AVALIAÇÃO DO COMPRIMENTO DA COROA CLÍNICA DOS DENTES ÂNTERO-INFERIORES EM PACIENTES TRATADOS COM APARELHO REGULADOR DE FUNÇÃO FRÄNKEL-2

O objetivo do estudo consistiu em verificar uma possível alteração no tamanho da coroa clínica dos dentes ântero-inferiores em 50 indivíduos portadores de má Oclusão de Angle Classe II. A amostra foi dividida em 2 grupos: um grupo tratado com 25 indivíduos (14 do sexo masculino e 11 do feminino) com idade média em T1 (tempo inicial do tratamento) de 11 anos (dp = 9 meses), e em T2 (tempo pós-tratamento) de 12 anos e 7 meses (dp = 7 meses), tratados com o aparelho regulador de função Fränkel-2, durante 18 meses; e, um grupo controle com 25 indivíduos (12 do sexo masculino e 13 do feminino) com idade média em T1 de 10 anos e 3 meses (dp = 11 meses) e em T2 de 12 anos e 1 mês (dp = 11 meses). Os 100 modelos em gesso dos indivíduos foram analisados e comparados em relação ao início e ao término do tratamento por meio de um paquímetro digital, utilizando-se como medida a distância da borda incisal até a porção mais côncava da margem gengival dos incisivos e caninos inferiores. Os dados foram analisados por meio do teste t de Student e teste t pareado. Dentre os seis dentes ântero-inferiores, todos apresentaram aumento significante no grupo tratado, e apenas três dentes (33,42 e 43) apresentaram aumento significante no grupo controle. Já em relação ao grupo tratado e o grupo controle em T2, houve um aumento significante da coroa nos dentes 32, 33 e 43. Houve um aumento estatisticamente significante em apenas dois dentes (31 e 41) em ambos os sexos. Os resultados não demonstraram relevância estatística quando comparados com a alteração do tamanho da coroa no decorrer da idade. Conclui-se que as medidas das coroas clínicas dos dentes diferiram entre os grupos, sendo maior no grupo tratado. O aumento da coroa clinica dos dentes, não esta relacionado somente pela presença de inclinação para vestibular dos mesmo, mas pode ser considerado como multifatorial.

COMPARAÇÃO DA UTILIZAÇÃO DAS TÉCNICAS WATSU E RELAXAMENTO AQUÁTICO EM FLUTUAÇÃO ASSISTIDA NOS SINTOMAS DE ANSIEDADE, DEPRESSÃO E PERCEPÇÃO DA DOR

Este estudo teve como objetivo comparar o efeito do método Watsu e do relaxamento aquático em flutuação assistida em piscina, no tratamento da dor crônica. Também objetiva avaliar o efeito dos sintomas de depressão e ansiedade como co-fatores nesses tratamentos. A amostra é constituída por 23 indivíduos de ambos os sexos, acima de 18 anos. No método Watsu são atendidas 13 pessoas, sendo 11 mulheres e 02 homens. Na técnica de relaxamento assistido são atendidas 10 pessoas, sendo 07 mulheres e 03 homens, entre pacientes que procuram tratamento fisioterápico no centro clínico Escola de Fisioterapia da UMESP, com dor crônica. Os dados são colhidos através de entrevista estruturada. Aplicada escala associada para avaliar percepção de dor, questionário de avaliação de sintomas de depressão Beck, de Ansiedade Idate-Estado e Ansiedade Idate-Traço. Devido ao pequeno tamanho da amostra, as comparações entre os dois tipos de tratamento (Watsu e relaxamento) e, como os resultados obtidos são equivalentes em ambos os procedimentos, optou se por apresentar os resultados apenas das análises por métodos paramétricos (teste t de média, regressão linear e análise de variância). Não são observadas diferenças significativas entre os dois grupos em relação aos escores de ansiedade e depressão antes e após a realização da pesquisa. Em relação à comparação entre os dois grupos pesquisados, quanto à percepção de dor, observou-se que tanto o método de Watsu quanto as técnicas de relaxamento mostram um efeito significativo na redução da dor. Esta pesquisa sugere que o método Watsu é tão eficaz para o controle da dor quanto o método de relaxamento, porém, o grupo de pacientes submetidos ao método Watsu é constituído por pessoas com níveis de intensidade de dor iniciais maiores do que o grupo de relaxamento. Com isso, pode-se supor que a demanda por eficácia clinica é maior para o método Watsu. Outro achado interessante é que os níveis de ansiedade ou depressão presentes nos participantes não parecem influenciar a resposta ao efeito do tratamento sobre a dor. Novos estudos do tipo duplo-cego controlados são necessários para, além de confirmar a eficácia do método, ajudar a entender quais detalhes dos procedimentos da técnica Watsu são mais eficazes para cada tipo de dor e de estado afetivo do paciente.

Validação do conteúdo do diagnóstico de enfermagem proteção ineficaz para pacientes submetidos à hemodiálise

Methodological study, in order to validate the content of the nursing diagnosis protection ineffective in patients undergoing hemodialysis. The research took place in two stages, namely: concept analysis and content analysis of the instrument by experts. T he first step was operationalized through an integrative review of the databaes LILACS, CINAHL, PubMed, Scopus and Cochrane, with the key words protection and hemodialysis, in October and November 2013. The sample consisted of 32 articles, which were analyz ed by a c areful reading to identify the sections that correspond ed to the defining attributes , antecedents and consequences of protection in patients undergoing hemodialysis. T he interpretation for the diagnosis of effective protection was made by transpos ing the components of the diagnosis (definition, defining characteristics and related factors) to the denial form . In the second stage, we elaborated an instrument with the components of the nursing diagnostic s studied and proceeded to the analysis conduct ed in April 2014 by 22 specialists in nephrology and in the terminology of the NANDA International, selected by means of th e Lattes Platform . We used the binomial test to assess the proportion of experts who rated each item as appropriate, considering a si gnificance level of 5%. The project was approved by the Ethics Committee of the institution responsible for the research, an opinion on num b er 387 837 and CAAE 18486413.0.0000.5537. The results show that the proposal for the nursing diagnosis of ineffectiv e protection in patients undergoing hemodialysis is: definition - the same as that presented in the NANDA International Taxonomy II, location - domain safety / protection and class injury. Related factors are: Absence of routine vaccines; Non - adherence to care related to vascular access; Non - adherence to infection control measures; Non - adherence to prescribed diet; Non - adherence to drug therapy; Presence of comorbidities; Drug abuse; Immune disorders; Extremes of age; Abnormal blood profiles; Drugs that red uce immunity; and side effects and adverse treatment - related. The defining characteristics are: Presence of invading the bloodstream; Nutritional disorders; Increase in the number of hospitalizations; Uncontrolled dry weight; Infected vascular access; Vasc ular inadequate access; Increased blood pressure; fever; Bleeding disorder; Disability immunity; fatigue; weakness; itching; and maladaptive response to stress. It follows that the identification of the defining attributes, antecedents and consequences inc reased the wealth of vocabulary, allowing the construction of theoretical and empirical definitions for a broader understanding of the concept protection. Furthermore, the study contributed to the enrichment of nursing specific body of knowledge, as well a s in the direction of nursing care for patients undergoing hemodialysis.

Avaliação da atividade anti-inflamatória do extrato aquoso, frações e compostos identificados nos frutos de Hancornia Speciosa Gomes (Apocynaceae)

Hancornia speciosa Gomes (Apocynaceae), popularly known as ‘mangabeira’, has been used in folk medicine to treat inflammatory disorders, hypertension, dermatitis, diabetes, liver diseases and stomach disorders. Regarding the Hancornia speciosa fruits, the ethnobotany indicates its use especially for treating inflammation and tuberculosis. However, no study has been done so far to prove such biological activities. The objective was evaluation anti-inflammatory activity from the fruits of Hancornia speciosa Gomes (mangabeira). Aqueous extract was prepared by decoction, subsequently submitted the liquid-liquid fractionation. The secondary metabolites were identified by high performance liquid chromatography coupled with detector diode array (HPLC-DAD) and liquid chromatography diode array detector coupled with mass spectrometry (LC-DAD-MS). The anti-inflammatory properties of the aqueous extract, dichloromethane (CH2Cl2), ethyl acetate (EtOAc) and n-butanol (n-BuOH) fractions of the fruits from H. speciosa, as well as rutin and chlorogenic acid were investigated using in vitro and in vivo models. In vivo tests comprised the xylene-induced ear edema that was measured the formation of edema, carrageenan-induced peritonitis was evaluated the total leukocytes at 4h and zymosan-induced air pouch was measured the total leukocytes and differential cell count at 6, 24 and 48 hours, whereas in vitro tests were evaluated levels of cytokines IL-1β, IL-6, IL-12 and TNF-α using ELISA obtained of carrageenan-induced peritonitis model. The results showed the presence of rutin and chlorogenic acid were detected in the aqueous extract from H. speciosa fruits by HPLC-DAD and LC-DAD-ME. Furthermore, the aqueous extracts and fractions, as well as rutin and chlorogenic acid significantly inhibited the xilol-induced ear edema and reduced cell migration in the animal models such as carrageenan-induced peritonitis and zymosan-induced air pouch. In addition, reduced levels of cytokines IL-1β, IL-6, IL-12 and TNF-α were observed. This is the first study that demonstrated the anti-inflammatory effect of aqueous extract from Hancornia speciosa fruits against different inflammatory agents in animal models, suggesting that their bioactive molecules, especially rutin and chlorogenic acid contributing, at least in part, to the anti-inflammatory effect of aqueous extract. These findings support the widespread use of Hancornia speciosa in popular medicine and demonstrate that this aqueous extract has therapeutic potential for the development of a herbal drugs with anti-inflammatory properties.

Spondias tuberosa Arr. (UMBU): estudo fitoquímico e avaliação do potencial anti-inflamatório

Spondias tuberosa Arruda (Anacardiaceae) is a fruitful tree popularly known as umbuzeiro, tapereba or umbu. It is a native and endemic species from Brazil, widespread in Brazilian Northeast. The species is important in folk medicine of the semi-arid Northeast, where it is mainly used to treat various inflammatory conditions, digestive problems as well as viral and bacterial infections. However, despite the common use in folk medicine, there are scarce pharmacological and phytochemicals studies that afford scientific evidence to its popular use. Therefore, this study aimed to characterize the chemical markers in S. tuberosa leaves extract, obtained by maceration ethanol:water (70:30, [v/v]), and evaluate its anti-inflammatory potential in vivo. The phytochemical profile in TLC analysis suggested the occurence of the flavonoids rutin and isoquercitrin. HPLC analysis enabled us to confirm the presence of flavonoids and also, were detected the phenolic acids, chlorogenic acid and caffeic acid. In addition was developed and validated a HPLC method to evaluate the content of the identified compounds in S. tuberosa leaves extract according to RDC 899/2003 of ANVISA and ICH Guidelines 2005. In order to evaluate the anti-inflammatory potential of S. tuberosa leaves extract, the peritonitis and paw edema models induced by carrageenan were used, administration i.p. in mice. The results highlighted the anti-inflammatory property in vivo at 125, 250 and 500 mg/kg since a decrease in leukocyte influx to the site of inflammation, diameter of the edema and the level of myeloperoxidase were observed when compared to the drug control dexamethasone (2 mg/kg, i.p. route). Taken together, the results pointed out S. tuberosa as a potential species for developing phytotherapic derivatives in according to its popular use. With regard to the characterization markers, chlorogenic acid, caffeic acid, rutin and isoquercitrin were identified and quantified in Spondias tuberosa leaves extract so they could be used in quality control analyses of the raw material and extracts of this species.

Avaliação do acesso aos serviços de reabilitação física para vítimas de acidentes de trânsito: caminhos para melhoria da qualidade do sistema de saúde

The Physical Rehabilitation services (PR) are of fundamental importance in combating the global epidemic of Traffic Accidents (TA). Considering the numerous physical and social consequences of the survivors, quality problems in access to PR are a hazard to recovery of victims. It is necessary to improve the management of quality of services, assessing priority dimensions and intervening in their causes, to ensure rehabilitation available in time and suitable conditions. This study aimed to identify barriers to access to rehabilitation considering the perception of TA victims and professionals. The aim is also to estimate the access to rehabilitation and their associated factors. This is a qualitative and quantitative study of exploratory nature developed in Natal / RN with semi-structured interviews with 19 health professionals and telephone survey to 155 victims of traffic accidents. To explore barriers to access the speeches were transcribed and analyzed using the Alceste software (version 4.9). During the interviews used the following guiding question: “What barriers hinder or prevent access to physical rehabilitation for victims of traffic accidents?”. The names of classes and axes resulting from Alceste was performed by ad hoc query to three external researchers with subsequent consensus of the most representative name of analysis. We conducted multivariate analysis of the influence of the variables of the accident, sociodemographic, clinical and assistance on access to rehabilitation. Associations with p <0.20 in the bivariate analysis were submitted to logistic regression, step by step, with p <0.05 and confidence interval (CI) of 95%. The main barriers identified were: “Bureaucratic regulation”, “Long time to start rehabilitation”, “No post-surgery referral” and “inefficiency of public services”. These barriers were divided into a theoretical model built from the cause-effect diagram, in which we observed that insufficient access to rehabilitation is the product of causes related to organizational structure, work processes, professional and patients. Was constructed two logistic regression models: “General access to rehabilitation” and “Access to rehabilitation to public service”. 51.6% of patients had access to rehabilitation, and 32.9% in public and 17.9% in the private sector. The regression model “General access to rehabilitation” included the variables Income (OR:3.7), Informal Employment (OR:0.11), Unemployment (OR:0.15), Perceived Need for PR (OR:10) and Referral (OR: 27.5). The model “Access to rehabilitation in the public service” was represented by the “Referral to Public Service” (OR: 23.0) and “Private Health Plan” (OR: 0.07). Despite the known influence of social determinants on access to health services, a situation difficult to control by the public administration, this study found that the organizational and bureaucratic procedures established in health care greatly determine access to rehabilitation. Access difficulties show the seriousness of the problem and the factors suggest the need for improvements in comprehensive care for TA survivors and avoid unnecessary prolongation of the suffering of the victims of this epidemic.

Atividade de formação interprofissional em urgência pré-hospitalar

To acting in emergencies it is important that health professionals develop specific and differentiated skills, which shows us the importance of training in emergency planning. So undergraduate courses in medicine and nursing should encourage the development of these skills and evaluate them through various instruments targeted to the different fields. The aim of this study was to implement an optional and interprofessional curricular component, focusing on interprofessional education in pre-hospital emergency for medical and nursing courses Federal University of Rio Grande do Norte (UFRN). This is an exploratory descriptive study, with 24 medical and nursing graduates of last year undergraduate of supervised training, who underwent theoretical and practical training in the care of pre-hospital emergency services. There were theoretical and practical lessons per week for one school semester, taught by doctors and nurses of the Emergency Medical Service (EMS), where the topics discussed were: basic and advanced life support, safe transport in clinical emergencies, trauma, gynecological, obstetric, pediatric and psychiatric diseases, and have been carried out practical activities in ambulances. The students were evaluated by pre-test, post-test and practical stations made through the Objective Structured Clinical Evaluation (OSCE), in the skills laboratory of the Health Sciences Center. During the activities the students were encouraged to critical and reflective thinking, highlighting the importance of integration between the various health care professionals. It was observed that 88% of the students had a score increase over the pre-test. In the evaluation process carried out by medical students and nursing UFRN have similar expectations regarding the essential skills acquired during the training activity. The results of this study will form the basis for the organization of interprofessional education activity in pre-hospital emergency medical students and nursing, as well as helped to organize practices stations, identifying basic clinical skills, and implementing student assessment tools UFRN.

Reanimação neonatal: capacitação de profissionais de saúde com base na aprendizagem baseada em problemas

In whole world, including in Brazil, there is an absence of professionals who are able to be present at the moment of birth and give to the newborn the cares that they need to because either an absence of opportunity or inappropriate training to those professionals. This master´s thesis describes a construction and application of a neonatal resuscitation course that uses the problem based learning (PBL) methodology. The course has done in two meetings, one for the tutorial session, and another for practice session. The students were divided in groups of eight students each, under supervision of two teachers with experience in PBL methodology. The experience was considered successfully because there were students involvement and motivation. Some course aspects were rebuilt for its upgrading, like the correct use of methodology and building of custom educational material for students learning necessity. It suggests that the course can be used by the medical and nursing schools and perhaps other kind of health courses.

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

Desenvolvimento e avaliação do emprego de dispositivo ajustável ao corpo para treinamento de habilidade de acesso venoso periférico no membro superior

OBJECTIVE: To dev elop and evaluate the use of a body adjustable device for training of peripheral venous catheterization for healthcare undergraduate students . METHODS: This study involved two phases: I) development of the innovative simulator and II) a controlled trial co mparing the performance of the body adjustable device in relation to the commercial simulator for the training of venipuncture skills. A total of 79 first - year medical students participated in the intervention phase, which consisted of pretest assessment, lecture on peripheral venous access, randomization into two groups according to the simulator used for training (Commercial Simulator and Experimental Simulator), real venipuncture procedure, post - test assessment and evaluation of satisfaction. RESULTS: Gr oups were homogeneous in age, sex, pre - test and post - test scores, attitudinal assessment and performance in performing the real venipuncture. Students from the Experimental Simulator group performed better on the filling of simulated records. At the end of the study, cognitive gain significantly increased in both groups. The degree of realism perceived by students was equivalent for two groups. A total of 85.7% of students rated the Experimental Simulator as good or excellent. CONCLUSIONS: Experimental simu lator proved to be a low cost alternative for the training of venipuncture skills in upper limb. The cognitive procedural and attitudinal performances of students who used the experimental simulator were similar to those observed in the group trained with commercial simulator.

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.

Corpo, movimento e aprendizagem na psicocinética de Jean Le Boulch

School teachers in the discipline of Physical Education, we find ourselves constantly in question of methodological and epistemological issues of practice. This research aims to identify human body understanding, movement and theoretical learning proposed by examining the work of Jean Le Boulch and his approach to Physical Education. We seek to indicate epistemological elements about Physical Education theory and practice, believing that this approach and dialog comes to contribute with this field of knowledge. Boulch, a French teacher of Physical Education, Medicine and Psychology, had an important influence in Brazilian Physical Education during the 1970s and 1980s. His main contribution was teaching courses and knowledge about psychomotricity. Boulch’s studies helped to build knowledge of human movement; considering his importance in people’s development and a critic to a mechanistic view of body and movement. Our reflections will be based on the concepts brought from psychokinetics presented in the bibliographic references of Le Boulch in Brazil, and other references developed by him in this country including conferences, lectures and interviews. This reflection includes the debaters of his work. We chose a theoretical approach referring to the Phenomenology of philosopher Maurice Merleau-Ponty (1999) as a methodological reference considering the influence of his thought in Le Boulch studies. This thesis examines the learning and practice of teaching the Physical Education field of knowledge. We conclude that the body being an entity that exists for itself in the world and that contact with the world starts from human movement. Ultimately, new trains of thought for the teaching of physical education can be set from the reflection of phenomenological concepts brought by Le Boulch in his theory.

Inibição dos efeitos locais induzidos pelas peçonhas das serpentes Bothrops erythromelas e Bothrops jararaca pelo extrato aquoso das folhas de Jatropha mollissima (Pohl) Bail

Snakebites are a serious public health problem in tropical and subtropical countries and Bothrops genus is responsible for the accidents in Brazil and throughout Latin America (90% of cases). The local effects (pain, edema, hemorrhage and myonecrosis) and systemic (cardiovascular alterations, shock and blood clotting disorders) caused by the venom of Bothrops are due to the numerous protein and non-protein components, which are part of the constitution of the poison. The only form of therapy is scientifically validated antivenom serum therapy which, however, is not effective with respect to local effects produced, risk of immunological reactions, high cost and difficult access in some regions. Thus, the search for new alternatives to serum therapy becomes important, and in this context, many medicinal plants have been highlighted by the popular use as antiophidic. Among these plants, we can mention the species Jatropha mollissima (Euphorbiaceae) which has popular use in traditional medicine as antiophidic, anti-inflammatory, antimicrobial and antipyretic. Therefore, this study aims to evaluate the neutralizing potential of local effects induced by the venom of Bothrops erythromelas and Bothrops jararaca with the aqueous extract of the leaves of J. mollissima. The leaf extracts were prepared by decoction, fractionated (by liquid-liquid partition) and characterized by thin layer chromatography (TLC) and High Performance Liquid Chromatography (HPLC). Antiophidic activity of the extract was evaluated in model of paw edema, peritonitis, bleeding and myotoxicity induced by venoms of B. jararaca and B. erythromelas. In all models, the extract was evaluated by intraperitoneal route at the doses of 50, 100 and 200 mg/kg, administered 30 minutes prior to injection of the venom (pretreatment protocol). Stains suggestive of the presence of flavonoids: apigenin, luteolin, orientin, isoorientin, vitexin and vitexin-2-O-rhamnoside were detected in the extract by co-CCD. By means of HPLC were identified isoorientin, orientin, vitexin and isovitexin. All tested doses of J. mollissima extract reduced the paw edema induced by the venom with intensity similar to dexamethasone. The aqueous extract of J. mollissima leaves on all evaluated doses, inhibited cell migration induced by B. jararaca and B. erythromelas promoting inhibition of recruitment of mononuclear cells and the polymorphonuclear cells. Local bleeding induced by B. jararaca venom was significantly inhibited by the extract. Both venoms were inhibited by the extract in myotoxic activity. These results indicate that the aqueous extract of J. mollissima leaves have snakebite potential, particularly with respect to local effects, which may justify the use of this plant in traditional medicine and complementary therapy as anti-venom serum.

Inibição dos efeitos locais induzidos pelas peçonhas das serpentes Bothrops erythromelas e Bothrops jararaca pelo extrato aquoso das folhas de Jatropha mollissima (Pohl) Bail

Snakebites are a serious public health problem in tropical and subtropical countries and Bothrops genus is responsible for the accidents in Brazil and throughout Latin America (90% of cases). The local effects (pain, edema, hemorrhage and myonecrosis) and systemic (cardiovascular alterations, shock and blood clotting disorders) caused by the venom of Bothrops are due to the numerous protein and non-protein components, which are part of the constitution of the poison. The only form of therapy is scientifically validated antivenom serum therapy which, however, is not effective with respect to local effects produced, risk of immunological reactions, high cost and difficult access in some regions. Thus, the search for new alternatives to serum therapy becomes important, and in this context, many medicinal plants have been highlighted by the popular use as antiophidic. Among these plants, we can mention the species Jatropha mollissima (Euphorbiaceae) which has popular use in traditional medicine as antiophidic, anti-inflammatory, antimicrobial and antipyretic. Therefore, this study aims to evaluate the neutralizing potential of local effects induced by the venom of Bothrops erythromelas and Bothrops jararaca with the aqueous extract of the leaves of J. mollissima. The leaf extracts were prepared by decoction, fractionated (by liquid-liquid partition) and characterized by thin layer chromatography (TLC) and High Performance Liquid Chromatography (HPLC). Antiophidic activity of the extract was evaluated in model of paw edema, peritonitis, bleeding and myotoxicity induced by venoms of B. jararaca and B. erythromelas. In all models, the extract was evaluated by intraperitoneal route at the doses of 50, 100 and 200 mg/kg, administered 30 minutes prior to injection of the venom (pretreatment protocol). Stains suggestive of the presence of flavonoids: apigenin, luteolin, orientin, isoorientin, vitexin and vitexin-2-O-rhamnoside were detected in the extract by co-CCD. By means of HPLC were identified isoorientin, orientin, vitexin and isovitexin. All tested doses of J. mollissima extract reduced the paw edema induced by the venom with intensity similar to dexamethasone. The aqueous extract of J. mollissima leaves on all evaluated doses, inhibited cell migration induced by B. jararaca and B. erythromelas promoting inhibition of recruitment of mononuclear cells and the polymorphonuclear cells. Local bleeding induced by B. jararaca venom was significantly inhibited by the extract. Both venoms were inhibited by the extract in myotoxic activity. These results indicate that the aqueous extract of J. mollissima leaves have snakebite potential, particularly with respect to local effects, which may justify the use of this plant in traditional medicine and complementary therapy as anti-venom serum.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.