Informatics Analysis of Health Indicators and Pathological Manifestations of Foot-Process in Patients with Primary IgA Nephropathy

2021 ◽  
Vol 11 (7) ◽  
pp. 1985-1994
Author(s):  
Shanhong Shi ◽  
Fang Xing ◽  
Weiyuan Lin
Keyword(s):  
Iga Nephropathy ◽  
Statistical Difference ◽  
Lesion Group ◽  
Oxford Classification ◽  
Clinical Indicators ◽  
Mesangial Hypercellularity ◽  
Group A ◽  
The Oxford Classification ◽  
Foot Process ◽  
Group B

Objective: This paper focuses on the foot-process in renal biopsies of patients with lgA, and examines their correlation with baseline clinical indicators and pathological manifestations in patients with lgA. Method: A retrospective data of patients who performed renal biopsy proven IgA nephropathy was selected. The patients who reached the agreed standard were grouped based on the degree of foot-process. There were three groups (ABC Groups) (Du, Y. and Huang, C, 2009. The value of proteinuria and foot process fusion in the onset of prognosis of acute kidney disease. Chinese Journal of Integrated Traditional and Western Medicine, 10(1), pp.44-45): group A for patients with no obvious foot-process lesion; group B for patients with segmental foot-process; group C for patients with massive foot-process. The three groups were reviewed in the aspects of baseline clinical indicators and Oxford classification, so as to discover foot-process’ effect on patients with IgA nephropathy. Results: A total of 129 patients with IgA nephropathy were included in the study. Concerning about the clinical baseline indicators related to the degree of foot-process, the 24-hour proteinuria level at admission was statistically significant and positively correlated (r = 0.324, P = 0.000). The comparison between groups showed there was statistically significant difference between group C and group A and group B (P = 0.001, P = 0.035). According to the Oxford Classification, only the differences of mesangial hypercellularity (M) and segmental sclerosis/adhesion (S) were statistically significant (r = 0.239, P = 0.006; r = 0.257, P = 0.003) and were positively correlated. In terms of mesangial hypercellularity (M), the differences between group A and B, group A and C were statistically significant (P = 0.01, P = 0.003). The comparison between group B and group C showed statistical difference (P = −0.031) in segmental sclerosis/adhesion (S). Among the 76 patients with S0 revealed by the Oxford classification, there were 55 patients of glomerulosclerosis, which was positively correlated with the degree of foot process (r = 0.211, P = 0.016). The comparison between group A and group C showed statistical difference (P = 0.014). Conclusion: The severity foot-process was positively correlated with the level of proteinuria. Foot-process is positively related with mesangial hypercellularity, segmental sclerosis and glomerulosclerosis. With more severe the foot-process, there will be more serious mesangial hypercellularity and irreversible glomerular injury. Foot-process is positively correlated with Lee’s Pathological Grading.

scholarly journals Predictive Capabilities of Three Widely Used Pathology Classification Systems and a Simplified Classification (Beijing Classification) in Primary IgA Nephropathy

2019 ◽  
Vol 44 (5) ◽  
pp. 928-941
Author(s):  
Shu-Wei Duan ◽  
Yan Mei ◽  
Jian Liu ◽  
Pu Chen ◽  
Ping Li ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Prognostic Value ◽  
Cox Regression ◽  
Hierarchical Classification ◽  
Information Criterion ◽  
Classification Systems ◽  
Oxford Classification ◽  
Clinical Indicators ◽  
Pathological Classification ◽  
The Oxford Classification

Background/Aims: Several pathological classification systems were commonly used in clinical practice to predict the prognosis of IgA nephropathy (IgAN). However, how prognostic value differs between these systems is unclear. The aim of this study was to compare the Lee grade, the Oxford classification, and the Haas classification and to find a simplified classification. Methods: We retrospectively analyzed IgAN cases diagnosed between January 2002 and December 2007. The endpoints were progression to end-stage renal disease (ESRD) or a ≥50% decline in estimated glomerular filtration rate (eGFR). The predictive capabilities were evaluated by comparing the ability of discrimination (continuous net reclassification) and calibration (Akaike information criterion [AIC]). Results: A total of 412 IgAN patients were included in the study. The average follow-up period was 80.62 ± 23.63 months. A total of 44 (10.68%) patients progressed to ESRD, and 70 (16.99%) patients showed a ≥50% decline in eGFR. All multivariate Cox regression models had limited power for high AIC values. The prognostic values of the Lee grade and the Oxford classification were higher than those of models containing only established baseline clinical indicators for progression to ESRD or a ≥50% decline in eGFR (Lee grade 0.50, 95% CI 0.21–0.74; Oxford classification 0.48, 95% CI 0.28–0.71). The prognostic value of the Haas classification was lower than that of the other pathological classification systems for progression to ESRD or a ≥50% decline in eGFR (Lee grade 0.53, 95% CI 0.23–0.92; Oxford classification 0.59, 95% CI 0.10–0.74). The prognostic value of hierarchical classification (Beijing classification) using M and T lesion was similar to the Oxford classification. Conclusions: Both the Lee grade and the Oxford classification showed incremental prognostic values beyond established baseline clinical indicators. The Haas classification was slightly inferior to the Lee grade and the Oxford classification. The hierarchical classification (Beijing classification) using less pathological parameters does not lose predictive efficiency.

scholarly journals Tonsillectomy reduces recurrence of IgA nephropathy in mesangial hypercellularity type categorized by the Oxford classification

2015 ◽  
Vol 20 (3) ◽  
pp. 425-432 ◽  
Author(s):  
Keita Hirano ◽  
Hoichi Amano ◽  
Tetsuya Kawamura ◽  
Kyoko Watanabe ◽  
Kentaro Koike ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Oxford Classification ◽  
Mesangial Hypercellularity ◽  
The Oxford Classification

The Oxford Classification of IgA Nephropathy: A Retrospective Analysis

2011 ◽  
Vol 34 (5) ◽  
pp. 435-444 ◽  
Author(s):  
Timothy Yau ◽  
Stephen M. Korbet ◽  
Melvin M. Schwartz ◽  
David J. Cimbaluk
Keyword(s):  
Retrospective Analysis ◽  
Iga Nephropathy ◽  
Oxford Classification ◽  
The Oxford Classification

scholarly journals Grading system utilising the total score of Oxford classification for predicting renal prognosis in IgA nephropathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoei Miyabe ◽  
Kazunori Karasawa ◽  
Kenichi Akiyama ◽  
Shota Ogura ◽  
Tomo Takabe ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Clinical Findings ◽  
Grading System ◽  
Oxford Classification ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
The Oxford Classification ◽  
Renal Prognosis ◽  
Renal Survival Rate

AbstractThe Oxford classification of IgA nephropathy (IgAN) can evaluate each MEST-C score individually. We analysed a new grading system that utilised the total MEST-C score in predicting renal prognosis. Altogether, 871 IgAN patients were classified into three groups using the new Oxford classification system (O-grade) that utilised the total MEST-C score (O-grade I: 0–1, II: 2–4, and III: 5–7 points), and the 10-year renal prognosis was analysed. The clinical findings became significantly severer with increasing O-grades, and the renal survival rate by the Kaplan–Meier method was 94.1%, 86.9%, and 74.1% for O-grades I, II, and III, respectively. The hazard ratios (HRs) for O-grades II and III with reference to O-grade I were 2.8 (95% confidence interval [CI] 1.3–6.0) and 6.3 (95% CI 2.7–14.5), respectively. In the multivariate analysis, mean arterial pressure and eGFR, proteinuria at the time of biopsy, treatment of corticosteroids/immunosuppressors, and O-grade (HR 1.63; 95% CI 1.11–2.38) were the independent factors predicting renal prognosis. Among the nine groups classified using the O-grade and Japanese clinical-grade, the renal prognosis had an HR of 15.2 (95% CI 3.5–67) in the severest group. The O-grade classified by the total score of the Oxford classification was associated with renal prognosis.

scholarly journals A pilot study comparing two physiotherapy techniques in patietnts with cystic fibrosis

2004 ◽  
Vol 60 (2) ◽  
Author(s):  
S. M. Milne ◽  
C. J. Eales
Keyword(s):  
Cystic Fibrosis ◽  
Pilot Study ◽  
Lung Function ◽  
Statistical Difference ◽  
Positive Pressure ◽  
Lung Function Tests ◽  
Bronchial Secretions ◽  
Group A ◽  
Group B ◽  
Minimal Research

The flutter is a simple hand held device designed to facilitate the mobilisation of excess bronchial secretions by means of oscillating positive pressure. Traditionally patients at the Johannesburg Hospital Cystic Fibrosis clinic used the active cycle of breathing technique as a means of facilitating secretion mobilisation and clearance. When the flutter became available in South Africa in 1999 many cystic fibrosis patients wanted to change to this technique. Minimal research has been conducted comparing these two techniques. The aim of this pilot study was therefore to determine which technique is more effective in the mobilisation of  secretions in cystic fibrosis patients. The pilot study was conducted on seven cystic fibrosis patients (mean age 28 years, range 16-42 years) admitted to the Johannesburg Hospital for antibiotic therapy. The study lasted four days and consisted of two treatment days  separated by a washout day on which no physiotherapy was performed. Patients randomised into Group A performed the flutter technique on day two and the active cycle of breathing technique on day four. Group B performed the active cycle of breathing technique on day two and the flutter on day four. The techniques were performed twice a day for  15 minutes. The measurements taken were daily 24-hour sputum samples and daily lung function tests. A questionnaire to determine patient preference to a technique concluded the study.  The results showed no statistical difference between the two techniques with regard to sputum weight or lung function (p<0.05). The questionnaire indicated that on a whole, patients had no preference for a technique.

scholarly journals Comments on the Oxford classification of IgA nephropathy

2009 ◽  
Vol 76 (11) ◽  
pp. 1207 ◽  
Author(s):  
Gary S. Hill ◽  
Dominique Nochy ◽  
Khalil El Karoui
Keyword(s):  
Iga Nephropathy ◽  
Oxford Classification ◽  
The Oxford Classification

the value of patient hydration prior to bone scintigraphy

2003 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
s. m. stace ◽  
s. m. huggett ◽  
b. k. denton ◽  
a. m. harries
Keyword(s):  
Soft Tissue ◽  
Bone Scintigraphy ◽  
Statistical Difference ◽  
Mean Value ◽  
Regions Of Interest ◽  
Femoral Diaphysis ◽  
Post Injection ◽  
Group A ◽  
The Mean ◽  
Group B

the aim of this study was to establish whether hydration prior to radiopharmaceutical injection, in addition to post injection hydration, contributed any value to image quality during bone scintigraphy. two hundred patients referred for bone imaging over a four month period were randomised into two groups. group a was issued with instructions to hydrate pre and post injection, and group b was only advised to hydrate between injection and scan. equal regions of interest (roi) were then drawn on each image: firstly over the femoral diaphysis, and secondly over the contra-lateral adductor area. the total number of gamma counts from the bone roi and the soft tissue roi was then expressed as a ratio, and a mean value for each group was established.the mean ratio for group a was found to be 2.25, and for group b 2.30. a t test of variance confirmed that there was no statistical difference between the ratios of the groups (t = 50.272, n = 5100, p = 50.618). it was concluded that hydration levels prior to bone scintigraphy injection, where it is preserved post injection, have no significant effect on the bone-soft tissue (b:st) ratio in the image.

scholarly journals MP084APPLICATION OF THE OXFORD CLASSIFICATION OF IGA NEPHROPATHY IN THE REAL WORLD

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii456-iii457
Author(s):  
Alastair Rankin ◽  
Bruce Mackinnon ◽  
David Kipgen ◽  
Jonathan Fox ◽  
Colin Geddes ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Real World ◽  
Oxford Classification ◽  
The Real ◽  
The Oxford Classification

scholarly journals A comparative study between dexmedetomidine and dexamethasone as an intrathecal adjuvant for prevention of perioperative shivering in cesarean section

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Abdul Mohsen Abdul Naiem Ismaiel ◽  
Omar Mohamed Taha El Safty ◽  
Ashraf El Sayed El-Agamy ◽  
Omar Mohamed Zafer Mohamed ◽  
Mohamed Mourad Mohsen Mohamed Ali
Keyword(s):  
Cesarean Section ◽  
Statistical Difference ◽  
Sensory Block ◽  
List Type ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background One of the most common problems in parturients receiving regional anesthesia during cesarean section is shivering. It usually interferes with the readings of the oxygen plethysmography (SpO2) and electrocardiogram (ECG). It expands the needs for oxygen and increases creation of carbon dioxide about four folds. The aim of this work is to compare the efficacy of dexamethasone and dexmedetomidine in prevention of perioperative shivering when added to hyperbaric bupivacaine intrathecally in cesarean sections (CS) and their effect on the intraoperative hemodynamics, intensity of the block, sedation, and postoperative analgesic requirement. Results Study included 60 obstetric patients who fulfilled all the inclusion criteria and were randomized into 2 equal groups, each consisting of 30 patients, namely group A (dexmedetomidine group) and B (dexamethasone group). Group A patients received 5 μg dexmedetomidine with 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. Group B patients received 8 mg dexamethasone then 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. The comparison included assessment of intra- and postoperative hemodynamics, duration of surgery, assessment of sensory and motor block, assessment for shivering and sedation, and assessment of adverse events. This study showed that there were a small number of patients complaining of shivering (five patients in group A and seven patients in group B) with no statistical difference between both groups in the incidence and intensity of shivering. Time to two segment regression (minutes) was longer in group B compared to group A, and also, time to first analgesic rescue was longer in group B compared to group A. For sedation intensity, there was statistical difference between both groups as all patients in group A were sedated compared to six patients only in group B. There was no statistical difference between both groups as regards incidence of adverse effects. Conclusion We concluded that both drugs can be added safely to bupivacaine, and both dexmedetomidine and dexamethasone decreased the incidence and the intensity of shivering. Dexamethasone was found to prolong the duration of sensory block and delay opioid requirements post-operatively, while dexmedetomidine is more effective in sedating the patients intra- and postoperatively.

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