Ensino baseado em problemas como prática pedagógica aplicada a alunos ingressantes no curso de Odontologia / Problem based learning as a pedagogical practice apllied to freeschman in Dental course

A dificuldade apresentada pelos profissionais da área da saúde quando no início do exercício de sua profissão tem sido amenizada com o uso de práticas metodológicas diferenciadas durante a sua formação, como o ABP (Aprendizado Baseado em Problemas) mais conhecido como Problem Based Learning (PBL). O presente estudo relata a experiência do uso do PBL como prática de extensão para os alunos ingressantes no curso de Odontologia. Casos clínicos reais e hipotéticos são apresentados com o objetivo de resgatar o conteúdo da estrutura curricular e acrescentar gradualmente o uso de termos específicos da área e o desenvolvimento da capacidade de avaliar condutas. Cada caso foi apresentado em duas sessões, a partir das quais cada grupo elaborava um diagnóstico, identificava os conceitos multidisciplinares presentes e os a serem adquiridos. Com o decorrer da prática, as discussões dos casos e propostas de diagnósticos foram realizadas como reuniões clínicas para prática de liderança e interação de equipe. Concluímos que a prática pedagógica PBL, utilizada desde o início do curso, contribui para a formação de um estudante com perfil diferenciado, mais capacitado ao aprendizado de disciplinas específicas e mais seguro para atuação no mercado de trabalho (AU).

The difficulty presented by health professionals when the beginning of the exercise of their profession has been reduced with the use of different methodological practices during their training, as Problem Based Learning, known as PBL. This study adopts the PBL as an extension activity for students entering in the Dental course. Real clinical and hypothetical cases are presented with the aim of rescuing the contents of the curriculum and gradually add the use of specific terms and the development of the ability to manage behavior. The cases were presented in two sessions, where each group elaborated a diagnosis, identify the multidisciplinary concepts present and to be acquired. In the course of practice, cases were discussed and diagnoses were proposed, as well as the clinical meetings allowed to practice leadership and team interaction. We conclude that the PBL pedagogical practice, used since the beginning of Dental course, helps to form a student with a different profile, more capable of learning specific subjects and safer to act in the labor market (AU).

Loss of neuronal projections in the dystrophin-deficient mdx mouse is not progressive.

Lack of dystrophin is known to reduce several cerebral fiber systems. To investigate if the loss of fibers is progressive, we analyzed projections of the trigeminal sensory system to the red nucleus in 3, 6, and 12 month old dystrophin-deficient mdx mice. The retrograde tracer fluorogold was injected in the magnocellular part of the red nucleus, and the number of labeled neurons in the oral part of the spinal trigeminal nucleus (Sp5O) was counted. We found that the number of labeled Sp5O neurons was reduced by 50% in mdx mice compared to age-matched control mice. The number of labeled Sp5O neurons did not change significantly between 3 and 12 months neither in mdx nor in control mice. In addition, the number of labeled neurons in the interstitial system of the trigeminal nerve was reduced by 43% in mdx mice. We conclude that fiber loss did not continue beyond the age of 3 months. Our data suggest that lack of full-length dystrophin impairs neuronal migration or axonal outgrowth, or increases neuronal death during fetal or early life.

The interstitial system of the trigeminal spinal tract projects to the red nucleus in mice.

We studied projections from the interstitial system of the spinal trigeminal tract (InSy-S5T) to the red nucleus of the mouse with retrograde tracers (fluorogold and latex microbeads impregnated with rhodamine and fluorescein). Injections in the magnocellular part of the red nucleus caused labeling of cells in the rostral, intermediate, and caudal paratrigeminal nucleus (Pa5), dorsal paramarginal nucleus (PaMD), insular trigemeo-lateral cuneate nucleus (I5CuL), and the trigeminal extension of the parvocellular reticular formation (5RPC). All projections were bilateral, but contralateral projections were stronger. The number of retrogradely labeled cells in the InSy-S5T in 3-, 6-, and 12-month-old mice was similar. Injections restricted to the parvocellular red nucleus did not label the nuclei of the InSy-S5T. This projection from the InSy-S5T to the red nucleus may mediate modulation of the facial muscles by pain and other sensory information.

Morphological changes in the trigemino-rubral pathway in dystrophic (mdx) mice.

The lack of dystrophin that causes Duchenne muscle disease affects not only the muscles but also the central nervous system. Dystrophin-deficient mdx mice present changes in several brain fiber systems. We compared the projections from the trigeminal sensory nuclear complex to the red nucleus in control and mdx mice using retrograde tracers. Injection of 200 nL 2% fluorogold into the red nucleus caused labeling in the mesencephalic trigeminal nucleus, the principal sensory nucleus and the oral, interpolar, and caudal subnuclei of the spinal trigeminal nucleus in both control and mdx mice. Injection of latex microbeads labeled with rhodamine and fluorescein gave results similar to those seen with fluorogold. The number of labeled neurons in the trigeminal sensory nuclear complex was significantly reduced in mdx mice. In the oral subnucleus of the spinal trigeminal nucleus this reduction was 50%. These results indicate that the trigemino-rubral pathway is reduced in dystrophin-deficient mice.

Topographic organization of the projections from the interstitial system of the spinal trigeminal tract to the parabrachial nucleus in the rat.

Neurons in the paratrigeminal nucleus are known to project to the parabrachial region, but both these areas are heterogeneous, and the subnuclei that account for these connections are not known. To characterize better these projections, we injected small amounts of fluorogold or latex beads labeled with rhodamine or fluorescein into the parabrachial area in the rat and evaluated the retrograde transport of tracer to the paratrigeminal nucleus and neighboring regions. The results show that the rostral part of the paratrigeminal nucleus projects to the medial subnucleus of the parabrachial nucleus. The intermediary part of the paratrigeminal nucleus projects to both the external lateral and to the external medial subnuclei of the parabrachial nucleus. The caudal part of the paratrigeminal nucleus projects to the ventral lateral subnucleus of the parabrachial nucleus. The dorsal paramarginal nucleus projects to the external lateral and the extreme lateral subnuclei of the parabrachial nucleus. Lamina I and II of the spinal trigeminal nucleus also project to the external lateral and the extreme lateral subnuclei of the parabrachial nucleus. In conclusion, the rostral, intermediate, and caudal parts of the paratrigeminal nucleus and the dorsal paramarginal nucleus each have clearly different projection patterns and presumably have different functions.