Adesão dos dentistas do Sistema Único de Saúde à prescrição de plantas medicinais/fitoterápicos: um estudo observacional / Adherence of dentists in the Unified System of Health to prescription of medicinal plants/phytotherapy: an observational study

O objetivo desta dissertação é avaliar a prevalência de cirurgiões-dentistas da APS/SUS que prescrevem plantas medicinais/fitoterápicos e associar com aspectos sociodemográficos, profissionais, conhecimento sobre o tema, prática clínica, capacitação e uso pessoal. Trata-se de estudo observacional, com coleta de dados de março a julho de 2023, em amostra de 563 cirurgiões-dentistas dentistas brasileiros. Foi aplicado um instrumento previamente testado, via Google Forms, com questões sobre aspectos sociodemográficos e profissionais; conhecimentos sobre fitoterapia/plantas medicinais no SUS e na Odontologia, além da prática clínica, capacitação e uso pessoal sobre o tema. Constou-se que 161 (28,6%) dentistas afirmaram prescrever fitoterápicos/plantas medicinais. O hábito de perguntar ao paciente se usa esse tipo de recurso, o embasamento teórico prévio, o sentimento de se considerar capacitado para prescrição e o uso pessoal apresentaram associação com a adesão à prescrição. Por outro lado, características sociodemográficas e profissionais, assim como o conhecimento sobre regulamentações e políticas sobre a oferta dessa terapia complementar não estiveram associados estatisticamente à prescrição. Conclui-se que há ferramentas de sensibilização dos CD sobre a importância da Fitoterapia/Plantas Medicinais, com vistas a capacitá-los e que garantir segurança para abordagem desse tema, na relação profissional-paciente, é fundamental no direcionamento de ações de implementação efetivas das políticas públicas para oferta dessa prática por CD da APS/SUS. Além disso, o aspecto cultural/histórico de uso da Fitoterapia/Plantas Medicinais, assim como ocorre na população em geral, deve ser destacado e fortalecido.

The aim of this dissertation is to evaluate the prevalence of Primary Health Care (PHC)/Unified System of Health (USH) dentists who prescribe medicinal plants/herbal medicines and associate them with sociodemographic and professional aspects, knowledge on the subject, clinical practice, training and personal use. This is an observational study, with data collection from March to July 2023, in a sample of 563 Brazilian dentists. A previously tested instrument was applied, via Google Forms, with questions about sociodemographic and professional aspects; knowledge about Phytotherapy/medicinal plants in USH and Dentistry, in addition to clinical practice, training and personal use on the subject. It was found that 161 (28.6%) dentists claimed to prescribe herbal medicines/medicinal plants. The habit of asking the patient if he uses this type of resource, previous theoretical background, the feeling of considering himself capable of prescribing and personal use showed association with adherence to the prescription. On the other hand, sociodemographic and professional characteristics, as well as knowledge about regulations and policies regarding the provision of this complementary therapy, were not statistically associated with prescription. It is concluded that there are tools for sensitization of Dental Surgeons (DS) about the importance of Phytotherapy/Medicinal Plants, with a view to qualifying them and that guaranteeing security for approaching this theme, in the professionalpatient relationship, is fundamental in directing effective implementation actions of the public policies to offer this practice through the PHC/USH DSs. In addition, the cultural/historical aspect of the use of Phytotherapy/Medicinal Plants, as it occurs in the general population, must be highlighted and strengthened.

Neurotoxicity of "ecstasy" and its metabolites in human dopaminergic differentiated SH-SY5Y cells.

"Ecstasy" (3,4-methylenedioxymethamphetamine or MDMA) is a widely abused recreational drug, reported to produce neurotoxic effects, both in laboratory animals and in humans. MDMA metabolites can be major contributors for MDMA neurotoxicity. This work studied the neurotoxicity of MDMA and its catechol metabolites, α-methyldopamine (α-MeDA) and N-methyl-α-methyldopamine (N-Me-α-MeDA) in human dopaminergic SH-SY5Y cells differentiated with retinoic acid and 12-O-tetradecanoyl-phorbol-13-acetate. Differentiation led to SH-SY5Y neurons with higher ability to accumulate dopamine and higher resistance towards dopamine neurotoxicity. MDMA catechol metabolites were neurotoxic to SH-SY5Y neurons, leading to caspase 3-independent cell death in a concentration- and time-dependent manner. MDMA did not show a concentration- and time-dependent death. Pre-treatment with the antioxidant and glutathione precursor, N-acetylcysteine (NAC), resulted in strong protection against the MDMA metabolites' neurotoxicity. Neither the superoxide radical scavenger, tiron, nor the inhibitor of the dopamine (DA) transporter, GBR 12909, prevented the metabolites' toxicity. Cells exposed to α-MeDA showed an increase in intracellular glutathione (GSH) levels, which, at the 48 h time-point, was not dependent in the activity increase of γ-glutamylcysteine synthetase (γ-GCS), revealing a possible transient effect. Importantly, pre-treatment with buthionine sulfoximine (BSO), an inhibitor of γ-GCS, prevented α-MeDA induced increase in GSH levels, but did not augment this metabolite cytotoxicity. Even so, BSO pre-treatment abolished NAC protective effects against α-MeDA neurotoxicity, which were, at least partially, due to GSH de novo synthesis. Inversely, pre-treatment of cells with BSO augmented N-Me-α-MeDA-induced neurotoxicity, but only slightly affected NAC neuroprotection. In conclusion, MDMA catechol metabolites promote differential toxic effects to differentiated dopaminergic human SH-SY5Y cells.

Chemical and microbiological characterization of mangrove sediments after a large oil-spill in Guanabara Bay - RJ - Brazil

Seventeen months after a 1,3 million L oil spill into Guanabara Bay, analyses of mangrove sediments showed that the three sites closest to the spill remain highly polluted (>10 µg-g-1 polyaromatic hydrocarbons). A fourth site was less polluted, from which most hydrocarbon degrading bacteria were isolated.

Dezessete meses após um derramamento de 1,3 milhões de litros de óleo na Baía de Guanabara, análises de sedimento do manguezal mostraram que os três pontos de amostragem mais próximos do local do acidente permanecem altamente poluídos (>10 µg-g-1 hidrocarbonetos poliaromáticos). Do quarto ponto de amostragem, o menos poluído, foi isolada a maioria das bactérias degradadoras de hidrocarbonetos.