Proteolytic degradation of atrial sarcomere proteins underlies contractile defects in atrial fibrillation.

Atrial fibrillation (AFib) is the most common cardiac rhythm disturbance, often treated via electrical cardioversion. Following rhythm restoration, a period of depressed mechanical function known as atrial stunning occurs, suggesting that defects in contractility occur in AFib and are revealed upon restoration of rhythm. This project aims to define the contractile remodeling that occurs in AFib. To assess contractile function, we used a canine atrial tachypacing model of induced AFib. Mass spectrometry analysis showed dysregulation of contractile proteins in samples from AFib compared to sinus rhythm atria. Atrial cardiomyocytes showed reduced force of contraction, decreased resting tension, and increased calcium sensitivity in skinned single cardiomyocyte studies. These alterations correlated with degradation of myofilament proteins including myosin heavy chain altering force of contraction, titin altering resting tension, and TnI altering calcium sensitivity. We measured degradation of other myofilament proteins including cMyBP-C and actininshowing significant degradation in the AFib samples compared to sinus rhythm atria. Many of the protein degradation products appeared as discrete cleavage products that are generated by calpain proteolysis. We assessed calpain activity and found it to be significantly increased. These results provide an understanding of the contractile remodeling that occurs in AFib and provide insight into the molecular explanation for atrial stunning and the increased risk of atrial thrombus and stroke in AFib.

Proteolytic degradation of atrial sarcomere proteins underlies contractile defects in atrial fibrillation.

Aims: Atrial fibrillation (AFib) is the most common cardiac rhythm disturbance. Treatment of AFib involves restoration of the atrial electrical rhythm. Following rhythm restoration, a period of depressed mechanical function known as atrial stunning occurs that involves decreased blood flow velocity and reduced atrial contractility. This suggests that defects in contractility occur in AFib and are revealed upon restoration of rhythm. The aim of this project is to define the contractile remodeling that occurs in AFib. Methods and Results: To assess contractile function, we used a canine atrial tachypacing model of induced AFib. Mass spectrometry analysis showed dysregulation of contractile proteins in samples from AFib compared to sinus rhythm atria. Atrial cardiomyocytes showed reduced force of contraction in skinned single cardiomyocyte calcium-force studies. There were no significant differences in myosin heavy chain isoform expression. Resting tension is decreased in the AFib samples correlating with reduced full-length titin in the sarcomere. We measured degradation of other myofilament proteins including cMyBP-C, actinin, and cTnI, showing significant degradation in the AFib samples compared to sinus rhythm atria. Many of the protein degradation products appeared as discrete cleavage products that are generated by calpain proteolysis. We assessed calpain activity and found it to be significantly increased. Skinned cardiomyocytes from AFib atria showed decreased troponin I phosphorylation, consistent with the increased calcium sensitivity that was found within these cardiomyocytes. Conclusions: With these results it can be concluded that AFib causes alterations in contraction that can be explained by both molecular changes occurring in myofilament proteins and overall myofilament protein degradation. These results provide an understanding of the contractile remodeling that occurs in AFib and provides insight into the molecular explanation for atrial stunning and the increased risk of atrial thrombus and stroke in AFib.

Reassessing the genetic variability of Tectona grandis through high-throughput genotyping: Insights on its narrow genetic base.

Teak (Tectona grandis Linn. f.) is considered one of the most expensive hardwoods in the world. The dispersion of the species over the years has taken the teak beyond its first sources of diversity and little is known about the genetic origin and genetic variability. Thus, this study aimed to investigate the genetic diversity and genetic population structure existing in a representative teak germplasm bank collection. DNA was extracted from young leaves and each sample were genotyped by whole genome sequencing at 3 giga bases per sample, the sequences are aligned using the genome, and SNPcalls and quality control were made. To study the population structure of the genotypes, Bayesian variational inference was used via fastStructure, the phylogenetic tree was based on the modified Euclidean distance and the clustering by the UPGMA hierarchical method. Genetic diversity was analyzed based on the pairwise genetic divergence (Fst) of Weir and Cockerham. Genotyping by sequencing resulted in a database of approximately 1.4 million of variations SNPs were used for analysis. It was possible to identify four populations with considerable genetic variability between and within them. While the genetic variability in teak is generally known to be narrow, this study confirmed the presence of genetic variability scale in teak, which is contrary to what was initially expected.

Application of Near-Infrared Reflectance Spectroscopy for Predicting Damage Severity in a Diverse Panel of Tectona grandis Caused by Ceratocystis fimbriata.

Tectona grandis Linn., also known as teak, is a highly valued species with adaptability to a wide range of climatic conditions and high tolerance to soil variations, making it an attractive option for both commercial and conservation purposes. In this sense, the classification of cultivated teak genotypes is crucial for both breeding programs and conservation efforts. This study examined the relationship between traits related to damage in the stem of teak plants caused by Ceratocystis fimbriata (a soil-borne pathogen that negatively impacts the productivity of teak plantations) and the spectral reflectance of 110 diverse clones, using near-infrared spectroscopy (NIRS) data and partial least squares regression (PLSR) analysis. Cross-validation models had R2 = 0.894 (ratio of standard error of prediction to standard deviation: RPD = 3.1), R2 = 0.883 (RPD = 2.7), and R2 = 0.893 (RPD = 2.8) for predicting stem lesion area, lesion length, and severity of infection, respectively. Teak genotypes (clones) can benefit from the creation of a calibration model utilizing NIRS-generated data paired with PLSR, which can effectively screen the magnitude of damage caused by the fungus. Overall, while the study provides valuable information for teak breeding and conservation efforts, a long-term perspective would be essential to evaluate the sustainability of teak genotypes over various growth stages and under continuous pathogen pressure.

Mechanisms of Sarcomere Protein Mutation-Induced Cardiomyopathies.

PURPOSE OF REVIEW: The pace of identifying cardiomyopathy-associated mutations and advances in our understanding of sarcomere function that underlies many cardiomyopathies has been remarkable. Here, we aim to synthesize how these advances have led to the promising new treatments that are being developed to treat cardiomyopathies. RECENT FINDINGS: The genomics era has identified and validated many genetic causes of hypertrophic and dilated cardiomyopathies. Recent advances in our mechanistic understanding of sarcomere pathophysiology include high-resolution molecular models of sarcomere components and the identification of the myosin super-relaxed state. The advances in our understanding of sarcomere function have yielded several therapeutic agents that are now in development and clinical use to correct contractile dysfunction-mediated cardiomyopathy. New genes linked to cardiomyopathy include targets with limited clinical evidence and require additional investigation. Large portions of cardiomyopathy with family history remain genetically undiagnosed and may be due to polygenic disease.

Trifluridine/tipiracil (FTD/TPI) and regorafenib in older patients with metastatic colorectal cancer.

Colorectal cancer is a disease of older patients, but few guidelines directly address age in their recommendations. Older patients may present comorbidities that affect the choice of chemotherapy, and care must be taken when choosing the best approach. This narrative review aimed to describe the literature regarding approved oral agents for third-line treatment in older patients with refractory metastatic colorectal cancer, regorafenib, and trifluridine/tipiracil (FTD/TPI).

National multicentric study on the incidence of alcohol burns during the COVID-19 pandemic.

BACKGROUND: Burns are traumatic wounds that occur when skin is exposed to an amount of energy greater than its maximum dissipation capacity. Alcohol, because it fuels flames and its vapor can cause an explosion, is one of the most common causal agents of burns in Brazil. In late 2019, the COVID-19 pandemic caused a sudden and substantial increase in the use of 70% alcohol (w/v) for antisepsis. OBJECTIVES: To analyze the epidemiological characteristics of alcohol burns during the COVID-19 pandemic in participating Burn Treatment Centers, as well as the severity and treatment of these burns. METHOD: Descriptive, cross-sectional, quantitative and retrospective study based on data obtained from medical records of patients treated in participating Burn Treatment Centers. Data collection included origin, gender, education level, occupation, circumstance of the accident, wound depth and type of treatment. RESULTS: Of eight participating centers, theHospital da Restauraç ão Gov. Paulo Guerra Burn Treatment Center experienced the highest number of alcohol burn patients (38.4%) and male gender accounted for 53.6% of all cases. Predominant occupations were those that involve domestic activities (29%) and 48.6% of patients had not completed elementary school. The most common cause was an accident during cooking (35.5%) followed by suicide attempt (18.3%). More than half (58.6%) of the patients had concomitant second and third degree burns and wound treatment of choice was surgical (43.1%). CONCLUSIONS: The predominant population in this study was male, had a lower level of education, resided in the northeast region and had an occupation carried out in a domestic environment. The latter may reflect the population's longer stay at home due to social constraints caused by the COVID-19 pandemic. There were a large number of second and third degree burns and, as a consequence, a high number of cases in which surgical treatment was required.

Partial and complete loss of myosin binding protein H-like cause cardiac conduction defects.

A premature truncation of MYBPHL in humans and a loss of Mybphl in mice is associated with dilated cardiomyopathy, atrial and ventricular arrhythmias, and atrial enlargement. MYBPHL encodes myosin binding protein H-like (MyBP-HL). Prior work in mice indirectly identified Mybphl expression in the atria and in small puncta throughout the ventricle. Because of its genetic association with human and mouse cardiac conduction system disease, we evaluated the anatomical localization of MyBP-HL and the consequences of loss of MyBP-HL on conduction system function. Immunofluorescence microscopy of normal adult mouse ventricles identified MyBP-HL-positive ventricular cardiomyocytes that co-localized with the ventricular conduction system marker contactin-2 near the atrioventricular node and in a subset of Purkinje fibers. Mybphl heterozygous ventricles had a marked reduction of MyBP-HL-positive cells compared to controls. Lightsheet microscopy of normal perinatal day 5 mouse hearts showed enrichment of MyBP-HL-positive cells within and immediately adjacent to the contactin-2-positive ventricular conduction system, but this association was not apparent in Mybphl heterozygous hearts. Surface telemetry of Mybphl-null mice revealed atrioventricular block and atrial bigeminy, while intracardiac pacing revealed a shorter atrial relative refractory period and atrial tachycardia. Calcium transient analysis of isolated Mybphl-null atrial cardiomyocytes demonstrated an increased heterogeneity of calcium release and faster rates of calcium release compared to wild type controls. Super-resolution microscopy of Mybphl heterozygous and homozygous null atrial cardiomyocytes showed ryanodine receptor disorganization compared to wild type controls. Abnormal calcium release, shorter atrial refractory period, and atrial dilation seen in Mybphl null, but not wild type control hearts, agree with the observed atrial arrhythmias, bigeminy, and atrial tachycardia, whereas the proximity of MyBP-HL-positive cells with the ventricular conduction system provides insight into how a predominantly atrial expressed gene contributes to ventricular arrhythmias and ventricular dysfunction.

Trifluridina/cloridrato de tipiracila no tratamento de pacientes com carcinoma colorretal metastático politratados: uma análise de custo-efetividade na perspectiva de pagadores privados no Brasil / Trifluridine/tipiracil hydrochloride in the treatment of polytreated metastatic colorectal carcinoma: a cost-effectiveness analysis in the private payer perspective in Brazil

Objetivo: Avaliar a custo-efetividade da trifluridina/cloridrato de tipiracila (FTD/TPI) em comparação ao melhor cuidado de suporte (sigla em inglês BSC, best supportive care) e ao regorafenibe para o tratamento em pacientes com câncer colorretal metastático (CCRm) politratados (terceira linha ou linhas posteriores) sob a perspectiva de pagadores privados no Brasil. Métodos: Foi construído um modelo de sobrevida particionado considerando três estados de saúde. A efetividade foi medida em anos-vida ganhos e Quality-Adjusted Life Years (QALY). Os custos foram obtidos a partir da perspectiva do sistema de saúde privado brasileiro considerando um horizonte temporal de cinco anos. Também foram realizadas análises de sensibilidade univariada e probabilística para avaliar a robustez do modelo. Resultados: A utilização de FTD/TPI pode gerar melhores desfechos clínicos versus BSC e economia de recursos versus regorafenibe. FTD/TPI proporcionou mais 0,098 anos de vida por paciente e uma qualidade de vida incremental de 0,072, comparada ao BSC. Já em relação ao regorafenibe, a FTD/TPI apresentou redução de R$ 2.088,49 nos custos por paciente e benefícios clínicos com incremento marginal. Conclusão: FTD/TPI representa uma opção de tratamento de CCRm custo-efetiva, comparada ao regorafenibe, na perspectiva de pagadores privados no Brasil

Objective: To determine the cost-effectiveness analysis of trifluridine/tipiracil chloridrate (FTD/TPI) compared to best supportative care (BSC) and regorafenib for the treatment of polytreated metastatic colorectal carcinoma (mCRC) (3rd line or later lines) in the private payer perspective in Brazil. Methods: A partitioned survival model was developed based on three health states. Effectiveness was measured in life-years gained and Quality-Adjusted Life Years (QALYs). Costs were obtained from the perspective of the supplementary healthcare system in Brazil considering a time horizon of five years. Univariate and probabilistic sensitivity analyses were performed to evaluate the robustness of the model. Results: The use of FTD/TPI may generate better clinical outcomes versus BSC and resource savings versus regorafenib. FTD/TPI provided more 0,098 years of life per patient and an incremental quality of life of 0,072 compared to BSC. Regarding regorafenib, FTD/TPI provided a cost reduction of R$ 2.088,49 per patient and similar clinical benefits. Conclusion: FTD/TPI represents a cost-effective treatment option for mCRC compared to regorafenib from the perspective of the supplementary healthcare system in Brazil

Zidovudine Glycosylation by Filamentous Fungi Leads to a Better Redox Stability and Improved Cytotoxicity in B16F10 Murine Melanoma Cells.

BACKGROUND: The strategic development of therapeutic agents, capable of being targeted at their active sites, has been a major goal in treatment of cancer. The delivery of drugs for tumors has as its main challenge the development of safe and effective drugs, since the goal of chemotherapy is to eliminate the tumor completely without affecting healthy cells. The aim of present study was to investigate the antioxidant, anticancer activities of zidovudine and its α-O-glycosylated derivative obtained by biosynthesis of a filamentous fungi, Cunninghamela echinulata. METHODS: An evaluation of the cytotoxic potential of zidovudine and its α-O-glycosylated was performed in fibroblasts and melanoma cells by the tetrazolium reduction method (MTT) and the antioxidant activity of this derivative was observed. RESULTS: The antioxidant activity of zidovudine demonstrated an electrochemical oxidation potential of 0.91V, while the α-O-glycosylated derivative did not exhibit any antioxidant activity. The zidovudine exhibited low cytotoxicity for melanoma and fibroblast cells, while the α-O-glycosylated derivative presented better cytotoxicity on melanoma cells at a concentration of 10mg. mL-1. CONCLUSION: This study demonstrates the specific cytotoxicity of the glycoconjugate and suggests that glycosylation by biosynthesis can be a useful strategy for obtaining new anticancer compounds.

GIV/Girdin promotes cell survival during endoplasmic reticulum stress.

Endoplasmic reticulum (ER) stress is a form of cellular stress that is experienced by cells both under normal physiological conditions such as in professional secretory cells and disease states such as cancer, diabetes, and neurodegeneration. Upon facing ER stress, cells activate a conserved signaling pathway called the unfolded protein response (UPR) to restore normal function by halting general protein translation, upregulating expression of chaperones, and promoting ER-associated degradation. However, if the stress is overwhelming and cells are not able to recover within a reasonable time frame, the UPR ultimately commits cells to programmed cell death. How cells make this life-or-death decision remains an exciting yet poorly understood phenomenon. Here, we show that Gα-interacting vesicle-associated protein (GIV) aka Girdin plays an important role in promoting cell survival during ER stress. Cells lacking GIV are impaired in activating the pro-survival Akt pathway upon induction of ER stress. These cells also show enhanced levels of the pro-apoptotic transcription factor, CCAAT/enhancer binding protein homologous protein (CHOP) as compared to control cells. Due to decreased pro-survival signals and a concomitant increase in pro-apoptotic signals, GIV-depleted cells show a significant reduction in cell survival upon prolonged ER stress which can be rescued by re-expression of GIV or by directly activating Akt in these cells. Together, this study shows a novel, cytoprotective role for GIV in ER-stressed cells and furthers our understanding of the mechanisms that contribute to cell survival during ER stress.

Análise retrospectiva de pacientes com neoplasias de esôfago localmente avançado submetidos a tratamento com quimiorradioterapia neoadjuvante no Instituto Nacional de Câncer - INCA / Retrospective analysis of patients with locally advanced esophageal neoplasms undergoing treatment with neoadjuvant chemoradiotherapy at the National Cancer Institute - INCA

O câncer de esôfago é a oitava neoplasia mais freqüente no mundo. Corresponde à sexta causa de óbito por câncer em homens e à 9ª causa em mulheres, e tem apresentado melhora discreta em sobrevida nas últimas décadas devido ao diagnóstico tardio na maioria dos casos. O manejo da doença localmente avançada é tema controverso e estes pacientes constituem um grupo heterogêneo. Para os candidatos à cirurgia, o tratamento trimodal, combinando quimioterapia (Carboplatina e Paclitaxel) e radioterapia (com dose de 41.4Gy) seguidas de cirurgia, apresenta resultados superiores em termos de sobrevida global. No caso de pacientes com doença irressecável ou não candidatos à cirurgia, a combinação de quimioterapia com Cisplatina + 5-Fluoracil e radioterapia com dose de 50.4Gy é considerada como tratamento de escolha. Recentemente, alguns estudos retrospectivos têm demonstrado a eficácia de tratamento definitivo com quimiorradioterapia usando Carboplatina e Paclitaxel, associado à melhor perfil de toxicidade. Foi realizado estudo observacional, retrospectivo, com análise de pacientes com neoplasia de esôfago (escamoso e adenocarcinoma) com doença localmente avançada submetidos a tratamento com quimioterapia neoadjuvante com Carboplatina (AUC2) + Paclitaxel (50mg/m2) semanais e radioterapia. Todos os pacientes foram tratados no período de janeiro de 2012 a dezembro de 2013, com um follow-up de 4 anos (até janeiro/2016). Dados clínicos e patológicos foram revisados. Foram avaliados 46 pacientes, em maioria homens (78%), com ECOG/PS igual a 0 ou 1 (80%) e idade mediana de 62 anos (45-76 anos). O subtipo histológico mais comum foi carcinoma escamoso (83%) e 61% apresentavam estadiamento clínico T3N0. Aproximadamente 70% dos pacientes receberam 5 ou mais ciclos de quimioterapia e 89% fizeram radioterapia com doses entre 45Gy e 50.4Gy. Apenas 4 pacientes foram submetidos à tratamento combinado com quimiorradioterapia seguida de cirurgia, e destes, 50% apresentaram resposta patológica completa. O tempo médio entre término de quimioterapia e cirurgia foi de 4,5 meses (IC 1.5-7.5). As principais complicações grau 3 foram anemia (2%) e fadiga (13%). Não foram registradas toxicidades grau 4 ou óbitos associados ao tratamento. A sobrevida global mediana foi de 13,4 meses (IC 95%, 7.69 a 19.25) e sobrevida livre de doença foi de 9,5 meses (IC 95% 8.15 a 10.9). Concluímos, portanto, que o tratamento definitivo de quimiorradioterapia com Carbotaxol e radioterapia de 50.4Gy pode ser uma opção para pacientes com doença localmente avançada que não sejam candidatos cirúrgicos, uma vez que este regime foi associado com baixo perfil de toxicidade e controle locorregional durável, apresentando resultados comparáveis a estudos retrospectivos prévios na literatura. Porém, a observação de taxa tão reduzida de cirurgia neste período ressalta a necessidade de discussão do tratamento em equipe multidisciplinar. Uma pré-seleção e programação de tratamentos mais rigorosos são fundamentais para assegurar a intervenção cirúrgica destes pacientes na instituição após o tratamento combinado.(AU)

Multivariate analysis for the detection of Passiflora species resistant to collar rot / Análise multivariada na distinção de espécies de Passiflora resistentes à podridão do colo

Collar rot is a disease difficult to control that has hindered passion fruit cultivation in many regions of Brazil. Therefore, this study aimed to find genetic resistance to the fungus Fusarium solani in Passiflora species using the multivariate analysis methodology to discriminate the most resistant species. The following fourteen Passiflora species were assessed: P. quadrangularis, P. nitida, P. foetida, P. tenuifila, P. alata, P. setacea, P. cincinnata, P. mucronata, P. micropetala, P. suberosa, P. morifolia, P. eichleriana, P. edulis and P. coccinea. These plants were arranged in a casualized block design with 14 treatments (species), three replications and three plants per plot. The reactions of the inoculated species of Passiflora were evaluated with the use of 12 resistance traits. The generalized Mahalanobis distance was used to form groupings by the UPGMA method. 3D projection with the canonical variables and quantification of the relative contribution of characters were also conducted. The UPGMA method revealed the formation of three distinct groups of species, which composed the susceptible, moderately resistant and resistant groups. The groups formed by threedimensional dispersion were similar to those formed by the dendrogram. The following traits contributed most to genetic diversity: inoculation time until the lesion reached more than 50% of the circumference of the injured stem and area under the curve of the expansion of the lesion width. The use of the set of traits and their joint assessment through multivariate analysis allowed greater accuracy in the inference of the most resistant species, mainly P. nitida and P. cincinnata.

A podridão do colo é uma doença de difícil controle e que em muitas regiões do Brasil tem dificultado o cultivo do maracujazeiro. Neste contexto, este estudo teve por objetivos avaliar resistência genética em espécies de Passiflora ao fungo Fusarium solani utilizando análise multivariada como metodologia para distinguir as espécies quanto à resistência. Foram avaliadas 14 espécies de Passiflora, sendo elas: P. quadrangularis, P. nitida, P. foetida, P. tenuifila, P. alata, P. setacea, P. cincinnata, P. mucronata, P. micropetala, P. suberosa, P. morifolia, P. eichleriana, P. edulis e P. coccinea. Estas plantas foram dispostas em blocos ao acaso com 14 tratamentos (espécies), três repetições e três plantas por parcela. A reação das espécies de Passiflora inoculadas foi avaliada utilizando 12 características de resistência. Através dessas características, por meio da distância generalizada de Mahalanobis, foram realizados agrupamentos pelo método UPGMA, projeção 3D com as variáveis canônicas e também foi quantificada a contribuição relativa dos caracteres. Verificou-se, por meio do método de agrupamento UPGMA, a formação de três grupos distintos de espécies, e estes foram classificados como sendo suscetíveis, moderadamente resistentes e resistentes. Os agrupamentos formados pela dispersão tridimensional se assemelharam aos formados pelo dendrograma. As características que mais contribuíram para a diversidade genética foram período da inoculação até a lesão atingir mais que 50% da circunferência do caule lesionado e área abaixo da curva de expansão da largura da lesão. O uso do conjunto de características e a avaliação conjunta das mesmas através de análise multivariada possibilitaram maior acurácia na inferência das espécies mais resistentes, destacando-se P. nitida e P. cincinnata.

Bioconversion of quercetin and rutin and the cytotoxicity activities of the transformed products.

Quercetin and rutin are well-know flavonoids. In spite of this, the comprehension of their metabolism is still incomplete. In this work, the cytotoxic activity of quercetin and rutin and its metabolites produced by metabolism of filamentous fungi was investigated. Flavonoids metabolism was monitored by HPLC and LC-MS. Both flavonoids were extensively metabolized. Quercetin was converted into metabolite methylquercetin (2) and quercetin glucuronide (3) and rutin into metabolite rutin sulphate (5), methylrutin (6) and rutin glucuronide (7). Cytotoxic effects of rutin, quercetin and its metabolites were measured by MTT tetrazolium reduction test and the trypan blue exclusion assay on HL-60 leukemic cells. The results showed similar concentration-dependent cytotoxic effect for rutin and rutin sulphate (5), while no cytotoxic effect was detected with the metabolites 6 and 7. In relation to the quercetin and its metabolites the results showed that all compounds have a similar concentration-dependent inhibitory effect on HL-60 cells. These findings corroborate the literature, showing that bioconversion is a useful strategy for production of biological active metabolites.

[Family planning: significance for women of reproductive age]. / Planejamento familiar: significado para mulheres em idade reprodutiva.

The study sought to comprehend the significance of family planning from the standpoint of women of reproductive age and identify their perceptions about the care received and the partner's participation in the decisions about the use of contraceptive methods. It is a descriptive study using a qualitative approach, conducted with 24 women who participated in the Family Planning program in a Basic Family Health Unit in Fortaleza, State of Ceará, Brazil, between August and October 2007. The information gleaned from interviews was recorded, organized into themes and analyzed on the basis of the concept of significance of symbolic interactionism. The results revealed three significant themes: the significance of family planning from the viewpoint of women of fertile age; interactions of women of fertile age in a family planning service; and male participation in family planning in terms of female significance. It was revealed that the significance of family planning for these women is related to avoiding pregnancy and according to values pertaining to their cultural, economic and social reality. The care is received in an isolated manner, without prioritizing women's needs and without input of an educational or empowerment stamp.

Planejamento familiar: significado para mulheres em idade reprodutiva / Family planning: significance for women of reproductive age

O estudo teve como objetivo compreender o significado do planejamento familiar dado por mulheres em idade reprodutiva, identificar suas percepções sobre a assistência recebida e a participação do parceiro nas decisões do uso do método anticoncepcional. Trata-se de um estudo descritivo, com abordagem qualitativa, desenvolvido com 24 mulheres que participavam do Programa de Planejamento Familiar (PF) em uma Unidade Básica de Saúde da Família de Fortaleza (Ceará), no período de agosto a outubro de 2007. As informações contidas nas entrevistas foram gravadas, organizadas em temáticas e analisadas com base no conceito de significado do interacionismo simbólico. Os resultados evidenciaram três temáticas significativas: o significado de planejamento familiar dado por mulheres em idade fértil; interações de mulheres em idade fértil em um serviço de planejamento familiar; e participação masculina no planejamento familiar conforme significado feminino. Constatou-se que o significado de planejamento familiar para essas mulheres está relacionado a evitar filhos e com valores pertinentes às suas realidades cultural, econômica e social. A assistência é recebida de forma isolada, não priorizando as necessidades da mulher, sem cunho educativo e emancipatório.

The study sought to comprehend the significance of family planning from the standpoint of women of reproductive age and identify their perceptions about the care received and the partner's participation in the decisions about the use of contraceptive methods. It is a descriptive study using a qualitative approach, conducted with 24 women who participated in the Family Planning program in a Basic Family Health Unit in Fortaleza, State of Ceará, Brazil, between August and October 2007. The information gleaned from interviews was recorded, organized into themes and analyzed on the basis of the concept of significance of symbolic interactionism. The results revealed three significant themes: the significance of family planning from the viewpoint of women of fertile age; interactions of women of fertile age in a family planning service; and male participation in family planning in terms of female significance. It was revealed that the significance of family planning for these women is related to avoiding pregnancy and according to values pertaining to their cultural, economic and social reality. The care is received in an isolated manner, without prioritizing women's needs and without input of an educational or empowerment stamp.