Estudio de caso: Adulto Mayor sedentario en contexto de pandemia a través de teleenfermería / Case study: Sedentary older adults inthe context of pandemic through telenursing

Debido a la pandemia por COVID-19, la población se vio confinada bajo estrictos reglamentos y controles sanitarios con el objetivo de disminuir los contagios, esto evocado sobre todo a los grupos etarios de riesgo, principalmente adultos mayores. El encierro, y las pocas posibilidades de que la pandemia cese, trajo consecuencias relacionadas con diferentes aristas, sobre todo las relacionadas con su salud. La nula posibilidad de presencialidad para los pacientes en relación a sus controles periódicos, contribuyeron a empeorar su situación de salud física, psicológica y mental, por lo tanto se tuvieron que implementar nuevas estrategias para poder atender a los pacientes, para así brindar cuidados atingentes y de calidad. Una de estas estrategias corresponde a la tele-enfermería, la cual tiene enfoques de promoción, prevención y educación en salud. El presente trabajo utilizó esta estrategia para la atención de un adulto mayor perteneciente al programa Vínculos, para la posterior valoración de enfermería, identificación y priorización de problemas. Considerando el contexto de pandemia, el problema de salud principal que se abordará es el sedentarismo, el cual es un factor de riesgo para enfermedades cardiovasculares y un indicador de calidad de vida. Por esto se trabajó para contribuir con respecto a la reflexión sobre el aporte del proceso de teleenfermería y el desarrollo de habilidades blandas, para crear nuevas estrategias alternativas que se puedan implementar para realizar cuidados integrales pertinentes en adultos mayores en el contexto COVID-19 actual[AU]

Introduction: Low back pain is a common occupational disease in Due to the COVID-19 pandemic, the population was confined under strict regulations and sanitary controls with the objective of reducing contagion, especially among at-risk age groups, mainly the elderly. The confinement, and the few possibilities that the pandemic would cease, brought consequences related to different aspects, especially those related to their health. The lack of possibility for patients to be present for their periodic check-ups contributed to worsen their physical, psychological and mental health situation, so new strategies had to be implemented to attend patients, in order to provide attentive and quality care. One of these strategies corresponds to tele-nursing, which focuses on health promotion, prevention and education. The present study used this strategy for the care of an older adult belonging to the Vínculos program, for the subsequent nursing assessment, identification and prioritization of problems. Considering the pandemic context, the main health problem to be addressed is sedentary lifestyle, which is a risk factor for cardiovascular diseases and an indicator of quality of life. For this reason, we worked to contribute to the reflection on the contribution of the tele-nursing process and the development of soft skills, to create new alternative strategies that can be implemented to perform relevant comprehensive care in older adults in the current COVID-19 context[AU]

Devido à pandemia da COVID-19, a população foi confinada sob regulamentos rigorosos e controlos sanitários com o objectivo de reduzir o contágio, especialmente entre os grupos etários de risco, principalmente os idosos. O confinamento, e as poucas possibilidades de que a pandemia cessasse, trouxe consequências relacionadas com diferentes aspectos, especialmente os relacionados com a sua saúde. A falta de possibilidade de os pacientes estarem presentes para os seus controlos regulares contribuiu para piorar a sua situação física, psicológica e mental, pelo que foi necessário implementar novas estratégias para poder atender os pacientes, a fim de proporcionar cuidados atenciosos e de qualidade. Uma destas estratégias é a tele-educação, que se centra na promoção, prevenção e educação para a saúde. Este estudo utilizou esta estratégia para o cuidado de um adulto mais velho pertencente ao programa Vínculos, para a subsequente avaliação, identificação e atribuição Considerando o contexto pandémico, o principal problema de saúde a abordar é o sedentarismo, que é um factor de risco para as doenças cardiovasculares e um indicador da qualidade de vida. É por isso que trabalhámos para contribuir para a reflexão sobre a contribuição do processo de tele-nursão e o desenvolvimento de competências transversais, a fim de criar novas estratégias alternativas que possam ser implementadas para realizar cuidados abrangentes relevantes para adultos mais velhos no actual contexto da COVID-19 [AU]

Genistein restores caveolin-1 and AT-1 receptor expression and vascular function in large vessels of ovariectomized hypertensive rats.

OBJECTIVE: The soy-derived phytoestrogen genistein improves endothelial function in postmenopausal women and ovariectomized (OVX) normotensive rats. We hypothesized that genistein would improve vascular reactivity involving changes in endothelial nitric oxide synthase (NOS) expression and its regulatory proteins (caveolin and calmodulin), angiotensin II receptor, and/or oxidative status in OVX spontaneously hypertensive rats (SHRs). DESIGN: After ovariectomy or sham operation, 23-week-old female SHRs received either 17beta-estradiol (2 mg/kg/wk SC), genistein (10 mg/kg/d by gavage), or placebo. RESULTS: In OVX rats, final body weight was increased and uterus weight was decreased, and these values were reduced and increased, respectively, by 17beta-estradiol but unaffected by genistein. Acetylcholine-induced endothelium-dependent vasorelaxation was significantly blunted in aortas from OVX placebo SHRs. The contractions induced by the NOS inhibitor L-NAME and angiotensin II in OVX placebo were lower and higher, respectively, than in sham rats. Estradiol and genistein restored these functional changes. Aortic endothelial NOS and calmodulin-1 expression were unchanged, whereas caveolin-1 and angiotensin II receptor expression was increased in OVX rats. Estradiol and genistein treatment did not modify endothelial NOS, but normalized caveolin-1 and angiotensin II receptor and increased calmodulin-1 expression. Vascular superoxide production was increased in OVX placebo and normalized by both estradiol and genistein. CONCLUSIONS: Genistein prevented all cardiovascular changes induced by estrogen depletion in SHRs to a similar extent as estradiol but had no uterotrophic effect. The present findings may help to explain the potential benefits of genistein as a therapeutic agent for preventing menopausal vascular complications, especially in hypertensive women.

Endothelial nitric oxide production stimulated by the bioflavonoid chrysin in rat isolated aorta.

In the present study, the effects of the bioflavonoid chrysin (5,7-dihydroxyflavone) were analysed on nitric oxide (NO) production from vascular endothelium. In aortic rings, incubation with chrysin or acetylcholine (both at 10 microM) increased L-NAME-sensitive endothelial NO release as measured using the fluorescent probe 4,5-diaminofluorescein diacetate (DAF-2 DA). Moreover, chrysin increased cGMP accumulation only in aortic rings with endothelium. However, at this concentration, chrysin had no effect either on basal or on NADPH-stimulated vascular superoxide production. Moreover, at this low concentration, chrysin, similar to acetylcholine, induced aortic relaxation, which was abolished by both endothelial deprivation and NO synthase inhibition. Endothelium-dependent relaxation induced by chrysin was unaltered by removal of extracellular calcium and incubation with the intracellular calcium chelator BAPTA, while the phosphatidylinositol (PI)-3 kinase inhibitor wortmannin suppressed the endothelial dependence. In conclusion, chrysin stimulated NO release from endothelial cells leading to vascular cGMP accumulation and subsequent endothelium dependent aortic relaxation. Chrysin-stimulated NO release is calcium independent and possibly mediated via PI3-kinase.

A diet supplemented with husks of Plantago ovata reduces the development of endothelial dysfunction, hypertension, and obesity by affecting adiponectin and TNF-alpha in obese Zucker rats.

The aim of the present study was to analyze whether consumption of a fiber-supplemented diet containing 3.5% Plantago ovata husks prevented many of the abnormalities clustered in the metabolic syndrome, including obesity, dyslipidemia, hypertension and endothelial dysfunction. For this purpose, obese Zucker rats, a model of type 2 diabetes, and their lean littermates were studied. Rats consumed a standard control diet or that diet supplemented with 3.5% P. ovata husks for 25 wk. Body weights were measured weekly. Systolic blood pressure (SBP) was measured monthly. At the end of the treatment, plasma concentrations of triglycerides, total cholesterol, FFAs, glucose, insulin, adiponectin, and tumor necrosis factor alpha (TNF-alpha) were determined, and studies on vascular function were performed using aortic rings. Rats fed the P. ovata husk-supplemented diet had a significantly reduced body weight gain compared with those fed the standard diet. Decreased endothelium-dependent relaxation in response to acetylcholine (ACh) by aortic rings from obese Zucker rats was improved in those fed the fiber-supplemented diet. The greater SBP, higher plasma concentrations of triglycerides, total cholesterol, FFA, glucose, insulin, and TNF-alpha, and the hypoadinectinemia that occurred in obese Zucker rats that consumed the control diet were significantly improved in those fed the fiber-supplemented diet. We conclude that intake of a P. ovata husk-supplemented diet prevents endothelial dysfunction, hypertension, and obesity development, and ameliorates dyslipidemia and abnormal plasma concentrations of adiponectin and TNF-alpha in obese Zucker rats.

Effects of the flavonoid quercetin and its methylated metabolite isorhamnetin in isolated arteries from spontaneously hypertensive rats.

Chronic oral quercetin exerts antihypertensive effects in spontaneously hypertensive rats (SHR). In the present study, the vasodilator effects of the flavonoid quercetin and its main metabolite isorhamnetin were analysed in isolated thoracic aorta, iliac artery and on the isolated perfused mesenteric resistance vascular bed from SHR and normotensive Wistar Kyoto rats (WKY). In noradrenaline-precontracted vessels from SHR there was an inverse correlation between the relaxant potency (pIC50) of quercetin (4.76 +/- 0.02, 5.08 +/- 0.12, 5.30 +/- 0.18, in aorta, iliac arteries and mesentery, respectively) and isorhamnetin (4.90 +/- 0.11, 5.38 +/- 0.15 and 5.80 +/- 0.10, respectively) and the diameter of the vessel studied. Both flavonoids were more potent in endothelium-denuded aortae and iliac arteries from SHR than from normotensive WKY rats. In addition, in aortae from SHR both flavonoids restored the endothelial-dependent vasodilation. Isorhamnetin, but not quercetin, also reduced the endothelium-dependent contractile responses induced by acetylcholine. These direct vasodilator effects, together with the improvement of endothelial function, are good candidates to explain the blood pressure reduction and vascular protective effects of quercetin in animal models of hypertension and possibly in human cardiovascular diseases.