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991.
In the seventeenth century, opportunities to discover chyle came about through the revival of vivisection. Gaspare Aselli discovered chyle vessels in a living well-fed dog in 1622. He introduced the term 'lacteals' or milky veins. According to Aselli, the lacteals passed through a mesenteric gland which he called 'pancreas'. The 1627 edition of Aselli's booklet was the start of a 'lymphomania', which led to the dissection and vivisection of hundreds of animals, with the University of Leiden being the clear leader in this field. The prominent researchers in Leiden were Jacobus Sylvius and Johannes Walaeus, who performed diverse experiments to support Harvey's theories on systemic circulation, and to find out the correct anatomy and physiology of lacteals and mesenteric glands. Another centre of excellence was Padua, where Veslingius and Wirsüng introduced the idea of the prominent role of the 'real pancreas', and its duct in the transformation of digested food into clear chyle. The idea of the transport of chyle to the liver was an additional support for Galen's theories regarding the function of the liver. Nevertheless, as time went on, there were fewer and fewer believers in Galenic doctrine. 相似文献
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Jan Kottner Janet Cuddigan Keryln Carville Katrin Balzer Dan Berlowitz Susan Law Mary Litchford Pamela Mitchell Zena Moore Joyce Pittman Dominique Sigaudo-Roussel Chang Yee Yee Emily Haesler 《Journal of tissue viability》2019,28(2):51-58
Aim
The European Pressure Ulcer Advisory Panel, the Pan Pacific Pressure Injury Alliance, and the National Pressure Ulcer Advisory Panel are updating the ‘Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline’ (CPG) in 2019. The aim of this contribution is to summarize and to discuss the guideline development protocol for the 2019 update.Methods
A guideline governance group determines and monitors all steps of the CPG development. An international survey of consumers will be undertaken to establish consumer needs and interests. Systematic evidence searches in relevant electronic databases cover the period from July 2013 through August 2018. Risk of bias of included studies will be assessed by two reviewers using established checklists and an overall strength of evidence assigned to the cumulative body of evidence. Small working groups review the evidence available for each topic, review and/or draft the guideline chapters and recommendations and/or good practice statements. Finally, strength of recommendation grades are assigned. The recommendations are rated based on their importance and their potential to improve individual patient outcomes using an international formal consensus process.Discussion
Major methodological advantages of the current revision are a clear distinction between evidence-based recommendations and good practice statements and strong consumer involvement.Conclusion
The 2019 guideline update builds on the previous 2014 version to ensure consistency and comparability. Methodology changes will improve the guideline quality to increase clarity and to enhance implementation and compliance. The full guideline development protocol can be accessed from the guideline website (http://www.internationalguideline.com/). 相似文献994.
Evaluating the use of plerixafor in stem cell mobilisation – an economic analysis of the PHANTASTIC trial
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Antony P. Martin Sarah Richards Alan Haycox Rachel Houten Claire McLeod Barbara Braithwaite Jack O. Clark Joanne Bell Richard E. Clark 《Journal of clinical apheresis》2016,31(5):434-442
Plerixafor is an effective haematopoietic stem cell mobilising agent in candidates for autologous transplantation, including patients with myeloma and lymphoma. Here we compare 98 plerixafor recipients in the PHANTASTIC trial with 151 historic controls mobilised by conventional chemotherapy (each with granulocyte colony‐stimulating factor, G‐CSF). Seventy (71.4%) plerixafor‐mobilised patients achieved the composite primary endpoint of ≥4 × 106 CD34+ cells kg?1 in ≤2 aphereses and no clinically significant neutropenia, compared to 48 (31.8%) historic controls (P < 0.001), and this significant advantage was maintained in scenario analyses testing components of this composite endpoint. A patient‐level cost analysis was undertaken for 249 patients, which included the cost of remobilising patients where initial mobilisation had failed. Combined mean treatment cost for plerixafor mobilised patients was £12,679 compared with £11,694 for historical controls. However, plerixafor produces an average saving of £3,828 per lymphoma patient but average cost increase by £5,245 per myeloma patient. The present data demonstrate cost‐effectiveness for plerixafor as a first line mobilisation agent, certainly for lymphoma patients, where substantial resource savings and achievement of the primary endpoint are likely. J. Clin. Apheresis 31:434–442, 2016. © 2015 Wiley Periodicals, Inc. 相似文献
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997.
David M. Janicke Monica J. Mitchell Alexandra L. Quittner Carrie Piazza-Waggoner Lori J. Stark 《Children's Health Care》2013,42(1):49-66
The current study evaluated the impact of a behavioral intervention (Be In Charge!), targeting caloric intake and weight gain in children with CF, on family interactions at mealtime. Forty-five families of children with cystic fibrosis (CF), ages 4 to 12 years, were randomized to Be In Charge! or nutrition education and assessed using the McMaster Mealtime Family Interaction Coding System. No differences were found in family functioning between the two interventions pre- to posttreatment or 1-year follow-up, except for Affect Management. A significantly greater percentage of families receiving Be In Charge! demonstrated improvement in Affect Management from pretreatment to 1-year follow-up. Implications for developing the next generation of behavioral interventions are discussed. 相似文献
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999.
Simone Ohlwein Frauke Hennig Sarah Lucht Brge Schmidt Lewin Eisele Marina Arendt Ulrich Dührsen Jan Dürig Karl-Heinz Jckel Susanne Moebus Barbara Hoffmann 《Environmental health perspectives》2021,129(2)
Background: Residential exposure to air pollution (AP) has been shown to activate the immune system (IS). Although innate immune responses to AP have been studied extensively, investigations on the adaptive IS are scarce.Objectives: The aim of this study was to investigate the association between short- to long-term AP exposure and polyclonal free light chains (FLC) produced by plasma cells.Methods: We used repeated data from three examinations (: 2000–2003; : 2006–2008; and : 2011–2015) of the population-based German Heinz Nixdorf Recall cohort of initially 4,814 participants (45–75 y old). Residential exposure to total and source-specific particulate matter (PM) with an aerodynamic diameter of 10 or ( and respectively), nitrogen dioxide (), and particle number concentrations (accumulation mode; ) was estimated using a chemistry transport model with different time windows (1- to 365-d mean ± standard deviation) before blood draw. We applied linear mixed models with a random participant intercept to estimate associations between total, traffic- and industry-related AP exposures and log-transformed FLC, controlling for examination time, sociodemographic and lifestyle variables, estimated glomerular filtration rate and season.Results: Analyzing 9,933 observations from 4,455 participants, we observed generally positive associations between AP exposures and FLC. We observed strongest associations with middle-term exposures, e.g., 3.0% increase in FLC (95% confidence interval: 1.8%, 4.3%) per interquartile range increase in 91-d mean of (). Across the different pollutants, showed strongest associations with FLC, followed by and . Effect estimates for traffic-related exposures were mostly higher compared with total exposures. Although and estimates remained stable upon adjustment for PM, PM estimates decreased considerably upon adjustment for and .Discussion: Our results suggest that middle-term AP exposures in particular might be positively associated with activation of the adaptive IS. Traffic-related PM, , and showed strongest associations. https://doi.org/10.1289/EHP7164 相似文献
1000.