Targeting heme in sickle cell disease: new perspectives on priapism treatment.

Men with sickle cell disease (SCD) frequently experience priapism, defined as prolonged, painful erections occurring without sexual arousal or desire. This urological emergency can lead to penile fibrosis and permanent erectile dysfunction if not treated adequately. Due to its complex pathophysiology, there is currently no effective preventative treatment for this condition. Recent studies have highlighted the dysfunction of the nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) pathway in erectile tissues as a critical mechanism in developing priapism in SCD. Additionally, further research indicates that intravascular hemolysis promotes increased smooth muscle relaxation in the corpus cavernosum and that excess heme may significantly contribute to priapism in SCD. Pharmacological treatments should ideally target the pathophysiological basis of the disease. Agents that reduce excess free heme in the plasma have emerged as potential therapeutic candidates. This review explores the molecular mechanisms underlying the excess of heme in SCD and its contribution to developing priapism. We discuss pharmacological approaches targeting the excess free heme in the plasma, highlighting it as a potential therapeutic target for future interventions in managing priapism.

The multidrug resistance protein 4 is expressed and functionally active in isolated bladder from pig.

Multidrug resistance proteins type 4 (MRP4) and 5 (MRP5) play pivotal roles in the transport of cyclic nucleotides in various tissues. However, their specific functions within the lower urinary tract remain relatively unexplored. This study aimed to investigate the effect of pharmacological inhibition of MRPs on cyclic nucleotide signaling in isolated pig bladder. The relaxation responses of the bladder were assessed in the presence of the MRP inhibitor, MK571. The temporal changes in intra- and extracellular levels of cAMP and cGMP in stimulated tissues were determined by mass spectrometry. The gene (ABCC4) and protein (MRP4) expression were also determined. MK571 administration resulted in a modest relaxation effect of approximately 26% in carbachol-precontracted bladders. The relaxation induced by phosphodiesterase inhibitors such as cilostazol, tadalafil, and sildenafil was significantly potentiated in the presence of MK571. In contrast, no significant potentiation was observed in the relaxation induced by substances elevating cAMP levels or stimulators of soluble guanylate cyclase. Following forskolin stimulation, both intracellular and extracellular cAMP concentrations increased by approximately 15.8-fold and 12-fold, respectively. Similarly, stimulation with tadalafil + BAY 41-2272 resulted in roughly 8.2-fold and 3.4-fold increases in intracellular and extracellular cGMP concentrations, respectively. The presence of MK571 reduced only the extracellular levels of cGMP. This study reveals the presence and function of MRP4 transporters within the porcine bladder and paves the way for future research exploring the role of this transporter in both underactive and overactive bladder disorders.NEW & NOTEWORTHY This study investigates the impact of pharmacological inhibition of MRP4 and MRP5 transporters on cyclic nucleotide signaling in isolated pig bladders. MK571 administration led to modest relaxation, with enhanced effects observed in the presence of phosphodiesterase inhibitors. However, substances elevating cAMP levels remained unaffected. MK571 selectively reduced extracellular cGMP levels. These findings shed light on the role of MRP4 transporters in the porcine bladder, opening avenues for further research into bladder disorders.

Methylglyoxal and Advanced Glycation End Products (AGEs): Targets for the Prevention and Treatment of Diabetes-Associated Bladder Dysfunction?

Methylglyoxal (MGO) is a highly reactive α-dicarbonyl compound formed endogenously from 3-carbon glycolytic intermediates. Methylglyoxal accumulated in plasma and urine of hyperglycemic and diabetic individuals acts as a potent peptide glycation molecule, giving rise to advanced glycation end products (AGEs) like arginine-derived hydroimidazolone (MG-H1) and carboxyethyl-lysine (CEL). Methylglyoxal-derived AGEs exert their effects mostly via activation of RAGE, a cell surface receptor that initiates multiple intracellular signaling pathways, favoring a pro-oxidant environment through NADPH oxidase activation and generation of high levels of reactive oxygen species (ROS). Diabetic bladder dysfunction is a bothersome urological complication in patients with poorly controlled diabetes mellitus and may comprise overactive bladder, urge incontinence, poor emptying, dribbling, incomplete emptying of the bladder, and urinary retention. Preclinical models of type 1 and type 2 diabetes have further confirmed the relationship between diabetes and voiding dysfunction. Interestingly, healthy mice supplemented with MGO for prolonged periods exhibit in vivo and in vitro bladder dysfunction, which is accompanied by increased AGE formation and RAGE expression, as well as by ROS overproduction in bladder tissues. Drugs reported to scavenge MGO and to inactivate AGEs like metformin, polyphenols, and alagebrium (ALT-711) have shown favorable outcomes on bladder dysfunction in diabetic obese leptin-deficient and MGO-exposed mice. Therefore, MGO, AGEs, and RAGE levels may be critically involved in the pathogenesis of bladder dysfunction in diabetic individuals. However, there are no clinical trials designed to test drugs that selectively inhibit the MGO-AGEs-RAGE signaling, aiming to reduce the manifestations of diabetes-associated bladder dysfunction. This review summarizes the current literature on the role of MGO-AGEs-RAGE-ROS axis in diabetes-associated bladder dysfunction. Drugs that directly inactivate MGO and ameliorate bladder dysfunction are also reviewed here.

GKT137831 and hydrogen peroxide increase the release of 6-nitrodopamine from the human umbilical artery, rat-isolated right atrium, and rat-isolated vas deferens.

Introduction: The human umbilical artery (HUA), rat-isolated right atrium, and rat-isolated vas deferens present a basal release of 6-nitrodopamine (6-ND). The basal release of 6-ND from these tissues was significantly decreased (but not abolished) when the tissues were pre-incubated with Nω-nitro-L-arginine methyl ester (L-NAME). Methods: In this study, the effect of the pharmacological modulation of the redox environment on the basal release of 6-ND was investigated. The basal release of 6-ND was measured using Liquid chromatography with tandem mass spectrometry (LC-MS/MS). Results and Discussion: Pre-incubation (30 min) of the tissues with GKT137831 (1 µM) caused a significant increase in the basal release of 6-ND from all tissues. In the HUA, pre-incubation with diphenyleneiodonium (DPI) (100 µM) also caused significant increases in the basal release of 6-ND. Preincubation of the HUA with hydrogen peroxide (H2O2) (100 µM) increased 6-ND basal release, whereas pre-incubation with catalase (1,000 U/mL) significantly decreased it. Pre-incubation of the HUA with superoxide dismutase (SOD) (250 U/mL; 30 min) also significantly increased the basal release of 6-ND. Preincubation of the HUA with either allopurinol (100 µM) or uric acid (1 mM) had no effect on the basal release of 6-ND. Pre-treatment of the HUA with L-NAME (100 µM) prevented the increase in the basal release of 6-ND induced by GKT137831, diphenyleneiodonium, and H2O2. The results obtained indicate a major role of endogenous H2O2 and peroxidases as modulators of 6- ND biosynthesis/release and a lack of peroxynitrite contribution.

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.

6-NitroDopamine is an endogenous modulator of rat heart chronotropism.

6-Nitrodopamine (6-ND) is released by rat vas deferens and exerts a potent contractile response that is antagonized by tricyclic antidepressants and α1-, ß1- and ß1/ß2-adrenoceptor antagonists. The release of 6-ND, noradrenaline, adrenaline and dopamine from rat isolated right atria was assessed by tandem mass spectrometry. The effects of the catecholamines were evaluated in both rat isolated right atria and in anaesthetized rats. 6-ND was the major catecholamine released from the isolated atria and the release was significantly reduced in nitric oxide synthase inhibitor L-NAME pre-treated atria or in atria obtained from L-NAME chronically treated animals, but unaffected by tetrodotoxin. 6-ND (1 pM) significantly increased the atrial frequency, being 100 times more potent than noradrenaline and adrenaline. Selective ß1-blockers reduced the atrial frequency only at concentrations that prevented the increases in atrial frequency induced by 6-ND 1pM. Conversely, ß1-blockade did not affect dopamine (10 nM), noradrenaline (100 pM) or adrenaline (100 pM) effect. The reductions in atrial frequency induced by the ß1-adrenoceptor antagonists were absent in L-NAME pre-treated atria and in atria obtained from chronic L-NAME-treated animals. Tetrodotoxin did not prevent the reduction in atrial frequency induced by L-NAME or by ß1-blockers treated preparations. In anaesthetized rats, at 1 pmol/kg, only 6-ND caused a significant increase in heart rate. Inhibition of 6-ND synthesis by chronic L-NAME treatment reduced both atrial frequency and heart rate. The results indicate that 6-ND is a major modulator of rat heart chronotropism and the reduction in heart rate caused by ß1-blockers are due to selective blockade of 6-ND receptor.

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.

Faith, Family, and Social Networks: Effective Strategies for Recruiting Brazilian Immigrants in Maternal and Child Health Research.

Participation of racial/ethnic minority and immigrant populations in research studies is essential to understand and address health disparities. Nonetheless, these populations are often underrepresented in research because of limited participation that may be due to barriers to participation such as fear and mistrust of research, lack of or limited access to healthcare and social services, time and employment constraints, participation-associated costs (e.g., travel costs), language barriers, undocumented status, and cultural differences. Brazilians comprise a rapidly growing immigrant population group in the United States (US), and there is a need to identify and understand factors affecting the health status of Brazilian immigrants that are amenable to intervention. Therefore, this paper presents effective strategies and lessons learned from outreach and recruiting Brazilian immigrants living in the US to enroll in maternal and child health research studies. Using a data recruitment log, we collected quantitative and qualitative data on recruitment strategies that were employed to recruit pregnant women and parents into six health research studies. Direct recruitment strategies included personal contacts of research staff and recruiting partners, and on-site, in-person outreach and recruitment at faith- and community-based events (e.g., meeting participants after church services, at faith-based community events), and private and social events (e.g., household parties) conducted by bilingual, bicultural research assistants who were members of the priority population. We also used snowball sampling as a recruitment strategy by asking enrolled participants to share information about our studies and encourage their family and friends to participate. Indirect recruitment methods included posting flyers at local businesses, social service agencies, faith-based and healthcare organizations, and posting announcements on social media (Facebook). Direct recruitment methods in combination with snowball sampling were the most successful strategies for recruiting Brazilian immigrant parents, while social media was an effective indirect method for recruiting first-time pregnant women. In addition, analyses of qualitative data found that research staff's understanding of the sociocultural context of the target population combined with the use of linguistically and culturally sensitive recruitment strategies tailored to meet the needs of Brazilian immigrants was important for overcoming barriers to participation and facilitating successful recruitment and enrollment of participants. Study findings provide information on a suite of effective strategies and lessons learned for reaching, recruiting, and enrolling Brazilian immigrants in maternal and child health research. Future studies should continue to purposefully collect information on recruitment strategies and disseminate the findings, which will be instrumental in researchers' efforts to increase participation of ethnic minority and immigrant populations such as Brazilians in health research.

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.

Magnetic fields: biomass potential of Spirulina sp. for food supplement.

This study evaluated the influence of the magnetic field on the chemical composition of Spirulina sp. LEB 18 and its digestibility and protein solubility. The highest protein digestibility of biomass was obtained at 30 °C and with 2.5 g L-1 NaNO3 (78.4%) in the medium, and the highest solubility was found in the cultivated biomass exposed to 60 mT, 30 °C and 2.5 g L-1 NaNO3 (89%, pH 6). MF application did not modify the protein concentration of biomass, but reduced the carbohydrate concentration by 69.1%, showing that the biomass obtained in the culture submitted to MF may be used as an ingredient in the development of protein supplements.

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.

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.

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.