Eficiência de duas técnicas de recuperação de espermatozoides epididimários de cães e avaliação seminal pós-criopreservação / [Efficiency of two techniques for recovering epididymal spermatozoids from dogs and seminal evaluation post cryopreservation]

O objetivo deste trabalho foi avaliar a recuperação de espermatozoides epididimários de cães castrados, utilizando as técnicas de fluxo retrógrado (FR) e flutuação (FL) em diluidor Tris-gema, antes e após a criopreservação. Foram coletados 30 complexos testículo-epididímos (CTE), sendo 15 para FR e 15 para FL, e, logo após a recuperação dos espermatozoides, foram analisadas as alterações morfológicas nessas células espermáticas. Após a adição do diluidor, foram avaliados os parâmetros de motilidade total (MOT) e vigor (V) espermáticos. O sêmen pós-criopreservado foi submetido ao teste de termorresistência nos tempos T0, T30, T60 e T90 minutos, além da avaliação das membranas plasmática e acrossomal por sondas fluorescentes. Não houve diferença estatística entre as técnicas quanto à MOT e ao vigor no sêmen diluído (FR-MOT: 82,3% e V: 3,4; FL-MOT: 79,6% e V: 3,2) e pós-criopreservado (FR-MOT: 34% e V: 2,8; FL-MOT: 30% e V: 2,7). A partir do T30, houve diferença significativa quanto à MOT e ao vigor nas técnicas utilizadas, e o tempo também prejudicou o acrossoma espermático a partir do T30. Conclui-se que as técnicas de recuperação de espermatozoides epididimários de cães castrados, testadas neste trabalho, podem ser utilizadas para refrigeração e criopreservação de sêmen.(AU)

The objective of this work was to evaluate the recovery of epididymal spermatozoa from castrated dogs using retrograde flow (FL) and flotation (FL) techniques in Tris-egg yolk diluent, before and after cryopreservation. Thirty testicle-epididymal complexes (CTE) were collected, 15 for FR and 15 for FL and soon after spermatozoid recovery, morphological changes in these spermatic cells were analyzed. After addition of the diluent, the parameters of total motility (MOT) and vigor (V) were evaluated. The post-cryopreserved semen was submitted to thermoresistance (TTR) test at T0, T30, T60 and T90 minutes, as well as the plasma and acrosomal membrane evaluation by fluorescent probes. There was no statistically significant difference between techniques tested for MOT and vigor in the diluted semen (FR-MOT: 82.3% and V: 3.4, FL-MOT: 79.6% and V: 3.2) and post-cryopreserved (FR-MOT: 34% and V: 2.8, FL-MOT: 30% and V: 2.7). From the T30 there was a significant difference regarding MOT and vigor in the used techniques, and the time also damaged the spermatic acrosome from the T30. It is concluded that the epididymal spermatozoa recovering techniques from castrated dogs, tested in this study, can be used for semen refrigeration and cryopreservation.(AU)

Plasminogen activator inhibitor 1 and Antipain preserve acrosome integrity of bovine spermatozoa during cryopreservation / Inibidor do ativador do plasminogênio 1 e antipaína preservam a integridade do acrossoma de espermatozoides bovinos durante a criopreservação

Seminal plasma contains serine proteases and serine protease inhibitor, which are involved in mammalian fertilization, and the inhibitors can be applied to prevent cold-induced sperm capacitation. The effects of different concentrations of two serine protease inhibitors were analyzed, Plasminogen activator inhibitor 1 - PAI-1 (70ƞg, 140ƞg and 210 ƞg) and Antipain (10µg, 50µg and 100µg) as supplementation to bovine semen cryopreservation extender. The effects of the inhibitors on the sperm parameters (sperm kinetics - CASA, acrosome integrity, plasma membrane integrity, mitochondrial membrane potential, sperm defects and acrosome reaction rate) were evaluated in the post-thaw semen. Cryopreservation of sperm with Antipain decreased post-thaw kinetic parameters of MP, VSL, LIN, SRT and the percentage of hyper-activated sperm while PAI-1 (210 ƞg) decreased VSL and LIN. Antipain and PAI-1 had no effect on the integrity parameters of the plasma membrane, mitochondrial membrane potential and sperm defects. Sperm cryopreserved in the presence of Antipain and PAI-1 (70 and 140 ƞg) preserved acrosome integrity, as they were able to complete the in vitro acrosome reaction. In conclusion, the serine protease inhibitors, Antipain and PAI-1 (70 and 140ƞg) are able to preserve the acrosome integrity of cryopreserved bovine sperm.(AU)

A criopreservação é parcialmente prejudicial à fertilidade do sêmen de bovinos e induz mudanças semelhantes à capacitação em espermatozoides. O plasma seminal contém serina-proteases e inibidores de serina-proteases que estão envolvidos na fertilização de mamíferos, e os inibidores podem ser aplicados para evitar uma capacitação espermática induzida pelo frio. Analisaram-se os efeitos de diferentes concentrações de dois inibidores de serina-proteases, inibidor do ativador do plasminogênio 1 - PAI-1 (70ƞg, 140ƞg e 210ƞg) e antipaína (10µg, 50µg e 100µg) na suplementação ao diluidor de criopreservação de sêmen bovino. Trinta e seis ejaculados de quatro bovinos Curraleiro Pé-Duro foram usados para criopreservação. Os efeitos dos inibidores sobre os parâmetros dos espermatozoides (cinética espermática - CASA, integridade acrossomal, integridade da membrana plasmática, potencial de membrana mitocondrial, defeitos espermáticos e taxa de reação acrossomal) foram avaliados no sêmen pós-descongelamento. A criopreservação de espermatozoides com antipaína diminuiu os parâmetros cinéticos pós-descongelamento de MP, VSL, LIN, SRT e a porcentagem de espermatozoides hiperativados, PAI-1 (210ƞg) diminuiu VSL e LIN. Antipaína e PAI-1 não tiveram efeitos nos parâmetros de integridade da membrana plasmática, no potencial de membrana mitocondrial e nos defeitos espermáticos. Espermatozoides criopreservados na presença de antipaína e PAI-1 (70 e 140ƞg) preservaram a integridade acrossomal, assim como foram capazes de completar a reação acrossômica in vitro. Em conclusão, os inibidores de serina-proteases, antipaína e PAI-1 (70 e 140ƞg) são capazes de preservar a integridade acrossomal de espermatozoides criopreservados de bovinos.(AU)

Avaliação in vitro do sêmen criopreservado de cães naturalmente infectados por Leishmania sp / In vitro evaluation of cryopreserved semen of dogs naturally infected by Leishmania sp

O objetivo deste trabalho foi avaliar a qualidade in vitro do sêmen criopreservado de cães naturalmente infectados por Leishmania sp. Foram coletadas amostras de sêmen de 12 cães, sendo seis positivos (GI) e seis negativos (GII) para leishmaniose visceral (LV), semanalmente, totalizando quatro coletas por animal. O sêmen criopreservado foi avaliado pelo teste de termorresistência rápida (TTR), nos tempos zero, 30 e 60 minutos, pela análise computadorizada (CASA) e por meio de sondas fluorescentes; esta última técnica com o intuito de avaliar a integridade das membranas espermáticas. Houve diferença estatística pela técnica de TTR no parâmetro motilidade progressiva, no tempo 0min (68,33% GI e 72,50% GII), e no vigor espermático (2,67 GI e 3,0 GII), no tempo 30min. Quanto ao CASA, houve diferença estatística apenas na motilidade total (27,50% GI e 57,08% GII), embora os demais parâmetros seminais tenham apresentado valores relativos diminuídos nos cães do GI. Nas análises com sondas fluorescentes, foram observadas diferenças estatísticas entre os grupos quanto à integridade das membranas plasmática e acrossomal e ao potencial mitocondrial das células espermáticas. Concluiu-se que a LV pode comprometer a qualidade do sêmen criopreservado de cães parasitados.(AU)

The aim of this study was to evaluate the in vitro quality of cryopreserved semen of dogs naturally infected by Leishmania sp. 12 dog semen samples were collected, with 06 positive (GI) and 06 negative (GII) for Visceral Leishmaniasis (LV), weekly, totaling 04 collections per animal. The cryopreserved semen was evaluated by the Rapid Termorresistência Test (TTR), at 0, 30 and 60 minutes by computer analysis (CASA) and by means of fluorescent probes, the latter technique in order to assess the integrity of the sperm membrane. There was no statistical difference for the TTR technique in the progressive motility parameter, at time 0min (68.33% GI and GII 72.50%), and sperm vigor (2.67 GI and GII 3.0), time 30min. As for the CASA, there was statistical difference only in total motility (27.50% GI and GII 57.08%), although other semen parameters have submitted lower figures for GI dogs. In the analyzes with fluorescent probes statistical differences were noted between the groups in terms of plasma membrane integrity and acrosomal and mitochondrial potential of sperm cells. It was concluded that LV can compromise the quality of cryopreserved semen of infected dogs.(AU)

Relationship between psychosocial variables and compliance in patients with heart failure.

OBJECTIVE: The purpose of this study was to describe the socio-demographic, psychosocial, and social support variables that predict compliance to treatment regimens in HF patients. DESIGN AND SETTING: Semistructured interviews were conducted on 82 patients at an outpatient heart failure clinic to gather data related to compliance behaviors. Five standardized instruments were used to gather data on patients' psychosocial health status and perceived social support. RESULTS: The overall compliance rate was 85.13 (10.01%). Higher levels of compliance (> 90%) were noted for follow-up appointments, medications, smoking, and alcohol cessation. Poor compliance was observed with dietary and exercise recommendations (71% and 53%, respectively). In a multivariate model, higher education, higher mental and physical health status and neuroticism independently contributed to 24% of the variance in overall compliance. CONCLUSION: The study supports that HF patients had poor compliance with dietary and exercise regimens. Since following a dietary and exercise regimen has been demonstrated to reduce morbidity in this population, strategies to increase compliance should be rigorously pursued [corrected].

Gender differences in health perceptions and meaning in persons living with heart failure.

OBJECTIVE: The goal of this study was to determine whether gender differences exist in health perceptions, psychosocial adjustment to illness, and concerns related to illness in patients with heart failure (HF). DESIGN: Thirty-two patients (50% women) from a single outpatient HF clinic were asked to complete standardized tools to assess health perceptions and psychosocial adjustment to illness. Open-ended questions were used to obtain data on concerns related to HF. RESULTS: The women had higher health perceptions than men did; they also demonstrated better psychosocial adjustment to illness. The qualitative data further suggest that women ascribed more positive meanings to their illness than men did. CONCLUSION: The current study underscored the importance of gender differences in health perceptions related to HF. Patient teaching and counseling can be tailored to address the gender-specific concerns of men and women suffering with this condition to improve patient outcomes.

Hemodynamic benefits of treatment modalities for hypertrophic cardiomyopathy: a case study.

Hypertrophic cardiomyopathy is a primary disease of the cardiac muscle characterized by a hypertrophied and nondilated left ventricle in the absence of other cardiac or systemic disease. The disorder occurs twice as often in men than in women and is relatively more common in young adults. Early treatment of symptoms may improve hemodynamic benefits and prevent complications, including sudden death. This case illustrates various treatment modalities used to manage symptoms and describes the challenges in effectively maintaining hemodynamic stability.

Usefulness of a history of tobacco and alcohol use in predicting multiple heart failure readmissions among veterans.

Multiple hospital readmissions for heart failure (HF) are progressively increasing and may be related to continued tobacco and alcohol use. To study this relation, we conducted a retrospective chart audit of all veterans discharged with HF at a large Veterans Administration (VA) facility from 1997 to 1998. Using a multivariate logistic regression model, the smoking and alcohol use of patients who required > 1 HF admission within 1 year were compared with those who did not. Demographic, clinical, and psychosocial variables were also included in the model. Of 753 patients admitted with HF during the review period (mean age 69.1 years, 99% men), 220 patients (29.2%) were readmitted to the hospital at least once (range 1 to 8 readmissions, mean 1.79 +/- 0.27) after the index admission. In a multivariate analysis, current smoking (odds ratio [OR] 1.82; confidence interval [CI] 1.17 to 2.82) and current alcohol use (OR 5.92; CI 3.83 to 9.13) were independent predictors of readmissions. Other predictors included living alone (OR 2.09; CI 1.42 to 3.09), HF associated with ischemic etiology (OR 3.99; CI 2.58 to 6.18), higher New York Heart Association class (OR 2.57; CI 1.86 to 3.55), and care provided by a primary care physician compared with a cardiologist (OR 2.41; CI 1.57 to 3.67). This study confirms that noncompliance to smoking and alcohol restrictions, which are amenable to change, dramatically increases the risk for multiple hospital readmissions among patients with HF. Consequently, evaluation of noncompliance to smoking and alcohol consumption with targeted interventions in this population may be a key component for the reduction of multiple hospital readmissions.

Treatment-seeking delays in heart failure patients.

BACKGROUND: Patients having cardiac symptoms often delay for hours before seeking treatment. Delay time is usually defined as the amount of time between the patient's first awareness of symptoms and arrival at the hospital. Excessive delays in seeking medical care for heart failure (HF) symptoms may influence patient outcomes. However, the treatment-seeking patterns of HF patients are not well understood. METHODS: We obtained data through a retrospective chart audit to describe the treatment-seeking behaviors of 753 HF patients, at a Veterans Administration facility, and to identify predictors of delay in seeking medical care for HF symptoms. Using univariate and multivariate analyses, we assessed relationships among delay time, presenting symptoms, and patient characteristics. RESULTS: The mean delay time was 2.93 +/- 0.68 days. The most common symptoms on admission were dyspnea (76%), edema (66%), fatigue (37%), and angina (25%). Variables negatively affecting delay time included presence of dyspnea and edema (odds ratio [OR], 2.10 and 1.82; confidence interval [CI], 1.38 to 3.19 and 1.17 to 2.82, respectively), care by a primary care physician (OR, 2.04; CI, 1.45 to 2.88), and higher New York Heart Association (NYHA) Class (OR, 1.96; CI, 1.47 to 2.61). Variables positively affecting delay time were the presence of chest pain (OR, 0.42; CI, 0.29 to 0.62) and a history of previous admission for HF (OR, 0.42; CI, 0.28 to 0.62). CONCLUSIONS: Delays in seeking treatment for HF symptoms are significantly high. This study supports the need for interventions that will increase early symptom recognition and management on the part of patients and their families.

A closer look at compliance research in heart failure patients in the last decade.

Compliance with a complex healthcare regimen is required of most patients with heart failure. Noncompliance with even some aspects of the recommended treatment can lead to repeated and preventable hospitalizations, or even death. This paper reviews the extent of noncompliance for general health-seeking behavior and recommended lifestyle modifications in the general population, as well as the research on compliance conducted specifically in patients with heart failure. Research findings are reviewed in three areas: the extent and predictors of compliance, the relationship of compliance and clinical outcomes, and interventions designed to increase compliance in heart failure patients. Based on research findings to date, strategies to enhance compliance are offered.

Compliance: a concept analysis.

Compliance has a myriad of definitions. Understanding it as a phenomenon is complicated by the different perspectives of different disciplines. Nurses need to define compliance in a manner that best fits the philosophy of the nursing discipline. This article makes a distinction between the ordinary use and the scientific use of the term compliance. Nurses are challenged to embrace an interactive, transactional process in order to form a partnership with clients, which allows for client choice and control in decision making about carrying out the prescribed behavior.