Information campaign on organ donation and transplant in school children

OBJECTIVES: To increase schoolchildren's understanding and clarify their wrong ideas on organ donation and transplant (ODT). DESIGN: Quasi-experimental study. SETTING: 12 schools in the Autonomous Community of Murcia. PARTICIPANTS: 428 schoolchildren from the fourth and fifth years of Basic General Education during the academic year 1996 to 1997. INTERVENTIONS: An informative campaign carried out by health-service staff, which consists of four activities connected with ODT. Their knowledge was evaluated through a questionnaire on ODT from the ALCER (Murcia) Organisation for children in the first EGB cycle. MEASUREMENTS AND MAIN RESULTS: Average score was 5.15 points pre-campaign, 8.01 soon after and 7.39 long after, the differences between the pre-campaign and the two after, and between both the afters, were statistically significant. CONCLUSIONS: Knowledge of ODT was increased and wrong ideas were clarified. After three months there is a significant drop from the immediate post-campaign situation, which shows that subsequent activities to maintain children's level of knowledge must be carried out.     

The relative impact of presumed-consent legislation on thoracic organ donation in the Eurotransplant area

A country's organ donation rate and hence the availability of thoracic organs can be increased by organizational measures, by legislative incentives, and by increasing awareness among the public and healthcare professionals. We analyzed the relative impact of organ procurement legislation or policy on heart and lung donation rates per million population per year in the four countries participating in the Eurotransplant organization (population, 112.7 million) between January 1992 and December 1994. Within this organization, Austria and Belgium have presumed-consent legislation, whereas Germany and the Netherlands have an opting-in (explicit-consent) policy. Although practices vary even among countries with similar policies (eg. in Belgium, relatives of the donor retain the right to object to procurement of organs in the absence of an explicit consent from the deceased before death), rates of heart and lung donation were at least twice as high in the two countries with presumed-consent legislation as in the two countries that rely on a policy of explicit consent from the donor's next of kin.     

First report of invasive amebiasis in an organ transplant recipient

T-cell mediated immunity is an important defense mechanism against amebiasis. However, organ transplant recipients with severe T-cell immunosuppression are not at increased risk of having Entamoeba histolytica invasive disease. The reasons are unclear and probably multifactorial, but it is likely that the absence of intestinal colonization with pathogenic strains in countries where transplants occur and the judicious intake of possible contaminated food and water are important contributing factors. We describe the first report of a liver transplant recipient with severe E. histolytica colitis who was successfully treated with metronidazole without modifying his immunosuppression therapy.     

Estimating the impact of health services in a community

The advantages of clinical and mechanical combination of observations for prediction are mutually reinforced by an application of Bayesian statistics. The technique is shown to be particularly advantageous in a situation which is characterized by a paucity of observations available to suppliment a prior expert judgment. The approach also presents a basis for evaluating relative expertise and tracing the learning experience of experts. Taking the community as the organizational level of analysis, data on the classification of aged persons in Durham County, North Carolina, and data on the changes in classification of these individuals within the population over time are gathered and studied. These data are combined with clinical judgments of changes as a demonstration of the merits of the technique developed in this paper.     

Attitudes and beliefs of Afro-Americans related to organ and tissue donation

The authors found pulp stones in more teeth of a 12-years-old girl. The present work discusses the concerning literature and it establishes that these stones are traced back to different aetiological factors. Their role in the toothaces without caries and presence impeding at root treatment is also emphasized.     

Antimicrobial strategies in the care of organ transplant recipients

OBJECTIVE: To evaluate amniotic fluid lamellar body counting as a fetal lung maturity test. Lamellar body particles can be rapidly counted using the platelet channel of most blood cell analyzers. METHODS: We conducted a 3-year prospective clinical outcome study. During the interval under study, outcomes of 247 neonates were used to evaluate the test; 28 neonates developed respiratory distress syndrome (RDS). Lecithin-sphingomyelin ratio (L/S) was available for 187 cases. RESULTS: All cases of RDS had lamellar body counts of 55,000/microL or less and L/S of 2.2 or less; 59% of cases with no RDS had counts greater than 55,000/microL and 70% of normal cases had L/S higher than 2.2. CONCLUSION: Use of lamellar body counts is justified as a rapid screening test to predict fetal lung maturity. Immature results should be followed by a more specific test such as L/S.     

Two initiatives designed to maximize the potential for organ donation from intensive care units

Urgent perforating keratoplasty was carried out in 52 patients with infective involvement of the cornea at the site of sutures after cataract extraction, perforating keratoplasty, and treatment of penetrating wounds of the cornea. The inflammation was most often caused by Pseudomonas aeruginosa (32%), cocci (33.6%), and fungi (14.1%). The technique of perforating keratoplasty for cases with different localization and extent of purulent infiltration is described and results of pathohistological examination of removed disks presented. The authors emphasize the importance of timely removal of monofilament sutures and thorough care of sutured sites. Urgent perforating keratoplasty arrested acute inflammations in 90% of cases and preserved or improved visual acuity in 70% of cases.     

Oral and dental problems in the organ transplant patient

The number of people receiving organ transplants has dramatically increased over the last decade. It is now likely that a dental surgeon will come across patients who have undergone transplantation. This paper considers the particular problems that these patients are likely to present their general dental practitioners.     

Estimating time to contact and impact velocity when catching an accelerating object with the hand.

To catch a moving object with the hand requires precise coordination between visual information about the target's motion and the muscle activity necessary to prepare for the impact. A key question remains open as to if and how a human observer uses velocity and acceleration information when controlling muscles in anticipation of impact. Participants were asked to catch the moving end of a swinging counterweighted pendulum, and resulting muscle activities in the arm were measured. The authors also simulated muscle activities that would be produced according to different tuning strategies. By comparing data with simulations, the authors provide evidence that human observers use online information about velocity but not acceleration when preparing for impact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Non-adherence with medications in organ transplant patients: a literature review

The problems of non-adherence with treatment in health care in general, and with medication adherence in particular, is an area with a voluminous and burgeoning literature. However, there appears to be no review of the literature on non-adherence with medications in organ transplant patients. This comprehensive review therefore considers literature on adherence in adult kidney, heart and liver transplantation. The particular problem of adherence in paediatric transplant patients is also addressed. This transplant research literature is then evaluated within the broader context of social science research on medication adherence. From the review it is apparent that there is an urgent need for research which examines the patient's beliefs about their illness and medicines. Such research is a precursor for rigorous nursing intervention studies which aim to promote adherence by being tailored to the patient's perceptions.     

Epstein-Barr virus transmission from a blood donor to an organ transplant recipient with recovery of the same virus strain from the recipient's blood and oropharynx

A previous study (Savoie et al, Blood 83:2715, 1994) identified eight transplant patients who acquired Epstein-Barr virus (EBV) infection during the peritransplant period. Three of these patients subsequently developed B-cell lymphoproliferative disease within 4 months of transplantation. Among these, there was a 16-year-old liver transplant patient who was negative for EBV at the time of transplant and who received an EBV-negative organ. After transplant, this patient was transfused with 9 U of packed red blood cells. Eight of the donors were EBV-positive and one was EBV-negative. We succeeded in obtaining spontaneous lymphoblastoid cell lines (LCLs) from the blood of three of these donors, one of whom also yielded a cord-blood line established with his throat-wash EBV. Blood from a fourth donor did not yield an LCL, but his throat washing did have transforming activity when inoculated onto cord-blood leukocytes. We initially could establish spontaneous LCLs only from the recipient's blood. However, a throat-wash sample taken 11 weeks later did show transforming activity. The recipient was shown to have acquired the EBV infection from one of eight EBV-seropositive blood donors. Analysis of fragment length polymorphisms after polymerase chain reaction amplification of the EBV BamHI-K fragment was used to establish strain identity. Western blot analysis for existence of size polymorphisms in three classes of Epstein-Barr nuclear antigens (EBNA-1, EBNA-2, and EBNA-3) confirmed the DNA results. It is noteworthy that the blood donor responsible for transmitting his EBV strain to the recipient had experienced clinical infectious mononucleosis 15 months before donating blood. Our results may, thus, indicate a requirement for leukodepletion of blood destined for immunosuppressed EBV-negative patients. Finally, blood donors with a recent history of infectious mononucleosis should probably be identified so that their blood is not given to EBV-negative transplant patients.