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Objectives: To present the data available and discuss the progress, current advances and challenges of the initiatives, current policies and guidance implemented by the Health and Education Ministries in Brazil to target transformation of health teaching in order to improve the health care offered by the Brazilian National Health System. Study design: Literature review. Methods: Documentary analysis and review of articles identified in a search of electronic databases, along with reports and documents acquired from the Health and Education Ministries between 1988 and 2013. Results: This study identified some important initiatives, including the Programme for the Encouragement of Curricular Changes in Medical Courses (PROMED), implemented in 2002 for medical courses alone. Inspired by PROMED and covering a wider range of graduate courses, the National Programme for Re-orientation of Health Professionals was implemented in 2005. This initiative launched its third edition in 2012, covering 14 health professional areas. Another relevant innovation was the National Policy of Permanent Health Education, implemented in 2007, with the goal of transforming public health services into a locus of teaching-learning through working. The Unified Health System Open University was also implemented. Conclusions: There is general concern and ongoing actions involving different sectors in Brazil in an attempt to improve the health of the Brazilian population in the future. However, the changes pursued involve deep transformations and may take considerable time. [ABSTRACT FROM AUTHOR]

Unlabelled: Hypertension-associated hypoalgesia is widely recognized in acute pain conditions. In chronic pain states, however, the relationship between blood pressure and pain sensitivity is still ill-defined, with different authors reporting negative, positive, or even no relationship at all. This work addresses this issue, using complete Freund's adjuvant (CFA)-induced monoarthritis in different models of hypertension: Spontaneous (spontaneously hypertensive rats, SHR), induced by infusion of angiotensin II (ANG) or 1,3-dipropyl-8-sulfophenylxanthine (DPSPX, an adenosine receptors' antagonist), and renal artery ligation (RAL). Nociceptive responses associated with monoarthritis were evaluated by different behavioral tests (von Frey, ankle-bend and CatWalk) and by quantification of Fos expression at the dorsal horn upon noxious stimulation. In all hypertension models, higher von Frey thresholds and lower Fos expression were detected in hypertensive rats with chronic inflammatory pain, as compared to normotensive monoarthritic rats. In SHR and DPSPX, but not ANG or RAL models, hypertensive animals displayed lower inflammation than normotensives. Ankle-bend and CatWalk results indicated lower pain sensitivity in hypertensive rats only in SHR and DPSPX models. The present study shows the importance of using multiple models of hypertension, and evaluating pain responses by various methods, to better understand the complexity of the interactions between pain and cardiovascular regulatory systems.Perspective: This study used different models of hypertension to investigate whether chronic pain alters the normal integration of cardiovascular and pain regulatory systems. A complete understanding of the mechanisms underlying the complex interactions between these systems may disclose future therapeutic approaches to treat hypertension/chronic pain comorbidity states. [ABSTRACT FROM AUTHOR]

• Blood analogue fluids should match the rheology of blood at both macro and microscale level. • Development of Polydimethylsiloxane (PDMS) microparticles with similar properties to RBCs. • The deformability of PDMS microparticles are compared against RBCs. • The proposed particles replicate RBCs in terms of deformability, steady shear viscosity and cell-free layer phenomenon. Polydimethylsiloxane (PDMS) has a wide variety of commercial and industrial applications due to its mechanical and rheological properties in a range similar to the living tissues. In this study, we demonstrate that PDMS can be used to produce deformable microparticles to be integrated in the development of particulate blood analogue fluids. The difficulties associated with the use of in vitro blood make it necessary to perform in vitro experiments of blood flow with blood analogue fluids. However, an ideal analogue must match the rheology of blood at several points, and for that, blood analogue fluids should be a suspension of microparticles with similar properties (size, shape and flexibility) to blood cells, in particular to the red blood cells (RBCs). The microparticles used in this study were produced from a transparent PDMS with crosslinking ratios of 10:1, 8:2 and 6:4; from a black PDMS with a ratio of 1:1 and from a red-pigmented PDMS. Each PDMS microparticles sample was suspended in Dextran 40 to perform deformability assays and cell-free layer analysis in a hyperbolic-shaped microchannel and steady shear viscosity measurements in a rheometer. The proposed microparticles suspensions show a great potential to mimic the structural and rheological properties of RBC suspensions and consequently to develop blood analogue fluids with rheological properties similar to real blood. [ABSTRACT FROM AUTHOR]

Abstract: Nociceptive transmission from the spinal cord is controlled by supraspinal pain modulating systems that include the caudal ventrolateral medulla (CVLM). The neuropeptide angiotensin II (Ang II) has multiple effects in the CNS and at the medulla oblongata. Here we evaluated the expression of angiotensin type 1 (AT1) receptors in spinally-projecting CVLM neurons, and tested the effect of direct application of exogenous Ang II in the CVLM on nociceptive behaviors. Although AT1-immunoreactive neurons occurred in the CVLM, only 3% of AT1-positive neurons were found to project to the dorsal horn, using double-immunodetection of the retrograde tracer cholera toxin subunit B. In behavioral studies, administration of Ang II (100 pmol) in the CVLM gave rise to hyperalgesia in both the tail-flick and formalin tests. This hyperalgesia was significantly attenuated by local administration of the AT1 antagonist losartan. The present study demonstrates that Ang II can act on AT1 receptors in the CVLM to modulate nociception. The effect on spinal nociceptive processing is likely indirect, since few AT1-expressing CVLM neurons were found to project to the spinal cord. The renin-angiotensin system may also play a role in other supraspinal areas implicated in pain modulation. [Copyright &y& Elsevier]

There is a continuous search for better and more complete in vitro models with mechanical properties closer to in vivo conditions. In this work a manufacturing process, based on a lost core casting technique, is herein reported to produce aneurysm biomodels to perform experimental hemodynamic studies. By using real artery images combined with a lost core casting technique, three materials were tested: paraffin, beeswax and glycerin-based soap. All in vitro biomodels were compared according to their transparency and final structure. Additionally, comparisons between experimental and numerical flow studies were also performed. The results have shown that the biomodels produced with beeswax and glycerine-based soap were the most suitable in vitro models to perform direct flow visualizations of particulate blood analogue fluids. The biomodels proposed in this works, have the potential to provide further insights into the complex blood flow phenomena happening at different kinds of pathologies and answer to important hemodynamics questions that otherwise cannot be tackled with the existing in vitro models. • Manufacture PDMS biomodels with low-cost lost core casting materials. • These materials allow to manufacture channels with diameters less than 2 mm. • Lost core casting materials can be removed from PDMS biomodels using water. • PDMS biomodels with high level of transparency to be used experimentally. • The PDMS biomodels are used to validate numerical simulations. Image, graphical abstract [ABSTRACT FROM AUTHOR]