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.

Effect of extender supplementation with various antimicrobial agents on viability of Brucella ovis and Actinobacillus seminis in cryopreserved ovine semen.

The objective was to determine the effectiveness of various antimicrobial agents added to semen extender for inactivation of B. ovis or A. seminis in ovine semen after cryopreservation. In Experiment 1, 20 ejaculates from a crossbred ram infected with B. ovis were cryopreserved in Tris-based extenders with various antimicrobial agents: (I) control without antibiotics, (II) with penicillin and streptomycin (1000 IU/mL and 1 mg/mL, respectively), (III) lincomycin (0.15 mg/mL), (IV) sulphadiazine (0.60 mg/mL), and (V) gentamicin sulphate (0.25 mg/mL). Semen was stored in 0.25 mL straws at a final concentration of 150 × 10(6) spermatozoa/mL. After thawing (37 °C for 30 s), sperm total motility (TM), sperm morphology, integrity of sperm membranes, and bacterial growth were assessed. In Experiment 2, six B. ovis isolates were separately inoculated into aliquots of a fresh ejaculate from a B. ovis-free ram. Mock inoculated semen was processed for cryopreservation using the five extenders described above, and bacteriologically evaluated after thawing. In Experiment 3, sensitivity of A. seminis to the same antimicrobial agents was evaluated by inoculating an ejaculate from an A. seminis and B. ovis-free ram. There were no significant differences among treatments in post-thawing sperm parameters. B. ovis was isolated from 100% (20/20), 0% (0/20), 95% (19/20), 100% (20/20), and 5% (1/20) of semen samples diluted in tris-based extender of untreated (I) and treated semen samples with antimicrobial agents II, III, IV, and V, respectively. Frequencies of isolation from samples treated with antimicrobial agent II and V were significantly lower than untreated ones (P < 0.05). There were no significant differences in the profile of antimicrobial resistance of different B. ovis isolates. A. seminis had a similar sensitivity to the antimicrobial agents. We concluded that addition of a combination of penicillin and streptomycin or gentamicin alone to ram semen cryo-extenders inactivated B. ovis and A. seminis.

Analysis of the gene expression profile of Schistosoma mansoni cercariae using the expressed sequence tag approach.

ESTs constitute rapid and informative tools with which to study gene-expression profiles of the diverse stages of the schistosome life cycle. Following a comprehensive EST study of adult worms, analysis has now targeted the cercaria, the parasite larval form responsible for infection of the vertebrate host. Two Schistosoma mansoni cercarial cDNA libraries were examined and partial sequence obtained from 957 randomly selected clones. On the basis of database searches, 551 (57.6%) ESTs generated had no homologs in the public databases whilst 308 (32.2%) were putatively identified, totaling 859 informative ESTs. The remaining 98 (10.2%) were uninformative ESTs (ribosomal RNA and non-coding mitochondrial sequences). By clustering analysis we have identified 453 different genes. The most common sequences in both libraries represented Sm8 calcium binding protein (8% of ESTs), fructose-1,6-bisphosphate aldolase, glyceraldehyde-3-phosphate dehydrogenase, cytochrome oxidase subunit 1, ATP guanidine kinase and triose phosphate isomerase. One hundred and nineteen identified genes were sorted into 11 functional categories, with genes associated with energy metabolism being the most abundant (13%) and diverse. The diversity and abundance of genes associated with the transcription/translation machinery and with regulatory/signaling functions were also marked. A paramyosin transcript was identified, indicating that this gene is not exclusively expressed in adult worms and sporocysts (as had been suggested previously). The possible physiological relevance to cercariae of the presence of transcripts with homology to calcium binding proteins of the EF-hand superfamily, Gq-coupled rhodopsin photoreceptor, rod phosphodiesterase 8 subunit and peripheral-type benzodiazepine receptor is discussed.

Osteopatia hipertrófica pulmonar / Hypertrophic pulmonary osteopathy

Descrevem-se os achados anatomopatológicos de um caso de osteopatia hipertrófica pulmonar em um cäo adulto sem raça definida e sem histórico clínico. A necropsia, foi observado um nódulo cutâneo na cabeça. Havia outros nódulos nos pulmöes, nos rins e no coraçäo. Macroscopicamente, estes apresentavam coloraçäo esbranquiçada, consistência firme e diâmetro que variavam de pouco milímetros a 10 centímetros, como foi observado nos pulmöes. Todos os quatro membros apresentavam-se grossos e duros, com acentuada proliferaçäo periosteal simétrica. Histologicamente, na superfície externa da cortical havia trabéculas ósseas entremeadas por tecido medular e a proliferaçäo periosteal caracterizada por tecido ósseo imaturo. Foram observadas várias cavidades na cortical. Concluiu-se pelo diagnóstico de osteopatia hipertrófica, secundária à metástase pulmonar de fibrossarcoma cutânea