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“Objective To determine maternal fetal medicine (MFM) referral trends in a Medicaid population over time.\n\nStudy
design Sixteen clinical guidelines and 23 clinical conditions were identified where co-management/consultation with MFM specialist is recommended. Linked Medicaid claims and birth certificate data for 2001-2006 were used to identify pregnancies with these conditions and whether they received co-management/consultation from a MFM specialist.\n\nResults Between 2001 and 2006, there were 108,703 pregnancies with delivery of 110,890 neonates. Forty-five percent had one or more of the conditions identified for co-management/consultation. Overall pregnancies receiving MFM contact remained unchanged at 22.2 % in 2001 and 22.1 % in 2006. However, face to face contacts
decreased from 14.6 % (2001) to 8.7 % (2006) while telemedicine AZD7762 in vitro consults increased from 7.6 % (2001) to 13.3 % (2006). Health departments were most likely and family practitioners least likely to refer to MFM (p < 0.001). Pregnancy complications leading to MFM referrals include cardiac complications, renal disease, systemic disorders, PPROM, suspected fetal abnormalities, Dorsomorphin purchase and cervical insufficiency.\n\nConclusion Referral of high-risk pregnancies to MFMs varies with the level of expertise at the primary prenatal site. Increased contact between MFMs and local providers selleck compound increased MFM referrals.”
robust and novel analytical procedures were developed for the speciation of chromium by carrier element co-precipitation (CECP) and dispersive liquid-liquid microextraction (DLLME) coupled with microsample injection system-flame atomic absorption spectrophotometry (MIS-FAAS). Ammonium pyrrolidine dithiocarbamate (APDC), carbon tetrachloride and ethanol were used as chelating agent, extraction solvent and disperser solvent, respectively for the determination of Cr(VI) by DLLME. For total chromium, Cr(III) was oxidized by Ce(SO4)(2) in acidic media (0.07 mol L-1 H2SO4) and the resulting solution was co-precipitated with APDC. The concentration of Cr(III) was estimated by determining the difference between the concentration of total chromium and that of Cr(VI). The maximum recovery of Cr(VI) was obtained with DLLME at optimal conditions of pH 3.0, 0.25% APDC, 100 mu L CCl4, 1.00 mL of CH3CH2OH and 0.01 mg L-1 Cr(VI). Whereas, the optimal conditions for CECP were 40 mL initial volume of water samples, 0.25% APDC, 0.02% Ce(SO4)(2) and 0.10 mg L-1 Cr(VI) concentration. The limits of detection and enrichment factor of DLLME and CECP were [0.037 and 2.13] and [400 and 100] mu g L-1, respectively with 40 mL initial volumes. The relative standard deviations (RSD, n = 6) were <4%.