scholarly journals MO295RESULTS OF 30 YEARS OF RENAL BIOPSIES IN THE GENERAL HOSPITAL OF CIUDAD REAL. WHAT HAS CHANGED?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Esperanza Moral Berrio ◽  
Carmen Vozmediano Poyatos ◽  
Minerva Arambarri Segura ◽  
Lucía González López ◽  
Agustín Carreño Parrilla ◽  
...  
Keyword(s):  
General Hospital ◽  
Kidney Diseases ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Categorical Variables ◽  
Average Standard Deviation ◽  
Primary Glomerulonephritis ◽  
Urinary Disorders ◽  
Ciudad Real ◽  
Nephritic Syndrome

Abstract Background and Aims The renal biopsy (RB) has been performed in the General Hospital of Ciudad Real (HGUCR) since the year 1989. It allows kidney diseases to be diagnosed and treated and pronostics to be made. We will analyse the results of these 30 years as well as the evolution of the various parameters studied. Method Descriptive study of the RB carried out in the HGUCR between 1989 and 2019. Age, sex, clinical syndrome (CS) at the time of the RB, number of glomeruli and histological diagnosis will be analysed. The patients are divided into 3 groups according to age: children (<15), adults (15-65) and the elderly (>65). We will establish three periods of 10 years: period A (1989-1998), period B (1999-2008) and period C (2009-2019). The categorical variables are expressed as percentages and the quantitative variables average ± standard deviation. Statistical analysis with SPSS 25.0. Results 898 RB have been performed, average number of glomeruli 16, 70% of the RB with more than 10 glomeruli. The average age of the patients was 53±19 years old, 58% male. The most frequent CS was acute kidney failure (AKF) (35%), followed by nephrotic syndrome (NS) (30.5%), asymptomatic urinary disorders (19%), chronic kidney disease (11%), nephritic syndrome (3.6%), haematuria (0.7%) and arterial hypertension (0.7%). The most common in children were asymptomatic urinary disorders (50%), in adults NS (34%) and in the elderly AKF (55.5%). The predominant primary glomerulonephritis (GN): IgA nephropathy (IgAN) (15%), followed by membranous nephropathy (MN) (12%) and focal segmental glomerulosclerosis (FSGS) (11%). The most frequent secondary GN: vasculitis (11%) and lupus nephropathy (10%). 164 RB were performed in period A, 370 in period B and 346 in period C. In all three periods the predominant sex was male and the average age increased: 48 years old in A, 51 years old in B and 56 years old in C. Together with the increase in age, the indication of RB changes: NS in the first two periods and AKF in period C. The most frequent pathology in period A: FSGS (17%), IgAN (16%) in period B and IgAN (15%) followed by vasculitis (11%) in period C. Conclusion In the HGUCR the most common biopsied kidney pathology is IgAN, followed by MN. There has been an increase in the age of the patients as well as an increase in AKF and vasculitis. The KB constitutes a highly useful diagnostic test that allows us to establish prognostics and appropriate treatments.

MO312MAIN TRENDS AND OUTCOMES OF KIDNEY DISEASE IN GEORGIA: THE FIRST REVIEW OF KIDNEY BIOPSY DATABASE FROM 2011 TO 2020

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nora Sarishvili ◽  
Irma Tchokhonelidze ◽  
Tamar Tevdoradze ◽  
Tamar Kasradze ◽  
Dalakishvili Ketevan ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Treatment Options ◽  
Clinical Syndrome ◽  
Current Data ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
Histological Data ◽  
Registry Database

Abstract Background and Aims Kidney biopsy registry has been established in Georgia in 2011 by Dialysis, Nephrology and Kidney Transplantation Union of Georgia (DNT Union) to address the natural history of kidney disease, describe the clinical features, improve disease understanding and tracking, healthcare planning, patient care and outcomes. This report is the first review of histological data over a period of 10 years (2011-2020) covering the entire population of 3.7 million inhabitants and demonstrates the current data on trends of kidney disease in Georgia. Method 1267 ultrasound-guided kidney biopsies were performed during the 10 years. Data were extracted from the DNT Union kidney biopsy registry as of 1st of December 2020. Data on kidney function, urinalysis, treatment options and outcomes were also included in biopsy registry database. After exclusion of transplant and re-biopsies, kidney biopsies were analyzed for evaluation main trends in kidney biopsy rates and diagnosis of glomerular and non-glomerular diseases in two groups divided in 5-year time frames: the first group 2011-2015 and the second group 2016-2020. The overall treatment outcome was evaluated as complete remission (CR), partial remission (PR) and progression to ESRD. Results Final cohort consisted of 1089 patients. Mean age was 39 years [SD 13 years]. Fifty five percent of the cohort were male. The average annual biopsy incidence was 455 biopsies in the first group and 634 cases in the second group. The most common indication as clinical syndrome for performing the kidney biopsy was a decrease of glomerular filtration rate GFR (35%), followed by nephrotic syndrome (30%) and nephritic syndrome (21 %) and in lesser degree asymptomatic urinary abnormalities (14 %). The frequency of kidney biopsies increased significantly over the years (Fig.1). The distribution of major histological groups of kidney disease in both groups is shown in the Table 1. As for comparison of the major trends among various histological patterns, there was 3,6 times more heredity kidney diseases diagnosed in the second group, followed by tubulointerstitial nephritis with 3.3 times increase, acute tubular necrosis 1.5 times increase and glomerulonephritis (primary and secondary) with 1.3 times increase. There was found statistically no changes in the incidence of vascular kidney disease between two groups (p=0.005). Overall outcome demonstrates some changes during the time. PR was the most prevalent outcome in both time groups. However, proportion of PR cases increased (45%vs.64%) and proportion of CR (25% vs.17%) and ESRD (30% vs.18%) cases decreased. This change is statistically significant at p<0.0001. There were no data obtained from 15% (173) of patients. The distribution of overall outcome among patients with primary glomerulonephritis (PGN) repeated the same trend. Out of total PGN patients (481 cases) 61% showed PR, 24% reached CR and 15% progressed to ESRD. The proportion of patients with PR was higher (69%) among patients diagnosed with PGN in the second group compared with the first (48%). Proportion of patients, who developed ESRD, was lower in the second group (12% vs.19%). ( Fig. 2). Conclusion The present data are an important contribution to the epidemiology of kidney disease in Georgia. The incidence of glomerulonephritis generally increased between 2011 and 2020, that may be related to changes in kidney biopsy policy. Substantial decrease in numbers of kidney biopsies were registered in 2020 due to pandemic issues. Membranous nephropathy was the most common primary glomerular disease according to the registry database. The prognosis regarding progression to ESRD has improved.

scholarly journals Epidemiological Review of Kidney Biopsy during 30 years - Single Center Experience

2015 ◽  
Vol 13 (1) ◽  
pp. 4-9
Author(s):  
Aleksandar Jankovic ◽  
Jovan Ikonomovski ◽  
Petar Djuric ◽  
Milos Mitrovic ◽  
Jelena Tosic- Dragovic ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Biopsy ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Renal Diseases ◽  
Adequate Treatment ◽  
Primary Glomerulonephritis ◽  
The Third ◽  
Single Center Experience ◽  
Nephritic Syndrome

Abstract Introduction. Renal biopsy represents a diagnostic method that provides an acurrate diagnosis and adequate treatment of different renal diseases. The first biopsy in our Center was done in June 1982, but it has been performing routinely since 1984. The aim of this study was to report the histopathological features of biopsy proven kidney disease during the past 30 years. Methods. During 30 years, a total of 563 biopsies were performed, of which 530(94%) were succesfull. Data about gender, age, clinical syndrome and histopatological finding were collected from the medical records. Results. The mean age of our patients was 48±11 years, 53% were man (No=272). In the first decade (1982-1994) we performed 118(mean age 50±13), in the second (1995- 2004) 208 (mean age 46±14), and in the third decade (2005-2014) 189 renal biopsies (mean age 50±16). Mean number of glomeruli per biopsy was 18±11. There were only two serious complications. The most common clinical syndromes as indication for renal biopsy were: nephrotic proteinuria (41%) followed by asymptomatic urinary abnormalities (AUA-14.8%), chronic renal failure (CRF-13.8%), acute kidney injury (AKI-12.8%), nephritic syndrome (7.6%), systemic lupus erytematosus (SLE- 4.5%), isolated haematuria (2.7% of the cases) and other (2.9%). The major histological groups identified were: primary glomerulonephritis (GN) (62.3%), secondary GN (21.2%), and other (16.5% of the cases). The most common primary glomerulonephritis (PGN) were focal segmental glomerulosclerosis-FSGS (19.4%) followed by IgA nephropathy-IgAN (18.8%), membranous GNMGN (16.4%) and mesangial proliferation-MesGN (16%). Interstitial changes were present in 55% of biopsy samples in the first, in 66% in the second and in 63% in the third decade. Blood vessel changes were present in 39% of biopsy samples in the first, in 62% in the second and in 72% in the third decade. Conclusions. The most frequent finding among PGN was mesangioproliferative GN (including IgAN, alltogether 34.8%) followed by FSGS and MGN. Apart from succesful biopsies, there are several aspects to be improved in the future including expanding indications and earlier procedure during the course of chronic kidney disease-CKD.

Psychogeriatric Care in the General Hospital*

1981 ◽  
Vol 26 (5) ◽  
pp. 334-336 ◽  
Author(s):  
Joel Sadavoy
Keyword(s):  
General Hospital ◽  
Psychiatric Care ◽  
Treatment Approach ◽  
The Elderly ◽  
Term Therapy ◽  
Psychiatric Ward ◽  
Short Term ◽  
General Hospitals ◽  
Organic Brain

This study examines treatment outcome in 52 psychogeriatric patients to help determine the role of the general hospital in psychiatric care of the elderly. The author reviewed the charts of all patients 65 years of age and over admitted to the psychiatric ward from 1974 to 1978. Approximately 80% of this group showed symptom remission. Treatment failures correlated closely with the presence of major organic brain syndrome. Despite an average age of 73.4 years and a high proportion of widowed patients only 10 patients needed new placements on discharge. The author discusses the reluctance of general hospitals to treat the psychogeriatric patient despite the high success rate, the merits of such an active treatment approach and the effect of short-term therapy programs on the treatment of this group.

scholarly journals 79 Relationship Between Depression and Nutritional Status Among the Elderly Attending Selected Primary Healthcare Centers in Lagos

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
B A Akodu ◽  
S O Akinwunmi ◽  
A Onajole
Keyword(s):  
Nutritional Status ◽  
Primary Healthcare ◽  
Living Arrangement ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Categorical Variables ◽  
Antidepressant Effect ◽  
Significant Difference ◽  
Primary Healthcare Centers

Abstract Introduction Depression causes and worsens malnutrition. The prevalence of malnutrition in the elderly of the developed world was about 22.6% and about 40% of hospitalized elderly are malnourished while about 4.8% have one major depressive episode in people aged 50 and above. Food rich in omega-3 has antidepressant effect and its low intake is linked with dementia. Decrease dietary folate has been linked with depression. This study was aimed at determining the relationship between depression and nutritional status among the elderly in selected primary healthcare centers (PHC) in Lagos Nigeria. Method A descriptive cross-sectional study was conducted using multi-stage technique to select 219 participants by systematic sampling method from the selected PHC centers. Data was collected using structured interviewer-administered questionnaires. Nutritional status and Depression were assessed using Mini-Nutritional Assessment and Geriatric Depression Scale respectively. Data analysis was carried out using Epi-info 7.1. Associations were tested using Chi-square for categorical variables while t-test and analysis of variance were used for continuous variables. Associations were statistically significant if two-tailed probability was less than 5% (0.05). Results It was found that 57.9% and 47.1% were malnourished and depressed respectively. There was a statistically significant association between the sex of the participants and the nutritional status (p = 0.048). Statistically significant association existed between sex (p = 0.024), marital status (p = <0.001), educational qualification and depression. Statistically significant association between monthly income (p = <0.001), living arrangement (p = 0.002) and depression was demonstrated. There was a statistically significant association between family support (p = <0.001), nutritional status (p = <0.001) and depression. There was statistically significant difference between the height (p = 0.00885), weight (p = 0.00052, waist-hip ratio (p = 0.036) and the nutritional status. Remarkably, there was statistically significant difference between the waist (p = 0.023) and hip circumference (p = 0.047) and their level of depression. Conclusion A high prevalence of poor nutritional status and depression existed among the elderly primary healthcare centers.

scholarly journals Patterns of medication use and adherence to medications among residents in the elderly homes

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Magda AlGameel
Keyword(s):  
Side Effects ◽  
Patient Education ◽  
Chronic Diseases ◽  
Kidney Diseases ◽  
Medication Use ◽  
The Elderly ◽  
Current Therapy ◽  
Creative Commons ◽  
National Medical ◽  
Liver And Kidney

Objective: To evaluate health care related to medication regimens among institutionalized elders in Damanhour, Beheira Governate, Egypt. Methods: A prospective, multi-centered, observational study was conducted in the two elderly residential homes in Damanhour between March and May 2017. A questionnaire was developed and validated to test for elderly socio-economic, chronic diseases, current therapy adherence, vaccination history and patient education. Descriptive and quantitative analysis were performed. Results: sixty-three elderly residents were included in the study. The sample showed broad socioeconomic variability posing a true reflection of Egyptian population. 63.5% had no hearing problems, 31.7% had proper vision and 57% could move with no help. More than three quarters had chronic diseases of which 58.7% were previously hospitalized. The most prevalent diseases were hypertension, diabetes and arthritis 46%, 41.3%, 26.9% respectively. Only 7.9% and 4.7% showed chronic liver and kidney diseases, respectively and less than 10% suffered from respiratory related diseases. No alcohol drinker, 25.3% were smokers and 58.7% drank caffeine. Only 25.3% of residents showed full adherence to their medication pattern. Approximately 80% of residents never received proper patient education. Forty-three residents did not know the indication of their medications and 92% ignored its side effects. Conclusion: Absence of proper medical care exposure for the elderly residents was reflected in their low medication adherence, adverse side effects and hospitalization. We suggest extension of the national medical insurance system to include larger number of elderly population. To monitor the care given concerning medication, a daily resident gerontological nurse needs to be assigned, visits by clinical pharmacists weekly or bi-weekly from the nearby governmental hospital can improve improper medication. doi: https://doi.org/10.12669/pjms.36.4.1923 How to cite this:Algameel M. Patterns of Medication use and adherence to medications among residents in the elderly homes. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1923 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Progression in Neuroimaging of Normal Pressure Hydrocephalus

2021 ◽  
Vol 12 ◽  
Author(s):  
Rui Yin ◽  
Junxian Wen ◽  
Junji Wei
Keyword(s):  
Future Development ◽  
Normal Pressure Hydrocephalus ◽  
Large Scale ◽  
Elderly Population ◽  
Normal Pressure ◽  
The Elderly ◽  
Rapid Identification ◽  
Clinical Syndrome ◽  
Surgical Interventions ◽  
Large Scale Screening

Normal-pressure hydrocephalus is a clinical syndrome that mainly targets the elderly population. It features dementia, impaired walking, and the malfunction of sphincters. The rapid identification and large-scale screening of patients with normal-pressure hydrocephalus (NPH) are of great significance as surgical interventions can greatly improve or even reverse the symptoms. This review aims to summarize the traditional parameters used to diagnose NPH and the emerging progression in neuroimaging of the disease, hoping to provide an up-to-date overall perspective and summarize the possible direction of its future development.

scholarly journals Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ping Nie ◽  
Rui Chen ◽  
Manyu Luo ◽  
Changqing Dong ◽  
Liangmei Chen ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Northeast China ◽  
Kidney Diseases ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
B Virus ◽  
Renal Biopsies ◽  
Interstitial Nephropathy ◽  
Schonlein Purpura ◽  
Over Time

Purpose. To identify the epidemiology and pathological types of kidney diseases and their changes during the past decade, in a population from Northeast China. Methods. We retrospectively analysed clinical and renal pathological data from 4910 patients who received renal biopsies in the Second Hospital of Jilin University from 2008 to 2017. Results. Males received more renal biopsies than females (p < 0.001). The average age (p < 0.001) and percentage of elderly patients (p < 0.001) increased over time. The pathological types were primary glomerulonephritis (PGN, 73.2%), secondary glomerulonephritis (SGN, 23.7%), tubular-interstitial nephropathy (TIN, 2.8%), and hereditary nephropathy (HN, 0.3%). The most common forms of PGN were membranous nephropathy (MN, 37.2%) and IgA nephropathy (IgAN, 29.9%). Over time, the prevalence of IgAN decreased, but the prevalence of MN increased. MN was more common in middle-aged and elderly patients, but IgAN was most common in young adults. Analysis of SGN data indicated that lupus nephritis (LN, 34.0%), Henoch-Schönlein purpura glomerulonephritis (HSPN, 17.9%), and diabetic nephropathy (DN, 11.7%) were the most common forms. Over time, the prevalence of DN (p = 0.003), hypertension-associated renal damage (p = 0.005), and systemic vasculitis-associated nephritis (SVARD, p < 0.001) increased, but the prevalence of HSPN (p < 0.001) and hepatitis B virus-associated glomerulonephritis (HBV-GN, p = 0.001) decreased. Nephrotic syndrome was the main clinical manifestation of PGN. Conclusion. From 2008 to 2017, renal biopsies were increasingly performed in the elderly. There were notable changes in the epidemiology and pathological types of kidney disease among renal biopsy patients at our centre.

scholarly journals Integrating 5S Methodology into Oral Hygiene Practice for Elderly with Alzheimer’s Disease

2020 ◽  
Vol 8 (2) ◽  
pp. 29 ◽  
Author(s):  
Sherry Shiqian Gao ◽  
Chun Hung Chu ◽  
Fanny Yuk Fun Young
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dental Care ◽  
Oral Hygiene ◽  
Periodontal Diseases ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Hygiene Practice ◽  
Effective Community ◽  
Oral Hygiene Practice

Dementia is a clinical syndrome of loss of intellectual capability. Alzheimer’s disease (AD) is the dominant subtype of dementia and is common among the elderly. Because of impaired memory and disturbed executive functioning, the elderly with AD often have difficulty to perform oral hygiene practice and are at high risk of dental caries and periodontal diseases. These dental problems are ambulatory care-sensitive conditions where effective community dental care can help prevent the need for hospital admission. Community dental care practitioners can formulate effective strategies for the elderly with AD to reduce their risk of dental diseases. One of these strategies is to integrate 5S into oral hygiene practice. 5S was originally developed for organising spaces for people to work efficiently, effectively, and safely. It consists of five steps which are (i) sorting to remove unnecessary items, (ii) setting-in-order to place the items in order of flow, (iii) shining to clean and maintain the environment, (iv) standardising to establish discipline for good oral hygiene habits, and (v) sustaining to keep 5S going by auditing and improving the environment and oral hygiene practice. This system helps the elderly with AD to put things where they belong and keep the workplace clean. Moreover, it facilitates the elderly with AD to perform oral hygiene practice without wasting time and risking injury. This paper discusses the use of 5S to help the elderly with AD build and sustain an effective oral hygiene practice habit to improve their oral health.

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