The Value of Protocol Biopsies to Identify Patients With De Novo Donorâ Specific Antibody at High Risk for Allograft Loss

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137430/1/ajt14161_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137430/2/ajt14161-sup-0001-TableS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137430/3/ajt14161.pd

Peripheral arterial disease and risk of hip fracture: A systematic review and meta-analysis of cohort studies

Background: Previous studies have suggested an increased risk of hip fracture among patients with peripheral arterial disease (PAD), however, the results have been inconsistent. This meta-analysis was conducted with the aim to summarize all available evidence to better characterize the risk of incident hip fracture among these patients. Materials and Methods: A comprehensive literature review was conducted using the MEDLINE and EMBASE databases through October 2017 to identify all cohort and case-control studies that compared the risk of subsequent hip fracture between patients with PAD and individuals without PAD. Effect estimates of the included studies were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: The systematic review process yielded six eligible cohort studies comprising 15,895 patients with PAD. There was a significant association between incident hip fracture and PAD with the pooled relative risk (RR) of 1.64 (95% CI, 1.17–2.29; I2, 80%), comparing patients with PAD and individuals without PAD. Subgroup analysis by study design revealed significant results for both prospective studies (pooled RR 1.60; 95% CI, 1.12–2.28; I2, 0%) and retrospective studies (pooled RR 1.72; 95% CI, 1.07–2.77; I2, 92%). The funnel plot is relatively asymmetric suggesting publication bias. Conclusion: This study found a significant association between PAD and hip fracture with the pooled RR of 1.64 (95% CI, 1.17–2.29) on comparing patients with PAD and individuals without PAD. Major limitations include high between-study heterogeneity, possibility of publication bias, and lack of data on the characteristics and type of hip fracture which may limit the clinical significance of the observations

Associations of new-onset atrial fibrillation and severe visual impairment in type 2 diabetes: A multicenter nationwide study

BACKGROUND Many studies have demonstrated an association between type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF). However, the potential independent contributions of T2DM and AF to the prevalence of visual impairment have not been evaluated. AIM To determine whether such an association between T2DM and incident AF with visual impairment exists, and if so, the prevalence and magnitude of this association. METHODS We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study had evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013. T2DM patients were categorized into two groups: patients without and with incident AF. T2DM patients without AF were selected as the reference group. The association between incident AF and visual impairment among T2DM patients was assessed using multivariate logistic regression. RESULTS A total of 27281 T2DM patients with available eye examination data were included in this analysis. The mean age was 60.7 ± 10.5 years, and 31.2% were male. The incident AF was 0.2%. The prevalence of severe visual impairment in all T2DM patients, T2DM patients without AF, and T2DM patients with incident AF were 1.4%, 1.4%, and 6.3%, respectively. T2DM patients with incident AF were associated with an increased OR of 3.89 (95%CI: 1.17-13.38) for severe visual impairment compared with T2DM patients without AF. CONCLUSION T2DM patients with incident AF were independently associated with increased severe visual impairment. Therefore, early eye screening should be provided for these high-risk individuals. ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Epidemiology of Parvovirus B19 and Anemia Among Kidney Transplant Recipients

Purpose: Persistent anemia has been described in kidney transplant (KTX) recipients with Parvovirus B19 virus infection. However, epidemiology of Parvovirus B19 and Parvovirus B19-related anemia after KTx remains unclear. The study\u27s aims were 1) to investigate the frequency of Parvovirus B19 infection and 2) to assess the incidence of Parvovirus B19-related anemia in KTx recipients. Methods: Aliterature search for studies that reported the occurrence rate of Parvo-virus B19 infection and/or seroprevalence of Parvovirus B19 inKTx recipientswas conducted using Medline, Embase, and Cochrane Database from inception through October 2018. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. Results: 15 observational studies with a total of 1, 757 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of Parvovirus B19 IgG was 87. 4% (950/oCI: 64. 4°/\u3c, 96. 4%). The pooled estimated occurrence rate of positive Parvovirus B19 DNA in the first year after KTx was 9. 7% (95%CI: 4. 7°/\u3c, 18. 9%). Sensitivity analysis excluding a study (that solely included KTx patients with anemia) was performed, and showed the pooled estimated occurrence rate of positive Parvovirus B19DNAafterKTxof8. 6%(95%CI: 4. 0%-17. 6%). Meta-regression analysis demonstrated no significant correlations between the year of study and occurrence rate of positive Parvovirus B19 DNA (P = 0. 93). Among KTx recipients with positive Parvovirus B19 DNA, the pooled estimated incidence rates of anemia and severe anemiawere37. 6o/o(95o/oCL25. 8o/o-51. 1o/o)and22. 3o/o(7. 1o/\u3c, 51. 9o/o), respectively. Egger\u27s regression asymmetry test was perforated and showed no publication bias in all analyses. Conclusions: Parvovirus B19 infection occurs mostly within the first year post-transplant. The overall estimated occurrence of positive Parvovirus Bl 9 DNA after KTX is 9. 70/0. The estimated incidence of anemia among KTx recipients with positive Parvovirus B19 DNA is 21. 6%. Parvovirus B 19 should be ruled out in cases of persistent anemia after transplant. [Figure Presented]

Polyomavirus Genotypes in Renal Transplant Recipients in the United States

Purpose: BK Polyomavirus (BKV) subtypes and subgroups present uneven geo-graphical distribution, suggesting a potential relationship with ethnicity. In the United States where there is a definite racial and ethnic diversity, the epidemiology of BKV genotypes remains unclear. This meta-analysis was conducted with the aim to assess BKV genotypes among kidney transplant (KTX) recipients. Methods: A comprehensive literature review was conducted utilizing MEDLINE. Embase and Cochrane Database through October 2018 to identify all studies that reported BKV subtypes and/or subgroups in KTx recipients in the United States. Effect estimates from each individual study were extracted and combined using random-effect, generic inverse variance method of DerSimoman and Laird. Results: 8 observational studies with a total of 193 samples (urine, blood, and kidney tissues) from 188 BKV-mfected KTx recipients in the United States were enrolled. The study years ranged from 2001 to 2016. Overall, the pooled estimated percentages of BKV subtypes were 72. 2% (95%CI: 62. 7%-80. 0%) for subtype I, 6. 8%(95%CI: 2. 5%-16. 9%)forsubtypeII, 8. 3% (95%CI: 4. 4%-15. 1%)for subtype III, and 16. 1% (95%CI: 10. 4%-24. 2%) for subtype IV, respectively. While meta-regression analysis demonstrated a significant positive correlation between year of study and the percentage of BKV subtype I (slopes =+0. 1023, P =0. 01), there were no significant correlations between year of study and percentages of BKV subtype II-IV (P \u3e0. 05). Among KTx recipients with BKV subtype I, the pooled estimated percentages of BKV subgroups were 22. 4% (95%CI: 13. 7%-34. 5%) for subgroup la, 30. 6% (95%CI: 17. 7%-47. 5%)for subgroup Ibl, 47. 7% (95%CI: 35. 8%-59. 9%) for subgroup Ib2, and 4. 1% (95%CI: 1. 2%-13. 3%) for subgroup Ic, respectively. Conclusions: BKV subtype I is the most prevalent subtype among KTx recipients in the United States and its percentage seems to increase overtime. Subgroup Ib2 is the most common among BKV subtype I. Further analysis is needed to assess the effect of BKV genotype on the clinical course of BK viremia in KTx