Association between psoriasis and chronic obstructive pulmonary disease: A systematic review and meta-analysis

<p>Psoriasis has been linked to an increased risk of several co-morbidities. However, its association with chronic obstructive pulmonary disease (COPD) remains unclear. To further characterize this relationship, we conducted a systematic review and meta-analysis of case–control and cross-sectional studies that compared the risk of COPD in patients with psoriasis versus non-psoriasis participants. Generic inverse variance method of DerSimonian and Laird was used to combine all the point estimates. Out of 502 potentially relevant articles, seven studies met our inclusion criteria and were included in the data analysis. The pooled odds ratio of COPD in patients with psoriasis versus control was 1.45 (95% CI, 1.21–1.73). The statistical heterogeneity was high with an <i>I</i>² of 91%. Therefore, our study provided evidence to support the increased risk of COPD among patients with psoriasis.</p

Admission hypomagnesemia and hypermagnesemia increase the risk of acute kidney injury

<div><p></p><p><i>Background</i>: The association between admission serum magnesium (Mg) levels and risk of in-hospital acute kidney injury (AKI) is limited. The aim of this study was to assess the risk of developing AKI in all hospitalized patients with various admission Mg levels. <i>Methods</i>: This is a single-center retrospective study conducted at a tertiary referral hospital. All hospitalized adult patients who had admission Mg available from January to December 2013 were analyzed in this study. Admission Mg was categorized based on its distribution into six groups (less than 1.5, 1.5–1.7, 1.7–1.9, 1.9–2.1, 2.1–2.3 and greater than 2.3 mg/dL). The primary outcome was in-hospital AKI occurring after hospital admission. Logistic regression analysis was performed to obtain the odds ratio of AKI of various admission Mg levels using Mg with lowest AKI incidence (1.9–2.1 mg/dL) as the reference group. <i>Results</i>: Of 9241 patients enrolled, AKI occurred in 1124 patients (12.2%). The lowest incidence of AKI was when serum Mg was within 1.7–1.9 and 1.9–2.1 mg/dL. A U-shaped curve emerged demonstrating higher incidences of AKI associated with both hypoMg (<1.7) and hyperMg (>2.1). After adjusting for potential confounders, both hypoMg (<1.5 mg/dL) and hyperMg (>2.3 mg/dL) were associated with an increased risk of developing AKI with odds ratios of 1.70 (95% CI 1.31–2.18) and 1.42 (95% CI 1.11–1.81), respectively. <i>Conclusion</i>: Both admission hypoMg and hyperMg were associated with an increased risk for in-hospital AKI.</p></div

Trends in the use of renal replacement therapy modality in intensive care unit: a 7 year study

<div><p></p><p><i>Background</i>: The use of renal replacement therapy (RRT) modality in the intensive care unit (ICU) depends primarily on provider preference and hospital resource. This study aims to describe the prevalence of RRT use and the trends in RRT modality use in the ICU over the past 7 years. <i>Methods</i>: All ICU admissions, including medical, cardiac, and surgical ICUs from 1 January 2007 to 31 December 2013, were included in this study. RRT use was defined as the use of intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) within a given ICU day. The RRT use was reported as the proportion of ICU days on each RRT modality divided by the total ICU days with RRT usage. <i>Results</i>: Over the course of this study (72,005 ICU admissions), 272,271 ICU days were generated. RRTs were used in 4110 ICU admissions (5.7%) and on 21,159 ICU days (7.8%). RRT use was 10,402 (49%) for IHD, and 10,954 (52%) for CRRT. The trend of IHD and CRRT use did not change from year 2007 to 2013. On ICU days with RRT, the choice of RRT modality was associated with the number of vasopressor use (<i>p</i> < 0.001). CRRT was more preferred on the ICU days with the increasing number of vasopressor use. <i>Conclusions</i>: RRTs were used in about 6% of ICU admission. The use of IHD and CRRT was similar and did not change over 7 years. The choice of RRT modality mainly depended on the number of vasopressors used on ICU days with RRT.</p></div

Hospital mortality in patients with Cl evolution within 48 hours of hospital admission.

<p>Hospital mortality in patients with Cl evolution within 48 hours of hospital admission.</p

Hospital mortality in subgroups of patients with various serum Cl levels.

<p>Hospital mortality in subgroups of patients with various serum Cl levels.</p

Clinical outcomes.

<p>Clinical outcomes.</p

Hospital mortality analyzed by restricted cubic spline.

<p>Hospital mortality analyzed by restricted cubic spline.</p

Hospital mortality in percentage (%) among patients with AG ≤12 and >12 mmol/L with various admission Cl levels.

<p>Hospital mortality in percentage (%) among patients with AG ≤12 and >12 mmol/L with various admission Cl levels.</p

Baseline clinical characteristics of patients with AG > 12.

<p>Baseline clinical characteristics of patients with AG > 12.</p

Days of patient survival relating to Cl increase within 48 hours of admission.

<p>Days of patient survival relating to Cl increase within 48 hours of admission.</p