Incidence of cystic changes in impacted lower third molar.

Objective: To assess the incidence of cystic changes in the impacted lower third molar (ILTM) in which the pericoronal (follicular) space is less than 2.5 mm as measured from the radiograph. The relationship between the cystic changes and patient's age, sex, and angular position and contact of ILTM with adjacent tooth was also evaluated. Materials and Methods: Follicular space less than 2.5 mm as measured from the panoramic radiograph was included in the study. A total of 73 tissue samples collected during the extraction ILTM were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with an adjacent tooth. Results: There were 37 male and 36 female patients, age ranging from 17 to 35 years (mean 23.95 years). Out of 73 specimens, 17 (23.3%) showed cystic changes; among them 16 (22.1%) showed dentigerous cysts and 1 (1.2%) showed odontogenic keratocysts. Most of the cystic changes occurred in the 26-30 year age range. The cystic changes showed male predominance but could not gain statistical significance. The relationship between cystic changes and angular position was statistically significant (P < 0.05). Higher probability was found in distoangular positioned ILTM. The relationship between cystic changes and communication of ILTM with the second molar was not statistically significant. Conclusion: Incidence of cystic changes in ILTM justifies extraction of the impacted tooth associated with symptoms. The decision to extract or not to extract impacted third molar should be individualized, rather than generalized.

Furosemide is associated with acute kidney injury in critically ill patients

Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).

Limnology in the Upper Paraná River floodplain: large-scale spatial and temporal patterns, and the influence of reservoirs / Limnologia na planície de inundação do Alto Rio Paraná: padrões em amplas escalas espaciais e temporais e influência de reservatórios

Knowledge of abiotic limnological factors is important to monitor changes caused by humans, and to explain the structure and dynamics of populations and communities in a variety of inland water ecosystems. In this study, we used a long term data-set (eight years) collected in 10 habitats with different features (river channels, and connected and isolated lakes) to describe the spatial and temporal patterns of some of the principal limnological factors. In general, the degree of connectivity of the lakes, together with the rivers to which the lakes are connected, were important determinants of their limnological characteristics. These differences are expected, because rivers entering the floodplain come from different geological regions and are subject to different human impacts. At large spatial scales, these differences contribute to the increased habitat diversity of the floodplain and thus to its high biodiversity. With regard to temporal variation, Secchi-disk transparency increased, and total phosphorus decreased in the Paraná River main channel during the last 20 years. Although these changes are directly attributed to the several reservoir cascades located upstream, the closing of the Porto Primavera dam in 1998 enhanced this effect. The increase in water transparency explains biotic changes within the floodplain. The lower-phosphorus Paraná River water probably dilutes concentrations of this element in the floodplain waterbodies during major floods, with future consequences for their productivity.

Fatores limnológicos abióticos têm sido importante para monitorar as mudanças causadas pelo homem e para explicar a estrutura e a dinâmica de populações e comunidades em uma variedade de ecossistemas aquáticos. Neste estudo, foram usados dados de vários anos (oito anos) coletados em 10 habitats com características distintas (rios, canais, lagoas isoladas e conectadas) para descrever padrões espaciais e temporais de alguns fatores limnológicos. Em geral, o grau de conectividade das lagoas com o rio ao qual estão conectadas foi importante para determinar as suas características limnológicas. Estas diferenças são esperadas porque os rios que chegam à planície de inundação vêm de diferentes regiões geológicas e estão sujeitos a diferentes impactos humanos. Em grandes escalas espaciais, tais diferenças contribuem para o aumento da diversidade de habitats da zona sujeita a inundações e assim, a sua alta biodiversidade. A respeito da variação temporal, observou-se um aumento nos valores de disco de Secchi e diminuição na carga de fósforo total no canal principal do rio Paraná nos últimos 20 anos. Embora estas mudanças estejam diretamente atribuídas ao efeito cascata de vários reservatórios a montante, o fechamento da represa de Porto Primavera em 1998 realçou este efeito. O aumento na transparência da água explica as mudanças bióticas observadas na planície de inundação. Em função das baixas concentrações de fósforo no rio Paraná, este está provavelmente diluindo a sua planície de inundação durante as grandes cheias, o que poderá acarretar em efeitos negativos para a sua produtividade no futuro.