Abstract Background: People with haemophilia (PwH) are living longer. Therefore, they can develop atherosclerotic cardiovascular disease (ASCVD). Electrocardiogram (ECG) alterations may be a sign of initial ASCVD before the occurrence of symptoms. Objective: To describe the prevalence of resting ECG alterations among PwH adults asymptomatic for ASCVD. Methods: PwH aged ≥ 30 years without previous ASCVD events were considered for the analysis. Resting ECG traces were analysed according to international reference values and the Brazilian Longitudinal Adult Health Study (ELSA-Brasil) results for asymptomatic Brazilian men. Based on the established normal values and using the QT index, we further described the altered ECGs as minor or major changes, according to the Minnesota Code. Differences between prevalences were evaluated by Pearson's χ2 test. Differences between medians were evaluated by the Mann-Whitney U test. A p-value < 0.05 was accepted as statistically significant. Results: A total of 64 PwH were included in the study. Median age was 44 years (interquartile range 35-52). Most patients had haemophilia A (81%) and 47% were severe. The prevalence of obesity, systemic arterial hypertension (SAH), diabetes mellitus (DM), and dyslipidaemia were 16%, 56%, 14%, and 72%, respectively. All the PwH had sinus rhythm, except for one, who had an implanted pacemaker due to idiopathic third-degree atrioventricular block. Altered ECGs were found in 25% and 30% of PwH, according to established criteria and ELSA-Brasil criteria, respectively. Major changes were found in eight (13%) PwH according to the Minnesota Code, including two ECGs with ischaemia-like wall inactivity. Conclusions: The prevalence of altered ECG varied from 25% to 30% among asymptomatic PwH. Background (PwH longer Therefore . (ASCVD) (ECG symptoms Objective Methods 3 analysis ELSABrasil ELSA Brasil (ELSA-Brasil men index Code Pearsons Pearson s χ test MannWhitney Mann Whitney pvalue p value 005 0 05 0.0 significant Results 6 study 4 interquartile 3552. 3552 35 52 35-52) 81% 81 (81% 47 severe obesity SAH, SAH , (SAH) DM, DM (DM) 16 16% 56 56% 14 14% 72 72% respectively rhythm one thirddegree third degree block 25 13% 13 (13% ischaemialike ischaemia like inactivity Conclusions (ASCVD 00 0. 355 5 35-52 8 (81 (SAH (DM 1 7 2 (13 35-5 (8 (1 35- (

Resumo Fundamento A taxa de mortalidade de pessoas com hemofilia (PCH) no Brasil está diminuindo, mas a incidência relativa de mortes associadas a doenças cardiovasculares (DCV) tem aumentado. Objetivos Nosso objetivo foi descrever o escore de risco de DCV de PCHs de acordo com a ferramenta Pooled Cohort Equations Risk (PCER) Calculator e suas recomendações de tratamento. Além disso, foram comparadas as estimativas da PCER com o respectivo escore de risco de Framingham (FRS). Métodos Este estudo transversal incluiu PCHs do sexo masculino, com idade igual ou superior a 40 anos, tratados no Centro de Tratamento Integral de Hemofilia de Pernambuco (Recife/Brasil). PCHs com um evento cardiovascular prévio ou colesterol lipídico de baixa densidade ≥ 5,0 mmol/L foram excluídas. Entrevistas, revisões de prontuários médicos e exames de sangue foram realizados. A ferramenta PCER foi utilizada para estimar o risco de DCV e compará-lo com o respectivo FRS. Um valor de p < 0,05 foi aceito como estatisticamente significativo. Resultados Trinta PCHs foram incluídas. A idade mediana foi de 51,5 [intervalo interquartil-IIQ; 46,0-59,5] anos. A prevalência de obesidade, hipertensão arterial sistêmica, diabetes mellitus, hipertrigliceridemia, hipercolesterolemia e hipoHDLemia foi de 20%, 67%, 24%, 14%, 47% e 23%, respectivamente. O escore mediano da PCER foi de 6,9% [IIQ; 3,1-13,2], com 50% de alto risco (PCER ≥ 7,5%). O uso de estatina foi sugerido para 54% das PCHs. A pressão arterial estava mal controlada em 47% das PCHs. A concordância entre PCER e FRS foi de 80% (κ = 0,60; p = 0,001). Conclusões Metade dos homens com hemofilia, com 40 anos de idade ou mais, teve um alto risco de desenvolver DCV em 10 anos, com fortes recomendações para melhorar o controle da dislipidemia e da pressão arterial. PCH (PCH diminuindo (DCV aumentado tratamento disso . (FRS) masculino 4 Recife/Brasil. RecifeBrasil Recife/Brasil Recife (Recife/Brasil) 50 5 0 5, mmolL mmol L excluídas Entrevistas realizados comparálo compará lo 005 05 0,0 significativo incluídas 515 51 51, intervalo interquartilIIQ interquartil IIQ interquartil-IIQ 46,059,5 460595 46,0 59,5 46 59 46,0-59,5 obesidade sistêmica mellitus hipertrigliceridemia 20 20% 67 67% 24 24% 14 14% 47 23 23% respectivamente 69 6 9 6,9 [IIQ 3,113,2, 31132 3,1 13,2 , 3 1 13 2 3,1-13,2] 7,5%. 75 7,5% 7 7,5%) 54 80 κ 0,60 060 60 0,001. 0001 0,001 001 0,001) mais (FRS (Recife/Brasil 00 0, 059 46,059, 46059 460 46, 595 59, 46,0-59, 6, 113 3,113,2 3113 31 3, 132 13, 3,1-13,2 7,5 8 0,6 06 000 0,00 46,059 4605 46,0-59 11 3,113, 311 3,1-13, 7, 46,05 46,0-5 3,113 3,1-13 46,0- 3,11 3,1-1 3,1-

Abstract Background The mortality rate of Brazilian people with haemophilia (PwH) is decreasing, but the relative incidence of deaths associated with cardiovascular disease (CVD) is increasing. Objectives We aimed to describe the CVD risk score of PwH according to Pooled Cohort Equations Risk (PCER) Calculator tool and its treatment recommendations. We also compared the PCER estimates with the respective Framingham Risk Score (FRS). Methods This cross-sectional study included male PwH ≥ 40 years treated at the Comprehensive Haemophilia Treatment Centre of Pernambuco (Recife/Brazil). PwH with a previous CVD event or a low-density lipid cholesterol ≥ 5.0 mmol/L were excluded. Interviews, medical file reviews, and blood tests were performed. The PCER tool was used to estimate the CVD risk and compare it with the respective FRS. A p-value < 0.05 was accepted as statistically significant. Results Thirty PwH were included. Median age was 51.5 [interquartile range-IQR; 46.0-59.5] years. The prevalence of obesity, systemic arterial hypertension, diabetes mellitus, hypertriglyceridaemia, hypercholesterolaemia, and hypoHDLaemia were 20%, 67%, 24%, 14%, 47%, and 23%, respectively. The median PCER score was 6.9% [IQR; 3.1-13.2], with 50% having a high risk (PCER ≥ 7.5%). Statin use was suggested for 54% of PwH. Blood pressure was poorly controlled in 47% of PwH. The agreement between PCER and FRS was 80% (κ = 0.60; p = 0.001). Conclusions Half of the male people with haemophilia aged 40 years or older had a 10-year high risk of developing CVD with strong recommendations to improve control of dyslipidaemia and blood pressure. (PwH decreasing (CVD increasing . (FRS) crosssectional cross sectional 4 Recife/Brazil. RecifeBrazil Recife/Brazil Recife Brazil (Recife/Brazil) lowdensity low density 50 5 0 5. mmolL mmol L excluded Interviews reviews performed pvalue value 005 05 0.0 significant 515 51 51. interquartile rangeIQR range IQR range-IQR 46.059.5 460595 46.0 59.5 46 59 46.0-59.5 obesity hypertension mellitus hypertriglyceridaemia hypercholesterolaemia 20 20% 67 67% 24 24% 14 14% 47 23 23% respectively 69 6 9 6.9 [IQR 3.113.2, 31132 3.1 13.2 , 3 1 13 2 3.1-13.2] 7.5%. 75 7.5% 7 7.5%) 54 80 κ 0.60 060 60 0.001. 0001 0.001 001 0.001) 10year year 10 (FRS (Recife/Brazil 00 0. 059 46.059. 46059 460 46. 595 59. 46.0-59. 6. 113 3.113.2 3113 31 3. 132 13. 3.1-13.2 7.5 8 0.6 06 000 0.00 46.059 4605 46.0-59 11 3.113. 311 3.1-13. 7. 46.05 46.0-5 3.113 3.1-13 46.0- 3.11 3.1-1 3.1-

Abstract INTRODUCTION: Metabolic disorders in people living with HIV/AIDS (PLH) have been described even before the introduction of antiretroviral (ARV) drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART). METHODS: This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. RESULTS: The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS) was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF) criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria). CONCLUSIONS: Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet). The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.

Este estudo teve como objetivo descrever a distribuição espacial e temporal dos candidatos à doação de sangue, do Município de Belo Horizonte, Minas Gerais, Brasil, que se apresentaram no hemocentro da Fundação Hemominas, nos anos de 1994 e 2004. Comparou no espaço e no espaço-tempo as características idade, sexo e aptidão clínica destes candidatos. As informações de 1994, obtidas de estudo transversal, e as de 2004, amostrados entre os candidatos à doação durante o ano. As amostras foram georreferenciadas através dos endereços de residência. As técnicas espaciais utilizadas foram: mapas Kernel, mapas temáticos de taxas Bayesianas empíricas e de taxas brutas e o índice de Moran global. Os resultados indicaram que a distribuição espacial de candidatos não foi aleatória. Os mapas Kernel auxiliaram na detecção de locais com maior ou menor concentração de candidatos. Os mapas temáticos descreveram a concentração de candidatos relativos à população para as diferentes categorias analisadas. Estes resultados ajudam na detecção de locais para ações direcionadas à captação de candidatos à doação bem como locais com necessidades de campanhas a públicos específicos.

The main goal of this study was to describe the spatial and temporal distribution of candidates for blood donation in Belo Horizonte, Minas Gerais State, Brazil, who appeared at the Hemominas Foundation in 1994 and 2004. The study also compared the candidates for age, gender, and clinical approval for blood donation in space and space-time. Data were obtained from a cross-sectional study for 1994 and were randomly selected from all donor candidates for 2004. The samples were georeferenced using the residential address. The spatial analysis techniques employed were: Kernel maps, thematic maps of Bayesian empirical rates and crude rates, and Moran Global. According to the findings, spatial distribution of candidates was non-random. The Kernel maps helped detect points with higher or lower concentration of candidates. Thematic maps described the concentration of candidates in relation to the population for the various categories. The results could help detect areas for actions targeting donor recruitment and areas with specific blood donation public campaign needs.

Este estudo teve como objetivo descrever a distribuição espacial e temporal dos candidatos à doação de sangue, do Município de Belo Horizonte, Minas Gerais, Brasil, que se apresentaram no hemocentro da Fundação Hemominas, nos anos de 1994 e 2004. Comparou no espaço e no espaço-tempo as características idade, sexo e aptidão clínica destes candidatos. As informações de 1994, obtidas de estudo transversal, e as de 2004, amostrados entre os candidatos à doação durante o ano. As amostras foram georreferenciadas através dos endereços de residência. As técnicas espaciais utilizadas foram: mapas Kernel, mapas temáticos de taxas Bayesianas empíricas e de taxas brutas e o índice de Moran global. Os resultados indicaram que a distribuição espacial de candidatos não foi aleatória. Os mapas Kernel auxiliaram na detecção de locais com maior ou menor concentração de candidatos. Os mapas temáticos descreveram a concentração de candidatos relativos à população para as diferentes categorias analisadas. Estes resultados ajudam na detecção de locais para ações direcionadas à captação de candidatos à doação bem como locais com necessidades de campanhas a públicos específicos.

The main goal of this study was to describe the spatial and temporal distribution of candidates for blood donation in Belo Horizonte, Minas Gerais State, Brazil, who appeared at the Hemominas Foundation in 1994 and 2004. The study also compared the candidates for age, gender, and clinical approval for blood donation in space and space-time. Data were obtained from a cross-sectional study for 1994 and were randomly selected from all donor candidates for 2004. The samples were georeferenced using the residential address. The spatial analysis techniques employed were: Kernel maps, thematic maps of Bayesian empirical rates and crude rates, and Moran Global. According to the findings, spatial distribution of candidates was non-random. The Kernel maps helped detect points with higher or lower concentration of candidates. Thematic maps described the concentration of candidates in relation to the population for the various categories. The results could help detect areas for actions targeting donor recruitment and areas with specific blood donation public campaign needs.

O trabalho descreve um inquérito sorológico para rickettsioses em escolares e cães de Novo Cruzeiro, Minas Gerais, Brasil, em 1998. Trezentos e trinta e um escolares pertenciam a uma área endêmica e 142 a uma área não endêmica do município. Trinta e nove (10,1%) soros foram reativos à Reação de Imunofluorescência Indireta (RIFI) para Rickettsia rickettsiino título de 1:64, sendo que dentre esses reativos, 35 eram de estudantes de escolas de área endêmica. Dentre os 73 cães analisados quanto à presença de anticorpos anti R. rickettsii, anti Ehrlichia chaffeensise anti Ehrlichia canisà RIFI no título de 1:64, 3 (4,11%), 11 (15,07%) e 13 (17,81%) desses animais foram reativos respectivamente aos antígenos testados. Conclui-se que, a sororeatividade para R. rickettsiiem indivíduos sadios sem história prévia de febre maculosa brasileira, uma doença marcante por sua alta letalidade, e a presença de sororeatividade para Ehrlichiacom potencial patogênico para o homem em cães, nos leva a indagar sobre a transmissão ao homem de outras espécies da família Rickettsiae na área estudada.

This article describes a serological survey for rickettsiosis in the county of Novo Cruzeiro, Minas Gerais State, Brazil, in 1998, testing schoolchildren and dogs. Sera included 331 samples from schoolchildren from an endemic area and 142 samples from schoolchildren from a non-endemic area in the county. All children examined were healthy and had not reported clinical symptoms of Brazilian spotted fever prior to the serological survey. Some 35 children in the endemic area were reactive to Rickettsia rickettsiiby indirect fluorescent antibody (IFA) with a titer of 1:64, corresponding to 10.6%. Sera from 73 dogs were tested, showing seroreactivity (IFA 1:64) to Rickettsia rickettsi, Ehrlichia chaffeensis, and Ehrlichia canisin 3 (4.11%), 11 (15.07%), and 13 (17.81%), respectively. The results in schoolchildren and the presence of canine seroreactivity to Ehrlichiaspecies that are potentially pathogenic to humans suggests the risk of transmission of other Rickettsiaein the study area.

O trabalho descreve um inquérito sorológico para rickettsioses em escolares e cães de Novo Cruzeiro, Minas Gerais, Brasil, em 1998. Trezentos e trinta e um escolares pertenciam a uma área endêmica e 142 a uma área não endêmica do município. Trinta e nove (10,1%) soros foram reativos à Reação de Imunofluorescência Indireta (RIFI) para Rickettsia rickettsiino título de 1:64, sendo que dentre esses reativos, 35 eram de estudantes de escolas de área endêmica. Dentre os 73 cães analisados quanto à presença de anticorpos anti R. rickettsii, anti Ehrlichia chaffeensise anti Ehrlichia canisà RIFI no título de 1:64, 3 (4,11%), 11 (15,07%) e 13 (17,81%) desses animais foram reativos respectivamente aos antígenos testados. Conclui-se que, a sororeatividade para R. rickettsiiem indivíduos sadios sem história prévia de febre maculosa brasileira, uma doença marcante por sua alta letalidade, e a presença de sororeatividade para Ehrlichiacom potencial patogênico para o homem em cães, nos leva a indagar sobre a transmissão ao homem de outras espécies da família Rickettsiae na área estudada.

This article describes a serological survey for rickettsiosis in the county of Novo Cruzeiro, Minas Gerais State, Brazil, in 1998, testing schoolchildren and dogs. Sera included 331 samples from schoolchildren from an endemic area and 142 samples from schoolchildren from a non-endemic area in the county. All children examined were healthy and had not reported clinical symptoms of Brazilian spotted fever prior to the serological survey. Some 35 children in the endemic area were reactive to Rickettsia rickettsiiby indirect fluorescent antibody (IFA) with a titer of 1:64, corresponding to 10.6%. Sera from 73 dogs were tested, showing seroreactivity (IFA 1:64) to Rickettsia rickettsi, Ehrlichia chaffeensis, and Ehrlichia canisin 3 (4.11%), 11 (15.07%), and 13 (17.81%), respectively. The results in schoolchildren and the presence of canine seroreactivity to Ehrlichiaspecies that are potentially pathogenic to humans suggests the risk of transmission of other Rickettsiaein the study area.