Identificação e notificação de violência contra crianças e adolescentes: limites e possibilidades de atuação de profissionais de saúde / Identification and reporting of violence against children and adolescents: limits and possibilities of action of health professionals

A violência contra crianças e adolescentes é um desafio para área da saúde e os profissionais tem um papel importante nesse contexto. O presente estudo objetivou caracterizar a percepção de profissionais de saúde sobre violência contra crianças e adolescentes e suas dificuldades para o manejo desse fenômeno. Foi realizado um estudo descritivo com 72 profissionais de saúde da atenção básica do município de Belém-Pará-Brasil. Em relação aos tipos de violência a negligência foi a mais referida pelos profissionais (60,74%) seguida da violência sexual (24,14%), da física (39,47%) e a psicológica (34,88%), porém a mais notificada foi a sexual (50%). Em relação à ficha de notificação (50,00%) dos participantes disseram que não a conhece e 86,11% nunca a utilizaram. Os resultados sugerem que há necessidade de capacitação permanente e de condições instrumentais adequadas para fortalecer a atuação dos profissionais de saúde a superarem os desafios que a intervenção em casos de violência exige.

Violence against children and adolescents is a challenge for health and professionals play an important role in this context. This study aimed to characterize the perception of health professionals about violence against children and adolescents and their difficulties in managing this phenomenon. A descriptive study was carried out with 72 healthcare professionals from the city of Belém-Pará-Brazil. Regarding the types of violence, negligence was the most reported by professionals (60,74%) followed by sexual violence (24,14%), physical violence (39,47%) and psychological violence (34,88%). The most reported was sexual (50,00%). Regarding the notification form (50,00%) of the participants said that they did not know it and 86,11% never used it. The results suggest that there is a need for permanent training and adequate instrumental conditions to streng then the performance of health professionals to overcome the challenges that intervention in cases of violence requires.

[Notification of violence as a strategy for health surveillance: profile of a metropolis in Brazil]. / Notificação da violência como estratégia de vigilância em saúde: perfil de uma metrópole do Brasil.

Violence is a serious public health problem and notification of incidents is fundamental for epidemic surveillance and for the definition of priorities and public politics of health prevention and promotion. The study sought to characterize the occurrence of domestic violence, sexual and other forms of violence, based on the information of the database of the Information System of Notification of Offences (Sinan), on the records of violence of the city of Belém in the state of Pará, in the period from January 2009 to December 2011. In this period 3,267 notifications were recorded, which represented an increase of 240% in the number of notifications of the year 2009 compared to 2011. In relation to the sex of the victims it was observed that, on average, 83.2% of cases against women and this proportion was similar in all three years analyzed. Sexual violence was the most prevalent with 41.8% of reported cases; followed by psychological violence at 26.3% and physical violence at 24%. The results show that notification is fundamental for understanding the profile of violence and for intervention and elaboration of integrated public politics that promote health and the quality of life in this area of Brazil.

Notificação da violência como estratégia de vigilância em saúde: perfil de uma metrópole do Brasil / Notification of violence as a strategy for health surveillance: profile of a metropolis in Brazil

Violence is a serious public health problem and notification of incidents is fundamental for epidemic surveillance and for the definition of priorities and public politics of health prevention and promotion. The study sought to characterize the occurrence of domestic violence, sexual and other forms of violence, based on the information of the database of the Information System of Notification of Offences (Sinan), on the records of violence of the city of Belém in the state of Pará, in the period from January 2009 to December 2011. In this period 3,267 notifications were recorded, which represented an increase of 240% in the number of notifications of the year 2009 compared to 2011. In relation to the sex of the victims it was observed that, on average, 83.2% of cases against women and this proportion was similar in all three years analyzed. Sexual violence was the most prevalent with 41.8% of reported cases; followed by psychological violence at 26.3% and physical violence at 24%. The results show that notification is fundamental for understanding the profile of violence and for intervention and elaboration of integrated public politics that promote health and the quality of life in this area of Brazil.

A violência é um problema de saúde pública e sua notificação é fundamental para a vigilância epidemiológica e para a definição de políticas públicas de prevenção e promoção de saúde. O estudo objetivou caracterizar a ocorrência de violência doméstica, sexual e de outras, a partir das informações do banco de dados do Sistema Informação de Agravos de Notificação (SINAN), das fichas de notificação de violência da cidade de Belém (PA), no período de janeiro de 2009 a dezembro de 2011. Foram sistematizadas 3.267 notificações, representando um aumento de 240% de 2009 a 2011. Em relação ao sexo das vítimas, observou-se que, em média, 83,2% dos casos atingiram as mulheres, proporção esta semelhante nos três anos analisados. A violência sexual foi a mais presente com 41,8%; seguida da violência psicológica com 26,3% e da violência física com 24,0%. Os resultados demonstram a importância do conhecimento do perfil das violências para intervenção e elaboração de políticas públicas intersetoriais que promovam a saúde e a qualidade de vida nesta região do Brasil.

Establishment and conventional cytogenetic characterization of three gastric cancer cell lines.

Gastric cancer is the fourth most frequent type of cancer and the second most frequent cause of cancer mortality worldwide. Only a modest number of gastric carcinoma cell lines have been isolated thus far. Here we describe the establishment and cytogenetic characterization of three new gastric cancer cell lines obtained from primary gastric adenocarcinoma (ACP02 and ACP03) and cancerous ascitic fluid (AGP01) of individuals from northern Brazil. ACP02, ACP03, and AGP01 cell lines are presently in the 60th passage. The cell lines grew in a disorganized single layer with some agglomerations and heterogeneous divisions (bipolar and multipolar). All cell lines exhibited a composite karyotype with several clonal chromosome alterations. Trisomy 8 was the most frequent alteration. Chromosome 8 aneusomy was confirmed by fluorescence in situ hybridization. All cell lines also exhibited trisomy 7 and deletion of chromosome arm 17p. These results suggest that, although frequent chromosome alterations are commonly observed due to culture process, the ACP02, ACP03, and AGP01 cell lines and primary gastric cancer from individuals of northern Brazil share genetic alterations, supporting use of these cell lines as a model of gastric carcinogenesis in this population.

Genotoxic effect of Physalis angulata L. (Solanaceae) extract on human lymphocytes treated in vitro.

Physalis angulata L (Solanaceae) is a medicinal plant from North of Brazil, whose different extracts and infusions are commonly used in the popular medicine for the treatment of malaria, asthma, hepatitis, dermatitis and rheumatism. However, the genotoxic effects of P. angulata on human cells is not well known. The main purpose of the present study was to evaluate the in vitro genotoxic effects of aqueous extract of P. angulata using the comet assay and the micronucleus assay in human lymphocytes provided from 6 healthy donors. Treatments with P. angulata extracts were performed in vitro in order to access the extent of DNA damage. The comet assay has shown that treatments with P. angulata at 0.5, 1.0, 2.0, 3.0 and 6.0 microg/mL in culture medium were genotoxic. Lymphocytes treated with P. angulata at the concentrations of 3.0 and 6.0 microg/mL in culture medium showed a statistically significant increase in the frequency of micronucleus (p<0.05), however, the cytokinesis blocked proliferation index (CBPI) was not decreased after P. angulata treatment. In conclusion, the present work demonstrated the genotoxic effects of P. angulata extract on human lymphocytes in vitro.

Genotoxic effects of white fluorescent light on human lymphocytes in vitro.

Sources of light beams such as white fluorescent light, are present in our daily life to meet the needs of life in the modern world. This study was conducted with the objective of determining the possible genotoxic, cytotoxic and aneugenic effects caused by this agent in different stages of the cell cycle (G0/early G1, S, and late G2), using different cytogenetic parameters (sister chromatid exchanges--SCE, chromosome aberrations--CA, and detection of aneugenic effects) in lymphocytes from temporary cultures of human peripheral blood. WFL showed a genotoxic effect in vitro, expressed by an increase in the frequency of SCE's, regardless of the cell cycle stage. However, no increase in the frequency of CAs was observed. In addition, disturbances in cell cycle kinetics and chromosomal segregation were also observed. Taken together, such data may contribute to a better understanding and a different management in the use of phototherapy for some pathological conditions.

Molecular heterogeneity of G6PD deficiency in an Amazonian population and description of four new variants.

To characterize the molecular variation in the glucose-6-phosphate dehydrogenase gene (G6PD), 196 asymptomatic and unrelated male G6PD-deficient blood donors from Belém, an Amazonian metropolis (Brazil), were analyzed. This deficiency was detected by horizontal agarose gel electrophoresis and quantitative spectrophotometric assay for enzyme activity. The mutations were searched by PCR/RFLP, SSCP, and direct DNA sequencing. The most frequent G6PD variant was the widespread and common G6PD A- (202G --> A, 376A --> G) observed in 161 subjects (82.1%). Besides this, we found another form of G6PD A- (968T --> C, 376A --> G) in 14 (7.1%) individuals, G6PD Seattle (844G --> C) in 4.6%, G6PD Santamaria (542A --> T, 376A --> G) in 2.5%, and G6PD Tokyo (1246G --> A) in one blood donor. Four novel variants were also identified: G6PD Belém (409C --> T; Pro137His), G6PD Ananindeua (376A --> G, 871G --> A; Asn126Asp, Val291Met), G6PD Crispim with four point mutations (375G --> T, 379G --> T, 383T --> C, and 384C --> T) leading to three amino acid substitutions (Met125Ile, Ala127Ser, and Leu128Pro), and G6PD Amazonia (185C --> A; Pro62His). The reported frequencies do not reflect the real values for blood donors from Belém, since an excess of individuals with "non A-" phenotype was included in this study to enhance the probability to find rare variants. Haplotype analyses were carried out for the less common G6PD variants identified in our study using PCR/RFLP for five polymorphic sites (FokI, PvuII, PstI, BclI, NlaIII). G6PD Crispim and G6PD Amazonia variants presented the most common haplotype found in G6PD B (- - + - -). G6PD Belém presented two haplotypes (- - + + +, - + + + +) and G6PD Ananindeua was found with the + - + - + haplotype. The reported heterogeneity probably is due to the great miscegenation, characteristic of the population of the Amazonian region, besides the apparently common occurrence of recurrent mutations in the G6PD gene.

Polymorphisms in the DNA repair gene XRCC1 and susceptibility to alcoholic liver cirrhosis in older Southeastern Brazilians.

The population of Southeastern Brazil has a very high mortality rate from liver cirrhosis, a disease that is considered an irreversible pre-malignant condition. This is largely due to the high prevalence of alcohol abuse in the region. Chronic alcohol consumption is associated with the production of free radical intermediates that can cause several DNA lesions. Reduced repair of these DNA lesions would, therefore, constitute a significant risk factor for liver cirrhosis and subsequent cancer. Recently, a number of polymorphisms in several DNA repair genes have been discovered, and it is possible that these polymorphisms may affect DNA repair capacity and thus modulate susceptibility to the disease. In this study, we tested the hypothesis that polymorphisms in the DNA repair gene XRCC1 are associated with increased risk of liver cirrhosis in Southeastern Brazilians. We conducted a pilot case-control study of 97 liver cirrhosis cases and 96 controls (matched for age, sex, and ethnicity) to investigate the role of two allelic variants coding for amino acid changes in the XRCC1 gene (the Arg194Trp and the Arg399Gln polymorphisms). Overall, we observed a 1.8-fold increase in the relative risk of liver cirrhosis associated with the 399Gln allele (either the heterozygous Arg/Gln or the homozygous Gln/Gln genotypes). The adjusted odds ratio (OR) was 1.82 (95% confidence limit (CL) 1.10-3.30). The relative risk appears to be highest among the Mestiso ethnic group (OR 2.60, 95% CL 0.92-7.34). There was a significant association between the 399Gln polymorphism and the risk of liver cirrhosis in older individuals over the age of 45 years (OR 2.70 (95% CL 1.14-6.48) compared to an OR of 1.24 (95% CL 0.55-2.78) for those under 45 years of age. No association was observed between the XRCC1 194Trp polymorphism and risk of liver cirrhosis. These preliminary results suggest that the XRCC1 399Gln polymorphism may be a significant risk modifier for alcoholic liver cirrhosis and justifies additional studies in that direction.