Plantas medicinais: uma abordagem sobre o uso seguro e racional / Medicinal plants: an approach to rational and safe use

Resumo Muitas plantas são utilizadas com finalidades medicinais, constituindo alternativas terapêuticas complementares ao tratamento de doenças, trazendo inúmeros benefícios à saúde, quando utilizadas racionalmente e de maneira adequada. No entanto, as plantas constituem um arsenal grande de constituintes químicos, que podem ser benéficos, mas também podem representar um risco potencial à saúde. Desse modo, é importante que o usuário, os profissionais de saúde, e os prescritores, tenham conhecimentos sobre a planta, a correta identificação, conservação, modo de preparo e uso, além dos possíveis efeitos colaterais. As plantas medicinais, seus riscos e benefícios, são discutidos à luz das publicações científicas contemporâneas, atentando para a contribuição dos profissionais de saúde em relação ao seu papel de educadores e promotores de saúde atuantes em comunidades, especialmente aquelas usuárias do Sistema Único de Saúde.

Abstract Many plants are used for medicinal purposes, constituting therapeutic alternatives complementary to the medical treatment, bringing numerous health benefits, when used rationally and in an appropriate way. However, plants constitute a large arsenal of chemicals constituents, which may be beneficial, but may also pose a potential health risk. So, it is important that the user, the health professionals, and the prescribers, have knowledge about the plant, ensuring correct identification, conservation, preparation and use, as well as possible side effects. The study of the medicinal plants, their risks and benefits, and efficacy confirmation by carefully designed studies will be discussed in the light of contemporary scientific publications, paying attention to the contribution of health professionals in relation to their role as active educators and health promoters in communities, especially those users of the Unified Health System.

Influência de fatores de risco na mortalidade por doenças infecciosas e parasitárias / Influence of mortality risk factors by infectious and parasite diseases

O Brasil tem grande extensão e características socioeconômicas, demográficas e culturais distintas. Sendo assim, em algumas regiões, as doenças infecciosas e parasitárias (DIPs) ainda fazem parte do cotidiano da população. Desse modo, objetivou-se avaliar se as DIPs, nos municípios que constituem a Superintendência Regional de Saúde (SRS) de Alfenas (MG), têm relação com fatores de risco selecionados. Trata-se de um estudo transversal de base populacional, de caráter descritivo e abordagem quantitativa, utilizando-se dados secundários obtidos no censo demográfico (2010) e empregando-se a análise de correlação de Pearson. Todos os indicadores de saúde e educação estudados, correlacionaram-se significativamente com a mortalidade por DIPs. O sistema de abastecimento de água por rede geral de distribuição, juntamente com o número de esgotamento sanitário por rede geral de esgoto ou pluvial, foram as variáveis dos indicadores de saneamento básico que demonstraram os mais elevados índices de correlação. Dentre os indicadores relativos à economia, o rendimento nominal mensal até » de salário mínimo ou sem rendimento mensal influenciaram significativamente a mortalidade por DIPs e, entre os indicadores de mortalidade infantil, somente o número de nascidos com peso inferior a 2500g demonstrou relação com as DIPs. Os resultados mostraram que as condições ambientais e de saneamento assim como as condições socioeconômicas dos residentes nos domicílios servidos por esses bens, aliadas à divulgação de medidas básicas de higiene pessoal, doméstica e comunitária impactam na saúde da população, refletindo na morbidade e mortalidade por enfermidades de diferentes etiologias, incluindo-se às DIPs. Dessa maneira, o conhecimento da prevalência e das principais variáveis associadas pode fornecer subsídio para dimensão do problema, planejamento e implementação de ações de promoção à saúde e à prevenção de agravos do processo saúde-doença.

Due to Brazil´s huge extension and to different social, economic, demographic and cultural conditions, several regions in Brazil feature infectious and parasite diseases (IPDs). Current analysis assesses whether IPDs in the municipalities of the Health Regional Superintendence of Alfenas MG Brazil are related to specific risk factors. Current populated-based transversal, descriptive and quantitative study employs secondary data from the 2010 demographic census, by Pearson´s co-relationship. All health and educational indicators significantly co-relate themselves with mortality due to IPDs, The water supply system and the number of sewerage and rainwater per network unit were the variables of basic sanitation indexes with the highest co-relation scores. In the case of economic indicators, the monthly income of half the minimum wage or without any monthly earnings significantly affected IPD-based mortality. Only the number of births weighing less than 2500g had any relationship to IPDs. Results showed environmental and sanitation conditions, coupled to the social and economic factors of residents in homes with such characteristics, plus the dissemination of basic measures for personal, home and community hygiene impact population´s health. The latter influences morbidity and mortality by diseases of different etiologies, including IPDs. Knowledge on the prevalence and main associated variables may be a help in evaluating the problem and the planning and implementation of activities for the health and prevention of health-disease relationships.

Evaluation of the antibacterial potential of Petroselinum crispum and Rosmarinus officinalis against bacteria that cause urinary tract infections

In this study we evaluated the antibacterial activity of the crude hydroalcoholic extracts, fractions, and compounds of two plant species, namely Rosmarinus officinalis and Petroselinum crispum, against the bacteria that cause urinary tract infection. The microdilution method was used for determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The crude hydroalcoholic extract of R. officinalis displayed in vitro activity against Gram-positive bacteria, with satisfactory MBC for the clinical isolate S. saprophyticus. The fractions and the pure compound rosmarinic acid did not furnish promising results for Gram-negative bacteria, whereas fractions 2, 3, and 4 gave encouraging results for Gram-positive bacteria and acted as bactericide against S. epidermidis as well as E. faecalis (ATCC 29212) and its clinical isolate. R. officinalis led to promising results in the case of Gram-positive bacteria, resulting in a considerable interest in the development of reliable alternatives for the treatment of urinary infections.

Candida parapsilosis complex water isolates from a haemodialysis unit: biofilm production and in vitro evaluation of the use of clinical antifungals

Candida parapsilosis, currently divided into three distinct species, proliferates in glucose-rich solutions and has been associated with infections resulting from the use of medical devices made of plastic, an environment common in dialysis centres. The aims of this study were (i) to screen for Candida orthopsilosis and Candida metapsilosis (100 environmental isolates previously identified as C. parapsilosis), (ii) to test the ability of these isolates to form biofilm and (iii) to investigate the in vitro susceptibility of Candida spp biofilms to the antifungal agents, fluconazole (FLC) and amphotericin B (AMB). Isolates were obtained from a hydraulic circuit collected from a haemodialysis unit. Based on molecular criteria, 47 strains were re-identified as C. orthopsilosis and 53 as C. parapsilosis. Analyses using a formazan salt reduction assay and total viable count, together with microscopy studies, revealed that 72 strains were able to form biofilm that was structurally similar, but with minor differences in morphology. A microtitre-based colorimetric assay used to test the susceptibility of fungal biofilms to AMB and FLC demonstrated that the C. parapsilosis complex displayed an increased resistance to these antifungal agents. The results from these analyses may provide a basis for implementing quality controls and monitoring to ensure the microbiological purity of dialysis water, including the presence of yeast.

Microbiological monitoring mf mineral water commercialized in Brazil

The quality of mineral water commercialized in Brazil regarding the microbial content was analyzed and the results were compared with the standards established by the current legislation. Results demonstrated there was no bacterial contamination, but several types of fungi were found. Therefore, bottled mineral water could be considered a possible route for the transmission of filamentous fungi and yeasts.

Microbiological contamination of a hemodialysis center water distribution system / Contaminação microbiológica no sistema de distribuição de água de um centro de hemodiálise

The microbiological monitoring of the water used for hemodialysis is extremely important, especially because of the debilitated immune system of patients suffering from chronic renal insufficiency. To investigate the occurrence and species diversity of bacteria in waters, water samples were collected monthly from a hemodialysis center in upstate São Paulo and tap water samples at the terminal sites of the distribution system was sampled repeatedly (22 times) at each of five points in the distribution system; a further 36 samples were taken from cannulae in 19 hemodialysis machines that were ready for the next patient, four samples from the reuse system and 13 from the water storage system. To identify bacteria, samples were filtered through 0.22 µm-pore membranes; for mycobacteria, 0.45 µm pores were used. Conventional microbiological and molecular methods were used in the analysis. Bacteria were isolated from the distribution system (128 isolates), kidney machine water (43) and reuse system (3). Among these isolates, 32 were Gram-positive rods, 120 Gram-negative rods, 20 Gram-positive cocci and 11 mycobacteria. We propose the continual monitoring of the water supplies in hemodialysis centers and the adoption of effective prophylactic measures that minimize the exposure of these immunodeficient patients to contaminated sources of water.

O monitoramento microbiológico da água utilizada no procedimento de hemodiálise é de extrema importância, principalmente devido à imunodebilidade dos pacientes com insuficiência renal crônica. Nosso objetivo foi verificar qualitativa e quantitativamente a presença de bactérias na água de um centro de hemodiálise do interior do Estado de São Paulo. Foram realizadas 22 coletas de cada um dos cinco pontos do sistema de distribuição; 36 amostras de 19 máquinas de hemodiálise, prontas para utilização; quatro amostras do sistema de reuso e 13 amostras do sistema de armazenamento de água, empregando-se a técnica da membrana filtrante com poros de 0,22 µm para bactérias e de 0,45 µm para micobactérias. A identificação foi realizada através de métodos microbiológicos convencionais e de biologia molecular. Isolados bacterianos foram obtidos de sistema de distribuição (128), águas das máquinas (43) e sistema de reuso (3). Entre os isolados 32 foram de bacilos Gram-positivos, 120 bacilos Gram-negativos, 20 Cocos Gram-positivos e 11 micobactérias. Neste estudo, sugerimos que suprimentos de água para o Centro de Hemodiálise devam ser monitorados, adotando-se medidas profiláticas eficazes que minimizem a exposição destes pacientes imunodeficientes a fontes aquáticas ambientais contaminadas.