RESUMO
PSR handles the vast majority of malpractice injuries in Sweden. PSR is a claims handling company which settles claims for malpractice on behalf of the insurance company owned by the Swedish county councils: the County Councils Mutual Insurance Company. A central issue in the law regulating patient injuries in Swedish health care is to define injuries that could have been avoided if a certain therapeutic/diagnostic procedure or a more appropriate method had been utilized. PSR arranged a multiprofessional conference regarding guidelines to decrease the number of malpractice injuries in the treatment of distal radius fractures. Among the most important issues defined were: To improve and standardize diagnostic imaging Patient information Early decision making in surgery and physical/occupational therapy A more well-defined indication for surgery, in which type of trauma, biological age and functional demands are considered in addition to radiographs Less stereotyped thinking in follow-up Controlled randomized trials.
Assuntos
Imperícia , Fraturas do Rádio/terapia , Competência Clínica , Seguimentos , Fixação de Fratura/efeitos adversos , Fixação de Fratura/métodos , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Consolidação da Fratura , Guias como Assunto , Humanos , Incidência , Revisão da Utilização de Seguros , Seguro Saúde/economia , Seguro Saúde/estatística & dados numéricos , Imperícia/estatística & dados numéricos , Terapia Ocupacional , Radiografia , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , SuéciaRESUMO
Expression of growth hormone receptor mRNA was investigated by in situ hybridization in skeletal muscle from normal and hypophysectomized rats during the first seven days of regeneration after ischemic injury. A digoxigenin-labelled RNA probe directed against the extracellular part of the rat GH receptor was used. In both normal and hypophysectomized rats distinct expression of GH receptor mRNA could be demonstrated in the regenerating muscle cells at the myoblast/myotube stage. The GH receptor expression appeared to decline with increasing maturation of the regenerated muscle fibres. In hypophysectomized rats, the regeneration process and the expression of GH receptor mRNA was delayed compared with that in normal animals. It is concluded that growth hormone may affect also the early phase of muscle regeneration in normal animals. To what extent lack of growth hormone contributes to the delayed regeneration observed in the hypophysectomized rats remains to be elucidated.
Assuntos
Hipofisectomia , Músculos/fisiologia , RNA Mensageiro/genética , Receptores da Somatotropina/genética , Regeneração/genética , Animais , Células Cultivadas , DNA/análise , DNA/genética , Expressão Gênica , Imuno-Histoquímica , Masculino , Músculos/química , Músculos/ultraestrutura , Hibridização de Ácido Nucleico , Hipófise/cirurgia , Hipófise/ultraestrutura , Sondas RNA , RNA Mensageiro/análise , Ratos , Ratos Endogâmicos , Receptores da Somatotropina/análise , Receptores da Somatotropina/fisiologia , Regeneração/fisiologiaRESUMO
We have shown recently by light microscopy that insulin-like growth factor I (IGF-I) immunoreactivity is localized in cells in the collecting ducts and in the thin loop of Henle in the normal rat kidney. In the present study, we have investigated the ultrastructural localisation of IGF-I using preembedding immunocytochemistry. The light microscopical findings were confirmed at the electronmicroscopical level. In collecting ducts as well as in the thin limb of Henle's loop a focal expression of IGF-I immunoreactivity was evident, i.e. distinctly IGF-I positive cells were intermingled with cells lacking IGF-I immunoreactivity. IGF-I immunoreactivity was found to have a diffuse cytoplasmatic distribution in both cell types. No specific association to organelles was found.
Assuntos
Fator de Crescimento Insulin-Like I/metabolismo , Rim/metabolismo , Somatomedinas/metabolismo , Animais , Imuno-Histoquímica , Rim/ultraestrutura , Masculino , Microscopia Eletrônica , Ratos , Ratos Endogâmicos , Distribuição TecidualRESUMO
The localization of insulin-like growth factor I (IGF-I, somatomedin C) was investigated in the kidney of adult rats during normal conditions and after nephrectomy, using immunocytochemical and biochemical methods. In the normal kidney, IGF-I immunoreactivity could be demonstrated mainly in cells in the medullary collecting ducts and in those parts of the thin limb of Henle's loop located in the outer medulla. During compensatory growth all parts of the collecting ducts, including those in the cortex, showed IGF-I immunoreactivity, as did cells in the entire thin limb of Henle's loop. No IGF-I immunoreactivity could be demonstrated in the proximal or distal tubules, either in the control kidney or during compensatory growth. Biochemical measurements showed a significantly higher content of IGF-I in the inner medulla than in the cortex in the normal kidney. Uninephrectomy resulted in significantly increased IGF-I content in the cortex. It is suggested that IGF-I is produced mainly in the collecting ducts and in the thin limb of Henle's loop and exerts its effect on other parts of the nephron by paracrine mechanisms.
