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Objective Objective: We aim to estimate the risk of perpetrating aggression in Alzheimer disease (AD) and mild cognitive impairment (MCI) by conducting a systematic review and meta-analysis of primary studies. Methods: A systematic search was conducted in six bibliographic databases according to a preregistered protocol. Studies that reported aggressive behaviors in individuals with AD and MCI compared with healthy individuals or those with other dementia etiologies were identified. Risks of aggressive behaviors were assessed using random effects models to calculate pooled odds ratios (ORs). Publication bias was examined. Results: In total, 17 studies involving 6,399 individuals with AD and 2,582 with MCI were identified. Compared with healthy individuals, significantly increased risks of aggressive behaviors were found in AD (OR, 4.9, 95% CI, 1.8−13.2) but not in MCI (OR, 1.8, 95% CI, 0.7−4.3). When comparing AD with MCI, the risk in AD was higher (OR, 2.6, 95% CI, 1.7−4.0). We found no differences in risk of aggressive behaviors between AD and other dementia subtypes or between amnestic and nonamnestic MCI. Conclusion: Individuals with AD are at higher risk of manifesting aggressive behaviors than healthy individuals or those with MCI. Our findings not only underscore the necessity of treatment of aggressive behaviors in AD but also highlight the importance of preventing the transition from MCI to AD.

Purpose: The objective of this study was to determine the potential efficacy and safety of dual energy pulsed electromagnetic field therapy (PEMF) on painful distal symmetric diabetic sensorimotor polyneuropathy (DSPN). Methodology: Subjects with Type 2 diabetes and painful DSPN were randomized to receive either an active or sham PEMF device. Objective measures of efficacy (skin biopsy, nerve conduction velocity (NCV) studies, dorsal and plantar foot skin perfusion pressure (SPP) were performed prior to and following 60-days of twice daily 30 minute treatments. Patient reported outcomes included perception of pain, concomitant medication use and adverse events. Major findings: Dorsal foot SPP improved with PEMF (n=11), change from baseline=19.6 mmHg) vs. sham (n=7, change=-17.4 mmHg), p=0.03. Trends in favor of PEMF vs sham were observed for medial nerve (n=4), planter nerve (n=4) and sural nerve (n=15) onset time and amplitude (p>0.05) other than medial planter onset time (p=0.04). Although change in pain scores were similar, compliance with device use was higher in the active group compared to the sham control. The series of tests and long-term use of PEMF was well-tolerated and feasible. No device related adverse effects were recorded. Principal conclusions: Twice daily PEMF therapy was feasible, well-tolerated, and associated with trends suggesting improved nerve function and microcirculation in patients with painful DSPN. Future, large randomized controlled trials are necessary to confirm these findings and evaluate the potential longer term benefits on symptoms and pathology of DSPN.

Numerous types of limited intercarpal arthrodeses have been reported in dozens of articles in the English-language medical literature. The nonunion rate varies considerably within and between the different types of arthrodeses. This may be due in part to the small number of cases in most studies. The data on the number of good results and nonunion rates for 27 different types of limited carpal arthrodeses reported in the English-language medical literature from 1946 to 1993 were collected, and for each study, the 95% confidence intervals (95% CI) were calculated. The studies were then combined for specific types of arthrodeses and the overall nonunion rates and confidence intervals were calculated to more accurately determine the actual nonunion rate expected for limited intercarpal arthrodeses. Nonunion rates (95% CI) for the most popular types of limited arthrodeses were as follows: of 385 scaphotrapezium-trapezoid arthrodeses reported, there was a 14% nonunion rate (95% CI, 11%-18%); of 104 lunotriquetral arthrodeses, the nonunion rate was 27% (95% CI, 19%-36%); and of 17 scapholunate arthrodeses, the nonunion rate was 47% (95% CI, 26%-69%).