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https://www.readbyqxmd.com/read/28925582/the-dangers-of-oversimplification-quality-metrics-and-lung-transplantation
#1
EDITORIAL
Victor van Berkel
While many aspects of medical care are learning how to cope with the sudden proliferation of publicly reported quality metrics[1], the transplant community has been interpreting this type of data for over thirty years. Under the National Organ Transplantation Act of 1984, transplant centers are required to report their candidate and recipient information to the Organ Procurement and Transplantation Network (OPTN), and that data is then analyzed by the Scientific Registry of Transplant Recipients (SRTR), with outcomes reported on a twice yearly basis on a public website (www...
September 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28924467/how-to-avoid-injury-to-the-renal-artery-due-to-inclusion-of-superior-mesenteric-artery-patch-during-organ-procurement
#2
B V Dasari, S Asthana, N Ahmad
No abstract text is available yet for this article.
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28924465/brain-dead-donation-rate-in-month-of-ramadan-and-the-other-months-2005-2014
#3
M Aghighi, M Mahdavi-Mazdeh, M Saberi Isfeedvajani, S A Tavakoli, N Tirgar, A Heidary Rouchi
Regardless of the level of development, religion and beliefs have crucial impact on people's attitude towards organ donation. Although organ donation in Islam is obviously appraised, mainly due to lack of an appropriate infrastructure, post-mortem donation rate in Islamic countries is not comparable to successful settings. We conducted this study to assess the extent of contribution of factors that reduce the level of effectiveness, and also to determine the impact of altruistic feelings in the month of Ramadan on family refusal as the leading modifiable contributor to organ donation rate...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#4
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#5
Mark J Cherry
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28899444/use-of-implementation-science-for-a-sustained-reduction-of-central-line-associated-bloodstream-infections-in-a-high-volume-regional-burn-unit
#6
Geeta Sood, Julie Caffrey, Kelly Krout, Zeina Khouri-Stevens, Kevin Gerold, Stefan Riedel, Janet McIntyre, Lisa L Maragakis, Renee Blanding, Jonathan Zenilman, Richard Bennett, Peter Pronovost
OBJECTIVE We describe the use of implementation science at the unit level and organizational level to guide an intervention to reduce central-line-associated bloodstream infections (CLABSIs) in a high-volume, regional, burn intensive care unit (BICU). DESIGN A single center observational quasi-experimental study. SETTING A regional BICU in Maryland serving 300-400 burn patients annually. INTERVENTIONS In 2011, an organizational-level and unit-level intervention was implemented to reduce the rates of CLABSI in a high-risk patient population in the BICU...
September 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28892875/development-of-parafollicular-cells-and-their-relationship-with-developing-thyroid-follicles-in-human-foetuses
#7
Sushant Swaroop Das, Sabita Mishra, J M Kaul
INTRODUCTION: The parafollicular cells or clear (C) cells in man are part of neuroendocrine system under Amine Precursor Uptake and Decarboxylation (APUD) cells. Their role in adults has been reputable but in foetus is still unclear. AIM: The present study was a baseline study endeavouring to describe the chronological development of the parafollicular cells with particular focus on its correlation with developing human thyroid follicles. MATERIALS AND METHODS: The study was conducted on 10 aborted foetuses (14-28 weeks), procured from the Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890007/medical-training-and-the-brain-death-exam-a-single-institution-s-experience
#8
Ahmed Kashkoush, Amy Weisgerber, Kiruba Dharaneeswaran, Nitin Agarwal, Lori Shutter
BACKGROUND: Clinicians may have limited opportunities to perform neurological determination of death (NDD; brain death) certification during their training. This study aims to evaluate the level of resident exposure to the brain death exam at a large volume donor hospital. METHODS: In March 2014, we adapted a dual-physician model for NDD certification at our institution to improve resident education regarding NDD. To evaluate the incidence of resident exposure, we collected examiner information from all brain death exams conducted between January 2014 and July 2015...
September 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28885970/essential-medications-for-patients-with-suspected-or-confirmed-ebola-virus-disease-in-resource-limited-environments
#9
William F Pierce, Selena D Ready, John Tyson Chapman, Corrinne Kulick, Anastasia Shields, Jialynn Wang, Kimberly Andrews, Richard W Childs, Carlos Bell, Alexandr Kosyak, Jade Pham
BACKGROUND: In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28883707/donor-derived-infections-among-chinese-donation-after-cardiac-death-liver-recipients
#10
Qi-Fa Ye, Wei Zhou, Qi-Quan Wan
AIM: To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. METHODS: We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors...
August 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28858421/deceased-donor-uterus-retrieval-a-novel-technique-and-workflow
#11
G Testa, T Anthony, G McKenna, E C Koon, K Wallis, G B Klintmalm, J C Reese, L Johannesson
Uterus transplantation has proven successful when performed with a living donor. Subsequently, interest in the novel field of reproductive transplantation is growing. The procedure is still considered experimental, with fewer than 25 cases performed worldwide, and the techniques of both uterus procurement and transplantation are still developing. We detail a new approach to deceased donor uterus procurement. In contrast to reported techniques and our own initial experience, in which the deceased donor uterus was procured post cross-clamp and after other organs were procured, our approach now is to perform the uterus procurement prior to the procurement of other organs in a multiorgan donor and hence prior to cross-clamp...
August 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28858174/trends-in-characteristics-of-patients-listed-for-liver-transplantation-will-lead-to-higher-rates-of-waitlist-removal-due-to-clinical-deterioration
#12
Zinan Yi, Maria E Mayorga, Eric S Orman, Stephanie B Wheeler, Paul H Hayashi, A Sidney Barritt
BACKGROUND: Changes in the epidemiology of end-stage liver disease may lead to increased risk of dropout from the liver transplant waitlist. Anticipating the future of liver transplant waitlist characteristics is vital when considering organ allocation policy. METHODS: We performed a discrete event simulation to forecast patient characteristics and rate of waitlist dropout. Estimates were simulated from 2015 to 2025. The model was informed by data from the Organ Procurement and Transplant Network, 2003 to 2014...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28852629/essential-medicine-utilization-and-situation-in-selected-ten-developing-countries-a-compendious-audit
#13
REVIEW
Mainul Haque
Medicine improves the quality of life and increases mean age of human beings as it fights against diseases. Accessibility to medicines is the fundamental right of every person. The principle of the essential medicines (EMs) is that a limited number of availability of medicine will promote to a better supply chain and rational prescribing to the rural and remote health centers for any developing countries. Furthermore, it was also expected that this concept will also ensure better procurement policy at lower costs, more in amount, with easier storage...
July 2017: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/28851844/the-new-xpert-mtb-rif-ultra-improving-detection-of-mycobacterium-tuberculosis-and-resistance-to-rifampin-in-an-assay-suitable-for-point-of-care-testing
#14
Soumitesh Chakravorty, Ann Marie Simmons, Mazhgan Rowneki, Heta Parmar, Yuan Cao, Jamie Ryan, Padmapriya P Banada, Srinidhi Deshpande, Shubhada Shenai, Alexander Gall, Jennifer Glass, Barry Krieswirth, Samuel G Schumacher, Pamela Nabeta, Nestani Tukvadze, Camilla Rodrigues, Alena Skrahina, Elisa Tagliani, Daniela M Cirillo, Amy Davidow, Claudia M Denkinger, David Persing, Robert Kwiatkowski, Martin Jones, David Alland
The Xpert MTB/RIF assay (Xpert) is a rapid test for tuberculosis (TB) and rifampin resistance (RIF-R) suitable for point-of-care testing. However, it has decreased sensitivity in smear-negative sputum, and false identification of RIF-R occasionally occurs. We developed the Xpert MTB/RIF Ultra assay (Ultra) to improve performance. Ultra and Xpert limits of detection (LOD), dynamic ranges, and RIF-R rpoB mutation detection were tested on Mycobacterium tuberculosis DNA or sputum samples spiked with known numbers of M...
August 29, 2017: MBio
https://www.readbyqxmd.com/read/28844586/performance-of-serum-creatinine-and-kidney-injury-biomarkers-for-diagnosing-histologic-acute-tubular-injury
#15
Dennis G Moledina, Isaac E Hall, Heather Thiessen-Philbrook, Peter P Reese, Francis L Weng, Bernd Schröppel, Mona D Doshi, F Perry Wilson, Steven G Coca, Chirag R Parikh
BACKGROUND: The diagnosis of acute kidney injury (AKI), which is currently defined as an increase in serum creatinine (Scr) concentration, provides little information on the condition's actual cause. To improve phenotyping of AKI, many urinary biomarkers of tubular injury are being investigated. Because AKI cases are not frequently biopsied, the diagnostic accuracy of concentrations of Scr and urinary biomarkers for histologic acute tubular injury is unknown. STUDY DESIGN: Cross-sectional analysis from multicenter prospective cohort...
August 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28838179/implementing-the-synchronized-global-switch-from-trivalent-to-bivalent-oral-polio-vaccines-lessons-learned-from-the-global-perspective
#16
Alejandro Ramirez Gonzalez, Margaret Farrell, Lisa Menning, Julie Garon, Hans Everts, Lee M Hampton, Samantha B Dolan, Stephanie Shendale, Sarah Wanyoike, Chantal Laroche Veira, Gaël Maufras du Châtellier, Feyrouz Kurji, Jennifer Rubin, Liliane Boualam, Diana Chang Blanc, Manish Patel
In 2015, the Global Commission for the Certification of Polio Eradication certified the eradication of type 2 wild poliovirus, 1 of 3 wild poliovirus serotypes causing paralytic polio since the beginning of recorded history. This milestone was one of the key criteria prompting the Global Polio Eradication Initiative to begin withdrawal of oral polio vaccines (OPV), beginning with the type 2 component (OPV2), through a globally synchronized initiative in April and May 2016 that called for all OPV using countries and territories to simultaneously switch from use of trivalent OPV (tOPV; containing types 1, 2, and 3 poliovirus) to bivalent OPV (bOPV; containing types 1 and 3 poliovirus), thus withdrawing OPV2...
July 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28838178/introduction-of-inactivated-poliovirus-vaccine-and-trivalent-oral-polio-vaccine-bivalent-oral-polio-vaccine-switch-in-the-african-region
#17
Carol Tevi-Benissan, Joseph Okeibunor, Gaël Maufras du Châtellier, Afework Assefa, Joseph Nsiari-Muzenyi Biey, Dah Cheikh, Messeret Eshetu, Blanche-Philomene Anya, Halima Dao, Yusuf Nasir, Bartholomew Dicky Akanmori, Richard Mihigo
The Polio Eradication and Endgame Strategic plan outlines the phased removal of oral polio vaccines (OPVs), starting with type 2 poliovirus-containing vaccine and introduction of inactivated polio vaccine in routine immunization to mitigate against risk of vaccine-associated paralytic polio and circulating vaccine-derived poliovirus. The objective includes strengthening routine immunization as the primary pillar to sustaining high population immunity. After 2 years without reporting any wild poliovirus (July 2014-2016), the region undertook the synchronized switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) as recommended by the Strategic Advisory Group of Experts on Immunization...
July 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28838170/experience-with-inactivated-polio-vaccine-introduction-and-the-switch-from-trivalent-to-bivalent-oral-polio-vaccine-in-the-world-health-organization-s-western-pacific-region
#18
Santosh Gurung, Jennifer B Harris, Abu Obeida Eltayeb, Lee M Hampton, Sergey Diorditsa, Tigran Avagyan, W William Schluter
The World Health Organization (WHO) Western Pacific Region (WPR) has maintained its polio-free status since 2000. The emergence of vaccine-derived polioviruses (VDPVs), however, remains a risk, as oral polio vaccine (OPV) is still used in many of the region's countries, and pockets of unimmunized or underimmunized children exist in some countries. From 2014 to 2016, the region participated in the globally coordinated efforts to introduce inactivated polio vaccine (IPV) into all countries that did not yet include it in their national immunization schedules, and to "switch" from trivalent OPV (tOPV) to bivalent OPV (bOPV) in all countries still using OPV in 2016...
July 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28836706/the-utility-of-serial-echocardiograms-for-organ-procurement-in-brain-death
#19
Chiara Lazzeri, Cristiana Guetti, Maria Luisa Migliaccio, Marco Ciapetti, Adriano Peris
Heart transplantation rates are limited by a shortage of donor hearts and left ventricular dysfunction is an important cause. We hypothesized that an early echocardiographic evaluation in severe brain injury (performed within 12 hours from ICU admission) could allow the detection of potentially reversible left ventricular (LV) abnormalities and thus the initiation of tailored treatment whose effects could be assessed at a second echocardiogram performed when brain death develops. We assessed this hypothesis in 49 patients with severe brain injury who were potential heart donors...
August 24, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28833326/projected-increase-in-obesity-and-non-alcoholic-steatohepatitis-related-liver-transplantation-waitlist-additions-in-the-united-states
#20
Neehar D Parikh, Wesley J Marrero, Jingyuan Wang, Justin Steuer, Elliot B Tapper, Monica Konerman, Amit G Singal, David W Hutton, Eunshin Byon, Mariel S Lavieri
Non-alcoholic steatohepatitis (NASH) cirrhosis is the fastest growing indication for liver transplantation (LT) in the US. We aimed to determine the temporal trend behind the rise in obesity and NASH-related additions to the LT waitlist in the US and make projections for future NASH burden on the LT waitlist. We used data from the Organ Procurement and Transplantation Network database from 2000-2014 to obtain the number of NASH-related LT waitlist additions. The obese population in the US from 2000-2014 was estimated using data from the US Census Bureau and the National Health and Nutrition Examination Survey...
August 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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