The complicated role of mitochondria in the podocyte.

Mitochondria play a complex role in maintaining cellular function including ATP generation, generation of biosynthetic precursors for macromolecules, maintenance of redox homeostasis, and metabolic waste management. Although the contribution of mitochondrial function in various kidney diseases has been studied, there are still avenues that need to be explored under healthy and diseased conditions. Mitochondrial damage and dysfunction have been implicated in experimental models of podocytopathy as well as in humans with glomerular diseases resulting from podocyte dysfunction. Specifically, in the podocyte, metabolism is largely driven by oxidative phosphorylation or glycolysis depending on the metabolic needs. These metabolic needs may change drastically in the presence of podocyte injury in glomerular diseases such as diabetic kidney disease or focal segmental glomerulosclerosis. Here, we review the role of mitochondria in the podocyte and the factors regulating its function at baseline and in a variety of podocytopathies to identify potential targets for therapy.

Mutagenesis of a specificity-determining residue in tyrosine hydroxylase establishes that the enzyme is a robust phenylalanine hydroxylase but a fragile tyrosine hydroxylase.

The aromatic amino acid hydroxylases tyrosine hydroxylase (TyrH) and phenylalanine hydroxylase (PheH) have essentially identical active sites; however, PheH is nearly incapable of hydroxylating tyrosine, while TyrH can readily hydroxylate both tyrosine and phenylalanine. Previous studies have indicated that Asp425 of TyrH is important in determining the substrate specificity of that enzyme [Daubner, S. C., Melendez, J., and Fitzpatrick, P. F. (2000) Biochemistry 39, 9652-9661]. Alanine-scanning mutagenesis of amino acids 423-427, a mobile loop containing Asp425, shows that only mutagenesis of Asp425 alters the activity of the enzyme significantly. Saturation mutagenesis of Asp425 results in large (up to 10(4)) decreases in the V(max) and V(max)/K(tyr) values for tyrosine hydroxylation, but only small decreases or even increases in the V(max) and V(max)/K(phe) values for phenylalanine hydroxylation. The decrease in the tyrosine hydroxylation activity of the mutant proteins is due to an uncoupling of tetrahydropterin oxidation from amino acid hydroxylation with tyrosine as the amino acid substrate. In contrast, with the exception of the D425W mutant, the extent of coupling of tetrahydropterin oxidation and amino acid hydroxylation is unaffected or increases with phenylalanine as the amino acid substrate. The decrease in the V(max) value with tyrosine as the substrate shows a negative correlation with the hydrophobicity of the amino acid residue at position 425. The results are consistent with a critical role of Asp425 being to prevent a hydrophobic interaction that results in a restricted active site in which hydroxylation of tyrosine does not occur.

GPS Tracking to Monitor the Spatiotemporal Dynamics of Cattle Behavior and Their Relationship with Feces Distribution.

The sustainability of agrosilvopastoral systems, e.g., dehesas, is threatened. It is necessary to deepen the knowledge of grazing and its environmental impact. Precision livestock farming (PLF) technologies pose an opportunity to monitor production practices and their effects, improving decision-making to avoid or reduce environmental damage. The objective of this study was to evaluate the potential of the data provided by commercial GPS collars, together with information about farm characteristics and weather conditions, to characterize the distribution of cattle dung in paddocks, paying special attention to the identification of hotspots with an excessive nutrient load. Seven animals were monitored with smart collars on a dehesa farm located in Cordoba, Spain. Dung deposition was recorded weekly in 90 sampling plots (78.5 m2) distributed throughout the paddock. Grazing behavior and animal distribution were analyzed in relation to several factors, such as terrain slope, insolation or distance to water. Animal presence in sampling plots, expressed as fix, trajectory segment or time counting, was regressed with dung distribution. Cattle showed a preference for flat terrain and areas close to water, with selection indices of 0.30 and 0.46, respectively. The accumulated animal presence during the experimental period explained between 51.9 and 55.4% of the variance of dung distribution, depending on the indicator used, but other factors, such as distance to water, canopy cover or ambient temperature, also had a significant effect on the spatiotemporal dynamics of dung deposition. Regression models, including GPS data, showed determination coefficients up to 82.8% and were able to detect hotspots of dung deposition. These results are the first step in developing a decision support tool aimed at managing the distribution of dung in pastures and its environmental effects.

Increase in C-reactive protein as early predictor of anastomotic leakage in abdominal surgery.

OBJECTIVES: The aim of this study was to evaluate the role of the C-reactive protein (CRP) and white cell count (WC) in the prediction of anastomotic leakage (AL) in major abdominal surgery. METHODS: Multicenter, prospective, and observational study of adult patients who underwent major abdominal surgery. CRP and hemogram were measured after post-operative day (POD) 3 and POD 5. Complications were classified according to the Clavien-Dindo classification. Diagnostic accuracy was evaluated by the area under the receiver operating characteristic curve (AUC). RESULTS: A total of 97 patients were included in the study. The mean age was 63 ± 12 years and 47 (48%) were male. Colorectal (56%) and gastric cancer (36%) were the most frequent diagnoses. About 23% had post-operative complications, of which 5% had AL. The most significant predictive factor was the increase in CRP ≥ 2.84 mg/L among POD 3 and 5 (AUC, 0.99, sensitivity, 95.6%, specificity, 100%, positive likelihood ratio, 23.0). The accuracy of the other biomarkers was lower, CRP on POD 3 (AUC, 0.55), on POD 5 (AUC, 0.93), WC on POD 3 (AUC, 0.33), and POD 5 (AUC, 0.35). CONCLUSION: The increase of CRP among POD 3 and 5 was an early predictor of AL in adult patients with major abdominal surgery.

OBJETIVO: El objetivo de este estudio fue evaluar el papel de la proteína C-reactiva (PCR) y el recuento de glóbulos blancos (RGB) en la predicción de la Fuga Anastomotica (FA) en la cirugía abdominal mayor. MÉTODO: Estudio multicéntrico, prospectivo y observacional de pacientes adultos sometidos a cirugía abdominal mayor. Se midieron la PCR y el hemograma después del día postoperatorio (DPO) 3 y DPO 5. Las complicaciones se categorizaron según la clasificación de Clavien-Dindo y la precisión diagnóstica se evaluó mediante el área bajo la curva (AUC). RESULTADOS: Se incluyeron un total de 97 pacientes. La edad media era de 63 ± 12 años y 47 (48%) eran hombres. El factor predictivo más significativo fue el aumento de la PCR ≥ 2,84 mg/L entre los DPO 3 y 5 (AUC, 0,99, sensibilidad, 95,6%, especificidad, 100%, ratio de probabilidad positiva, 23,0). La precisión de los demás biomarcadores fue menor, la PCR en el DPO 3 (AUC, 0,55), en el DPO5 (AUC, 0,93), el RGB en el DPO 3 (AUC, 0,33) y en el DPO 5 (AUC, 0,35). CONCLUSIONES: El aumento de la PCR entre los DPO 3 y 5 fue un predictor temprano de FA en pacientes adultos con cirugía abdominal mayor.

Loss of Functional SCO2 Attenuates Oxidative Stress in Diabetic Kidney Disease.

Increased oxidative stress in glomerular endothelial cells (GEnCs) contributes to early diabetic kidney disease (DKD). While mitochondrial respiratory complex IV activity is reduced in DKD, it remains unclear whether this is a driver or a consequence of oxidative stress in GEnCs. Synthesis of cytochrome C oxidase 2 (SCO2), a key metallochaperone in the electron transport chain, is critical to the biogenesis and assembly of subunits required for functional respiratory complex IV activity. Here, we investigated the effects of Sco2 hypomorphs (Sco2 KO/KI , Sco2 KI/KI ), with a functional loss of SCO2, in the progression of DKD using a murine model of Type II Diabetes Mellitus, db/db mice. Diabetic Sco2 KO/KI and Sco2 KI/KI hypomorphs exhibited a reduction in complex IV activity, but an improvement in albuminuria, serum creatinine, and histomorphometric evidence of early DKD as compared to db/db mice. Single-nucleus RNA sequencing with gene set enrichment analysis of differentially expressed genes in the endothelial cluster of Sco2 KO/KI ;db/db mice demonstrated an increase in genes involved in VEGF-VEGFR2 signaling and reduced oxidative stress as compared to db/db mice. These data suggest that reduced complex IV activity due to a loss of functional SCO2 might be protective in GEnCs in early DKD.

Loss of Functional SCO2 Attenuates Oxidative Stress in Diabetic Kidney Disease.

Increased oxidative stress in glomerular endothelial cells (GEnCs) contributes to early diabetic kidney disease (DKD). While mitochondrial respiratory complex IV activity is reduced in DKD, it remains unclear whether this is a driver or a consequence of oxidative stress in GEnCs. Synthesis of cytochrome C oxidase 2 (SCO2), a key metallochaperone in the electron transport chain, is critical to the biogenesis and assembly of subunits required for functional respiratory complex IV activity. Here, we investigated the effects of Sco2 hypomorphs (Sco2KO/KI, Sco2KI/KI), with a functional loss of SCO2, in the progression of DKD using a murine model of Type II Diabetes Mellitus, db/db mice. Diabetic Sco2KO/KI and Sco2KI/KI hypomorphs exhibited a reduction in complex IV activity, but an improvement in albuminuria, serum creatinine, and histomorphometric evidence of early DKD as compared to db/db mice. Single-nucleus RNA sequencing with gene set enrichment analysis of differentially expressed genes in the endothelial cluster of Sco2KO/KI;db/db mice demonstrated an increase in genes involved in VEGF-VEGFR2 signaling and reduced oxidative stress as compared to db/db mice. These data suggest that reduced complex IV activity due to a loss of functional SCO2 might be protective in GEnCs in early DKD.

Genetics of the Andean bear (Tremarctos ornatus; Ursidae, Carnivora) in Ecuador: when the Andean Cordilleras are not an Obstacle.

One of the top carnivores in the Andean mountains is the Andean bear (Tremarctos ornatus, Ursidae), the only bear in South America. This is a flagship and key umbrella species in Ecuador because its conservation has a positive impact on the conservation of many other species in the Andes. But to preserve, first one must know the genetic characteristics of a species, among other things. For this, we analyzed six mitochondrial genes and seven nuclear DNA microsatellites of 108 Andean bear specimens sampled throughout Ecuador. We adopted three strategies for analyzing the data: by Province, by Region (north vs south), and by Cordillera. Four main results were obtained. First, the mitochondrial genetic diversity levels were elevated, but there were no differences in genetic diversity by Province or by Cordillera. By Regions, southern Ecuador had higher genetic diversity levels than to northern Ecuador. The genetic diversity for the microsatellites was only medium for the Andean bear at this country. Second, there was clear and significant evidence of female population expansions, for the overall sample, by Province, Region, and Cordillera. This population expansion was determined to have occurred in the time interval of 30,000-20,000 years ago (YA), during the last phase of the Pleistocene. We detected a population decrease to have occurred more recently, within the last 5000 years. It continued until about 300-200 YA when a population increase was again detected. Third, there were, practically, no phylogeographic pattern nor genetic differentiation among Andean bear populations in Ecuador by Province or by Cordillera for either mitochondrial or microsatellite markers. There was a little more genetic differentiation between northern and southern areas. Fourth, there was no trace of significant spatial genetic structure for the Andean bear in Ecuador in agreement with the genetic differentiation analyses. This shows that the Andean Cordilleras in this country did not present an obstacle to the dispersion of this species. Therefore, all of the Andean bear specimens in Ecuador should be treated as a unique Management Unit (MU) for conservation purposes, differently to that determined for other countries as Colombia.

Invalidation of taxa within the silvery wooly monkey (Lagothrix lagothricha poeppigii, Atelidae, Primates).

The systematics of the Humboldt's wooly monkeys (L. lagothricha; Atelidae) is essential to preserve this Neotropical primate species. Traditionally, four morphological subspecies have been described, which recently have been molecularly confirmed. However, no population genetics studies have been carried out throughout the geographical distribution of one of these subspecies, Lagothrix lagothricha poeppigii. For this reason, we analyzed nine mitochondrial genes of L. l. poeppigii mainly collected from the Ecuadorian and Peruvian Amazon in order to better understand the evolutionary history of this taxon. The mitochondrial genetic diversity levels (haplotype and nucleotide diversity) we estimated are likely the highest yet reported for L. lagothricha. Our results did not detect important genetic structure within L. l. poeppigii. Furthermore, our phylogenetic analyses did not detect any relevant molecular cluster in the area where Groves hypothesized the existence of L. poeppigii castelnaui. Therefore, based on these data, castelnaui is not a valid taxon from a molecular perspective. The most differentiated subpopulation within L. l. poeppigii was from Morona-Santiago province (Ecuador) and had a genetic distance of 0.8-1.2% relative to the other subpopulations studied. However, this genetic distance range is within the variability found within a population. We estimated the mitochondrial temporal diversification within L. l. poeppigii to have occurred during the Pleistocene, 1.8-1.2 million years ago. Similarly, all our analyses detected a strong Pleistocene female population expansion for this taxon. Diverse spatial genetic analyses, perhaps with the exception of Monmonier's Algorithm, did not detect differentiated taxa within the area analyzed for L. l. poeppigii. These genetics results could be of importance to conservation efforts to preserve this taxon as one unit.

Paederus dermatitis - A bibliometric analysis of an emerging disease in travelers.

Not available.

Parent-Centered Perspectives on a Validated Asthma Questionnaire in the Emergency Department.

OBJECTIVE: Although national asthma guidelines recommend use of validated questionnaires to improve asthma care, little is known about the extent to which these questionnaires are patient-centered. This qualitative study evaluated parent perceptions of a validated asthma questionnaire. METHODS: We administered the Pediatric Asthma Control and Communication Instrument for the Emergency Department (PACCI-ED) to parents of children 2 to 17 years old presenting to a large urban pediatric ED for asthma care and assessed their perceptions of the tool's utility and acceptability via a structured interview. Responses were recorded, transcribed, and analyzed using a phenomenological approach. RESULTS: Eighty-three parents participated. Qualitative analysis revealed 2 major themes (with 5 subthemes). The first major theme (and 3 subthemes) was that the PACCI-ED facilitated communication with the health care team and caregivers: improving communication 1) with ED providers, 2) in other settings such as schools, and 3) in the primary care setting where the relationship with primary care providers was felt to be variable. The second major theme (and 2 subthemes) was that the PACCI-ED increased parents' capacity to manage their child's asthma: by helping parents understand 1) what symptoms were related to asthma and 2) how those symptoms might change over time. CONCLUSIONS: Parents perceive that the PACCI-ED is acceptable and useful for facilitating communication in the ED and other health care settings, and for building parent capacity to track and manage their child's asthma. A validated structured asthma questionnaire in the ED may facilitate patient-centered asthma care.

Podocyte-Specific Loss of Krüppel-Like Factor 6 Increases Mitochondrial Injury in Diabetic Kidney Disease.

Mitochondrial injury is uniformly observed in several murine models as well as in individuals with diabetic kidney disease (DKD). Although emerging evidence has highlighted the role of key transcriptional regulators in mitochondrial biogenesis, little is known about the regulation of mitochondrial cytochrome c oxidase assembly in the podocyte under diabetic conditions. We recently reported a critical role of the zinc finger Krüppel-like factor 6 (KLF6) in maintaining mitochondrial function and preventing apoptosis in a proteinuric murine model. In this study, we report that podocyte-specific knockdown of Klf6 increased the susceptibility to streptozotocin-induced DKD in the resistant C57BL/6 mouse strain. We observed that the loss of KLF6 in podocytes reduced the expression of synthesis of cytochrome c oxidase 2 with resultant increased mitochondrial injury, leading to activation of the intrinsic apoptotic pathway under diabetic conditions. Conversely, mitochondrial injury and apoptosis were significantly attenuated with overexpression of KLF6 in cultured human podocytes under hyperglycemic conditions. Finally, we observed a significant reduction in glomerular and podocyte-specific expression of KLF6 in human kidney biopsies with progression of DKD. Collectively, these data suggest that podocyte-specific KLF6 is critical to preventing mitochondrial injury and apoptosis under diabetic conditions.

Descripción de la variación en el tiempo del cáncer gastrointestinal en el centro occidente de Colombia / Description of the variation in time of gastrointestinal cancer In Central-Western Colombia

Introducción. A nivel mundial los tumores gastrointestinales tienen un impacto importante en la mortalidad y se asocian a diferentes factores, entre ellos regionales y sociodemográficos. El objetivo de este estudio fue describir la variación en el tiempo del cáncer gastrointestinal en una población del centro occidente de Colombia, dada su alta incidencia y desenlace frecuentemente fatal.Métodos. Se realizó un estudio retrospectivo observacional con muestreo no probabilístico en un tiempo de seis años. Se seleccionaron pacientes diagnosticados con algún tipo de neoplasia del tracto digestivo, en un hospital de tercer nivel del centro occidente de Colombia. Resultados. Se evaluaron un total de 1152 pacientes. Los tumores del tracto digestivo superior (esófago, unión esófago-gástrica y estómago) fueron los más frecuentes (44 %), seguidos de los tumores del tracto digestivo medio e inferior (intestino delgado, colon, recto y ano; 31 %) y de los tumores hepato-bilio-pancreáticos (25 %). La edad media de presentación fue 64,6 años, con una mayor frecuencia en el sexo masculino (51,6 %). El adenocarcinoma fue el tipo histológico más común.Conclusión. Los resultados de este estudio muestran que los tumores gastrointestinales son una neoplasia frecuente en nuestro país, siendo los tumores gástricos los que se presentan con mayor prevalencia, seguidos de los tumores colorrectales y las neoplasias biliopancreáticas, las cuales se mantiene en el tiempo.

Introduction. Worldwide, gastrointestinal tumors have a significant impact on mortality and are associated with different factors, including regional and sociodemographics. The objective of this study was to describe the variation over time of gastrointestinal cancer in a population from Central-Western Colombia, given its high incidence and frequently fatal outcome. Methods. An observational retrospective study with non-probabilistic sampling was carried out over a period of six years. Patients diagnosed with some type of neoplasm of the digestive tract were selected in a tertiary care hospital in the Central-Western Colombia. Results. A total of 1152 patients were evaluated. Tumors of the upper digestive tract (esophagus, esophagogastric junction, and stomach) were the most frequent (44%), followed by tumors of the middle and lower digestive tract (small intestine, colon, rectum and anus; 31%), and hepatobiliary-pancreatic tumors (25%). The mean age of presentation was 64.6 years with a higher frequency in males (51.6%). Adenocarcinoma was the most common histological type.Conclusion. The results of this study show that gastrointestinal tumors are a frequent neoplasm in our country, with gastric tumors being the most prevalent, followed by colorectal tumors and biliopancreatic neoplasms, which are maintained over time.

Estrategias de intervención Comunitaria en Salud en un Campamento Universitario Multidisciplinario de Investigación y Servicio / Health's Community intervention strategies in a Multidisciplinary Research and Service´s University Camp

Introducción: La atención primaria en salud busca una mejor salud en la población, que sea accesible a todos los individuos y familias de la comunidad, con su plena participación y a un costo asequible, mediante diferentes mecanismos dentro de las cuales están las intervenciones comunitarias. Objetivos: Describir los resultados obtenidos tras la intervención a través de consultas y visitas domiciliarias como estrategias para la identificación, tamizaje, promoción y prevención en salud. Métodos: Se creó una brigada de salud bajo el emblema de Misión Médica en Santa Cecilia, corregimiento del municipio Pueblo Rico, Risaralda, Colombia. Se realizaron actividades de información, educación, acercamiento y atención en salud para la población general de la localidad y veredas aledañas. Se efectuaron valoraciones médicas, se diligenciaron historias clínicas y se evaluó la percepción de la actividad por los miembros de la comunidad y por el personal de la salud. Se contó con el apoyo y aprobación departamental y local. Resultados: Se realizaron 606 historias clínicas, 63,9 por ciento era población menor de edad, 55,6 por ciento eran de sexo femenino. Las enfermedades de mayor prevalencia en la población intervenida fueron patologías infecciosas como parasitosis, neumonía y enfermedades transmitidas por vectores. Conclusiones: Las intervenciones primarias en salud son difíciles de realizar, requieren apoyo de equipos multidisciplinarios e instituciones para generar impacto positivo en las comunidades, es importante realizar mayor número de intervenciones comunitarias con participación estatal y de la comunidad, utilizando estrategias científicas de evaluación con el fin de establecer más objetivamente los resultados de las intervenciones(AU)

Introduction: Primary health care looks for better health indicators in the population, to be accessible to all individuals and families in the community, with their full participation and at an affordable cost, through different mechanisms, among which are the community interventions. Objectives: To describe the results obtained after the intervention through consultations and home visits as strategies for identification, screening, health promotion and prevention. Methods: A health brigade was created under the emblem of Medical Mission in Santa Cecilia, Pueblo Rico municipality, Risaralda, Colombia. Information, education, outreach and health care activities were performed for the general population of the town and surrounding districts. Medical assessments were made, and the clinical histories were used to evaluate perception of the activity done by the community members and the health staff. There was local and departmental support and approval. Results: 606 clinical histories were made. The 63.9 percent were children and 55.6 percent were female. The predominant diseases in the population under the intervention were infectious ones as: parasitic infections, pneumonia and vector-borne diseases. Conclusions: The primary interventions in health are difficult to perform as they require support of multidisciplinary teams and institutions to generate a positive impact on communities. It is important to perform a greater number of community-based interventions with state and community participation, using scientific strategies of evaluation in order to establish more objectively the results of the interventions(AU)

Taller de salud mental: programa psicoeducativo dirigido a comunidad de adultos jubilados de una institución de gendarmería / Mental health workshop: psychoeducative program to a retired people in a gendarmerie institution

El grupo objetivo al cual está dirigido el presente programa psicoeducativo de salud mental corresponde a una comunidad de adultos mayores jubilados de Gendarmería de Chile. Mediante la generación de un diagnóstico participativo por parte de los integrantes de la comunidad, se constató la necesidad de desarrollar herramientas para la superación de problemas de la vida, lo que se enmarca en la promoción de la resiliencia. La realización del taller de salud mental constó de once sesiones. Primero, se abarcaron los cambios fisiológicos y patológicos del envejecimiento, para luego trabajar en conjunto la resiliencia en la adultez. Al inicio de las sesiones educativas, se aplicó la escala de resiliencia de SV-RES 60 de Saavedra y Villalta (2008), validada en nuestro país, con el fin de conocer los niveles basales de resiliencia. Luego de finalizadas las intervenciones, se realizó una nueva toma, para así poder evaluar el impacto de estas en los participantes. Se constató un aumento del nivel de resiliencia desde un 49.8% a un 75.1%, lo que se traduce en un ascenso desde un nivel promedio a un nivel alto, evidenciando la efectividad de la metodología aplicada.

The target group for this psychoeducative program in mental health is a community of elderly retired Gendarmerie of Chile. Through a participatory diagnosis with the participants, it could be possible to identify necessities about working and creating tools to resolve problems of life, in the framework of the resiliency. This workshop in mental health takes eleven sessions. At the first time, it includes physiological and pathological changes in the aging, and in the second part, the program includes working together in the resiliency. At the beginning of the sessions, it was applicated the Saavedra and Villata's resiliency scale SV-RES 60, which is validated in Chile, with the objective to know the baseline of resiliency of the group. When the workshop was finished, it was taken in a second opportunity the same scale to evaluate the impact of the sessions in the participants. It was verified an increment of the resiliency levels since the first time with a 49,8%, to a 75,1% in the finish, which it could be traduced in a increase to an average level of resiliency to a high level of resiliency, making evident the effectiveness of the methodology.

Factores que arriesgan las necesidades de autocuidado universal en los adultos mayores del programa de ayuda intrafamiliar del Hogar de Cristo del área Metropolitana / Factors that affect universal self-care needs of aged adults at the intrafamily aid programme of the Hogar de Cristo

El envejecimiento de la población en Chile es uno de los acontecimientos sociales y demográficos más relevantes de las últimas décadas. El objetivo de esta investigación es conocer cuales son los factores que arriesgan la satisfacción de las necesidades de autocuidado universal de los adultos mayores autovalentes, que pertenecen al Programa de Ayuda Intrafamiliar del Hogar de Cristo de la región Metropolitana. Para recoger la información se diseñó una encuesta basada en factores de riesgo para la conservación de la autonomía funcional de los adultos mayores y en las necesidades de autocuidado universal, de acuerdo al Modelo de autocuidado en Enfermería de Dorothea Orem. Esta encuesta fue aplicada en el domicilio de los adultos mayores seleccionados. Las principales necesidades de autocuidado que resultaron en riesgo para su satisfacción son la alimentación, liquido, reposo y sueño, interacción social y la prevención de peligros para la vida y el bienestar. Entre los factores que arriesgan estas necesidades en los adultos mayores están el consumir una dieta poco balanceada en cantidad y calidad, influido principalmente por el bajo nivel socioeconómico de las población; escasa ingesta de liquido al día; presentar insomnio, lo que conlleva al consumo de medicamentos para dormir; la no participación a club o grupos de adultos mayores, lo que fomenta el aislamiento social; finalmente presentaron problemas con el riesgo de caídas en el adulto mayor y el no uso de prótesis dental. Es importante destacar que ninguno de los adultos mayores del estudio tenían sus necesidades de autocuidado universal satisfechas. Para enfermería sería importante realizar un control par supervisar el estado de salud por lo menos dos veces al año, con el fin de identificar riesgos o elteraciones de la salud e implementar estrategias de intervención para revertirlos y por tanto mejorar la calidad de vida