[Proposal for an anonymous reporting code organ trafficking: how transplant professionals can play a role in preventing this trafficking]. / Voorstel voor een anoniem meldpunt orgaanhandel.

Patients travel worldwide to undergo kidney transplantations. Care providers in the Netherlands encounter these patients, both before and after the transplantation. We present the results of a survey that was distributed among Dutch transplant professionals about their experiences with patients who have undergone a kidney transplantation abroad. We propose that care providers should report illegal transplantations. Of the 241 surveyed professionals, 100 treated patients who travelled to a country outside the European Union for a kidney transplant. Thirty-one professionals were certain that patients purchased their kidney, and sixty-five had suspicions that it had been purchased. The majority reported a conflict of duties. Professionals can help prevent organ purchase by detecting and disclosing information about organ trafficking networks. The aim of reporting is two-fold. Firstly, such disclosure can lead to increased knowledge and information about organ trafficking. Secondly, it can support the police and law enforcement agencies to investigate if networks are involved in facilitation of these transplantations. In this manner, those who facilitate organ trafficking can be prosecuted and exploitation of donors can be prevented.

Interviews With Patients Who Traveled From Macedonia/Kosovo, The Netherlands, and Sweden for Paid Kidney Transplantations.

BACKGROUND: Patients travel worldwide for paid kidney transplants. Although transplantations abroad are not always illegal, they are commonly perceived to be illegal and unethical involving risks. AIM: We aimed to describe the motivations and experiences of patients who traveled abroad for paid kidney transplantations and to examine how these transplantations were facilitated. METHODS: We interviewed 22 patients who traveled from Macedonia/Kosovo, the Netherlands, and Sweden for paid kidney transplantations between years 2000 and 2009. RESULTS: Patients traveled because of inadequate transplant activity in their domestic countries and dialysis-related complaints. However, 6 patients underwent preemptive transplantations. Cultural factors such as patients' affinity with destination countries, feelings of being discriminated against by the health-care system, and family ties also help explain why patients travel abroad. Seven of the 22 patients went to their country of origin. They were able to organize their transplantations by arranging help from family and friends abroad who provided contacts of caregivers there and who helped cover the costs of their transplants. The costs varied from €5000 to €45 000 (US$6800-US$61 200). Seven patients paid the hospital, 5 paid their doctor, 4 paid a broker, and 6 paid their donors. CONCLUSION: Research should include interviews with brokers, transplant professionals, and other facilitators to achieve a full picture of illegally performed transplantations.

Reporting Organ Trafficking Networks: A Survey-Based Plea to Breach the Secrecy Oath.

Patients travel worldwide to purchase kidneys. Transplant professionals can play a role in identifying kidney purchase. However, due to the tension between their rights and obligations, a lack of understanding and knowledge exists on how to prevent and report purchase. We present the results of a national survey that describes transplant professionals' experiences, attitudes, behaviors, conflicts of duties, legal knowledge and needs for guidelines toward patients who purchase kidneys abroad. Second, we clarify professionals' rights and obligations regarding organ purchase and propose actions that they can take to report purchase. Of the 100/241 (42%) professionals who treated patients who traveled to a country outside the European Union for a kidney transplant, 31 (31%) were certain that patients purchased kidneys. Sixty-five (65%) had suspicions that patients had bought kidneys. The majority reported a conflict of duties. Eighty percent reported a need for guidelines. Professionals can help prevent organ purchase by disclosing information about organ trafficking networks to law enforcement. Such disclosure can support the investigation and prosecution of networks. We offer key components for guidelines on disclosure of these networks.

Efeito da via de inoculaçäo na patogenicidade de amostras patôgenica e apatogênica de Escherichia coli em galinha / Effect of route of inoculation on the pathogenicity of pathogenic and apathogenic Escherichia coli strains in chickens

Estudou-se o efeito da via de inoculaçäo sobre a patogenicidade de amostras de Escherichia coli patogênica de apatogênica, para a galinha, utilizando-se aves SPF com um e 45 dias de idade. Nas aves com um dia de idade, a via oral pareceu ser a porta de entrada mais importante, enquanto que nas de 45 dias, a via respiratória pareceu ser a mais importante na reproduçäo da colibacilose. A amostra apatogênica esteve ausente ou foi rapidamente eliminada do sangue, enquanto que a amostra patogênica quase sempre provocou bacteremia. O pulmäo pareceu atuar como reservatório e disseminador de E. coli quando a bactéria foi inoculada através das vias respiratórias. A colonizaçäo do trato intestinal das aves ocorreu nos seus vários segmentos, do esôfago ao reto, com ambas as amostras. A amostra patogênica mostrou maior habilidade na colonizaçäo do trato digestivo das aves, tanto no tempo de persistência quanto na quantidade de bactérias. Cecos e, sequencialmente, reto foram os locais com maior intensidade de colonizaçäo, independente da via e amostra inoculada. Aerosaculite e pericardite foram as lesöes macroscópica mais evidentes, caracaterizadas microscopicamente por processos inflamatórios, com presença de células polimorfonucleares e mononucleares, somados a focos necróticos, principalmente no coraçäo

Proteçäo de galinhas pela cepa vacinal Conn-F de Mycoplasma gallisepticum, na forma liofilizada e como cultura fresca / Protection against Mycoplasma gallisepticum in chickens vaccinated with the Conn-F strain in the lyophilized form or as a broth culture

Estudou-se a cepa Conn-F de Mycoplasma gallisepticum como vacina para galinhas, utilizada na forma liofilizada, com títulos variáveis, e como cultura fresca. A resposta vacinal foi avaliada através da inoculaçäo no saco aéreo da cepa patogênica R de M. gallisepticum aos 28 e 49 dias pós-vacinaçäo. Os resultados foram verificados pela freqüência de aves com lesöes nos sacos aéreos, severidade das lesöes e níveis de anticorpos circulantes medidos pelos testes de soroaglutinaçäo rápida (SAR) e inibiçäo da hemaglutinaçäo (IH). A imunoproteçäo conferida foi dependente do título vacinal, do tempo pós-vacinaçäo e da forma de apresentaçäo da cultura. Resultados ligeiramente melhores foram observados com a vacina na forma de cultura fresca. Os títulos vacinais de 105 UFC/dose conferiram considerável melhor proteçäo que o título de 103 UFC/dose. As aves vacinadas foram mais resistentes ao desafio aos 49 dias. O teste de SAR foi mais sensível que o de IH, sendo o mais indicado na detecçäo da resposta sorológica à vacinaçäo. A soroconversäo, medida pelo teste de SAR, foi dependente do período pós-vacinaçäo e do título vacinal e mostrou tendência de cair aos 49 dias pós-vacinaçäo. A resposta sorológica de galinhas à cepa Conn-F näo se relacionou com a proteçäo

Patogenicidade de amostras de Mycoplasma synoviae isoladas no Brasil / Pathogenicity of Mycoplasma sinoviae strains isolated in Brazil

Comparou-se, em ovos embrionados, a virulência de quatro amostras brasileiras de Mycoplasma sinoviae (Ms) com a da amostra padräo MS WVU 1853. Um dos isolados e a amostra padräo tiveram o mesmo índice de mortalidade embrionária indicando alta virulência. Dois isolados tiveram virulência semelhante à do grupo controle, näo detectável pelo método utilizado, e o quinto isolado apresentou virulência intermediária