Organ and Tissue Donations for Transplants in the Macroregional North of Paraná, Brazil.

BACKGROUND: Few studies have analyzed the results of the organ and tissue donation process for transplants. OBJECTIVES: To analyze donations of organs and tissues for transplants in the Macroregional North of Paraná. MATERIAL AND METHODS: Cross-sectional and retrospective study, using data from 7383 death certificates of eligible donors notified in 2015 by 16 hospitals accredited to the Organ Procurement Organization. The data were analyzed using the prevalence ratio (PR) and the Wald test. RESULTS: Among the 934 eligible donors, the prevalence of effective donations was 23.4% (219) Among the 582 organs and tissues donated, corneas were predominant. Organs became available for donation from younger individuals (PR = 0.992), due to brain death (PR = 2.482), notified by the type III Intra-Hospital Organ and Tissue Donation Commissions for Transplants (PR = 2.016), which took place in intensive care units (PR = 1.471). The relatives interviewed were the partners and/or children (PR = 0.469), and the interviews were held by the nurse (PR = 1.324). CONCLUSION: Effective donations were able to take place through proper organizational structure and trained human resources, highlighting the role of the nurse in the optimization of the organ and tissue donation process for transplants.

Screening for mutations in RPGR and RP2 genes in Jordanian families with X-linked retinitis pigmentosa.

Retinitis pigmentosa (RP) is a clinically and genetically heterogeneous disease causing progressive degeneration of retinal photoreceptor cells. X-linked RP (XLRP), in which photoreceptor degeneration begins in early childhood and complete blindness often occurs by the fourth decade of life, constitutes the most severe form of this disease. Two genes commonly associated with XLRP have previously been cloned: retinitis pigmentosa GTPase regulator (RPGR) and retinitis pigmentosa 2 (RP2). We sought to identify mutations in these genes in Jordanian families suffering from this disease. Five unrelated Jordanian families with confirmed XLRP were screened for such mutations using direct sequencing. Three mutations were identified in the ORF15 exon of RPGR. The silent g.ORF15+470G>A substitution and the g.ORF15+1822insA insertion in the 3ꞌ-untranslated region were found in both normal and affected male family members at comparable frequencies, and thus were considered normal variants. The third mutation, g.ORF15+588G>A, in which alanine is substituted by threonine, was found in all affected men and one unaffected man in the two families harboring this variant. Thus, this mutation may be pathogenic, but with incomplete penetrance. No RP2 mutations were found among the examined families. Mutation screening of RP patients is essential to understand the mechanism behind this disease and develop treatments. A complete family history is required to identify its inheritance pattern and provide genetic counseling for patients and their families.

Electrical activity of the orbicularis muscles before and after installation of ocular prostheses.

This study examined the electrical activity of the superior (SO) and inferior (IO) orbicularis oculi muscles before and after installing ocular prostheses in patients who had undergone unilateral enucleation. Twelve volunteers requiring prostheses were selected. Their electrical activity was monitored at rest and during normal opening and closing of the eyelids, rapid opening and closing of the eyelids, and squeezing. Data were recorded before and 7, 30, and 60 days after the ocular prosthesis was installed. Two-way analysis of variance was performed to verify whether there were any significant differences between the muscles and periods, and means were compared by Tukey-Kramer honestly significant difference (HSD) tests (P < 0.05). Results from the initial period differed significantly from those after prosthesis installation in all clinical situations. The SO had significantly higher electrical activity levels than the IO in all clinical situations but squeezing. The authors observed the same values during the initial period for the condition of rest (SO 8.42/IO 5.93) and the highest values for the condition of squeezing after 60 days (SO 131.50/IO 117.12). Rehabilitative treatment promoted an increase in the electrical activity of the orbicularis oculi muscles, restoring part of the muscle tone and motor function to muscles of the affected area.

Psychosocial impact on anophthalmic patients wearing ocular prosthesis.

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.

Influence of natural weathering on colour stability of materials used for facial prosthesis.

Colour stability of resin and silicone is an important factor for longevity of facial prostheses. The aim of this study was to evaluate the colour stability of resins and silicone for facial prostheses. Three brands of acrylic resin and one of facial silicone were evaluated considering pigment incorporation for the colourless materials. Ten samples of each material were fabricated and submitted to measurements of chromatic alteration initially and after 90 and 180 days of weathering natural through visual analysis and spectrophotometry. Data were evaluated by ANOVA and Tukey test (p < 0.05). Statistically significant colour alteration was observed among some materials regardless of the period. The materials did not present a statistical difference between 90 and 180 days except for the pigmented heat-polymerized resin. The colour difference between pigmented Silastic MDX4-4210 and colourless Silastic was statistically significant (p < 0.01) in both periods as well as between pigmented and colourless heat-polymerized resin, and between the resins Rapidaflex and Lentaflex. The visual method demonstrated colour alteration in all materials evaluated during the first 90 days of ageing. All materials exhibited colour alteration due to exposure to environment.

Effect of disinfection and accelerated ageing on dimensional stability and detail reproduction of a facial silicone with nanoparticles.

The aim of the present study was to evaluate the effect of disinfection and accelerated ageing on the dimensional stability and detail reproduction of a facial silicone with different types of nanoparticle. A total of 60 specimens were fabricated with Silastic MDX 4-4210 silicone and they were divided into three groups: colourless and pigmented with nanoparticles (make-up powder and ceramic powder). Half of the specimens of each group were disinfected with Efferdent tablets and half with neutral soap for 60 days. Afterwards, all specimens were subjected to accelerated ageing. Both dimensional stability and detail reproduction tests were performed after specimen fabrication (initial period), after chemical disinfection, and after accelerated ageing periods (252, 504 and 1008 hours). The dimensional stability test was conducted using AutoCAD software, while detail reproduction was analysed using a stereoscope magnifying glass. Dimensional stability values were statistically evaluated by analysis of variance (ANOVA) followed by Tukey's test (p < 0.01). Detail reproduction results were compared using a score. Chemical disinfection and also accelerated ageing affected the dimensional stability of the facial silicone with statistically significant results. The silicone's detail reproduction was not affected by these two factors regardless of nanoparticle type, disinfection and accelerated ageing.

Influence of dietary vitamin A content on serum and liver vitamin A concentrations and health in preruminant Holstein calves fed milk replacer.

Evidence has suggested that the current requirement for vitamin A tabulated by the NRC [(approximately 3800 IU of vitamin A/kg of dry matter (DM)] for dairy calves fed liquid diets is too low. The objective of this study was to assess the effects of vitamin A content in milk replacers on serum and liver vitamin A concentrations, growth, and development of clinical signs of vitamin A deficiency in calves. Male Holstein calves were separated from their dams at birth and given standardized feedings of colostrum and milk replacer for 3 d. On d 4, calves were assigned to five groups and fed milk replacer containing 2300, 6200, 9000, 18,300, or 44,000 IU of vitamin A/kg of DM. Liver biopsies and serum samples were taken on d 4, 9, 15, 21, and 28 to monitor vitamin A concentrations. Weekly physical and neurological examinations were performed to monitor the development of deficiency signs. Fecal scores, body temperature, and the presence of nasal and ocular discharge were recorded daily. Liver vitamin A concentrations in calves allotted to diets with 2300 and 6200 IU of vitamin A/kg decreased from d 4 to 28. Calves fed 9000 IU of vitamin A/kg maintained liver stores, while those fed 18,300 and 44,000 IU of vitamin A/kg had significant increases in hepatic vitamin A. A strong negative association existed between incidence of hyperthermic temperatures and vitamin A concentration in the diet; calves fed 2300 IU of vitamin A/kg had approximately three times more hyperthermic readings than did calves fed other treatments. A strong negative association also existed between fecal score and concentration of vitamin A in the diet; calves fed diets containing low vitamin A concentration had a higher incidence of high fecal scores (more watery) than did calves fed diets with higher vitamin A concentrations. Although slight differences were detected in serum retinol concentration, growth performance and incidence of ocular and nasal discharges were not different among treatment groups. Our data indicate that vitamin A concentrations of less than 9000 IU/kg of DM in milk replacers result in declining liver vitamin A stores in preruminant calves. Using the human Dietary Reference Intakes as a model for calculating the requirement, we recommend that the vitamin A requirement for preruminant calves should be increased to 11,000 IU of vitamin A/kg of DM.