Assuntos
Dibenzofuranos/toxicidade , Dioxinas/toxicidade , Sondas Moleculares/toxicidade , Animais , Dibenzofuranos/história , Dibenzofuranos/metabolismo , Dioxinas/história , Dioxinas/metabolismo , História do Século XX , História do Século XXI , Humanos , Sondas Moleculares/história , Sondas Moleculares/metabolismoRESUMO
The Ah receptor (AHR) has been studied for almost five decades. Yet, we still have many important questions about its role in normal physiology and development. Moreover, we still do not fully understand how this protein mediates the adverse effects of a variety of environmental pollutants, such as the polycyclic aromatic hydrocarbons (PAHs), the chlorinated dibenzo-p-dioxins ("dioxins"), and many polyhalogenated biphenyls. To provide a platform for future research, we provide the historical underpinnings of our current state of knowledge about AHR signal transduction, identify a few areas of needed research, and then develop concepts such as adaptive metabolism, ligand structural diversity, and the importance of proligands in receptor activation. We finish with a discussion of the cognate physiological role of the AHR, our perspective on why this receptor is so highly conserved, and how we might think about its cognate ligands in the future.
Assuntos
Poluentes Ambientais/farmacologia , Dibenzodioxinas Policloradas/farmacologia , Hidrocarbonetos Policíclicos Aromáticos/farmacologia , Receptores de Hidrocarboneto Arílico/metabolismo , Animais , Poluentes Ambientais/química , Humanos , Ligantes , Estrutura Molecular , Dibenzodioxinas Policloradas/química , Hidrocarbonetos Policíclicos Aromáticos/química , Receptores de Hidrocarboneto Arílico/genética , Transdução de Sinais/efeitos dos fármacosAssuntos
Infarto Cerebral/etiologia , Histiocitose/complicações , Idoso de 80 Anos ou mais , Antígenos CD/análise , Antígenos CD1/análise , Antígenos de Diferenciação Mielomonocítica/análise , Artéria Carótida Interna/cirurgia , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Infarto Cerebral/diagnóstico por imagem , Colite/etiologia , Colite/patologia , Diarreia/etiologia , Endarterectomia das Carótidas , Feminino , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Histiócitos/química , Histiócitos/patologia , Histiocitose/diagnóstico , Histiocitose/patologia , Humanos , Imageamento por Ressonância Magnética , Inibidores da Agregação Plaquetária/uso terapêutico , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Recidiva , Ultrassonografia , Insuficiência Vertebrobasilar/etiologia , Redução de PesoRESUMO
In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Medical Services (CMS) implemented guidelines for the preauthorization of therapy services for Children with Special Health Care Needs (CSHCN). The University of Arkansas for Medical Sciences (UAMS) in partnership with Arkansas Medicaid (MCD), and Chidren's Medical Services (CMS) were given the charge of developing clinical practice guidelines for physical therapy (PT), occupational therapy (OT), and speech/language therapy (SLP) for this population based on primary diagnosis and age appropriateness. This process involved the implementation of a statewide, internet-based, clinical information support network. The objective of this article is to describe KIDSCARE, a clinical information support network, currently under development, for the determination of medical necessity and allocation of therapy services for CSHCN.
Assuntos
Serviços de Saúde da Criança/organização & administração , Crianças com Deficiência , Sistemas de Informação Hospitalar , Centros Médicos Acadêmicos , Adolescente , Algoritmos , Arkansas , Criança , Necessidades e Demandas de Serviços de Saúde/organização & administração , Humanos , Internet , Redes Locais , Medicare , Guias de Prática Clínica como AssuntoRESUMO
Although the number of states moving toward managed care for Medicaid beneficiaries is increasing, little is known about the extent to which managed care delivery systems are prepared to address the special needs of children with chronic illness and disabilities. This study explores the change in the process of care provided by the State Title V Programs for Children With Special Health Care Needs (CSHCN) and in parent and provider satisfaction when Medicaid changes the method of payment from fee-for-service to capitation. The findings suggest that CSHCN are vulnerable in a managed care environment and that states should proceed cautiously to integrate this population into their managed care arrangements.
Assuntos
Serviços de Saúde da Criança , Atenção à Saúde , Pessoas com Deficiência , Programas de Assistência Gerenciada , Medicaid , Alabama , Criança , Doença Crônica , Humanos , Ohio , Enfermagem Pediátrica , Tennessee , Estados UnidosRESUMO
An overview is provided of forense aspects of the scene of multiple fatal shootings at Port Arthur and subsequent mortuary investigations along with a brief review of injury patterns of the victims. The forensic aspects of this disaster were handled extremely well by all personnel involved, despite outdated mortuary facilities. The mortuary is located within a teaching hopital which provided full support and backup allowing the forensic personnel work effectively and effeciently in a non-ideal enviroment.The autopsies were more lengthy and complex than would have been expeced in a similar number of cases in a bus or aviation accident. (AU)