scholarly journals Beyond the microscope: interpreting renal biopsy findings in the era of precision medicine

2018 ◽  
Vol 315 (6) ◽  
pp. F1652-F1655
Author(s):  
Serena M. Bagnasco
Keyword(s):  
Renal Disease ◽  
Gold Standard ◽  
New Technologies ◽  
Kidney Biopsy ◽  
Diagnostic Assessment ◽  
Renal Pathology ◽  
Diagnostic Process ◽  
Rapid Progress ◽  
New Knowledge

As rapid progress in science and biotechnology is affecting the practice of renal medicine, increasingly precise diagnostic assessment is needed to select the most effective therapeutic approach for individual patients. The kidney biopsy remains the gold standard for the diagnosis of renal disease, but the field of renal pathology is evolving, classification of renal parenchyma lesions and histopathological diagnostic criteria are undergoing more validation and updates, and new technologies and assays are sought to improve efficiency and accuracy of the diagnostic process. How new knowledge and scientific advances may potentially affect renal pathology is discussed.

INVESTIGATING ETIOLOGIES AND RENAL HISTOLOGIC PATTERNS IN 6 ELDERLY PATIENTS WITH NEPHROTIC SYNDROME

2015 ◽  
pp. 85-92
Author(s):  
Bach Nguyen ◽  
Thi Thuy Trang Le ◽  
Ngoc Linh Huynh
Keyword(s):  
Nephrotic Syndrome ◽  
Elderly Patients ◽  
Kidney Biopsy ◽  
The Elderly ◽  
Minimal Change ◽  
Renal Pathology ◽  
Invasive Technique ◽  
Renal Amyloidosis ◽  
Glomerular Diseases

Background: Nephrotic syndrome (NS) is the most common manifestation of glomerular diseases in the elderly and a most common indication of kidney biopsy. NS in the elderly is not as common as the young but more difficult to make diagnosis of etiologies, classification of renal histologic patterns and treatment because NS is frequently associated with various coexisting conditions. In Vietnam, the elderly population has been increased significantly therefore frequency of the elderly patients with NS is also increasing. Kidney biopsy is an invasive technique that is useful in diagnosing etiologies and classifying renal pathology. During recent years, renal pathology and biochemical immunology have been progressing rapidly. Therefore, the results of kidney biopsy are usually potential and valuable in clinical practice. We reported 6 elderly patients with NS performed kidney biopsy in Department of Nephrology, HCMCity during the period from 2/2012 to 12/2014 to investigate etiologies and renal histologic patterns. Materials and method: case report. The reported clinical cases were primary renal amyloidosis, IgA nephropathy secondary to liver cancer, minimal change NS associated with diabetes, NS caused by renal lymphoma infiltration, NS with minimal change associated by interferon and thrombotic microangiopathy. Conclusions: Nephrotic syndrome in the elderly might be associated with coexisting conditions and caused by several primary and secondary causes. Therefore, kidney biopsy should be considered to perform to make exact diagnosis in etiology, and to classify histologic patterns. Key words: Nephrotic syndrome, elderly, histologic patterns, kidney biopsy

scholarly journals Validity of classification of distal radial fractures in the Swedish fracture register

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Malena Bergvall ◽  
Carl Bergdahl ◽  
Carl Ekholm ◽  
David Wennergren
Keyword(s):  
Gold Standard ◽  
Reference Group ◽  
Observer Agreement ◽  
Distal Radial Fractures ◽  
Young Males ◽  
Small Peak ◽  
National Quality ◽  
Fracture Register ◽  
Standard Classification

Abstract Background Distal radial fractures (DRF) are one of the most common fractures with a small peak in incidence among young males and an increasing incidence with age among women. The reliable classification of fractures is important, as classification provides a framework for communicating effectively on clinical cases. Fracture classification is also a prerequisite for data collection in national quality registers and for clinical research. Since its inception in 2011, the Swedish Fracture Register (SFR) has collected data on more than 490,000 fractures. The attending physician classifies the fracture according to the AO/OTA classification upon registration in the SFR. Previous studies regarding the classification of distal radial fractures (DRF) have shown difficulties in inter- and intra-observer agreement. This study aims to assess the accuracy of the registration of DRF in adults in the SFR as it is carried out in clinical practice. Methods A reference group of three experienced orthopaedic trauma surgeons classified 128 DRFs, randomly retrieved from the SFR, at two classification sessions 6 weeks apart. The classification the reference group agreed on was regarded as the gold standard classification for each fracture. The accuracy of the classification in the SFR was defined as the agreement between the gold standard classification and the classification in the SFR. Inter- and intra-observer agreement was evaluated and the degree of agreement was calculated as Cohen’s kappa. Results The accuracy of the classification of DRF in the SFR was kappa = 0.41 (0.31–0.51) for the AO/OTA subgroup/group and kappa = 0.48 (0.36–0.61) for the AO/OTA type. This corresponds to moderate agreement. Inter-observer agreement ranged from kappa 0.22–0.48 for the AO/OTA subgroup/group and kappa 0.48–0.76 for the AO/OTA type. Intra-observer agreement ranged from kappa 0.52–0.70 for the AO/OTA subgroup/group and kappa 0.71–0.76 for the AO/OTA type. Conclusions The study shows moderate accuracy in the classification of DRF in the SFR. Although the degree of accuracy for DRF appears to be lower than for other fracture locations, the accuracy shown in the current study is similar to that in previous studies of DRF.

Revised ISN/RPS 2018 classification of lupus renal pathology predict clinical remission

2021 ◽  
Author(s):  
Kornwipa Krassanairawiwong ◽  
Mongkon Charoenpitakchai ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Clinical Remission ◽  
Renal Pathology

Revenue management and price optimization techniques in the hotel sector

2018 ◽  
Vol 24 (6) ◽  
pp. 720-752 ◽  
Author(s):  
Aldric Vives ◽  
Marta Jacob ◽  
Marga Payeras
Keyword(s):  
Revenue Management ◽  
Airline Industry ◽  
New Technologies ◽  
Customer Segmentation ◽  
Optimization Techniques ◽  
Hotel Management ◽  
Price Optimization ◽  
Hotel Sector ◽  
Measurement Effects

Pricing and revenue management (RM) techniques have become a popular field of research in hotel management literature. The sector’s background framework and evolution and the widespread use of new technologies have allowed a customer-oriented approach to be taken to pricing and the development of RM tools, while also contributing to better processes in hotel management performance at individual hotel level. Thus, price optimization (PO) methods that seek to maximize hotel revenue are based on inventory scarcity, customer segmentation and pricing. In the hotel sector, as in the airline industry, different pricing policies have a greater impact than competition measurement effects. This is mainly as differentiation strategies and specific policies at hotels can reduce the pressure of a competitive environment. The main contributions of the article are the presentation, description and classification of the principal RM and PO techniques in hotel sector literature.

Classification of Technological Development Trends Based on the Analysis of US Patent Time Series. An Empirical Approach

2021 ◽  
pp. 251-278
Author(s):  
Vladimir I. Karnyshev ◽  
◽  
Vladimir I. Avdzeyko ◽  
Evgenia S. Paskal ◽  
◽  
...  
Keyword(s):  
Time Series ◽  
New Technologies ◽  
Practical Interest ◽  
The United States ◽  
Direct Access ◽  
Investment Planning ◽  
Short Term ◽  
Development Trends ◽  
Technical Problems

The forecasting of development trends and the timely revealing of new technical (technological) fields are the key prerequisite for an effective development of modern economy. Only reliable results of technological analysis (forecast) allow identifying new technologies, understanding the evolution of entire industries, carrying out strategic investment planning at the state level, and also planning R&D correctly. The aim of this work is to justify one of the possible approaches to the classification of technical (technological) fields in terms of assessing their relevance, novelty and short-term prospects. This approach is based on patent analysis, in particular, on the study of the time series features of US invention patents (1976-2018) for more than seventy-three thousand main groups (subgroups) of the 17th edition of the International Patent Classification (IPC17). The United States Patent and Trademark Office (USPTO) has been selected as the primary source of information because it is one of the world’s largest and constantly updated patent resources, providing direct access to full-text descriptions. In the authors’ opinion, a feature analysis of the US patent issue dynamics at time intervals (1976-2015, 2009-2018 and 2016-2018) allows dividing the IPC groups (subgroups) into the following three main clusters: “unpromising”, “promising” and “breakthrough”. In terms of the timely revealing of new, previously unknown, technologies or solutions in the technical field, or of the steadily growing technological trends, the “breakthrough” and “promising” subgroups are of the greatest practical interest. The article presents the results of an empirical classification of 71,266 subgroups (with a non-zero number of the issued patents since 1976 to 2018) in eight sections of the IPC17. These data may be useful for developers, researchers and R&D planners in solving complex scientific and technical problems, as well as for making short-term forecast estimates of a specific technical (technological) field development.

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 287-296
Author(s):  
W. F. Dodge ◽  
C. W. Daeschner ◽  
J. C. Brennan ◽  
H. S. Rosenberg ◽  
L. B. Travis ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Importance ◽  
Renal Diseases ◽  
Renal Lesion ◽  
Bleeding Tendency ◽  
Percutaneous Renal Biopsy ◽  
The One ◽  
Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

scholarly journals Cerebrospinal fluid approach on neuro-oncology

2013 ◽  
Vol 71 (9B) ◽  
pp. 677-680 ◽  
Author(s):  
Helio Rodrigues Gomes
Keyword(s):  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
New Technologies ◽  
Major Complication ◽  
High Specificity ◽  
Csf Cytology ◽  
Cns Involvement ◽  
Effective Prophylaxis ◽  
Diagnostic Sensitivity And Specificity ◽  
Standard Marker

Central nervous system (CNS) involvement is a major complication of haematological and solid tumors with an incidence that ranges from 10% in solid malignances up to 25% in specific leukaemia or lymphoma subtypes. Cerebrospinal fluid (CSF) patterns are unspecific. Though CSF cytology has a high specificity (up to 95%), its sensitivity is generally less than 50% and no diagnostic gold standard marker is available, yet. New technologies such as flow cytometry, molecular genetics and newer biomarkers may improve diagnostic sensitivity and specificity, leading to the CNS involvement diagnosis, and consequently, to an effective prophylaxis and successful treatment.

scholarly journals AUTOMATED INTELLIGENT RELAY COUPLED DOOR CONTROL SYSTEM USING ANDROID MOBILE TECHNOLOGY

2015 ◽  
pp. 192-195
Author(s):  
A.RAJESH KUMAR ◽  
C. DINESH ◽  
R. ARAVIND ◽  
SRIKRISHNA. C ◽  
PL. NAGARTHINAM
Keyword(s):  
Mobile Technology ◽  
New Technologies ◽  
Smart Homes ◽  
Disabled Persons ◽  
Disabled People ◽  
New Knowledge ◽  
The Disabled ◽  
Door Lock ◽  
Effectiveness And Efficiency

The purpose of this project is to increase the knowledge of technology and services of smart homes for disabled people. There is a clear need for such new knowledge since the number of disabled people is significant. Indeed, new technologies and services of smart homes have the potential to increase effectiveness and efficiency of caring disabled. With right solutions there is a great potential to increase disabled persons' quality of life. The need for the development of such technologies and services increases due to the disabled individuals' desire to remain independent in their own homes, the increasing costs of health care, and the aging of the population. This article discusses the concept of secured door lock/unlock system for the differently able. The juxtaposition of safety vs. privacy can be alleviated with this technology. Moreover, as there is need to assist disabled to protect them from various forms of abuse, and prevent immoderation of pleasure giving activities.

scholarly journals MO638ANEMIA IN DIABETIC PATIENTS REFLECTS SEVERE TUBULOINTERSTITIAL INJURY AND ASSISTS CLINICALLY IN PREDICTING DIAGNOSIS OF DIABETIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Soichiro Yokota ◽  
Kenji Ito ◽  
Maho Watanabe ◽  
Koji Takahashi ◽  
Naoko Himuro ◽  
...  
Keyword(s):  
Renal Function ◽  
Regression Analysis ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Kidney Biopsy ◽  
Renal Pathology ◽  
Diabetic Patients ◽  
Pathological Findings

Abstract Background and Aims Diabetic nephropathy (DN) is currently a leading cause of end-stage kidney disease worldwide. Kidney biopsy is generally performed in diabetic patients to discriminate between DN and non-diabetic kidney disease (NDKD), and to provide more specific treatments. In addition to conventional predicting factors of DN, recent studies suggested the predictive value of anemia in the diagnosis of DN, however detailed pathophysiology and the significance of anemia in renal pathology are not fully understood. This study aimed to investigate the impact of anemia on renal pathology and clinical course in patients who underwent kidney biopsy. Method We reviewed 81 patients (60.4 ± 13.7 years, 54 men and 27 women) with type 2 diabetes who underwent percutaneous kidney biopsy in Fukuoka University Hospital from January 2001 through March 2020. DN was diagnosed by mesangial expansion or nodular glomerulosclerosis observed under a light microscope, and immunofluorescence assisted in differentiating NDKD from DN. Anemia was defined as hemoglobin level <13 g/dL in males and <12 g/dL in females in accordance with the World Health Organization standards. Laboratory and pathological findings, and clinical courses were investigated. Results According to their pathological findings, patients were classified into two groups: isolated DN (DN group, n=30) and NDKD alone or concurrent DN (NDKD group, n=51). There were 11 types of NDKD. Of these, membranous nephropathy was the most common (23.5%), followed by IgA nephropathy (17.6%), and crescentic glomerulonephritis (13.7%). In multiple logistic regression analysis, absence of severe hematuria (odds ratio (OR) 11.66, 95% confidence interval (CI) 1.68 - 89.9) and presence of anemia (OR 11.38, 95% CI 2.51 - 51.52) were significantly related with the diagnosis of DN. Akaike’s information criterion (AIC) and net reclassification improvement (NRI) analyses revealed improved predictive performance by adding anemia to the conventional factors (AIC 100.152 to 91.844; NRI 27.0%). The tissues of patients in the DN group demonstrated more severe interstitial fibrosis and tubular atrophy (IF/TA) than the NDKD group (p<0.05) regardless of the rate of global glomerulosclerosis (figure), and IF/TA was related to the prevalence of anemia (odds ratio: 7.31, 95% confidence interval: 2.33 - 23.00) in multivariate regression analysis. These results suggest DM-associated severe IF/TA (compared with NDKD) impaired erythropoietin production, resulting in earlier anemia, independent of glomerular injuries and renal function. Furthermore, the renal prognosis was significantly better in the NDKD group than in the DN group using Log-rank test (p<0.05). Conclusion DN is associated with anemia because of severe IF/TA regardless of renal function, and anemia helps clinician discriminate clinically between isolated DN and NDKD.

scholarly journals Towards a better understanding of the low recall of insertion variants with short-read based variant callers

2020 ◽  
Author(s):  
Wesley Delage ◽  
Julien Thevenon ◽  
Claire Lemaitre
Keyword(s):  
Gold Standard ◽  
Insertion Site ◽  
Structural Variants ◽  
Genomic Context ◽  
Breakpoint Junction ◽  
Short Read ◽  
Depth Analysis ◽  
Long Read ◽  
The Impact

AbstractSince 2009, numerous tools have been developed to detect structural variants (SVs) using short read technologies. Insertions >50 bp are one of the hardest type to discover and are drastically underrepresented in gold standard variant callsets. The advent of long read technologies has completely changed the situation. In 2019, two independent cross technologies studies have published the most complete variant callsets with sequence resolved insertions in human individuals. Among the reported insertions, only 17 to 37% could be discovered with short-read based tools. In this work, we performed an in-depth analysis of these unprecedented insertion callsets in order to investigate the causes of such failures. We have first established a precise classification of insertion variants according to four layers of characterization: the nature and size of the inserted sequence, the genomic context of the insertion site and the breakpoint junction complexity. Because these levels are intertwined, we then used simulations to characterize the impact of each complexity factor on the recall of several SV callers. Simulations showed that the most impacting factor was the insertion type rather than the genomic context, with various difficulties being handled differently among the tested SV callers, and they highlighted the lack of sequence resolution for most insertion calls. Our results explain the low recall by pointing out several difficulty factors among the observed insertion features and provide avenues for improving SV caller algorithms and their [email protected]

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