ABSTRACT Introduction: Urethral stricture is a common, albeit complex, condition that predominantly affects men. The aim of this study was to translate, culturally adapt, and validate the Patient-Reported Outcome Measure questionnaire for patients undergoing urethroplasty (USS-PROM) into Brazilian Portuguese using validated psychometric criteria. Materials and Methods: The process involved translating and culturally adapting the original USS-PROM into Brazilian Portuguese (USS-PROMbr), synthesizing, back-translating, cross-culturally adapting, and analyzing the pre-final version with experts from our committee. This pre-version was administered to 10 patients who had undergone urethroplasty by the Reconstructive Urology team at the Hospital de Clínicas de Porto Alegre for face validation, linguistic, and semantic adjustments, resulting in the final USS-PROMbr version. Subsequently, well-established psychometric criteria, including content validity, internal consistency, and test-retest reproducibility, were assessed after administering the questionnaire to a total of 56 patients, with 50 of them responding to the test and retest. Results: Evaluation of the pre-final version identified 15 questions as clear, and only one question was considered somewhat unclear necessitating modifications based on patient suggestions and subsequent reassessment by the research team. Psychometric criteria demonstrated good content validity, with a content validity index exceeding 0.80 for all questions; good internal consistency, Cronbach's alpha of 0.77, ranging from 0.70 to 0.78 with the exclusion of any item, and item-total correlations ranging from 0.33 to 0.67. The test-retest intraclass correlation coefficient was 0.74 for the lower urinary tract symptoms construct (Q1-Q6). Conclusion: The USS-PROMbr demonstrated acceptable cross-cultural adaptation and psychometric properties, making it a valid and useful tool for evaluating patients undergoing urethroplasty. Introduction common complex men translate adapt PatientReported Patient Reported USSPROM USS PROM (USS-PROM Methods USSPROMbr, USSPROMbr PROMbr , (USS-PROMbr) synthesizing backtranslating, backtranslating back translating, back-translating crossculturally cross prefinal pre committee preversion 1 validation linguistic adjustments Subsequently wellestablished well established consistency testretest retest reproducibility 5 Results clear 080 0 80 0.8 Cronbachs Cronbach s 077 77 0.77 070 70 0.7 078 78 item itemtotal 033 33 0.3 067 67 0.67 074 74 Q1Q6. Q1Q6 QQ Q1 Q6 . Q (Q1-Q6) Conclusion crosscultural cultural properties (USS-PROMbr 08 8 0. 07 7 03 3 06 6 0.6 Q1Q (Q1-Q6 (Q1-Q

Abstract This study aims to understand the meanings related to sexual health and the delineations that define the experience of accessing health services for lesbian women in Manaus, Brazil. This study followed a qualitative approach, counting on the participation of ten women who self-reported themselves as lesbians. Semi-structured interviews were carried out and their analyses occurred through three thematic axes. The first addressed the representations concerning prevention and sexual practices, highlighting the notion of fidelity in the relationship as a “protective factor”. Difficulties in the use of condoms in relationships between two women were reported. The second discussed heteronormativity and its effects on self-care, reporting the participants’ difficulties in being understood and welcomed by health services. The third addressed the search for one’s own knowledge as a care tactic, highlighting the importance of information and autonomy for health promotion and prevention of Sexually Transmitted Infections (STIs). It can therefore be concluded that there is a need for public policies aimed at promoting the sexual health of lesbian women and the recognition of their specificities by health services. Manaus Brazil approach selfreported self reported lesbians Semistructured Semi structured axes practices protective factor. factor . factor” selfcare, selfcare care, self-care participants ones one s tactic STIs. STIs (STIs) (STIs

Resumo O estudo tem por objetivo compreender os significados relacionados à saúde sexual e os contornos que definem a experiência de acesso aos serviços de saúde para mulheres lésbicas de Manaus, Amazonas. Trata-se de uma pesquisa de abordagem qualitativa. Contou com a participação de dez mulheres que se autoidentificaram como lésbicas. Foram realizadas entrevistas semiestruturadas e suas análises ocorreram por meio de três eixos temáticos. O primeiro abordou as representações sobre prevenção e práticas sexuais, destacando a noção de fidelidade no relacionamento como “fator de proteção”. Foram relatadas dificuldades no uso de preservativos em relações entre duas mulheres. O segundo discutiu a heteronormatividade e seus efeitos no cuidado de si, relatando as dificuldades de as participantes serem compreendidas e acolhidas pelos serviços de saúde. O terceiro abordou a busca do próprio conhecimento como tática de cuidado, destacando a importância da informação e da autonomia para a promoção da saúde e a prevenção de infecções sexualmente transmissíveis. Conclui-se que existe a necessidade de políticas públicas voltadas para a promoção da saúde sexual de mulheres lésbicas e o reconhecimento de suas especificidades pelos serviços de saúde. Manaus Amazonas Tratase Trata qualitativa temáticos sexuais fator proteção. proteção . proteção” si transmissíveis Concluise Conclui

Abstract Background: Tele-cardiology tools are valuable strategies to improve risk stratification. Objective: We aimed to evaluate the accuracy of tele-electrocardiography (ECG) to predict abnormalities in screening echocardiography (echo) in primary care (PC). Methods: In 17 months, 6 health providers at 16 PC units were trained on simplified handheld echo protocols. Tele-ECGs were recorded for final diagnosis by a cardiologist. Consented patients with major ECG abnormalities by the Minnesota code, and a 1:5 sample of normal individuals underwent clinical questionnaire and screening echo interpreted remotely. Major heart disease was defined as moderate/severe valve disease, ventricular dysfunction/hypertrophy, pericardial effusion, or wall-motion abnormalities. Association between major ECG and echo abnormalities was assessed by logistic regression as follows: 1) unadjusted model; 2) model 1 adjusted for age/sex; 3) model 2 plus risk factors (hypertension/diabetes); 4) model 3 plus history of cardiovascular disease (Chagas/rheumatic heart disease/ischemic heart disease/stroke/heart failure). P-values < 0.05 were considered significant. Results: A total 1,411 patients underwent echo; 1,149 (81%) had major ECG abnormalities. Median age was 67 (IQR 60 to 74) years, and 51.4% were male. Major ECG abnormalities were associated with a 2.4-fold chance of major heart disease on echo in bivariate analysis (OR = 2.42 [95% CI 1.76 to 3.39]), and remained significant after adjustments in models (p < 0.001) 2 (OR = 2.57 [95% CI 1.84 to 3.65]), model 3 (OR = 2.52 [95% CI 1.80 to3.58]), and model 4 (OR = 2.23 [95%CI 1.59 to 3.19]). Age, male sex, heart failure, and ischemic heart disease were also independent predictors of major heart disease on echo. Conclusions: Tele-ECG abnormalities increased the likelihood of major heart disease on screening echo, even after adjustments for demographic and clinical variables. Background Telecardiology Tele cardiology stratification Objective teleelectrocardiography tele electrocardiography (ECG (echo PC. . (PC) Methods months protocols TeleECGs ECGs cardiologist code 15 5 1: remotely moderatesevere moderate severe dysfunctionhypertrophy dysfunction hypertrophy dysfunction/hypertrophy effusion wallmotion wall motion follows age/sex agesex sex hypertension/diabetes hypertensiondiabetes hypertension diabetes (hypertension/diabetes) Chagas/rheumatic Chagasrheumatic Chagas rheumatic diseaseischemic diseasestrokeheart stroke failure. failure failure) Pvalues P values 005 0 05 0.0 Results 1411 411 1,41 1149 149 1,14 81% 81 (81% IQR 74 years 514 51 51.4 2.4fold 24fold fold 2.4 OR 242 42 95% 95 [95 176 76 1.7 3.39, 339 3.39 , 39 3.39]) p 0.001 0001 001 257 57 2.5 184 84 1.8 3.65, 365 3.65 65 3.65]) 252 52 180 80 to3.58, to358 to3.58 to3 58 to3.58]) 223 23 2.2 95%CI 95CI 159 59 1.5 3.19. 319 3.19 19 3.19]) Age Conclusions TeleECG variables (PC (hypertension/diabetes 00 0. 141 41 1,4 114 14 1,1 8 (81 7 51. 4fold 24 2. 9 [9 1. 33 3.3 3.39] 0.00 000 25 18 36 3.6 3.65] to35 to3.5 to3.58] 22 31 3.1 3.19] 1, 11 (8 [ 3. to3. (

Resumo Fundamento: As ferramentas de telecardiologia são estratégias valiosas para melhorar a estratificação de risco. Objetivo: Objetivamos avaliar a acurácia da tele-eletrocardiografia (ECG) para predizer anormalidades no ecocardiograma de rastreamento na atenção primária. Métodos: Em 17 meses, 6 profissionais de saúde em 16 unidades de atenção primária foram treinados em protocolos simplificados de ecocardiografia portátil. Tele-ECGs foram registrados para diagnóstico final por um cardiologista. Pacientes consentidos com anormalidades maiores no ECG pelo código de Minnesota e uma amostra 1:5 de indivíduos normais foram submetidos a um questionário clínico e ecocardiograma de rastreamento interpretado remotamente. A doença cardíaca grave foi definida como doença valvular moderada/grave, disfunção/hipertrofia ventricular, derrame pericárdico ou anormalidade da motilidade. A associação entre alterações maiores do ECG e anormalidades ecocardiográficas foi avaliada por regressão logística da seguinte forma: 1) modelo não ajustado; 2) modelo 1 ajustado por idade/sexo; 3) modelo 2 mais fatores de risco (hipertensão/diabetes); 4) modelo 3 mais história de doença cardiovascular (Chagas/cardiopatia reumática/cardiopatia isquêmica/AVC/insuficiência cardíaca). Foram considerados significativos valores de p < 0,05. Resultados: No total, 1.411 pacientes realizaram ecocardiograma, sendo 1.149 (81%) com anormalidades maiores no ECG. A idade mediana foi de 67 anos (intervalo interquartil de 60 a 74) e 51,4% eram do sexo masculino. As anormalidades maiores no ECG se associaram a uma chance 2,4 vezes maior de doença cardíaca grave no ecocardiograma de rastreamento na análise bivariada (OR = 2,42 [IC 95% 1,76 a 3,39]) e permaneceram significativas (p < 0,001) após ajustes no modelo 2 (OR = 2,57 [IC 95% 1,84 a 3,65]), modelo 3 (OR = 2,52 [IC 95% 1,80 a 3,58]) e modelo 4 (OR = 2,23 [IC 95% 1,59 a 3,19]). Idade, sexo masculino, insuficiência cardíaca e doença cardíaca isquêmica também foram preditores independentes de doença cardíaca grave no ecocardiograma. Conclusões: As anormalidades do tele-ECG aumentaram a probabilidade de doença cardíaca grave no ecocardiograma de rastreamento, mesmo após ajustes para variáveis demográficas e clínicas. Fundamento Objetivo teleeletrocardiografia tele eletrocardiografia (ECG Métodos meses portátil TeleECGs Tele ECGs cardiologista 15 5 1: remotamente moderadagrave moderada moderada/grave disfunçãohipertrofia disfunção hipertrofia ventricular motilidade forma idade/sexo idadesexo hipertensão/diabetes hipertensãodiabetes hipertensão diabetes (hipertensão/diabetes) Chagas/cardiopatia Chagascardiopatia Chagas cardiopatia reumáticacardiopatia reumática isquêmicaAVCinsuficiência AVC cardíaca. . cardíaca) 005 0 05 0,05 Resultados total 1411 411 1.41 1149 149 1.14 81% 81 (81% intervalo 74 514 51 51,4 masculino 24 2, OR 242 42 IC 95 176 76 1,7 3,39 339 39 3,39] 0,001 0001 001 257 57 2,5 184 84 1,8 3,65, 365 3,65 , 65 3,65]) 252 52 180 80 3,58 358 58 3,58] 223 23 2,2 159 59 1,5 3,19. 319 3,19 19 3,19]) Idade Conclusões teleECG clínicas (hipertensão/diabetes 00 0,0 141 41 1.4 114 14 1.1 8 (81 7 51, 9 1, 3,3 33 0,00 000 25 18 36 3,6 3,65] 3,5 35 22 31 3,1 3,19] 0, 1. 11 (8 3, (

Background: Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. Objective: To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. Methods: Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. Results: No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. Conclusions: Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption. Background Objective Methods Crosssectional Cross sectional 2358 2 358 2,35 Trial. Trial . Trial" assessed (PUFA 10 ≥10 MUFA, , (MUFA) 20% 20 SFA, (SFA) 7 <7 Cardiology 5 analysis Results simultaneously 1,482 1482 1 482 (1,48 62.9% 629 62 9 [62.9%] prevalent 65 28% 28 (28% 178 (17 7.6% 76 6 [7.6%] ( 0.2% 02 0 [0.2%] p 0.269. 0269 0.269 269 0.269) 38.42% 3842 38 42 (38.42% 3.52% 352 3 52 (3.52% <0.001 0001 001 regions Conclusions sample 235 35 2,3 ≥1 (MUFA (SFA < 1,48 148 48 (1,4 62.9 [62.9% (28 17 (1 7.6 [7.6% 0.2 [0.2% 026 0.26 26 38.42 384 4 (38.42 3.52 (3.52 <0.00 000 00 23 2, ≥ 1,4 14 (1, 62. [62.9 (2 7. [7.6 0. [0.2 38.4 (38.4 3.5 (3.5 <0.0 1, [62. [7. [0. 38. (38. 3. (3. <0. [62 [7 [0 (38 (3 <0 [6 [

Resumo Fundamento: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. Objetivo: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. Métodos: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS), <7%. Na análise estatística foi considerando nível de significância de 5%. Resultados: Nenhum participante aderiu a todas as recomendações de forma simultânea e mais da metade (1482 [62,9%]) não aderiu a nenhuma recomendação. A adesão exclusivamente à recomendação de AGS foi a mais prevalente, sendo cumprida por 659 (28%) dos participantes, seguida da adesão exclusivamente à recomendação de AGP (178 [7,6%]) e de AGM (5 [0,2%]). Não houve associação entre o número de comorbidades e a adesão às recomendações nutricionais (p =0,269). Os participantes da região Nordeste do país apresentaram maior proporção de adesão às recomendações para consumo de AGS (38,42%), e menor para ingestão de AGPI (3,52%) (p <0,001) em comparação às demais. Conclusões: Na amostra avaliada, evidenciou-se baixa adesão às recomendações nutricionais para consumo de ácidos graxos. Fundamento cardiovasculares Objetivo Métodos 235 Brazilian Trial. Trial . Trial" alimentar avaliados considerada Cardiologia poliinsaturados poli insaturados (AGPI 10 ≥10 diária AGM, , (AGM) 20 AGS, (AGS) 7 <7% 5 5% Resultados 1482 (148 62,9% 629 62 9 [62,9%] prevalente 65 28% 28 (28% 178 (17 7,6% 76 6 [7,6%] ( 0,2%. 02 0,2% 0 2 [0,2%]) p =0,269. 0269 =0,269 269 =0,269) 38,42%, 3842 38,42% 38 42 (38,42%) 3,52% 352 3 52 (3,52% <0,001 0001 001 demais Conclusões avaliada evidenciouse evidenciou 23 1 ≥1 (AGM (AGS <7 148 (14 62,9 [62,9% (28 17 (1 7,6 [7,6% 0,2 [0,2%] 026 =0,26 26 384 38,42 4 (38,42% 3,52 35 (3,52 <0,00 000 00 ≥ < 14 62, [62,9 (2 7, [7,6 0, [0,2% =0,2 38,4 (38,42 3,5 (3,5 <0,0 [62, [7, [0,2 =0, 38, (38,4 3, (3, <0, [62 [7 [0, =0 (38, (3 <0 [6 [ [0 = (38

ABSTRACT Objective: To assess dentists' knowledge from Minas Gerais, Brazil, about dentoalveolar trauma (DT) and their experiences during the COVID-19 pandemic. Material and Methods: An online questionnaire with 34 questions was applied to collect personal data, professional training, self-assessment of experience/knowledge about DT, experience in care provided during the social distancing, and knowledge/conduct. The specific responses were evaluated based on the guidelines of the International Association of Dental Traumatology (IADT). Descriptive analysis and Pearson's chi-square test were performed. The level of significance was set at p≤0.05. Results: Most professionals (97.7%) had received information on DT, and only 4.6% of the participants considered their knowledge poor or very poor. However, 92.7% felt the need for more information on the subject. Regarding experiences during the pandemic, 55.7% provided trauma care during that period. Forty percent of the consultations were performed in person, and 33.3% of the professionals noted an increase in cases during the pandemic; 56.6% reported that the frequency did not change. The overall mean number of correct answers about DT was 5.29±2.11, indicating an acceptable level of knowledge. The mean percentage of hits for the specific questions was 44.1%. Conclusion: Although the level of knowledge of the dentists evaluated was acceptable, some aspects were deficient, with the need for more information about the IADT guidelines. Objective Gerais Brazil (DT COVID19 COVID 19 COVID-1 pandemic Methods 3 data training selfassessment self assessment experienceknowledge distancing knowledgeconduct conduct knowledge/conduct IADT. . (IADT) Pearsons Pearson s chisquare chi square p005 p 0 05 p≤0.05 Results 97.7% 977 97 7 (97.7% 46 4 6 4.6 However 927 92 92.7 subject 557 55 55.7 period person 333 33 33.3 566 56 56.6 change 529211 5 29 2 11 5.29±2.11 441 44 1 44.1% Conclusion deficient COVID1 COVID- (IADT p00 p≤0.0 97.7 9 (97.7 4. 92. 55. 33. 56. 52921 5.29±2.1 44.1 p0 p≤0. 97. (97. 5292 5.29±2. 44. p≤0 (97 529 5.29±2 p≤ (9 52 5.29± ( 5.29 5.2 5.

Abstract Background Patients with epilepsy (PWE) frequently have comorbid psychiatric disorders, the most common of which are depression and anxiety. Attention deficit disorder with hyperactivity (ADHD) is also more frequent among PWE, though that condition has been scarcely studied among the adult PWE population. Objective This study aimed to compare the presence of ADHD symptoms between adult PWE and the general population. Methods This was an observational case-control study. Ninety-five adult PWE from a tertiary center in southern Brazil were compared with 100 healthy controls. All subjects were submitted to three structured scales: 1) the World Health Organization Adult ADHD Self-Report Scale version 1.1 (ASRS); 2) the Hospital Anxiety and Depression Scale (HADS); and 3) the Adverse Events Profile (AEP). Dichotomic variables were analyzed through chi-square test and Fisher's exact test, as appropriate, and non-parametric variables were analyzed through the Mann-Whitney U test. Results Medians and interquartile ranges (IR) were: 1) ASRS: 26.00 (IR: 18 to 38) among PWE versus 17.00 (IR: 11 to 24) among controls, p< 0.001; 2) HADS: 14.00 (IR: 8 to 21) among PWE versus 11.00 (IR: 8 to 16) among controls, p= 0.007; 3) AEP: 3800 (IR: 31 to 49) among PWE versus 33.00 (IR: 23 to 43) among controls, p= 0.001. Conclusion PWE showed a higher burden of symptoms of ADHD, depression, and anxiety when compared with controls, which replicates in the Brazilian population the findings of current literature that point toward a higher prevalence of such disorders among PWE. (PWE (ADHD casecontrol case control Ninetyfive Ninety five 10 controls scales 1 SelfReport Self Report 1. ASRS (ASRS) 2 HADS (HADS) 3 AEP. AEP . (AEP) chisquare chi square Fishers Fisher s appropriate nonparametric non parametric MannWhitney Mann Whitney IR (IR 2600 26 00 26.0 38 1700 17 17.0 24 p 0.001 0001 0 001 1400 14 14.0 21 1100 11.0 16 0.007 0007 007 380 49 3300 33 33.0 43 (ASRS (HADS (AEP 260 26. 170 17. 0.00 000 140 14. 110 11. 4 330 33. 0.0 0.

Resumo Antecedentes Pacientes com epilepsia (PCE) frequentemente apresentam comorbidades psiquiátricas, principalmente depressão e ansiedade. O transtorno do déficit de atenção e hiperatividade (TDAH) também é mais frequente nos PCE, porém foi pouco estudado na população adulta de PCE. Objetivo Comparar a presença de sintomas de TDAH entre PCE adultos e a população geral. Métodos Noventa e cinco PCE adultos de um centro terciário no Sul do Brasil foram comparados a 100 controles saudáveis. Todos os sujeitos foram submetidos a três escalas estruturadas: 1) a Escala Autorrelatada de TDAH em Adultos da Organização Mundial da Saúde, versão 1.1 (ASRS); 2) a Escala Hospitalar de Ansiedade e Depressão (HADS); e 3) o Perfil de Eventos Adversos (AEP). Variáveis dicotômicas foram analisadas através dos testes chi-quadrado e exato de Fisher, conforme apropriado, e as variáveis não paramétricas foram analisadas através do teste U de Mann-Whitney. Resultados As medianas e os intervalos interquartis (IIQ) foram: 1) ASRS: 26.00 (IIQ: 18 a 38) em PCE versus 17.00 (IIQ: 11 a 24) nos controles, p< 0,001; 2) HADS: 14.00 (IIQ: 8 a 21) em PCE versus 11.00 (IIQ: 8 a 16) nos controles, p= 0,007; 3) AEP: 38.00 (IIQ: 31 a 49) em PCE versus 33.00 (IIQ: 23 a 43) nos controles, p= 0,001. Conclusão PCE apresentaram uma maior carga de sintomas de TDAH, depressão e ansiedade quando comparados aos controles, o que replica na população brasileira os achados da literatura atual, que apontam para uma maior prevalência de tais transtornos entre PCE. (PCE psiquiátricas (TDAH geral 10 saudáveis estruturadas 1 Saúde 1. ASRS (ASRS) 2 HADS (HADS) 3 AEP. AEP . (AEP) chiquadrado chi quadrado Fisher apropriado MannWhitney. MannWhitney Mann Whitney. Whitney Mann-Whitney IIQ (IIQ 2600 26 00 26.0 38 1700 17 17.0 24 p 0,001 0001 0 001 1400 14 14.0 21 1100 11.0 16 0,007 0007 007 3800 38.0 49 3300 33 33.0 43 atual (ASRS (HADS (AEP 260 26. 170 17. 0,00 000 140 14. 110 11. 380 38. 4 330 33. 0,0 0,

Abstract Objective: To identify the prevalence, severity, hypersensitivity, and distribution of Non-carious cervical lesions (NCCL) among university students in Brazil. Material and Methods: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Results: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Conclusion: The prevalence of NCCL was 15.1% and abfraction was the most frequent lesion. Premolars were the teeth most affected by non-carious cervical lesions. Objective severity Noncarious Non carious (NCCL Brazil Methods 17 lesion classification surfaces index water chisquare chi square p<0.01. p001 p p<0.01 . 0 01 (p<0.01) Results Conclusion 151 15 1 15.1 noncarious non p00 p<0.0 (p<0.01 15. p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

ABSTRACT The use of tank mixtures has long been a practice in the phytosanitary management of agricultural crops. However, when different molecules are mixed in a tank, interactions may occur that reduce the efficiency of the products and cause a loss of selectivity in the crops. The aim of this study was to evaluate selectivity in maize, with a tank mixture of different phytosanitary products recommended for use with the crop. The following products were used: herbicides - Sanson®, Soberan®, Callisto®, Zapp Pro®; fungicides - Priori Xtra®, Nativo®, Tebufort®, Aproach Prima®; insecticides - Connect®, Lorsban® 480 BR, Karate Zeon®; and nutrition - Kellus Manganese®, Kellus Blindex®. The experimental units consisted of 5-litre pots, containing two plants per pot, with the products applied at phenological stage V6. Assessments were made of phytotoxicity, transient chlorophyll a fluorescence, chlorophyll content and shoot dry weight. The data obtained in the experiment were submitted to ANOVA (p ≤ 0.05), and when significant, to the Scott-Knott test (p ≤ 0.05). The maize crop suffered phytotoxicity of up to 30%, with the plants recovering from 28 DAA. The phytotoxicity was caused by mixing the different products in the spraying solution, mainly due to the synergism caused by the mixture of the herbicides nicosulfuron and tembotrione with the insecticide chlorpyrifos and the fertiliser Kellus Manganese®, which aggravated the incompatibility of some treatments. The results of this study defined which phytosanitary products recommended for use with maize should not be mixed in the same spraying solution due to the possibility of damaging the crop. crops However used Sanson Sanson® Soberan Soberan® Callisto Callisto® Pro® Pro Xtra Xtra® Nativo Nativo® Tebufort Tebufort® Prima® Prima Connect Connect® Lorsban 48 BR Zeon® Zeon Manganese Manganese® Blindex Blindex® 5litre litre 5 pots pot V6 V fluorescence weight p 0.05, 005 0.05 , 0 05 0.05) significant ScottKnott Scott Knott 0.05. . 30 30% 2 DAA treatments 4 00 0.0 3 0.

ABSTRACT: This study evaluated the antiseptic effect of 0.25% chlorhexidine nanoemulsion (NM-Cl) on cat skin and compare its effect with that of 2.0% chlorhexidine digluconate (CS-Cl). NM-Cl was synthesized using the spontaneous emulsification method, and physical and chemical properties were analyzed. The antiseptic effects of NM-Cl and CS-Cl were randomly tested on the thoracic limbs of 10 healthy male cats. After a wide trichotomy of the thoracic limbs, NM-Cl was randomly applied to the trichotomy area of the right (n = 5) or left (n = 5) thoracic limbs. Then, a catheter was inserted aseptically in the cephalic vein. Subsequently, the same procedure was performed using CS-Cl on the contralateral limb. Cutaneous microbiota swab samples were obtained before antisepsis (Tpre); immediately after antisepsis (Tpost); and 4, 8, and 24 h after antisepsis. The collected samples were immediately inoculated on blood agar plates and incubated at 35 ºC ± 2 ºC in aerobiosis. Colony-forming units (CFUs) were manually counted after 24 h of inoculation. The Kruskal-Wallis and Mann-Whitney U tests were performed between groups and within the same group at different sample times, respectively. The NM-Cl and CS-Cl groups showed a reduction in CFUs between Tpre and Tpost in all animals (P < 0.001). Both formulations presented an antiseptic effect 24 h of antisepsis (P < 0.05), and no difference was observed between formulations at different times (P < 0.05). With a lower concentration of chlorhexidine than CS-Cl, NM-Cl presents effective antiseptic action and prolonged residual effect in antisepsis for cat venipuncture. ABSTRACT 025 0 25 0.25 NMCl NM Cl (NM-Cl 20 2.0 CSCl. CSCl CS . (CS-Cl) method analyzed 1 cats n 5 Then vein Subsequently limb (Tpre) (Tpost) 4 8 3 aerobiosis Colonyforming Colony forming (CFUs inoculation KruskalWallis Kruskal Wallis MannWhitney Mann Whitney respectively P 0.001. 0001 0.001 001 0.001) 0.05, 005 0.05 , 05 0.05) 0.05. CSCl, Cl, venipuncture 02 0.2 2. (CS-Cl (Tpre (Tpost 000 0.00 00 0.0 0.

RESUMO: O objetivo do presente estudo foi avaliar o efeito antisséptico da nanoemulsão de clorexidina a 0,25% (NM-Cl) na pele de gatos e compará-lo com a solução comercial de clorexidina a 2,0% (CS-Cl). A NM-Cl foi desenvolvida através do método de emulsificação espontânea, com posterior análise e caracterização das propriedades físicas e químicas. O efeito antisséptico de NM-Cl e CS-Cl foi testado de forma randomizada nos membros torácicos de dez gatos machos saudáveis. Após ampla tricotomia dos membros torácicos, a antissepsia foi realizada com NM-Cl aplicada nos membros torácicos direito (n = 5) ou esquerdo (n = 5), e um cateter foi inserido assepticamente na veia cefálica. Posteriormente, o mesmo procedimento foi realizado com a CS-Cl no membro contralateral. Amostras da microbiota cutânea foram obtidas antes da antissepsia (Tpre), imediatamente após a antissepsia (Tpos) e quatro, oito e 24 horas após a antissepsia. As amostras coletadas foram imediatamente inoculadas em placas de ágar sangue e incubadas a 35 ºC ± 2 ºC em aerobiose. A contagem manual da unidade formadora de colônia (UFC) foi realizada 24 horas após a inoculação. Os testes de Kruskal-Wallis e Mann-Whitney foram usados entre os grupos e dentro do mesmo grupo em diferentes tempos amostrais. Os grupos NM-Cl e CS-Cl apresentaram redução nas UFC entre Tpre e Tpos em todos os animais (P < 0,001). Ambas as formulações apresentaram efeito antisséptico 24 horas após a antissepsia (P < 0,05), não havendo diferença entre as formulações nos diferentes tempos (P < 0,05). O NM-Cl (com menor concentração de clorexidina que o CS-Cl) apresenta ação antisséptica eficaz e efeito residual prolongado na antissepsia para a punção venosa em gatos. RESUMO 025 0 25 0,25 NMCl NM Cl (NM-Cl comparálo compará lo 20 2,0 CSCl. CSCl CS . (CS-Cl) espontânea químicas saudáveis n 5 5, , cefálica Posteriormente contralateral Tpre, (Tpre) (Tpos quatro 3 aerobiose (UFC inoculação KruskalWallis Kruskal Wallis MannWhitney Mann Whitney amostrais P 0,001. 0001 0,001 001 0,001) 0,05, 005 0,05 05 0,05) 0,05. 02 0,2 2, (CS-Cl (Tpre 000 0,00 00 0,0 0,

Abstract Background: Loxoscelism refers to a set of clinical manifestations caused by the bite of spiders from the Loxosceles genus. The classic clinical symptoms are characterized by an intense inflammatory reaction at the bite site followed by local necrosis and can be classified as cutaneous loxoscelism. This cutaneous form presents difficult healing, and the proposed treatments are not specific or effective. This study aimed to evaluate the protective effect of mesenchymal stromal cells-derived secretome on dermonecrosis induced by Loxosceles intermedia spider venom in rabbits. Methods: Sixteen rabbits were distributed into four groups (n = 4). Except for group 1 (G1), which received only PBS, the other three groups (G2, G3, and G4) were initially challenged with 10 μg of L. intermedia venom, diluted in 100 μL of NaCl 0.9%, by intradermic injection in the interscapular region. Thirty minutes after the challenge all groups were treated with secretome, except for group 2. Group 1 (G1-control group) received intradermal injection (ID) of 60 μg of secretome in 0.15 M PBS; Group 2 (G2) received 0.9% NaCl via ID; Group 3 (G3) received 60 μg of secretome, via ID and Group 4 (G4), received 60 μg of secretome by intravenous route. Rabbits were evaluated daily and after 15 days were euthanized, necropsied and skin samples around the necrotic lesions were collected for histological analysis. Results: Rabbits of G1 did not present edema, erythema, hemorrhagic halo, or necrosis. In animals from G2, G3, and G4, edema appeared after 6h. However, minor edema was observed in the animals of G2 and G3. Hemorrhagic halo was observed in animals, six hours and three days after, on G2, G3, and G4. Macroscopically, in G4, only one animal out of four had a lesion that evolved into a dermonecrotic wound. No changes were observed in the skin of the animals of G1, by microscopic evaluation. All animals challenged with L. intermedia venom showed similar alterations, such as necrosis and heterophilic infiltration. However, animals from G4 showed fibroblast activation, early development of connective tissue, neovascularization, and tissue re-epithelialization, indicating a more prominent healing process. Conclusion: These results suggest that secretome from mesenchymal stromal cells cultured in a xeno-free and human component-free culture media can be promising to treat dermonecrosis caused after Loxosceles spiders bite envenoming. Background genus loxoscelism effective cellsderived derived Methods n 4. . 4) G , (G1) PBS (G2 G3 L 09 0 9 region G1control Gcontrol control (ID 6 015 0.1 0.9 (G3 (G4) route euthanized analysis Results erythema 6h h However Macroscopically wound evaluation alterations infiltration activation neovascularization reepithelialization, reepithelialization re epithelialization, epithelialization re-epithelialization process Conclusion xenofree xeno free componentfree component envenoming (G1 (G 01 0. (G4

RESUMO JUSTIFICATIVA E OBJETIVOS: Embora as mulheres pareçam ser mais suscetíveis à dor, há poucos estudos comparando os diagnósticos obtidos por meio do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) entre mulheres e homens. Assim, este estudo teve como objetivo verificar a influência do sexo nas disfunções temporomandibulares (DTM) e suas comorbidades em uma amostra brasileira. MÉTODOS: Os pacientes foram avaliados por meio do RDC/ TMD. Os diagnósticos foram obtidos para o Eixo I (dor miofascial, deslocamento de disco e outras condições articulares) e Eixo II (sintomas de depressão, dor crônica, somatização e limitação da função mandibular). Modelos de regressão logística foram utilizados para verificar se existe diferença na prevalência e nas chances de desenvolver DTM entre mulheres e homens. RESULTADOS: A amostra incluiu 310 pacientes. As mulheres apresentaram mais dor miofascial e foram mais propensas a desenvolvê-la (73,04%; OR: 1,91; IC 95%: 1,08 - 3,39), bem como mais distúrbios articulares (54,78%; OR: 2,07; IC 95%: 1,08 - 3,99), em comparação aos homens. Ademais, as mulheres compuseram a maioria da amostra, procuraram tratamento com maior frequência e apresentaram níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial. CONCLUSÃO: As mulheres apresentam mais DTM e são mais propensas a desenvolvê-la, bem como apresentam níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial. OBJETIVOS RDC/TMD RDCTMD RDC TMD (RDC/TMD homens Assim (DTM brasileira MÉTODOS depressão crônica mandibular. . mandibular) RESULTADOS 31 desenvolvêla desenvolvê la 73,04% 7304 73 04 (73,04% OR 1,91 191 1 91 95% 95 108 08 1,0 3,39, 339 3,39 , 3 39 3,39) 54,78% 5478 54 78 (54,78% 2,07 207 2 07 3,99, 399 3,99 99 3,99) Ademais CONCLUSÃO desenvolvêla, la, 73,04 730 7 0 (73,04 1,9 19 9 10 1, 33 3,3 54,78 547 5 (54,78 2,0 20 3,9 73,0 (73,0 3, 54,7 (54,7 2, 73, (73, 54, (54, (73 (54 (7 (5 (

ABSTRACT BACKGROUND AND OBJECTIVES: Although women seem to be more susceptible to pain, there are few studies comparing the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses between women and men. Thus, this study aimed to verify the influence of gender on Temporomandibular Disorders (TMD) and their comorbidities in a Brazilian sample. METHODS: Patients were assessed using the RDC/TMD. Diagnoses were obtained for Axis I (myofascial pain, disc displacement, and other joint conditions) and Axis II (depressive symptoms, chronic pain, somatization, and limitation of mandibular function). Logistic regression models were used to verify whether there is a difference in the prevalence and odds of developing TMD between women and men. RESULTS: The sample included 310 patients. Women had more myofascial pain and were more likely to develop it (73.04%; OR: 1.91; IC 95%: 1.08 - 3.39), as well as more joint disorders (54.78%; OR: 2.07; IC 95%: 1.08 - 3.99), in comparison to men. Furthermore, women composed the majority of the sample, more often sought treatment, and had more severe levels of depressive symptoms, somatization of pain, limitation of mandibular function, and myofascial pain. CONCLUSION: Women have more TMD and are more likely to develop it, and also show more severe levels of depressive symptoms, pain somatization, limited mandibular function, and myofascial pain. OBJECTIVES RDC/TMD RDCTMD RDC (RDC/TMD men Thus (TMD METHODS displacement conditions symptoms function. function . function) RESULTS 31 patients 73.04% 7304 73 04 (73.04% OR 1.91 191 1 91 95% 95 108 08 1.0 3.39, 339 3.39 , 3 39 3.39) 54.78% 5478 54 78 (54.78% 2.07 207 2 07 3.99, 399 3.99 99 3.99) Furthermore treatment CONCLUSION 73.04 730 7 0 (73.04 1.9 19 9 10 1. 33 3.3 54.78 547 5 (54.78 2.0 20 3.9 73.0 (73.0 3. 54.7 (54.7 2. 73. (73. 54. (54. (73 (54 (7 (5 (

Resumen: Este estudio tuvo como objetivo analizar las condiciones operativas para la conservación de inmunobiológicos en Brasil. Estudio de método mixto con diseño explicativo secuencial, desarrollado en las salas de vacunación de las distintas regiones brasileñas, entre 2021 y 2022. En la etapa cuantitativa se desarrolló un estudio transversal descriptivo, con la aplicación de la Escala de Evaluación de la Conservación de Inmunobiológicos a los profesionales de enfermería. Los datos fueron analizados mediante estadística descriptiva. En la etapa cualitativa se desarrolló un estudio descriptivo-exploratorio en las instancias de la cadena de frío, con los respectivos responsables técnicos y profesionales de enfermería. Las entrevistas se analizaron por medio del Análisis de Contenido en la Modalidad Temática. Los datos fueron combinados mediante conexión, con elaboración de joint-displays y metainferencias. Se analizaron 280 salas. Gran parte era de uso exclusivo (79,6%); utilizaba cajas de poliuretano (77,8%) y mantenía sus equipos alejados de la incidencia de la luz solar/fuentes de calor (73,5%). Solo el 27,5% disponía de baterías/generadores y el 26,5% de otros instrumentos de medición de temperatura. El 60% tenía cámaras refrigeradas y el 67,6% ambientes climatizados. Se revelaron debilidades asociadas a las condiciones geográficas, la infraestructura, los insumos de materiales, los recursos humanos y financieros, la organización y gestión del trabajo, la rotación y la capacitación. Los hallazgos posibilitaron conocer la pluralidad de la cadena de frío brasileña y permitieron la identificación de potencialidades y debilidades de la conservación de inmunobiológicos relacionadas con las estructuras y los procesos de trabajo que requieren mejoras. Resumen Brasil secuencial brasileñas 202 2022 descriptivo enfermería descriptiva descriptivoexploratorio exploratorio Temática conexión jointdisplays joint displays metainferencias 28 79,6% 796 79 6 (79,6%) 77,8% 778 77 8 (77,8% solarfuentes solar fuentes 73,5%. 735 73,5% . 73 5 (73,5%) 275 27 27,5 bateríasgeneradores baterías generadores 265 26 26,5 temperatura 60 676 67 67,6 climatizados geográficas infraestructura materiales financieros capacitación mejoras 20 2 79,6 7 (79,6% 77,8 (77,8 73,5 (73,5% 27, 26, 67, 79, (79,6 77, (77, 73, (73,5 (79, (77 (73, (79 (7 (73 (

Resumo: Este estudo objetivou analisar as condições operacionais para conservação de imunobiológicos no Brasil. Trata-se de um estudo de método misto com delineamento explanatório sequencial, desenvolvido nas salas de vacinação de distintas regiões brasileiras entre 2021 e 2022. Na etapa quantitativa, desenvolveu-se um estudo transversal descritivo, com a aplicação da Escala de Avaliação da Conservação de Imunobiológicos aos profissionais de enfermagem. Os dados foram analisados por meio de estatística descritiva. Já na etapa qualitativa, desenvolveu-se um estudo descritivo-exploratório nas instâncias da cadeia de frio, com os respectivos responsáveis técnicos e profissionais de enfermagem. Analisou-se as entrevistas por meio da Análise de Conteúdo na Modalidade Temática. Os dados foram combinados mediante conexão, com elaboração de joint-displays e metainferências. Foram analisadas 280 salas, em que grande parte: era de uso exclusivo (79,6%); utilizava caixas de poliuretano (77,8%); e mantinha seus equipamentos distantes da incidência de luz solar/fontes de calor (73,5%). Apenas 27,5% dispunham de baterias/geradores e 26,5% de outros instrumentos de medição de temperatura. Sessenta por cento detinham câmaras refrigeradas e 67,6% ambientes climatizados. Revelaram-se fragilidades associadas a condições geográficas, infraestrutura, insumos materiais, recursos humanos e financeiros, organização e gestão do trabalho, rotatividade e capacitação. Os achados possibilitaram conhecer a pluralidade da cadeia de frio brasileira e permitiram a identificação de potencialidades e fragilidades na conservação de imunobiológicos relacionadas às estruturas e aos processos de trabalho que requerem aprimoramento. Resumo Brasil Tratase Trata se sequencial 202 2022 quantitativa desenvolveuse desenvolveu descritivo enfermagem descritiva qualitativa descritivoexploratório exploratório Analisouse Analisou Temática conexão jointdisplays joint displays metainferências 28 parte 79,6% 796 79 6 (79,6%) 77,8% 778 77 8 (77,8%) solarfontes solar fontes 73,5%. 735 73,5% . 73 5 (73,5%) 275 27 27,5 bateriasgeradores baterias geradores 265 26 26,5 temperatura 676 67 67,6 climatizados Revelaramse Revelaram geográficas infraestrutura materiais financeiros capacitação aprimoramento 20 2 79,6 7 (79,6% 77,8 (77,8% 73,5 (73,5% 27, 26, 67, 79, (79,6 77, (77,8 73, (73,5 (79, (77, (73, (79 (77 (73 (7 (

Abstract: This study aimed to analyze the operational conditions to preserve immunobiological products in Brazil. This mixed-method study with a sequential explanatory design was developed in vaccination rooms in several Brazilian regions from 2021 to 2022. Its quantitative stage developed a descriptive cross-sectional study by applying the Immunobiological Conservation Assessment Scale to nursing professionals. Data were analyzed by descriptive statistics. Its qualitative stage developed a descriptive-exploratory study in cold chain instances with the respective technical managers and nursing professionals. The interviews were evaluated by thematic content analysis. The data were combined by connection, and joint-displays and meta-inferences were elaborated. Overall, 280 rooms were analyzed. Most were for exclusive use (79.6%), had polyurethane boxes (77.8%), and kept their equipment away from sunlight/heat (73.5%). Only 27.5% had batteries/generators and 26.5% had other temperature measuring instruments. In total, 60% had refrigerated rooms and 67.6%, air-conditioned rooms. This study found weaknesses associated with geographical conditions, infrastructure, material inputs, human and financial resources, work organization and management, turnover, and training. These findings showed the plurality of the Brazilian cold chain and identified the potentialities and weaknesses related to the structures and work processes in preserving immunobiological products, which require improvement. Abstract Brazil mixedmethod mixed method 202 2022 crosssectional cross sectional professionals statistics descriptiveexploratory exploratory analysis connection jointdisplays joint displays metainferences meta inferences elaborated Overall 28 79.6%, 796 79.6% , 79 6 (79.6%) 77.8%, 778 77.8% 77 8 (77.8%) sunlightheat sunlight heat 73.5%. 735 73.5% . 73 5 (73.5%) 275 27 27.5 batteriesgenerators batteries generators 265 26 26.5 instruments total 60 676 67 67.6% airconditioned air conditioned infrastructure inputs resources management turnover training improvement 20 2 79.6 7 (79.6% 77.8 (77.8% 73.5 (73.5% 27. 26. 67.6 79. (79.6 77. (77.8 73. (73.5 67. (79. (77. (73. (79 (77 (73 (7 (

Resumo O estudo tem por objetivo compreender os significados relacionados à saúde sexual e os contornos que definem a experiência de acesso aos serviços de saúde para mulheres lésbicas de Manaus, Amazonas. Trata-se de uma pesquisa de abordagem qualitativa. Contou com a participação de dez mulheres que se autoidentificaram como lésbicas. Foram realizadas entrevistas semiestruturadas e suas análises ocorreram por meio de três eixos temáticos. O primeiro abordou as representações sobre prevenção e práticas sexuais, destacando a noção de fidelidade no relacionamento como “fator de proteção”. Foram relatadas dificuldades no uso de preservativos em relações entre duas mulheres. O segundo discutiu a heteronormatividade e seus efeitos no cuidado de si, relatando as dificuldades de as participantes serem compreendidas e acolhidas pelos serviços de saúde. O terceiro abordou a busca do próprio conhecimento como tática de cuidado, destacando a importância da informação e da autonomia para a promoção da saúde e a prevenção de infecções sexualmente transmissíveis. Conclui-se que existe a necessidade de políticas públicas voltadas para a promoção da saúde sexual de mulheres lésbicas e o reconhecimento de suas especificidades pelos serviços de saúde.

Abstract This study aims to understand the meanings related to sexual health and the delineations that define the experience of accessing health services for lesbian women in Manaus, Brazil. This study followed a qualitative approach, counting on the participation of ten women who self-reported themselves as lesbians. Semi-structured interviews were carried out and their analyses occurred through three thematic axes. The first addressed the representations concerning prevention and sexual practices, highlighting the notion of fidelity in the relationship as a “protective factor”. Difficulties in the use of condoms in relationships between two women were reported. The second discussed heteronormativity and its effects on self-care, reporting the participants’ difficulties in being understood and welcomed by health services. The third addressed the search for one’s own knowledge as a care tactic, highlighting the importance of information and autonomy for health promotion and prevention of Sexually Transmitted Infections (STIs). It can therefore be concluded that there is a need for public policies aimed at promoting the sexual health of lesbian women and the recognition of their specificities by health services.

Resumen: Este estudio tuvo como objetivo analizar las condiciones operativas para la conservación de inmunobiológicos en Brasil. Estudio de método mixto con diseño explicativo secuencial, desarrollado en las salas de vacunación de las distintas regiones brasileñas, entre 2021 y 2022. En la etapa cuantitativa se desarrolló un estudio transversal descriptivo, con la aplicación de la Escala de Evaluación de la Conservación de Inmunobiológicos a los profesionales de enfermería. Los datos fueron analizados mediante estadística descriptiva. En la etapa cualitativa se desarrolló un estudio descriptivo-exploratorio en las instancias de la cadena de frío, con los respectivos responsables técnicos y profesionales de enfermería. Las entrevistas se analizaron por medio del Análisis de Contenido en la Modalidad Temática. Los datos fueron combinados mediante conexión, con elaboración de joint-displays y metainferencias. Se analizaron 280 salas. Gran parte era de uso exclusivo (79,6%); utilizaba cajas de poliuretano (77,8%) y mantenía sus equipos alejados de la incidencia de la luz solar/fuentes de calor (73,5%). Solo el 27,5% disponía de baterías/generadores y el 26,5% de otros instrumentos de medición de temperatura. El 60% tenía cámaras refrigeradas y el 67,6% ambientes climatizados. Se revelaron debilidades asociadas a las condiciones geográficas, la infraestructura, los insumos de materiales, los recursos humanos y financieros, la organización y gestión del trabajo, la rotación y la capacitación. Los hallazgos posibilitaron conocer la pluralidad de la cadena de frío brasileña y permitieron la identificación de potencialidades y debilidades de la conservación de inmunobiológicos relacionadas con las estructuras y los procesos de trabajo que requieren mejoras.

Resumo: Este estudo objetivou analisar as condições operacionais para conservação de imunobiológicos no Brasil. Trata-se de um estudo de método misto com delineamento explanatório sequencial, desenvolvido nas salas de vacinação de distintas regiões brasileiras entre 2021 e 2022. Na etapa quantitativa, desenvolveu-se um estudo transversal descritivo, com a aplicação da Escala de Avaliação da Conservação de Imunobiológicos aos profissionais de enfermagem. Os dados foram analisados por meio de estatística descritiva. Já na etapa qualitativa, desenvolveu-se um estudo descritivo-exploratório nas instâncias da cadeia de frio, com os respectivos responsáveis técnicos e profissionais de enfermagem. Analisou-se as entrevistas por meio da Análise de Conteúdo na Modalidade Temática. Os dados foram combinados mediante conexão, com elaboração de joint-displays e metainferências. Foram analisadas 280 salas, em que grande parte: era de uso exclusivo (79,6%); utilizava caixas de poliuretano (77,8%); e mantinha seus equipamentos distantes da incidência de luz solar/fontes de calor (73,5%). Apenas 27,5% dispunham de baterias/geradores e 26,5% de outros instrumentos de medição de temperatura. Sessenta por cento detinham câmaras refrigeradas e 67,6% ambientes climatizados. Revelaram-se fragilidades associadas a condições geográficas, infraestrutura, insumos materiais, recursos humanos e financeiros, organização e gestão do trabalho, rotatividade e capacitação. Os achados possibilitaram conhecer a pluralidade da cadeia de frio brasileira e permitiram a identificação de potencialidades e fragilidades na conservação de imunobiológicos relacionadas às estruturas e aos processos de trabalho que requerem aprimoramento.

Abstract: This study aimed to analyze the operational conditions to preserve immunobiological products in Brazil. This mixed-method study with a sequential explanatory design was developed in vaccination rooms in several Brazilian regions from 2021 to 2022. Its quantitative stage developed a descriptive cross-sectional study by applying the Immunobiological Conservation Assessment Scale to nursing professionals. Data were analyzed by descriptive statistics. Its qualitative stage developed a descriptive-exploratory study in cold chain instances with the respective technical managers and nursing professionals. The interviews were evaluated by thematic content analysis. The data were combined by connection, and joint-displays and meta-inferences were elaborated. Overall, 280 rooms were analyzed. Most were for exclusive use (79.6%), had polyurethane boxes (77.8%), and kept their equipment away from sunlight/heat (73.5%). Only 27.5% had batteries/generators and 26.5% had other temperature measuring instruments. In total, 60% had refrigerated rooms and 67.6%, air-conditioned rooms. This study found weaknesses associated with geographical conditions, infrastructure, material inputs, human and financial resources, work organization and management, turnover, and training. These findings showed the plurality of the Brazilian cold chain and identified the potentialities and weaknesses related to the structures and work processes in preserving immunobiological products, which require improvement.