ABSTRACT
Donation after circulatory death (DCD) has become an accepted practice in many countries and remains a focus of intense interest in the transplant community. The present study is aimed at providing a description of the current situation of DCD in European countries. Specific questionnaires were developed to compile information on DCD practices, activities and post-transplant outcomes. Thirty-five countries completed the survey. DCD is practiced in 18 countries: eight have both controlled DCD (cDCD) and uncontrolled DCD (uDCD) programs, 4 only cDCD and 6 only uDCD. All these countries have legally binding and/or nonbinding texts to regulate the practice of DCD. The no-touch period ranges from 5 to 30 min. There are variations in ante and post mortem interventions used for the practice of cDCD. During 2008-2016, the highest DCD activity was described in the United Kingdom, Spain, Russia, the Netherlands, Belgium and France. Data on post-transplant outcomes of patients who receive DCD donor kidneys show better results with grafts obtained from cDCD versus uDCD donors. In conclusion, DCD is becoming increasingly accepted and performed in Europe, importantly contributing to the number of organs available and providing acceptable post-transplantation outcomes.
Subject(s)
Tissue and Organ Procurement/trends , Transplantation/trends , Belgium , Death , Europe , France , Graft Survival , Humans , Netherlands , Russia , Spain , Tissue Donors , United KingdomABSTRACT
In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.
Subject(s)
Anti-HIV Agents/administration & dosage , HIV Antibodies/blood , HIV Antigens/blood , HIV Infections/diagnosis , HIV Infections/prevention & control , Post-Exposure Prophylaxis/methods , Serologic Tests/methods , Chemoprevention/methods , Early Diagnosis , HIV Infections/virology , HIV-1/isolation & purification , HIV-2/isolation & purification , Health Personnel , Humans , Occupational Exposure , Sweden , Time FactorsABSTRACT
The purpose of this study was to investigate QOL in parents/caretakers of children with cerebral palsy in the province of Kampong Cham, Cambodia. Forty parents/caretakers of children with cerebral palsy aged 1-13 years (F19/M21) participated in this study. The study was carried out using the Comprehensive Quality of life Scale A5 (ComQOL-A5) questionnaire. Results point out three major domains where quality of life is unsatisfactory: health, material well-being and emotional well-being. Of these areas, QOL in the health domain demonstrates the lowest scores. Results support a further commitment in providing comprehensive rehabilitation for parents and their children with CP in Kampong Cham. This study identifies the need for further research on QOL in parents/caretakers of children with CP in Cambodia and the need for development of valid and reliable QOL instruments targeting the developing world.
Subject(s)
Caregivers/psychology , Parents/psychology , Quality of Life/psychology , Adolescent , Cambodia , Cerebral Palsy/psychology , Cerebral Palsy/rehabilitation , Child , Child, Preschool , Female , Health Status , Humans , Infant , Male , Psychiatric Status Rating Scales , Severity of Illness Index , Socioeconomic Factors , Stress, Psychological , Surveys and QuestionnairesABSTRACT
Rapid and reliable detection of varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV-1) and -2 (HSV-2) is of clinical significance in immunocompromised patients and patients with infections of the central nervous system. This paper describes the detection of VZV and HSV using the commercially available Affigene VZV and Affigene HSV 1/2 tracer kits in comparison to "in-house" polymerase chain reaction (PCR) assays. For sample preparation, Qiagen (Hilden, Germany) and Affigene (Cepheid AB, Bromma, Sweden) DNA extraction kits were used. 175 samples were analyzed for VZV and 352 samples for HSV-1 and -2. Generally more positive results were obtained using the Affigene assays compared to the "in-house" methods independent of the DNA preparation method used. There were significant differences in sensitivity between the Affigene HSV 1/2 tracer and the "in-house" PCR assays for the detection of both HSV-1 and -2 in cerebrospinal fluid and vesicle/skin swabs. The Affigene HSV 1/2 and VZV tracers are very sensitive assays for detection of VZV and HSV. A wide variety of clinical samples can be examined in combination with either the Qiagen or the Affigene DNA extraction kits for preparation.
