Plantas medicinais e fitoterápicos na Atenção Primária em Saúde: percepção dos profissionais

Exploring the Pharmacognostical and Phytochemical Profiles of Aqueous Extracts of Kalanchoe

The use of plants for medicinal purposes has a long history, however it is desirable a continuous evaluation seeking for complementary scientific evidences for their safe application. Species within the Kalanchoe genus are often referred to as "miracle leaf" due to their remarkable healing properties. Traditionally, these plants have been used to treat infections, inflammation, and cancer. Despite their widespread use, the identification of their active components remains incomplete. This study aimed to differentiate K. crenata (KC), K. marmorata (KM), and K. pinnata (KP) by conducting detailed histochemical and phytochemical analyses, and to assess their antioxidant capabilities. The investigation revealed significant differences between the species, highlighting the variability in phenolic (PC) and flavonoid contents (FC) and their distinct antioxidant effects. The KM demonstrated the greatest results (PC: 59.26±1.53 mgEqGA/g; FC: 12.63±0.91 mgEqCQ/g; DPPH⋅ (IC50): 110.66 ug/mL; ABTS⋅+ (IC50): 26.81 ug/mL; ORAC: 9.65±0.75 mmolTE) when compared to KC and KP. These findings underscore a new reference for research within the Kalanchoe genus.

Chemical Profile and Biological Activities Of Piper mikanianum (Kunth) Steud Essential Oil for Development and Improvement of Oral Rinse

INTRODUCTION

Studies prove that the use of medicinal plants is a custom carried out by man since ancient times, the evolution of the pharmaceutical industry makes more people consume more natural products. Currently, we can observe that mouthwashes containing natural compounds have shown a growth in demand in the markets and in the professional community.

OBJECTIVE

The present study aims to carry out the chemical characterization and microbiological potential of Piper mikanianum (Kunth) Steud essential oil (EOPm), providing data that allows the development of a low-cost mouthwash formulation aimed at vulnerable communities.

METHODS

The evaluation of the antibacterial activity and modulator of bacterial resistance was performed by the microdilution method to determine the minimum inhibitory concentration (MIC). The chemical components were characterized by gas chromatography coupled to mass spectrometry, identified 28 constituents, in which Safrole Phenylpropanoid is the major compound, representing 72.6 % of the total composition, followed by α-pinene (10.7 %), Limonene (2 %), β-caryophyllene (2 %), E-nerolidol (1.9 %), spathulenol (1.3 %) and camphene (1.1 %).

RESULTS

The EOPm showed a MIC minimum inhibitory concentration≥1024 μg/mL for all bacterial strains used in the tests. When the EOPm modulating activity combined with chlorhexidine, mouthwash, ampicillin, gentamicin and penicillin G was evaluated against bacterial resistance, the oil showed significant synergistic activity, reducing the MIC of the products tested in combination, in percentage between 20.6 % to 98 .4 %.

CONCLUSIONS

We recommend the expansion of tests with greater variation of EOPm concentration combinations and the products used in this study, as well as toxicity evaluation and in vivo tests, seeking the development of a possible low-cost mouthwash formulation accessible to the most vulnerable population.

Phytochemical characterization, isolation, antioxidant and cytogenotoxic activity of leaves of Heliotropium elongatum (Lehm) I.M. Johnst

Heliotropium elongatum is used to treat inflammation, cough, and flu. This study aimed to characterize the phytochemical profile and determine the total phenolic content (TPC), antioxidant and cytogenotoxic activity of the ethanolic extract (EE), and fractions of H. elongatum leaves. In the phytochemical profile analysis, organic acids, reducing sugars, flavonoids, saponins, anthraquinones, steroids/triterpenes, and depsides/depsidones were detected in the EE and/or fractions (hexanic/FH, chloroformic/FC, ethyl acetate/FAE, and hydromethanolic/FHM). The highest TPC and highest antioxidant activity (DPPH and ABTS) was detected in FHM. In FH, 16 compounds were identified by GC-MS, and ursolic acid was isolated by 1H NMR and 13C NMR. HPLC-DAD from EE, FAE, and FHM demonstrated characteristic wavelengths for flavonoids, flavonols, flavones, and anthraquinones. ESI-IT/MSn analysis of EE, FC, FAE, and FHM revealed alkaloids, steroids, terpenoids, flavonoids, and phenolic acids. In Allium cepa assay there was no significant cytotoxic effect initiated by EE (62.5 to 1,000 µg/ml), FHM (1,000 µg/ml), and FAE (62.5 µg/ml). Genotoxicity was evidenced only with EE at 500 and 1,000 µg/ml, and FHM (62.5 to 1,000 µg/ml) as evidenced by presence of micronuclei (MN) and nuclear buds (NB). Our results identified compounds of medicinal interest with antioxidant activity; however observed cytogenotoxic changes indicated the need for caution when using these compounds for therapeutic purposes.

Semeando saúde

Problema: Atualmente, o paradigma da produção de saúde é prodigalizado por uma miríade de interesses mercantis galanteadores do modelo biomédico, que supervaloriza o conhecimento científico moderno. Mesmo que seja desprestigiado pela soberania científica, cerca de 70% do uso popular das plantas medicinais é confirmado cientificamente, e esses saberes não institucionais são frequentes nas práticas cotidianas. Segundo dados da Organização Mundial da Saúde (OMS), 80% da população de países em desenvolvimento utiliza-se de práticas tradicionais na atenção primária à saúde e, desse total, 85% fazem uso de plantas medicinais. No Brasil, 82% dos brasileiros usam produtos à base de plantas medicinais para cuidar da saúde. Perante este descompasso, a atenção primária à saúde destaca-se como espaço estratégico para adubar o terreno das práticas fitoterápicas. Metodologia: Trata-se de um estudo descritivo, qualitativo, do tipo relato de experiência, sobre o desenvolvimento de um jardim medicinal localizado numa Unidade de Saúde da Família do município de Recife, Pernambuco. Utilizou-se um registro sistemático das atividades por meio da confecção de um diário de campo com registro fotográfico, complementado por levantamento bibliográfico e pesquisa documental. Resultados: O projeto perpassou pelas etapas informacional, estrutural e de plantio, constelando vários saberes com base no espírito da multiprofissionalidade e da participação comunitária. Ao fim, os esforços culminaram na efetivação de um jardim medicinal, propiciando um espaço para a troca de conhecimentos e experiências. Conclusão: Conclui-se que a estruturação de um jardim medicinal no âmbito da atenção primária à saúde conclama um prodigioso potencial no fortalecimento dos princípios que norteiam esse nível de atenção, reposicionando o usuário no centro do modelo de cuidado e ampliando as opções terapêuticas eficazes e de baixo custo.

O uso de plantas medicinais na atenção primária à saúde: revisão integrativa

Resumo O uso de plantas medicinais (PM) favorece a integralidade do cuidado na atenção primária à saúde (APS), valorizando o saber popular e o autocuidado. Esta revisão integrativa de literatura objetiva analisar estudos sobre a inserção do uso de PM na APS. A estratégia PICO norteou a busca de evidências, reunindo 18 artigos publicados de janeiro de 2015 a agosto de 2020 nos bancos de dados Biblioteca Virtual de Saúde e PubMed. As variáveis de análise foram o conhecimento dos profissionais da saúde da APS sobre PM e políticas associadas, o uso de PM pelos usuários, destacando seu perfil, fatores que favorecem o uso e a falta de segurança no uso de PM. A literatura aponta insuficiência de conhecimento dos profissionais de saúde sobre as políticas de práticas integrativas e complementares e o uso de plantas para fins medicinais. Os principais usuários são mulheres, idosas, com baixa renda e escolaridade, tanto no Brasil quanto em outros países. Sobre a segurança no uso de PM, frequentemente não há correta identificação de espécie, origem, preparo e dose adequada para cada caso. Por fim, a não abordagem desses conteúdos durante a formação de profissionais da saúde gera menos conhecimento, menos pesquisas e mais preconceito por falta de informação, prejudicando o incentivo e divulgação à comunidade.

Current uses and knowledge of medicinal plants in the Autonomous Community of Madrid (Spain): a descriptive cross-sectional study

BACKGROUND

The usage of medicinal plants as a key component of complementary and alternative medicine, has acquired renewed interest in developed countries. The current situation of medicinal plants in Spain is very limited. This paper provides new insights and greater knowledge about current trends and consumption patterns of medicinal plants in the Autonomous Community of Madrid (Spain) for health benefits.

METHODS

A descriptive cross-sectional study was designed for a population-based survey on medicinal plants. The data were collected (May 2018 to May 2019) using semi-structured face-to-face interviews in independent pharmacies, hospital centers and primary care health centers in the Autonomous Community of Madrid. The survey had 18 multiple choice and open-ended questions. Quantitative indices were calculated: Fidelity Level (FL), Use Value (UV) and Informants Consensus Factor (ICF). Chi-square test was used for data analysis.

RESULTS

Five hundred forty-three people were interviewed. The majority of the participants (89.6%) have used medicinal plants to treat health disorders in the past 12 months, mainly for digestive problems, sleep disorders and central nervous system diseases. A total of 78 plants were recorded, being Matricaria recutita, Valeriana officinalis, Tilia spp. and Aloe vera the most used. The highest UV was found for Mentha pulegium (UV 0.130) followed by Aloe vera (UV 0.097) and Vaccinium macrocarpon. (UV 0.080). The highest FL values were for Eucalyptus spp. (FL 90.47%) for respiratory conditions and, Matricaria recutita (85.55%) and Mentha pulegium (84.09%) for digestive problems. The highest ICF corresponded to metabolism and depression (ICF = 1), pain (ICF = 0.97), insomnia (ICF = 0.96) and anxiety (ICF = 0.95). Participants mostly acquired herbal medicines from pharmacies, herbal shops and supermarkets. Some side effects (tachycardia, dizziness and gastrointestinal symptoms) and potential interactions medicinal plants-drugs (V. officinalis and benzodiazepines) were reported.

CONCLUSION

Many inhabitants of the Autonomous Community of Madrid currently use herbal products to treat minor health problems. The most common consumer pattern are young women between 18 and 44 years of age with higher education. In order to confirm the pattern, further research should be focused to investigate current uses of medicinal plants in other Spanish regions.

The registration of the usage of medicinal plants on e-SUS program: a case study in a city in the upper Jequitinhonha Valley

Abstract The e-SUS is a software used to computerize the health work process in Brazil. Among the population registration data is the record about the use of medicinal plants in Primary Health Care (AB). Thus, our objective was to analyze the records of the e-SUS in a Basic Health Unit (UBS) in the Jequitinhonha Valley and conduct a survey with individuals from the same UBS, where they were asked about the use of medicinal plants. The hypothesis of the study is that although the registration is relevant, the software data underestimate the reality about medicinal plants use. In a survey with 77 users of an UBS randomly selected, 93.5% reported using medicinal plants, while in e-SUS reports only 0.8% of the individuals from the same UBS use medicinal plants. Therefore, the recorded data cannot yet be used to develop medicinal plant policies in the AB. Reliable record of medicinal plant use in e-SUS is still a challenge. It is important to make professionals aware of the benefits of correctly completing the forms for the development of public policies that include what is recommended by the National Medicinal Plants Policy in order to recognize, guide and value the use of medicinal plants.