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Alok Srivastav Helen Pearson Jennifer Bryant Emmanuel Favaloro Nelly Coulits Jan Jindra Brenton Wylie 《Vox sanguinis》1993,65(2):146-150
With the aim of reducing the damage to platelets while effectively removing class I HLA antigens from their surfaces, we developed a new method using acidified chloroquine diphosphate. Platelets were treated with a 0.2 M solution of chloroquine diphosphate (pH 4.0). More than 90% of the platelets remained viable after treatment. While a marked reduction in reactions of acidified chloroquine-treated platelets with multispecific HLA antisera was noted in comparison with phosphate-buffered-saline-(PBS)-treated platelets, reactions with platelet-specific antibodies were preserved. This was demonstrated by immunofluorescence tests and solid-phase and monoclonal antibody immobilization of platelet antigen assays. Aggregation responses, though reduced in comparison with PBS-treated platelets, were still preserved after acidified chloroquine treatment. Ultrastructural analysis did not show any significant difference from PBS-treated platelets. We conclude that treatment of platelets with acidified chloroquine diphosphate is a simple and effective method for removing class I HLA antigens from their surfaces with minimal damage to their structure and function. 相似文献
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The SOAR stroke score predicts hospital length of stay in acute stroke: an external validation study 下载免费PDF全文
C. S. Kwok A. B. Clark S. D. Musgrave J. F. Potter G. Dalton D. J. Day A. George A. K. Metcalf J. Ngeh A. Nicolson P. Owusu‐Agyei R. Shekhar K. Walsh E. A. Warburton M. O. Bachmann P. K. Myint the Anglia Stroke Clinical Network Evaluation Study Group 《International journal of clinical practice》2015,69(6):659-665
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Background:
The surgical management of advanced, incurable, malignant disease presents particular ethical and technical challenges. The clear goal is palliation and the surgical futility must be avoided. This case series presents some particular challenges in end-of-life surgery.Materials and Methods:
Fifteen patients referred with advanced malignant disease involving a limb girdle were reviewed.Results:
In one case, a patient pleaded for surgery after initially requesting a delay to seek treatment from a Chinese Traditional Herbalist. The increase in tumour bulk led to problems with surgery and the patient died in a hospital a few weeks later. This case illustrates ‘futility’ not recognized and encountered. The remaining 14 patients exhibited positive palliation with improved quality of dying and appreciation expressed by patients, relatives and staff.Conclusion:
In selected cases, with a skilled and experienced surgical team, patients with advanced malignant disease can still benefit from aggressive surgical palliation. The margin of error is small between palliation being attempted and futility being achieved. This considerably adds to the challenge of end-of-life surgery.KEY WORDS: Futility, palliation, quality of life, surgery 相似文献107.
Critical illness hyperglycemia (CIH) is common in pediatric and adult intensive care units (ICUs). Children undergoing surgical repair or palliation of congenital cardiac defects are particularly at risk for CIH and its occurrence has been associated with increased morbidity and mortality in this population. Strict glycemic control through the use of intensive insulin therapy (IIT) has been shown to improve outcomes in some adult and pediatric studies, yet these findings have sparked controversy. The practice of strict glycemic control has been slow in extending to pediatric ICUs because of the documented increase in the incidence of hypoglycemia in patients treated with IIT. Protocol driven approaches with more liberal glycemic targets have been successfully validated in general and cardiac critical care pediatric patients with low rates of hypoglycemia. It is unknown whether a therapeutic benefit is obtained by keeping patients in this more liberal glycemic control target. Definitive randomized controlled trials of IIT utilizing these targets in critically ill children are ongoing. 相似文献
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Lora A Kohn R Levav I McBain R Morris J Saxena S 《Bulletin of the World Health Organization》2012,90(1):47-54, 54A-54B