IntroductionRisk of mortality in the setting of acute kidney injury (AKI) in cats and dogs remains unclear.ObjectivesTo evaluate the incidence of mortality in cats and dogs with AKI based on etiology (i.e. infectious versus non-infectious; receiving dialysis versus conservative treatment).Materials and methodsOvid Medline, EMBASE, and LILACS were searched up to July 2016. Articles were deemed eligible if they were case series studies evaluating the incidence of all-cause mortality in cats and dogs with AKI, regardless of etiology or the nature of treatment.ResultsEighteen case series involving 1,201animalsproved eligible. The pooled proportions for overall mortality were: cats53.1% [95% CI 0.475, 0.586; I2 = 11,9%, p = 0.3352]; dogs 45.0% [95% CI 0.33, 0.58; I2 = 91.5%, P < 0.0001]. A non-significant increase in overall mortality risk was found among dialysed animals relative to those managed with conservative treatment, independent of animal type and the etiology of their AKI. The pooled proportions for overall mortality according to etiology, regardless of treatment type, were: AKI due infectious etiology for cats and dogs, 19.2% [95% CI 0.134, 0.258; I2 = 37.7%, P = 0.0982]; AKI due non-infectious etiology for cats and dogs, 59.9% [95% CI 0.532, 0.663; I2 = 51.0%, P = 0.0211].ConclusionOur findings suggest higher rates of overall mortality in cats and dogs with AKI due to non-infectious etiologies relative to infectious etiologies, and showed non-significant differences in terms of higher rates associated with dialysis compared to conservative management. Further investigations regarding optimal time to initiate dialysis and the development of clinical models to prognosticate the course of disease and guide optimal treatment initiation for less severe cases of AKI in cats and dogs is warranted.

There is high quality evidence that sevoflurane reduces death within 180 to 365days of surgery and, inotropic and vasoconstrictor support compared to propofol for patients undergoing coronary artery bypass grafting. There is also some evidence showing that the cardiac index is minimally influenced by administration of sevoflurane and desflurane compared to propofol.

Objectives: To evaluate the efficacy of blood transfusion compared to no intervention in obstetric patients. Material and methods:A systematic review was performed with Cochrane Database of Clinical Trials, PubMed, EMBASE and LILACS databases searched as of September, 2016. Two authors independently selected relevant clinical trials, assessed their methodological quality and extracted data, using the GRADE approach.Results: Five studies within a total of 6,297 met the inclusion criteria, with women generally aged 20-40 years. Three included studies allocated women to receive blood transfusion or no intervention. Two other studies allocated women with either restricted or full blood supplies. The major issue regarding risk of bias was the extent of concealment of randomization and blinding. There was no statistically significant difference between blood transfusion versus no transfusion or restricted blood supply on mortality (relative risk 0.82 [95% confidential interval 0.32 to 2.09], p = 0.68; two studies; I 2 = not applicable). Conclusions:Very low-quality evidence suggests no significant difference between blood transfusion and no intervention in obstetric patients, underlining the need for more robust clinical trials evaluating this area.

BACKGROUND AND OBJECTIVES: Pain evaluation and the choice of the analgesic best providing its control are extremely important for patients' quality of life. This study aimed at describing the characteristics which make meperidine unfeasible for pain management, at calling the attention to the incidence of its prescriptions and to the need of a multidisciplinary educative action aiming at decreasing its use, in addition to presenting two opioids as options for analgesia. CONTENTS: National or international scientific and governmental publications between the years 1997 and 2013 used in this study report that meperidine is not indicated for pain management, primarily due to its short action time, presence of neurotoxic metabolite (normeperidine) and possibility of rapidly developing tolerance. CONCLUSION: According to analyzed data, meperidine was the most widely used opioid for analgesic or was among the most prescribed analgesics. This fact shows the real need for an educative multidisciplinary action to promote awareness of meperidine risks and to decrease its prescription. According to searched literature, morphine and methadone have longer action time and higher analgesic potency, with metabolites which are less toxic and noxious for patients as compared to meperidine.