Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.

Background: Hematooncology patients admitted to intensive care units (ICUs) are at high risk for mortality due to the severity of their critical illness. Such complications can develop into complex clinical management, thus signaling an urgent need to identify mortality-related factors to improve interventions and outcomes for these patients. Methods: A systematic review of studies published between 2012 and 2023 in databases such as PubMed, Scopus, and Web of Science was conducted, following the PRISMA guidelines. A meta-analysis was carried out to determine the significance of mortality-related factors. Results: In a review of twenty-four studies, it was found that invasive mechanical ventilation (IMV) was associated with an odds ratio (OR) between 2.70 and 8.26 in 75% of the studies. The use of vasopressor support had an OR of 6.28 in 50% of the studies, while pulmonary involvement by tumor had an OR of 6.73 in 30% of the studies. Sepsis showed an OR of 5.06 in 60% of the studies, and neutropenia upon admission increased mortality in 40% of the studies. Severe respiratory failure (PaO₂/FiO₂ < 150) had an OR of 7.69 in 55% of the studies. Additionally, ICU readmission and late admission were identified as risk factors for increased mortality. Conclusions: Mortality among hematooncology ICU patients is associated with IMV, vasopressor support, pulmonary involvement, sepsis, neutropenia, severe respiratory failure, ICU readmission, and late admission. Identifying and managing these factors in a timely manner can improve survival and the quality of care.

Staphylococcus aureus infections are an important cause of morbidity and mortality among patients in intensive care units (ICUs), particularly those with multiple comorbidities and critical conditions. Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains differ in resistance, clinical behavior, and prognoses, making it important to understand their effects on clinical outcomes. Comparing clinical outcomes of MRSA and MSSA infections is important. This retrospective cohort study analyzed ICU patients with confirmed S. aureus infections at a quaternary care hospital. Demographic, clinical, and comorbidity data were collected. Poisson regression was used to analyze 7-day mortality and identify adjusted risk factors. Seven-day mortality was higher in patients with MSSA than MRSA infections, with an adjusted relative risk for MRSA of 0.380 (95% confidence interval: 0.15–0.95; p = 0.039). Independent risk factors for mortality included lack of an infectious disease consultation, vascular comorbidities, such as peripheral vascular disease and cerebrovascular events, chronic kidney disease, and inotropic support requirement. Patients with MRSA infections required significantly longer ventilatory support (mean 43.5 days vs. 13 days for MSSA; p = 0.019). Staphylococcus aureus infections in ICU patients were associated with poor outcomes, particularly in patients without infectious disease consultation and those with vascular comorbidities. Mortality differences between MRSA and MSSA highlight the importance of appropriate empiric therapy and standardized protocols incorporating infectious disease consultation to improve outcomes in critically ill patients.

Background/Objective: Cancer significantly impairs physical function and quality of life. Exercise has gained recognition as a therapeutic strategy; however, its long-term efficacy in terms of multidimensional outcomes in patients with cancer remains underexplored. This review aimed to evaluate and summarize the available evidence regarding the effects of multicomponent exercise programs on pain and psychosocial outcomes in individuals with cancer. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42022321183). Comprehensive searches were performed in MEDLINE, OVID, LILACS, Scopus, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar, without date restrictions. Search terms included “exercise” and “cancer.” Only randomized controlled trials (RCTs) were included. Methodological quality and risk of bias were assessed using the PEDro scale. Results: Sixteen randomized controlled trials met the inclusion criteria. Multicomponent exercise programs combining aerobic, resistance, and flexibility training significantly improved muscle strength, balance, and quality of life. Several studies reported meaningful reductions in pain intensity and interference, whereas others found no significant changes. Overall, exercise interventions demonstrated superior effects compared with usual care or educational controls across physical and psychosocial outcomes. Conclusions: Multicomponent exercise is a safe and feasible intervention for adults with cancer, including those with advanced disease or complex clinical profiles. Evidence supports consistent benefits in physical function and quality of life, with partially consistent yet favorable effects on pain. Programs integrating multiple exercise modalities appear most effective and should be considered as part of comprehensive oncological care to enhance therapeutic outcomes and long-term well-being.

We present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response.