scholarly journals Organ Donor Risk Stratification in Italy

2020 ◽  
pp. 319-323
Author(s):  
Adriano Peris ◽  
Jessica Bronzoni ◽  
Sonia Meli ◽  
Juri Ducci ◽  
Erjon Rreka ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Risk Stratification ◽  
Disease Transmission ◽  
Potential Benefit ◽  
Survival Rates ◽  
Organ Donor ◽  
No Donor ◽  
Demand And Supply ◽  
Risk Of Disease ◽  
Standard Risk

AbstractThe permanent gap between organ demand and supply has prompted use of organs from extended criteria donors (ECD). These carry a higher risk of disease transmission, with regard to infections and malignancies. We present herein the donor risk stratification algorithm implemented in Italy since 2004 for identification management of donor-to-recipient risk of disease transmission. The principles underlying this algorithm are: (1) the risk of disease transmission must be assessed against the potential benefit for the transplant recipient (i.e., no donor can be excluded from evaluation and their organs might benefit potential candidates); (2) patients awaiting organ transplantation must be informed that the risk of disease transmission is small but finite (standard risk); and (3) risk evaluation is an ongoing process based on information collected longitudinally after transplantation. Regional and national transplant authorities are committed to regular updating of guidelines based on clinical data derived from clinicians and on evaluation of posttransplant graft and patient survival rates.

Characteristics of diluted-stored and post-thawed semen of Hutsul stallions

2021 ◽  
Keyword(s):  
Sperm Motility ◽  
Disease Transmission ◽  
Survival Rates ◽  
Genetic Material ◽  
Sperm Bank ◽  
Resource Protection ◽  
Frozen Semen ◽  
Genetic Reserve ◽  
Basic Parameters ◽  
Risk Of Disease

Abstract The use of frozen semen lowers the risk of disease transmission, eliminates geographical limitations and supports the implementation of genetic resource protection programs. However, due to the very rare use of frozen semen from Hutsul stallions, their genetic material is not secured in sperm banks, and very little information is available about their semen, including its suitability for cryopreservation, and sperm survival rates after thawing. The aim of this study was to analyse basic parameters such as sperm motility, vitality and morphology in diluted-stored and post-thawed Hutsul semen, using a CASA system. There were no differences in sperm motility (P = 0.3372) or morphology between the groups, although the progressive motility was higher in thawed semen (P = 0.0151), while the sperm vitality was higher in diluted-stored semen (P = 0.00517). This study demonstrates that semen from Hutsul horses is suitable for cryopreservation, thus supporting the creation of a sperm bank as a genetic reserve for representatives of this breed.

scholarly journals MPC-08 Molecular risk stratification using genome-wide DNA methylation data of standard-risk medulloblastomas treated with 18-Gy craniospinal irradiation

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii12-ii12
Author(s):  
Tomoya Irikura ◽  
Kohei Fukuoka ◽  
Makiko Mori ◽  
Koichi Oshima ◽  
Yuki Arakawa ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Disease Onset ◽  
Low Risk ◽  
Craniospinal Irradiation ◽  
Diagnostic Tools ◽  
Late Relapse ◽  
Mycn Amplification ◽  
Group 4 ◽  
Radiation Induced ◽  
Standard Risk

Abstract A novel risk stratification of medulloblastoma has been proposed based on retrospective data from patients undergoing standard treatment. However, it remains unclear whether the classification is applicable to patients receiving reduced-dose craniospinal irradiation (CSI). We performed molecular diagnosis and copy number analysis using methylation array on patients with standard-risk medulloblastoma treated with 18 Gy CSI at our institution. Nine tumor samples were available for analysis from seven patients who had a median age of 7.4 years at disease onset and a median observation period of 73 months. Three patients had recurrence, and another patient developed radiation-induced glioblastoma. From the three recurrent cases, one was molecularly diagnosed as SHH subtype with MYCN amplification; another case was a Group 4 tumor without favorable prognostic chromosomal aberrations, and the remaining patient experienced a very late relapse despite low-risk stratification. Of the recurrence-free cases, one was classified as WNT subtype, and another was a Group 4 tumor with chromosome 7 gain, and loss of chromosomes 8 and 11, both of which were associated with good prognosis. Methylation analysis also unveiled the fact that the recurrent tumor diagnosed as relapsing medulloblastoma by conventional diagnostic tools was in fact a radiation-induced glioblastoma. Our data suggested that the new risk stratification may be useful for cases treated with CSI reduced to 18 Gy. However, due to the presence of the late-relapsed case stratified to low risk, further investigations with a larger cohort should be required to confirm the data.

scholarly journals Livestock movement informs the risk of disease spread in traditional production systems in East Africa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Divine Ekwem ◽  
Thomas A. Morrison ◽  
Richard Reeve ◽  
Jessica Enright ◽  
Joram Buza ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Production Systems ◽  
Control Strategies ◽  
Herd Size ◽  
Transmission Risk ◽  
Disease Spread ◽  
Transmission Potential ◽  
Spatial And Temporal Scales ◽  
Transmission Distance ◽  
Risk Of Disease

AbstractIn Africa, livestock are important to local and national economies, but their productivity is constrained by infectious diseases. Comprehensive information on livestock movements and contacts is required to devise appropriate disease control strategies; yet, understanding contact risk in systems where herds mix extensively, and where different pathogens can be transmitted at different spatial and temporal scales, remains a major challenge. We deployed Global Positioning System collars on cattle in 52 herds in a traditional agropastoral system in western Serengeti, Tanzania, to understand fine-scale movements and between-herd contacts, and to identify locations of greatest interaction between herds. We examined contact across spatiotemporal scales relevant to different disease transmission scenarios. Daily cattle movements increased with herd size and rainfall. Generally, contact between herds was greatest away from households, during periods with low rainfall and in locations close to dipping points. We demonstrate how movements and contacts affect the risk of disease spread. For example, transmission risk is relatively sensitive to the survival time of different pathogens in the environment, and less sensitive to transmission distance, at least over the range of the spatiotemporal definitions of contacts that we explored. We identify times and locations of greatest disease transmission potential and that could be targeted through tailored control strategies.

Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison

Blood ◽  
2009 ◽  
Vol 113 (6) ◽  
pp. 1375-1382 ◽  
Author(s):  
Jan J. Cornelissen ◽  
Bronno van der Holt ◽  
Gregor E. G. Verhoef ◽  
Mars B. van 't Veer ◽  
Marinus H. J. van Oers ◽  
...  
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Lymphoblastic Leukemia ◽  
Adult Patients ◽  
Donor Group ◽  
No Donor ◽  
Sibling Donor ◽  
Standard Risk

Abstract While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (± 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with http://www.trialregister.nl under trial ID NTR228.

No Advantage of Dexamethasone Over Prednisolone for the Outcome of Standard- and Intermediate-Risk Childhood Acute Lymphoblastic Leukemia in the Tokyo Children's Cancer Study Group L95-14 Protocol

2005 ◽  
Vol 23 (27) ◽  
pp. 6489-6498 ◽  
Author(s):  
Shunji Igarashi ◽  
Atsushi Manabe ◽  
Akira Ohara ◽  
Masaaki Kumagai ◽  
Tomohiro Saito ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Controlled Trial ◽  
Survival Rates ◽  
Maintenance Phase ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Intermediate Risk ◽  
Free Survival ◽  
Prospective Randomized Controlled Trial ◽  
Standard Risk

Purpose To evaluate whether dexamethasone (DEXA) yields a better outcome than prednisolone (PRED) in a prospective, randomized, controlled trial for the treatment of childhood acute lymphoblastic leukemia (ALL). Patients and Methods Two hundred thirty-one standard-risk (SR) patients and 128 intermediate-risk (IR) non–B-cell ALL patients were registered from March 1995 to March 1999. After random assignment in each group, the PRED arm patients received PRED 60 mg/m2 during induction followed by PRED 40 mg/m2 over four intensifications in the SR group and three intensifications in the IR group. DEXA arm patients received DEXA 8 mg/m2 during induction and DEXA 6 mg/m2 during the intensifications. The maintenance phase was continued until week 104. Results Event-free survival rates at 8 years in the DEXA and PRED arms were 81.1% ± 3.9% (n = 117) and 84.4% ± 5.2% (n = 114), respectively, in the SR group (P = .217) and 84.9% ± 4.6% (n = 62) and 80.4% ± 5.1% (n = 66), respectively, in the IR group (P = .625). The primary reason for treatment failure was marrow relapse. Only two extramedullary relapses occurred in the DEXA arm compared with seven relapses in the PRED arm. Although complications were more prevalent in the DEXA arm than in the PRED arm, fatal toxicity was rare both groups. Conclusion DEXA administered at 8 mg/m2 during induction and 6 mg/m2 during intensification showed no advantage over PRED administered at 60 mg/m2 during induction and 40 mg/m2 during intensification in both the SR and IR groups.

scholarly journals Telemedicine: A Paradigm Shift in Healthcare in the wake of COVID-19 in India

2020 ◽  
Author(s):  
Ria Saha ◽  
Vinoth Gnana Chellaiyan
Keyword(s):  
Disease Transmission ◽  
Healthcare Services ◽  
National Guidelines ◽  
Medical Practitioners ◽  
Regulatory Guidelines ◽  
Risk Of Disease ◽  
Wide Scale ◽  
The Government ◽  
Institutional Challenges

The COVID-19 pandemic has severely affected the delivery of essential healthcare services in India. The massive disruption of the routine healthcare services had been circumvented to a certain extent with the application of telemedicine. In the wake of the COVID-19 pandemic, the Government of India has issued regulatory guidelines and approved Registered Medical Practitioners (RMP) to adopt the usage of teleconsultation service which can be real-time or asynchronous to minimise the risk of disease transmission. The commentary provides an in-depth review of the regulatory guidelines implemented by the Government of India and discusses the inherent structural and fundamental challenges associated with its wide scale adoption, accessibility, and utilisation. Though the Government of India had issued national guidelines to promote safe and effective usage of telemedicine practice, there remains certain primary structural, technical and institutional challenges regarding expansion of uninterrupted services to periurban and rural peripheral health facilities and its nationwide sustainability. The article demands the attention of the policymakers and relevant stakeholders to identify the inherent bottlenecks intrinsic to the guidelines and amend the regulatory framework accordingly to ensure its long-term sustainability.

scholarly journals Pembinaan dan Pendampingan Perilaku Hidup Bersih dan Sehat (PHBS) di Madrasah Ibtidaiyah Hidayatul Insan Kota Palangkaraya

2017 ◽  
Vol 2 (1) ◽  
pp. 37-46
Author(s):  
Nurhalina Nurhalina ◽  
Suratno Suratno ◽  
Jarot Marchel
Keyword(s):  
Student Achievement ◽  
Primary School ◽  
Community Service ◽  
Primary Education ◽  
Public Interest ◽  
Disease Transmission ◽  
Education Institution ◽  
Healthy Behavior ◽  
Behavior Development ◽  
Risk Of Disease

Household Health Survey on 2013 shows that 60% children�s disease in Palangka Raya continue to increase especially related to clean and healthy behavior. Islamic Primary School (MI) Hidayatul Insan Palangka Raya is one of primary education institution in Palangka Raya at risk of disease transmission. It is because the school has not implement clean and healthy behavior in the school environtment optimally. Clean and healthy behavior development and accompaniment in MI Hidayatul Insan Palangka Raya aimed to provide assistance to the school in planning clean and healthy behavior policy, supporting infrastructure preparation, education, observation and evaluation of clean and healthy behavior implementation. The method of the communty service involved preparation, implementation and evaluation. The output of the community service were the school has implemented clean and healthy behavior; clean and healthy school environtment; increasing student achievement; and increasing public interest to send their children to the school.

scholarly journals Livestock Movement Informs the Risk of Disease Spread in Traditional Production Systems in East Africa

2021 ◽  
Author(s):  
Divine Ekwem ◽  
Thomas A. Morrison ◽  
Richard Reeve ◽  
Jessica Enright ◽  
Joram Buza ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Production Systems ◽  
Control Strategies ◽  
Herd Size ◽  
Disease Spread ◽  
Transmission Potential ◽  
Spatial And Temporal Scales ◽  
Transmission Distance ◽  
Cattle Movements ◽  
Risk Of Disease

Abstract In Africa, livestock are important to local and national economies, but their productivity is constrained by infectious diseases. Comprehensive information on livestock movements and contacts is required to devise appropriate disease control strategies; yet, understanding contact risk in systems where herds mix extensively, and where different pathogens can be transmitted at different spatial and temporal scales, remains a major challenge. We deployed Global Positioning System collars on cattle in 52 herds in a traditional agropastoral system in western Serengeti, Tanzania, to understand fine-scale movements and between-herd contacts, and to identify locations of greatest interaction between herds. We examined contact across spatiotemporal scales relevant to different disease transmission scenarios. Daily cattle movements increased with herd size and rainfall. Generally, contact was greatest away from households, during periods with low rainfall and in locations close to dipping points. We demonstrate how movements and contacts affect the risk of disease spread. For example, contact rate was relatively sensitive to the survival time of different pathogens in the environment, and less sensitive to transmission distance, at least over the range of values that we explored. We identify times and locations of greatest disease transmission potential and that could be targeted through tailored control strategies.

scholarly journals Assessment of fomites and infection risk to seniors in recreational curling

2020 ◽  
Author(s):  
Elliot Spicer ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock
Keyword(s):  
Disease Transmission ◽  
Sampling Error ◽  
Total Coliform ◽  
Infection Risk ◽  
Age Group ◽  
Enteric Disease ◽  
Health Promotion And Education ◽  
Increased Risk ◽  
Colony Forming Units ◽  
Risk Of Disease

Background: Seniors participate in sports to improve physical, mental, and social health; however, such activities may increase the risk of illness and injury. Curling is popular in this age group because it is physically manageable, strategic, and provides social connection. Certain factors in curling such as handshaking, play during the flu season, and shared contact with curling stones suggest an increased risk of disease transmission. The purpose of this study was to determine the qualitative risk of communicable enteric disease transmission due to shared contact with curling stone handles in a senior men’s curling league. Methods: 3M™ Quick Swabs were used to sample 22 curling stone handles for total coliforms before a senior’s league game. To analyze microbial shedding during gameplay, the same 22 handles were sampled after the game. Samples were plated on 3M™ Petrifilm™ Coliform Count Plates and incubated at 30ºC ± 1ºC for 24 hours ± 2 hours. Colonies were enumerated in units of CFU (colony forming units)/cm2. Ambient and handle surface temperatures were measured, and curler hygiene-related behaviours documented. Results: Total coliform counts for all samples were 0 CFU/cm2. The ambient temperature was 6.6°C pre-game, and 8.0°C post-game. Mean handle surface temperature was 3.6°C. Hygiene behaviours of concern were hand-face contact, handkerchief/tissue use, and handshaking. Conclusion: There is low risk of enteric disease transmission due to shared contact with curling stone handles by male curlers 55 years and older. Absence of coliforms may have been due to adequate player hygiene, transference of microbial load before sampling, error, or environmental conditions. Health promotion and education can reduce the infection risk elevated by poor hand hygiene, face contact, and handshaking in senior’s curling, thereby protecting the health and welfare of all participants.

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