Single-cell transcriptomic atlas of mouse cochlear aging

Progressive functional deterioration in the cochlea is associated with age-related hearing loss (ARHL). However, the cellular and molecular basis underlying cochlear aging remains largely unknown. Here, we established a dynamic single-cell transcriptomic landscape of mouse cochlear aging, in which we characterized aging-associated transcriptomic changes in 27 different cochlear cell types across five different time points. Overall, our analysis pinpoints loss of proteostasis and elevated apoptosis as the hallmark features of cochlear aging, highlights unexpected age-related transcriptional fluctuations in intermediate cells localized in the stria vascularis (SV) and demonstrates that upregulation of endoplasmic reticulum (ER) chaperon protein HSP90AA1 mitigates ER stress-induced damages associated with aging. Our work suggests that targeting unfolded protein response pathways may help alleviate aging-related SV atrophy and hence delay the progression of ARHL.

Single-nucleus profiling unveils a geroprotective role of the FOXO3 in primate skeletal muscle aging

Age-dependent loss of skeletal muscle mass and function is a feature of sarcopenia, and increases the risk of many aging-related metabolic diseases. Here, we report phenotypic and single-nucleus transcriptomic analyses of non-human primate skeletal muscle aging. A higher transcriptional fluctuation was observed in myonuclei relative to other interstitial cell types, indicating a higher susceptibility of skeletal muscle fiber to aging. We found a downregulation of FOXO3 in aged primate skeletal muscle, and identified FOXO3 as a hub transcription factor maintaining skeletal muscle homeostasis. Through the establishment of a complementary experimental pipeline based on a human pluripotent stem cell-derived myotube model, we revealed that silence of FOXO3 accelerates human myotube senescence, whereas genetic activation of endogenous FOXO3 alleviates human myotube aging. Altogether, based on a combination of monkey skeletal muscle and human myotube aging research models, we unraveled the pivotal role of the FOXO3 in safeguarding primate skeletal muscle from aging, providing a comprehensive resource for the development of clinical diagnosis and targeted therapeutic interventions against human skeletal muscle aging and the onset of sarcopenia along with aging-related disorders.

Activation-induced cytidine deaminase (AID) involved in the regulation of B cell immune senescence / 细胞与分子免疫学杂志

The humoral immune response of B cells is the key to the protection of specific immunity, and immune aging reshapes its production and function. The decreased B cell immune function is an indicator of immune senescence. The impaired humoral immune function mediated by antibody secreted by B cells leads to a decline in the response of elderly individuals to the vaccine. These people are therefore more susceptible to infection and deterioration, and have a higher incidence of tumors and metabolic diseases. Activation-induced cytidine deaminase (AID) is an enzyme that triggers immunoglobulin class conversion recombination (CSR) and somatic high frequency mutation (SHM). It decreases during immune senescence and is considered to be a biomarker of decreased B cell function in aging mice and humans. Understanding the inherent defects of B-cell immune senescence and the regulation mechanism of AID in the aging process can provide new research ideas for the susceptibility, prevention and treatment of diseases in the elderly.

Avaliação dos efeitos modulatórios da hematopoese no envelhecimento: Papel das células tronco mesenquimais medulares / Evaluation of the modulatory effects of hematopoiesis during aging: Role of bone marrow mesenchymal stem cells

O envelhecimento é um processo fisiológico que traz consigo uma série de alterações no organismo que se estendem até o nível molecular. Diante disto, este é um processo complexo que afeta diversos tecidos, sendo um deles o hematopoético, local onde, através de interações da Célula Tronco Hematopoética (CTH) com o ambiente ao seu redor, incluindo a Célula Tronco Mesenquimal (CTM), ocorre a hematopoese. Embora já sejam descritas na literatura algumas alterações na medula óssea consequentes do envelhecimento, os mecanismos por trás de tais mudanças permanecem elusivas, principalmente no âmbito das interações celulares ocorrentes na medula óssea. Portanto, este trabalho buscou investigar como o envelhecimento afeta a regulação hematopoética no contexto de sua relação com as CTM medulares. Para esta pesquisa, foram utilizados camundongos machos isogênicos da linhagem C57BL/6, dividindoos em grupos conforme sua idade: jovens (3 ­ 5 meses) e idosos (18 ­ 19 meses). Foi realizada a caracterização do modelo através de aspectos físicos como consumo proteico, variação de peso, entre outros, seguido de avaliação bioquímica e hematológica. Adicionalmente, foram coletadas células medulares e, posteriormente, realizado o isolamento das CTMs. Para estudar a relação destas células com a hematopoese, foram realizados ensaios in vitro utilizando a linhagem celular leucêmica C1498 (TIB-49™, ATCC®) mantidas em contato com o sobrenadante das CTMs isoladas. Quanto aos parâmetros bioquímicos, os animais idosos apresentaram menores níveis de albumina, aspartato alanina transferase (ALT) e de triglicerídeos quando comparados aos animais jovens. Contrariamente, os animais idosos apresentaram um maior nível de colesterol. Na avaliação hematológica, foi constatado pelo hemograma que os animais idosos apresentaram valores comparáveis aos animais jovens, todavia, o mielograma mostrou menor celularidade geral, seguido de menor número de células da linhagem eritroide e maior número de precursores granulocíticos. Através da imunofenotipagem, foi revelado um maior número de CTHs e de precursores grânulosmonocíticos na medula de animais idosos quando comparado aos jovens, e uma menor frequência de progenitores linfoides. Na imunofenotipagem de sangue periférico de animais idosos houve uma redução no número de linfócitos B e de eritrócitos, e aumento na população de células natural killers. Na imunofenotipagem de CTMs, o marcador CD73 apresentou menor expressão nos animais idosos. Avaliando o secretoma destas células estromais, foram encontrados no sobrenadante de CTMs de animais idosos aumentos significativos nas concentrações de CXCL12 e SCF e redução de IL-11. No âmbito molecular, as CTMs de animais idosos apresentaram aumento na expressão de Akt1, Nos e Ppar-γ, e redução na expressão de Csf3 e Cdh2. Adicionalmente, quando comparado a ação das CTMs de animais idosos em relação as CTMs de animais jovens, observou-se que CTMs de animais idosos foram capazes de aumentar a expressão de Sox2, Pou5f1 e Nanog e diminuir a expressão de Cdkn1a de células da linhagem C1498. O sobrenadante de CTMs de animais idosos também resultou na maior proliferação e migração de células da linhagem C1498. Portanto, levando em consideração a importância das CTMs sobre a regulação do sistema hematopoético, pode-se concluir que, no envelhecimento, as CTMs criam um ambiente propício para a proliferação celular no qual a manutenção da pluripotência é estimulada, o que pode acarretar em uma desregulação do sítio hematopoético quando habitado por células malignas

Aging is a physiological process in which occurs a series of alterations in an organism that extend to a molecular level. It is a complex process that affects various tissues, one of them being the bone marrow, wherethrough the interactions of the hematopoietic stem cell (CTH) with its surrounding environment, including with the mesenchymal stem cell (CTM), hematopoiesis takes place. Although some aging-associated alterations in the bone marrow can be found described in the literature, the mechanisms behind said changes remain elusive, especially when regarding the cellular interactions present inside the bone marrow. Therefore, this research aimed to investigate how aging affects the regulation of hematopoiesis in the context of its interactions with bone marrow-derived CTMs. For this investigation, male isogenic C57BL/6 mice were used as animal models. These were separated in two groups according to their age: young (3 ­ 5 months) and aged (18 ­ 19 months). The animal models were characterized by their physical properties such as protein intake and weight variation, followed by biochemical and hematological evaluation. Bone marrow cells were obtained and identified through immunophenotyping, thus isolating different cell populations, including the CTMs. To study the relationship between these cells and hematopoiesis, in vitro assays were conducted utilizing the leukemic cell lineage C1498 (TIB-49™, ATCC®) maintained in contact with the supernatant of isolated CTMs. By their biochemical profile, aged mice showed lower levels of albumin, alanine-aspartate transferase (ALT) and triglycerides compared to the young group. In contrast, aged mice had a higher cholesterol level. Hematological evaluation by total blood count showed similar results between the two groups, however, the myelogram revealed that the aged animals had lower cellularity, with less frequent cells from the erythroid lineage, with an increase in granulocytic precursors. Through immunophenotyping, it was also revealed that aged mice have higher numbers of hematopoietic stem cells, while also being noted a reduced population of lymphoid progenitors. An increase in the granulomonocytic progenitors was also found. Immunophenotyping peripheral blood cells of aged mice revealed reduced numbers of B lymphocytes and erythrocytes, and an increased natural killer cell population. Additionally, the cell surface marker CD73 was found to be less expressed in aged mice CTMs. The secretome of these stromal cells obtained from aged mice showed higher levels of CXCL12 and SCF, and lower levels of IL-11when compared to the young counterparts. At a molecular level, CTMs obtained from aged mice expressed more Akt1, Nos and Ppar-γ, while the expression of Csf3 and Cdh2 was reduced. Additionally, when comparing the effects of aged mice CTMs with young mice CTMs, it was observed that the first expressed were capable of increasing the expression of Sox2, Pou5f1 and Nanog, while decreasing Cdkn1a expression in the C1498 cell lineage. The supernatant obtained from aged mice also favored the proliferation and cell migration of the C1498 cell line. Thus, considering the importance that CTMs have over the hematopoietic system, we can conclude that, in aging, CTMs create a special environment which favors cell proliferation and maintenance of pluripotency, which can result in a dysregulation of the hematopoietic tissue when malignant cells are present

Estudo do composto STX140, um análogo do estradiol, em linhagens de melanoma humano / STX140 compound study in human melanoma

O câncer de pele pode ser classificado como não melanoma e melanoma. O melanoma apresenta baixa incidência entre os cânceres de pele, porém é a forma mais letal e é considerado um dos tipos mais resistentes ao tratamento. Devido à infiltração de células malignas nos tecidos, vasos linfáticos e vasos sanguíneos, o melanoma invade e se espalha rapidamente. Suas metástases são frequentemente localizadas em linfonodos, cérebro, fígado e outros órgãos. Melanomas metastáticos abrigam múltiplas mutações gênicas e muitos tumores apresentam resistência aos tratamentos, como por exemplo com inibidores BRAF, devido à mutações e ativação de vias paralelas. Ou seja, existe uma necessidade clara da busca de novas opções de tratamento. Em trabalho realizado por nosso grupo, Massaro et al mostraram que o derivado de estradiol 2- Metoxiestradiol induz apoptose em células de melanoma e senescência. Neste sentido, o composto STX140, (um análogo do estradiol com biodisponibilidade superior), que já se mostrou eficaz no combate ao câncer de mama em diversos estudos in vitro e in vivo, será então avaliado para sua ação no melanoma de forma inédita. Este trabalho teve como principal objetivo explorar a ação antitumoral em células de melanoma do composto STX140, especialmente a indução de senescência. Utilizando a cultura de células de melanoma foram realizados os ensaios de: viabilidade celular - IC50, formação de colônias, análise do ciclo celular e caracterização de morte celular por citometria de fluxo, ensaio In vitro scratch, coloração para ß-galactosidase, PCR quantitativo e ELISA. Os resultados mostraram que o composto STX140: diminui a viabilidade celular, inibe a proliferação, formação de colônias e migração em linhagens de melanoma (não resistentes e resistentes ao vemurafenibe, inibidor de BRAF). Além do mais, o composto atuou diminuindo a secreção da interleucina pró-tumoral IL-8 em células resistentes. O STX140 induziu senescência nas células de melanoma que foram positivas para ß-galactosidase, também havendo aumento da expressão de genes chave de vias de senescência (CDKN1A e GADD45A) nas células de melanoma resistentes tratadas com o composto. Em conclusão, o STX140 mostrou ter um potencial antitumoral contra o melanoma, diminuindo sua viabilidade celular, inibindo sua proliferação e migração, induzindo senescência, diminuindo a secreção de interleucina pró- tumoral, com efeito mais acentuado nas linhagens de melanoma resistente

Skin cancer can be classified as non-melanoma and melanoma. Melanoma has a low incidence among skin cancers, but it is the most lethal form and is considered one of the most resistant to treatment. Due to the infiltration of malignant cells into tissues, lymphatic vessels and blood vessels, melanoma invades and spreads rapidly. Its metastases are often located in lymph nodes, brain, liver and other organs. Metastatic melanomas presents multiple gene mutations and many tumors are resistant to treatments, such as with BRAF inhibitors, due to mutations and activation of parallel pathways. In other words, there is a clear need to search for new treatment options. In work carried out by our group, Massaro et al showed that the estradiol derivative 2- Methoxyestradiol induces apoptosis in melanoma cells and senescence. In this sense, the compound STX140, (an estradiol analogue with superior bioavailability), which has already been shown to be effective against breast cancer in vitro and in vivo studies will be then evaluated for its action on melanoma. The main objective of this work is to explore the antitumor action of the compound STX140 in melanoma cells, especially the induction of senescence. Using the melanoma cell culture the following assays were performed: cell viability - IC50, clonogenic, cell cycle analysis and cell death characterization by flow cytometry, wound assay, staining for ß-galactosidase, quantitative PCR and ELISA. Preliminary data from this work showed that the compound STX140: decreases cell viability, inhibits proliferation, colony formation and migration in melanoma cell lines (non-resistant and resistant to vemurafenib, BRAF inhibitor). It also decreased the secretion of pro-tumor interleukin IL-8 in resistant cells. STX140 induced senescence in melanoma cells, that were positive for ß-galactosidase, and there was also increased expression of key genes of senescence pathways (CDKN1A and GADD45A) in resistant melanoma cells treated with the compound. In conclusion, STX140 has been shown to have antitumor potential against melanoma, decreasing its cell viability, inhibiting its proliferation and migration, inducing senescence, decreasing pro-tumor interleukin secretion, with a more pronounced effect on resistant melanoma cell lines

Envejecimiento y caídas. Su impacto social / Ageing and falls. Its social impact

RESUMEN El creciente envejecimiento demográfico observado en los diferentes países constituye un fenómeno complejo de relevancia mundial, que repercute en los diversos sectores de la sociedad, entre ellos, el de la salud. Entre los grandes problemas geriátricos que afectan la calidad de vida de los ancianos y constituyen un marcador de fragilidad se encuentran las caídas; las mismas constituyen un evento frecuente entre los adultos mayores de 60 años. Aproximadamente 1 de cada 3 adultos que viven en la comunidad tiene riesgo de presentar una caída en un año. Ese riesgo aumenta con la edad, la presencia de comorbilidades, el antecedente de caídas previas y los trastornos en la marcha, entre otros. Sus consecuencias son graves y pueden llevar a la institucionalización e incluso a la muerte. Tienen implicaciones sociales y de salud pública; por este motivo se considera de fundamental relevancia que el personal de salud y la sociedad en general puedan adquirir conocimientos básicos acerca de las caídas en los adultos mayores, para detectarlas e intervenir de manera adecuada, lo que garantiza el logro de una longevidad con bienestar (AU).

ABSTRACT The growing demographic ageing observed in different countries constitutes a complex phenomenon of global relevance, which has an impact on the various sectors of society, public health among them. Falls are found among the great geriatric problems affecting elder people´s life quality, constituting a fragility marker and a frequent event in people aged 60 years and more. Almost one of each three adults living in the community have the risk of falling once a year. The risk increases with age, the presence of co morbidities, antecedents of previous falls and gait disorders, among others. Its consequences are serious and could lead to the admittance in institutions and even death. They have social and public health implications; for that reason it is considered very relevant that health care staff and the society in general could acquire basic knowledge on falls in elder people, to detect them and properly intervene; it warranties the achievement of longevity with wellbeing (AU).

Aging and low-intensity exercise change oxidative biomarkers in brain regions and radiographic measures of femur of Wistar rats

We investigated changes in oxidative biomarkers in brain regions such as brainstem, cerebellum, and cerebral cortex of 3-, 6-, 18-, 24-, and 30-month-old rats. We also assessed the effects of low-intensity exercise on these biomarkers in these regions of 6-, 18-, and 24-month-old rats that started exercise on a treadmill at 3, 15, and 21 months of age, respectively. Radiographic images of the femur were taken for all rats. A total of 25 rats (age: twelve 6-, ten 18-, ten 24-, and three 30-month-old rats) were used. Lipid hydroperoxide levels increased in cerebellum at 18 months. Total antioxidant activity exhibited lowest values in brainstem at 3 months. Superoxide dismutase activity did not exhibit significant changes during aging. Total thiol content exhibited lowest values in brain regions of 24- and 30-month-old rats. Exercise reduced total thiol content in brainstem at 6 months, but no change occurred in other regions and other ages. Femur increased its length and width and cortical thickness with advancing age. No change occurred in medullary width. Radiolucency increased and sclerosis was found in cortical and medullary bone with advancing age. Exercise reduced radiolucency and medullary sclerosis. Therefore, aging differentially changed oxidative biomarkers in different brain regions and radiographic measures of the femur. Low-intensity exercise only ameliorated some radiographic measurements of femur. Since the present study possessed limitations (small number of rats per group), a beneficial effect of regular low-intensity exercise on oxidative markers in brain cannot be ruled out.

Contribuições da prática de pilates na aptidão física e na força de preensão manual de idosos / Elderly physical fitness and manual grip strength improvement as a result of pilates

O objetivo deste estudo foi verificar a influência do Pilates de solo na aptidão física e na força de preensão manual de idosos. Participaram do estudo 11 idosos, nove mulheres e dois homens, com média de idade de 68,73 anos (DP= 6,06). Estes realizaram 34 sessões de exercícios do Pilates de Solo, em 17 semanas, duas vezes por semana, com duração de 60 minutos cada sessão. No início da intervenção foi aplicada a ficha diagnóstica em forma de entrevista individual. Antes e após a intervenção foram aplicados os seguintes instrumentos: medidas antropométricas, preensão manual e a bateria de testes físicos para idosos (Senior Fitness Test ­ SFT). Quanto às aptidões físicas verificou-se diferença significativa após o programa de Pilates de solo na força dos membros superiores e inferiores, flexibilidade de membros inferiores, agilidade/equilíbrio dinâmico e resistência aeróbia. Não houve diferença na flexibilidade de membros superiores e na força de preensão manual. Concluiu-se neste estudo que o Método Pilates de solo influenciou na melhora da força, flexibilidade de membros inferiores, agilidade/equilíbrio dinâmico e resistência aeróbia, demonstrando ser um método que proporciona benefícios na aptidão física dos idosos.

The purpose of this study was to verify the influence of Mat Pilates in physical fitness and manual grip strength of the elderly. Eleven elderly individuals - 9 women and two men - with mean age of 68.73 years (SD = 6.06) participated in the study. They were submitted to 34 sessions of Mat Pilates exercises twice a week for 17 weeks, with 60-minute sessions. At the beginning of the intervention, a diagnostic form was applied in the form of an individual interview. Before and after the intervention, the following instruments were applied: anthropometric measures, manual gripping and a set of physical tests for the elderly (Senior Fitness Test - SFT). Regarding physical fitness, there was a significant difference after the Pilates program on the upper and lower limb strength, lower limb flexibility, dynamic agility/balance, and aerobic resistance. No differences were found in upper limb flexibility and manual grip strength. It can be concluded that the Mat Pilates Method influenced the improvement of the strength, flexibility of lower limbs, dynamic agility/balance and aerobic resistance, proving to be a method that provides benefits in the physical fitness of the elderly.

Mientras haya vida, hay todo: una mirada en la sexualidad del adulto mayor / While there is life, there is everything: a look at the elderly sexuality

Introducción.Desde un punto de vista integral, la sexualidad comprende aspectos de orden biopsicosocial. Los prejuiciosy el desconocimiento llevan a evitar hablar sobre este tema en la consulta con el adulto mayor (AM).Objetivo.Profundizar en la vivencia de la sexualidad del AM.Metodología.Estudio cualitativo, fenomenológico, realizado en dos centros de actividades recreativas para AM en SanMiguel de Tucumán, que incluyó 13 entrevistas semiestructuradas en profundidad a pacientes mayores de 60 años, 11 desexo femenino, seleccionados en forma intencional y por conveniencia en Agosto de 2018.Resultados.Existe una dicotomía entre quienes hablan del tema y quienes no; sin embargo, todos expresan el deseode naturalizarlo tanto en su círculo social como en la consulta médica. Los AM aceptan el proceso de envejecimiento,tienen una autopercepción positiva de su imagen y pese a los prejuicios, experiencias, comorbilidades y adversidades, seadaptan buscando formas para sentirse bien y disfrutar de una sexualidad plena.Conclusión.El envejecimiento y la sexualidad son conceptos dinámicos que confluyen con las experiencias de vida.Creemos que como médicos de familia es importante brindar una atención integral, abordando las diferentes dimensionesdel ser humano, incluyendo su sexualidad. (AU)

Introduction.Sexuality from an integral point of view includes aspects of biopsychosocial order. Prejudice and ignorancelead to avoid talking about this topic in the medical consultation with the Eldery.Objective.To deepen the experience of the sexuality of the Eldery.Methodology.Qualitative, phenomenological study, conducted in two centres of recreational activities for Senior Citizensin San Miguel de Tucumán, which included 13 in-depth semi-structured interviews to patients over 60 years of age, 11female, selected intentionally and for convenience in August 2018.Results.There is a dichotomy between those who talk about the subject and those who do not; however, all of themexpress the desire to naturalize it in both, their social circle and the medical consultation. The eldery patients acceptthe ageing process, have a positive self-perception of their image and despite prejudices, experiences, comorbidities andadversities, they adapt looking for ways to feel good and enjoy a full sexuality.Conclusion.Aging and sexuality are dynamic concepts that converge with life experiences. We believe that, as familydoctors, it is important to provide comprehensive care, addressing the different dimensions of the human being, wheresexuality is included. (AU)

Genes related to maintenance of autophagy and successful aging / Genes relacionados à manutenção da autofagia e envelhecimento bem-sucedido

ABSTRACT Considering aging as a phenomenon in which there is a decline in essential processes for cell survival, we investigated the autophagic and proteasome pathways in three different groups: young, older and oldest old male adults. The expression profile of autophagic pathway-related genes was carried out in peripheral blood, and the proteasome quantification was performed in plasma. No significant changes were found in plasma proteasome concentrations or in correlations between proteasome concentrations and ages. However, some autophagy- and/or apoptosis-related genes were differentially expressed. In addition, the network and enrichment analysis showed an interaction between four of the five differentially expressed genes and an association of these genes with the transcriptional process. Considering that the oldest old individuals maintained both the expression of genes linked to the autophagic machinery, and the proteasome levels, when compared with the older group, we concluded that these factors could be considered crucial for successful aging.

RESUMO Considerando o envelhecimento como um fenômeno em que há um declínio nos processos essenciais a sobrevivência celular, investigamos as vias autofágica e proteassômica em três grupos: jovens, idosos e longevos. O perfil de expressão dos genes relacionados à via autofágica foi analisado em sangue periférico, e a quantificação do proteassoma realizada em plasma. Não foram encontradas alterações significativas nas concentrações plasmáticas de proteassoma ou na correlação entre as concentrações de proteassoma e as idades. No entanto, alguns genes relacionados a autofagia e / ou apoptose foram expressos diferencialmente. Além disso, as análises de rede e de enriquecimento mostraram uma interação entre quatro dos cinco genes diferencialmente expressos e a associação desses ao processo transcricional. Considerando que os indivíduos longevos mantiveram tanto a expressão de genes ligados à maquinaria autofágica, quanto os níveis de proteassoma quando comparados aos idosos, concluímos que esses fatores poderiam ser considerados cruciais para o envelhecimento bem-sucedido.

Relación entre dependencia en pacientes con enfermedad de Alzheimer y la sobrecarga en el cuidador principal / Relationship between dependence in patients with Alzheimer's disease and primary caregiver overload

RESUMEN Introducción: El envejecimiento poblacional ha traído como consecuencia un aumento de las enfermedades en adultos mayores, entre ellas la enfermedad de Alzheimer, que resulta una amenaza para los cuidadores del paciente y la familia. Objetivo: Demostrar la relación que existe entre la dependencia del paciente con enfermedad de Alzheimer para realizar las actividades básicas de la vida diaria con la sobrecarga percibida por el cuidador principal, Métodos: Se realizó un estudio descriptivo correlacional. Fue seleccionada una muestra de 35 cuidadores principales de pacientes con enfermedad de Alzheimer pertenecientes al Policlínico "Carlos Manuel Portuondo", en Marianao. Los familiares eran encargados y responsables de la realización de los cuidados del paciente y residentes en el domicilio, sin recibir retribución económica a cambio, brindando cuidados por más de seis meses y dieron su consentimiento para la participación en el estudio. Se aplicó el Índice de Katz y la entrevista de sobrecarga del cuidador: Escala de Zarit. Para el procesamiento de la información se utilizó el SPSS 15.0. Se utilizó la estadística descriptiva y el coeficiente de correlación de Pearson para la relación entre variables. Resultados: Predominaron los cuidadores con sobrecarga y los pacientes que requieren asistencia para realizar las actividades básicas de la vida diaria. Los mismos requirieron asistencia para bañarse, trasladarse y alimentarse, variables que se relacionaron significativamente con la sobrecarga. Conclusiones: Existe una relación significativa entre la dependencia para las actividades básicas de la vida diaria de los pacientes con enfermedad de Alzheimer y la sobrecarga percibida por el cuidador principal(AU)

ABSTRACT Introduction: The aging population has resulted in an increase of disease in older adults. Including Alzheimer's disease, which is a threat to patient caregivers and family. Objective: To demonstrate the relationship between the patient's dependence with Alzheimer's disease to perform the basic activities of daily life with the perceived overload the primary caregiver, at the Polyclinic Carlos Manuel Portuondo, in Marianao. Methods: A descriptive correlational study. It was selected a sample of 35 primary caregivers of patients with Alzheimer's disease who were familiar charge and responsible for the realization of patient care and resident at home, without receiving financial compensation in return, providing care for more than six months and they gave their consent for participation in the study. Zarit Scale: Katz Index and caregiver burden interview was applied. For information processing SPSS 15.0 was used. Descriptive statistics and Pearson correlation coefficient for the relationship between variables was used. Results: predominated overloaded caregivers and patients who require assistance to perform basic activities of daily life. They required assistance with bathing, moving and feeding, variables that were significantly related to overloading. Conclusions: There is a significant relationship between dependence for basic activities of daily living of patients with Alzheimer's disease and perceived overload the primary caregiver(AU)

The economic burden of noncommunicable diseases and mental health conditions: results for Costa Rica, Jamaica, and Peru / La carga económica de las enfermedades no transmisibles y la enfermedad mental: resultados para Costa Rica, Jamaica y Perú / A carga econômica das doenças não transmissíveis e condições de saúde mental: resultados para a Costa Rica, Jamaica e Peru

ABSTRACT Objective We extend the EPIC model of the World Health Organization (WHO) and apply it to analyze the macroeconomic impact of noncommunicable diseases (NCDs) and mental health conditions in Costa Rica, Jamaica, and Peru. Methods The EPIC model quantifies the impact of NCDs and mental health conditions on aggregate output solely through the effect of chronic conditions on labor supply due to mortality. In contrast, the expanded EPIC-H Plus framework also incorporates reductions in effective labor supply due to morbidity and negative effects of health expenditure on output via the diversion of productive savings and reduced capital accumulation. We apply this methodology to Costa Rica, Jamaica, and Peru and estimate gross domestic product (GDP) output lost due to four leading NCDs (cardiovascular disease, cancer, chronic respiratory disease, and diabetes) and mental health conditions in these countries from 2015 to 2030. We also estimate losses from all NCDs and mental health conditions combined. Results Overall, our results show total losses associated with all NCDs and mental health conditions over the period 2015-2030 of US$ 81.96 billion (2015 US$) for Costa Rica, US$ 18.45 billion for Jamaica, and US$ 477.33 billion for Peru. Moderate variation exists in the magnitude of the burdens of diseases for the three countries. In Costa Rica and Peru, respiratory disease and mental health conditions are two leading contributors to lost output, while in Jamaica, cardiovascular disease alone accounts for 20.8% of the total loss, followed by cancer. Conclusions These results indicate that the economic impact of NCDs and mental health conditions is substantial and that interventions to reduce the prevalence of chronic conditions in countries of Latin America and the Caribbean are likely to be highly cost-beneficial.

RESUMEN Objetivo Ampliamos el modelo EPIC de la Organización Mundial de la Salud y lo aplicamos para analizar el impacto macroeconómico de las enfermedades no transmisibles y la enfermedad mental en Costa Rica, Jamaica y Perú. Métodos El modelo EPIC cuantifica el impacto de las enfermedades no transmisibles y la enfermedad mental en la producción agregada únicamente a través del efecto que las enfermedades crónicas producen sobre la oferta de trabajo debido a la mortalidad que estas causan. En cambio, el marco ampliado EPIC-H Plus también incorpora reducciones en la oferta efectiva de trabajo debido a la morbilidad y los efectos negativos del gasto en salud sobre la producción a través del desvío del ahorro productivo y la reducción de la acumulación de capital. Aplicamos esta metodología a Costa Rica, Jamaica y Perú y estimamos la pérdida en términos de producto interno bruto debida a cuatro enfermedades no transmisibles (enfermedades cardiovasculares, cáncer, enfermedad respiratoria crónica y diabetes) y a la enfermedad mental en estos países desde 2015 a 2030. También estimamos las pérdidas de todas las enfermedades no transmisibles y la enfermedad mental combinadas. Resultados En general, nuestros resultados muestran pérdidas totales asociadas con todas las enfermedades no transmisibles y la enfermedad mental durante el período 2015-2030 de USD 81,96 mil millones (en dólares de 2015) para Costa Rica, USD 18,45 mil millones para Jamaica y USD 477,33 mil millones para Perú. Existe una variación moderada en la magnitud de la carga de las enfermedades para los tres países. En Costa Rica y Perú, las afecciones respiratorias y la enfermedad mental son los dos factores principales que contribuyen a la pérdida de producción, mientras que en Jamaica la enfermedad cardiovascular sola representa el 20,8% de la pérdida total, seguida por el cáncer. Conclusiones Estos resultados indican que el impacto económico de las enfermedades no transmisibles y la enfermedad mental es considerable y que las intervenciones para reducir la prevalencia de enfermedades crónicas en América Latina y el Caribe probablemente sean muy beneficiosas en relación al costo.

RESUMO Objetivo Estendemos o modelo EPIC da Organização Mundial da Saúde e aplicamos para analisar o impacto macroeconômico das doenças não transmissíveis (DNT) e as condições de saúde mental na Costa Rica, Jamaica e Peru. Métodos O modelo EPIC quantifica o impacto das DNT e condições de saúde mental na produção agregada unicamente através do efeito de condições crônicas na oferta de trabalho devido à mortalidade. Em contrapartida, a estrutura ampliada EPIC-H Plus também incorpora reduções na oferta de trabalho efetiva devido à morbidade e aos efeitos negativos das despesas de saúde na produção através do desvio de poupanças produtivas e redução da acumulação de capital. Aplicamos essa metodologia à Costa Rica, Jamaica e Peru e estimamos a perda de produto interno bruto devido a quatro DNT (doenças cardiovasculares, câncer, doenças respiratórias crônicas e diabetes) e condições de saúde mental nesses países de 2015 a 2030. Também estimamos as perdas de todas as DNT e condições de saúde mental combinadas. Resultados No geral, nossos resultados mostram perdas totais associadas a todas as DNT e condições de saúde mental no período 2015-2030 de USD 81,96 bilhões (USD de 2015) para a Costa Rica, USD 18,45 bilhões para a Jamaica e USD 477,33 bilhões para o Peru. Existe variação moderada na magnitude da carga das doenças para os três países. Na Costa Rica e no Peru, as doenças respiratórias e as condições de saúde mental são dois principais contribuintes para a perda de produção, enquanto na Jamaica, a doença cardiovascular sozinha representa 20,8% da perda total, seguida de câncer. Conclusões Esses resultados indicam que o impacto econômico das doenças não transmissíveis e as condições de saúde mental são substanciais e que as intervenções para reduzir a prevalência de condições crônicas em países da América Latina e do Caribe são benéficos em relação ao custo.

Síndrome da fragilidade e o comprometimento cognitivo em idosos: revisão sistemática da literatura / Frailty syndrome and cognitive impairment in older adults: a systematic literature review

O processo de envelhecimento é universal, contínuo, heterogêneo, de caráter lento e complexo. Dentre os possíveis danos do processo de envelhecimento destaca-se o comprometimento cognitivo e a síndrome da fragilidade. O objetivo deste estudo foi sintetizar o conhecimento sobre a associação entre a síndrome da fragilidade e o comprometimento cognitivo do idoso. Para este estudo, foi adotado o referencial do The Joanna Briggs Institute (2017) e dentre os modelos propostos por este Instituto e considerando os objetivos deste estudo, optou-se pela revisão sistemática de etiologia e fatores de risco, que se desenvolveu em nove passos. O primeiro é a elaboração do protocolo. O segundo foi a formulação da questão de estudo e teve como referência a estratégia PEO. No terceiro foram definidos os critérios de inclusão e exclusão. Posteriormente, no quarto passo, foi realizada a busca dos artigos com a utilização das seguintes bases de dados: National Center for Biotechnology Information (NCBI/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Latin-American and Caribbean Center on Health Sciences Information (LILACS) e a Excerpta Medica Database (EMBASE), além da busca manual, tendo como resultado uma amostra inicial de 3024 estudos. A seguir, no quinto passo, foi realizada a seleção dos artigos, após serem excluídos os duplicados, houve a seleção por título e resumo e leitura na íntegra dos artigos selecionados. Tais ações foram realizadas por três revisores, sendo incluído um total de 10 artigos no estudo e posteriormente a avaliação crítica. O sétimo passo se refere à extração dos dados, seguida de síntese e análise e, por último a apresentação dos resultados. Os estudos incluídos apresentaram diferentes definições operacionais sobre a síndrome da fragilidade. A definição mais utilizada foi o Fenótipo da Fragilidade, utilizada em nove estudos. Já a avaliação do comprometimento cognitivo foi realizada por instrumentos validados para cada população de estudo, dos quais destaca-se o Mini Exame do Estado Mental (MMSE), uma vez que esteve presente em cinco estudos. Sobre as associações entre a síndrome da fragilidade e o comprometimento cognitivo, três estudos identificaram a associação por meio da medida de Odds Ratio (OR) e de quatro estudos foi possível estabelecer a relação pela análise do Relative Risk (RR). Assim, foram realizadas duas meta-análises entre a síndrome da fragilidade e o comprometimento cognitivo. Na primeira, pela comparação do OR, demonstrou-se que os idosos frágeis apresentam 1,24 mais chance de apresentarem comprometimento cognitivo em relação aos não frágeis. Já, na segunda metaanálise, realizada através do RR, os resultados encontrados não foram estatisticamente significantes. Assim, os resultados sugerem que a ausência da uniformidade entre os estudos para avaliar a síndrome da fragilidade e o comprometimento cognitivo, compromete a comparação entre os resultados. Tornase evidente a necessidade de desenvolver outras pesquisas na área que unifiquem a avaliação dessas duas condições de saúde, tendo em vista sua relevância para a prevenção de desfechos adversos de saúde

The aging process is universal, continuous, heterogeneous, with a slow and complex character. Possible and noteworthy damages of the aging process include cognitive impairment and the frailty syndrome. The objective of this study was to synthesize knowledge about the association between the frailty syndrome and cognitive impairment in older adults. In this study, the authors adopted the framework of the Joanna Briggs Institute (2017) and among the models proposed by this institute, and considering the objectives of this study, a systematic review of etiology and risk factors was chosen and developed in nine steps. The first step was the protocol creation. The second step was the formulation of the study question, which was based on the PEO strategy. At a third moment, inclusion and exclusion criteria were defined. Next, at the fourth step, articles were searched in the following databases: National Center for Biotechnology Information (NCBI/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Latin-American and Caribbean Center on Health Sciences Information (LILACS) and the Excerpta Medica Database (EMBASE), in addition to a manual search as well, which resulted in an initial sample of 3,024 studies. At the fifth step, the articles were selected, once duplicates were removed, and later there was a second selection by title, abstract, and reading of the full texts selected. These actions were conducted by three reviewers, who reached a total of 10 articles to be included in the study. The seventh stage consisted of the data extraction, followed by its synthesis and analysis, and, at last, the presentation of the results. The included studies presented different operational definitions regarding the frailty syndrome. The most commonly used definition was the Frailty Phenotype, which was used in nine studies. The cognitive impairment evaluation was conducted by means of tools previously validated to each study population, among which the Mini-Mental State Examination (MMSE) stood out, for being present in five studies. Regarding the associations between the frailty syndrome and cognitive impairment, three studies identified an association by means of the Odds Ratio (OR) measurement, and in four studies it was possible to establish a relationship by the Relative Risk (RR) analysis. Thus, two meta-analyses were conducted between the frailty syndrome and cognitive impairment. The first, by comparison of the OR, showed that frail older people had 1.24 higher chances of presenting cognitive impairment in relation to non-frail individuals. In the second meta-analysis, performed through the RR analysis, the results found were not statistically significant. Therefore, the results suggest that the absence of uniformity among the studies to assess the frailty syndrome and cognitive impairment compromises their comparison. Hence, there is a clear need for developing further research in the area to consolidate the assessment of these two health conditions, considering their relevance to preventing adverse health outcomes

Protein carbonyl content: a novel biomarker for aging in HIV/AIDS patients

Abstract Background: The major complications of “treated” Human Immunodeficiency Virus (HIV) infection are cardiovascular disease, malignancy, renal disease, liver disease, bone disease, and perhaps neurological complications, which are phenomena of the normal aging process occurring at an earlier age in the HIV-infected population. The present study is aimed to explore protein carbonyl content as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. Objective: To investigate the potential of carbonyl content as a biomarker for detecting oxidative Deoxyribonucleic acid (DNA) damage induced Antiretroviral Theraphy (ART) toxicity and/or accelerated aging in HIV/AIDS patients. Methods: In this case–control study a total 600 subjects were included. All subjects were randomly selected and grouped as HIV-negative (control group) (n = 300), HIV-infected ART naive (n = 100), HIV-infected on first line ART (n = 100), and HIV-infected on second line ART (n = 100). Seronegative control subjects were age- and sex-matched with the ART naive patients and the two other groups. Carbonyl protein was determined by the method described in Levine et al. DNA damage marker 8-OH-dG was determined using 8-hydroxy-2-deoxy Guanosine StressXpress ELA Kit by StressMarq Biosciences. Results: Protein carbonyl content levels and oxidative DNA damage were significantly higher (p < 0.05) in HIV-infected patients on second line ART and HIV-infected patients on first line ART than ART naive patients and controls. In a linear regression analysis, increased protein carbonyl content was positively associated with increased DNA damage (OR: 0.356; 95% CI: 0.287–0.426) p < 0.05. Conclusions: Carbonyl content may has a role as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients.

Avaliação dos efeitos da exposição prolongada às isoflavonas em ratas na senescência: aspectos comportamentais, bioquímicos e anatomopatológicos / Evaluation of the effects of prolonged isoflavones exposure in rats on senescence: behavioral, biochemical and anatomopathological aspects

O envelhecimento é um processo acompanhado por uma série de mudanças físicas, fisiológicas e psicológicas, além de ser caracterizado pelo declínio de diferentes funções motoras e cognitivas, que afetam a independência do idoso. Particularmente na mulher, um acompanhante inevitável do envelhecimento é a menopausa. Desse modo, é natural o interesse em medidas terapêuticas que possam ser utilizadas para minimizar os sintomas da menopausa, bem como o prejuízo motor e cognitivo. Assim, o presente estudo teve como objetivo (i) avaliar o efeito da idade nos aspectos comportamentais, neuroquímicos e de ácidos graxos poli-insaturados em ratas jovens (3 meses de idade), de meia-idade (12 meses de idade) e senescentes (18 meses de idade); e, (ii) avaliar os efeitos da administração prolongada (90 dias) de diferentes doses (50, 100 e 200 mg/kg/dia) de isoflavonas (ISOs) no perfil comportamental, na análise bioquímica sérica e de estradiol, na quantificação dos níveis de neurotransmissores encefálicos e achados anatomopatológicos em ratas de meia-idade. Os resultados da primeira etapa mostraram que: ratas com 12 e 18 meses de idade apresentaram: 1) diminuição da frequência de levantar e de grooming no campo aberto; 2) aumento do comportamento tipo-ansioso no labirinto em cruz elevado e na caixa claro-escuro; 3) prejuízo na memória espacial observada no labirinto de Barnes; 4) diminuição, sobretudo, nos níveis de dopamina e de seus metabólitos no córtex pré-frontal (CPF), no hipotálamo, no hipocampo e no estriado; 5) diminuição dos níveis dos hidróxidos 12 e 15/14 do ácido araquidônico (AA) no CPF de ratas com 18 meses de idade. Esses dados em conjunto evidenciam prejuízo motor e cognitivo, aumento do comportamento tipo-ansioso, bem como redução nos níveis de monoaminas e dos hidróxidos do AA com o avanço da idade das ratas. Em relação ao tratamento prolongado com diferentes doses de ISOs em ratas de meia-idade, os resultados mostraram que: 1) não houve alterações motoras e no comportamento tipo-ansioso; 2) evidenciou melhora no desempenho cognitivo espacial; 3) mostrou aumento nos níveis séricos de estradiol e 4) promoveu aumento nos níveis de glutamato e de GABA no CPF e no hipotálamo. Esses achados sugerem que o tratamento prolongado com diferentes doses de ISOs em ratas de meia-idade, foi capaz de melhorar a performance cognitiva espacial e esse efeito pode ser associado ao aumento dos níveis de estrógeno, bem como ao aumento dos níveis de glutamato e de GABA no córtex pré-frontal e no hipotálamo, evidenciando também um possível efeito neuroprotetor das ISOs em ambas regiões.

Aging is a process accompanied by a series of physical, physiological and psychological changes, besides being characterized by the decline of different motor and cognitive functions, which affect the independence of the elderly. Specifically, in women, an inevitable companion of aging is menopause. Therefore, it is of high interest therapeutic procedures that can be used to reduce the symptoms of menopause, as well as motor and cognitive impairment. Thus, the present study aimed to (i) evaluate the effect of age on behavioral, neurochemical and polyunsaturated fatty acids aspects in young (3 months old), middle-aged (12 months old) and senescent (18 months of age) female rats; and (ii) to evaluate the effects of prolonged (90 days) administration of different doses (50, 100 and 200 mg/kg/day) of isoflavones (ISOs) in the behavioral profile, biochemical and estradiol serum analysis, brain neurotransmitters levels and anatomopathological findings in middle-aged rats. Our first results showed that rats at 12 and 18 months of age: 1) presented a decrease in rearing and grooming frequency in the open field; 2) increase of anxiety-like behavior in the elevated plus maze and light-dark box; 3) spatial memory impairment observed in the Barnes maze; 4) a decrease mainly in the levels of dopamine and its metabolites in the prefrontal cortex (PFC), hypothalamus, hippocampus and striatum; 5) decreased levels of 12 and 15/14 arachidonic acid (AA) hydroxides in the PFC in 18-month old rats . These data altogether show motor and cognitive impairment, increase in anxiety-like behavior, as well as reductions in monoamine levels and AA hydroxides as the rat age progresses. Regarding the prolonged treatment with different doses of ISOs in middle-aged rats, the results showed that: 1) there were no motor or anxiety-like behavior alterations; 2) there was an improvement in spatial cognitive performance; 3) increase in serum estradiol levels and 4) increase in glutamate and GABA levels in the PFC and hypothalamus. These findings suggest that prolonged treatment with different doses of ISOs could improve spatial cognitive performance and that this effect may be associated with increased estrogen levels, as well as increased levels of glutamate and GABA in the prefrontal cortex and hypothalamus, evidencing a possible neuroprotective effect of ISOs in both regions.

Physiological regulation of the heat shock response by glutamine: implications for chronic low-grade inflammatory diseases in age-related conditions

Aging is an intricate process modulated by different molecular and cellular events, such as genome instability, epigenetic and transcriptional changes, molecular damage, cell death and senescence, inflammation, and metabolic dysfunction. Particularly, protein quality control (chaperone systems) tends to be negatively affected by aging, thus leading to cellular senescence in metabolic tissues and, as a consequence, to the increasing dissemination of inflammation throughout the body. The heat shock (HS) response and its associated expression of the 70 kDa family of heat shock proteins (HSP70),which are anti-inflammatory molecular chaperones, are found to be markedly decreased during muscle inactivity and aging, while evidence supports the loss of HSP70 as a key mechanism which may drive muscle atrophy, contractile dysfunction, and reduced regenerative capacity. In addition, abnormal stress response is linked with higher incidence of neurodegenerative diseases as well as low-grade inflammatory diseases that are associated with physical inactivity and obesity. Therefore, strategies to increase or, at least, to maintain the levels of HSP70, and its accompanying HS response to stress, are key to reduce biological cell dysfunctions that occur in aging. In this sense, physical exercise is of note as it is the most powerful inducer of the HS response, comparable only to heat stress and fever-like conditions. On the other hand, the amino acidL-glutamine, whose production within the skeletal muscle and liberation into the bloodstream is dependent on muscle activity, is a potentializer of HSP70 expression and HS response, particularly via its entering in hexosamine biosynthetic pathway (HBP). Herein, we discuss the collaborative role of glutamine (and its donors/precursors) and physical exercise (mostly responsible for glutamine release into the circulation) as potential tools to increase HSP70 expression and the HS response in the elderly.

Cambios en la erección en adultos mayores, su relación con la testosterona sérica y otros factores / Changes in older adult penile erection, its association with serum testosterone and other factors

Introducción: los cambios en la erección asociados al envejecimiento frecuentemente se asumen desde conceptos erróneos. Objetivo: describir los cambios en la erección en varones adultos mayores, y su relación con el grado de satisfacción con sus erecciones actuales, la testosterona sérica y otros factores. Métodos: estudio correlacional y transversal. Muestra probabilística de 510 varones adultos mayores de Plaza de la Revolución. Se empleó cuestionario autoadministrado y se determinó testosterona, se emplearon estadísticas descriptivas, prueba chi2 y regresión logística multivariable. Resultados: la edad promedio fue 70 años (rango 60-93). El 92,86 por ciento reconoció cambios en la erección con respecto a edades previas: erecciones matutinas (71,16 por ciento disminución/ ausencia); en las relaciones sexuales (44,8 por ciento disminución, 14,29 por ciento ausencia, 3,17 por ciento aumento); y período refractario (55,02 por ciento aumento). No se demostró relación estadísticamente significativa entre los cambios y la testosterona sérica (p> 0,05). La disminución o ausencia de erección se relacionó positivamente con mayor edad, consumo de medicamentos y autopercepción de no buen estado psicológico, y negativamente con poco tiempo sin pareja (p< 0,05). No se asoció con: presencia de pareja, tiempo de relación, estado civil, escolaridad, ocupación, creencias religiosas, enfermedades, tabaquismo, consumo de alcohol, realización o no de ejercicios físicos, privacidad, actividades de socialización, tristeza, pérdida de autoestima, educación sexual, importancia que conceden a la sexualidad, o actitud hacia esta. Conclusiones: la erección cambia con el envejecimiento, predominantemente en sentido de disminución, pero no siempre ocurre pérdida. Los cambios son independientes de la testosterona sérica, y se relacionan con: mayor edad, consumo de medicamentos, autopercepción del estado psicológico como no bueno y tiempo sin pareja. La disminución/ausencia se asocia a insatisfacción(AU)

Introduction: changes in penile erection associated to aging are frequently understood according to wrong concepts. Objective: to describe the changes in penile erection of older men and their association with the level of satisfaction with their current erections, serum testosterone and other factors. Methods: cross-sectional correlational study on a probabilistic sample of 510 older male adults from Plaza de la Revolucion municipality. A self-administered questionnaire was used, the level of testosterone was estimated and summary statistics, Chi-square test and multivariable logistic regression were used as methods. Results: the average age was 70 years (range of 60 to 93). In this group, 92.86 percent of participants admitted that they had experienced changes in penile erection in comparison to early ages; erections in the morning (71.16 percent reduction/absence); sexual relations (44.8 percent reduction, 14.29 percent absence and 3.17 percent increase) and refractory period (55.02 percent increase). There was no statistically significant association between changes and serum testosterone (p>0.05). The reduction or absence of penile erection was positively associated with older age, drug consumption and self-perception of unsatisfactory psychological state and negatively associated with short period of time without a couple (p< 0.05). There was no association of penile erection with presence of a sexual partner, length of time of the relationship, marital status, schooling, occupation, religious beliefs, diseases, smoking, alcohol consumption, exercising or not, privacy, socializing activities, sadness, low self-esteem, sexual education, importance attached to sexuality or attitude towards it. Conclusions: erection changes with aging; mainly it lowers but not always disappears. There are serum testosterone-independent changes related to older age, drug consumption, self-perception of unsatisfactory psychological condition and length of time without a couple. Reduction/absence of penile erection is associated to dissatisfaction(AU)

A percepção do idoso com diabetes acerca de sua doença e o cuidado de enfermagem / La percepción de los ancianos con diabetes sobre su enfermedad y cuidados de enfermería / The perception of the elderly with diabetes on their disease and the nursing care

RESUMO A Diabetes tornou-se um importante problema de Saúde Pública, frente ao envelhecimento populacional. O enfermeiro deve dispor de um atendimento holístico no cuidado aos idosos diabéticos, visando a sua qualidade de vida. Objetivou-se conhecer a percepção dos idosos com diabetes sobre essa doença e o cuidado de enfermagem na atenção básica. Trata-se de uma pesquisa exploratória descritiva com abordagem qualitativa, realizada no município de Sobral-CE, em outubro de 2013. Participaram 13 idosos, que foram entrevistados por meio de visitas domiciliares. Após a realização da técnica de análise temática, emergiram como categorias: Percepções dos idosos acerca do diabetes; Autocuidado do idoso com diabetes; O olhar dos idosos com diabetes sobre o cuidado de enfermagem na atenção básica. Percebeu-se que os idosos não tinham um conhecimento adequado sobre a doença, mas adotam práticas de autocuidado por reconhecer as complicações da doença na sua qualidade de vida. Sobre os cuidados de enfermagem, observou-se nos discursos diferentes opiniões com relação ao estabelecimento de vínculos entre enfermeiros-idosos. Portanto, aponta-se a necessidade de investir em ações de educação em saúde, além de superar as fragilidades da assistência de enfermagem, já que o estabelecimento de vínculos entre profissionais e usuários é um fator determinante no processo de cuidar.

RESUMEN La diabetes se ha convertido en un importante problema de salud pública, en comparación con el envejecimiento de la población. La enfermera debe tener un cuidado integral a la atención de los diabéticos de edad avanzada, en busca de su calidad de vida. Este estudio tuvo como objetivo conocer la percepción de las personas mayores con diabetes sobre la enfermedad y los cuidados de enfermería en la atención primaria. Se trata de un estudio exploratorio descriptivo con un enfoque cualitativo, realizado en Sobral, Ceará municipio, en octubre de 2013. Los participantes incluyeron 13 ancianos que fueron entrevistados mediante visitas a domicilio. Una vez completado el análisis temático, surgido como categorías: Percepción de la tercera edad sobre la diabetes; El autocuidado de las personas mayores con la diabetes; La mirada de las personas mayores con diabetes acerca de cuidados de enfermería en la atención primaria. Se observó que las personas mayores no tienen un conocimiento suficiente acerca de la enfermedad, pero adoptan prácticas de autocuidado para reconocer las complicaciones de la enfermedad en su calidad de vida. Acerca de los cuidados de enfermería, se observó en los diferentes dictámenes discursos en relación con el establecimiento de vínculos entre las enfermeras de la tercera edad. Por lo tanto señala la necesidad de invertir en actividades de educación para la salud, además de superar las deficiencias de la atención de enfermería, desde el establecimiento de vínculos entre los profesionales y los usuarios es un factor determinante en el proceso de atención.

ABSTRACT Diabetes has become an important public health problem, in the face of an aging population. The nurse must have a holistic care in the care to diabetic elderly, aiming at their quality of life. The objective was to know the perception of the elderly with diabetes on the disease and the nursing care in basic care. This is a descriptive, exploratory study, with a qualitative approach, carried out in the municipality of Sobral-CE, in October 2013. It involved 13 elderly people, interviewed through home visits. After the thematic analysis, the following categories emerged: Perceptions of the elderly on diabetes; Self-care of the elderly with diabetes; The view of the elderly with diabetes on nursing care in basic care. The elderly did not have an adequate knowledge on the disease, but adopted self-care practices by recognizing the complications of the disease in their quality of life. Regarding nursing care, there were different opinions in the discourses regarding the establishment of bonds between nursing and elderly people. Therefore, it is necessary to invest in health education actions, in addition to overcoming the weaknesses of nursing care, since establishing bonds between professionals and users is a determining factor in the care process.

Possible senescence associated change in the predominant &alpha -Na+/K+ ATP-ase isoform in the renal cortex of the rat

With aging the kidney exhibits progressive deterioration, with a decrease in renal function. Most of the filtered Na+ is actively reabsorbed in the proximal tubules through different transporters located in apical membrane. This process is possible because basolateral Na+/K+-ATP-ase generates electrochemical conditions necessary for energetically favorable Na+ transport. The α-subunit is the catalytic domain of Na+/K+-ATP-ase. There are three isoforms of the α/subunit present in rat kidney. The present study was undertaken to examine the expression pattern of rat α-Na+/K+-ATP-ase during senescence. We tested the impact of aging on mRNA expression of α-Na+/K+-ATP-ase in cortex and medulla of aged Wistar rats. We observed a significant expression decrease in mRNA levels and a possible change of isoform in the cortex of aged animals. These expression changes observed for αsubunit could be contributing to affect the renal function in conditions of water and salt stress.

Con el avance de la edad los riñones exhiben un deterioro funcional progresivo con disminución de la función renal. La mayor parte del sodio (Na+) filtrado es reabsorbido activamente en los túbulos proximales a través de diferentes transportadores ubicados en la membrana apical. Este proceso es posible por la existencia de la Na+/K+-ATP-asa basolateral, que genera las condiciones electroquímicas necesarias para que el transporte de Na+ sea energéticamente favorable. La subunidad αde la Na+/K+-ATP-asa es el dominio catalítico de la enzima. Existen tres isoformas de subunidad α, que están presentes en el riñón de la rata. En este trabajo se examinan los patrones de expresión de la α-Na+/K+-ATP-asa durante la senescencia. Se estudió así si el aumento de la edad incidía en la expresión del ARNm de la α-Na+/K+-ATP-asa en corteza y médula renal de ratas Wistar senescentes. Se observó una disminución en la expresión del ARNm de la subunidad αy un posible cambio de isoforma predominante en la corteza de los animales senescentes. Los cambios observados para la expresión de la subunidad αpodrían contribuir a afectar la función renal en condiciones de estrés hídrico y salino.