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排序方式: 共有970条查询结果,搜索用时 15 毫秒
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.
13.
RC Curran 《Journal of clinical pathology》1983,36(2):239-240
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16.
JS Pooni Dr DWL Hukins PF Harris RC Hilton KE Davies 《Surgical and radiologic anatomy : SRA》1986,8(3):175-182
Posterior and anterior heights, cross-sectional area and shape were measured for all the intervertebral discs in four spines from elderly human cadavers. Disc height was a minimum at the T4-5 level; thoracic discs were less wedge-shaped than those in the cervical and lumbar regions. Cross-sectional area increased from the cranial to caudal extremity; at the L5-S1 level the nucleus pulposus occupied a high proportion of this area. Cervical discs tended to have an elliptical cross-sectional shape, thoracic discs were more circular and lumbar discs tended to have an elliptical cross-section which was flattened or re-entrant posteriorly. This shape distribution was quantified by defining a shape index which had a maximum value of 1 for a circular cross-section. Orientations of the reinforcing fibres in the outer lamellae of the anterior annulus fibrosus were measured from 27 discs by X-ray diffraction. For these measurements, C3-4, T7-8 and L2-3 were chosen as representative of cervical, thoracic and lumbar discs. The fibre tilt, with respect to the axis of the spine, was significantly less in the cervical discs (at 65 degrees) than in the thoracic and lumbar discs (about 70 degrees). These findings are interpreted in relation to differing functional requirements and possible mechanisms of failure in the cervical, thoracic and lumbar regions of the spine in the light of current knowledge on the biomechanics of the intervertebral disc. 相似文献
17.
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
18.
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
19.
Susan L. Swain Javed N. Agrewala Deborah M. Brown Dawn M. Jelley-Gibbs Susanne Golech Gail Huston Stephen C. Jones Cris Kamperschroer Won-Ha Lee K. Kai McKinstry Eulogia Román Tara Strutt Nan-ping Weng 《Immunological reviews》2006,211(1):8-22
Summary: We have outlined the carefully orchestrated process of CD4+ T‐cell differentiation from naïve to effector and from effector to memory cells with a focus on how these processes can be studied in vivo in responses to pathogen infection. We emphasize that the regulatory factors that determine the quality and quantity of the effector and memory cells generated include (i) the antigen dose during the initial T‐cell interaction with antigen‐presenting cells; (ii) the dose and duration of repeated interactions; and (iii) the milieu of inflammatory and growth cytokines that responding CD4+ T cells encounter. We suggest that heterogeneity in these regulatory factors leads to the generation of a spectrum of effectors with different functional attributes. Furthermore, we suggest that it is the presence of effectors at different stages along a pathway of progressive linear differentiation that leads to a related spectrum of memory cells. Our studies particularly highlight the multifaceted roles of CD4+ effector and memory T cells in protective responses to influenza infection and support the concept that efficient priming of CD4+ T cells that react to shared influenza proteins could contribute greatly to vaccine strategies for influenza. 相似文献
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