Guidelines on management of human infection with the novel virus influenza A (H1N1)--a report from the Hospital das Clínicas of the University of São Paulo.

The pandemic novel influenza A (H1N1) infection was considered widespread in Brazil on July, 2009. Since then, 9.249 cases were confirmed in Brazil, most of them concentrated in São Paulo. The Hospital das Clínicas of the University of São Paulo is a reference center for H1N1 cases in São Paulo. The purpose of this review is to analyze the evidence concerning diagnosis, prevention, and treatment of novel influenza A (H1N1) infection. In addition, we propose guidelines for the management of this pandemic emphasizing Hospital das Clínicas "bundles" for the control of the pandemic novel influenza A (H1N1).

Epidemiology of human infection with the novel virus influenza A (H1N1) in the Hospital das Clínicas, São Paulo, Brazil--June-September 2009.

The pandemic novel influenza A (H1N1) infection was considered widespread in Brazil on July 16, 2009. Since then, 46,810 cases of acute respiratory syndrome have been reported in Brazil, most of them concentrated in São Paulo. Through September 16, we have confirmed 9,249 cases of novel influenza A H1N1in Brazil, including 699 deaths. The mortality rate observed in Brazil is 0.47/100,000 inhabitants and varies according to region. In this period, São Paulo registered 3733 cases (40.3% of the total) of novel influenza A (H1N1) infection and 327 deaths, reflecting a mortality rate of 0.79/100,000 inhabitants. The Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC) is a reference center for H1N1 cases in São Paulo. During the winter of 2009, 472 patients in this hospital were diagnosed with H1N1 infection; of these, 210 were admitted, and 16 died. To control this pandemic and to provide adequate care for these patients, the Hospital das Clínicas implemented "bundles" including prevention strategies, an epidemiologic surveillance service, availability of fast diagnosis, antiviral treatment and training of staff. The purpose of this manuscript is to describe the epidemiologic features of novel human influenza A (H1N1) infection in the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo during the winter period of the 2009 pandemic.

Study of mural paintings by Fulvio Pennacchi in São Paulo City by mineralogical techniques

The present research deals with two mural paintings made in 1947 with the fresco technique by Fulvio Pennacchi in the Catholic Chapel of the Hospital das Clínicas (São Paulo City, Brazil), namely the Virgin Annunciation and the Supper at Emmaus. This study regards the materials and painting techniques used by the artist, based on historical research,on in situ observations and laboratory analytical techniques (stereomicroscopy,scanning electron microscopy with an energy dispersive spectrometer, X-ray diffractometry, electron microprobe, images obtained with UV-light), aiming to improve the methods of characterization of objects of our cultural heritage, and to enhance its preservation accordingly. The results lead to the identification of the plaster components and of distinct layers in the frescoes, besides further information on grain size, impurities and textures, composition of pigments, and features of deterioration, such as efflorescences. The degree of degradation of the murals painting was assessed by this way. Our data suggest that a single layer of plaster was used by Pennacchi, as a common mortar with fine- and medium-grained aggregates. Differences in texture were obtained by adding gypsum to the plaster.

A presente pesquisa trata de duas pinturas murais feitas em 1947 por Fulvio Pennacchi com a técnica do afresco na Capela Católica do Hospital das Clínicas (São Paulo, Brasil), intituladas Anunciação da Virgem e Ceia de Emaús. Este estudo considera os materiais e as técnicas de pintura usadas pelo artista, baseado na pesquisa histórica, observações in situ e técnicas analíticas de laboratório (estereomicroscopia, microscopia eletrônica de varredura com detector de espectro de energia dispersiva, difração de raios X, microssonda eletrônica, imagens obtidas com luz ultravioleta), visando aperfeiçoar os métodos de caracterização de objetos do nosso patrimônio cultural, e otimizar sua preservação adequadamente. Os resultados conduziram à identificação dos componentes da argamassa e as diferentes camadas nos afrescos, além de informações sobre a granulação, impurezas e texturas, composição dos pigmentos, e feições de deterioração, tal como eflorescência. O grau de degradação das pinturas murais foi avaliado desta maneira. Nossos dados sugerem que Pennacchi usou uma camada única de argamassa com agregados de granulação fina a média. Diferenças na textura foram obtidas pela adição de gesso à argamassa.

Guidelines on management of human infection with the novel virus influenza A (H1N1): a report from the Hospital das Clínicas of the University of São Paulo

The pandemic novel influenza A (H1N1) infection was considered widespread in Brazil on July, 2009. Since then, 9.249 cases were confirmed in Brazil, most of them concentrated in São Paulo. The Hospital das Clínicas of the University of São Paulo is a reference center for H1N1 cases in São Paulo. The purpose of this review is to analyze the evidence concerning diagnosis, prevention, and treatment of novel influenza A (H1N1) infection. In addition, we propose guidelines for the management of this pandemic emphasizing Hospital das Clínicas "bundles" for the control of the pandemic novel influenza A (H1N1).

Epidemiology of human infection with the novel virus influenza A (H1H1) in the Hospital das Clínicas, São Paulo, Brazil - june-september 2009

The pandemic novel influenza A (H1N1) infection was considered widespread in Brazil on July 16, 2009. Since then, 46,810 cases of acute respiratory syndrome have been reported in Brazil, most of them concentrated in São Paulo. Through September 16, we have confirmed 9,249 cases of novel influenza A H1N1in Brazil, including 699 deaths. The mortality rate observed in Brazil is 0.47/100,000 inhabitants and varies according to region. In this period, São Paulo registered 3733 cases (40.3 percent of the total) of novel influenza A (H1N1) infection and 327 deaths, reflecting a mortality rate of 0.79/100,000 inhabitants. The Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC) is a reference center for H1N1 cases in São Paulo. During the winter of 2009, 472 patients in this hospital were diagnosed with H1N1 infection; of these, 210 were admitted, and 16 died. To control this pandemic and to provide adequate care for these patients, the Hospital das Clínicas implemented "bundles" including prevention strategies, an epidemiologic surveillance service, availability of fast diagnosis, antiviral treatment and training of staff. The purpose of this manuscript is to describe the epidemiologic features of novel human influenza A (H1N1) infection in the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo during the winter period of the 2009 pandemic.

Estudo da implantação de dosagem de drogas terapêuticas no Laboratório Central do Hospital das Clínicas da Universidade Federal de Minas Gerais / Introduction study of therapeutic drugs at the Central Laboratory Clinics Hospital from Universidade Federal of Minas Gerais

A Monitorização de Drogas ou Controle Terapêutico (CT) é a determinação da concentração de uma ou mais drogas em fluidos biológicos com o objetivo principal de individualização da dose. Nesses termos, vários grupos de fármacos têm sido avaliados. Apesar disso, a dosagem de neurolépticos tem maior difusão nos laboratórios especializados, em função, principalmente, da gravidade apresentada pelos pacientes; sob terapia dessas drogas, tanto na ausência de efeitos farmacológicos (subdose) ou no desenvolvimento de efeitos tóxicos (superdose). Devido à pequena demanda que existia no Laboratório Central do Hospital das Clínicas da Universidade Federal de Minas Gerais (LCHC UFMG), as dosagens eram realizadas por laboratórios conveniados. No entanto, com o crescimento da demanda, verificou-se a viabilidade da implantação dessa rotina no LCHC UFMG, quanto aos custos e rapidez dos resultados. Dessa forma, verificou-se que as drogas mais requisitadas no período de agosto/93 a julho/94 foram o ácido valpróico, carbamazepina, fenitoína, fenobarbital, pelas Clínicas Médicas, Neurologia, Pediatria. Sendo o valor pago por dosagem ao laboratório conveniado, cerca de US$ 21,00, o valor recebido pelo INAMPS variou de US$ 6,00 a US$ 12,00 no decorrer do período citado anteriormente, e o valor de custos para o LCHC UFMG implantar, cerca de US$ 8,30. A média dos custos totais, de exames realizados, pago ao laboratório conveniado nesse período foi de US$ 10.262,00, o valor recebido pelo INAMPS foi de US$ 4.498,00, enquanto o valor de custos para LCHC UFMG seria em média US$ 4.048,00, usando o aparelho Cobas Mira (Roche). Desta forma, optou-se pela implantação das dosagens dessas drogas terapêuticas.