RESUMEN
The effects of 4NO2PDPMe and 4APDPMe, which are thalidomide (Tha) analogs that act as selective phosphodiesterase (PDE-4) inhibitors, on estrous behavior (lordosis and proceptive behaviors) and on uterine contraction were studied in ovariectomized (OVX) estrogen-primed Sprague Dawley (SD) and in intact non-pregnant Wistar rats, respectively. We found that intracerebroventricular (ICV) infusion of either 4NO2PDPMe or 4APDPMe (20 to 80⯵g) stimulated intense lordosis and proceptive behavior in response to mounts from a sexually active male, within the first 4â¯h after infusion, and persisting for up to 24â¯h. Inhibitors of the progesterone receptor (RU486, administered subcutaneously), the estrogen receptor (tamoxifen, ICV), the adenylate cyclase (AC)/ cyclic AMP (cAMP)/protein kinase A (PKA) pathway (administered ICV), and the mitogen activated protein kinase (MAPK) pathway (administered ICV) significantly decreased lordosis and proceptive behavior induced by Tha analogs. Uterine contractility studies showed that Tha analogs inhibited both the K+- and the Ca2+-induced tonic contractions in rat uterus. Tha analogs were equally effective, but 4APDPMe was more potent than 4NO2PDPMe. These results strongly suggest the central role of cAMP in both processes, sexual behavior, and uterine relaxation, and suggest that Tha analogs may also act as Ca2+-channel blockers.
Asunto(s)
AMP Cíclico/metabolismo , Inhibidores de Fosfodiesterasa 4/farmacología , Ftalimidas/farmacología , Propionatos/farmacología , Conducta Sexual Animal/efectos de los fármacos , Talidomida/análogos & derivados , Contracción Uterina/efectos de los fármacos , Adenilil Ciclasas/efectos de los fármacos , Adenilil Ciclasas/metabolismo , Animales , Calcio , Proteínas Quinasas Dependientes de AMP Cíclico/efectos de los fármacos , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Didesoxiadenosina/farmacología , Estradiol/análogos & derivados , Estradiol/farmacología , Antagonistas de Estrógenos/farmacología , Estrógenos/farmacología , Estro , Femenino , Técnicas In Vitro , Infusiones Intraventriculares , Inyecciones Subcutáneas , Lordosis , Luteolíticos/farmacología , Mifepristona/farmacología , Ovariectomía , Potasio , Ratas , Ratas Sprague-Dawley , Ratas Wistar , Receptores de Progesterona , Tamoxifeno/farmacología , Talidomida/farmacología , Contracción Uterina/metabolismo , Útero/efectos de los fármacosRESUMEN
The present study assessed the participation of membrane G-protein coupled estrogen receptor 1 (GPER-1) and gonadotropin releasing hormone 1 (GnRH-1) receptor in the display of lordosis induced by intracerebroventricular (icv) administration of G1, a GPER-1 agonist, and by unesterified 17ß-estradiol (free E2). In addition, we assessed the participation of both estrogen and progestin receptors in the lordosis behavior induced by G1 in ovariectomized (OVX), E2-benzoate (EB)-primed rats. In Experiment 1, icv injection of G1 induced lordosis behavior at 120 and 240min. In Experiment 2, icv injection of the GPER-1 antagonist G15 significantly reduced lordosis behavior induced by either G1 or free E2. In addition, Antide, a GnRH-1 receptor antagonist, significantly depressed G1 facilitation of lordosis behavior in OVX, EB-primed rats. Similarly, icv injection of Antide blocked the stimulatory effect of E2 on lordosis behavior. In Experiment 3, systemic injection of either tamoxifen or RU486 significantly reduced lordosis behavior induced by icv administration of G1 in OVX, EB-primed rats. The results suggest that GnRH release activates both estrogen and progestin receptors and that this activation is important in the chain of events leading to the display of lordosis behavior in response to activation of GPER-1 in estrogen-primed rats.
Asunto(s)
Estradiol/farmacología , Postura/fisiología , Receptores de Estrógenos/fisiología , Receptores Acoplados a Proteínas G/agonistas , Receptores LHRH/fisiología , Receptores de Progesterona/fisiología , Conducta Sexual Animal/efectos de los fármacos , Animales , Femenino , Antagonistas de Hormonas/farmacología , Mifepristona/farmacología , Oligopéptidos/farmacología , Ratas , Ratas Sprague-Dawley , Conducta Sexual Animal/fisiología , Tamoxifeno/farmacologíaRESUMEN
The role of classical estrogen receptors (ERs) in priming female reproductive behavior has been studied previously; however, the participation of this receptor during activation of estrous behavior has not been extensively studied. The purpose of this work was to test the possibility that the facilitation of lordosis behavior in estrogen-primed rats by progesterone (P) and its 5α- and 5ß-reduced metabolites, gonadotropin-releasing hormone (GnRH), leptin, prostaglandin E2 (PGE2) and vagino-cervical stimulation (VCS) involves interactions with classical ERs by using the selective ER modulator, tamoxifen. To further assess the role of ERs, we also explored the effects of the pure ER antagonist, ICI182780 (ICI), on estrous behavior induced by P and GnRH. Ovariectomized, estrogen-primed rats (5µg estradiol benzoate 40h earlier) were injected intraventricularly with the above-mentioned compounds, or they received VCS. All compounds and VCS effectively facilitated estrous behavior when tested at 60, 120 or 240min after infusion or application of VCS. Intraventricular infusion of tamoxifen (5µg), 30min before, significantly attenuated estrous behaviors induced in estradiol-primed rats by P, most of its 5α- and 5ß-reduced metabolites, GnRH, and PGE2, but not by VCS. Although there was a trend for reduction, tamoxifen did not significantly decrease lordosis in females treated with 5ß-pregnan-3,20-dione. ICI also inhibited lordosis behavior induced by P and GnRH at some testing intervals. These results suggest that activation of classical ERs participates in the triggering effects on estrous behavior induced by agents with different chemical structures that do not bind directly to ERs.
Asunto(s)
Conducta Animal/efectos de los fármacos , Dinoprostona/farmacología , Ciclo Estral/efectos de los fármacos , Péptidos/farmacología , Progestinas/farmacología , Receptores de Estrógenos/fisiología , Animales , Antagonistas de Estrógenos/farmacología , Femenino , Hormona Liberadora de Gonadotropina/farmacología , Inyecciones Intraventriculares , Leptina/farmacología , Ratas , Ratas Sprague-Dawley , Receptores de Estrógenos/antagonistas & inhibidores , Receptores de Estrógenos/efectos de los fármacos , Tamoxifeno/farmacologíaRESUMEN
Objetivo Determinar si hay relación entre el modelo organizativo «Enfermería Primaria» y la calidad de los cuidados percibida por el paciente. Método Estudio observacional, descriptivo, de corte transversal, que incluyó a los pacientes dados de alta, durante 12 meses, en cuatro unidades organizadas según el modelo de asignación «Enfermería Primaria». El grado de aplicación del modelo se evaluó mediante el Índice de Personalización del Cuidado, y la calidad percibida por los pacientes con el cuestionario LOPSS12 de satisfacción con los cuidados enfermeros. Se realizó un análisis bivariado mediante ANOVA y t de student, y un análisis multivariado mediante regresión lineal con las variables que habían mostrado asociación (p<0,05).Resultados Se incluyeron 817 pacientes, 447 de dos unidades médicas y 370 de dos unidades quirúrgicas. Tras un análisis preliminar realizado a los 6 meses de iniciado el estudio se eliminaron cuatro ítems del cuestionario LOPSS 12 y se analizaron por separado cada uno de los ítems restantes. Tanto la implantación del modelo como la satisfacción alcanzaron valores más altos en las unidades quirúrgicas. Los análisis bivariado y multivariado demostraron una asociación estadísticamente significativa (p<0,05) entre la implantación del modelo y los ítems del cuestionario, a excepción de uno de ellos. Conclusiones La organización de las unidades de hospitalización con el modelo de asignación «Enfermería Primaria», que reconoce la figura de la enfermera referente y permite personalizar los cuidados, se asocia a una mayor calidad percibida de los cuidados enfermeros(AU)
Objective To determine whether there is an association between the Primary Nursing Model and perceived quality of care. Method An observational, descriptive, cross-sectional study in four hospital wards with Primary Nursing organization. Over a 12-month period, all the patients discharged from each ward were included in this study. The degree of development of Primary Nursing was measured by using the Personalization of Nursing Care Index and the perceived quality of care was measured with the LOPSS-12. Bivariate statistical analysis was carried out through ANOVA and Student's t-tests. Multivariate linear regression analysis was then applied to correlated variables (p<0.05).Results817 patients were included, 447 from two medical wards and 370 from two surgical wards. After a preliminary data analysis performed 6 months after the start of the study, four items were removed from the LOPSS-12 and each of the remaining items were analyzed separately. Scores for both patient satisfaction and the introduction of the Primary Nursing Model were higher in the surgical wards. Bivariate and multivariate regression analyses showed a statistically significant (p<0.05) association between implantation of the model and all except one of the items included in the questionnaire. Conclusions The introduction of the Primary Nursing Model in hospital wards allows the presence of a primary nurse for each patient and consequently improves the nurse-patient relationship, increasing perceived quality of care among patients(AU)
Asunto(s)
Humanos , Atención de Enfermería/tendencias , Calidad de la Atención de Salud/organización & administración , Relaciones Enfermero-Paciente , Satisfacción del Paciente , Humanización de la AtenciónRESUMEN
OBJECTIVE: To determine whether there is an association between the Primary Nursing Model and perceived quality of care. METHOD: An observational, descriptive, cross-sectional study in four hospital wards with Primary Nursing organization. Over a 12-month period, all the patients discharged from each ward were included in this study. The degree of development of Primary Nursing was measured by using the Personalization of Nursing Care Index and the perceived quality of care was measured with the LOPSS-12. Bivariate statistical analysis was carried out through ANOVA and Student's t-tests. Multivariate linear regression analysis was then applied to correlated variables (p < 0.05). RESULTS: 817 patients were included, 447 from two medical wards and 370 from two surgical wards. After a preliminary data analysis performed 6 months after the start of the study, four items were removed from the LOPSS-12 and each of the remaining items were analyzed separately. Scores for both patient satisfaction and the introduction of the Primary Nursing Model were higher in the surgical wards. Bivariate and multivariate regression analyses showed a statistically significant (p < 0.05) association between implantation of the model and all except one of the items included in the questionnaire. CONCLUSIONS: The introduction of the Primary Nursing Model in hospital wards allows the presence of a primary nurse for each patient and consequently improves the nurse-patient relationship, increasing perceived quality of care among patients.
Asunto(s)
Departamentos de Hospitales/organización & administración , Satisfacción del Paciente , Medicina de Precisión/enfermería , Enfermería Primaria/organización & administración , Calidad de la Atención de Salud , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Medicina Interna/organización & administración , Masculino , Persona de Mediana Edad , Modelos Teóricos , Relaciones Enfermero-Paciente , Habitaciones de Pacientes/organización & administración , Medicina de Precisión/psicología , Enfermería Primaria/normas , Percepción Social , Servicio de Cirugía en Hospital/organización & administración , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To determine the validity and reliability of the personalised nursing care index (PNCI). METHODS: A descriptive study was carried out in the Puerta del Mar Hospital (Cádiz) of the Andalusian Health Service, which included all patients admitted to an Internal Medicine ward from May 2007 to July 2008. A descriptive analysis was performed on the population included in the study. Furthermore, reliability was analysed with the 20-Kuder-Richardson coefficient and a correlation matrix between PNCI items; and validity via a maximum likelihood factorial analysis, and a ROC curve to determine sensitivity and specificity. RESULTS: A total of 219 people were included in the survey, of whom 74.4% were patients and 26.6% caregivers. The percentages of males and females were similar with a mean age of 62.5 years and 48.4% finished basic school education. The 20-Kuder-Richarson value was 0.835; and a positive correlation between items, which corresponded to 3 groups of items (factors). The maximum likelihood factorial analysis confirmed the 3 items-factor groups with a Promax rotation due to the high correlation between them. The maximum explained variance was 91.42%. The ROC curve area was 90.1% with a cut-off point of 8, for a sensitivity of 79.9% and a specificity of 90.6%. CONCLUSIONS: The PCNI is reliable, with the internal consistency coefficient value in between an optimum range. Furthermore, factors obtained from the matrix correlation inter-items were confirmed with a factorial analysis, resulting in a high explained variance. The curve ROC area is excellent compared to the gold standard, considered as the perception of confidence relationship.
Asunto(s)
Encuestas de Atención de la Salud , Atención de Enfermería , Personal de Enfermería en Hospital/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Medicina de Precisión , Adulto , Anciano , Cuidadores/psicología , Estudios Transversales , Femenino , Unidades Hospitalarias , Hospitales Urbanos , Humanos , Medicina Interna , Masculino , Persona de Mediana Edad , Pacientes/psicología , Proyectos Piloto , Curva ROC , Reproducibilidad de los Resultados , España , Encuestas y CuestionariosRESUMEN
Brief vaginocervical stimulation using a glass rod (VCS) combined with manual flank-perineal stimulation (FS) rapidly (within 5 min) induced both receptive and proceptive behavioural responses to males in ovariectomised, oestrogen-primed rats. This receptive-proceptive response to males, resulting from a single brief (5-s duration) instance of manual VCS + FS, declined markedly within 4 h. However, the decline was prevented if the females were mounted by males immediately after the manual VCS + FS and 2 h later. We tested the participation of the cAMP-dependent protein kinase A system and the mitogen-activated protein kinase (MAPK) system in the response to VCS + FS by infusing either 100 ng of Rp-adenosine 3',5'-cyclic monophosphorothiate triethylamonium salt (a protein kinase A blocker) or 3.3 microg of PD98059 (a MAPK blocker) i.c.v. 15 min prior to VCS + FS. Both inhibitors blocked the ability of VCS + FS to induce the proceptive-receptive responses to males at all testing intervals. In experiment 2, systemic administration of 5 mg of RU486 1 h before VCS + FS also blocked the ability of VCS + FS to induce the proceptive-receptive responses to males. The present findings suggest that both VCS + FS and mating stimuli provided by males release neurotransmitters and neuromodulators that trigger the protein kinase A and the MAPK signalling systems, which interact with the progestin receptor to rapidly (within 5 min) induce proceptive-receptive behaviour in females.
Asunto(s)
Proteínas Quinasas Dependientes de AMP Cíclico/antagonistas & inhibidores , Proteínas Quinasas Activadas por Mitógenos/antagonistas & inhibidores , Inhibidores de Proteínas Quinasas/farmacología , Receptores de Progesterona/antagonistas & inhibidores , Conducta Sexual Animal/efectos de los fármacos , Animales , Cuello del Útero/fisiología , Anticonceptivos Sintéticos Poscoito/farmacología , AMP Cíclico/análogos & derivados , AMP Cíclico/farmacología , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Estradiol/análogos & derivados , Estradiol/metabolismo , Femenino , Flavonoides/farmacología , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Sistema de Señalización de MAP Quinasas/fisiología , Masculino , Mifepristona/farmacología , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Ovariectomía , Perineo/fisiología , Postura , Ratas , Ratas Sprague-Dawley , Receptores de Progesterona/metabolismo , Conducta Sexual Animal/fisiología , Tionucleótidos/farmacología , Vagina/fisiologíaRESUMEN
Estrous behavior in rodents is triggered by the binding of progesterone (P) to its intracellular receptor (PR). Non-steroidal agents (i.e., gonadotropin-releasing hormone, noradrenaline, dopamine and others), acting at the membrane, can facilitate estrous behavior in estrogen-primed rats. This action is mediated through the generation of second messengers (cyclic AMP, cyclic GMP, calcium) which, in turn, phosphorylate through diverse kinase systems (protein kinases A, G or C) either the PR or associated effector proteins linking the PR to the trans-activation machinery. P or its metabolites also activate cyclic AMP-signaling pathways by acting directly on the membrane or by modulating neurotransmitter release. Molecular processes resulting from second messenger signaling pathways and those from the progesterone-RP interaction synergize to elicit a full behavioral response.