How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Prevalence and circulant genotypes of Chlamydia trachomatis in university women from cities in the Brazilian Amazon.

BACKGROUND: Approximately 80% of infected women infected by Chlamydia trachomatis are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection and genotypes are available in Amazonian communities. OBJECTIVES: To describe the prevalence of and associated factors and to identify the genotypes of sexual C. trachomatis infection in female university students in different urban centers (capital and interiors) in the Brazilian state of Pará, in the eastern Amazon region. METHODS: A cross-sectional study was performed among young women attending public universities in four different urban centers in the eastern Amazon region. They were invited to participate in the studt and cervical secretions were collected for molecular diagnosis of C. trachomatis. We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by nucleotide sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Qui-square and Binominal regression test were used to evaluate the degree of association of these variables with the infection. RESULTS: A total of 686 female students was included in the study. The overall prevalence of C. trachomatis was 11.2% (77/686). The prevalence of this infection was higher in interiors (15.2% vs 9.5%/ p: 0.0443). Female university students who do not have a sexual partner (11.8%/p <0.008), who do not use a condom in their sexual relations (17.8%/p <0.0001) and who reported having suffered a miscarriage (32%/p <0.0001) have high chances of acquiring this sexual infection. The ompA gene was sequenced in only 33 (42.8%) samples, revealing the genotype J was the most frequent (27.2% [9/33]), followed by genotypes D (24.2% [8/33]), and then genotypes F (18.2% [6/33]), E (15.1% [5/33]) K (6.1% [2/33]), Ia (6.1% [2/33]), and G (3.1% [1/33]). CONCLUSIONS: The high prevalence of sexual infection by C. trachomatis in the female university students from the interior of the state of Pará, individuals with no fixed sexual partner, those that had had a miscarriage, the students that do not use condoms in their sexual relations. The genotype J of C. trachomatis genotypes was the most frequent. These data are important to help defining the epidemiological effects of chlamydial infections in Amazonian populations.

An electrogram-guided transvenous temporary pacemaker implant simulator.

INTRODUCTION: Transvenous temporary pacemaker (TvTP) implantation is a critical procedure often performed under time limitations, playing a crucial role in patient survival. However, the amount of training provided for resident cardiologists is variable, due to the availability of patients. Thus, the use of simulators for this cardiologic procedure could be used as training tools. OBJECTIVE: The present study aimed to develop a simulator system for TvTP implantation based on electrograms, called ETTIS (Electrogram-guided Transvenous Temporary-pacemaker Implantation Simulator), and to evaluate its educational potential and cardiology residents' perceived learning efficacy as a training tool. METHODOLOGY: The development of the ETTIS involved three stages: (1) Adaptation of an anatomical mannequin; (2) Design and manufacture of electronic circuits and software capable of identifying the catheter contact site within the heart chambers and reproducing electrograms in both surfaces (mode-on) and intracavitary (mode-off); (3) To evaluate its educational potential, a modified Likert questionnaire was administered to nine cardiology experts. Additionally, to evaluate the perceived learning efficacy, another modified Likert questionnaire was given to six cardiology residents both before and after training with the ETTIS. Descriptive statistics with measures of position and dispersion were employed, and the weighted Kappa test was used for agreement analysis. RESULTS: A high rate of acceptance (over 90%) was found among experts who evaluated the ETTIS. The cardiology residents showed significant self-perceived learning gains, as evidenced by a lack of agreement between their responses to a questionnaire before and after training. CONCLUSION: The ETTIS is a promising tool for medical training, displaying both educational potential and efficacy. It has been shown to be effective in learning a variety of skills, including cardiac catheterization and electrophysiology. Additionally, the ETTIS is highly engaging and allows cardiology residents to practice in a safe and controlled environment.

Sistema de cotas e desempenho acadêmico: estudo seccional em uma universidade pública brasileira / Quota system and academic performance: sectional study in a brazilian public university / Sistema de cuotas y rendimiento académico: estudio seccional en una universidad pública brasileña

Introdução: A lei de cotas (nº 12.711/2012) foi criada com o intuito de oportunizar o acesso de alunos oriundos de escolas públicas ao ensino superior. Desde então, medidas adicionais foram tomadas para garantir, não só o acesso, mas a permanência destes alunos nas universidades. Objetivo: Este estudo teve como objetivo avaliar o desempenho acadêmico dealunos cotistas e não cotistas da Faculdade de Odontologia da Universidade Federal do Pará. Metodologia: Foram coletados dados de alunos matriculados nos anos de 2020 e2021 por meio de um questionário on-line e realizada a análise de histórico acadêmico dos voluntários. A análise dos dados foi realizada com software Jamovi versão 1.6.23, utilizando os testesQui-quadrado, t de Student para amostras independentes e análise de regressão linear multivariada. Em todas as análises foi adotado o nível de significância de 0,05. Resultados: Com uma taxa de resposta de 39,92% (n=200), os resultados demonstraram haver um melhor desempenho acadêmico para o grupo não-cotista no que se refere ao Coeficiente de Rendimento Geral (p=0,001). Além disso, alunos do grupo cotista enfrentam mais dificuldades quando comparados aos não-cotistas (p<0,0001). Na análise múltipla verificou-se que juntas, forma de ingresso (cotista ou não), o enfrentamento de dificuldades, recebimento de auxílios e atividades fora da Faculdade explicam quase 10% da variável Coeficiente de Rendimento Geral (R² = 0,098). Conclusões: A complexidade da comparação sugere a possibilidade de múltiplas causas, entre elas o fator socioeconômico e outras dificuldades experienciadas. Entender e atuar nestas causas é de fundamental importância para a construção de uma universidade inclusiva de qualidade (AU).

Introduction:The quota law (nº 12.711/2012) was created with the objective of providing opportunities for students from public schools to enter federal universities. Since then, additional measures have been taken to ensure not only the access, but the permanence of these students in universities. Objectives:This study aimed to assess the academic performance of quota students and non-quota students at the Faculty of Dentistry of the Federal University of Pará. Methods:Data were collected from students enrolled in the years 2020 and 2021 through an online questionnaire and the academic history of the volunteers was analyzed. Data analysis was performed with Jamovi software version 1.6.23, using the chi-square test, Student's t test for independent samples, and multivariate linear regression analysis. In all analyses, a significance level of 0.05 was adopted. Results:With a response rate of 39.92% (n=200), the results showed a better academic performance for the non-quotastudents with regard to the General PerformanceCoefficient (p=0.001). In addition, quota students face more difficulties when compared to non-quota students (p<0.0001). In the multiple analysis, it was found that the admission modality (quota students or non-quota students), facing difficulties, receiving aid, and activities outside the University explained together almost 10% of the General Performance Coefficient variable (R² = 0.098). Conclusion:The complexity of the comparison suggests the possibility of multiple causes, including the socioeconomic factor and other difficulties experienced. Understanding and acting on these causes is of fundamental importance for the construction of a quality inclusive university (AU).

Introducción: La ley de cuotas (nº 12.711/2012) fue creada con el objetivo de brindar a estudiantes de colegios públicosla oportunidad de ingresar a una universidad federal. Desde entonces, se han tomado medidas adicionales para asegurar, no solo el acceso, sino también la permanencia de estos estudiantes en las universidades. Objetivos:Este estudio tuvo como objetivo evaluar el rendimiento académico de los alumnos con cuota y los sin cuota de la Facultad de Odontología de la Universidad Federal de Pará. Métodos:Se recolectaron datos de estudiantes matriculados en los años 2020 y 2021 a través de un cuestionario en línea y se realizó el análisis del historial académico de los voluntarios. El análisis de datos se realizó con el software Jamovi versión 1.6.23, utilizando la prueba de qui-cuadrado, prueba t de Student para muestras independientes y análisis de regresión lineal multivariado. En todos los análisis se adoptó un nivel de significación de 0.05. Resultados:Con una tasa de respuesta del 39.92% (n=200), los resultados mostraron un mejor rendimiento académico de los alumnos sin cuotacon respecto al Coeficiente de Rendimiento General (p=0.001). Además, los estudiantes con cuota enfrentan más dificultades cuando comparados a los estudiantes sin cuota (p<0.0001). En el análisis múltiple, se encontró que,en conjunto, la forma de ingreso (alumnos con cuota o sin cuota), enfrentar las dificultades, recibir ayudas y actividades fuera de la Facultad explican casi el 10% de la variable Coeficiente de Rendimiento General(R² = 0,098). Conclusión:La complejidad de la comparación sugiere la posibilidad de múltiples causas, incluido el factor socioeconómico y otras dificultades experimentadas. Comprender y actuar sobre estas causas es de fundamental importancia para la construcción de una universidad inclusiva de calidad (AU).

Ocurrence of rotavirus and picobirnavirus in wild and exotic avian from amazon forest.

The present study reports the occurrence of rotavirus A (RVA), rotavirus D (RVD), rotavirus F (RVF), rotavirus G (RVG), and picobirnavirus (PBV) in fecal specimens of wild (n = 22), and exotic birds (n = 1) from different cities of Pará state. These animals were hospitalized at Veterinary Hospital of the Federal University of Pará, Brazil, in a period from January 2018 to June 2019. The animals exhibited different clinical signs, such as diarrhea, malnutrition, dehydration, and fractures. The results showed 39.1% (9/23) of positivity for RVA by RT-qPCR. Among these, one sample (1/9) for the NSP3 gene of T2 genotype was characterized. About 88.9% (8/9) for the VP7 gene belonging to G1, G3 equine like and G6 genotypes, and 55.5% (5/9) for the VP4 gene of P[2] genotype were obtained. In the current study, approximately 4.5% of the samples (1/23) revealed coinfection for the RVA, RVD and RVF groups. Furthermore, picobirnavirus (PBV) was detected in one of the 23 samples tested, and was classified in the Genogroup I. The findings represent the first report of RVA, RVD, RVF, RVG, and PBV genotypes in wild birds in Brazil, and due to wide distribution it can implies potential impacts of RVs, and PBVs on avian health, and other animals contributing to construction of new knowledge, and care perspectives.

Serological evidence of Eastern equine encephalitis circulation in equids in Pará state, Brazil.

Serum samples from 89 equids were analyzed (75 horses, 9 donkeys, and 5 mules) from the municipality of Viseu, Pará state, Brazil. Samples were collected in November 2014 and August 2015. The antibody prevalence against the following alphaviruses was estimated: Eastern equine encephalitis virus, Western equine encephalitis virus, Mucambo virus, and Mayaro virus. Seroprevalence was determined by the hemagglutination inhibition (HI) technique. Sera that exhibited HI antibodies with heterotypic reactions for the analyzed viruses were subjected to the 90% plaque reduction neutralization test (PRNT90). The HI prevalence of monotypic reactions to EEEV was 7.9%, and that of WEEV was 1.1%, as confirmed by PRNT90. Viral isolation attempts were negative for all tested blood samples. Our results suggest the circulation of equine encephalitis complex viruses. Future studies should evaluate the possible involvement of arthropod hosts and residents in the viral transmission in the study area.

Foram analisadas amostras de soros de 89 equídeos (75 equinos, 9 asininos e 5 muares) oriundos do município de Viseu, estado do Pará. As amostras foram coletadas no período de novembro de 2014 e agosto de 2015. Foram estimadas as prevalências de anticorpos contra os seguintes Alfavírus: vírus da Encefalite equina leste (EEEV), vírus da Encefalite equina oeste (WEEV), vírus Mucambo (MUCV), and vírus Mayaro (MAYV). A soroprevalência foi determinada por técnicas de Inibição da Hemaglutinação (IH), porém os soros que apresentaram anticorpos IH com reações heterotípicas para os vírus analisados foram submetidos ao PRNT90. A prevalência de reações monotípicas por IH para EEEV foi de 7, 9% e para WEEV foi de 1,1%, confirmadas por PRNT90. A tentativa de isolamento viral foi negativa em todas as amostras de sangue testadas. Nossos resultados sugerem a circulação de vírus do complexo das encefalites equinas. Estudos futuros devem ser realizados para avaliar possível envolvimento de hospedeiros artrópodes e residentes na área de abrangência do estudo.

Percepção sobre o mercado de trabalho odontológico dos estudantes do curso de odontologia da Universidade Federal do Pará / Perception of the undergraduate students in dentistry at the Federal University of Pará of the job market for dentists

Objetivo: Avaliar o perfil do estudante do Curso de Odontologia da Universidade Federal do Pará e sua percepção quanto à formação e mercado de trabalho. Métodos: Participaram do estudo 100 estudantes com idade igual ou superior a 18 anos, que estavam cursando o 2º, 4º, 6º, 8º e 10º períodos do curso. O instrumento de pesquisa foi um questionário com 18 questões de múltipla escolha e 1 discursiva, elaboradas por dois estudantes do 10º período e um docente. Os estudantes foram divididos em 2 grupos: grupo 1 correspondente ao período pré-clínico e grupo 2 ao clínico. Para análise de dados foi realizada estatística descritiva e Teste G com nível de significância de 0,05. Resultados: A maioria dos estudantes era do sexo feminino (67%), com renda familiar de até 06 salários mínimos (70%), que escolheram a odontologia por vocação (37%) e primeira opção de curso (55%). A maioria relatou que o curso tem condições adequadas para formação, apesar das dificuldades existentes (53%). O mercado de trabalho foi percebido como bom por 56%. O interesse em aprimorar os estudos antes da inserção no mercado foi predominante (83%), com pretensão salarial de 04 a 06 salários mínimos (31%). Não houve associação estatística entre as variáveis e semestres do curso (p > 0,05). Conclusão: O perfil dos estudantes foi de jovens, predominando o sexo feminino e renda salarial de até 06 salários mínimos, ingressantes pelos sistemas de ampla concorrência e cotas. O curso de Odontologia foi considerado adequado, apesar das dificuldades apresentadas. O mercado de trabalho foi percebido como bom pela maioria dos entrevistados.

Aim:To evaluate the profile of undergraduate students in Dentistry at the Federal University of Pará and their perception of education and the job market. Methods:A hundred students participated in the study, 18 years of age or over, who were in the 2nd, 4th, 6th, 8th, and 10th periods of the course. The research instrument was a questionnaire with 18 multiple choice questions and one discursive question, which was prepared by two students from the 10th period and one teacher. The students were divided into 2 groups: group 1 corresponding to the preclinical and group 2 to the clinician period. Descriptive statistics and G test were used in the data analysis with a 0.05 significance level. Results: Most students were female (67%), with a family income of up to 06 minimum wages (70%), who chose dentistry by vocation (37%) and as their first course option (55%). Most reported that the course has suitable conditions for training, despite the existing difficulties (53%). The job market was perceived as good by 56%. They showed interest in improving studies before entering the market (83%), with a wage expectation of 04 to 06 minimum wages (31%). There was no statistical association between the variables and periods of the course (p > 0.05). Conclusion: The profile of the students was of young individuals (23.4 years old), with predominance of females and salary income of up to 06 minimum wages, who entered the university through the systems of wide competition (49%) and quotas (43%). The undergraduate dentistry course was considered suitable, despite the adversities. The job market was perceived as good by the majority of respondents.

Capacidade para o trabalho em trabalhadores de um instituto de pesquisa / Working ability in workers of a research institute

O estudo objetivou avaliar a capacidade para o trabalho (CT) e analisar os fatores associados à capacidade inadequada em funcionários de um instituto de pesquisa, segundo o vínculo empregatício. Realizou-se uma pesquisa transversal com 515 servidores e terceirizados de uma instituição de pesquisa no Estado do Pará. Utilizou-se um questionário com variáveis sociodemográficas, funcionais e o Índice de Capacidade para o Trabalho (ICT). A média do ICT do grupo dos servidores foi 40,9, e a CT inadequada somou 20,7%. Para os terceirizados, os valores foram 44,3 e 5,1%, respectivamente. A análise múltipla dos servidores mostrou que apenas as variáveis sexo e idade permaneceram significativas. Para os terceirizados, nenhuma variável apresentou significância estatística. As categorias profissionais com maior prevalência de ICT inadequado foram: entre os servidores, os pesquisadores; entre os terceirizados, os trabalhadores da manutenção. Os resultados demonstram que as diferenças existentes entre esses funcionários estão fortemente relacionadas ao vínculo empregatício.

Current study assessed work ability ( WA) and analyzed factors associated with inadequate capacity in employees of a research institute, according to their work contract. A cross-sectional study was conducted with 515 civil servants and outsourced employees of a research institution in the state of Pará, Brazil. A questionnaire with sociodemographic, functional variables and the Work Ability Index ( WAI) was applied. Average WAI of the civil servant group was 40.9 and inadequate WA was 20.7%. Rates for outsourced workers were 44.3 and 5.1%, respectively. Multiple analysis of civil servants showed that only variables of gender and age remained significant. For the outsourced agents, no variable presented any statistical significance. The professional category with the highest prevalence of inadequate WAI were researchers, among civil servants; construction workers, among outsourced workers. Results show that the differences between these employees are strongly related to work contract.

Prevalence and risk indicators of non-carious cervical lesions in male footballers.

BACKGROUND: Non-carious cervical lesions (NCCLs) have shown a significant incidence and prevalence and have been increasingly associated with people's lifestyles and youths. This cross-sectional study aimed to determine the prevalence of NCCLs in footballers and to address potential risk indicators. METHODS: Fourty-three male semi-professional footballers with an average of 27 years old completed a questionnaire and were subjected to intraoral examination in terms of cervical tooth wear, morphological characteristics of NCCLs, tooth sensitivity, occlusal/incisal wear, and malocclusion classification. Also, laboratory assays were performed to determine salivary parameters: flow rate, pH, buffer capacity, level of Ca (calcium), Na (sodium), and K (potassium) ions, and level of cortisol. The data obtained from the questionnaire and intraoral examinations were subjected to Chi-square and Poisson regression models while the data obtained from the laboratory assays were analyzed by using analysis of variance (p <  0.05). RESULTS: The prevalence of NCCLs was 39.5%. The participants presented predominantly initial lesions with signs of mechanical stress. The daily training time was found as a significant risk indicator (p = 0.028). The multivariate analysis showed a significant difference in the variables daily training time (p = 0.023), lemon water intake while fasting (p = 0.002), toothpaste type (p = 0.004), tooth sensitivity (p = 0.006); previous orthodontic treatment (p = 0.003), and occlusion type (p = 0.008). All participants presented normal salivary parameters and levels of cortisol. CONCLUSION: The prevalence of NCCLs among footballers was remarkable. The premolars were the most affected teeth and presented symptoms/signs of initial lesions. The daily training time was a dominant risk indicator of NCCLs development. Footballers presented adequate salivary parameters and cortisol levels.

Desafios à ampliação da cobertura da fluoretação da água em municípios brasileiros com mais de 50 mil habitantes na primeira metade do século XXI / Challenges to spreading water fluoridation coverage in Brazilian municipalities with 50 thousand inhabitants or more at first half of XXI century / Desafíos para el aumento de la cobertura de la fluoruración del agua en municipios brasileños com más de 50 mil habitantes en la primera mitad del siglo XXI

Embora a fluoretação da água de abastecimento público seja um importante determinante para explicar o declínio da cárie dentária nos países que implementaram sua provisão, é grande o desafio para assegurar sua expansão para todas as regiões e territórios. O objetivo do estudo foi determinar as características dos municípios brasileiros com mais de 50 mil habitantes correlacionadas com a cobertura da fluoretação da água. Estudo ecológico transversal com 614 municípios cujo desfecho é representado pela cobertura populacional da política pública e as variáveis independentes referem-se a indicadores municipais socioeconômicos, de saneamento e de serviços de atenção primária à saúde. As relações foram analisadas por meio de regressão linear múltipla. Na análise ajustada (R2=0,39), a cobertura populacional correlacionou-se positivamente com a renda familiar percapita e negativamente com desigualdade da renda, água e esgoto inadequados, cobertura potencial da saúde bucal na estratégia saúde da família. Nas regiões Sudeste, Sul e Centro-Oeste (R2=0,33), analfabetismo e nível de desenvolvimento humano mostraram correlação positiva, enquanto desigualdade de renda e saneamento inadequado apresentaram correlação negativa. Já nas regiões Norte e Nordeste (R2=0,40), saneamento inadequado e nível de desenvolvimento humano mostraram correlação negativa. As desigualdades na expansão dos serviços de saneamento e dos sistemas de vigilância da concentração do fluoreto entre as regiões brasileiras trazem importantes desafios nas próximas décadas que vão requerer sua inclusão na agenda regulatória dos respectivos setores e a implementação de mecanismos de coordenação intersetorial da política pública. (AU)

Although fluoridation of public water is an important determinant to explain the decline in dental caries in countries that have implemented it, the challenge to ensure its expansion to all regions and territories is great. The objective of this study was to determine the characteristics of Brazilian municipalities with more than 50,000 inhabitants correlated with water fluoridation coverage. Method: Cross-sectional ecological study encompassing Brazilian municipalities with more than 50,000 inhabitants in which the outcome is represented by population coverage of the public policy and the independent variables refer to municipal socioeconomic, sanitation and primary health care services indicators. Relations were analyzed by multiple linear regression. Results: 614 municipalities were analyzed. In the adjusted analysis (R2 = 0.39), population coverage correlated positively with per capita household income and negatively correlated with income inequality, inadequate water and sewage, potential oral health coverage in the family health strategy. While illiteracy and human development level showed positive correlation and income inequality and inadequate sanitation, negative correlation in the Southeast, South and Central West (R2 = 0.33) Brazilian regions; in the North and Northeast (R2 = 0.40) regions, inadequate sanitation and human development level showed a negative correlation. Inequalities in the expansion of sanitation services and fluoride concentration adjustment systems among Brazilian regions pose important challenges in the coming decades that will require their inclusion in the regulatory agenda of the corresponding sectors and the implementation of intersectoral coordination mechanisms for public policy. (AU)

Aunque la fluoruración del agua proveniente del abastecimiento público sea un determinante importante del declive de la prevalencia de caries en los países que han implementado su provisión, es grande el desafío para garantizar su expansión a todas las regiones y territorios. El objetivo de este estudio fue determinar las características de los municipios brasileños con más de 50.000 habitantes en relación con la cobertura de fluoruración del agua. Estudio ecológico transversal que abarcó 614 municipios. La variable dependiente es la población cubierta por la política pública y las variables independientes se refieren a los indicadores municipales socioeconómicos, de saneamiento y de servicios de atención primaria de salud. Las relaciones se analizaron utilizando una regresión lineal múltiple. En el análisis ajustado (R2 = 0,39), la cobertura de la población mostró una correlación positiva con el ingreso familiar per cápita y negativa con la insuficiencia de ingresos, la desigualdad de agua y alcantarillado, y la cobertura potencial de salud bucal en la estrategia de salud familiar. En las regiones Sureste, Sur y Centro Oeste (R2 = 0,33), el analfabetismo y el nivel de desarrollo humano mostraron una correlación positiva, mientras que la desigualdad de ingresos y el saneamiento inadecuado presentaron una correlación negativa. Por otro lado, las regiones Norte y Noreste (R2=0,40) mostraron una correlación negativa entre el saneamiento inadecuado y el nivel de desarrollo humano. Las desigualdades tanto en la expansión de los servicios de saneamiento cuanto en los sistemas de vigilancia de concentración de fluoruro entre las regiones brasileñas plantean retos importantes en las próximas décadas que requerirán su inclusión en la agenda reguladora de los sectores respectivos, así como la implementación de mecanismos de coordinación intersectorial de esa política pública. (AU)

Acesso e acessibilidade na atenção primária à saúde no Brasil / Access and accessibility in primary health care in Brazil

Objetivos: Avaliar o acesso e a acessibilidade às Unidades Básicas de Saúde (UBS) nas diferentes regiões do Brasil, caracterizando-os segundo os componentes organizacional e de infraestrutura. Metodologia: Pesquisa avaliativa, de natureza quantitativa, com delineamento transversal descritivo, fundamentada nos dados do terceiro ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Resultados: A maioria das UBS (84,4%) possuem horário fixo de funcionamento; 46,3% mantém atividades no horário do almoço; 87,1% apresentaram todos os ambientes com sinalização, facilitando acesso dos usuários; 21,7% apresenta estrutura divergente do estabelecido pelo Ministério da Saúde. Conclusão: Houve disparidades regionais nos achados encontrados em âmbito nacional quanto ao acesso e à acessibilidade. Na avaliação geral, o componente organizacional aponta conformidade com o preconizado pelo Ministério da Saúde e, no componente infraestrutura, a acessibilidade indicou percentuais que demandam avanços para melhoria do acesso. (AU)

Objectives: Evaluate access and accessibility to Basic Health Units (BHU) in different regions of Brazil, characterizing them according to organizational and infrastructure components. Methodology: Evaluative research, of quantitative nature, with descriptive cross-sectional design, based on data from the third cycle of National Program for Improvement of Access and Quality of Primary Care. Results: Most BHU (84.4%) have fixed opening hours; 46.3% maintain activities at lunchtime; 87.1% presented all environments with signage, facilitating access of users; 21.7% presents a structure that differs from that established by the Ministry of Health. Conclusão: There were regional disparities in the findings found nationwide regarding access and accessibility. In the overall assessment, the organizational component points to compliance with the recommended by the Ministry of Health, and the infrastructure component, accessibility indicated percentages that require advances to improve access. (AU)

Objectivos: Evaluar el acceso y la accesibilidad a las Unidades Básicas de Salud (UBS) en diferentes regiones de Brasil, multiplasándolas de acuerdo con los componentes organizativos y de infraestructura. Metodología: Investigación evaluativa, de naturaleza cuantitativa, con diseño transversal descriptivo, basada en datos del tercer ciclo del Programa Nacional para la Mejora del Acceso y la Calidad de la Atención Primaria. Resultados: Más UBS (84,4%) tienen horarios de apertura fijos; 46,3% mantener actividades a la hora del almuerzo; El 87,1% presentó todos los entornos con señalización, facilitando el acceso de los usuarios; El 21,7% presenta una estructura que difiere de la establecida por el Ministerio de Salud. Conclusión: Hubo disparidades regionales en los resultados encontrados en todo el país con respecto al acceso y la accesibilidad. En la evaluación general, el componente organizacional apunta al cumplimiento del componente recomendado por el Ministerio de Salud y del componente de infraestructura, la accesibilidad indicó porcentajes que requieren avances para mejorar el acceso. (AU)

Water fluoridation in the ten largest municipalities of the state of Tocantins, Brazil. / Fluoretação da água dos dez maiores municípios do estado do Tocantins, Brasil.

Water fluoridation is a strategy for caries control recommended by the WHO. In Brazil, it is regulated by law but this program has not been successfully implemented in the North region. This research aimed to collect data on the existence of external control (heterocontrol) in the ten largest municipalities in the state of Tocantins, Brazil, and to analyze fluoride concentration in the public water supply of these cities. The study was conducted from May-August/17, and its theoretical-methodological framework was a quantitative, descriptive and cross-sectional analysis. Water collections were carried out monthly, using sampling protocol of water collection of the network. Fluoride concentration in the waters was determined with ion specific electrode by the direct technique. It was verified that water fluoridation monitoring is only been done in Palmas, capital of the state, starting in 2016. Thirty-two percent of waters samples analyzed showed fluoride concentration to obtain the maximum benefit of reduction caries and 27.5% of them presented a high or very high risk of dental fluorosis. It is necessary to implement a program to control the concentration of fluoride in the water of the municipalities of Tocantins, in order to ensure that the population is not deprived of the anticaries' benefits of the adjustment of fluoride concentration of the treated water.

Fluoretação da água é uma estratégia de controle da cárie, recomendada pela OMS. No Brasil ela é regulamentada por lei, mas não tem sido implementada com sucesso na região Norte. Os objetivos desta pesquisa foram levantar dados sobre a existência do heterocontrole nos 10 maiores municípios tocantinenses e analisar a concentração de fluoreto presente na água de abastecimento público destas cidades. A pesquisa foi realizada de maio-agosto/17 e teve como marco teórico-metodológico a análise quantitativa, descritiva e transversal. Coletas de água foram realizadas mensalmente, utilizando protocolo de amostragem de coleta de água da rede. A concentração de fluoreto nas águas foi feita com eletrodo íon específico pela técnica direta. Constatou-se que a vigilância da fluoretação da água está em operação na capital do estado desde 2016. Com relação a concentração de fluoreto na água, foi encontrado que 31,6% das amostras analisadas estavam adequadas para o máximo benefício de redução de cárie e 27,5% delas apresentavam risco alto ou muito alto de fluorose dentária. É necessário implementar um programa de controle da concentração de flúor na água no Tocantins, a fim de garantir que a população não seja privada dos benefícios anticárie da agregação de flúor à agua tratada.

Fluoretação da água dos dez maiores municípios do estado do Tocantins, Brasil / Water fluoridation in the ten largest municipalities of the state of Tocantins, Brazil

Resumo Fluoretação da água é uma estratégia de controle da cárie, recomendada pela OMS. No Brasil ela é regulamentada por lei, mas não tem sido implementada com sucesso na região Norte. Os objetivos desta pesquisa foram levantar dados sobre a existência do heterocontrole nos 10 maiores municípios tocantinenses e analisar a concentração de fluoreto presente na água de abastecimento público destas cidades. A pesquisa foi realizada de maio-agosto/17 e teve como marco teórico-metodológico a análise quantitativa, descritiva e transversal. Coletas de água foram realizadas mensalmente, utilizando protocolo de amostragem de coleta de água da rede. A concentração de fluoreto nas águas foi feita com eletrodo íon específico pela técnica direta. Constatou-se que a vigilância da fluoretação da água está em operação na capital do estado desde 2016. Com relação a concentração de fluoreto na água, foi encontrado que 31,6% das amostras analisadas estavam adequadas para o máximo benefício de redução de cárie e 27,5% delas apresentavam risco alto ou muito alto de fluorose dentária. É necessário implementar um programa de controle da concentração de flúor na água no Tocantins, a fim de garantir que a população não seja privada dos benefícios anticárie da agregação de flúor à agua tratada.

Abstract Water fluoridation is a strategy for caries control recommended by the WHO. In Brazil, it is regulated by law but this program has not been successfully implemented in the North region. This research aimed to collect data on the existence of external control (heterocontrol) in the ten largest municipalities in the state of Tocantins, Brazil, and to analyze fluoride concentration in the public water supply of these cities. The study was conducted from May-August/17, and its theoretical-methodological framework was a quantitative, descriptive and cross-sectional analysis. Water collections were carried out monthly, using sampling protocol of water collection of the network. Fluoride concentration in the waters was determined with ion specific electrode by the direct technique. It was verified that water fluoridation monitoring is only been done in Palmas, capital of the state, starting in 2016. Thirty-two percent of waters samples analyzed showed fluoride concentration to obtain the maximum benefit of reduction caries and 27.5% of them presented a high or very high risk of dental fluorosis. It is necessary to implement a program to control the concentration of fluoride in the water of the municipalities of Tocantins, in order to ensure that the population is not deprived of the anticaries' benefits of the adjustment of fluoride concentration of the treated water.

[Water fluoridation in Brazil: regional distribution and accuracy of information on surveillance in municipalities with more than 50,000 inhabitants]. / Fluoretação da água no Brasil: distribuição regional e acurácia das informações sobre vigilância em municípios com mais de 50 mil habitantes.

Sanitation data for 2008 indicated that 74.4% of Brazilian municipalities (counties) with more than 50,000 inhabitants were receiving fluoridated water, but no criteria were adopted to validate the information. The study aimed to verify the accuracy of information on water fluoridation, using as the reference water surveillance data from municipalities with more than 50,000 inhabitants in 2008 and during 2010-2015. Data from different sources were used, comparing the information pertaining to the period. Water samples were collected, and fluoride concentration was obtained by the electrometric method. Verification was performed by comparing the data obtained from different sources. Data were compared for 601 (97.9%) municipalities. The proportion of municipalities that performed surveillance based on external control increased from 39.4% to 48.5%. There was a high rate of false positives and false negatives (15.1%) in the data for 2008. Municipal coverage was 70.2%, or 4.2 percentage points below the published estimate (74.4%) for 2008. Surveillance records were observed in 54.3% of the fluoridated municipalities whose population coverage reached at least 50% of the population receiving treated water. There was an important improvement in fluoridation surveillance data, despite a high percentage of false positives and negatives. There are still wide interregional differences in the surveillance of water fluoridation in this sample of Brazilian municipalities, raising important public health challenges.

Dados de saneamento para 2008 indicavam que 74,4% dos municípios com mais de 50 mil habitantes recebiam água fluoretada, entretanto, critérios para a validação desta informação não foram adotados. O estudo objetivou verificar a acurácia da informação sobre a fluoretação da água, tomando-se por referência dados de vigilância da água em municípios com mais de 50 mil habitantes no ano de 2008 e no período de 2010-2015. Dados de diferentes fontes foram empregados comparando-se as informações relativas ao período. Amostras da água foram coletadas e a concentração de fluoreto foi obtida pelo método eletrométrico. O processo de verificação ocorreu pela confrontação dos dados obtidos por diferentes fontes. Seiscentos e um municípios (97,9%) tiveram os dados confrontados. A taxa de municípios que realizam vigilância com base no heterocontrole passou de 39,4% para 48,5%. Observou-se elevada taxa de falsos positivos ou negativos (15,1%) em relação aos dados de 2008. A cobertura municipal foi de 70,2%, 4,2 pontos abaixo da estimativa (74,4%) divulgada para 2008. Registros da prática da vigilância foram observados em 54,3% dos municípios fluoretados, cuja cobertura populacional alcança 50% ou mais da população que recebe água tratada. Houve sensível melhoria nos dados de vigilância em relação ao fluoreto, embora com porcentual importante de falsos positivos e negativos. Ainda são largas as diferenças inter-regionais relacionadas tanto à provisão da fluoretação da água quanto à implementação da vigilância nos municípios pesquisados, trazendo importantes desafios para a saúde pública.

Los datos de saneamiento en 2008 indicaban que un 74,4% de los municipios con más de 50 mil habitantes recibían agua fluorada, no obstante, no se adoptaron criterios para la validación de esta información. El estudio tuvo como objetivo verificar la exactitud de la información sobre la fluorización del agua, tomando como referencia datos de vigilancia del agua en municipios con más de 50 mil habitantes en el año 2008, y durante el período de 2010-2015. Se emplearon datos de diferentes fuentes comparando la información relativa a este período. Se recogieron muestras de agua y la concentración de fluoruro se obtuvo mediante un método electrométrico. El proceso de verificación se produjo por el contraste de datos obtenidos de diferentes fuentes. Se compararon los datos de 601 (97,9%) municipios. La tasa de municipios que realizan vigilancia en base al heterocontrol pasó de un 39,4% a un 48,5%. Se observó una elevada tasa de falsos positivos o negativos (15,1%), en relación con los datos de 2008. La cobertura municipal fue de un 70,2%, 4,2 puntos por debajo de la estimativa (74,4%) divulgada en 2008. Se observaron registros de la práctica de vigilancia en un 54,3% de los municipios fluorados, cuya cobertura poblacional alcanza a un 50% o más de la población que recibe agua tratada. Hubo una sensible mejoría en los datos de vigilancia respecto al fluoruro, a pesar de que había un porcentaje importante de falsos positivos y negativos. Todavía son grandes las diferencias interregionales relacionadas tanto respecto a la fluorización del agua, como a la implementación de vigilancia en los municipios investigados, implicando importantes desafíos para la salud pública.

Correction: Rotavirus A in wild and domestic animals from areas with environmental degradation in the Brazilian Amazon.

[This corrects the article DOI: 10.1371/journal.pone.0209005.].

Fluoretação da água no Brasil: distribuição regional e acurácia das informações sobre vigilância em municípios com mais de 50 mil habitantes / Water fluoridation in Brazil: regional distribution and accuracy of information on surveillance in municipalities with more than 50 000 inhabitants / Fluorización del agua en Brasil: distribución regional y exactitud de la información sobre su vigilancia en municipios con más de 50 mil habitantes

Resumo: Dados de saneamento para 2008 indicavam que 74,4% dos municípios com mais de 50 mil habitantes recebiam água fluoretada, entretanto, critérios para a validação desta informação não foram adotados. O estudo objetivou verificar a acurácia da informação sobre a fluoretação da água, tomando-se por referência dados de vigilância da água em municípios com mais de 50 mil habitantes no ano de 2008 e no período de 2010-2015. Dados de diferentes fontes foram empregados comparando-se as informações relativas ao período. Amostras da água foram coletadas e a concentração de fluoreto foi obtida pelo método eletrométrico. O processo de verificação ocorreu pela confrontação dos dados obtidos por diferentes fontes. Seiscentos e um municípios (97,9%) tiveram os dados confrontados. A taxa de municípios que realizam vigilância com base no heterocontrole passou de 39,4% para 48,5%. Observou-se elevada taxa de falsos positivos ou negativos (15,1%) em relação aos dados de 2008. A cobertura municipal foi de 70,2%, 4,2 pontos abaixo da estimativa (74,4%) divulgada para 2008. Registros da prática da vigilância foram observados em 54,3% dos municípios fluoretados, cuja cobertura populacional alcança 50% ou mais da população que recebe água tratada. Houve sensível melhoria nos dados de vigilância em relação ao fluoreto, embora com porcentual importante de falsos positivos e negativos. Ainda são largas as diferenças inter-regionais relacionadas tanto à provisão da fluoretação da água quanto à implementação da vigilância nos municípios pesquisados, trazendo importantes desafios para a saúde pública.

Abstract: Sanitation data for 2008 indicated that 74.4% of Brazilian municipalities (counties) with more than 50,000 inhabitants were receiving fluoridated water, but no criteria were adopted to validate the information. The study aimed to verify the accuracy of information on water fluoridation, using as the reference water surveillance data from municipalities with more than 50,000 inhabitants in 2008 and during 2010-2015. Data from different sources were used, comparing the information pertaining to the period. Water samples were collected, and fluoride concentration was obtained by the electrometric method. Verification was performed by comparing the data obtained from different sources. Data were compared for 601 (97.9%) municipalities. The proportion of municipalities that performed surveillance based on external control increased from 39.4% to 48.5%. There was a high rate of false positives and false negatives (15.1%) in the data for 2008. Municipal coverage was 70.2%, or 4.2 percentage points below the published estimate (74.4%) for 2008. Surveillance records were observed in 54.3% of the fluoridated municipalities whose population coverage reached at least 50% of the population receiving treated water. There was an important improvement in fluoridation surveillance data, despite a high percentage of false positives and negatives. There are still wide interregional differences in the surveillance of water fluoridation in this sample of Brazilian municipalities, raising important public health challenges.

Resumen: Los datos de saneamiento en 2008 indicaban que un 74,4% de los municipios con más de 50 mil habitantes recibían agua fluorada, no obstante, no se adoptaron criterios para la validación de esta información. El estudio tuvo como objetivo verificar la exactitud de la información sobre la fluorización del agua, tomando como referencia datos de vigilancia del agua en municipios con más de 50 mil habitantes en el año 2008, y durante el período de 2010-2015. Se emplearon datos de diferentes fuentes comparando la información relativa a este período. Se recogieron muestras de agua y la concentración de fluoruro se obtuvo mediante un método electrométrico. El proceso de verificación se produjo por el contraste de datos obtenidos de diferentes fuentes. Se compararon los datos de 601 (97,9%) municipios. La tasa de municipios que realizan vigilancia en base al heterocontrol pasó de un 39,4% a un 48,5%. Se observó una elevada tasa de falsos positivos o negativos (15,1%), en relación con los datos de 2008. La cobertura municipal fue de un 70,2%, 4,2 puntos por debajo de la estimativa (74,4%) divulgada en 2008. Se observaron registros de la práctica de vigilancia en un 54,3% de los municipios fluorados, cuya cobertura poblacional alcanza a un 50% o más de la población que recibe agua tratada. Hubo una sensible mejoría en los datos de vigilancia respecto al fluoruro, a pesar de que había un porcentaje importante de falsos positivos y negativos. Todavía son grandes las diferencias interregionales relacionadas tanto respecto a la fluorización del agua, como a la implementación de vigilancia en los municipios investigados, implicando importantes desafíos para la salud pública.

Rotavirus A in wild and domestic animals from areas with environmental degradation in the Brazilian Amazon.

Acute gastroenteritis is one of the main causes of mortality in humans and young animals. Domestic and mainly wild animals such as bats, small rodents and birds are highly diversified animals in relation to their habitats and ecological niches and are widely distributed geographically in environments of forest fragmentation in some areas of the Amazon, being considered important sources for viruses that affect humans and other animals. Due to the anthropical activities, these animals changed their natural habitat and adapted to urbanized environments, thus representing risks to human and animal health. Although the knowledge of the global diversity of enteric viruses is scarce, there are reports demonstrating the detection of rotavirus in domestic animals and animals of productive systems, such as bovines and pigs. The present study investigated the prevalence of Rotavirus A in 648 fecal samples of different animal species from the northeastern mesoregion of the state of Pará, Brazil, which is characterized as an urbanized area with forest fragments. The fecal specimens were collected from October 2014 to April 2016 and subjected to a Qualitative Real-Time Polymerase Chain Reaction (RT-qPCR), using the NSP3 gene as a target. It was observed that 27.5% (178/648) of the samples presented positive results for RVA, with 178 samples distributed in birds (23.6%), canines (21.35%), chiropterans (17.98%), bovines (14.6%), horses (8.43%), small rodents (6.74%), pigs (3.93%) and felines (3.37%), demonstrating the circulation of RVA in domestic animals and suggesting that such proximity could cause transmissions between different species and the occurrence of rearrangements in the genome of RVA as already described in the literature, associated to the traces of environmental degradation in the studied areas.

Condições de trabalho de equipes de saúde da família do Pará / Working conditions of Family Health Teams from Pará / Condiciones de trabajo de los Equipos de Salud Familiar de Pará

Esta pesquisa investiga as condições de trabalho das equipes de saúde da família do estado do Pará com base nos dados do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Foram selecionados registros referentes às condições de trabalho de 776 equipes, tais como: agentes contratantes, tipo de vínculo, materiais e estrutura das unidades. Realizou-se uma Estatística Descritiva. Como resultado, percebeu-se que a maioria dos contratos de trabalho são temporários (65,4%) e a maior forma de seleção dos trabalhadores é por meio de indicação (36,7%). As unidades de saúde têm, em sua quase totalidade, sala de recepção e espera (94,5%) e sala de vacina (89,2). A melhoria das condições de trabalho das equipes é fundamental para sustentar a saúde destes trabalhadores e trabalhadoras. Ela pode reduzir adoecimentos e acidentes no trabalho, além de aumentar a resolutividade do cuidado.(AU)

This study investigates the working conditions of the family health teams from state of Pará based on the data of the National Program for Access and Quality Improvement in Primary Care. Records were selected that refer to the working conditions of 776 teams from the State of Pará, such as: forms of employment, type of employment contract, materials and the structural part of the health units. Descriptive Statistics were performed. As a result, it was noticed that most of the employment contracts are temporary (65.4%) and the largest form of employee selection is by indication (36.7%). Almost all of the health units have reception and waiting room (94.5%) and vaccine room (89.2). The improvement of the working conditions of the teams is fundamental to sustain the health of these workers. It can reduce illness and accidents at work. As well as increasing the resolution of the care.(AU)

Este estudio investiga las condiciones de trabajo de los equipos de salud familiar del estado de Pará con base en los datos del Programa Nacional de Acceso y Mejoramiento de la Calidad en Atención Primaria. Se seleccionaron registros que se refieren a las condiciones de trabajo de 776 equipos, tales como: formas de empleo, tipo de contrato de trabajo, materiales y la parte estructural de las unidades de salud. Se realizaron Estadísticas Descriptivas. Como resultado, la mayoría de los contratos de trabajo son temporales (65,4%) y la mayor forma de selección de empleados es por indicación (36,7%). Casi todas las unidades de salud disponen de recepción y sala de espera (94,5%) y sala de vacunas (89,2). La mejora de las condiciones de trabajo de los equipos es fundamental para sostener la salud de estos trabajadores. Puede reducir la enfermedad y los accidentes en el trabajo y aumentar la resolución del cuidado.(AU)

O modelo de vigilância da água e a divulgação de indicadores de concentração de fluoreto / The surveillance framework of water and the reporting of fluoride concentration indicators

RESUMO A vigilância da água é uma estratégia essencial para assegurar padrões de segurança e qualidade para o consumo humano. Entre os parâmetros de qualidade, destaca-se o fluoreto. O objetivo deste estudo foi descrever o modelo de vigilância da qualidade da água e apresentar uma proposta de indicadores e disseminação das informações à população com relação ao parâmetro fluoreto. Com base nas principais evidências científicas, explica-se a importância de se manter o parâmetro sob controle nos sistemas de abastecimento e apresenta-se uma descrição sumária do modelo de vigilância da água no Brasil, mostrando que o desenho não oferece indicadores para monitorar longitudinalmente o parâmetro nem a visibilidade a todos os que têm direito à informação. Em seguida, apresentam-se as bases técnicas e operacionais do Sistema de Vigilância da Fluoretação da Água de Abastecimento Público, uma proposta para aprimoramento do modelo. Indicadores para disseminação das informações são descritos, argumentando-se que o País dispõe de recursos e condições para superar a precariedade das informações sobre a concentração de fluoreto e sobre a cobertura da fluoretação da água em todas as unidades do território nacional.

ABSTRACT Water surveillance is an essential strategy to ensure safety and high quality standards for human consumption. Among the parameters, fluoride stands out. The objective of this study was to describe the surveillance framework of water quality and present a proposal of indicators and dissemination of information to the population regarding the fluoride concentration indicators. Based on main scientific evidences, it is explained the importance of maintaining the parameter under control in the supplies systems and it is presented a concise description of the water surveillance framework in Brazil, showing that the design does not offer indicators for longitudinally monitoring the parameter or visibility to all those who have right to information. Next, the operational and technical foundations of Public Water Supply Fluoridation Surveillance System are presented, a proposal to improve the framework. Indicators to the dissemination of the information are described, arguing that the Country has resources and conditions to overcome the precariousness of information on fluoride concentration and on the coverage of water fluoridation in all units of national territory.

The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases.

OBJECTIVES: To evaluate the impact and risk factors associated with an abnormal exercise test (ET) in systemic inflammatory rheumatic disease (SIRD) patients before commencing supervised physical exercise. METHODS: A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. RESULTS: SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P < 0.001). The disease itself was involved with higher likelihood of having an abnormal ET [Odds ratio (OR) = 12.0, 95% CI: 2.5, 56.7; P = 0.002 for SLE; OR = 13.56, 95% CI: 6.16, 29.8; P < 0.001 for RA; and OR = 4.31, 95% CI: 1.17, 15.8; P = 0.028, for AS]. Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6; P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99; P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0; P = 0.067). CONCLUSION: Our results showed a higher prevalence of abnormal ETs in asymptomatic cardiovascular SIRD patients, and the disease itself was associated with a higher likelihood of having an abnormal test, emphasizing the relevance and need of performing it before starting supervised physical exercise.