Prognostic factors in anti-neutrophil cytoplasmic antibody-associated glomerulonephritis with severe glomerular sclerosis: a national registry-based cohort study

Background. Classification of patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) into histological classes is useful for predicting a patient’s risk of progression to end-stage renal disease (ESRD). However, even in the worst prognostic group, the 5-year end-stage renal disease-free survival rate is as high as 50%. Objectives. To investigate those prognostic factors indicative of progression to ESRD in patients with ANCA-GN and sclerosing histology. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1991 and 2012 who had biopsy verified pauci-immune glomerulonephritis, positive ANCA serology, and sclerosing histology were included. Cases with ESRD during follow-up were identified via linkage with the Norwegian Renal Registry. Potential prognostic factors with relevant cut-offs were compared in patients with and without progression to ESRD during follow-up. Results. Of 23 included patients, 10 progressed to ESRD. ESRD patients had a lower initial estimated glomerular filtration rate (eGFR; 21 versus 52 ml/min/1.73 m2) and a lower percentage of normal glomeruli (4% versus 15%). Five-year risks of ESRD with eGFR >15 versus ≤15 ml/min/1.73 m2 were 77% and 15%, with percentage normal glomeruli >10% versus ≤10%, 83% and 39%. Conclusions. eGFR and percentage of normal glomeruli are strong risk factors for ESRD in ANCA-GN with sclerosing histology.publishedVersio

Beach litter dynamics: A Mark-Recapture Study

En betydelig del av marin forsøpling forurenser verdens kystlinjer. Søppelets akkumulering på strender representerer et produkt av de to prosessene avsetning og oppbevaring, som er to prosesser det ikke finnes mye kunnskap om. Et fangst-gjenfangststudie av strandsøppelgjenstander ble utført med to-ukers intervall mellom gjenfangst på tre steder i Lofoten, Norge. Avsetning og oppbevaring av søppel varierer over små romlige skalaer (ca. 13 km radius). Det ble ikke funnet noen sammenheng mellom strendene i tidspunktet for hendelser med høy og lav avsetning, noe som tyder på at disse styres av lokale faktorer. I kontrast til dette, ble det funnet en sammenheng mellom strendene i tidspunktet for høy og lav oppbevaring (når søppel ble liggende og når det forlot strender), noe som tyder på at disse påvirkes av regionale faktorer. Resultatene understreker viktigheten av å tilpasse ryddefrekvensen for forskjellige strender, da romlig variasjon i den relative betydningen av avsetning og oppbevaring bestemmer den optimale frekvensen for maksimal fjerning av søppel fra sirkulasjon i det lokale marine miljøet, som ikke kan sees ut fra akkumulering (søppel som har lagret seg på en strand) alene

Impact of proteinase 3 versus myeloperoxidase positivity on risk of end-stage renal disease in ANCA-associated glomerulonephritis stratified by histological classification: A population-based cohort study

Background: End-stage renal disease (ESRD) risk in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated glomerulonephritis (ANCA-GN) according to ANCA serotype and stratified by histological classification has not been previously investigated. Methods: Patients from the Norwegian Kidney Biopsy Registry (NKBR) between 1991 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody serology were included. Cases with ESRD during follow-up were identified in the Norwegian Renal Registry. ESRD-free survival with proteinase 3 (PR3) versus myeloperoxidase- (MPO-) ANCA positivity stratified into 4 histological classes was investigated. Results: Three hundred fifty-eight patients, of whom 87 progressed to ESRD during follow-up, were included. Patients with PR3- as compared to MPOANCA were younger (58 versus 64 years, p = 0 001), had a higher percentage of males (62 versus 41%, p < 0 001), had a lower percentage with a sclerozing glomerulonephritis pattern (4 versus 16%, p < 0 001), and had a significantly higher cumulative ESRD-free survival (90 versus 80%, p = 0 007) at 1-year follow-up. No significant differences in cumulative ESRD-free survival with PR3- as compared to MPO-ANCA were observed by histological stratification. Conclusion: Advanced glomerular sclerosis is found more frequently in patients with MPO-ANCA, explaining the higher risk of ESRD. ANCA serotypes have no impact on prognosis of patients with similar histological findings

Hvordan kan sykepleier fremme sårtilheling og samtidig lindre plager hos pasienter med venøse leggsår?

Introduksjon/ Bakgrunn: Forekomsten av venøse sår hos personer over 65 år er 3-4 %. På grunn av eldrebølgen vil man kunne anslå at dette tallet vil øke drastisk de neste årene. Hensikt: Å belyse hva forskning og annen faglitteratur vektlegger når det gjelder behandling og lindring av plager knyttet til venøse sår. Metode: En littearturstudie som inkluderer fem forskningsartikler Artiklene ble funnet med søkeordene: Practice, nursing, venous ulcer, varicose ulcer, leg ulcer, venous insufficiency, healing, wound healing, treatment, bandages, compression bandages, pain og quality of life. Resultat: Analyseprosessen avdekket følgende temaer: Opplæring, kompresjonsbehandling, smerter og kompetanse, trening og livskavlitet. Konklusjon: Det finnes mange ulike tiltak som vil fremme sårtilheling og lindre plager hos pasienter med venøse leggsår. Kompresjon kommer frem som selve essensen i sårbehandlingen, men aktivitet og smertelindring er også viktige tiltak. En forutsetning for behandlingen er at sykepleier arbeider fagutviklende for å sikre god veiledning og undervisning av pasienten

Prognostic Factors in Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis with Severe Glomerular Sclerosis: A National Registry-Based Cohort Study

Background. Classification of patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) into histological classes is useful for predicting a patient’s risk of progression to end-stage renal disease (ESRD). However, even in the worst prognostic group, the 5-year end-stage renal disease-free survival rate is as high as 50%. Objectives. To investigate those prognostic factors indicative of progression to ESRD in patients with ANCA-GN and sclerosing histology. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1991 and 2012 who had biopsy verified pauci-immune glomerulonephritis, positive ANCA serology, and sclerosing histology were included. Cases with ESRD during follow-up were identified via linkage with the Norwegian Renal Registry. Potential prognostic factors with relevant cut-offs were compared in patients with and without progression to ESRD during follow-up. Results. Of 23 included patients, 10 progressed to ESRD. ESRD patients had a lower initial estimated glomerular filtration rate (eGFR; 21 versus 52 ml/min/1.73 m2) and a lower percentage of normal glomeruli (4% versus 15%). Five-year risks of ESRD with eGFR >15 versus ≤15 ml/min/1.73 m2 were 77% and 15%, with percentage normal glomeruli >10% versus ≤10%, 83% and 39%. Conclusions. eGFR and percentage of normal glomeruli are strong risk factors for ESRD in ANCA-GN with sclerosing histology

Prognostic factors in anti-neutrophil cytoplasmic antibody-associated glomerulonephritis with severe glomerular sclerosis: a national registry-based cohort study

Background. Classification of patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) into histological classes is useful for predicting a patient’s risk of progression to end-stage renal disease (ESRD). However, even in the worst prognostic group, the 5-year end-stage renal disease-free survival rate is as high as 50%. Objectives. To investigate those prognostic factors indicative of progression to ESRD in patients with ANCA-GN and sclerosing histology. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1991 and 2012 who had biopsy verified pauci-immune glomerulonephritis, positive ANCA serology, and sclerosing histology were included. Cases with ESRD during follow-up were identified via linkage with the Norwegian Renal Registry. Potential prognostic factors with relevant cut-offs were compared in patients with and without progression to ESRD during follow-up. Results. Of 23 included patients, 10 progressed to ESRD. ESRD patients had a lower initial estimated glomerular filtration rate (eGFR; 21 versus 52 ml/min/1.73 m2) and a lower percentage of normal glomeruli (4% versus 15%). Five-year risks of ESRD with eGFR >15 versus ≤15 ml/min/1.73 m2 were 77% and 15%, with percentage normal glomeruli >10% versus ≤10%, 83% and 39%. Conclusions. eGFR and percentage of normal glomeruli are strong risk factors for ESRD in ANCA-GN with sclerosing histology

Impact of proteinase 3 versus myeloperoxidase positivity on risk of end-stage renal disease in ANCA-associated glomerulonephritis stratified by histological classification: A population-based cohort study

Background. End-stage renal disease (ESRD) risk in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated glomerulonephritis (ANCA-GN) according to ANCA serotype and stratified by histological classification has not been previously investigated. Methods. Patients from the Norwegian Kidney Biopsy Registry (NKBR) between 1991 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody serology were included. Cases with ESRD during follow-up were identified in the Norwegian Renal Registry. ESRD-free survival with proteinase 3 (PR3) versus myeloperoxidase- (MPO-) ANCA positivity stratified into 4 histological classes was investigated. Results. Three hundred fifty-eight patients, of whom 87 progressed to ESRD during follow-up, were included. Patients with PR3- as compared to MPO-ANCA were younger (58 versus 64 years, ), had a higher percentage of males (62 versus 41%, ), had a lower percentage with a sclerozing glomerulonephritis pattern (4 versus 16%, ), and had a significantly higher cumulative ESRD-free survival (90 versus 80%, ) at 1-year follow-up. No significant differences in cumulative ESRD-free survival with PR3- as compared to MPO-ANCA were observed by histological stratification. Conclusion. Advanced glomerular sclerosis is found more frequently in patients with MPO-ANCA, explaining the higher risk of ESRD. ANCA serotypes have no impact on prognosis of patients with similar histological findings

Impact of Proteinase 3 versus Myeloperoxidase Positivity on Risk of End-Stage Renal Disease in ANCA-Associated Glomerulonephritis Stratified by Histological Classification: A Population-Based Cohort Study

Background. End-stage renal disease (ESRD) risk in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated glomerulonephritis (ANCA-GN) according to ANCA serotype and stratified by histological classification has not been previously investigated. Methods. Patients from the Norwegian Kidney Biopsy Registry (NKBR) between 1991 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody serology were included. Cases with ESRD during follow-up were identified in the Norwegian Renal Registry. ESRD-free survival with proteinase 3 (PR3) versus myeloperoxidase- (MPO-) ANCA positivity stratified into 4 histological classes was investigated. Results. Three hundred fifty-eight patients, of whom 87 progressed to ESRD during follow-up, were included. Patients with PR3- as compared to MPO-ANCA were younger (58 versus 64 years, p=0.001), had a higher percentage of males (62 versus 41%, p<0.001), had a lower percentage with a sclerozing glomerulonephritis pattern (4 versus 16%, p<0.001), and had a significantly higher cumulative ESRD-free survival (90 versus 80%, p=0.007) at 1-year follow-up. No significant differences in cumulative ESRD-free survival with PR3- as compared to MPO-ANCA were observed by histological stratification. Conclusion. Advanced glomerular sclerosis is found more frequently in patients with MPO-ANCA, explaining the higher risk of ESRD. ANCA serotypes have no impact on prognosis of patients with similar histological findings

Livets siste dager «Hvordan kan sykepleier ivareta eldre pasienter i den terminale fasen?»

Bakgrunn: Så mange som 21.181 personer døde i norske helseinstitusjoner i 2020. Erfaringsmessig har vi opplevd at mange sykepleiere synes temaet om livets slutt kan være utfordrende. Det finnes flere ulike verktøy som kan være er til god hjelp for sykepleieren i forhold til ivaretakelsen av den døende pasienten. Hensikt: Ut i fra praksis ser vi mye usikkerhet rundt dette temaet og derfor har vi blitt blir vi engasjert på tematikken “livets siste dager”. Formålet med denne systematiske litteraturstudien er å sette søkelys på ivaretakelsen av pasienten i den terminale fasen. For å kunne ivareta pasienten må sykepleiere se hver enkelt pasient for den de er og behandle deres individuelle behov. Metode: Ved å bruke databasene Svemed+, Medline Ovid og Cinahl, med ulike søkeord som vi kombinerte satt vi igjen med seks vitenskapelige artikler som blir anvendt med relevant faglitteratur og praksiserfaring der det faller seg naturlig inn. Resultat: Etter å ha analysert disse seks vitenskapelige artiklene ble vi sittende igjen med tre faktorer som påvirker ivaretakelsen i den terminale fasen. Faktorene er; kommunikasjon, kompetanse- og bemanning og palliativ- og lindrende pleie. Konklusjon: For å ivareta pasienten i den terminale fasen, ser vi at ved å styrke bemanningen, øke kompetanse og å ha god kommunikasjon mellom de ulike yrkesgruppene er med på å trygge pasienten og deres pårørende. Disse komponentene er viktige slik at pasienten får den hjelpen de trenger i den terminale fasen