Implementation and Sustainability of European Training Program on Organ Donation in Poland: Results and the Impact on Donation Indicators.

BACKGROUND: Hospital training called ETPOD-Essentials in Organ Donation-was introduced in Poland in 31 hospitals with under-utilized potential of donation. The aim of this study was to assess the effect in hospitals included and not included in program, before and after trainings. METHODS: The number of potential and effective donors, organs used, and number (%) of family refusals were compared at 10 and in 20 months after the training and in equal periods before. RESULTS: In trained hospitals, the number of potential donors increased (17% in 10 months, 10% in 20 months); in remaining hospitals, donors increased in 5% in both periods. In hospitals included in ETPOD, the number of effective donors increased (2% and 4.5%); in the whole country, donors also increased (5.6% and 2.7%). In ETPOD hospitals, the number of utilized organs increased (14.5% and 8.5%); in the rest, the increase was 3% and 7%. In trained hospitals, family refusals increased from 6.9% to 16.2% and from 8.9% to 10.7%; in the whole country, family refusals decreased from 11.7% to 11% in the short term and increased from 9.6% to 12.1% in the long term. CONCLUSIONS: In hospitals involved in the ETPOD program, the increase in organ donation is greater than in the rest of hospitals. Distinct benefit was observed in consent to organ donation.

The Model of Postgraduate Studies for Transplant Coordinators in Poland: 500 Graduates in the Years 2007-2015.

BACKGROUND: Since 2007, the Medical University of Warsaw has been organizing the Transplant Coordinators Postgraduate Studies, which are funded by the National Programme for the Development of Transplantation Medicine. The aim of the studies is to recruit medical professionals for every hospital with the potential of deceased donations. The goal of the present study was to formally evaluate the previous 16 editions of Transplant Coordinators Postgraduate Studies by assessing graduate profiles and analyzing the efficiency and sustainability of their education. METHODS: Graduate profiles were determined by gathering sociodemographic information contained in student records. Training efficiency and sustainability were defined by assessing the actual performance of the coordinators' functions in the hospital after taking the course. RESULTS: As of May 2015, the number of Transplant Coordinators Postgraduate Studies graduates totals 501. Approximately one half of the graduates (n = 248) had nursing degrees; training was also finished by 199 physicians, and 54 individuals had other medical education. The number of graduates per million population across the whole country totals 13. A total of 226 of the graduates (45%) were employed in the years 2007-2015 in hospitals as transplant coordinators; physicians (93 graduates), nurses (107 graduates) and other medical proffessionals (26 graduates). CONCLUSIONS: The academic formula of the Transplant Coordinators Postgraduate Studies funded by public sources makes it possible to educate practicing staff (physicians and nurses alike) for a nationwide system of donor hospital transplant coordinators posted in >200 hospitals and maintained by a national transplant organization.

Partnership for transplantation: a new initiative to increase deceased organ donation in Poland.

Despite the long-standing history of transplantation, the shortage of organs has remained its most restrictive factor. In 2010, the number of actual deceased organ donors in Poland was 13.5/million population (pmp). However, a huge difference in organ recovery rates is evident between various regions, eg, 32 pmp, in western Pomerania compared with 1-3 pmp in southern districts. A substantial number of patients who die while awaiting organ transplantations could be saved were effective programs able to overcome barriers in deceased organ donation. Such programs, eg, the European Donor Hospital Education Program, Donor Action, European Training Program on Organ Donation, United States Collaborative in Donation were introduced several years ago, but after transient improvements there has not been real progress. A new comprehensive program-Regional Partnership for Transplantation-was initiated a year ago in 4 districts of southern Poland by the Polish Union for Transplantation Medicine. The letter of intent to activate the donation program was signed by the local administration, the president of the local medical school, president of the Physician's Chamber, transplant centers, the Polish Union for Transplantation, and the Polish Transplant Coordinating Center. The plan of action included training of in-hospital coordinators, visits to all regional hospitals in company of a representative of the hospital founding body, examination of the real donation pool and the need for participation in a donation program training and education of the hospital staff in legal and organizational aspects of donation, brain death recognition, and various aspects of donor care. In addition, the program included communication skills workshops for intensive care unit physicians (with participation of 2 actors, an experienced anesthesiologist, and a psychologist), lectures for high school and university students and for hospital chaplains as well as alumni of higher seminaries. The preliminary results (after the first year) showed 40%-70% increases in activity of the local hospitals in the organ donation process.

Educational system for transplant coordinators in Poland: postgraduate studies at Warsaw Medical University; 2 years of experience.

Donor hospital transplant coordinators play crucial roles in the donation process. There are only a few coordinators in Poland, while there are about 400 hospitals with intensive care units (ICU). Coordinators must be professionals in medical sciences, clinical psychology, law, organization, management, and statistics. Coordinators acquire these skills during the Transplant Coordinators Postgraduate Studies at Warsaw Medical University which began in 2007. Lectures, seminars and exercises (99 hours, 6 weekends) are run by experts. The studies end with an examination and a diploma. The main criterion for acceptance of a candidate is employment in a key department in the donation process. The aim of studies is to educate coordinators for each hospital in the country. Until now 4 editions of the course have been completed. Among 123 graduates, 71 (60%) are employed in strategic departments of 48 hospitals. Preliminary results of graduates' activities in donor detection were compared in the periods before (2005-2006) and after the course (2007-2008). The background was the overall activity in Poland, where in 2007-2008 the activity fell to 79% of 2005-2006. This fall for hospitals with the graduates of this program was 82% versus hospitals without them (76%). Of the 48 hospitals that employed the graduates: 14 improved donation 5 were the same, in 12 in both periods showed no donations; whereas in 11 it was much lower (>20%), and in 6 lower but consistent with the national trend.

Nanotechnology on duty in medical applications.

At the beginning of 21(st) century, fifty years after discovery of deoxyribonucleic acid (DNA) double helix structure, scientific world is faced with a great progress in many disciplines of biological research, especially in the field of molecular biology and operating on nucleid acid molecules. Many molecular biology techniques have been implemented successfully in biology, biotechnology, medical science, diagnostics, and many more. The introduction of polymerase chain reaction (PCR) resulted in improving old and designing new laboratory devices for PCR amplification and analysis of amplified DNA fragments. In parallel to these efforts, the nature of DNA molecules and their construction have attracted many researchers. In addition, some studies concerning mimicking living systems, as well as developing and constructing artificial nanodevices, such as biomolecular sensors and artificial cells, have been conducted. This review is focused on the potential of nanotechnology in health care and medicine, including the development of nanoparticles for diagnostic and screening purposes, the manufacture of unique drug delivery systems, antisense and gene therapy applications and the enablement of tissue engineering, including the future of nanorobot construction.

A modified mordant technique for staining plant chromosomes.

The ability to produce ferric acetate in house has provided a new mordant source for use in Newcomer's fluid (6:3:1:1:1 isopropanol, propionic acid, acetone, petroleum ether, 1,4-dioxane) for species with small chromosomes. This method improves on one first published in 1970.

Optimizing the assessment of age-related changes in trabecular bone.

The goal of this study was to develop an optimal procedure to determine age-related changes in trabecular bone. The investigations were based on two-dimensional images of the human vertebral trabecular bone specimens. The following indices of trabecular structure were considered: bone volume/total volume, star volume of the marrow cavity, Euler number and the probability of disconnection (straightforwardly connected with the number of separated parts of the network). To follow precisely the changes in the trabecular structure with age, a computer simulation model was used. Up to 35 years of physiological remodelling were simulated. The validation of the model calculations was based on a quantitative comparison with the data measured for older individuals. The simulations confirmed that the description of the age-related changes in the trabecular bone by means of the architectural parameter (star volume) constitutes a promising tool for subjects older than approximately 50 years. For individuals younger than approximately 50 years bone mineral density (bone volume/total volume) seems to be the best suited descriptor. The results suggest that the optimal diagnostic procedure is age-dependent and should not be limited to the bone mineral density measurement. The clinical usefulness of the procedure has been validated by examination of the CT images.

[Double intertrochanteric distraction osteotomy.]. / Dvojitá intertrochanterická predlzujúca osteotómia.

The authors present four case-histories pertaining to double intertrochanteric distraction osteotomy of the proximal portion of the femur. In two female patients the result was excellent, in one female patient a 130 degrees splint broke and in another the splint was bent and the splints had to be replaced. All patients are satisfied with the operation because the extremity was prolonged on average by 2 cm. The authors objective is to demonstrate, based on their own practice, the static and biomechanical demands laid not only on bone but also on the metal fixation material (splint) in double distraction osteotomy of the proximal femur. Based on these observations the authors recommend in double distraction osteotomy of the proximal femur in adults prolonged immobilization of the hip joint either in bed with extension applied for four weeks or use of a plaster spike for a four-week period. Key words: dysplasia of the hip joint, intertrochanteric distraction osteotomy.

Potentiometric determination of chlorides with an "Air-Gap" cyanide sensor.

A new electroanalytical method for determining chloride ions with an Air-Gap cyanide sensor system is described. The method is based on the reaction of chloride with mercury(II) cyanide in dilute sulphuric acid. This reaction leads to hydrogen cyanide which can be determined with an Air-Gap cyanide sensor. Optimum concentrations of mercury(II) cyanide and sulphuric acid were established and an analytical curve was prepared for 1 x 10(-1)-1 x 10(-5)M Cl(-). The slope of the calibration curve was equal to 62.8 mV/log C. The correlation coefficient (R) was equal to 0.9992. The method can determine chloride with good results in high saline solutions and in the presence of surfactants, which is in contrast to direct potentiometry with a chloride electrode. The method was applied for chloride determination in fuses used for initiating explosions. The chlorides were determined both in the raw materials used to prepare the fuse braids and in the other fuse components. Chloride was also determined in drinking water and river water. In dependence of source, chloride amount analyzed in drinking water was in the range 2.18-182.6 mg/l. and 25.8 mg/l. in river water. A comparative analysis was carried out. In the first case, chloride was determined by a turbidimetric method, whereas in the second one by potentiometric titration against a chloride-ISE.