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Objective This study describes epidemiological and clinical features of patients with confirmed infection by SARS-CoV-2 diagnosed and treated at Hospital Israelita Albert Einstein , which admitted the first patients with this condition in Brazil. Methods In this retrospective, single-center study, we included all laboratory confirmed COVID-19 cases at Hospital Israelita Albert Einstein , São Paulo, Brazil, from February until March 2020. Demographic, clinical, laboratory and radiological data were analyzed. Results A total of 510 patients with a confirmed diagnosis of COVID-19 were included in this study. Most patients were male (56.9%) with a mean age of 40 years. A history of a close contact with a positive/suspected case was reported by 61.1% of patients and 34.4% had a history of recent international travel. The most common symptoms upon presentation were fever (67.5%), nasal congestion (42.4%), cough (41.6%) and myalgia/arthralgia (36.3%). Chest computed tomography was performed in 78 (15.3%) patients, and 93.6% of those showed abnormal results. Hospitalization was required for 72 (14%) patients and 20 (27.8%) were admitted to the Intensive Care Unit. Regarding clinical treatment, the most often used medicines were intravenous antibiotics (84.7%), chloroquine (45.8%) and oseltamivir (31.9%). Invasive mechanical ventilation was required by 65% of Intensive Care Unit patients. The mean length of stay was 9 days for all patients (22 and 7 days for patients requiring or not intensive care, respectively). Only one patient (1.38%) died during follow-up. Conclusion These results may be relevant for Brazil and other countries with similar characteristics, which are starting to deal with this pandemic.

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ABSTRACT Objective This study describes epidemiological and clinical features of patients with confirmed infection by SARS-CoV-2 diagnosed and treated at Hospital Israelita Albert Einstein , which admitted the first patients with this condition in Brazil. Methods In this retrospective, single-center study, we included all laboratory confirmed COVID-19 cases at Hospital Israelita Albert Einstein , São Paulo, Brazil, from February until March 2020. Demographic, clinical, laboratory and radiological data were analyzed. Results A total of 510 patients with a confirmed diagnosis of COVID-19 were included in this study. Most patients were male (56.9%) with a mean age of 40 years. A history of a close contact with a positive/suspected case was reported by 61.1% of patients and 34.4% had a history of recent international travel. The most common symptoms upon presentation were fever (67.5%), nasal congestion (42.4%), cough (41.6%) and myalgia/arthralgia (36.3%). Chest computed tomography was performed in 78 (15.3%) patients, and 93.6% of those showed abnormal results. Hospitalization was required for 72 (14%) patients and 20 (27.8%) were admitted to the Intensive Care Unit. Regarding clinical treatment, the most often used medicines were intravenous antibiotics (84.7%), chloroquine (45.8%) and oseltamivir (31.9%). Invasive mechanical ventilation was required by 65% of Intensive Care Unit patients. The mean length of stay was 9 days for all patients (22 and 7 days for patients requiring or not intensive care, respectively). Only one patient (1.38%) died during follow-up. Conclusion These results may be relevant for Brazil and other countries with similar characteristics, which are starting to deal with this pandemic.

RESUMO Objetivo Descrever as características epidemiológicas e clínicas de pacientes com infecção confirmada pelo SARS-CoV-2, diagnosticados e tratados no Hospital Israelita Albert Einstein, que admitiu os primeiros pacientes com essa condição no Brasil. Métodos Neste estudo retrospectivo, de centro único, incluímos todos os casos com confirmação laboratorial de COVID-19 no Hospital Israelita Albert Einstein, em São Paulo (SP) de fevereiro a março de 2020. Foram analisados dados demográficos, clínicos, laboratoriais e radiológicos. Resultados Foram incluídos 510 pacientes com diagnóstico confirmado de COVID-19. A maioria dos pacientes era do sexo masculino (56,9%), com média de idade de 40 anos. Foi relatada história de contato próximo com um caso positivo/suspeito por 61,1% dos pacientes, e 34,4% tinham história de viagens internacionais recentes. Os sintomas mais comuns foram febre (67,5%), congestão nasal (42,4%), tosse (41,6%) e mialgia/artralgia (36,3%). A tomografia computadorizada de tórax foi realizada em 78 (15,3%) pacientes, e 93,6% deles apresentaram resultados anormais. A hospitalização foi necessária para 72 (14%) pacientes, e 20 (27,8%) foram admitidos na Unidade de Terapia Intensiva. Quanto ao tratamento clínico, os medicamentos mais utilizados foram antibióticos intravenosos (84,7%), cloroquina (45,8%) e oseltamivir (31,9%). A ventilação mecânica invasiva foi necessária em 65% dos pacientes na Unidade de Terapia Intensiva. O tempo médio de internação foi 9 dias para todos os pacientes (22 e 7 dias para pacientes que necessitaram ou não de cuidados intensivos, respectivamente). Apenas um (1,38%) paciente morreu durante o acompanhamento. Conclusão Estes resultados podem ser relevantes para o Brasil e outros países com características semelhantes, que começaram a lidar com essa pandemia.

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INTRODUCTION: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. OBJECTIVE: To describe the characteristics of central venous catheterization and the complication rate related to it. METHOD: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU) of a teaching hospital were selected from March 2014 to February 2015. Data were collected from medical charts using an electronic form. Clinical and laboratory characteristics from patients, procedure characteristics, and mechanical and infectious complications rates were assessed. Patients with and without complications were compared. RESULTS: Three hundred and eleven (311) central venous catheterizations were evaluated. The main reasons to perform the procedure were lack of peripheral access, chemotherapy and sepsis. There were 20 mechanical complications (6% of procedures). Arterial puncture was the most common. Procedures performed in the second semester were associated with lower risk of complications (odds ratio 0.35 [95CI 0.12-0.98; p=0.037]). Thirty-five (35) catheter-related infection cases (11.1%) were reported. They were related to younger patients and procedures performed by residents with more than one year of training. Procedures performed after the first trimester had a lower chance of infection. CONCLUSION: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.

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Summary Introduction: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. Objective: To describe the characteristics of central venous catheterization and the complication rate related to it. Method: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU) of a teaching hospital were selected from March 2014 to February 2015. Data were collected from medical charts using an electronic form. Clinical and laboratory characteristics from patients, procedure characteristics, and mechanical and infectious complications rates were assessed. Patients with and without complications were compared. Results: Three hundred and eleven (311) central venous catheterizations were evaluated. The main reasons to perform the procedure were lack of peripheral access, chemotherapy and sepsis. There were 20 mechanical complications (6% of procedures). Arterial puncture was the most common. Procedures performed in the second semester were associated with lower risk of complications (odds ratio 0.35 [95CI 0.12-0.98; p=0.037]). Thirty-five (35) catheter-related infection cases (11.1%) were reported. They were related to younger patients and procedures performed by residents with more than one year of training. Procedures performed after the first trimester had a lower chance of infection. Conclusion: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.

Resumo Introdução: Cateteres venosos centrais são fundamentais na prática clínica diária. Em hospitais de ensino, esse procedimento é realizado por médicos residentes, frequentemente sem supervisão ou treinamento estruturado. Objetivo: Descrever as características das punções venosas centrais e a taxa de complicações relacionadas. Método: Estudo de coorte retrospectiva. Foram selecionados pacientes adultos submetidos a punção venosa central fora de unidade de terapia intensiva (UTI) de um hospital de ensino no ano letivo de 2014 (março de 2014 a fevereiro de 2015). Os dados foram coletados por meio de revisão de prontuários com o uso de formulário eletrônico. Foram avaliadas características clínicas e laboratoriais dos pacientes, características do procedimento, taxa de complicações mecânicas e infecciosas relacionadas. Foram comparados os pacientes com complicações em relação àqueles sem complicações. Resultados: Foram avaliadas 311 punções venosas centrais. Os principais motivos para realização do procedimento foram falta de rede periférica, quimioterapia e sepse. Ocorreram 20 complicações mecânicas (6% dos procedimentos); punção arterial foi a mais comum. Procedimentos realizados no segundo semestre do ano letivo foram associados a menor risco de complicações (razão de chances de 0,35 [IC95 0,12-0,98; p=0,037]). Foram descritos 35 casos de infecção relacionada ao cateter (11,1%). Casos de infecção foram associados a pacientes mais jovens e procedimentos realizados por residentes com mais de um ano de treinamento. Procedimentos realizados após o primeiro trimestre tiveram menor chance de infecção. Conclusão: Esses resultados mostram que a taxa de complicações mecânicas de punção venosa central em nosso hospital é semelhante à da literatura; porém, maior atenção deve ser dada para medidas de prevenção de infecção.

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Introdução: A Hepatite C tem uma prevalência estimada de cerca de 170 milhões de pessoas mundialmente e cursa com grande morbimortalidade. O tratamento deste deste vírus tem se alterado significativamente nos últimos anos, porém, no Brasil, ainda imperam os tratamentos baseados em interferon convencional ou em interferon -peguilado associado à ribavirina. Métodos: Estudo de coorte, retrospectivo, conduzido no Hospital de Clínicas de Porto Alegre. Foram incluídos 237 pacientes com Hepatite C tratados com interferon e ribavirina ou com interferon -peguilado e ribavirina. Resultados: A taxa global de resposta virológica sustentada obtida foi de 33,33%, sendo 37,93% nos pacientes com regime baseado em interferon convencional e 32,69% nos pacientes com interferon -peguilado. A análise demonstrou uma maior taxa de resposta virológica sustentada entre os pacientes que apresentaram, à análise genética, expressão CC do polimorfismo do IL 28B.

Introduction: Hepatitis C affects approximately 170 million people worldwide and it results in great morbidity and mortality. The virus treatment has changed significantly. However, in Brazil, treatments based on conventional interferon or pegylated-interferon associated with ribavirin are still the most usual ones. Methods: Retrospective cohort study conducted at Hospital de Clínicas de Porto Alegre. That included 237 patients treated for hepatitis C with interferon and ribavirin or pegylated--interferon and ribavirin. Results: The overall rate of sustained virologic response was 33.33%, with a rate of 37.93% in patients treated with conventional interferon and 32.69% in with pegylatedinterrferon. The analysis showed a higher rate of sustained virologic response among patients who, in genetic analysis, CC expression of IL28B polymorphism.

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Introdução: Tumores estromais gastrointestinais (GIST) são neoplasias raras que se originam das células intersticiais de Cajal. Objetivo: Descrever a experiência do Hospital de Clínicas de Curitiba no tratamento do GIST localizado e avançado, com análise das características clínicas e anatomopatológicas e uso do imatinibe. Método: Estudo retrospectivo com 32 pacientes com diagnóstico por imuno-histoquímica, c-Kit positivo, no período de 2003 a 2008. Resultados: Idade mediana: 66 anos; tamanho mediano do tumor de 8,4 cm; e as localizações mais frequentes foram estômago em 46,9 por cento e intestino delgado em 40,9 por cento. Pacientes com alto risco de agressividade: 37,5 por cento; apresentavam doença localizada no diagnóstico 23 pacientes: 39,1 por cento recaíram e 9 com doença avançada. O seguimento mediano foi de 43,7 meses, com sobrevida global em 5 anos no grupo total de 56,2 por cento. Na doença localizada, a sobrevida global em 5 anos foi de 73,8 por cento e na avançada de 37,5 por cento (p=0,03). Não ocorreu impacto dos fatores prognósticos na sobrevida. Utilizou-se omesilato de imatinibe em 16 pacientes: 43,8 por cento por metástase inicial, 37,5 por cento recaída a distância, 12,5 por cento recaída local e 6,2 por cento margem comprometida. A sobrevida global com uso do imatinibe mediana foi de 53 meses e a sobrevida livre de primeira progressão de 32,9 meses. Houve boa tolerabilidade ao imatinibe e apenas dois pacientes utilizaram osunitinibe. Conclusão: A maioria dos tumores era grande, de localização gástrica e de alto risco de agressividade. A taxa de recaída na doença localizada foi alta. E a sobrevida global dos pacientes de doença localizada e que utilizaram o imatinibe foi considerada satisfatória.

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