Retrospective comparison between non-treponemal and treponemal tests for screening of blood donors for syphilis and their correlation with donor history in a tertiary care teaching hospital

Background and objectivesTreponemal tests provide advantage of better detection during early, late and latent stages of syphilis with equal or higher sensitivity & specificity in comparison to non-treponemal tests. The objective of the present study was to analyse the level of concordance between treponemal and non-treponemal tests for donor screening and to correlate them with donor history.Materials and methodsRetrospective analysis of syphilis screening by treponemal (Chemiluminescence & TPHA) and non-treponemal tests (RPR) was done and donor history for high-risk behaviour and factors associated with false positivity were collected from post-donation counselling and collected data was coded and analysed.ResultsAmongst the 12,000 donors screened, reactivity rate by RPR, TPHA and Chemiluminescence was 0.45%, 0.8% and 1.17% respectively. There was discordance of 62% and 32% for reactive results by RPR and TPHA respectively when compared with Chemiluminescence. History of high-risk behaviour was present in ∼ 50% and 15% of donors with discordant results by RPR and TPHA respectively. Of 34 donors who were reactive only by Chemiluminescence and were followed up, 15% had history of high-risk behaviour and 56% had factors associated with false reactivity.ConclusionTreponemal tests showed high syphilis reactivity amongst blood donors as compared to non-treponemal tests most likely due to their ability to detect early, late and latent syphilis cases. This may confer added transfusion safety in centres dependent on replacement donors without NAT testing by identifying donors with high-risk history with negligible increase in discard rate due to false reactivity.     

Why search for a sperm donor online? The experiences of women searching for and contacting sperm donors on the internet

Whilst studies have examined the experiences of women who use clinic donors, to date there has been limited research investigating women’s motivations and experiences of searching for a sperm donor online. A total of 429 women looking for a sperm donor on Pride Angel (a website that facilitates contact between donors and recipients) completed an online survey. Fifty-eight percent (249) saw advantages of obtaining donated sperm online with the most common advantage reported as being able to connect with and meet the donor (n?=?50 (24%)). A third (n?=?157 (37%)) of the participants gave disadvantages, the most common reported was encountering ‘dishonest donors’ (n?=?63 (40%)). Most recipients (n?=?181 (61%)) wanted the donor to be ‘just a donor’ (i.e. to provide sperm and have no further contact). Whilst it was important for recipients to know the identity of the donor, some did not see this as important for the child and thus the level of information that parents have about the donor, and that which the child has, can differ. Finding a donor online blurs the distinction between categories of ‘anonymous’, ‘known’ and ‘identity release’ donations. Whilst the survey had a large sample size, the representativeness of the sample is not known.     

Prevalence of restless legs syndrome and associated factors in an otherwise healthy population: results from the Danish Blood Donor Study

ObjectiveRestless legs syndrome (RLS) is a neurological sensorimotor disorder characterized by uncomfortable sensations in the legs. RLS often occurs as a comorbid condition. Besides an increased risk of iron deficiency, blood donors are considered to be generally healthy. Blood donors are therefore an ideal population for studying factors associated with RLS occurrence, herein the role of iron. It is suggested that RLS is linked to sex, age, low socioeconomic status, unhealthy lifestyle, and iron deficiency. The objective of this study is therefore to estimate the RLS prevalence and identify associated biological, sociodemographic, economic, and lifestyle factors in a population of blood donors.MethodsA total of 13,448 blood donors enrolled in the Danish Blood Donor Study from May 2015 to May 2016. RLS cases were identified using the validated Cambridge–Hopkins RLS-questionnaire. Logistic regression models were applied to assess the relationship between RLS and data on socially related factors collected using questionnaires and population registers.ResultsIn this study, 7.2% women and 4.5% men were classified with RLS. RLS was associated with: female sex, high age, smoking, frequent alcohol consumption, and low education. RLS-related symptoms were associated with obesity, parity and donation intensity three years prior to inclusion among women. RLS was not related to: reduced plasma ferritin, employment status, and income.ConclusionsRLS is a frequent disorder in otherwise healthy individuals. The associations discovered in this study can be utilized in preventing or reducing RLS symptoms.     

Ethical issues in organ transplantation

Critical care clinicians are central to the organ transplantation process and therefore should be aware of the myriad ethical issues it raises. Organ donation can transform the lives of transplant recipients. However, it also warrants particular ethical scrutiny. Organ procurement is a procedure that cannot physically benefit the patient upon whom it is performed. Moreover, the potential donor incapacitated by terminal illness is usually unable to actively consent to donation. This article reviews contemporary debates in vital organ transplantation, including the definition of death, perimortem interventions and research, and merits of ‘opt-in’ versus ‘opt-out’ donor registries.     

Synthesis and characterization of metal oxide based ion exchanger from chicken egg shell biomass for the removal of arsenic from water

A new metal oxided-based high capacity biosorbent for As(III) was designed and synthesized from egg shell biomass and characterized using FTIR, FE-SEM, EDX, XRD, chemical analysis. For this, raw egg shell (RES) powder was first dissolved with HCl and mixed with ZrOCl₂18H₂O solution then precipitated to obtain hydrated double oxide precipitate (HDOP), which was employed for As(III) removal. As(III) biosorption onto HDOP is fast, depends on pH and As(III) concentration. Pseudo second order kinetics and Langmuir isotherm models successfully described the As(III) biosorption mechanism. HDOP provided exchangeable hydroxide/or chloride ligands for improved biosorption of As(III). Maximum biosorption capacity of HDOP for As(III) from Langmuir isotherm modelling was found to be 40 mg g^?1 at optimum pH 10. Chloride and nitrate cause negligible interference whereas sulphate and phosphate significantly reduced As(III) biosorption capacity of HDOP. HDOP completely removed arsenic from contaminated ground water and the remaining concentration was reached below the safe drinking water standard (10 μg L^?1) set by WHO. Moreover, HDOP exhibited effective regeneration and high stability with As(III) removal up to 8 cycles. Thus, HDOP synthesized from egg shell biomass can be used as a low cost, environmentally benign and high capacity biosorbent for the treatment of arsenic polluted water.     

Welsh 2013 deemed consent legislation falls short of expectations

Wales, in 2013, was the first country in the United Kingdom to pass legislation introducing presumed (or deemed) consent for organ donation, and remains the only one. It was introduced in an attempt to increase the number of life-saving transplants taking place in the UK, in a move that policy makers hoped would mirror Spain’s success. More recently, pressure has been mounting for England to follow suit, with a public consultation currently in progress. However, the Welsh system has been far from a success, raising the question of why campaigners are so adamant that it should be replicated. Before the Welsh Government introduced the Human Transplantation (Wales) Act there had been no strong evidence to suggest it would make a difference, with countries boasting both high organ donation rates and presumed consent legislation demonstrating no clear causal relationship between the two facts. In addition, a recent report evaluating the Act has highlighted its failure to improve donation rates, and has even presented some potentially concerning statistics that may suggest a negative impact. This paper first considers presumed consent in other countries – Spain and Brazil – before illustrating the underwhelming progression of Wales’ new system and the need to look to other options.