Portuguese / English: www.scielo.br/reeusp RESUMO A hipertensão arterial é um dos principais fatores de risco para as doenças cardiovasculares, sendo grande a responsabilidade da enfermagem na atenção aos hipertensos. Objetivou-se, portanto, avaliar o conhecimento sobre hipertensão e seu tratamento com a equipe de enfermagem, antes e após onze intervenções educativas. Utilizou-se questionário abordando aspectos teóricos ligados ao conhecimento sobre hipertensão em enfermeiros (5), técnicos (2), auxiliares (11) e agentes comunitários (37), de duas Unidades Bá-sicas de Saúde da cidade de São Paulo. Para análise estatística utilizou-se o teste T de Student, análise da variância e p<0,05. Verificou-se aumento no conhecimento após as intervenções educativas para o grupo formado por enfermeiros, técnicos e auxiliares de enfermagem (84,6±12,0% vs 92,7±15,0%, p<0,05), enquanto que para agentes comunitários de saúde não houve mudança significante (80,8±12,2% vs 83,5±24,0%). Portanto, conclui-se que as ações educativas foram efetivas e que devem ser implementadas junto à equipe de enfermagem, considerando que elas podem influenciar no aprimoramento da assistência às pessoas hipertensas. DESCRITORES ABSTRACTHypertension is one of the main risk factors for cardiovascular diseases. Nursing carries a large responsibility in care delivery to hypertensive individuals. Thus, the goal was to assess a nursing team's knowledge on hypertension and its treatment before and after educational interventions. A questionnaire was used, addressing theoretical aspects of hypertension knowledge among nurses (5), technicians (2), auxiliaries (11) and community agents (37) at two Basic Health Units in São Paulo City, Brazil. For statistical analysis, Student's T test was used, as well as variance analysis and p<0.05. A knowledge increase was verified after the educational interventions for the group constituted by nurses, technicians and nursing auxiliaries (84.6±12.0% vs. 92.7±15.0%, p <0.05), while no significant change occurred for community health agents (80.8±12.2% vs. 83.5±24.0%). Thus, it was concluded that the educational actions were effective and must be put in practice in the nursing team, which they can influence the improvement of care delivery for hypertensive patients. KEY WORDSHypertension. Nursing. Knowledge. RESUMENLa hipertensión arterial es uno de los principales factores de riesgo para las enfermedades cardiovasculares. Es grande la responsabilidad de la enfermería en la atención a los hipertensos. Se objetivó entonces evaluar los conocimientos sobre hipertensión y su tratamiento en el equipo de enfermería antes y después de once intervenciones educativas. Fue utilizado un cuestionario abordando aspectos teóricos relativos al conocimiento sobre hipertensión en enfermeros (5), técnicos (2), auxiliares (11) y agentes comunitarios de la salud (37) de dos Unidades Básicas de Salud en la ciudad de São Paulo, Brasil. Para el análisis estadístico, fue aplicado el test T de Student, además de análisis de varianza y p<0,05. Se ver...

Objective: To determine independent predictors of prolonged mechanical ventilation in patients undergoing coronary artery bypass graft surgery.Methods: Data of patients undergoing coronary artery bypass graft surgery were included prospectively from July 2009 to July 2010. All data were input into an electronic database. The resulting cohort included a total of 2952 patients of which 77 remained more than 48 hours on mechanical ventilation. Patients were divided into two groups: 1) a prolonged ventilation group, needing mechanical ventilation for more than 48 hours and 2) not prolonged ventilation group, undergoing a successful extubation within 48 hours.Results: After adjustment for confounding factors a multivariate analysis identified the following factors as independent predictors of prolonged mechanical ventilation: age (OR 1.06 95% CI 1.03 -1.09; P <0.001), chronic renal failure (OR 3.52 95% CI 1.84 -6.74; P <0.001), chronic obstructive pulmonary disease (OR 2.65 95% CI 1.38 -5.09; P = 0.004), coronary artery bypass graft associated with other procedures (OR 3.33 95 % CI 1.89 -5.58; P <0.001) and clamping time (OR 1.01 95% CI 1.00 -1.02; P = 0.018).Conclusion: The identification of these predictors allows the development of preventive strategies that could reduce invasive ventilation time, since patients on prolonged mechanical ventilation present greater morbidity and mortality rates.Descriptors: Myocardial revascularization. Respiration, artificial. Intensive care units. 521Rev Bras Cir Cardiovasc 2012;27(4) :520-8 Piotto RF, et al. -Independent predictors of prolonged mechanical ventilation after coronary artery bypass

Objective:To identify the association between blood pressure control and the following variables: a) bio-social and lifestyle characteristics of hypertensive patients; and b) factors related to the antihypertensive treatment. Methods: This is an exploratory study with 290 people with hypertension from primary care. We used a specific instrument, selfadministered, with 21 questions on factors that can hinder treatment, divided into four dimensions: medication, socioeconomic, institutional and personal beliefs. We adopted a significance level of p <0.05. Results: The control of blood pressure was associated (p <0.05) with female gender, Caucasian ethnicity, primary/secondary education, not drinking alcohol, higher income and regular physical activity. Regarding the factors that can hinder treatment, there was association of hypertension control with only two questions: "feel nothing" and "have to do treatment for life". Conclusion: Sociodemographic variables and beliefs concerning the absence of symptoms and chronicity of the disease influenced the control of hypertension and should be considered in the adherence process to the treatment. DESCRIPTORSHypertension; Medication Adherence; Therapeutics; Life Style; Public Health Nursing. Chronic and asymptomatic diseases influence the control of hypertension treatment in primary careCronicidade e doença assintomática influenciam o controle dos hipertensos em tratamento na atenção básica Cronicidad y enfermedad asintomática influencian el control de los hipertensos en tratamiento en la atención básica

RESUmoRealizou-se estudo comparativo randomizado para avaliar o controle de hipertensos, com uso da medida residencial da pressão arterial (MRPA) e medida casual, bem como para analisar o efeito do avental branco. Hipertensos atendidos em unidades básicas de saúde foram divididos aleatoriamente em: grupo I, participante das atividades educativas, e grupo II, que seguiu a rotina de atendimento. Os hipertensos do grupo I realizaram MRPA no início e final do estudo. Efeito do avental branco foi avaliado pela diferença entre a medida casual e MRPA. Foram incluídos 290 hipertensos, porém realizaram MRPA 82 hipertensos. Houve aumento no controle da pressão do início ao final do estudo nos hipertensos do grupo I (p < 0,05) avaliado pela MRPA (60% para 68,3%) e pela medida casual (62% para 71%); no grupo II o controle foi maior na MRPA do que na medida casual (63% vs 50%). O efeito do avental branco foi maior no grupo II. Original article AbStRActA randomized comparative study was performed to evaluate the control of hypertension with use of home blood pressure measurement (HBPM) and casual blood pressure measurement, and analyze the white coat effect. Hypertensive patients in primary health care units were randomly divided into two groups: group I, participating of the educational activities and group II that followed the routine treatment. The hypertensive patients from group I realized HBPM at the beginning and the end of the study. White-coat effect was evaluated by the difference between the casual blood pressure measurement and HBPM. The study included 290 hypertensive patients, but realized HBPM 82 hypertensive patients. There was increase in blood pressure control from the beginning to end of study in hypertensive patients from group I (p < 0.05) measured by HBP (60% to 68.3%) and casual measurement (62% to 71%) and in group II, HMBP hypertension control was higher than the casual blood pressure measurement (63% vs 50%). The white coat effect was greater in hipertensive patients from group II. RESUmENUn estudio comparativo aleatorizado se realizó para evaluar el control de la hipertensión con el uso de la medición de la presión arterial en el hogar y la medición ocasional de la presión arterial, y analizar el efecto de bata blanca. Los pacientes hipertensos en las unidades de atención primaria de salud fueron divididos aleatoriamente en dos grupos: grupo I, participando de las actividades educativas y el grupo II que siguieron el tratamiento de rutina. Los pacientes hipertensos del grupo I se dio cuenta de medición de la presión arterial en el hogar en el comienzo y el final del estudio. Blanco-capa efecto fue evaluado por la diferencia entre la medición de la presión arterial casual y medición de la presión arterial en el hogar. El estudio incluyó a 290 pacientes hipertensos, pero se dio cuenta de la medición de la presión arterial en el hogar 82 pacientes hipertensos. Hubo un aumento en el control de la presión arterial desde el principio hasta el final del estudio en los pacientes hipertensos del grupo I (p...

IntroductionCost management has been identified as an essential tool for the general control and evaluation of health organizations.ObjectivesTo identify the coverage percentage of transferred funds from the Unified Health System for coronary artery bypass grafts in a philanthropic hospital having a consolidated costing system in the municipality of São Paulo.MethodsA quantitative, descriptive and cross-sectional research with information provided from a database composed of 1913 patients undergoing coronary artery bypass graft from March 13 to September 30, 2012, including isolated elective coronary artery bypass graft with the use of extracorporeal circulation. It excluded 551 (28.8%) patients, among them 76 (4.0%) deaths and 8 hospitalized patients, since the cost was compared according to the length of hospital stay. Therefore, the sample consisted of 1362 patients.ResultsThe average total cost per patient was $7,992.55. The average fund transfer by the Unified Health System was $3,450.73 (48.66%), resulting in a deficit of $4,541.82 (51.34%).ConclusionThe Unified Health System transfers covered 48.66% of the average total cost of hospitalization. Although the amount transferred increased with increasing costs, it was not proportional to the total cost, resulting in a percentage difference in revenue that was increasingly negative for each increase in cost and hospital stay. Those hospitalized for longer than seven days presented higher costs, older age, higher percentage of diabetics and chronic kidney disease patients and more postoperative complications.