ABSTRACT
La evaluación de las tecnologías tiene una serie de definiciones que terminan precisando de un análisis multidisciplinario que sirven para tomar decisiones. La evolución de la evaluación de tecnologías sanitarias se manifiesta a través de la Oficina de evaluación de tecnologías del congreso de Estados Unidos, la sociedad internacional para la evaluación de tecnologías en salud, la red internacional de agencias de evaluación de tecnologías en salud y las distintas organizaciones mundiales y regionales que siguen impulsando su desarrollo en el mundo y la Región Latinoamericana. La evaluación de las tecnologías sanitarias es una herramienta para la toma de decisiones que, según el apoyo político, que reciba, su crecimiento está asegurado(AU)
The technology assessment has a number of definitions that require a multidisciplinary analysis for decision-making. The evolution of the health technology assessment becomes evident through the Office of Technology Assessment of the US Congress, the International Society for Health Technology Assessment, the international network of health technology assessment and the global and regional organizations that continue to drive its development agencies and the various regional and world organizations that continue advancing its development in Latin America and the world. The health technology assessment is a tool for decision-making and, depending on the political support, its growth is assured(AU)
Subject(s)
Technology Assessment, Biomedical/standards , Latin AmericaABSTRACT
The mechanism of anticonvulsant action of topiramate includes inhibition of glutamate-activated ion channels. The evidence is most convincing for direct inhibitory action at the ionotropic AMPA (alpha-Amino-3-hydroxy-5-methylisoxazole-4-propionic acid) and kainate ((2S,3S,4S)-3-(Carboxymethyl)-4-prop-1-en-2-ylpyrrolidine-2-carboxylic acid) glutamate receptor subtypes. Less direct connection has been made to the NMDA (N-Methyl-d-aspartate) subtype. In the present study, we demonstrate that NMDA and AMPA produce concentration-dependent seizure-like activity in planarians, a type of flatworm which possesses mammalian-like neurotransmitters. In contrast, planarians exposed to the inhibitory amino acid, glycine, did not display pSLA. For combination experiments, topiramate significantly reduced planarian seizure-like activity (pSLA) produced by NMDA or AMPA. Additionally, NMDA-induced pSLA was antagonized by either an NMDA receptor antagonist (MK-801) or AMPA receptor antagonist (DNQX), thus suggesting that NMDA-induced pSLA was mediated by NMDA and non-NMDA receptors. The present results provide pharmacologic evidence of a functional inhibitory action of topiramate on glutamate receptor activity in invertebrates and provide a sensitive, quantifiable end-point for studying anti-seizure pharmacology.
