RESUMO
RESUMO Este estudo buscou caracterizar os Coordenadores de Saúde Bucal (CSB) envolvidos na implantação da Política Nacional de Saúde Bucal (PNSB) em um município baiano, caso exemplar, entre 1997 e 2015. Foi realizado um estudo de caso com abordagem qualitativa, baseado no referencial bourdieusiano, por meio de entrevistas em profundidade com seis CSB, com média de 45 anos. Foram analisadas as suas trajetórias profissionais a partir das categorias: origem social, formação profissional, trajetória e inserção profissional e trajetória no campo burocrático. A maioria graduou-se em instituições públicas e apresentou trajetória ascendente no campo burocrático. A inserção na gestão foi influenciada pelas disposições, pela rede de relações e pelo desempenho profissional na Estratégia Saúde da Família (ESF). A qualificação profissional parece ser aspecto diferenciador. A pós-graduação em saúde coletiva representou maior possibilidade de inserção na ESF. A equipe gestora manteve o exercício da clínica. O apoio da gestão municipal e da saúde foi ressaltado por quase todos os entrevistados. A PNSB contribuiu para expansão da rede de saúde bucal, contudo, as principais proposições já estavam implantadas anteriormente. Evidencia-se a importância da gestão na implantação da PNSB e recomenda-se a realização de análise semelhante de outros casos para identificação de regularidades que contribuam para a explicação dos diferentes graus de implementação dessa política.
ABSTRACT This study aimed to characterize Oral Health Coordinators (OHC) involved in the implantation of the Brazilian Oral Health Policy (BOHP) in a municipality of Bahia, exemplary case, between 1997-2015. A qualitative approach case study was carried out, based on the Bourdieu theoretical, through in-depth interviews with six OHC, with an average of 45 years of age. Their professional trajectories were analyzed from the following categories: social origin, professional training, professional trajectory and insertion, and trajectory in the bureaucratic field. The majority of them graduated from public institutions and presented an upward trajectory in the bureaucratic field. The insertion in management was influenced by dispositions, network relations, and professional performance in Family Health Strategy (FHS). Professional qualification seems to be a differentiating aspect. Post-graduation in public health represented a greater possibility of insertion in the FHS. The management team maintained clinical practice. The support of municipal management and health was highlighted by almost all interviewees. The BOHP contributed to the expansion of the oral health network, however, the main propositions were implanted previously. The importance of management in the BOHP implementation is evident and it is recommended to carry out similar analysis of other cases to identify regularities that contribute to the explanation of the different degrees of BOHP implementation.
RESUMO
Bothrops leucurus venom causes significant local effects, such as necrosis, pain, hemorrhage and edema. These effects are important because of their high frequency and severity. The treatment of these local effects is not simple because of their quick triggering and a variety of components that induce these effects. Myonecrosis, dermonecrosis and edema are primarily caused by the action of hemorrhagins and myotoxins. A number of investigators have demonstrated the influence of thyroid hormones on inflammatory processes, particularly on wound healing. We investigated the edematogenic, hemorrhagic and necrotic activity of the B. leucurus venom in the hypothyroid, hyperthyroid and euthyroid of rats. The CK (creatine kinase) plasma level decreased in the animals in a hypothyroid state. The hypothyroid condition also significantly reduced the hemorrhagic and dermonecrotic area compared to the euthyroidism and hyperthyroidism states. It also mitigated the rat paw edema compared to that found in the euthyroid and hyperthyroid animals. The hyperthyroid animals showed no significant differences in the three treatments compared to the euthyroid animals. Our results suggest that the triggering of local effects induced by envenomation by B. leucurus is attenuated in hypothyroid animals, possibly by the effect of hypothyroidism on the immune system and blood flow.
