The global, prevalence, and risk factors of postoperative fever after percutaneous nephrolithotomy: A systematic review and meta-analysis

Objective

This study aimed to explore the global, prevalence, and risk factors of fever after percutaneous nephrolithotomy (PCNL) by conducting a systematic review and meta-analysis.

Methods

The high-sensitivity searching was conducted without time limitation until December 30, 2020 in Web of Sciences, Scopus, and PubMed based on inclusion and exclusion criteria.

Results

The prevalence rates of fever and sepsis among patient undergoing PCNL were estimated 9.5% (95% confidence interval [CI]: 9.3%-9.7%), and 4.5% (95% CI: 4.2%-4.8%), respectively. Nephrostomy tube was used in 9.96% (95% CI: 9.94%-9.97%) of patients. The mean preoperative white blood cells of patients were 6.401×109/L; 18.3% and 4.55% of patients were considered as the positive urinary culture and pyuria, respectively. About 20.4% of patients suffered from residual stones. The odds ratios (ORs) of fever in patients who suffering from diabetes mellitus, hydronephrosis, staghorn stones, and blood transfusion were 4.62 (95% CI: 2.95-7.26), 1.04 (95% CI: 0.81-1.34), 2.57 (95% CI: 0.93-7.11), and 2.65 (95% CI: 1.62-4.35), respectively. Patients who underwent PCNL in prone position were more likely to develop fever (OR: 1.23; 95% CI: 0.75-2.00) than patients in supine position.

Conclusion

The current study showed that patients who suffer from diabetes mellitus, hydronephrosis, staghorn stones, nephrostomy tube or double-J stent, blood transfusion, and also patients who underwent PCNL in prone position surgery are more likely to develop a postoperative fever after PCNL.

The Effects of Statins on Respiratory Symptoms and Pulmonary Fibrosis in COVID-19 Patients with Diabetes Mellitus: A Longitudinal Multicenter Study

The aim of this prospective cohort study was to explore the effect of statins on long-term respiratory symptoms and pulmonary fibrosis in coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM). Patients were recruited from three tertiary hospitals, categorized into Statin or Non-statin groups, and assessed on days 0, 28, and 90 after symptoms onset to record the duration of symptoms. Pulmonary fibrosis was scored at baseline and follow-up time points by high-resolution computed tomography scans. Each group comprised 176 patients after propensity score matching. Data analysis revealed that the odds of having cough and dyspnea were significantly higher in the Non-statin group compared to the Statin group during the follow-up period. Overall, there was no significant difference in the change in pulmonary fibrosis score between groups. However, Non-statin patients with > 5 years of DM were more likely to exhibit a significantly higher fibrosis score during the follow-up period as compared to their peers in the Statin group. Our results suggest that the use of statins is associated with a lower risk of developing chronic cough and dyspnea in diabetic patients with COVID-19, and may reduce pulmonary fibrosis associated with COVID-19 in patients with long-term (> 5 years) DM.

Epigenetic regulation of autophagy in coronavirus disease 2019 (COVID-19)

The coronavirus disease 2019 (COVID-19) pandemic has become the most serious global public health issue in the past two years, requiring effective therapeutic strategies. This viral infection is a contagious disease caused by new coronaviruses (nCoVs), also called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Autophagy, as a highly conserved catabolic recycling process, plays a significant role in the growth and replication of coronaviruses (CoVs). Therefore, there is great interest in understanding the mechanisms that underlie autophagy modulation. The modulation of autophagy is a very complex and multifactorial process, which includes different epigenetic alterations, such as histone modifications and DNA methylation. These mechanisms are also known to be involved in SARS-CoV-2 replication. Thus, molecular understanding of the epigenetic pathways linked with autophagy and COVID-19, could provide novel therapeutic targets for COVID-19 eradication. In this context, the current review highlights the role of epigenetic regulation of autophagy in controlling COVID-19, focusing on the potential therapeutic implications.