RESUMO
Estimado Editor: Consciente o inconscientemente los profesionales de la salud actúan de acuerdo a un modelo de relación atención de la salud-usuarios de los servicios de salud. Se opta por este término sobre el de relación médico-paciente, pues contempla la complejidad de la relación y de las dos realidades que interactúan.1 Generalmente, adoptan el modelo que han aprendido a lo largo de su formación, habitualmente el modelo biomédico que, además, consideran más vanguardista. El problema del enfoque biomédico de la atención radica en su simplificación de los problemas de salud, promoviendo una forma de relación con los usuarios fría e incompleta. A manera de ejemplo, en 2007 en México, el entonces presidente de la Republica Felipe de Jesús Calderón Hinojosa declara la guerra al narcotráfico. Desde su perspectiva la solución era clara, muerto el perro, terminada la rabia. No obstante, esta es una respuesta sencilla para un problema complejo. Si no se entienden los determinantes estructurales responsables del narcotráfico en México, lo único que se logra con esta estrategia es inaugurar una fábrica de muertes prevenibles, principalmente de hombres jóvenes.2 Con esto, se pretende ilustrar el riesgo de simplificar los problemas, al tiempo que se resalta la importancia de entender los fenómenos en toda su extensión para poder proponer soluciones complejas y correctas a problemas complejos. Ciertamente, la pandemia...(AU)
Assuntos
Humanos , Masculino , Feminino , Relações Médico-Paciente/ética , Doença Crônica/epidemiologia , Cuidados Médicos/ética , COVID-19/epidemiologia , MéxicoRESUMO
The medial prefrontal cortex (mPFC) has reciprocal projections with many cerebral structures that are crucial in the control of food ingestion behavior and reward processing; Thus the mPFC has an important function in taste memory recognition. Previous results indicate that long-term consumption of sugar produces changes in appetitive re-learning and suggest that this could trigger an escalating consumption due to the inability to learn new negative consequences related to the same taste. Further evidence suggests that general identity reward value could be encoded in the mPFC. Therefore, the purpose of this study was to evaluate in rats whether after 21 days of sugar consumption the increase in sweet taste preference and latent inhibition of conditioned taste aversion (CTA) were affected differentially by pharmacological activation or blockage of dopaminergic and ß-adrenergic receptors, in the mPFC, during CTA acquisition. Results showed that after long-term sugar exposure, mPFC activation of ß-adrenergic receptors with clenbuterol delayed aversive memory extinction, but the blockade with propranolol or activation of dopaminergic receptors with apomorphine increased CTA latent inhibition and accelerated aversive memory extinction only after acute sugar exposure. Only dopaminergic blockade with haloperidol prevented sweet taste preference expression after long-term sugar consumption, increased CTA latent inhibition and accelerated extinction after acute sugar exposure. Taken together, the present data provide evidence that catecholaminergic receptors in the mPFC after prolonged sugar consumption underwent functional changes related to re-learning and new aversive taste learning.
Assuntos
Aprendizagem da Esquiva/efeitos dos fármacos , Memória/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , Açúcares/efeitos adversos , Animais , Córtex Cerebral/fisiologia , Condicionamento Clássico/fisiologia , Extinção Psicológica/efeitos dos fármacos , Masculino , Memória/fisiologia , Córtex Pré-Frontal/fisiologia , Propranolol/farmacologia , Ratos Wistar , Paladar/efeitos dos fármacos , TempoRESUMO
Since the pioneering work of Gadea-Ciria (Gadea-Ciria M, Stadler H, Lloyd KG, Bartholini G. Acetylcholine release within the cat striatum during the sleep-wakefulness cycle. Nature 1973; 243:518-519) indicating pointing to the involvement of acetylcholine and basal ganglia in sleep regulation; extensive literature has suggested that this brain complex participates in the control of the sleep-waking cycle (SWC). On the other hand, it has been demonstrated that the endocannabinoid system (eCBS) is prominently involved in the regulation of the SWC, mood and its related disorders. Since cannabinoid receptor 1 (CB1R) is highly expressed in basal ganglia, in particular in the entopeduncular nucleus (EP), we believe that it is important to know what the role of the EP CB1R is on SWC, depression, and anxiety. To provide insight into the role of the EP CB1R in the regulation of wakefulness (W), non-rapid eye movement sleep (NREMs) and rapid eye movement sleep (REMs), rats were recorded for 24h immediately after a single intra-EP administration of N-arachidonoylethanolamine (AEA) or 1-(2,4-dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-(1-piperidyl)pyrazole-3-carboxamide (AM251; CB1 inverse agonist). Likewise, the effect of these drugs on anxiety and depression was tested by means of the elevated plus maze (EPM) and forced swim test (FST), respectively. Results demonstrate that AEA increases NREMs expression, while AM251 increases W and decreases both NREMs and REMs. In addition, administration of AM251 decreases the time rats spent in the open arms and increases immobility time in the FST. It seems that activation of the CB1R in the EP is important to induce sleep, while its blockade promotes W, as well as anxiety and depression, somewhat resembling insomnia in humans. These results suggest that the EP CB1R is modulating sleep and mood.
Assuntos
Afeto/fisiologia , Endocanabinoides/fisiologia , Núcleo Entopeduncular/fisiologia , Sono/fisiologia , Vigília/fisiologia , Afeto/efeitos dos fármacos , Animais , Ácidos Araquidônicos , Agonistas de Receptores de Canabinoides/administração & dosagem , Agonistas de Receptores de Canabinoides/farmacologia , Endocanabinoides/administração & dosagem , Endocanabinoides/farmacologia , Núcleo Entopeduncular/efeitos dos fármacos , Resposta de Imobilidade Tônica/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Microinjeções , Piperidinas/administração & dosagem , Piperidinas/farmacologia , Alcamidas Poli-Insaturadas , Pirazóis/administração & dosagem , Pirazóis/farmacologia , Ratos , Receptor CB1 de Canabinoide/antagonistas & inibidores , Receptor CB1 de Canabinoide/fisiologia , Teste de Desempenho do Rota-Rod , Sono/efeitos dos fármacos , Fases do Sono/efeitos dos fármacos , Vigília/efeitos dos fármacosRESUMO
Alcohol use disorder is a compulsive behavior driven by motivational systems and by a poor control of consummatory behavior. The entopeduncular nucleus (EP) seems to be involved in the regulation of executive mechanisms, hence, in the expression of behavior. Endocannabinoids (eCB) are involved in alcohol intake mechanisms. The eCB receptor name cannabinoid receptor 1 (CB1R) is expressed in the EP in GABAergic terminals. The role of the eCB system (eCBs) of the EP in the modulation of alcohol seeking and intake behavior is unknown. Therefore, we decided to investigate the role of the eCBs and its interaction with GABA transmission in rat EP, in the regulation of alcohol intake behavior. Rats were submitted to a 10-day period of moderate alcohol (10% in tap water) ingestion. No tap water was available. On day 11, either anandamide (AEA, CB1 receptor agonist), AM251 (CB1R inverse agonist), baclofen (BAC, GABAB receptor agonist), or CGP35348 (GABAB receptor antagonist) was administered into the EP. One bottle of water and one of alcohol (10% in water) were available ad libitum for the following 24 h, and consumption was quantified at the end of this period. Results show that administration of AEA into the EP decreased alcohol consumption while AM251 and BAC administered independently increased alcohol consumption. AEA prevented the increase induced by AM251 or BAC. Likewise, CGP35348 prevented alcohol ingestion induced by AM251. These data suggest that eCBs dysfunction in the EP may be playing a crucial role in the abuse and dependence of alcohol and other drugs.