[Medico-economic evaluation of the PRADO-BPCO post-exacerbation support program]. / Évaluation médicoéconomique du PRADO-BPCO, programme d'accompagnement post-exacerbation.

INTRODUCTION: The "Programme d'Accompagnement du retour à Domicile" (PRADO) COPD is a home discharge support program dedicated to organizing care pathways following hospitalization for COPD exacerbation. This study aimed at assessing its medico-economic impact. METHODS: This was a retrospective database study of patients included in the PRADO BPCO between 2017 and 2019. Data were extracted from the National Health Data System. A control group was built using propensity score matching. Morbi-mortality and costs (national health insurance perspective) were measured during the year following hospitalization. RESULTS: While the proportion of patients with a care pathway complying with recommendations from the National Health Authority was higher in the PRADO group, there was no significant effect on mortality and 12-month rehospitalization. In the PRADO group, the rehospitalization rate was lower when the care pathway was optimal. Healthcare costs per patient were 670 € higher in the PRADO group. CONCLUSIONS: The PRADO COPD improves quality of care but without decreasing rehospitalizations and mortality, although rehospitalizations did decrease among PRADO group patients benefiting from an optimal care pathway.

Crop photoperiodism model 2.0 for the flowering time of sorghum and rice that includes daily changes in sunrise and sunset times and temperature acclimation.

BACKGROUND AND AIMS: Daylength determines flowering dates. However, questions remain regarding flowering dates in the natural environment, such as the synchronous flowering of plants sown simultaneously at highly contrasting latitudes. The daily change in sunrise and sunset times is the cue for the flowering of trees and for the synchronization of moulting in birds at the equator. Sunrise and sunset also synchronize the cell circadian clock, which is involved in the regulation of flowering. The goal of this study was to update the photoperiodism model with knowledge acquired since its conception. METHODS: A large dataset was gathered, including four 2-year series of monthly sowings of 28 sorghum varieties in Mali and two 1-year series of monthly sowings of eight rice varieties in the Philippines to compare with previously published monthly sowings in Japan and Malaysia, and data from sorghum breeders in France, Nicaragua and Colombia. An additive linear model of the duration in days to panicle initiation (PI) and flowering time using daylength and daily changes in sunrise and sunset times was implemented. KEY RESULTS: Simultaneous with the phyllochron, the duration to PI of field crops acclimated to the mean temperature at seedling emergence within the usual range of mean cropping temperatures. A unique additive linear model combining daylength and daily changes in sunrise and sunset hours was accurately fitted for any type of response in the duration to PI to the sowing date without any temperature input. Once calibrated on a complete and an incomplete monthly sowing series at two tropical latitudes, the model accurately predicted the duration to PI of the concerned varieties from the equatorial to the temperate zone. CONCLUSIONS: Including the daily changes in sunrise and sunset times in the updated photoperiodism model largely improved its accuracy at the latitude of each experiment. More research is needed to ascertain its multi-latitudinal accuracy, especially at latitudes close to the equator.

Electron quantum optics: partitioning electrons one by one.

We have realized a quantum optics like Hanbury Brown-Twiss (HBT) experiment by partitioning, on an electronic beam splitter, single elementary electronic excitations produced one by one by an on-demand emitter. We show that the measurement of the output currents correlations in the HBT geometry provides a direct counting, at the single charge level, of the elementary excitations (electron-hole pairs) generated by the emitter at each cycle. We observe the antibunching of low energy excitations emitted by the source with thermal excitations of the Fermi sea already present in the input leads of the splitter, which suppresses their contribution to the partition noise. This effect is used to probe the energy distribution of the emitted wave packets.

[Communication around the cancer diagnosis: patient satisfaction and process quality in French Comprehensive Cancer Centers]. / L'annonce de la maladie: satisfaction des patients et démarche qualité dans les Centres de lutte contre le cancer.

BACKGROUND: Our survey was designed to evaluate the satisfaction of patients treated in French Comprehensive Cancer Centers (CCC) with the communication of their cancer diagnosis and treatments, and to use the data obtained to optimize current practices. METHODS: One thousand six hundred (and) six CCC patients participated in a telephone survey. Eligible patients were attending a visit to a CCC for initial care of their disease (i.e. not a relapse). The questionnaire assessed patient satisfaction with the communication of diagnosis and treatment options, globally and with respect to potential individual determinants of satisfaction. FINDINGS: Complete satisfaction was recorded by 77% of patients with their overall care at the CCC and by 63% of patients with the initial consultation when diagnosis was communicated and/or treatment discussed. Overall, 90% of patients were satisfied with the level of their implication in discussions about their care. A model established by Partial Least Squares (PLS) regression analysis, identified four major areas and their relative contributions to patient satisfaction: patient's relationship with their physician (64%); nature of the information provided (14%; influenced strongly by information on type, duration and practical organization of planned treatment); agenda/diary issues (14%; influenced strongly by waiting room delay); accompaniment (8%; influenced equally by support from close family and patient association/self-help groups). INTERPRETATION: Overall satisfaction was high in cancer patients attending visits for initial care in French CCC. The model we devised to understand components of satisfaction could serve as a benchmark for evolution of outcomes in this field.

Degradation of foot-and-mouth disease virus during composting of infected pig carcasses.

The objective of this study was to investigate the inactivation and degradation of foot-and-mouth disease (FMD) virus during composting of infected pig carcasses as measured by virus isolation in tissue culture and by real-time reverse transcriptase polymerase chain reaction (RRT-PCR). Three FMD-infected pig carcasses were composted in a mixture of chicken manure and wood shavings in a biocontainment level 3 facility. Compost temperatures had reached 50 degrees C and 70 degrees C by days 10 and 19, respectively. Under these conditions, FMD virus was inactivated in specimens in compost by day 10 and the viral RNA was degraded in skin and internal organ tissues by day 21. In comparison, at ambient temperatures close to 20 degrees C, FMD virus survived to day 10 in the skin tissue specimen from the pig that had the highest initial level of viral RNA in its tissues and the viral RNA persisted to day 21. Similarly, beta-actin mRNA, tested as a PCR control, persisted to day 21 in specimens held at ambient temperatures, but it was degraded in the remnants of tissues recovered from compost on day 21. Results from this study provide evidence that composting could be used for safe disposal of pig carcasses infected with FMD virus.

[Update on the epidemiology of malaria in French Guiana]. / Situation epidémiologique du paludisme en Guyane.

The last study describing the epidemiology of malaria in French Guiana was published 20 years ago. Yet French Guiana in the Americas along with Mayotte in the Indian Ocean is the only French territory with persisting endemic malaria. The purpose of this study is to provide an update based on official malaria surveillance data as well as on information from hospital records and various field surveys that have been carried out in recent years. Due to recurrent problems in collecting thorough, continuous, and consistent data, exact determination of incidence by plasmodium species has always been difficult in French Guiana. These problems include not only the remote location of endemic areas and intense unpredictable migration patterns but also poor data collection methods that do not always ensure consistency and homogeneity. Another factor hindering thorough collection of conventional epidemiological data is the requirement for rapid effective treatment in remote regions. The overall incidence of malaria in French Guiana appears to have remained stable since the beginning of the decade with an average of 3,920 case reports per year for an incidence rate of 20 per thousand, noting that three fourths of the 206,000 inhabitants of French Guiana live outside of endemic areas. Overall involvement of P. falciparum and P. vivax appears to be equal with P. malariae accounting for only 2.6% of cases. Trends in recent years indicate an increase in the number of cases involving P. vivax especially in the eastern zones, i.e. in the Oyapock focus where annual incidences in children have reached up to 500 per thousand and in the whole region located between Saint Georges and Cayenne. Conversely a decrease in endemic levels has been observed in western areas, especially for P. falciparum in the upper and middle focuses of the Maroni. Most zones now causing problems are located near migration points, particularly in relation with clandestine gold panning activities. In the coastal strip where the three main cities with most of the population are located, most reported cases are imported but local cases may occur. In general local transmission in these areas has been promptly controlled but trends indicate that incidence of these events may be rising. Anopheles darlingi is still recognized as the main vector but its role in transmission is less obvious in eastern areas where increasing evidence suggests that other species may contribute to maintaining endemic levels. These findings indicate that the extensive resources deployed in this French territory (public financing, health care network, public awareness campaigns, and training of health care personnel in diagnosis and treatment of malaria) have helped reduce the number of severe cases in an unfavorable epidemiological setting.

Survival of avian influenza and Newcastle disease viruses in compost and at ambient temperatures based on virus isolation and real-time reverse transcriptase PCR.

In four composting experiments, survival of avian influenza (AI) and Newcastle disease (ND) viruses was assessed by virus isolation in embryonated chicken eggs (ECEs) and by real-time reverse transcriptase-polymerase chain reaction. Specimens contained in nylon mesh bags consisted of 20-g samples of chicken manure, used litter, or feed that had been inoculated with allantoic fluid containing an AI virus (H6N2, Expt. 1) or an ND vaccine virus (Expt. 2). Other specimens consisted of 20-g samples of infected ECEs that had been homogenized and mixed with corn silage. As a control, allantoic fluid diluted in phosphate-buffered saline was contained in sealed vials. Except for the feed, in which the AI virus was inactivated soon after the specimen was inoculated, on day 0 the specimens buried in compost or placed outside at ambient temperatures contained at least 5.0 log10 of virus and 7.7 log10 of viral RNA. By day 7, temperatures in compost ranged from 50 C to 65 C, and viruses had been killed in all specimens in bags. In comparison, viruses in sealed vials remained viable to day 10. Viral RNA in mesh-bag specimens had been degraded to nondetectable levels by day 10, but it was still detected in sealed vials on day 21. In specimens that were held at ambient temperatures (13 C-28 C), the viruses in mesh-bag specimens were inactivated by day 21, but their RNA was still detected. In comparison, the viruses in sealed vials survived to day 21. In Expts. 3 and 4, viruses were inactivated in carcass specimens and in whole ECEs during composting. In an in vitro experiment, the time required for a 1-log10 reduction of viruses was significantly shorter (P < 0.05) in water extracts from compost than in phosphate buffers at temperatures of 25 C to 45 C. This study provided evidence that microbial activity during composting contributed to the rapid killing of AI and ND viruses and to the degradation of their viral RNA.

[The COMPAQH project: researches on quality indicators in hospitals]. / COMPAQH : recherches sur le développement des indicateurs qualité hospitaliers.

After three years, the coordination de la mesure de la performance pour l'amélioration de la qualité hospitalière (COMPAQH) project can deliver its first findings and consider new perspectives of development. Which indicators are diffused? Under which criteria are they assessed? Which interhospital variability is observed? How to consider their application into hospitals? Which balance can we define between internal and external use? And finally, which consideration can we give to this program of quality measurement? This article addresses these different questions, giving a state of the development of this program.

Development of methods for detection and quantification of avian influenza and Newcastle disease viruses in compost by real-time reverse transcription polymerase chain reaction and virus isolation.

Composting has been used for disposal of poultry carcasses and manure following outbreaks caused by avian influenza virus (AIV) and Newcastle disease virus (NDV), but methods are needed to test for survival of the viruses in compost to ensure biosecurity. Methods developed in the present study include extracting viruses from compost and purifying viral RNA. The extracted viruses were detected by virus isolation using embryonated chicken eggs, and the purified RNA was detected by real-time reverse transcription PCR (RRT-PCR). The virus isolation and the RRT-PCR methods were evaluated with 3 compost preparations that were produced from chicken manure mixed with corn silage, wood shavings, or wheat straw. The detection limits of both methods were 1,700 and 1,000 embryo lethal doses of AIV and NDV per gram of compost, respectively. The copy number of viral RNA quantified by RRT-PCR was highly correlated with the amount of virus in compost. The results suggested that the RRT-PCR method may be used as an alternative to the virus isolation method for rapid detection and accurate quantification of AIV and NDV in compost.

Influence of temperature on survival and conjugative transfer of multiple antibiotic-resistant plasmids in chicken manure and compost microcosms.

The aim of this study was to determine if mobile plasmids carrying antibiotic-resistant genes could survive and be transferred in chicken manure maintained under conditions similar to those found in commercial cage layer operations and during composting. Escherichia coli J5 harboring a self-transmissible plasmid (RP4) and E. coli C600 harboring a mobile plasmid (pIE723) were used as plasmid donors; E. coli CV601 was used as a plasmid recipient. At 23 degrees C both plasmids were transferred to E. coli CV601 in chicken manure and in compost microcosms that consisted of a mixture of chicken manure and peat. The transfer frequencies ranged from 8.1 x 10(-5) to 2.4 x 10(-3) per donor cell in manure and from 2.4 x 10(-5) to 5.5 x 10(-4) per donor cell in compost microcosms. After 45 d of incubation at 23 degrees C, RP4, but not pIE723, was recovered by an exogenous isolation method although their E. coli hosts were not cultured from the microcosms. However, when the temperatures of the compost microcosms were elevated to 50 degrees C or above, neither the plasmids nor their E. coli hosts could be detected. The results suggested that composting of chicken manure at high temperatures could help prevent the spread of antibiotic-resistant genes via plasmids in the environment.

In vitro study of Salmonella enteritidis and Salmonella typhimurium definitive type 104: survival in egg albumen and penetration through the vitelline membrane.

Salmonella enteritidis and Salmonella typhimurium definitive type 104 (DT104) have been detected in the chicken oviduct, and their survival in egg albumen at the chicken body temperature of 42 degrees C may be important in oviductal and transovarian contamination of intact shell eggs. Eight S. enteritidis and 24 S. typhimurium DT104 strains were tested for their in vitro survival in egg albumen. The concentration of the organisms declined more rapidly when incubated at 42 degrees C than at 37 degrees C and dropped to nondetectable levels within 96 h at the higher, but not at the lower, temperature. In another experiment, 3 S. enteritidis and 3 S. typhimurium DT104 strains were randomly selected, and dosages of 20 and 200 cells of each strain were inoculated onto the vitelline membranes of egg yolks, which were then submerged in the original albumen and incubated for 24 h at 42 degrees C. Under these conditions, the organisms survived in albumen but did not penetrate the vitelline membrane. However, in a similar experiment, penetration did occur when the specimens were incubated at 30 degrees C for 72 h. The results suggest that low numbers of S. enteritidis and S. typhimurium DT104 can be expected to survive in egg albumen during the 24-h period of egg formation in the oviduct but would be unlikely to invade the yolk.before oviposition. However, depending on storage conditions following oviposition, S. enteritidis, as well as S. typhimurium DT104, could survive longer and may eventually invade the egg yolks.

90Sr migration to the geo-sphere from a waste burial in the Chernobyl exclusion zone.

Results are presented from an ongoing field-scale experimental study (namely the Chernobyl Pilot Site project) aimed at characterization of processes controlling (90)Sr releases from a shallow trench containing nuclear fuel particles, and subsequent radionuclide transport in the underlying sandy aquifer at the Chernobyl nuclear power plant site. Microscopic analyses of waste material and leaching experiments have shown that 10-30% of the radioactive inventory is associated with chemically extra-stable Zr-U-O particles. The largest fraction of (90)Sr activity in the trench ( approximately 30-60%) is currently associated with relatively slowly dissolving non-oxidized UO(2) matrix fuel particles. The (90)Sr migration velocity in the eolian sand aquifer is retarded by sorption to approximately 9% of groundwater flow velocity (K(d) approximately 2 ml/g). The dispersivity values for non-reactive solute transport in the aquifer predicted by geostatistics (i.e. 0.8 6 cm) were confirmed by a natural gradient tracer test using (36)Cl. The observed negative correlation between hydraulic conductivity and K(d) of aquifer sediments suggests that (90)Sr could be subjected to larger dispersion in the subsurface compared with (36)Cl.

Assessments of managed care organizations in the Greater Baton Rouge area by physicians and physicians' office managers.

Health care quality assessment under managed care organizations is usually derived from two sources: (1) consumer satisfaction surveys, and (2) The Health Plan Employer Data Information Set reports. There is little published data regarding physicians' critiques. This study surveyed physicians and office managers as to the quality of healthcare under 10 managed care organizations in the Greater Baton Rouge area. Performance indicators in the physician questionnaire focused on personal satisfaction, perception of patient satisfaction, and mental health coverage. The office managers' checklist included payment and certification issues, telephone time spent gaining certification, level of knowledge among plan enrollees of their benefits, appeal process, and adequacy of reimbursement. Means were calculated for each performance indicator and managed care organizations were ranked. Tukey-Kramer's post-hoc multiple comparisons test was used to confirm rank order validity. Significant differences were found among companies. Significant rank-order agreement by both physicians and office managers was evident. The usefulness of such surveys and performing them annually is discussed.

Description of 10 new mutations in platelet glycoprotein IIb (alphaIIb) and glycoprotein IIIa (beta3) genes.

In this study we have used denaturing gradient gel electrophoresis (DGGE) for identifying sequence alterations in glycoprotein (GP) IIb and IIIa genes from 20 patients affected by Glanzmann's thrombasthenia. These patients were from 16 different families. Using computer modelling, we divided the promoters, coding sequences and flanking splicing regions, in 31 segments for the GPIIb gene and 19 domains for the GPIIIa gene. We were able to find a mutation potentially affecting GPIIb-IIIa expression or function in 16 patients out of 20. In six patients from three families, the gypsy mutation modifying the splice donor site of intron 15 of the GPIIb gene was detected. In the other patients, 10 novel mutations were characterised, which were located either in the GPIIb gene (nine cases) or in the GPIIIa gene (one case). The type of mutation was nonsense mutation (one case), missense mutation (five cases), small insertion of 1 bp (one case) and splicing modifications (three cases). Among these genetic events, three were directly responsible for Glanzmann's thrombasthenia, four were localised in regions known to be involved in GPIIb-IIIa complex expression and three mutations were potentially responsible for Glanzmann's thrombasthenia.

Total plasma antioxidant capacity in cystic fibrosis.

Several studies have demonstrated ongoing oxidative stress in cystic fibrosis (CF). With the complexity of the antioxidant network, measurement of individual antioxidants does not necessarily assess how they work in combination. One measure that has been proposed as a gauge of total plasma antioxidant capacity is the Trolox-equivalent antioxidant capacity (TEAC) of plasma. We decided to look at plasma TEAC levels in children with CF, and relate this measure to their nutritional status, lung function, and blood measurements of several known antioxidants. We hypothesized that values in general would be lower than healthy control values, especially during acute pulmonary exacerbations. Twenty-nine children were evaluated, five of whom were during an acute pulmonary exacerbation. Height and weight, expiratory spirometry, and lung volumes were assessed, as were serum concentrations of vitamins A and E, uric acid, albumin, and lymphocyte glutathione (GSH) concentrations. TEAC values for nonhospitalized patients (1.40 +/- 0. 20 mmol/L) were not different from laboratory control values (1.35 +/- 0.11 mmol/L), but greater than values for hospitalized patients (1.09 +/- 0.17 mmol/L). TEAC correlated with anthropometric values (height: r = 0.39, P < 0.03; weight: r = 0.50, P < 0.01; body mass index: r = 0.47, P < 0.01), and pulmonary function (forced expiratory volume in 1 sec: r = 0.43, P < 0.02; residual volume/total lung capacity: r = -0.42, P < 0.03), but not with age. Univariate correlation with blood measurements demonstrated a significant correlation of TEAC with uric acid (r = 0.49, P < 0.02), but not with albumin, vitamins A or E, or lymphocyte GSH. Multiple regression analysis demonstrated a correlation between TEAC and uric acid, albumin, and lymphocyte GSH in the non-hospitalized group (r(2) = 0.38, P < 0.03). We conclude that TEAC appears to represent a mixed antioxidant response, rather than response to a single antioxidant. While being responsive to oxidative stress, the mechanism of the response may differ between clinical situations, such that the clinical significance of changes in plasma TEAC remains to be defined.

Ectopic pregnancy and occupational exposure of hospital personnel.

OBJECTIVES: An earlier study found a relationship between occupational exposure to antineoplastic drugs and ectopic pregnancy. The present investigation aimed at confirming this finding in a larger and specifically planned study and at analyzing the relationship between ectopic pregnancy and other chemical or physical agents in the hospital work environment. METHODS: A case-referent study (140 cases and 279 referents) was carried out in 1995 in a population of women working in hospitals throughout France. The sample size was computed to have an 80% statistical power to detect a 2-fold increased risk of ectopic pregnancy (odds ratio 2). Information was collected about past and present work conditions (exposures to antineoplastic drugs, solvents, disinfectants, anesthetic gases and ionizing radiation), and known risk factors of ectopic pregnancy. Multivariate analysis was performed using logistic regression. RESULTS: No significant association between occupational exposure and ectopic pregnancy was found, either when past exposure was considered or when exposure was considered within the 3 months before conception. The relationships remained nonsignificant after adjustment for job category and for the known risk factors of ectopic pregnancy. CONCLUSIONS: It was concluded that the results of this study should be interpreted as an absence of relationship between exposure to chemical or physical agents and ectopic pregnancy.

Illegitimate transcription: its use for studying genetic abnormalities in lymphoblastoid cells from patients with Glanzmann thrombasthenia.

Glanzmann thrombasthenia is the most common inherited disorder of platelets that may induce severe bleeding complications. Molecular biology techniques have offered the possibility to assess the basis of this chronic haemorrhagic disease at the molecular level. However, the accessibility of mRNA in platelets is limited by the availability of the patient's blood samples and the relatively weak amount of this material in these cells. Taking advantage of the genetic phenomenon of illegitimate transcription, we have demonstrated that glycoprotein IIb and glycoprotein IIIa mRNA could be detected in lymphoblastoid cell lines issued from normal EBV-transformed lymphoblasts. We further analysed the sequences of the two glycoprotein transcripts in lymphoblastoid cell lines from two previously characterized patients presenting with Glanzmann thrombasthenia. The results showed that illegitimate transcripts presented similar molecular abnormalities to those found in platelets. These data demonstrated that the nucleotide sequences of illegitimate transcripts were identical to tissue-specific mRNA found in platelets. We applied this methodology to screen for the genetic defect in a new thrombasthenic patient, and found a homozygous nonsense mutation GCA-->TGA converting Arg8 to stop in the glycoprotein IIIa gene. This immortalized source of genetic material is therefore particularly useful for molecular genetic studies in inherited platelet disorders, avoiding repetitive and large blood samplings in frequently anaemic patients.

Identification of new and known polymorphisms in glycoprotein IIb and IIIa genes by denaturing gradient gel electrophoresis.

Glycoprotein IIb and IIIa contain antigenic determinants involved in the potential production of allo- or autoantibodies directed against platelets, that may result in severe thrombocytopenia. Most of these epitopes appear to be supported by single nucleotide substitutions. We have used denaturing gradient gel electrophoresis (DGGE) to identify sequence variations within the promoter and the coding regions of the glycoprotein IIb and glycoprotein IIIa genes. Using genomic DNA from 60 unrelated normal individuals, we have amplified short domains that encompass the coding sequences and the exon-intron boundaries of both genes that were further separated according to their melting behaviour during the denaturant electrophoretic migration. Only the fragments with an abnormal migration pattern were sequenced. We confirmed the sensitivity of this method by recognizing both previously described Human Platelet Antigen polymorphisms and mutations affecting either the glycoprotein IIb or the glycoprotein IIIa genes in thrombasthenic patients. We also identified four other polymorphisms. Two were located in the glycoprotein IIb gene, involving intron 21 (C<-->G at nucleotide 10480) and first codon of exon 30 (codon GTC<-->GTT coding for residue Val 990), and two in the glycoprotein IIIa gene (exon 6 CCC<-->CCT coding for residue Pro 268; intron 14 C<--> T at position 37126). The screening of the GPIIIa promoter also revealed three different polymorphisms located at position-468 (A/T polymorphism), -425 (A/C polymorphism) and-400 (A/C polymorphism), which could influence the expression of the complex at the cell surface. Denaturing gradient gel electrophoresis appears to be a sensitive and specific technique for identifying polymorphisms and mutations in the GPIIb and GPIIIa genes.

A nonsense mutation in the GPIIb heavy chain (Ser 870-->stop) impairs platelet GPIIb-IIIa expression.

Glanzmann thrombasthenia (GT) is a rare autosomal recessive bleeding disorder, caused by a quantitative or qualitative defect of the GPIIb-IIIa integrin (alpha IIb beta 3), which functions as the platelet fibrinogen receptor. We report a case of type I GT due to a homozygous mutation resulting in Ser 870 to stop codon substitution. This residue is located near the proteolytic cleavage site of proGPIIb. The mutation results in a GPIIb truncated of 138 amino acids, including transmembrane and intracytoplasmic domains. Cotransfection of an expression vector containing the mutant GPIIb and wild-type GPIIIa showed that the mutant Ser 870-->stop GPIIb was able to associate to GPIIIa. However, this heterodimer failed to mature as shown by endoglycosidase-H digestion and was therefore not expressed at the COS-7 cell surface. This report is the first description of a homozygous nonsense mutation in the GPIIb gene and highlights the role of the GPIIb light chain.

Perceptions and attitudes toward organ procurement and transplantation: a medical community survey analysis.

The practitioner who recognizes and facilitates donor referral plays a pivotal role in the donor process. Mechanisms that help to identify and resolve issues for these practitioners are crucial. To identify barriers and issues that the community perceives as important, a survey to elicit the perceptions, attitudes, and ethical values of its respondents-specifically with regard to the donor process-was commissioned. The main components of the instrument included perceived problems, attitudes and ethical values, knowledge of consent process, medical and legal knowledge of brain death, organ procurement organization problems and suggestions for improvement, future education recommendations, and socio-demographic characteristics of the respondent. The survey confirmed issues of concern and brought to surface issues that have an underlying negative influence on the donor process.