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11.
Laura A Hawryluck William RC Harvey Louise Lemieux-Charles Peter A Singer 《BMC medical ethics》2002,3(1):3-9
Background
Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia.Methods
Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12).Results
After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU.Conclusion
Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. 相似文献12.
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14.
RC Curran 《Journal of clinical pathology》1983,36(2):239-240
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17.
Simultaneous isolation of simian foamy virus and HTLV-III/LAV from chimpanzee lymphocytes following HTLV-III or LAV inoculation 总被引:9,自引:0,他引:9
18.
The mean maximum nuclear diameter (Dmax) in 21 cases of non-Hodgkin's lymphoma (NHL) has been determined, using the Reichert-Jung (Kontron) MOP-AMO3 user-controlled image analyser. Nuclear diameters of high-grade malignancy NHL were found to be considerably greater than those of low-grade malignancy lymphomas, although there was some overlap of their ranges. These findings confirm objectively subjective estimates of nuclear size in NHL. The relative usefulness of the user-controlled (interactive) image analyser for the measurement of nuclei in tissue sections is compared with that of a fully automatic machine. 相似文献
19.
Preliminary report of an ultrasonography and colour Doppler uterine score to predict uterine receptivity in an in-vitro fertilization programme 总被引:1,自引:4,他引:1
Salle B; Bied-Damon V; Benchaib M; Desperes S; Gaucherand P; Rudigoz RC 《Human reproduction (Oxford, England)》1998,13(6):1669-1673
A total of 96 women undergoing in-vitro fertilization (IVF) treatment were
examined by transvaginal ultrasonography with colour and pulsed Doppler
ultrasound on the 22nd day of the menstrual cycle preceding IVF. We
assessed endometrial thickness, endometrial morphology, myometrial
echogenicity, subendometrial vascularization, the uterine artery
pulsatility index, protodiastolic notch and end diastolic blood flow in
order to define a uterine score which could be correlated with the
pregnancy rate. The overall pregnancy rate was 30.2%, and there was no
difference between the pregnant and non-pregnant groups with regard to any
of the ultrasonographic and Doppler parameters when examined separately.
However, the uterine score was significantly higher in the pregnant group
(15.9 +/- 2.81 versus 12.7 +/- 5.3, P = 0.002; t-test). No pregnancy
occurred if the score was between 0 and 10. With a score of 11-15 there was
a 34.7% chance of pregnancy, and scores >16 had a 42% chance of
pregnancy. In conclusion, individual ultrasonographic and Doppler
parameters are not of sufficient accuracy to predict uterine receptivity.
The uterine score calculated prior to IVF cycles appears to be a useful
predictor of implantation.
相似文献
20.
Immunoperoxidase stains of ganglion cells and abnormal mucosal nerve proliferations in Hirschsprung's disease 总被引:1,自引:0,他引:1
Hirschsprung's disease is congenital aganglionosis of the distal colon. The affected bowel shows an abnormal proliferation of mucosal nerve fibers by acetylcholinesterase stains. We retrospectively reviewed biopsy specimens from patients with suspected and proven Hirschsprung's disease, performed immunoperoxidase stains for S-100 protein and neuron-specific enolase (NSE), and compared these results to routine histologic findings and acetylcholinesterase stains. Ganglion cells were demonstrated by immunoperoxidase in 63 of 69 specimens containing ganglion cells and in 1 specimen interpreted as aganglionic by hematoxylin-eosin staining. Increased numbers of nerve fibers in the muscularis mucosae and deep lamina propria by S-100 staining were detected in 8 of 8 specimens diagnostic for Hirschsprung's disease by hematoxylin-eosin and acetylcholinesterase stains and in 1 specimen diagnostic for colonic neuronal dysplasia (a disorder related to Hirschsprung's disease). Whereas 45 of 67 specimens from unaffected bowel showed a normal number and distribution of nerve fibers by S-100 staining, in 22 the pattern resembled that of Hirschsprung's disease. Specimens from affected colon also showed hypertrophied submucosal nerve trunks by S-100 stain (average nerve trunk thickness, 29.8 micron in affected bowel, 16.1 micron in unaffected segments--p less than 0.03). We conclude that NSE and S-100 stains are of value in demonstrating ganglion cells in suspected cases of Hirschsprung's disease and colonic neuronal dysplasia. The acetylcholinesterase stain is preferred over S-100 stain for detecting mucosal nerve proliferations in affected bowel. Submucosal nerve trunk thickness, although significantly different in affected and unaffected colon, is not of diagnostic value because of the wide variation in the measurements in the two groups. 相似文献