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RESUMO Objetiva-se analisar o processo de implantação, situação atual e perspectivas do Programa de Homeopatia, Acupuntura e Medicina Antroposófica (PRHOAMA) da rede pública de saúde de Belo Horizonte (Brasil) segundo as diretrizes da Política Nacional de Práticas Integrativas e Complementares (PNPIC). Realizou-se estudo de caso por meio de análise documental de 32 textos oficiais; dados secundários obtidos pelo número de profissionais e procedimentos ofertados em sistemas de informação em saúde; e realização de um grupo focal com profissionais do PRHOAMA. O programa foi implantado em 1994 nas Unidades Básicas de Saúde (UBS), configurando-se uma experiência pioneira no Brasil. As práticas são realizadas exclusivamente por médicos, o que diverge das recomendações da PNPIC, cujo modelo preconizado é o multiprofissional. O processo de institucionalização do PRHOAMA é parcial, não se configurando uma política pública consolidada. O PRHOAMA atende às diretrizes da PNPIC, tais como ênfase na Atenção Primária, divulgação e informação sobre as Práticas Integrativas e Complementares em Saúde (Pics). Entretanto, é necessário avançar na promoção do acesso aos medicamentos homeopáticos, na definição de mecanismos de financiamento e na ampliação da equipe gestora e de profissionais.
ABSTRACT The objective of this study was to analyze the process of implementation, the current situation and perspectives of the Homeopathy, Acupuncture and Anthroposophical Medicine Program (PRHOAMA) in public health service in Belo Horizonte (Brazil) considering the guidelines of the National Policy for Integrative and Complementary Practices (PNPIC). The case study was carried out through document analysis of 32 official texts, secondary data (number of professionals and procedures offered) in health information systems and a focus group with professionals of PRHOAMA. The program was implemented in 1994, in Basic Health Units (UBS), configuring itself as a pioneering experience in Brazil. Practices are performed exclusively by physicians, which diverges from the recommendations of the PNPIC, whose recommended the ideal model is multi-professional. PRHOAMA's institutionalization process is partial, not constituting a consolidated public policy. PRHOAMA complies with the PNPIC guidelines, such as emphasis on Primary Care, dissemination and information about Complementary Therapies. However, it is necessary to advance in the promotion of access to homeopathic medicines, in the definition of financing mechanisms and in the expansion of the management team and professionals.
RESUMEN
OBJECTIVE: The aim of this study was to present a new topical treatment protocol for oral hairy leukoplakia (OHL), consisting of a 25% podophyllin resin with a 1% penciclovir cream (PP), and to compare this topical treatment protocol's efficacy with that of 2 other topical treatment protocols: a 25% podophyllin resin (P) and a 25% podophyllin resin with a 5% acyclovir cream (PA). STUDY DESIGN: Forty-two human immunodeficiency virus-positive patients with 69 OHL lesions were randomly treated using P, PA, or PP (14 patients in each topical treatment protocol). Clinical healing was determined when the white plaque could no longer be seen in the primary location of the lesion. Topical treatment performance was evaluated by clinical healing within each week of topical treatment protocol as well as by the recurrence of the lesion. Statistical survival analysis was performed using a Cox proportional hazards model. RESULTS: Approximately 55% of the patients presented with clinical healing of OHL within 7-8 weeks of each topical treatment protocol. After the sixth week, the PA treatment protocol presented a faster clinical healing rate of OHL. Recurrence was observed in 3 and 7 OHL lesions treated with P and PP treatment protocols, respectively. CONCLUSIONS: The PP treatment protocol proved to be effective; however, the PA treatment protocol was more effective in the clinical healing rate for OHL than P and PP after the sixth week of treatment, and no recurrent OHL was observed in the PA treatment group.