scholarly journals Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wanessa T. Clemente ◽  
Luciana C. Faria ◽  
Gláucia F. Cota ◽  
Leandro Ricardo de Navarro Amado ◽  
Jaqueline G. F. Oliveira ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
General Population ◽  
High Mortality ◽  
Organ Procurement ◽  
Rare Event ◽  
Efficient Approach ◽  
Organ Procurement Organizations ◽  
Main Strategy

Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.

scholarly journals AB0407 CARDIOVASCULAR BURDEN IN SYSTEMIC SCLEROSIS: QRISK3 VERSUS FRAMINGHAM FOR RISK ESTIMATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1232.1-1232
Author(s):  
M. Di Battista ◽  
S. Barsotti ◽  
A. Della Rossa ◽  
M. Mosca
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systemic Sclerosis ◽  
High Risk ◽  
General Population ◽  
Risk Score ◽  
Predictive Accuracy ◽  
Risk Estimation ◽  
Cross Sectional

Background:Cardiovascular (CV) diseases, namely myocardial infarction and stroke, are not among the most known and frequent complications of systemic sclerosis (SSc), but there is growing evidence that SSc patients have a higher prevalence of CV diseases than the general population [1].Objectives:To compare two algorithms for CV risk estimation in a cohort of patients with SSc, finding any correlation with clinical characteristics of the disease.Methods:SSc patients without previous myocardial infarction or stroke were enrolled. Traditional CV risk factors, SSc-specific characteristics and ongoing therapies were assessed. Framingham and QRISK3 algorithms were then used to estimate the risk of develop a CV disease over the next 10 years.Results:Fifty-six SSc patients were enrolled. Framingham reported a median risk score of 9.6% (IQR 8.5), classifying 24 (42.9%) subjects at high risk, with a two-fold increase of the mean relative risk in comparison to general population. QRISK3 showed a median risk score of 15.8% (IQR 19.4), with 36 (64.3%) patients considered at high-risk. Both algorithms revealed a significant role of some traditional risk factors and a noteworthy potential protective role of endothelin receptor antagonists (p=0.003). QRISK3 was also significantly influenced by some SSc-specific characteristics, as limited cutaneous subset (p=0.01), interstitial lung disease (p=0.04) and non-ischemic heart involvement (p=0.03), with the first two that maintain statistically significance in the multivariate analysis (p=0.02 for both).Conclusion:QRISK3 classifies more SSc patients at high-risk to develop CV diseases than Framingham, and it seems to be influenced by some SSc-specific characteristics. If its predictive accuracy were prospectively verified, the use of QRISK3 as a tool in the early detection of SSc patients at high CV risk should be recommended.References:[1]Ngian GS, Sahhar J, Proudman SM, Stevens W, Wicks IP, Van Doornum S. Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis. Ann Rheum Dis. 2012;71:1980-3.Disclosure of Interests:None declared

scholarly journals Surgical management of chronic hyperplastic candidiasis refractory to systemic antifungal treatment

2017 ◽  
Vol 9 (02) ◽  
pp. 136-139 ◽  
Author(s):  
Neha Shah ◽  
Jay Gopal Ray ◽  
Sanchita Kundu ◽  
Divesh Sardana
Keyword(s):  
Candida Albicans ◽  
Case Report ◽  
High Risk ◽  
Oral Candidiasis ◽  
Smoking Habit ◽  
Definitive Diagnosis ◽  
Antifungal Drugs ◽  
Antifungal Treatment ◽  
White Patch

AbstractChronic hyperplastic candidiasis (CHC), earlier known as candidal leukoplakia, is a variant of oral candidiasis that classically presents as a white patch on the commissures of the oral mucosa and it is mostly caused by Candida albicans. Clinically, the lesions are usually asymptomatic and regress after appropriate antifungal therapy and correction of the underlying cause. If the lesions are untreated, a small portion may develop dysplasia and later progress into carcinoma. The purpose of this article is to report a case of CHC in a 57-year-old male patient with a significant smoking habit, who presented with a thick, nonscrapable, brownish-white coating on the dorsum of the tongue for 9 years. This case is of particular importance and concern because of the high risk for malignant transformation in CHC. The role of biopsy and histopathology is also stressed through this case report in arriving at a definitive diagnosis and treatment planning. Further, this case is interesting because it was refractory to local and systemic antifungal treatment and so, surgery was chosen as an alternative treatment modality considering the side effects of the prolonged use of antifungal drugs.

scholarly journals The clot thickens: role of mechanical thrombectomy in intermediate to high-risk pulmonary embolism in the peri-operative setting—a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Maria Isabel Camara Planek ◽  
Clay H Hoster ◽  
Aviral Vij ◽  
Steve Attanasio
Keyword(s):  
Pulmonary Embolism ◽  
Case Report ◽  
High Risk ◽  
Risk Stratification ◽  
Mechanical Thrombectomy ◽  
Operative Risk ◽  
Decompression Surgery ◽  
Lower Extremity Weakness ◽  
Right Ventricular Strain

Abstract Background European Society of Cardiology (ESC) recommends catheter-directed thrombectomy for management of high-risk pulmonary embolism (PE) with contraindications to thrombolytics or in patients that have failed thrombolytic therapy, as well as intermediate-risk PE with haemodynamic deterioration. In this case report, the role of catheter-directed mechanical thrombectomy is highlighted in the urgent peri-operative setting. Case summary A 71-year-old female presented with 10 days of progressive lower extremity weakness and was found to have malignant cord compression along with incidental saddle, intermediate–high-risk PE that extended to all lobes on chest computed tomography. Given the intermediate to high-risk PE with acute cor pulmonale, urgent need for surgery, and risk of haemodynamic collapse upon induction of general anaesthesia, the decision was made to proceed with urgent percutaneous treatment of the PE. Percutaneous catheter-directed thrombectomy was successfully performed. The patient returned to the intensive care unit in stable condition and was able to then receive urgent cord decompression and further treatment for malignancy with no complication. Discussion In this case, single-session thrombectomy resulted in rapid reduction of pre-operative cardiopulmonary risk by alleviating the right ventricular strain, allowing urgent cord decompression surgery to proceed with optimized haemodynamics, no bleeding events, and no further oxygen requirements. While peri-operative risk stratification for cardiovascular outcomes is well established in current guidelines, there are no clear guidelines for peri-operative risk stratification in the setting of pulmonary embolism. The importance of the multidisciplinary PE Response Team is thus emphasized, as well as the importance of continuous evaluation of clinical decompensation in PE.

scholarly journals When gambling with derivative products can become problematic: a case report of excessive trading

2021 ◽  
pp. 50
Author(s):  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Gambling Disorder ◽  
Trading Behavior ◽  
Research Interview ◽  
Trading Activities ◽  
Derivative Products ◽  
Shed Light

For some individuals, trading can become a problematic activity and be considered a gambling disorder due to its adverse consequences. Because few studies have been conducted to date investigating this issue, the aim of this study is to improve knowledge on this topic by presenting a case study of a participant playing the stock market. A research interview was conducted, transcribed, and analyzed using Alceste®. This case study revealed three classes of meaning: the role of family in trading behavior; trading history, motives, and beliefs; and the tilt. Results shed light on the link between gambling and trading activities, and tend to support the existence of a trading behavior resembling addiction, which may be more significant when trading with high-risk derivative products due to their unique characteristics.

Donor Factors That Affect the Number of Organs Transplanted per Donor

2009 ◽  
Vol 19 (3) ◽  
pp. 259-266 ◽  
Author(s):  
Leslie Olson ◽  
Lynn Cravero
Keyword(s):  
Body Mass Index ◽  
Heart Disease ◽  
High Risk ◽  
Social History ◽  
Organ Procurement ◽  
Demographic Factors ◽  
High Risk Behavior ◽  
Donor Factors ◽  
Organ Procurement Organizations ◽  
Deceased Donors

Background Demographic factors and factors from donors' medical and social history influence the number of organs transplanted per donor. The goal for organ procurement organizations is 4.30 organs transplanted per standard criteria donor. Objective To examine the influence of factors related to donors' demographics and donors' medical and social histories on the number of organs transplanted per donor. Methods The medical and social histories of 772 deceased donors were reviewed to assess demographic factors (eg, age, sex), diseases (eg, heart disease, hepatitis, diabetes, hypertension), and other factors (eg, body mass index, high-risk behavior, alcohol abuse). Statistics were calculated by using MarketSight software. Results Between 2003 and 2007, 2409 organs were recovered and transplanted from 772 donors (number of organs per donor, mean [SD], 3.12 [1.73]) in our designated service area. Some demographic factors (eg, age, sex) were associated with significantly fewer organs transplanted per donor. Other factors from donors' medical and social histories also played a major role, with each added factor significantly decreasing the number of organs transplanted per donor. The number of organs transplanted differed significantly between donors with 0 vs 1, 1 vs 2, and 2 vs 3 or more factors related to their medical and social histories. Conclusion Demographic factors and other factors in donors' medical and social histories significantly reduced the number of organs transplanted per donor. An algorithm that uses all potential demographic factors and factors related to medical and social history nested within each other could be developed to predict number of organs transplanted.

scholarly journals The role of a sequencing-based clinical intestinal screening test in patients at high-risk for Clostridium difficile and other pathogens: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Maureen Hitschfeld ◽  
Elena Tovar ◽  
Sarah Gupta ◽  
Elisabeth M. Bik ◽  
Christina Palmer ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Clostridium Difficile ◽  
Screening Test

Adapting Teaching Styles to Accommodate Learning Preferences for Effective Hospital Development

2008 ◽  
Vol 18 (4) ◽  
pp. 297-300 ◽  
Author(s):  
Kelly Y. Eshleman
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Teaching Styles ◽  
Hospital Staff ◽  
Learning Preferences ◽  
Educational Design ◽  
Development Professionals ◽  
Organ Procurement Organizations ◽  
Hospital Development

Hospital development professionals in organ procurement organizations engage in many roles in the hospital. The important role of educator requires making the most of each teaching opportunity by understanding the characteristics of the learning audience and applying proven principles of adult educational design, with a focus on collaborative learning and variety in presentation techniques. The goal is to provide effective education, enabling hospital staff to transfer this learning to the job setting, with the outcome of facilitating a supportive process that saves lives through organ donation.

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