Esta pesquisa discute a Comunicação em Saúde no contexto das Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS), no que concerne ao tratamento do câncer realizado num hospital público de Campinas. O arcabouço teórico se debruça sobre as diretrizes do ideário da Promoção da Saúde e sobre as discussões da Educação em Saúde, por serem premissas fundamentais para que a Comunicação em Saúde seja participativa e democrática, e que a Comunicação das PIC conquiste maior espaço na Saúde Pública. O objetivo geral foi investigar o processo de comunicação entre profissionais de saúde e usuários do SUS participantes do Projeto de Construção do Cuidado Integrativo (PCCI). A metodologia utilizada foi a qualitativa tendo como instrumentos pesquisa documental e entrevistas semi-estruturadas para a coleta dos dados. Os participantes do estudo foram usuários que fizeram parte do grupo de Acupuntura e de Fitoterapia e usaram práticas complementares ao tratamento convencional do câncer, e também os profissionais de saúde envolvidos no PCCI realizado no Hospital de Clínicas da Universidade Estadual de Campinas (UNICAMP)/SP. Os dados foram analisados por meio da análise temática de conteúdo de Bardin, que permitiu identificar as seguintes categorias: Medo da intervenção, Analgesia como resultado, Continuidade do tratamento, Falta de informação e Divulgação das práticas. Os resultados mostraram que houve dificuldades de comunicação, indicando lacunas importantes em relação à infraestrutura, à falta de divulgação e continuidade do tratamento complementar com as PIC, a falta de valorização da participação popular e estímulo à autonomia como preconiza o ideário da Promoção da Saúde. Concluiu-se que o modelo de saúde vigente, de base biomédica, não tem permitido a participação dos usuários, e, mais ainda, tem dificultado o desenvolvimento da comunicação democrática, humanizada e solidária. O Projeto (PCCI) foi importante em sua execução, uma vez que trouxe resultados positivos com o uso das PIC por melhorar as condições da qualidade de vida dos usuários e ter promovido analgesia, conferido maior disposição e recuperação dos movimentos. Entretanto, o Projeto (PCCI) não teve potencial o suficiente para provocar uma mudança na lógica do tratamento convencional que está hegemonicamente imerso no modelo biomédico, com isso limitando a inserção e a comunicação das PIC na Saúde Pública e dificultando a abertura para o diálogo entre os diferentes saberes. Entende-se que este é um dos principais desafios da Medicina Tradicional e Complementar (MTC). / In this research is discussed Health Communication in the light of Integrative and Complementary Practices (PIC) of the Brazilian Unified Health System (SUS), regarding cancer treatment performed in a public hospital in Campinas. The rationale is Health Promotion as an idealistic guideline, as well as the discussions of Health Education. These are fundamental premises to guarantee Health Communication in a participatory and democratic manner, and that the communication of PIC conquers more space in Public Health. The overall objective was to investigate the process of communication between health professionals and users of the Unified Health System (SUS) that participate in the Construction of Integrative Care Project (Projeto de Construção do Cuidado Integrativo - PCCI). The methodology was qualitative having as documentary research tools and semi-structured interviews for data collection. Study participants were users part of the Acupuncture and Herbal Medicine Group, which used the practices complementing the conventional cancer treatment, and also the health professionals involved in the PCCI conducted at the Clinical Hospital of the State University of Campinas (Unicamp) / SP. The data were analyzed using thematic analysis of content (Bardin), which identified the following categories: \"Intervention Fear\", \"Analgesia as a Result\", \"Follow-up Care\", \"Lack of Information\" and \"Propagation of Practices\". The results showed that there were communication difficulties, indicating significant gaps in relation to infrastructure, lack of propagation and continuity of complementary treatment with PIC, and yet no proper appreciation of popular participation neither the encouragement of autonomy advocated by the ideas of Health Promotion. Concluding, the current Public Health policy, which is biomedical based, has not yet allowed the participation of users and, even more, has hindered the development of democratic, humane and supportive communication. The Project (PCCI) was important in its execution as it brought positive results regarding the use of PIC to improve the quality of life of users, promote analgesia, confer greater willingness and recovery of movement. However, the project (PCCI) did not have enough potential, yet, to promote a change in the logic of conventional treatment, which is hegemonic immersed in the biomedical model, thereby limiting the inclusion and communication of PIC in Public Health, and hindering an opening for dialogue between different knowledge. This is one of the main challenges of Traditional and Complementary Medicine (TCM).

There is a global rise in the use of herbal products in combination with allopathic medicines, while most patients do not inform their health care providers of the use of these natural products. Both pharmacodynamic and pharmacokinetic interactions between herbal products and conventional drugs must be avoided for the wellbeing of the patient. Increasing evidence from in vitro and in vivo studies indicate that changed drug pharmacokinetics by co-administered herbs may be attributed to modulation of efflux drug transporters such as P-glycoprotein (P-gp). Garlic (Allium sativum), lemon (Citrus limonum) and beetroot (Beta vulgaris) are widely used by human immunodeficiency virus (HIV) patients, especially following the pronouncement by a former President of South Africa and the Ministers of Health at that time who promoted the use of these botanicals in HIV patients. The aim of this study was to measure the bi-directional in vitro transport of indinavir, a protease inhibitor, in the presence of crude extracts and pure phytoconstituents of A. sativum (L-alliin and diallyl disulphide), C. limonum (hesperidin and eriocitrin) and B. vulgaris (betaine monohydrate and ß-carotene) across excised porcine intestinal tissue in Sweetana-Grass diffusion chambers. In the negative control group, the transport of indinavir alone (200 M) was determined with no modulator added. In the positive control group, the transport of indinavir was determined in the presence of verapamil (100 M), a known P-gp related efflux inhibitor. The control experiments were used to indicate that the effects of the test compounds were caused by their action and not by chance interferences or external factors. Samples collected at pre-determined time intervals were analysed by means of a validated high performance liquid chromatography (HPLC) method and the transport was expressed as the apparent permeability coefficient (Papp) and the transepithelial flux (J) from which the efflux ratio (ER) and the net flux (Jnet) values were calculated. Statistical analysis was used to compare the results of the test compounds with the control groups in order to indicate significant differences. The mean ER value for indinavir in the negative control group was 1.41 ± 0.170 and in the positive control group it was 0.56 ± 0.0426. Statistically significant (p < 0.05) inhibition of indinavir efflux as indicated by reduced ER values was obtained for L-alliin (ER = 0.280 ± 0.030), diallyl disulphide (ER = 0.505 ± 0.034) and ß-carotene (ER = 0.664 ± 0.075). Inhibition of indinavir efflux will lead to increased transport and therefore a potentially higher bioavailability. Statistically significant (p < 0.05) promotion of indinavir efflux as indicated by increased ER values was obtained for C. limonum crude extract (ER = 5.551 ± 0.575) and hesperidin (ER = 3.385 ± 0.477), which potentially may lead to lower bioavalability. B. vulgaris crude extract (p = 0.8452), betaine monohydrate (p = 0.9982), A. sativum crude extract (p = 0.7161) and eriocitrin (p = 0.4431) displayed no statistically significant effect compared to the negative control group on indinavir transport across excised porcine intestinal tissue. The results from this study demonstrate that L-alliin, diallyl disulphide and ß-carotene have an inhibitory effect on indinavir efflux, which may significantly increase indinavir plasma levels after oral administration. C. limonum crude extract and hesperidin promote indinavir efflux, which may significantly reduce indinavir plasma levels. These pharmacokinetic interactions between certain drugs and plant extracts may negatively affect the anti-retroviral treatment of HIV patients, but deliberate and controlled inclusion of L-alliin, diallyl disulphide and ß-carotene in dosage forms may possibly cause more effective delivery of protease inhibitors after oral administration resulting in less frequent dosing intervals. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

There is a global rise in the use of herbal products in combination with allopathic medicines, while most patients do not inform their health care providers of the use of these natural products. Both pharmacodynamic and pharmacokinetic interactions between herbal products and conventional drugs must be avoided for the wellbeing of the patient. Increasing evidence from in vitro and in vivo studies indicate that changed drug pharmacokinetics by co-administered herbs may be attributed to modulation of efflux drug transporters such as P-glycoprotein (P-gp). Garlic (Allium sativum), lemon (Citrus limonum) and beetroot (Beta vulgaris) are widely used by human immunodeficiency virus (HIV) patients, especially following the pronouncement by a former President of South Africa and the Ministers of Health at that time who promoted the use of these botanicals in HIV patients. The aim of this study was to measure the bi-directional in vitro transport of indinavir, a protease inhibitor, in the presence of crude extracts and pure phytoconstituents of A. sativum (L-alliin and diallyl disulphide), C. limonum (hesperidin and eriocitrin) and B. vulgaris (betaine monohydrate and ß-carotene) across excised porcine intestinal tissue in Sweetana-Grass diffusion chambers. In the negative control group, the transport of indinavir alone (200 M) was determined with no modulator added. In the positive control group, the transport of indinavir was determined in the presence of verapamil (100 M), a known P-gp related efflux inhibitor. The control experiments were used to indicate that the effects of the test compounds were caused by their action and not by chance interferences or external factors. Samples collected at pre-determined time intervals were analysed by means of a validated high performance liquid chromatography (HPLC) method and the transport was expressed as the apparent permeability coefficient (Papp) and the transepithelial flux (J) from which the efflux ratio (ER) and the net flux (Jnet) values were calculated. Statistical analysis was used to compare the results of the test compounds with the control groups in order to indicate significant differences. The mean ER value for indinavir in the negative control group was 1.41 ± 0.170 and in the positive control group it was 0.56 ± 0.0426. Statistically significant (p < 0.05) inhibition of indinavir efflux as indicated by reduced ER values was obtained for L-alliin (ER = 0.280 ± 0.030), diallyl disulphide (ER = 0.505 ± 0.034) and ß-carotene (ER = 0.664 ± 0.075). Inhibition of indinavir efflux will lead to increased transport and therefore a potentially higher bioavailability. Statistically significant (p < 0.05) promotion of indinavir efflux as indicated by increased ER values was obtained for C. limonum crude extract (ER = 5.551 ± 0.575) and hesperidin (ER = 3.385 ± 0.477), which potentially may lead to lower bioavalability. B. vulgaris crude extract (p = 0.8452), betaine monohydrate (p = 0.9982), A. sativum crude extract (p = 0.7161) and eriocitrin (p = 0.4431) displayed no statistically significant effect compared to the negative control group on indinavir transport across excised porcine intestinal tissue. The results from this study demonstrate that L-alliin, diallyl disulphide and ß-carotene have an inhibitory effect on indinavir efflux, which may significantly increase indinavir plasma levels after oral administration. C. limonum crude extract and hesperidin promote indinavir efflux, which may significantly reduce indinavir plasma levels. These pharmacokinetic interactions between certain drugs and plant extracts may negatively affect the anti-retroviral treatment of HIV patients, but deliberate and controlled inclusion of L-alliin, diallyl disulphide and ß-carotene in dosage forms may possibly cause more effective delivery of protease inhibitors after oral administration resulting in less frequent dosing intervals. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

Herbal medicines remain integral part of indigenous health care system in Ghana. Most conventional health medicines are directly or indirectly derived from plants or herbs. Despite its significant role in modern medicine indigenous herbal practices has been on the low light for some time due to perceived antagonistic relationship that exists between practitioners of herbal medicine and their counterpart in the conventional system. Using an indigenous knowledge discursive framework, the thesis examined the relevance of herbal medicine to the contemporary Ghanaian society. The thesis also examined the tension between the indigenous herbal practitioners and their orthodox counterparts. The thesis noted that for health care system in Ghana to be effective, there is a need for collaborate relations between these two practitioners. Also, it was noted that for health care system to be effective in Ghana, spirituality has to be central in the works of the herbal practitioners.

Herbal medicines remain integral part of indigenous health care system in Ghana. Most conventional health medicines are directly or indirectly derived from plants or herbs. Despite its significant role in modern medicine indigenous herbal practices has been on the low light for some time due to perceived antagonistic relationship that exists between practitioners of herbal medicine and their counterpart in the conventional system. Using an indigenous knowledge discursive framework, the thesis examined the relevance of herbal medicine to the contemporary Ghanaian society. The thesis also examined the tension between the indigenous herbal practitioners and their orthodox counterparts. The thesis noted that for health care system in Ghana to be effective, there is a need for collaborate relations between these two practitioners. Also, it was noted that for health care system to be effective in Ghana, spirituality has to be central in the works of the herbal practitioners.

Made available in DSpace on 2014-12-17T14:25:22Z (GMT). No. of bitstreams: 1 AlineCC_TESE.pdf: 5713119 bytes, checksum: 5863ea9920b2303b3df108c3054d1dd2 (MD5) Previous issue date: 2014-02-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / A asma ? uma doen?a cr?nica caracterizada por dispneia, tosse, espirro intermitente e opress?o tor?cica, sintomas decorrentes de processos fisiol?gicos como edema, aumento de secre??o de muco e contra??o da musculatura lisa br?nquica e tamb?m encontra nas plantas medicinais sugest?es para seu tratamento. A esp?cie Cissampelos sympodialis Eichl ? uma esp?cie vegetal bastante estudada, tendo sido avaliadas e comprovadas uma s?rie de a??es farmacol?gicas (anti-anafil?tica, anti-inflamat?ria e efeito imunomodulador) que a colocam em posi??o de destaque para terapia da asma. Esses efeitos farmacol?gicos s?o associados ? presen?a de alcaloides, destacando-se a warifte?na. O controle de qualidade do material vegetal segundo m?todos farmacopeicos foi realizado na busca de especifica??es de qualidade para as folhas de Cissampelos sympodialis e garantia de uso seguro desse insumo vegetal. A aplica??o de t?cnicas quimiom?tricas do tipo planejamento experimental foi ?til no estabelecimento de condi??es ?timas de extra??o para obten??o de extratos hidroalco?lcios das folhas de Cissampelos sympodialis, cuja otimiza??o ocorreu tamb?m atrav?s de an?lise univariada relacionada ao tamanho de part?cula do material vegetal e m?todo de extra??o. A monitora??o de atividade biol?gica anti-inflamat?ria, presumida atrav?s de modelos de cultura de c?lulas de linfonodos e macr?fagos para quantifica??o de citocinas associadas ao processo inflamat?rio, foi realizada para os extratos com maior e menor teor de warifte?na, decorrentes do planejamento experimental, na forma de suas respectivas fra??es aquosas. A rela??o do teor de warifte?na com a pot?ncia de atividade anti-inflamat?ria p?de ser sugerida, havendo ainda necessidade de otimiza??o da obten??o da fra??o aquosa. As condi??es padronizadas para obten??o do extrato hidroalco?lico envolvem a utiliza??o de material vegetal com part?culas de 500 ?m, na propor??o 1:10 (droga: solvente p/v), com o sistema de solvente extrator sendo etanol : ?gua na propor??o 80 : 20 (v/v), atrav?s da macera??o por 48h, com reposi??o de solvente ap?s as primeiras 24 h. Foram realizados alguns ensaios de secagem por spray dryer das fra??es aquosas obtidas, sendo sugerida a utiliza??o de maltodextrina, isolada ou em associa??o a di?xido de sil?cio coloidal, havendo ainda necessidade de ensaios definitivos. Todo o estudo foi realizado com o intuito de se obter insumo farmac?utico est?vel e de qualidade para futuro desenvolvimento de formula??es e consequente obten??o de medicamento fitoter?pico para o tratamento de asma

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