RESUMO
A health system's approach to capital access in the coming year should include an in-depth analysis of different financing options, including: Tax-exempt fixed rate bonds. Tax-exempt variable rate bonds. Taxable bonds. Direct purchases. New financing products.
Assuntos
Financiamento de Capital/tendências , Administração Financeira de Hospitais , Isenção Fiscal , Estados UnidosRESUMO
Acquired intradural arachnoid cystic lesions of the spine have been associated with trauma, hemorrhage, parasitic infections, and other insults that cause inflammation and subarachnoid adhesions. The authors describe the case of a previously healthy 36-year-old woman who presented with a chronic myelopathy due to the progressive development of a giant spinal arachnoid cyst that resulted after the intrathecal injection of phenol for the management of chronic upper extremity pain. Neurological examination, spinal computed tomography, and magnetic resonance imaging were used for diagnostic and follow-up purposes. Even after the initial excision of the cyst, the patient remained symptomatic with minimal functional recovery.
Assuntos
Cistos Aracnóideos/etiologia , Injeções Espinhais/efeitos adversos , Fenol/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Doenças da Medula Espinal/etiologia , Adulto , Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/cirurgia , Doença Crônica , Feminino , Humanos , Dor/tratamento farmacológico , Fenol/efeitos adversos , Soluções Esclerosantes/efeitos adversos , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/cirurgiaRESUMO
Gene expression in archived frozen sural nerve biopsies of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) was compared to that in vasculitic nerve biopsies (VAS) and to normal nerve (NN) by DNA microarray technology. Hierarchical clustering analysis demonstrated distinct gene expression patterns distinguishing these disease groups. Of particular interest were: (1) Tachykinin precursor 1, which may be involved in pain mediation; (2) Stearoyl-CoA-desaturase, which may be a marker for remyelination and (3) the Allograft Inflammatory Factor 1 (AIF-1), a modulator of immune response during macrophage activation. Differential gene expression may help distinguish between CIDP, VAS and NN in sural nerve biopsies and identify genes that may be involved in disease pathogenesis.