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ObjectiveTo evaluate the association between acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit.MethodsThis retrospective cohort study assessed all children admitted to the pediatric intensive care unit of a reference hospital in Brazil from January to December 2016. Patients were screened for the presence of acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score. Patients were subdivided into the stages of Risk, Injury and Kidney Failure.ResultsThe sample comprised 192 children, of whom 45.8% developed acute kidney injury, with 79.5% of the cases identified up to 72 hours after admission. Patients with acute kidney injury showed a 3.74 increase risk of death (p = 0.01) than the control group. Patients with kidney failure had a mortality rate that was 8.56 times greater than that of the remaining sample (p < 0.001). The variables that were associated with the stages of acute kidney injury were nephrotoxic drugs (p = 0.025), renal replacement therapy (p < 0.001), vasoactive drugs (p < 0.001), pediatric risk of mortality 2 score (p = 0.023), fluid overload (p = 0.005), pediatric intensive care unit length of stay (p = 0.001) and death (p < 0.001).ConclusionIn this study, the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score proved to be a useful tool for the early identification of severely ill children with acute kidney injury, showing an association with mortality. We thus suggest its use for pediatric intensive care unit patient admission.

Os estudantes de medicina têm sido alvo de pesquisas nos últimos anos, devido à importância que esses futuros profissionais apresentam no processo de aprimoramento do Sistema Único de Saúde (SUS). O objetivo deste trabalho é identificar o nível de conhecimento desses alunos sobre os Princípios/Doutrinas/Diretrizes do SUS. Para isso, foi definida uma amostra representativa composta por 224 estudantes de uma escola médica do nordeste brasileiro distribuídos igualitariamente entre os 12 semestres do curso. Os dados foram obtidos mediante a aplicação de um  questionário confeccionado pelos próprios autores, aplicado aos alunos no período de abril a agosto de 2011. Os resultados mostram que 59,8% dos estudantes entrevistados não apresentam conhecimentos consolidados sobre o tema; os melhores resultados estavam relacionados com o sexo feminino; idade menor que 20 anos; renda familiar menor que 20 salários mínimos; desejo de trabalhar no setor público; e o fato de o aluno estar cursando os primeiros semestres. Conclui-se que são necessárias reformas no ensino médico, por meio de projetos pedagógicos, curriculares e extracurriculares, que favoreçam a formação de indivíduos mais éticos e comprometidos com a Saúde Pública.

Suppurative appendicitis is an acute inflammatory reaction of the ileocecal appendix of an infectious etiology and it can result in complications and death if treatment is not started early. This pathology is rare in children under 2 years old. The present study aims to present the case of a one-year-old child who developed complicated suppurative appendicitis. Despite the efforts, the patient evolved to death with 15 days. Suppurative acute appendicitis is one of the differential diagnosis of acute abdomen in infants. The diagnosis is difficult due to the non-specific signs. It is necessary to have a high level of suspicion in order to make early diagnosis and promote treatment as early as possible to reduce mortality in this population.