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Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide. The diagnostic histologic hallmark is dominant or codominant IgA staining on kidney biopsy; however, patients may present with various clinical syndromes ranging from asymptomatic abnormalities noted on urinalysis to rapidly progressive glomerulonephritis. Given substantial heterogeneity in the clinical course of disease, online risk calculators are available that may assist in prognostication and inform discussions with patients. Comprehensive supportive treatment is central in the initial therapy of IgAN; the additive benefit of currently available immunosuppressive agents remains an area of controversy. Although proteinuria is attenuated by the use of corticosteroids, the long-term benefits have been questioned, and the use of corticosteroids is associated with severe adverse effects, notably infection. Recent advances in our understanding of mucosal immunity and the role of the complement system in IgAN pathogenesis are leading to development of novel therapeutic options, which are being evaluated in ongoing clinical trials. In this installment of the AJKD Core Curriculum in Nephrology, IgAN pathogenesis, clinical manifestations, histology, prediction tools, and treatment are reviewed, and case examples are presented to illustrate the approach to the management of patients with IgAN.
Patient reported outcome measures are used to evaluate hand therapy outcomes. Yet, limited evidence is available regarding the outcomes children desire from hand therapy.
To determine the desired treatment outcomes of children with acquired upper extremity impairments.
Descriptive case series METHODS Two raters independently applied International Classification of Function, Disability and Health (ICF) linking rules to the Canadian Occupational Performance goals of 151 children, age 6-18, receiving occupational therapy for acquired upper extremity impairments. Prevalence of the linked ICF codes was examined using frequency distributions. Kappa and the proportion of positive agreement assessed inter-rater agreement of the linked codes.
Following consensus, two independent raters linked 894 meaningful concepts to the study population's 501 goals derived from the Canadian Occupational Performance. Ninety-two unique ICF codes were linked to these 894 meaningful concepts. Twenty-three ICF codes account for se and participation in sports and fitness, performing arts, and play. Further research may elucidate alignment of these patient-desired outcomes and the item banks of commonly used patient reported outcome measurement scales in this population.
Brachial plexus injuries (BPI) affect not only body structure and function, but also several aspects of individual's well-being. Considering the crescent need for assessing such patients through a biopsychosocial perspective, linking meaningful concepts of BPI instruments to the International Classification of Functioning, Disability and Health (ICF) provides a useful overview of how the ICF components are contemplated on the current measurements available.
To identify patient-reported outcome measures (PROMs) specifically designed for BPI assessment and link the content with the ICF.
Content Analysis through ICF linking.
The study was conducted in two steps the first one encompassed a literature review to identify questionnaires specifically designed for assessing patients with BPI, where two PROMs were eligible the Brachial Assessment Tool (BrAT) and the Impact of Brachial Plexus Injury Questionnaire (IBPIQ); in the second phase, the items of such instruments were linked to the ICF by two independenaddressed environmental factors. https://www.selleckchem.com/products/i-191.html Thus, other instruments could be considered in a complementary way for clinical assessment.
This study aimed to evaluate the content quality, reliability, and audience participation analysis of YouTube videos as a source of information about COVID-19 for children.
This study was conducted in a descriptive design. The keywords "COVID-19, explain, children" were searched on the YouTube platform on March 17, 2021, and 294 videos were reviewed. The content of the selected videos was analyzed by 2 independent reviewers. Meet the inclusion criteria, 57 videos were evaluated according to the presenter source and the presented audience with the COVID-19 for Children Checklist (CCC), DISCERN score and the Global Quality Score (GQS).
When the contents of 57 videos included in the study were reviewed, it was determined that 56.1% (n = 32) were informative and 43.9% (n = 25) were misleading. Kappa value among the two independent observers was 0.89. 17.5% (n = 10) of the videos scored 5 points from DISCERN and 31.6% (n = 18) scored 4 points from GQS. The mean scores of GQS, DISCERN and CCC of videos with the grouped as informative were found to be statistically higher. There was a significant difference between the DISCERN mean score of ministry/academic/hospital/physician channel videos was higher than the mean score of entertainment/individual channel videos.
This study has shown that videos explaining COVID-19 to children have high viewing rates, but also videos that are low in terms of quality and reliability.
It is thought that this study will reduce the rates of hospitalization by protecting children from COVID-19 by providing them access to healthier and more reliable sources.
It is thought that this study will reduce the rates of hospitalization by protecting children from COVID-19 by providing them access to healthier and more reliable sources.
Toxoplasma retinochoroiditis (TRC) is the main cause of posterior uveitis in immunocompetent patients. Several studies have shown safety and efficacy of treatment with intravitreal clindamycin injection in patients with contraindications, inadequate response or side effects with classic oral therapy. The goal of this study is to describe anatomic and functional results of local treatment with intravitreal clindamycin injection.
We performed an observational, retrospective, single-center study in the ophthalmology service of Bordeaux university medical center between December 2017 and January 2020 on management of toxoplasma retinochoroiditis by intravitreal clindamycin injection. We analyzed the efficacy of this treatment on improvement in visual acuity, decrease in size of the retinal lesion and decrease in macular thickness.
A total of 10 eyes of 9 patients were injected. Only a single injection was required in 9 of the 10 cases. Injections demonstrated improvement in the 3 study criteria; visual acuity went from a mean of 1 LogMAR (1.
