OBJECTIVES:To evaluate the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the discontinuation of treatment among hypertensive patients.INTRODUCTION:Many reasons exist for non-adherence to medical regimens, and one of the strategies employed to improve treatment compliance is the use of active telephone calls.METHODS:Hypertensive patients (n = 354) who could receive telephone calls to remind them of their medical appointments and receive instruction about hypertension were distributed into two groups: a) “uncomplicated” – hypertensive patients with no other concurrent diseases and b) “complicated” - severe hypertensive patients (mean diastolic ≥110 mmHg with or without medication) or patients with comorbidities. All patients, except those excluded (n = 44), were open-block randomized to follow two treatment regimens (“traditional” or “current”) and to receive or not receive telephone calls (“phone calls” and “no phone calls” groups, respectively).RESULTS:Significantly fewer patients in the “phone calls” group discontinued treatment compared to those in the “no phone calls” group (4 vs. 30; p<0.0094). There was no difference in the percentage of patients with controlled blood pressure in the “phone calls” group and “no phone calls” group or in the “traditional” and “current” groups. The percentage of patients with controlled blood pressure (<140/90 mmHg) was increased at the end of the treatment (74%), reaching 80% in the “uncomplicated” group and 67% in the “complicated” group (p<0.000001).CONCLUSION:Guidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment.

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A partir do método dialético materialista, com destaque para a centralidade do trabalho no modo de produção capitalista, analisa-se como o Sistema Único de Saúde vem abordando a questão do trabalho. Para tanto, foi realizada uma revisão narrativa da literatura a partir de três importantes periódicos do campo da Saúde Coletiva: Cadernos de Saúde Pública; Ciência & Saúde Coletiva; e Trabalho, Educação e Saúde. Foram contemplados os artigos científicos desses periódicos constantes nas bases de dados Lilacs – Literatura Latino-americana e do Caribe em Ciências da Saúde e Medline – Medical Literature Analysis and Retrieval System Online, da Biblioteca Virtual de Saúde – BVS. Utilizou-se o item-chave ‘Saúde do Trabalhador’, e, após o processo de seleção, 19 artigos foram considerados incluídos. A discussão sobre esses artigos foi organizada de forma a abordar cinco questões centrais: (1) os antecedentes históricos da política de Saúde do Trabalhador; (2) a estratégia mais recente denominada Rede Nacional de Atenção Integral à Saúde do Trabalhador – RENAST, assim como a Política Nacional de Saúde do Trabalhador e da Trabalhadora – PNSTT;(3) o papel da Atenção Primária à Saúde;(4) os desafios estruturais do SUS; (5) a atuação intersetorial. Avaliou-se que o debate sobre a Rede Nacional de Atenção Integral à Saúde do Trabalhador aparece nos artigos de forma descritiva, abordando pouco a precariedade e a insuficiência da atenção à saúde dos trabalhadores no SUS. O papel da Atenção Primária à Saúde é mencionado sem levar em conta que a população trabalhadora já é atendida por esses serviços, como se as questões de Saúde do Trabalhador constituíssem uma nova atribuição. Os desafios estruturais do SUS são abordados de forma fragmentada e superficial. A atuação desarticulada dos setores do Estado sobre a questão do trabalho é retratada, mas não se analisam as contradições de forma mais ampla.

Introduction In 2002, the Surviving Sepsis Campaign defi ned a strategy that aimed to reduce the high mortality due to sepsis. One point of this strategy was a recommendation to recognize that sepsis is a frequent cause of death and high economic costs in the pediatric intensive care unit. Knowledge of the disease is the fi rst step to impact it. There are few studies on pediatric sepsis epidemiology in the world and none in Colombia. Hypothesis The epidemiological features of Colombian children are diff erent from other countries. Methods We constructed a website where 14 intensive care units across the country reported in a prospective way the epidemiological features of children with sepsis using an electronic process [1]. We asked for sociodemographics, microbiological data, sepsis classifi cation, complications, and outcome. Results We collected 253 patients from March to May 2009. Fifty-fi ve percent of the cases were male and 45% were female; 53% were less than 1 year old. A total of 67.2% came from urban areas and 33% came from rural villages. Eighty-fi ve percent were very poor (score 1 and 2 over 6 used in Colombia as socioeconomic classifi cation). Forty-fi ve percent have governmentsupported insurance. In total, 23.72% of the population presented with sepsis; 30.04% with severe sepsis; and 46.5% with septic shock. The infection origin was respiratory in 54.55%, followed by abdominal in 17.39%. In 50.2% no cause was identifi ed. A total of 75.1% required mechanical ventilation. The mortality rate was 20.4%. Conclusions Sepsis, severe sepsis, or septic shock is a common diagnosis in Colombian intensive care units. The majority of pediatric patients are 2 years or younger and from the poorest communities. It aff ected males more. In the majority, the process starts in the respiratory system. We had diffi culty identifying the cause. The disease causes high mortality and cost for a developing society. We need a complete survey to fi nd a correct approach to the problem. Reference 1. Sepsis en Columbia [www.sepsisencolombia.com] P2 Randomized controlled trials are not designed to prove the safety of third-generation hydroxyethyl starch for resuscitation: results from a systematic review