ObjectiveTo determine the prevalence and epidemiological characteristics of inmates diagnosed with infectious diseases living in a region with a high number of prisons, São Paulo, Brazil.DesignThis is a retrospective and descriptive study conducted from November 2017 to October 2018.SettingPrisons located in the western and northwestern regions of São Paulo, Brazil.MethodsWe conducted a retrospective analysis on infectious diseases and coinfections (HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and tuberculosis (TB)) of inmates from 28 prisons. Inmates were previously diagnosed following the protocol for control and surveillance of infectious diseases, through laboratory or imaging methods. A questionnaire was completed by the healthcare staff. Prevalence was obtained by dividing the number of individuals with positive results by the number of inmates in each prison. Locations of prisons were obtained and maps were constructed using geographic information systems.ResultsA total of 741 of 37 497 inmates (1.97%) were diagnosed with HIV, HBV, HCV, syphilis or TB. HIV was the most prevalent infectious disease (0.68%), followed by TB (0.66%), syphilis (0.2%), HCV (0.2%) and HBV (0.04%). For all of these diseases, prevalence rates varied from very low to high (3.11% and 2.45%) for TB and HIV, respectively, in the five prisons where they were most prevalent. HIV-syphilis was the most associated coinfection (OR, 63.7; 95% CI 41.4 to 96.7). Three of those diagnosed with the infection were female and the ratio of female to men was 0.004:1.ConclusionsOur findings demonstrate that the number of cases of infectious disease among inmates in the northwestern and western region of São Paulo is probably underestimated, with lower rates of HCV, HBV and syphilis. This represents a challenge to prisoners’ health. Improvements in diagnosis, mainly to reduce viral hepatitis, are crucial with benefits for inmates and the general population.

Co-epidemics of COVID-19 and dengue in dengue-endemic countries represent a serious public health concern. In Brazil, São Paulo state ranks first for cases and deaths from COVID-19, and dengue is endemic in most regions of the country. In 2020, an outbreak of dengue occurred in western São Paulo. We determined the spatiotemporal distribution of dengue in the context of COVID-19 cases in Presidente Prudente, a mid-sized city in western São Paulo. To illustrate the burden of both infections, a case report of a doctor and his family, infected with dengue and COVID-19, is presented. There were three clusters of dengue and COVID-19 in the periphery. A dengue cluster was found in a region where there were no corresponding COVID-19 cases. Meanwhile, there were COVID-19 clusters where dengue activity was lower. In 2020, the COVID-19 epidemic emerged when dengue reached its seasonal peak, resulting in a simultaneous outbreak of both diseases. Lower rates of dengue were found in the city compared with 2019, and the fear of patients with mild dengue symptoms about remaining in hospital and acquiring COVID-19 infection may be the main cause. Simultaneous spatial clusters of dengue and COVID-19 in environmentally and socioeconomically vulnerable areas can guide public health authorities in intensive interventions to improve clinical diagnosis, epidemiological surveillance, and management of both diseases. The patient and his family were first infected with dengue and he then carried COVID-19 to his family, reinforcing the risk of health care workers spreading the virus to the community. We highlight the epidemiological significance of presenting a case report and spatial analysis of COVID-19 in the same study in the context of a dengue outbreak.

Introdução: A Hipertensão Arterial é uma das principais doenças que acometem a população mundial sendo causada por um conjunto de fatores de risco. Nesse contexto, os medicamentos anti-hipertensivos são essenciais para a prevenção de morbimortalidade cardiovascular e cerebrovascular decorrentes do controle insatisfatório da Pressão Arterial. Objetivo: conhecer o perfil epidemiológico, clínico e terapêutico anti-hipertensivo de pacientes atendidos no ambulatório de hipertensão de um hospital público terciário. Métodos: Trata-se de estudo coorte retrospectivo, realizado por meio de busca ativa em prontuários eletrônicos de 165 pacientes em tratamento anti-hipertensivo atendidos entre janeiro de 2019 e junho de 2020 no ambulatório de hipertensão de um hospital público terciário do interior Paulista. Resultados: com este estudo foi possível observar uma correlação entre a hipertensão arterial e o perfil lípidico, a glicemia de jejum alterada e o hormônio tireoestimulante e uma correlação moderada entre a pressão arterial diastólica e a pressão arterial sistólica. Em relação a terapêutica anti-hipertensiva, a mais utilizada foi preferencialmente os anti-hipertensivos de primeira linha, independente se monoterapia ou em combinação. Conclusões: As correlações encontradas e as drogas anti- hipertensivas prescritas estão em concordância com a VII Diretriz Brasileira de Hipertensão Arterial e o plano terapêutico prescrito está de acordo com a realidade nacional em que a maioria dos pacientes que usam drogas anti-hipertensivas utilizam os medicamentos disponibilizadas gratuitamente pelo SUS favorecendo a adesão ao tratamento.

The study reports the case of a patient with multiple aneurysms and ectasias of the coronary arteries whose first manifestation was acute coronary syndrome. This is a 42-year-old male patient who was diagnosed with acute myocardial infarction without ST segment elevation. Cineangiocoronariography showed a three-vessel lesion with aneurysmatic and ectatic coronary dilations. Myocardial revascularization surgery was chosen, but he refused to undergo surgical treatment. He was discharged with optimized clinical treatment with outpatient follow-up. Months after diagnosis, the patient died and was being followed up in another service. Coronary artery aneurysm is a rare entity. The ideal management is still not well established, with doubts and disagreements about surgical and interventional treatment and when to indicate them.

This study, based on medical records analysis and literature review, addresses the condition of an acute myocardial infarction (AMI) of non-atherosclerotic etiology, resulting from coronary embolism, consequent to atrial fibrillation (AF). IAM caused by embolism has poorly established pathophysiology, control and prognosis, although the therapeutic approach corresponds to that observed in atherosclerotic AMI, in most cases. The goal of this study was to report and discuss the episode of a non-atherosclerotic AMI due to coronary embolism, in order to prevent new diagnoses from going unnoticed. In conclusion, AF was the etiological factor involved in this event and the involvement of the right coronary artery, as observed in this case, is not recurrent.