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991.
Bradbury RA Cropley J Kifor O Lovicu FJ de Iongh RU Kable E Brown EM Seely EW Peat BB Conigrave AD 《Placenta》2002,23(2-3):192-200
We have demonstrated using immunohistochemistry and in situ hybridization that the calcium-sensing receptor (CaR) is expressed in both villous and extravillous regions of the human placenta. CaR expression was detected in both first trimester and term placentas. In the villous region of the placenta, the CaR was detected in syncytiotrophoblasts and at lower levels in cytotrophoblasts. Local expression of the CaR in the brush border of syncytiotrophoblasts suggests a role for maternal Ca(2+) concentration in the control of transepithelial transport between the mother and fetus. In the extravillous region of the placenta, the CaR was detected in cells forming trophoblast columns in anchoring villi, in close proximity to maternal blood vessels and in transitional cytotrophoblasts. Given the importance of extravillous cytotrophoblasts in the process of uterine invasion and maintenance of placental immune privilege, the CaR represents a possible target by which the maternal extracellular Ca(2+) concentration could promote or maintain placentation. Thus, the results support hypotheses that the CaR contributes to the local control of transplacental calcium transport and to the regulation of placental development. 相似文献
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Reshma Jagsi Rebecca Spence W. Kimryn Rathmell Angela Bradbury Jeffrey Peppercorn Stephen Grubbs Beverly Moy 《The oncologist》2014,19(2):186-192
Shortages of injectable drugs affect many cancer patients and providers in the U.S. today. Scholars and policymakers have recently begun to devote increased attention to these issues, but only a few tangible resources exist to guide clinical oncologists in developing strategies for dealing with drug shortages on a recurring basis. This article discusses existing information from the scholarly literature, policy analyses, and other relevant sources and seeks to provide practical ethical guidance to the broad audience of oncology professionals who are increasingly confronted with such cases in their practice. We begin by providing a brief overview of the history, causes, and regulatory context of oncology drug shortages in the U.S., followed by a discussion of ethical frameworks that have been proposed in this setting. We conclude with practical recommendations for ethical professional behavior in these increasingly common and challenging situations. 相似文献
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'Inappropriate' attenders at accident and emergency departments I: definition, incidence and reasons for attendance 总被引:4,自引:0,他引:4
BACKGROUND AND OBJECTIVES: Significant numbers of patients refer themselves
to A&E departments for conditions which are neither accidents nor
emergencies, relatively few of which require specific hospital treatment.
These patients and their conditions have been described as 'inappropriate'.
The objective of this paper is to review research relating to the
definition, incidence and reasons for attendance of 'inappropriate'
attenders. There is no accepted practical definition of what constitutes an
'appropriate' attender to an A&E department nor of what constitutes an
'emergency'. It is therefore not surprising that there is enormous
variability (from 6 to 80%) regarding the proportion of visits judged to be
inappropriate. All definitions rely completely on implicit and subjective
judgements to determine appropriateness. The decision making of patients in
opting to attend accident and emergency departments in preference to
consulting their GP is complex, involving an interplay of social,
psychological and medical factors. CONCLUSIONS: An analysis of reported
work suggests that the most important factors are the perceived
appropriateness of the condition for A&E, A&E accessibility and GP
availability. A major deficiency in the available research is that patients
have been retrospectively labelled as 'inappropriate' by medical personnel
on the basis of the results of patient assessment and treatment. This
review suggests that definitions and putative management strategies must
consider the social and psychological context of the patients' decisions to
attend.
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