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Abstract
This paper describes a simple application of decision theory involving a balance between the subjectively estimated risks of death from a disease and its treatment in various circumstances. A treatment allocation rule is obtained and its application to a prospective series of 62 patients is reported.
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2
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Koster RW, Baubin MA, Bossaert LL, Caballero A, Cassan P, Castrén M, Granja C, Handley AJ, Monsieurs KG, Perkins GD, Raffay V, Sandroni C. Basismaßnahmen zur Wiederbelebung Erwachsener und Verwendung automatisierter externer Defibrillatoren. Notf Rett Med 2010; 13:523-542. [PMID: 32214895 PMCID: PMC7087822 DOI: 10.1007/s10049-010-1368-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- R W Koster
- 1_1368Department of Cardiology, Academic Medical Center, Amsterdam, Niederlande
| | - M A Baubin
- 2_1368Department of Anaesthesiology and Critical Care Medicine, University Hospital Innsbruck, Innsbruck, Österreich
| | - L L Bossaert
- 3_1368Department of Critical Care, University of Antwerp, Antwerpen, Belgien
| | - A Caballero
- 4_1368Hospital Universitario Virgen del Rocío, Sevilla, Spanien
| | - P Cassan
- European Reference Centre for First Aid Education, French Red Cross, Paris, Frankreich
| | - M Castrén
- 6_1368Department of Clinical Science and Education, Karolinska Institute, Stockholm, Schweden
| | - C Granja
- 7_1368Emergency and Intensive Medicine Department, Hospital Pedro Hispano, Matosinhos, Porto, Portugal
| | - A J Handley
- 8_1368Colchester Hospital University NHS Foundation Trust, Colchester, Großbritannien
| | - K G Monsieurs
- 9_1368Emergency Department, Ghent University Hospital, Gent, Belgien
| | - G D Perkins
- 10_1368University of Warwick, Warwick Medical School, Warwick, Großbritannien
| | - V Raffay
- Municipal Institute for Emergency Medicine Novi Sad, Novi Sad, AP Vojvodina, Serbien
| | - C Sandroni
- 12_1368Catholic University School of Medicine, Policlinico Universitario Agostino Gemelli, Rom, Italien
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3
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Handley AJ, Koster R, Monsieurs K, Perkins GD, Davies S, Bossaert L, Bahr J. Lebensrettende Basismaßnahmen für Erwachsene und Verwendung automatisierter externer Defibrillatoren. Notf Rett Med 2006. [DOI: 10.1007/s10049-006-0792-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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4
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Idris AH, Berg RA, Bierens J, Bossaert L, Branche CM, Gabrielli A, Graves SA, Handley AJ, Hoelle R, Morley PT, Papa L, Pepe PE, Quan L, Szpilman D, Wigginton JG, Modell JH. Recommended guidelines for uniform reporting of data from drowning: the "Utstein style". Resuscitation 2004; 59:45-57. [PMID: 14580734 DOI: 10.1016/j.resuscitation.2003.09.003] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A H Idris
- Emergency Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-8579, USA
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5
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Idris AH, Berg RA, Bierens J, Bossaert L, Branche CM, Gabrielli A, Graves SA, Handley AJ, Hoelle R, Morley PT, Papa L, Pepe PE, Quan L, Szpilman D, Wigginton JG, Modell JH. Recommended guidelines for uniform reporting of data from drowning: the "Utstein style". Circulation 2003; 108:2565-74. [PMID: 14623794 DOI: 10.1161/01.cir.0000099581.70012.68] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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6
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Monsieurs KG, Handley AJ, Bossaert LL. [European Resuscitation Council Guidelines 2000 for automated external defibrillation]. Med Clin (Barc) 2002; 118:421-2. [PMID: 11943106 DOI: 10.1016/s0025-7753(02)72407-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K G Monsieurs
- Ghent University Hospital. Intensive Care Unit 1K121C. De Pintelaan 185. 9000 Ghent. Bélgica
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7
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Affiliation(s)
- A J Handley
- Departamento de Cardiología, Colchester General Hospital, Essex, United Kingdom
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8
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Handley AJ. Teaching resuscitation. Singapore Med J 2001; Suppl 1:36-7. [PMID: 11811599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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9
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Handley AJ. BCLS. Singapore Med J 2001; Suppl 1:26-8. [PMID: 11811595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The combined American Heart Association and ILCOR publication, International Guidelines 2000, presents a wealth of scientific data on the management of victims before, during and after cardiopulmonary resuscitation. By reference to this publication, individual National Resuscitation Councils can develop their own guidelines for basic and advanced and paediatric life support in the knowledge that they will be following uniform, international guidelines.
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Handley AJ. ACLS. Singapore Med J 2001; Suppl 1:29-30. [PMID: 11811596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
It must be emphasised that the published International Guidelines 2000 contain an in-depth presentation of the scientific evidence behind advanced life support. The exact interpretation of this evidence, and the algorithms adopted by a national resuscitation council will depend upon various factors such as local interpretation of the evidence, local practice and availability of drugs. The ERC is publishing its own summaries of the guideline changes and the sequences of action for both BLS and ALS and these papers are recommended for further reading.
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Chamberlain D, Smith A, Colquhoun M, Handley AJ, Kern KB, Woollard M. Randomised controlled trials of staged teaching for basic life support: 2. Comparison of CPR performance and skill retention using either staged instruction or conventional training. Resuscitation 2001; 50:27-37. [PMID: 11719126 DOI: 10.1016/s0300-9572(01)00342-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Teaching CPR in stages is a strategy designed to improve skill acquisition and retention. This method has been compared with conventional teaching in a randomised trial involving 495 volunteers. The first ('bronze') stage was simplified by omitting ventilation and giving compressions in sets of 50 with pauses to open the victim's airway; in the second ('silver') stage ventilation was introduced in a ratio of 50 compressions to five breaths, and in the third ('gold') stage, the volunteers were converted to conventional CPR. 51% of those taught by this method reattended for the second ('silver') stage compared with 25% who were taught conventional CPR and advised to return for a revision session. 38% of the staged group reattended for the third ('gold') compared with 8% for the conventional group. Modest improvement in skill acquisition has earlier been reported for the 'bronze' stage teaching, and this has been followed by better performance in some of the components tested after the subsequent stages. Comparisons after the 'gold' stage were limited by the small numbers who reattended for a third session of conventional training, but no special difficulties were noted in changing the ratio of compressions to ventilation that was necessary to convert the staged training volunteers to conventional CPR. The increased number of compressions that can be achieved by teaching 'bronze' stage CPR with no ventilation was retained, to a lesser degree, when the 'silver' ratio of 50 compressions to five breaths was compared with the conventional 15:2 ratio. Our observations suggest that during the first critical 8 min of a resuscitation attempt, 58% more compressions might be delivered by using the 50:5 ratio - an increase that is likely to result in a significant augmentation of blood flow with important clinical implications. More comparative information will become available when the results of unannounced home testing are analysed.
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Affiliation(s)
- D Chamberlain
- The Pre-hospital Emergency Research Unit, Lansdowne Hospital, Sanatorium Road, Canton, Cardiff CF1 8OL, Wales, UK.
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Chehardy P, Doherty A, Dracup K, Handley AJ, Hawkins H, Juarbe TC, Kloeck WG, Lynch BC, Mancini MB, Mason P, Palmer EL, Stapleton ER, Terndrup TE, Wilson E. Cardiopulmonary resuscitation and emergency cardiovascular care. Education. Ann Emerg Med 2001; 37:S49-59. [PMID: 11290970 DOI: 10.1067/mem.2001.114177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- P Chehardy
- Tulane School of Medicine, New Orleans, LA, USA
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14
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Berg RA, Cobb LA, Doherty A, Ewy GA, Gerardi MJ, Handley AJ, Kinney S, Phillips B, Sanders A, Wyllie J. Chest compressions and basic life support-defibrillation. Ann Emerg Med 2001; 37:S26-35. [PMID: 11290967 DOI: 10.1067/mem.2001.114173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- R A Berg
- Department of Pediatrics, University of Arizona, Tucson, AZ 85724-0001, USA.
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Pepe PE, Gay M, Cobb LA, Handley AJ, Zaritsky A, Hallstrom A, Hickey RW, Jacobs I, Berg RA, Bircher NG, Zideman DA, de Vos R, Callanan V. Action sequence for layperson cardiopulmonary resuscitation. Ann Emerg Med 2001; 37:S17-25. [PMID: 11290966 DOI: 10.1067/mem.2001.114175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although some minor modifications were forged, the general consensus was to maintain most of the current guidelines for phone first/phone fast, no-assisted-ventilation CPR, the A-B-C (vs C-A-B) sequence of CPR, and the recovery position. The decisions to leave these guidelines as they are were based on a lack of evidence to justify the proposed changes, coupled with a reluctance to make revisions that would require major changes in worldwide educational practices without such evidence.Nonetheless, some major changes were made. The time-honored procedure ol pulse check by lay rescuers was eliminated altogether and replaced with an assessment for other signs of circulation. Likewise, it was recommended that even the professional rescuer now check for these other signs of circulation. Although professional rescuers may simultaneously check for a pulse, they should do so only for a short period of time (within 10 seconds). There was also enthusiasm for deleting the ventilation aspect of EMS dispatcher-assisted CPR instructions that are provided to rescuers at the scene who are inexperienced in CPR. lt was made clear, though, that the data are applicable only to adult patients who are receiving CPR and that the data are appropriate most for EMS systems with rapid response times.
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Affiliation(s)
- P E Pepe
- University of Texas Southwestern Medical Center, Parkland Health and Hospitals System, Dallas, TX 75390-8579, USA.
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Monsieurs KG, Handley AJ, Bossaert LL. European Resuscitation Council Guidelines 2000 for Automated External Defibrillation. A statement from the Basic Life Support and Automated External Defibrillation Working Group(1) and approved by the Executive Committee of the European Resuscitation Council. Resuscitation 2001; 48:207-9. [PMID: 11278084 DOI: 10.1016/s0300-9572(00)00378-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The European Resuscitation Council (ERC) last issued guidelines for Automated External Defibrillators (AEDs) in 1998 [1]. The American Heart Association, together with representatives from the International Liaison Committee on Resuscitation (ILCOR), then undertook a series of evidence-based evaluations of the science of resuscitation [2] which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Basic Life Support and Automated External Defibrillation Working Group (BLS&AED Working Group of the ERC) has considered this document and has recommended changes in the ERC AED guidelines. These are presented in this paper.
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Affiliation(s)
- K G Monsieurs
- Ghent University Hospital, Intensive Care Unit 1K12IC, De Pintelaan 185, 9000 Ghent, Belgium.
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Handley AJ, Monsieurs KG, Bossaert LL. European Resuscitation Council Guidelines 2000 for Adult Basic Life Support. A statement from the Basic Life Support and Automated External Defibrillation Working Group(1) and approved by the Executive Committee of the European Resuscitation Council. Resuscitation 2001; 48:199-205. [PMID: 11278083 DOI: 10.1016/s0300-9572(00)00377-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The European Resuscitation Council (ERC) last issued guidelines for Basic Life Support (BLS) in 1998 [1]. These were based on the "Advisory Statements" of the International Liaison Committee on Resuscitation (ILCOR) published in 1997 [2]. Following this, the American Heart Association, together with representatives from ILCOR, undertook a series of evidence-based evaluations of the science of resuscitation [3] which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [4,5]. The Basic Life Support and Automated External Defibrillation Working Group (BLS&AED Group) has considered this document and has recommended changes in the ERC BLS guidelines. These are presented in this paper.
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Affiliation(s)
- A J Handley
- Department of Cardiology, Colchester General Hospital, Turner Road, Colchester, Essex, CO4 5JL, UK.
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Assar D, Chamberlain D, Colquhoun M, Donnelly P, Handley AJ, Leaves S, Kern KB. Randomised controlled trials of staged teaching for basic life support. 1. Skill acquisition at bronze stage. Resuscitation 2000; 45:7-15. [PMID: 10838234 DOI: 10.1016/s0300-9572(00)00152-0] [Citation(s) in RCA: 155] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We have investigated a method of teaching community CPR in three stages instead of in a single session. These have been designated bronze, silver, and gold stages. The first involves only opening of the airway and chest compression with back blows for choking, the second adds ventilation in a ratio of compressions to breaths of 50:5, and the third is a conversion to conventional CPR. In a controlled randomised trial of 495 trainees we compared the performance in tests immediately after instruction of those who had received a conventional course and those who had had the simpler bronze level tuition. The tests were based on video recordings of simulated resuscitation scenarios and the readouts from recording manikins. Differences occurred as a direct consequence of ventilation being required in one group and not the other, some variation probably followed from unforeseen minor changes in the way that instruction was given, whilst others may have followed from the greater simplicity in the new method of training. A careful approach was followed by slightly more trainees in the conventional group whilst appreciably more in the bronze group remembered to shout for help (44% vs. 71%). A clear advantage was also seen for bronze level training in terms of those who opened the airway as taught (35% vs. 56%), for checking breathing (66% vs. 88%), and for mentioning the need to phone for an ambulance (21% vs. 32%). Little difference was observed in correct or acceptable hand position between the conventional group who were given detailed guidance and the bronze group who were instructed only to push on the centre of the chest. The biggest differences related to the number of compressions given. The mean delay to first compression was 63 s and 34 s, and the mean duration of pauses between compressions was 16 s and 9 s, respectively. Average performed rates were similar in the two groups, but more in the conventional group compressed too slowly whereas more in the bronze group compressed too rapidly. Observations were made for only three cycles of compression, but extrapolating these to the 8 min often considered a watershed for chances of survival for victims of cardiac arrest, an average of 308 compressions would be expected from those using conventional CPR compared with 675 for those using bronze level CPR. The implications of this difference are discussed.
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Affiliation(s)
- D Assar
- The Centre for Applied Public Health Medicine, Lansdowne Hospital, Cardiff, UK
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Handley AJ, Becker LB, Allen M, Van Drenth A, Kramer EB, Montgomery WH. [Basic life support in adults by a single rescuer. International Liaison Committee on Resuscitation]. Arq Bras Cardiol 1998; 71 Suppl 1:9-14. [PMID: 10347904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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20
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Abstract
Basic life support is a crucial part of the Chain of Survival. Unfortunately, however the skill is complex and cannot readily be acquired--let alone retained--in the course of a single training session. Although the problem has long been recognised, no new strategies have been widely implemented to counter the problem. We believe that staged teaching of CPR might provide a solution, and we have devised a program to test this new method. It involves three stages of instruction that we have called bronze, silver, and gold standards. The bronze standard involves opening the airway and providing chest compression without active ventilation: this alone may widen the window of opportunity for successful defibrillation in adult victims in out-of-hospital cardiac arrest. Ventilation is introduced at silver stage using a ratio of 50:5, with emphasis on its value in the resuscitation of children being used as motivation to bring people back for a second period of instruction. The gold stage teaches conventional CPR. A pilot study has been encouraging and a randomized trial on skill acquisition and skill retention is planned.
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Affiliation(s)
- D Assar
- The Centre for Applied Public Health Medicine, Lansdowne Hospital, Cardiff, UK
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Handley AJ. Advanced cardiac life support. Hosp Med 1998; 59:663. [PMID: 9829069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Handley AJ, Bahr J, Baskett P, Bossaert L, Chamberlain D, Dick W, Ekström L, Juchems R, Kettler D, Marsden A, Moeschler O, Monsieurs K, Parr M, Petit P, van Drenth A. Einfache lebensrettende Sofortmaßnahmen beim Erwachsenen. Notf Rett Med 1998. [DOI: 10.1007/s100490050035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Macrophage tropic HIV-1 is predominant during the initial viremia after person to person transmission of HIV-1 (Zhu, T., H. Mo, N. Wang, D.S. Nam, Y. Cao, R.A. Koup, and D.D. Ho. 1993. Science. 261:1179-1181.), and this selection may occur during virus entry and carriage to the lymphoid tissue. Human skin explants were used to model HIV-1 selection that may occur at the skin or mucosal surface. Macrophage tropic, but not T cell line tropic strains of HIV-1 applied to the abraded epidermis were recovered from the cells emigrating from the skin explants. Dermis and epidermis were separated by dispase digestion after virus exposure to determine the site of viral selection within the skin. Uptake and transmission to T cells of all HIV-1 isolates was found with the dermal emigrant cells, but only macrophage tropic virus was transferred by emigrants from the epidermis exposed to HIV-1, indicating selection only within the epidermis. CD3+, CD4+ T cells were found in both the dermal and epidermal emigrant cells. After cell sorting to exclude contaminating T cells, macrophage tropic HIV-1 was found in both the dermal emigrant dendritic cells and in dendritic cells sorted from the epidermal emigrants. These observations suggest that selective infection of the immature epidermal dendritic cells represents the cellular mechanism that limits the initial viremia to HIV-1 that can use the CCR5 coreceptor.
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Affiliation(s)
- J C Reece
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia 3052
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Handley AJ, Bahr J, Baskett P, Bossaert L, Chamberlain D, Dick W, Ekström L, Juchems R, Kettler D, Marsden A, Moeschler O, Monsieurs K, Parr M, Petit P, Van Drenth A. The 1998 European Resuscitation Council guidelines for adult single rescuer basic life support: A statement from the Working Group on Basic Life Support, and approved by the executive committee. Resuscitation 1998; 37:67-80. [PMID: 9671079 DOI: 10.1016/s0300-9572(98)00036-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A J Handley
- European Resuscitation Council Secretariat, Antwerpen, Belgium
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Abstract
This study is an attempt to see if simplifying the teaching of basic life support leads to better skill acquisition and retention. Forty-eight lay volunteers received instruction in CPR; 24 were taught the standard 8-step sequence whereas 24 were taught a simplified 4-step sequence. Tests of performance were carried out on a manikin before and after training. Those in the 4-step group were significantly better than those in the 8-step group at remembering the sequence of skills immediately after training (P = 0.04), 1 week later (P < 0.001) and at 6 weeks (P < 0.001). Twenty-three out of the 24 volunteers in the 4-step group got the sequence completely correct each time they were tested, in contrast to only 2 out of the 24 in the 8-step group. There was no difference, however, in the quality of performance of the skills between the two groups. In addition, it was shown that use of the 4-step sequence should result in a useful reduction in the time taken before a rescuer calls for the emergency services and commences CPR. Whether such a radical change in teaching should be introduced is a matter for further discussion and research.
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Handley AJ. Resuscitation. Resuscitation Council (UK) wants everyone who uses new recovery position to report experiences. BMJ 1997; 315:1308. [PMID: 9390073 PMCID: PMC2127791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Donnelly PD, Chamberlain D, Handley AJ, Assar D, Lester CA, Handley AJ. Resuscitation. West J Med 1997. [DOI: 10.1136/bmj.315.7118.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Donnelly PD, Chamberlain D, Handley AJ, Assar D, Lester CA. Resuscitation. New advisory statements on life support have been published. BMJ 1997; 315:1308. [PMID: 9390072 PMCID: PMC2127796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Affiliation(s)
- A J Handley
- Department of Medicine, Colchester General Hospital, Essex
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Handley AJ, Becker LB, Allen M, van Drenth A, Kramer EB, Montgomery WH. Single-rescuer adult basic life support: an advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation. Circulation 1997; 95:2174-9. [PMID: 9133531 DOI: 10.1161/01.cir.95.8.2174] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Handley AJ, Becker LB, Allen M, van Drenth A, Kramer EB, Montgomery WH. Single rescuer adult basic life support. An advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation (ILCOR). Resuscitation 1997; 34:101-8. [PMID: 9141154 DOI: 10.1016/s0300-9572(97)01099-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
One of the arguments put forward in support of a relatively fast rate of chest compression during CPR, is that it facilitates the achievement of a high compression:relaxation ratio. This has been shown to increase blood flow. In this study a group of volunteers carried out chest compression at the rate that each felt was correct and comfortable. There was no significant relationship between compression rate and compression:relaxation ratio. In a second study volunteers carried out chest compression on a manikin at rates of 40/min; 60/min; 80/min and 100/min. There was no significant rate related difference in the compression:relaxation ratios recorded. The ability to achieve a high compression duration is not related to compression rate, and should not be a consideration when guidelines on CPR are revised.
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Affiliation(s)
- A J Handley
- Department of Medicine, Colchester General Hospital, UK
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35
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Abstract
As part of a study of the factors affecting the risk of deep vein thrombosis after myocardial infarction a surprising and unexplained finding was that non-smokers had a significantly higher incidence of thrombosis than cigarette smokers.
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36
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Emerson PA, Teather D, Handley AJ. The application of decision theory to the prevention of deep vein thrombosis following myocardial infarction. Q J Med 1974; 43:389-98. [PMID: 4417792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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Teather D, Emerson PA, Handley AJ. Decision theory applied to the treatment of deep vein thrombosis. Methods Inf Med 1974; 13:92-7. [PMID: 4465645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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38
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Abstract
A bedside test of heparin activity (whole blood activated partial thromboplastin time) was assessed during clinical control of anticoagulation. It correlated closely (r = 0.94) with the whole blood clotting time but had a number of advantages.
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40
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Abstract
A case of sarcoidosis with involvement of the rectum is described. This is believed to be the first unequivocal case of large bowel sarcoidosis.
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41
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42
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Abstract
A trial of continuous intravenous heparin in the prevention of deep vein thrombosis was undertaken in 48 patients who had suffered a myocardial infarction. Of the 24 control patients who did not receive heparin seven (29%) developed calf vein thrombosis as detected by the radioactive fibrinogen technique. None of the 24 heparinized patients had any evidence of venous thrombosis. This difference is significant at the 1% level.
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43
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44
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Handley AJ. Portable heparin injector. Lancet 1970; 2:313-4. [PMID: 4194393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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45
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Abstract
Oral and intravenous phenytoin tolerance tests showed distinctive biphasic curves with a fall in plasma phenytoin to very low levels after an initial peak and a rise to a secondary peak one to four hours later. It is suggested that this pattern should be borne in mind when intravenous phenytoin is being used, as in the control of status epilepticus or cardiac arrhythmias.
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Abstract
Serum phenytoin concentrations in outpatients and inpatients with epilepsy have been contrasted. Individual patients were receiving prescriptions ranging from 100 to 300 mg. of sodium phenytoin daily, but the two groups were comparable in respect of dosage, age, and sex distribution. Whereas the mean phenytoin concentration among 14 inpatients was 28 mug./ml. that among 15 outpatients was only 15.7 mug./ml. When the supervision of a further 12 outpatients was changed to include more frequent visits and regular provision of blood samples their mean serum concentration of phenytoin rose from 17.5 to 27.7 mug./ml.The results indicate that failure to follow dosage instructions is a factor of major importance among epileptic patients whose response to treatment is inadequate or erratic.
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48
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Handley AJ. Anticoagulant therapy. Nurs Mirror Midwives J 1969; 129:20-2. [PMID: 5194295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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49
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Handley AJ. Dose of heparin. Br Med J 1969; 1:644. [PMID: 5766145 PMCID: PMC1982406 DOI: 10.1136/bmj.1.5644.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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50
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Handley AJ. Metoclopramide in the prevention of post-operative nausea and vomiting. Br J Clin Pract 1967; 21:460-2. [PMID: 4864491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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