Background: Intradialytic hypotension (IDH) is a common and serious complication in renal replacement therapy, especially in hospitalized patients. The absence of a standardized definition complicates data synthesis and the development of evidence-based guidelines. Current definitions vary, including different blood pressure thresholds, clinical symptoms, and the need for medical intervention during dialysis. IDH is linked to increased mortality and cardiovascular morbidity and may impede renal recovery in patients with acute kidney injury and chronic kidney disease. Methods: A systematic review was conducted using MEDLINE via PubMed, Embase, and Web of Science to identify studies reporting IDH prevalence. A meta-analysis of proportions was performed to determine the global prevalence of IDH, with subgroup analyses to explore heterogeneity. The Joanna Briggs Institute's checklist was used to assess the risk of bias in prevalence studies. The PRISMA guidelines were followed to report the results of this study, PROSPERO registration number CRD42024500622. Results: The meta-analysis found a global IDH prevalence of 31% (95% CI 0.18–0.44) across nine studies. Significant heterogeneity was observed (I²: 97.87%; p < 0.01), with prevalence rates ranging from 10.7% to 64% based on patient demographics and session characteristics. Sensitivity analysis suggested prevalence could range between 27% and 33% depending on study criteria. Conclusions: IDH is a significant complication during hospital-based renal replacement therapy, with a global prevalence of 31%. These findings highlight the need for a standardized, evidence-based definition of IDH to improve diagnostic consistency and clinical outcomes through more accurate diagnosis, better treatment strategies, and tailored patient management.

Background: The state of prior immunosuppression in cancer enhances harmful effects (eg, sepsis). Despite advances in cancer treatment and sepsis management, the number of critically ill patients with cancer is increasing. Although the overall survival of patients with cancer experiencing septic shock has improved, the mortality observed in studies remains high. Purpose: To determine the rate mortality from septic shock in patients with cancer by analyzing variations. Design: Systematic review and meta-analysis. Data Sources and Methods: A systematic search was performed in Medline, EMBASE, SCOPUS, Web of Science, and BIREME-BVS. Articles assessing mortality in patients with cancer experiencing septic shock (aged >18 years) were included. Review articles, letters to the editor, case reports, and conference proceedings were excluded. Methodological quality was assessed with the MInCir-Prognosis Scale and the Joanna Briggs Institute checklist to assess the risk of bias in prevalence studies. Results: Overall mortality rate from septic shock was 58% (95% confidence interval [95%CI]: 54-63). Mortality rate during 2000–2010 and 2010–2024 was 61% (95%CI: 53-68) and 58% (95%CI: 52-63), respectively. Mortality rate by continent was 50% (95%CI: 24-76) in Africa, 61% (95%CI: 53-69) in Asia, 53% (95%CI: 48-59) in Europe, 64% (95%CI: 48-78) in North America, and 61% (95%CI: 37-82) in South America. Mortality rate in the intensive care unit was 53% (95%CI: 50-57). In-hospital mortality rate was 59% (95%CI: 49-68), and 50% (95%CI: 43-57), 61% (95%CI: 40-81), 69% (95%CI: 58-80) at 28–30, 90 and 180 days, respectively. Conclusions: Despite advances in oncology and hematology, mortality among patients with cancer experiencing septic shock remains high and increases over time after discharge from the intensive care unit. Registration: PROSPERO [ID: CRD42023472191].

Background: Cystic echinococcosis (CE) is a zoonotic disease caused by Echinococcus granulosus, with hepatic localization being the most frequent presentation in humans (70–80%). Surgical intervention remains the most common therapeutic option, despite an associated recurrence rate of 8% (95% CI: 6%–10%). CE recurrence increases postoperative morbidity, hospital stay, and healthcare costs. Several prognostic factors (PFs), such as cyst size, presence of multiple cysts, and personal or family history of CE, have been linked to recurrence. However, associations with cyst location, type, and biliary complications remain uncertain due to conflicting evidence. This systematic review (SR) aims to identify PFs associated with recurrence in patients undergoing surgery for hepatic CE. Methods: We will conduct a systematic review of primary longitudinal observational, and experimental studies evaluating the association between clinical, parasitic, and surgical PFs and CE recurrence. We will search Medline, Scopus, Embase, Web of Science, BIREME-BVS, and SciELO using a sensitive search strategy. Two reviewers will independently screen studies, extract data, and assess risk of bias using the QUIPS tool. Methodological quality will be assessed using MInCir-Pr2, and data extraction will follow the CHARMS-PF checklist. A qualitative synthesis will be performed, and where appropriate, random-effects meta-analyses will be conducted using the inverse-variance and restricted maximum likelihood methods. Heterogeneity will be assessed using Chi², Tau², I², and 95% prediction intervals. Publication bias will be explored via funnel plots and statistical tests (Egger’s). Certainty of evidence will be assessed using GRADE. Discussion: The results of this SR will support early risk stratification and inform clinical decision-making in the management of hepatic CE, a neglected tropical disease. Registration: PROSPERO, CRD42024538005.

Introduction: Long COVID syndrome is defined as persistent or new symptoms that appear after an acute SARS-CoV-2 infection and last at least three months without explanation. It is estimated that between 10% and 20% of those infected develop long COVID; however, data is not precise in Latin America. Although high immunization rates have reduced acute symptoms and the pandemic’s impact, there is a lack of evidence of its efficacy in preventing long COVID in the region. Methods: This scoping review followed PRISMA-ScR guidelines. Studies on vaccinated adults with long COVID from Central and South America and the Caribbean were included (Mexico was also considered). A comprehensive search across multiple databases was conducted. Data included study design, participant characteristics, vaccine type, and efficacy outcomes. Results are presented narratively and in tables. Results: Out of 3466 initial records, 8 studies met the inclusion criteria after rigorous selection processes. These studies encompassed populations from Brazil, Mexico, Latin America, and Bonaire, with 11,333 participants, 69.3% of whom were female. Vaccination, particularly with three or more doses, substantially reduces the risk and duration of long COVID. Variability was noted in the definitions and outcomes assessed across studies. Conclusions: This scoping review highlights that SARS-CoV-2 vaccination exhibits potential in reducing the burden of long COVID in the Americas. However, discrepancies in vaccine efficacy were observed depending on the study design, the population studied, and the vaccine regimen employed. Further robust, region-specific investigations are warranted to delineate the effects of vaccination on long COVID outcomes.

Bilateral perirenal lymphangiectasia is a rare condition characterized by the dilation of lymphatic ducts and the formation of fluid-filled cavities. Renal lymphangiectasia is rarely observed, affecting approximately 1% of cases, with only 34 bilateral cases reported in adults by 2025. This case report discusses a 55-year-old male with a history of recurrent pyelonephritis who was eventually diagnosed with bilateral acquired perirenal lymphangiectasia based on CT, MRI, and cytochemical analysis of perirenal fluid. The patient exhibited mild left flank pain without further complications, and given the disease's benign nature, an expectant management approach was adopted. Follow-up assessments confirmed an asymptomatic status. This report highlights the importance of considering lymphangiectasia in differential diagnoses for renal cystic lesions to avoid unnecessary procedures. Our case is the 35th documented instance of bilateral renal lymphangiectasia in the literature, underscoring the need for medical awareness of this condition to improve diagnosis and patient care.

Cranioplasty restores skull integrity after decompressive craniectomy, but high costs limit access in low-resource settings. This case highlights an artificial intelligence (AI)-assisted design method for a low-cost, patient-specific cranial prosthesis. A 15-year-old male with a traumatic brain injury and left intraparenchymal hematoma underwent cranioplasty complicated by infection and necrosis. A second procedure obtained positive outcomes using a custom AI-designed prosthesis generated from computed tomography imaging, 3D modeling, and polymethylmethacrylate fabrication. AI-enabled modeling ensured precise anatomical fit, reducing intraoperative adjustments and overcoming limitations of manual techniques. This approach enhances surgical outcomes and prosthesis accessibility in resource-limited settings. AI improves the design of cranial prostheses, lowering costs and production time. Its application could be cost-effective, especially in low-resource settings.