A 2-week treatment with 5-azacytidine improved the hypercontractility state in prostate from obese mice: Role of the nitric oxide-cyclic guanosine monophosphate signalling pathway.

Benign prostatic hyperplasia (BPH) is characterised by increases in prostate volume and contraction. Downregulation of the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) signalling pathway contributes to prostate dysfunctions. Previous studies in cancer cells or vessels have shown that the epigenetic mechanisms control the gene and protein expression of the enzymes involved in the production of NO and cGMP. This study is aimed to evaluate the effect of a 2-week treatment of 5-azacytidine (5-AZA), a DNA-methyltransferase inhibitor, in the prostate function of mice fed with a high-fat diet. Functional, histological, biochemical and molecular assays were carried out. Obese mice presented greater prostate weight, α-actin expression and contractile response induced by the α-1adrenoceptors agonist. The relaxation induced by the NO-donor and the protein expression of endothelial nitric oxide synthase (eNOS) and soluble guanylate cyclase (sGC) were significantly decreased in the prostate of obese mice. The treatment with 5-AZA reverted the higher expression of α-actin, reduced the hypercontractility state of the prostate and increased the expression of eNOS and sGC and intraprostatic levels of cGMP. When prostates from obese mice treated with 5-AZA were incubated in vitro with inhibitors of the NOS or sGC, the inhibitory effect of 5-AZA was reverted, therefore, showing the involvement of NO and cGMP. In conclusion, our study paves the way to develop or repurpose therapies that recover the expression of eNOS and sGC and, hence, to improve prostate function in BPH.

Inhibition of multidrug resistance proteins by MK571 restored the erectile function in obese mice through cGMP accumulation.

BACKGROUND: Intracellular levels of cyclic nucleotides can also be controlled by the action of multidrug resistance protein types 4 (MRP4) and 5 (MRP5). To date, no studies evaluated the role of their inhibition in an animal model of erectile dysfunction (ED). OBJECTIVES: To evaluate the effect of a 2-week treatment with MK571, an inhibitor of the efflux of cyclic nucleotides in the ED of obese mice. MATERIALS AND METHODS: Mice were divided in three groups: (i) lean, (ii) obese, and (iii) obese + MK571. The corpus cavernosum (CC) were isolated, and concentration-response curves to acetylcholine (ACh), sodium nitroprusside (SNP), and tadalafil in addition to electrical field stimulation (EFS) were carried out in phenylephrine pre-contracted tissues. Expression of ABCC4 and ABCC5, intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), the protein levels for pVASPSer157 and pVASPSer239 , and the intracavernous pressure (ICP) were also determined. The intracellular and extracellular (supernatant) ratios in CC from obese and lean stimulated with a cGMP-increasing substance (BAY 58-2667) in the absence and presence of MK571 (20 µM, 30 min) were also assessed. RESULTS: The treatment with MK571 completely reversed the lower relaxing responses induced by EFS, ACh, SNP, and tadalafil observed in obese mice CC in comparison with untreated obese mice. Cyclic GMP and p-VASPSer239 expression were significantly reduced in CC from obese groups. MK571 promoted a sixfold increase in cGMP without interfering in the protein expression of p-VASPSer239 . Neither the cAMP levels nor p-VASPSer157 were altered in MK571-treated animals. The ICP was ∼50% lower in obese than in the lean mice; however, the treatment with MK571 fully reversed this response. Expressions of ABCC4 and ABCC5 were not different between groups. The intra/extracellular ratio of cGMP was similar in CC from obese and lean mice stimulated with BAY 58-2667. CONCLUSIONS: The MRPs inhibition by MK571 favored the accumulation of cGMP in the smooth muscle cells, thus improving the smooth muscle relaxation and the erectile function in obese mice.

Endothelial and vascular smooth muscle dysfunction in hypertension.

The development of essential hypertension involves several factors. Vascular dysfunction, characterized by endothelial dysfunction, low-grade inflammation and structural remodeling, plays an important role in the initiation and maintenance of essential hypertension. Although the mechanistic pathways by which essential hypertension develops are poorly understood, several pharmacological classes available on the clinical settings improve blood pressure by interfering in the cardiac output and/or vascular function. This review is divided in two major sections. The first section depicts the major molecular pathways as renin angiotensin aldosterone system (RAAS), endothelin, nitric oxide signalling pathway and oxidative stress in the development of vascular dysfunction. The second section describes the role of some pharmacological classes such as i) RAAS inhibitors, ii) dual angiotensin receptor-neprilysin inhibitors, iii) endothelin-1 receptor antagonists, iv) soluble guanylate cyclase modulators, v) phosphodiesterase type 5 inhibitors and vi) sodium-glucose cotransporter 2 inhibitors in the context of hypertension. Some classes are already approved in the treatment of hypertension, but others are not yet approved. However, due to their potential benefits these classes were included.

The Role of Periprostatic Adipose Tissue on Prostate Function in Vascular-Related Disorders.

The lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are highly prevalent worldwide. Clinical and experimental data suggest that the incidence of LUTS-BPH is higher in patients with vascular-related disorders such as in pelvic ischemia, obesity and diabetes as well as in the ageing population. Obesity is an important risk factor that predisposes to glucose intolerance, insulin resistance, dyslipidemia, type 2 diabetes mellitus and cardiovascular disorders. Prospective studies showed that obese men are more likely to develop LUTS-BPH than non-obese men. Yet, men with greater waist circumferences were also at a greater risk of increased prostate volume and prostate-specific antigen than men with lower waist circumference. BPH is characterized by an enlarged prostate and increased smooth muscle tone, thus causing urinary symptoms. Data from experimental studies showed a significant increase in prostate and epididymal adipose tissue weight of obese mice when compared with lean mice. Adipose tissues that are in direct contact with specific organs have gained attention due to their potential paracrine role. The prostate gland is surrounded by periprostatic adipose tissue (PPAT), which is believed to play a paracrine role by releasing growth factors, pro-inflammatory, pro-oxidant, contractile and anti-contractile substances that interfere in prostate reactivity and growth. Therefore, this review is divided into two main parts, one focusing on the role of adipokines in the context of obesity that can lead to LUTS/BPH and the second part focusing on the mediators released from PPAT and the possible pathways that may interfere in the prostate microenvironment.

Guanosine, a guanine-based nucleoside relaxed isolated corpus cavernosum from mice through cGMP accumulation.

In corpus cavernosum (CC), guanosine triphosphate (GTP) is converted into cyclic guanosine monophosphate (cGMP) to induce erection. The action of cGMP is terminated by phosphodiesterases and efflux transporters, which pump cGMP out of the cell. The nucleotides, GTP, and cGMP were detected in the extracellular space, and their hydrolysis lead to the formation of intermediate products, among them guanosine. Therefore, our study aims to pharmacologically characterize the effect of guanosine in isolated CC from mice. The penis was isolated and functional and biochemical analyses were carried out. The guanine-based nucleotides GTP, guanosine diphosphate, guanosine monophosphate, and cGMP relaxed mice corpus cavernosum, but the relaxation (90.7 ± 12.5%) induced by guanosine (0.000001-1 mM) was greater than that of the nucleotides (~ 45%, P < 0.05). Guanosine-induced relaxation was not altered in the presence of adenosine type 2A and 2B receptor antagonists. No augment was observed in the intracellular levels of cyclic adenosine monophosphate in tissues stimulated with guanosine. Inhibitors of nitric oxide synthase (L-NAME, 100 µM) and soluble guanylate cyclase (ODQ, 10 µM) produced a significant reduction in guanosine-induced relaxation in all concentrations studied, while in the presence of tadalafil (300 nM), a significant increase was observed. Pre-incubation of guanosine (100 µM) produced a 6.6-leftward shift in tadalafil-induced relaxation. The intracellular levels of cGMP were greater when CC was stimulated with guanosine. Inhibitors of ecto-nucleotidases and xanthine oxidase did not interfere in the response induced by guanosine. In conclusion, our study shows that guanosine relaxes mice CC and opens the possibility to test its role in models of erectile dysfunction.

Construção e validação de cartilha educativa para sala de apoio à amamentação / Construcción y validación de un folleto educativo para la sala de apoyo a la lactancia / Construction and validation of educational booklet for breastfeeding support room

RESUMO Objetivo: construir e validar uma cartilha educativa para a sala de apoio à amamentação. Métodos: estudo metodológico realizado em três etapas: levantamento bibliográfico, elaboração do material educativo e validação por juízes especialistas. A estrutura do material quanto à sequência das informações, design, ilustrações, cores e diagramação foi feita por profissional especializado. Resultados: a produção final resultou na cartilha intitulada: "Voltei a trabalhar, como vou amamentar?". Participaram da validação nove juízes especialistas na área, avaliando os aspectos: "conteúdo" e "exatidão científica" validados a partir do cálculo do IVC, com média de 0,81, seguindo corte indicado pela literatura considerando esses itens validados para "aparência". Considerou-se nível de concordância entre os especialistas variando entre 86,8 e 97,6%, sendo o mínimo estabelecido de 75%, validando esse aspecto. Conclusão: o objetivo de construir e validar uma tecnologia educativa voltada para a sala de amamentação, pioneira neste enfoque específico, foi alcançado.

RESUMEN Objetivo: construir y validar un folleto educativo para la sala de apoyo a la lactancia materna. Métodos: estudio metodológico realizado en tres etapas: encuesta bibliográfica, preparación de material educativo y validación por jueces expertos. La estructura del material, en cuanto a la secuencia de información, diseño, ilustraciones, colores y diagramación, fue realizada por un profesional especializado. Resultados: la producción final resultó en el folleto titulado: "He vuelto a trabajar, ¿cómo haré para amamantar?". Nueve jueces expertos en el área participaron en la validación, evaluando los aspectos: "contenido" y "precisión científica" validados a partir del cálculo del IVC, con un promedio de 0.81, siguiendo el corte indicado por la literatura considerando estos elementos validados para "apariencia". Se consideró que el nivel de acuerdo entre expertos variaba entre 86.8 y 97.6%, con un mínimo establecido de 75%, validando este aspecto. Conclusión: se logró el objetivo de construir y validar una tecnología educativa dirigida a la sala de lactancia, pionera en este enfoque específico.

ABSTRACT Objective: to build and validate an educational booklet for the breastfeeding support room. Methods: methodological study carried out in three stages: bibliographic survey, preparation of educational material and validation by specialist referees. The material structure regarding the sequence of information, design, illustrations, colors and diagramming was made by a specialized professional. Results: the final production resulted in the booklet entitled: "I went back to work, how am I going to breastfeed?". Nine specialist referees in the area participated in the validation, evaluating the aspects: "content" and "scientific accuracy" validated from the CVI calculation, with an average of 0.81, following the cut indicated by the literature considering these items validated for "appearance". The level of agreement between specialist was considered to vary between 86.8 and 97.6%, with the minimum established being 75%, validating this aspect. Conclusion: the objective of building and validating an educational technology aimed at the breastfeeding room, pioneer in this specific focus, was achieved.

Consultoria em amamentação durante a pandemia COVID-19: relato de experiência / Asesoría en lactancia materna durante la pandemia de COVID-19: informe de experiencia / Breastfeeding consultancy during the COVID-19 pandemic: experience report

Objetivo: relatar a experiência de consultoras em amamentação no atendimento às lactantes durante a pandemia de COVID-19. Método: relato de experiência de atendimentos de consultoria em amamentação, nas modalidades online e presencial, na cidade de Fortaleza-CE, Brasil, entre março e abril de 2020. Resultados: diante de sentimentos de medo e ansiedade das lactantes, as consultoras prestaram apoio por meio de aconselhamento, bem como orientações com equipe multiprofissional. Todas as lactantes estavam amamentando e realizando distanciamento social e cuidados de higiene pessoal, sendo reforçado pelas consultoras a importância do acesso às fontes confiáveis de informação. Quanto aos problemas mamários, foram realizadas intervenções preventivas e curativas. Percebeu-se a satisfação das lactantes pelo serviço. Conclusão e implicações para a prática: a consultoria em amamentação constitui-se como um dispositivo agregador na saúde das mulheres que favorece tanto a promoção do aleitamento materno quanto a saúde mental durante a pandemia de Covid-19. Este relato traz direcionamentos para uma prática holística, com vistas à melhoria da qualidade do cuidado prestado, levando-se em consideração os atuais desafios da promoção da saúde diante da pandemia e pode fomentar novas estratégias exitosas

Objective: to report the experience of breastfeeding consultants in caring for breastfeeding women during the Covid-19 pandemic. Method: an experience report of breastfeeding consultancy services, online and face-to-face modalities, in the city of Fortaleza­CE, between March and April 2020. Results: given the mothers' feelings of fear and anxiety, the consultants provided support through counseling, as well as guidance with a multidisciplinary team. All the women were breastfeeding and performing social distancing and personal hygiene care actions, the importance of access to reliable information sources being reinforced by the consultants. As for breast problems, preventive and curative interventions were carried out. The mothers' satisfaction with the consultant service was noticed. Conclusion and implications for practice: breastfeeding consultancy is an aggregating device in women's health that favors both the promotion of breastfeeding and mental health during the Covid-19 pandemic. This report provides directions for a holistic practice, to improve the provided care quality, considering the current challenges of health promotion given the pandemic, and can foster new successful strategies

Objetivo: relatar la experiencia de consultores de lactancia materna en el cuidado de mujeres en periodo de lactancia durante la pandemia de Covid-19. Método: informe de experiencia de los servicios de consultoría en lactancia materna en modalidades en línea y cara a cara, en la ciudad de Fortaleza-CE, entre marzo y abril de 2020. Resultados: ante los sentimientos de miedo y ansiedad de las mujeres lactantes, los consultores proporcionaron apoyo a través de asesoramiento, así como orientación con un equipo multidisciplinario. Todas las mujeres amamantaban y practicaban el distanciamiento social y cuidados de higiene personal, siendo que los consultores reforzaron la importancia del acceso a fuentes confiables de información. En cuanto a los problemas mamarios, se realizaron intervenciones preventivas y curativas. Se notó la satisfacción de las madres lactantes por el servicio. Conclusión e implicaciones para la práctica: la consultoría sobre lactancia materna es un dispositivo agregado en la salud de la mujer que favorece tanto la promoción de la lactancia materna como la salud mental frente a la pandemia de Covid-19. Este estudio proporciona instrucciones para una práctica holística, con miras a mejorar la calidad de la atención brindada, teniendo en cuenta los desafíos actuales de la promoción de la salud frente a la pandemia y puede fomentar nuevas estrategias exitosas

Sentimentos de mulheres com depressão pós-parto frente ao aleitamento materno / Feelings of women with postpartum depression in front of maternal breastfeeding

Objetivo: descrever sentimentos de mulheres com depressão pós-parto frente ao aleitamento materno. Metodologia: estudo qualitativo, descritivo e exploratório, com 20 mulheres com depressão pós-parto, entre abril e maio de 2017 em Fortaleza- CE. Para coletar dados realizou-se entrevista, roteiro sociodemográfico e obstétrico e relatos gravados e analisados por método de Bardin. Resultados: as dificuldades da depressão pós-parto no aleitamento são: falta de condições psicológicas, desencantamento e sentimentos como estresse, medo e tristeza. Conclusão: Constatou-se que mulheres com depressão pósparto sofreram impacto negativo durante o aleitamento, é essencial a atenção a sentimentos depressivos entre puérperas, devido forte relação ao desmame precoce. (AU)

Objective: To describe the feelings of women with postpartum depression in the face of breastfeeding. Methodology: This is a qualitative, descriptive and exploratory study, carried out in Fortaleza-CE, with 20 women who have or had postpartum depression. Results: The difficulties of postpartum depression in breastfeeding according to the interviewees were: lack of psychological conditions, difficulty in contact with the child, disenchantment, and feelings such as stress, fear, sadness, involved in the moment of breastfeeding. Conclusion: The present study found that women with postpartum depression had a negative impact during breastfeeding. More attention is needed to the mental health of the women, considering the depressive symptoms present in puerperas and the strong association with the shorter breastfeeding time. (AU)

Objetivo: describir los sentimientos de mujeres con depresión posparto frente a la lactancia materna. Metodología: Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado en Fortaleza-CE, con 20 mujeres que tienen o tuvieron depresión posparto. Resultados: Las dificultades de la depresión posparto en la lactancia materna según las entrevistadas fueron: falta de condiciones psicológicas, dificultad en el contacto con el niño, desencanto, y sentimientos como estrés, miedo, tristeza, involucrados en el momento de la lactancia. Conclusión: El presente estudio constató que las mujeres con depresión posparto sufrieron un impacto negativo durante la lactancia. Se hace necesaria una mayor atención a la salud mental de las mujeres, considerando los síntomas depresivos presentes en puérperas y la fuerte asociación con el menor tiempo de lactancia materna. (AU)

Autonomic dysregulation at multiple sites is implicated in age-associated underactive bladder in female mice.

AIMS: To evaluate the functional and molecular alterations of contractile and relaxant machinery in the bladder and urethra that lead to the underactive bladder (UAB) in old female mice. METHODS: Female young (3-months) and old (18-months) C57BL/6 mice were used. Urodynamic was assessed in awake and anaesthetized mice. Electrical-field stimulation (EFS) and concentration-response curves to contractile and relaxing agents in isolated bladders and urethras were performed. Messenger RNA (mRNA) expressions of muscarinic, adrenergic, and transient receptor potential vanilloid-4 (TRPV4), and of the enzymes tyrosine hydroxylase and neuronal nitric oxide synthase (nNOS) were determined. Bladder cyclic adenosine monophosphate (cAMP) levels were measured. RESULTS: Cystometry in old mice showed incapacity to produce bladder emptying. On filter paper, old mice showed reduced urinary spots. Compared to the young group, bladder contractions induced by EFS and carbachol were lower in old mice. The ß3 -adrenoceptor agonist mirabegron promoted higher bladder relaxation and elevation of cAMP levels in old mice. In old mice urethras, the α1a -adrenoceptor agonist phenylephrine produced higher contractions, but no differences were found for the NO donor sodium nitroprusside-induced relaxations. In old mice, increased mRNA expressions of ß3 - and α1a -adrenoceptors in bladder and urethra were found, respectively, whereas the muscarinic M2 and M3 receptors and ß2 -adrenoceptors did not change between groups. Reduced mRNA expressions of tyrosine hydroxylase and nNOS were found in old mouse urethras. Additionally, TRPV4 expression was reduced in bladder urothelium from old mice. CONCLUSION: Age-associated mouse UAB is the result of autonomic dysfunction at multiple levels leading to the less sensitive and overrelaxed bladder, along with urethral hypercontractility.

Percepção das mulheres que receberam consultoria em amamentação / Perception of women who received consultancy in breastfeeding

Objetivo: Conhecer a percepção das mulheres que receberam consultoria em amamentação. Metodologia: Estudo exploratório com abordagem qualitativa realizado nos meses de agosto e setembro de 2018 no município de Fortaleza. Os sujeitos foram 10 mães que receberam consultoria em amamentação, as quais foram abordadas via ligação telefônica. Os dados foram analisados por meio da análise de conteúdo. Resultados: Emergiram quatro categorias: Percepção e satisfação das mães acerca da consultoria em amamentação; A consultoria como incentivador do AME; Determinantes que levaram a busca do profissional Consultor em Amamentação; e Participação familiar no processo de amamentar. Conclusão: conclui-se que o atendimento das consultoras em amamentação influencia na promoção da prática do AM, sendo importante a divulgação desses profissionais. (AU)

Objective: To know the perception of women who received breastfeeding counseling. Methodology: Exploratory study with a qualitative approach carried out in August and September of 2018 in the city of Fortaleza. The subjects were 10 mothers who received breastfeeding counseling, which were addressed via phone call. Data were analyzed through content analysis. Results: Four categories emerged: Perception and satisfaction of mothers about breastfeeding counseling; The consultancy as an incentive for the AME; Determinants that led to the search of the professional Consultant in Breastfeeding; and Family participation in the breastfeeding process. Conclusion: it is concluded that the assistance of breastfeeding consultants influences the promotion of breastfeeding practice, and it is important to publicize these professionals. (AU)

Objetivo: Conocer la percepción de las mujeres que recibieron asesoramiento sobre lactancia materna. Metodología: estudio exploratorio con enfoque cualitativo realizado en agosto y septiembre de 2018 en la ciudad de Fortaleza. Los sujetos fueron 10 madres que recibieron asesoramiento sobre la lactancia materna, que se abordaron a través de una llamada telefónica. Los datos fueron analizados mediante análisis de contenido. Resultados: Surgieron cuatro categorías: percepción y satisfacción de las madres con respecto al asesoramiento sobre lactancia materna; La consultoría como incentivo para la AME; Determinantes que llevaron a la búsqueda de la Consultora profesional en Lactancia Materna; y Participación familiar en el proceso de lactancia. Conclusión: se concluye que la asistencia de los consultores de lactancia influye en la promoción de la práctica de la lactancia materna, y es importante divulgar a estos profesionales. (AU)

Breastfeeding self-efficacy among blind mothers / Autoeficacia de madres ciegas en la lactancia / Autoeficácia em amamentar entre mães cegas

ABSTRACT Objective: To evaluate breastfeeding self-efficacy among blind mothers. Method: This is a descriptive and exploratory research carried out in Fortaleza-Ceara, with ten blind mothers. Data were collected through an interview with the application of a socioeconomic and obstetric questionnaire and the Breastfeeding Self-Efficacy Scale - Short Form. Results: The majority of blind mothers presented high breastfeeding self-efficacy, but there were also mothers with low breastfeeding self-efficacy. Conclusion: It is necessary to follow-up mothers throughout the entire breastfeeding period to maintain or improve breastfeeding self-efficacy in this specific public.

RESUMEN Objetivo: Evaluar la autoeficacia de madres ciegas en la lactancia. Método: Se trata de una investigación descriptiva y exploratoria realizada en Fortaleza, Ceará, entre diez madres ciegas. Los datos se recogieron mediante entrevistas con la aplicación de un cuestionario socioeconómico y obstétrico y con la versión reducida de la Escala de Autoeficacia para la Lactancia Materna Breastfeeding Self - Efficacy Scale - Short Form. Resultados: La mayoría de las madres ciegas presentaba una autoeficacia elevada en la lactancia, aunque también había algunas con autoeficacia baja. Conclusión: Es evidente que existe una necesidad de seguimiento durante todo el período de amamantamiento para mejorar y mantener la autoeficacia de la lactancia en este público especifico.

RESUMO Objetivo: Avaliar a autoeficácia em amamentar entre mães cegas. Método: Trata-se de uma pesquisa descritiva e exploratória, realizada em Fortaleza-Ceará, com dez mães cegas. Os dados foram coletados por meio de uma entrevista com a aplicação de questionário socioeconômico e obstétrico e escala Breastfeeding Self - Efficacy Scale - Short Form. Resultados: A maioria das mães cegas apresentou elevada autoeficácia em amamentar, mas também foram evidenciadas mães com baixa autoeficácia em amamentar. Conclusão: Percebe-se a necessidade do acompanhamento das mães durante todo o período da amamentação para buscar manutenção e melhora da autoeficácia em amamentar nesse público específico.

Teaching blind women about the anatomy and physiology of the female reproductive system through educational manual / Aprendizado de cegas sobre anatomia e fisiologia do sistema reprodutor feminino mediante manual educativo

Abstract Objectives: to evaluate blind women's learning on the anatomy and physiology of the female reproductive system through the use of an educational material. Methods: methodological development study performed with blind women. The participants responded the pre-test to evaluate their knowledge on sexual and reproductive health and received a manual on anatomy and the reproduction of the physiology After an individual reading, in a period ranging from three to fifteen days, they responded the post-test. Results: there was an increase of correct answers in the post-test in all the items in relation to the categories of The Woman's Body and How One Gets Pregnant becoming significant in the following knowledge of "clitoris increases with the woman excited" (p=0.009), "the function of the vagina in a sexual intercourse "(p<0.001), "How does fertilization occurs"(p<0.001) and "the ovulating period" (p<0.001). Conclusions: the manual enabled the participants to learn about the female anatomy and the physiology of fertilization after educational assistive technology.

Resumo Objetivos: avaliar o aprendizado de cegas sobre anatomia e fisiologia do sistema reprodutor feminino mediante o uso de manual educativo. Métodos: estudo de desenvolvimento metodológico, realizado com mulheres cegas. As participantes responderam o pré-teste para avaliação do conhecimento sobre saúde sexual e reprodutiva, e receberam o manual sobre anatomia e fisiologia da reprodução. Após leitura individual, em prazo que variou entre três e quinze dias, responderam o pós-teste. Resultados: houve aumento de respostas corretas no pós-teste em todos os itens com relação às categorias O Corpo da Mulher e Como se Engravida, sendo significativo os seguintes conhecimentos "clitóris aumenta com a mulher excitada" (p=0,009), "função da vagina na relação sexual" (p<0,001), "como ocorre a fecundação" (p<0,001) e "período da ovulação" (p<0,001). Conclusões: o manual permitiu aprendizado das participantes quanto à anatomia feminina e à fisiologia da fecundação após utilização da tecnologia educativa assistiva.

Inhibition of Multidrug Resistance Proteins by MK 571 Enhances Bladder, Prostate, and Urethra Relaxation through cAMP or cGMP Accumulation.

The biologic effect of cAMP and cGMP is terminated by phosphodiesterases and multidrug resistance proteins MRP4 and MRP5, which pump cyclic nucleotides out of the cell. Therefore, this study aimed to characterize the role of MRP inhibitor, MK 571 (3-[[[3-[(1E)-2-(7-chloro-2-quinolinyl)ethenyl]phenyl][[3-(dimethylamino)-3-oxopropyl]thio]methyl]thio]propanoic acid), in the bladder, prostate, and urethra of male mice by means of functional assays, protein expression, and cyclic nucleotide quantification. The cumulative addition of MK 571 (1-30 µM) produced only small relaxation responses (approximately 25%) in all studied tissues. In the bladder, isoprenaline/fenoterol and forskolin concentration-dependently relaxed and MK 571 (20 µM) increased the maximal response values by 37% and 24%, respectively. When MK 571 was coincubated with fenoterol or forskolin, intracellular levels of cAMP and protein expression of phospho-vasodilator-stimulated phosphoprotein (p-VASP) Ser157 were significantly greater compared with bladders stimulated with fenoterol or forskolin alone. In the prostate and urethra, sodium nitroprusside concentration-dependently relaxed and MK 571 (20 µM) significantly increased relaxation responses by 70% and 56%, respectively, accompanied by greater intracellular levels of cGMP and protein expression of p-VASP Ser239 in the prostate. Tadalafil and BAY 41-2272 (5-cyclopropyl-2-[1-[(2-fluorophenyl)methyl]-1H-pyrazolo[3,4-b]pyridin-3-yl]-4-pyrimidinamine) also relaxed the prostate and urethra, respectively, and MK 571 markedly enhanced this response. The stable analog of cGMP (8-Br-cGMP) induced concentration-dependent relaxation responses in the prostate and urethra, and MK 571 significantly increased the relaxation response. In conclusion, to our knowledge, this is the first study to show that efflux transporters are physiologically active in the bladder, prostate, and urethra to control intracellular levels of cAMP or cGMP.

Dificuldades enfrentadas pelas mulheres para realizar o exame papanicolau: revisão integrativa / Difficulties faced by women to perform the pap smear examination: integrative review

Objetivo: buscar as evidencias cientificas das principais dificuldades enfrentadas pelas mulheres, para realizar o exame Papanicolau. Método: Revisão integrativa, realizada nos meses de abril e maio de 2017 nas bases de dados on-line Scielo e LILACS no período de 2006 a 2016. Para a pesquisa, utilizou-se o cruzamento do descritor “esfregaço vaginal” com a palavra-chave “câncer”,utilizando o boleando “and” entre as palavras. Foram encontrados 573 artigos, 51 do Scielo e 523 do Lilacs, sendo selecionados 25 e excluídos 549, com a associação dos descritores. Resultados: Percebeu-se que muitas mulheres ainda são resistentes em realizar esse tipo de exame por conceitos e valores culturais que foram absorvidos por toda a vida. Conclusão: Portanto, a partir do conhecimento desses fatores de dificuldade na realização do exame preventivo, considera-se essencial para as mulheres a adoção de uma nova postura para prevenção de doenças.

Objective: to search the scientific evidences of the main difficulties faced by women, to perform the Papanicolau exam. Method: Integrative review, carried out in the months of April and May 2017 in the online databases Scielo and LILACS from 2006 to2016. For the research, the cross-reference of the descriptor "vaginal smear" key "cancer", using the "and" between the words. Wefound 573 articles, 51 of Scielo and 523 of Lilacs, being selected 25 and excluded 549, with the association of the descriptors. Results: It was noticed that many women are still resistant to this type of examination by cultural concepts and values that have been absorbedthroughout life. Conclusion: Therefore, considering the knowledge of these factors of difficulty in performing the preventive examination,it is considered essential for women to adopt a new posture for disease prevention.

Objetivo: Buscar las evidencias científicas de las principales dificultades enfrentadas por las mujeres, para realizar el examen Papanicolau. Método: Revisión integrativa, realizada en los meses de abril y mayo de 2017 en las bases de datos en línea Scielo y LILACSen el período de 2006 a 2016. Para la investigación, se utilizó el cruce del descriptor "frotis vaginal" con la palabra- clave "cáncer",utilizando el boleando "and" entre las palabras. Se encontraron 573 artículos, 51 del Scielo y 523 del Lilacs, siendo seleccionados 25y excluidos 549, con la asociación de los descriptores. Resultados: Se percibió que muchas mujeres todavía son resistentes en realizarese tipo de examen por conceptos y valores culturales que fueron absorbidos por toda la vida. Conclusión: Por lo tanto, a partir del conocimiento de estos factores de dificultad en la realización del examen preventivo, se considera esencial para las mujeres la adopción de una nueva postura para la prevención de enfermedades.

Validação do manual saúde sexual e reprodutiva: métodos anticoncepcionais comportamentais para cegas

Mulheres cegas tem baixa oferta de material educativo em saúde. Manual educativo acessívelé possibilidade de ensino-aprendizado fornecendo informação sobre saúde sexual ereprodutiva com enfoque nos métodos anticoncepcionais comportamentais. Este estudo tevecomo objetivos: Validar Tecnologia Assistiva para cegas na modalidade de Manual sobremétodos anticoncepcionais comportamentais para promoção da saúde. Trata-se de pesquisaquase experimental, desenvolvida na cidade de Fortaleza no Estado do Ceará no período defevereiro 2014 a setembro 2015...

Blind women have low supply of educational material on health. Affordable educational manual is potential teaching-learning by providing access to sexual and reproductive health focusing on behavioral contraceptive methods. The objectives of this study are: to validate assistance technology for the blind using behavioral contraceptive methods manual modules for the promotion of heatlh. This is a quase-experimental research developed in the city of Fortaleza, state of Ceara from February 2014 to September 2015 that used a non-probability convenience sample composed of specialists in the content and blind women...

Repercussão de políticas públicas inclusivas segundo análise das pessoas com deficiência / Repercussion of inclusive public policies according to disabled people / Repercusión de políticas públicas inclusivas según el análisis de personas con discapacidad

Objetivo:Analisou-se repercussão de políticas públicas inclusivas na óptica das pessoas com deficiência auditiva, visual e física.Métodos:Estudo descritivo, quantitativo, apoiado no Modelo Híbrido de análise de conceito. Entrevista com deficientes apoiada em questionário estruturado. Dados organizados em tabelas, realizados testes Crosstab e Chi-Square Tests.Resultados:Os deficientes apontaram políticas que contribuíram para inclusão, havendo concordância parcial entre os três tipos de deficiência. Foram relevantes para os auditivos o passe livre (65,0%) e, a Lei de Integração da Pessoa com Deficiência para os visuais (82,5%) e motores (62,5%). Das políticas previstas e não implementadas foram apontadas a não efetivação das leis (auditiva, 67,5% e motora 45,0%); Lei de acessibilidade (visual (80,0% e motora 45,0%) e mudanças atitudinais (visual 80,%).Conclusão:É pertinente a criação e implementação de políticas a fim de garantir o direito dessa clientela.

Objective:The repercussion of inclusive public policies was analyzed from the perspective of people with hearing, visual and physical impairments.Methods:Descriptive and quantitative study, based on the Hybrid Model of concept analysis. Disabled people were interviewed, using a structured questionnaire. Data were organized in tables and Crosstab and Chi-Square tests were carried out.Results:The disabled people indicated policies that contributed towards inclusion, with partial agreement among the three types of disability. Free transportation was relevant for the hearing impaired (65.0%) and the Integration Law for Disabled People for the visually (82.5%) and physically impaired (62.5%). Among the intended and not implemented policies, the non-execution of the laws (hearing 67.5% and motor 45.0%); Accessibility Law (visual 80.0% and motor 45.0%) and attitudinal changes (visual 80.0%) were indicated.Conclusion:The creation and implementation of policies is relevant, to guarantee the rights of these clients.

Objetivo:Analizar la repercusión de políticas públicas inclusivas bajo la perspectiva de las personas con deficiencia auditiva, visual y física.Métodos:Estudio descriptivo, cuantitativo, apoyado en el Modelo Híbrido de análisis de concepto. Entrevista con deficientes apoyada en cuestionario estructurado. Datos organizados en tablas, pruebas Crosstab y Chi-Square Tests.Resultados:Los deficientes indicaron políticas que contribuyeron para la inclusión, con concordancia parcial entre los tres tipos de deficiencia. Para 65,0% de los auditivos, fue relevante el billete libre. La Ley de Integración de la Persona con Deficiencia fue la medida más importante para aquellos con deficiencia visual (82,5%) y motora (62,5%). De las políticas previstas y no implementadas, fueron indicadas la no efectuación de las leyes (auditiva: 67,5%; y motora: 45,0%); Ley de Accesibilidad (visual: 80,0%; y motora: 45,0%) y cambios actitudinales (visual: 80%).Conclusión:Se necesita la creación e implementación de políticas para garantizar el derecho de esa clientela.

Conhecimento de escolares acerca de pessoa com deficiência: jogo de labirinto na promoção da saúde / Schoolchildren’s knowledge about disabled people: labyrinth game in health promotion / Conocimiento de escolares sobre persona con discapacidad: juego del laberinto en la promoción de salud

Estudo transversal, de abordagem quantitativa, que objetivou verificar o conhecimento de escolares antes e após aplicação do jogo de labirinto acerca de pessoa com deficiência. Participaram do estudo 94 escolares do nono ano do ensino fundamental, de escolas públicas e particulares, em duas cidades do Ceará, no segundo semestre de 2013. Aplicou-se jogo educativo, com pré e pós-teste para avaliar o conhecimento dos escolares. Os resultados evidenciaram que após o jogo houve aumento do percentual de acertos, com significância estatística nas escolas públicas (p<0,0001) e particulares (p=0,001), gêneros feminino (p<0,0001) e masculino (p=0,004), faixas etárias de 13-14 anos (p<0,0001) e 15-17 anos (p=0,003). Conclui-se que houve apreensão do conhecimento acerca do tema abordado. A inclusão da pessoa com deficiência deve ser uma temática frequentemente discutida no âmbito escolar, com vistas à sensibilização do estudante para criar e participar da escola inclusiva ideal.

This quantitative, cross-sectional study examined schoolchildren’s knowledge about disabled people before and after application of a labyrinth game. The study participants were 94 ninth-year middle school students at public and private schools in two towns in Ceará State, in the second semester of 2013. Students’ knowledge was assessed by applying an educational game, with pre- and post-testing. The results showed that, after the game, the percentage of correct answers increased, with statistical significance at the public (p<0.0001) and private schools (p=0.001), among girls (p<0.0001) and boys (p=0.004), and in the 13-14 year (p<0.0001) and 15-17 year (p=0.003) age groups. It was concluded that the students gained knowledge on the subject addressed. The subject of inclusion for disabled people should be discussed frequently in the school context, with a view to making students receptive to creating, and participating in, the ideal inclusive school.

Estudio trasversal, de abordaje cuantitativo, cuyo objetivo fue verificar el conocimiento de escolares antes y después de la aplicación del juego de laberinto sobre persona con discapacidad. Participaron del estudio 94 estudiantes del tercer año de secundaria de escuelas públicas y particulares en dos ciudades de Ceará, en el segundo semestre de 2013. Se aplicó un juego educativo, con pre y post-prueba para evaluar el conocimiento de los escolares. Los resultados evidenciaron que, después del juego, aumentó el porcentaje de aciertos, con significancia estadística en las escuelas públicas (p<0,0001)y particulares (p=0,001), sexos femenino (p<0,0001) y masculino (p=0,004) grupos de edad de 13-14 años (p<0,0001) y 15-17 años (p=0,003). Se concluye que los alumnos adquirieron conocimientos sobre el tema abordado. La inclusión de la persona con discapacidad debe ser un tema frecuentemente discutido en el contexto escolar, con vistas a la sensibilización del estudiante para crear y participar de la escuela inclusiva ideal.

Nietsche EA, Teixeira E, Medeiros HP, organizadores. Tecnologias cuidativo-educacionais: uma possibilidade para o empoderamento do (a) enfermeiro (a)? Porto Alegre (RS): Moriá; 2014 / Nietsche EA, Teixeira E, Medeiros HP, organizers

Para os pesquisadores em tecnologias de/em Enfermagem foi lançada a obra “Tecnologias cuidativo-educacionais: uma possibilidade para o empoderamento do/a enfermeiro/a?”. O interesse inicial para elaboração do livro emergiu de três organizadores: Elisabeta Albertina Nietsche, doutora, enfermeira e docente da Universidade Federal de Santa Maria; Elizabeth Teixeira, doutora, enfermeira e docente da Universidade do Estado do Pará; Horácio Pires Medeiros, enfermeiro e mestrando da Universidade Federal do Pará. Além destes, houve a participação de mais autores enfermeiros e de um engenheiro de alimentos.

Conocimiento de los trabajadores sobre el cáncer de próstata: un estudio exploratorio descriptivo / Conhecimento de Trabalhadores sobre Câncer de Próstata: estudo descritivo exploratório / The workers knowledge about prostate cancer: a descriptive exploratory study

Objective: The objective of this project is to identify the workers knowledge about prostate cancer. Methods: This is a descriptive and exploratory study conducted in the city of Quixeramobim - Ceará, in August 2009. We worked with a questionnaire containning open and closed questions, which also allowed large and subjective answers. Results: We interviewed 20 men aged 30 to 40 years old. Discussion: All interviewed people reported having heard of such pathology and signs, but about symptoms, some said they did not have the knowledge and others reported dysuria itching. Conclusion: I find nurses a very important tool in the process of health education.

Meta: identificar el conocimiento de trabajadores sobre el Neoplasías de próstata. Método: Estudio descriptivo exploratorio, que se realizó en la ciudad de Quixeramobim- Ceará, en agosto de 2009. En el que se utilizó una encuesta compuesta de preguntas abiertas y cerradas, en el que también se permitió contestaciones ampliasy subjetivas. Resultados: Se realizaron las entrevistas a 20 hombres , entre 30 y 40 años. Tertulia: Todos los que fueron entrevistados afirmaron conocer dicha patología; respecto a las señales y los síntomas , algunos dijeron no tener conocimiento y los demás relataron disuria, prurido. conclusión: por tratarse de acciones de educación en salud los enfermeros se convierten en importantes herramientas en ese proceso.

Objetivo: identificar o conhecimento de trabalhadores sobre o câncer de próstata. Método: Estudo descritivo exploratório, realizado na cidade de Quixeramobim - Ceará, em agosto de 2009. Utilizou um questionário composto por perguntas abertas e fechadas, o qual permitiu também respostas amplas e subjetivas. Resultados: Foram entrevistados 20 homens com idade entre 30 a 40 anos. Discussão: Todos os inquiridos referiram já terem ouvido falar em tal patologia, sobre os sinais e sintomas alguns disseram não ter o conhecimento e os demais relataram disúria, prurido. Conclusão: Por se tratar de ações de educação em saúde os enfermeiros se põem como importantes ferramentas nesse processo

Programa de mobilidade acadêmica internacional em enfermagem: relato de experiência / Programa internacional de movilidad académica en enfermería: relato de experiencia / International academic mobility program in nursing: experience report

Experiência de estudos no exterior, intercâmbio, agrega valor profissional e pessoal. Objetivou-se descrever experiência discente em programa de mobilidade acadêmica internacional. Estudo de 2008 até 2009 no Brasil e na Espanha. Enfatizaram-se as vivências, observações e atividades realizadas, por acreditar que a formação de discentes e pesquisadores não se restringe somente à universidade e ao país de origem, dando possibilidades de experiências e conhecimentos. Conclui-se, essa oportunidade promoveu repercussões no amadurecimento psicológico, cultural, social e científico.

Experiencia de estudiar en el extranjero, o de cambio, añade valor al crecimiento profesional y personal. El objetivo fue describir la experiencia del estudiante en programa de movilidad académica internacional. Estudio desarrollado desde 2008 hasta 2009 en Brasil y España. Destacar las experiencias, observaciones y actividades realizadas durante el período de movilidad, en la creencia de que la formación de estudiantes e investigadores no se restringe a la universidad y el país de origen, dando posibilidades de nuevas experiencias y conocimientos diferenciados. Se concluye que esta oportunidad ha promovido un profundo efecto sobre su perfil psicológico, cultural, social y científico.

An experience of studying abroad, or of academic exchange, really adds value to the professional and personal development of exchange students. This report aims to describe a student's experience in an international academic mobility program. It was developed from 2008 to 2009 in Brazil and Spain. The experiences, observations and activities of the student were emphasized, believing that the training of students and researchers is not only restricted to the university and the students' home country, and that it is important to have possibilities of new experiences and differentiated knowledge. The conclusion is that this opportunity promoted a profound effect on psychological, cultural, social and scientific development of the exchange student.