Abstract The interface between the fields of health and communication brings together a wide diversity of topics, perspectives and articulations between academic production (scientific content) and its dissemination to the public (health journalism). The development and convergence of communication technologies, the progressive mediatization of society and institutions, the new generation of readers and their ways of consuming health content are some of the examples of the various issues addressed in health communication. The aim of this article is to reflect on the relationship between media and health and its current importance in the production and dissemination of contents, in light of the new information and communication technologies, producing efficient and credible information, directed to different audiences.

OBJECTIVES: This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward. INTRODUCTION: Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries. METHODS: From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, São Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded. RESULTS: Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5 + 13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV), herpes simplex virus 1 (HSV1), Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients. CONCLUSION: Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance.

Relatamos o primeiro caso de acidente por Bothriopsis taeniata no Brasil. A vítima, trabalhador rural com 43 anos de idade, foi picada pouco acima do calcanhar direito, apresentando quadro clínico compatível por envenenamento botrópico leve: discreto edema com hemorragia no local da picada e dor, embora com ausência de coagulopatia.

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.

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.

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).

Severe pulmonary involvement in malaria has been frequently reported in cases of Plasmodium falciparum infection, but rarely in vivax malaria. Among the 11 previous cases of vivax-related severe respiratory involvement described in the literature, all except one developed it after the beginning of anti-malarial treatment; these appear to correspond to an exacerbation of the inflammatory response. We report the case of a 43-year-old Brazilian woman living in a malaria-endemic area, who presented acute respiratory distress syndrome (ARDS) caused by P. vivax before starting anti-malarial treatment. The diagnosis was made based on microscopic methods. A negative rapid immunochromatographic assay, based on the detection of Histidine Rich Protein-2 (HRP-2) of P. falciparum, indicated that falciparum malaria was unlikely. After specific anti-plasmodial therapy and intensive supportive care, the patient was discharged from the hospital. We conclude that vivax malaria-associated ARDS can develop before anti-malarial therapy.

Embora a gota espessa corada por Giemsa (GTS) permaneça o padrão ouro para o diagnóstico de malária, métodos moleculares são mais sensíveis e específicos para detectar parasitas e podem ser utilizados em centros de referência para avaliar o desempenho da microscopia. A descrição das seqüências dos genes ssrRNA de Plasmodium falciparum, P. vivax, P. malariae e P. ovale permitiu o desenvolvimento de uma reação em cadeia da polimerase (PCR) que tem sido utilizada para diferenciar as quatro espécies. O objetivo deste estudo foi determinar as espécies de Plasmodium através de PCR em 190 lâminas positivas de pacientes para verificar a qualidade do diagnóstico realizado no Laboratório de Malária da SUCEN. Considerando somente os 131 resultados positivos em ambas as técnicas, GTS detectou 4,6% de infecções mistas e 3,1% de P. malariae enquanto o PCR identificou 19,1% e 13,8%, respectivamente.

Although the Giemsa-stained thick blood smear (GTS) remains the gold standard for the diagnosis of malaria, molecular methods are more sensitive and specific to detect parasites and can be used at reference centers to evaluate the performance of microscopy. The description of the Plasmodium falciparum, P. vivax, P. malariae and P. ovale ssrRNA gene sequences allowed the development of a polymerase chain reaction (PCR) that had been used to differentiate the four species. The objective of this study was to determine Plasmodium species through PCR in 190 positive smears from patients in order to verify the quality of diagnosis at SUCEN's Malaria Laboratory. Considering only the 131 positive results in both techniques, GTS detected 4.6% of mixed and 3.1% of P. malariae infections whereas PCR identified 19.1% and 13.8%, respectively.

OBJETIVO: Avaliar o efeito da administração intramuscular de artemether a camundongos infectados experimentalmente por Schistosoma mansoni no momento da infecção, durante a maturação dos esquistossômulos e após iniciada a oviposição. MÉTODOS: Oitenta camundongos Balb/c, fêmeas adultas, foram divididos em oito grupos com 10 animais cada. Sete grupos foram infectados por S. mansoni empregando-se 60 cercárias para cada animal, inoculadas por via subcutânea; o grupo restante foi mantido sem infecção. Entre os sete grupos infectados, seis foram tratados com artemether, segundo o seguinte esquema: três grupos receberam dose correspondente a 100 mg/kg no dia 0, 20 ou 60 após inoculação das cercárias; os demais receberam 50 mg/kg de artemether, no mesmo período que os lotes anteriores. Da 9ª, 10ª e 11ª semanas após infecção os camundongos infectados por S. mansoni foram submetidos a exames de fezes pela técnica de Kato-Katz. No 80º dia do experimento, os animais sobreviventes foram sacrificados e submetidos à perfusão do sistema porta para recuperação de vermes. Determinaram-se, nessa ocasião, os pesos corporal, hepático e esplênico de cada animal. RESULTADOS: Observou-se queda na oviposição e no número de vermes recuperados entre os camundongos tratados com artemether (50 ou 100 mg/kg) no 20º dia após infecção. A diminuição do número de vermes foi mais expressiva no caso de fêmeas de S. mansoni. Verificou-se, ainda, diminuição significativa nos pesos hepático e esplênico entre os animais tratados com 50 e 100 mg/kg de artemether no 20º dia e também entre os que receberam a droga na dose de 50 mg/kg 60 dias após infecção. CONCLUSÕES: Ficou evidenciada a atividade anti-Schistosoma do artemether, mesmo ao se empregar dose correspondente a 50 mg/kg, quando a droga foi administrada durante o período de maturação dos esquistossômulos no sistema porta do hospedeiro vertebrado.

OBJECTIVE: To evaluate the effect of intramuscular injection of artemether in mice experimentally infected with Schistosoma mansoni , at the time of infection, during schistosomula maturation and after the beginning of egg-laying. METHODS: Eighty adult females Balb/c mice were divided into 8 groups with 10 animals each. Seven groups were infected with S. mansoni using 60 cercariae for each animal, inoculated subcutaneously, and the remaining group was maintained without infection. Among the seven infected groups, six were treated with artemether, according to the following schedule: three groups received doses of 100 mg/kg on days 0, 20 or 60 after inoculation of the cercariae; the other three received 50 mg/kg of artemether, also on days 0, 20 or 60. At the end of the 9th, 10th and 11th weeks after infection all the mice infected with S. mansoni were submitted to fecal examination using the Kato-Katz technique. On the 80th day of the experiment, the surviving animals were sacrificed and submitted to perfusion of the portal system in order to recover the worms. Body, liver and spleen weights of each animal were determined at that time. RESULTS: A reduction in egg-laying and the number of worms recovered was observed in mice treated with artemether (50 or 100 mg/kg) on the 20th day after infection. The decrease in the number of worms was more notable among S. mansoni females. A significant decrease in liver and spleen weights was also seen on the 20th day among animals treated with 50 or 100 mg/kg of artemether and also among those that received the drug at a dose of 50 mg/kg 60 days after infection. CONCLUSIONS: Evidence of the antischistosomal activity of artemether was shown, even at a dose of 50 mg/kg, when the drug was administered during the schistosomula maturation period in the portal system of the vertebrate host.

OBJETIVO: Avaliar o efeito da administração intramuscular de artemether a camundongos infectados experimentalmente por Schistosoma mansoni no momento da infecção, durante a maturação dos esquistossômulos e após iniciada a oviposição. MÉTODOS: Oitenta camundongos Balb/c, fêmeas adultas, foram divididos em oito grupos com 10 animais cada. Sete grupos foram infectados por S. mansoni empregando-se 60 cercárias para cada animal, inoculadas por via subcutânea; o grupo restante foi mantido sem infecção. Entre os sete grupos infectados, seis foram tratados com artemether, segundo o seguinte esquema: três grupos receberam dose correspondente a 100 mg/kg no dia 0, 20 ou 60 após inoculação das cercárias; os demais receberam 50 mg/kg de artemether, no mesmo período que os lotes anteriores. Da 9ª, 10ª e 11ª semanas após infecção os camundongos infectados por S. mansoni foram submetidos a exames de fezes pela técnica de Kato-Katz. No 80º dia do experimento, os animais sobreviventes foram sacrificados e submetidos à perfusão do sistema porta para recuperação de vermes. Determinaram-se, nessa ocasião, os pesos corporal, hepático e esplênico de cada animal. RESULTADOS: Observou-se queda na oviposição e no número de vermes recuperados entre os camundongos tratados com artemether (50 ou 100 mg/kg) no 20º dia após infecção. A diminuição do número de vermes foi mais expressiva no caso de fêmeas de S. mansoni. Verificou-se, ainda, diminuição significativa nos pesos hepático e esplênico entre os animais tratados com 50 e 100 mg/kg de artemether no 20º dia e também entre os que receberam a droga na dose de 50 mg/kg 60 dias após infecção. CONCLUSÕES: Ficou evidenciada a atividade anti-Schistosoma do artemether, mesmo ao se empregar dose correspondente a 50 mg/kg, quando a droga foi administrada durante o período de maturação dos esquistossômulos no sistema porta do hospedeiro vertebrado.

OBJECTIVE: To evaluate the effect of intramuscular injection of artemether in mice experimentally infected with Schistosoma mansoni , at the time of infection, during schistosomula maturation and after the beginning of egg-laying. METHODS: Eighty adult females Balb/c mice were divided into 8 groups with 10 animals each. Seven groups were infected with S. mansoni using 60 cercariae for each animal, inoculated subcutaneously, and the remaining group was maintained without infection. Among the seven infected groups, six were treated with artemether, according to the following schedule: three groups received doses of 100 mg/kg on days 0, 20 or 60 after inoculation of the cercariae; the other three received 50 mg/kg of artemether, also on days 0, 20 or 60. At the end of the 9th, 10th and 11th weeks after infection all the mice infected with S. mansoni were submitted to fecal examination using the Kato-Katz technique. On the 80th day of the experiment, the surviving animals were sacrificed and submitted to perfusion of the portal system in order to recover the worms. Body, liver and spleen weights of each animal were determined at that time. RESULTS: A reduction in egg-laying and the number of worms recovered was observed in mice treated with artemether (50 or 100 mg/kg) on the 20th day after infection. The decrease in the number of worms was more notable among S. mansoni females. A significant decrease in liver and spleen weights was also seen on the 20th day among animals treated with 50 or 100 mg/kg of artemether and also among those that received the drug at a dose of 50 mg/kg 60 days after infection. CONCLUSIONS: Evidence of the antischistosomal activity of artemether was shown, even at a dose of 50 mg/kg, when the drug was administered during the schistosomula maturation period in the portal system of the vertebrate host.

This study was done to determine the occurrence of mycobacteria in the bloodstreams of patients with fever and advanced AIDS in a Brazilian hospital. We also verified the capability of an automated method for recovering these bacteria. During a period of 19 months, 254 patients with AIDS were evaluated. Blood cultures were generally submitted in pairs and drawn separately. Blood cultures were processed by the BACTEC 460TB System (Becton Dickinson Microbiology Systems, Sparks, MD), using the Bactec 13A media (Becton Dickinson Microbiology Systems, Sparks, MD). Of the 530 vials submitted, 77 (14.5%) from 41 (16%) patients were positive. Mycobacterium avium complex was recovered from 45 (58.4%) of the 77 positive vials, corresponding to 22 (53.6%) patients with positive blood cultures. The average time to detect Mycobacterium avium complex was 15 days. Mycobacterium tuberculosis was recovered from 26 (33.8%) of the 77 positive vials, corresponding to 15 (36.6%) patients with positive blood cultures, with an average detection time of 24 days. Other species of mycobacteria were recovered from 6 (7.8%) of the 77 vials, corresponding to 4 (9.8%) patients. M.avium complex was fairly prevalent (8.7%) in severely ill patients with AIDS in our hospital. M. tuberculosis was also an important (6.0%) agent of systemic bacterial infections in these patients. The rapid diagnosis of mycobacteremia was possible with the implementation of this automated technology.