Region specific galanin receptor/neuropeptide Y Y1 receptor interactions in the tel- and diencephalon of the rat. Relevance for food consumption.

The aim of this work was to determine the interactions between NPY and GAL receptor (GALR) subtypes in the hypothalamus and the amygdala using quantitative receptor autoradiography to analyze the binding characteristics of NPY-Y1 and Y2 receptor subtypes in the presence and absence of GAL. Food intake in satiated animals was evaluated after intraventricular co-injections of GAL and NPY-Y1 or Y2 agonists. The expression of c-Fos IR in both regions was also investigated. GAL decreases NPY-Y1 agonist binding in the arcuate nucleus by about 15% (p<0.01), but increases NPY-Y1 agonist binding in amygdala (18%) (p<0.01). These effects were blocked with the GAL antagonist M35. Y2-agonist binding was not modified by GAL. GAL blocked the food intake induced by the Y1 agonist (p<0.01). Co-injections of Y1 agonist and GAL also reduced the c-Fos expression induced by the Y1 agonist in the arcuate nucleus and the dorsomedial hypothalamic nucleus but increased c-Fos expression in amygdala. These results indicate the existence of antagonistic interactions between GALR and NPY-Y1 receptors in the hypothalamus and their functional relevance for food intake. In contrast, a facilitatory interaction between GALR and Y1 receptors exists in the amygdala which may be of relevance for fear related behaviour.

Galanin/alpha2-adrenoceptor interactions in telencephalic and diencephalic regions of the rat.

The aim of this study was to evaluate whether galanin could affect central alpha2-adrenoceptors in telencephalic and diencephalic regions in the rat using quantitative receptor autoradiography with the alpha2 agonist radioligand [3H]p-aminoclonidine. Galanin 1 nM significantly and substantially increased the Kd value of the [3H]p-aminoclonidine binding sites in the medial hypothalamus and amygdala by 86% (p < 0.01) and 73% (p < 0.05) respectively. The Bmax value was only significantly increased with 3 nM galanin in the amygdala and the medial hypothalamus (both p < 0.05). The antagonist M35 counteracted the increase of the Kd values of the alpha2-adrenoceptor agonist binding sites produced by galanin 1 nM in the amygdala and the medial hypothalamus (both p < 0.001). These findings suggest the existence of an antagonistic galanin/alpha2 adrenoceptor interaction in the medial hypothalamus and amygdala that may be of relevance for alpha2-adrenoceptor-regulated neuroendocrine functions and food intake.

[Prescription and costs of artificial nutrition before and after a new utilization protocol]. / Prescripción y costes de nutrición artificial antes y después de un nuevo protocolo de utilización.

In order to improve the quality of prescription and reduce expenditure, the artificial nutrition department has designed a new usage protocol: justification sheet, table of indications for parenteral nutrition (PN), nutritional assessment, etc. The Pharmacy Department is in charge of the follow-up of this programme and maintaining the database derived from it. Comparing the data for the year before (1996) and after (1998) implementation of this programme, we can see that as a result 9 patients/day switched from total parenteral nutrition by central administration to hypocaloric peripheral nutrition, with the prevalence of the former dropping to 1.4% of admissions and 2% of stays. The share of enteral nutrition (30.6%) and hypocaloric peripheral nutrition (27.8%) increases in the overall expenditure on artificial nutrition, with a reduction in the total parenteral nutrition (41.6%). The costs of parenteral nutrition per admission and stay are reduced by 39.3% and 33.5%, respectively, to 1,625 and 183 pesetas. This represents a saving of 16.5 million pesetas. The expenditure on PN elements declines by two percentage points to 2.2% of pharmaceutical expenditure. As an additional benefit, it is possible to identify each of the clinical situations which give rise to this indication and to allocate costs by diagnosis and department. Together with the containment of expenditure, it has been possible to increase the participation of everyone in the rational use of clinical nutrition thus highlighting its interdisciplinary nature.

Prescripción y costes de nutrición artificial antes y después de un nuevo protocolo de utilización / Prescription and costs of artificial nutrition before and after a new usage protocol

Para mejorar la calidad en la prescripción y disminuir el gasto, la comisión de nutrición artificial diseña un nuevo protocolo de utilización: hoja de justificación, tabla de indicaciones para nutrición parenteral (NP), valoración nutricional, etc. El Servicio de Farmacia se encarga del seguimiento del mismo y del mantenimiento de la base de datos que de ello se deriva. Comparando los datos de los años anterior (1996) y posterior (1998) al de la implantación de este programa, vemos como resultado que 9 pacientes/día pasaron de nutrición parenteral total vía central a periférica hipocalórica, reduciendo la prevalencia de aquélla hasta el 1,4 por ciento de los ingresos y el 2 por ciento de las estancias. Aumenta la participación de la nutrición entera¡ (30,6 por ciento) y periférica hipocalórica (27,8 por ciento) en el gasto global de nutrición artificial, reduciendo la de nutrición parenteral total (41,6 por ciento).Los costes de nutrición parenteral por ingreso y por estancia se reducen en un 39,3 por ciento y 33,5 por ciento respectivamente, situándose en 1.625 y 183 pesetas. Esto se traduce en un ahorro de 16,5 millones de pesetas. El gasto en componentes de NP baja dos puntos, situándose en el 2,2 por ciento del gasto farmacéutico. Como beneficio adicional nos permite conocer cada una de las situaciones clínicas que son objeto de indicación e imputar costes por diagnóstico y servicio. Junto a la contención del gasto, se consigue elevar la participación de todos en el uso racional de la nutrición clínica, poniendo de manifiesto su carácter interdisciplinar (AU)

In order to improve the quality of prescription and reduce expenditure, the artificial nutrition department has designed a new usage protocol: justification sheet, table of indications for parenteral nutrition (PN), nutritional assessment, etc. The Pharmacy Department is in charge of the follow-up of this programme and maintaining the database derived from it. Comparing the data for the year before (1996) and after (1998) implementation of this programme, we can see that as a result 9 patients/day switched from total parenteral nutrition by central administration to hypo-caloric peripheral nutrition, with the prevalence of the former dropping to 1.4% of admissions and 2% of stays. The share of enteral nutrition (30.6%) and hypocaloric peripheral nutrition (27.8%) increases in the overall expenditure on artificial nutrition, with a reduction in the total parenteral nutrition (41.6%). The costs of parenteral nutrition per admission and stay are reduced by 39.3% and 33.5%, respectively, to 1,625 and 183 pesetas. This represents a saving of 16.5 million pesetas. The expenditure on PN elements declines by two percentage points to 2.2% of pharmaceutical expenditure. As an additional benefit, it is possible to identify each of the clinical situations which give rise to this indication and to allocate costs by diagnosis and department. Together with the containment of expenditure, it has been possible to increase the participation of everyone in the rational use of clinical nutrition thus highlighting its interdisciplinary nature (AU)