Necesidades de salud desde la percepción de las personas mayores: revisión integrativa / Health needs from the perception o folder people: integrative review / Necessidades de saúde percepção de idosos: revisão integrativa

Objetivo: Conocer las necesidades de salud desde la perspectiva de las personas mayores que viven en la comunidad y que promueven a un envejecimiento saludable a través de un estudio bibliográfico, tipo revisión integrativa. Material y Método: La Revisión integradora de la literatura se oriento por los planteamientos de Ganong, el período fue del año 2010 al 2020. Se seleccionaron los buscadores Scielo, Lilacs, Medline. Los idiomas fueron español, portugués e inglés. Resultados: En los 113 artículos encontrados se aplicaron los criterios de inclusión, seleccionando 30, luego de un análisis detallado se recuperaron 6 artículos. Por lo amplio del concepto de Necesidades de Salud en las Personas Mayores, se utilizó la taxonomía de Matsumoto, relacionando cada uno de los artículos con los componentes y a su vez la relación entre los artículos. Conclusiones: A través de la revisión integrativa se encontraron artículos que hacen referencia a las necesidades de salud de las personas mayores. El envejecimiento activo y saludable implica un cambio de paradigma y él debe ser el parámetro para seguir por parte de los Estados, centrar la atención en la persona es un cambio y no enfocarla en la enfermedad o en la discapacidad. Respetar y promover en la persona mayor su libertad, autonomía y poder de decisión como individuos que forman parte de la comunidad.

Objective: To know the health needs from the perspective of older people who live in the community and who promote healthy aging through a bibliographic study, integrative review type. Material and Method: The integrative review of the literature was guided by Ganong's approaches; the period was from 2010 to 2020. The search engines Scielo, Lilacs, Medline were selected. The languages were Spanish, Portuguese and English Results: In the 113 articles found, the inclusion criteria were applied, selecting 30, after a detailed analysis 6 articles were recovered. Due to the broad concept of Health Needs in the Elderly, the Matsumoto taxonomy was used, relating each of the items to the components and, in turn, the relationship between the items. Conclusions: Through the integrative review, articles that refer to the health needs of the elderly were found. Active and healthy aging implies a paradigm shift and it must be the parameter to be followed by the States, focusing attention on the person is a change and not focusing on illness or disability. Respect and promote in the elderly their freedom, autonomy and decision-making power as individuals who are part of the community.

Objetivo: Conhecer as necessidades de saúde na perspectiva dos idosos que vivem na comunidade e que promovem o envelhecimento saudável por meio de um estudo bibliográfico, tipo revisão integrativa. Material e Método: A revisão integrativa da literatura foi norteada pelas abordagens de Ganong, o período foi de 2010 a 2020. Foram selecionados os mecanismos de busca Scielo, Lilacs, Medline. Os idiomas eram espanhol, português e inglês. Resultados: Nos 113 artigos encontrados, foram aplicados os critérios de inclusão, selecionando 30, após uma análise detalhada foram recuperados 6 artigos. Devido ao conceito amplo de Necessidades de Saúde do Idoso, foi utilizada a taxonomia de Matsumoto, relacionando cada um dos itens aos componentes e, por sua vez, a relação entre os itens. Conclusões: Por meio da revisão integrativa, foram encontrados artigos que se referemàs necessidades de saúde do idoso. O envelhecimento ativo e saudável implica uma mudança de paradigma e deve ser o parâmetro a ser seguido pelos Estados, focar a atenção na pessoa é uma mudança e não focar na doença ou incapacidade. Respeitar e promover nos idosos a sua liberdade, autonomia e poder de decisão enquanto indivíduos que fazem parte da comunidade.

Accesibilidad en la alimentación en personas mayores / Accessibility in food for older people / Acessibilidade alimentar em idosos

La alimentación adecuada es un derecho humano que contribuye a una buena calidad de vida de las personas y uno de sus componentes básicos es la accesibilidad. En el Plan de cuidados de Enfermería, se valora el proceso de envejecimiento y las modificaciones que éste genera pudiendo contribuir a situaciones de vulnerabilidad desde el punto de vista nutricional. La accesibilidad a la alimentación se puede ver afectada por diferentes factores, como es el acceso físico, alimentos suficientes y adecuados, y las dificultades económicas. El objetivo fue conocer la accesibilidad en la alimentación de personas mayores (65 años y más) que residen en complejos habitacionales para jubilados y pensionistas. Se realizó un estudio de tipo cuantitativo de corte transversal. La recolección de los datos se llevó a cabo en tres complejos habitacionales para jubilados y pensionistas, seleccionados dos de ellos en la ciudad de Montevideo y uno en la ciudad de Rivera. La muestra estuvo conformada por 68 personas (69% de los residentes) que residen en los complejos.Los resultados demuestran que un 18% de esta población tiene dificultades en la accesibilidad en la alimentación, las causas fueron la falta de dinero en un 70% y un 30% por problema en la movilidad. Es reconocido en Uruguay el derecho a la alimentación y en generar políticas públicas y programas que contribuyan a satisfacer esta necesidad vital y garantizar el acceso a la misma, en grupos de población vulnerables como puede ser en las personas mayores.

Adequate food is a human right that contributes to a good quality of life for people and one of its basic components is accessibility. In the Nursing Care Plan, the aging process and the changes it generates are valued and may contribute to situations of vulnerability from the nutritional point of view. Accessibility to food can be affected by different factors, such as physical access, sufficient and adequate food, and economic difficulties. The objective was to know the accessibility in food of older people (65 years and over) who reside in housing complexes for retirees and pensioners. A quantitative cross-sectional study was carried out. Data collection was carried out in three housing complexes for retirees and pensioners, two of them selected in the city of Montevideo and one in the city of Rivera. The sample consisted of 68 people (69% of the residents) who reside in the complexes. The results show that 18% of this population has difficulties in food accessibility, the causes were lack of money in 70% and 30% due to mobility problems. The right to food is recognized in Uruguay and to generate public policies and programs that contribute to satisfying this vital need and guaranteeing access to it, in vulnerable population groups such as the elderly.

A alimentação adequada é um direito humano que contribui para uma boa qualidade de vida das pessoas e um de seus componentes básicos é a acessibilidade. No Plano de Assistência de Enfermagem, o processo de envelhecimento e as mudanças que ele gera são valorizados e podem contribuir para situações de vulnerabilidade do ponto de vista nutricional. A acessibilidade aos alimentos pode ser afetada por diversos fatores, como acesso físico, alimentação suficiente e adequada e dificuldades econômicas. O objetivo foi conhecer a acessibilidade na alimentação de pessoas idosas (65 anos ou mais) que residem em conjuntos habitacionais para aposentados e pensionistas. Foi realizado um estudo quantitativo transversal. A coleta de dados foi realizada em três conjuntos habitacionais para aposentados e pensionistas, dois deles selecionados na cidade de Montevidéu e um nacidade de Rivera. A amostra foi composta por 68 pessoas (69% dos moradores) que residem nos complexos. Os resultados mostram que 18% dessa população tem dificuldades na acessibilidade alimentar, as causas foram falta de dinheiro em 70% e 30% por problemas de locomoção. O direito à alimentação é reconhecido no Uruguai e para gerar políticas e programas públicos que contribuam para satisfazer esta necessidade vital e garantir o acesso a ela, em grupos populacionais vulneráveis como os idosos.

Synthesis of single-chain antibody fragment fused to the elastin-like polypeptide in Nicotiana benthamiana and its application in affinity precipitation of difficult to produce proteins.

Plants are economical and sustainable factories for the production of recombinant proteins. Currently, numerous proteins produced using different plant-based systems with applications as cosmetic and tissue culture ingredients, research and diagnostic reagents, and industrial enzymes are marketed worldwide. In this study, we aimed to demonstrate the usefulness of a plant-based system to synthesize a single-chain antibody (scFv)-elastin-like polypeptide (ELP) fusion to be applied as an affinity precipitation reagent of the difficult to produce recombinant proteins. We used the human tissue transglutaminase (TG2), the main celiac disease autoantigen, as a proof of concept. We cloned a TG2-specific scFv and fused it to a short hydrophobic ELP tag. The anti-TG2-scFv-ELP was produced in Nicotiana benthamiana and was efficiently recovered by an inverse transition cycling procedure improved by coaggregation with bacteria-made free ELP. Finally, the scFv-ELP was used to purify both plant-synthesized human TG2 and also Caco-2-TG2. In conclusion, this study showed for the first time the usefulness of a plant-based expression system to produce an antibody-ELP fusion designed for the purification of low-yield proteins.

Manifestaciones clínicas y desenlaces maternos y perinatales en gestantes con síndrome antifosfolípido obstétrico de una institución de alta complejidad: estudio descriptivo / Clinical manifestations and maternal and perinatal outcomes in expectant mothers with obstetric antiphospholipid syndrome at a high complexity institution: Descriptive study

RESUMEN Objetivo: Describir las características clínicas, así como los desenlaces maternos y perinatales en gestantes con síndrome antifosfolípido en una institución de alta complejidad. Materiales y métodos: Estudio descriptivo retrospectivo que evaluó gestantes con síndrome antifosfolípido según criterios de Sidney o según criterio de reumatólogo entre 2010 y 2016. Se excluyeron aquellos casos con trombofilias hereditarias, incompetencia cervical o con antecedente de hepatitis B, hepatitis C y virus de inmunodeficiencia humana. La información se recolectó a partir de la revisión de historias clínicas. Resultados: Se incluyeron 16 gestantes; 7 (43,8%) pacientes tenían antecedente de aborto, 5 (71,4%) en más de una ocasión; estas pérdidas ocurrieron después de la semana 10. Nueve (56,3) tenían síndrome antifosfolípido asociado a lupus eritematoso sistémico; el principal marcador serológico fue el anticoagulante lúpico en 12 (75%) gestantes. Dos (12,5%) pacientes tenían triple positividad y 6 (37,5%) doble positividad de anticuerpos antifosfolípidos. Las complicaciones obstétricas más frecuentes fueron: rompimiento prematuro de membranas (28,6%), preeclampsia (13,3%) e insuficiencia placentaria (11,8%), las cuales se presentaron más en pacientes con lupus eritematoso sistémico, así como en aquellas con triple y doble positividad de anticuerpos antifosfolípidos. Conclusiones: En esta cohorte, el síndrome antifosfolípido obstétrico estuvo asociado a lupus eritematoso sistêmico en la mayoría de los casos; sin embargo, éste último estaba en remisión. Los peores desenlaces obstétricos se observaron en pacientes con síndrome antifosfolípido y lupus, o en los casos que tenían triple o doble positividad de anticuerpos antifosfolípidos.

ABSTRACT Objective: To describe the clinical characteristics, as well as the maternal and perinatal outcomes in pregnant women with the antiphospholipid syndrome in a reference institution. Materials and methods: A retrospective descriptive study was carried out in order to evaluate pregnant women with antiphospholipid syndrome according to Sydney criteria or rheumatologist criteria between 2010 and 2016. Cases with hereditary thrombophilia, cervical incompetence, history of hepatitis B, hepatitis C, and human immunodeficiency virus were excluded. The information on sociodemographic and clinical variables was collected from the review of medical records. Results: Sixteen pregnant women were included; seven (43.8%) patients had a history of abortion, five (71.4%) on more than one occasion; these losses occurred after week ten. Nine (56.3) had antiphospholipid syndrome associated with systemic lupus erythematosus. The main serological marker was lupus anticoagulant in 12 (75%) pregnant women. Two (12.5%) patients had triple positivity and six (37.5%) double positivity of antiphospholipid antibo-dies. The most frequent obstetric complications were premature rupture of membranes (28.6%), pre-eclampsia (13.3%), and placental insufficiency (11.8%), which were more com-mon in patients with systemic lupus erythematosus, as well as in those with triple and double antiphospholipid antibody positivity. Conclusions: Obstetric antiphospholipid syndrome was associated with systemic lupus erythematosus in the majority of cases; however, the latter was in remission. The worst obstetric outcomes were observed in patients with this association or in cases with triple or double antiphospholipid antibody positivity.

Vacuolar Targeting and Characterization of Recombinant Antibodies.

Plant-based platforms are extensively use for the expression of recombinant proteins, including monoclonal antibodies (mAbs). Generally, immunoglobulins (Igs) are sorted to the apoplast, which is often afflicted with intense proteolysis. Here, we describe methods to transiently express mAbs sorted to central vacuole in Nicotiana benthamiana leaves and to characterize the obtained IgG. Central vacuole is an appropriate compartment for the efficient production of Abs, consequently vacuolar sorting should be considered as an alternative strategy to obtain high protein yields.

Vacuolar deposition of recombinant proteins in plant vegetative organs as a strategy to increase yields.

Delivery of recombinant proteins to vegetative tissue vacuoles was considered inconvenient since this compartment was expected to be hydrolytic; nevertheless there is growing evidence that certain foreign proteins accumulate at high yields in vacuoles. For example avidin, cellulolytic enzymes, endolysin, and transglutaminases were produced at high yields when were sorted to leaf central vacuole avoiding the detrimental effect of these proteins on plant growth. Also, several secretory mammalian proteins such as collagen, α1-proteinase inhibitor, complement-5a, interleukin-6 and immunoglobulins accumulated at higher yields in leaf vacuoles than in the apoplast or cytosol. To reach this final destination, fusions to sequence specific vacuolar sorting signals (ssVSS) typical of proteases or proteinase inhibitors and/or Ct-VSS representative of storage proteins or plant lectins were used and both types of motifs were capable to increase accumulation. Importantly, the type of VSSs or position, either the N or C-terminus, did not alter protein stability, levels or pos-translational modifications. Vacuolar sorted glycoproteins had different type of oligosaccharides indicating that foreign proteins reached the vacuole by 2 different pathways: direct transport from the ER, bypassing the Golgi (high mannose oligosaccharides decorated proteins) or trafficking through the Golgi (Complex oligosaccharide containing proteins). In addition, some glycoproteins lacked of paucimannosidic oligosaccharides suggesting that vacuolar trimming of glycans did not occur. Enhanced accumulation of foreign proteins fused to VSS occurred in several plant species such as tobacco, Nicotiana benthamiana, sugarcane, tomato and in carrot and the obtained results were influenced by plant physiological state. Ten different foreign proteins fused to vacuolar sorting accumulated at higher levels than their apoplastic or cytosolic counterparts. For proteins with cytotoxic effects vacuolar sorted forms yields were superior than ER retained variants, but for other proteins the results were the opposite an there were also examples of similar levels for ER and vacuolar variants. In conclusion vacuolar sorting in vegetative tissues is a satisfactory strategy to enhance protein yields that can be used in several plant species.

Vacuolar targeting of recombinant antibodies in Nicotiana benthamiana.

Plant-based platforms are extensively used for the expression of recombinant proteins, including monoclonal antibodies. However, to harness the approach effectively and leverage it to its full potential, a better understanding of intracellular processes that affect protein properties is required. In this work, we examined vacuolar (vac) targeting and deposition of the monoclonal antibody (Ab) 14D9 in Nicotiana benthamiana leaves. Two distinct vacuolar targeting signals (KISIA and NIFRGF) were C-terminal fused to the heavy chain of 14D9 (vac-Abs) and compared with secreted and ER-retained variants (sec-Ab, ER-Ab, respectively). Accumulation of ER- and vac-Abs was 10- to 15-fold higher than sec-Ab. N-glycan profiling revealed the predominant presence of plant typical complex fucosylated and xylosylated GnGnXF structures on sec-Ab while vac-Abs carried mainly oligomannosidic (Man 7-9) next to GnGnXF forms. Paucimannosidic glycans (commonly assigned as typical vacuolar) were not detected. Confocal microscopy analysis using RFP fusions showed that sec-Ab-RFP localized in the apoplast while vac-Abs-RFP were exclusively detected in the central vacuole. The data suggest that vac-Abs reached the vacuole by two different pathways: direct transport from the ER bypassing the Golgi (Ab molecules containing Man structures) and trafficking through the Golgi (for Ab molecules containing complex N-glycans). Importantly, vac-Abs were correctly assembled and functionally active. Collectively, we show that the central vacuole is an appropriate compartment for the efficient production of Abs with appropriate post-translational modifications, but also point to a reconsideration of current concepts in plant glycan processing.

Maltrato infantil según la escala de estrategias de resolución de conflictos (CTSPC), en población escolarizada de la ciudad de Manizales (Colombia), 2011 / Child abuse according to conflict tactics scale (CTSPC), in school population of Manizales City (Colombia), 2011

Antecedentes: El maltrato infantil actualmente ha aumentado en frecuencia y formas, considerándose un problema de salud pública. Los niños siguen siendo los que presentan más riesgo de ser maltratados. Materiales y Métodos: se seleccionó una muestra de 449 estudiantes, de cuarto a sexto grado de tres instituciones públicas de Manizales (Colombia), se estudiaron en esta población variables demográficas, necesidades básicas, historia de maltrato, escala CTSPC versión niños. Resultados: La escala CTSPC mostró en promedio 9,21% o 29,29 en puntaje absoluto. Según el resultado de esta escala al 33,7% lo castigan pegándole con cinturón, al 9,5% con cable, el 10,9% han presentado quemaduras con plancha, el 9% han sido amenazados con abandono, o ser hechados de la casa, solo al 61,3% nunca le pegan cuando lo castigan. El valor de la escala CTSPC mostró relación significativa con género (p=0,015), funcionalidad familiar (p=0,028), el consumo de licor (p=0,013), y maltrato infantil (p=0,001) anterior de las personas que los cuidan, el pelear con los compañeros (p=0,004). El 29,1% presenta consumo de licor en la familia, el 18,3% antecedente de maltrato en algún miembro de la familia, el 51,5% presenta algún tipo de disfuncionalidad familiar. Conclusiones: Una considerable proporción de la población, según la escala CTSPC, aún sufre maltrato intrafamiliar, lo cual es inaceptable. Se hacen necesarias campañas que erradiquen imaginarios culturales anticuados y primitivos alrededor de la educación de los hijos, y que a lo único que contribuyen es a perpetuar el ambiente generalizado de violencia tan propio de Colombia...

Formacion de biocapas por Enterococcus faecalis y Enterococcus faecium sobre cateteres intravasculares / Bacterial biofilm formation on surfaces of intravascular catheters

La formación de biocapas por bacterias en la superficie de los catéteres intravasculares es un evento muy importante en la patogénesis y evolución de infecciones asociadas con el uso de estos dispositivos médicos. Los objetivos de este estudio fueron desarrollar biocapas y evaluar los eventos de adhesión y colonización "in vitro " de Enterococcus faecalis y Enterococcus faecium sobre catéteres intravasculares de teflón, poliuretano y vialón. Con este fin se utilizaron dos cepas, una de Enterococcus faecalis y una Enterococus faecium, en las que se determinó la susceptibilidad a antibióticos y la producción de P-lactamasas. Para la formación de biocapas se hicieron cortes de los catéteres y se pusieron en contacto con inocules independientes de 3 x IOS UFC/mI de Enterococcus faecalis y Enterococcus faecium, y se incubaron a 37ºC durante diferentes tiempos. Los resultados muestran que las dos cepas objeto de estudio presentaron resistencia a ampicilina, baja resistencia a gentamicina y sensibilidad a vancomicina; además de ser productoras de P-lactamasas de amplio espectro. El Enterococcus faecalis se adhiere mucho mejor que Enterococcus faecium a los catéteres intravasculares evaluados en este estudio. La mejor adherencia y formación de biocapas tanto de Enterococcus faecalis como de Enterococcus faecium se dio sobre el catéter intravascular de teflón. En conclusión se sugiere que a la hora de escoger un catéter intravascular, deberá ser de material de vialón ya que en él es donde los dos enterococos se adhieren muy mal, lo que conduciría a una deficiente formación de biocapas que evitaría complicaciones como endocarditis