Background: In 2011, the Japanese Society of Nephrology (JSN) published new clinical guidelines for IgA nephropathy (IgAN) with a new risk stratification based on clinical and histological severity. For classification, patients are divided into four groups (low, medium, high, and very high risk). However, differences in responsiveness to each treatment among different groups remain unclear. We evaluate the responsiveness of tonsillectomy plus steroid pulse (TSP) therapy using the new risk stratification.
Methods: We retrospectively reviewed 111 IgAN patients with TSP therapy between January 2003 and January 2013. Study patients were divided into three groups [low- (n = 40), medium- (n = 43) and high-/very high-risk group (n = 28)]. The primary outcome was clinical remission (CR). The observation period was 1 year following tonsillectomy.
Results: 57 out of 111 patients (51.4 %) reached CR. The CR incidence was 70.0, 41.9 and 39.3 % (the low-, the medium- and the high-/very high-risk group, respectively). The incidence of CR was significantly higher in the low-risk group (P = 0.013). In a multivariate logistic regression analysis, both the medium- and the high-/very high-risk group showed significantly lower incidence of inducing CR than the low-risk group [(odds ratio 0.324; 95 % confidence interval 0.106-0.939, P = 0.041) (odds ratio 0.239; 95 % confidence interval 0.058-0.910, P = 0.040), respectively].
Conclusions: The new risk stratification in the 2011 JSN clinical guidelines for IgAN had a positive impact on early CR of TSP therapy.
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http://dx.doi.org/10.1007/s10157-014-1052-4 | DOI Listing |
Pediatr Cardiol
January 2025
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, Japan.
We reviewed the outcomes of truncus arteriosus repair (primary vs. staged repair incorporating bilateral pulmonary artery banding), focusing on survival, reintervention, and functional data. We analyzed 39 patients who underwent a first intervention for truncus arteriosus (staged, n = 19; primary, n = 20) between 1992 and 2022.
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January 2025
Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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J Endovasc Ther
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Department of Vascular Surgery, Rijnstate, Arnhem, The Netherlands.
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Vasa
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Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany.
Pulmonary embolism (PE) can result in high mortality. Early risk stratification and treatment are critical for individualized management. In patients with intermediate-high-risk (IHR) PE, guidelines recommend to consider a percutaneous catheter-directed treatment (CDT).
View Article and Find Full Text PDFCurr Opin Infect Dis
January 2025
Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna.
Purpose Of Review: Recurrent skin and soft tissue infections (RSSTIs) are challenging for the clinicians due to morbidity and healthcare-related costs. Here, we review updates on risk factors and management.
Recent Findings: RSSTIs rates range between 7 and 45%.
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