Evaluation of emerging infectious disease and the importance of SINAN for epidemiological surveillance of Venezuelans immigrants in Brazil.

BACKGROUND: Following socio-economic turmoil in Venezuela, millions of the Venezuelan people are migrating to the neighboring Latin American countries including Brazil. Besides the social and economic burden of these migrants, Brazil must manage the health-related issues arising as consequence of these Venezuelan migrants. Poor health services in Venezuela along with unhygienic travelling conditions, lack of food (malnutrition) and potable water, unhealthy and overcrowded refugee camps or shelters, poor availability of medical services have made the migrant Venezuelan population susceptible to various diseases, especially infectious diseases. SINAN system is a health-related system in Brazil that keeps track of different health occurrences in the society and allows health care workers and policymakers free access to these data. OBJECTIVES: To evaluate the emergence of infectious diseases as a consequence of the arrival of Venezuelans immigrants in Brazil and to assess the importance of SINAN for epidemiological surveillance. METHODS: Observational retrospective study. Data were collected from the SINAN system between 2015 and 2017 and was analyzed using descriptive statistics, and Mann-Whitney test (using SPSS tool version 12). Evaluated infectious diseases in this study were tuberculosis, sexually transmitted infections (STIs), HIV/AIDS, syphilis, viral hepatitis, leishmaniasis, and malaria. RESULTS: STIs were the most commonly reported diseases. Compared to Brazilians, Venezuelan migrants reported significantly higher number of HIV/Aids (p < 0.046) and leishmaniasis cases (p < 0.049), while Brazilians reported significantly higher number of hepatitis cases (p < 0.046). Malaria was also more prevalent among Venezuelan migrants than native Brazilians. CONCLUSION: Increased incidence of infectious diseases among the migrant population should be considered seriously as lack of adequate control of these diseases might lead to outbreaks.

Cardiovascular Risk in Men Aged Over 40 in Boa Vista, Brazil.

BACKGROUND: Cardiovascular disease is the most common cause of disease in the developed world. Early detection and risk prediction are a key component in reducing cardiovascular mortality. The Framingham Risk Score uses age, sex, cholesterol, blood pressure, diabetes, and smoking to calculate the 10-year risk probability of developing cardiovascular disease for a given patient. The aim of this study was to examine cardiovascular disease risk in men aged over 40 years in Boa Vista, Brazil and identify socioeconomic factors contributing to the risk. METHODS: This was an epidemiological, cross-sectional, descriptive study. Physical examination and questionnaire survey were conducted on the participants. RESULTS: Of the 598 participants (average age = 55.38 ± 10.77 years), 346 completed all the examinations and answered the survey, while 252 completed the survey and the physical examinations but did not undertake the laboratory tests. A large proportion of participants were overweight (42.6%) or obese (23.6%), 14.5% were hypertensive, and 71.9% were prehypertensive. Consumption of red meat and junk food was high, while participation in the exercise was low. Framingham scores ranged from -3 to 13 (mean score: 3.86 ± 3.16). A total of 204 participants (34.1%) had a low risk of cardiovascular disease, 98 (16.4%) had a medium risk, and 44 (7.4%) possessed high risk. Increased abdominal circumference (P = 0.013), resting pulse (P = 0.002), and prostate-specific antigen levels (P < 0.001) were associated with increased risk of cardiovascular disease. CONCLUSIONS: Our study highlights a worrying trend in increasing obesity and hypertension, most likely associated with increasingly poor diet and reduced participation in exercises. As the Brazilian population ages, this will drive increasing rates of cardiovascular mortality unless these trends are reversed. This study suggests that such campaigns should focus on men over the age of 40, who are married or divorced and of lower income.

Leiomyoma--a rare benign tumor of the female urethra: a case report.

INTRODUCTION: Leiomyoma in the urethra is a rare occurrence. These are rare benign mesenchymal tumors that arise from the smooth muscle of the urethra. Such tumors often appear in females during their reproductive age (from menarche to menopause); the mean age of their appearance is approximately 41 years. CASE PRESENTATION: We report here a case of a 52-year-old White woman who presented with complaints of sporadic hematuria, dyspareunia, and feeling of nodulation in her vagina. CONCLUSIONS: Histopathological studies confirmed the urethral leiomyoma, and the surgery completely resolved the original symptoms. Although the average age of occurrence of such tumors in females is about 41 years, the present case involves an older woman of 52 years. Most importantly, the mass was located in the distal urethra, an uncommon site of presentation of leiomyoma in females.

N-acetyltransferase-2 gene polymorphisms and prostate cancer susceptibility in Latin American patients.

We investigated the role of N-acetyltransferases (NAT) in prostate cancer (PCa) susceptibility. NAT are polymorphic in the population and metabolize important carcinogenic products directly involved in the tumor initiation process. This prospective case-control study utilized the polymerase chain reaction-based restriction fragment length polymorphism method and comprised a cohort of consecutive 478 individuals: 126 men with prostate cancer; 101 men with benign prostatic hyperplasia (BPH); and a control health population of 177 female and 74 male blood donors from the same region. NAT2 slow or fast acetylators genotypes were determined by the combination of four variant alleles. Lifetime occupational history, dietary patterns, cigarette smoking and other anamnestic data were obtained by interviews. We were not able to find any correlation among smoking, dietary patterns, parameters of tumor aggressiveness or patient outcome and any NAT2 genotypes or phenotypes considered in separate or in different combinations. However, there was an association between NAT2T481C (OR=0.47; 95% CI=0.26-0.84; P=0.01) and NAT2A803G (OR=0.57; 95% CI=0.33-0.97; P=0.04) polymorphisms and PCa protection. Conversely, the presence of NAT2G857A genotype increased the risk of PCa more than 3 times (OR=3.57; 95% CI=1.39-9.15; P=0.005). Slow acetylator NAT2*7A and NAT2*6B genotypes occurred in 10.31% of PCa but in none of BPH patients (P=0.0007). The control health population confirmed the results and allowed the exclusion of possible biases caused by gender influence on genotype inheritance and by the inclusion of not diagnosed prostate diseases patients among the control individuals. We suggest that the investigation of germline polymorphisms of NAT2 gene may be useful in the assessment of Latin American patients at risk of BPH and PCa.