scholarly journals Clinicopathological discordance in biopsy-proven nephrosclerosis: a nationwide cross-sectional study of the Japan Renal Biopsy Registry (J-RBR)

2021 ◽  
Author(s):  
Keiichi Sumida ◽  
Asami Takeda ◽  
Kengo Furuichi ◽  
Noriko Uesugi ◽  
Yoshifumi Ubara ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Clinical Diagnosis ◽  
Clinical Characteristics ◽  
Antihypertensive Drugs ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Phenotypes ◽  
Nephritic Syndrome ◽  
Multivariable Adjustment

Abstract Background Patients with nephrosclerosis display heterogenous clinical phenotypes, often leading to a clinical diagnosis discordant with pathological nephrosclerosis diagnosis. However, little is known about clinical factors associated with clinicopathological discordance of biopsy-proven nephrosclerosis. Methods In a cross-sectional study of 891 patients with biopsy-proven nephrosclerosis registered in the Japan Renal Biopsy Registry (J-RBR) between July 2007 and June 2016, we examined clinical characteristics associated with a pre-biopsy clinical diagnosis discordant with pathological nephrosclerosis diagnosis using multivariable logistic regression with adjustment for relevant clinical characteristics. Results Overall, the mean (SD) age was 58.6 (13.7) years; 67.6% of patients were male; and 63.2% were on antihypertensive drugs. The median estimated glomerular filtration rate (eGFR) was 43.8 mL/min/1.73 m2 and the median proteinuria was 0.5 g/day. Of the 891 patients, 497 (55.8%) had a clinical diagnosis discordant with pathological nephrosclerosis diagnosis, with chronic nephritic syndrome being the most common (> 75%) discordant clinical diagnosis. After multivariable adjustment, age (odds ratio 1.34, [95% confidence interval, 1.16–1.55], per 10 years increase), eGFR (1.10 [1.00–1.21], per 10 mL/min/1.73 m2 increase), and proteinuria (1.20 [1.03–2.16], per 1 g/day decrease) were found to be significantly associated with the clinicopathological discordance. Conclusions Patients with older age, higher eGFR, and lower proteinuria had significantly higher likelihood of being clinically diagnosed with other glomerular disease in patients with biopsy-proven nephrosclerosis. Our findings highlight the heterogeneous clinical phenotypes of nephrosclerosis and suggest the need for continuous improvement of clinical diagnostic accuracy as well as for wider kidney biopsy indications for nephrosclerosis.

scholarly journals Clinical Characteristics of Pigment Dispersion Syndrome and Pigmentary Glaucoma Patients: A Cross-sectional Study

2020 ◽  
Author(s):  
Vijay Pratap Singh Tomar ◽  
Sandeep Sharma ◽  
Rahul Bhardwaj ◽  
Sindhuja Singh ◽  
Virendra Kumar Pal ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pigment Dispersion Syndrome

Introduction: Pigmentary Glaucoma (PG) and Pigment Dispersion Syndrome (PDS) are two different spectrums of a single disease. Since the disease is seen in younger population and is rapidly progressive blinding disease, therefore early diagnosis and treatment will reduce the burden of the disease and improve the quality of life. Aim: To evaluate clinical characteristics of PDS and PG patients in eastern part of Uttar Pradesh. Materials and Methods: This was a two years (1st January 2018 to 31st December 2019) hospital‑based retrospective cross‑sectional study of patients who attended the glaucoma clinic. Diagnosis of PDS was made when they had normal optic disc, normal visual field {with or without increased Intra Ocular Pressure (IOP)} and at least two of the following three signs were found clinically: Krukenberg spindle, homogenous moderate‑to‑heavy (≥Spaeth 2+) Trabecular Meshwork (TM) pigmentation, and any degree of zonular and/or lenticular pigment granule dusting. Patients with PDS were diagnosed with PG, if they had two or more of the following findings: initial IOP >21 mmHg, glaucomatous optic nerve damage or glaucomatous visual field loss. Various parameters such as influence of demographics, IOP, Best‑Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT), Mean Deviation (MD), Visual Field Index (VFI %), spherical equivalent and clinical finding of anterior segment of study patients were analysed. Mean, standard deviation and percentage were calculated using GraphPad Instat version 3.0. Results: Among 40 patients, nine eyes of the six patients had myopia of ‑0.5D or greater, with mean refractive error of ‑3.55±4.72 spherical equivalent. The average baseline IOP in study patients (PDS+PG), was 30.21±11.42 mmHg. Twenty four (60%) patients, either in one or both eyes had glaucoma, secondary to PDS at the initial diagnosis. Thirty three (82.5%) patients had Krukenberg spindles. Homogeneous TM pigmentation was seen in all patients. Typical spoke‑like radial Iris Transillumination Defects (ITDs) were not observed in any of the patients except in one patient, who had isolated short slit‑like trans‑illumination defects in iris crypts. Conclusion: PDS patients with normal optic disc and visual field and raised IOP, should be started prophylactic treatment and needs to be monitored more closely. Thus, the finding of PDS in Indians should alert the ophthalmologist to look for glaucoma during the initial examination.

scholarly journals The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10691
Author(s):  
Yimeng Hu ◽  
Qinge Li ◽  
Rui Min ◽  
Yingfeng Deng ◽  
Yancheng Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Clinical Characteristics ◽  
Independent Risk Factor ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Background The relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications. Results SUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, ∗P = 0.0013; ORs Female = 1.002, ∗P = 0.015) and DN (ORs Male = 1.006, ∗P < 0.001; ORs Female = 1.005, ∗P < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, P = 0.004) and 4th quartile (ORs = 2.064, P = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, P = 0.039), quartile 3 (ORs = 3.967, P = 0.024) and quartile 4 (ORs = 9.133, P < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, P = 0.042) in women Conclusion For patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.

scholarly journals Demographic and Clinical Characteristics of Epilepsy in Childhood: A Prospective Cross Sectional Study from Sudan

2021 ◽  
pp. 6
Author(s):  
Keyword(s):  
Low Socioeconomic Status ◽  
Clinical Characteristics ◽  
Genetic Disorders ◽  
Positive Family History ◽  
Cross Sectional Study ◽  
High Rate ◽  
Idiopathic Epilepsy ◽  
Cns Infection ◽  
Sectional Study ◽  
Cross Sectional

Background: Epilepsy is a common neurological disorder affecting around 1% of children. The incidence in Sudan is likely to be higher given the high rate of genetic disorders related to consanguity and acquired disorders caused by CNS infection and birth injury. Epilepsy can be idiopathic or non-idiopathic, symptomatic epilepsy indicates a known cause while cryptogenic epilepsy implies a presumed unknown cause. Objective: To understand the demographic and clinical characteristics of epilepsy in children in the setting of a tertiary epilepsy clinic in Khartoum, Sudan. Methods: This is a hospital-based cross sectional study recruiting patients with epilepsy attending a tertiary pediatric neurology clinic. All patients attending the clinic in the 6 month period were included. Data was collected by medical students and was analyzed on IBM SPSS Version 20.0 in a descriptive fashion. Results: 284 Children were recruited. The mean age for children with epilepsy was 5.74 (range 0-12 Years). Females constituted 59.9%; while 94.7% of patients were of low socioeconomic status. The most common type of seizures found were generalized tonic clinic at 51.8% (147/284), followed by focal seizures at 21.1% (60/284). 71% of our patients (201/284) had no identifiable cause (idiopathic), while 29% were non-idiopathic. Of the non-idiopathic group; 41% were due to congenital anomalies, followed by HIE at 24.1%, infections at 16.9% trauma at 10.8% and tumors at 7.2%. Only 18.3% (52/284) had a positive family history of epilepsy. Conclusions: There appears to be a higher incidence of epilepsy in Children with low socio – economic status with a slight female predominance. The incidence of idiopathic epilepsy appears to be similar to inter-national figures. We recommend broader community based and long-term studies for better understanding of epilepsy in Sudan.

Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Home Environment ◽  
Clinical Characteristics ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Mitigation Measures ◽  
Sectional Study ◽  
Cross Sectional

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.

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