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INTRODUCTION: Southern Hemisphere countries have been underrepresented in epidemiological studies on acute kidney injury (AKI). The objectives of this study were to determine the frequency, risk factors, and outcomes of AKI in adult hospitalized patients from the emergency department of a public high-complexity teaching hospital in the city of São Paulo, Brazil. METHODS: Observational and prospective study. AKI was defined by the KDIGO guidelines (Kidney Disease: Improving Global Outcomes) using only serum creatinine. RESULTS: Among the 731 patients studied (age: median 61 years, IQR 47-72 years; 55% male), 48% had hypertension and 28% had diabetes as comorbidities. The frequency of AKI was 52.1% (25.9% community-based AKI [C-AKI] and 26.3% hospital-acquired AKI [H-AKI]). Dehydration, hypotension, and edema were found in 29%, 15%, and 15% of participants, respectively, at hospital admission. The in-hospital and 12-month mortality rates of patients with vs. without AKI were 25.2% vs. 11.1% (p<0.001) and 36.7% vs. 12.9% (p<0.001), respectively. The independent risk factors for C-AKI were chronic kidney disease (CKD), chronic liver disease, age, and hospitalization for cardiovascular disease. Those for H-AKI were CKD, heart failure as comorbidities, hypotension, and edema at hospital admission. H-AKI was an independent risk factor for death in the hospital, but not at 12 months. C-AKI was not a risk factor for death. CONCLUSIONS: AKI occurred in more than half of the admissions to the clinical emergency department of the hospital and was equally distributed between C-AKI and H-AKI. Many patients had correctable risk factors for AKI, such as dehydration and arterial hypotension (44%) at admission. The only independent risk factor for both C-AKI and H-AKI was CKD as comorbidity.

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INTRODUCTION: Southern Hemisphere countries have been underrepresented in epidemiological studies on acute kidney injury (AKI). The objectives of this study were to determine the frequency, risk factors, and outcomes of AKI in adult hospitalized patients from the emergency department of a public high-complexity teaching hospital in the city of São Paulo, Brazil. METHODS: Observational and prospective study. AKI was defined by the KDIGO guidelines (Kidney Disease: Improving Global Outcomes) using only serum creatinine. RESULTS: Among the 731 patients studied (age: median 61 years, IQR 47-72 years; 55% male), 48% had hypertension and 28% had diabetes as comorbidities. The frequency of AKI was 52.1% (25.9% community-based AKI [C-AKI] and 26.3% hospital-acquired AKI [H-AKI]). Dehydration, hypotension, and edema were found in 29%, 15%, and 15% of participants, respectively, at hospital admission. The in-hospital and 12-month mortality rates of patients with vs. without AKI were 25.2% vs. 11.1% (p<0.001) and 36.7% vs. 12.9% (p<0.001), respectively. The independent risk factors for C-AKI were chronic kidney disease (CKD), chronic liver disease, age, and hospitalization for cardiovascular disease. Those for H-AKI were CKD, heart failure as comorbidities, hypotension, and edema at hospital admission. H-AKI was an independent risk factor for death in the hospital, but not at 12 months. C-AKI was not a risk factor for death. CONCLUSIONS: AKI occurred in more than half of the admissions to the clinical emergency department of the hospital and was equally distributed between C-AKI and H-AKI. Many patients had correctable risk factors for AKI, such as dehydration and arterial hypotension (44%) at admission. The only independent risk factor for both C-AKI and H-AKI was CKD as comorbidity.

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OBJECTIVE: To examine the factor structure of the Portuguese version of State-Trait Anger Expression Inventory (STAXI) in clinical patients. METHOD: 400 subjects from an internal medicine outpatient unit and 200 from a medical ward were recruited. Patients answered questions about clinical data, the STAXI, and the Beck Depression Inventory (BDI). Raw score of the STAXI was submitted to reliability assessment and factor analysis. RESULTS: Internal consistency using the Cronbach's alpha coefficient was of 0.84. The STAXI significantly correlated with BDI at r=0.352 (p<0.01). The final solution of Principal Component Analysis identified five meaningful factors: Trait-Anger, State-Anger, Anger-Control, Anger-Out, and Anger-In. This structural model is close to the original theoretical construct of Spielberger's STAXI. CONCLUSION: The Portuguese version of STAXI presented an adequate factorial structure that permits the evaluation of anger dimensions among clinical patients.

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OBJECTIVE: To examine the factor structure of the Portuguese version of State-Trait Anger Expression Inventory (STAXI) in clinical patients. METHOD: 400 subjects from an internal medicine outpatient unit and 200 from a medical ward were recruited. Patients answered questions about clinical data, the STAXI, and the Beck Depression Inventory (BDI). Raw score of the STAXI was submitted to reliability assessment and factor analysis. RESULTS: Internal consistency using the Cronbach's alpha coefficient was of 0.84. The STAXI significantly correlated with BDI at r=0.352 (p<0.01). The final solution of Principal Component Analysis identified five meaningful factors: Trait-Anger, State-Anger, Anger-Control, Anger-Out, and Anger-In. This structural model is close to the original theoretical construct of Spielberger's STAXI. CONCLUSION: The Portuguese version of STAXI presented an adequate factorial structure that permits the evaluation of anger dimensions among clinical patients.

OBJETIVO: Avaliar o construto e as propriedades psicométricas da versão em português do Inventário de Expressão de Raiva Estado-Traço (STAXI) em pacientes clínicos. MÉTODO: 400 indivíduos de uma unidade ambulatorial e 200 de uma enfermaria de clínica médica foram recrutados. Foram coletadas informações sobre aspectos clínicos, o STAXI e o Inventário de Depressão de Beck (BDI). Os escores brutos do STAXI foram submetidos à análise de confiabilidade e análise fatorial. RESULTADOS: A consistência interna pelo coeficiente alfa de Cronbach foi de 0,84. O STAXI se correlacionou significativamente com BDI (r=0,352; p<0,01). A análise de Componentes Principais identificou cinco fatores significativos: Raiva-traço, Raiva-estado, Controle-de-raiva, Raiva-para-fora e Raiva-para-dentro. Esse modelo estrutural é similar ao apresentado originalmente por Spielberger. CONCLUSÃO: A versão em português do STAXI apresenta uma estrutura fatorial adequada que permite a avaliação das dimensões da raiva em pacientes clínicos.

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Há vários relatos na literatura que referem a associação de fatores psicossociais com doenças crônicas e sintomas clínicos. O estudo tem como objetivo determinar a freqüência dos fatores psicossociais em pacientes e a correlação com doenças e sintomas. Foi realizado um estudo transversal onde foi aplicado o Inventário Beck, o IDATE, o STAXI, o PRIME, o SF-36, as escalas de Eventos vitais e Coping em 782 pacientes. Os sintomas depressivos predominaram no ambulatório geral. O grupo cardiovascular demonstrou maior carga em relação aos fatores. O domínio Raiva-Dentro apresentou score alto no ambulatório geral e o Raiva-Fora na enfermaria. Os fatores psicossociais apresentam um perfil diferenciado de acordo com a clínica de origem e gênero / To evaluated prevalence the psychosocial factors in patients of different clinical practice and your association with the more common diseases and symptoms.Methods: Cross section study , where applied Inventory, IDATE , STAXI, Prime , quality of life, a life events and coping scale to 782 patients.Results: The depressive symptoms predominated in a chronic disease out-patients clinic . The Cardiovascular Group demonstrated large burden of psychosocial factors. Anger-out had the highest score in patients from the chronic disease out-patients clinic and anger –out in in-patients.So, the psychosocial factors demonstrated a specific profile according origin clinic and gender...

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