Organ donation

Introduction 

Hi girls, I hope you’re having a nice holiday. Below you will find the article that I chose.

I think that this article is very relevant because it shows us the importance of organ donation.

I hope that you find it useful for your personal lives and your work as doctors.

Organ donation 

Organ donation is where a person donates their organs for transplant.

There are two types of organ donation: living and deceased.

Donated organs are given to someone who has damaged organs that need to be replaced.

An organ transplant may save a person's life or significantly improve their health and quality of life.

 

The need for donors

Between April 1 2013 and March 31 2014, 4,655 organ transplants were carried out in the UK thanks to the generosity of 2,466 donors.

But there are always significantly more people waiting for an organ transplant than there are suitable donors. At the time of writing (24 November 2014), 6,856 people were waiting for transplants.

There's a particular need for more people of African, African-Caribbean and south Asian ethnicities to join the NHS Organ Donor Register and agree to donate their organs in the event of their death. This is because donation rates among these ethnic groups are low but the need is great.

People from black, Asian and ethnic minority communities are more likely to develop health conditions that can lead to kidney failure, and on average they'll wait a year longer for a kidney transplant than a white patient.

There's no upper age limit for joining the register and recording your wish to be a donor.

If you die in circumstances where you could potentially donate, specialist healthcare professionals decide which organs and tissues are suitable based on a number of factors, including your medical and travel history.

Tissue from people in their 70s and 80s is often transplanted successfully, although organs are only selected from those under 80 years of age.

Most people waiting for a donated organ need to have a kidney, heart, lung or liver transplant. One donor can help several people as they can donate a number of organs, including:

• kidneys
• liver
• heart
• lungs
• small bowel
• pancreas

Tissues that can be donated include: 

• the cornea (the transparent layer at the front of the eye)
• bone
• skin 
• heart valves
• tendons
• cartilage

All donors can choose which organs and tissues they wish to donate.

Even though about a third of the population have joined the register, less than 5,000 people a year die in circumstances that allow them to donate their organs.

This means it's even more important for as many people as possible to talk about donation and join the register so no donation is wasted.

Remember to discuss your decision with your family so they're aware.

 

Checking for a match

When an organ becomes available for donation, it's checked to make sure it's healthy.

The blood and tissue type of both donor and recipient are also checked to ensure they're compatible. The better the match, the greater the chance of a successful outcome.

People from the same ethnic group are more likely to be a close match. Those with rare tissue types may only be able to accept an organ from someone of the same ethnic origin. This is why it's important that people from all ethnic backgrounds register to donate their organs.

 

Types of donation

There are three different ways of donating an organ. These are known as:

• donation after brain stem death
• donation after circulatory death
• living organ donation

These are described below.

 

Donation after brain stem death

Most organ donors are patients who die as a result of a brain haemorrhage, severe head injury or stroke and are on a ventilator in a hospital intensive care unit (ICU). These donors are called donation after brain stem death donors.

Death is diagnosed by brain stem tests. There are very strict standards for doing these tests and they're always carried out by two experienced doctors.

A ventilator provides oxygen, which keeps the heart beating and blood circulating after death. Organs such as hearts, lungs and livers can be donated by a DBD donor.

 

Donation after circulatory death

Patients who die in hospital but aren't on a ventilator can donate their kidneys and, in certain circumstances, other organs. They're called donors after circulatory death.

In these cases, the organs must be removed within a few minutes of the heart stopping to prevent them being damaged by a lack of oxygenated blood.

Both types of donors can donate their corneas and other tissue.

 

Living organ donation

Living organ donation usually involves one family member donating an organ to another family member or partner. The relative is usually related by blood – a parent, brother, sister, or child.

It's also now possible to be an altruistic donor. Altruistic donors are unrelated to the patient but become donors as an act of personal generosity.

Kidneys are often donated from living donors as a healthy person can lead a normal life with only one kidney.

- Why do you think that not everyone registers as a donor?

- What would you do to increase the number of donors?

Conclusion

Thank you for your comments.

There are not enough organ donors to cover our needs, a way of increasing the number of donors would be to inform people about it. Also it is a controversial subject as it involves certain ethical values, hence the need to address this issue in depth. The practice of organ donation is a very beneficial activity for everyone as many lives can be saved.

Maximizing our efforts to inform people would most likely translate into an increase in the number of donors.

 

Dunia Jové

http://www.nhs.uk/Conditions/organ-donation/Pages/Introduction.aspx

Brain Swelling Tied to Deaths From Malaria

Introduction

Hi girls! I hope you enjoy this article, I chose it for I found  interesting because it is a recent evidence that can help to improve the treatment of this disease that although well known, little is known about how  to treat it. Despite is uncommon among us, I think as future doctors is important not to forget it because many travelers may be infecting.

When children die from a severe form of malaria, swelling of the brain is often what kills them, a new study finds. This insight will not change medical practice immediately, but it may lead to improved treatments, researchers said.

The disease, caused by a parasite spread by mosquitoes, is a major killer in the tropics. Worldwide, there were 198 million cases in 2013. About 500,000 people died, mostly children in Africa. There is no vaccine. Drugs can prevent the infection and treat it, but malaria can still be rapidly fatal even with treatment, especially in young children.

Cerebral malaria, which involves the brain, is an extremely dangerous form of the disease and can lead to coma and death. Fifteen percent to 25 percent of African children who contract this type of malaria die. Survivors can be left deaf, blind or with learning disabilities.

Doctors suspected that brain swelling had a role in fatal cases, but the evidence was not clear.

Hoping to resolve the issue, researchers in Malawi performed M.R.I. scans on 168 children whose illness met a strict definition of cerebral malaria.

The results were published on Wednesday in The New England Journal of Medicine. Twenty-five children died, 21 of whom — 84 percent — had severe brain swelling. Among the survivors, only 27 percent had severe swelling.

“What’s killing these kids is that they stop breathing, because the respiratory center in the brain stem is compressed by the swelling,” said Dr. Terrie E. Taylor, the senior author of the study and a professor at the Michigan State College of Osteopathic Medicine. She spends about half the year working in Malawi.

Ventilators might save some children, Dr. Taylor said, by maintaining their breathing through the worst of the brain swelling, which usually lasts for only a few days. Ventilators are not widely available in Africa, but providing them “is not beyond the pale,” she said.

Certain drugs, including steroids and mannitol, may also help with brain swelling, but studies are needed to find out, she said.

How do you think this new evidence will contribute to new treatments?

Do you think you more  ventilators   available  in Africa would be an easy measure to apply?

Do you think  important malaria prevention in short-term travelers?

Conclusion

Hello girls, thank you for your comments. I couldn´t agree more with you. Research is the key to the advancement of medicine in all its branches.

I think that the risk assessment should be individualized on the consultation, which ideally should occur 1 month before the person´s departure. Brief country-specific statements regarding malaria transmission and interative resources that are regulary updated are available from the centers for Disease crontrol and prevention. 

Joana Gonçalves

CERVICAL CANCER VACCINE

Introduction

Hi girls! I have chosen this article about HPV vaccine because I find really interesting this theme and I think there are so many girls that they aren't vaccinated because it is a "new" vaccine unknown for more of us and maybe we should know more about it.

Like future doctors, I think it is important that we inform our patients about importance of cervical screening, HPV vaccine and sex with protection.

I hope you like it and you can learn something new about this theme.

Cervical cancer vaccine

All girls aged 12 to 13 are offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme. The vaccine protects against cervical cancer. It's usually given to girls in year eight at schools in England.

The HPV vaccine is delivered largely through secondary schools, and consists of two injections into the upper arm spaced at least six, and not more than 24 months apart (girls who began vaccination before September 2014 receive three injections).

Research has indicated that the HPV vaccine protects against cervical cancer for at least 20 years.

What is HPV?

The human papilloma virus (HPV) is the name given to a family of viruses.

Different types of HPV are classed as either high risk or low risk, depending on the conditions they can cause. For instance, some types of HPV can cause warts or verrucas. Other types are associated with cervical cancer.

In 99% of cases, cervical cancer occurs as a result of a history of infection with high-risk types of HPV. Often, infection with the HPV causes no symptoms. 

How is HPV infection spread?

The HPV virus is very common and is easily spread by sexual activity.

As much as half the population will be infected at some time in their life. In most cases, the virus doesn't do any harm because your immune system gets rid of the infection. But in some cases, the infection persists and can lead to health problems.

Although most girls don't start having sex until after they're 16 years of age, it's important that they get this protection early enough and a good time is in the early teenage years – getting the vaccine as early as possible will protect them in the future.

Using a condom during sex can help to prevent HPV infection. However, as condoms do not cover the entire genital area and are often put on after sexual contact has begun, a condom is no guarantee against the spread of HPV.

How the HPV vaccine helps

A vaccine called Gardasil is used in the national NHS cervical cancer vaccination programme. Gardasil protects against the two types of HPV, between them responsible for more than 70% of cervical cancers in the UK.

A bonus of using Gardasil to prevent cervical cancer is that it prevents genital warts too.

Which girls should have the HPV vaccination?

The HPV vaccine is part of the NHS childhood vaccination programme and is routinely offered to secondary school girls aged 12 and 13.

It's a safe vaccine and there are very few girls who aren't suitable for HPV vaccination. However, special precautions may need to be taken if the girl being vaccinated has certain health conditions, or has ever had a severe allergic reaction (anaphylaxis).

The HPV vaccine is currently given as a series of two injections within a six- to 24-month period.

Girls who began their course of HPV vaccination before September 2014 receive three injections.

Can girls who missed HPV vaccination still have it?

Yes, if a girl misses either of her vaccinations, for whatever reason, speak to her nurse or doctor about making another appointment, ideally as close as possible to the original one.

Girls can have the HPV vaccination on the NHS up to age of 18.

Girls who have the HPV vaccination after the age of 15 will need three doses as the response to two doses is not so good in older girls.

Cervical screening and the HPV vaccine

Cervical screening is a way of picking up abnormal cells in the cervix before they progress to cancer. It's been shown that early detection and treatment of cervical abnormalities picked up by screening can prevent three-quarters of cervical cancers.

The NHS cervical screening programme involves checking women between the ages of 25 and 64 every three to five years for early cervical abnormalities.

Regular cervical screening is the best way to identify abnormal cell changes in the cervix. So it's important that all girls who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.

- Do you find necessary that girls are vaccinated of HPV?

- Do you think that girls follow the cervical screening?

- Why do you think there are so many girls that they aren't vaccinated?

CONCLUSION

We think that it's a good vaccine that it has improved, but it be improved more because, at the moment only covers for two types of virus.

All of us agree that cervical screening is really important and it should give more information at school and different areas about this, in order to increase women's visits to gynaecologist for revisions.

The main cause to not choose this vaccine is the insufficient information about disease and importance to prevent it, and about real side effects of this vaccine, which are less than people think.

We conclude that it is important to have a safe sexual life and to follow screening programmes.

ANDREA GARCÍA GÓMEZ

CERVICAL CANCER VACCINE

THE AUTISTIC SYNDROME AND ITS STIGMA IN OUR SOCIETY

INTRODUCTION

Hi! I am Marta Córdoba Calonge and now it is my turn to post so I will try to do the best I can. I hope you enjoy with it and it serves to make you reflect a little bit.

I choose this topic because I like psychiatrics and many of you like pediatrics and the autistic syndrome is a mental disorder that appears since the childhood so I have tried to agree everyone.

Like the tittle says this article talks about the stigmatization of the autistic syndrome and my intention with it is change your perspectives about it because we are not only doctors who treat diseases; we are people who treat people.

I hope you liked this article and I look forward to read your comments and opinions!

Stigma and Discrimination

Caley and I encourage people with autism to be open about their diagnosis because in our experience there's a degree of protection from bullying that comes with the label, not to mention that openness can help educate others about autism. That said, these benefits come with a steep price because as soon as someone says they're on the autism spectrum, we categorize them and treat them differently. Don't believe me? We'll start off with a story of the stigma I've seen, and then move on to stories of discrimination told by others. Keep in mind as you read the first section that I'm not actually autistic myself.

My discrimination story begins in a place I really wish was surprising – an autism support group. I volunteered there for many years, caring for children during meetings. One day, a new mother came to the group, and brought her autistic son with her. I asked if I could care for him in another room, and was met with a flat out refusal. I was surprised. I’d been doing this successfully for a long time with many parents’ children and had never been met with anything but appreciation. Why now would this change? At the end of the meeting, the mother approached me in embarrassment, apologizing for not having trusted me with her son. Someone had been talking about another girl at the meeting who was autistic, she said – and she’d thought that someone was me.

In short, even this mother of an autistic child was judging me not by my actions, but by her stigmatized view of autistic people. The moment was made all the more painful because the girl the woman mistook me for? She was Caley, my Autistic sister. 

I was the same person as I had always been, but as soon as she thought I was autistic this mother deemed that I was no longer trustworthy. I was being judged not by my actions, but by my label, and that was in a group of parents who are presumably more open and educated about autism than the average person. That's how deep the stigma of autism goes. Up until that point, I’d never really given much thought to the stigma Caley bore, thinking that people would just see her for who she was. It was a shocking moment for me when I realized that Caley had to confront that stigma every single day.

The stigma definitely exists, and we all buy into it to some degree. The only difference is that most non-autistic (neurotypical) people don't realize that they're treating a person negatively because of their autism label. In short, neurotypical people run the risk of using the autism label as justification for treating other people differently, for the worse. 

Being autistic isn't something that someone should have to be ashamed about. It's not something that should be used to discriminate against people, not something that should keep others from disclosing for fear of how they'll be viewed by society.

We may not be able to change society's views on autism (although we can try!), but we can change and monitor our own. So when you interact with someone autistic, keep this stigma in mind. If you're aware of the stigma, you're far less likely to fuel or fall victim to it. 

Judge people by their actions, not their label. 


CONCLUSION

Hi girls! First of all is that I’m so happy you liked the article and the second is thanking you for your comments because they have made me reflect more about. I have found your opinions very different and because it I’m going to say something about each of them.

NURIA: I think the same as you, erroneous values are instilled by society and we, as a doctors, with our knowledge  can and have to change this, first with our children and after with children of our family and friends.

JOANA: I’m with you Joana, many parents, if not almost all, are not prepared to have an autistic child. But you are right, many of these children, fortunately, if are treated from they are little, can have an almost normal development and integrate successfully into society.

DUNIA: It’s true and it’s very sad the fact that people who know better this mental illness are the most prejudices have.

I’m with you when you say that autistic children probably never will live a normal life (from our point of view), but it doesn’t mean that they couldn’t be happy and integrate, they only need a little bit of our help and collaboration.

CLAUDIA: We already know it and in these days the government isn’t going to spend money or time with “things” that doesn’t make benefits, so what can we do? Making us hear.

ANDREA: That you have said is so motivating. When I read your comment I think if we could do it once, we can do it again! And yes, everyone deserves a decent treatment.

ELI: Yes, like Nuria has said, all of wrong thinking about mental illness is because bad or poor information since we are very little, so we must change this view for next generations!

MARIA: I’m glad I surprised you. I think it’s important to do new and different things, not everything consists on study, there are many other things we have to learn that are not in the books.

MERCÈ: Yes, hopefully in a few years, when we are doctors, this problem doesn’t exist, but for this we have to work, it isn’t enough with dream.

Thank you so much to all again for your comments!!