Clinicopathological study of male and female patients with lupus nephritis: a retrospective study

Purpose

The aim of this study was to assess the impact of sex on long-term outcomes in patients with lupus nephritis (LN).

Methods

Data of patients were collected at a single tertiary hospital from June 2010 to June 2016. Clinicopathological features and treatment responses of LN patients with different genders were compared. The primary endpoint was serum creatinine level doubled, GFR < 15 mL/min, initiation of renal replacement treatment or death. The secondary endpoint was complete remission or partial remission.

Results

In total, 101 male patients and 579 females were included. The follow-up time was 49.7 ± 15.2 months. In clinical data, photosensitivity and mouth ulcers were more common in the female patients, while males had more serositis and vasculitis. In laboratory data, males had higher values of blood pressure, hemoglobin, urine protein, serum creatinine and a lower level of serum albumin. Activity index and endocapillary hypercellularity scores in the male group were significantly increased. No sex disparity was identified across secondary endpoints in all cases, despite a lower ratio of CR in males. As for the long-term survival, no statistic difference between the two groups was observed. In a further multivariate Cox hazard analysis, male gender was not identified as an independent risk factor for poor outcomes.

Conclusion

Despite a greater disease activity and more severe organ damage in males with LN, we did not observe any significant gender disparity in long-term survival. Large multicenter collaborative efforts are necessary.

     

Smooth muscle cells of human veins show an increased response to injury at valve sites

Objective

Venous valves are essential but are prone to injury, thrombosis, and fibrosis. We compared the behavior and gene expression of smooth muscle cells (SMCs) in the valve sinus vs nonvalve sites to elucidate biologic differences associated with vein valves.

Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review

Early access to care is essential to improve survival rates for childhood cancer. This study evaluates the determinants of delays in childhood cancer care in low- and middle-income countries (LMICs) through a systematic review of the literature. We proposed a novel Three-Delay framework specific to childhood cancer in LMICs by summarizing 43 determinants and 24 risk factors of delayed cancer care from 95 studies. Traditional medicine, household income, lack of transportation, rural population, parental education, and travel distance influenced most domains of our framework. Our novel framework can be used as a policy tool toward improving cancer care and outcomes for children in LMICs.     

Imaging of pediatric liver tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Primary hepatic malignancies are relatively rare in the pediatric population, accounting for approximately 1%–2% of all pediatric tumors. Hepatoblastoma and hepatocellular carcinoma are the most common primary liver malignancies in children under the age of 5 years and over the age of 10 years, respectively. This paper provides consensus-based imaging recommendations for evaluation of patients with primary hepatic malignancies at diagnosis and follow-up during and after therapy.     

Prevalence and predictors of postoperative thiamine deficiency after vertical sleeve gastrectomy

Background

As the vertical sleeve gastrectomy (VSG) becomes increasingly popular, its effect on postoperative micronutrient levels, such as thiamine, becomes more important. We previously found a 1.8% prevalence of thiamine deficiency in bariatric patients before surgery.