Medicinal Plants in Pregnancy and Lactation: Perception of the Health Risk and Practical Educational Group in Araraquara, São Paulo State, Brazil

The use of medicinal plants among pregnant women and lactating is a common practice in diverse countries. However, many medicinal plants are contraindicated during pregnancy and lactating, due to various adverse effects, such as teratogenic, embryotoxic and abortive effects, exposing these women, their fetus and babies to health unknown risks. Thus, the purpose of this commentary, was to analyze the perception about the use of medicinal plants by pregnant women and lactating registered in the "baby on board" NGO, Araraquara, São Paulo state, Brazil, between 2010 at 2013. The group was constituted by 48 women, between the first and last trimester of pregnancy or whilst breastfeeding. Information was collected during group meetings by oral interview, using a questionnaire, as script. The nature of the study was a qualitative analysis. The results were based on reports about the use of medicinal plants by pregnant women during group meetings: use, indication of use, knowledge about risks. All participants received written and oral information about the study and they gave a written informed consent. The use of medicinal plants is a reality among pregnant and lactating women of the "baby on board" NGO. They reported that they feel that "natural" products are not harmful for their health. The primary information sources for the majority of women about medicinal plants during pregnancy are family, neighbors and herbalists. The plants most cited were: senna, chamomile, boldo, lemon balm, lemon grass. They were used mainly for: nausea, heartburn, indigestion, flatulence, intestinal and abdominal pain, anxiety, intestinal constipation and low milk production. The pregnant and lactating women lacked knowledge about the health risks of the use of medicinal plants and herbal medicines in pregnancy and lactation. They also reported difficulties in clarifying some questions about the use of medicinal plants with their doctors. The results of the present study showed that educative actions about the rational use of medicinal plants in pregnancy and breastfeeding could be part of the operating protocols to promote the maternal and child health programs in Araraquara. Thus, our results also suggest the importance of creating institutionalized places, to the implementation of continued education programs about rational use of medicinal plants in pregnancy and lactation. These targeted programs are not only for health professionals, but also for community members, pregnant women and breastfeeding. Our results pointed out the importance of guidance of doctors and healthcare professionals on the scientific studies about medicinal plants and herbal medicines and the risk/benefit of using herbs during pregnancy. Finally, it is noted the importance of the health professionals to inform women of childbearing on risks to their health, as well as on possibilities of utilization of herbs during fertile period, giving special attention to the potential risk of self-medication

A autonomia do profissional dentro do processo de cuidado na Atenção Primária”: um sonho realizado por Francine Campolim

In this interview, Francine Campolim talks about the experience of implementing phytotherapy in Itapeva/SP in collaboration with a local cooperative.Nesta entrevista, Francine Campolim fala sobre a experiência da implantação da fitoterapia em Itapeva/SP em colaboração com uma cooperativa local

Avaliação de cardápio e identificação de alimentos funcionais: estudo qualitativo de restaurante popular de Araraquara, São Paulo, Brasil

Este estudo avalia qualitativamente o cardápio e a presença de alimentos funcionais nas preparações do restaurante popular do município de Araraquara, São Paulo. Esse estabelecimento integra a rede de ações e programas da Fome Zero, política de inclusão social, administrada pelo Ministério do Desenvolvimento Social e Combate à Fome, visando à oferta de refeições prontas saudáveis e a preços acessíveis, reduzindo assim, o número de pessoas em situação de insegurança alimentar. Realizou-se um estudo de caso descritivo, de caráter qualitativo, durante o período de fevereiro a abril de 2014. Analisou-se qualitativamente o cardápio do almoço de 12 semanas pelo método Análise Qualitativa das Preparações do Cardápio. A presença de alimentos funcionais foi avaliada por meio da identificação, quantidade e frequência oferecida nas preparações do cardápio, seguindo as recomendações da American Dietetic Association de 2004. O cardápio apresentou como aspectos positivos, oferta de frutas como sobremesa 89,7%, carnes gordurosas 6,9%, doces 12,1% e não foi observada oferta de frituras e doces no mesmo dia. A baixa oferta de saladas de folhosos e a monotonia de cores das preparações foram evidentes, sendo um aspecto negativo do cardápio. Os alimentos funcionais foram identificados principalmente em frutas e verduras, oferecidos todos os dias. Conclui-se que o restaurante popular avaliado ofereceu um cardápio adequado quanto aos itens analisados. Destaca-se que a introdução de uma alimentação saudável e de alimentos funcionais na dieta de cada indivíduo deve ser contínua, auxiliando na prevenção de doenças e na busca da saúde

A DONOR-DEPENDENT SUBSET OF CYTOKINE-INDUCED KILLER (CIK) CELLS EXPRESS CD16 AND CAN BE RETARGETED TO EXERT A POTENT ANTIBODY-DEPENDENT CELL-MEDIATED CYTOTOXICITY (ADCC)

Cancer adoptive cell therapy (ACT) relies on the infusion of immune cell populations mediating direct antitumor effects, such as cytotoxic CD8+ T lymphocytes (CTL), natural killer (NK) cells and Cytokine-Induced Killer (CIK) cells. In this study, we aimed at improving CIK cell potential for adoptive immunotherapy strategies. CIK cells are a heterogeneous population of ex vivo expanded lymphocytes, which share phenotypic and functional features with both NK and T cells. They exert a potent MHC-independent antitumor activity against both hematological and solid malignancies, but not normal tissues and hematopoietic precursors. Several clinical trials have demonstrated the feasibility and the therapeutic efficacy together with low toxicity of CIK cells infusion, supporting CIK cells as a very promising cell population for adoptive immunotherapy. In this work, CIK cells were obtained from PBMCs of healthy donors by the timed addition of IFN-γ, anti-CD3 antibody and IL-2. Analyzing their phenotype, we demonstrated for the first time a relevant expression of CD16 in a donor-dependent manner and, based on this observation, we proved the ability of CIK cells to kill tumors by an Antibody-Dependent Cell-mediated Cytotoxicity (ADCC) mechanism. Indeed, the concurrent administration of clinically therapeutic mAbs, such as trastuzumab or cetuximab, led to a significant improvement of their antitumor activity in vitro against both ovarian and breast cancer cell lines. To formally prove that the CD16 receptor is functional and directly involved in the ADCC, an anti-CD16 blocking antibody was added to the assays. NK cell depletion from bulk cultures confirmed that the ADCC activity is accountable to the CIK CD16+ subpopulation. This novel function of CIK cells, never exploited before, was assessed for therapeutic efficacy in mouse models of human ovarian carcinoma xenografted in NOD/SCID common γ chain knockout (NSG) mice. Co-administration of CIK cells and mAbs significantly increased the survival of tumor-bearing mice, as compared to animals receiving CIK cells alone. CIK cell antitumor activity in vitro was also enhanced by the combination with bispecific antibodies and immunoligands, which are able to target both a tumor-associated antigen and activating receptors expressed by effector cells. Taken together, these data envisage new perspectives for adoptive immunotherapy where antigen-specific retargeting of T cells can be achieved by a combination therapy with clinical-grade monoclonal antibodies already widely used in cancer therapy, and CIK cell populations that are easily expandable in very large numbers, inexpensive, safe and do not require genetic manipulations. In conclusion, this new therapeutic strategy for the ACT treatment of different types of tumors could find wide implementation and application, and be expanded to the use of additional therapeutic antibodies

Synergic and antibiofilm effects of melampodium divaricatum l. (asteracae) essential oil upon bacteria associated with dental caries

Melampodium divaricatum is an herbaceous species, naturally occurring in the Northeast regions of Brazil and is known for its medicinal value and the action against oral pathogens. The objective of this study was to verify the synergistic effect and activity against biofilm formation of the EO from M. divaricatum against bacteria associated with dental caries. The checkerboard assays was used to investigate the in vitro antimicrobial efficacy of the combination of Chlorhexidine dichlorohydrate with M. divaricatum EO. The microtitration plate assay was used for determination the Minimum Inhibitory Concentration of Biofilm (MICB50) of essential oil against the bacteria. The synergistic effect and activity against biofilm formation of the essential oil (EO) from M. divaricatum against bacteria associated with dental caries were observed. The combination effects of EO with chlorhexidine were additive to L. casei, antagonic to S. mutans and indifferent to S. sobrinuns and S. mitis. The antibiofilm activity revealed significant results MICB50 values (200 at 400 µg/mL). This report suggests that the EO is a promising natural product to develop novel therapeutic strategies to fight against cariogenic bacteria

Antileishmanial activity of Melampodium divaricatum and Casearia sylvestris essential oils on Leishmania amazonensis

Leishmaniasis is a disease that affects millions of people and it is an important public health problem. The drugs currently used for the treatment of leishmaniasis present undesirable side effects and low efficacy. In this study, we evaluated the in vitro activity of Melampodium divaricatum (MD-EO) and Casearia sylvestris (CS-EO) essential oils (EO) against promastigote and amastigote forms of Leishmania amazonensis. Sesquiterpenes E-caryophyllene (56.0%), germacrene D (12.7%) and bicyclogermacrene (9.2%) were identified as the main components of MD-EO, whereas E-caryophyllene (22.2%), germacrene D (19.6%) and bicyclogermacrene (12.2%) were the main constituents of CS-EO. CS-EO and E-caryophyllene were active against promastigote forms of L. amazonensis (IC50 24.2, 29.8 and 49.9 µg/mL, respectively). However, MD-EO, CS-EO and E-caryophyllene were more active against amastigote forms, with IC50 values of 10.7, 14.0, and 10.7 µg/mL, respectively. E-caryophyllene presented lower cytotoxicity against macrophages J774-A1 (CC50 of 62.1 µg/mL) than the EO. The EOs and E-caryophyllene should be further studied for the development of new antileishmanial drugs

Experiência exitosa na implantação de projeto piloto de Farmácia Viva em Araraquara-SP

The Living Pharmacy (FV) Program was planned with the aim of producing quality herbal medicines with guaranteed safety and efficacy from validated medicinal plants, seeking to offer a therapeutic option, in addition to developing educational work on the correct use of medicinal plants. This article aims to describe the implementation of a FV pilot project at the Family Health Unit (USF) in Araraquara, with the aim of offering phytotherapy as a therapeuticresource, promoting the rational use of medicinal plants in Primary Health Care (PHC), rescuing popular knowledge based on scientific knowledge. A survey of the main diseases that affect the local population was carried out and, from there, the medicinal plants of the project were selected. Subsequently, the preparation of the land for the cultivationof seedlings began. Concomitantly, conversation circles, courses and workshops were held with the community and the USF health team on the preparation of seedlings and the rational use of medicinal plants. The results showed that anxiety, respiratory and gastric problems, and inflammation are the conditions that most affect the local population. The following species were selected to be cultivated: Curcuma longa (turmeric), Cymbopogon citratus (lemon grass), Lippia alba (lippia), Maytenus ilicifolia (espinheira santa), Mikania glomerata (guaco) and Plectrantus barbatus (boldo nacional), following the Phytotherapic Formulary of the Brazilian Pharmacopoeia. The conversation circles, workshops and courses made it possible for the community and local health team to access scientific information, in simple language, valuing exchanges of experiences, describing medicinal plants, their therapeutic properties, preparation, dosage and contraindications. The tea workshops allowedparticipants to rescue the family’s affective memory, an important factor for the success of the FV project. The FV is a social project that has demonstrated to rescue the community’s self-esteem and the ability to guide the rational use of medicinal plants, valuing phytotherapy as a therapeutic resource of choice in the health system.O Programa Farmácia Viva (FV) foi planejado com o objetivo de produzir fitoterápicos de qualidade com garantia de segurança e eficácia a partir de plantas medicinais validadas, buscando oferecer uma opção terapêutica, além de desenvolver trabalhos educativos sobre o uso correto de plantas medicinais. Este artigo tem por objetivo descrever a implantação de projeto piloto de FV na Unidade de Saúde da Família (USF) de Araraquara, com a finalidade de oferecer a fitoterapia como recurso terapêutico, promovendo o uso racional de plantas medicinais na Atenção Primária à Saúde (APS), resgatando o saber popular e baseado no conhecimento científico. Foi realizado um levantamento das principais doenças que acometem a população local e, a partir daí, foram selecionadas as plantas medicinais do projeto. Posteriormente iniciou-se o preparo do terreno para cultivo das mudas. Concomitantemente, foram realizadas rodas de conversa, cursos e oficinas com a comunidade e a equipe de saúde da USF sobre preparo de mudas e uso racional de plantas medicinais. Os resultados mostraram que ansiedade, problemas respiratórios, gástricos e inflamação são as patologias que mais acometem a população local. As seguintes espécies foram selecionadas para serem cultivadas: Curcuma longa (cúrcuma), Cymbopogon citratus (capim limão), Lippia alba (lípia), Maytenus ilicifolia (espinheira santa), Mikania glomerata (guaco) e Plectrantus barbatus (boldo nacional), seguindo o Formulário Fitoterápico da Farmacopeia Brasileira. As rodas de conversa, oficinas e cursos possibilitaram à comunidade e equipe de saúde local o acesso às informações científicas, em linguagem simples, valorizando trocas de experiências, descrevendo as plantas medicinais, suas propriedades terapêuticas, forma de preparo, dosagem e contraindicações. As oficinas de chá permitiram aos participantes resgatar a memória afetiva da família, fator importante para o sucesso do projeto FV. A FV é um projeto social que tem demonstrado resgatar a autoestima da comunidade e a capacidade de orientar o uso racional de plantas medicinais, valorizando a fitoterapia como recurso terapêutico de escolha no sistema de saúde