Background: In the USA, the lower rate of live donor kidney transplant among Black transplant candidates may stem from lower rates of donation among potential live donors who are Black. We determined whether outcomes of the evaluation of potential live kidney donors varied according to the potential donors’ demographic characteristics. Methods: We performed a single-center, retrospective observational cohort study of 1,179 potential live kidney donors, who came forward between 2000 and 2007. Potential donors’ intended recipients were first-time transplant recipients who were evaluated between 2000 and 2005. Results: There were 268 (22.7%) potential live kidney donors who were Black, of whom 93.7% were recruited by Black transplant candidates. Donor outcomes included actual donation (38.3%), exclusion due to blood group or crossmatch incompatibility (20.4%), exclusion due to medical contraindication to donation (13.7%), and lack of further donor interest (11.2%). Black (vs. non-Black) potential donors were less likely to actually donate (27.2 vs. 41.6%, p < 0.001). Black potential donors were more likely to stop pursuing live donation (p = 0.047) or be excluded from donation for medical reasons (p = 0.008) or blood group or crossmatch incompatibility (p = 0.01). These racial differences persisted in a multivariable multinomial logistic regression model of factors associated with outcomes of the donor evaluation. Conclusions: Potential live kidney donors who are Black are less likely to actually donate. Future studies should determine whether paired exchange and desensitization programs decrease these racial differences and why Black potential donors appear more likely to stop pursuing live donation.
SummaryA postal survey investigating the administration of supplemental oxygen to women undergoing Caesarean section under regional anaesthesia was sent to 262 lead consultant obstetric anaesthetists in the UK. Two hundred and fifteen (82%) completed questionnaires were returned. In 139 units (65%) supplemental oxygen was administered routinely to all Caesarean sections under regional techniques, while in 71 (33%), supplemental oxygen was given only if the procedure was an emergency or if there was evidence of fetal or maternal compromise. In 196 units (91%), the common gas outlet was used as the source of supplemental oxygen, with the standard anaesthetic breathing circuit disconnected in 194 (90%) and the vaporisers left on the back bar in 191 (89%). Critical incidents had occurred in 39 (18%) units using the common gas outlet as a source of supplemental oxygen and 63 (30%) had experience of critical incidents with this practice in a non-obstetric setting. We suggest that supplemental oxygen is more safely administered from a separate and dedicated source.Keywords Anaesthesia: obstetric. Anaesthetic techniques: regional. Oxygen: delivery systems. Equipment: breathing systems. Caesarean section. It is usual for mothers undergoing Caesarean section under regional anaesthesia to receive supplemental oxygen. From our own experience it is often the common gas outlet of the anaesthetic machine that is the source of such oxygen, with the standard anaesthetic breathing circuit disconnected from the anaesthetic machine and replaced by simple tubing and an oxygen mask. It also seems to be usual for the vaporisers to be left in position on the back bar. Following a critical incident in one of our units, we decided to explore practices of supplemental oxygen administration for Caesarean section under regional anaesthesia in obstetric units in the UK. We wanted to ascertain whether it is common practice to use the common gas outlet as a source of supplemental oxygen, with the standard breathing circuit disconnected and the vaporisers left in situ. We aimed to establish whether this was a factor leading to critical incidents in other obstetric units. We also wanted to establish whether problems had been encountered with such practices in a non-obstetric setting. Finally, as the value of supplemental oxygen for elective Caesarean sections has recently been questioned [1, 2], we took the opportunity to look into which groups of mothers routinely receive supplemental oxygen. MethodsAfter approval from the Obstetric Anaesthetists' Association (OAA), a questionnaire and covering letter were distributed in a single posting to the 262 lead consultants in obstetric anaesthesia in the UK listed on the OAA database. Respondents were asked about departmental, rather than personal, use of supplemental oxygen for Caesarean section under regional anaesthesia in that unit (which cases received it; whether the common gas outlet was used; whether the standard breathing system was disconnected; whether the vaporisers are removed from the ba...
We applied a digital holographic detection technique to detect the scratches on glass surfaces with scattering noise. In the experiment, scratches with widths of 1.67 µm were generated on the front sides of the glass slides, and three different gray levels were painted on the back sides of the glass slides to generate the scattering noise. It demonstrated that the digital holographic detection method can enhance the image contrast of the scratch under high scattering noise. The high defocus tolerance promises a detection process without optical focusing and thus benefits the high-speed automatic optical inspection.
Background: Epistaxis is one of the most common emergencies in the department of otolaryngology, which gives a burden to the health care system. Objectives: This study aimed to investigate the patients’ characteristics of hospital admission with epistaxis and provide an optimized protocol. Methods: This study was a retrospective analysis of patients with epistaxis admitted to The Third Affiliated Hospital of Sun Yat-sen University in Guangzhou, China. The data were analyzed in terms of gender, age, seasonal differences, length and expenses of hospitalization, pathogenesis of epistaxis, primary medical management before hospital admission, bleeding sites, and treatment. Results: A total of 387 patients were included, which consisted of 270 males and 117 females with an average of 43 years. Most patients could be identified with underlying diseases, and the most commonly observed bleeding site was Little area (n = 164). Most patients received electrocauterization as a precision medical treatment (n = 288). The duration of hospitalization length ranged from a mean of 5.17–4.48 days, and the expenses of hospitalization ranged from a mean of RMB 4881–4951 yuan over the last 5 years. Conclusion: Most patients with epistaxis could be treated as outpatients by endoscopic electrocauterization, and hospitalization is indicated when patients need improvement of poor general condition, posterior packing, embolization, or surgery. This study enables to provide an optimized protocol for patient with epistaxis.
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