BACKGROUND: There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE). METHODS: This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted. RESULTS: A total of 92 patients were included, with a mean age of 36 ± 9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (or 9.9, 95% ci 1.2-96.3, p < 0.0001). CONCLUSION: AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.

Objetivo: Avaliar a eficácia do tratamento do diabetes mellitus tipo 1 por um período de 18 meses, em 17 pacientes, utilizando-se um processo de infusão subcutânea contínua de insulina (ISCI) e de um análogo da insulina (insulina lispro) através de uma bomba infusora. Estudamos os seguintes parâmetros: hemoglobina glicosilada, peso, índice de massa corpórea, relação insulina/peso, quantidade de insulina/dia administrada, relação da insulina administrada na forma de bolus (antes das refeições) com a insulina basal e efeitos adversos desta terapia. Após esse período observamos que os pacientes estavam melhor controlados com níveis de HbA1c significativamente reduzidos (p< 0,05). Apresentavam uma redução significativa da relação insulina/peso (p< 0,05) e melhor aproveitamento da insulina relacionado a alimentação dado pelo aumento significativo da relação bolus/basal quando comparado com a relação de insulina regular/NPH antes do tratamento (p< 0,05).

Objective: To evaluate the treatment efficacy of type 1 diabetes mellitus during 18 months with a continuous subcutaneous insulin infusion pump and insulin lispro. The following paramethers were studied: glycosylated hemoglobin, weight, body mass index, amount of insulin administered daily, ratio between daily insulin dose and weight, ratio between insulin administered as bolus and as basal and the colateral effects of this form of therapy. After 18 months the patients were in better diabetic control with a significant lower level of glycosylated hemoglobin (p< 0.05). They presented a significant reduction in the ratio between insulin daily dose and weight (p< 0.05) and a better utilization of insulin related to meal observed by the significant rise in the ratio between insulin administered as bolus and as basal when compared with the ratio of regular and NPH before the SCII treatment (p< 0.05).