RESUMEN
Access to and reducing disparities in oral health for older adults is a complex problem that requires innovative strategies. In addition to offering dental services in alternative settings, such as senior centers, places that are familiar to older adults, and where physical limitations can be better accommodated, alternatives to the traditional provider should be considered. Many states are changing laws and practice acts to allow dental hygienists to provide preventive services without the supervision of a dentist. Also, collaborations between dental and non-dental professionals can be a successful strategy for increasing access to oral health care for this high-risk population.
Asunto(s)
Atención a la Salud/organización & administración , Cuidado Dental para Ancianos/organización & administración , Anciano , Higienistas Dentales/educación , Educación en Odontología , Instituciones de Salud , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Humanos , Grupo de Atención al Paciente , Atención Primaria de SaludRESUMEN
It has been demonstrated by numerous studies that apoptotic cell death pathways are implicated in ischemic cerebral injury in ischemia models in vivo. Experimental ischemia and reperfusion models, such as transient focal/global ischemia in rodents, have been thoroughly studied and the numerous reports suggest the involvement of cell survival/death signaling pathways in the pathogenesis of apoptotic cell death in ischemic lesions. In these models, reoxygenation during reperfusion provides oxygen as a substrate for numerous enzymatic oxidation reactions and for mitochondrial oxidative phosphorylation to produce adenosine triphosphate. Oxygen radicals, the products of these biochemical and physiological reactions, are known to damage cellular lipids, proteins, and nucleic acids and to initiate cell signaling pathways after cerebral ischemia. Genetic manipulation of intrinsic antioxidants and factors in the signaling pathways has provided substantial understanding of the mechanisms involved in cell death/survival signaling pathways and the role of oxygen radicals in ischemic cerebral injury. Future studies of these pathways could provide novel therapeutic strategies in clinical stroke.