scholarly journals Pairwise Kidney Exchange over the Blood Group Barrier

2019 ◽  
Vol 87 (3) ◽  
pp. 1091-1133 ◽  
Author(s):  
Tommy Andersson ◽  
Jörgen Kratz
Keyword(s):  
Kidney Transplant ◽  
Blood Group ◽  
Medical Technology ◽  
Immunosuppressive Treatment ◽  
Preference Domain ◽  
Exchange Programs ◽  
Kidney Exchange ◽  
Patient Groups ◽  
To Receive ◽  
Positive Effect

Abstract Advances in medical technology have made kidney transplants over the blood group barrier feasible. This article investigates how such technology should be implemented when designing pairwise kidney exchange programs. The possibility to receive a kidney transplant from a blood group incompatible donor motivates an extension of the preference domain, allowing patients to distinguish between compatible donors and half-compatible donors (i.e. blood group incompatible donors that only become compatible after undergoing an immunosuppressive treatment). It is demonstrated that the number of transplants can be substantially increased by providing an incentive for patients with half-compatible donors to participate in kidney exchange programs. The results also suggest that the technology is beneficial for patient groups that are traditionally disadvantaged in kidney exchange programs (e.g. blood group O patients). The positive effect of allowing transplants over the blood group barrier is larger than the corresponding effects of including altruistic patient–donor pairs or of allowing three-way exchanges in addition to pairwise exchanges.

scholarly journals Use of Anti-Cytokine Therapy in Kidney Transplant Recipients with COVID-19

2021 ◽  
Vol 10 (8) ◽  
pp. 1551
Author(s):  
Marta Bodro ◽  
Frederic Cofan ◽  
Jose Ríos ◽  
Sabina Herrera ◽  
Laura Linares ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Ordinal Scale ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kidney Recipients ◽  
Secondary Infections ◽  
Statistical Effect ◽  
Randomized Control ◽  
The Impact ◽  
To Receive

In the context of the coronavirus disease 2019 (COVID-19) pandemic, we aimed to evaluate the impact of anti-cytokine therapies (AT) in kidney transplant recipients requiring hospitalization due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This is an observational retrospective study, which included patients from March to May 2020. An inverse probability of treatment weighting from a propensity score to receive AT was used in all statistical analyses, and we applied a bootstrap procedure in order to calculate an estimation of the 2.5th and 97.5th percentiles of odds ratio (OR). outcomes were measured using an ordinal scale determination (OSD). A total of 33 kidney recipients required hospitalization and 54% of them received at least one AT, mainly tocilizumab (42%), followed by anakinra (12%). There was no statistical effect in terms of intensive care unit (ICU) admission, respiratory secondary infections (35% vs. 7%) or mortality (16% vs. 13%) comparing patients that received AT with those who did not. Nevertheless, patients who received AT presented better outcomes during hospitalization in terms of OSD ≥5 ((OR 0.31; 2.5th, 97.5th percentiles (0.10; 0.72)). These analyses indicate, as a plausible hypothesis, that the use of AT in kidney transplant recipients presenting with COVID-19 could be beneficial, even though multicenter randomized control trials using these therapies in transplanted patients are needed.

scholarly journals How Do Patients with Life-Limiting Illness and Caregivers Want End-Of-Life Prognostic Information Delivered? A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 784
Author(s):  
Ebony T. Lewis ◽  
Kathrine A. Hammill ◽  
Maree Ticehurst ◽  
Robin M. Turner ◽  
Sally Greenaway ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Health Services ◽  
End Of Life ◽  
Older Patients ◽  
Prognostic Information ◽  
Clinical Scenarios ◽  
Delivery Format ◽  
Patient Groups ◽  
To Receive

We aimed to identify the level of prognostic disclosure, type of prognostic information and delivery format of prognostic communication that older adults diagnosed with a life-limiting illness or caregivers prefer to receive. We developed and pilot tested an open-ended survey to 15 older patients and caregivers who had experience in health services for life-limiting illness either for a relative, friend or themselves. Five hypothetical clinical scenarios of prognostic options were presented to ascertain preferences. The preferred format to receive prognostic information was verbal delivery by the clinician with a written summary. Photos and videos were less favoured, and a table with numbers/percentages was least preferred. Distress levels to the prognostic scenarios were low, with the exception of a photo. We conclude that older patients/caregivers want end-of-life prognostic information delivered the traditional way, verbally by clinicians. Options to deliver prognostic information may vary across patient groups but empower clinicians in introducing end-of-life discussions with patients/caregivers. Our study illustrates the feasibility of involving terminal patients and caregivers in research that contributes to eliciting prognostic preferences. Further research is needed to understand whether the prognostic preferences of hospitalized patients with life-limiting illness differ.

scholarly journals The Effect of Supplemental Oxygen on the Incidence of Hypoxaemia after Premedication in Patients Undergoing Cardiac Surgery

1997 ◽  
Vol 25 (4) ◽  
pp. 347-349 ◽  
Author(s):  
C. F. Royse ◽  
R. J. B. Tiernan ◽  
S. M. Portelli ◽  
S. Davies ◽  
R. Arblaster ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Arterial Oxygen Saturation ◽  
Supplemental Oxygen ◽  
Arterial Oxygen ◽  
Patient Demographics ◽  
Routine Administration ◽  
High Incidence ◽  
Patient Groups ◽  
To Receive ◽  
Elective Patients

Opiate premedication may cause significant respiratory depression, particularly when other sedative agents such as scopolamine or benzodiazepines are added. This can cause hypoxaemia with potential for worsening myocardial ischaemia in cardiac surgery patients. The aim of this study was to investigate the incidence of hypoxaemia (SpO2 <90%) in elective patients undergoing cardiac surgery and to assess the efficacy of supplemental oxygen in preventing it. One hundred elective patients without significant respiratory disease or cardiac failure, who received both an opiate and a sedative premedication, were prospectively randomized to receive either oxygen via a facemask at 4 l/min or no oxygen. Continuous arterial oxygen saturation was recorded using a pulse oximeter from the time of premedication until the patient arrived in theatre. An SpO2 <90% was recorded as a significant event and oxygen was administered to the patients. Six patients were excluded because of equipment failure or protocol violations. The patient groups were comparable with respect to patient demographics, premedication type and dose or the duration of monitoring. In patients receiving oxygen (n=48) there were no episodes of hypoxaemia (0%). In patients not receiving oxygen (n=46) there were 14 episodes of hypoxaemia (30%, P<0.0001). We conclude that there is a significantly high incidence of hypoxaemia in cardiac surgery patients following combined opiate and sedative premedication and that it can be reduced by the routine administration of supplemental oxygen.

The Mathematics behind Lifesaving Kidney Exchange Programs

Math Horizons ◽  
2010 ◽  
Vol 18 (1) ◽  
pp. 26-29
Author(s):  
Olivia M. Carducci
Keyword(s):  
Exchange Programs ◽  
Kidney Exchange

62 Feeding Chicory-plantain Silage and Se-yeast to Lactating Ewes Subjected to Intramammary Infection: Effect on the Immune System

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 32-33
Author(s):  
Hunter Ford ◽  
Massimo Bionaz ◽  
Serkan Ates ◽  
Joe Klopfenstein ◽  
Jorge Vanegas ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Complete Blood Count ◽  
Random Effect ◽  
Mean Cell Volume ◽  
Distribution Width ◽  
Intramammary Infection ◽  
Alfalfa Meal ◽  
The Mean ◽  
To Receive ◽  
Positive Effect

Abstract The objective was to test the effect on the immune status by feeding a combination of chicory-plantain and Se-yeast in lactating ewes subjected to intramammary infection (IMI) with 2×107CFU of Strep uberis in both glands. For the purpose we enrolled 28 Polypay lactating sheep from a prior study where they were randomly allocated to receive chicory (CS) or grass (GC) silage and either 3.6 mg of Se/day as Se-yeast (DiaMune, Diamond V) (Y) or isoenergetic-isonitrogenous alfalfa meal (C) for 2 months. For the present study, ewes were kept on the original dietary regiment except the CT group received a chicory-plantain silage(50% each). Blood was collected prior to and for 10 days after IMI for a complete blood count(VetScan HM5), leukocytes migration, and rectal temperature (RT). Data were analyzed using GLIMMIX (SAS)with time, silage type, and Se and their interactions as the fixed effects and ewe as random effect with significance declared at P ≤ 0.05. RT was lower in chicory vs. grass before IMI and Se limited the RT increase after IMI. Total WBC levels tended (P = 0.06) to increase in animals fed with Se after IMI, which was driven by a larger number of lymphocytes. Hematocrit, red blood cells, and hemoglobin were strongly decreased by IMI. The mean cell volume was overall larger in ewes fed with chicory-plantain silage while mean cell hemoglobin was larger in animal fed with grass silage. The platelet distribution width was affected by silage*Se interaction due to a positive effect by Se in grass-fed but negative in chicory-plantain-fed ewes. Migration of neutrophils was larger in animals fed with chicory-plantain before IMI but similar between groups after IMI. Overall, these findings indicate that Se supplementation can increase lymphocytes with no effect on neutrophils while activity of neutrophils is positively affected by feeding chicory-plantain silage.

scholarly journals 2658. Meningitis in Kidney Transplant Recipients: TransMéninges, a French Multicentric Retrospective Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S930-S930
Author(s):  
Yanis Tamzali ◽  
Anne Scemla ◽  
Pierre Taupin ◽  
Sunny Randhawa ◽  
Valérie Moal ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Immunosuppressive Treatment ◽  
Induction Treatment ◽  
High Dose ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Specific Population ◽  
Gram Negative ◽  
Wide Range

Abstract Background The management of meningitis requires the prompt introduction of high-dose probabilistic anti-infectious therapy. The literature reporting on meningitis in kidney transplant recipients (KTR) is scarce and no recommendation exists for this specific population. Methods We retrospectively included all adult KTRs diagnosed with meningitis (cerebro-spinal fluid (CSF) cell count >10/mm3 or positive fungal antigen or direct examination) between 2007 and 2018 in 16 French hospitals. Clinical, biological, and therapeutic data, and 1-year kidney and patient survival were collected. Results Meningitis occurred in 134 KTRs (mean age 57+/11.8 years, 56% male), after a median time of 27 months (IQR 8–65); 25% of patients received an immunosuppressive treatment before kidney transplantation, induction treatment included lymphocyte-depleting antibodies in 63%, and 53% presented diabetes (34% before and 19% after the transplantation). The etiologies included Cryptococcus neoformans (30%), Herpesviridae (22%, including Varicella-Zoster Virus 15%), idiopathic forms (11%), Gram-negative bacilli (8% of which 20% produced an extended spectrum β-lactamase), %), infusion of intravenous immunoglobulins (6%), post-transplant lymphoproliferative disorders (5%), Aspergillus fumigatus (4%), Listeria monocytogenes (4%), Enterovirus (4%), and Mycobacterium tuberculosis (3%). The most common symptoms were fever (82.5%), headaches (75%), encephalitis (55%), and convulsion (22.5%). CSF hypercellularity (found in 92% of the cases) was lymphocytic in 65% of the cases and neutrophilic in 35%. Initial anti-infectious therapy was inappropriate in 27% of the cases. One-year patient, graft, and death-censored graft survival rates were 84%, 76%, and 89%, respectively. Conclusion Meningitis after kidney transplantation encompasses a wide range of causes, with C. neoformans and VZV explaining more than 50% of the cases. Gram-negative bacilli are the most represented bacteria with a high rate of antimicrobial resistance. Treatment guidelines should be reconsidered in the specific population of KTRs as the etiology greatly differs from what is observed in the general population. Disclosures All authors: No reported disclosures.

scholarly journals FAKTOR DETERMINAN PENGUNGKAPAN SUKARELA OLEH YAYASAN DI INDONESIA

2021 ◽  
Vol 21 (1) ◽  
pp. 1
Author(s):  
Marfuah Marfuah ◽  
Alifia Rachma Diani ◽  
Chivalrind G Ayuntari
Keyword(s):  
Voluntary Disclosure ◽  
Complete Data ◽  
The Internet ◽  
Organizational Size ◽  
Significant Positive Effect ◽  
Financial Reports ◽  
To Receive ◽  
Positive Effect

<p><em>The purpose of this study was to determine the effect of donations, restricted funds, organizational size, and age of the organization age on the voluntary disclosure of the foundation. All foundations in Indonesia are the population in this study. The sample of this research is foundations in Indonesia that submit financial reports via the internet between 2013-2019 and have complete data. Based on these criteria, 114 financial reports were obtained as the research sample. The results of this study prove that restricted funds and organizational size have a significant positive effect on voluntary disclosure, while the donations and age of the organization have no significant positive effect on voluntary disclosure. The implication of this research is that funders must consider the restricted funds and the size of the organization to assess the prospects of the foundation. In addition, the foundation must increase voluntary disclosure to be more transparent in providing information about its foundation. With transparency, the foundation will more easily get the trust to receive funds that are beneficial to the foundation's survival.</em></p>

scholarly journals The main aspects of the immunoprophylaxis of infectious diseases in the Republic of Dagestan

2019 ◽  
Vol 18 (3) ◽  
pp. 42-45
Author(s):  
N. S. Karnayeva ◽  
L. U. Ulukhanova ◽  
A. G. Gadzhimirzaevа ◽  
S. G. Agaevа
Keyword(s):  
Hepatitis B ◽  
Infectious Diseases ◽  
Viral Hepatitis ◽  
Viral Hepatitis B ◽  
The Republic ◽  
Vaccine Prophylaxis ◽  
Religious Reasons ◽  
To Receive ◽  
Positive Effect ◽  
Epidemiological Situation

The analysis of the epidemiological situation of vaccine-preventable infections in the Republic of Dagestan. The introduction of mass vaccine prophylaxis had a positive effect on reducing the incidence of infections such as poliomyelitis, diphtheria, tetanus, rubella, and viral hepatitis B in the Republic of Dagestan. However, despite the ongoing routine immunization of the population for “controlled” infections, the incidence of measles and parotitis infection remains high in 2018, this is due to an increase in the number of people who refuse to receive preventive vaccinations, in most cases, for religious reasons.

Parent Stress and Coping: Waiting for a Child to Receive a Kidney Transplant

2007 ◽  
Vol 14 (4) ◽  
pp. 320-329 ◽  
Author(s):  
Nataliya Zelikovsky ◽  
Aileen P. Schast ◽  
Daphnee Jean-Francois
Keyword(s):  
Kidney Transplant ◽  
Parent Stress ◽  
Stress And Coping ◽  
And Coping ◽  
To Receive

scholarly journals Revalidation for general practitioners: randomised comparison of two revalidation models

BMJ ◽  
2004 ◽  
Vol 328 (7441) ◽  
pp. 687-691 ◽  
Author(s):  
David Bruce ◽  
Katie Phillips ◽  
Ross Reid ◽  
David Snadden ◽  
Ronald Harden
Keyword(s):  
Professional Development ◽  
Primary Care ◽  
General Practitioners ◽  
Outcome Measures ◽  
Continuing Professional Development ◽  
Summative Assessment ◽  
Educational Outcome ◽  
Acceptable Model ◽  
Patient Groups ◽  
Positive Effect

AbstractObjective To compare two models of revalidation for general practitioners.Design Randomised comparison of two revalidation models.Setting Primary care in Tayside, Scotland.Participants 66 Tayside general practitioners (principals and non-principals), 53 of whom completed the revalidation folders.Interventions Two revalidation models: a minimum criterion based model with revalidation as the primary purpose, and an educational outcome model with emphasis on combining revalidation with continuing professional development.Main outcome measures Feasibility and acceptability of each approach and effect on the doctor's continuing professional development. The ability to make a summative judgment on completed models and whether either model would allow patient groups to have confidence in the revalidation process.Results The criterion model was preferred by general practitioners. For both models doctors reported making changes to their practice and felt a positive effect on their continuing professional development. Summative assessment of the folders showed reasonable inter-rater reliability.Conclusions The criterion model provides a practical and acceptable model for general practitioners to use when preparing for revalidation.

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