Asunto(s)
Atención a la Salud/organización & administración , Organizaciones de Planificación en Salud/organización & administración , Relaciones Interprofesionales , Inglaterra , Reforma de la Atención de Salud/legislación & jurisprudencia , Humanos , Liderazgo , Quinolinas , Medicina Estatal/legislación & jurisprudencia , SulfonamidasRESUMEN
Expression of isotopically labeled peptide standards as artificial concatamers (QconCATs) allows for the multiplex quantification of proteins in unlabeled samples by mass spectrometry. We have developed a generalizable QconCAT design strategy, which we term IQcat, wherein concatenated peptides are binned by pI to facilitate MS-sample enrichment by isoelectric focusing. Our method utilizes a rapid (â¼2 weeks), inexpensive and scalable purification of arg/lys labeled IQcat standards in the Escherichia coli auxotroph AT713. With this pipeline, we assess the fidelity of IQcat-based absolute quantification for ten yeast proteins over a broad concentration range in a single information-rich isoelectric fraction. The technique is further employed for a quantitative study of androgen-dependent protein expression in cultured prostate cancer cells.
Asunto(s)
Focalización Isoeléctrica/métodos , Espectrometría de Masas/métodos , Péptidos/análisis , Proteínas/análisis , Proteómica/métodos , Secuencia de Aminoácidos , Animales , Línea Celular Tumoral , Humanos , Focalización Isoeléctrica/economía , Masculino , Espectrometría de Masas/economía , Datos de Secuencia Molecular , Neoplasias de la Próstata/química , Proteómica/economía , Saccharomyces cerevisiae/química , Proteínas de Saccharomyces cerevisiae/análisisRESUMEN
This article reviews the use of adjuvants to local anaesthesia for ophthalmic regional anaesthesia. Hyaluronidase, bicarbonate, epinephrine, muscle relaxants, opiates and clonidine have all been described singly and in combination for use as an adjuvant to ophthalmic regional anaesthesia. The article focuses on the efficacy of the adjuvants with regard to improving akinesia, analgesia, speed of onset and reducing block failure. A description of the pharmacological action of each adjuvant is given followed by a review of randomised control trials, dosage and notable papers on the subject. There is no effective consensus between anaesthetists or surgeons on the use of adjuvants to local anaesthesia and it so is the purpose of this review to draw attention to the wealth of current data and allow an informed decision on the choices available.
Asunto(s)
Adyuvantes Farmacéuticos , Anestesia Local , Procedimientos Quirúrgicos Oftalmológicos , Anestésicos Locales/administración & dosificación , Bicarbonatos/administración & dosificación , Bicarbonatos/efectos adversos , Clonidina/administración & dosificación , Clonidina/efectos adversos , Epinefrina/administración & dosificación , Epinefrina/efectos adversos , Humanos , Hialuronoglucosaminidasa/administración & dosificación , Hialuronoglucosaminidasa/efectos adversosRESUMEN
In 2001, the English Department of Health announced a radical re-organisation of the NHS under the banner of 'shifting the balance of power'. As part of this re-organisation health authorities were abolished and the main NHS public health responsibilities devolved to the new primary care trusts (PCTs) from April 2002. Following several years of campaigning by the Multidisciplinary Public Health Forum (MPHF), in November 2001 the Acting Minister for Public Health, Lord Hunt, announced that PCT director of public health (DPH) posts would be open to 'suitably qualified' candidates from any discipline. From April 2002 a number of new DsPH from backgrounds other than medicine were appointed. This paper reports on the experiences of two such DsPH who shared a commitment to multidisciplinary public health, but who did not wholly share the objectives of the MPHF. We place the opening of PCT DPH posts in the context of tensions within NHS public health between a focus on health services versus the wider determinants of health, and the development of multidisciplinary public health. The paper reflects on both the degree of change this opening represented and the limitations and tensions such appointments exposed.
Asunto(s)
Comunicación Interdisciplinaria , Administración en Salud Pública , Medicina Estatal/organización & administración , Movilidad Laboral , Humanos , Competencia Profesional , Reino UnidoRESUMEN
Based primarily on anecdotal evidence, patients with reflex sympathetic dystrophy (RSD) have often been suspected of having a high degree of psychosocial disturbance prior to the onset of symptoms as well as in reaction to the disorder. In the present study, patients presenting to a pain center with RSD were compared to patients with low back (LBP) and headache pain (HAP) on a variety of self-reported demographic, behavioral, pain, and mood measures. Typical of most patients experiencing chronic pain, all three groups demonstrated elevations indicative of pain, emotional distress, and behavioral disturbance. However, although the RSD patient group reported the highest level of pain intensity, the most employment disruption, and contained the highest percentage of patients receiving financial compensation, this same group paradoxically reported less emotional distress on the Symptom Checklist-90R than did LBP and HAP patients. This paradox may be due to the lesser chronicity of the RSD patients as well as to their apparently experiencing a more sympathetic response from doctors, employers, and insurance carriers than their LBP and HAP counterparts. On balance, the present data do not support the hypothesis the RSD patients, relative to other pain patients, are uniquely disturbed in psychosocial functioning.