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Acute kidney injury (AKI) is a common and severe complication of cirrhosis.

To evaluate the impact of AKI staging on 30-day mortality of patients with cirrhosis.

We performed a retrospective cohort study of hospitalized patients with cirrhosis. Acute kidney injury (AKI) was diagnosed according to the International Club of Ascites recommendations and staged according to the European Association for the Study of the Liver guidelines. Comparisons between groups were made by one-way analysis of variance and Tukey test. Chi-square was calculated for dichotomous variables. Comparisons of renal impairment status among patients were performed using Kaplan-Meier statistics and differences between groups were analyzed using the log-rank test. A P-value <0.05 was considered to be statistically significant.

Two hundred and thirty-two patients were included in the study. The diagnosis of AKI was performed in 98 (42.2%) of them. The overall 30-day mortality was 19.8% (46/232). Mortality increased as the degree of AKI progressed. Among patients who did not have AKI, mortality was 5.2% (7/134). When compared to patients without AKI, patients diagnosed with AKI stage 1a had mortality of 12.1% (4/33, P=0.152); patients with AKI stage 1b had mortality of 45% (18/40, P<0.001); and patients with AKI stages 2 or 3 had mortality of 68% (17/25, P<0.001). Moreover, it is noteworthy that full response to treatment was associated to a decreased mortality when compared to patients who did not show complete recovery of renal function (14.3% vs 57.9%, P<0.001).

AKI stages 1b or greater, but not AKI stage 1a, are associated to higher 30-day mortality of patients with cirrhosis.

AKI stages 1b or greater, but not AKI stage 1a, are associated to higher 30-day mortality of patients with cirrhosis.

Biologics have revolutionized the treatment of inflammatory bowel disease (IBD). However, these drugs had a significant influence on treatment-related costs, which resulted in the development of biosimilars.

This systematic review and meta-analysis aimed to evaluate the drug discontinuation rate in the IBD population who switched from originator to biosimilars in real-world switching studies and address potential nocebo effects as reasons for drug discontinuation.

Medline (via PubMed), EMBASE, Cochrane Library, and abstract databases of selected congresses were screened for reports of monoclonal antibody (mAb) switching with a minimum post-switch follow-up of >6 months or three infusions. All available information on discontinuation rates was assessed.

A total of 30 observational studies were included, involving 3,594 patients with IBD. Twenty-six studies reported a switch from infliximab to CT-P13, two studies involved a switch to SB2, and switching information was not available in two studies. Thebo effect as a reason for discontinuation. Therefore, long-term studies evaluating the use of biosimilars to monitor adverse events and potential nocebo effects in post-marketing surveillance are still needed.

Older adults frequently experience nonspecific clinical features. However, there is limited evidence on how often admission diagnoses for hospitalized older patients are incorrect, potentially leading to treatment delays.

To determine the consistency between hospital admission and discharge diagnoses, and identify factors associated with diagnostic discrepancies in older adults.

Population-based cohort study in the United States. We included adults aged ≥ 18 years who were admitted from emergency departments (EDs) to hospitals, identified using the 2005-2010 National Hospital Ambulatory Medical Survey, a nationally representative survey.

Three admission diagnoses and the principal discharge diagnosis were captured and classified as discrepant if they involved considerably different conditions within the same organ system, or different organ systems altogether.

Each year, 12 million adults were hospitalized following ED visits in the United States; 45% were aged ≥ 65 years. These patients' mean age wyed diagnoses are a critical safety problem, clinicians should be vigilant and frequently cogitate alternative diagnostic possibilities.An extensive field survey was conducted to evaluate the spreading of the invasive estuarine bivalve Mytilopsis leucophaeata into the metropolitan region of Rio de Janeiro (Brazil), in which the single invaded site so far recorded is Rodrigo de Freitas Lagoon. A novel record is made to the Marapendi coastal lagoon, where M. Neuronal Signaling peptide leucophaeata mainly colonizes mangrove roots. A reef composed of druses above the unconsolidated substratum is recorded for the first time for this species. The fauna associated to agglomerates of M. leucophaeata was composed of eight taxa polychaetes Alitta succinea and Polydora sp., amphipods Melita mangrovi and Elasmopus sp., barnacles Amphibalanus eburneus and A. improvisus, the crab Eurypanopeus cf. dissimilis and the gastropod Heleobia spp. Based on COI sequences, the haplotype diversity of M. leucophaeata invasion in Marapendi Lagoon is high, like that previously recorded in Rodrigo de Freitas Lagoon. The expansion of M. leucophaeata demands a continuous investigation, including the knowledge of its impacts on the biota.Metacercariae of Diplostomidae are widely distributed in America and may cause diplostomiasis, an ocular disease in fishes. The aim of this study is to report the occurrence of metacercariae of Austrodiplostomum compactum in Plagioscion squamosissimus (non-native fish species) from Nova Avanhandava Reservoir, Tietê River, Brazil and an explanation for the high infection rates with this parasite in the Paraná River Basin is proposed. Eyes of 70 hosts were examined, the metacercariae were preserved and identified. The prevalence (P), mean intensity of infection (MII) ± standard deviation, mean abundance (MA) ± standard deviation, were calculated and a bibliographic review was performed. There was no difference in parasitism between male and female hosts. The values of P = 80%, MII = 21.55 ± 3.25 and MA = 17.24 ± 2.91 were high, as in most studies in areas where P. squamosissimus were introduced, while these values were low in areas of natural occurrence. This may be explained by the genetic susceptibility of the host to the parasite.

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