ABSTRACT Purpose: to evaluate biocompatibility and osteogenic potential of hydroxyapatite/alginate composite after its implantation on rat calvarian critical bone defect. Methods: thirty adults male Wistar rats were randomly distributed into two groups: GHA – critical bone defect filled with hydroxyapatite/alginate composite granules (HA/Alg) and CG – critical bone defect without biomaterial; evaluated at biological points of 15, 45 and 120 days. Results: the histomorphometrically analyses for GHA showed osteoid matrix deposition (OM) among the granules and towards the center of the defect in centripetal direction throughout the study, with evident new bone formation at 120 days, resulting in filling 4/5 of the initial bone defect. For CG, this finding was restricted to the edges of the bone margins and formation of connective tissue on the residual area was found in all biological points. Inflammatory response on GHA was chronic granulomatous type, discrete and regressive for all biological points. Throughout the study, the CG presented mononuclear inflammatory infiltrate diffuse and regressive. Histomorphometry analyses showed that OM percentage was evident for GHA group when compared to CG group in all analyzed periods (p > 0.05). Conclusions: the biomaterial evaluated at this study showed to be biocompatible, bioactive, osteoconductive and biodegradable synchronously with bone formation. Purpose hydroxyapatitealginate hydroxyapatite alginate Methods groups HA/Alg HAAlg HA Alg (HA/Alg 15 4 12 days Results (OM 5 4/ type p 0.05. 005 0.05 . 0 05 0.05) Conclusions biocompatible bioactive 1 00 0.0 0.

ABSTRACT Objective: To establish the accuracy of frozen section examination in identifying tumor spread through air spaces (STAS), as well as to propose a reproducible technical methodology for frozen section analysis. We also aim to propose a method to be incorporated into the decision making about the need for conversion to lobectomy during sublobar resection. Methods: This was a nonrandomized prospective study of 38 patients with lung cancer who underwent surgical resection. The findings regarding STAS in the frozen section were compared with the definitive histopathological study of paraffin-embedded sections. We calculated a confusion matrix to obtain the positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and accuracy. Results: The intraoperative frozen section analysis identified 7 STAS-positive cases that were also positive in the histopathological examination, as well as 3 STAS-negative cases that were positive in the in the histopathological examination. Therefore, frozen section analysis was determined to have a sensitivity of 70%, specificity of 100%, PPV of 100%, NPV of 90.3%, and accuracy of 92% for identifying STAS. Conclusions: Frozen section analysis is capable of identifying STAS during resection in patients with lung cancer. The PPV, NPV, sensitivity, and specificity showed that the technique proposed could be incorporated at other centers and would allow advances directly linked to prognosis. In addition, given the high accuracy of the technique, it could inform intraoperative decisions regarding sublobar versus lobar resection. Objective STAS, , (STAS) Methods paraffinembedded paraffin embedded sections (PPV) (NPV) Results STASpositive STASnegative Therefore 70 70% 100 100% 903 90 90.3% 92 Conclusions prognosis addition (STAS (PPV (NPV 10 9 90.3 1 90.

RESUMO Este artigo teve como objetivo apresentar a experiência da implementação dos Consultórios de Rua na cidade do Recife-PE como estratégia de prevenção ao HIV/Aids e Redução de Danos (RD) decorrentes do uso de álcool, crack e outras drogas. Ainda que o resgate da história desse processo apresente tensões, impermanências e alternâncias nos modelos de cuidado implementados pela gestão municipal, sua análise aponta a importância de reafirmar, no contexto atual, a proposição de práticas e experiências nesse campo, ancoradas na RD e na defesa da cidadania e dos direitos humanos. Observa-se que os Consultórios de Rua contribuem para fortalecer a prática de RD no Sistema Único de Saúde (SUS) como estratégia de saúde pública, assim como reduzem as vulnerabilidades às Infecções Sexualmente Transmissíveis (IST) e Aids associadas ao uso de álcool, crack e outras drogas. A experiência do CR ampliou a promoção à linha de cuidado para pessoas que usam álcool, crack, e outras drogas, reduzindo também as vulnerabilidades das IST/Aids associadas a esse consumo. No entanto, vê-se que é preciso investir e manter processos formativos que sejam permanentes, além de estudos e pesquisas epidemiológicas que demonstrem os resultados alcançados nos diferentes contextos. RecifePE Recife PE HIVAids HIV (RD álcool drogas tensões municipal reafirmar atual campo humanos Observase Observa se SUS (SUS pública IST (IST ISTAids consumo entanto vêse vê permanentes contextos

ABSTRACT This article aims to present the experience of implementing ‘Street Outreach Teams’ in the city of Recife-PE as a strategy for HIV/AIDS prevention and Harm Reduction (HR) associated with the use of alcohol, crack, and other drugs. Although the review of the history of this process reveals tensions, volatility, and alternations in the care models implemented by the city management, the analysis points out the importance of reaffirming, in the current context, the practices and experiences in that field, anchored in HR and in the defense of civil and human rights. Street outreach teams have been found to help strengthen the practice of HR in the Unified Health System, as a public health strategy to reduce vulnerabilities to Sexually Transmitted Infections (STI) and AIDS associated with the use of alcohol, crack, and other drugs. The experience has expanded the promotion of the line of care for people who use alcohol, crack, and other drugs and reduced the vulnerabilities of STI/AIDS associated with such use. However, it seems that it is necessary to invest and maintain permanent training processes, in addition to epidemiological studies and research demonstrating the results achieved in different contexts. Teams RecifePE Recife PE HIVAIDS HIV (HR alcohol crack tensions volatility management reaffirming context field rights System STI (STI STIAIDS However processes contexts

ABSTRACT This article aims to present the experience of implementing ‘Street Outreach Teams’ in the city of Recife-PE as a strategy for HIV/AIDS prevention and Harm Reduction (HR) associated with the use of alcohol, crack, and other drugs. Although the review of the history of this process reveals tensions, volatility, and alternations in the care models implemented by the city management, the analysis points out the importance of reaffirming, in the current context, the practices and experiences in that field, anchored in HR and in the defense of civil and human rights. Street outreach teams have been found to help strengthen the practice of HR in the Unified Health System, as a public health strategy to reduce vulnerabilities to Sexually Transmitted Infections (STI) and AIDS associated with the use of alcohol, crack, and other drugs. The experience has expanded the promotion of the line of care for people who use alcohol, crack, and other drugs and reduced the vulnerabilities of STI/AIDS associated with such use. However, it seems that it is necessary to invest and maintain permanent training processes, in addition to epidemiological studies and research demonstrating the results achieved in different contexts.

RESUMO Este artigo teve como objetivo apresentar a experiência da implementação dos Consultórios de Rua na cidade do Recife-PE como estratégia de prevenção ao HIV/Aids e Redução de Danos (RD) decorrentes do uso de álcool, crack e outras drogas. Ainda que o resgate da história desse processo apresente tensões, impermanências e alternâncias nos modelos de cuidado implementados pela gestão municipal, sua análise aponta a importância de reafirmar, no contexto atual, a proposição de práticas e experiências nesse campo, ancoradas na RD e na defesa da cidadania e dos direitos humanos. Observa-se que os Consultórios de Rua contribuem para fortalecer a prática de RD no Sistema Único de Saúde (SUS) como estratégia de saúde pública, assim como reduzem as vulnerabilidades às Infecções Sexualmente Transmissíveis (IST) e Aids associadas ao uso de álcool, crack e outras drogas. A experiência do CR ampliou a promoção à linha de cuidado para pessoas que usam álcool, crack, e outras drogas, reduzindo também as vulnerabilidades das IST/Aids associadas a esse consumo. No entanto, vê-se que é preciso investir e manter processos formativos que sejam permanentes, além de estudos e pesquisas epidemiológicas que demonstrem os resultados alcançados nos diferentes contextos.

SUMMARY OBJECTIVE: The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery. METHODS: A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019. RESULTS: A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications. CONCLUSION: Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary. OBJECTIVE symptombased 201 METHODS 202 Hospital Fortaleza CE Brazil transcriptionpolymerase transcription polymerase RESULTS 5 55/1,026, 551026 1 026 (55/1,026 5.4% 54 4 50/1,026, 501026 (50/1,026 4.8% 48 8 respectively n=23, n23 n 23 (n=23 46%. 46 46% . 46%) 7/50, 750 7 (7/50 14% 14 birth complications CONCLUSION Symptombased Symptom necessary 20 55/1,026 55102 02 (55/1,02 5.4 50/1,026 50102 (50/1,02 4.8 n=23 n2 (n=2 7/50 75 (7/5 55/1,02 5510 0 (55/1,0 5. 50/1,02 5010 (50/1,0 4. n=2 (n= 7/5 (7/ 55/1,0 551 (55/1, 50/1,0 501 (50/1, n= (n 7/ (7 55/1, (55/1 50/1, (50/1 ( 55/1 (55/ 50/1 (50/ 55/ (55 50/ (50 (5

ABSTRACT The ability to maintain high competitiveness under a wide range of conditions is common among successful invasive species. The performance of rhizomatous macrophytes in different habitats is closely related to morphological and physiological adaptations in the rhizome system. We investigated the effects of soil moisture conditions on the microstructure of rhizomes of Hedychium coronarium (Zingiberaceae), an aggressive invader of Neotropical riparian sites. We collected rhizome fragments of H. coronarium and soil samples in wet and dry regions of riparian areas dominated by this species in southeastern Brazil. We measured soil moisture content gravimetrically and rhizome fragments were fixed, sectioned, and stained for histological analysis. Only rhizomes from wet regions exhibited aerenchyma, whereas amyloplasts were much more abundant and larger in rhizomes from dry regions than in rhizomes from wet regions. Even though low starch content in wet soils indicates the occurrence of anaerobic metabolism, the presence of aerenchyma may contribute to the typically high performance of H. coronarium in waterlogged soils. Although further studies are needed to assess how responses at the rhizome level affect the competitive ability of H. coronarium, our findings show that they may play a role in the dominance of this species in Neotropical riparian sites.

RESUMO Objetivo: O objetivo deste estudo foi revisar a literatura e comparar diferentes métodos de tratamento cirúrgico para hiperplasia do coronoide, além de relatar um caso clínico de hiperplasia coronoide unilateral tratada por coronoidectomia pelo acesso intraoral. Métodos: A revisão eletrônica crítica da literatura foi feita selecionando artigos publicados nos últimos 20 anos sobre o tratamento da hiperplasia do coronoide em adultos nas bases de dados PubMed, Medline, Scielo e Lilacs com os termos coronoid hyperplasia OR coronoid elongation AND treatment OR management. Os dados foram extraídos para análise. Resultados: Foram selecionados 24 artigos. Incluindo um total de 42 pacientes, dentre eles 69% eram pacientes do sexo masculino e 81% foram acometidos bilateralmente. O grupo etário com a maior prevalência compreendeu de 20 a 30 anos. Sessenta e nove por cento dos pacientes foram tratados com coronoidectomia e 26,2% com coronoidotomia, a maioria (83,3%) com acesso intra-oral. Nenhum caso teve complicações cirúrgicas relatadas e 71,4% foram submetidas à fisioterapia após a cirurgia. Em relação aos resultados, 83,3% foram considerados satisfatórios, e 11,9% insatisfatórios. Conclusão: A grande maioria dos casos que trouxeram resultados significativos na melhora da abertura bucal pré e pós-operatória foram tratados pela coronoidectomia, demonstrando ser um tratamento cirúrgico eficiente e seguro para a hiperplasia do coronoide.

ABSTRACT Objective: The objective of this research was to review the literature, compare different methods of surgical treatment for coronoid hyperplasia and report a clinical case of unilateral coronoid hyperplasia treated by coronoidectomy with intraoral access. Methods: A critical review of the literature was performed by selection of papers published in the last 20 years on the treatment of coronoid in adults in the PubMed, Medline, Scielo and Lilacs databases, with the terms coronoid hyperplasia OR coronoid elongation AND treatment OR management. The data was extracted for analysis. Results: twenty-four articles were selected. It included 42 patients, among them 69% were male patients and 81% were bilaterally affected. The age group with the highest prevalence was the people in the 20's and 30's. Sixty-nine percent of the patients were treated with coronoidectomy and 26.2% with coronoidotomy. The majority (83.3%) with intraoral access. No cases had surgical complications reported, and 71.4% underwent physiotherapy after surgery. Regarding the results, 83.3% were considered satisfactory, 11.9% were unsatisfactory. Conclusion: The great majority of the cases that brought significant results in the improvement of the pre and postoperative mouth opening were treated by coronoidectomy, proving to be an efficient and safe surgical treatment for the coronoid hyperplasia.

Abstract The aim of the present overview was to evaluate the outcomes of systematic reviews to determine the incidence of condylar resorption in patients submitted to orthognathic surgery and analyze whether the risk of developing this condition is related to a specific type of surgery. Searches were conducted in the PubMed/MEDLINE, Embase, and Cochrane electronic databases for systematic reviews with quantitative data on condylar resorption due to any type of orthognathic surgery for dentoskeletal deformities published up to May 25, 2019. The AMSTAR 2 and Glenny tools were applied for the quality appraisal. Five systematic reviews were included for analysis. Only one article was considered to have high quality. Among a total of 5128 patients, 12.32% developed condylar resorption. From those patients, 70.1% had double jaw surgery, 23.4% had mandibular surgery alone, and in 6.5% a Lefort I technique was used. Based on these findings, bimaxillary surgery could be considered a risk factor for condylar resorption. However, these results should be interpreted with caution, since other factors, such as pre-operative skeletal deformities, type of movement, and type of fixation, can contribute to the development of this condition. Further studies should consider reporting main cephalometric data, temporomandibular diagnosis, hormonal levels, and tomographic measures before and after the surgery at least every 6 months during the firsts two years to identify accurately risk factors for condylar resorption.

Resumo Objetivo Comparar o efeito de dois protocolos de ultrassom terapêutico com diferentes tempos de exposição para regeneração de defeito ósseo crítico. Métodos Foram utilizados 45 ratos, machos, distribuídos em três grupos: grupo ultrassom terapêutico 5 minutos (GUS 5); grupo ultrassom terapêutico 10 minutos (GUS 10); e grupo controle (GC). Em todos os grupos, confeccionou-se um defeito ósseo crítico, com 8,5 mm de diâmetro, na região da calvária. O protocolo foi iniciado no 1º dia do pós-operatório, no GUS 5 e no GUS 10, com ultrassom terapêutico na frequência de 1,0 MHz, modo pulsado, 5 vezes por semana, nos períodos de 15, 30, e 60 dias. Resultados Dentre os grupos experimentais, houve maior neoformação de matriz osteoide no GUS 10, seguido do GUS 5 quando comparados ao GC, no qual a neoformação foi restrita à região de borda. O uso do ultrassom promoveu aumento na espessura da matriz conjuntiva, proliferação de capilares, alinhamento das fibras colágenas, redução do edema e do processo inflamatório, tendo sido mais significativo no tempo de 10 minutos. Conclusão O ultrassom terapêutico estimulou o reparo do defeito ósseo crítico, e o maior tempo de exposição promoveu maior estímulo osteogênico.

Abstract Objective To compare the effect of two therapeutic ultrasound protocols, with different times of exposure in the regeneration of critical bone defect. Methods Forty-five male rats were distributed among three experimental groups: therapeutic ultrasound group 5 minutes (TUG 5); therapeutic ultrasound group 10 minutes (TUG 10); and control group (CG). In all groups, a critical bone defect of 8.5 mm diameter was made in the calvaria region. The protocol was initiated on the 1st postoperative day in TUGs 5 and 10, with therapeutic ultrasound at the frequency of 1.0 MHz, pulsed mode, five times a week, at periods of 15, 30, and 60 days. Results Among the experimental groups, the highest volume of neoformation of osteoid matrix took place in the TUG 10 group followed by TUG 5, when compared with the CG group, in which the neoformation was restricted to the border region. The use of ultrasound promoted an increase in the thickness of the conjunctive matrix, proliferation of capillaries, alignment of the collagen fibers, reduction of edema and inflammatory process, being more significant in the 10-minutes time period. Conclusion Therapeutic ultrasound stimulated the repair of a critical bone defect, and the longer exposure time promoted greater osteogenic stimulation.

ABSTRACT The aim of the study is to discuss the use of crack in the form of “virado” as a harm reduction strategy in Pernambuco, Brazil. This is a cross-sectional study with a qualitative approach in which semi-structured interviews were conducted regarding aspects related to the culture of crack use with 39 crack users between March and August 2016. Participants were recruited using saturation criteria and data were analyzed through content analysis. Respondents discussed the use of “virado” and compared its effects in relation to crack, addressing improvement in interpersonal relationships, libido, and non-compulsive drug use, which can all be understood as harm reduction strategies. On the other hand, equipment sharing for the use of “virado” was identified as a high-risk practice with regards to the transmission of infectious diseases. Knowing about the culture of crack use in different contexts is essential in order to plan and develop health care actions.

RESUMEN El objetivo del estudio es discutir uno de los usos del crack denominado “virado”, como estrategia de reducción de daños entre las personas que usan crack en Pernambuco, Brasil. Se realizó una investigación cualitativa y transversal. Desde marzo hasta agosto de 2016, se realizaron entrevistas semiestructuradas sobre la cultura del uso de crack a 39 personas que usan esta substancia. El límite de participantes se estableció por el criterio de saturación. Los datos se analizaron con la técnica de análisis de contenido. Las personas que participaron relataron que el virado es una manera distinta de utilizar el crack y, al comparar su efecto con el uso fumado o inhalado, mencionaron que el virado produce menos impacto en las relaciones interpersonales y en la libido, además de reducir el uso compulsivo de crack, cuestiones que se podrían considerar como estrategias de reducción de daños. Un aspecto negativo es que comparten los canutos para aspirar el virado, lo cual es una situación de riesgo para la transmisión de enfermedades infecciosas. Conocer la cultura del uso del crack en distintas formas y situaciones es imprescindible para la planificación y desarrollo de acciones de atención a la salud.

RESUMO Objetivo Correlacionar a prevalência e o prognóstico de cada padrão de TCAR de pneumonia intersticial usual (PIU) típica, provável e indeterminada com o diagnóstico clínico multidisciplinar de doença pulmonar intersticial (DPI). Métodos Incluímos todos os pacientes com diagnóstico multidisciplinar de DPI com padrão de TCAR de PIU típica, PIU provável ou indeterminada para PIU. Dados clínicos e histopatológicos, teste de função pulmonar e status de sobrevida foram obtidos retrospectivamente. O diagnóstico final foi validado por uma equipe multidisciplinar. Resultados Foram incluídos no estudo 244 pacientes, com média de idade de 68 ± 13 anos sendo 52,5% do sexo masculino. Em um total de 106 pacientes com padrão típico de PIU, 62% tiveram o diagnóstico multidisciplinar de FPI, 20% de pneumonia por hipersensibilidade crônica (PHC) e 10% de DPI relacionada à doença do tecido conjuntivo (DPI-DTC). Dos 114 casos com provável PIU, DPI-DTC correspondeu a 39%, FPI a 31%, pneumonia intersticial descamativa a 11%, doença pulmonar relacionada a medicamentos a 9% e PHC a 8%. Nos 24 pacientes com TC indeterminada para PIU, o DPI-DTC foi o diagnóstico final em 33%, seguido por pneumonia intersticial descamativa (21%) e FPI (13%). Pacientes com PIU típica apresentaram maior probabilidade de morrer ou realizar transplante de pulmão no seguimento (17,9% e 11,3%, respectivamente). Conclusões FPI, PHC e DPI-DTC foram os principais diagnósticos diferenciais em pacientes com padrão de TCAR de PIU típica, provável e indeterminada. Pacientes com padrão de PIU típico na TCAR tiveram maior probabilidade de morrer ou realizar transplante de pulmão no seguimento.

ABSTRACT Objective To correlate the prevalence and prognosis of each HRCT pattern of typical, probable, and indeterminate usual interstitial pneumonia (UIP) with the clinical multidisciplinary diagnosis of interstitial lung disease (ILD). Methods We included all patients with a multidisciplinary diagnosis of ILD with an HRCT pattern of typical UIP, probable UIP, or indeterminate for UIP. Clinical and histopathological data, pulmonary function tests, and survival status were retrospectively obtained. The final diagnosis was validated by a multidisciplinary team. Results A total of 244 patients were included in the study, with a mean age of 68 ±13 years and being 52.5% males. In a total of 106 patients with typical UIP pattern, 62% had the multidisciplinary diagnosis of IPF, 20% had chronic hypersensitivity pneumonitis (CHP), and 10% had connective tissue disease-related ILD (CTD-ILD). Out of the 114 cases with probable UIP, CTD-ILD corresponded to 39%, IPF to 31%, desquamative interstitial pneumonia to 11%, drug-related lung disease to 9%, and CHP to 8%. In the 24 patients with CT indeterminate for UIP, CTD-ILD was the final diagnosis in 33%, followed by desquamative interstitial pneumonia (21%), and IPF (13%). Patients with typical UIP were more likely to die or had lung transplantation in the follow-up (17.9% and 11.3%, respectively). Conclusion IPF, CHP, and CTD-ILD were the main differential diagnoses in patients with HRCT patterns of typical, probable and indeterminate UIP. Patients with HRCT typical UIP pattern were more likely to die or had lung transplantation in the follow-up.

Resumo A Cadeia de Custódia implica no adequado processo de coleta, registro e armazenagem do vestígio da violência sexual, garantindo a confiabilidade do material que será encaminhado como prova pericial. Sua instalação no Sistema Único de Saúde tem enfrentado desafios. Objetivos: Conhecer o atendimento à vítima de violência sexual em maternidade pública do DF e avaliar o conhecimento da equipe acerca da legislação sobre cadeia de custódia. Método: Estudo transversal, quantitativo e descritivo, com 134 profissionais de medicina e enfermagem que atuam na emergência obstétrica, que responderam a um questionário, submetido à análise estatística descritiva e o Teste Qui-Quadrado. Resultados: Dentre os 78,95% dos profissionais que afirmaram atender vítimas de violência sexual, 25,71% as consultam em 10 minutos e 14.18% receberam capacitação específica. O diagnóstico situacional revela que o atendimento é superficial, centrado em questões médicas e a coleta de vestígios é inexistente. Conclusão e implicações para a prática de enfermagem: Uma mudança generalizada de postura é necessária para que seja possível implantar a cadeia de custódia na maternidade estudada. É fundamental desenvolver um o atendimento para além de questões médicas, e que inclua questões periciais. Sugere-se uma atuação colaborativa entre médicos e enfermeiros, tendo a enfermagem como epicentro desse processo.

Abstract Chain of Custody implies adequate collection, recording, and storage of the vestige of sexual violence, guaranteeing the reliability of the material that will be forwarded as expert evidence. Its implementation in the Unified Health System has faced challenges. Objective: To know the attendance to victims of sexual violence in the public maternity of Federal District and evaluate the knowledge of the team about the legislation on a chain of custody. Method: Cross-sectional, quantitative, and descriptive study with 134 medical and nursing professionals working in the obstetric emergency, who answered a questionnaire, submitted to descriptive statistical analysis and the Qui-Square Test. Results: Of the 78.95% of professionals who reported attending to victims of sexual violence, 25.71% consulted in 10 minutes, and 14.18% received specific training. The situational diagnosis reveals that the care is superficial, centered on medical issues, and the collection of vestiges is non-existent. Conclusion and implications to nursing practice: A generalized change of posture is necessary so that it is possible to implant the chain of custody in the maternity studied. It is essential to develop care beyond medical issues, and which includes forensics. It is suggested a collaborative action between physicians and nurses, with nursing as the epicenter of this process.

Resumen La Cadena de Custodia implica el adecuado proceso de recolección, registro y almacenamiento del vestigio de la violencia sexual, garantizando confiabilidad al material encaminado como prueba pericial. Su instalación en el Sistema Unico de Salud ha enfrentado desafíos. Objetivos: Conocer la atención a la víctima de violencia sexual en maternidad pública del Distrito Federal y evaluar el conocimiento del equipo acerca de la legislación sobre cadena de custodia. Método: Estudio transversal, cuantitativo y descriptivo, con 134 profesionales de medicina y enfermería actuantes en la emergencia obstétrica, que respondieron un cuestionario, sometido al análisis estadístico descriptivo y al Test Qui-Cuadrado. Resultados: Entre el 78,95% de los profesionales que afirmaron atender a víctimas de violación, 25,71% las consultan en 10 minutos y 14.18% recibieron capacitación específica. El diagnóstico situacional revela que la atención es superficial, centrada en cuestiones médicas y la recolección de vestigios es inexistente. Conclusión e implicaciones para la práctica de enfermería: Un cambio generalizado de postura es necesario para posibilitar la implantación de la cadena de custodia en la maternidad estudiada. Es fundamental desarrollar una atención más allá de cuestiones médicas y que incluya cuestiones periciales. Se sugiere una actuación colaborativa entre médicos y enfermeros, teniendo la enfermería como epicentro de ese proceso.