REPORTING OF SEXUAL VIOLENCE AGAINST WOMEN IN BRAZIL

Objetivo: Apresentar o quadro de violência sexual contra a mulher no Brasil, com base nas notificações realizadas no Sistema de Informação de Agravos de Notificação (SINAN). Métodos: Trata-se de um estudo descritivo, com abordagem quantitativa, que analisou informações referentes às notificações de violência sexual contra a mulher, no período de 2009 a 2013, considerando a unidade da federação, perfil das mulheres, características da ocorrência e encaminhamentos realizados pelo setor saúde. Os dados foram analisados por meio da estatística descritiva, sendo apresentados números absolutos e relativos derivados das notificações. Resultados: No Brasil, foram registradas 21.871 notificações no período estudado. Observaram-se maiores taxas de registros no ano de 2013 e na região Norte. Predominou o ciclo de vida de 10 a 19 anos (10.806/49,4%), as raças branca (8.894/40,7%) e parda (8.535/39,0%), e a escolaridade ensino fundamental incompleto (5.444/24,9%). Os casos de violência sexual ocorreram com maior frequência na residência da mulher (13.259/60,6%), com agressor conhecido (5.649/25,8%) e sem suspeita do uso de álcool (9.249/42,3%). A maior parte do atendimento no setor saúde foi de nível ambulatorial (15.842/72,6%), e os casos evoluíram para alta (16.879/77,2%). Conclusão: As notificações cresceram progressivamente no período estudado, e a violência sexual contra a mulher no país, registrada pelo setor saúde, atingiu, principalmente, adolescentes, no ambiente doméstico e com agressor conhecido.

ADVANCES AND CHALLENGES OF BREASTFEEDING IN BRAZIL: AN INTEGRATIVE REVIEW

Objective: To analyze the panorama of breastfeeding in Brazil through an integrative literature review highlighting its advances and challenges. Methods: We carried out an integrative literature review in the SciELO and PubMed databases and in booklets published on the websites of the Ministry of Health and the International Baby Food Action Network (IFBAN) using the following Portuguese and English descriptors: aleitamento materno (breastfeeding), autoeficácia (self-efficacy), promoção da saúde (health promotion) and desmame (weaning) in the period from 2002 to 2015. Results: We identified at first 43 articles, 33 booklets, 1 thesis and 3 dissertations, including in the study 17 articles, 3 dissertations and 19 booklets due to information saturation. It was verified that breastfeeding rates have reduced significantly over time with direct implications in infant mortality rates, being associated with early weaning and the lack of promotion of maternal self-efficacy in the prenatal and postpartum. To change this situation, Brazil imposed a number of public policies aimed at breastfeeding success, which advocated to raise rates. Conclusion: Despite the advances, the Brazilian panorama of breastfeeding shows that the country remains below the recommendations of international organizations, and overcoming the obstacles to successful breastfeeding constitutes a major challenge for the Brazilian public health.

First description of Candida nivariensis in Brazil: antifungal susceptibility profile and potential virulence attributes

This study evaluated the antifungal susceptibility profile and the production of potential virulence attributes in a clinical strain of Candida nivariensis for the first time in Brazil, as identified by sequencing the internal transcribed spacer (ITS)1-5.8S-ITS2 region and D1/D2 domains of the 28S of the rDNA. For comparative purposes, tests were also performed with reference strains. All strains presented low planktonic minimal inhibitory concentrations (PMICs) to amphotericin B (AMB), caspofungin (CAS), and voriconazole. However, our strain showed elevated planktonic MICs to posaconazole (POS) and itraconazole, in addition to fluconazole resistance. Adherence to inert surfaces was conducted onto glass and polystyrene. The biofilm formation and antifungal susceptibility on biofilmgrowing cells were evaluated by crystal violet staining and a XTT reduction assay. All fungal strains were able to bind both tested surfaces and form biofilm, with a binding preference to polystyrene (p < 0.001). AMB promoted significant reductions (≈50%) in biofilm production by our C. nivariensis strain using both methodologies. This reduction was also observed for CAS and POS, but only in the XTT assay. All strains were excellent protease producers and moderate phytase producers, but lipases were not detected. This study reinforces the pathogenic potential of C. nivariensis and its possible resistance profile to the azolic drugs generally used for candidiasis management.