Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List.

BACKGROUND: It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES: To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS: Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS: More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS: Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List.

BACKGROUND: The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved. OBJECTIVE: To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list. METHOD: Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished. RESULTS: Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire. CONCLUSIONS: Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

Teenagers in Rural Areas Faced With Organ Donation and Transplantation.

INTRODUCTION: In rural areas it is common to find unfavorable attitudes toward organ donation, and therefore it is important to find out the attitude and profile of new generations for improving predisposition to organ donation in these areas. Our objective was to analyze the attitude toward organ donation and the related variables of teenagers in a rural area. MATERIALS AND METHODS: Students in the final year of compulsory education (mostly 15-16 years of age) were selected from secondary schools in a rural area in southeastern Spain (n = 319; population density <300 inhabitants/km2). The instrument of measurement used was a validated psychosocial questionnaire. Completion was anonymous and self-administered. Descriptive statistical analysis, Student t test, χ2 test, and multivariate analysis were employed. RESULTS: There was a completion rate of 96% (n = 306). Overall, 65% (n = 200) were in favor of donating their organs, 30% (n = 90) were undecided, and 5% (n = 16) were against. Attitude toward the donation of one's own organs was related with sex (P = .015), previous experience of organ donation or transplantation (P = .046), comment on the topic of organ donation within the family (P = .003; odds ratio 2.155), knowing one's mother's opinion about the matter (P = .021), knowing the correct concept of brain death (P = .012; odds ratio 2.076), and religion (P = .014). CONCLUSIONS: A favorable attitude of teenagers in rural areas toward organ donation is slightly higher than in the adult population and is determined by many psychosocial variables, above all family discussion about organ donation and transplantation and correct knowledge of the brain death concept.

Importance for the Elderly of Discussion in the Family and Society About Attitude Toward Organ Donation.

BACKGROUND: The aging of the population has changed some of the approaches to the organ donation and transplant (ODT) process, such as considering elderly people as potential donors. We aimed to assess social and family discussions among the elderly about ODT and its effect on their attitude toward organ donation. METHODS: A study was carried out at 2 publicly-funded social centers for the elderly. Contact was made with individuals >65 years of age (n = 120) to seek their participation in the study. A questionnaire was distributed to them with questions about ODT. A descriptive assessment was performed with the Student t test and χ2 test used for statistical analysis. RESULTS: The completion rate was 87% (n = 104). Of the respondents with a partner and children, 48% had discussed the topic of ODT. It was found that talking about the subject with one's partner, children, or friends had a favorable influence on attitude compared with when this was not done (93%, 86%, and 83% vs 19%, 30%, and 31%, respectively; P < .001). In addition, the opinion of one's partner and children toward ODT also had an influence; if favorable, the respondent's attitude was more favorable, compared with when they did not know their opinion (92% to 88% vs 58% to 37%, respectively; P < .001). Other ODT-related variables did not affect their attitude (P > .05). CONCLUSIONS: Almost half of the elderly people had discussed ODT socially or with their family. This discourse has a favorable influence on their attitude toward organ donation and, therefore, it is important to encourage social and family dialog among this group.

Teenagers and Their Future Role in Transplantation: An Analysis of Their Attitudes Toward Solid Organ Xenotransplantation.

INTRODUCTION: It is important to determine the level of social acceptance of xenotransplantation, especially in places where there are preclinical xenotransplantation projects. In this sense, it is important to know the attitude of teenagers, given that their attitude could have an influence on this kind of donation in the future. OBJECTIVES: The aim of this study is to analyze the attitudes of teenagers toward xenotransplantation and to determine the variables affecting their attitudes. MATERIAL AND METHODS: A random simple was obtained of students who were between 12 and 16 years of age in secondary schools in the southeast of Spain (n = 3633). Their attitudes were assessed with the use of a validated psychosocial questionnaire about xenotransplantation (PCID-XenoTx Ríos). The questionnaire was completed anonymously and was self-administered. Descriptive statistical analysis, Student t, and χ2 tests were used. RESULTS: The completion rate was 97% (n = 3531). With regard to animal organ donation for humans, 44% (n = 1569) would be in favor, 22% (n = 784) against, and 34% (n = 1178) undecided. Attitude was related to knowing a transplantation patient (P = .02), believing that transplant organ needs are not covered (P = .004), having received information about organ donation and transplantation (ODT) on television and from schools (P = .001), family discussion about ODT (P < .001), attitude of the respondent's parents (P < .001), and attitude toward human donation (P < .001). CONCLUSIONS: More than half of the teenagers had unfavorable attitudes toward xenotransplantation as this was determined by factors related to knowledge of and previous information about ODT, the attitude of one's family, and attitudes toward the different types of human organ donation.

Information received by secondary school teaching personnel about organ donation and transplantation: a study in the southeast of Spain.

BACKGROUND: Information about organ donation and transplantation (ODT) is the basis on which attitude toward this subject is shaped. The information about ODT that teachers can provide to school children is fundamental for them to develop a favorable attitude to this matter in the future. OBJECTIVES: The aims of this study were: 1) to determine the type of information on ODT received by secondary school teachers; 2) to determine through which means teachers obtain information about donation; and 3) to determine the influence of each information source on their attitudes. METHODS: A sample was selected from 10 secondary schools, which were geographically stratified in southeast Spain. A validated questionnaire was applied about attitude toward ODT among teachers (n = 327), which was completed anonymously and was self-administered. The statistical analysis used the Student t test and the chi-square test. RESULTS: The questionnaire completion rate was 88% (n = 288); 99% (n = 286) of the responding teachers stated that they had received some information about ODT, and 40% (n = 117) indicated that they had good or very good information. The teachers received information about ODT from several sources, the most frequent being audiovisual means: television (89%), press (60%), and radio (47%). Social/family means were also important, such as conversations with other people (51%) and conversations with family members (39%). Teachers who reported having good information were more in favor of ODT than those who had limited or no information (P = .001). Only the exchange of information through conversations with family members was related to a positive attitude (P = .009). CONCLUSIONS: Most secondary school teachers in southeast Spain receive information about ODT. However, fewer than half think that the information is good. Teachers receive information through different means, especially audiovisual means, mainly television. Nevertheless, the social/family means has the most influence on attitude.

Feasibility study of the anaerobic digestion of dewatered pig slurry by means of polyacrylamide.

Liquid livestock waste can be managed by separating liquid and solid fractions then treating each separately by applying best available technology, such as anaerobic digestion for the solid fraction. There is an increasing use of polyacrylamide (PAM) as a flocculant agent to improve solid-liquid separation. In the present work, the anaerobic toxicity of PAM residues and the optimal range of total solids concentration for maximum methane production were studied as a function of PAM dosage. Results showed that dry matter and its volatile solids content increased significantly with increasing PAM dosage. Batch anaerobic tests showed that methane yield decreased linearly with increasing total solids, while the methane production per unit of raw substrate reached a maximum at 16.4% total solids. No PAM toxicity was measured for PAM concentrations below 415 g/kg total solids, but some indirect inhibitory phenomena were observed, such as a limited hydrolysis rate due to particle aggregation, and inhibition of methanogenesis by high ammonia concentration.

Fosfomycin in treatment of chronic urinary tract infection.

A study was made of fosfomycin in the treatment of chronic urinary infection in 51 patients. 72% of the 67 bacteria isolated and tested in the laboratory with discs containing 50 mug of fosfomycin were found to be sensitive to the antibiotic. The majority of E. coli, Klebsiella, P. mirabilis and Ps. aeruginosa strains were sensitive to the antibiotic. Generally, 60 mg of fosfomycin/kgbody weight was administered intramuscularly 6-hourly for 7-15 days. A clinical and bacteriological cure was obtained in 39 patients (76%), and after 4-6 weeks in 31 patients (61%). Blood and urine fosfomycin levels were determined in seven patients, three with normal renal function, three with moderate renal insufficiency, and one with severe renal insufficiency. The antibiotic levels and elimination time maintained a clear relation with the degree of renal insufficiency.