Continuous Kidney replacement Therapy Dosage and Mortality in Critically Ill Patients: a Retrospective Cohort Study using Marginal Structural Model.

Background: Continuous kidney replacement therapy (CKRT) is a crucial intervention for hemodynamically unstable patients with acute kidney injury (AKI). Despite the recommendations to offer a CKRT dose of 20-25 mL/kg/h, the optimal CKRT dose remains uncertain, especially whether low-dose CKRT is associated with poor outcomes. This study investigated the association between low CKRT dosage and 90-day mortality using a marginal structural model (MSM).

Endothelium-related biomarkers and cognitive decline in prevalent hemodialysis patients: A prospective cohort study.

Introduction: Cognitive decline is prevalent in maintenance hemodialysis patients. The blood-brain barrier has been implicated in cognitive decline. In this prospective cohort study, we investigated the associations between endothelium-related biomarkers and steeper cognitive decline in this population.

Redefining urine output thresholds for acute kidney injury criteria in critically Ill patients: a derivation and validation study.

Introduction: The current definition of acute kidney injury (AKI) includes increased serum creatinine (sCr) concentration and decreased urinary output (UO). Recent studies suggest that the standard UO threshold of 0.5 ml/kg/h may be suboptimal.

Urine Output and Acute Kidney Injury in Neonates/Younger Children: A Prospective Study of Cardiac Surgery Patients with Indwelling Urinary Catheters.

Key Points: Using indwelling urinary catheters, urine output (UO) shows good performance in neonates and younger children. Using higher UO thresholds in neonates post-cardiac surgery improves discriminatory capacity for outcomes compared to neonatal Kidney Disease Improving Global Outcomes. In younger children (1–24 months), higher UO thresholds were not better than the adult Kidney Disease Improving Global Outcomes criteria.

Comorbidities, acute kidney injury and long-term mortality in elderly patients hospitalized because of hip fracture: a moderation analysis.

Introduction: Femoral fractures in elderly individuals present significant health challenges, often leading to increased morbidity and mortality. Acute kidney injury (AKI) during hospitalization further complicates outcomes, yet the interaction between AKI severity and comorbidities, as quantified by the Charlson Comorbidity Index (CCI), remains poorly understood in this population. This study aimed to assess the associations between AKI severity and the CCI and between AKI severity and one-year mortality postfemoral fracture in elderly patients.

Endothelium-related biomarkers enhanced prediction of kidney support therapy in critically ill patients with non-oliguric acute kidney injury.

Acute kidney injury (AKI) is a common condition in hospitalized patients who often requires kidney support therapy (KST). However, predicting the need for KST in critically ill patients remains challenging. This study aimed to analyze endothelium-related biomarkers as predictors of KST need in critically ill patients with stage 2 AKI.

Syndecan-1 predicts hemodynamic instability in critically ill patients under intermittent hemodialysis.

Introduction: Up to 70% of intermittent hemodialysis (IHD) sessions in critically ill patients are complicated by hemodynamic instability. Although several clinical characteristics have been associated with hemodynamic instability during IHD, the discriminatory capacity of predicting such events during IHD sessions is less defined. In the present study, we aimed to analyse endothelium-related biomarkers collected before IHD sessions and their capacity to predict hemodynamic instability related to IHD in critically ill patients.

Needs, Roles, and Challenges of Young Latin American and Caribbean Neurosurgeons.

Background: Barriers to neurosurgery training and practice in Latin American and Caribbean countries (LACs) have been scarcely documented. The World Federation of Neurosurgical Societies Young Neurosurgeons Forum survey sought to identify young neurosurgeons' needs, roles, and challenges. We present the results focused on Latin America and the Caribbean.

Endothelial biomarkers as predictors for haemodialysis need in severe leptospirosis patients (Weil's disease).

Objective: To investigate the prediction ability of vascular injury biomarkers for haemodialysis requirement in patients with severe leptospirosis.

Methods: Prospective study with severe leptospirosis patients hospitalised in Fortaleza, Brazil. Blood samples were collected hospital admission to quantify vascular injury biomarkers: syndecan-1, ICAM-1, VCAM-1, angiopoietin-2 and FGF-23.

Association between angiopoietin-2 and functional cardiac remodeling in hemodialysis patients with normal left ventricular ejection.

Cardiac remodeling is the initial process in heart failure development. The aim of this study is to evaluate the association between endothelium-related biomarkers and cardiac remodeling in hemodialysis (HD) patients and how the presence of high blood pressure and diabetes mellitus modulates these associations. This was a cross-sectional study with adult HD and normal left ventricular (LV) ejection fraction-LVEF-patients.

Fiber-reinforced fixed dental prosthesis to replace missing anterior teeth: case reports.

The direct fiber-reinforced fixed dental prosthesis (FRFDP) is a minimally invasive approach to replacing missing anterior teeth, offering good survival rates and sound mechanical properties. This report describes the placement and 12-month follow-up results of FRFDPs used to replace missing anterior teeth in 2 patients. In the first case, the extraction of the maxillary right central incisor was related to trauma.

Correlation between functional capacity and oxidative stress and inflammation in hemodialysis patients.

Introduction: Patients with chronic kidney disease (CKD) may present impaired functional capacity due to peripheral muscle involvement. Oxidative stress and inflammation are probably involved in this pathophysiology. This study aimed to evaluate the association between functional capacity and biomarkers of oxidative stress as well as biomarkers of inflammation in patients under chronic hemodialysis therapy.

Biomarkers of acute kidney injury in pediatric cardiac surgery.

Acute kidney injury (AKI) is characterized by a sudden decrease in kidney function. Children with congenital heart disease are a special group at risk of developing AKI. We performed a systematic review of the literature to search for studies reporting the usefulness of novel urine, serum, and plasma biomarkers in the diagnosis and progression of AKI and their association with clinical outcomes in children undergoing pediatric cardiac surgery.

Intraoperative systemic biomarkers predict post-liver transplantation acute kidney injury.

Objective: Liver transplant (LT) is a definitive therapeutic option for patients with chronic liver disease. However, acute kidney injury after LT (post-LT AKI) is a frequent complication that may lead to graft dysfunction and decrease life expectancy. Delay in AKI detection by traditional biomarkers boosted research with new biomarkers for post-LT AKI as neutrophil gelatinase-associated lipocalin (NGAL) and syndecan-1.

Cognitive impairment, endothelial biomarkers and mortality in maintenance haemodialysis patients: a prospective cohort study.

Background: Haemodialysis (HD) patients have a high prevalence of cardiovascular disease risk factors as well as cognitive impairment. The objective of the present study was to evaluate the interrelationship between cognitive impairment, endothelium-related biomarkers and cardiovascular/non-cardiovascular mortality.

Methods: A total of 216 outpatients were recruited from three centres in a dialysis network in Brazil between June 2016 and June 2019.

Signs, meanings and practices of people living with human t-cell lymphotropic virus type 1 or tropical spastic myelopathy.

Background: Human T-cell lymphotropic virus type 1 (HTLV-1) spreads silently in the world's population and causes several syndromes. Among these, HTLV-1 associated myelopathy, also called tropical spastic paraparesis (HAM/TSP), affects the nervous system. It causes sensorimotor losses, spasticity, muscle weakness, voiding and sexual dysfunction, pain, and balance disorders.

Respiratory parameters and acute kidney injury in acute respiratory distress syndrome: a causal inference study.

Background: Assess the respiratory-related parameters associated with subsequent severe acute kidney injury in mechanically ventilated patients with acute respiratory distress syndrome (ARDS).

Methods: Retrospective cohort, analyzing a large public database-Multiparameter Intelligent Monitoring in Intensive Care-III. Adult patients with at least 48 h of mechanical ventilation (MV), under volume controlled ventilation and an oxygenation index less than 300 mmHg were included.

Attributable nephrotoxicity of vancomycin in critically ill patients: a marginal structural model study.

Background: Although vancomycin nephrotoxicity is recognizable, critically ill patients have other potential reasons for acute kidney injury (AKI) and determining its attributable nephrotoxic risk in this population can be cumbersome.

Objectives: To determine the risk of AKI attributable to vancomycin, controlling for baseline and time-dependent confounders.

Methods: Time-fixed and daily time-varying variables were extracted from a large public database.

Impact of loop diuretics on critically ill patients with a positive fluid balance.

The impact of the use of loop diuretics to prevent cumulative fluid balance in non-oliguric patients is uncertain. This is a retrospective study to estimate the association of time-averaging loop diuretic exposure in a large population of non-cardiac, critically ill patients with a positive fluid balance (> 5% of body weight). The exposure was loop diuretic and the main outcomes were 28-day mortality, severe acute kidney injury and successful mechanical ventilation weaning.