In recent years, several international urological societies have published guidelines on the diagnosis, treatment, and follow-up of urethral strictures, but a guideline for the German-speaking region has not been available to date. This summary provides a detailed comparison of the guidelines of the European Association of Urology (EAU), American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) with regard to the treatment of anterior urethral strictures, i.e. from the bulbar urethra to the meatus. In the following work, differences and specific recommendations in the guidelines are highlighted. In particular, the three guidelines largely agree with regard to diagnostic workup and follow-up. However, divergences exist in the management of anterior urethral strictures, particularly with regard to the use of endoscopic therapeutic approaches and the use of urethral stents. In addition, the EAU provides more comprehensive and detailed recommendations on urethroplasty techniques and specific patient follow-up. The EAU guidelines are the most current and were the first to include instructions for urethral strictures in women and individuals with gender incongruence after genital approximation surgery. Reconstructive urology is a rapidly evolving specialty and, thus, the clinical approach has been changing accordingly. Although guideline recommendations have become more inclusive and comprehensive, more high-quality data are needed to further improve the level of evidence.
- MeSH
- Humans MeSH
- Data Accuracy MeSH
- Urethral Stricture * diagnosis MeSH
- Urethra surgery MeSH
- Urology * MeSH
- Plastic Surgery Procedures * MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- Review MeSH
- Geographicals
- United States MeSH
OBJECTIVES: This study aims to describe the data structure and harmonisation process, explore data quality and define characteristics, treatment, and outcomes of patients across six federated antineutrophil cytoplasmic antibody-associated vasculitis (AAV) registries. METHODS: Through creation of the vasculitis-specific Findable, Accessible, Interoperable, Reusable, VASCulitis ontology, we harmonised the registries and enabled semantic interoperability. We assessed data quality across the domains of uniqueness, consistency, completeness and correctness. Aggregated data were retrieved using the semantic query language SPARQL Protocol and Resource Description Framework Query Language (SPARQL) and outcome rates were assessed through random effects meta-analysis. RESULTS: A total of 5282 cases of AAV were identified. Uniqueness and data-type consistency were 100% across all assessed variables. Completeness and correctness varied from 49%-100% to 60%-100%, respectively. There were 2754 (52.1%) cases classified as granulomatosis with polyangiitis (GPA), 1580 (29.9%) as microscopic polyangiitis and 937 (17.7%) as eosinophilic GPA. The pattern of organ involvement included: lung in 3281 (65.1%), ear-nose-throat in 2860 (56.7%) and kidney in 2534 (50.2%). Intravenous cyclophosphamide was used as remission induction therapy in 982 (50.7%), rituximab in 505 (17.7%) and pulsed intravenous glucocorticoid use was highly variable (11%-91%). Overall mortality and incidence rates of end-stage kidney disease were 28.8 (95% CI 19.7 to 42.2) and 24.8 (95% CI 19.7 to 31.1) per 1000 patient-years, respectively. CONCLUSIONS: In the largest reported AAV cohort-study, we federated patient registries using semantic web technologies and highlighted concerns about data quality. The comparison of patient characteristics, treatment and outcomes was hampered by heterogeneous recruitment settings.
- MeSH
- Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis * drug therapy epidemiology complications MeSH
- Granulomatosis with Polyangiitis * drug therapy epidemiology complications MeSH
- Humans MeSH
- Microscopic Polyangiitis * drug therapy epidemiology MeSH
- Antibodies, Antineutrophil Cytoplasmic MeSH
- Registries MeSH
- Data Accuracy MeSH
- Information Storage and Retrieval MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Keywords
- DEXCOM G6-Pro,
- MeSH
- Diabetes Mellitus MeSH
- Renal Dialysis * MeSH
- Clinical Trials as Topic MeSH
- Continuous Glucose Monitoring * instrumentation MeSH
- Blood Glucose analysis MeSH
- Humans MeSH
- Renal Insufficiency MeSH
- Blood Glucose Self-Monitoring instrumentation MeSH
- Data Accuracy * MeSH
- Check Tag
- Humans MeSH
Nepřímý imunofluorescenční mikroskopický průkaz autoprotilátek patří mezi nosné metody imunologické laboratorní diagnostiky. Jsou nezbytné pro diagnostiku a monitorování autoimunitních, imunopatologických onemocnění. Výsledky těchto metod jsou velmi závislé na zkušenostech hodnotitele. Běžně se hodnotitelé střídají nebo je třeba zacvičit nového pracovníka. V těchto případech je kontinuita nálezů ohrožena. Z tohoto důvodu je žádoucí shodu mezi hodnotiteli ověřovat. Cílem této studie bylo prověřit shodu mezi třemi hodnotiteli imunofluorescenčních nálezů. V období čtyř měsíců bylo hodnoceno 163 vzorků pro stanovení přítomnosti protilátek proti antigenům cytoplasmatických granulí neutrofilů ANCA, 301 vzorků pro stanovení protilátek proti endomysiu a 772 vzorků protilátek proti jaderným antigenům ANA. Pro posouzení shody mezi hodnotiteli bylo použito Cohenovo kappa (κ) nebo vážené Cohenovo kappa (κwlin ) a shoda byla vyjádřena v procentech. V souhrnu lze shodu mezi sledovanými hodnotiteli označit jako dobrou. U kvalitativního srovnání (pozitivní/negativní) se hodnota κ pohybovala od 0,79 až po 1,00. U kvantitativního hodnocení metod byla nejmenší shoda, vyjádřena hodnotou κ wlin , zjištěna u ANA 0,82 a nejlepší u ANCA 0,98. Největší rozdíly byly pozorovány u rozlišení fluorescenčních obrazů ANA a ANCA. Tady se hodnoty κ pohybovaly od 0,54 do 0,68, což odpovídá interpretaci průměrná až dobrá shoda. Dle názoru autorů by ověření shody mezi hodnotiteli mělo být součástí řízení kvality v imunologické laboratoři alespoň při zácviku nového pracovníka nebo při přechodu na jiné diagnostiky. Autoři doporučují analyzovat shodu pomocí Cohenova kappa a nikoli pouhým procentuálním vyjádřením shody.
Detection of autoantibodies by indirect immunofluorescence microscopy is one of the principal method of the immunological laboratory diagnostic procedures. This method is essential for the diagnosis and monitoring of various autoimmune immunopathological diseases. The results of this tests are always dependent on the experience of the evaluator. It is common for evaluators to alternate or for a new worker to be trained. In those cases, the continuity of the results is at the risk. For this reason, it is appropriate to verify the agreement between evaluators. The aim of this study was to examine the agreement between three evaluators of immunofluorescence tests. Within 4 months, 163 samples were evaluated for the presence of antibodies against autoantigens of cytoplasmic granules of neutrophils ANCA, 301 samples for antibodies against endomysium, and 772 samples for antibodies against nuclear antigens ANA. Cohen’s kappa (κ) or weighted Cohen’s kappa (κwlin ) in combination with agreement expressed as a percentage were used to determine the inter-observer agreement. Overall, the agreement between the monitored evaluators was characterized as good. In the qualitative comparison (positive/negative), the κ value ranged from 0.79 to 1.00. In the quantitative evaluation, the lowest agreement, expressed by the value of κ wlin , was found for ANA 0.82 and the best for ANCA 0.98. The greatest differences were observed in differentiating of the fluorescence patterns of ANA and ANCA. In this case, values of kappa were in the range from 0.54 to 0.68, which was interpreted as moderate to substantial agreement. In the opinion of the authors, verification of agreement between evaluators should be a part of quality control in the immunology laboratory at least during the training of a new evaluater or when transitioning to other diagnostics. The authors recommend to analyze the agreement using Cohen’s kappa, rather than just a simple agreement expressed as a percentage.
Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models provide specific, quantitative, and evaluable predictions that inform short-term decisions such as healthcare staffing needs, school closures, and allocation of medical supplies. Starting in April 2020, the US COVID-19 Forecast Hub (https://covid19forecasthub.org/) collected, disseminated, and synthesized tens of millions of specific predictions from more than 90 different academic, industry, and independent research groups. A multimodel ensemble forecast that combined predictions from dozens of groups every week provided the most consistently accurate probabilistic forecasts of incident deaths due to COVID-19 at the state and national level from April 2020 through October 2021. The performance of 27 individual models that submitted complete forecasts of COVID-19 deaths consistently throughout this year showed high variability in forecast skill across time, geospatial units, and forecast horizons. Two-thirds of the models evaluated showed better accuracy than a naïve baseline model. Forecast accuracy degraded as models made predictions further into the future, with probabilistic error at a 20-wk horizon three to five times larger than when predicting at a 1-wk horizon. This project underscores the role that collaboration and active coordination between governmental public-health agencies, academic modeling teams, and industry partners can play in developing modern modeling capabilities to support local, state, and federal response to outbreaks.
- MeSH
- COVID-19 * mortality MeSH
- Humans MeSH
- Pandemics MeSH
- Probability MeSH
- Forecasting MeSH
- Data Accuracy MeSH
- Public Health trends MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- United States MeSH
Ig gene (IG) clonality analysis has an important role in the distinction of benign and malignant B-cell lymphoid proliferations and is mostly performed with the conventional EuroClonality/BIOMED-2 multiplex PCR protocol and GeneScan fragment size analysis. Recently, the EuroClonality-NGS Working Group developed a method for next-generation sequencing (NGS)-based IG clonality analysis. Herein, we report the results of an international multicenter biological validation of this novel method compared with the gold standard EuroClonality/BIOMED-2 protocol, based on 209 specimens of reactive and neoplastic lymphoproliferations. NGS-based IG clonality analysis showed a high interlaboratory concordance (99%) and high concordance with conventional clonality analysis (98%) for the molecular conclusion. Detailed analysis of the individual IG heavy chain and kappa light chain targets showed that NGS-based clonality analysis was more often able to detect a clonal rearrangement or yield an interpretable result. NGS-based and conventional clonality analysis detected a clone in 96% and 95% of B-cell neoplasms, respectively, and all but one of the reactive cases were scored polyclonal. We conclude that NGS-based IG clonality analysis performs comparable to conventional clonality analysis. We provide critical parameters for interpretation and discuss a first step toward a quantitative scoring approach for NGS clonality results. Considering the advantages of NGS-based clonality analysis, including its high sensitivity and possibilities for accurate clonal comparison, this supports implementation in diagnostic practice.
- MeSH
- Lymphoma, B-Cell genetics MeSH
- B-Lymphocytes immunology MeSH
- Clone Cells immunology MeSH
- Phenotype MeSH
- Lymphoma, Follicular genetics MeSH
- Gene Rearrangement * MeSH
- Genes, Immunoglobulin * MeSH
- Immunoglobulin kappa-Chains genetics MeSH
- Humans MeSH
- Multiplex Polymerase Chain Reaction methods MeSH
- Sensitivity and Specificity MeSH
- Data Accuracy MeSH
- Immunoglobulin Heavy Chains genetics MeSH
- High-Throughput Nucleotide Sequencing methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Validation Study MeSH
Honey consumption is attributed to potentially advantageous effects on human health due to its antioxidant capacity as well as anti-inflammatory and antimicrobial activity, which are mainly related to phenolic compound content. Phenolic compounds are secondary metabolites of plants, and their content in honey is primarily affected by the botanical and geographical origin. In this study, a high-resolution mass spectrometry (HRMS) method was applied to determine the phenolic profile of various honey matrices and investigate authenticity markers. A fruitful sample set was collected, including honey from 10 different botanical sources (n = 51) originating from Greece and Poland. Generic liquid-liquid extraction using ethyl acetate as the extractant was used to apply targeted and non-targeted workflows simultaneously. The method was fully validated according to the Eurachem guidelines, and it demonstrated high accuracy, precision, and sensitivity resulting in the detection of 11 target analytes in the samples. Suspect screening identified 16 bioactive compounds in at least one sample, with abscisic acid isomers being the most abundant in arbutus honey. Importantly, 10 markers related to honey geographical origin were revealed through non-targeted screening and the application of advanced chemometric tools. In conclusion, authenticity markers and discrimination patterns were emerged using targeted and non-targeted workflows, indicating the impact of this study on food authenticity and metabolomic fields.
- MeSH
- Antioxidants analysis isolation & purification MeSH
- Benzaldehydes analysis isolation & purification MeSH
- Cinnamates analysis isolation & purification MeSH
- Flavonoids analysis isolation & purification MeSH
- Mass Spectrometry methods MeSH
- Hydroxybenzoates analysis isolation & purification MeSH
- Humans MeSH
- Honey analysis MeSH
- Metabolome * MeSH
- Metabolomics methods MeSH
- Sensitivity and Specificity MeSH
- Data Accuracy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Validation Study MeSH
- Geographicals
- Poland MeSH
- Greece MeSH
Data o úmrtnosti jsou považována za jedna z nejtvrdších a nejvalidnějších údajů z oblasti zdravotnické statistiky. Při určování příčin smrti však narážíme na řadu problémů a omezení souvisejících s vyplněním příslušné dokumentace. COVID-19 přinesl nové potřeby a možnosti zpracování zdravotnických dat. Do popředí zájmu se dostávají kompletnost a kvalita sbíraných dat, případně další, běžně nevyhodnocované kvalitativní parametry. ÚZIS ČR ve spolupráci s Ministerstvem zdravotnictví ČR realizoval rozsáhlou revizi úmrtnostních dat v souvislosti s COVID-19 za rok 2020. Tato revize byla založena na fúzi dvou různých informačních zdrojů – List o prohlídce zemřelého (LPZ) a Informační systém infekčních nemocí. Na ni navázala aktivita spočívající v ověření základní příčiny smrti (undelying cause of death), vybírané podle pravidel WHO na základě posloupnosti příčin smrti uvedených na LPZ s využitím informací ze zdravotnické dokumentace hospitalizovaných osob prostřednictvím panelu klinických expertů. Příspěvek popisuje metodiku a výstupy provedené revize mortality pacientů s COVID-19 za rok 2020.
