Serum thymic stromal lymphopoietin (TSLP) levels in atopic dermatitis patients: a systematic review and meta-analysis.

Thymic stromal lymphopoietin (TSLP) is critical in developing allergic responses, including atopic dermatitis (AD). We systematically reviewed the literature to complete a meta-analysis to quantitatively summarize the levels of serum TSLP in AD. The study was prospectively registered in the PROSPERO database (ID = CRD42021242628). The PUBMED, SCOPUS, and Cochrane Library databases were reviewed, and original articles investigating serum TSLP in AD patients were included. Differences in TSLP levels of AD patients and controls were summarized by standardized mean differences (SMD) using a random effects model. Study quality was assessed by applying the Newcastle‒Ottawa Scale. Fourteen studies, which included 1,032 AD patients and 416 controls, were included. Meta-analysis showed that TSLP levels were significantly higher in the AD group than in the control group (SMD = 2.21, 95% CI 1.37-3.06, p < 0.001). Stratification by geographical region, age, disease severity, TSLP determination method, sample size, and study quality revealed significantly elevated TSLP levels in European AD patients (SMD = 3.48, 95% CI 1.75-5.21, p < 0.0001), adult AD patients (SMD = 4.10, 95% CI 2.00-6.21, p < 0.0001), child AD patients (SMD = 0.83, 95% CI 0.08-1.59, p = 0.031), and all severity groups with AD compared with the control group (mild: SMD = 1.15, 95% CI 0.14-2.16, p = 0.025; moderate: SMD = 2.48, 95% CI 0.33-4.62, p = 0.024; and severe: SMD = 8.28, 95% CI 4.82-11.74, p = 2.72e-6). Noticeably, adults showed higher serum TSLP levels than children with AD, and serum TSL levels increased according to AD severity. In conclusion, our meta-analysis demonstrates that circulating TSLP levels are elevated in patients with AD. Future studies are warranted to further elucidate the sources of heterogeneity.

Risk Factors for Community-Acquired Acute Kidney Injury in Medical Patients: A Nested Case-Control Study.

INTRODUCTION: Research about the risk factors associated with community-acquired acute kidney injury (CA-AKI) in acute medical diseases is scarce. Data extrapolation from surgical to medical illnesses is questionable. OBJECTIVES: To evaluate potential risk factors and hospital outcomes associated with a CA-AKI in medical illnesses. METHODS: We performed an unmatched nested case-control study from a previous prospective cohort study. We included adult patients with acute illnesses treated with internal medicine. Cases were defined as patients with a CA-AKI diagnosis upon hospital admission, and controls included patients from the same cohort who did not develop AKI during the first 5 days of hospitalisation. A logistic regression model was used to assess the association between potential risk factors and -CA-AKI. RESULTS: A total of 868 patients were included in the study (223 cases and 645 controls). The median age was 65 years (interquartile range 50-78). In a logistic regression model, the risk factors associated with CA-AKI included chronic kidney disease (CKD; OR 6.27; 95% CI 2.95-13.3, p < 0.001), ≥65 years old (OR 1.72; 95% CI 1.16-2.57, p = 0.007), acute bacterial infection (OR 1.95; 95% CI 1.36-2.80, p < 0.001), hypovolaemia (OR 1.88; 95% CI 1.32-2.69, p < 0.001), pre-hospital nephrotoxic drugs (OR 1.77; 95% CI 1.23-2.55, p = 0.002), anaemia (OR 1.49; 95% CI 1.03-2.14, p = 0.031) and systolic blood pressure (SBP) <107 mm Hg (OR 2.25; 95% CI 1.38-3.67, p = 0.001). A significant interaction between CKD and age was found (p = 0.017) and included in the model (patients with CKD and ≥65 years old [OR 10.85; 95% CI 4.14-28.41, p < 0.001]). The area under the receiver operating characteristic curve of the final model was 0.743. CONCLUSIONS: CKD is strongly associated with CA-AKI upon hospital admission in medical illnesses patients. Older age enhances the risk of CA-AKI in patients with CKD. Other risk factors include pre-hospital nephrotoxic drugs, acute bacterial infection, anaemia, low SBP and hypovolaemia.

Testicular granulomatous vasculitis mimicking testicular torsion in an anti-neutrophil cytoplasmic antibody-associated vasculitis patient.

Testicular vasculitis is uncommon and can be easily misdiagnosed. Early identification and treatment are essential for patient care. A 63-year-old man, presenting with testicular pain and swelling, had been treated with antibiotics for weeks. A month later, he developed severe left testicular pain and systemic symptoms. Scrotal ultrasound was suggestive of testicular torsion due to no blood flow. Pathology of the orchiectomy specimen demonstrated testicular granulomatous vasculitis involving small- to medium-sized arteries. Additional work-up of blood tests contained positive antinuclear, anti-proteinase 3 and anti-myeloperoxidase antibodies. Erythrocyte sedimentation rate and C-reactive protein were also elevated. Diagnosis of anti-neutrophil cytoplasmic antibody-associated vasculitis was made and prednisone was started. During more than 1-year follow-up, the patient's systemic symptoms were resolving gradually with no involvement of the other testis.

Trabajos originales en Colombia de lesión renal aguda: ¿Qué hay disponible a nivel nacional? / Original works on acute kidney injury: what is currently available in Colombia?

Introducción: la lesión renal aguda (LRA) es una entidad sindromática con múltiples etiologías cuyas estrategias de prevención y tratamiento se deben basar en los datos epidemiológicos locales. En América Latina los trabajos originales son escasos y no hay certeza del estado de la investigación sobre LRA en Colombia. Objetivo: conocer la literatura colombiana disponible sobre LRA. Metodología: se realizó la búsqueda en Embase, Medline-Cochrane Library y Lilacs por medio electrónico y físico en los índices de las revistas más representativas a nivel nacional desde 1970. Se excluyeron las relacionadas con enfermedad renal crónica, trasplante renal y enfermedad glomerular primaria. Resultados: Se identificaron 46 trabajos de investigación colombiana en LRA de los cuales 16 (34,7%) son originales, 11 (23,9%) reportes y series de casos, 10 (21,7%) revisiones de tema, 7 (15,2%) póster de congreso y 2 (4,3%) guías y consensos. De los trabajos originales, 11 (68,7%) pertenecen a pacientes en unidades de cuidado intensivo (UCI). La revista nacional con más publicaciones en el tema es Acta Colombiana de Cuidado Crítico. Conclusiones: la literatura colombiana en LRA es heterogénea, la mayoría de los trabajos originales se enfocan en el paciente crítico hospitalizado en UCI. Son escasas las publicaciones sobre epidemiología de la enfermedad y no existen datos unificados a nivel nacional.

Introduction: acute kidney injury (AKI) is a clinical syndrome encompassing various etiologies. Strategies for prevention and management of affected patients should be based on local epidemiologic data. Original works on this topic in Latin America are scarce and current status of research on AKI in Colombia is unknown. Objective: to determine the available AKI literature in Colombia. Methodology: a review of the literature from Embase, Medline-Cochrane Library and Lilacs online databases and the most representative printed local journal articles on the topic from 1970 to date. Articles related to chronic kidney disease, kidney transplantation and primary glomerular disease were excluded. Results: we identified 46 Colombian research articles on AKI of which 16 (34.7%) were original works, 11 (23.9%) were reports and case series, 10 (.21.7%) were topic reviews, 7 (15.2%) were poster presentations and 2 (4.3%) were guides and consensus protocols. Of the original works, 11 (68.7%) were on intensive care unit (ICU) patients. The highest number of articles published in Colombia on AKI was found in the Colombian Journal of Critical Care. Conclusions: Colombian AKI literature is heterogeneous and most of the original works focus on critically ill patients hospitalized at the ICU. There are few publications on the epidemiology of AKI and there is no unified data at the national level

The role of a multimodality imaging approach in diagnosis and stratification of aborted sudden cardiac death.

A 34-year-old man was admitted after an episode of aborted sudden cardiac death. The initial investigation including electrocardiogram, chest x-ray, transthoracic echocardiogram, and biomarkers were normal. Although coronary angiography showed nonsevere stenosis, optical coherence tomography revealed severe obstruction in the artery with a layered appearance of the vessel wall; it was consistent with the presence of mural thrombus.