scholarly journals Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study

2020 ◽  
Vol Volume 12 ◽  
pp. 12269-12276
Author(s):  
Jie Xu ◽  
Can Chen ◽  
Jing Xiong ◽  
Hua Linghu
Keyword(s):  
Endometrial Cancer ◽  
Cohort Study ◽  
Observational Cohort Study ◽  
Type I ◽  
Type Ii ◽  
Differential Impact ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

scholarly journals Crescentic glomerulonephritis: what’s different in South Asia? A single center observational cohort study

2020 ◽  
Vol 5 ◽  
pp. 164 ◽  
Author(s):  
Suceena Alexander ◽  
Sabina Yusuf ◽  
Gautham Rajan ◽  
Elenjickal Elias John ◽  
Sanjeet Roy ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Asia ◽  
Crescentic Glomerulonephritis ◽  
Interstitial Fibrosis ◽  
Observational Cohort Study ◽  
Type I ◽  
Type Ii ◽  
Double Positive ◽  
Type Iii ◽  
Observational Cohort

Background: The spectrum and outcomes of crescentic glomerulonephritis (Cr.GN) in South Asia is vastly different from that reported worldwide and there is a paucity of information. The aim of the study was to study the demography, clinical presentation, histology and predictors of longitudinal outcomes of Cr.GN in this population. Methods: An observational cohort study of renal biopsies was performed in the largest tertiary center in South India over a period of 10 years (January 2006 to December 2015) with ≥50% crescents on renal histology indicating Cr.GN. Results: A total of 8645 kidney biopsies were done; 200 (2.31%) were Cr.GN. Patients were categorized into three etiological groups: anti-glomerular basement membrane (type I), immune complex (type II), and pauci-immune (type III). Type II was the most common (96, 46.5%), followed by type III (73, 38%) and type I (31, 15.5%). Female preponderance was seen across all types. About half of all patients presented with recent onset hypertension. Type II had the highest median proteinuria (4.2 (2.1-6) g/day, p=0.06) and the median estimated glomerular filtration rate was lowest in type I (5 (4-8) ml/min/1.73m2, p<0.001). Among type III, anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis was seen only in ~50% of patients. Nearly one third of patients with type I were also positive for ANCA making them ‘double positive’. Acute glomerular insults like tuft necrosis and chronic changes as evidenced by moderate to severe interstitial fibrosis, was a predominant feature of type I. Conclusions: ANCA-negative pauci-immune vasculitis, as well as double positive Cr.GN, are reported for the first time in South-Asia. Renal survival was significantly worse in type I/III compared to type II. Types I/III, moderate to severe interstitial fibrosis and tubular atrophy, presence of oliguria/anuria and increasing percentage of crescents in renal biopsy were significant predictors of end stage kidney disease in our cohort.

scholarly journals Crescentic Glomerulonephritis: What’s different in South Asia? - A Single Center Observational Cohort Study

2020 ◽  
Author(s):  
Suceena Alexander ◽  
Sabina Yusuf ◽  
Gautham Rajan ◽  
Elenjickal Elias John ◽  
Sanjeet Roy ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Asia ◽  
Crescentic Glomerulonephritis ◽  
Observational Cohort Study ◽  
Type I ◽  
Type Ii ◽  
Double Positive ◽  
Type Iii ◽  
Tertiary Center ◽  
Observational Cohort

ABSTRACTBackgroundThe spectrum and outcomes of crescentic glomerulonephritis in South Asia is vastly different from that reported worldwide and there is a paucity of information.MethodsIt was an observational cohort study of renal biopsies done in the largest tertiary center in South India over a period of 10 years with ≥50% crescents on histology.ResultsA total of 8645 kidney biopsies were done at our center from January 2006 to December 2015, and 200 (2.31%) were crescentic glomerulonephritis. Patients were categorized into three etiological groups - anti-GBM (type I), immune complex (type II) and pauci-immune (type III). The most common was type II (96, 46.5%), followed by type III (73, 38%) and then type I (31, 15.5%). Female preponderance was seen across all three types. About half of all the three types presented with recent onset hypertension. Type II had the highest median proteinuria (4.2 (2.1-6) g/day, p=0.06) and the median eGFR was lowest in type I (5 (4-8) ml/min/1.73m2, p<0.001). Among type III, ANCA associated vasculitis (AAV) was seen only in about half of the patients. Nearly one third patients with type I was also positive for ANCA making them ‘double positive’. Severe glomerular insults like tuft necrosis and chronicity as evidenced by moderate to severe interstitial fibrosis was a predominant feature of type I.ConclusionsANCA negative vasculitis as well as double positive types are reported for the first time from South-Asia. Prevalence of ANCA negative vasculitis (type III subgroup) was much higher in our population. Renal survival was significantly worse in type I & III compared to type II. Types I/III, moderate to severe IFTA, presence of oliguria/anuria and increasing percentage of crescents in renal biopsy were significant predictors of dialysis dependence at index visit or of end stage kidney disease at follow-up in our cohort.

scholarly journals Disorders of placental villous maturation in fetal death

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sunil Jaiman ◽  
Roberto Romero ◽  
Percy Pacora ◽  
Eunjung Jung ◽  
Gaurav Bhatti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fetal Death ◽  
Prevalence Ratio ◽  
Normal Pregnancy ◽  
Observational Cohort Study ◽  
Maturation Arrest ◽  
Inflammatory Lesions ◽  
Multiple Gestations ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Objective The aims of this study were to ascertain the frequency of disorders of villous maturation in fetal death and to also delineate other placental histopathologic lesions in fetal death. Methods This was a retrospective observational cohort study of fetal deaths occurring among women between January 2004 and January 2016 at Hutzel Women’s Hospital, Detroit, MI, USA. Cases comprised fetuses with death beyond 20 weeks’ gestation. Fetal deaths with congenital anomalies and multiple gestations were excluded. Controls included pregnant women without medical/obstetrical complications and delivered singleton, term (37–42 weeks) neonate with 5-min Apgar score ≥7 and birthweight between the 10th and 90th percentiles. Results Ninety-two percent (132/143) of placentas with fetal death showed placental histologic lesions. Fetal deaths were associated with (1) higher frequency of disorders of villous maturation [44.0% (64/143) vs. 1.0% (4/405), P < 0.0001, prevalence ratio, 44.6; delayed villous maturation, 22% (31/143); accelerated villous maturation, 20% (28/143); and maturation arrest, 4% (5/143)]; (2) higher frequency of maternal vascular malperfusion lesions [75.5% (108/143) vs. 35.7% (337/944), P < 0.0001, prevalence ratio, 2.1] and fetal vascular malperfusion lesions [88.1% (126/143) vs. 19.7% (186/944), P < 0.0001, prevalence ratio, 4.5]; (3) higher frequency of placental histologic patterns suggestive of hypoxia [59.0% (85/143) vs. 9.3% (82/942), P < 0.0001, prevalence ratio, 6.8]; and (4) higher frequency of chronic inflammatory lesions [53.1% (76/143) vs. 29.9% (282/944), P < 0.001, prevalence ratio 1.8]. Conclusion This study demonstrates that placentas of womem with fetal death were 44 times more likely to present disorders of villous maturation compared to placentas of those with normal pregnancy. This suggests that the burden of placental disorders of villous maturation lesions is substantial.

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