989 resultados para State Medicine


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The experiment was conducted throughout the year 2005, at the Universidade Federal de Pelotas campus. The objectives of the study were to analyze the decomposition of rabbit (Oryctolagus cunniculus L.) with mean weight 2.67 Kg carcass and describe the interaction of insects acting on it, as well as the insect's potential use in legal medicine. We collected 5.239 insect specimens; 1.827 of them were obtained from larvae collected from carcasses and reared. The specimens were identified and 20 species were of forensic importance. The species Lucilia eximia (Wiedemann, 1819) and Chrysomya albiceps (Wiedemann, 1819) (Diptera, Calliphoridae) were better indicators of post-mortem interval (PMI) because they occurred in all seasons and were the first to reach the carcass. Hemilucilia semidiaphana (Rondani, 1850), H. segmentaria (Fabricius, 1805) (Diptera, Calliphoridae), Muscina stabulans (Fallén, 1817) and Synthesiomyia nudiseta (Wulp, 1883) (Diptera, Muscidae) can disclose death time because they occur only in certain months of the year. Oxyletrum discicolle (Brullé, 1840) (Coleoptera, Silphidae) and Dermestes maculates De Geer, 1774 (Coleoptera, Desmestidae) were found in advanced stages of decomposition.

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The state of Vaud model of the pre-hospital chain of survival is an example of an efficient way to deal with pre-hospital emergencies. It revolves around a centrally located dispatch center managing emergencies according to specific key words, allowing dispatchers to send out resources among which we find general practitioners, ambulances, physician staffed fast response cars or physician staffed helicopters and specific equipment. The Vaud pre-hospital chain of survival has been tailored according to geographical, demographical and political necessities. It undergoes constant reassessment and needs continuous adaptations to the ever changing demographics and epidemiology of pre-hospital medicine.

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Inventories on necrophagous insects carried out in Brazil encompass mostly species from the southeastern and central-western regions of the country. This review aims to produce the first checklist of necrophagous Diptera and Coleoptera species of forensic relevance in northeastern Brazil, an area that concentrates high rates of homicides. We performed a literature survey on scientific articles, theses and dissertations regarding necrophagous insect species in the region, and contacted scientists who develop research on forensic entomology. Fifty-two species of Diptera belonging to eight families with previous record of necrophagy were reported in the region: Sarcophagidae, Calliphoridae, Muscidae, Fanniidae, Piophilidae, Phoridae, Anthomyiidae and Stratiomyidae. Coleopteran species from six families of forensic relevance were registered, although taxonomical identification remained superficial. Bait traps were the most frequent methodology used, followed by collection on animal carcasses. Seven Dipteran species from two families were registered on human cadavers. All species had been previously reported in other Brazilian states and/or other countries, although none has been effectively used in legal procedures in the region. The status of research on forensic entomology in northeastern Brazil is incipient, and the checklist produced here contributes to the knowledge on the local diversity of necrophagous insects.

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OBJECTIVES: To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. METHODS: GRADE-based systematic review followed by expert consensus achieved using Web-based Delphi methodology, conference calls and face-to-face meetings. Predictors based on clinical examination, electrophysiology, biomarkers and imaging were included. RESULTS AND CONCLUSIONS: Evidence from a total of 73 studies was reviewed. The quality of evidence was low or very low for almost all studies. In patients who are comatose with absent or extensor motor response at ≥72 h from arrest, either treated or not treated with controlled temperature, bilateral absence of either pupillary and corneal reflexes or N20 wave of short-latency somatosensory evoked potentials were identified as the most robust predictors. Early status myoclonus, elevated values of neuron-specific enolase at 48-72 h from arrest, unreactive malignant EEG patterns after rewarming, and presence of diffuse signs of postanoxic injury on either computed tomography or magnetic resonance imaging were identified as useful but less robust predictors. Prolonged observation and repeated assessments should be considered when results of initial assessment are inconclusive. Although no specific combination of predictors is sufficiently supported by available evidence, a multimodal prognostication approach is recommended in all patients.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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The official newsletter of the Iowa Office of the State Medical Examiner.

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A brochure describing the general duties and functions of the Iowa Office of the State Medical Examiner.

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A brochure describing how a family may request an autopsy from the Iowa Office of the State Medical Examiner.

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The State Long-Term Care Ombudsman program (SLTCOP)operates as a unit within the Iowa Department on Aging. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing, skilled nursing, residential care, and nursing facilities in hospitals as well as elder group homes and assisted living facilities. In order to carry out all of the mandates of the Older Americans Act this office recommends to establish a fully functioning volunteer ombudsman program that meets the criteria set forth in the Federal Older Americans Act as well as to strengthen family & resident councils, and to increase collaboration between the SLTCOP and Iowa’s Aging Network.

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The Department’s recommendation for closure and consolidation is based on an analysis of the existing programs, persons served, physical plant costs, expenses and renovation/infrastructure costs for relocation, and review of the draft report from the MHI Task Force. Further detail surrounding the analysis used to drive the recommendation is found under the Recommendations section, beginning on page 12 of this report. In response to the legislative requirement to recommend closure and consolidation of an MHI, the Department recommends the closure of the Mount Pleasant Mental Health Institute with consolidation of its programs and operational beds at the Independence Mental Health Institute. With this recommendation, Independence MHI will add beds to accommodate the 15 adult psychiatric beds, 14 dual diagnosis beds, and 50 substance abuse treatment beds now located at the Mount Pleasant MHI. This relocation will take an estimated six months from the time statutory authority and corresponding appropriations are received.

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CMS has established the medicaid Quality Improvement which serves to fulfill the objectives of they Medicaid Quality goal established through the Federal Government Performance and Results At. One of the objectives of the goal calls for the Centers foe Medicare and Medicaid Services to work in partnership with State Medicaid Directors to develop a Nation Medicaid Quality Framework that will articulate broad principles and a common vision of quality for the program.