Estatinas x ácido lipóico na prevenção e tratamento das doenças cardiovasculares / Statins x lipoic acid in the prevention and treatment of cardiovascular diseases

Cardiovascular diseases (CVD) are the leading cause of death worldwide and atherosclerosis is the most important process underlying CVD. Statins are widely used in primary and secondary prevention of CVD, though their adverse side effects, such as myopathy and hepatotoxicity, justify the search for therapeutic alternatives. Alpha lipoic acid is a potent antioxidantand its potential use to combat various conditions, such as diabetic nephropathy, metal poisoning, Alzheimer's disease and CVD has been under intense study. The aim of this review was to gather information on the use of statins and alpha lipoic acid in the prevention and treatment of CVD. The literature suggests that inaddition to the known side effects most associated with the use of statins, they can also cause reduced levels of coenzyme Q10 (CoQ10), an important mitochondrial antioxidant and electron transport chain carrier that has the capacity to antagonize oxidation of plasma lowdensity lipoprotein (LDL). The loss of CoQ10 can reduce adenosine triphosphate (ATP) levels in cardiac cells, further worsening the overall state of the individual. Alpha lipoic acid produces favorable metabolic and endothelial anti-inflammatory effects, without adverse side effects, and thus may be an alternative treatment for the prevention of CVD. However, more controlled clinical studies are needed to establish definitively the prophylactic and therapeutic potential of alpha lipoic acid and to decide whether it might be more effective than statins for the prevention and treatment of CVD...

As doenças cardiovasculares (DCVs) são a principal causa de morte no mundo e tem a aterosclerose como componente mais importante. As estatinas são extensamente utilizadas na prevenção primária e secundária das DCVs, todavia seus efeitos adversos como miopatia e toxicidade hepática justificam a busca por alternativas terapêuticas. O ácido lipóico é um potente antioxidante e vem sendo intensamente investigado no combate de diversas condições tais como nefropatia diabética, intoxicação por metais, doença de Alzheimer e nas DCVs. O objetivo desta revisão foi reunir informações acerca da utilização das estatinas e do ácido lipóico na prevenção e tratamento das DCVs. A literatura aponta que além dos efeitos adversos mais conhecidos associados ao uso das estatinas, elas também podem ocasionar a redução dos níveis de Coenzima Q10 (CoQ10), um importante antioxidante mitocondrial e transportador de elétrons, que possui a capacidade de antagonizar a oxidação da Lipoproteína de Baixa Densidade (LDL) plasmática. Ainda, a deficiência da CoQ10, por sua vez, pode levar a diminuição da adenosina trifosfato (ATP) nas células cardíacas, comprometendo ainda mais o estado global do indivíduo. Enquanto isso, o ácido lipóico apresenta favoráveis efeitos antiinflamatórios, metabólicos e endoteliais, contudo sem a presença de efeitos adversos, podendo ser uma opção terapêutica na prevenção das DCVs. Entretanto, mais estudos clínicos controlados são necessários para estabelecer de maneira definitiva os potenciais terapêuticos e profiláticos do ácido lipóico, avaliando se ele pode ser mais efetivo para a prevenção e tratamento das DCVs do que as estatinas...

Phytohemagglutinin improves the development and ultrastructure of in vitro-cultured goat (Capra hircus) preantral follicles

The objective this study was to determine the effect of phytohemagglutinin (PHA) on survival, growth and gene expression in caprine secondary follicles cultured in vitro. Secondary follicles (∼0.2 mm) were isolated from the cortex of caprine ovaries and cultured individually for 6 days in α-MEM+ supplemented with PHA (0, 1, 10, 50, 100, or 200 µg/mL). After 6 days of culture, follicle diameter and survival, antrum formation, ultrastructure and expression of mRNA for FSH receptors (FSH-R), proliferating cell nuclear antigen (PCNA), and neuronal nitric oxide synthase were determined. All treatments maintained follicular survival [α-MEM+ (94.59%); 1 µg/mL PHA (96.43%); 10 µg/mL PHA (84.85%); 50 µg/mL PHA (85.29%); 100 µg/mL PHA (88.57%), and 200 µg/mL PHA (87.50)], but the presence of 10 µg/mL PHA in the culture medium increased the antrum formation rate (21.21%) when compared with control (5.41%, P < 0.05) and ensured the maintenance of oocyte and granulosa cell ultrastructures after 6 days of culture. The expression of mRNA for FSH-R (2.7 ± 0.1) and PCNA (4.4 ± 0.2) was also significantly increased in follicles cultured with 10 µg/mL PHA in relation to those cultured in α-MEM+ (1.0 ± 0.1). In conclusion, supplementation of culture medium with 10 µg/mL PHA maintains the follicular viability and ultrastructure, and promotes the formation of antral cavity after 6 days of culture in vitro.

Análise sobre a fitoterapia como prática integrativa no Sistema Único de Saúde / Analysis about phytotherapy as an integrating practice in the Brazilian Unified Health System (UHS)

É notável o crescente uso da fitoterapia como prática médica integrativa em diversos países. A utilização de plantas medicinais no Brasil tem como facilitadores a grande diversidade vegetal e o baixo custo associado à terapêutica, o que vem despertando a atenção dos programas de assistência à saúde e profissionais. O Ministério da Saúde, com a finalidade de evitar o uso inadequado desta prática medicinal, tem demonstrado interesse por meio do incentivo de pesquisas relacionadas ao assunto, favorecendo a implantação de programas de saúde visando à distribuição e utilização destes medicamentos de forma racional. Baseado neste contexto foi realizado levantamento de como esta temática vem sendo abordada e implementada no Sistema Único de Saúde (SUS). Trata-se de estudo descritivo com abordagem qualitativa, realizado através de levantamento bibliográfico em bases de dados relacionado ao tema "medicamentos fitoterápicos no sistema único de saúde". Os descritores utilizados durante toda a pesquisa foram fitoterapia, medicamentos fitoterápicos, medicina integrativa, medicamentos, medicina herbária, fitoterapia no SUS, medicina integrativa e sistemas públicos de saúde. Observou-se que o governo tem demonstrado interesse no desenvolvimento de políticas que associem o avanço tecnológico ao conhecimento popular em prol de procedimentos assistenciais em saúde que apresentem eficácia, abrangência, humanização e menor dependência com relação à indústria farmacêutica. Nas duas últimas décadas, alguns estados e municípios brasileiros vêm realizando a implantação de Programas de Fitoterapia na atenção primária à saúde, com o intuito de suprir as carências medicamentosas de suas comunidades. Apesar da crescente busca por integrativas medicamentosas, os estudos acerca da fitoterapia ainda são precários no Brasil, fazendo-se ainda necessárias pesquisas nesta área, de modo a ampliar o conhecimento dos profissionais e estudantes da saúde, auxiliando e tornando mais sólidas as bases de segurança e eficácia para implementação das praticas fitoterápicas no SUS.

The growing use of phytotherapy as an integrating medical practice in several countries has been remarkable. The use of medicinal plants in Brazil is facilitated by the plant diversity and low cost associated with therapeutics, which has called the attention of health assistance programs and professionals. The Brazilian Ministry of Health, in order to avoid misuse of this medical practice, has demonstrated interest, developing policies that encourage research related to this issue and favoring the establishment of health programs focused on the distribution and use of these drugs in a rational way. Based on this context, a survey about how this issue has been addressed and implemented in the Unified Health System (UHS) was carried out. This was a descriptive study of qualitative approach, performed through a literature review in databases, related to the theme "phytotherapic medicines in the unified health system". The key words used throughout the study were: phytotherapy, phytomedicines, integrating medicine, medicines, herbal medicine, phytotherapy in the UHS, integrating medicine and public health systems. The government has shown interest in developing policies which combine technological advances with common knowledge for the sake of assistance health procedures that show effectiveness, coverage, humanization and less dependence on the pharmaceutical industry. In the last two decades, some Brazilian states and municipalities have implemented Phytotherapy Programs in primary health care in order to meet the drug needs of their communities. Despite the growing search for integrating drugs, studies about phytotherapy are still limited in Brazil, with the need of research in this area in order to increase the knowledge of health professionals and students, helping and making more solid the safety and efficacy bases for the implementation of phytotherapic practices in the UHS.

Políticas públicas de medicamentos: trajetória e desafios / Public policies for medicines: trajectory and challenges

Por meio de um levantamento bibliográfico sobre as políticas públicas no setor de medicamentos brasileiro, o artigo examina as principais características das ações aplicadas na área, ressaltando seus resultados e deficiências, bem como as dificuldades encontradas para consolidar uma política de medicamentos no Brasil. O estudo realizado se fundamentou na análise de artigos por meio das bases de dados Scielo e Lilacs e de outras fontes. Desde a extinta Central de Medicamentos (CEME) até a aprovação da Política Nacional de Medicamentos (PNM), todas as ações e projetos foram voltados principalmente para a reorientação da Assistência Farmacêutica na atenção básica, garantindo, por conseguinte, o acesso e o uso racional dos medicamentos essenciais.

Through a bibliography review of public policies in Brazilian medicine sector, this paper examines the main characteristics of actions implemented in this area, lighting their results and deficiencies, as well as the difficulties to consolidate a policy for medicines in Brazil. The study is based on analysis of articles searched in the Scielo and Lilacs databases and other sources. Since the extinct Medicine Center to the approval of the National Medicine Policy, all the actions and programs aimed mainly at the reorientation of Pharmaceutical Assistance in primary health are, to guarantee access and rational use of essential medicines essential.

Do intrauterine growth restriction and overweight at primary school age increase the risk of elevated body mass index in young adults?

Obesity is one of the rising public health problems characterized as a risk factor for many chronic diseases in adulthood. Early life events such as intrauterine growth restriction, as well as life style, are associated with an increased prevalence of this disease. The present study was performed to determine if intrauterine growth restriction interacts with overweight at primary school age to affect body mass index (BMI) in young adults. From June 1, 1978 to May 31, 1979, 6827 singleton liveborns from Ribeirão Preto, São Paulo State, Brazil, corresponding to 98 percent of all births at the 8 maternity hospitals, were examined and their mothers were interviewed. Samples from the initial cohort were examined again at primary school age (8 to 11 years of age) and at the time of military service (18 years of age). There were 519 male individuals with complete measurements taken in the three surveys. Intrauterine growth-restricted individuals had a BMI 0.68 kg/m² lower than that of individuals who were not restricted (95 percentCI = -1.34 to -0.03) and overweight at primary school age showed a positive and strong effect on BMI at 18 years of age (coefficient 5.03, 95 percentCI = 4.27 to 5.79). However, the increase in BMI was much higher - 6.90 kg/m² - when the conscript had been born with intrauterine growth restriction and presented overweight at primary school age (95 percentCI = 4.55 to 9.26). These findings indicate that the effect of intrauterine growth restrictionon BMI at 18 years of age is modified by later weight gain during school age.

Expresión como proteínas de fusión de las subunidades PB1 y PB2 de la polimerasa del virus de la influenza / Expression how proteins of fusion of the subunits PB1 and PB2 of the influenza viral of polymerase

Los cADNs de los genes que codifican las proteínas PB1 y PB2 de la ARN polimerasa del virus de la influenza, se clonaron en fase en un sitio distal del ATG que codifica la proteína 10 del bacteriógafo T7, en el vector de expresión pAR3040, bajo el control de un promotor de la ARN polimerasa de T7. Los plásmidos recombinantes se introdujeron en la cepa bacteriana. E coli BL21 (DE3)plysS, que contiene en su genoma el gen de la ARN polimerasa del fago T7, bajo el control de un promotor (lac uv5) inducible por IPTG. La inducción de la ARN polimerasa del fago T7 en las células hospederas, resultó en la expresión de las proteínas PB1 y PB2 en forma de proteínas de fusión. Las proteínas expresadas se acumularon en grandes cantidades en el interior de las células bacterianas y fueron recuperadas de los lisados en forma de precipitados insolubles.