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BackgroundAcute kidney injury (AKI) is common among intensive care unit (ICU) patients and is associated with high mortality. Type of ICU, category of admission diagnosis, and socioeconomic characteristics of the region can impact AKI outcomes. We aimed to determine incidence, associated factors and mortality of AKI among trauma and non-trauma patients in a general ICU from a low-income area.MethodsWe studied 279 consecutive patients in an ICU during a follow-up of one year. Patients with less than 24-hour stay in the ICU and with chronic kidney disease were excluded. AKI was classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria in three stages. Comparisons were performed by the Student-t and Mann–Whitney tests for continuous variables, respectively with and without normal distribution. Comparisons of frequencies were carried out by the Fisher test. Multivariate logistic regression was used to test variables as predictors for AKI and death.ResultsAdmission categories were proportionally divided into 51.6% of non-trauma diagnosis and 48.4% of trauma cases. Most trauma cases involved brain injury (79.5%). The overall incidence of AKI was 32.9%, distributed among the three stages: 33.7% stage 1, 29.4% stage 2 and 36.9% stage-3. Patients who developed AKI were older, had more diabetes, stayed longer in the ICU, presented higher APACHE II and more often needed mechanical ventilation and use of vasopressors. In comparison with non-trauma cases, trauma patients had a greater prevalence of males, higher APACHE II score, higher urine output, and younger age. There was no difference concerning development of AKI and crude mortality between trauma and non-trauma patients. Age, presence of diabetes, APACHE score and use of vasopressors were independent predictors for AKI, and AKI increased the risk of death ten-fold (OR = 14.51; CI 95% = 7.94-26.61; p < 0.001).ConclusionsThere was a high incidence of AKI in this study. AKI was strongly associated with mortality both among trauma and non-trauma patients. Trauma cases, especially brain injury due to traffic accidents involving motorized two-wheeled vehicles, should be seen as an important preventable cause of AKI.

Purpose:The aim of the study was to determine the effect of a combination of medium chain triglycerides (caprylic, capric, caproic and lauric acids), linoleic acid (essential fatty acid), vitamins A and E and soy lecithin, through a morphometric study, on the wound healing kinetics of experimental cutaneous ulcers. Methods: A total of 45 male Wistar rats were used, in which a skin flap of total thickness with an area of 4 cm 2 was removed. The animals were divided randomly into 3 groups of 15 rats each, Control, Reference and Test groups, which were treated topically with 0.9% NaCl, a preparation of clostebol combined with neomycin sulfate and the test formulation, respectively. The wound areas were measured by digital planimetry at days zero, 3, 7 and 12 postoperative. Based on the wound area, we determined the degree of tissue repair and mean rate of repair at different time intervals. Results: At day 3, an expansion of the wound area was observed in the Reference group and slight contraction in the Control and Test groups. On the subsequent days, the healing process, according to the degree of repair, proceeded in a linear manner, such that, at day 12, the healed area reached 77.95% of the initial ulcerated region in the Control group, 78.40% in the Reference group and 83.49% in the Test group, showing no significant differences. The overall mean rate of repair was equally similar at 12 days of treatment: 25.79 mm 2 /dia in the Control group, 25.42 mm 2 /dia in the Reference group and 27.38 mm 2 /dia in the Test group. Conclusion: The test preparation, applied topically on the experimentally induced cutaneous ulcers in rats, did not accelerate the process of tissue repair by secondary union. Key words: Triglycerides. Linoleic Acid. Wound Healing. Rats. RESUMO Objetivo:Avaliar o efeito da associação de triglicerídeos de cadeia média (ácidos caprílico, cáprico, capróico e láurico), ácido linoléico (ácido graxo essencial), vitaminas A e E e lecitina de soja, através de estudo morfométrico, na cinética de reparação de úlceras cutâneas experimentais. Métodos: Utilizaram-se 45 ratos, machos, da linhagem Wistar, nos quais foi removido um retalho cutâneo de espessura total com 4 cm 2 de área. Os animais foram divididos aleatoriamente em 3 grupos constituídos de 15 ratos, Controle, Referência e Teste, que foram tratados por via tópica respectivamente, com solução salina 0,9%, composto de clostebol associado a sulfato de neomicina e a formulação em teste. As áreas das feridas foram mensuradas por planimetria digital nos dias zero, 3, 7 e 12 de pós-operatório. A partir da área da ferida, calcularam-se ainda o grau de reparação e a taxa média de reparação em intervalo de tempo. Resultados: No 3o dia observou-se uma expansão da área da ferida no grupo referência e uma leve contração nos grupos controle e teste. Nos dias subseqüentes o processo de reparação, medido pela variável grau de reparação, evoluiu de forma linear, de modo que, no 12 o dia, a área reparada alcançou 77,95% da região ulcerada inicial no grupo...

Bardet-Biedl syndrome is rare. Although its diagnosis depends on cardinal clinical manifestations which appear in childhood, we report four cases of Bardet-Biedl syndrome lately diagnosed in a dialysis center. Three cases were diagnosed in end-stage renal disease patients when they started maintenance hemodialysis, and one case was diagnosed through screening among hemodialysis patients' relatives. Although pediatricians have more opportunity to diagnose the syndrome, nephrologists are important during the treatment, since renal failure is the main cause of death among Bardet-Biedl syndrome patients. Moreover, late diagnosis of the syndrome among patients with end-stage renal disease can help to detect new cases through the screening among hemodialysis patients' relatives.

Hypervolaemia is associated with dyspepsia among ESRD patients on HD.