Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors

New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III followed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV-positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C virus coinfection) and compared these estimates with those from similarly selected HIV-negative scenarios. For 40-year-old HIV-positive individuals with health characteristics that were similar to those of age-matched kidney donors, viral load <400 copies/mL, and CD4+ count ≥500 cells/μL, the 9-year cumulative incidence of ESRD was higher than that of their HIV-negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV-positive individuals with no comorbidities and well-controlled disease may be considered low-risk kidney donor candidates

Adult front car occupant thorax injury experience following frontal impacts

The following paper presents the nature and mechanism of injuries sustained in frontal impacts, focusing on car to car impacts. It was found that the body regions most frequently sustaining severe to fatal injuries were the legs and the thorax. The nature and mechanism of the injury sustained was investigated only for the thorax injuries, due to their potentially life threatening nature. The analysis revealed that the most frequent cause of the injury recorded was the seatbelt for low severity injuries and the front structure of the vehicle for higher severity injuries. An analysis of the effect of load limiter technology in the restraint system showed that the proportion of occupants who sustained "no thorax injury" did not increase when a load limiter was fitted to the restraint system. However, a decrease in the "organ" and "organ and skeletal" injuries was observed in the load limiter sample. Sample size and variation mean that these findings are not conclusive