Serum il-18 and rs187238 single nucleotide polymorphism are associated with high-density lipoprotein changes in covid-19 outpatients.

AIM: COVID-19 is an inflammatory disease and its prognosis is associated with cardiovascular risk, which can be associated with changes in lipoprotein metabolism. The single nucleotide polymorphism (SNP) rs187238 of Interleukin (IL)-18 is extensively reported in association with worsening inflammatory and cardiovascular disease (CVD). This study evaluated the association of IL-18 levels and its SNP rs187238 with lipoprotein profile changes in COVID-19 outpatients. METHODS: Observational, analytical, cross-sectional study that evaluated 250 patients with respiratory syndrome, 36% (n = 90) with COVID-19. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), apolipoproteins A-I and B (Apo A-I and Apo B) and IL-18 levels were determined. Polymorphism genotyping was done by real-time polymerase chain reaction (qPCR). The significance level was p < 0.05. RESULTS: Patients with COVID-19 showed a reduction in TC and HDL-c, without difference in IL-18. HDL-c and LDL-c had a high frequency outside the reference values. There was a negative correlation of IL-18 with HDL-c and a positive correlation with Apo B/Apo A-I ratio. The frequencies of the C (wild) and G (polymorphic) alleles between patients with and without COVID-19 followed the Hardy-Weinberg equilibrium. However, COVID-19 was associated with reduced HDL-c and Apo A-I values in patients with the CC genotype. CONCLUSION: IL-18 levels and its SNP rs187238 were associated with decreased HDL-c and Apo A-I in COVID-19 outpatients.

Identificação de competências em Saúde Coletiva na graduação em Odontologia pelo consenso entre docentes de Instituições de Ensino Superior brasileiras

O ensino da Odontologia vem passando por transformações que implicam uma mudança paradigmática de perfil profissional. A implantação das Diretrizes Curriculares Nacionais reforçou a articulação entre o Sistema Educacional e o de Saúde, além do alinhamento aos princípios do Sistema Único de Saúde. A área da Saúde Coletiva passa a ter mais centralidade, com a valorização de seus conteúdos e experiências. Objetivo: Identificar competências, em Saúde Coletiva, a serem desenvolvidas, na graduação em Odontologia, pelo consenso entre docentes de Instituições de Ensino Superior brasileiras. Método: Estudo descritivo, transversal, de caráter quantitativo. Utilizou-se a técnica Delphi em três etapas e grau de concordância estipulado em ≥ 70%. Resultados: Foram identificados, pelo consenso docente, 18 itens para o tópico conhecimentos, sendo os mais citados: determinantes sociais de saúde e processo saúde-doença. Em habilidades, houve consenso em 13 itens, sendo os mais citados: atuar a partir das necessidades de saúde do paciente e reconhecer problemas a partir da observação da realidade. Em atitudes, houve consenso em 31 itens, sendo os mais citados: autonomia e exercer liderança na equipe de saúde. Conclusão: As dimensões que caracterizam o campo da Saúde Coletiva, como saber e prática, podem ser identificados no consenso obtido. Para a formação do cirurgião-dentista, há necessidade de mudanças na organização do trabalho em saúde e no cuidado das pessoas. Indica-se mais estudos sobre o tema que incluam estratégias para diversificar o perfil docente, pois o consenso obtido refletiu, preponderantemente, a visão de docentes de Instituições de Ensino Superior públicas.

α-Lipoic Acid as Adjunctive Treatment for Schizophrenia: A Randomized Double-Blind Study.

BACKGROUND/PURPOSE: There is evidence for low endogenous antioxidant levels and oxidative imbalance in patients with schizophrenia. A previous open-label study with α-lipoic acid (ALA), a potent antioxidant, improved patients' negative and cognitive symptoms and markers of lipid peroxidation. Here we report the results of a randomized double-blind, placebo-controlled study to verify the response of patients with schizophrenia to adjunctive treatment with ALA (100 mg/d) in a 4-month follow-up. METHODS: We conducted a 16-week, double-blind, placebo-controlled study of ALA at 100 mg/d dosages. We compared negative and positive symptoms, cognitive function, extrapyramidal symptoms, body mass index, and oxidative/inflammatory parameters between placebo and control groups. RESULTS: We found no significant improvement in body mass index, cognition, psychopathology, antipsychotic adverse effects, or oxidative stress and inflammation in the experimental group compared with placebo. The whole group of patients improved in several measures, indicating a strong placebo effect in this population. A surprising finding was a significant decrease in red blood cells, white blood cells, and platelets in the group treated with ALA. CONCLUSIONS: The decrease in red blood cells, white blood cells, and platelet counts requires further investigation and attention when prescribing ALA for patients with schizophrenia.

Association of serum lipoproteins and inflammatory parameters derived from the blood test with renal function in COVID-19 outpatients

Abstract Changes in lipoprotein metabolism are among the main causes of hemodynamic impairment in renal function. COVID-19 is an multisystemic inflammatory disease, aggravating this situation. This cross-sectional study investigated the relationship of serum lipoprotein profile with inflammatory parameters and renal function in 95 COVID-19 outpatients in comparison with 173 with flu-like symptoms. Serum samples were collected for the determination of total cholesterol and fractions, apolipoproteins (Apo A-I and Apo B), urea (sUr) and creatinine (sCr). The glomerular filtration rate (eGFR) was calculated. Neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratios were calculated as inflammatory parameters derived from the blood tests. COVID-19 patients presented lower high-density lipoprotein cholesterol (HDL-c) (47.90 ± 1.543 vs. 51.40 ± 0.992) and higher PLR (190.9 ± 9.410 vs. 137.6 ± 5.534) and NLR (3.40 ± 0.22 vs. 2.80 ± 0.15). Both NLR and PLR correlated with each other (r = 0.639). Furthermore, the Apo B/Apo A-I ratio was correlated with PLR (r = 0.5818) and eGFR (r = -0.2630). COVID-19 patients classified as at high risk of developing acute myocardial infarction based on the Apo B/ Apo A-I ratio had higher values for sUr/sCr. Thus, serum apolipoproteins, PLR, and NLR could be related to renal dysfunction in COVID-19.

Estágio Comunitário Interprofissional na formação do estudante de Odontologia: relato de experiência da Universidade Federal de Goiás / Interprofessional Community Internship in Dental Student Education: experience report of the Federal University of Goiás

O Sistema Único de Saúde configura-se como um potente cenário de atuação e campo de formação interprofissional, principalmente,no que se refere aos estágios supervisionados. Esse relato de experiência (RE) tem como objetivo descrever o processo de construção do Estágio Comunitário Interprofissional (ECI) da Universidade Federal de Goiás na perspectiva da formação do cirurgião-dentista. A construção parte das experiências vivenciadas e refletidas pelas autoras/sujeitos do RE: as professoras do estágio em cada curso (enfermagem, nutrição, medicinae odontologia) e a coordenadora da integração ensino-serviço-comunidade do campus do município onde ocorre o estágio. Foram ainda consultados os planos de ensino e projetos pedagógicos dos cursos envolvidos, as memórias das oficinas avaliativas realizadas ao longo do estágioe o Manual do Estágio Comunitário. O contexto do ECI, o processo ensino-aprendizagem na formação interprofissional do estudante de odontologia, a busca da sustentabilidade do estágio e a potencialidade da aprendizagem informal são apresentados e discutidos. Considera-se os avanços históricos alcançados no percurso do ECI e os dispositivos que favorecem tais mudanças na perspectiva da educação e prática interprofissional, além dos potenciais pontos de evolução do estágio para garantir a formação integral do cirurgião-dentista, no que tange às competências colaborativas (AU).

The Unified Health System (SUS) in Brazil is a powerful scenario for action and a field of interprofessional education, particularly with regard to supervised internships. This experiencereport (ER) describes the structure of the interprofessional community internship (ICI) at the Federal Universityof Goiás from the perspective of dental education. The articleis based on the experiences and reflectionsofthe authorsand subjectsof the ER: the faculty of each study program (Dentistry, Medicine, Nursing, and Nutrition) and the coordinator for the integration of teaching, service, and community on the campus where the internshiptakes place. The pedagogical projects and teaching plans of the participating programs, the evaluation workshops during the internship, and the community internship manualwere also consulted.The ICI context, the learning process in interprofessional dental student education, the sustainability of the internship, and the potential of informal learning are presented and discussed. The historical advances made during the ICIand the means by which such changes in the perspective of education and interprofessional practice are fostered, as well as the potential points of development of the internshipto ensure the holistic education of dental studentsin terms of collaborativeskills, are considered (AU).

Tyramine exerts hypolipidemic and anti-obesity effects in vivo

Abstract Obesity and dyslipidemia are conditions often associated with cardiovascular risk, inflammation, oxidative stress, and death. Thus, a new approach has been highlighted to promote research and development of pharmacological tools derived from natural sources. Among the most widely studied groups of substances, polyphenols such as tyramine stand out. This study investigated hypolipidemic and anti-obesity properties of tyramine. Oral toxicity evaluation, models of dyslipidemia and obesity were used. To induce dyslipidemia, Poloxamer-407 (P-407) was administered intraperitoneally. In the hypercholesterolemic and obesity model, specific diet and oral tyramine were provided. After 24h of P-407 administration, tyramine 2 mg/kg (T2) decreased triglycerides (TG) (2057.0 ± 158.5 mg/dL vs. 2838 ± 168.3 mg/dL). After 48h, TG were decreased by T2 (453.0 ± 35.47 vs. 760.2 ± 41.86 mg/dL) and 4 mg/kg (T4) (605.8 ± 26.61 760.2 ± 41.86 mg/dL). T2 reduced total cholesterol (TC) after 24h (309.0 ± 11.17 mg/dL vs. 399.7 ± 15.7 mg/dL); After 48h, 1 mg/kg (T1) (220.5 ± 12.78 mg/dL), T2 (205.8 ± 7.1 mg/dL) and T4 (216.8 ± 12.79 mg/dL), compared to P-407 (275.5 ± 12.1 mg/dL). The treatment decreased thiobarbituric acid reactive substances and nitrite in liver, increased superoxide dismutase, reduced the diet-induced dyslipidemia, decreasing TC around 15%. Tyramine reduced body mass, glucose, and TC after hypercaloric feed. Treatment with 5 mg/L (0.46 ± 0.04 ng/dL) and 10 mg/L (0.44 ± 0.02 ng/dL) reduced plasma insulin (1.18 ± 0.23 ng/dL). Tyramine increased adiponectin at 5 mg/L (1.02 ± 0.02 vs. 0.83 ± 0.02 ng/mL) and 10mg/L (0.96 ± 0.04 ng/mL). In conclusion, tyramine has low toxicity in rodents, has antioxidant effect, reduces plasma triglycerides and cholesterol levels. However, further studies should be conducted in rodents and non-rodents to better understand the pharmacodynamic and pharmacokinetic properties of tyramine

Análise dos casos notificados de tuberculose na região centro-oeste / Análisis de los casos notificados de tuberculosis en la región del medio oeste / Analysis of reported cases of tuberculosis in the midwest region

Objetivo: analisar a caracterização dos casos de tuberculose notificados na região Centro-Oeste, no período de 2010 a 2019. Método: estudo ecológico, longitudinal, que utilizou, para análise estatística, o programa Microsoft Excel 2010 (cálculo das frequências) e o teste Chi quadrado (X2) (verificar se as frequências diferiam). Resultados: observou-se maior prevalência da tuberculose em pacientes do sexo masculino (70,8%), pertencentes à faixa etária entre 25-34 anos (23,6%), da raça/cor parda (53%), moradores da zona urbana (83%) e que não tiveram sua escolaridade declarada (28,6%). Ao considerar aspectos epidemiológicos, destacaram-se casos novos (82,6%), na forma pulmonar (85,6%), com soropositividade negativa ao HIV (60,4%) e que não tiveram declarado o hábito de tabagismo (51,1%). Conclusão: os casos de tuberculose notificados na região Centro-Oeste assemelham-se aos encontrados na literatura, reforçando que a tuberculose é uma doença infecciosa atual e sua erradicação ainda exige muito trabalho e políticas públicas efetivas.

Objetivo: analizar la caracterización de los casos de tuberculosis reportados en la región Medio Oeste, en el período de 2010 a 2019. Método: estudio ecológico, longitudinal, que utilizó, para el análisis estadístico, el programa Microsoft Excel 2010 (cálculo de frecuencias) y la prueba de Chi cuadrado (X2) (comprobar si las frecuencias diferían). Resultados: se observó una mayor prevalencia de tuberculosis en pacientes varones (70,8%), con edades comprendidas entre 25-34 años (23,6%), mestizos/color (53%), residentes urbanos (83%) y a quienes no se les declaró la escolaridad (28,6%). Al considerar los aspectos epidemiológicos, se destacaron los nuevos casos (82,6%), en la forma pulmonar (85,6%), con seropositividad VIH negativa (60,4%) y que no habían declarado fumar (51,1%). Conclusión: los casos de tuberculosis reportados en la región del Medio Oeste son similares a los encontrados en la literatura, reforzando que la tuberculosis es una enfermedad infecciosa actual y su erradicación aún requiere mucho trabajo y políticas públicas efectivas.

Objective: to analyze the characterization of tuberculosis cases reported in the Midwest region, in the period from 2010 to 2019. Method: ecological, longitudinal study, which used, for statistical analysis, the Microsoft Excel 2010 program (calculation of frequencies) and the Chi square test (X2) (check if the frequencies differed). Results: a higher prevalence of tuberculosis was observed in male patients (70.8%), aged between 25-34 years (23.6%), mixed race/color (53%), urban residents (83%) and who did not have their schooling declared (28.6%). When considering epidemiological aspects, new cases (82.6%), in the pulmonary form (85.6%), with HIV-negative seropositivity (60.4%) and who had not declared smoking (51.1%) were highlighted. Conclusion: the cases of tuberculosis reported in the Midwest region are similar to those found in the literature, reinforcing that tuberculosis is a current infectious disease and its eradication still requires a lot of work and effective public policies.

Hypertriglyceridemia promotes dysfunctions in high-density lipoprotein increasing the cardiovascular risk

Abstract Hypertriglyceridemia is associated with several metabolic diseases. The triglycerides (TG) disrupt the cholesterol reverse transport and contribute to increased levels of low-density lipoprotein (LDL). High-density lipoprotein (HDL) acts in cholesterol reverse transport as an anti-inflammatory and antioxidant. This study aims to investigate the role of hypertriglyceridemia in the functionality of HDL. Individuals were divided into 4 groups based on high or low HDL-c and triglycerides levels. Biochemical and anthropometric analysis were performed. This study demonstrated that triglycerides promote dysfunctions on HDL, increasing the cardiovascular risk. Blood pressure was higher in subjects with low HDL. Women presented higher levels of HDL-c and low percentage of fat mass. The highest levels of triglycerides were observed in older age. In addition, high levels of triglycerides were associated with higher total cholesterol and LDL-c levels, non-HDL-c, non-esterified fatty acids, and blood glucose, increasing in the ratio of non-HDL-c/HDL-c and ApoB/ApoA-I. The increase of triglycerides levels progressively impairs the antioxidant capacity of HDL, probably due to a higher occurrence of fatty acid peroxidation in individuals with hypertriglyceridemia. Patients with high HDL and low TG levels increased the Lag Time. Furthermore, a positive correlation was found between TG versus HDL particle size, variables that depend on age and anthropometric parameters.

Health education and the municipal health network: practices of nutritionists. / Educação em saúde na rede municipal de saúde: práticas de nutricionistas.

Health education must be seen as an instrument used to promote quality of life. The objective of this study was to evaluate health education practices of nutritionists in a municipal health network. This is a qualitative study using Grounded Theory. Interviews and observation of educational activities were carried out. The use of materials was evaluated, together with attempts to engage the service users. Five analysis categories were applied. The intention of raising awareness and changing habits highlights the preference of professionals toward actions that are articulated and consistent with reality. Productivity valorization, insufficient training, and lack of physical structure were mentioned as restrictions. Most respondents did not evaluate results; they believe in sharing knowledge as a process that transforms reality; and defend the multidisciplinary approach and care by putting the concepts of integrality and equity into practice. The nutritionists' concepts of health education guide their professional performance, as they reflect the perspectives of the educational practices adopted.

A educação em saúde deve ser vista como instrumento de promoção da qualidade de vida. O objetivo do presente trabalho foi avaliar práticas de educação em saúde de nutricionistas de rede municipal de saúde, em uma cidade da região centro-oeste. Optou-se pela pesquisa qualitativa e, especificamente, pela teoria fundamentada nos dados. Foram realizadas entrevistas e observação de atividades educativas e, por meio dessas, avaliou-se a utilização de recursos materiais, estratégias e, ainda, a tentativa de envolver os usuários do serviço. Foram definidas cinco categorias de análise. A intenção da conscientização e a mudança de hábitos salienta a predileção do profissional por ações articuladas e coerentes com a realidade. Valorização da produtividade, insuficiência de capacitação, a falta de estrutura física foi citada como limitação. A maioria das entrevistadas não avalia resultados; acredita no compartilhamento de saberes como processo transformador da realidade e defende o trabalho multiprofissional e o cuidado em colocar em prática a integralidade e a equidade. As concepções de educação em saúde dos nutricionistas implicam em sua atuação profissional pois refletem a perspectiva das práticas educativas desenvolvidas.

Educação em saúde na rede municipal de saúde: práticas de nutricionistas / Health education and the municipal health network: practices of nutritionists

Resumo A educação em saúde deve ser vista como instrumento de promoção da qualidade de vida. O objetivo do presente trabalho foi avaliar práticas de educação em saúde de nutricionistas de rede municipal de saúde, em uma cidade da região centro-oeste. Optou-se pela pesquisa qualitativa e, especificamente, pela teoria fundamentada nos dados. Foram realizadas entrevistas e observação de atividades educativas e, por meio dessas, avaliou-se a utilização de recursos materiais, estratégias e, ainda, a tentativa de envolver os usuários do serviço. Foram definidas cinco categorias de análise. A intenção da conscientização e a mudança de hábitos salienta a predileção do profissional por ações articuladas e coerentes com a realidade. Valorização da produtividade, insuficiência de capacitação, a falta de estrutura física foi citada como limitação. A maioria das entrevistadas não avalia resultados; acredita no compartilhamento de saberes como processo transformador da realidade e defende o trabalho multiprofissional e o cuidado em colocar em prática a integralidade e a equidade. As concepções de educação em saúde dos nutricionistas implicam em sua atuação profissional pois refletem a perspectiva das práticas educativas desenvolvidas.

Abstract Health education must be seen as an instrument used to promote quality of life. The objective of this study was to evaluate health education practices of nutritionists in a municipal health network. This is a qualitative study using Grounded Theory. Interviews and observation of educational activities were carried out. The use of materials was evaluated, together with attempts to engage the service users. Five analysis categories were applied. The intention of raising awareness and changing habits highlights the preference of professionals toward actions that are articulated and consistent with reality. Productivity valorization, insufficient training, and lack of physical structure were mentioned as restrictions. Most respondents did not evaluate results; they believe in sharing knowledge as a process that transforms reality; and defend the multidisciplinary approach and care by putting the concepts of integrality and equity into practice. The nutritionists' concepts of health education guide their professional performance, as they reflect the perspectives of the educational practices adopted.

The Effects of the Alkaloid Tambjamine J on Mice Implanted with Sarcoma 180 Tumor Cells.

The tambjamines are a small group of bipyrrolic alkaloids that, collectively, display a significant range of biological activities including antitumor, antimicrobial and immunosuppressive properties. The key objective of the present study was to undertake preclinical assessments of tambjamine J (T-J) so as to determine its in vivo antitumor effects. To that end, sarcoma 180 cells were transplanted in mice and the impacts of the title compound then evaluated using a range of protocols including hematological, biochemical, histopathological, genotoxic and clastogenic assays. As a result it was established that this alkaloid has a significant therapeutic window and effectively reduces tumor growth (by 40 % and 79 % at doses of 10 and 20 mg/kg/day, respectively). In this regard it displays similar antitumor activity to the anticancer agent cyclophosphamide and alters animal weight in an analogous manner.

Interleukin-18 promoter -137 G/C polymorphism (rs187238) is associated with biochemical markers of renal function and cardiovascular disease in type 2 diabetes patients.

BACKGROUND: Interleukin-18 (IL-18), a proinflammatory and proatherogenic cytokine, has been associated with type 2 diabetes, metabolic syndrome, stroke and coronary artery disease. Some studies have indicated that the IL-18 promoter -137 G/C polymorphism seems to be associated with changes in the IL-18 expression and may contribute to the development of cardiovascular disease (CVD). The aim of this study was to evaluate the association between -137 G/C polymorphism and the levels of IL-18, biochemical markers for cardiovascular disorders, anthropometric profile and cardiovascular disease in Brazilian patients with type 2 diabetes (T2DM). DESIGN & METHODS: Study subjects comprised 125 T2DM patients undergoing follow-up at a reference endocrinology service in northeastern Brazil. The -137G/C polymorphism in the IL-18 gene and serum IL-18 levels were determined by using allele-specific polymerase chain reaction (PCR) and enzyme-linked immune assay (ELISA), respectively. The anthropometric parameters were assessed using a Body Composition Monitor with Scale, and the laboratory data were measured using an automatic analyzer as well as spectrophotometric analysis. RESULTS: The genotype distribution of IL-18 -137 G/C genetic polymorphism was significantly different among T2DM patients with and without CVD. The results show an association between the CC genotype of -137G/C polymorphism and CVD in T2DM patients (p < 0.001). Serum levels of IL-18 were significantly higher in CC carriers (843.1 pg/mL) compared with GG or GC carriers (303.6 pg/mL and 292.0 pg/mL, respectively). In addition, the present study showed that carriers of the CC genotype also had significantly higher concentrations of creatinine and albuminuria than carriers of the GG or GC genotypes (p < 0.05 in both). CONCLUSION: These results suggest that Brazilian T2DM patients with the CC genotype seem to show a predisposition to CVD, as well as an elevation in markers of renal function.

Comparison of early cardiovascular risk among Brazilian and African university students.

Cardiovascular diseases are among the main causes of mortality worldwide, and dyslipidemia is a principal factor risk. Hence the study of biochemical markers is necessary for early diagnosis. OBJECTIVES: Evaluate biomarkers to diagnose the risks of cardiovascular diseases in healthy Brazilian and African young adults. DESIGN & METHODS: Weight, height, waist circumference, percentage of body fat and systemic blood pressure were measured; and fasting blood samples were taken for biochemical analysis. Triglycerides, total cholesterol, HDL-c, and apolipoproteins A-I and B were measured on automated equipment using commercially available kits, in addition to the tests of antioxidant capacity of HDL and the enzymatic activity of Paraoxonase 1. RESULTS: After statistical analysis, it was found that BMI, WC, fat (%), triglycerides, ApoB/ApoA-I ratio and Vmax were higher in Brazilians, while HDL-c, ApoA-I, Lag Time, Vmax and PON1 activity were higher in Africans. In Brazilians, the ApoB/ApoA-I ratio was related to obesity factors and lipid profile, but in Africans it was related only to lipids. The antioxidant capacity of HDL and PON1 activity was better in Africans. Through independence testing, we observed an association with moderate risk of myocardial infarction with gender in Africans. In the binary logistic regression analysis, it was found that men in general - and particularly African men - have higher risk of myocardial infarction than women; Odds Ratio 2144 (CI95%: 1343-3424) and 2281 (CI95%: 1082-4811), respectively. CONCLUSIONS: The anthropometric and biochemical parameters of Brazilians, especially men, predispose them to greater risks of cardiovascular diseases.

Gastrointestinal effects of standardized Brazilian phytomedicine (Arthur de Carvalho Drops®) containing Matricaria recutita, Gentiana lutea and Foeniculum vulgare.

Arthur de Carvalho Drops® (ACD) is a traditional Brazilian herbal medicine used to treat functional gastrointestinal disorders (FGIDs). ACD is a formulation of herbal extracts from Matricaria recutita (chamomile), Foeniculum vulgare (fennel) and Gentiana lutea L. (gentian). Considering the popular use for FGIDs, the aim of this work was to investigate the ACD effect on gastric and intestinal parameters with emphasis in a mechanistic approach using isolated duodenal preparations of rodents. Analytical method was developed and validated for quantify three actives principles/markers (Apigenin-7-glucoside, gentiopicroside and anethole) in ACD. The treatment with ACD significantly reduced the emetogenic stimuli induced by cisplatin in rats, showed a laxative effect, reduced the bethanechol-enhanced gastrointestinal transit and completely reversed the contraction induced by carbachol in rat duodenum. However, ACD did not alter the secretory gastric volume or total gastric acidity. The ACD affect the contractions of duodenal smooth muscle mediated by Ca2+ channels and it is also able to inhibit the contractile response mediated by the release from its intracellular store. Furthermore, the relaxant effects of ACD appear independent of the nitric oxide pathway in rat duodenum. These results suggest that ACD could be beneficial for the treatment of disorders of the gastrointestinal tract.

Avaliação do Impacto dos Programas de Reorientação Profissional em Cursos da Área da Saúde / Evaluation of the Impact of Professional Reorientation Programs in Health Courses

RESUMO Problematizou-se a percepção dos atores dos cursos da área da saúde da Universidade Federal de Goiás quanto ao impacto do Programa Nacional de Reorientação da Formação Profissional em Saúde articulado ao Programa de Educação pelo Trabalho para a Saúde (Propet-Saúde) na reestruturação curricular. Realizou-se um estudo transversal com a participação de 300 atores de sete cursos, entre estudantes, tutores, preceptores, professores e coordenadores de graduação. Para isto, foi construído e validado um instrumento atitudinal do tipo Likert com duas dimensões: D1: reestruturação curricular e os princípios do Propet-Saúde e D2: projeto pedagógico do curso e o Propet-Saúde. A validação de conteúdo do instrumento considerou as equivalências semântica, cultural e conceitual, atribuição de pontos (de 1 a 4) e randomização das assertivas. A pontuação gerou três intervalos interpretativos: de 1 a 1,99 (insatisfação); 2 a 2,99 (relativa satisfação) e 3 a 4 (satisfação). Foi feito pré-teste e, após a inserção das contribuições, o instrumento foi aplicado. Após a aplicação, o instrumento foi validado estatisticamente quanto à dispersão e confiabilidade. Foi realizada análise fatorial considerando função e curso. A dispersão por meio da correlação linear evidenciou perda de quatro asserções (11,77%) denotando excelente validação de conteúdo; a confiabilidade foi de 0,93 (p < 0,01), evidenciando ótima densidade estatística. As médias gerais de D1 e D2 foram 3,09 e 3,11 respectivamente, indicando satisfação entre os respondentes. Conclui-se que os participantes reconhecem importantes avanços, como a reestruturação curricular a partir dos programas, inserção dos alunos já no início do curso em cenários de prática, estímulo à interdisciplinaridade, diversificação de práticas avaliativas e uso de metodologias ativas. Na análise fatorial, verificou-se que os cursos de Medicina e Biomedicina mostram-se mais refratários às contribuições dos programas Pró-Saúde e Pet-Saúde. Outros desafios foram apontados, como carga horária excessiva, que dificulta a integração entre cursos e o desenvolvimento da competência em administração/gestão ainda incipiente. A junção dos programas na forma Propet-Saúde deve ser fortalecida, pois evidenciou grande assertividade na organização curricular, bem como na integração ensino-serviço, aspecto central para o fortalecimento do Sistema Único de Saúde (SUS).

ABSTRACT This study problematized the perception of stakeholders in the health care field at the Federal University of Goiás regarding the impact of the National Program for Professional Training and Reorientation in Health under the Program for Education for Work in Health (Propet-Saúde) on curricular restructuring. This cross-sectional study included 300 students, tutors, preceptors, teachers and graduation coordinators from seven courses. A Likert-type instrument was constructed and validated with the following dimensions: D1: curricular restructuring and the principles of Propet-Saúde and D2: the pedagogical project of the Propet-Saúde course. The instrument was validated considering semantic, cultural and conceptual equivalence, assignment of points (from 1 to 4), and randomization of the assertions tested. The score generated three interpretive intervals: from 1 to 1.99 (dissatisfaction); 2 to 2.99 (relative satisfaction) and 3 to 4 (satisfaction). The instrument was applied following a pre-test and the placement of the contributors. The instrument was then statistically validated for dispersion and reliability. Factorial analysis was performed considering function and course. Dispersion through linear correlation showed a loss of 4 assertions (11.77%), signifying excellent content validation. Reliability was 0.93 (p < 0.01), showing excellent statistical density. The general averages of D1 and D2 were 3.09 and 3.11 respectively, indicating satisfaction among the respondents. In conclusion, the participants recognize important advances such as curricular restructuring from these programs, placement of students already at the beginning of the course into practice scenarios, motivation toward interdisciplinarity, diversification of evaluation practices, and use of active methodologies. After factorial analysis, it was shown that medical and biomedical courses are more resistant to the contributions of the Pró-Saúde and PET-Saúde Programs and other hurdles were identified, such as excessive workload that hinders the integration of courses and the development of still-evolving administration and management skills. The interaction of the programs in Propet-Saúde should be strengthened, as it demonstrated significant assertiveness in curricular organization as well as in the teaching and service integration, a central aspect for the strengthening of Brazilian Public Health.

Estudantes de Odontologia cotistas e o instrumental odontológico / Dentistry quota students and dental instruments

A Política de Cotas para o ensino superior no Brasil propõe a reserva de vagas para estudantes oriundos de escolas públicas, pretos, pardos, indígenas e de baixo poder aquisitivo. A aquisição do instrumental exigido no curso de Odontologia representa uma dificuldade para a permanência da maioria desses estudantes. O objetivo deste estudo foi conhecer a experiência de cotistas em relação à aquisição e uso dos instrumentais e materiais para as aulas práticas de um curso de graduação em Odontologia. Foi realizada pesquisa de abordagem qualitativa, por meio de entrevistas semiestruturadas, com 16 estudantes de todos os anos do curso, de todas as modalidades de cotas segundo a Lei 12.711/2012, escolhidos de forma aleatória. O tratamento dos dados baseou-se na modalidade temática da Análise de Conteúdo, de onde emergiram três categorias: "Inclusão", "Exclusão" e "Discriminação". O apoio da comunidade universitária, família e colegas figura como mecanismo de inclusão, por favorecer a permanência desses estudantes, assim como o programa de empréstimo de instrumental a estudantes de baixa renda dessa Universidade. Por outro lado, o programa também foi considerado fator de exclusão por não oferecer todo instrumental solicitado e alguns apresentarem baixa qualidade. Os entrevistados relataram sofrer discriminação, por pequena parte dos professores, e se sentirem excluídos quando utilizam instrumentos fora do padrão exigido. O desafio para a instituição pesquisada é garantir as adequadas condições materiais para o aprendizado desses estudantes, propor estratégias para a melhoria do programa de instrumental e implementar ações visando à capacitação docente (AU).

The Quota Policy for higher education in Brazil proposes to reserve vacancies for black, brown and indigenous students from public and lowincome schools. The acquisition of the required instruments in the dentistry course represents a difficulty for the permanence on the course for most of these students. The objective of this study was to understand the experience of quota students regarding the acquisition and use of instruments and materials for the practical classes of an undergraduate course in dentistry. Qualitative research was conducted through semi-structured interviews with 16 students chosen at random from all years of the course, and from all quota groups according to Law 12.711 / 2012. The treatment of the data was based on the thematic modality of Content Analysis, from which three categories emerged: "Inclusion", "Exclusion" and "Discrimination". The support of the university community, family and colleagues appears as an inclusion mechanism, as it favors the permanence of these students, as well as the instrumental loan program for low-income students of this University. On the other hand, the program was also considered an exclusion factor because it did not offer all the requested instruments and some were of low quality. Respondents reported being discriminated against by a small number of teachers and feeling excluded when using non-standard instruments. The challenge for the researched institution is to guarantee the adequate material conditions for the education of these students, to propose strategies for the improvement of the instrumental program and to implement actions aiming at teacher development (AU).

α-Lipoic Acid as Adjunctive Treatment for Schizophrenia: An Open-Label Trial.

PURPOSE/BACKGROUND: Accumulating evidence suggests an involvement of oxidative stress in the pathophysiology of schizophrenia. This offers a hypothesis-derived therapeutic approach to hinder oxidative damage and its clinical sequelae. α-Lipoic acid (ALA) is a powerful natural antioxidant indicated to treat diabetic neuropathy. METHODS/PROCEDURES: In this pilot investigation, we administered ALA (100 mg/d) for 4 months, as an adjunct to antipsychotic medication, to 10 patients with schizophrenia. FINDINGS/RESULTS: We found robust improvement in measures of psychopathology (63.9% reduction in Brief Psychiatric Rating Scale scores), neurocognitive parameters, extrapyramidal symptoms, and decreased lipid peroxidation. IMPLICATIONS/CONCLUSIONS: If larger, double-blind, placebo-controlled studies confirm these preliminary findings, ALA could prove useful as adjunctive therapy for schizophrenia.

Perception of Dentists about the Functioning of Emergency Public Dental Services

Objective: To know the perception of dentists about the functioning of emergency public dental services (PEDS). Material and Methods: Cross-sectional exploratory study performed in Goiania, a large municipality in the mid-west of Brazil. Participated as subjects the dentists of all ten municipal PEDS. The perception was measured by Likert scale ranging from 1 to 5, where value 5 represented maximum agreement with assertions contained in a questionnaire about the functioning of the services. Results: The final sample consisted of 44 dentists (Response rate=70%.) The perception of the professionals, measured by average agreement with the assertions, ranged from 3.54 and 4.68 in a maximum score of 5.00. Conclusion: For all items discussed there was a favorable perception of the participants. In the perception of the professionals, emergency public dental services meet a spontaneous demand, commonly of endodontic emergencies, with performance of non-conclusive procedures and dental extraction. The professionals recognize that there is a need to improve the embracement of patients, as well as to adopt clinical protocols for the treatment, yet there are flaws in the system of reference of patients, in continuing education of professionals and in the conditions of provision of the services to the population.

Dengue in the State of Rio Grande do Norte, Brazil, 2010-2012.

OBJECTIVE: To present results of virological surveillance and epidemiological aspects of dengue in the State of Rio Grande do Norte, Brazil. METHODS: A total of 1581 cases, reported from 2010 to 2012 at various health centres in the state, were analysed by viral isolation and/or RT-PCR for viral detection and typing. To identify whether different genotypes were circulating in the state during this period, sequencing of the complete E gene for DENV (1485 bp in length) was performed directly from patient serum samples. RESULTS: All four serotypes of dengue virus circulated in Rio Grande do Norte, with the introduction of DENV-4 in the state in 2011. In 2012, DENV-4 represented 100% of positive confirmed cases. 53.97% of cases occurred in Natal. Case numbers peaked in April (21%) and May (23%). Genetic characterisation of circulating strains confirmed the circulation of genotypes V, south-east Asian/American and II, respectively, for DENV-1, DENV-2 and DENV-4. CONCLUSIONS: This work furthers a better understanding of dengue viruses in the State of Rio Grande do Norte. Strengthening control efforts in the region is important considering the impact of dengue.

Cytotoxic and toxicological effects of phthalimide derivatives on tumor and normal murine cells.

Eleven phthalimide derivatives were evaluated with regards to their antiproliferative activity on tumor and normal cells and possible toxic effects. Cytotoxic analyses were performed against murine tumors (Sarcoma 180 and B-16/F-10 cells) and peripheral blood mononuclear cells (PBMC) using MTT and Alamar Blue assays. Following, the investigation of cytotoxicity was executed by flow cytometry analysis and antitumoral and toxicological potential by in vivo techniques. The molecules 3b, 3c, 4 and 5 revealed in vitro cytotoxicity against Sarcoma 180, B-16/F-10 and PBMC. Since compound 4 was the most effective derivative, it was chosen to detail the mechanism of action after 24, 48 and 72 h exposure (22.5 and 45 µM). Sarcoma 180 cells treated with compound 4 showed membrane disruption, DNA fragmentation and mitochondrial depolarization in a time- and dose-dependent way. Compounds 3c, 4 and 5 (50 mg/kg/day) did not inhibit in vivo tumor growth. Compound 4-treated animals exhibited an increase in total leukocytes, lymphocytes and spleen relative weight, a decreasing in neutrophils and hyperplasia of spleen white pulp. Treated animals presented reversible histological changes. Molecule 4 had in vitro antiproliferative action possibly triggered by apoptosis, reversible toxic effects on kidneys, spleen and livers and exhibited immunostimulant properties that can be explored to attack neoplasic cells.