RESUMO
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.
Assuntos
Hemoglobinas Anormais/química , Hemoglobinas Anormais/genética , Mutação/genética , Adulto , Eletroforese das Proteínas Sanguíneas , Cromatografia Líquida de Alta Pressão , Éxons/genética , Hemoglobina E/química , Hemoglobina E/genética , Hemoglobinas/análise , Hemoglobinas Anormais/fisiologia , Humanos , Masculino , Linhagem , Peptídeos/química , Análise de Sequência de DNA , TripsinaAssuntos
Programas de Assistência Gerenciada/economia , Indigência Médica/economia , Grupos Minoritários , Planos Governamentais de Saúde/economia , Análise Custo-Benefício , Previsões , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/tendências , Humanos , Programas de Assistência Gerenciada/tendências , Indigência Médica/tendências , Rhode Island , Planos Governamentais de Saúde/tendências , Estados UnidosRESUMO
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.
Assuntos
Continuidade da Assistência ao Paciente/estatística & dados numéricos , Serviço Hospitalar de Emergência , Cooperação do Paciente , Adolescente , Criança , Pré-Escolar , Centros Comunitários de Saúde , Feminino , Humanos , Masculino , Pediatria , Áreas de Pobreza , Atenção Primária à Saúde/estatística & dados numéricos , Rhode Island , População UrbanaAssuntos
Asma/epidemiologia , Adolescente , Adulto , Idoso , Asma/diagnóstico , Asma/economia , Asma/terapia , População Negra , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Morbidade , Educação de Pacientes como Assunto , Estados Unidos/epidemiologia , População Urbana , População BrancaAssuntos
Neoplasias da Mama/prevenção & controle , Programas de Rastreamento , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Feminino , Seguimentos , Humanos , Meios de Comunicação de Massa , Pessoa de Meia-Idade , Rhode Island/epidemiologia , População Urbana , Neoplasias do Colo do Útero/epidemiologiaAssuntos
Família , Maus-Tratos Conjugais/epidemiologia , Violência , Adolescente , Adulto , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Anamnese , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Gravidez , Rhode Island/epidemiologia , Fatores de Risco , Classe Social , Maus-Tratos Conjugais/prevenção & controle , População UrbanaRESUMO
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.
Assuntos
Lesões Encefálicas/reabilitação , Psicoterapia , Lesões Encefálicas/psicologia , Saúde Holística , HumanosRESUMO
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.