Atenção preventiva e educativa em saúde do idoso: uma proposta de integração de saberes e práticas / Preventive care and education in elderly health: a proposal for the integration of knowledges and practices

O envelhecimento da população brasileira trouxe mudanças em seu perfil epidemiológico, como o aumento da ocorrência de doenças crônicas e incapacidades funcionais, além de maior demanda por serviços de saúde, representando um desafio para a Saúde Coletiva no conhecimento das suas especificidades. Nesse sentido, idosos do Programa de Assistência ao Idoso do SESC Minas, na cidade de Governador Valadares (MG), responderam a um questionário semiestruturado para variáveis socioeconômicas, condições de saúde e hábitos de vida a fim de se traçar um diagnóstico desta população e direcionar ações interdisciplinares educativas e preventivas como incentivo ao envelhecimento ativo. Os dados revelaram as principais doenças: hipertensão arterial (63,8%), osteoartrite (25,5%), cardiopatias (17%) e diabetes (10,6%). A polifarmácia foi identificada em 29,8% dos idosos, incluindo o uso de medicamentos alopáticos, fitoterápicos e plantas medicinais. Doze idosos (25,5%) relataram possuir lesões de pele, 72,3% informaram uso de próteses dentárias e 2,1% próteses ortopédicas. A maioria dos idosos classificou sua alimentação como saudável (85,1%), mas todos relataram algum tipo de perda funcional. Os resultados demonstram que o Programa Assistencial conta com idosos com o perfil de saúde semelhante ao da população idosa brasileira, com ampla ocorrência de doenças crônicas, edentulismo, incapacidades funcionais e elevado consumo de medicamentos. O presente estudo reforça a importância do trabalho interdisciplinar como subsídio para o desenvolvimento de intervenções mais sensíveis e eficazes, considerando a perspectiva do próprio indivíduo e suas necessidades. (AU)

The aging of the Brazilian population brought changes in their epidemiological profile: increased occurrence of chronic illnesses and functional disabilities; increased demand for health services. The knowledge of the characteristics and elements of such changes have represented a challenge to public health researchers. A preliminary attempt to meet such challenge comes from a program of assistance to the elderly in the city of Governador Valadares, Minas Gerais, Brazil, with the support of an independent agency backed by the commercial sector (SESC-Minas). A sample of individuals aged 60 and above responded to a semi-structured questionnaire to socioeconomic variables, health conditions and life styles. The survey was a research instrument for the proposal of preventive action and active ageing. The data revealed the main diseases: arterial hypertension (63.8 percent); osteoarthritis (25.5 percent); heart diseases (17%) and diabetes (10.6 percent). “`Polipharmacy” was identified in 29.8% of seniors, including the use of allopathic drugs, phytotherapy and medicinal plants. 25.5 percent reported skin lesions, 72.3% wore dentures and 2.1% orthopedic prostheses. Most elderly people claimed to follow a healthy diet (85.1%), but all reported some form of functional loss. The results suggest that the Program relies on the participation of seniors with health profile similar to the general population of Brazilian elderly, with wide occurrence of chronic diseases, edentulism and high consumption of medicines. This study reinforces the importance of interdisciplinary work as subsidy for the development of more effective interventions, taking into account the perspectives of the elderly and their needs. (AU)

Atenção preventiva e educativa em saúde do idoso: uma proposta de integração de saberes e práticas / Preventive care and education in elderly health: a proposal for the integration of knowledges and practices

O envelhecimento da população brasileira trouxe mudanças em seu perfil epidemiológico, como o aumento da ocorrência de doenças crônicas e incapacidades funcionais, além de maior demanda por serviços de saúde, representando um desafio para a Saúde Coletiva no conhecimento das suas especificidades. Nesse sentido, idosos do Programa de Assistência ao Idoso do SESC Minas, na cidade de Governador Valadares (MG), responderam a um questionário semi estruturado para variáveis socioeconômicas, condições de saúde e hábitos de vida a fim de se traçar um diagnóstico desta população e direcionar ações interdisciplinares educativas e preventivas como incentivo ao envelhecimento ativo. Os dados revelaram as principais doenças: hipertensão arterial (63,8%), osteoartrite (25,5%), cardiopatias (17%) e diabetes (10,6%). A poli farmácia foi identificada em 29,8% dos idosos, incluindo o uso de medicamentos alopáticos, fitoterápicos e plantas medicinais. Doze idosos (25,5%) relataram possuir lesões de pele, 72,3% informaram uso de próteses dentárias e 2,1% próteses ortopédicas. A maioria dos idosos classificou sua alimentação como saudável (85,1%), mas todos relataram algum tipo de perda funcional. Os resultados demonstram que o Programa Assistencial conta com idosos com o perfil de saúde semelhante ao da população idosa brasileira, com ampla ocorrência de doenças crônicas, edentulismo, incapacidades funcionais e elevado consumo de medicamentos. O presente estudo reforça a importância do trabalho interdisciplinar como subsídio para o desenvolvimento de intervenções mais sensíveis e eficazes, considerando a perspectiva do próprio indivíduo e suas necessidades.

The aging of the Brazilian population brought changes in their epidemiological profile: increased occurrence of chronic illnesses and functional disabilities; increased demand for health services. The knowledge of the characteristics and elements of such changes have represented a challenge to public health researchers. A preliminary attempt to meet such challenge comes from a program of assistance to the elderly in the city of Governador Valadares, Minas Gerais, Brazil, with the support of an independent agency backed by the commercial sector (SESC-Minas). A sample of individuals aged 60 and above responded to a semi-structured questionnaire to socioeconomic variables, health conditions and life styles. The survey was a research instrument for the proposal of preventive action and active ageing. The data revealed the main diseases: arterial hypertension (63.8 percent); osteoarthritis (25.5 percent); heart diseases (17%) and diabetes (10.6 percent). “`Polipharmacy” was identified in 29.8% of seniors, including the use of allopathic drugs, phytotherapy and medicinal plants. 25.5 percent reported skin lesions, 72.3% wore dentures and 2.1% orthopedic prostheses. Most elderly people claimed to follow a healthy diet (85.1%), but all reported some form of functional loss. The results suggest that the Program relies on the participation of seniors with health profile similar to the general population of Brazilian elderly, with wide occurrence of chronic diseases, edentulism and high consumption of medicines. This study reinforces the importance of interdisciplinary work as subsidy for the development of more effective interventions, taking into account the perspectives of the elderly and their needs.

Polyploidy Analysis and Attenuation of Oxidative Stress in Hepatic Tissue of STZ-Induced Diabetic Rats Treated with an Aqueous Extract of Vochysia rufa.

Diabetes mellitus (DM) is characterized by hyperglycemia and alterations in the metabolism of lipids, carbohydrates, and proteins. Due to its hypoglycemic effect Vochysia rufa is frequently used in Uberlandia, Brazil, to treat DM. Despite its popularity, there is little information about its effect on hepatic tissue. Therefore, we evaluated the histoarchitecture, oxidative stress parameters, and polyploidy of liver tissue from streptozotocin- (STZ-) induced diabetic rats treated with aqueous extract of Vochysia rufa (AEV). Histology was determined by fixing the livers, processing, and staining with HE. Oxidative stress was determined by evaluating CAT, GPx, and SOD activity in liver homogenates and hepatic mitochondria fraction and by measuring GST, GSH levels and lipid peroxidation (MDA). Polyploidy was determined by subjecting isolated hepatocyte nuclei to flow cytometry. In the diabetic group, GST activity and GSH rates decreased whereas liver homogenate analysis showed that GPx, SOD activity and MDA increased. AEV treatment restored all parameters to normal levels. The oxidative stress analysis of hepatic mitochondria fraction showed similar results. Lower polyploid cell populations were found in the diabetic rat livers, even after glibenclamide treatment. Thus, AEV treatment efficiently reduced hepatic oxidative stress caused by STZ-induced diabetes and produced no morphological changes in the histological analysis.

Neuroprotective effects of Pouteria ramiflora (Mart.) Radlk (Sapotaceae) extract on the brains of rats with streptozotocin-induced diabetes.

Diabetes mellitus is a chronic disease involving persistent hyperglycemia, which causes an imbalance between reactive oxygen species and antioxidant enzymes and results in damage to various tissues, including the brain. Many societies have traditionally employed medicinal plants to control the hyperglycemia. Pouteria ramiflora, a species occurring in the savanna biome of the Cerrado (Brazil) has been studied because of its possible ability to inhibit carbohydrate digestion. Rats with streptozotocin-induced diabetes treated with an alcoholic extract of Pouteria ramiflora show an improved glycemic level, increased glutathione peroxidase activity, decreased superoxide dismutase activity, and reduced lipid peroxidation and antioxidant status. The extract also restored myosin-Va expression and the nuclear diameters of pyramidal neurons of the CA3 subregion and that of the polymorphic cells of the hilus. We conclude that Pouteria ramiflora extract exerts a neuroprotective effect against oxidative damage and myosin-Va expression and is able to prevent hippocampal neuronal loss in the CA3 and hilus subfields of diabetic rats. However, future studies are needed to understand the mechanism of action of Pouteria ramiflora extract in acute and chronic diabetes.

Overexpression of myosin-IIB in the brain of a rat model of streptozotocin-induced diabetes.

The Ca(2+)/calmodulin complex interacts with and regulates various enzymes and target proteins known as calmodulin-binding proteins (CaMBPs). This group of proteins includes molecular motors such as myosins. In this study, we show that non-muscle myosin-IIB is overexpressed in the brains of diabetic rats. We isolated CaMBPs from the brains of non-diabetic rats and rats with streptozotocin-induced diabetes and purified them by immobilized-calmodulin affinity chromatography. The proteins were eluted with EGTA and urea, separated by SDS-PAGE, digested and submitted to peptide mass fingerprinting analysis. Thirteen intense bands were found in both types of brains, two were found exclusively in non-diabetic brains and four were found exclusively in diabetic brains. A large fraction of the eluted proteins contained putative IQ motifs or calmodulin-binding sites. The results of the myosin-IIB affinity chromatography elution, western blot and RT-PCR analyses suggest that myosin-IIB protein and mRNA are expressed at high levels in diabetic brains. This is the first study that has demonstrated differential expression of CaMBPs in diabetic and non-diabetic brain tissue through a comparative proteomic analysis, and it opens up a new approach to studying the relationship between the expression of myosins in the brain, hyperglycemia and intracellular calcium regulation.

Alterations of antioxidant biomarkers and type I collagen deposition in the parotid gland of streptozotocin-induced diabetic rats.

BACKGROUND AND OBJECTIVE: Acarbose is a competitive inhibitor of intestinal alpha-glycosidases that slows the breakdown of sucrose and starch, thereby reducing glucose and fructose absorption. The aim of this study was to evaluate the effect of acarbose treatment on antioxidant parameters and deposition of type I collagen in the parotid glands of diabetic rats. METHODS: Diabetes mellitus was induced by intravenous injection of streptozotocin, and rats were divided into four groups: non-diabetic (NDM), diabetic (DM), diabetic treated with 25mg/kg acarbose (DMA) and non-diabetic treated with acarbose (NDMA). Changes in enzymatic antioxidant systems, such as the activity of SOD and GPx enzymes, were evaluated, and the specific staining pattern of the type I collagen fibres was investigated in the rat parotid glands. RESULTS: The DM group presented high levels of SOD and GPx enzymes, which were reduced by acarbose treatment. Tissue damage, which was indicated by an increased MDA concentration in the parotid glands of rats in the DM group, was also reversed in the DMA group. Moreover, type I collagen fibres from DM rats were more intensely stained than those of NDM rats. Acarbose treatment was effective in decreasing collagen deposition, which was shown by a decrease in staining intensity of approximately 25%. CONCLUSIONS: These results suggest that the diabetic state influences the type I collagen concentration in the parotid glands of rats. In addition, acarbose treatment was helpful in preventing the deposition of such fibres, as well the increase in oxidative stress induced by hyperglycemia.