Abstract Ischemia/reperfusion (I/R) -induced Acute kidney injury (AKI) is characterized by hypoxia and production of reactive oxygen species (ROS), which could be prevented with antioxidant agents. The essential oil of Lippia alba (EOLA) chemotype citral-limonene is rich in components with antioxidant activity. So, this study aims to evaluate the nephroprotective effect of the EOLA on in vivo and in vitro models of renal I/R. Male Wistar rats were submitted to right nephrectomy, followed by ischemia by clamping the renal artery in the left kidney and a reperfusion. Animals received EOLA (200 mg/kg) or vehicle three days prior to I/R surgery. Blood and urine samples were obtained to evaluate creatinine, urea, uric acid, and creatinine clearance. The left kidney was collected for histological evaluations and analysis of thiobarbituric acid reactive substances (TBARS) and reduced glutathione (GSH). HK-2 cells were used to evaluate the effect of EOLA on I/R in vitro, using the MTT assay. Moreover, scanning electron microscopy (SEM) was performed to evaluate cell morphological alterations. The I/R resulted in biochemical parameter alterations, with EOLA reverting all these alterations. Histological evaluation showed that EOLA protected the morphological changes caused by I/R. Also, EOLA was able to reduce TBARS and increase GSH levels in renal tissue. In the tubular cells, the EOLA partially reversed the damage caused by I/R, which was observed through the SEM. The EOLA showed effect against I/R-induced AKI through pre-treatment, protecting biochemical and oxidative parameters in vivo and reversing tubular cell damage in vitro.

Abstract Ischemia/reperfusion injury (I/R) is commonly related to acute kidney injury (AKI) and oxidative stress. Antioxidant agents are used to treat this condition. Lippia sidoides is a brazillian shrub with anti-inflammatory and anti-oxidative properties. Thus, the aim of this study is to evaluate the effect of Lippia sidoides ethanolic extract (LSEE) on in vivo and in vitro models of AKI induced by I/R. Male Wistar rats were submitted to unilateral nephrectomy and ischemia on contralateral kidney for 60 min via clamping followed by reperfusion for 48 h. They were divided into four groups: Sham, LSEE (sham-operated rats pre-treated with LSEE), I/R (rats submitted to ischemia) and I/R-LSEE (rats treated with LSEE before ischemia). Kidney tissues homogenates were used to determine stress parameters and nephrin expression. Plasma and urine samples were collected for biochemical analysis. I/R in vitro assays were evaluated by 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) and flow cytometry assays in Rhesus Monkey Kidney Epithelial Cells (LLC-MK2). The LSEE treatment prevented biochemical and nephrin expression alterations, as well as oxidative stress parameters. In the in vitro assay, LSEE protected against cell death, reduced the reactive oxygen species and increased mitochondrial transmembrane potential. LSEE showed biotechnological potential for a new phytomedicine as a nephroprotective agent.

Estudo exploratório-descritivo, com abordagem quali-quantitativa, que buscou analisar a percepção dos profissionais quanto à pertinência dos indicadores de saúde bucal do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) em Fortaleza, Ceará. A desmotivação, a descontinuidade no fornecimento de insumos odontológicos, o abandono do tratamento por parte do paciente, a cultura popular de que a gestante não pode realizar tratamento odontológico e a insegurança do profissional no manejo clínico relacionado à prótese dentária, ao atendimento à gestante, ao atendimento à urgência odontológica e ao diagnóstico de alteração da mucosa oral dos usuários foram problemas identificados na operacionalização desses indicadores e mencionados como interferência para o cumprimento de suas metas.

Exploratory-descriptive study, with qualitative and quantitative approach, which aims to analyze the perception by professionals on the relevance of oral health indicators of the National Program for Access and Quality Improvement of Primary Care (PMAQ-AB) in Fortaleza, Ceará. The demotivation, the discontinuity in providing dental inputs, the abandonment of treatment by the patient, the popular culture in which the pregnant cannot carry out the dental treatment and the insecurity of the professional in the clinical handling related to dental prosthesis, to the attendance of the pregnant, to the attendance of dental urgency and to the diagnosis of user's oral mucosa alteration were problems identified in the operationalization of these indicators and mentioned as interference for the fulfillment of their goals.

Estudo exploratório-descritivo, com abordagem quali-quantitativa, que buscou analisar a percepção dos profissionais quanto à pertinência dos indicadores de saúde bucal do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) em Fortaleza, Ceará. A desmotivação, a descontinuidade no fornecimento de insumos odontológicos, o abandono do tratamento por parte do paciente, a cultura popular de que a gestante não pode realizar tratamento odontológico e a insegurança do profissional no manejo clínico relacionado à prótese dentária, ao atendimento à gestante, ao atendimento à urgência odontológica e ao diagnóstico de alteração da mucosa oral dos usuários foram problemas identificados na operacionalização desses indicadores e mencionados como interferência para o cumprimento de suas metas.

Exploratory-descriptive study, with qualitative and quantitative approach, which aims to analyze the perception by professionals on the relevance of oral health indicators of the National Program for Access and Quality Improvement of Primary Care (PMAQ-AB) in Fortaleza, Ceará. The demotivation, the discontinuity in providing dental inputs, the abandonment of treatment by the patient, the popular culture in which the pregnant cannot carry out the dental treatment and the insecurity of the professional in the clinical handling related to dental prosthesis, to the attendance of the pregnant, to the attendance of dental urgency and to the diagnosis of user's oral mucosa alteration were problems identified in the operationalization of these indicators and mentioned as interference for the fulfillment of their goals.

Os fitoterápicos são utilizados por automedicação ou por prescrição médica e a maior parte não tem o seu perfil tóxico bem conhecido. Atualmente estão incorporados aos vários Programas de Fitoterapia como opção terapêutica eficaz e pouco custosa. A importância da inclusão dos fitoterápicos nos programas de farmacovigilância vem sendo reconhecida nos últimos anos por vários países da Europa, como Reino Unido e Alemanha, onde várias plantas foram submetidas à farmacovigilância e muitas delas foram retiradas do mercado devido a importantes efeitos tóxicos e risco para uso humano. O aumento no número de reações adversas reportado é possivelmente justificado pelo aumento do interesse populacional pelas terapias naturais observado nas últimas décadas. A farmacovigilância de plantas medicinais e fitoterápicos é uma preocupação emergente e através do sistema internacional será possível identificar os efeitos indesejáveis desconhecidos, quantificar os riscos e identificar os fatores de riscos e mecanismos, padronizar termos, divulgar experiências, entre outros, permitindo seu uso seguro e eficaz.

The herbal drugs are used by self-medication or by medical prescription and most of them do not have their toxic profile well know. Currently they are incorporate to the Phytotherapy Programs as an effective and little expensive therapeutic option. The importance of the inclusion of the herbal drugs in the pharmacovigilance programs has been recognized in the last years by several countries from Europe, like United Kingdom and Germany, where several plants were submitted to pharmacovigilance and many of them were removed from the market due to important toxic effects and risk for human use. The pharmacovigilance of medicinal plants and herbal drugs is an emergent concern and through the international system it will be possible to identify the ignored undesirable effects, to quantify the risks and to identify the risks factors and mechanisms, to standardize terms, to publish experiences, etc., allowing their safe and effective use.