Living organ donation practices in Europe – results from an online survey

In Europe, living organ donation (LOD) is increasingly accepted as a valuable solution to overcome the organ shortage. However, considerable differences exist between European countries regarding frequency, practices and acceptance of donor–recipient relations. As a response, the Coordination Action project ‘Living Organ Donation in Europe’ ( www.eulod.eu ), funded by the Seventh Framework Programme of the European Commission, was initiated. Transplant professionals from 331 European kidney and liver transplant centres were invited to complete an online survey on living kidney donation (LKD) and living liver donation (LLD). In total, 113 kidney transplant centres from 40 countries and 39 liver transplant centres from 24 countries responded. 96.5% and 71.8% performed LKD and LLD respectively. The content of the medical screening of donors was similar, but criteria for donor acceptance varied. Few absolute contraindications for donation existed. The reimbursement policies diverged and the majority of the donors did not get reimbursed for their income loss during recovery. Large discrepancies were found between geographical European regions (the Eastern, the Mediterranean and the North‐Western). As a result of this survey we suggest several recommendations to improve quality and safety of LOD in Europe.     

New classification of ELPAT for living organ donation

In the literature, varying terminology for living organ donation can be found. However, there seems to be a need for a new classification to avoid confusion. Therefore, we assessed existing terminology in the light of current living organ donation practices and suggest a more straightforward classification. We propose to concentrate on the degree of specificity with which donors identify intended recipients and to subsequently verify whether the donation to these recipients occurs directly or indirectly. According to this approach, one could distinguish between "specified" and "unspecified" donation. Within specified donation, a distinction can be made between "direct" and "indirect" donation.     

Health risk assessment of exposure to formaldehyde in dental materials

Purpose

The aim of the study was to evaluate the health status and to assess the risk of adverse health effects among dental professionals occupationally exposed to formaldehyde in dental materials.

Methods

A questionnaire survey was carried out with 78 participants: 30 occupationally exposed to formaldehyde as dental professionals and 48 non-exposed healthy referents. All participants were clinically examined, including a review of the participant’s medical history. Skin patch testing with formaldehyde and glutaraldehyde was performed.

Results

A significantly increased incidence and relative risk of manifestation of subjective symptoms from the upper respiratory tract, respiratory system and the skin were established in the group of occupationally exposed dental professionals. No significantly increased incidence of suppressed resistance to upper respiratory tract infectious diseases as a possible immunotoxic effect of formaldehyde was established by studying occupational exposure. Occupationally induced contact allergy to formaldehyde was found to have a significantly higher incidence and relative risk among dental professionals. A significantly higher prevalence of sensitization among women was observed.

Conclusions

The study documented well the irritant and skin-sensitizing effect of formaldehyde in materials used in dental practice; the results suggest a stronger skin-sensitizing potential of formaldehyde compared with glutaraldehyde.     

Head Transplants,Personal Identity and Neuroethics

The possibility of a human head transplant poses unprecedented philosophical and neuroethical questions. Principal among them are the personal identity of the resultant individual, her metaphysical and social status: Who will she be and how should the “new” person be treated - morally, legally and socially - given that she incorporates characteristics of two distinct, previously unrelated individuals, and possess both old and new physical, psychological, and social experiences that would not have been available without the transplant? We contend that this situation challenges linguistic conventions and conceptual binaries (“part-whole”), and calls into question the major philosophical approaches to personal identity: animalism and reductionism. We examine these views critically vis-a-vis head transplantation and conclude that they fail to provide an adequate account of the identity of the resultant individual because both neglect the key role of embodiment for personal identity. We maintain that embodiment is central to personal identity and a radical alteration of the body will also radically alter that person, making her a different person. Consequently, a human head transplant will result in an individual partly continuous with the head/brain (in terms of connected memories and mental events), and partly continuous with the body donor (in terms of the inputs and regulatory patterns afforded by the structure and functions of the nervous system, and the self-image of this new embodiment). We conclude that the resultant person would be different from both the individual whose head was transplanted and the one to whose body the “new” head is attached.     

Changes in serum carboxyterminal telopeptide of type I collagen in an experimental model of canine osteomyelitis

Blood biochemical indices of bone turnover were followed up for 1 month in six dogs with experimental osteomyelitis. The bone infection resulted in significant increase in parameters of bone formation (serum bone alkaline phosphatase and serum osteocalcin) and bone resorption [serum carboxyterminal telopeptide of type I collagen (i-ICTP)] as early as the end of the second week after the operation and inoculation. There was strong evidence that serum i-ICTP levels could be useful for the early diagnosis of postoperative complications in veterinary orthopedics, such as posttraumatic osteomyelitis.     

Epidemiological and aetiological study on tinea pedis and onychomycosis in Algeria

Epidemiological studies on tinea pedis and onychomycosis, common fungal infections, have been conducted in many parts of the world. There are currently no studies of tinea pedis and/or onychomycosis in Algeria. The aim of this paper was to study the epidemiology of foot diseases, including tinea pedis and onychomycosis and to identify the aetiological factors of these infections in outpatients attending the Department of Dermatology of the Central Hospital of Army in Algiers, Algeria. A total of 1300 male subjects, mean age 35.9 +/- 16 years (range: 16-80) were recruited during the period November 2003 to November 2004 and were clinically examined. A complete dermatological examination was performed on all subjects, and skin and nail specimens of the feet were taken from those patients presenting signs of tinea pedis and/or onychomycosis for microscopy and fungal culture. Clinical diagnosis for tinea pedis and onychomycosis was suspected in 249 and 72 subjects, respectively, and confirmed in 197 and 60 cases, respectively, by positive cultures, resulting in a global prevalence of tinea pedis and toenail onychomycosis of 15% and 4.6% respectively. The age groups most commonly infected were 50-59 and 20-29 years. The yeast species Candida parapsilosis and the dermatophytic species Trichophyton rubrum were shown to be the most common pathogens in both tinea pedis (C. parapsilosis 20.4%; T. rubrum 17%) and onychomycosis (T. rubrum 35%; C. parapsilosis 28.3%). This is the first investigation dealing with fungal foot diseases in Algeria. The clinical and epidemiological data collected would serve as reference for future research and may be useful in the development of preventive and educational strategies.     

Concomitant contact allergy to formaldehyde and methacrylic monomers in students of dental medicine and dental patients

Objectives

A multitude of acrylic monomers is used in dentistry. Formaldehyde is a ubiquitous chemical agent, which is an ingredient of some dental materials and may be released from methacrylate-based composites. The purpose of the study is to evaluate the incidence and the risk of cross-sensitization to some methacrylic monomers (methylmethacrylate — MMA, triethyleneglycol dimethacrylate — TEGDMA, ethyleneglycol dimethacrylate — EGDMA, 2,2-bis-[4-(2-hydroxy-3-methacrylo-xypropoxy)phenyl]-propane — Bis-GMA, 2-hydroxy-ethyl methacrylate 2-HEMA, and tetrahydrofurfuryl methacrylate) and formaldehyde in students of dentistry, dental professionals and dental patients.

Material and Methods

A total of 139 participants were included in the study, i.e., occupationally exposed dental professionals, students of the 3rd, 4th and 6th year of dental medicine, and occupationally unexposed dental patients. They were patch-tested with methacrylic monomers and formaldehyde. The results were subjected to statistical analysis (p < 0.05).

Results

From the allergic to formaldehyde students of the 3rd and 4th year of dental medicine, 46.2% were also sensitized to MMA. Among the group of patients, the incidence of cross-sensitization to formaldehyde and methacrylic monomers was as follows: to TEGDMA — 20.6%, to ethyleneglycol dimethacrylate — 20.7%, to 2-HEMA — 20.7% and to tetrahydrofurfuryl methacrylate — 24.1%. Contact allergy to MMA was diagnosed among 22.7%, and to TEGDMA — among 27.1% of the students of the 3rd and 4th year of dental medicine. In the group of occupationally unexposed dental patients the prevalence of contact allergy to ethyleneglycol dimethacrylate was 20.7%, to Bis-GMA — 27.6%, to 2-HEMA — 44.9% and to tetrahydrofurfuryl methacrylate — 38.0%.

Conclusions

The students of the 3rd and 4th year of dental medicine could be outlined as a group at risk of sensitization to MMA and TEGDMA and of cross-sensitization to MMA and formaldehyde. Probably, due to the ubiquitous occurrence of formaldehyde and the wide use of composite resins and bonding agents containing TEGDMA, ethyleneglycol dimethacrylate, 2-HEMA and tetrahydrofurfuryl methacrylate in dentistry, the group of dental patients could be at risk of cross-sensitization to formaldehyde and some methacrylic monomers.