Associations of Colonoscopy and Risk of Hypoglycemia in Patients with Type 2 Diabetes.

Purpose: Inpatients undergoing colonoscopy may be at increased risk of hypoglycemia. However, few high-quality studies have examined the relationship between hypoglycemia and colonoscopy in patients with type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 1016 patients from a large tertiary hospital were enrolled in this retrospective study. We collected demographic information, laboratory indices, colonoscopy information and hypoglycemia information from the enrolled patients during hospitalization. Logistic regression analysis was adopted to estimate the adjusted odds ratios to determine the association between hypoglycemia and colonoscopy. Results: Hypoglycemia occurred in 80 of 788 (10.1%) patients without colonoscopy exposure and 37 of 228 (16.2%) patients with colonoscopy exposure. 25 patients (67.6%) had hypoglycemic events from 3 hours to 68 hours after the end of colonoscopy. Adjusting for demographic and clinical covariates, the risk of hypoglycemia was 1.99 times higher in those who underwent colonoscopy than in those who did not (OR 1.99, 95% CI 1.25-3.19). The association was consistent in subgroups of females, the elderly, the overweight patients, patients with long duration of disease or patients with suboptimal glycemic control. Conclusion: A strong association between colonoscopy and an increased risk of hypoglycemia is observed in patients with T2DM. When performing a colonoscopy for diabetics, the risk of hypoglycemia should be considered even within 68 hours after colonoscopy.

Gender Differences in Prevalence and Clinical Correlates of Lipohypertrophy in Insulin-Exposed Patients with Diabetes Mellitus.

Purpose: The purpose of this systematic review was to assess potential gender differences in prevalence and clinical relevance of insulin-related lipohypertrophy (LH). Patients and Methods: Five electronic databases (PubMed, Embase, CNKI, Wanfang and VIP) were systematically searched for studies, from inception to 1st Sep 2022, on the prevalence of insulin-related LH. The eligibility of articles was independently screened, and the included studies were evaluated using standardized quality assessment tools. Results: A total of 22 studies mentioned the LH prevalence in different genders, of which two are about gestational diabetes; therefore, 20 studies were eventually included, providing data on 6238 patients. The prevalence of LH varied from 30.26% to 72.54%. Ten studies (4392 patients) were conducted with the adult diabetes patients of different genders over the age of 18, the total prevalence rate of LH was 51.73%, the LH prevalence in male gender was from 41.94% to 68.57% and the rate of the total population was 54.89% (2046 patients); The LH prevalence in female gender was from 33.18% to 70% and the rate of the total population was 48.98% (2346 patients), and the prevalence of LH was significantly different between male and female gender (P<0.001). Interestingly, only one study (n=1227) showed that there were dramatic differences between different genders (P<0.001), the subjects were T2DM patients, the LH prevalence rate of male vs female was 70.52% (299/424) VS 52.18% (419/803), while the other studies either only include T1DM or both T1DM and T2DM. Conclusion: The evidence shows that the results of gender differences in the LH prevalence are inconsistent with different types of DM. Probably, there is no gender differences in the LH prevalence in adult patients with T1DM, but it has a gender difference between male and female in T2DM. More strictly designed clinical studies are needed to further verify and reveal the underlying mechanisms.

Association of Mycoplasma fermentans and the risk of HIV-1 infection: A meta-analysis.

BACKGROUND: Previous studies have reported the association between Mycoplasma fermentans (M. fermentans) and the risk of human immunodeficiency virus 1 (HIV-1) infection, but the results were inconsistent. The present study aims to systematically review reported studies on M. fermentans and its association with HIV-1 infection, as well as to summarize the findings using a meta-analysis. METHODS: Studies meeting the inclusion criteria in the PubMed, Embase, China National Knowledge Infrastructure, WanFang Data, and Chongqing VIP databases up to March 2019 were identified. Cochran Q and I statistics were used to assess heterogeneity. Additionally, pooled odds ratio (OR) with 95% confidence intervals (CI) were calculated and displayed by Forest plots. Also, the funnel plot, Begg test, and Egger test were used to evaluate potential publication bias. In addition, the source of heterogeneity was investigated by subgroup and sensitivity analyses. RESULTS: A total of 11 studies comprising 1028 HIV-1-positive patients and 1298 controls were ultimately included in this meta-analysis. Our results indicated that M. fermentans could increase the risk of HIV-1 infection among humans (OR = 3.66, 95%CI 1.26-10.64). Subgroup analysis showed that the risk of HIV-1 infection associated with M. fermentans was, based on the geographical distribution, 1.19 (95%CI 0.33-4.33) in Europe, 2.83 (95%CI 0.94-8.52) in United States, 11.92 (95%CI 3.93-36.15) in Asia; based on the source of the sample, 2.97 (95%CI 0.89-9.95) in blood samples, 4.36 (95%CI 1.63-11.68) in urine samples; based on the detection method, 2.80 (95%CI 0.72-10.96) with the polymerase chain reaction method, 5.54 (95%CI 1.21-25.28) with other detection methods; based on the source of controls, 1.91 (95%CI 0.53-6.89) in sexually transmitted diseases individuals, and 8.25 (95%CI 2.16-31.60) in health individuals. CONCLUSION: Our study revealed evidence of the association between M. fermentans and HIV-1 infection. Considering the heterogeneity, further studies are warranted to understand the relationship between M. fermentans and HIV-1 infection.

[Comparison of two schemes of daily arousal and comfort analgesia and sedation in patients on mechanical ventilation in intensive care unit].

OBJECTIVE: To explore the efficacy of comfort analgesia and sedation in patients with mechanical ventilation in intensive care unit (ICU). METHODS: Eighty patients with mechanical ventilation admitted to ICU of Pingxiang People's Hospital from June 2017 to May 2018 were enrolled, and they were randomly divided into control group and observation group by random number table method, with 40 patients in each group. The control group was given a daily analgesic and sedation regimen with critical-care pain observation tool (CPOT) 0-3 and Richmond agitation-sedation scale (RASS) maintained at -3 to -4. The observation group was given comfort analgesic sedative scheme with immediate analgesia and sedation score, CPOT 0-1 and RASS -1-0. Under these circumstances, patients could be waken up at any time, feel comfortable and cooperate with treatment. The duration of mechanical ventilation, the length of ICU stay, ventilator associated pneumonia (VAP) rate, delirium rate and sedatives drugs usage were compared between the two groups. RESULTS: There were no significant differences in baseline data such as gender [male (cases): 25 vs. 28], age (years old: 55.2±8.3 vs. 56.1±7.9), acute physiology and chronic health evaluation II (APACHE II: 19.4±3.0 vs. 19.8±3.2) and etiology [sepsis (cases): 13 vs. 16, chronic obstructive pulmonary disease (cases): 12 vs. 10, acute lung injury (cases): 8 vs. 9, hemorrhagic shock (cases): 5 vs. 4, cardiogenic shock (cases): 2 vs. 1] between the observation group and the control group (all P > 0.05). Compared with control group, the duration of mechanical ventilation and the length of ICU stay were significantly decreased in observation group (days: 5.6±1.9 vs. 7.8±2.7, 6.6±2.1 vs. 9.8±2.5, both P < 0.01), the VAP rate and delirium rate were significantly decreased (17.5% vs. 40.0%, 25.0% vs. 47.5%, both P < 0.05), the average dose and total dose of sedative drugs were significantly reduced [propofol average dose (mg): 200.3±94.2 vs. 455.7±143.1, propofol total dose (mg): 1 266.4±419.7 vs. 2 682.6±734.1; dexmedetomidine average dose (g): 726.6±241.1 vs. 1 312.7±841.6, dexmedetomidine total dose (g): 5 647.3±2 215.2 vs. 9 864.5±4 268.0; all P < 0.01]. CONCLUSIONS: The therapy of comfort analgesia and sedatives on ICU patients with mechanical ventilation, can decrease the treatment time, lower the risk of adverse events, and reduce the dosage of sedatives drugs.