Internato médico rural na Serra Gaúcha: a experiência da Universidade de Caxias do Sul / Rural medical internship in Serra Gaúcha: the experience of the Universidade de Caxias do Sul

Um dos desafios das comunidades rurais e remotas é a dificuldade no recrutamento e a retenção de recursos humanos em saúde. A educação médica em áreas rurais é uma das estratégias para enfrentar tal deficiência. No Brasil, há relativamente poucos relatos de experiências de educação médica em áreas rurais, especialmente de duração prolongada, e há necessidade de se avaliar as existentes para contribuir com a formulação de políticas públicas. Este trabalho descreve o estágio rural do internato médico em Medicina de Família e Comunidade (MFC) da Universidade de Caxias do Sul (UCS). Até agora, durante os treze anos desde seu início, mais de 550 estagiários passaram pelas unidades de saúde de quatro municípios da Serra Gaúcha. Reflexões sobre a experiência para a formação médica e para as políticas de recursos humanos são apresentadas. O estágio rural tem sido importante espaço de diversificação de cenário para educação, reforçando o papel da Atenção Primária à Saúde e da MFC, além de possibilitar a aproximação da Universidade com a comunidade, confirmando sua responsabilidade social. Os resultados contribuem para as estratégias de formação médica e para as políticas de recrutamento e retenção de recursos humanos na saúde para áreas rurais e remotas.(AU)

One of the challenges of rural and remote communities is the difficulty in recruiting and retaining human resources in health. Medical education in rural areas is one of the strategies to tackle this deficiency. In Brazil, there are relatively few reports of medical education experiences in rural areas, especially of long duration, and there is a need to evaluate the existing ones to generate useful reflections for the formulation of public policies. This work describes the medical internship in Family Medicine (FM) at the Universidade de Caxias do Sul (UCS). To date, during the thirteen years since its inception, more than 550 medical students have passed through four municipalities in the Serra Gaúcha. Reflections on the experience about medical training and human resources policies for rural health are presented. The rural internship has been an important space for diversifying the scenario for medical education, reinforcing the role of Primary Health Care and of FM, in addition to making it possible to bring the University closer to the community, confirming its social responsibility. The results of this report contribute to medical training strategies and policies for the recruitment and retention of human resources in health for rural and remote areas.(AU)

Gene expression and tyrosine kinase activity of insulin receptor in uterine leiomyoma and matched myometrium.

OBJECTIVE: Our objective was to determine the insulin receptor (IR) mRNA levels and IR tyrosine kinase activity in normal myometrium and leiomyoma. DESIGN: Experimental study. SETTING: Academic research center. PATIENTS: Five women with leiomyoma submitted to hysterectomy. INTERVENTION: Plasma membrane fraction of human myometrium and leiomyoma were prepared and samples were incubated with and without insulin. mRNA was isolated and RT-PCR with specific primers was performed. MAIN OUTCOME MEASURE: Western blots of plasma membranes incubated with and without insulin were performed. Chemoluminescent methods followed by densitometry were used to assess IR autophosphorylation. RT-PCR with specific primers for IR gene sequences was used to determine IR mRNA levels. RESULTS: IR mRNA levels in myometrium (0.634+/-0.038) and in leiomyoma (0.649+/-0.047; p=0.813) were not different. The degree of insulin-stimulated IR autophosphorylation (relative optical density of the 95 kDa band) was also not different between myometrium (1.496+/-0.310) and leiomyoma (1.593+/-0.129; p=0.650). CONCLUSIONS: There was no difference in IR receptor expression and IR autophosphorylation between normal myometrium and leiomyoma. Other steps of insulin signaling chain may participate in the altered proliferation of leiomyomas.