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A new documentary capably navigates the life and legacy of Benjamin Franklin.
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Quality is the watchword for health plans that wish to survive to see the new century, and accreditation by the National Committee for Quality Assurance is becoming quality's indispensable stamp. Practice guidelines are an imperative for that accreditation. Here's what seven managed care leaders had to say about guidelines in a recent round-table discussion.
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Programas de Assistência Gerenciada/normas , Guias de Prática Clínica como Assunto , Acreditação/organização & administração , Comunicação , Humanos , Programas de Assistência Gerenciada/economia , Programas de Assistência Gerenciada/legislação & jurisprudência , Organizações , Equipe de Assistência ao Paciente , Papel do Médico , Estados UnidosRESUMO
Colonic diverticulitis can produce gas in the portal and inferior mesenteric veins. Such an occurrence is usually associated with massive bowel necrosis and carries a grave prognosis. The authors report a case in which the patient survived.
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Colo Sigmoide , Doença Diverticular do Colo/complicações , Embolia Aérea/etiologia , Veias Mesentéricas/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Colo Sigmoide/diagnóstico por imagem , Doença Diverticular do Colo/diagnóstico por imagem , Embolia Aérea/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia , Ruptura Espontânea , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/etiologiaAssuntos
Etanol/farmacologia , Suco Gástrico/metabolismo , Mucosa Gástrica/fisiopatologia , Adolescente , Adulto , Alcoolismo/fisiopatologia , Difusão , Feminino , Mucosa Gástrica/efeitos dos fármacos , Gastroscopia , Humanos , Ácido Clorídrico , Concentração de Íons de Hidrogênio , Masculino , PermeabilidadeAssuntos
Bilirrubina/metabolismo , Feto/metabolismo , Animais , Cães , Feminino , Glucuronatos/metabolismo , Haplorrinos , Fígado/metabolismo , Troca Materno-Fetal , Gravidez , TrítioRESUMO
Bilirubin metabolism was studied in dog and monkey fetuses. Bilirubin-(3)H was administered to fetal animals in utero by prolonged intravenous infusion. Fetal plasma disappearance, hepatic uptake, biliary excretion, and placental transfer of bilirubin-(3)H were measured.Bilirubin metabolism and excretion in the fetus was much less efficient than in the adult. Fetal plasma levels of tritium were elevated for prolonged periods, and the combined rate of placental and fetal hepatic excretion was lower than normal values for adult hepatic excretion. Species differences were noted. Hepatic conjugation and excretion appeared to be the primary mechanism of fetal metabolism in the dog. In contrast, the amounts of conjugated bilirubin-(3)H excreted in fetal monkey bile were negligible. Small amounts of (3)H-labeled bilirubin derivatives were excreted in fetal bile, but 10 times as much of the administered material was transferred intact across the placenta and excreted by the maternal liver. The relationship of this functional difference to known anatomic and biochemical species differences is discussed. Preliminary observations on alternate routes of fetal bilirubin metabolism were obtained.
