Aim The present study comprehensively investigated the relationship between diabetic peripheral neuropathy (DPN) and sarcopenia by identifying all eligible studies and summarizing their results. Methods Records were identified through MEDLINE and EMBASE database searching from inception to March 9, 2022. We included all cross‐sectional studies investigating the association between DPN and sarcopenia among patients with diabetes. Data from eligible studies, including point estimates and standard errors, were pooled together using the generic inverse variance method. Results Of 2989 retrieved articles, five studies met the inclusion criteria and were allowed for meta‐analysis. The pooled analysis found a significant association between DPN and sarcopenia with the pooled odds ratio of 1.62 (95% confidence interval: 1.30–2.02; I2 0%). The funnel plot was relatively symmetric and was not suggestive of the presence of publication bias. Conclusions The current study discovered a significant association between DPN and sarcopenia in patients with diabetes. However, given summarized data from cross‐sectional studies, the temporality between DPN and sarcopenia could not be established. Geriatr Gerontol Int 2022; 22: 785–789.
Introduction/Aims Previous studies have shown inconsistent data on the relationship between statin use and polyneuropathy (PN). The current systematic review and meta‐analyses were conducted to comprehensively investigate the risk of incident PN among statin‐users compared with non‐users by identifying all available studies and summarizing their results. Methods A systematic review was conducted from MEDLINE and EMBASE databases from inception to October 31, 2020. We included cohort and case–control studies that compared the risk of incident PN between statin‐users and non‐users. Point estimates and standard errors from eligible studies were pooled together using the generic inverse variance method. Results Of 4968 retrieved articles, 6 studies in non‐diabetic populations and 2 studies in diabetic populations fulfilled the inclusion criteria. Two meta‐analyses were performed. The pooled analyses did not find a statistically significant association between the use of statins and risk of incident PN with the pooled odds ratio of 1.24 (95% confidence interval [CI], 0.88–1.76; I2 74%) and 0.82 (95% CI, 0.56–1.21; I2 80%) in non‐diabetic and diabetic groups respectively. Discussion No significant association between the use of statins and the risk of PN was observed in this systematic review and these two meta‐analyses. However, there was a high degree of heterogeneity of the meta‐analyses.
Background International guidelines recommended screening for AVF stenosis using various non-invasive methods. The previous studies have reported con icting results. This study aims to evaluate the utility of the different non-invasive AVF ow measurements for detecting AVF stenosis. Methods We evaluated 23 HD patients with the clinical suspicion for AVF stenosis based on physical examination or high venous pressures during. Patients underwent all three non-invasive measurements including ultrasound dilution, urea dilution, and Doppler ultrasonography. Fistulography was performed to con rm the degree of AVF stenosis in all patients. Results Fistulography revealed AVF stenosis in eighteen patients, twelve of whom had severe stenosis (greater than 50% stenosis). About the location of the stenotic lesions, eight were at the in ow site, six at the out ow site, and four at both sites. In those AVFs with severe stenosis, median access ows were 625 mL/min by ultrasound dilution method, 615 mL/min by urea dilution method, and 590 mL/min by Doppler ultrasonography. Receiver operating characteristic (ROC) curve analysis showed that Doppler ultrasonography had a high discriminative ability and the averaged areas under the curves were 0.933 (95% con dence interval [CI], 0.81 to 0.99) for stenosis and 0.929 (95% CI, 0.82 to 0.99) for severe stenosis. The sensitivity of each method for prediction of access stenosis was 73%, 73%, 80% by using the ultrasound dilution, urea dilution, and Doppler ultrasonography methods, respectively. The speci city of each method was 40%, 80%, and 100% respectively. Physical examination showed 80% sensitivity and 80% speci city for detecting AVF stenosis. The combination of non-invasive access ow measurement with physical examination increased the sensitivity for detection of AVF stenosis to 80%, 93%, and 93% respectively. Conclusions Doppler ultrasound combine with physical examination, was more accurate than other non-invasive methods for detection of AVF stenosis.
Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p < 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.
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