ABSTRACT
Hemoglobin variants with two amino acid substitutions affecting one globin chain are relatively rare. Hb T-Cambodia, a doubly substituted beta-globin variant, was characterized previously by amino acid sequencing as having sequence alterations in beta 26 (beta 8)Glu-->Lys and beta 121(GH4) Glu-->Gln (1). It is a variant that migrates cathodic to Hb A2 on alkaline electrophoresis and with Hb A on acid citrate agar electrophoresis. We report here the mutations of Hb T-Cambodia at the nucleotide level using DNA sequencing, in beta-globin gene codon 121 (GAA-->CAA) and in codon 26 (GAG-->AAG). These are the mutations of Hb D-Punjab and Hb E, respectively.
Subject(s)
Hemoglobins, Abnormal/chemistry , Hemoglobins, Abnormal/genetics , Mutation/genetics , Adult , Blood Protein Electrophoresis , Chromatography, High Pressure Liquid , Exons/genetics , Hemoglobin E/chemistry , Hemoglobin E/genetics , Hemoglobins/analysis , Hemoglobins, Abnormal/physiology , Humans , Male , Pedigree , Peptides/chemistry , Sequence Analysis, DNA , TrypsinSubject(s)
Managed Care Programs/economics , Medical Indigency/economics , Minority Groups , State Health Plans/economics , Cost-Benefit Analysis , Forecasting , Health Services Accessibility/economics , Health Services Accessibility/trends , Humans , Managed Care Programs/trends , Medical Indigency/trends , Rhode Island , State Health Plans/trends , United StatesABSTRACT
OBJECTIVE: Inner city families often use multiple sites for nonemergent medical care, including the pediatric emergency department. This practice raises concerns about continuity of care. The present study examined one aspect of continuity of care: Do children who receive care in a pediatric emergency department return to their primary care site so that appropriate follow up may be obtained? METHODS: Over a 4-week period two groups of neighborhood health center children were studied: Those who sought care at the pediatric emergency department and those who were "walk-ins" at the health centers. All visits during the 4-week study period which resulted in a recommendation for the child to be seen within 6 weeks at the health centers were included in the analysis. RESULTS: During the study period there were 87 patient visits to the pediatric emergency department with a documented physician instruction to be seen at their health center within 6 weeks. In 66 (76%) of the cases, the patient was seen at one of the health centers during the 6 weeks following the pediatric emergency department visit. There were 146 "walk-in" visits to the health centers with a documented physician instruction to be seen again at the health centers during the 6 weeks following the walk-in visit. In 111 (76%) of the cases, the patient was seen during the 6-week period. CONCLUSION: Our study shows that revisit rates were comparable for the two groups. We conclude that the rate of compliance with follow-up recommendations is similar for those who utilized the pediatric emergency department versus those who used the primary care site.
Subject(s)
Continuity of Patient Care/statistics & numerical data , Emergency Service, Hospital , Patient Compliance , Adolescent , Child , Child, Preschool , Community Health Centers , Female , Humans , Male , Pediatrics , Poverty Areas , Primary Health Care/statistics & numerical data , Rhode Island , Urban PopulationSubject(s)
Community Health Centers , Health Care Reform , Minority Groups , Humans , Medically Uninsured , United StatesSubject(s)
Asthma/epidemiology , Adolescent , Adult , Aged , Asthma/diagnosis , Asthma/economics , Asthma/therapy , Black People , Child , Female , Humans , Male , Middle Aged , Monitoring, Physiologic , Morbidity , Patient Education as Topic , United States/epidemiology , Urban Population , White PeopleSubject(s)
Breast Neoplasms/prevention & control , Mass Screening , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , Aged, 80 and over , Breast Neoplasms/epidemiology , Female , Follow-Up Studies , Humans , Mass Media , Middle Aged , Rhode Island/epidemiology , Urban Population , Uterine Cervical Neoplasms/epidemiologySubject(s)
Family , Spouse Abuse/epidemiology , Violence , Adolescent , Adult , Child , Female , Humans , Infant, Newborn , Male , Medical History Taking , Middle Aged , Patient Education as Topic , Pregnancy , Rhode Island/epidemiology , Risk Factors , Social Class , Spouse Abuse/prevention & control , Urban PopulationABSTRACT
This paper describes an holistic approach to the psychotherapy of the brain injured individual in which the biological, intrapsychic, family, social and spiritual systems are taken into account. By acknowledging that the patient's innate goodness has not been destroyed, technical issues are addressed that enable the patient to deal with his losses and achieve higher levels of adjustment.
Subject(s)
Brain Injuries/rehabilitation , Psychotherapy , Brain Injuries/psychology , Holistic Health , HumansSubject(s)
Carbamazepine/poisoning , Isoniazid/poisoning , Adolescent , Drug Interactions , Female , Humans , Seizures/drug therapyABSTRACT
A case report of a family with severe recurrent staphylococcal furunculosis, requiring multiple courses of antibiotics is presented herein. Treatment with Betadine solution proved to reduce the recurrence rate, however, TSH levels were elevated in four of the seven family members.
