ResumoAs metodologias ativas geram estresse na medida em que o estudante é responsável pelo gerenciamento do próprio aprendizado. Na aprendizagem centrada no estudante, o ambiente das discussões ocorre, geralmente, em pequenos grupos em quase todos os cenários. O aluno vivencia tanto suas emoções quanto as de seus colegas. Os aspectos de sua personalidade, suas fragilidades, seu desempenho nos estudos sua capacidade de se adaptar ao grupo podem gerar conflitos internos. A ansiedade causada por estes sentimentos pode ser considerada, por si só, um estímulo estressor e na sociedade moderna vem se tornando algo comum, devido ao estresse e às exigências que o cotidiano traz. O método de ensino "Aprendizagem Baseada em Problemas" (PBL) na formação acadêmica médica acaba sendo mais um fator, que pode causar a ansiedade. Este estudo teve como objetivo avaliar a percepção dos estudantes de Medicina quanto ao processo de aprendizagem e ansiedade na metodologia de ensino PBL. Os resultados obtidos com base em um questionário modificado, após assinatura do termo de consentimento livre e esclarecido, sugerem que a maioria dos estudantes de medicina de Campo Grande -MS, 64,7% (223)

The present study confirms that NH4Cl-induced acidosis causes disturbances in renal sodium handling. In addition, these findings demonstrate a sustained pre-stimuli activation of kidney MAPK/ERKs signalling pathways in the NH4Cl-treated rats that may correlate with an increased rate of kidney hypertrophy and a transient renal tubule inability to handle sodium. Thus, the altered renal electrolyte handling may result from a reciprocal relationship between the level of renal tubule metabolic activity and ion transport. In addition, the study shows that the appropriate regulation of tyrosine kinase protein phosphorylation, and its downstream signal transduction pathway, plays an important role on renal growth in the NH4Cl-treated rats.

Background. We have previously shown that chronic metabolic acidosis, induced in rats by NH 4 Cl feeding, leads to nephron hypertrophy and to a decreased water-salt reabsorption by the kidneys. Since mitochondria are the main source of metabolic energy that drives ion transport in kidney tubules, we examined energy-linked functions (respiration, electrochemical membrane potential and coupling between respiration and ADP phosphorylation) in mitochondria isolated from rat kidney and liver at 48 h after metabolic acidosis induced by NH 4 Cl. Methods. Mitochondria isolated from the kidneys and liver of metabolic acidotic rats, induced by NH 4 Cl, was used to study of the oxygen consumption by Clarktype electrode, mitochondrial electrical transmembrane potential estimated by the safranine O method and the variations in free medium Ca 2+ concentrations examined by absorbance spectrum of Arsenazo III set at the 675-685 nm wavelength pair. Results. Whole kidney and liver mitochondria isolated from 48 h acidotic rats presented higher resting respiration, lower respiratory control and a lower ADP/O ratio than controls. These differences in mitochondrial coupling, between respiration and oxidative phosphorylation (ATP synthesis), were totally corrected when experiments were carried out in the presence of carboxyatractyloside, GDP and BSA, indicating that mitochondrial uncoupling proteins are more active in acidotic rat kidneys. Interestingly, determination of Ca 2þ transport demonstrated a faster rate of initial Ca 2þ uptake by acidotic kidney mitochondria, which resulted in a lower concentration of extra-mitochondrial Ca 2þ under steady-state conditions (Ca 2þ set point) when compared with control mitochondria.In contrast, there were no significant differences in the rates of Na þ or ruthenium red induced Ca 2þ efflux. Conclusions. We suggest that the mild uncoupling and higher Ca 2þ accumulation represents an adaptation of the mitochondria to cope with conditions of oxidative stress and high cytosolic Ca 2þ , which are associated with a decreased efficiency of oxidative phosphorylation that may explain, at least in part, the striking natriuresis observed under chronic acidosis. Finally, there were no changes in Ca 2þ transport or coupling in liver mitochondria isolated from the acidotic rats.

Speculatively, it may be suggested that one of the renal sensory nerve signal defects associated with decreased kidney energy generation, induced by kidney ablation, may result in an inability to control the body temperature.

ResumoO presente estudo teve como objetivo avaliar o impacto da educação nutricional no controle do ganho de peso interdialítico de pacientes em hemodiálise. Foram avaliados sessenta pacientes e as variáveis estudadas foram: perfil social, conhecimento prévio e adquirido com o projeto, média do GPID e IMC. O estudo avaliou que o sexo masculino foi predominante, a idade variou de 18 a 81 anos, o tempo de tratamento de 4 a 160 meses e a doença de base mais frequente foi a Hipertensão Arterial. Quanto ao IMC, o excesso de peso foi encontrado em 48,33% dos pacientes. O número de acertos no questionário de conhecimento aumentou em 7,75%, e não houve alteração significativa no GPID (de 2,65 ± 1,00 kg para 2,66 ± 1,15 kg). Conclui-se que com a intervenção nutricional houve aumento do conhecimento dos participantes com relação ao ganho de peso, no entanto, a mudança comportamental não foi significativa ao ponto de justificar redução do GPID.Palavras-chave: Educação Nutricional. Programa Crônico de Hemodiálise. Doença Renal Crônica. AbstracThis study aimed at assessing the impact of nutritional education at the interdyalitic weight gain control of Hemodialysis patients. 60 students were evaluated and the variables studies were: social profile, previous and acquired knowledge with the Project, IDWG and BMI average. The study assessed that male gender was predominant , the age ranged from 18 to 81 years old, the treatment time from 4 to 160 months and the the most frequent basis sickness was high-blood pressure. Regarding BMI, the weight excess was found in 48.33% of the patients. The number of hits at the questionnaire increased in 7.75%, and there was no significative change at the IDWG (from 2,65 ± 1,00 kg to 2,66 ± 1,15 kg). It is concluded that through the nutritional intervention there was knowledge improvement of the participants concerning weight gain, although, the behavioral change was not significative to the extent of justifying IDWG reduction.