Epidemiology of hepatitis C virus antibodies in blood donors from the province of Latina, Italy.

In order to calculate the incidence of hepatitis C virus (HCV) antibodies in blood donors and to verify the efficacy of the pre-donation method (testing blood samples of potential donors at least 3 months in advance of their first donation), we performed a retrospective cohort study in 1995 and in the period 1996-2000 at the blood transfusion unit in Latina (Italy). Third generation ELISA method as well as RIBA-3 were used. 5,978 donors in 1995 and 20,741 in the 1996-2000 period were analysed. The age of donors (prevalently male, 78.5%) was between 18 and 65 (median 38). A total of 110 borderline and 62 positives were found with ELISA, of which 75 borderlines and 42 positives in 1995, and the remaining in the 1996-2000 period (p > 0.5). Percentage of HCV antibodies dropped from 8.5% in 1995 to 5.45% in the 1996-2000 period. The non reactivity and undetermined status were found in 82.1 and 9.4% respectively in 1995, and 69.1 and 25.45% respectively in the 1996-2000 period. The incidence of HCV antibodies was 167.28 cases per 100,000 person-years in 1995 and 4.13 per 100,000 person-years in the 1996-2000 period, 2.5 times lower than the national one. There was a statistically significant association between dental care and RIBA positivity (RR: 2.63; p = 0.045). This study, moreover, evidences how pre-donation practices, if extended to a national basis, may be able to nullify the dangers associated with post-transfusional hepatitis and to reduce the number of false positives and of blood packs donated but either unused or destroyed.

The process of defining a profile of student competencies at the University of Vienna Medical School.

CONTEXT: A new law enabling curriculum reform led a small circle of interested faculty members at the University of Vienna medical school to launch the Medizin Curriculum Wien project (MCW) to plan a new curriculum under the supervision of the Committee on Educational Affairs (Studienkommission). OBJECTIVE: The first stage of the project dealt with the definition of a profile of competencies (Qualifikationsprofil), which describes all the competencies we want our students to possess upon graduation. METHOD: This paper presents the approach to and process of defining this profile at one of Europe's largest medical schools, currently enrolling over 1500 new students per year. The procedure involved: preparing materials; communication with stakeholders; information dissemination; feedback gathering; information structuring, and formulating the profile of competencies. RESULTS: Application of the outlined steps in two rounds proved successful for the development of a profile of student competencies for Vienna. General acceptance and awareness of the new profile as well as commitment for a further reform process was engendered. The distinct characteristics of the profile are discussed. CONCLUSION AND UTILIZATION: A profile of student competencies must balance the demanding objectives of curriculum planners and the actual challenges presented by many local parameters; this can be done by employing the process outlined in this paper. The defined profile serves as an accepted reference point in the further development of the medical curriculum.

[MR-pool: the "Vienna blend". An interactive computer-assisted teaching system for MRI]. / MR-Pool: die "Wiener Mischung". Ein interaktives computerunterstütztes Lehrsystem für MRI.

Advances in the field of computer technology have facilitated the development of computer-assisted instruction. In this paper we present an interactive computer-based MR teaching system for education in radiology. Our program contains 120 teaching files. Various MR sequences can be displayed and compared to conventional X-ray images, CT, angiography and scintigraphy. Using a text field, additional clinical and diagnostic hints are offered. This teaching file can be easily upgraded and distributed on CD-ROM. Furthermore, we compare computer-assisted teaching in general to other conventional instruction media.

Automated interpretation of planar thallium-201-dipyridamole stress-redistribution scintigrams using artificial neural networks.

UNLABELLED: To develop an automated image interpretation system of planar cardiac 201Tl dipyridamole stress/redistribution scintigrams, the authors used artificial neural networks that associate patterns of segmental myocardial thallium uptake with a diagnostic assessment about the presence, severity and localization of significant coronary artery disease. METHODS: Artificial neural networks were trained and evaluated using the results from segmental thallium analysis and either expert readings in 159 cases or coronary angiography in a subgroup of 81 patients. RESULTS: Based on receiver operating characteristics analysis, the sensitivity for the detection of significant coronary artery disease at a specificity of 90% was 51% compared with angiography and 72% compared with the human expert. For severity and localization of disease, two vascular territories assigned to the vascular bed of the left anterior descending (LAD) artery and to the territory subtended by the left circumflex artery and the right coronary artery together (CX/RCA) were included in the analysis. CONCLUSION: Artificial neural networks may be useful to develop automated computer-based image interpretation systems of 201Tl perfusion scintigrams. However, utilization of large training datasets appears to be a prerequisite to achieve adequate diagnostic performance.