scholarly journals IgA Nephropathy: A Twenty Year Retrospective Single Center Experience

2009 ◽  
Vol 3 ◽  
pp. CMPed.S2224 ◽  
Author(s):  
Jacob Rube ◽  
Alexandra Peyser ◽  
Freya Tarapore ◽  
Bari Scheckner ◽  
Rachel Frank ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Severe Disease ◽  
Albumin Level ◽  
Prognostic Indicators ◽  
Glomerular Injury ◽  
Injury Score ◽  
Lower Serum ◽  
Single Center Experience ◽  
Recorded Data

IgA nephropathy (IgAN) is a common glomerular disease whose etiology is unknown. Previous studies have described the clinical and laboratory features but none have specifically compared patients during different time periods. This 20 year retrospective study was performed to assess trends in the severity of IgAN from 1989–2008. We reviewed 57 patient charts that contained a confirmed biopsy diagnosis of IgAN and recorded data at the time of diagnosis and the final follow-up appointment. Clinical data included physical examination, urine, and blood tests. Patients were separated into two cohorts, Cohort 1 1989–1998 and Cohort 2 1999–2008. An increase in severity was noted in Cohort 2 based on a significantly higher Up/c and lower serum albumin level. Other prognostic indicators including GFRe, hematocrit, and glomerular injury score also demonstrated a trend towards more severe disease over the past 20 years. The patients in both Cohorts received similar treatments and had comparable renal function at the last follow-up visit. Based on our findings, we suggest that although a kidney biopsy is required to diagnose IgAN, the procedure may not be necessary in patients clinically suspected of having the disease but who have normal kidney function and minimal urine abnormalities.

scholarly journals Specific strains of Streptococcus mutans, a pathogen of dental caries, in the tonsils, are associated with IgA nephropathy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Seigo Ito ◽  
Taro Misaki ◽  
Shuhei Naka ◽  
Kaoruko Wato ◽  
Yasuyuki Nagasawa ◽  
...  
Keyword(s):  
Dental Caries ◽  
Iga Nephropathy ◽  
Streptococcus Mutans ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Human Macrophage ◽  
Lower Serum ◽  
Collagen Binding ◽  
Macrophage Marker ◽  
Positive Rate

AbstractStreptococcus mutans is known to be a major causative agent of dental caries, and strains expressing the cell surface collagen-binding Cnm protein contribute to the development of several systemic diseases. A relationship between tonsillar immunity and glomerulonephritis has been recognized in IgA nephropathy (IgAN), and specific pathogens may have effects on tonsillar immunity (mucosal immunity). Here, we present findings showing a relationship between the presence of Cnm-positive S. mutans strains in the tonsils of IgAN patients and IgAN condition/pathogenesis. Analyses of tonsillar specimens obtained from patients with IgAN (n = 61) and chronic tonsillitis (controls; n = 40) showed that the Cnm protein-positive rate was significantly higher in IgAN patients. Among IgAN patients, the tonsillar Cnm-positive group (n = 15) had a significantly higher proportion of patients with high urinary protein (>1.5 g/gCr) and lower serum albumin level than the Cnm-negative group (n = 46). Additionally, Cnm protein and CD68, a common human macrophage marker, were shown to be merged in the tonsils of IgAN patients. These findings suggest that Cnm-positive S. mutans strains in the tonsils may be associated with severe IgAN.

scholarly journals High risk groups for severe COVID-19 in a whole of population cohort in Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bette Liu ◽  
Paula Spokes ◽  
Wenqiang He ◽  
John Kaldor
Keyword(s):  
Socioeconomic Status ◽  
New South ◽  
Severe Disease ◽  
Risk Groups ◽  
Prevention Strategies ◽  
Complete Case ◽  
Relative Risks ◽  
South Wales ◽  
Hazard Ratios

Abstract Background Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04). Conclusions In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.

scholarly journals Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome Resembling Juvenile Idiopathic Arthritis: A Single-Center Experience from Southern Turkey

2021 ◽  
pp. 1-6
Author(s):  
Rabia Miray Kisla Ekinci ◽  
Sibel Balci ◽  
Haldun Dogan ◽  
Serdar Ceylaner ◽  
Celal Varan ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Pericardial Effusion ◽  
Early Onset ◽  
Joint Space ◽  
Coxa Vara ◽  
Single Center ◽  
The Third ◽  
Single Center Experience ◽  
Southern Turkey

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome, caused by biallelic pathogenic mutations in the <i>PRG4</i> gene, is characterized by early-onset camptodactyly, noninflammatory arthropathy, coxa vara deformity, and rarely, pericardial effusion. Herein, we report 3 patients with CACP syndrome from 2 unrelated families. All patients are female, born to consanguineous parents, and had camptodactyly since the first years of their lives. Two patients had a prior diagnosis of juvenile idiopathic arthritis. Hip changes were present in 2 patients, and 2 of 3 patients had undergone surgery for camptodactyly. Routine echocardiographic evaluations were normal during the 2-year follow-up. This paper represents the third study including CACP patients from Turkey. Clinically, all 3 patients resembled juvenile idiopathic arthritis cases and received unnecessary medication. There is also an ongoing need for improving awareness of CACP and an effective treatment focusing on the lubrication of the joint space in CACP patients.

scholarly journals Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

2021 ◽  
Vol 10 (10) ◽  
pp. 2056
Author(s):  
Frank Herbstreit ◽  
Marvin Overbeck ◽  
Marc Moritz Berger ◽  
Annabell Skarabis ◽  
Thorsten Brenner ◽  
...  
Keyword(s):  
Influenza A ◽  
Health Care Systems ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
High Volume ◽  
Single Center Experience ◽  
Severe Influenza ◽  
Tertiary Care Facility ◽  
Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

scholarly journals Endocardial vs endo-epicardial ablation of ventricular arrhythmia in arrhythmogenic right ventricular cardiomyopathy: a single center experience

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K.A Simonova ◽  
A.V Kamenev ◽  
R.B Tatarskiy ◽  
M.A Naymushin ◽  
V.S Orshanskaya ◽  
...  
Keyword(s):  
Ventricular Arrhythmia ◽  
Low Voltage ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Control Group ◽  
Definite Diagnosis ◽  
Premature Ventricular Contractions ◽  
Single Center Experience ◽  
Voltage Mapping ◽  
Epicardial Access

Abstract Background The majority of patients have a sub-epicardial scar as a substrate for VT episodes. Purpose We sought to compare the efficacy of endocardial (ENDO) and epicardial (EPI) substrate modification in patients with ARVC. Methods 20 consecutive ARVC patients (mean age 41,4±13,8, 70% males; ICD previously implanted in 10 patients) with indications to ventricular arrhythmia ablation (RFA) were included into a prospective observational study. The EPI group consisted of 10 patients with sustained ventricular tachycardia (VT) (definite diagnosis ARVC – 8 patients; borderline – 1, possible – 1) who signed an informed consent to epicardial access. The ENDO group included 10 patients (definite diagnosis ARVC – 9 patients), five of them demonstrated sustained VT and 5 patients had frequent symptomatic premature ventricular contractions (PVC). Epicardial access in the EPI group was obtained through subxyphoid puncture. Bi- and unipolar voltage mapping of endocardial and epicardial surfaces was performed. Maps were evaluated for the presence of local abnormal ventricular electrical activity (LAVA, low-voltage areas and sites with highly fractionated or late activity). Ablation was performed at sites of LAVA on either side of the ventricular wall. In the ENDO group endocardial only ablation at LAVA sites was performed. RF energy ablation was 40W at the epicardial surface and 40–50W at the endocardial surface. Results In the EPI group endocardially mapped area of unipolar endocardial low voltage zone (LVZ) significantly prevailed over bipolar endocardial area of LVZ: 75.4 cm2 [IQR: 23.2; 211.9] vs 6.7 cm2 [IQR: 4.4; 35.5](P=0.009). Epicardial bipolar LVZ area prevailed over unipolar epicardial LVZ area: 65.3 cm2 [IQR: 55.6; 91.3] vs 6.7 cm2 [IQR: 4.4; 35.3] (P=0.005). Endocardial unipolar LVZ area in the EPI group was larger than in the ENDO group (P&gt;0,05). After ablation non-inducibility of any ventricular arrhythmia was achieved in 90% of patients in the EPI group and in 80% of cases in the ENDO group. During a mean follow-up period of 22.3±10.5 months freedom of ventricular arrhythmia recurrence was 70% in the EPI group and 100% in the control group. Conclusions Although epicardial area of abnormal potentials significantly prevails over endocardial area, endocardial unipolar mapping and higher RF ablation power allow performing successful ventricular arrhythmia treatment in the majority of ARVC patients. Funding Acknowledgement Type of funding source: None

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