donor

捐赠者
  • 文章类型: Journal Article
    建议使用正常人免疫球蛋白(NHIG)进行被动免疫接种,作为禁忌接种的高风险麻疹接触者的暴露后预防(PEP)。然而,NHIG中麻疹特异性抗体的浓度取决于合并供体血浆中的抗体水平.有人担心,随着时间的推移,澳大利亚人群的麻疹免疫力可能会下降,献血者的水平会逐渐下降,影响麻疹PEP产生有效NHIG所需的水平。澳大利亚血浆置换供体的横断面研究使用年龄分层,回收血清标本的随机样本,2019年10月至11月收集(n=1199)。麻疹特异性IgG抗体通过ELISA定量(Enzygnost抗麻疹病毒IgG,Siemens),阴性和模棱两可的标本(n=149)也进行了斑块减少中和测试(PRNT)。平均抗体水平(光密度值)从年龄较大到年龄较小的出生队列逐渐下降,从2.09[±0.09,95%CI]到0.58[±0.04,95%CI]出生在1940-1959和1990-2001(p<0.0001)。这项研究表明,年轻的澳大利亚捐献者平均麻疹特异性IgG水平明显较低。虽然目前的NHIG选择政策针对年长的捐助者,随着年轻的出生队列成为越来越大的贡献捐助者的比例,NHIG的麻疹特异性抗体浓度将逐渐降低。因此,我们建议在澳大利亚和其他在最年轻的献血者出生前消除麻疹的国家中监测未来献血者和NHIG产品的麻疹特异性抗体水平。
    Passive immunisation with normal human immunoglobulin (NHIG) is recommended as post-exposure prophylaxis (PEP) for higher-risk measles contacts where vaccination is contraindicated. However, the concentration of measles-specific antibodies in NHIG depends on antibody levels within pooled donor plasma. There are concerns that measles immunity in the Australian population may be declining over time and that blood donors\' levels will progressively decrease, impacting levels required to produce effective NHIG for measles PEP. A cross-sectional study of Australian plasmapheresis donors was performed using an age-stratified, random sample of recovered serum specimens, collected between October and November 2019 (n = 1199). Measles-specific IgG antibodies were quantified by ELISA (Enzygnost anti-measles virus IgG, Siemens), and negative and equivocal specimens (n = 149) also underwent plaque reduction neutralisation testing (PRNT). Mean antibody levels (optical density values) progressively decreased from older to younger birth cohorts, from 2.09 [±0.09, 95% CI] to 0.58 [±0.04, 95% CI] in donors born in 1940-1959 and 1990-2001, respectively (p < 0.0001). This study shows that mean measles-specific IgG levels are significantly lower in younger Australian donors. While current NHIG selection policies target older donors, as younger birth cohorts become an increasingly larger proportion of contributing donors, measles-specific antibody concentrations of NHIG will progressively reduce. We therefore recommend monitoring measles-specific antibody levels in future donors and NHIG products in Australia and other countries that eliminated measles before the birth of their youngest blood donors.
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  • 文章类型: Journal Article
    背景:肾脏活体捐赠存在风险,然而,关于肾切除术风险和对候选人的心理影响的标准化信息提供仍然缺乏.
    目的:本研究评估了交互式健康技术在改善肾脏活体捐赠知情同意过程中的益处。
    方法:肾脏中心机构开放门户提供关于肾脏疾病和捐献的全面信息。愿意在赫尔辛基大学医院(2019年1月至2022年1月)开始肾脏活体捐赠过程的个人被邀请使用肾脏中心中包含的患者量身定制的数字护理路径(活体捐赠者数字护理路径)。该平台提供详细的捐赠过程信息,并促进医疗保健专业人员和患者之间的沟通。通过电子健康素养量表(eHEALS)评估电子健康素养,系统可用性量表(SUS)的可用性,和系统效用通过李克特量表调查,得分为1-5分。定性内容分析解决了一个开放式问题。
    结果:肾脏中心门户每月接受8000多次访问,包括其关于捐赠福利(n=1629次)和对捐赠者生活的影响(n=4850次)的部分。在127名活体肾脏捐赠候选人中,7没有使用活人数字护理路径。用户年龄从20岁到79岁不等,他们交换了3500多条信息。共有74名活体捐献者参加了调查。女性候选人更经常在互联网上搜索有关肾脏捐赠的信息(n=79女性候选人,n=48男性候选人;P=.04)。平均eHEALS评分与互联网使用健康决策相关(r=0.45;P<.001)及其重要性(r=0.40;P=.01)。参与者发现,活体捐赠者数字护理路径在技术上令人满意(平均SUS得分为4.4,SD0.54),并且有用,但在捐赠决策中并不重要。关注集中在手术后应对捐助者和接受者。
    结论:远程医疗有效地教育活体肾脏捐献者的捐献过程。活体捐献者数字护理路径是一种有价值的电子健康工具,帮助临床医生规范知情同意的步骤。
    背景:ClinicalTrials.govNCT04791670;https://clinicaltrials.gov/study/NCT04791670。
    RR2-10.1136/bmjopen-2021-051166。
    BACKGROUND: Kidney living donation carries risks, yet standardized information provision regarding nephrectomy risks and psychological impacts for candidates remains lacking.
    OBJECTIVE: This study assesses the benefit of interactive health technology in improving the informed consent process for kidney living donation.
    METHODS: The Kidney Hub institutional open portal offers comprehensive information on kidney disease and donation. Individuals willing to start the kidney living donation process at Helsinki University Hospital (January 2019-January 2022) were invited to use the patient-tailored digital care path (Living Donor Digital Care Path) included in the Kidney Hub. This platform provides detailed donation process information and facilitates communication between health care professionals and patients. eHealth literacy was evaluated via the eHealth Literacy Scale (eHEALS), usability with the System Usability Scale (SUS), and system utility through Likert-scale surveys with scores of 1-5. Qualitative content analysis addressed an open-ended question.
    RESULTS: The Kidney Hub portal received over 8000 monthly visits, including to its sections on donation benefits (n=1629 views) and impact on donors\' lives (n=4850 views). Of 127 living kidney donation candidates, 7 did not use Living Donor Digital Care Path. Users\' ages ranged from 20 to 79 years, and they exchanged over 3500 messages. A total of 74 living donor candidates participated in the survey. Female candidates more commonly searched the internet about kidney donation (n=79 female candidates vs n=48 male candidates; P=.04). The mean eHEALS score correlated with internet use for health decisions (r=0.45; P<.001) and its importance (r=0.40; P=.01). Participants found that the Living Donor Digital Care Path was technically satisfactory (mean SUS score 4.4, SD 0.54) and useful but not pivotal in donation decision-making. Concerns focused on postsurgery coping for donors and recipients.
    CONCLUSIONS: Telemedicine effectively educates living kidney donor candidates on the donation process. The Living Donor Digital Care Path serves as a valuable eHealth tool, aiding clinicians in standardizing steps toward informed consent.
    BACKGROUND: ClinicalTrials.gov NCT04791670; https://clinicaltrials.gov/study/NCT04791670.
    UNASSIGNED: RR2-10.1136/bmjopen-2021-051166.
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  • 文章类型: Journal Article
    本研究的新颖性和基本目的是使用阴离子表面活性剂(SAA)的临界胶束浓度在水绿色溶剂中制备新型抗炎铁配合物。已经制备了三种新的抗炎铁复合物。噻吩电子给体(D)席夫碱(2-(2-OH-亚苄基)-氨基)-4,5,6,7-四羟基苯并[b]噻吩-3-甲腈)已制备。基于CNH分析确认了所有样品的分子结构,1HNMR和13CNMR光谱。通过使用DFT-B3LYP方法的计算化学进一步证实了席夫碱的分子结构,6-31G(D)基准集。观察和模拟1HNMR,UV-Vis。红外/拉曼光谱证实了D的分子结构。将该席夫碱插入氯化铁(FeCl3)中,得到纯铁电荷转移络合物(CTC)。体外和动力学研究证实Fe-CTC复合物具有(浓度依赖性)有效的抗微生物剂-,良好的抗炎活性。自由基清除活性一氧化二氮(NO。)的Fe(III)CTC归因于几何形状的Fe(III)离子通过官能团(-C]N-O变形为八面体(单斜晶系或三斜晶系单晶),NH2)。元素分析和EDS光谱证实了铁与杂原子之间的强结合(N,S,D分子的O)。
    The novelty and the essential purpose of this research is the preparation of new anti-inflammatory iron complexes in water green solvent using critical micelle concentration of anionic surface active agent (SAA). Three new anti-inflammatory iron complexes have been prepared. Thiophene-electron (es) donor (D) Schiff base (2-(2-OH-benzylidene)-amino)-4, 5, 6, 7-tetrah ydrobenzo[b] thiophene-3-carbonitrile) has been prepared. Molecular structures of all samples were confirmed based on CNH analysis, 1H NMR and 13C NMR spectra. The molecular structure of Schiff base is further confirmed by computational chemistry using the DFT-B3LYP method, 6-31G (d) basis set. Observed and simulated 1H NMR, UV-Vis. IR/Raman spectra confirmed the molecular structure of D. This Schiff base is intercalated to ferric chloride (FeCl3) giving pure iron charge transfer complex (CTCs). In vitro and kinetic studies confirmed Fe-CTC complexes had (concentration-dependent) potent antimicrobial-, good anti-inflammatory activities. Free radical scavenging activity nitrous oxide (NO.) of Fe (III)CTCs is attributed to geometry Fe(III) ions as distorted octahedral (either monoclinic or triclinic single crystals) via functional groups (-C]N-O, NH2). Elemental analysis and EDS spectra confirmed strong binding between iron and hetero atoms (N, S, O) of D molecules.
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  • 文章类型: Journal Article
    使用移植后环磷酰胺(Cy后)的单倍体干细胞移植(haplo-SCT)被认为是缺乏匹配供体或由于高风险疾病而迫切需要移植程序的患者的合理治疗选择。我们分析了2018-2023年进行的haplo-SCT的结果。在大多数情况下,中位年龄为52岁的81名患者(46名男性)接受了使用外周血作为干细胞来源的单倍体SCT。适应症包括血液恶性肿瘤(88%的病例为急性白血病)。在25例(31%)中,复发/难治性疾病进行了移植。大多数患者(61%)表现出非常高的疾病风险指数(DRI)。调理方案如下:非清髓性-46例(57%),清髓性-在18(22%)和降低强度-17(20%)。90%的患者移植。所有患者均接受统一的免疫抑制治疗(Cy/TAC/MMF后)。中位随访时间为12个月,急性和慢性GVHD的累积发生率分别为37.5%和37.6%,分别。估计2年总生存率(OS)为43.1%,供体年龄是影响生存率的唯一因素。2年无进展生存率(PFS)为42.5%,而复发率(RI)-35%。非复发死亡率(NRM)的累积发生率为44%,主要是由于感染。Haplo-SCT是血液学患者可行的治疗选择。年轻的捐赠者提高了移植后的存活率。降低感染相关死亡率和复发率的策略仍然是一个挑战。
    Haploidentical stem cell transplantation (haplo-SCT) using post-transplantation cyclophosphamide (post-Cy) is considered a reasonable therapeutic option for patients who lack matched donor or who urgently need transplant procedure due to high risk disease. We analyzed the results of haplo-SCT performed in years 2018-2023. Eighty one patients (46 males) at median age of 52 years underwent haplo-SCT using peripheral blood as a stem cell source in most cases. Indications included hematological malignancies (acute leukemias in 88% of cases). In 25 cases (31%) transplantation was performed in relapsed/refractory disease. Majority of patients (61%) presented with very high and high disease risk index (DRI). Conditioning regimens were as follows: nonmyeloablative - 46 cases (57%), myeloablative - in 18 (22%) and reduced intensity - 17(20%). 90% of patients engrafted. All patients received unified immunosuppressive treatment (post-Cy/TAC/MMF). Median follow-up time was 12 months The cumulative incidence of acute and chronic GVHD was 37.5% and 37.6%, respectively. Estimated 2-year overall survival (OS) was 43.1% and donor\'s age was the only factor influencing survival. The 2-year progression-free survival (PFS) was 42.5%, whereas relapse incidence (RI) - 35%. The cumulative incidence of non-relapse mortality (NRM) was 44% and was mostly due to infections. Haplo-SCT is a feasible treatment option for hematological patients. Younger donor improves post-transplant survival. Strategies to reduce infection-related mortality and relapse rate remain a challenge.
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  • 文章类型: Journal Article
    在线精子捐赠允许那些希望怀孕的人(“接受者”)在网上与潜在的精子捐赠者会面,通过“连接”网站或社交媒体。这些网站为临床捐赠提供了一些优势(包括更低的成本和更多的捐赠安排选择),但先前的研究表明,这些网站也可能对使用它们的人构成风险和挑战。因此,这项探索性研究的目的是更好地了解在线精子捐赠社区以及接受者和捐赠者的经验,特别是在可能“道德上具有挑战性”或涉及伤害的情况下。
    使用深入的叙述方法采访了三个多产的捐助者和五个接受者。CarolGilligan的听力指南被用来分析数据。
    调查结果表明,捐助者寻求找到在捐赠实践中保持自主权的方法,并关注接受者的性格和育儿能力,以及收件人提出不必要投诉的可能性。接受者担心他们的安全,并找到他们可以信任的捐赠者,讨论与捐赠者“不诚实”有关的问题,网上滥用,以及缺乏连接站点和相关当局的支持。捐赠者和接受者都确定了与捐赠者匿名(捐赠者使用虚假的在线个人资料或别名)以及某些捐赠者的性动机或(错误)行为有关的“道德上具有挑战性”的行为。每个参与者都讨论了他们管理感知风险的方式。
    参与者对在线精子捐赠社区中挑战性行为的接受或拒绝程度各不相同,强调人们在这种环境中互动方式的复杂性。需要进一步的研究来了解这种形式的精子捐赠如何尽可能安全和支持。同时也尊重捐助者和接受者在作出捐赠安排时的自主权和选择权的重要性。
    UNASSIGNED: Online sperm donation allows those hoping to conceive a baby (\"recipients\") to meet prospective sperm donors online, via \"connection\" websites or social media. These sites offer some advantages to clinical donation (including lower costs and greater choice over donation arrangements) but previous research has suggested that these sites may also pose risks and challenges to those who use them. Therefore, the aim of this exploratory research was to better understand online sperm donation communities and the experiences of both recipients and donors, particularly with respect to situations that could be \"morally challenging\" or involve harm.
    UNASSIGNED: Three prolific donors and five recipients were interviewed using an in-depth narrative approach. Carol Gilligan\'s Listening Guide was employed to analyse the data.
    UNASSIGNED: The findings demonstrated that the donors sought to find ways to maintain autonomy in their donating practices and were concerned about the character and parenting abilities of recipients, as well as the potential for recipients to make unwarranted complaints. The recipients were concerned about their safety and finding a donor they could trust, discussing issues relating to donor \"dishonesty\", online abuse, and a lack of support from connection sites and related authorities. Both donors and recipients identified \"morally challenging\" behaviour relating to donor anonymity (donor use of fake online profiles or aliases) and the sexual motivations or (mis)conduct of some donors. The participants each discussed the ways in which they managed perceived risks.
    UNASSIGNED: The degree to which the participants voiced their acceptance or rejection of challenging behaviour in online sperm donation communities varied across and within participants, highlighting the complexity of the way in which people interact in this environment. Further research is required to understand how this form of sperm donation can be as safe and supportive as possible, while also respecting the importance to donors and recipients of autonomy and choice when making donation arrangements.
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  • 文章类型: Journal Article
    HLA匹配的异基因造血细胞移植(HCT)是许多患者的治愈性疗法。不相关的HLA匹配的供体是HCT最常用的供体。当不止一个供体移植选项可用时,移植中心可以根据非HLA因素选择供体.提高预防和治疗免疫并发症的能力,如移植物抗宿主病和感染,可以更频繁地使用HLA不匹配的供体,允许更多地考虑非HLA因素,比如捐赠者的年龄,CMV血清状态,和ABO血型匹配,对移植结果有重要影响。需要考虑的其他因素是捐助者的可用率和国内捐助者的使用以优化结果。在此更新的当前背景下,提供了对非HLA因素的回顾以及对HCT的最佳无关供体选择的考虑。
    HLA-matched allogeneic hematopoietic cell transplantation (HCT) is a curative therapy for many patients. Unrelated HLA-matched donors are the most frequently used donor for HCT. When more than one donor transplant option is available, transplant centers can select donors based on non-HLA factors. With improved ability to prevent and treat immune complications, such as graft-versus-host disease and infections, it may be possible to proceed more often using HLA-mismatched donors, allowing greater consideration of non-HLA factors, such as donor age, CMV serostatus, and ABO blood group matching, which have demonstrated important impacts on transplant outcomes. Additional factors to consider are donor availability rates and the usage of domestic donors to optimize outcomes. A review of non-HLA factors and considerations on the selection of optimal unrelated donors for HCT are provided within this updated current context.
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  • 文章类型: Journal Article
    背景:捐赠的眼部组织的可用性可以节省并增强移植受者的视力;然而,目前对纸巾的需求超过了现有供应。角膜供体短缺导致等待时间增加,延迟手术,延长视力障碍,增加了需要眼组织移植的患者的不便。以前开发了一个基于网络的应用程序,以方便轻松直观地提交潜在的捐助者信息。
    目的:本研究的主要目的是评估卫生保健专业人员对潜在应用的态度,并根据用户反馈和通过应用的捐赠者注册情况评估其有效性。
    方法:研究人员使用了混合方法方法,从文献综述开始,以确定与捐助方采购相关的挑战。进行了利益相关者访谈,以评估医疗保健专业人员对应用程序的看法。通过问卷调查收集用户反馈,调查,和访谈来评估应用程序的可用性和影响。分析了对报告的潜在捐助者的评估和问卷答复。
    结果:该申请的最终版本成功报道了24位真正的角膜捐献者。在64位使用该应用程序与潜在捐赠者进行交流的医疗保健提供者中,其中32人仅出于测试目的提交了试用条目。其余8名卫生保健专业人员报告了潜在的捐助者;然而,这些人不符合捐献者资格标准.大多数参与者认为该应用程序对用户友好,并表示愿意在将来使用它。为布局分配了正面评级,外观,目的,和应用程序的特定功能。受访者强调了通过SMS文本消息自动发送通知,以及整合捐赠者资格和组织收集的所有必要文档,这是该应用程序最有价值的功能。
    结论:研究表明,供体报告应用为提高组织供体的采购提供了有希望的解决方案。此应用程序简化了报告过程,减少文书工作,促进沟通,并收集了有价值的数据进行分析。
    BACKGROUND: The availability of donated eye tissue saves and enhances vision in transplant recipients; however, the current demand for tissue surpasses the available supply. Corneal donor shortages lead to increased wait times, delayed surgeries, prolonged visual impairment, and increased inconvenience to patients requiring eye tissue transplantation. A web-based application was previously developed to facilitate easy and intuitive submission of potential donor information.
    OBJECTIVE: The primary objectives of this study were to assess health care professionals\' attitudes toward the potential application and evaluate its effectiveness based on user feedback and donor registrations through the application.
    METHODS: Researchers used a mixed methods approach, commencing with a literature review to identify challenges associated with donor procurement. Stakeholder interviews were conducted to gauge health care professionals\' perspectives regarding the application. User feedback was collected through questionnaires, surveys, and interviews to assess the application\'s usability and impact. An assessment of the reported potential donors and questionnaire responses were analyzed.
    RESULTS: The final version of the application successfully reported 24 real cornea donors. Among 64 health care providers who used the application to communicate about potential donors, 32 of them submitted trial entries exclusively for testing purposes. The remaining 8 health care professionals reported potential donors; however, these individuals did not meet the donor qualification criteria. The majority of participants found the application user-friendly and expressed their readiness to use it in the future. Positive ratings were assigned to the layout, appearance, purpose, and specific features of the application. Respondents highlighted the automatic sending of notifications via SMS text messages and the integration of all necessary documents for donor qualification and tissue collection as the most valuable functions of the application.
    CONCLUSIONS: The study indicates that donor reporting applications offer promising solutions to enhance tissue donor procurement. This application streamlined the reporting process, reduced paperwork, facilitated communication, and collected valuable data for analysis.
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  • 文章类型: Journal Article
    心脏移植(HTx)的结果通过仔细的供体选择和管理得到了改善;尽管如此,捐助者短缺仍然是一个重大挑战。优化捐助者管理对于提高捐助者效用率和HTX后成果至关重要。脑死亡导致各种病理生理变化,可以影响多个器官,包括心脏。了解这些变化和相应的管理策略是优化供体器官状况的关键。这篇综述评估了这些病理生理变化的几个方面,包括血液动力学和内分泌方面的考虑,并强调对潜在心脏捐献者的特殊考虑,包括对可逆性心功能不全的连续超声心动图评估和对有危险因素的献血者的冠状动脉评估。
    Heart transplantation (HTx) outcomes have improved with careful donor selection and management; nonetheless, donor shortages remain a major challenge. Optimizing donor management is crucial for improving donor utility rates and post-HTx outcomes. Brain death leads to various pathophysiological changes that can affect multiple organs, including the heart. Understanding these alterations and corresponding management strategies is key to optimizing the donor organ condition. This review assesses several aspects of these pathophysiological changes, including hemodynamic and endocrinological considerations, and emphasizes special consideration for potential cardiac donors, including serial echocardiographic evaluations for reversible cardiac dysfunction and coronary assessments for donors with risk factors.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    硫化氢(H2S)是一种重要的活性硫物质,参与许多生物功能,和H2S失衡已被表明是各种疾病的潜在生物标志物。已经开发了不同的H2S供体将H2S直接输送到生物系统,但很少有报道包括具有允许跟踪H2S释放的光学响应的供体。此外,仍然缺乏使用相同的化学物质在荧光响应的调色板中递送H2S的供体系统。在这里,我们报告了五个硫醇激活的荧光开启COS/H2S供体,它们利用蓝色,黄色,橙色,红色,和近红外发射染料用释放H2S的次硫基硫代碳酸酯支架官能化。用硫醇处理后,每个供体提供荧光开启响应(3-310倍)和高H2S释放效率(>60%)。采用联合电极和荧光实验,我们将测量的H2S释放与荧光响应直接相关。所有供体都是生物相容的并且在活细胞环境中释放H2S。此外,我们证明,NIR供体允许通过皮下注射装载到藻酸盐凝胶中的供体在活大鼠中的H2S释放成像,据我们所知,这是首次在体内追踪非透明生物中荧光供体释放的H2S。
    Hydrogen sulfide (H2S) is an important reactive sulfur species that is involved in many biological functions, and H2S imbalances have been indicated as a potential biomarker for various diseases. Different H2S donors have been developed to deliver H2S directly to biological systems, but few reports include donors with optical responses that allow for tracking of H2S release. Moreover, donor systems that use the same chemistry to deliver H2S across a palette of fluorescent responses remain lacking. Here we report five thiol-activated fluorescence turn-on COS/H2S donors that utilize blue, yellow, orange, red, and near infrared-emitting dyes functionalized with an H2S-releasing sulfenyl thiocarbonate scaffold. Upon treatment with thiols, each donor provides a fluorescence turn-on response (3-310-fold) and high H2S release efficiencies (>60 %). Using combined electrode and fluorescence experiments, we directly correlate the measured H2S release with the fluorescence response. All donors are biocompatible and release H2S in live cell environments. In addition, we demonstrate that the NIR donor allows for imaging H2S release in live rats via subcutaneous injection of the donor loaded into an alginate gel, which to the best of our knowledge is the first in vivo tracking of H2S release from a fluorogenic donor in non-transparent organisms.
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