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Desperate to stop the flow of red ink, level I trauma center will deny transfers.

Despite financial hardship, the Emergency Medical Treatment & Labor Act (EMTALA) may place severe limitations on solutions available to overcrowded EDs. --It is not up to the receiving hospital to determine capabilities of the transferring facility. --If you suspect an improper transfer request, accept the transfer and then file a complaint with the Centers for Medicare & Medicaid Services. --Whistle-blower laws protect ED managers if they refuse or complain about orders that violate EMTALA.

Financial Management, Hospital↗

[The relationship between methylation of p16 INK 4/CDKN2 gene in promoter region and progress of squamous cell carcinoma of buccal mucosa].

OBJECTIVE: To determine the correlation between methylation of p16 gene in promoter region and the carcinogenesis and progression of squamous cell carcinoma (SCC) of buccal mucosa. METHODS: Methylation of pl6 gene in SCC and leukoplakia of buccal mucosa was investigated by MSP and pl6 protein was analyzed by Western blot. RESULTS: The methylation of p16 gene was found in 15 of 30 cases SCC and 1 of 10 cases of leukoplakia of buccal mucosa (P < 0.05). Methylation of p16 gene in SCC of buccal mucosa was not related with age, sex, cell differentiation and clinical stage. But methylation of p16 in the cases with lymph node-metastasis was higher than that in the cases without lymph node-metastasis protein (P < 0.05). Meanwhile Methylation of p16 gene was positively correlated with no-expression of p16 protein (P < 0.01). CONCLUSIONS: The methylation of p16 gene leaded to the inactivation of p16 gene and was related with the carcinogenesis and progress of SCC of buccal mucosa.

Carcinoma, Squamous Cell↗