Benign mesenchymal tumours and tumour‐like lesions in end‐stage renal disease

Aims: Mesenchymal neoplasms of the kidney are rare, and most represent sporadic angiomyolipomas. A few haemangiomas have been reported in end‐stage renal disease (ESRD) but, to date, no study has focused on the frequency and morphological spectrum of mesenchymal lesions in ESRD. Methods and results: We evaluated retrospectively 90 nephrectomy specimens with ESRD. Haemangiomas were detected in eight cases (8.8%; six males and two females; mean age: 55 years); four were multifocal and four had concurrent renal epithelial neoplasms. Lesions involved the medulla (three), cortex (two) or both (three), and the size range was 1–25 mm (mean 4.8 mm). Histologically, all were capillary haemangiomas with an at least focally detectable spleen‐like anastomosing pattern. All tumours stained positively for CD31 and FLI‐1, but none expressed pankeratin (KL‐1), podoplanin/D2‐40, HHV8 or GLUT‐1. Minute angiomyolipomas (mean size 2.3 mm) were detected in four patients (mean age 49.5 years). Tumour‐like smooth muscle proliferations were seen surrounding muscular arteries (eight), occasionally admixed with fat extending from the renal sinus mimicking angiomyolipoma. No similar tumours were found in 105 control kidneys. Conclusions: Benign haemangiomas are not uncommon in ESRD, but may be under‐recognized. They display distinctive morphology and should be distinguished from angiosarcomas and capillary‐rich renal cell carcinomas.     

Use of rating of perceived exertion for determining plyometric exercises intensity in physically active men

The purpose of this study was to use rating of perceived exertion (RPE) scale to evaluate popular bilateral plyometric exercise intensities. Fourteen physically active men (age 20.64 ± 1.4 years; height 176.93 ± 6.83 cm; weight 75.28 ± 11.1 kg) volunteered to participate in this study and performed a set of ten repetitions plyometric exercises to depth jump from 35 cm box, 35 cm box jump, depth jump from 60 cm box, 60 cm box jump, pike jump, tuck jump, and squat jump in a session with 5-min rest in between exercises. RPE was measured following the completion of each exercise using 0–10 Borg RPE scale. Data were analyzed using repeated measures ANOVA and the level of significant was set at p <0.05. The results indicated that squat jump was harder than other types of bilateral plyometric exercises such as 35 cm box jump, depth jump from 35 cm box, and tuck jump (p < 0.05). Moreover, the 35 cm box jump was easier than other plyometric exercises (p < 0.05). With regard to the results of this investigation, it can be recommended that athletes and strength and conditioning professionals use these findings to design plyometric training in their training schedule and keep in their mind that plyometric exercises have different intensities, however, the total volume was matched.     

Patterns of marriage and reproductive practices: is there any relationship?

Today, a transition from traditional to modern marriages can be observed in many countries. This shift in patterns of marriage has evidently affected childbearing and reproductive practices. This study aimed to examine the relationship between patterns of marriage and reproductive practices in Iran. Hence, 880 married women, aged 15–49 years old, living in the North of Iran were selected using a multi-stage cluster sampling strategy and their patterns of marriage and reproductive practices were cross sectionally studied. The results revealed that there were no significant differences in the reproductive practices by three main patterns of marriage in Babol, Iran. The study also indicated that there were no significant differences in reproductive practices in three patterns of marriage after controlling for socio-economic variables. It seems that apart from the patterns of marriage, other influencing factors are the determinants of fertility in women, and the policy-makers of Iran need to pay attention to these determinants before making any decisions in this area.     

Ensuring cultural sensitivity for Muslim patients in the Australian ICU: Considerations for care

Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered ‘traditional’ to very ‘liberal’.It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care.This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit.     

Making health systems more equitable

Health systems are consistently inequitable, providing more and higher quality services to the well-off, who need them less, than to the poor, who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet this situation need not be accepted as inevitable, for there are many promising measures that might be pursued: establishment of goals for improved coverage in the poor, rather than in entire populations, and use of those goals to direct planning toward the needs of the disadvantaged; use of one or more of the several techniques that seem to have been effective in at least some of the settings where they have been tried; and empowerment of poor clients to have a more central role in health system design and operation.