When disaster hits home. EMS agencies aren't immune to catastrophes.
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Biomedical subjects
Publications and source records attributed to N Perry.
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Critical administrative functions in operationalizing a system of care approach to service delivery include: defining and selecting clients to be served, planning and developing responsive services, and ensuring that services are provided in the most therapeutic and least restrictive family and community-based environments. This article presents an overview of several administrative strategies and mechanisms developed by the Continuum of Care for Emotionally Disturbed Children in South Carolina to carry out these functions. Administrative tools are described, as well as the assumptions underlying their development. Evaluation methods, which include analyzing existing client data, surveying parents, and conducting research within a public/academic partnership, are also briefly described.
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The glycerol dehydrogenase (GDH) from Bacillus stearothermophilus is inactivated by incubation with pyridoxal-5-phosphate (PALP). The complex formed between the two can be trapped by reduction with sodium borohydride to yield a protein with an absorbance band at 325 nm and a fluorescence emission band at 430 nm, typical of trapped pyridoxal-5-phosphate moieties. Total loss of catalytic activity of the enzyme is associated with the modification of approximately one equivalent of the reagent; the incorporation of the reagent and the loss of activity can be prevented by the additional presence of the oxidised or reduced coenzyme. Peptides derived from the labelled protein have been sequenced and have identified Lys-97 as the reactive residue. Site-directed mutagenesis had been used to replace Lys-97 by a His residue. This mutated enzyme has no catalytic activity and fluorescence spectroscopy studies suggest that it is unable to bind NADH.
One hundred seventy-seven consecutive patients with newly diagnosed stage II Hodgkin's disease (HD) (supradragmatic 157; infra diaphragmatic 20) were treated at St. Bartholomew's Hospital on the basis of pathologic stage (PS) in 84 (IIA 69; IIB 15) and clinical stage (CS) in 93 (IIA 33, IIB 60) between January 1968 and December 1984. The median follow up is 13 years. Overall, complete remission (CR) was achieved in 143 patients (75%) of whom 53 have had a recurrence. One hundred twenty-seven patients remain alive, the cumulative predicted survival at 15 yrs being 70%. Mantle radiotherapy was prescribed to 88 patients with supradiaphragmatic HD, of whom 75 entered CR and 9 achieved good partial remission (GPR) (95%). The duration of remission correlated strongly with ESR (greater than 50 mm/h) and mediastinal thoracic ratio (less than 33% vs. greater than 33%) in a multivariate analysis (p = 0.05 and 0.02, respectively). 46/88 patients remain in continuous first remission, the median duration of remission having not reached at 15 years. Combined modality therapy or chemotherapy alone was prescribed to 69 patients with supradiaphragmatic HD, CR being achieved in 51 patients and GPR in 8 at the completion of all therapy. 48/59 patients continue in first remission. The duration of remission of patients receiving combined modality therapy or CT alone was significantly longer (p = 0.002) than that of patients receiving RT alone, in spite of the fact that the former group comprised predominantly of patients with unfavourable features.(ABSTRACT TRUNCATED AT 250 WORDS)
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The problem of radiation-induced cataract development in the lenses of patients and users exposed to diagnostic-quality radiation is reviewed. A cataractogenic dose appears to be about 200 rads from a single exposure and up to 750 rads in protracted doses. Routine use of new protective glasses developed by the authors is recommended for patients. For users, any of the commercially available high lead-content glasses will reduce doses to safe levels. About 70% reduction of dose is afforded by the new photochromic sunglasses.