Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Limitation of life support: Frequency and practice in a London and a Cape Town intensive care unit (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1020-1025 
    Details
    ISSN: 1432-1238
    Keywords: Critical care ; Ethics ; Resuscitation orders ; Advance directives ; Life support withdrawal ; Prognosis ; Severity of illness index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives To examine the frequency of limiting (withdrawing and withholding) therapy in the intensive care unit (ICU), the grounds for limiting therapy, the people involved in the decisions, the way the decisions are implemented and the patient outcome. Design Prospective survey. Ethical approval was obtained. Setting ICUs in tertiary centres in London and Cape Town. Patients All patients who died or had life support limited. Interventions Data collection only. Results There were 65 deaths out of 945 ICU discharges in London and 45 deaths out of 354 ICU discharges in Cape Town. Therapy was limited in 81.5% and 86.7% respectively (p=0.6) of patients who died. The mean ages of patients whose therapy was limited were 60.2 years and 51.9 years (p=0.014) and mean APACHE II scores 18.5 and 22.6 (p=0.19) respectively. The most common reason for limiting therapy in both centres was multiple organ failure. Both medical and nursing staff were involved in most decisions, which were only implemented once wide consensus had been reached and the families had accepted the situation. Inotropes, ventilation, blood products, and antibiotics were most commonly withdrawn. The mean time from admission to the decision to limit therapy was 11.2 days in London and 9.6 days in Cape Twon. The times to outcome (death in all patients) were 13.2 h and 8.1 h respectively. Conclusions Withdrawal of therapy occurred commonly, most often because of multiple organ failure. Wide consensus was reached before a decision was made, and the time to death was generally short.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01699222
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Limitation of life support: frequency and practice in a London and a Cape Town intensive care unit (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1020-1025 
    Details
    ISSN: 1432-1238
    Keywords: Key words Critical care ; Ethics ; Resuscitation orders ; Advance directives ; Life support withdrawal ; Prognosis ; Severity of illness index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To examine the frequency of limiting (withdrawing and withholding) therapy in the intensive care unit (ICU), the grounds for limiting therapy, the people involved in the decisions, the way the decisions are implemented and the patient outcome. Design: Prospective survey. Ethical approval was obtained. Setting: ICUs in tertiary centres in London and Cape Town. Patients: All patients who died or had life support limited. Interventions: Data collection only. Results: There were 65 deaths out of 945 ICU discharges in London and 45 deaths out of 354 ICU discharges in Cape Town. Therapy was limited in 81.5% and 86.7% respectively (p=0.6) of patients who died. The mean ages of patients whose therapy was limited were 60.2 years and 51.9 years (p=0.014) and mean APACHE II scores 18.5 and 22.6 (p=0.19) respectively. The most common reason for limiting therapy in both centres was multiple organ failure. Both medical and nursing staff were involved in most decisions, which were only implemented once wide consensus had been reached and the families had accepted the situation. Inotropes, ventilation, blood products, and antibiotics were most commonly withdrawn. The mean time from admission to the decision to limit therapy was 11.2 days in London and 9.6 days in Cape Town. The times to outcome (death in all patients) were 13.2 h and 8.1 h respectively. Conclusions: Withdrawal of therapy occurred commonly, most often because of multiple organ failure. Wide consensus was reached before a decision was made, and the time to death was generally short.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01699222
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Striated anchoring fibrils-anchoring plaque complexes and their relation to hemidesmosomes of myoepithelial and secretory cells in mammary glands of lactating rats (1993)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 237 (1993), S. 318-325 
    Details
    ISSN: 0003-276X
    Keywords: Basement membrane ; Striated anchoring fibrils ; Anchoring filaments ; Anchoring plaques ; Hemidesmosomes ; Myoepithelial cells ; Acinar cells ; Mammary glands ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Striated anchoring fibrils (SAF) are associated with the basement membrane underlying myoepithelial and acinar cells of mammary glands. Their proximal extremities are inserted in electron-dense areas of the lamina densa, the anchoring plaques seen facing the hemidesmosomes of both myoepithelial and acinar cells. In the case of myoepithelial cells, the hemidesmosomes show a thick cytoplasmic plaque applied to the basal plasma membrane in which cytoplasmic filaments are inserted. Facing this plaque but on the extracellular aspect and at a short distance of 5-10 nm, there is a thin layer of electron-dense nodular material called the subcell membrane plate, which is connected to the plasma membrane by short filamentous bridges. Between this subcell membrane plate and the anchoring plaque, there is an abundance of fine anchoring filaments crossing the lamina lucida. Such anchoring filaments are less abundant in the lamina lucida outside the hemidesmosomal areas. In the case of acinar cells, the cytoplasmic plaques of the hemidesmosomes are thin and the associated cytoplasmic filaments less conspicuous. No distinct subcell membrane plate is seen on the extracellular aspect of the plasma membrane facing the cytoplasmic plaque of the hemidesmosomes. However, in this area numerous anchoring filaments cross the lamina lucida between the plasma membrane and the SAF-anchoring plaque complex. The abundance, in these cells, of hemidesomomes and their association with SAF-anchoring plaque complexes seen in the basement membrane must constitute a strong attachment for both myoepithelial and acinar cells and bind them to the underlying collagen fibrils, thus preventing their detachment from the connective tissue during the contractions of myoepithelial cells during milk ejection. © 1993 Wiley-Liss, Inc.
    Additional Material: 9 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092370304
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Structure of the Golgi apparatus in stimulated and nonstimulated acinar cells of mammary glands of the rat (1993)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 237 (1993), S. 308-317 
    Details
    ISSN: 0003-276X
    Keywords: Golgi apparatus ; Mammary gland ; Acinar cells ; Lactation ; Post-lactation ; Lactose ; Casein ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The structural features of the Golgi apparatus of acinar cells of mammary glands were examined with the electron microscope in 3 groups of rats: (1) in lactating female animals at 8 days postpartum, which served as controls; (2) in female rats sacrificed at various intervals from 2 to 30 hours following separation from their 8-day old pups; and (3) in females separated from their 8-day-old pups for a period of 12 hours and returned to their litters for durations of 1, 2, 4, and 8 horus. In animals of group 2, the Golgi stacks remained identical to that of controls between 2 and 8 hours. At 12 hours and later, the Golgi stacks decreased progressively in size, but the number of elements composing the stacks remained similar to that of lactating females and all contained casein submicelles. At 24 and 30 hours, typical secretory granules containing casein micelles disappeared from the trans aspect of the stacks. The earliest and most striking changes observed in the Golgi apparatus of the rats of group 2 took place at 12 hours. At this time, the prosecretory and secretory granules decreased considerably in volume and lost most of their electron-lucent content. This indicated that the delivery of small molecules, i.e., lactose and H2O, to these structures was soon altered following arrest of the sucking stimulus. In animals of group 3, the size of prosecretory and secretory granules and the amount of their electron-lucent content reverted to normal at 4 hours. Thus the influx of lactose and H2O into these structures appears to be rapidly restored after returning the pups to their mothers. The decrease in size of the Golgi stacks noted at 12, 18, and 24 hours following arrest of lactation (group 2), was accompanied by an increase in number of small vesicles that formed clusters next to the Golgi stacks and in “wells.” Thus in these regressing Golgi stacks, many of the associated small vesicles appear to arise by vesiculation of the saccules. © 1993 Wiley-Liss, Inc.
    Additional Material: 11 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092370303
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...