Chronic diseases are a global problem, yet information on their determinants is generally scant in low- and middle-income countries. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information regarding the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes, in one such setting. At Visit 1, we enrolled 15 105 civil servants from predefined universities or research institutes. Baseline assessment (2008–10) included detailed interviews and measurements to assess social and biological determinants of health, as well as various clinical and subclinical conditions related to diabetes, cardiovascular diseases and mental health. A second visit of interviews and examinations is under way (2012–14) to enrich the assessment of cohort exposures and to detect initial incident events. Annual surveillance has been conducted since 2009 for the ascertainment of incident events. Biological samples (sera, plasma, urine and DNA) obtained at both visits have been placed in long-term storage. Baseline data are available for analyses, and collaboration via specific research proposals directed to study investigators is welcome.

Our results reinforce the need to increase detection and treatment of hypertension and to approach patients' global risk profiles.

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In order to characterize the epidemiology of American Cutaneous Leishmaniasis (ACL) in a periurban area of the municipality of Sabará in the metropolitan region of Belo Horizonte (MRBH), an area until then considered free of the disease, a cross sectional survey was undertaken in 1990. The survey of the population consisted of 1119 interviews and 881 clinical examinations using Montenegro's skin test (MST). A low prevalence (3.7%) of positive MST was encountered. The disease had been occurring in the area for about 20 years in the form of sporadic cases. The predominant species of sandfly both in domestic areas and nearby areas of secondary vegetation was Lutzomyia whitmani. A canine survey of delayed hypersensitivity to the antigen P10,000 identified only one dog with a positive reaction out of 113 examined. The transmission of ACL in MRBH was confirmed. The occurrence of the disease in women, children and individuals with no contact with forest areas as well as the presence of potential vector species in the domiciliar environment, suggests the transmission of the disease in this environment.

Granuloma formation and modulation around Schistosoma mansoni eggs that are trapped in host tissues play a pivotal role during schistosomiasis. It has been demonstrated that the granuloma reactions differ in patients with the different clinical forms of the disease. The pathology during murine schistosomiasis has been correlated with a Th2 response while resistance to infection with a Th1 type response. In humans, very little is known about the role of different cytokines on the development of the disease. Here we demonstrate that IL-10 is an important cytokine regulating the in vitro granulomatous reactivity of PBMC from intestinal (INT) patients. This was evidenced by the fact that blockage of this cytokine in the in vitro granuloma assay lead to a significant increase in granuloma size with cells from INT patients but not with individuals in the acute phase or with the hepatosplenic (HS) form of schistosomiasis. These results demonstrate for the first time that, in context with the model, a Th2 cytokine in human schistosomiasis plays an important role in controlling morbidity.

PAT exam is feasible and has acceptable reproducibility in adults when compared with other noninvasive methods for endothelial function assessment. This performance makes PAT a promising method for future clinical and epidemiological studies.

OBJECTIVE:To estimate the prevalence and factors associated to healthy behavior among young adults. METHODS:A total of 14,193 respondents aged 18-29 years who participated in the system Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL -Telephone-Based Surveillance of Risk and Protective Factors for Chronic Diseases) carried out in 27 Brazilian capitals in 2006 were studied. Healthy behavior was defi ned as non-smoking, reported regular physical activity and intake of fruits and vegetables fi ve days or more a week. Data analysis was based on prevalence ratios estimated using Poisson regression. RESULTS:The prevalence of healthy young adults was 8.0%; 39.6% reported two healthy behaviors, 45.3% one; and 7.0% none. In the multivariate analysis, healthy behavior was more commonly seen among those aged 25-29 years with 9 or more years of schooling and who reported engaging in physical activities near home. Inverse associations were found with non-white skin color, consumption of whole milk and fatty meat or poultry, being on a diet, and poor self-perception of health status. CONCLUSIONS:Young adults who show fewer healthy behaviors perceive their health as poor, which suggests that these behaviors negatively affect their own health perception. Positive associations with higher schooling, white skin color, and living near physical activity facilities indicate social inequalities in access to healthy behaviors. Exposure to risk behaviors such as smoking, unhealthy diet, and physical inactivity usually starts in early adolescence and it consistently persists through adult life. DESCRIPTORS:6 These risk factors are associated to increased risk of chronic non-communicable diseases (CNCD) including cardiovascular diseases, diabetes, and cancer, which are leading causes of morbidity and mortality during adult life. Lifetime experiences and exposures, mostly from childhood to young adulthood, have long-term health impact and can contribute to health inequalities in adult and elder life. 9,12,16 Epidemiological studies have evidenced that cardiovascular diseases would be a rare cause of death in the absence of main risk factors. The Interheart study was conducted in 52 countries and showed that factors such as dyslipidemia, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable intake, excess alcohol intake, and physical inactivity account for 90% of population attributable risk in men and 94% in women, affecting all age groups and countries.