Educational practices are widely used in the health field, both in continuing education for health professionals and health education for the general population. These two fields intersect through the development of educational knowledge oriented by a set of target representations of man and society. Such representations are demonstrated by teaching/learning processes in the four main pedagogical trends in Brazil: traditional, renewed, conditioning-based, and liberating (or the Paulo Freire approach). Based on their respective principles, methods, and individual and social consequences, we contend that liberating pedagogy can produce better results than the others by allowing the student's active participation in the learning process, thus fostering continuous development of human skills in both the health services clientele and health workers.

BackgroundOxaliplatin, the third-generation platinum compound, has evolved as one of the most important therapeutic agents in colorectal cancer chemotherapy. The main limiting factor in oxaliplatin treatment is painful neuropathy that is difficult to treat. This side effect has been studied for several years, but its full mechanism is still inconclusive, and effective treatment does not exist. Data suggest that oxaliplatin’s initial neurotoxic effect is peripheral and oxidative stress-dependent. A spinal target is also suggested in its mechanism of action. The flavonoids rutin and quercetin have been described as cell-protecting agents because of their antioxidant, antinociceptive, and anti-inflammatory actions. We proposed a preventive effect of these agents on oxaliplatin-induced painful peripheral neuropathy based on their antioxidant properties.MethodsOxaliplatin (1 mg/kg, i.v.) was injected in male Swiss mice, twice a week (total of nine injections). The development of sensory alterations, such as thermal and mechanical allodynia, was evaluated using the tail immersion test in cold water (10°C) and the von Frey test. Rutin and quercetin (25-100 mg/kg, i.p.) were injected 30 min before each oxaliplatin injection. The animals’ spinal cords were removed for histopathological and immunohistochemical evaluation and malondialdehyde assay.ResultsOxaliplatin significantly increased thermal and mechanical nociceptive response, effects prevented by quercetin and rutin at all doses. Fos immunostaining in the dorsal horn of the spinal cord confirmed these results. The oxidative stress assays mainly showed that oxaliplatin induced peroxidation in the spinal cord and that rutin and quercetin decreased this effect. The flavonoids also decreased inducible nitric oxide synthase and nitrotyrosine immunostaining in the dorsal horn of the spinal cord. These results suggest that nitric oxide and peroxynitrite are also involved in the neurotoxic effect of oxaliplatin and that rutin and quercetin can inhibit their effect in the spinal cord. We also observed the preservation of dorsal horn structure using histopathological analyses.ConclusionsOxaliplatin induced painful peripheral neuropathy in mice, an effect that was prevented by rutin and quercetin. The mechanism of action of oxaliplatin appears to be, at least, partially oxidative stress-induced damage in dorsal horn neurons, with the involvement of lipid peroxidation and protein nitrosylation.

In this scenario, by collecting data for the research, the nurses contributed to the promotion of gender equality and women's empowerment, as recommended by the Millennium Development Goals.

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Background and purpose Severe diarrhoea, a common gastrointestinal manifestation of anticancer treatment with irinotecan, might involve single nucleotide polymorphisms (SNPs) of toll‐like receptors (TLRs), described as critical bacterial sensors in the gut. Here, colorectal cancer patients carrying missense TLR4 A896G (rs4986790) or C1,196T (rs4986791) SNPs and Tlr4 knockout (Tlr4−/−) mice were given irinotecan to investigate the severity of the induced diarrhoea. Experimental approach Forty‐six patients treated with irinotecan‐based regimens had diarrhoea severity analysed according to TLR4 genotypes. In the experimental setting, wild‐type (WT) or Tlr4−/− mice were given irinotecan (45 or 75 mg·kg−1, i.p.) or saline (3 ml·kg−1). Diarrhoea severity was evaluated by measuring intestinal injury and inflammatory markers expression after animals were killed. Key results All patients with TLR4 SNPs chemotherapy‐treated presented diarrhoea, whereas gastrointestinal toxicity was observed in 50% of the wild homozygous individuals. Mice injected with irinotecan presented systemic bacterial translocation and increased TLR4 immunostaining in the intestine. In line with the clinical findings, Tlr4 gene deficiency enhanced irinotecan‐related diarrhoea and TLR9 expression in mice. An increased myeloperoxidase activity and Il‐18 expression along with IL‐10 decreased production in Tlr4−/− mice also indicated an intensified intestinal damage and inflammatory response. Conclusion and implications TLR4 deficiency upregulates TLR9 expression and enhances intestinal damage and the severity of late‐onset diarrhoea during irinotecan‐based treatment. Identifying patients genetically predisposed to chemotherapy‐associated diarrhoea is a strategy toward precision medicine.

Objective: to describe the compliance of obstetric nursing care practices with the technical recommendations for normal birth. Methods: cross-sectional study of records of normal birth care delivered by nurse-midwifes from two public maternity hospitals. The compliance assessment was based on the World Health Organization recommendations. The two-tailed Z-test was applied. Results: Appropriate compliance was found for all practices assessed at maternity hospital A. At maternity hospital B, the timely clamping of the umbilical cord obtained partial compliance (70.9%). Prescriptions were found for a null diet, 85.7% and 59.8%; oxytocin during labor, 38.7% and 48.4%; and peri-parturient tocodynamometry, 30.5% and 47.2%, at maternity hospitals A and B, respectively. Conclusion: the presence of the companion; use of the partogram; non-pharmacological care; intermittent auscultation of fetal heart beat; non-supinal maternal position during child birth; and postpartum application of intramuscular oxytocin obtain appropriate compliance, although inappropriate conducts were observed, such as prescriptions for a null diet, oxytocin and intrapartum tocodynamometry. Descriptors: Obstetric Nursing; Nursing Care; Humanizing Delivery.Objetivo: descrever a conformidade das práticas assistenciais de enfermagem obstétrica com as recomendações técnicas para o parto normal. Métodos: estudo transversal dos registros da assistência ao parto normal prestada pelas enfermeiras obstétricas em duas maternidades públicas. A avaliação da conformidade fundamentou-se nas recomendações da Organização Mundial da Saúde. Aplicou-se o teste Z bicaudal. Resultados: todas as práticas avaliadas têm conformidade adequada na maternidade A. Na maternidade B, o clampeamento oportuno do cordão umbilical obteve conformidade parcial (70,9%). Verificaram-se prescrições de dieta zero, 85,7% e 59,8%; ocitocina no trabalho de parto, 38,7% e 48,4%; e cardiotocografia periparto, 30,5% e 47,2%, nas maternidades A e B respectivamente. Conclusão: a presença do acompanhante; uso do partograma; cuidados não farmacológicos; ausculta intermitente dos batimentos cardiofetais; posição materna não supina no parto; e aplicação de ocitocina intramuscular no pós-parto tem conformidade adequada, contudo, observou-se condutas inapropriadas, como prescrições de dieta zero, ocitocina e cardiotocografia intraparto.

Mouta RJO, Prata JA. Percepções das enfermeiras obstetras sobre sua formação na modalidade de residência e prática profissional. REME -Rev Min Enferm. 2018 [citado em ];22:e-1107. Disponível em: DOI: 10.5935/1415DOI: 10.5935/ -2762 RESUMO Este estudo objetivou descrever as percepções das enfermeiras obstetras sobre a formação na modalidade de residência e suas interfaces com a prática profissional. Trata-se de pesquisa qualitativa, que entrevistou 25 enfermeiras obstetras qualificadas em curso de especialização na modalidade de residência. A técnica da análise temática foi aplicada para análise das entrevistas semiestruturadas. Os resultados mostraram que as enfermeiras obstetras têm percepção positiva sobre sua formação em programa de residência, mas mencionam contradições entre o enfoque no cuidado humanizado do ensino teórico e a persistência do modelo medicalizado nos cenários do ensino em serviço. Quanto à atuação profissional na área, as enfermeiras destacam a facilidade no uso das tecnologias de cuidados e os obstáculos decorrentes dos conflitos profissionais, do baixo reconhecimento e da sobrecarga de trabalho. Concluiu-se que a modalidade de residência promove segurança para o exercício da especialidade, mas as restrições identificadas impõem desafios para a qualificação e prática profissional, ressaltando a necessidade de adequação do programa de ensino com vistas à formação de especialistas com atitudes capazes de enfrentar e superar tais desafios. Palavras-chave: Enfermagem Obstetra; Educação em Enfermagem; Prática Profissional. ABSTR ACT This study aimed at describing the perceptions of nurse-midwives of their training in the residency modality and its interfaces with the professional practice. This is a qualitative research conducted with twenty-five nurse-midwives qualified in the residency specialization course. To analyze the semi-structured interviews, the thematic analysis technique was applied. The results showed that nurse-midwives have a positive perception of their training in a residency program, but they mention contradictions between the theoretical teaching focus on