3 research outputs found
Regional variations in inpatient decompensated cirrhosis mortality may be associated with access to specialist care: results from a multicentre retrospective study
No full text\ua9 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.Introduction: Specialist centres have been developed to deliver high-quality Hepatology care. However, there is geographical inequity in accessing these centres in the United Kingdom (UK). We aimed to assess the impact of these centres on decompensated cirrhosis patient outcomes and understand which patients transfer to specialist centres. Methods: A UK multicentred retrospective observational study was performed including emergency admissions for patients with decompensated cirrhosis in November 2019. Admissions were grouped by specialist/non-specialist centre designation, National Health Service region and whether a transfer to a more specialist centre occurred or not. Univariable and multivariable comparisons were made. Results: 1224 admissions (1168 patients) from 104 acute hospitals were included in this analysis. Patients at specialist centres were more likely to be managed by a Consultant Gastroenterologist/Hepatologist on a Gastroenterology/Hepatology ward. Only 24 patients were transferred to a more specialist centre. These patients were more likely to be admitted for gastrointestinal bleeding and were not using alcohol. Specialist centres eliminated regional variations in mortality which were present at non-specialist centres. Low specialist Consultant staffing numbers impacted mortality at non-specialist centres (aOR 2.15 (95% CI 1.18 to 4.07)) but not at specialist centres. Hospitals within areas of high prevalence of deprivation were more likely to have lower specialist Consultant staffing numbers. Conclusions: Specialist Hepatology centres improve patient care and standardise outcomes for patients with decompensated cirrhosis. There is a need to support service development and care delivery at non-specialist centres. Formal referral pathways are required to ensure all patients receive access to specialist interventions
Renatus Des Cartes de homine
No full textDutch physician and botanist Florentino Schuyl, the son of a pastor, lost his mother and two brothers to the plague in 1636. He began formal studies at the University of Utrecht, from which he received a degree in philosophy in 1639. He received his doctorate in medicine from the University of Leiden. His dissertation was on the spleen. He is best known for his translation into Latin of Rene Descartes\u27 work on physiology, Treatise of Man. Unfortunately, the copy he translated was not particularly accurate or complete. Schuyl, however, wrote an excellent introduction to Descartes\u27 ideas. Schuyl died in 1669 from plague. De Homine is the first in a series of works by French mathematician, philosopher, and physiologist Rene Descartes that set the agenda for later students of the distinction between mind and body. Descartes held back on the publication of this work after hearing of the condemnation of Galileo by the Inquisition. As a result, this work was published well after the author\u27s death.( . . h x W.. :»..rl» :( n. & ,... .\u27- u . , ,«kt \u27 x ün«-71! ( r . / / / »./, .,(..;. J/Z F! v. n(- 30» «f. L . / , ..tribu. £S. (, af/J f/ .f ( ( jf./.? r (wir/(;? fide. /.f\u27 " , n n , ,, . illli!!! r . Al.,,fïïrx ( u.- . 4 . ? A.-..[Qlöli J. RENATUS DES CARTES DE H 0 M I N E P I G V R I S ET LATINITATE DONATUS A FLORENTIO SCHUyL, Inclyta: Urbis Sylvæ Ducis Senatore,& ibidem Philofophiæ Profefïore. ." " \u27ï LVGDVNIBATAVORVM, Apud PETRVM LEFFEN &FRANCIS CVM MoyARDvM. claiocxxn. 7 doäZrinæ/älidiorzk AntzWizes. Quom" " , uidem ml midebatnrinj\u27zijz\u27iiie,aaam jt\u27erilem merita:») larvam, de\u27/j\u27ïcilibn; nugzä\u27 56 umbramaram contentionum atque rixartim aigina: fueram Sapientiam mentientem, invajgg picroþzno\u27fam meri; tatiäþa\u27em. 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Non ea\u27 tantum, quae in partium dlfþüffïlbïle (anf/iens, megetatianii\u27 cau/a iji-fid 65 alia:, quam ^oi- ræ cau/aignorantiiï , rue/ut mentem , ivo/iibjiaritiim a plantarum materia iw corpore plane diner/km, iijajyïnxit ex arbitrio. ,Qui uiridem error liauiz\u27 illi;)??Cltll\u27C?" wfi/litur. Omnium enim Plantarumfizeu/tatum exer- citia,nulliï ijïiufmoili animai confderatiï , fac:/e concipiuntur. Etenim non efi , quod quempiam lateat, qui? ratione pro tempeftatu, dierum , uoäïiumque wieijitu- r]iiainvii alii/iiriififzcrïione, quam Paulo Pof refici/uua, dingþiccuæ/rve alimentum in Planta; ante eti/ore rare- jacultatii æ/Zi\u27matiw: a cogitati-vaþ\u27ve ratione, Belua- faEZau,þrb/ä7uentefrigore , non aliter quiimþinguii ir; cucurbitula»: , quodam! vitrei? arou/Eu/ii aa\u27 oculum iie- rumanimar ab liiimiinijr Fjungere nitatur. SQ; defiat: hoc II)/(; tempore plurimi Emmæ-Farum nafæ irre- riti. iam etiam uniwr æ Regi-aner eo ufäue liii tene- mon/Jrari pote/Z,perporos radicum adigatur,fur/um Pellaturatilue atta/latur,, quaquaveifum (lll-þzïizIZI/JZZNH\u27X/ifï- Zir/i IIITW/Hfrf , ut [vitam pii/itu aut Pedicu/i precium mentetur, 5 redeunte calore cfärwfat, ?j e/a/zoreiim. Ey/ augent;\u27Filoeifiïi\u27tioiä redimere jatagant. largiora- Vna\u27ePlanta difendatur, (7 tandem oculi,fo/ia, rami, ]Q\u27ores,þmina,fruo7uf diu/iiant, eondenþntur, ïþ) vei/iit avia/ligentur. (.Diver/a [il/tidEWZ/H\u27O iuver,/tate funi, jiqïïï /J.(f\u27l\u27/6ï , omnes [warf/: pietati? nervi): incidens, f.!iiïä i-gxiii\u27fiiis i\u27ij/Zï/feiida, quanti) Prae/ivior in illam irfp-(1:11, liii/iriiilef»;\u27tilii/f enim facile contingit, quod te- ö\u27pororum, Per quo! i//i tmn/itu; (y?. Qu: quii,/fin 1120- ii. 747 iCirTfl , yim tre;/iubi"puppi" fvitam tribuit , quia» fï\u27f\u27TJ/ll il\u27lirirm moti./i (au/am ignorans , earumque roriim (l/l\u27VLJVViTZZ/ZJ-uärlgli/Ik Pt\u27ilffifdïlt172/[786/85/11fimi/2717, oritur e.v diveiftate Poi-orum matri) (If/\u27fac7716 femntir, mem- angue AD LECTOREM. AD L ECTORuM. atgaf plantæ.- Eäfmc; warm;; ;\u27l/os perfmwzm, q;;cm. - » x fäi\u27llf\u27il (f;.ïr;^.1510 , /; ,.liil/.; [Wer/;?! ;\u27.ztla gra/inmæ (uh;/Lc l;. igitur. Efraim plantarufn äwm Offlfïlilä m!)?! ainu! ci,-753, 75:35; ref.;izgffzzlazw, lamia-.f. mr./zam, mela;: c;;lþþtiz\u27, (unci-(mfi, auia/yi? con/Mt. V;;de/Eqmmr eodem Plaga: modo, (lmo ;";ziizz, öj?mi.w produc; , mm , argue creI 1 \u27 . animatum eæ aifrmaz. Qapropter, quia in Catalogo - ad,-nodum lla; A;!HHZC Fabrzmtor Przmsziz comädnf. 7 . F.. .. ... :\u27 "... \u27? . Ex* a: (y?/iuor.pari.-aqua;];yarfufc;/20;.ft.zf my.; .J-w; P!" A .n\u27. \u27 N*" *: . «: 7 ". 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In vitro digestibility in diets for ruminants with the inclusion of Guazuma ulmifolia extracts as an additive
No full textLos aditivos antibióticos para controlar la fermentación ruminal están asociados con la aparición de resistencia antimicrobiana en humanos. Los extractos naturales de plantas tropicales poseen metabolitos secundarios (flavonoides, los fenoles y los taninos) con efecto promisorio de uso en reemplazo a los antibióticos. Se busca determinar el efecto de diferentes niveles de inclusión de extracto de Guazuma ulmifolia sobre la digestibilidad in vitro en dietas para rumiantes. El sustrato ruminal se obtuvo de bovino canulado; fueron evaluadas 2 dietas, (Dieta 1. 100 % Fibra; Dieta 2. 70:30 Forraje: Concentrado) y 4 niveles de inclusión de extracto: cero, 2,5, 5 y 10 gr / Kg MS, respectivamente. Los datos fueron analizados con un modelo lineal generalizado (MINITAB 17™ (2014), efecto lineal y cuadrático de los niveles de inclusión. En la dieta 100% Forraje no se encontró efecto sobre la digestibilidad de la inclusión de extracto de G. ulmifolia (P>0,05). En la dieta 70:30 Forraje: Concentrado, en cada nivel de inclusión 0, 2,50, 5 y 10 gr / Kg MS se obtuvieron valores de 76,86 %, 78,59 %, 77,59 %, y 79,23, respectivamente. Se observó un efecto linear altamente significativo (P 0.05). In the 70:30 forage: Concentrate diet, digestibility values of 76.86%, 78.59%, 77.59% and 79.23% were obtained at each inclusion level (0, 2.5, 5 and 10 g/kg DM), respectively. A highly significant linear effect (P < 0.003) on digestibility was observed with increasing levels of extract inclusion (R² adjusted = 0.9871). Guazuma ulmifolia extracts were shown to effectively modulate rumen fermentation in vitro, significantly improving dry matter digestibility in mixed diets. Therefore, G. ulmifolia can be considered a promising and sustainable alternative to antibiotics in animal nutrition.Introducción -- Fermentación Ruminal -- Aditivos Antibióticos: Resistencia Antimicrobiana -- Guazuma ulmifolia: Propiedades y Usos --Planteamiento del Problema -- Justificación -- Objetivo General -- Objetivos Específicos -- Materiales y Métodos -- Diseño Experimental -- Obtención de la Microbiota Ruminal -- Técnica de Digestibilidad In Vitro -- Análisis Estadístico -- Resultados -- Discusion -- Conclusiones.Pregrad
