Renal Neoplasms in Younger Adults: Analysis of 112 Tumors From a Single Institution According to the New 2004 World Health Organization Classification and 2002 American Joint Committee on Cancer Staging System

2005 ◽  
Vol 129 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Ying Cao ◽  
Gladell P. Paner ◽  
Kent T. Perry ◽  
Robert C. Flanigan ◽  
Steven C. Campbell ◽  
...  
Keyword(s):  
Older Adults ◽  
Clear Cell ◽  
Staging System ◽  
Cancer Staging ◽  
World Health ◽  
Renal Tumors ◽  
Renal Neoplasms ◽  
Younger Adults ◽  
American Joint Committee ◽  
Health Organization

Abstract Context.—Adult renal neoplasms have a predilection for older patients and are clinically and morphologically distinct from renal neoplasms found in pediatric age groups. Relatively rare tumors occur in younger adults (18–45 years of age). Whether these renal tumors are morphologically and clinically distinct from those of older adults has been the subject of controversy. Recent modification of the World Health Organization histologic classification and the American Joint Committee on Cancer staging system of adult renal tumors further highlighted the need for case analysis in this age group. Objective.—To analyze renal tumors in younger adults based on a large surgical series from a single institution. Design.—Of 780 renal mass nephrectomy (partial, total, or radical) specimens that were available for evaluation and had been obtained between 1986 and 2004 at Loyola University Medical Center, 112 specimens were from patients between 18 and 45 years of age. The tumors were reevaluated according to the 2004 World Health Organization classification and the 2002 American Joint Committee on Cancer staging system. Results.—The likelihood of clear cell renal cell carcinoma was significantly reduced from 65% in older adults to 53% in younger adults (18–45 years, P = .04). The reduction trend was more significant when comparing an even younger age group. The majority (64%) of clear cell renal cell carcinoma in younger adults was low stage, T1a. Seventeen percent of these tumors had multilocular cystic features involving more than 50% of the tumor volume (55%–85%). The number of oncocytomas was also significantly lower in younger adults than in older adults (2% vs 11%, P < .001), and this presumably age-related benign neoplasm was not identified in patients younger than 40 years in this study. In contrast, the miscellaneous tumor category showed a remarkable increase, from 4% in older adults to 26% in younger adults (P < .001). The youngest patient group (18–35 years) had a higher incidence of miscellaneous tumors, 37%. Younger female adults tended to have more benign miscellaneous neoplasms than did their male counterparts (64% vs 36%, P < .001). Clear cell and chromophobe renal cell carcinoma occurred more frequently in younger male adults than in female adults (2:1 and 8:1, respectively). Conclusions.—Renal neoplasms are more heterogeneous in younger adults and have a different distribution pattern compared with that in older adults. Malignant and benign renal neoplasms tend to have a contrasting sex distribution in younger adults.

scholarly journals Personality and change in perceived control across the first four months of the coronavirus pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 726-726
Author(s):  
Amanda Sesker ◽  
Ji Hyun Lee ◽  
Martina Luchetti ◽  
Damaris Aschwanden ◽  
Yannick Stephan ◽  
...  
Keyword(s):  
Older Adults ◽  
Personality Traits ◽  
Perceived Control ◽  
Online Survey ◽  
National Sample ◽  
World Health ◽  
Middle Aged ◽  
Younger Adults ◽  
Health Organization ◽  
Over Time

Abstract Objective: This study examined change in perceived control (PC) across the first four months of the global coronavirus pandemic and whether change varied significantly by age and personality traits during the first four months of the pandemic. Methods: Personality was assessed prior to the pandemic in a large national sample of 2,455 American adults (18-100 years) from a preregistered online survey (https://osf.io/q8cpd), first conducted between January 31, 2020 and February 10, 2020. Three additional follow-up waves were conducted: mid-March 2020 (following the World Health Organization declaration of the coronavirus a pandemic), late April 2020 (toward the end of the White House’s 30 Days to Slow the Spread guidance), and late July 2020 (when patient deaths in the U.S. reached 132,918). PC was assessed in Waves 2-4. Results: There were age differences in the trajectory of PC such that PC increase for middle-aged and older adults, whereas younger adults had lower PC and did not increase over the follow-ups. All personality traits but Openness were associated with PC at the first assessment. Conscientiousness, Extraversion, and Agreeableness positively predicted PC change over time. The association between Conscientiousness and Extraversion and increased PC over time was stronger at older ages. Conclusion: Pre-pandemic personality predicted PC and PC change during the first four months of the pandemic, with middle-aged and older adults showing better adaption than younger adults. This study provides new evidence for PC change and associations between personality and PC during the COVID-19 pandemic.

scholarly journals Evolution of Classification of Thymic Epithelial Tumors in the Era of Dr Thomas V. Colby

2017 ◽  
Vol 141 (2) ◽  
pp. 232-246 ◽  
Author(s):  
Anja C. Roden
Keyword(s):  
Prognostic Significance ◽  
Staging System ◽  
Cancer Staging ◽  
World Health ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
New Concepts ◽  
Prognostic Implications ◽  
Health Organization

Context.—Numerous histomorphologic and staging classifications of thymic epithelial tumors (TETs) have been proposed during the last century, suggesting that the classification of these tumors is challenging and controversial. Difficulties of classifying TETs include various combinations of epithelial cells and lymphocytes and the paucity of these tumors. The prognostic significance, specifically of the histomorphologic classifications, has been debated. Early classifications were also challenged by the uncertainty of the neoplastic component(s) of the tumor.Objective.—To discuss the evolution of the histomorphologic classification and the staging system of TET. Controversies and problems of some classifications and their importance for therapeutic management and prognosis will be reviewed. Classifications that incorporated new concepts and approaches at the time or outcome studies will be highlighted. Current classifications will be discussed and the staging system that was recently proposed for the upcoming eighth American Joint Committee on Cancer staging will be described.Data Sources.—Search of literature database (PubMed) and current (2015) World Health Organization classification.Conclusions.—Histomorphologic and staging classifications of TET have evolved during the last century and especially during the era of Thomas V. Colby, MD. Evidence supports that the staging system has prognostic implications independent of and superior to the histomorphologic classification. Histomorphology appears to be important for biologic features of TET.

scholarly journals Urinary Bladder Pathology: World Health Organization Classification and American Joint Committee on Cancer Staging Update

2018 ◽  
Vol 143 (5) ◽  
pp. 571-577 ◽  
Author(s):  
Gang Wang ◽  
Jesse K. McKenney
Keyword(s):  
World Health Organization ◽  
Who Classification ◽  
Cancer Staging ◽  
World Health ◽  
Urinary System ◽  
American Joint Committee ◽  
Health Organization ◽  
8Th Edition ◽  
Male Genital

Context.— Since the publication of the previous World Health Organization (WHO) Classification of Tumours on the Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs in 2004, significant new knowledge has been generated regarding the pathology and genetics of bladder neoplasia. Publication of the 2016 WHO “Blue Book” has codified that new data into updated recommendations for classification and prognostication. Similarly, the recent release of the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, which was implemented in January 2018, has also addressed staging criteria for bladder cancer in several unique settings to clarify their application. Objective.— To highlight subtle changes within the recent WHO and AJCC publications that may affect daily surgical pathology practice. Data Sources.— Peer-reviewed published literature, the 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs, and the 8th edition of the AJCC Cancer Staging Manual were reviewed. Conclusions.— Selected changes and/or clarifications are discussed and include classification of flat and papillary urothelial neoplasia, select variant patterns of invasive urothelial carcinoma, staging of invasive carcinoma in bladder diverticula, and staging of carcinomas involving the prostate gland.

scholarly journals Distinct Expression Patterns of Carbonic Anhydrase IX in Clear Cell, Microcystic, and Angiomatous Meningiomas

2019 ◽  
Vol 78 (12) ◽  
pp. 1081-1088
Author(s):  
Rati Chkheidze ◽  
Patrick J Cimino ◽  
Kimmo J Hatanpaa ◽  
Charles L White ◽  
Manuel Ferreira ◽  
...  
Keyword(s):  
Carbonic Anhydrase ◽  
Clear Cell ◽  
Expression Patterns ◽  
Carbonic Anhydrase Ix ◽  
World Health ◽  
Loss Of Function ◽  
Ca Ix ◽  
Hypoxia Marker ◽  
Other World ◽  
Health Organization

Abstract Clear cell, microcytic, and angiomatous meningiomas are 3 vasculature-rich variants with overlapping morphological features but different prognostic and treatment implications. Distinction between them is not always straightforward. We compared the expression patterns of the hypoxia marker carbonic anhydrase IX (CA-IX) in meningiomas with predominant clear cell (n = 15), microcystic (n = 9), or angiomatous (n = 11) morphologies, as well as 117 cases of other World Health Organization recognized histological meningioma variants. Immunostaining for SMARCE1 protein, whose loss-of-function has been associated with clear cell meningiomas, was performed on all clear cell meningiomas, and selected variants of meningiomas as controls. All clear cell meningiomas showed absence of CA-IX expression and loss of nuclear SMARCE1 expression. All microcystic and angiomatous meningiomas showed diffuse CA-IX immunoreactivity and retained nuclear SMARCE1 expression. In other meningioma variants, CA-IX was expressed in a hypoxia-restricted pattern and was highly associated with atypical features such as necrosis, small cell change, and focal clear cell change. In conclusion, CA-IX may serve as a useful diagnostic marker in differentiating clear cell, microcystic, and angiomatous meningiomas.

scholarly journals Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ki-Soo Park ◽  
Gyeong-Ye Lee ◽  
Young-Mi Seo ◽  
Sung-Hyo Seo ◽  
Jun-Il Yoo
Keyword(s):  
Older Adults ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Normal Group ◽  
World Health ◽  
Common Disease ◽  
Using Data ◽  
Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

scholarly journals Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

2021 ◽  
pp. 1-23
Author(s):  
Kofi Awuviry-Newton ◽  
Kylie Wales ◽  
Meredith Tavener ◽  
Paul Kowal ◽  
Julie Byles
Keyword(s):  
Older Adults ◽  
Marital Status ◽  
Conceptual Framework ◽  
World Health ◽  
Adult Health ◽  
Care Needs ◽  
Functional Difficulties ◽  
The World ◽  
Health Organization ◽  
Global Ageing

Abstract Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

scholarly journals World Health Report on Vision: Aging Implications for Global Vision and Eye Health

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 807-808
Author(s):  
Bonnielin Swenor ◽  
Varshini Varadaraj ◽  
Moon Jeong Lee ◽  
Heather Whitson ◽  
Pradeep Ramulu
Keyword(s):  
Older Adults ◽  
Visual Impairment ◽  
Vision Loss ◽  
World Health ◽  
World Health Report ◽  
Global Public Health ◽  
Eye Care ◽  
Health Report ◽  
Public Health Challenges ◽  
Health Organization

Abstract In 2019, the World Health Organization World Report on Vision estimated that that 2.2 billion people have a vision impairment, of which almost half could have been prevented or is yet to be addressed. As the global population ages and the prevalence of visual impairment increases, inequities in eye care and the downstream health and aging consequences of vision loss will become magnified. This session will: (1) provide key information regarding the burden of eye disease and visual impairment among older adults worldwide; (2) outline a framework created to conceptualize the aging and long-term health implications of vision loss, and (3) discuss the global public health challenges to eye care and to maximizing health for older adults with visual impairments.

Final Version of the American Joint Committee on Cancer Staging System for Cutaneous Melanoma

2001 ◽  
Vol 19 (16) ◽  
pp. 3635-3648 ◽  
Author(s):  
Charles M. Balch ◽  
Antonio C. Buzaid ◽  
Seng-Jaw Soong ◽  
Michael B. Atkins ◽  
Natale Cascinelli ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Elevated Serum ◽  
Primary Melanoma ◽  
Staging System ◽  
Distant Metastases ◽  
Lactic Dehydrogenase ◽  
Cancer Staging ◽  
Sixth Edition ◽  
Stage Grouping ◽  
American Joint Committee

PURPOSE: To revise the staging system for cutaneous melanoma under the auspices of the American Joint Committee on Cancer (AJCC). MATERIALS AND METHODS: The prognostic factors analysis described in the companion publication (this issue), as well as evidence from the published literature, was used to assemble the tumor-node-metastasis criteria and stage grouping for the melanoma staging system. RESULTS: Major changes include (1) melanoma thickness and ulceration but not level of invasion to be used in the T category (except for T1 melanomas); (2) the number of metastatic lymph nodes rather than their gross dimensions and the delineation of clinically occult (ie, microscopic) versus clinically apparent (ie, macroscopic) nodal metastases to be used in the N category; (3) the site of distant metastases and the presence of elevated serum lactic dehydrogenase to be used in the M category; (4) an upstaging of all patients with stage I, II, and III disease when a primary melanoma is ulcerated; (5) a merging of satellite metastases around a primary melanoma and in-transit metastases into a single staging entity that is grouped into stage III disease; and (6) a new convention for defining clinical and pathologic staging so as to take into account the staging information gained from intraoperative lymphatic mapping and sentinel node biopsy. CONCLUSION: This revision will become official with publication of the sixth edition of the AJCC Cancer Staging Manual in the year 2002.

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