Biomimetic Mineralization on 3D Printed PLA Scaffolds: On the Response of Human Primary Osteoblasts Spheroids and In Vivo Implantation

This study aimed to assess the response of 3D printed polylactic acid (PLA) scaffolds biomimetically coated with apatite on human primary osteoblast (HOb) spheroids and evaluate the biological response to its association with Bone Morphogenetic Protein 2 (rhBMP-2) in rat calvaria. PLA scaffolds were produced via 3D printing, soaked in simulated body fluid (SBF) solution to promote apatite deposition, and characterized by physical-chemical, morphological, and mechanical properties. PLA-CaP scaffolds with interconnected porous and mechanical properties suitable for bone repairing were produced with reproducibility. The in vitro biological response was assessed with human primary osteoblast spheroids. Increased cell adhesion and the rise of in vitro release of growth factors (Platelet-Derived Growth Factor (PDGF), Basic Fibroblast Growth Factor (bFGF), Vascular Endothelial Growth Factor (VEGF) was observed for PLA-CaP scaffolds, when pre-treated with fetal bovine serum (FBS). This pre-treatment with FBS was done in a way to enhance the adsorption of serum proteins, increasing the number of bioactive sites on the surface of scaffolds, and to partially mimic in vivo interactions. The in vivo analysis was conducted through the implantation of 3D printed PLA scaffolds either alone, coated with apatite (PLA-CaP) or PLA-CaP loaded with rhBMP-2 on critical-sized defects (8 mm) of rat calvaria. PLA-CaP+rhBMP2 presented higher values of newly formed bone (NFB) than other groups at all in vivo experimental periods (p < 0.05), attaining 44.85% of NFB after six months. These findings indicated two new potential candidates as alternatives to autogenous bone grafts for long-term treatment: (i) 3D-printed PLA-CaP scaffold associated with spheroids, since it can reduce the time of repair in situ by expression of biomolecules and growth factors; and (ii) 3D-printed PLA-CaP functionalized rhBMP2 scaffold, a biocompatible, bioactive biomaterial, with osteoconductivity and osteoinductivity

A crescente escolarização do agente comunitário de saúde: uma indução do processo de trabalho? The increasing schooling of the community health agent: an induction of the work process?

O agente comunitário de saúde (ACS) é um dos atores profissionais que compõem as equipes da Estratégia Saúde da Família (ESF), sendo sua atuação considerada fundamental para a ampliação e consolidação dessa estratégia. Desde as primeiras experiências locais com ACS em fins dos anos 1970, seu perfil sociodemográfico vem apresentando mudanças. Este artigo tem por objetivo apresentar e discutir o aspecto da escolaridade e da capacitação dos ACS que atuam na Área Programática (AP) 5.2 do município do Rio de Janeiro, articulando trabalho e educação e entendendo o trabalho como um princípio emancipatório. Este estudo foi formulado com base na ideia de triangulação metodológica, aqui alcançada a partir da formulação original de Denzin. Os dados sobre a escolaridade dos ACS foram obtidos mediante questionário autoaplicável individual, respondidos por 301 ACS dos 12 módulos de ESF e seis módulos da Estratégia de Agentes Comunitários de Saúde (EACS) da AP 5.2. A apresentação e a discussão dos dados mostram mudanças no perfil de escolaridade desse trabalhador, concluindo-se que o ACS é um trabalhador que busca alternativas de escolarização e formação profissional. Defende-se a ampliação da escolaridade e o ensino técnico como processo para a consolidação do Sistema Único de Saúde.<br>Community health agents (CHA) are among the professional players that make up the Family Health Strategy (FHS) teams, and their performance is considered as critical to the expansion and consolidation of this strategy. Since the first local experiences with CHAs in the late 1970s, their sociodemographic profile has been changing. This article aims to present and discuss the aspect of education and training of the CHAs who work in Program Area (PA) 5.2 of the city of Rio de Janeiro, integrating work and education and understanding the work as an emancipatory principle. This study was formulated based on the methodological triangulation idea, reached here based on the original formulation of Denzin. Data on the CHAs' education were obtained via an individual self-applied questionnaire answered by 301 of the CHAs of the 12 FHS modules and six Community Health Workers Strategy (CHWS) modules of PA 5.2. The presentation and discussion of the data show changes in this worker's educational profile, and it can be concluded that the CHA is a worker who is in search of alternative schooling and vocational training. An expansion of the schooling and technical education is defended as a process to consolidate the Unified Health System