. It is intended to be used infrequently for items such as details about relevant conferences, or information about a new list being added to the group. ---------------------------------------------------------------------- Sub-lists in this group: attachment ---------- This list welcomes discussion on Bowlby-Ainsworth's theory of attachment. From theoretical and philosophical issues, to clinical or applied issues. Particular emphasis is given to socio-affective and defensive processes, and unconscious representations. To join send the message join attachment firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- psychiatry-resources -------------------- This list is intended for those who wish to co-operate in the compilation of a resource guide to enable clinicians and academics in the areas of psychiatry and abnormal psychology to gain maximum benefit from the facilities available over the Internet. To join send the message join psychiatry-resources firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- psychiatry ---------- Many research findings and viewpoints in psychiatry are controversial,leaving a gulf between those pursuing radically different approaches to mental illness. This forum will act as a bridge between those taking a biomedical approach and those taking a psychodynamic approach. To join send the message join psychiatry firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- depression ---------- This forum exists for scholarly discussion of issues related to mood disorders in clinical and research settings. Integrative biological- psychological contributions are particularly welcome. Topics include causation, correlates, consequences, co-morbidity, treatment/prevention, etc. To join send the message join depression firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- clinical-psychology ------------------- This list promotes the exchange of ideas on matters relevant to clinical psychology, and particularly to the practice of clinical psychology. To join send the message join clinical-psychology firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- child-psychiatry ---------------- The Child Psychiatry list is devoted to the discussion of various issues around Child and Adolescent Psychiatry. This includes treatment issues, psychopharmacology, inpatient/outpatient care plans, emergency child/adolescent psychiatry etcetera. To join send the message join child-psychiatry firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- helplessness ------------ Learned Helplessness and Explanatory Style was created to discuss the latest research on animals and humans, biological substratum, depression, anxiety, prevention, CAVE, politics, children, personal control, health, battering, bereavement, PTSD, sex differences, pessimism, work, heritability. To join send the message join helplessness firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- traumatic-stress ---------------- This list promotes the investigation, assessment, and treatment of the immediate and long-term psychosocial, biophysiological, and existential consequences of highly stressful (traumatic) events. Of special interest are efforts to identify a cure of PTSD (Post-traumatic Stress Disorder) To join send the message join traumatic-stress firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- transcultural-psychology ------------------------ Discussion of the delivery of mental health services to diverse cultures. Topics may include, cultural differences in views on mental disorders, culture-specific syndromes, collaboration between Western and traditional healers, and cultural variance in symptoms. To join send the message join transcultural-psychology firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- psychiatry-assessment --------------------- This sublist focusses on research and clinical issues related to use of psychological tests (including traditional clinical instruments & normal personality measures) in psychiatry and clinical psychology. To join send the message join psychiatry-assessment firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- psy-language ------------ For discussions related to language and psychopathology. Discussions could include: theories of language and their relevance for the study of psychopathological speech, new research and publications in the area, requests for help with one's own research. To join send the message join psy-language firstname lastname To mailbase@mailbase.ac.uk ---------------------------------------------------------------------- psychopharmacology ------------------ The purpose of the Psychopharmacology Mailing List list is to provide a forum for for the professional discussion of all aspects of clinical psychopharmacology. Clinical psychopharmacology is broadly defined as the treatment individuals with psychiatric disorders through the use of psychotropic medications. All mental health professionals, and graduate students may subscribe to the Psychopharmacology Mailing List. To join send the message subscribe psycho-pharm your Internet address To listserv@netcom.com ---------------------------------------------------------------------- ********************************* The InterPsych Board of Directors ********************************* InterPsych's Board of Directors is charged with promoting and preserving academic standards on the network, and with guiding the overall development of the network. The current members of the board are: President: ---------- Martin E.P. Seligman, Ph.D.; Professor of Psychology, University of Pennsylvania, USA Board Members: -------------- Charles R. Figley, Ph.D.: Professor and Director of the Psychosocial Stress Research Program and Clinic, Florida State University, USA. Stevan Harnad, PhD.; Professor of Psychology and Director of Cognitive Science Centre, University of Southampton, UK. Editor of Behavioral and Brain Sciences, Psycoloquy. Ivan K. Goldberg, M.D.; Director, New York Psychopharmacologic Institute. Juan Carlos Garelli, M.D.; Attachment Research Center, Buenos Aires, Argentina. Elizabeth Hudnall Stamm, PhD.; Assistant Professor of Psychology, University of Anchorage, Alaska, USA Edward Workman, EdD, M.D.; Assistant Professor of Psychiatric Medicine; Co-Director of Psychiatric Research, University of Virginia Medical School, USA David L. DiLalla, Ph.D.; Assistant Professor of Psychology, Southern Illinois University at Carbondale, USA. Thomas Joiner, Ph.D.; Assistant Professor of Psychiatry, University of Texas Medical Branch at Galveston, USA Ian Pitchford; Neuroscience Student, Founder & co-ordinator of InterPsych. University of Sheffield, UK. Greg Berns, M.D., Ph.D.: Resident in Psychiatry, University of Pittsburgh, USA. Edward Wakeman, D.Phil student, University of Oxford, UK. --------------------------------------------------------------------- InterPsych exists to provide a forum for scholarly and clinical discussion of all aspects of psychopathology. Individuals doing research, scholarship, or clinical work within this domain, broadly construed, are welcome. Faculty, graduate students, and undergraduate researchers are especially invited. The motto of InterPsych is 'There is someone wiser than any of us, and that is all of us.' Our hope is that, at the least, this forum will be entertaining and informative; at most, it may be a breeding ground for conceptual and theoretical innovation , and for establishment of cross-site, inter- disciplinary, empirical collaboration. All comments and suggestions to: Ian Pitchford <I.Pitchford@Sheffield.ac.uk> Copyright InterPsych, July, 1994 UNIVERSITY OF SHEFFIELD --------------------------------------------------------------------- INTERPSYCH: The International forum for the discussion and promotion of inter-disciplinary research in psychopathology. --------------------------------------------------------------------- ---------------------------------------------------------------------- Ian Pitchford, c/o Department of Biomedical Science, University of Shefffield, Western Bank, SHEFFIELD, S10 2TN, United Kingdom. E.mail: I.Pitchford@Sheffield.ac.uk, md932481@silver.shef.ac.uk ----------------------------------------------------------------------- For the psychiatry database telnet bubl.bath.ac.uk, login bubl. Search the subject tree for 616.89 Psychiatry. Contributions welcome. http://www.bubl.bath.ac.uk/BUBL/home.html (BUBL) http://mailbase.ac.uk/welcome.html (MAILBASE) ---------------------------------------------------------------------- ------------------------------ End of HICNet Medical News Digest V07 Issue #34 *********************************************** --- Editor, HICNet Medical Newsletter Internet: david@stat.com FAX: +1 (602) 451-1165 Bitnet : ATW1H@ASUACAD