RESUMO
Hypoxia in preterm infants is a clinical condition that has been associated with cognitive and behavioral disturbances for which treatment strategies are strongly required. Melatonin administration following brain insults has been considered a promising therapeutic strategy due to its antioxidant and anti-inflammatory effects. Not surprisingly, it has been extensively studied for preventing disturbances following brain injury. This study evaluated the effects of melatonin on developmental disturbances, memory disruption, and hippocampal cell loss induced by neonatal anoxia in rats. Neonatal Wistar rats were subjected to anoxia and subsequently treated with melatonin. Later, maturation of physical characteristics, ontogeny of reflexes, learning and memory in the Morris water maze (MWM), and estimates of the number of hippocampal neurons, were evaluated. Melatonin treatment attenuated (1) female anoxia-induced delay in superior incisor eruption, (2) female anoxia-induced vibrissae placement reflexes, and (3) male and female anoxia-induced hippocampal neuronal loss. Melatonin also promoted an increase (5) in swimming speeds in the MWM. In addition, PCA analysis showed positive associations between the acoustic startle, auditory canal open, and free fall righting parameters and negative associations between the male vehicle anoxia group and the male melatonin anoxia group. Therefore, melatonin treatment attenuates both anoxia-induced developmental deficits and hippocampal neuronal loss.
Assuntos
Animais Recém-Nascidos , Hipocampo , Aprendizagem em Labirinto , Melatonina , Ratos Wistar , Animais , Melatonina/farmacologia , Melatonina/uso terapêutico , Feminino , Hipocampo/efeitos dos fármacos , Ratos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Hipóxia/complicações , Neurônios/efeitos dos fármacos , Modelos Animais de Doenças , Antioxidantes/farmacologia , Antioxidantes/uso terapêuticoRESUMO
Neonatal oxygen deficiency in rats may disturb growth and long-term metabolic homeostasis. In order to facilitate metabolic evaluation, the subjects are usually housed individually. However, social isolation associated with individually housed conditions alters animal behavior, which may influence the experimental results. This study investigated the effects of social isolation on neonatal anoxia-induced changes in growth and energy metabolism. Male and female Wistar rats were exposed, on postnatal day 2 (P2), to either 25-min of anoxia or control treatment. From P27 onward, part of the subjects of each group was isolated in standard cages, and the remaining subjects were housed in groups. At P34 or P95, the subjects were fasted for 18 h, refeed for 1 h, and then perfused 30 min later. Glycemia, leptin, insulin, and morphology of the pancreas were evaluated at both ages. For subjects perfused at P95, body weight and food intake were recorded up to P90, and the brain was collected for Fos and NeuN immunohistochemistry. Results showed that male rats exposed to neonatal anoxia and social isolation exhibited increased body weight gain despite the lack of changes in food intake. In addition, social isolation (1) decreased post-fasting weight loss and post-fasting food intake and (2) increased glycemia, insulin, and leptin levels of male and female rats exposed to anoxia and control treatments, both at P35 and P95. Furthermore, although at P35, anoxia increased insulin levels of males, it decreased the area of the ß-positive cells in the pancreas of females. At P95, anoxia increased post-prandial weight loss of males, post-fasting food intake, insulin, and leptin, and decreased Fos expression in the arcuate nucleus (ARC) of males and females. Hyperphagia was associated with possible resistance to leptin and insulin, suspected by the high circulating levels of these hormones and poor neuronal activation of ARC. This study demonstrated that continuous social isolation from weaning modifies, in a differentiated way, the long-term energy metabolism and growth of male and female Wistar rats exposed to neonatal anoxia or even control treatments. Therefore, social isolation should be considered as a factor that negatively influences experimental results and the outcomes of the neonatal injury. These results should also be taken into account in clinical procedures, since the used model simulates the preterm babies' conditions and some therapeutic approaches require isolation.
Assuntos
Animais Recém-Nascidos , Peso Corporal , Ingestão de Alimentos , Metabolismo Energético , Hipóxia , Ratos Wistar , Isolamento Social , Animais , Isolamento Social/psicologia , Masculino , Feminino , Ratos , Metabolismo Energético/fisiologia , Ingestão de Alimentos/fisiologia , Hipóxia/metabolismo , Peso Corporal/fisiologia , Leptina/sangue , Leptina/metabolismo , Glicemia/metabolismo , Insulina/sangue , Insulina/metabolismo , Desmame , Fatores EtáriosRESUMO
Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the most important reasons for morbidity and mortality in term-born infants. HIE impacts early somatic, neurological, and motor development including social. To illustrate the damages in the sensorimotor system, an adapted and validated model of neonatal anoxia is used. This study evaluated the sex differences in Wistar rats, neurological reflex, and motor development at the suckling period. Short- and long-term impairments associated with sex differences were observed. In general, anoxic males were more affected in comparison to their control group and to anoxic females. Long-lasting effects of the injury in adolescent rats predominately affected males. Similar to previous studies, we also found a decrease in the number of the substantia nigra cells in both sexes, compared to their control. So far, the results indicate that HIE caused neurobehavioral alterations and asymmetrical motor behavior with brain damage, possibly related to cognitive impairments previously observed at adolescence. These alterations may represent a useful endpoint for studying the efficacy of potential strategies that may improve the developmental consequences of a perinatal asphyxia insult in humans.
Assuntos
Hipóxia-Isquemia Encefálica , Humanos , Lactente , Gravidez , Animais , Ratos , Feminino , Masculino , Ratos Wistar , Animais Recém-Nascidos , Modelos Animais de Doenças , HipóxiaRESUMO
Hypoxic-ischemic encephalopathy is a severe clinical condition, among others, affecting the brain after offspring exposure to neonatal anoxia, which causes persistent sensorimotor and cognitive deficits. During peripartum, maternal behaviors are crucial for the healthy development of the offspring. In rats, the vocalization of newborns, around 40 kHz, corresponds to separation calls that encourage their mothers to retrieve them. Alterations in this pattern affect the maternal behavior addressed to the offspring. This study aimed to evaluate the maternal behavior of primiparous rats whose offspring were exposed to neonatal anoxia in P2 (postpartum day) during the lactation period, to assess mother-pup interactions through the pups' vocalization from P3 to P18. It also intends to quantify eventual neuronal alterations in the mothers' medial preoptic area after the last weaning (P21) through FOS protein expression. Anoxia offspring were found to reduce maternal behaviors toward them, increased frequency of separation calls in the male anoxia group, and reduced vocalization rate in the female anoxia group compared to their respective controls. Body weight gain reduction of males' and females' anoxia was observed. We concluded that anoxia exerts deleterious effects on the vocalization patterns of the pups, with sex differences that alter maternal behavior toward them. Impaired USV makes an additional negative impact on the already noxious effects of neonatal anoxia. Understanding those phenomena applies/contributes to guiding procedures and strategies to mitigate the deleterious outcomes and orient research concerning the complexity of neonatal anoxia events and the influence of maternal care quality concerning the pups, which should also be considered sex differences.
Assuntos
Comportamento Materno , Vocalização Animal , Humanos , Ratos , Animais , Feminino , Masculino , Vocalização Animal/fisiologia , Mães , Lactação , Hipóxia , Animais Recém-NascidosRESUMO
Neonatal anoxia is a well-known world health problem that results in neurodevelopmental deficits, such as sensory alterations that are observed in patients with cerebral palsy and autism disorder, for which oxygen deprivation is a risk factor. Nociceptive response, as part of the sensory system, has been reported as altered in these patients. To determine whether neonatal oxygen deprivation alters nociceptive sensitivity and promotes medium- and long-term inflammatory feedback in the central nervous system, Wistar rats of around 30 h old were submitted to anoxia (100% nitrogen flux for 25 min) and evaluated on PND23 (postpartum day) and PND90. The nociceptive response was assessed by mechanical, thermal, and tactile tests in the early postnatal and adulthood periods. The lumbar spinal cord (SC, L4-L6) motor neurons (MNs) and the posterior insular cortex neurons were counted and compared with their respective controls after anoxia. In addition, we evaluated the possible effect of anoxia on the expression of astrocytes in the SC at adulthood. The results showed increased nociceptive responses in both males and females submitted to anoxia, although these responses were different according to the nociceptive stimulus. A decrease in MNs in adult anoxiated females and an upregulation of GFAP expression in the SC were observed. In the insular cortex, a decrease in the number of cells of anoxiated males was observed in the neonatal period. Our findings suggest that oxygen-deprived nervous systems in rats may affect their response at the sensorimotor pathways and respective controlling centers with sex differences, which were related to the used stimulus.
Assuntos
Hipóxia/fisiopatologia , Córtex Insular/fisiopatologia , Nociceptividade/fisiologia , Medula Espinal/fisiopatologia , Animais , Feminino , Masculino , Neurônios/fisiologia , Ratos , Ratos Wistar , Fatores SexuaisRESUMO
Therapeutic hypothermia (TH) is well established as a standard treatment for term and near-term infants. However, therapeutic effects of hypothermia following neonatal anoxia in very premature babies remains inconclusive. The present rodent model of preterm neonatal anoxia has been shown to alter developmental milestones and hippocampal neurogenesis, and to disrupt spatial learning and memory in adulthood. These effects seem to be reduced by post-insult hypothermia. Epigenetic-related mechanisms have been postulated as valuable tools for developing new therapies. Dentate gyrus neurogenesis is regulated by epigenetic factors. This study evaluated whether TH effects in a rodent model of preterm oxygen deprivation are based on epigenetic alterations. The effects of TH on both developmental features (somatic growth, maturation of physical characteristics and early neurological reflexes) and performance of behavioral tasks at adulthood (spatial reference and working memory, and fear conditioning) were investigated in association with the possible involvement of the epigenetic operator Enhancer of zeste homolog 2 (Ezh2), possibly related to long-lasting effects on hippocampal neurogenesis. Results showed that TH reduced both anoxia-induced hippocampal neurodegeneration and anoxia-induced impairments on risk assessment behavior, acquisition of spatial memory, and extinction of auditory and contextual fear conditioning. In contrast, TH did not prevent developmental alterations caused by neonatal anoxia and did not restore hippocampal neurogenesis or cause changes in EZH2 levels. In conclusion, despite the beneficial effects of TH in hippocampal neurodegeneration and in reversing disruption of performance of behavioral tasks following oxygen deprivation in prematurity, these effects seem not related to developmental alterations and hippocampal neurogenesis and, apparently, is not caused by Ezh2-mediated epigenetic alteration.
Assuntos
Hipocampo/crescimento & desenvolvimento , Hipotermia Induzida/métodos , Hipóxia Encefálica/fisiopatologia , Hipóxia Encefálica/terapia , Memória Espacial/fisiologia , Animais , Animais Recém-Nascidos , Feminino , Hipóxia Encefálica/psicologia , Lactação/fisiologia , Masculino , Ratos , Ratos Wistar , Resultado do TratamentoRESUMO
BACKGROUND: Neonatal anoxia may cause neurological injuries, behavioral alterations and changes in somatic growth. Somatic developmental changes suggest a possible effect of anoxia on energy metabolism and/or feeding behavior. Short-term effects of oxygen deficit on energy homeostasis have been described. In contrast, just a few studies report long-term effects. This study investigated the effects of neonatal anoxia on energy metabolism and somatic development at adulthood of males and females Wistar rats. METHOD: Male (m) and female (f) rats were exposed, on postnatal day 2 (P2), to either 25-min of Anoxia or Control treatment. At P34 part of the subjects of each group was fasted for 18 h, refeed for 1 h and then perfused 30 min later, at P35; the remaining subjects were submitted to these treatments at P94 and perfused at P95. Therefore, there were 8 groups: AmP35, AmP95, AfP35, AfP95, CmP35, CmP95, CfP35 and CfP95. For subjects perfused at P95, body weight and food intake were recorded up to P90. For subjects perfused at P35 and P95, glycemia, leptin and insulin were assessed after fasting and refeed. After perfusion the encephalon and pancreas were collected for Fos immunohistochemistry and Hematoxylin-Eosin stain analyses. RESULTS: Even though neonatal anoxia did not interfere with regular food intake, it reduced body weight gain along growing in both male and female subjects as compared to the corresponding controls. At P35 neonatal anoxia decreased post-prandial glycemia and increased insulin. While at P95 neonatal anoxia altered the pancreatic histomorphology and increased post-fasting weight loss, decreasing leptin, insulin and glycemia secretion, as well Fos immunoreactivity (IR) in ARC. CONCLUSION: Neonatal anoxia impairs long-term energy metabolism and somatic development in Wistar rats, with differences related to sex and age.
Assuntos
Metabolismo Energético/fisiologia , Jejum/metabolismo , Hipóxia/metabolismo , Aumento de Peso/fisiologia , Animais , Animais Recém-Nascidos , Glicemia , Feminino , Insulina/sangue , Leptina/sangue , Masculino , Ratos , Ratos WistarRESUMO
RESUMO O ensino da acupuntura vem sendo progressivamente introduzido em cursos médicos no Brasil e no mundo. Na Universidade Federal Fluminense (UFF), em Niterói (RJ), a reforma curricular da Faculdade de Medicina, implementada em 1994, possibilitou a oferta da disciplina optativa Medicina Tradicional Chinesa/Acupuntura a partir de 1995, além da criação, em 1997, de um curso de especialização em acupuntura destinado ao público médico. Este artigo apresenta um estudo que buscou identificar os principais desafios e perspectivas relacionados a esse ensino na graduação e pós-graduação médicas da UFF, resgatando o debate sobre a polarização paradigmática entre a acupuntura da MTC e a acupuntura neurofisiológica. Foi realizada uma pesquisa qualitativa de caráter etnográfico com análise documental, observação dos cenários de sala de aula e entrevistas semiestruturadas com o professor e alunos da disciplina e curso selecionados. De forma complementar, para garantir a triangulação de informações, utilizou-se a técnica do grupo focal com ex-alunos da graduação médica. O tratamento e a interpretação dos dados deste estudo se ancoraram na discussão epistemológica de Thomas Kuhn - o conceito de paradigmas e a questão da incomensurabilidade de ideias. Os resultados desta pesquisa mostraram que, apesar das diferenças paradigmáticas significativas, há interesse e receptividade de estudantes de Medicina e médicos na abordagem integrativa do processo saúde-doença oferecida pela medicina tradicional chinesa/acupuntura. Entre os aspectos positivos levantados, destacam-se a valorização da abordagem de dimensões do adoecimento humano negligenciadas pela biomedicina, o favorecimento da construção de um olhar integral sobre o sujeito e os bons resultados obtidos nos tratamentos com acupuntura. Os principais desafios apontados foram a necessidade de promover maior integração teórico-prática nas aulas, sugerida pelos alunos da graduação, e a crítica ao reducionismo no ensino da MTC/acupuntura, com simplificação exagerada de conteúdos complexos, feita pelos alunos da pós-graduação. Duas conclusões se destacaram neste estudo. Constatou-se um duplo padrão de aprendizado: abertura dos estudantes de graduação e pós-graduação médicas para o paradigma da medicina chinesa devido às suas especificidades e múltiplas abordagens terapêuticas, ao mesmo tempo em que se buscavam aproximações com o modelo biomédico. A complementaridade entre o paradigma da medicina chinesa e o das neurociências foi a principal característica do processo de incorporação da acupuntura ao ensino médico da UFF.
ABSTRACT The teaching of acupuncture has gradually been introduced into medical courses in Brazil and worldwide. At Universidade Federal Fluminense (UFF), in Niterói, Rio de Janeiro, the newly reformulated medical course curriculum, introduced in 1994, included the offer of an optative discipline in Traditional Chinese Medicine/Acupuncture to start the following year, and also the creation, in 1997, of a specialization course in Acupuncture for qualified medical doctors. In this article, we present a study that aims to identify major challenges and perspectives in Chinese Medicine teaching for undergraduate and graduate students at the UFF medical school, emphasizing the paradigmatic polarization between Traditional Chinese Medicine (TCM) and Neurophysiological Acupuncture. We performed a qualitative, ethnographic study involving document analysis, observation of classroom scenarios, and semi-structured interviews with the teacher and students of the selected discipline and course. In order to ensure triangulation of information, we also used the focus group technique, with former undergraduate students. The data treatment and interpretation of this study were anchored in the epistemological discussion of Thomas Kuhn - the concept of paradigms and the incommensurability of scientific theories. The results of this study show that despite the significant paradigmatic differences, medical students and doctors demonstrate interest in and receptivity towards the integrative approach of health-disease processes offered by traditional TCM. The following positive aspects were highlighted: the valorization of dimensions of human sickness hitherto neglected by biomedicine, the building of an integral perspective on the subject, and the good results obtained with acupuncture. The graduate students noted the need to increase integration between theory and practice, and criticized the reductionism in TCM teaching, with the excessive simplification of complex subjects. Two conclusions can be drawn from this study. A double learning pattern was observed: the interest among undergraduate and graduate students in Traditional Chinese Medicine paradigm, due to its specificities and multiple therapeutic approaches and, at the same time, a search for comparisons with the biomedical model. The complementarity between the paradigms of Traditional Chinese Medicine and neurosciences was the most important characteristic of the introduction of teaching on acupuncture at UFF.
RESUMO
Resumo O presente estudo reflete sobre o trajeto da histologia na transição do século XIX para o XX, em Portugal e em Espanha, para estabelecer um paralelo entre as contribuições de Santiago Ramón y Cajal e Marck Athias, ambos determinantes para o desenvolvimento da medicina experimental na Península Ibérica, reconhecidos como pilares de uma nova mentalidade científica europeia, na alvorada do século XX. Neste estudo de caso, refletimos sobre as vicissitudes da construção da ciência na “periferia” europeia, no contexto da categoria historiográfica centro-periferia desenvolvida pelo grupo Science and Technology in the European Periphery (Step), confrontando a realidade ibérica com o modelo de ciência alemã, no período em estudo.
Abstract The trajectory of histology at the cusp of the twentieth century in Portugal and Spain is investigated to draw a parallel between the contributions of Santiago Ramón y Cajal and Marck Athias, both of whom were instrumental in the development of experimental medicine in the Iberian Peninsula and recognized as pillars of a new European scientific mindset at the dawn of the twentieth century. In this case study we reflect on the vicissitudes of the construction of science in the “periphery” of Europe, in the context of the historiographical category of center-periphery developed by STEP (Science and Technology in the European Periphery), contrasting the reality in Iberia with the model of German science in the period under study.
Assuntos
Humanos , História do Século XIX , História do Século XX , Histologia/história , Sistema Nervoso/anatomia & histologia , Portugal , Ciência/história , Espanha , História da Medicina , Neurônios/citologiaRESUMO
The trajectory of histology at the cusp of the twentieth century in Portugal and Spain is investigated to draw a parallel between the contributions of Santiago Ramón y Cajal and Marck Athias, both of whom were instrumental in the development of experimental medicine in the Iberian Peninsula and recognized as pillars of a new European scientific mindset at the dawn of the twentieth century. In this case study we reflect on the vicissitudes of the construction of science in the "periphery" of Europe, in the context of the historiographical category of center-periphery developed by STEP (Science and Technology in the European Periphery), contrasting the reality in Iberia with the model of German science in the period under study.
Assuntos
Histologia/história , História do Século XIX , História do Século XX , Sistema Nervoso/anatomia & histologia , História da Medicina , Humanos , Neurônios/citologia , Portugal , Ciência/história , EspanhaAssuntos
Humanos , Masculino , Feminino , Neoplasias da Mama , Vigilância em Saúde Pública , Sistema Único de SaúdeRESUMO
Physical exercise stimulates cell proliferation in the adult dentate gyrus and facilitates acquisition and/or retention of hippocampal-dependent tasks. It is established that regular physical exercise improves cognitive performance. However, it is unclear for how long these benefits last after its interruption. Independent groups of rats received both free access to either unlocked (EXE Treatment) or locked (No-EXE Treatment) running wheels for 7 days, and daily injections of bromodeoxyuridine (BrdU) in the last 3 days. After a time delay period of either 1, 3, or 6 weeks without training, the animals were tested in the Morris water maze (MWM) either in a working memory task dependent on hippocampal function (MWM-HD) or in a visible platform searching task, independent on hippocampal function (MWM-NH). Data confirmed that exposure of rats to 7 days of spontaneous wheel running increases cell proliferation and neurogenesis. In contrast, neurogenesis was not accompanied by significant improvements of performance in the working memory version of the MWM. Longer time delays between the end of exercise and the beginning of cognitive training in the MWM resulted in lower cell survival; that is, the number of novel surviving mature neurons was decreased when this delay was 6 weeks as compared with when it was 1 week. In addition, data showed that while exposure to the MWM-HD working memory task substantially increased survival of novel neurons, exposure to the MWM-NH task did not, thus indicating that survival of novel dentate gyrus neurons depends on the engagement of this brain region in performance of cognitive tasks. © 2015 Wiley Periodicals, Inc.
Assuntos
Sobrevivência Celular/fisiologia , Cognição/fisiologia , Atividade Motora/fisiologia , Neurogênese/fisiologia , Neurônios/fisiologia , Aprendizagem Espacial/fisiologia , Análise de Variância , Animais , Antígenos Nucleares/metabolismo , Bromodesoxiuridina , Contagem de Células , Giro Denteado/citologia , Giro Denteado/fisiologia , Imuno-Histoquímica , Masculino , Memória de Curto Prazo/fisiologia , Proteínas do Tecido Nervoso/metabolismo , Neurônios/citologia , Distribuição Aleatória , Ratos Wistar , Memória Espacial/fisiologia , Percepção Visual/fisiologiaRESUMO
The classical description of the neural elements that compose the lining of brain ventricles introduces us to the single layer of ependymal cells. However, new findings, especially in the lateral ventricle (LV)-the major niche for the generation of new neurons in the adult brain-have provided information about additional cell elements that influence the organization of this part of the ventricular system and produce important contributions to neurogenesis. To complement the cell neurochemistry findings, we present a three-dimensional in situ description that demonstrates the anatomical details of the different types of ciliated cells and the innervation of these elements. After processing adult rat brains for ultrastructural analysis by high-resolution scanning electron microscopy (HRSEM) and transmission electron microscopy, we observed a heterogeneous pattern of cilia distribution at the different poles of the LV surface. Furthermore, we describe the particular three-dimensional aspects of the ciliated cells of the LV, in addition the fiber bundles and varicose axons surrounding these cells. Therefore, we provide a unique ultrastructural description of the three-dimensional in situ organization of the LV surface, highlighting its innervation, to corroborate the available neurochemical and functional findings regarding the factors that regulate this neurogenic niche.
RESUMO
The subdivisions of the medial geniculate complex can be distinguished based on the immunostaining of calcium-binding proteins and by the properties of the neurons within each subdivision. The possibility of changes in neurochemistry in this and other central auditory areas are important aspects to understand the basis that contributing to functional variations determined by environmental cycles or the animal's cycles of activity and rest. This study investigated, for the first time, day/night differences in the amounts of parvalbumin-, calretinin- and calbindin-containing neurons in the thalamic auditory center of a non-human primate, Sapajus apella. The immunoreactivity of the PV-IR, CB-IR and CR-IR neurons demonstrated different distribution patterns among the subdivisions of the medial geniculate. Moreover, a high number of CB- and CR-IR neurons were found during day, whereas PV-IR was predominant at night. We conclude that in addition to the chemical heterogeneity of the medial geniculate nucleus with respect to the expression of calcium-binding proteins, expression also varied relative to periods of light and darkness, which may be important for a possible functional adaptation of central auditory areas to environmental changes and thus ensure the survival and development of several related functions.
Assuntos
Proteínas de Ligação ao Cálcio/metabolismo , Corpos Geniculados/metabolismo , Animais , Vias Auditivas/citologia , Vias Auditivas/metabolismo , Calbindina 2/metabolismo , Calbindinas/metabolismo , Cebus , Ritmo Circadiano , Corpos Geniculados/citologia , Imuno-Histoquímica , Técnicas In Vitro , Masculino , Neurônios/metabolismo , Parvalbuminas/metabolismo , Tálamo/metabolismoRESUMO
Este artigo discute o processo de transformação da formação médica brasileira a partir da experiência de reforma curricular desenvolvida na escola médica da Universidade Federal Fluminense. Utilizou-se o referencial sócio-filosófico de Ludwig Fleck, partindo do pressuposto de que o olhar anatomoclínico orienta o estilo de pensamento biomédico. Considerou-se a hipótese de que a formação médica encontra-se estruturada entre dois polos (tecnocientífico e ético-humanista), com a valorização do primeiro, e o Sistema Único de Saúde (SUS) como superfície de emergência das mudanças na educação médica. Desenvolveu-se uma pesquisa de caráter etnográfico enfocando a disciplina Trabalho de Campo Supervisionado, com triangulação de métodos: observação participante dos cenários diversificados de aprendizagem nos dois primeiros anos de formação, entrevistas com alunos e preceptores e análise documental. Concluiu-se que a instituição de novos cenários de prática favorece a construção de um olhar ampliado dos estudantes sobre os usuários dos serviços de saúde, contribuindo para o resgate do polo ético-humanista da formação...
This article debates the transformation process of the Brazilian medical education based on the experience of the curriculum reformation developed in the Medical School of Universidade Federal Fluminense. We adopted Ludwig Fleck's socio-philosophical reference, assuming that the anatomoclinical viewpoint guides the biomedic thinking style. It was considered the hypothesis that the medical education finds itself structured between two poles: the technical-scientific and the ethical-humanist, the former being more appreciated, and that Brazil's Unified National Health System (SUS) as the platform for the emergence of changes in medical education. A study with ethnographic features was conducted focusing on the subject of "Supervised Fieldwork", with the following methods being triangulated: partaker observation of diversified learning sceneries throughout the first two years of education; interviews with student and preceptors; and document analysis. We concluded that the establishment of new practice scenarios favors the construction, by the students, of an amplified point of view about the health services users, which contributes for the rescue of the ethical-humanist pole of education...
Assuntos
Humanos , Capacitação de Recursos Humanos em Saúde , Prática Profissional/tendências , Sistema Único de Saúde/tendências , Brasil , Currículo , Atenção à Saúde , Processo Saúde-DoençaRESUMO
In the framework of forensic anthropology osteometric techniques are generally preferred over visual examinations due to a higher level of reproducibility and repeatability; qualities that are crucial within a legal context. The use of osteometric methods has been further reinforced by incorporating statistically-based algorithms and large reference samples in a variety of user-friendly software applications. However, the continued increase in admixture of human populations have made the use of osteometric methods for estimation of ancestry much more complex, which confounds one of major requirements of ancestry assessment - intra-population homogeneity. The present paper tests the accuracy of ancestry and sex assessment using four identification software tools, specifically FORDISC 2.0, FORDISC 3.1.293, COLIPR 1.5.2 and 3D-ID 1.0. Software accuracy was tested in a sample of 174 documented human crania of Brazilian origin composed of different ancestral groups (i.e., European Brazilians, Afro-Brazilians, and Japanese Brazilians and of admixed ancestry). The results show that regardless of the software algorithm employed and composition of the reference database, all methods were able to allocate approximately 50% of Brazilian specimens to an appropriate major reference group. Of the three ancestral groups, Afro-Brazilians were especially prone to misclassification. Japanese Brazilians, by contrast, were shown to be relatively easily recognizable as being of Asian descent but at the same time showed a strong affinity towards Hispanic crania, in particularly when the classification based on FDB was carried out in FORDISC. For crania of admixed origin all of the algorithms showed a considerable higher rate of inconsistency with a tendency for misclassification into Asian and American Hispanic groups. Sex assessments revealed an overall modest to poor reliability (60-71% of correctly classified specimens) using the tested software programs with unbalanced individual rates for males and females. The highest and atypically balanced rate of classification for sex assessment was provided by COLIPR software, which reached 78% of correctly assessed crania.
Assuntos
Antropologia Forense , Grupos Populacionais/etnologia , Determinação do Sexo pelo Esqueleto/métodos , Software/normas , Brasil , Feminino , Antropologia Forense/métodos , Humanos , MasculinoRESUMO
O artigo é um relato analítico da trajetória de 20 anos da categoria racionalidade médica, que emergiu no Campo da Saúde Coletiva, área das Ciências Sociais e Humanas em Saúde, no início da década de 1990, com o objetivo de estudar sistemas médicos complexos e terapêuticas tradicionais, complementares e alternativas. Com base em revisão crítica da literatura, apresentam-se aspectos do contexto cultural, político-institucional e social de seu surgimento, como também suas principais contribuições e desdobramentos nos planos teórico e das políticas e práticas sociais em saúde. Utiliza-se o conceito de epistemologia do sul de Boaventura de Sousa Santos, para a reflexão sobre a contribuição da categoria racionalidade médica à crítica da racionalidade científica pós-moderna e à construção de uma nova epistemologia em saúde.
This article is an analytical report on the 20-year trajectory of the 'medical rationale' category that emerged in the early 1990s in the area of Social and Human Sciences in Health in the field of Public Health. Its objective was to study complex and therapeutic medical systems and traditional, complementary and alternative medicines. Based on a critical review of the literature, it presents some aspects of the cultural, political, institutional and social context of its emergence, as well as its main contributions and developments on a theoretical level and on social policies and practices in health. The southern epistemology concept of Boaventura de Sousa Santos is used to reflect upon the contribution of the 'medical rationale' category to the critique of the post-modern scientific rationale and to the creation of a new epistemology in health.
Assuntos
Humanos , Saúde , Conhecimento , MedicinaRESUMO
This article is an analytical report on the 20-year trajectory of the 'medical rationale' category that emerged in the early 1990s in the area of Social and Human Sciences in Health in the field of Public Health. Its objective was to study complex and therapeutic medical systems and traditional, complementary and alternative medicines. Based on a critical review of the literature, it presents some aspects of the cultural, political, institutional and social context of its emergence, as well as its main contributions and developments on a theoretical level and on social policies and practices in health. The southern epistemology concept of Boaventura de Sousa Santos is used to reflect upon the contribution of the 'medical rationale' category to the critique of the post-modern scientific rationale and to the creation of a new epistemology in health.
Assuntos
Saúde , Conhecimento , Medicina , HumanosRESUMO
Este estudo apresenta a educação como instância modeladora dos sistemas de representação da realidade, a partir de uma reflexão sociofilosófica desenvolvida por Kuhn, Fleck e Wittgenstein. Através de uma pesquisa qualitativa, discute as especificidades da graduação biomédica e a formação de residentes em um Programa de Medicina de Família e da Comunidade como um processo de translação do olhar. No discurso dos residentes entrevistados, duas conclusões se destacaram: a inadequação da formação biomédica para a resolução dos problemas de saúde da população na atenção básica; e a necessidade de uma reorientação do olhar do profissional para o "sujeito doente" e suas subjetividades, para que ele possa se tornar um "médico da pessoa".
This paper introduces education as sign of reality representation of modeling systems starting from a socio-philosophical reflection developed by Kuhn, Fleck and Wittgenstein. Through a qualitative research, we discussed biomedical graduation and residence graduation specificities in a Family Medicine Program and the Community, as a process to change this view. During the interview with medicine residents, in their discourse, two conclusions emerged: the inadequation of the biomedical formation to solve population health care issues involving basic attention and the need to a reorientation to the "sick subject" and their subjectivities to become a "person's doctor".