RESUMO
Brain ischemia pathophysiology involves a complex cascade of events such as inflammation and oxidative stress that lead to neuronal loss and cognitive deficits. Caffeic acid (CA) is a natural phenolic compound with antioxidant and anti-inflammatory properties. To evaluate the neuroprotective efficacy of this compound in mice subjected to a permanent middle cerebral artery occlusion, animals were pretreated and post-treated with CA, 2, 20, and 60 mg/kg/day, intraperitoneally, at 24, 48, 72, 96, or 120 h after ischemia. Animals were evaluated at 24 h after the permanent middle cerebral artery occlusion for brain infarction and neurological deficit score. At 72 h after the occlusion, animals were evaluated for locomotor activity, working memory, and short-term aversive memory; long-term aversive memory was evaluated 24 h after the evaluation of short-term aversive memory. Finally, at 120 h after the event, spatial memory and the expression levels of synaptophysin (SYP), SNAP-25, and caspase 3 were evaluated. The treatment with CA reduced the infarcted area and improved neurological deficit scores. There was no difference in locomotor activity between groups. The working, spatial, and long-term aversive memory deficits improved with CA. Furthermore, western blotting data showed that the expression of SYP, which correlates with synaptic formation and function, decreased after ischemic insult, and CA inhibited the reduction of SYP expression. Ischemia also increased, and CA treatment decreased, caspase 3 expression. These results suggest that CA exerts neuroprotective and antidementia effects, at least in part, by preventing the loss of neural cells and synapses in ischemic brain injury.
Assuntos
Isquemia Encefálica/tratamento farmacológico , Ácidos Cafeicos/farmacologia , Transtornos da Memória/prevenção & controle , Fármacos Neuroprotetores/farmacologia , Animais , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Ácidos Cafeicos/administração & dosagem , Caspase 3/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Regulação da Expressão Gênica/efeitos dos fármacos , Infarto da Artéria Cerebral Média/complicações , Masculino , Transtornos da Memória/etiologia , Camundongos , Atividade Motora/efeitos dos fármacos , Fármacos Neuroprotetores/administração & dosagem , Sinaptofisina/genética , Proteína 25 Associada a Sinaptossoma/genética , Fatores de TempoRESUMO
El objetivo de este estudio es presentar una estrategia para la práctica de la enseñanza y la evaluación de la semiología cardiopulmonar a través de un examen objetivo clínico estructurado. Las clases prácticas se llevaron a cabo con estudiantes de Medicina. Los estudiantes realizaron anamnesis y examen físico de los pacientes, y posteriormente fue discutido el significado de cada signo y síntoma encontrado. Al final de las clases prácticas se realizó una evaluación práctica basada en el examen objetivo clínico estructurado. Se estableció una situación clínica en la que el estudiante tuvo que realizar la anamnesis, examen físico cardiopulmonar y describir los resultados. Se mostró, por medio de programas de ordenador, sonidos cardiopulmonares de ciertas enfermedades para que el estudiante las identificara. Fue realizada una evaluación de la actividad, a través de un cuestionario aplicado a cada estudiante. La puntuación media de la evaluación práctica fue 8,93. La evaluación de la actividad por los alumnos fue muy positiva, con puntuaciones que van de 3 a 5 en una escala de 0 a 5. La calidad de las clases y las historias clínicas también han sido bien evaluadas, con un promedio de 4. La aplicación de un examen objetivo clínico estructurado en la semiología ha demostrado ser una herramienta útil y eficaz en la evaluación del estudiante de Medicina, junto con las clases prácticas, que hicieron a los estudiantes aptos para reconocer los signos y síntomas principales de enfermedades cardiopulmonares(AU)
The aim of this study is to present a strategy for the teaching practice and evaluation of cardiopulmonary semiology through an objective structured clinical examination. Practical lessons were developed with medical students. The students did anamnesis and physical exams to patients and later, each sign and symptom that was found was analyzed. At the end of practical lessons, a practical evaluation based on the objective structured clinical examination was applied. We have established a clinical situation in which the student had to do anamnesis, physical and cardiopulmonary exam and describe the results. Using computing software, cardiopulmonary sounds present in some diseases were shown to ask the students to identify them. An evaluation of the activity was done by means of a questionnaire applied to each student. Average mark in practical evaluation was 8, 93. The students' evaluation of the activity was very positive, with marks ranging from 3 to 5 in a scale from 0 to 5. Qualities of lessons and clinical histories have also been evaluated with an average mark of 4. The implementation of an objective structured clinical examination in Semiology has proved to be an efficient and useful tool in the evaluation of the medical student together with the practical lessons that made the students apt to recognize main signs and symptoms in cardiopulmonary diseases(AU)
