Abstract The pathogenesis of systemic lupus erythematosus (SLE) is complex. Few studies in Brazilian population have addressed cell phenotypes associated with immunological responses and their associations with SLE activity. The aim of this study is to investigate cell phenotypes associated to SLE diagnosis, treatment and activity. Twenty-eight SLE female patients (17 inactive, 11 active) and 10 healthy women were included in this study. Markers of natural killer (Nk), T and B cells in peripheral blood were evaluated by flow cytometry. Nkt cells were decreased only in SLE active patients. Activated CD4+, regulatory T FoxP3+ and B cells were decreased in both active and inactive SLE patients, compared to control group. The data corroborate the disruption of immune regulatory response in SLE patients and suggest phenotipic changes as possible biomarkers of SLE activity.

ABSTRACT Introduction: Immunogenicity has emerged as a challenge in the development of vaccines against coronavirus disease of 2019 (COVID-19). Immunogenicity is a determinant of the efficacy and safety of vaccines. This systematic review and associated meta-analysis summarized and characterized the immunogenicity of COVID-19 vaccines in randomized controlled trials (RCTs). Methods: Relevant RCTs were systematically sourced from different medical databases in August 2021. The risk ratios and mean differences with 95% confidence intervals were calculated. Results: Of 2,310 papers, 16 RCTs were eligible for review. These RCTs involved a total of 26,698 participants (15,292 males and 11,231 females). The pooled results showed a significant difference in the geometric mean titer between the vaccinated and control groups in favor of the vaccine group after 1 and 2 months of follow-up, for the young age group (18 - < 55y), and with different doses (P < 0.001). The difference in the older age group (>55y) was insignificant (P = 0.24). The seroconversion rate of spike neutralizing antibodies favored the vaccine groups 1 or 2 months after vaccination (P < 0.001). The seroconversion rate of the vaccine group was significantly different (P < 0.001) from that of the control group. Conclusions: Vaccination elicits immunogenicity in the follow-up period for all age groups and at low and large doses. Therefore, people should be encouraged to receive vaccines currently being offered. A boost dose has been asserted for the elderly.

Abstract: The research was held in three Brazilian cities with participants from Program Criança Feliz (PCF), which aims to stimulate integral development. Family members and staff were interviewed, with posterior qualitative analysis, based on Winnicott’s theory. The results show that bureaucratic, legal and financial issues make the PCF fragile, whereas home visiting and bond strengthening helped families to be attentive towards children’s needs.

Resumo: Realizou-se pesquisa em três municípios com participantes do Programa Criança Feliz (PCF), que visa promover o desenvolvimento integral infantil. Familiares e equipes foram entrevistados, com posterior análise qualitativa, fundamentada pela teoria de Winnicott. Os resultados mostram que burocracia, insegurança jurídica e financeira fragilizam o PCF, enquanto visita domiciliar e fortalecimento de vínculos auxiliaram as famílias a estarem atentas às necessidades infantis.

RESUMO Dizer ao mundo de si, no sentido pleno do ser, do estar e do agir, constitui-se em um dos legados de Paulo Freire para a Educação. Ora, para além do gesto concreto de sua pedagogia, a palavra escrita denunciou negligências e empoderou atitudes de resistência e libertação. Nesse sentido, refletir sobre o direito à palavra como direito humano é o propósito desse texto. A metodologia utiliza-se da pesquisa bibliográfica, problematizando a singularidade dos direitos humanos nos livros: Pedagogia do Oprimido, Pedagogia da Esperança, entre outras obras, em diálogo com os fundamentos dos direitos humanos. O direito humano à palavra marca a singularidade da obra e pedagogia freireanas, que dizem ao mundo sobre si e sobre o outro. ser agir constituise constitui se Educação Ora libertação texto utilizase utiliza bibliográfica livros Oprimido Esperança obras freireanas outro

ABSTRACT Telling the world about oneself, in the full meaning of being and acting, is one of Paulo Freire’s legacy to the Education. Well, beyond the concrete gesture of his pedagogy, the written speech has denounced negligence and has powered resistance and liberation attitudes. In this manner, reflecting about the right of speech as human right is this text’s purpose. The methodology uses bibliographical search, discussing human rights singularity at the books: Pedagogia do Oprimido, Pedagogia da Esperança, and others opus, in dialog with human rights fundaments. The human right to speech marks the singularity of Freire’s opus and pedagogy, that talks about oneself and themselves. acting Freires Freire s Education Well pedagogy attitudes manner texts text purpose search books Oprimido Esperança fundaments themselves

ABSTRACT BACKGROUND: The thrombin generation test (TGT) has shown promise for investigation of hemorrhagic and thrombotic diseases. However, despite its potential, it still needs standardization. Moreover, few studies have established reference values for TGT parameters. In Brazil, these values have not yet been established. OBJECTIVE: To determine TGT performance and reference intervals for TGT parameters in healthy individuals. DESIGN AND SETTING: Cross-sectional study conducted among participants in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). METHODS: The reference sample consisted of 620 healthy individuals. The calibrated automated thrombogram (CAT) method, under low and high tissue factor (TF) conditions, was used to assess thrombin generation. Test performance was analyzed using intra and interassay coefficients of variation (CV) and reference intervals were calculated using the nonparametric method proposed by the International Federation of Clinical Chemistry and the Clinical and Laboratory Standards Institute. RESULTS: The intraassay CV ranged from 1.4% to 2.2% and the interassay CV, 6.8% to 14.7%. The reference intervals for TGT parameters under low and high TF conditions were, respectively: lagtime: 3.0-10.3 and 1.4-3.7 min; endogenous thrombin potential (ETP): 1134.6-2517.9 and 1413.6-2658.0 nM.min; normalized ETP: 0.6-1.3 and 0.7-1.4; peak: 103.2-397.7 and 256.4-479.0 nM; normalized peak: 0.3-1.3 and 0.7-1.2; and time-to-peak: 5.6-16.0 and 3.4-6.7 min. These parameters were categorized relative to sex. Conclusion: TGT performance was adequate and the proposed reference intervals were similar to those of other studies. Our findings may be useful for consolidating the TGT, through contributing to its standardization and validation.

Abstract Chronic Lymphocytic Leukemia (CLL) has shown great biological heterogeneity, with a variable prognosis, and a short survival in some patients. In this light, the present study focused on the prognostic utility of circulating microparticles (MPs) and a Thrombin Generation (TG) Profile for thrombotic risk and disease progression in CLL patients. Circulating microparticles and TG were evaluated in 35 patients with CLL and 35 healthy individuals. For circulating microparticles, significant differences were observed among the following groups: MPs derived from endothelial cells (p = 0.002), B lymphocytes (p < 0.001), platelets (p = 0.003), and Tissue Factor MPs in monocytes (p < 0.001). In all cases, MP values were higher for the CLL group. When compared to the controls, CLL patients presented a decrease in TG, characterized by a reduced endogen thrombin potential (ETP) (p = 0.031). When the results were analyzed according to the Binet stage, as compared to the controls, the Binet B+C group also presented lower ETP values (p = 0.009). No significant differences were observed between the control and the Binet A groups or between the Binet A and the Binet B + C groups. Although hemostatic alterations may occur in patients with CLL, these parameters do not seem to be useful to indicate disease progression.

Abstract Chronic lymphocytic leukemia (CLL) is a blood cancer characterized by the accumulation of clonal B-lymphocytes. This study evaluated the mRNA gene expression of miR-15a, miR-16- 1, ZAP-70, and Ang-2 by qPCR, as well as the plasma levels of Bcl-2 by Elisa immunoassay, in CLL patients and healthy controls. Significant differences were observed when comparing patients and controls regarding miR-15a (p < 0.001), miR-16-1 (p < 0.001) mRNA, Ang-2 gene expression, and Bcl-2 plasma levels (p < 0.001). When stratified by risk, differences were maintained with a significantly reduced expression in high-risk patients. A positive correlation was observed between miR-15a and platelets (R2 = 0.340; p = 0.009) as well as between Bcl-2 and leukocytes (R2 = 0.310; p = 0.019). Conversely, negative correlations were observed between ZAP-70 and platelets (R2 = - 0.334; p = 0.011), between miR-15a and lymphocytes (R2 = - 0.376; p = 0.004), as well as between miR-16-and lymphocytes (R2 = - 0.515; p = 0.00004). The data suggest that a reduction in miR-15a and miR-16-1 expressions, in addition to an overexpression of Bcl-2, are associated with the reduction in apoptosis and, consequently, to a longer survival of lymphocytes, thus contributing to lymphocyte accumulation and aggravation of the disease. By contrast, Ang-2 expression was significantly higher in A than in B + C Binet groups. This context leads to the speculation that this biomarker should be investigated in more robust studies within populations with a still relevantly indolent form of the disease in an attempt to identify those patients with a greater potential for an aggravation of the disease.

Abstract The main factors governing Hevea brasiliensis germination and seedling establishment remains unclear. We examined the effect of growth regulators Indole 3-Acetic Acid (IAA) and 6-Benzylaminopurine (BAP), and their interactions on germination and the development of mature zygotic embryos (MZE) and protein profile of Hevea brasiliensis seedlings from wild and cultivated (clone PB 250) genotypes. Embryonic axes excised from seeds (wild and clone PB 250) were inoculated in Murashige and Skoog medium (control) and supplemented with IAA (3 µM) and BAP (6 µM) individually and their combination (3 µM IAA + 6 µM BAP). For both genotypes, the mature embryos displayed a high percentage of germination and establishment, and the seedlings were characterized by protein bands ranging from 7 to 30 kDa. Notably, the wild genotype showed proteins in the 14 kDa range, which may be associated with one of the major rubber elongation factors (REF). The wild and clone genotypes presented different behavior and strategies in relation to the protein profile in the presence of different growth regulators. Although the latex biosynthetic pathway and its mechanisms of regulation still remain largely unknown, our results aid in our understanding of the dynamics of proteins in different rubber tree clones in vitro.

Abstract The present study evaluated 56 patients diagnosed with Chronic Lymphocytic Leukemia (CLL) and a control group of 44 clinically healthy subjects with no previous history of leukemia. Genetic expressions of AKT and microRNAs were evaluated by quantitative PCR (qPCR). A significant increase in AKT gene expression in patients when compared to controls was observed (p = 0.017). When the patients were stratified according to Binet subgroups, a significant difference was observed between the subgroups, with this protein kinase appearing more expressed in the B+C subgroup (p = 0.013). Regarding miRNA expression, miR-let-7b and miR-26a were reduced in CLL patients, when compared to controls. However, no significant differences were observed in these microRNA expressions between the Binet subgroups (A versus B+C). By contrast, miR-21 to miR-27a oncogenes showed no expression difference between CLL patients and controls. AKT protein kinase is involved in the signaling cascade that occurs with BCR receptor activation, leading to increased lymphocyte survival and protection against the induction of cell death in CLL. Thus, increased AKT protein kinase expression and the reduction of miR-let-7b and miR-26a, both tumor suppressors, may explain increased lymphocyte survival in CLL patients and may be promising markers for the prognostic evaluation of this disease.

RESUMO JUSTIFICATIVA E OBJETIVOS A literatura sugere que a enzima óxido nítrico sintase (NOS) desempenha um papel importante tanto na doença periodontal (DP) quanto na dor orofacial (DOF), embora poucos estudos associem estas duas condições simultaneamente. O objetivo deste estudo foi analisar a expressão da NOS em pacientes com DP e DOF em comparação a controles sem estas condições. CONTEÚDO Foram consultadas as bases de dados eletrônicas (Pubmed, Web of Science, Scopus, Cochrane Library, BBO, Lilacs e Clinical Trial) para identificar os estudos potencialmente relevantes publicados até abril de 2021. As pesquisas resultaram em 1.960 estudos, dos quais 11 foram selecionados para serem avaliados criticamente. Os critérios definidos na questão PECO (População, Exposição, Comparação e Desfecho) foram usados para selecionar títulos e resumos por dois revisores independentes. A avaliação metodológica dos estudos selecionados foi realizada de acordo com a ferramenta Effective Public Health Practice Project (EPHPP). CONCLUSÃO As evidências científicas demonstraram que a NOS desempenha um importante papel na patogênese da DP e da DOF, já que sua expressão está aumentada em pacientes com estas condições. Porém, estudos genéticos sobre mutações dos genes do óxido nítrico sintase endotelial (eNOS) em pacientes com migrânea e cefaleia em salvas não evidenciaram a esperada suscetibilidade a dor. Além disso, estudos sobre a associação da expressão da NOS na DP e na DOF, ocorrendo simultaneamente, são escassos. Este estudo pode subsidiar futuras pesquisas sobre NOS na correlação de duas doenças muito frequentes como a DP e a DOF.

ABSTRACT BACKGROUND AND OBJECTIVES The literature suggests that the enzyme nitric oxide synthase (NOS) plays an important role in both periodontal disease (PD) and orofacial pain (OP), although few studies associate these two conditions simultaneously. The objective of this study was to evaluate the expression of the NOS enzyme in PD and OP, in comparison to those patients who did not present PD and/or OP. CONTENTS Seven electronic databases (Pubmed, Web of science, Scopus, Cochrane Library, BBO, LILACS, Clinical trial) were used to identify the potentially relevant studies published until April 2021. The research resulted in 1,960 studies, of which 11 were selected to be critically evaluated. Two independent reviewers selected titles and abstracts using the criteria defined in the PECO question (Population, Exposure, Comparison, Outcome). The methodological evaluation of the selected studies was carried out according to the Effective Public Health Practice Project (EPHPP). CONCLUSION: Scientific evidence demonstrated that NOS may play a key role in the pathogenesis of PD and OP, since its expression is increased in patients with these conditions. However, genetic studies on endothelial nitric oxide synthase (eNOS) gene mutations in patients with migraine and cluster headache did not indicate the expected susceptibility to pain. In addition, studies on the association of NOS expression in PD and OP, occurring simultaneously, are scarce. This review may support future research on NOS in two very common correlated diseases such as PD and OP.

Resumen Marco contextual: El acoso escolar (bullying) es un fenómeno mundial. Los observadores son fundamentales para comprender el fenómeno y desarrollar acciones de prevención. Objetivo: Conocer la experiencia de los estudiantes identificados como testigos de situaciones de acoso escolar. Metodología: Estudio cualitativo y exploratorio desarrollado en una escuela brasileña, a partir de la teoría social cognitiva. Participaron 20 estudiantes con edades comprendidas entre los 13 y los 18 años. Los datos se recopilaron mediante entrevistas semiestructuradas y grupos de discusión. Se aplicó el análisis temático a los datos. Resultados: La tasa de prevalencia de los estudiantes que observaron el acoso escolar fue del 64%. Los participantes tienen buenos conocimientos sobre el acoso escolar, evalúan el comportamiento agresivo como negativo o perjudicial, pero esa comprensión no se traduce en autoeficacia y acciones para ayudar a las víctimas. Se construyó una categoría temática - Toma de actitud, refuerzo y sentimientos - “Lo que motivaba al acosador era el público”. Conclusión: La experiencia de los estudiantes está marcada por cuestiones individuales, escolares y contextuales. Se enuncian las implicaciones para la atención primaria de la salud.

Resumo Enquadramento: O Bullying escolar é um fenómeno mundial. Os observadores são centrais à compreensão do fenómeno e ao desenvolvimento de ações de prevenção. Objetivo: Conhecer a vivência de estudantes identificados como testemunhas de situações de bullying. Metodologia: Estudo qualitativo e exploratório desenvolvido numa escola brasileira, à luz da teoria social cognitiva. Participaram 20 estudantes com idades entre 13 e 18 anos. Os dados foram colhidos através de entrevistas semiestruturadas e grupos focais. A análise temática foi aplicada aos dados. Resultados: A taxa de prevalência de estudantes que observaram situações de bullying foi de 64%. Os participantes possuem bom conhecimento sobre o bullying, avaliam o comportamento agressivo como negativo ou prejudicial, mas esse entendimento não se converte em senso de autoeficácia e ações de ajuda às vítimas. Uma categoria temática foi construída - Tomada de atitude, reforço e sentimentos - “O que motivava o agressor era a plateia”. Conclusão: A vivência dos estudantes é assinalada por questões individuais, escolares e contextuais. Implicações para a atenção primária em saúde são enunciadas.

Abstract Background: Bullying at school is a worldwide phenomenon. Observers are central to understanding the phenomenon and developing preventive actions. Objective: To know the experience of students identified as witnesses of bullying situations. Methodology: Qualitative and exploratory study developed in a Brazilian school, in the light of the social cognitive theory. Twenty students aged between 13 and 18 years participated. Data were collected through semi-structured interviews and focus groups. Thematic analysis was applied to the data. Results: The prevalence rate of students who observed bullying was 64%. Participants have good knowledge about bullying, assess aggressive behavior as negative or harmful, but this understanding does not translate into a sense of self-efficacy and actions to help victims. A thematic category was built - Taking action, reinforcing and feeling - “What was also motivating the aggressor to do this is the audience”. Conclusion: The students’ experience is marked by individual, school and contextual issues. Implications for primary health care are spelled out.

Resumo O objetivo deste artigo é analisar a prevalência de polifarmácia e de polifarmácia excessiva, bem como seus fatores associados, entre idosos atendidos em duas Unidades Básicas de Saúde de Belo Horizonte-MG. Foi conduzido um estudo observacional transversal, realizado por meio de informações resultantes de uma entrevista estruturada ao paciente. Foram analisadas as associações individuais de cada variável explicativa com a polifarmácia e polifarmácia excessiva. Para as variáveis que apresentaram associação significativa com polifarmácia, foi realizada análise multivariada por meio do modelo de regressão logística. Os idosos utilizavam, em média, 5,2 fármacos. A prevalência de polifarmácia foi de 57,7% e de polifarmácia excessiva foi de 4,8%. Na análise univariada, mostraram-se associadas à polifarmácia as condições idade ≤ 70 anos, escolaridade > 8 anos, presença de mais de três doenças e presença de sintomas de depressão. Para polifarmácia excessiva, mostraram-se associadas as condições presença de mais de três doenças, autopercepção da saúde negativa e dependência parcial nas atividades instrumentais de vida diária. No modelo multivariado final para polifarmácia, permaneceram as variáveis idade ≤ 70 anos e presença de mais de três doenças.

Abstract The scope of this article is to analyze the prevalence of polymedication and excessive polypharmacy, as well as associated factors, among the elderly attended at two Basic Health Units in Belo Horizonte, State of Minas Gerais. A cross-sectional observational study was conducted using information obtained from a structured interview of the patient. The individual associations of each explanatory variable with polypharmacy and with excessive polypharmacy were analyzed. For the variables that showed a significant association with polypharmacy, multivariate analysis was performed using the logistic regression model. The elderly used, on average, 5.2 drugs. The prevalence of polymedication was 57.7% and excessive polypharmacy was 4.8%. In univariate analysis the conditions associated with polypharmacy were: age ≤ 70 years, schooling > 8 years, presence of more than three diseases and presenting symptoms of depression. For excessive polypharmacy, the presence of more than three diseases, self-perception of negative health, and partial dependence on instrumental activities of daily living were associated with the conditions. In the final multivariate model for polypharmacy, the age ≤ 70 years and presence of more than three disease variables remained.

Abstract Background Traditionally, the most effective therapy in the prevention of stroke in patients with atrial fibrillation (AF) has been oral anticoagulation with vitamin K inhibitors, particularly warfarin, whose disadvantages and adverse effects have led to their replacement by "direct oral anticoagulants", as factor X inhibitor. Objectives This study aimed to conduct a brief approach on atrial fibrillation (AF) and use of Rivaroxaban, and to comparatively evaluate the prothrombin time / International Normalized Ratio (PT/INR) in patients with AF in use of this oral anticoagulant, depending on the time elapsed between the last administration of the drug and the time of blood sample venipuncture. Methods We evaluated 34 patients with AF in use of Rivaroxaban by using PT / INR, distributed into a subgroup with blood collection time ≤ 12 hours (n = 7) and > 12 hours after the last drug intake (n = 27). Mann-Whitney test was used to compare the groups and p < 0.05 was considered significant. Results An analysis as a function of time between the Rivaroxaban intake and blood collection, revealed that PT / INR suffers the greatest effect up to 12 hours after ingestion of the drug, dropping to levels close to normal in subsequent hours before the next dose. Conclusion We concluded that, in contrast to warfarin, the knowledge of the time interval between drug intake and blood collection from patients taking Rivaroxaban is essential to properly interpret a laboratory test to assess hemostasis, particularly PT and its derivatives. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Resumo: Introdução: A acupuntura objetiva o equilíbrio energético por meio de estímulos na pele com a inserção de agulhas em pontos específicos. Ela faz parte do conjunto de conhecimentos teórico práticos da medicina tradicional chinesa. Atualmente, a Organização Mundial da Saúde vem apoiando ações relacionadas ao ensino, à pesquisa e à troca de informações em todo o mundo. Este estudo busca responder à seguinte questão de pesquisa: “Quais são as evidências sobre a inserção da acupuntura no ensino médico no Brasil?”. Objetivo: Este estudo teve como objetivo revisar a literatura no que concerne à inserção da acupuntura nas escolas médias do Brasil. Método: Trata-se de uma revisão sistemática, realizada em fevereiro de 2020, com a busca da combinação das expressões e dos termos “medicinas alternativas e complementares”, “acupuntura”, “acupuntura médica”, “ensino médico” e “Brasil”, com as adaptações terminológicas para as línguas inglesa e espanhola, e de acordo com as bases de dados: PubMed/Medline, Medline/BVS, Lilacs, HomeoIndex, Scopus e SciELO. Os manuscritos incluídos foram avaliados na íntegra por dois pesquisadores com a finalidade de identificar núcleos temáticos de discussão, a saber: “Acupuntura no Brasil: desafios e perspectivas”; “Acupuntura na graduação médica: experiências, percepções e desafios”; “Especialização/residência em acupuntura médica”; “Divulgação científica: importância na educação médica”. Resultados: Os 16 artigos selecionados foram classificados segundo objetivos, método, resultados e conclusões, e discutidos com base nos núcleos temáticos identificados. Conclusão: Os dados do estudo mostram que a acupuntura vem crescendo no Brasil, com maior divulgação e ensino lato sensu, com resumida participação durante a graduação. Espera-se que as políticas públicas voltadas para o Sistema Único de Saúde possam incentivar maiores investimentos no ensino durante a graduação.

Abstract: Introduction: Acupuncture aims to ensure energetic balance by means of skin stimulation with the insertion of needles at specific points. It is part of the theoretical-practical knowledge set of Traditional Chinese Medicine. The World Health Organization has been supporting acupuncture educational, research, and knowledge exchange actions all over the world. This study seeks to answer the following research question: “What evidence is there of acupuncture being included in Brazilian medical training?” Objective: To present a systematic review to answer the research question. Method: Systematic review conducted in February 2020, involving a search in the databases PubMed/Medline, Medline/BVS, Lilacs, Homeoindex, Scopus e Scielo for combinations of the following terms in English, Portuguese and Spanish: “complementary and alternative medicine teaching”, “Acupuncture medicine teaching” and “Brazil”. The manuscripts returned by the search were fully evaluated by two researchers to identify relevant discussion themes: acupuncture in Brazil: challenges and perspectives; acupuncture in undergraduate medical training: experiences, perceptions, and challenges; acupuncture medical specialization/residency; scientific publication: importance in Medical Education. Results: The sixteen selected papers were classified according to their objectives, method, results, and conclusions, and discussed based on the identified themes. Conclusion: The study data show that acupuncture is growing in Brazil, with greater publicity and latu sense teaching, with summary participation during undergraduate medical training. It is hoped that public policies focused on the Unified Health System can encourage more investment in teaching for undergraduate training.

Resumo A violência sexual é aquela que mais reações provoca nos profissionais que atuam na esfera forense, entretanto ainda são frágeis as estratégias que contribuem para minimizar o sofrimento das vítimas. O objetivo deste estudo foi conhecer e analisar os significados da violência sexual intrafamiliar vivenciada e seu atendimento durante as inquirições no sistema de justiça na perspectiva dos adolescentes inquiridos. Trata-se de estudo qualitativo mediante entrevista semiestruturada e observação livre com nove adolescentes realizada em vara específica da Infância e Juventude. Os dados foram analisados a partir da técnica de análise de conteúdo. O adolescente apresenta lapsos de memória, e sofre vitimização secundária, lacunas no atendimento e reprodução de relações de poder no Judiciário. Aponta-se a importância de uma articulação de um sistema de garantia de direitos a crianças e adolescentes, considerando-se os novos marcos sociais, bem como a questão do desenvolvimento humano.

Abstract The aim was to know and analyze the meanings of intrafamily sexual violence experienced and the Court support for adolescents who underwent the questioning. A qualitative research study through semi-structured interviews and free observation with nine adolescents aged between 13 and 17 years old, in a specific Court of Childhood and Youth. Data was analyzed using the technique of content analysis, with “Distance and negative”, and “Secondary victimization” pointed out. First, by signifying the intrafamily sexual violence suffered, the adolescent presents memory lapses about what happened, and it shows a wide spectrum of detrimental effects of intrafamily sexual violence. Secondly, it shows that the intervention of the Judiciary Branch has caused secondary victimization, gaps in care, and reproduction of power relationships. It was concluded on the importance to articulate a children and adolescents rights guaranteeing system, considering the new social frameworks, as well as the issue of human development.

Resumen El objetivo fue conocer y analizar los significados de la violencia sexual intrafamiliar vivida y la asistencia del tribunal para los adolescentes que se sometieron a la averiguación. Investigación cualitativa a través de entrevistas semiestructuradas y observación libre con nueve adolescentes, realizada en una jurisdicción específica de la Infancia y Juventud. Los datos se analizaron recurriendo a la técnica de análisis de contenido, se señalaron “Desapego y negación” y “Victimización secundaria”. En la primera, al significar la violencia sufrida, el adolescente presenta fallos de memoria sobre lo que sucedió, y evidencia un amplio espectro de efectos perjudiciales de la violencia. La segunda muestra que la intervención del Poder Judicial ha causado victimización secundaria, brechas en la atención y reproducción de relaciones de poder. Señala la importancia de articular un sistema de garantía de los derechos de la niñez y la adolescencia, considerando los nuevos marcos sociales, así como el tema del desarrollo humano.