[KIDNEY DISEASES IN NORTH ISRAEL ACCORDING TO KIDNEY BIOPSIES - BNAI-ZION MEDICAL CENTER 14 YEARS' EXPERIENCE].

INTRODUCTION: Little is known about the prevalence of kidney diseases according to renal biopsy in Israel. Since updated literature worldwide emphasizes changing etiologies of chronic kidney disease, it is crucial to research and define the epidemiology and pathology of kidney disease in Israel. Hereby, we introduce an original review of the prevalence of kidney diseases in our study population, which we believe reflects the prevalence of kidney diseases in the population of Israel. AIMS: To investigate the prevalence of kidney diseases diagnosed by renal biopsy, according to age, gender, race and clinical symptoms. METHODS: A total of 155 kidney biopsies were conducted in the years 2000-2014 in Bnai-Zion Medical Center in Haifa, according to formal accepted indications. Most of the biopsies (65%) were needle aspirations in a retroperitoneal approach, in which 90% were ultrasound guided and the rest computed tomography guided, while the other 35% of biopsies involved laparoscopic approaches. RESULTS: The most common indications for kidney biopsy were nephrotic syndrome, nephritic syndrome and proteinuria (37.4%, 25.8% and 24.5%, respectively). Average glomeruli number per biopsy was 17.5 vs. 82.2 for needle aspiration and laparoscopic approach, respectively (statistically significant). The most common diagnosis was focal segmental glomerulosclerosis (FSGS), followed by chronic glomerulonephritis, IgA nephropathy, lupus nephritis, minimal change disease (MCD), membranous nephropathy and tubulointerstitial disease (20%, 11.5%, 11.5%, 10.1%, 9.5%, 8.1% and 6.1%, respectively). CONCLUSIONS: FSGS was the most common diagnosis in patients presented with nephrotic syndrome or proteinuria, men, and patients above 60 years of age. Patients below 30 years of age were mainly diagnosed with IgA nephropathy. DISCUSSION: In recent years, FSGS is becoming more prevalent compared with other chronic kidney disease especially in the older population. IgA nephropathy is still the most common diagnosis in young patients and in patients presented with hematuria. To the best of our knowledge, no data exists on the prevalence of kidney diseases in Israel, and our study is an important contribution to the epidemiological and clinical knowledge on the subject.

Increased aortic wall thickness for the diagnosis of aortitis: a computed tomography-based study.

AIMS: To evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a sole imaging finding for the confirmation of clinically suspected aortitis. METHODS: CT scans of 20 patients with the diagnosis of aortitis, endorsed by the abnormally thickened aortic wall, as a single imaging finding, and 250 patients without known aortitis were reviewed and AWT manually measured at the levels of thoracic descending aorta, upper abdominal aorta and infrarenal aorta, as well as the level of maximal AWT in patients with diagnosed aortitis. Patients' charts were analyzed and demographic data and data on co-morbidities extracted. Correlations of measured AWT with patients' demographic data and co-morbidities were calculated for the control patients. Age-dependent upper 97.5 percentile points for AWT were calculated for different age groups as a reference. AWT of patients, diagnosed with aortitis, was compared with these reference values. RESULTS: AWT had significant positive correlation with patient age (P < 0.001), gender (P < 0.03) and presence of aortic wall calcifications (P < 0.001). In nine of 20 patients, with diagnosed aortitis confirmed by the increased CT-measured AWT, the revised values of AWT were lower than the calculated upper 97.5 percentile points for the relevant age group. In four of these patients, the values of the measured AWT were in the range of mean + SD for AWT for the same age. CONCLUSIONS: The confirmation of suspected aortitis by the increased CT-measured AWT only may be equivocal and necessitate more specific imaging, particularly in elderly patients.

The puzzle of acupuncture.

Acupuncture is based on the theory of channels, which serve as pathways for energy (Qi). On the course of the channels, acupuncture points are described, and by stimulation of these points, therapeutic effects may be achieved. This system is very complex and both channels and acupuncture points are anatomically invisible. Unlike in Western medicine, scientists fail to trace both the origin and the progress of acupuncture theory. Having developed in its full form not later than the 2nd century BC, it never underwent fundamental change. On the other hand, it has become a part of modern Western medicine as an effective therapy and the existence of acupuncture points, specified thousands of years ago, has been demonstrated by modern science. It is hardly probable that acupuncture theory, although dating back to ancient times, could have originated in primitive civilization. The origin of the energy channel theory does not fit into the traditional developmental scheme. The existence of the theory cannot be explained other than by its being a product of a highly developed civilization.