Objective: to investigate the understanding and practice ofpediatric palliative care. Method: it is a qualitative, exploratory and descriptive study, in a Maternal-Infant School Hospital with 30 Nursing professionals. A sociodemographic questionnaire and semi-structured interview were used to collect data. The data was submitted to the Content Analysis technique. Results: professionals presented difficulties related to the understanding of the philosophy and objectives of palliative care and difficulties in working with pediatric patients under this care, highlighting the feelings of failure and sadness in dealing with the situation. As a coping strategy, the affective detachment of the patient and his family, the spirituality and the offer to the patient of a differentiated and humanized care are used as coping strategies. Conclusion: it is necessary to include palliative care in the academic training of professionals, favoring the knowledge of the subject and preparing the professional to deal with death and dying, as well as the need for a space in the health institutions that provide shelter for the difficulties of professionals working in this context. Descritores: Palliative Care; Pediatrics; Pediatric Nursing; Death; Adaptation, Psychological; Humanization of Assistance. RESUMOObjetivo: investigar a compreensão e a prática dos profissionais de enfermagem sobre os cuidados paliativos pediátricos. Método: trata-se de estudo qualitativo, exploratório e descritivo, em um Hospital Escola Materno-Infantil com 30 profissionais de Enfermagem. Utilizaram-se, para a coleta de dados, questionário sociodemográfico e entrevista semiestruturada. Submeteram-se os dados à técnica de Análise de Conteúdo. Resultados: apresentaram-se, pelos profissionais, dificuldades relacionadas à compreensão da filosofia e aos objetivos dos cuidados paliativos e dificuldade em atuar com pacientes pediátricos que estão sob esse cuidado, destacando-se os sentimentos de fracasso e de tristeza ao lidarem com a situação. Empregam-se, com isso, como estratégias de enfrentamento, o distanciamento afetivo do paciente e de sua família, a espiritualidade e o oferecimento, ao paciente, de um atendimento diferenciado e humanizado. Conclusão: salienta-se a necessidade da inclusão de cuidados paliativos na formação acadêmica dos profissionais, favorecendo o conhecimento do tema e preparando o profissional para lidar com a morte e o morrer, assim como a necessidade de um espaço nas instituições de saúde que proporcione acolhimento frente às dificuldades dos profissionais que atuam nesse contexto. Descritores: Cuidados Paliativos; Pediatria; Enfermagem Pediátrica; Morte; Adaptação Psicológica; Humanização da Assistência. RESUMEN Objetivo: investigar la comprensión y la práctica de los profesionales de enfermería sobre los cuidados paliativos pediátricos. Método: se trata de un estudio cualitativo, exploratorio y descriptivo, en un Hospital Escuela Materno-Infantil con 30 profesionales de Enfermería. Se utilizaron, para la recolección de datos, cuestionario sociodemográfico y entrevista semiestructurada. Se sometieron los datos a la técnica de Análisis de Contenido. Resultados: se presentaron, por los profesionales, dificultades relacionadas a la comprensión de la filosofía y a los objetivos de los cuidados paliativos y dificultad en actuar con pacientes pediátricos que están bajo ese cuidado, destacándose los sentimientos de fracaso y de tristeza al lidiar con la situación. Se emplean, con ello, como estrategias de enfrentamiento, el distanciamiento afectivo del paciente y de su familia, la espiritualidad y el ofrecimiento, al paciente, de una atención diferenciada y humanizada. Conclusión: se destaca la necesidad de la inclusión de cuidados paliativos en la formación académica de los profesionales, favoreciendo el conocimiento del tema y preparando al profesional para lidiar con la muerte y el morir, así como la necesidad de un espacio en las instituciones de salud que proporcione acogida frente a las dificultades de los profesionales que actúan en ese contexto. Descritores: Cuidados paliativos; Pediatría; Enfermería Pediátrica; Muerte; Adaptación Psicológica; Humanización de la Atención.
Introduction Coitus in snakes may last up to 28 hours; however, the mechanisms involved are unknown. Aim To evaluate the relevance of the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-phosphodiesterase type 5 (PDE5) system in snake corpus cavernosum reactivity. Methods Hemipenes were removed from anesthetized South American rattlesnakes (Crotalus durissus terrificus) and studied by light and scanning electronic microscopy. Isolated Crotalus corpora cavernosa (CCC) were dissected from the non-spiny region of the hemipenises, and tissue reactivity was assessed in organ baths. Main Outcome Measures Cumulative concentration-response curves were constructed for acetylcholine (ACh), sodium nitroprusside (SNP), 5-cyclopropyl-2-[1-(2-fluorobenzyl)-1H-pyrazolo[3,4-b]pyridine-3-yl]pyrimidin-4-ylamine (BAY 41-2272), and tadalafil in CCC precontracted with phenylephrine. Relaxation induced by electrical field stimulation (EFS) was also done in the absence and presence of Nω nitro-L-arginine methyl ester (L-NAME; 100 µM), 1H-[1, 2, 4] oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10 µM) and tetrodotoxin (TTX; 1 µM). Results The hemipenes consisted of two functionally concentric corpora cavernosa, one of them containing radiating bundles of smooth muscle fibers (confirmed by α-actin immunostaining). Endothelial and neural nitric oxide synthases were present in the endothelium and neural structures, respectively; whereas soluble guanylate cyclase and PDE5 were expressed in trabecular smooth muscle. ACh and SNP relaxed isolated CCC, with the relaxations being markedly reduced by L-NAME and ODQ, respectively. BAY 41-2272 and tadalafil caused sustained relaxations with potency (pEC50) values of 5.84 ± 0.17 and 5.10 ± 0.08 (N=3–4), respectively. In precontracted CCC, EFS caused frequency-dependent relaxations that lasted three times longer than those in mammalian CC. Although these relaxations were almost abolished by either L-NAME or ODQ, they were unaffected by TTX. In contrast, EFS-induced relaxations in marmoset CC were abolished by TTX. Conclusions Rattlesnake CC relaxation is mediated by the NO-cGMP-PDE5 pathway in a manner similar to mammals. The novel TTX-resistant Na channel identified here may be responsible for the slow response of smooth muscle following nerve stimulation and could explain the extraordinary duration of snake coitus.
The purpose of this study was to compare different split resistance training routines on body composition and muscular strength in elite bodybuilders. Ten male bodybuilders (26.7 ± 2.7 years, 85.3 ± 10.4 kg) were randomly assigned into one of two resistance training groups: 4 and 6 times per week (G4× and G6×, respectively), in which the individuals trained for 4 weeks, 4 sets for each exercise performing 6-12 repetitions maximum (RM) in a pyramid fashion. Body composition was assessed by dual energy X-ray absorptiometry, muscle strength was evaluated by 1RM bench-press testing. The food intake was planned by nutritionists and offered individually throughout the duration of the experiment. Significant increases (p < .05) in fat-free mass (G4× = +4.2%, G6× = +3.5%) and muscular strength (G4× = +8.4%, G6× = +11.4%) with no group by time interaction were observed. We conclude that 4 and 6 weekly sessions frequencies of resistance training promote similar increases in fat-free mass and muscular strength in elite bodybuilders.
Glanidium melanopterum Miranda Ribeiro, a typical representative of the subfamily Centromochlinae (Siluriformes: Auchenipteridae), is herein described myologically and compared to other representative species within the group, Glanidium ribeiroi, G. leopardum, Tatia neivai, T. intermedia, T. creutzbergi, Centromochlus heckelii, and C. existimatus. The structure of seven pairs of striated cephalic muscles was compared anatomically: adductor mandibulae, levator arcus palatini, dilatator operculi, adductor arcus palatini, extensor tentaculi, retractor tentaculi, and levator operculi. We observed broad adductor mandibulae muscles in both Glanidium and Tatia, catfishes with depressed heads and smaller eyes. Similarities between muscles were observed: the presence of a large aponeurotic insertion for the levator arcus palatini muscle; an adductor arcus palatini muscle whose origin spread over the orbitosphenoid, pterosphenoid, and parasphenoid; and the extensor tentaculi muscle broadly attached to the autopalatine. There is no retractor tentaculi muscle in either the Glanidium or Tatia species. On the other hand, in Centromochlus, with forms having large eyes and the tallest head, the adductor mandibulae muscles are slim; there is a thin aponeurotic or muscular insertion for the levator arcus palatini muscle; the adductor arcus palatini muscle originates from a single osseous process, forming a keel on the parasphenoid; the extensor tentaculi muscle is loosely attached to the autopalatine, permitting exclusive rotating and sliding movements between this bone and the maxillary. The retractor tentaculi muscle is connected to the maxilla through a single tendon, so that both extensor and retractor tentaculi muscles contribute to a wide array of movements of the maxillary barbels. A discussion on the differences in autopalatine-maxillary movements among the analyzed groups is given.
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