No abstract

No abstract

This study compared the levels of anxiety presented by patients with acute myocardial infarction in bed and shower baths and the influence of antecedent variables: age, gender, medications, previous hospitalization and/or bed bath, patients' preference regarding the professional's gender, risk factors and anxiety-traits. This crossover study was conducted between February and August 2007 in coronary units. The sample was composed of 71 patients with acute myocardial infarction. The State-Trait Anxiety Inventory (STAI) was applied before the baths (bed and shower baths), immediately after the baths and twenty minutes after the second evaluation. Results revealed that patients were more anxious in the bed bath than in the shower in the three assessments (p <0.0001) and the only variable that interfered with state-anxiety was high blood pressure. Comparación del nivel de ansiedad entre el baño de ducha y el realizado en la cama en pacientes con infarto agudo del miocardio Este estudio tuvo como objetivo comparar los niveles de ansiedad, generados en el baño en la cama y en el baño de ducha, en pacientes con infarto agudo del miocardio, así como la influencia de las variables antecedentes: edad, sexo, medicaciones, internación y/o baño en la cama previo, preferencia del paciente en cuanto al sexo del profesional, factores de riesgo y la ansiedad de trazo. Esta investigación es un estudio cross-over, realizado entre febrero y agosto de 2007, en Unidades Coronarias. La muestra fue constituida por 71 pacientes con infarto agudo del miocardio. El instrumento utilizado fue el IDATE-estado, siendo aplicado antes de los baños (cama y ducha), inmediatamente después de los baños y veinte minutos después de la segunda evaluación. Los resultados mostraron que los pacientes quedaron más ansiosos cuando realizaron su baño en la cama que cuando realizaron el baño de ducha, en las tres evaluaciones (p<0,0001) y la única variable que interfirió en la ansiedad estado fue la hipertensión arterial.

Objective: Evaluate the impact of anxiety and depression on morbidity and mortality of patients with acute coronary syndrome. Method: Retrospective cohort study, with follow-up of two years, conducted with 94 patients. The morbidity and mortality (readmission, myocardial revascularization, and death) was evaluated immediately after discharge and after one and two years. Anxiety and depression were evaluated by the State-Trait Anxiety Inventory and by Beck’s Depression Inventory. The Kaplan-Meier estimator and the Logrank test were used. The significance level adopted was 0.05. Results: We observed that 76.6% of the patients did not present symptoms of depression or had mild signs, while 78.8% had low to moderate anxiety. The symptoms of depression and anxiety were not related to morbidity (need for MR p=0.098 and 0.56, respectively; readmission p=0.962 and 0.369, respectively) and mortality (p=0.434 and 0.077, respectively). Conclusion: No relationship was found between levels of anxiety and depression with the morbidity and mortality of patients.

Objectives: To identify the frequency of the Acute Kidney Injury and to compare the application of the AKIN classification with the separate use of the serum creatinine in the postoperative period of cardiac surgery. Methods: This study was prospectively developed in a teaching and specialized research hospital in cardiology of the public health system of the state of São Paulo. Forty-four patients submitted to the elective cardiac surgery since the immediate post-surgical period up to the 2 nd post-surgical period were followed. Results: It was possible to verify that from the forty-four patients, 75% were hypertensive, 27% were diabetic and mostly were male (64%), with an average age of 55+16 years old. It was observed that advanced age and the elevated body mass index shows a significant correlation to renal dysfunction (p<0, 05). According to the AKIN classification, the urinary flow criterion identified more renal dysfunction than creatinine criterion. It was verified that the renal dysfunction occurred more frequently in the postsurgery period and the majority (82%) from the 63,6% of the patients which were submitted to the revascularization of the myocardium surgery. Conclusion: The majority of patients (75%) evolved initially with renal dysfunction signaled it mainly by the urinary flow criterion from the AKIN classification, a higher number compared to the separated creatinine. This fact confirms that the serum creatinine association with the urinary flow has a higher discriminatory performance for the early identification of this syndrome comparatively with the routinely use of the isolated creatinine.

Objectives: to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy. Methods: a cohort study, carried out in a public hospital specialized in cardiology. Treatment, comorbidities, duration of treatment, laboratory tests, discharge and deaths were analyzed. Results: of the 101 patients, 75 (74.3%) received non-dialysis treatment. The most frequent cardiological diagnoses were hypertension, cardiomyopathies and coronary syndrome. Hospitalization in patients undergoing dialysis was 18 days, hemoglobin <10.5g/dl and anuria in the first days of hospitalization contributed to the type of treatment. Each increase in hemoglobin units from the first day of hospitalization decreases the chance of dialysis by 19.2%. There was no difference in mortality. Conclusions: the main cardiological diseases were not predictive of dialysis indication, and clinical treatment was the most frequent. Anuria and anemia were predictors for dialysis treatment.

No abstract

RESUMO Objetivos: verificar a relação de patologias cardíacas com injuria renal aguda e avaliar o prognóstico do paciente em terapia de substituição renal. Métodos: estudo de coorte, realizado em hospital público especializado em cardiologia. O tratamento, comorbidades, tempo de tratamento, exames laboratoriais, alta e óbitos foram analisados. Resultados: dos 101 pacientes, 75 (74,3%) receberam tratamento não dialítico. Os diagnósticos cardiológicos mais frequentes foram hipertensão arterial, miocardiopatias e síndrome coronariana. A internação nos pacientes dialíticos foi de 18 dias, a hemoglobina <10,5g/dl e a anuria nos primeiros dias de internação contribuíram para o tipo de tratamento. Cada aumento de unidade de hemoglobina a partir do primeiro dia de internação diminui em 19,2% a chance de diálise. Não houve diferença na mortalidade. Conclusões: as principais doenças cardiológicas não foram preditivas de indicação de diálise, e o tratamento clínico foi o mais frequente. Anuria e anemia foram preditores para o tratamento dialítico.