11 results on '"C Santiago"'
Search Results
2. Cross-Cultural Donation and Donation Interview
- Author
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M. Fuentes, D. Pérez, P. Gómez, S. Mira, J. Olivares, M. de La Concepción, and C. Santiago
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tissue and Organ Procurement ,Latin Americans ,Adolescent ,Language barrier ,Young Adult ,Cause of Death ,Cadaver ,Humans ,Medicine ,media_common.cataloged_instance ,Cross-cultural ,Family ,European Union ,European union ,Child ,Aged ,media_common ,Transplantation ,business.industry ,Infant ,Middle Aged ,Surgery ,Europe ,Eastern european ,Latin America ,Child, Preschool ,Donation ,Family medicine ,Africa ,Nationality ,Female ,business - Abstract
The increased number of donors from other countries leads to language, cultural, and communication barriers during the donation interview. Understanding how people have acquired their attitudes and beliefs will help create better intervention strategies. We studied the interviews performed during the last 7 years with the families of 90 donors who came from various countries. Our objectives to improve this situation were: first, to overcome language barriers with translators; second, we sought to bridge the cultural barrier by gaining knowledge of the cultures and religions via cultural mediators; and third, we prepared the professionals on methods to properly conduct the interview. We studied the impact of the introduction of cultural and linguistic mediators: health professionals with knowledge of various languages, which in some groups were of the same nationality as the family and had been trained in the donation interview. We also translated the information to be given to the family. Among 90 donors, 52% came from the European Union (65% British); 29% Latin America; 13%, Eastern European countries; and 5%, Northern Africa, totaling 26 nationalities. The average donor age was 54.16 ± 20.1 years (range, 1–69 years); 42% were females and 58% males. Since the introduction of the cultural and linguistic mediators, family refusal of donation decreased from 40% to 7.1%.
- Published
- 2008
- Full Text
- View/download PDF
3. Evaluation of Organ Procurement in an Area Under the Influence of a Training Program
- Author
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M. de La Concepción, J. Olivares, P. Gómez, and C. Santiago
- Subjects
Brain Death ,medicine.medical_specialty ,Attitude to Death ,Tissue and Organ Procurement ,Population ,law.invention ,law ,Humans ,Medicine ,Organ donation ,education ,Refusal to Participate ,Transplantation ,education.field_of_study ,business.industry ,Intensive care unit ,Tissue Donors ,Surgery ,Organ procurement ,Spain ,Renal transplant ,Donation ,Emergency medicine ,Training program ,business - Abstract
Introduction The procurement of organs was evaluated in an area of 1,450,000 inhabitants. This area provides two international programs and two training courses for transplant coordinators. One of them deals with the entire process of donation and transplantation, and the other is a monographic course about family consent and donation request. One transplantation coordinator manages the area. Methods The results of the last 6 years have been analyzed concerning the procurement of organ donors (related to brain death [BD] donors, exitus at the hospital, and the intensive care unit [ICU]); loss in the process, such as medically unsuitable; problem detection; and family refusals. Results During the past 6 years the donor potential increased from 1.67% to 4.06%. The BD by exitus in the ICU increased from 7% to 14.01% (the average in Spain 12.2%); the cases of BD in ICU beds increased from 0.5% to 1.31% (average in Spain 0.8%). The loss for medical exclusion criteria decreased from 27% to 20% and in family refusals from 19.7% to 13.6%. The efficiency of the process in percentage of actual donations by BD increased from 52.4% to 65.3% (average in Spain 49%). The actual donors per million population (PMP) increased from 37 PMP to 59 PMP. The average number of organs obtained from donors increased from 3.1 to 3.6, and the transplants increased from 2.7 to 3.04 per donor. The average waiting period for a renal transplant was reduced from 365 days to 199 days. Conclusion The training of coordinators and the net system of regional coordinator, area coordinator, and hospital coordinator improved our donation rate.
- Published
- 2005
- Full Text
- View/download PDF
4. Asking for the family consent: Analysis and refusals
- Author
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P. Gomez and C. Santiago
- Subjects
Brain Death ,Transplantation ,medicine.medical_specialty ,Informed Consent ,business.industry ,media_common.quotation_subject ,MEDLINE ,Tissue Donors ,Surgery ,Interviews as Topic ,Religion ,Denial ,Attitude ,Spain ,Informed consent ,Family medicine ,Humans ,Medicine ,Family ,Organ donation ,business ,media_common - Published
- 1997
- Full Text
- View/download PDF
5. Cross-cultural donation and donation interview.
- Author
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Santiago C, Gómez P, Mira S, Pérez D, Fuentes M, Olivares J, and de La Concepción M
- Subjects
- Adolescent, Adult, Africa, Aged, Cadaver, Cause of Death, Child, Child, Preschool, Europe, European Union, Family, Female, Humans, Infant, Latin America, Male, Middle Aged, Young Adult, Tissue and Organ Procurement statistics & numerical data
- Abstract
The increased number of donors from other countries leads to language, cultural, and communication barriers during the donation interview. Understanding how people have acquired their attitudes and beliefs will help create better intervention strategies. We studied the interviews performed during the last 7 years with the families of 90 donors who came from various countries. Our objectives to improve this situation were: first, to overcome language barriers with translators; second, we sought to bridge the cultural barrier by gaining knowledge of the cultures and religions via cultural mediators; and third, we prepared the professionals on methods to properly conduct the interview. We studied the impact of the introduction of cultural and linguistic mediators: health professionals with knowledge of various languages, which in some groups were of the same nationality as the family and had been trained in the donation interview. We also translated the information to be given to the family. Among 90 donors, 52% came from the European Union (65% British); 29% Latin America; 13%, Eastern European countries; and 5%, Northern Africa, totaling 26 nationalities. The average donor age was 54.16 +/- 20.1 years (range, 1-69 years); 42% were females and 58% males. Since the introduction of the cultural and linguistic mediators, family refusal of donation decreased from 40% to 7.1%.
- Published
- 2008
- Full Text
- View/download PDF
6. Association of the genetic polymorphisms of the renin-angiotensin system with kidney graft long-term outcome: preliminary results.
- Author
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Rodríguez-Moreno A, Sánchez-Fructuoso AI, Ridao-Cano N, Calvo N, Conesa J, Gómez-Gallego F, Santiago C, Bandrés F, and Barrientos A
- Subjects
- DNA blood, DNA genetics, DNA isolation & purification, Female, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Kidney Transplantation physiology, Polymorphism, Genetic, Renin-Angiotensin System genetics
- Abstract
Recent studies have demonstrated some association between the renin-angiotensin system (RAS) activity and the development and progression of different entities as diabetes mellitus (DM) or chronic allograft nephropathy. To investigate these associations, we studied some gene polymorphisms of RAS in a group of renal transplant recipients. We retrospectively analyzed 42 patients who underwent a primary renal transplantation for 2 years. A subgroup of 23 patients (55%) was diagnosed with postransplant DM in accordance with American Diabetes Association 2001 criteria. We studied two RAS gene polymorphisms: the angiotensin-converting enzyme insertion/deletion (ACE I/D) and angiotensinogen (AGTM235T). Genotyping was performed by DNA purification and amplification with a polymerase chain reaction technique. The distributions of genotypes were ACE DD, ID, II: 33%, 48%, 19%; and AGT TT, MT, MM: 15%, 45%, 40%, respectively. We observed a progressive loss in renal function measured by creatinine clearance (Cockroft) in D-allele carriers (DD+ID) between the first and the second transplantation year: 65.3 +/- 4.3 vs 59.8 +/- 4.6 mL/min (P = 0.02); that was not seen in II patients: 68.8 +/- 4.6 vs 68.4 +/- 4 mL/min (P = 0.87). Fifty percent of D-allele carriers developed DM vs 25% of non-D-allele carriers (P = 0.19). Eighty-three percent of homozygous patients for the AGT-TT allele developed DM vs 35% of non TT patients (P = 0.04). There were no significant differences regarding recipient demographic characteristics, type of donor, number and severity of acute rejections, and immunosuppressant treatment between the groups. In conclusion, ACE D-allele seems to be associated with a poorer kidney graft long-term outcome. ACE D and AGT T alleles may be implicated in glucose metabolism disorders after transplantation.
- Published
- 2005
- Full Text
- View/download PDF
7. Evaluation of organ procurement in an area under the influence of a training program.
- Author
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Santiago C, Gómez P, Olivares J, and de La Concepción M
- Subjects
- Attitude to Death, Brain Death, Humans, Spain, Refusal to Participate statistics & numerical data, Tissue Donors statistics & numerical data, Tissue and Organ Procurement organization & administration, Tissue and Organ Procurement trends
- Abstract
Introduction: The procurement of organs was evaluated in an area of 1,450,000 inhabitants. This area provides two international programs and two training courses for transplant coordinators. One of them deals with the entire process of donation and transplantation, and the other is a monographic course about family consent and donation request. One transplantation coordinator manages the area., Methods: The results of the last 6 years have been analyzed concerning the procurement of organ donors (related to brain death [BD] donors, exitus at the hospital, and the intensive care unit [ICU]); loss in the process, such as medically unsuitable; problem detection; and family refusals., Results: During the past 6 years the donor potential increased from 1.67% to 4.06%. The BD by exitus in the ICU increased from 7% to 14.01% (the average in Spain 12.2%); the cases of BD in ICU beds increased from 0.5% to 1.31% (average in Spain 0.8%). The loss for medical exclusion criteria decreased from 27% to 20% and in family refusals from 19.7% to 13.6%. The efficiency of the process in percentage of actual donations by BD increased from 52.4% to 65.3% (average in Spain 49%). The actual donors per million population (PMP) increased from 37 PMP to 59 PMP. The average number of organs obtained from donors increased from 3.1 to 3.6, and the transplants increased from 2.7 to 3.04 per donor. The average waiting period for a renal transplant was reduced from 365 days to 199 days., Conclusion: The training of coordinators and the net system of regional coordinator, area coordinator, and hospital coordinator improved our donation rate.
- Published
- 2005
- Full Text
- View/download PDF
8. Importance of early adequate exposure to cyclosporine in renal transplant outcome: study of 1-year creatinine.
- Author
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Dominguez J, Kompatzki A, Velasco A, Turpaud F, Norambuena R, Arenas J, Pais E, Llanos R, and Cortes-Monroy G
- Subjects
- Creatinine blood, Cyclosporine administration & dosage, Drug Administration Schedule, Female, Graft Rejection epidemiology, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents therapeutic use, Kidney Transplantation immunology, Male, Multivariate Analysis, Treatment Outcome, Cyclosporine therapeutic use, Kidney Transplantation physiology
- Abstract
Introduction: One-year serum creatinine (SCr) level has been used as a surrogate marker for graft survival in kidney transplantation. We evaluated the importance of different factors on this parameter, emphasizing the importance of adequate exposure to Cyclosporine (CyA)., Methods: Ninety-six consecutive renal transplant recipients who underwent transplantation between 1996 and 2002 were treated with CyA, steroids, and azathioprine. Univariate and multivariate regression analyses were performed for 1-year SCr, acute rejection episodes (ARE), and duration of delayed graft function (DGF). We considered adequate CyA levels within 1 week to be >250 ng/mL trough levels (38%) or 3 hour postdose level (C3) >1100 ng/mL (62%)., Results: Mean 1-year SCr was 1.52 +/- 0.5, ARE rate was 27%, and DGF rate was 31%. Overall, 53% of patients achieved adequate exposure to CyA at 1 week (68% on those monitored by C3). Univariate analysis identified female recipient gender, decreasing donor age, absence of ARE, and decreased DGF duration to yield lower 1-year SCr (P < .05). On multivariate analysis for donor age (lower), ARE rate, and duration of DGF (shorter) were the only factors considered to be significant for a lower 1-year SCr level. Multivariate analysis for ARE showed that adequate CyA exposure and lower HLA mismatch decreased ARE, whereas the ability to achieve adequate exposure to CyA and shorter cold ischemia time (CIT) correlated with a reduced incidence of DGF., Conclusions: One-year SCr level is affected primarily by the incidence of ARE, by donor age, and by duration of DGF. Adequate CyA exposure is related to lower ARE; however, its relation to DGF may be influenced by the reluctance to increase exposure on patients with a nonfunctioning graft.
- Published
- 2005
- Full Text
- View/download PDF
9. Pravastatin decreases cold ischemia--but not alloantigen-dependent transplant arteriosclerosis.
- Author
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Domínguez J and Schultz M
- Subjects
- Animals, Aorta, Abdominal drug effects, Aorta, Abdominal pathology, Arteriosclerosis etiology, Cold Temperature, Disease Models, Animal, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Ischemia, Isoantigens, Male, Rats, Rats, Inbred BN, Rats, Inbred Lew, Transplantation, Homologous pathology, Transplantation, Isogeneic pathology, Transplantation, Isogeneic physiology, Tunica Intima pathology, Aorta, Abdominal transplantation, Arteriosclerosis prevention & control, Pravastatin pharmacology, Transplantation, Homologous physiology
- Abstract
Background: Alloantigen mismatch and cold ischemia have been shown to induce transplant arteriosclerosis. Pravastatin (PR) decreases arteriosclerosis probably related to an immunosuppressive effect. Statins possess other nonimmune properties that may be beneficial to transplantation. We studied the effect of PR on cold ischemia and alloantigen-induced transplant arteriosclerosis in syngeneic (SYN) and allogeneic (ALLO) aortic transplantation models., Methods: Lewis rats served as the donors and recipients for SYN transplants and Brown Norway rats were donors for ALLO transplants. Aortic segments that had been preserved at 4 degrees C in Euro-Collins solution for 0 or 24 hours were transplanted to the infrarenal aorta of the recipients PR (10 mg/kg/d) was administered for 12 weeks prior to morphometric studies. Areas of intimal thickness and its relation to total vessel area were calculated. Lipid levels were measured at 12 weeks., Results: Aorta rings preserved for 24 hours showed marked intimal thickening compared to controls (SYN, CI 0 hours = 21.5% +/- 16.5% vs SYN, CI 24 hours = 50.7 +/- 9.5%, P <.05). PR significantly decreased thickening (SYN, CI 24 hours + PR = 41.7 +/- 12.2 (P <.05) vs SYN, CI 0 hours on SYN, CI 24 hours). There was a nonsignificant decrease in thickening among ALLO transplants treated with PR (ALLO = 31.4 +/- 15.9 vs ALLO + PR = 23.8 +/- 18.8; P >.05). PR had no effect on lipid levels. PR decreases cold ischemia induced transplant arteriosclerosis in this syngeneic aortic transplant model, but does not affect an alloantigen-mediated process. The beneficial effect of PR is not related to its lipid-lowering properties but probably to a nonimmune effect.
- Published
- 2003
- Full Text
- View/download PDF
10. Family and personal consent to donation.
- Author
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Santiago C
- Subjects
- Attitude to Death, Communication, Humans, Interviews as Topic, Social Support, Family psychology, Informed Consent, Physicians, Professional-Family Relations, Tissue Donors
- Published
- 1997
- Full Text
- View/download PDF
11. Asking for the family consent: analysis and refusals.
- Author
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Santiago C and Gomez P
- Subjects
- Attitude, Brain Death, Humans, Interviews as Topic, Religion, Spain, Family, Informed Consent, Tissue Donors
- Published
- 1997
- Full Text
- View/download PDF
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