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  • Book
    Bernard Lo.
    Summary: What are the ethical issues raised by the increasing use of big data and artificial intelligence in health care? How should physicians respond when they have a conscientious objection to an intervention requested by a patient? How should health care organizations respond to physician requests? How can physicians best help patients make informed decisions about end-of-life and life-sustaining care? How should interns and residents respond to ethical dilemmas created by duty hours restrictions? Resolving Ethical Dilemmas: A Guide for Clinicians helps residents, students, and practitioners work through these and many more common and challenging ethical questions that affect patient care. The 6th Edition reflects important changes in medicine and healthcare policy and provides additional clarity to complex concepts. Offering practical, real-world advice, it helps you think through and resolve difficult cases, prompting thoughtful, well-reasoned answers to the question of “What do I do in this situation?” --Provided by publisher.
    Digital Access
    Provider
    Version
    Ovid
    2020
    LWW Health Library (Medical education)
    2020
    LWW Health Library (Internal Medicine)
    2020
  • Book
    edited by Susan M. Pearce.
    Print 1989
  • Article
    Yabusaki KK, Ballou CE.
    Proc Natl Acad Sci U S A. 1978 Feb;75(2):691-5.
    The long-chain polyenoic fatty acids alpha- and beta-paranaric acid form complexes with the 6-O-methylglucose polysaccharide from Mycobacterium smegmatis as demonstrated by an enhanced fluorescence emission of the paranaric acid. This interaction is eliminated by digestion of the methylglucose polysaccharide with alpha-amylase and glucoamylase, which removes four hexose units from the nonreducing end of the chain. Titration of the methylglucose polysaccharide with either paranaric acid isomer suggests formation of a 1:1 complex with a dissociation constant (K(d)) of 0.4 muM. The fluorescence emission of this complex is quenched by palmitoyl-CoA, which indicates that the paranaric acid can be displaced by the acoyl-CoA, a conclusion confirmed by gel filtration. The presumed polysaccharide/palmitoyl-CoA complex has a K(d) of about 0.1 muM. Acoyl-CoA derivatives with shorter fatty acid chains and free palmitic acid complete less effectively, indicating that they form weaker complexes with the polysaccharide. The methylmannose polysaccharides with 12 or 13 sugar units also complex paranaric acid strongly (K(d) approximately 0.4 muM), whereas the isomer with 11 sugar units complexes weakly.The methylglucose polysaccharide has been coupled to L-tryptophan methyl ester. The fluorescence emission spectrum of the attached tryptophan group is shifted to a shorter wavelength relative to N-acetyl-L-tryptophan methyl ester, and this effect is enhanced in the corresponding derivative made with the amylase-digested polysaccharide. The circular dichroism spectrum of the polysaccharide-tryptophan derivative shows three bands with negative ellipticity, in the 270-300 nm region, not observed in the amylase-digested derivative. These results imply that the tryptophan is in a more structured environment in the former than in the latter derivative. alpha-Paranaric acid binds to the polysaccharide-tryptophan conjugate and shows an enhanced fluorescence emission with partial quenching of the tryptophan fluorescence emission, suggestive of Förster energy transfer from tryptophan to paranaric acid.
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