Elane de Fátima Taipeiro

Estresse Isolado ou Associado ao Etanol Libera Prostanóides em Aorta de Ratos via ?2-Adrenoceptores

Background Stress and ethanol are both, independently, important cardiovascular risk factors. Objective To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. Methods Rats were separated into 4 groups: Control, ethanol (20% in drinking water for 6 weeks), stress (immobilization 1h day/5 days a week for 6 weeks) and stress/ethanol. Concentration-responses curves to noradrenaline - in the absence and presence of yohimbine, L-NAME or indomethacin - or to phenylephrine were determined in thoracic aortas with and without endothelium. EC50 and maximum response (n=8-12) were compared using two-way ANOVA/Bonferroni method. Results Either stress or stress in association with ethanol consumption increased the noradrenaline maximum responses in intact aortas. This hyper-reactivity was eliminated by endothelium removal or by the presence of either indomethacin or yohimbine, but was not altered by the presence of L-NAME. Meanwhile, ethanol consumption did not alter the reactivity to noradrenaline. The phenylephrine responses in aortas both with and without endothelium also remained unaffected regardless of protocol. Conclusion Chronic stress increased rat aortic responses to noradrenaline. This effect is dependent upon the vascular endothelium and involves the release of vasoconstrictor prostanoids via stimulation of endothelial alpha-2 adrenoceptors. Moreover, chronic ethanol consumption appeared to neither influence noradrenaline responses in rat thoracic aorta, nor did it modify the increase of such responses observed as a consequence of stress exposure.

Percepção do egresso de enfermagem sobre a contribuição do curso para o exercício do cuidado

O estudo avaliou a formacao em enfermagem ancorada na problematizacao e na aprendizagem baseada em problemas a partir da percepcao dos egressos. Trata-se de estudo transversal de natureza ex-post-facto. Os resultados foram analisados na triangulacao das abordagens quantitativa e qualitativa e na perspectiva hermeneutica dialetica. Na abordagem quantitativa 180 egressos responderam um questionario. Na qualitativa, 14 participaram das entrevistas, que buscaram sentidos relacionados ao cuidado ideal, para construcao dos indicadores que revelassem a logica da avaliacao. Esses indicadores nortearam a escolha das questoes para triangulacao. Os resultados apontaram que 85,1% dos egressos estao inseridos no mercado de trabalho, 92,1% cursaram pos-graduacao e 99,1% acreditam apresentar formacao necessaria ao cuidado etico, humanizado e fundamentado. A analise dos dados aponta para formacao comprometida com a construcao da autonomia e do conhecimento, bem como articulada aos principios do Sistema Unico de Saude e do mundo do trabalho em enfermagem.This present study evaluated nursing education based on problem-solving and learning based on problems originating from alumnis perceptions. This is an ex-post-facto cross-sectional study. Results were analyzed using both quantitative and qualitative approaches triangulation and through dialectical hermeneutics. In the quantitative approach 180 alumni answered a questionnaire. The qualitative approach involved 14 interviews that searched for meanings related to the notion of ideal care, in order to build indicators that would reveal this evaluation logic. These indicators guided the choice of triangulation questions. Results demonstrated that 85.1% of alumni are working in the nursing market, 92.1% have taken a post-graduate course and 99.1% believe they have the education required to deliver ethical, humanized and founded care. Data analysis demonstrates a compromised education as autonomy and knowledge are being built, and articulated to the Single Health System and the world nursing principles. DESCRIPTORS: Evaluation. Nursing care. Comprehensiveness.

EFFECTS OF VITAMIN C SUPPLEMENTATION ON THE CHRONIC PHASE OF CHAGAS DISEASE

Introduction: In order to examine the effectiveness of vitamin C (ascorbic acid) in combating the oxidative insult caused by Trypanosoma cruzi during the development of the chronic phase of Chagas disease, Swiss mice were infected intraperitoneally with 5.0 × 104 trypomastigotes of T. cruzi QM1strain. Methods: Mice were given supplements of two different doses of vitamin C for 180 days. Levels of lipid oxidation (as indicated by thiobarbituric acid reactive substances-TBARS), total peroxide, vitamin C, and reduced glutathione were measured in the plasma, TBARS, total peroxide and vitamin C were measured in the myocardium and histopathologic analysis was undertaken in heart, colon and skeletal muscle. Results: Animals that received a dose equivalent to 500 mg of vitamin C daily showed increased production of ROS in plasma and myocardium and a greater degree of inflammation and necrosis in skeletal muscles than those that received a lower dose or no vitamin C whatsoever. Conclusion: Although some research has shown the antioxidant effect of vitamin C, the results showed that animals subject to a 500 mg dose of vitamin C showed greater tissue damage in the chronic phase of Chagas disease, probably due to the paradoxical actions of the substance, which in this pathology, will have acted as a pro-oxidant or pro-inflammatory.

Endothelial AT1 and AT2 pathways in aortic responses to angiotensin II after stress and ethanol consumption in rats

Abstract Stress and ethanol are important cardiovascular risk factors. Their vascular and blood pressure (BP) effects were evaluated alone and in combination. Adult male Wistar rats (8–10 per group) were separated into control, ethanol (ethanol 20% in drinking water for 6 weeks), stress (restraint 1 h/d 5 d/week for 6 weeks), and ethanol/stress (in combination) groups. Systolic BP was evaluated weekly. Concentration–response curves for contractile responses to angiotensin II in the absence and the presence of losartan (AT1-blocker), PD123-319 (AT2-blocker), L-NAME (nitric oxide synthase inhibitor), or indomethacin (cyclooxygenase inhibitor) were obtained in isolated intact and endothelium-denuded aortas. Effective concentration 50% (EC50) and maximum response (MR) were compared among groups using MANOVA/Tukey tests. Stress and stress plus ethanol increased BP. Ethanol and stress, alone and in combination, did not alter angiotensin responses of intact aortas. PD123-319 decreased MR to angiotensin II in intact aortas from the ethanol and ethanol/stress groups relative to control in the presence of PD123-319. Losartan increased MR to angiotensin II in intact aortas from the stress and ethanol/stress groups relative to control in the presence of losartan. None of the protocols altered angiotensin responses of denuded aortas. Neither indomethacin nor L-NAME altered angiotensin responses of intact aortas from the experimental groups. Thus ethanol and ethanol plus stress may alter endothelial signaling via AT1-receptors, without changing systemic BP. Stress and stress plus ethanol may alter endothelial signaling via AT2-receptors, and thereby increase BP. Knowledge of such vascular changes induced by stress and/or ethanol may contribute to understanding adverse cardiovascular effects of stress and ethanol consumption in humans.

Indicadores de avaliação do cuidado individual: subsídios para a formação médica orientada por competência

No processo de formacao dos profissionais da area da saude, as DCN orientam a organizacao de um modelo curricular pautado no desenvolvimento de competencia profissional. Foi realizado um estudo descritivo com abordagem qualitativa, desenvolvido por meio de conferencia de consenso, com o objetivo de elaborar indicadores para avaliar o processo de ensino-aprendizagem na area de cuidado individual. Uma matriz foi organizada com base nos desempenhos contidos nos manuais de cada serie e formatos de avaliacao. Em seguida, os avaliadores analisaram esta matriz e a discutiram na conferencia de consenso, para a consolidacao dos indicadores. A analise dos resultados permitiu olhar para as acoes desenvolvidas no curso a partir da compreensao de que, durante essas atividades, os estudantes tem a oportunidade de realizar o cuidado na perspectiva da integralidade, como preconizado no Sistema Unico de Saude e nas DCN. Dessa maneira, foram construidos indicadores relacionados a historia clinica, exame fisico e raciocinio clinico para o monitoramento do processo de ensino-aprendizagem. No contexto do curriculo orientado por competencia, esses indicadores podem nortear o processo de planejamento educacional, bem como permitir a participacao ativa e a corresponsabilidade dos envolvidos para o alcance de uma aprendizagem significativa, que permita ao futuro profissional a realizacao de um cuidado qualificado em saude.

Evaluation of antioxidant therapy in experimental Chagas disease

INTRODUCTION: Stimulation of inflammatory mediators such as cytokines and chemokines may cause oxidative stress in Chagas disease. In this study, we evaluated the merit of vitamins C and E as antioxidant therapy to minimize the oxidative stress-induced damage in an experimental model of Chagas disease. METHODS: Ninety-six Swiss mice were infected with Trypanosoma cruzi QM2 and treated with vitamins C, E, or both (C/E) for 60 and 120 days, and their effects compared to placebo administration were evaluated in the acute and chronic disease phases. RESULTS: There was no difference in parasitemia among treatment groups. However, histological analysis showed more severe inflammation in the skeletal muscle in the vitamin supplementation groups at both the acute and chronic phases. Biochemical analyses during the acute phase showed increased ferric-reducing ability of plasma (FRAP) and glutathione (GSH) levels in the vitamin C and C/E groups. In the chronic phase, a decrease in GSH levels was observed in the vitamin E group and a decrease in thiobarbituric acid reactive substances (TBARS) was observed in the vitamin C/E group. Moreover, there was a decrease in TBARS in the cardiac tissues of the vitamin C and C/E groups compared to that of the placebo group, although this level was greater in the vitamin E group than in the vitamin C group. CONCLUSIONS: The antioxidant action of vitamins C and E reduced oxidative stress in both the acute and chronic phases of Chagas disease, with a marked effect from joint administration, indicating their inherent synergism.

Collagen‐induced arthritis increases inducible nitric oxide synthase not only in aorta but also in the cardiac and renal microcirculation of mice

Rheumatoid arthritis (RA) may promote endothelial dysfunction. This phenomenon requires further investigation, especially in collagen‐induced arthritis (CIA), as it is considered the experimental model most similar to RA. The objectives of this study were to identify CIA‐induced changes in noradrenaline (NE) and acetylcholine (ACh) responses in mice aortas that may suggest endothelial dysfunction in these animals. Moreover, we characterize CIA‐induced modifications in inducible nitric oxide synthase (iNOS) expression in the aortas and cardiac and renal tissues taken from these mice that may be related to possible endothelial dysfunction. Male DBA/1J mice were immunized with 100 μg of emulsified bovine collagen type II (CII) plus complete Freunds adjuvant. Twenty‐one days later, these animals received a boost of an additional 100 μg plus incomplete Freunds adjuvant. Fifteen days after the onset of the disease, aortic rings from CIA and control mice were challenged with NE and ACh in an organ bath. In these animals, iNOS was detected through immunohistochemical analysis of aorta, heart and kidneys. Plasma nitrite concentration was determined using the Griess reaction. CIA did not change NE or ACh responses in mice aorta but apparently increased the iNOS expression not only in aorta, but also in cardiac and renal microcirculation. In parallel, CIA reduced nitrite plasma concentration. In mice, CIA appears to increase the presence of iNOS in aorta, as well as in heart and in kidney microcirculation. This iNOS increase occurs apparently in parallel to a reduction of the bioavailability of NO. This phenomenon does not appear to change NE or ACh responses in aorta.

Effects of Continuous and Accumulated Exercise on Endothelial Function in Rat Aorta

Background The practice of exercise in short bouts repeated throughout the day may be an alternative strategy to lift people out of physical inactivity. Objective to evaluate if accumulated exercise, as occurs in continuous exercise training, improve endothelial function in rat aorta. Methods Wistar male rats were divided into three groups: continuous exercise (CEx, 1 hour on the treadmill) or accumulated exercise (AEx, 4 bouts of 15 minutes / day) for 5 days/week for 8 weeks, or sedentary (SED). During the training period, body weight gain and increase in exercise performance were recorded. On sacrifice day, aorta was dissected into rings (3-5 mm) and mounted on the organ bath. Results Fitness was significantly greater in CEx and AEx rats as compared with SED animals. In addition, compared with the SED group, CEx animals had a lower body mass gain, and the aorta obtained from these animals had reduced contractile response to norepinephrine and greater acetylcholine-induced relaxation. These results were not observed in ACEx animals. Conclusions Both CEx and AEx improved fitness, but only CEx led to reduced body weight gain and improved endothelial function.

La percepción de los graduados en enfermería sobre la contribución del curso para el ejercicio del cuidado

O estudo avaliou a formacao em enfermagem ancorada na problematizacao e na aprendizagem baseada em problemas a partir da percepcao dos egressos. Trata-se de estudo transversal de natureza ex-post-facto. Os resultados foram analisados na triangulacao das abordagens quantitativa e qualitativa e na perspectiva hermeneutica dialetica. Na abordagem quantitativa 180 egressos responderam um questionario. Na qualitativa, 14 participaram das entrevistas, que buscaram sentidos relacionados ao cuidado ideal, para construcao dos indicadores que revelassem a logica da avaliacao. Esses indicadores nortearam a escolha das questoes para triangulacao. Os resultados apontaram que 85,1% dos egressos estao inseridos no mercado de trabalho, 92,1% cursaram pos-graduacao e 99,1% acreditam apresentar formacao necessaria ao cuidado etico, humanizado e fundamentado. A analise dos dados aponta para formacao comprometida com a construcao da autonomia e do conhecimento, bem como articulada aos principios do Sistema Unico de Saude e do mundo do trabalho em enfermagem.This present study evaluated nursing education based on problem-solving and learning based on problems originating from alumnis perceptions. This is an ex-post-facto cross-sectional study. Results were analyzed using both quantitative and qualitative approaches triangulation and through dialectical hermeneutics. In the quantitative approach 180 alumni answered a questionnaire. The qualitative approach involved 14 interviews that searched for meanings related to the notion of ideal care, in order to build indicators that would reveal this evaluation logic. These indicators guided the choice of triangulation questions. Results demonstrated that 85.1% of alumni are working in the nursing market, 92.1% have taken a post-graduate course and 99.1% believe they have the education required to deliver ethical, humanized and founded care. Data analysis demonstrates a compromised education as autonomy and knowledge are being built, and articulated to the Single Health System and the world nursing principles. DESCRIPTORS: Evaluation. Nursing care. Comprehensiveness.

Grupo interdisciplinar: Construção de unidade educacional sistematizada em aprendizagem baseada em problemas

In 2003 the construction team of the 1st grade of the medical and nursing courses from a medical school began a work aiming at curriculum reconstruction, and restructured cognitive contents and the integration of basic and clinical aspects, in order to adapt to the incentive program for Curriculum Changes (PROMED) which allows for the continuity of curricular innovations. This team worked considering the group dynamics, a method already used in tutorial sessions which teachers have some familiarity with. For a good group performance the team participants were divided into two subgroups: one for constructing educational problems and the other for doing cognitive assessment exercises. The team and the subgroups met weekly, and every 15 days the group met for socialization of information, identifying the strengths and weaknesses of the process and/or products. A good adhesion, an active involvement of participants and satisfaction expressed by each participant with their inclusion in the group were reflected in the final product and contributed to the subjects’ commitment to the proposal. This way, in the process the individual transformations and relations in a situation requiring the collaboration of professionals were essential in the process of permanent curricular reconstruction.