Giving up reporting the aggressor: reports of female victims of domestic violence

The goal of this study is to describe the experience of female victims of domestic violence, who forfeited the lawsuits against their aggressors. The interviews were oriented by the question: What was your experience of forfeiting the denunciation of your aggressor? Three themes emerged from the convergence of the testimonies: time passed from the aggression to the denunciation and then to the forfeiting; the partner, the family, the women's precinct; reflecting about the experience, which described the studied phenomenon. The women expressed ambiguous feelings for their aggressor: affection, anger, humiliation and fear. They recognize that they are dominated and humiliated, but notions of justice and equality between spouses do not appear in the testimonies. Forfeiting can be understood in the context of the reproduction of the traditional family structure, conditioned to economic and social factors. Results highlight implications about the role of the Women's Precinct and the healthcare institutions in the care for women who were victims of domestic violence.

Epidemiological aspects of dog bites considering biter dogs and victims

The aim of this study was to characterize dog bites using data on biter dogs and victims. An exploratory cross-sectional study was performed using 203 records of individuals who had attended in public health services in 2009 in the municipality of Araçatuba, São Paulo, Brazil, after they had been bitten by a dog. Over 70% (92/129) of the biter dogs were male and most of them (71%) received as a gift. Dog owners reported companionship as the main reason for acquiring the dog. The victims who were children were predominantly male, while the victims who were elderly were predominantly female. Most children were bitten on the head/neck, while adults were bitten on the hands/feet and lower limbs (p<0.0001). The owner of the dog was known in 83.2% of cases. However, rabies observation of the biter dog following the attack was only reported in 59.4% of cases. Situations involving aggression were related to dogs having escaped from their home (18.7%) or roaming free on the streets (17.0%). The analysis of biting dog characteristics using information obtained from dog bite victims and biting dog owners can help direct the medical treatment for dog bite victims. Moreover, concepts of responsible dog ownership can reduce the occurrence of bites.

Identification of a novel melittin isoform from Africanized Apis mellifera venom

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tipos e consequências da violência sexual sofrida por estudantes do interior paulista na infância e/ou adolescência

Discutem-se os tipos de Violência Sexual (VS) sofridos na infância e/ou adolescência e suas vicissitudes, nas trajetórias sexuais de 236 adolescentes, de ambos os sexos, cursando o Ensino Médio no interior do Oeste Paulista que declararam ter sofrido um ou mais tipos de violência sexual. Dentre esses tipos, destacamos a Violência Doméstica Sexual (VDS), aqui definida como intrafamiliar. Nesse caso, observamos que, dentre os 236 adolescentes com histórico de VDS, 94 (39.8%) declararam ter pensado em suicídio e 39 (16.5%) disseram ter tentado, sendo que 35 (89.7%) deles se declararam heterossexuais (27 [77.1%] do sexo feminino) e 4 não-heterossexuais (3 bissexuais e 1 outro, sendo todos do sexo feminino). A maioria das vítimas finda por relatar o ocorrido aos amigos e responsáveis, mas pouco ou nada é feito, em termos de medidas protetivas a elas.

Injuries caused by scorpionfishes and (Scorpaena plumieri Bloch, 1789 Scorpaena brasiliensis Cuvier 1829) in the Southwestern Atlantic Ocean (Brazilian coast): epidemiologic, clinic and therapeutic aspects of 23 stings in humans

Fishes of the family Scorpaenidae are responsible for severe injuries and occasionally deaths in humans around the world. The more venomous fishes on the Brazilian coast and in the Southwestern Atlantic region are classified in the genus Scorpaena (family Scorpaenidae). However, there are few studies on the venomous apparatus, the effects of the venom, or clinical aspects of human envenoming provoked by Atlantic scorpionfishes.In this communication, the authors present 23 accidents caused by scorpionfishes of the genus Scorpaena among fishermen, and report the species that provoked the injuries, the circumstances of contacts, the clinical aspects observed and the therapeutic measures utilized for control of the symptoms of the victims. The intense pain and the systemic findings observed in the patients were very frequent and we think that the injuries provoked by scorpionfishes should be considered the most important manifestations caused by venomous fishes of the East Atlantic Ocean. (C) 2003 Elsevier B.V. Ltd. All rights reserved.

Freshwater stingrays: study of epidemiologic, clinic and therapeutic aspects based on 84 envenomings in humans and some enzymatic activities of the venom

Freshwater stingrays are very common in the Parana, Paraguay, Araguaia, and Tocantins Rivers and tributaries in Brazil. This study presents the clinical aspects of 84 patients injured by freshwater stingrays. Intense pain was the most conspicuous symptom. Skin necrosis was observed in a high percentage of the victims, mostly fishermen and bathers. The initial therapeutic procedures, like immersion of the affected member in hot water were effective in the initial phases of the envenoming, especially in the control of the acute pain; however, they did not prevent skin necrosis. By SDS-PAGE, the freshwater stingray (Potamotrygon falkneri) venom extract presented a major band of approximately 12 kDa. Several other components distributed between 15 and 130 kDa were detected in the venom extract. Many components with molecular mass above 80 and 100 kDa have gelatinolytic and caseinolytic activities, respectively. Hyaluronidase activity was detected only in a component around 84 kDa in P. falkneri venom extract. Our results demonstrated that the presence of these enzymes could explain partially the local clinical pictures presented by patients wounded by freshwater stingray. (C) 2004 Elsevier Ltd. All rights reserved.

Arraias em rios da região Sudeste do Brasil: locais de ocorrência e impactos sobre a população

INTRODUÇÃO: No presente trabalho objetivamos descrever o processo de colonização da Bacia do Alto Paraná, Sudeste do Brasil, por arraias, demonstrando sua atual situação e provável tendência, os impactos gerados e discutindo algumas ações de manejo e medidas mitigadoras. MÉTODOS: Foram realizadas entrevistas com ribeirinhos e profissionais de saúde para o levantamento de informações sobre a ocorrência de arraias e acidentes associados a estes animais, além de coletas e observações subaquáticas de potamotrigonídeos, entre 2004 e 2009, em localidades situadas nos Estados de São Paulo, Paraná e Mato Grosso do Sul, no Sudeste, Sul e parte do Centro-Oeste do Brasil. RESULTADOS: Três espécies de arraias foram identificadas na área de estudo, demonstrando utilizar os caminhos abertos pela Hidrovia Tietê-Paraná para se dispersarem. Dezesseis vítimas de acidentes envolvendo esses animais foram encontradas, notadamente banhistas e pescadores, chamando a atenção pelo fato dos casos não serem notificados e apresentarem elevada morbidade, com marcante incapacidade temporária para o trabalho. CONCLUSÕES: Este é o primeiro relato de invasão biológica envolvendo espécies de elasmobrânquios conhecido na literatura e, pelas arraias estarem colonizando áreas densamente povoadas e ampliando sua área de distribuição a cada ano, é de se esperar que sua interação negativa com humanos se intensifique, provocando alterações importantes no perfil epidemiológico dos acidentes por animais peçonhentos ocorridos no sudeste brasileiro.

HISTORICAL PERSPECTIVE and HUMAN CONSEQUENCES of AFRICANIZED BEE STINGS IN THE AMERICAS

In 1956, Africanized bees began to spread in the American continent from southern Brazil, where original African bees mated with European bees. A few years later, in 1990, these Africanized bees reached the United States and were found in Texas. Currently, these hybrid bees are found in several North American states and will probably reach the Canadian border in the future. Although the presence of Africanized bees had produced positive effects on Brazilian economy, including improvement in crop pollination and in honey production, turning Brazil into a major exporter, the negative impacts-such as swarming, aggressive behavior, and the ability to mass attack-resulted in serious and fatal envenomation with humans and animals. Victims of bee attacks usually develop a severe envenomation syndrome characterized by the release of a large amount of cytokines [interleukins (IL) IL-1, IL-6, IL-8], and tumor necrosis factor (TNF). Subsequently, such cytokines produce an acute inflammatory response that triggers adverse effects on skeletal muscles; bone marrow; hepatic and renal functions; and cardiovascular, central nervous, and immune systems. Finally, the aim of the present review is to study historical characteristics and current status of Africanized bees' spread, the composition of their venom, the impact of the bees on the Brazilian economy and ecology, and clinical aspects of their stings including immune response, and to suggest a protocol for bee sting management since there is no safe and effective antivenom available.

Bite by moray eel

Injuries caused by moray eels are not a common problem, but are distributed throughout the globe, affecting mainly fishermen while manipulating hooked or netted fish. on a lesser scale, scuba divers and snorkelers, practicing or not spear fishing, are occasional victims of bites. With more than 185 species distributed among 15 genera, mostly in tropical to temperate shallow water, moray eels easily come into contact with humans and occasional injuries are not uncommon. The current study reports one case of moray eel bite and discusses the circumstances in which the accident happened, as well as wound evolution and therapy.

Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): etiology and severity of accidents on the Brazilian coast

This work attempts to establish dermatological identification patterns for Brazilian enidarian species and it probable correlation with envenoming, severity In all observational prospective study, one hundred and twenty-eight patients from the North Coast re-ion of São Paulo State, Brazil were seen between 2002 and 2008. About 80% of these Showed only local effects (erythema, edema, and pain) with small, less than 20 cm, oval or round skin marks and impressions from Small tentacles. Approximately 20% of the victims had long, more than 20 cm, linear and crossed marks with frequent systemic phenomena, such as malaise, vomiting, dyspnea, and tachycardia. The former is compatible with the common hydromedusa from Southeast and Southern Brazil (Olindias sambaquiensis). The long linear marks with intense pain and systemic phenomena are compatible with envenoming, by the box jellyfish Tamoya haplonema and Chiropsalmus quadrumanus and the hydrozoan Portuguese man-of-war (Physalis physalis). There was an association between Skin marks and probable accident etiology. This simple observation rule can be indicative of severity as the Cubozoa Class (box jellyfish) and Portuguese man-of-war cause the most severe accidents. In such cases, medical attention, including intensive care, is important, as the systemic manifestations call be associated with death.

Retrospective analysis of post-exposure to human anti-rabies treatment in Botucatu, São Paulo State, Brazil

This analysis aimed to identify characteristics of accidents that would, probably, provoke rabies infection. A total of 14,409 survey questionnaires for surveillance of human rabies from the Brazilian Information System for Disease Notification (SINAN), from 2000 to 2005, were analyzed. Regarding demographics, it was observed that 7,377 (51.5%) of the victims were white, 4,458 (30.93%) were children and 8,008 (55.58%) were males. Urban cases were prevalent (88.10%) while dogs were the animals most frequently involved in accidents, in 11,700 cases (81.19%). Bites (84.35%) and scratches (19.15%) were the most prevalent exposure types, and occurred predominantly on victims' extremities (38.79%). The prophylactic measure taken in 6,179 cases comprised anti-rabies vaccine; of these victims, 421 (2.92%) showed systemic reactions while 693 (4.80%) reported no response. The importance of developing awareness in professionals that should correctly report post-exposure immunoprophylaxis cases is emphasized given the high number of individuals who receive this type of treatment annually.

Nutritional, immunological and microbiological profiles of burn patients

A burn is a lesion on an organic tissue resultant from direct or indirect action of heat on the organism. The present study aimed to evaluate the nutritional, immunological and microbiological status of burn patients at the Bauru State Hospital, São Paulo state, Brazil, in 2007. Eight patients, aged more than 18 years and injured up to 24 hours, were evaluated at the moment of hospitalization and seven days later. All victims were males with a mean age of 38 years. on average, 17.5% of their body surfaces were burned and 50% of the patients were eutrophic. There were significant alterations in levels of erythrocytes, hemoglobin, hematocrit, total protein and albumin due to increased endothelial permeability, direct destruction of proteins in the heat-affected area and blood loss from lesions or debridement. At a second moment, cytokines IL-6 and TNF-alpha had augmented significantly, with IL-6 presenting elevated levels in relation to controls at the first moment. Microbiological analysis showed that 100% of the samples collected at hospital admission were negative and after one week Staphylococcus aureus was found in all cultures. Therefore, a burn patient may be considered immunosuppressed and these results indicate significant nutritional, immunological and microbiological alterations that can interfere in his recovery.

Acidente com material perfurocortante entre profissionais de enfermagem de um hospital universitário

Os riscos ocupacionais a que os profissionais da equipe de enfermagem estão sujeitos no desempenho de suas funções são consideráveis. Assim estabeleceu-se como objetivo deste estudo analisar os acidentes perfurocortantes no período de 2002 a 2006, envolvendo a equipe de enfermagem de um hospital universitário, para compreender o contexto em que ocorrem. A utilização destas informações pode ser ferramenta de prevenção. Estudo descritivo, retrospectivo quantitativo e qualitativo. Na análise quantitativa foi utilizada estatística descritiva e na qualitativa o discurso do sujeito coletivo. Por meio das fichas de notificação do Núcleo de Vigilância Epidemiológica do Hospital, foi possível identificar acidentes do gênero no período pesquisado. Entrevistas foram direcionadas às vítimas de acidentes que tiveram como paciente-fonte portador de Síndrome da Imunodeficiência Adquirida/ Vírus da Imunodeficiência Humana, hepatite B e C. Os achados demonstraram que ainda persiste um grau significativo do desconhecimento ou banalização dos acidentes entre profissionais da saúde.