The objective of the work was to study admission parameters associated with an increased incidence of hypoglycemia during hospitalization of non-critically ill patients. Included in this cross-sectional study were patients admitted to internal medicine units. The Nutritional Risk Screening 2002 (NRS2002) was used for nutritional screening. Data recorded included admission serum albumin (ASA) and all glucose measurements obtained by the institutional blood glucose monitoring system. Neither of these are included in the NRS2002 metrics. Hypoalbuminemia was defined as ASA<3.5 g/dl. Patients were categorized as hypoglycemic if they had at least one documented glucose≤70 mg/dl during the hospitalization period. Included were 1342 patients [median age 75 years (IQR 61–84), 51.3% male, 52.5% with diabetes mellitus, (DM)], who were screened during three distinct periods of time from 2011–2018. The incidence of hypoglycemia was 10.8% with higher rates among DM patients (14.6 vs. 6.6%, p<0.001). Hypoglycemia incidence was negatively associated with ASA regardless of DM status. Multivariable regression showed that ASA (OR 0.550 per g/dl, 95% CI 0.387–0.781, p=0.001) and positive NRS2002 (OR 1.625, 95% CI 1.072–2.465, p=0.022) were significantly associated with hypoglycemia. The addition of hypoalbuminemia status to the NRS2002 tool improved the overall sensitivity from 0.55 to 0.71, but reduced specificity from 0.63 to 0.46. The negative predictive value was 0.93. Our data suggest that the combination of positive malnutrition screen and hypoalbuminemia upon admission are independently associated with the incidence of hypoglycemia among non-critically ill patients, regardless of diabetes mellitus status.

Background: Solar urticaria is a rare and disabling photodermatosis. Due to its low prevalence, most available data regarding treatment are derived from observational studies and case series, and a systematic evaluation of treatment efficacy is lacking. This systematic review and meta-analysis aims to assess therapeutic outcomes across treatment modalities in order to guide clinical care. Methods: We conducted a systematic literature search across PubMed, ScienceDirect, the Cochrane Library, and ClinicalTrials.gov. Studies reporting treatment outcomes in patients with solar urticaria were included. Pooled response rates were calculated for each treatment modality. Results: Out of 508 studies initially identified, 38 met the inclusion criteria. Antihistamines were evaluated in 21 studies (376 patients), with a pooled response rate (partial or complete) of 83.0% (95% CI, 70.4–91.1%) and a complete response rate of 7.7% (95% CI, 1.7–28.3%). Phototherapy was assessed in 11 studies (145 patients), showing a similar overall response (89.8%; 95% CI, 77.9–95.3%) but a higher complete response rate (39.8%; 95% CI, 18.3–66.1%). Omalizumab, evaluated in nine studies (76 patients), demonstrated the highest efficacy, with 93.2% (95% CI, 73.8–98.5%) achieving response and 68.4% (95% CI, 48.5–83.2%) complete remission. Limited data on IVIG, cyclosporine, and plasmapheresis suggested partial efficacy in selected refractory cases. Conclusions: This meta-analysis may support clinical decision-making by clinicians. A stepwise approach is suggested: high-dose H₁ antihistamines as first-line therapy, phototherapy as an alternative option in patients with access to treatment centers, and omalizumab for those with insufficient response. In refractory cases, additional options might be considered.