Acceptance of organ xenotransplantation among Latin American immigrants resident in the United States.

BACKGROUND: Making xenotransplantation socially acceptable is the first step in working toward the promotion of this potential therapy option for providing transplant organs. OBJECTIVE: To analyze the attitude toward xenotransplantation among the Latin American population resident in Florida (the USA), and to determine the variables affecting this attitude. METHODS: A sample of Latin American residents in the state of Florida was randomized and stratified according to nationality, age, and sex (n = 1524). Attitude was assessed using a validated questionnaire (PCID-XenoTx Rios) which was self-completed anonymously. STATISTICAL ANALYSIS: descriptive analysis, Student's t-test, the chi-square test, and a logistic regression analysis. RESULTS: The questionnaire completion rate was 95% (n = 1450). If it was assumed that xenotransplanted organs functioned as well as human ones, 10% (n = 147) would be in favor, 73% (n = 1092) against, and 17% (n = 246) undecided. If the results were worse, only 2% (n = 35) would be in favor. This favorable attitude was related to country of origin (Honduras and Guatemala; P < 0.001); age (P < 0.001); sex (women; P < 0.001); marital status (married; P < 0.001); descendents (yes; P < 0.001); level of formal education (secondary education and university; P < 0.001); participation in voluntary prosocial activities (yes; P < 0.001); having spoken about donation and transplantation within the family (yes; P < 0.001); a partner's favorable attitude toward transplantation (P = 0.040); religion (catholic; P < 0.001); knowing the attitude of one's religion toward donation (yes; P < 0.001); previous experience of donation and/or transplantation (yes; P < 0.001); a belief that one might need a transplant in the future (yes; P < 0.001); and a favorable attitude toward human donation (yes; P < 0.001). The following were associated with attitude in the multivariate analysis: age (≥40 yrs; OR = 1.152); marital status (married; OR = 500); prosocial activities (yes, I participate in them; OR = 9.196. No, but I would like to; OR = 332.538); religion (catholic; OR = 2000); attitude toward deceased organ donation (in favor; OR = 2000); and previous experience of donation and/or transplantation (yes; OR = 500). CONCLUSIONS: The attitude of Latin Americans resident in Florida toward xenotransplantation is very negative, and is determined by many psychosocial factors, mainly related to their prior attitude toward the different kinds of human organ donation.

The level of acceptance of spanish medical students of the transplantation of solid organs from animals: a stratified and multicentre study.

INTRODUCTION: Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice. OBJECTIVE: To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes. TYPE OF STUDY: A sociological, interdisciplinary, observational and multicentre study in Spain. STUDY POPULATION: Students enrolled on the medical degree in Spain (n = 34 000). SAMPLE SIZE: A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously. RESULTS: A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005). CONCLUSIONS: Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.

Outpatient Thyroid Surgery in a Low-Surgical Volume Hospital.

BACKGROUND: To determine the safety and outcome of outpatient thyroid surgery in a small low-surgical volume hospital. To evaluate clinical and social factors that may prohibit outpatient thyroid surgery. METHODS: Retrospective analysis of all thyroid surgery performed at a low-surgical volume hospital from August 2006 to July 2014. One-hundred and sixty patients underwent thyroid surgery during the study period. Electronic medical records were reviewed for all patients. Data collection included demographic information, extent of thyroid surgery, length of hospital stay, laboratory/pathology results, co-morbidities, and complications. RESULTS: Of the 160 patients who underwent thyroid surgery, 109 (68.1%) were discharged on the day of surgery. Forty-three patients (26.9%) were admitted for 23-h observation and eight patients (5%) required full admission (longer than 24 h). Sixty-one patients (38.1%) underwent a total thyroidectomy, while 99 patients (61.9%) underwent a hemithyroidectomy. Complications included four temporary recurrent laryngeal nerve (RLN) injuries (2.5% patients/1.8% of total RLN at risk), one permanent RLN injury (0.63% patients/0.45% of total RLN as risk), one temporary bilateral RLN injury (0.63%), two delayed hematomas (1.3%), and eight cases of transient hypocalcemia (5%). CONCLUSION: Outpatient thyroid surgery can be performed safely in a low-surgical volume center. Reasons for a longer stay include clinical as well as social factors.

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain.

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. STUDY TYPE: A sociological, interdisciplinary, multicenter and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. SAMPLE SIZE: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. STATISTICAL ANALYSIS: Student´s t test, χ(2) test and logistic regression analysis. RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001). CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

Gongylonema: a parasitic nematode of the oral cavity.

We report a rare parasitic nematode infection in a 26-year-old healthy African American man. Gongylonema nematode infections in humans are unique in their ability to localize in the submucosa of the oral cavity and oropharynx. Humans are incidental hosts for the Gongylonema nematode, which is more commonly found in rudimentary animals, birds, and rodents. Approximately 50 cases of human Gongylonema infections have been reported worldwide, including 11 documented cases in the United States.(1) The pathogenesis, characteristic clinic findings, and identification features will be discussed.

Laryngeal mask airway use in otologic surgery.

OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of the laryngeal mask airway (LMA) compared with oral endotracheal tube (ETT) in general anesthesia in patients who underwent otologic surgery. STUDY DESIGN: Retrospective review. SETTING: Military tertiary care teaching hospital. PATIENTS: A retrospective chart review study was conducted on 484 patients who underwent otologic surgery at a large military tertiary care teaching hospital from January 2002 to August 2005. A review of otologic surgical cases using the LMA (n = 167) was compared to a similar cohort managed with an oral ETT (n = 317). MAIN OUTCOME MEASURES: The patient's age, weight, indication for surgery, comorbid conditions, American Society of Anesthesiologists classification, duration of surgery, and adverse events were recorded. Specific data reviewed included airway complications, intraoperative times, anesthetic medications, postoperative nausea and vomiting, and time spent in the postanesthesia care unit. RESULTS: There were no major airway complications in either group requiring an emergency airway. A significant decreased use of neuromuscular blocking agents was noted in the LMA group. Statistical analysis of variances was performed using 2-sample Wilcoxon rank-sum (Mann-Whitney U) test and Fisher's exact test. The time in the operating room to the start of surgery and the time from completion of surgery to patient exiting the operating room were shorter for the LMA group than for the ETT group. There were no statistical differences in postanesthesia care unit time or postoperative nausea and vomiting. CONCLUSION: The LMA offers a safe alternative in children and adults to endotracheal intubation with no observed increased risk of airway complications in patients undergoing otologic surgery.

Pseudotumor hemofílico. Presentación de un caso / Hemophilic pseudotumor. A case report

El pseudotumor hemofílico es una complicación infrecuente en pacientes con antecedentes de hemofilia, que se presenta en el 1-2% de los casos.Se comunica el caso de un paciente de sexo masculino, de 62 años de edad, con antecedentes de hemofilia tipo A, que consultó por la presencia de una tumoración indolora en el muslo derecho, que había aparecido aproximadamente un año antes, luego de un antecedente traumático.Además de los aspectos clínicos, se valoraron y revisaron los diferentes hallazgos radiológicos por distintos métodos de imágenes (radiología convencional, ultrasonografía, tomografía computada y resonancia magnética), teniendo en cuenta sus características típicas y atípicas.Si bien el diagnóstico definitivo de pseudotumor hemofílico se efectuó mediante la anatomía patológica, los antecedentes y técnicas imagenológicas permitieron caracterizar adecuadamente la lesión y contribuir al correcto abordaje terapéutico...