RESUMO O artigo apresenta resultados da pesquisa qualitativa realizada em Resende, cidade localizada no interior do estado do Rio de Janeiro, sobre a implementação da Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais e Travestis e Transexuais (PNSI-LGBT). A fim de contribuir para a compreensão do processo de desenvolvimento de políticas públicas voltadas à população LGBTQIA+, com ênfase na área de saúde mental, foram realizados levantamento documental e entrevistas com a equipe gestora do programa de saúde mental do município. Os resultados evidenciaram que a PNSI-LGBT não se encontra implementada na rede de atenção à saúde e que a maioria dos gestores entrevistados pouco conhecia da política. Em relação as ações concretas voltadas à população LGBTQIA+, elas hoje estão limitadas à implantação de um serviço ambulatorial voltado para a hormonioterapia e transgenitalização das pessoas transgêneras na cidade. A pesquisa possibilitou suscitar a discussão sobre a PNSI-LGBT e a incipiência de sua implementação no município, evidenciando os desafios a serem enfrentados pela gestão pública.

ABSTRACT The article presents results of qualitative research carried out in Resende, a city located in the countryside of the state of Rio de Janeiro, on the implementation of the National Policy for Comprehensive Health for Lesbians, Gays, Bisexuals, and Transvestites and Transsexuals (PNSI-LGBT). It was carried out in order to contribute to the understanding of the process of developing public policies aimed at the LGBTQIA+ population, with an emphasis on the area of mental health, document analysis, and interviews with the management team of the municipality’s mental health program. The results showed that the PNSI-LGBT was not implemented in the health care network and that the majority of managers interviewed had little knowledge of the policy. Regarding concrete actions aimed at the LGBTQIA+ population, they are currently limited to the implementation in the city of an outpatient service focused on hormone therapy and transgenitalization of transgender people. The research made it possible to spark a discussion about the PNSI-LGBT and the incipience of its implementation in the municipality, highlighting the challenges to be faced by public management.

ABSTRACT The article presents results of qualitative research carried out in Resende, a city located in the countryside of the state of Rio de Janeiro, on the implementation of the National Policy for Comprehensive Health for Lesbians, Gays, Bisexuals, and Transvestites and Transsexuals (PNSI-LGBT). It was carried out in order to contribute to the understanding of the process of developing public policies aimed at the LGBTQIA+ population, with an emphasis on the area of mental health, document analysis, and interviews with the management team of the municipality’s mental health program. The results showed that the PNSI-LGBT was not implemented in the health care network and that the majority of managers interviewed had little knowledge of the policy. Regarding concrete actions aimed at the LGBTQIA+ population, they are currently limited to the implementation in the city of an outpatient service focused on hormone therapy and transgenitalization of transgender people. The research made it possible to spark a discussion about the PNSI-LGBT and the incipience of its implementation in the municipality, highlighting the challenges to be faced by public management. Resende Janeiro Lesbians Gays Bisexuals PNSILGBT. PNSILGBT PNSI LGBT . (PNSI-LGBT) LGBTQIA population analysis municipalitys municipality s program policy people (PNSI-LGBT

RESUMO O artigo apresenta resultados da pesquisa qualitativa realizada em Resende, cidade localizada no interior do estado do Rio de Janeiro, sobre a implementação da Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais e Travestis e Transexuais (PNSI-LGBT). A fim de contribuir para a compreensão do processo de desenvolvimento de políticas públicas voltadas à população LGBTQIA+, com ênfase na área de saúde mental, foram realizados levantamento documental e entrevistas com a equipe gestora do programa de saúde mental do município. Os resultados evidenciaram que a PNSI-LGBT não se encontra implementada na rede de atenção à saúde e que a maioria dos gestores entrevistados pouco conhecia da política. Em relação as ações concretas voltadas à população LGBTQIA+, elas hoje estão limitadas à implantação de um serviço ambulatorial voltado para a hormonioterapia e transgenitalização das pessoas transgêneras na cidade. A pesquisa possibilitou suscitar a discussão sobre a PNSI-LGBT e a incipiência de sua implementação no município, evidenciando os desafios a serem enfrentados pela gestão pública. Resende Janeiro Lésbicas Gays PNSILGBT. PNSILGBT PNSI LGBT . (PNSI-LGBT) LGBTQIA LGBTQIA+ município política pública (PNSI-LGBT

Abstract Introduction Gender dysphoria (GD) is characterized by a marked incongruence between experienced gender and one’s gender assigned at birth. Transsexual individuals present a higher prevalence of psychiatric disorders when compared to non-transsexual populations, and it has been proposed that minority stress, i.e., discrimination or prejudice, has a relevant impact on these outcomes. Transsexuals also show increased chances of having experienced maltreatment during childhood. Interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor-alpha (TNF-α) are inflammatory cytokines that regulate our immune system. Imbalanced levels in such cytokines are linked to history of childhood maltreatment and psychiatric disorders. We compared differences in IL-1β, IL-6, IL-10 and TNF-α levels and exposure to traumatic events in childhood and adulthood in individuals with and without GD (DSM-5). Methods Cross-sectional controlled study comparing 34 transsexual women and 31 non-transsexual men. They underwent a thorough structured interview, assessing sociodemographic information, mood and anxiety symptoms, childhood maltreatment, explicit discrimination and suicidal ideation. Inflammatory cytokine levels (IL-1β, IL-6, IL-10 and TNF-α) were measured by multiplex immunoassay. Results Individuals with GD experienced more discrimination (p = 0.002) and childhood maltreatment (p = 0.046) than non-transsexual men. Higher suicidal ideation (p < 0.001) and previous suicide attempt (p = 0.001) rates were observed in transsexual women. However, no differences were observed in the levels of any cytokine. Conclusions These results suggest that transsexual women are more exposed to stressful events from childhood to adulthood than non-transsexual men and that GD per se does not play a role in inflammatory markers.

BACKGROUND In Brazil the implementation of the Sentinel Surveillance System of Influenza began in 2000. Central public health laboratories use reverse transcription-quantitative polymerase chain reaction (RT-qPCR) for diagnosis of respiratory viruses, but this protocol identifies only specific targets, resulted in inconclusive diagnosis for many samples. Thus, high-throughput sequencing (HTS) would be complementary method in the identification of pathogens in inconclusive samples for RT-qPCR or other specific detection protocols. OBJECTIVES This study aimed to detect unidentified viruses using HTS approach in negative samples of nasopharynx/tracheal secretions by the standard RT-qPCR collected in the Federal District, Brazil. METHODS Nucleic acids were extracted from samples collected in winter period of 2016 and subjected to HTS. The results were confirmed by the multiplex PR21 RT-qPCR, which identifies 21 respiratory pathogens. FINDINGS The main viruses identified by HTS were of families Herpesviridae, Coronaviridae, Parvoviridae and Picornaviridae, with the emphasis on rhinoviruses. The presence of respiratory viruses in the samples was confirmed by the PR21 multiplex RT-qPCR. Coronavirus, enterovirus, bocavirus and rhinovirus were found by multiplex RT-qPCR as well as by HTS analyses. MAIN CONCLUSIONS Wide virus diversity was found by different methodologies and high frequency of rhinovirus occurrence was confirmed in population in winter, showing its relevance for public health.