Obviously, there are many aspects in clinical practice that lurk in the areas of no specific evidence yet considered to be perfectly acceptable because they are based on sound and generally accepted biological/physiological/anatomical/pathological concepts combined with longstanding and widespread experience.
Widespread experience with laparoscopic pancreatectomies has allowed safe splenectomies in the supine position, by a safe and even less invasive surgical method using TVSE without the changing of body positions as required in conventional laparoscopic splenectomy [5 10].
I do think that on the basis of what appears to be widespread experience anyone with chronic heartburn or any of the other ailments mentioned above would be missing an opportunity if he or she didn't give a nondairy diet a shot.
Multiple core biopsies of the breast is an option, but one with which there is neither widespread experience nor ready acceptance by either institutional review boards or patients, particularly if multiple samples over time are required.
With regard to the use of Lu-DOTATATE in children, there is no widespread experience, and activities should be adapted per square metre [ 68].
As a final clinical example, a 62 year-old male who progressed after receiving anti-CTLA4 and experienced debilitating right upper quadrant pain, nausea/vomiting and fatigue associated with widespread hepatic metastases experienced a substantial partial response that was durable for at least 15 months.
Although a majority of patients described their pain as worse when they were fatigued, a description often voiced by people with chronic pain, the higher percentage of those with widespread pain who experienced worse pain with after exercise, rest or exposure to cold is similar to those with the specific syndrome of FMS.
The military's experience with widespread trauma among troops in Iraq and Afghanistan, and numerous cases of suicides and dementia among recently retired football heroes, underscored that "getting your bell run" several times was likely to have long-term repercussions.
Earlier expectations that the ability to prime for immunologic memory could be a key determinant in direct protection to disease [ 14, 15] have been revisited in light of the extensive experience with widespread use of meningococcal C conjugate vaccines and that of conjugate vaccines against other encapsulated bacteria such as Hib [ 15– 17].
The aim of the wider study on which this article is based was to explore how people with chronic widespread pain experience, understand and make meaning of their 'condition', and attempt to influence or exert control over their pain [ 7, 8].
