Autopsies have shown that the main pathological changes associated with S-OIV infection are localized to the lungs, where three distinct histological patterns can be identified. We also show evidence of ongoing pulmonary aberrant immune response. Our results reinforce the usefulness of autopsy in increasing the understanding of the novel human influenza A (H1N1) infection.

Utilization of health care indicators in the monitoring of health system performance has become increasingly important in the last decades. The expansion of the public National Health System, Sistema Unico de Saúde/SUS, growth of the private health sector and implementation of specific types of health care regulation models stimulated the utilization of indicators in the evaluation of hospital care quality and performance and proposals of national indicator systems. This was not accompanied with a corresponding investment in the conditions in which the needed data and information are produced in health services. The objective of this article is to identify some of the necessary conditions for health care performance indicator quality in hospitals: a pervasive institutional culture favoring clinical, administrative and research information and adequate organization and administration of clinical registers, hospital statistics and hospital information systems. No ready made universal hospital information packages will be able to achieve this, and each institution has to develop the ability to incorporate and use, according to specific needs and contexts, capabilities and material and human resources that will turn information management into a dynamic process and part of hospital management in general.

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.

Estudar fatores associados à realização dos exames Papanicolaou e mamografia por mulheres brasileiras. Foram analisadas informações sobre mulheres com 25 anos ou mais, no suplemento Saúde da Pesquisa Nacional de Amostras Domiciliares (PNAD) do IBGE 2003, de realização de Papanicolaou nos últimos 5 anos e mamografia nos últimos 2 anos, sua prevalência por variáveis demográficas, socioeconômicas e saúde, acesso e utilização de serviços de saúde. Foram realizadas análise estatística bivariada e regressão logística para os dois procedimentos. A prevalência para Papanicolaou foi 75,5% e mamografia 36,1%. A regressão logística mostrou como principais fatores preditivos para Papanicolaou: ter filhos, consulta médica no último ano, renda elevada, médio a alto grau de escolaridade, ter plano de saúde e morar em zona urbana. Para mamografia mostraram-se fatores preditivos importantes: distribuição etária (40-59 anos), consulta médica no último ano, morar em zona urbana, renda elevada e ter plano de saúde. No Papanicolaou há maior incorporação na assistência, e o acesso à consulta médica fator essencial para a realização do exame. Na mamografia, a prevalência é mais elevada nas faixas etárias recomendadas, perfil diferenciado por acesso à consulta médica e condição socioeconômica, e muitos exames em mulheres em faixas etárias não recomendadas.

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).