Evaluation of antioxidant therapy in experimental Chagas disease.

INTRODUCTION:: Stimulation of inflammatory mediators such as cytokines and chemokines may cause oxidative stress in Chagas disease. In this study, we evaluated the merit of vitamins C and E as antioxidant therapy to minimize the oxidative stress-induced damage in an experimental model of Chagas disease. METHODS:: Ninety-six Swiss mice were infected with Trypanosoma cruzi QM2 and treated with vitamins C, E, or both (C/E) for 60 and 120 days, and their effects compared to placebo administration were evaluated in the acute and chronic disease phases. RESULTS:: There was no difference in parasitemia among treatment groups. However, histological analysis showed more severe inflammation in the skeletal muscle in the vitamin supplementation groups at both the acute and chronic phases. Biochemical analyses during the acute phase showed increased ferric-reducing ability of plasma (FRAP) and glutathione (GSH) levels in the vitamin C and C/E groups. In the chronic phase, a decrease in GSH levels was observed in the vitamin E group and a decrease in thiobarbituric acid reactive substances (TBARS) was observed in the vitamin C/E group. Moreover, there was a decrease in TBARS in the cardiac tissues of the vitamin C and C/E groups compared to that of the placebo group, although this level was greater in the vitamin E group than in the vitamin C group. CONCLUSIONS:: The antioxidant action of vitamins C and E reduced oxidative stress in both the acute and chronic phases of Chagas disease, with a marked effect from joint administration, indicating their inherent synergism.

Effects of Continuous and Accumulated Exercise on Endothelial Function in Rat Aorta.

BACKGROUND:: The practice of exercise in short bouts repeated throughout the day may be an alternative strategy to lift people out of physical inactivity. OBJECTIVE:: to evaluate if accumulated exercise, as occurs in continuous exercise training, improve endothelial function in rat aorta. METHODS:: Wistar male rats were divided into three groups: continuous exercise (CEx, 1 hour on the treadmill) or accumulated exercise (AEx, 4 bouts of 15 minutes / day) for 5 days/week for 8 weeks, or sedentary (SED). During the training period, body weight gain and increase in exercise performance were recorded. On sacrifice day, aorta was dissected into rings (3-5 mm) and mounted on the organ bath. RESULTS:: Fitness was significantly greater in CEx and AEx rats as compared with SED animals. In addition, compared with the SED group, CEx animals had a lower body mass gain, and the aorta obtained from these animals had reduced contractile response to norepinephrine and greater acetylcholine-induced relaxation. These results were not observed in ACEx animals. CONCLUSIONS:: Both CEx and AEx improved fitness, but only CEx led to reduced body weight gain and improved endothelial function. FUNDAMENTO:: A prática de exercícios em sessões curtas que se repetem ao longo do dia pode ser uma alternativa para tirar as pessoas da inatividade física. OBJETIVO:: Verificar se o exercício acumulado, tal como ocorre com o treinamento com exercício contínuo, melhora a função endotelial na aorta de ratos. MÉTODOS:: Ratos Wistar machos foram divididos em 3 grupos: treinamento com exercício contínuo (ExC; 1 hora em esteira) ou com exercício acumulado (ExA; 4 sessões de 15 minutos ao longo do dia) por 5 dias/semana, durante 8 semanas, ou grupo sedentário (SED). Durante o treinamento, foram registrados o ganho de peso corporal e desempenho na esteira. No dia do sacrifício, anéis (3-5 mm) da aorta foram obtidos e montados em banho de órgãos. RESULTADOS:: Animais ExC e ExA mostraram aptidão física significativamente maior em comparação com os SED. Paralelamente, em comparação com SED, animais ExC tiveram menor ganho de massa corporal, e aortas retiradas desses animais mostraram respostas contrácteis à noradrenalina reduzidas e maior relaxamento induzido pela acetilcolina. Esses resultados não foram observados no grupo ExA. CONCLUSÕES:: Tanto o ExC quanto o ExA melhoraram a aptidão física, mas somente o ExC foi capaz de reduzir o ganho de peso corporal dos animais e melhorar a função endotelial.

Effects of Continuous and Accumulated Exercise on Endothelial Function in Rat Aorta / Efeitos do Exercício Acumulado e Contínuo sobre a Função Endotelial em Aorta de Ratos

Abstract Background: The practice of exercise in short bouts repeated throughout the day may be an alternative strategy to lift people out of physical inactivity. Objective: to evaluate if accumulated exercise, as occurs in continuous exercise training, improve endothelial function in rat aorta. Methods: Wistar male rats were divided into three groups: continuous exercise (CEx, 1 hour on the treadmill) or accumulated exercise (AEx, 4 bouts of 15 minutes / day) for 5 days/week for 8 weeks, or sedentary (SED). During the training period, body weight gain and increase in exercise performance were recorded. On sacrifice day, aorta was dissected into rings (3-5 mm) and mounted on the organ bath. Results: Fitness was significantly greater in CEx and AEx rats as compared with SED animals. In addition, compared with the SED group, CEx animals had a lower body mass gain, and the aorta obtained from these animals had reduced contractile response to norepinephrine and greater acetylcholine-induced relaxation. These results were not observed in ACEx animals. Conclusions: Both CEx and AEx improved fitness, but only CEx led to reduced body weight gain and improved endothelial function.

Resumo Fundamento: A prática de exercícios em sessões curtas que se repetem ao longo do dia pode ser uma alternativa para tirar as pessoas da inatividade física. Objetivo: Verificar se o exercício acumulado, tal como ocorre com o treinamento com exercício contínuo, melhora a função endotelial na aorta de ratos. Métodos: Ratos Wistar machos foram divididos em 3 grupos: treinamento com exercício contínuo (ExC; 1 hora em esteira) ou com exercício acumulado (ExA; 4 sessões de 15 minutos ao longo do dia) por 5 dias/semana, durante 8 semanas, ou grupo sedentário (SED). Durante o treinamento, foram registrados o ganho de peso corporal e desempenho na esteira. No dia do sacrifício, anéis (3-5 mm) da aorta foram obtidos e montados em banho de órgãos. Resultados: Animais ExC e ExA mostraram aptidão física significativamente maior em comparação com os SED. Paralelamente, em comparação com SED, animais ExC tiveram menor ganho de massa corporal, e aortas retiradas desses animais mostraram respostas contrácteis à noradrenalina reduzidas e maior relaxamento induzido pela acetilcolina. Esses resultados não foram observados no grupo ExA. Conclusões: Tanto o ExC quanto o ExA melhoraram a aptidão física, mas somente o ExC foi capaz de reduzir o ganho de peso corporal dos animais e melhorar a função endotelial.

Evaluation of antioxidant therapy in experimental Chagas disease

Abstract INTRODUCTION: Stimulation of inflammatory mediators such as cytokines and chemokines may cause oxidative stress in Chagas disease. In this study, we evaluated the merit of vitamins C and E as antioxidant therapy to minimize the oxidative stress-induced damage in an experimental model of Chagas disease. METHODS: Ninety-six Swiss mice were infected with Trypanosoma cruzi QM2 and treated with vitamins C, E, or both (C/E) for 60 and 120 days, and their effects compared to placebo administration were evaluated in the acute and chronic disease phases. RESULTS: There was no difference in parasitemia among treatment groups. However, histological analysis showed more severe inflammation in the skeletal muscle in the vitamin supplementation groups at both the acute and chronic phases. Biochemical analyses during the acute phase showed increased ferric-reducing ability of plasma (FRAP) and glutathione (GSH) levels in the vitamin C and C/E groups. In the chronic phase, a decrease in GSH levels was observed in the vitamin E group and a decrease in thiobarbituric acid reactive substances (TBARS) was observed in the vitamin C/E group. Moreover, there was a decrease in TBARS in the cardiac tissues of the vitamin C and C/E groups compared to that of the placebo group, although this level was greater in the vitamin E group than in the vitamin C group. CONCLUSIONS: The antioxidant action of vitamins C and E reduced oxidative stress in both the acute and chronic phases of Chagas disease, with a marked effect from joint administration, indicating their inherent synergism.

EFFECTS OF VITAMIN C SUPPLEMENTATION ON THE CHRONIC PHASE OF CHAGAS DISEASE.

INTRODUCTION: In order to examine the effectiveness of vitamin C (ascorbic acid) in combating the oxidative insult caused by Trypanosoma cruzi during the development of the chronic phase of Chagas disease, Swiss mice were infected intraperitoneally with 5.0 × 104 trypomastigotes of T. cruzi QM1strain. METHODS: Mice were given supplements of two different doses of vitamin C for 180 days. Levels of lipid oxidation (as indicated by thiobarbituric acid reactive substances-TBARS), total peroxide, vitamin C, and reduced glutathione were measured in the plasma, TBARS, total peroxide and vitamin C were measured in the myocardium and histopathologic analysis was undertaken in heart, colon and skeletal muscle. RESULTS: Animals that received a dose equivalent to 500 mg of vitamin C daily showed increased production of ROS in plasma and myocardium and a greater degree of inflammation and necrosis in skeletal muscles than those that received a lower dose or no vitamin C whatsoever. CONCLUSION: Although some research has shown the antioxidant effect of vitamin C, the results showed that animals subject to a 500 mg dose of vitamin C showed greater tissue damage in the chronic phase of Chagas disease, probably due to the paradoxical actions of the substance, which in this pathology, will have acted as a pro-oxidant or pro-inflammatory.

Effects of vitaiin c supplementation on the chronic phase of chagas iisease / Efeitos da suplementação de vitamina C na fase crônica da doença de Chagas

Introduction: In order to examine the effectiveness of vitamin C (ascorbic acid) in combating the oxidative insult caused by Trypanosoma cruzi during the development of the chronic phase of Chagas disease, Swiss mice were infected intraperitoneally with 5.0 × 104 trypomastigotes of T. cruzi QM1strain. Methods: Mice were given supplements of two different doses of vitamin C for 180 days. Levels of lipid oxidation (as indicated by thiobarbituric acid reactive substances-TBARS), total peroxide, vitamin C, and reduced glutathione were measured in the plasma, TBARS, total peroxide and vitamin C were measured in the myocardium and histopathologic analysis was undertaken in heart, colon and skeletal muscle. Results: Animals that received a dose equivalent to 500 mg of vitamin C daily showed increased production of ROS in plasma and myocardium and a greater degree of inflammation and necrosis in skeletal muscles than those that received a lower dose or no vitamin C whatsoever. Conclusion: Although some research has shown the antioxidant effect of vitamin C, the results showed that animals subject to a 500 mg dose of vitamin C showed greater tissue damage in the chronic phase of Chagas disease, probably due to the paradoxical actions of the substance, which in this pathology, will have acted as a pro-oxidant or pro-inflammatory. .

Introdução: Para verificar a eficácia da vitamina C em combater o insulto oxidativo causado pelo Trypanosoma cruzi durante a evolução da fase crônica da doença de Chagas, camundongos Swiss foram previamente infectados via intraperitoneal com 5.0 × 104 tripomastigotas da cepa QM1 de T. cruzi. Métodos: Camundongos foram suplementados com duas diferentes doses de vitamina C por 180 dias. Foram mensurados os níveis de peroxidação lipídica (indicado por substâncias reativas ao ácido tiobarbitúrico-TBARS), peróxido total, vitamina C, e glutationa reduzida no plasma e TBARS, peróxido total e vitamina C no miocárdio, e foi realizado o estudo histopatológico em coração, cólon e músculo esquelético. Resultados: Animais que receberam diariamente uma dosagem equivalente a 500 mg de vitamina C apresentaram aumento na produção de ROS e RNS no plasma e no miocárdio e maior grau de inflamação e necrose em músculo esquelético em comparação àqueles que receberam doses menores ou nenhuma vitamina C. Conclusão: Embora muitas pesquisas tenham mostrado o efeito antioxidante da vitamina C, nossos resultados mostraram que os animais que foram expostos a 500 mg de vitamina C apresentaram maior dano tecidual na fase crônica da doença de Chagas, provavelmente devido a ações paradoxais desta substância, onde nesta patologia, poderá agir como pró-oxidante ou pró-inflamatória. .

Endothelial AT1 and AT2 pathways in aortic responses to angiotensin II after stress and ethanol consumption in rats.

Stress and ethanol are important cardiovascular risk factors. Their vascular and blood pressure (BP) effects were evaluated alone and in combination. Adult male Wistar rats (8-10 per group) were separated into control, ethanol (ethanol 20% in drinking water for 6 weeks), stress (restraint 1 h/d 5 d/week for 6 weeks), and ethanol/stress (in combination) groups. Systolic BP was evaluated weekly. Concentration-response curves for contractile responses to angiotensin II in the absence and the presence of losartan (AT1-blocker), PD123-319 (AT2-blocker), L-NAME (nitric oxide synthase inhibitor), or indomethacin (cyclooxygenase inhibitor) were obtained in isolated intact and endothelium-denuded aortas. Effective concentration 50% (EC50) and maximum response (MR) were compared among groups using MANOVA/Tukey tests. Stress and stress plus ethanol increased BP. Ethanol and stress, alone and in combination, did not alter angiotensin responses of intact aortas. PD123-319 decreased MR to angiotensin II in intact aortas from the ethanol and ethanol/stress groups relative to control in the presence of PD123-319. Losartan increased MR to angiotensin II in intact aortas from the stress and ethanol/stress groups relative to control in the presence of losartan. None of the protocols altered angiotensin responses of denuded aortas. Neither indomethacin nor L-NAME altered angiotensin responses of intact aortas from the experimental groups. Thus ethanol and ethanol plus stress may alter endothelial signaling via AT1-receptors, without changing systemic BP. Stress and stress plus ethanol may alter endothelial signaling via AT2-receptors, and thereby increase BP. Knowledge of such vascular changes induced by stress and/or ethanol may contribute to understanding adverse cardiovascular effects of stress and ethanol consumption in humans.

Indicadores de avaliação do cuidado individual: subsídios para a formação médica orientada por competência / Evaluative indicators of individual care: subsidies for competence-guided medical training

No processo de formação dos profissionais da área da saúde, as DCN orientam a organização de um modelo curricular pautado no desenvolvimento de competência profissional. Foi realizado um estudo descritivo com abordagem qualitativa, desenvolvido por meio de conferência de consenso, com o objetivo de elaborar indicadores para avaliar o processo de ensino-aprendizagem na área de cuidado individual. Uma matriz foi organizada com base nos desempenhos contidos nos manuais de cada série e formatos de avaliação. Em seguida, os avaliadores analisaram esta matriz e a discutiram na conferência de consenso, para a consolidação dos indicadores. A análise dos resultados permitiu olhar para as ações desenvolvidas no curso a partir da compreensão de que, durante essas atividades, os estudantes têm a oportunidade de realizar o cuidado na perspectiva da integralidade, como preconizado no Sistema Único de Saúde e nas DCN. Dessa maneira, foram construídos indicadores relacionados a história clínica, exame físico e raciocínio clínico para o monitoramento do processo de ensino-aprendizagem. No contexto do currículo orientado por competência, esses indicadores podem nortear o processo de planejamento educacional, bem como permitir a participação ativa e a corresponsabilidade dos envolvidos para o alcance de uma aprendizagem significativa, que permita ao futuro profissional a realização de um cuidado qualificado em saúde.

The National Curriculum Guidelines (NCG) recommend a professional competence-based curricular model for health care undergraduate education. A descriptive study with a qualitative approach was conducted through the use of a consensus conference to develop evaluative indicators of the teaching and learning process in the area of individual care. A matrix was organized based on performances obtained from manuals of each year of study and formats of evaluation. The evaluators then analyzed the matrix and discussed it in the consensus conference in order to consolidate the indicators. The analyzed results allowed the activities of the course to be considered based on the understanding that these actions offer students the opportunity to fulfill the comprehensive health care as recommended by the NCG and the Unified Health System. Therefore indicators were constructed related to clinical history, physical examination and clinical reasoning for monitoring the teaching and learning process. In the context of a competence-guided curriculum, these indicators can guide the educational planning, as well as enable active participation and co-responsibility of those involved in order to achieve meaningful learning that will allow the future professional to ensure qualified health care.

Stress alone or associated with ethanol induces prostanoid release in rat aorta via alpha2-Adrenoceptor.

BACKGROUND: Stress and ethanol are both, independently, important cardiovascular risk factors. OBJECTIVE: To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. METHODS: Rats were separated into 4 groups: Control, ethanol (20% in drinking water for 6 weeks), stress (immobilization 1h day/5 days a week for 6 weeks) and stress/ethanol. Concentration-responses curves to noradrenaline - in the absence and presence of yohimbine, L-NAME or indomethacin - or to phenylephrine were determined in thoracic aortas with and without endothelium. EC50 and maximum response (n=8-12) were compared using two-way ANOVA/Bonferroni method. RESULTS: Either stress or stress in association with ethanol consumption increased the noradrenaline maximum responses in intact aortas. This hyper-reactivity was eliminated by endothelium removal or by the presence of either indomethacin or yohimbine, but was not altered by the presence of L-NAME. Meanwhile, ethanol consumption did not alter the reactivity to noradrenaline. The phenylephrine responses in aortas both with and without endothelium also remained unaffected regardless of protocol. CONCLUSION: Chronic stress increased rat aortic responses to noradrenaline. This effect is dependent upon the vascular endothelium and involves the release of vasoconstrictor prostanoids via stimulation of endothelial alpha-2 adrenoceptors. Moreover, chronic ethanol consumption appeared to neither influence noradrenaline responses in rat thoracic aorta, nor did it modify the increase of such responses observed as a consequence of stress exposure.

Estresse Isolado ou Associado ao Etanol Libera Prostanóides em Aorta de Ratos via ?2-Adrenoceptores / Stress Alone or associated with Ethanol Induces Prostanoid Release in Rat Aorta via ?2-Adrenoceptor

Fundamento: Estresse e etanol são ambos, independentemente, importantes fatores de risco cardiovascular. Objetivo: avaliar o risco cardiovascular do consumo de etanol e exposição ao estresse, isolados e em associação, em ratos machos adultos. Métodos: Os ratos foram separados em quatro grupos: controle, etanol (20% na água de beber durante seis semanas), estresse (imobilização 1h dia/5 dias por semana/ 6 semanas) e estresse/etanol. As curvas de concentração-resposta à noradrenalina - na ausência e na presença de ioimbina, L-NAME ou indometacina - ou fenilefrina foram determinadas em aortas torácicas com e sem endotélio. EC50 e resposta máxima (n = 8-12) foram comparadas através de ANOVA de dois fatores (two-way) / método de Bonferroni. Resultados: Estresse ou estresse em associação com o consumo de etanol aumentaram as respostas máximas de noradrenalina em aortas intactas. Essa hiper-reatividade foi eliminada pela remoção do endotélio, ou pela presença da indometacina ou ioimbina, mas não foi alterada pela presença de L-NAME. Enquanto isso, o consumo de etanol não alterou a reatividade à noradrenalina. As respostas da fenilefrina em aortas com e sem endotélio também permaneceram inalteradas independentemente do protocolo. Conclusão: O estresse crônico aumentou as respostas aórticas dos ratos à noradrenalina. Esse efeito é dependente do endotélio vascular e envolve a liberação de prostanóides vasoconstritores através da estimulação de α-2 adrenoceptores endoteliais. Além disso, o consumo crônico de etanol pareceu não influenciar as respostas de noradrenalina em aorta de rato, nem modificar o aumento de tais respostas observadas em consequência da exposição ao estresse. .

Background: Stress and ethanol are both, independently, important cardiovascular risk factors. Objective: To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. Methods: Rats were separated into 4 groups: Control, ethanol (20% in drinking water for 6 weeks), stress (immobilization 1h day/5 days a week for 6 weeks) and stress/ethanol. Concentration-responses curves to noradrenaline - in the absence and presence of yohimbine, L-NAME or indomethacin - or to phenylephrine were determined in thoracic aortas with and without endothelium. EC50 and maximum response (n=8-12) were compared using two-way ANOVA/Bonferroni method. Results: Either stress or stress in association with ethanol consumption increased the noradrenaline maximum responses in intact aortas. This hyper-reactivity was eliminated by endothelium removal or by the presence of either indomethacin or yohimbine, but was not altered by the presence of L-NAME. Meanwhile, ethanol consumption did not alter the reactivity to noradrenaline. The phenylephrine responses in aortas both with and without endothelium also remained unaffected regardless of protocol. Conclusion: Chronic stress increased rat aortic responses to noradrenaline. This effect is dependent upon the vascular endothelium and involves the release of vasoconstrictor prostanoids via stimulation of endothelial alpha-2 adrenoceptors. Moreover, chronic ethanol consumption appeared to neither influence noradrenaline responses in rat thoracic aorta, nor did it modify the increase of such responses observed as a consequence of stress exposure. .

Indicadores de avaliação em gestão e saúde coletiva na formação médica / Evaluation indicators in management and collective health in medical education

A Faculdade de Medicina de Marília (Famema) utiliza metodologias ativas de ensino-aprendizagem, e sua organização curricular é orientada ao desenvolvimento de competência profissional e a um processo avaliativo critério-referenciado. Esta pesquisa tem por objetivo elaborar indicadores para avaliar o processo de ensino-aprendizagem nos âmbitos da gestão e da saúde coletiva, baseados na adaptação da proposta de Conferência de Consenso e descrever o caminho percorrido nessa elaboração. Com base na análise dos documentos institucionais que explicitavam o planejamento das atividades (cadernos de organização das séries) e nos critérios, formatos e instrumentos da avaliação nas diferentes séries e cenários de aprendizagem (Manual de Avaliação), foi elaborada a primeira matriz de indicadores, que continha a proposta curricular para o alcance da aprendizagem que embasara a análise dos especialistas e a realização da Conferência. Tal metodologia possibilitou entender, ampliar e aprofundar a avaliação nessas áreas específicas, o que poderá orientar a implementação das alterações curriculares necessárias, com ênfase em uma avaliação da aprendizagem comprometida com o processo formativo.

Marilia Medical School uses active methodologies of teaching-learning. Its curriculum organization is directed towards professional competence and to a criterion-referenced evaluative process. This research aims at elaborating indicators to evaluate teaching-learning processes in health management and collective health. These indicators are based on the adaptation of the Consensus Conference proposal; it also aims at describing the pathway followed in this elaboration. The first matrix of indicators showed the proposed curriculum as able to support the specialists' analyses and the organization of the Conference. It was based on the analysis of the institutional documents which explained the activities plan (notebooks on grades organization) and the criteria, formats and evaluations tools in different grades and learning scenarios (Evaluation Handbook). This methodology made it possible to understand the evaluation of these specific areas more deeply and widely, which may guide a better implementation of the necessary curriculum alterations which emphasize an evaluation committed with the formative process.

Percepção do egresso de enfermagem sobre a contribuição do curso para o exercício do cuidado / Perceptions of nursing alumni regarding the course contribution in providing health care / La percepción de los graduados en enfermería sobre la contribución del curso para el ejercicio del cuidado

O estudo avaliou a formação em enfermagem ancorada na problematização e na aprendizagem baseada em problemas a partir da percepção dos egressos. Trata-se de estudo transversal de natureza ex-post-facto. Os resultados foram analisados na triangulação das abordagens quantitativa e qualitativa e na perspectiva hermenêutica dialética. Na abordagem quantitativa 180 egressos responderam um questionário. Na qualitativa, 14 participaram das entrevistas, que buscaram sentidos relacionados ao cuidado ideal, para construção dos indicadores que revelassem a lógica da avaliação. Esses indicadores nortearam a escolha das questões para triangulação. Os resultados apontaram que 85,1% dos egressos estão inseridos no mercado de trabalho, 92,1% cursaram pós-graduação e 99,1% acreditam apresentar formação necessária ao cuidado ético, humanizado e fundamentado. A análise dos dados aponta para formação comprometida com a construção da autonomia e do conhecimento, bem como articulada aos princípios do Sistema Único de Saúde e do mundo do trabalho em enfermagem.

This present study evaluated nursing education based on problem-solving and learning based on problems originating from alumni's perceptions. This is an ex-post-facto cross-sectional study. Results were analyzed using both quantitative and qualitative approaches triangulation and through dialectical hermeneutics. In the quantitative approach 180 alumni answered a questionnaire. The qualitative approach involved 14 interviews that searched for meanings related to the notion of ideal care, in order to build indicators that would reveal this evaluation logic. These indicators guided the choice of triangulation questions. Results demonstrated that 85.1% of alumni are working in the nursing market, 92.1% have taken a post-graduate course and 99.1% believe they have the education required to deliver ethical, humanized and founded care. Data analysis demonstrates a compromised education as autonomy and knowledge are being built, and articulated to the Single Health System and the world nursing principles.

El estudio objetivó evaluar los resultados de la formación en enfermería anclada en la problematización y en el aprendizaje basado en problemas desde la percepción de los propios egresados. Estudio transversal y de naturaleza ex-post-facto. Los resultados fueron analizados en por la triangulación de métodos cuantitativos y cualitativos y la perspectiva hermenéutica dialéctica. En el abordaje cuantitativo 180 egresados respondieron un cuestionario. En el cualitativo, 14 participaron de entrevistas, relatando sus pensamientos relacionados al cuidado ideal, para la construcción de indicadores que revelasen la lógica de la evaluación. Esos indicaron nortearon las cuestiones para la triangulación. Los resultados mostraron: 85,1% de los graduados están en el mercado laboral, 92,1% asistieron al posgrado y 99,1% creen presentar una formación necesaria al cuidado ético, humanizado y fundamentado. Los datos resaltan una formación comprometida con la construcción de autonomía y conocimiento y articulada a los principios del Sistema Único de Salud y del mundo laboral en enfermería.