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O Centro de Referência e Treinamento DST/Aids-SP da Secretaria de Estado da Saúde de São Paulo, inaugurou, em junho de 2009, em suas dependências, o primeiro ambulatório voltado exclusivamente à saúde integral de travestis e transexuais do país, com ênfase no processo transexualizador do Sistema Único de Saúde (SUS) e nas necessidades dessa população. Este artigo tem por objetivo apresentar as modalidades assistenciais ofertadas no serviço, as demandas da população atendida no ambulatório, suas vulnerabilidades, fatores de risco e resiliência a que está submetida, assim como as considerações e os desafios no campo da política pública voltada à população trans para promover seu acesso à atenção em saúde de forma acolhedora, livre de preconceito, julgamentos morais e práticas discriminatórias.
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Este texto tem por finalidade apresentar a linha de cuidado (LC) planejada e articulada com a implementação de novos serviços, integrada a um conjunto de práticas mais abrangentes de assistência em saúde e aos demais setores responsáveis por políticas públicas que tenham como objetivo atender travestis e transexuais e outras variabilidades de gênero. Consideramos que a implementação de atenção integral à população travesti e transexual envolve um conjunto de ações e procedimentos em saúde ofertados para melhor qualificação e proposta para demandas de experiências integrais de pessoas trans e com variabilidade de gênero no campo da saúde e do Sistema Único de Saúde (SUS), incluindo modificação das características corporais, com o objetivo de adquirir e expressar características do gênero com o qual essas pessoas se identificam e ao qual declaram pertencer.
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As perdas de produtividade e fertilidade animal associadas ao estresse térmico durante os meses mais quentes do ano é um dos maiores desafios do setor pecuário. Na indústria de leite as perdas econômicas causadas pelo estresse térmico foram estimadas em mais de 1,5 bilhões de dólares por ano. No que tange a reprodução, já foi demonstrado que o estresse térmico exerce múltiplos efeitos deletérios, causando disfunções endócrinas e alterando a sequência orquestrada de eventos importantes para a gametogênese e para o desenvolvimento embrionário inicial. Estudos recentes têm esclarecido o padrão temporal no qual os danos são estabelecidos e carreados dependendo da intensidade do estresse. Enquanto os efeitos imediatos do estresse térmico nos gametas já são bem caracterizados, existem evidências de que alguns danos podem ser carreados de forma tardia e possivelmente entre gerações. Além disso, dados emergentes indicam que o estresse térmico compromete a reprogramação da metilação do DNA que ocorre durante a gametogênese e a programação do desenvolvimento in utero. Dessa forma, esse artigo visa explorar os efeitos imediatos, tardios e transgeracionais do estresse térmico nos gametas.(AU)
The drop on animal productivity and fertility associated with heat stress during the hot months of the year is one of the biggest challenges for the livestock sector. For the dairy industry the economic losses caused by heat stress have been estimated over 1.5 billion dollars per year. It has already been demonstrated that heat stress exerts multiple deleterious effects on reproductive function, causing endocrine dysfunctions as well as changes in the sequence of events required for gametogenesis and early embryonic development. Recent studies have shed a light in the temporal pattern in which heat-induced damage is established and carried forward depending on the intensity of stress. While the immediate effects of heat stress on gametes are well characterized, there is evidence that some damage can be carried over for longer periods and even across generations. Furthermore, emerging data indicate that heat stress compromises DNA methylation reprogramming that occurs during gametogenesis and developmental programming in utero. Thus, this paper aims to explore the immediate, late and transgenerational effects of heat stress on gametes.(AU)
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Animais , Resposta ao Choque Térmico/fisiologia , Desenvolvimento Embrionário/fisiologia , Células GerminativasRESUMO
In brief: Elevated temperatures disturbed sperm physiology. Bovine sperm cells exposed to heat shock led to diminished mitochondrial activity, fertilizing ability, increased oxidative stress and caspase activity concomitant with a delay in embryonic developmental kinetics and modulation of sperm-borne microRNAsmiRNAs. Abstract: Sperm function is susceptible to adverse environmental conditions. It has been demonstrated that in vivo and in vitro exposure of bovine sperm to elevated temperature reduces sperm motility and fertilizing potential. However, the cascade of functional, cellular, and molecular events triggered by elevated temperature in the mature sperm cell remains not fully understood. Therefore, the aim of this study was to determine the effect of heat shock on mature sperm cells. Frozen-thawed Holstein sperm were evaluated immediately after Percoll purification (0 h non-incubation control) or after incubation at 35, 38.5, and 41°C for 4 h. Heat shock reduced sperm motility after 3-4 h at 41°C while mitochondrial activity was reduced by 38.5 and 41°C when compared to the control. Heat shock also increased sperm reactive oxygen species production and caspase activity. Heat-shocked sperm had lower fertilizing ability, which led to diminished cleavage and blastocyst rates. Preimplantation embryo developmental kinetics was also slowed and reduced by sperm heat shock. The microRNA (miR) profiling identified >300 miRs in bovine sperm. Among these, three and seven miRs were exclusively identified in sperm cells exposed to 35 and 41°C, respectively. Moreover, miR-181d was enriched in sperm cells exposed to higher temperatures. Hence, elevated temperature altered the physiology of mature sperm cells by perturbing cellular processes and the miR profile, which collectively led to lower fertilizing ability and preimplantation development.
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MicroRNAs , Preservação do Sêmen , Animais , Caspases , Bovinos , Resposta ao Choque Térmico , Masculino , MicroRNAs/genética , Espécies Reativas de Oxigênio , Sêmen , Motilidade dos Espermatozoides , Espermatozoides/fisiologiaRESUMO
Neste artigo damos um panorama geral dos problemas e serviços já disponíveis para a população LGBT em todo o estado de São Paulo, destacando mais detalhadamente os localizados na capital.
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Saúde , Serviços Públicos de Saúde , Cidadania , Minorias Sexuais e de GêneroRESUMO
EPPIN (epididymal protease inhibitor) is a mammalian conserved sperm-binding protein displaying an N-terminal WFDC (whey-acidic protein four-disulfide core) and a C-terminal Kunitz protease inhibitor domains. EPPIN plays a key role in regulating sperm motility after ejaculation via interaction with the seminal plasma protein SEMG1 (semenogelin-1). EPPIN ligands targeting the SEMG1 binding site in the Kunitz domain are under development as male contraceptive drugs. Nevertheless, the relative contributions of EPPIN WFDC and Kunitz domains to sperm function remain obscure. Here, we evaluated the effects of antibodies targeting specific epitopes in EPPIN's WFDC (Q20E antibody, Gln20-Glu39 epitope) and Kunitz (S21C and F21C antibodies, Ser103-Cys123 and Phe90-C110 epitopes, respectively) domains on mouse sperm motility and fertilizing ability. Computer-assisted sperm analysis showed that sperm co-incubation with S21C antibody (but not F21C antibody) lowered progressive and hyperactivated motilities and impaired kinematic parameters describing progressive (straight-line velocity; VSL, average path velocity; VAP and straightness; STR) and vigorous sperm movements (curvilinear velocity; VCL, amplitude of lateral head movement; ALH, and linearity; LIN) compared with control. Conversely, Q20E antibody-induced milder inhibition of progressive motility and kinematic parameters (VAP, VCL and ALH). Sperm co-incubation with S21C or Q20E antibodies affected in vitro fertilization as revealed by reduced cleavage rates, albeit without changes in capacitation-induced tyrosine phosphorylation. In conclusion, we show that targeting specific epitopes in EPPIN Kunitz and WFDC domains inhibits sperm motility and capacitation-associated events, which decrease their fertilizing ability; nevertheless, similar observations in vivo remain to be demonstrated. Simultaneously targeting residues in S21C and Q20E epitopes is a promising approach for the rational design of EPPIN-based ligands with spermostatic activity.
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Anticorpos/farmacologia , Anticoncepcionais Masculinos/farmacologia , Desenho de Fármacos , Proteínas Secretadas Inibidoras de Proteinases/antagonistas & inibidores , Capacitação Espermática/efeitos dos fármacos , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Animais , Sítios de Ligação , Fenômenos Biomecânicos , Epitopos , Feminino , Ligantes , Masculino , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Fosforilação , Ligação Proteica , Domínios e Motivos de Interação entre Proteínas , Proteínas Secretadas Inibidoras de Proteinases/química , Proteínas Secretadas Inibidoras de Proteinases/metabolismo , Espermatozoides/metabolismo , TirosinaRESUMO
Mammals face environmental stressors throughout their lifespan, which may jeopardize cellular homeostasis. Hence, these organisms have acquired mechanisms to cope with stressors by sensing, repairing the damage, and reallocating resources to increase the odds of long-term survival. Autophagy is a pro-survival lysosome-mediated cytoplasm degradation pathway for organelle and macromolecule recycling. Furthermore, autophagy efflux increases, and this pathway becomes idiosyncratic depending upon developmental and environmental contexts. Mammalian germ cells and preimplantation embryos are attractive models for dissecting autophagy due to their metastable phenotypes during differentiation and exposure to varying environmental cues. The aim of this review is to explore autophagy during mammalian gametogenesis, fertilization and preimplantation embryonic development by contemplating its physiological role during development, under key stressors, and within the scope of assisted reproduction technologies.
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Autofagia , Desenvolvimento Embrionário , Gametogênese , Animais , Autofagia/genética , Humanos , Modelos Biológicos , Oogênese , EspermatogêneseRESUMO
In several species, oocyte and embryo competence are improved by the addition of endoplasmic reticulum (ER) stress inhibitors to in vitro maturation (IVM) medium and/or in vitro culture (IVC) medium. This study aimed to evaluate the effects of three concentrations of tauroursodeoxycholic acid (TUDCA; 50, 200, and 1,000 µM), a chemical chaperone for relieving ER stress, during IVM of bovine cumulus-oocyte complexes (COCs) for 24 h. Treated oocytes were analyzed for nuclear maturation, reactive oxygen species (ROS) production, mitochondrial activity, and abundance of target transcripts. In addition, the number of pronuclei in oocytes was evaluated after 18-20 h of insemination, and the rates of blastocyst and hatched blastocyst formation were evaluated after 7 and 8/9 days of culture, respectively. We further evaluated the transcript abundance of embryonic quality markers. Our findings showed that supplementation of IVM medium with 200 µM of TUDCA decreased ROS production and increased abundance of transcripts related to antioxidant activity in oocytes (CAT, GPX1, and HMOX1) and embryos (GPX1 and PRDX3). Interestingly, high concentration of TUDCA (1,000 µM) was toxic to oocytes, reducing the nuclear maturation rate, decreasing mitochondrial activity, and increasing the abundance of ER stress (HSPA5) and cellular apoptosis (CASP3 and CD40) related transcripts. The results of this study suggest that treatment with 200 µM of TUDCA is associated with a greater resistance to oxidative stress and indirectly with ER stress relief in bovine oocytes.
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A exposição de bovinos a temperaturas elevadas pode causar hipertermia e alterações fisiológicas denominadas de estresse térmico. Este fenômeno tem sido caracterizado em várias espécies, sendo exacerbado em vacas leiteiras de alta produção. Apesar de estas alterações serem observadas em diversos órgãos e tipos celulares, oócitos e embriões pré-implantacionais são mais susceptíveis ao estresse térmico, resultando em reduções na fertilidade das vacas lactantes durante os meses mais quentes do ano. Os oócitos bovinos expostos ao estresse térmico apresentam alterações celulares e moleculares que reduzem a competência oocitária sendo carreados ao embrião pré-implantacional. A maturação in vitro de oócitos bovinos em condições de temperatura elevada (choque térmico) recapitula as principais alterações observadas in vivo, permitindo investigar em mais detalhes a susceptibilidade e os mecanismos de sobrevivência. O entendimento dos processos mediados pelo estresse térmico na fisiologia do oócito permitirá o desenvolvimento de estratégias para mitigar os efeitos negativos mantendo a competência oocitária
The exposure of cattle to high environmental temperatures may lead to hyperthermia and physiological changes known as heat stress. This phenomenon has been characterized in several species, albeit is a more profound problem in high-yielding dairy cows. Although these alterations are observed in several organs and cell types, oocytes and preimplantation embryos are more susceptible to heat stress, resulting in reductions in the fertility of lactating cows during the hottest months of the year. Bovine oocytes exposed to heat stress undergo cellular and molecular changes reducing oocyte competence which is carried out to the preimplantation embryo. In vitro maturation of bovine oocytes under conditions of high temperature (heat shock) recapitulates the main changes observed in vivo, allowing us to investigate the susceptibilities and survival mechanisms. Understanding the processes mediated by heat stress in oocyte physiology will allow the development of strategies to mitigate the negative effects while maintaining oocyte competence.
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Feminino , Animais , Bovinos , Bovinos/embriologia , Desenvolvimento Embrionário , Oogênese , Transtornos de Estresse por Calor , FebreRESUMO
Heat stress is an environmental factor that challenges livestock by disturbing animal homeostasis. Despite the broad detrimental effects of heat stress on reproductive function, the germline and the early preimplantation embryo are particularly prone. There is extensive evidence that elevated temperature reduces oocyte developmental competence through a series of cellular and molecular damages. Further research revealed that the oocyte respond to stress by activating cellular mechanisms such as heat shock response, unfolded protein response and autophagy to improve survival under heat shock. Such knowledge paved the way for the identification of thermoprotective molecules that alleviate heat-induced oocyte oxidative stress, organelle damage, and apoptosis. Therefore, this review depicts the deleterious effects of heat shock on oocyte developmental competence, heat-induced cellular and molecular changes, outlines pro-survival cellular mechanisms and explores thermoprotective molecules to improve oocyte competence.