RESUMEN
RESUMO Esta pesquisa objetivou analisar opiniões e atitudes de profissionais da rede de atenção às mulheres em situação de violência em 10 municípios brasileiros. Estudo transversal quantitativo, realizado mediante entrevistas semiestruturadas com os participantes de oficinas realizadas nos municípios em estudo, totalizando 438 sujeitos. Realizou-se análise descritiva com distribuição de frequências, análise bivariada e análise de correspondência. O número de profissionais que atenderam casos suspeitos é maior do que o número dos que atenderam casos confirmados de violência contra a mulher. Menos da metade dos profissionais que atenderam casos suspeitos adotou alguma atitude frente a eles. A adoção de alguma atitude pelos profissionais foi mais comum - embora também abaixo da metade para a maioria das ações - diante dos casos confirmados. Subnotificação ocorre nos casos suspeitos e nos casos confirmados. A maioria dos entrevistados considera ser papel do setor saúde desenvolver ações de prevenção da violência contra a mulher, com elevada proporção de respostas deixadas em branco. Conclui-se que falta muito para que a atenção à mulher em situação de violência seja devidamente ofertada; os profissionais rotineiramente encaminham mais do que abordam os casos, notificam pouco, não se sentem capacitados e, às vezes, sequer se veem como responsáveis por essa atenção.
ABSTRACT This research aimed to analyze opinions and attitudes of professionals of the network of care to women in violence situation in 10 Brazilian cities. It is a quantitative cross-sectional study, carried out through semi-structured interviews with the participants of the workshops in these cities, totaling 438 individuals. A descriptive analysis was performed with frequency distributions, bivariate analysis and correspondence analysis. The number of professionals working on the suspected cases is higher than the number of those working on the confirmed cases of violence against women. Less than half of the professionals who attended the suspected cases has taken action on the matter of the fact. The adoption of some attitudes by the professionals was more common - even also being less than half of the majority of actions - in the face of the confirmed cases. Underreporting occurs in suspected cases and confirmed cases. Most of the interviewed people consider to be responsibility of the public health sector to develop preventing actions toward violence against women, with a high rate of unanswered cases. It is concluded that there is a long way for care to women in violence situation to be properly offered; professionals routinely refer more than address the cases, they poorly report them, they do not feel qualified, and sometimes do not even see themselves as the responsible for this care.
RESUMEN
Megacolon is frequently observed in patients who develop the digestive form of Chagas disease. It is characterized by dilation of the rectum-sigmoid portion and thickening of the colon wall. Microscopically, the affected organ presents denervation, which has been considered as consequence of an inflammatory process that begins at the acute phase and persists in the chronic phase of infection. Inflammatory infiltrates are composed of lymphocytes, macrophages, natural killer cells, mast cells, and eosinophils. In this study, we hypothesized that mast cells producing tryptase could influence the migration and the activation of eosinophils at the site, thereby contributing to the immunopathology of the chronic phase. We seek evidence of interactions between mast cells and eosinophils through (1) evaluation of eosinophils, regarding the expression of PAR2, a tryptase receptor; (2) correlation analysis between densities of mast cells and eosinophils; and (3) ultrastructural studies. The electron microscopy studies revealed signs of activation of mast cells and eosinophils, as well as physical interaction between these cells. Immunohistochemistry and correlation analyses point to the participation of tryptase immunoreactive mast cells in the migration and/or survival of eosinophils at the affected organ.