RESUMO

A violência contra mulheres é um problema com graves repercussões na saúde pública. A busca de estratégias para seu combate exige uma atuação multidisciplinar e multi-institucional, envolvendo o Sistema Único de Saúde (SUS). O objetivo desse estudo foi identificar as ações de enfrentamento à violência de gênero contextualizadas dentro do SUS, e sumarizar documentos e estudos publicados sobre o tema, no Brasil, de 2016 a 2020. Trata-se de uma revisão narrativa cuja base são os trabalhos publicados no período estudado, que discutissem a violência de gênero como um agravo à saúde e que mencionassem estratégias de enfrentamento na gestão do SUS. Os achados foram otimizados em três eixos básicos dentro da lógica narrativa: a proposta do trabalho em rede, a subnotificação dos casos, e a qualificação profissional. Os estudos revisados sugerem que vários desafios ainda devem ser superados para que a política nacional de enfrentamento à violência de gênero venha a ser devidamente implementada no país. Três dos desafios mencionados parecem destacar-se como fatores determinantes: os obstáculos para formação de uma rede interinstitucional efetiva direcionada à atenção à mulher em situação de violência; uma expressiva subnotificação dos casos; e uma carência de profissionais habilitados e preparados para atuar diante das situações de violência na sua prática diária. Uma vez que a violência de gênero se apresenta como uma questão social complexa, com um impacto importante na saúde pública, os gestores do setor saúde têm a responsabilidade de enfrentá-la, buscando parcerias governamentais interinstitucionais e na sociedade civil organizada.

Violence against women is a serious public health issue. Formulating strategies to combat it requires a multidisciplinary and multi-institutional mobilization involving the Unified Health System (SUS). This narrative review sought to identify actions undertaken to combat gender-based violence within the SUS, and to summarize documents and studies published on the topic in Brazil, from 2016 to 2020. Data were collected from works published in the studied period that discussed gender-based violence as a public health issue and cited combat strategies employed by SUS management. The findings were classified in three basic axes within the narrative logic: proposal of networking, underreporting of cases, and professional qualification. The reviewed studies suggest that several challenges are yet to be overcome if the national policy to combat gender-based violence is to be properly implemented in the country. Three of the challenges highlighted seem to be determining factors: obstacles in forming an effective interinstitutional network to care for women in situations of violence; a significant underreporting of cases; and a shortage of qualified and prepared professionals to deal with situations of violence in their daily practice. Since gender-based violence is a complex social issue of important impact on public health, health managers have a responsibility to address it, seeking interinstitutional partnerships with governments and organized civil society.

La violencia contra la mujer es un problema con graves repercusiones en la salud pública. La búsqueda de estrategias para combatirla requiere de una acción multidisciplinar y multiinstitucional, que involucra al Sistema Único de Salud (SUS). El objetivo de este estudio fue identificar acciones para enfrentar la violencia de género en el SUS y sintetizar los documentos y estudios publicados sobre el tema en Brasil, de 2016 a 2020. Se trata de una revisión narrativa basada en los trabajos publicados en el período estudiado, que abordaran la violencia de género como problema de salud y que mencionaran estrategias de afrontamiento en la gestión del SUS. Los hallazgos se distribuyeron en tres ejes básicos dentro de la lógica narrativa: la propuesta del trabajo en red, el subregistro de casos y la calificación profesional. Los estudios revisados apuntan que aún deben superarse varios desafíos para que se implemente adecuadamente la política nacional para enfrentar la violencia de género en el país. Tres de los desafíos mencionados parecen destacar como factores determinantes: los obstáculos para la formación de una red interinstitucional eficaz orientada hacia la atención a las mujeres en situación de violencia; un subregistro significativo de casos; y la escasez de profesionales calificados y preparados para actuar ante situaciones de violencia en su práctica diaria. Dado que la violencia de género se presenta como un tema social complejo, con un impacto importante en la salud pública, los gerentes del sector salud tienen la responsabilidad de abordarla, buscando alianzas gubernamentales interinstitucionales y en la sociedad civil organizada.

Assuntos

RESUMO

The objective of this study was to test the efficiency of powdered coconut water (ACP-406®) base-medium without or with the addition of supplements on in vitro culture of isolated goat secondary follicles. Follicles were cultured for 18 days in α-MEM or in ACP-406®, both without supplements (referred to as α-MEM and ACP, respectively), or both supplemented with BSA, insulin, transferrin, selenium, glutamine, hypoxanthine, and ascorbic acid (referred to as α-MEM+ and ACP+). Follicular morphology, antrum formation, follicular and oocyte diameter, levels of glutathione (GSH), and chromatin configuration after in vitro maturation were evaluated. At the end of culture, ACP-406® base-medium (without or with supplements) showed a higher (P < 0.05) percentage of normal follicles than α-MEM (without or with supplements). Antrum formation was similar among α-MEM+, ACP and ACP+, and significantly higher than α-MEM without supplements. The follicular diameter was greater in ACP+ than α-MEM, and similar to other treatments. Moreover, fully and daily grown rates were higher (P < 0.05) in ACP-406® base-medium (without or with supplements) than α-MEM (without or with supplements). Levels of GSH were similar between ACP+ and α-MEM+ treatments. Both ACP+ and α-MEM+ allowed meiotic resumption without a significant difference between the two groups. In conclusion, supplemented ACP-406® base-medium maintained follicular survival and promoted the development as well as meiotic resumption of isolated goat secondary follicles cultured in vitro for 18 days.

Assuntos

RESUMO

The objective of this study was to test the efficiency of powdered coconut water (ACP-406®) base-medium without or with the addition of supplements on in vitro culture of isolated goat secondary follicles. Follicles were cultured for 18 days in α-MEM or in ACP-406®, both without supplements (referred to as α-MEM and ACP, respectively), or both supplemented with BSA, insulin, transferrin, selenium, glutamine, hypoxanthine, and ascorbic acid (referred to as α-MEM+ and ACP+). Follicular morphology, antrum formation, follicular and oocyte diameter, levels of glutathione (GSH), and chromatin configuration after in vitro maturation were evaluated. At the end of culture, ACP-406® base-medium (without or with supplements) showed a higher (P < 0.05) percentage of normal follicles than α-MEM (without or with supplements). Antrum formation was similar among α-MEM+, ACP and ACP+, and significantly higher than α-MEM without supplements. The follicular diameter was greater in ACP+ than α-MEM, and similar to other treatments. Moreover, fully and daily grown rates were higher (P < 0.05) in ACP-406® base-medium (without or with supplements) than α-MEM (without or with supplements). Levels of GSH were similar between ACP+ and α-MEM+ treatments. Both ACP+ and α-MEM+ allowed meiotic resumption without a significant difference between the two groups. In conclusion, supplemented ACP-406® base-medium maintained follicular survival and promoted the development as well as meiotic resumption of isolated goat secondary follicles cultured in vitro for 18 days.(AU)

Assuntos

RESUMO

PURPOSE:: To realize a morphological examination of the musculoskeletal tissue, assessing the effect of a contusion method for the production in rat gastrocnemius, comparing the inflammatory responses generated by different impacts. METHODS:: For the analysis of a contusion method, twelve female Wistar rats were distributed into four groups. The lesion was generated by 324 g of mass that was dropped from different predetermined heights for each group (30, 45, 60 and 70 cm). RESULTS:: In the analysis of musculoskeletal tissue, the response to injury varied according to the mass of the height drop onto the muscle. Only the group that was injured from 70 cm responded with uniform and severe inflammation, whereas the groups 30, 45 and 60 cm showed inflammation in some regions of the tissue with mild and moderate infiltrates. CONCLUSION:: The method with the 324-gram mass dropped from a 70-cm height onto the gastrocnemius muscle of rats seems to be the most suitable for the production of muscle injury in these animals after 72 hours, showing an important inflammatory infiltrate.

Assuntos

RESUMO

Purpose: To realize a morphological examination of the musculoskeletal tissue, assessing the effect of a contusion method for the production in rat gastrocnemius, comparing the inflammatory responses generated by different impacts. Methods: For the analysis of a contusion method, twelve female Wistar rats were distributed into four groups. The lesion was generated by 324 g of mass that was dropped from different predetermined heights for each group (30, 45, 60 and 70 cm). Results: In the analysis of musculoskeletal tissue, the response to injury varied according to the mass of the height drop onto the muscle. Only the group that was injured from 70 cm responded with uniform and severe inflammation, whereas the groups 30, 45 and 60 cm showed inflammation in some regions of the tissue with mild and moderate infiltrates. Conclusion: The method with the 324-gram mass dropped from a 70-cm height onto the gastrocnemius muscle of rats seems to be the most suitable for the production of muscle injury in these animals after 72 hours, showing an important inflammatory infiltrate.(AU)

Assuntos

RESUMO

Abstract Purpose: To realize a morphological examination of the musculoskeletal tissue, assessing the effect of a contusion method for the production in rat gastrocnemius, comparing the inflammatory responses generated by different impacts. Methods: For the analysis of a contusion method, twelve female Wistar rats were distributed into four groups. The lesion was generated by 324 g of mass that was dropped from different predetermined heights for each group (30, 45, 60 and 70 cm). Results: In the analysis of musculoskeletal tissue, the response to injury varied according to the mass of the height drop onto the muscle. Only the group that was injured from 70 cm responded with uniform and severe inflammation, whereas the groups 30, 45 and 60 cm showed inflammation in some regions of the tissue with mild and moderate infiltrates. Conclusion: The method with the 324-gram mass dropped from a 70-cm height onto the gastrocnemius muscle of rats seems to be the most suitable for the production of muscle injury in these animals after 72 hours, showing an important inflammatory infiltrate.

Assuntos

RESUMO

This study evaluated the effect of caprine ovarian tissue transportation conditions (medium supplementation and transportation duration) on the morphology, DNA fragmentation and development of cultured and non-cultured preantral follicles. After the fragmentation of ovaries, one fragment was fixed (fresh control) while the remaining slices were placed individually in two different conservation media (Minimal Essential Medium - MEM without supplementation or supplemented MEM, i.e. MEM+) and stored at 35ºC for 6 or 12 h without (non-cultured) or with a subsequent 5-day in vitro culture in supplemented alfa-MEM. After transportation, followed or not by in vitro culture, the fragments were processed for histological and Terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) examination. For the preserved and non-cultured fragments, the percentages of normal follicles after the storage of ovarian tissue in MEM+ for 6 h and the DNA fragmentation rates after preservation in MEM for 6 h and MEM+ for 6 or 12 h were maintained similar to the fresh control. However, all cultured treatments reduced the proportion of normal follicles and increased the percentage of TUNEL-positive cells as compared to the fresh control and non-cultured treatments. On the contrary, all culture conditions (except after preservation in MEM for 6 h) promoted an increase in primordial follicle activation. In conclusion, the use of an enriched medium (MEM+) during ovary transportation is preferable to maintain satisfactory rates of normal follicles after the preservation of caprine ovarian tissue at 35ºC for up to 6 h, without affecting the ability of the primordial follicle to grow in vitro.

Assuntos

RESUMO

This study evaluated the effect of caprine ovarian tissue transportation conditions (medium supplementation and transportation duration) on the morphology, DNA fragmentation and development of cultured and non-cultured preantral follicles. After the fragmentation of ovaries, one fragment was fixed (fresh control) while the remaining slices were placed individually in two different conservation media (Minimal Essential Medium - MEM without supplementation or supplemented MEM, i.e. MEM+) and stored at 35ºC for 6 or 12 h without (non-cultured) or with a subsequent 5-day in vitro culture in supplemented alfa-MEM. After transportation, followed or not by in vitro culture, the fragments were processed for histological and Terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) examination. For the preserved and non-cultured fragments, the percentages of normal follicles after the storage of ovarian tissue in MEM+ for 6 h and the DNA fragmentation rates after preservation in MEM for 6 h and MEM+ for 6 or 12 h were maintained similar to the fresh control. However, all cultured treatments reduced the proportion of normal follicles and increased the percentage of TUNEL-positive cells as compared to the fresh control and non-cultured treatments. On the contrary, all culture conditions (except after preservation in MEM for 6 h) promoted an increase in primordial follicle activation. In conclusion, the use of an enriched medium (MEM+) during ovary transportation is preferable to maintain satisfactory rates of normal follicles after the preservation of caprine ovarian tissue at 35ºC for up to 6 h, without affecting the ability of the primordial follicle to grow in vitro.(AU)

Assuntos