Classification of diabetes. World Health Organization 2019. What’s new?

2020 ◽  
Vol 23 (4) ◽  
pp. 329-339
Author(s):  
Irina V. Kononenko ◽  
Olga M. Smirnova ◽  
Aleksandr Y. Mayorov ◽  
Marina V. Shestakova
Keyword(s):  
Molecular Genetic ◽  
Classification Systems ◽  
World Health ◽  
Β Cells ◽  
Appropriate Treatment ◽  
Practical Guidance ◽  
Health Organization ◽  
Selection Of ◽  
Hybrid Forms

The review focuses on the new WHO classification published in 2019. Unlike the previous classification, this classification does not recognize subtypes of T1DM and T2DM and offers new types of diabetes: “hybrid types of diabetes” and “unclassified diabetes”. This classification provides practical guidance to clinicians for assigning a type of diabetes to individuals and choose appropriate treatment (whether or not to start treatment with insulin), particularly at the time of diagnosis. This review presents the variety of forms of diabetes, the features of their clinical picture, and also emphasizes the importance of molecular genetic and immunological studies to identify types of diabetes and determine personalized therapy. The selection of “hybrid forms” of diabetes is due to the fact that the treatment of these types of diabetes has its own characteristics associated with the specific pathogenesis of diseases. However, it is obvious that further studies should relate to the study of the mechanisms of damage and decrease in the function of в-cells. Perhaps future classification systems and, as a consequence, personalized treatment will focus on various mechanisms of damage to β-cells.

scholarly journals IMPORTANCE OF CLASSICAL MORPHOLOGY IN THE DIAGNOSIS OF MYELODYSPLASTIC SYNDROME

2015 ◽  
Vol 7 ◽  
pp. e2015035 ◽  
Author(s):  
Rosangela Invernizzi ◽  
Federica Quaglia ◽  
Matteo Giovanni Della Porta
Keyword(s):  
Molecular Techniques ◽  
Classification Systems ◽  
World Health ◽  
Hematopoietic Stem ◽  
Morphological Alterations ◽  
Diagnosis And Classification ◽  
The Moment ◽  
Health Organization ◽  
Selection Of

Myelodysplastic syndromes (MDS) are hematopoietic stem cell disorders characterized by dysplastic, ineffective, clonal and neoplastic hematopoiesis. MDS represent a complex hematological problem: differences in disease presentation, progression and outcome  have necessitated the use of classification systems to improve diagnosis, prognostication and treatment selection. However, since a single biological or genetic reliable diagnostic marker has not yet been discovered for MDS, quantitative and qualitative dysplastic morphological alterations of bone marrow precursors and of peripheral blood cells are still fundamental for diagnostic classification. In this paper World Health Organization (WHO) classification refinements and current minimal diagnostic criteria proposed by expert panels are highlighted and related problematic issues are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies. Although in the future morphology should be supplemented with new molecular techniques, the morphological approach, at least for the moment, is still the cornerstone for the diagnosis and classification of these disorders.

Lung Tumors With Neuroendocrine Morphology: Essential Radiologic and Pathologic Features

2008 ◽  
Vol 132 (7) ◽  
pp. 1055-1061 ◽  
Author(s):  
Teri J. Franks ◽  
Jeffrey R. Galvin
Keyword(s):  
Neuroendocrine Tumors ◽  
Classification Systems ◽  
World Health ◽  
National Library ◽  
Molecular Features ◽  
Distinct Subset ◽  
Pathologic Features ◽  
The World ◽  
Health Organization

Abstract Context.—Tumors with neuroendocrine morphology are a distinct subset of lung neoplasms sharing characteristic histologic, immunohistochemical, ultrastructural, and molecular features. Objective.—To review the current histologic classification and the diagnostic criteria for the major categories of neuroendocrine tumors of the lung. Data Sources.—Published classification systems from the World Health Organization and pertinent peer-reviewed articles indexed in PubMed (National Library of Medicine) form the basis of this review. Conclusions.—Accurate classification of the neuroendocrine tumors of the lung requires knowledge of specific criteria separating the major categories, which is essential for determining prognosis and treatment.

Psychotic disorders in DSM-5 and ICD-11

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 349-354 ◽  
Author(s):  
Falko Biedermann ◽  
W. Wolfgang Fleischhacker
Keyword(s):  
Psychotic Disorders ◽  
Work Group ◽  
Theoretical Background ◽  
Classification Systems ◽  
World Health ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Health Organization ◽  
Diagnostic Criterion

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.

scholarly journals The unintended consequences of COVID-19 mitigation measures matter: practical guidance for investigating them

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Marie Turcotte-Tremblay ◽  
Idriss Ali Gali Gali ◽  
Valéry Ridde
Keyword(s):  
Unintended Consequences ◽  
Lessons Learned ◽  
World Health ◽  
Mitigation Measures ◽  
Extensive Experience ◽  
Systematic Assessment ◽  
Practical Guidance ◽  
Conducting Research ◽  
Health Organization

Abstract Background COVID-19 has led to the adoption of unprecedented mitigation measures which could trigger many unintended consequences. These unintended consequences can be far-reaching and just as important as the intended ones. The World Health Organization identified the assessment of unintended consequences of COVID-19 mitigation measures as a top priority. Thus far, however, their systematic assessment has been neglected due to the inattention of researchers as well as the lack of training and practical tools. Main text Over six years our team has gained extensive experience conducting research on the unintended consequences of complex health interventions. Through a reflexive process, we developed insights that can be useful for researchers in this area. Our analysis is based on key literature and lessons learned reflexively in conducting multi-site and multi-method studies on unintended consequences. Here we present practical guidance for researchers wishing to assess the unintended consequences of COVID-19 mitigation measures. To ensure resource allocation, protocols should include research questions regarding unintended consequences at the outset. Social science theories and frameworks are available to help assess unintended consequences. To determine which changes are unintended, researchers must first understand the intervention theory. To facilitate data collection, researchers can begin by forecasting potential unintended consequences through literature reviews and discussions with stakeholders. Including desirable and neutral unintended consequences in the scope of study can help minimize the negative bias reported in the literature. Exploratory methods can be powerful tools to capture data on the unintended consequences that were unforeseen by researchers. We recommend researchers cast a wide net by inquiring about different aspects of the mitigation measures. Some unintended consequences may only be observable in subsequent years, so longitudinal approaches may be useful. An equity lens is necessary to assess how mitigation measures may unintentionally increase disparities. Finally, stakeholders can help validate the classification of consequences as intended or unintended. Conclusion Studying the unintended consequences of COVID-19 mitigation measures is not only possible but also necessary to assess their overall value. The practical guidance presented will help program planners and evaluators gain a more comprehensive understanding of unintended consequences to refine mitigation measures.

Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Anna Marras ◽  
Naomi Fineberg ◽  
Stefano Pallanti
Keyword(s):  
International Classification Of Diseases ◽  
Classification Systems ◽  
World Health ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Draft Version ◽  
Health Organization

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders(DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO)International Classification of Diseases(ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.

Congruence Between 1994 WHO Classification of Endometrial Hyperplasia and Endometrial Intraepithelial Neoplasia System

2019 ◽  
Vol 153 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Gabriele Saccone ◽  
Massimo Mascolo ◽  
Maurizio Guida ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Meta Analysis ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Classification Systems ◽  
World Health ◽  
Endometrial Intraepithelial Neoplasia ◽  
Subgroup Analyses ◽  
Health Organization

Abstract Objectives To assess congruence between World Health Organization (WHO) 1994 and endometrial intraepithelial neoplasia (EIN) classification systems of endometrial hyperplasia. Methods Systematic review and meta-analysis were performed by searching electronic databases for studies that classified endometrial hyperplasia according to both WHO 1994 and EIN systems. Congruence was based on the rate of specimens classified as EIN in WHO categories, which should be virtually 0.000 in nonatypical hyperplasia (NAH) and 1.000 in atypical hyperplasia (AH). Subgroup analyses were performed based on architecture complexity. Results Eight studies with 1,352 hyperplasias were included. Congruence with EIN criteria was fair in NAH (0.241) and moderate in AH (0.815). Subgroup analyses of NAH showed high congruence in simple NAH (0.065), null in complex NAH (0.517), null in simple AH (0.148), and high in complex AH (0.901). Conclusions WHO 1994 system is not congruent with the EIN system and cannot be directly translated into a dual classification.

scholarly journals Implications of Historical Evidence for the Classification of Eating Disorders

1994 ◽  
Vol 165 (3) ◽  
pp. 287-292 ◽  
Author(s):  
William Li. Parry-Jones ◽  
Brenda Parry-Jones
Keyword(s):  
Eating Disorders ◽  
Temporal Distribution ◽  
Classification Systems ◽  
World Health ◽  
Major Influence ◽  
Historical Evidence ◽  
Icd 10 ◽  
Clinical Detail ◽  
Health Organization

Successive editions of the ICD and DSM classification systems have exercised a major influence over contemporary diagnostic practice and perceptions of the form and structure of disorders. Periodic revision has been based on clinical and epidemiological research, and minimal attention has been given to any possible contribution from historical evidence. To test the potential value of such evidence, the historical manifestations of four eating disorders (anorexia, bulimia, rumination and pica) were considered in relation to the clinical descriptions and diagnostic criteria of DSM–III–R (American Psychiatric Association, 1987) and ICD–10 (World Health Organization, 1992). For each disorder, evidence is presented of continuities and discontinuities with the phenomena recognised currently. Instances of symptom overlap between disorders and the implications of the historical findings for some current classificatory issues are discussed. When spread over several centuries, case numbers remain relatively small, the amount of clinical detail is highly variable, and temporal distribution is uneven. The conclusions that can be drawn, therefore, are necessarily somewhat tentative and subjective.

scholarly journals Pediatric Glioma: An Update of Diagnosis, Biology, and Treatment

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 758
Author(s):  
Yusuke Funakoshi ◽  
Nobuhiro Hata ◽  
Daisuke Kuga ◽  
Ryusuke Hatae ◽  
Yuhei Sangatsuda ◽  
...  
Keyword(s):  
Molecular Genetic ◽  
Molecular Data ◽  
Molecular Genetic Analysis ◽  
Cns Tumors ◽  
World Health ◽  
Biological Behavior ◽  
Cns Tumor ◽  
Health Organization ◽  
Prediction Of Prognosis

Recent research has promoted elucidation of the diverse biological processes that occur in pediatric central nervous system (CNS) tumors. Molecular genetic analysis is essential not only for proper classification, but also for monitoring biological behavior and clinical management of tumors. Ever since the 2016 World Health Organization classification of CNS tumors, molecular profiling has become an indispensable step in the diagnosis, prediction of prognosis, and treatment of pediatric as well as adult CNS tumors. These molecular data are changing diagnosis, leading to new guidelines, and offering novel molecular targeted therapies. The Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) makes practical recommendations using recent advances in CNS tumor classification, particularly in molecular discernment of these neoplasms as morphology-based classification of tumors is being replaced by molecular-based classification. In this article, we summarize recent knowledge to provide an overview of pediatric gliomas, which are major pediatric CNS tumors, and describe recent developments in strategies employed for their diagnosis and treatment.

Glioblastoma

2007 ◽  
Vol 131 (3) ◽  
pp. 397-406 ◽  
Author(s):  
C. Ryan Miller ◽  
Arie Perry
Keyword(s):  
Classification Scheme ◽  
Molecular Genetic ◽  
World Health ◽  
High Grade ◽  
World Health Organization Classification ◽  
Favorable Prognosis ◽  
Molecular Genetic Diversity ◽  
Dismal Prognosis ◽  
Appropriate Treatment ◽  
Health Organization

Abstract Context.—Glioblastoma (GBM), the most common primary intracranial malignancy, is a morphologically diverse neoplasm with dismal prognosis despite multimodality therapy. Only 3 distinct morphologic variants of GBM are currently recognized by the current World Health Organization classification scheme, including GBM, giant cell GBM, and gliosarcoma. Additional variants, some of which have significant morphologic overlap with tumors that have more favorable prognosis and treatment response rates, particularly anaplastic oligodendroglioma, have been described since its publication in 2000 and may be included in the next classification. Objective.—To summarize the morphologic and molecular genetic diversity of both well-established and novel GBM variants and outline our approach to these heterogeneous neoplasms and their distinction from other diffuse, high-grade gliomas. Data Sources.—Published literature and our own experience in an active academic diagnostic surgical neuropathology practice were reviewed. Conclusions.—Precise subclassification of GBM is required for accurate prognostication and appropriate treatment planning.

scholarly journals Informatics Approaches to Address New Challenges in the Classification of Lymphoid Malignancies

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Jacob Jordan ◽  
Jordan S. Goldstein ◽  
David L. Jaye ◽  
Metin Gurcan ◽  
Christopher R. Flowers ◽  
...  
Keyword(s):  
Image Analysis ◽  
Classification Systems ◽  
World Health ◽  
Computer Assisted ◽  
Lymphoid Malignancies ◽  
Pathology Informatics ◽  
Pathologic Assessment ◽  
Health Organization ◽  
Lymphoma Classification

Purpose Lymphoid malignancies are remarkably heterogeneous, with variations in outcomes and clinical, biologic, and histologic presentation complicating classification according to the World Health Organization guidelines. Incorrect classification of lymphoid neoplasms can result in suboptimal therapeutic strategies for individual patients and confound the interpretation of clinical trials involving personalized, class-based treatments. This review discusses the potential role of pathology informatics in improving the classification accuracy and objectivity for lymphoid malignancies. Design We identified peer-reviewed publications examining pathology informatics approaches for the classification of lymphoid malignancies, reviewed developments in the lymphoma classification systems, and summarized computational methods for pathologic assessment that can impact practice. Results Computer-assisted pathology image analysis algorithms in lymphoma most commonly have been applied to follicular lymphoma to address biologic heterogeneity and subjectivity in the process of classification. Conclusion Objective methods are available to assist pathologists in lymphoma classification and grading, and have been demonstrated to provide measurable benefits in specific contexts. Future validation and extension of these approaches will require datasets that link high resolution pathology images available for image analysis algorithms with clinical variables and follow up outcomes.

Sign in / Sign up

Export Citation Format

Share Document