Sex-dependent effects of monomeric α-synuclein on calcium and cell death of lateral hypothalamic mouse neurons are altered by orexin.

Parkinson's Disease (PD) patients experience sleeping disorders in addition to the disease-defining symptomology of movement dysfunctions. The prevalence of PD is sex-based and presence of sleeping disorders in PD also shows sex bias with a stronger phenotype in males. In addition to loss of dopamine-containing neurons in the striatum, arousal-related, orexin-containing neurons in the lateral hypothalamus (LH) are lost in PD, which could contribute to state-related disorders. As orexin has been shown to be involved in sleeping disorders and to have neuroprotective effects, we asked whether orexin could protect sleep-related LH neurons from damage putatively from the protein α-synuclein (α-syn), which is found at high levels in the PD brain and that we have shown is associated with putatively excitotoxic rises in intracellular calcium in brainstem sleep-controlling nuclei, especially in males. Accordingly, we monitored intracellular calcium transients induced by α-syn and whether concurrent exposure to orexin affected those transients in LH cells of the mouse brain slice using calcium imaging. Further, we used an assay of cell death to determine whether LH cell viability was influenced when α-syn and orexin were co-applied when compared to exposure to α-syn alone. We found that excitatory calcium events induced by α-syn were reduced in amplitude and frequency when orexin was co-applied, and when data were evaluated by sex, this effect was found to be greater in females. In addition, α-syn exposure was associated with cell death that was higher in males, and interestingly, reduced cell death was noted when orexin was present, which did not show a sex bias. We interpret our findings to indicate that orexin is protective to α-syn-mediated damage to hypothalamic neurons, and the actions of orexin on α-syn-induced cellular effects differ between sexes, which could underlie sex-based differences in sleeping disorders in PD.

¿Medicina: arte o ciencia? Una reflexión sobre las artes en la educación médica / Medicine: art or science? A reflection about the arts in medical education

La situación de los sistemas de salud en el mundo es crítica, sin embargo, dentro de este panorama la educación médica aporta estrategias que permiten generar cambios. Se plantea una reflexión en torno a la importancia de complementar la formación del estudiante de medicina con el desarrollo de habilidades de tipo humanístico. ¿Permitiría lo anterior ejecutar un ejercicio clínico con juicio y raciocinio, sin dejar de lado el componente de servicio, amabilidad, cordialidad, escucha y fraternidad? Este artículo intenta responder esta inquietud, reflexionando sobre algunas situaciones que condicionan la formación médica, y expone numerosos ejemplos de médicos de diferentes periodos de la historia y latitudes (Europa, Asia y América) que han complementado de forma exitosa el ejercicio de su profesión y la ejecución de artes como literatura, pintura y teatro, entre otras. Entre ellos se destacan Albert Schweitzer, de nacionalidad alemana, ganador del Premio Nobel de la Paz en 1952 y Jorge Drexler, uruguayo, Premio Oscar de la Academia de las Artes y las Ciencias Cinematográficas de los Estados Unidos, a la Mejor Banda Sonora en 2005. Finalmente se plantea la consideración de contar con espacios académicos y extracadémicos que beneficien la formación médica complementada con habilidades artísticas y humanísticas

The situation of health systems in the world is critical. However, in this scenario it is important that education can provide strategies to generate a change. Reflection regarding the training of the medical student must be complemented by the development of people skills, such as communication, the ability to understand others, etc. This could help in the development of clinical judgment and reasoning exercises, without neglecting the human components of kindness, warmth, listening, and fraternity. This article attempts to answer these concerns, reflecting on some situations that affect medical training, and sets out numerous examples of doctors from different periods of history and countries (Europe, Asia and America) who have successfully exercised their profession, as well as in the performing arts, including literature, painting and theatre. Among them can be included, Albert Schweitzer, German national, winner of the Nobel Peace Prize in 1952, and Jorge Drexler, aN Uruguayan who won an Oscar of the Academy of Motion Picture Arts and Sciences of the United States for best soundtrack in 2005. Finally, it should be considered having academic and extra-academic spaces that benefit medical training, complemented by artistic and humanistic skills

Investigación en el pre grado de medicina: una experiencia universitaria formativa / Research in the medicine undergraduate program: an educational university experience / Pesquisa em graduação de medicina: uma experiência universidataria educacional

Introducción: En nuestro país existe una figura denominada semillero de investigación como una herramienta de promoción de la formación integral de los estudiantes, que tiene el objetivo de promover nuevo talento en áreas investigativas que permita la generación de nuevo conocimiento. En consecuencia, el Departamento Administrativo de Ciencia, Tecnología e Innovación (Colciencias) y las universidades del país han creado múltiples estrategias para potenciar habilidades investigativas en sus estudiantes. Objetivo: Reflexionar acerca de la importancia de la investigación en el pregrado mediante la estrategia pedagógica de los semilleros de investigación en áreas de la salud. Reflexión: Esta estrategia permite mejorar la formación del estudiante y hacerlo competitivo en el contexto nacional e internacional. Sin embargo, estos esfuerzos no son suficientes pues se carece de recursos económicos, planes curriculares flexibles y docentes capacitados en investigación; todos estos factores, sumados al insuficiente interés de los estudiantes, convierten la tarea en un objetivo difícil de lograr. Conclusión: Los semilleros de investigación forman personas en trabajo colaborativo y desarrollan destrezas que permiten la formación integral de los estudiantes.

Introduction: In our country there is a figure called hotbed of research as a tool to encourage the comprehensive training of students, which aims to promote new talent in investigative areas that allow the generation of new knowledge. Additionally, the Administrative Department of Science, Technology and Innovation (Colciencias) and Colombian universities have created multiple strategies to enhance research skills in their students. Objective: To reflect on the importance of research in undergraduate programs by using the hotbed of research teaching strategy in health areas. Reflection: This strategy allows improving students' training and making it more competitive at national and international level. However, these efforts are not enough because it lacks sufficient financial resources, flexible curricula and teachers trained in research; all these factors, along with deficient student interest, transform the task into a difficult goal to achieve. Conclusion: Hotbeds of research educate people in collaborative work, and also develop skills that allow the comprehensive training of students.

Introdução: Na Colômbia existe uma tipo de grupo de estudantes chamado “semillero=sementeira” de pesquisa como uma ferramenta para promover a formação integral dos alunos, que visa promover novos talentos nas áreas da pesquisa com o objetivo de gerar novos conhecimentos. Além disso, o Departamento Administrativo de Ciência, Tecnologia e Inovação (Colciencias) e as universidades do país criaram várias estratégias para melhorar as habilidades de pesquisa em seus alunos. Objetivo: refletir sobre a importância da pesquisa com estudantes na graduação como uma estratégia pedagógica do ensino superior, no campo da saúde. Reflexão: Esta estratégia permite melhorar a formação dos alunos e torná-la competitiva a nível nacional e internacional. No entanto, estes esforços não são suficientes porque não conta com recursos financeiros suficientes, currículos flexíveis e professores treinados em pesquisa; todos esses fatores, mais o insuficiente interesse dos alunos, fazem com que o objetivo seja difícil de alcançar. Conclusão: Os grupos de pesquisa com estudantes formam as pessoas no trabalho colaborativo e desenvolvem habilidades que permitem a formação integral dos alunos.

El humor como estrategia terapéutica en niños hospitalizados en unidades pediátricas en Pereira (Colombia) Reporte de una experiencia / Humor as a Strategy to Treat Children Hospitalized in Pediatric Units in Pereira (Colombia): Report of an Experience

Introducción : Los pacientes pediátricos son especialmente susceptibles al estrés. De ahí que el humor se use como estrategia en muchos hospitales en el mundo para disminuir el estrés durante la hospitalización, especialmente en los niños. Métodos : Se realizaron intervenciones periódicas en las unidades intermedias de Kennedy y Cuba de la ESE Salud Pereira, que inicialmente se basaron en el cambio del ambiente hospitalario: la decoración de las salas y los implementos utilizados por el personal de salud. Los grupos de voluntarios fueron entrenados en técnicas de clown , construcción de personajes y juego personalizado. Resultados : Se realizaron 108 intervenciones, con un promedio de 12 por mes, en un período de 9 meses, en las cuales se trabajó con 648 niños, con una relación de 72 niños por mes; sus edades fl uctuaron entre los 2 meses y los 14 años. Se destaca el impacto favorable en el ambiente hospitalario y en la sensación subjetiva de un mayor bienestar por parte de pacientes, familiares de pacientes y personal de salud, además del interés y la necesidad de llevar a cabo estudios que utilicen marcadores biológicos de estrés para valorar el impacto en los pacientes pediátricos hospitalizados de este tipo de programas. Discusión y conclusiones : Los resultados cualitativos de esta intervención fueron los esperados y la valoración subjetiva del personal de salud, de los pacientes y de sus familiares fueron satisfactorias en cuanto al logro de este objetivo. Esta experiencia suma argumentos para la discusión acerca de la necesidad de implementar programas de este tipo en las instituciones de salud y la inclusión de formación acerca de terapia del humor en los currículos de las carreras de las áreas de la salud.

Introduction : Pediatric patients are specially susceptible to stress. Humor has been used in many hospitals around the world as a strategy to decrease stress levels during hospitalization, specially in children. Methods : Periodic interventions were made in two intermediatecare pediatric units in a public hospital in Pereira, Colombia. The initial intervention was based on changes of the hospital environment by modifying the decoration of wards and implements used by the health workers. The groups, made up of volunteers, were trained in clown techniques, construction of characters, and personalized games . Results : 108 in-terventions were made in a period of 9 months with a mean of 12 interventions per month, during which the group worked with 648 children (72 children per month with 6 children per intervention), with ages between 2 months and 14 years. The favorable impact in hospital environment and the subjective sensation of welfare in the patients, their families and the health personnel is worth noting. Discussion and conclusions : The qualitative results of this intervention were as expected. The subjective opinion of health workers, patients and their families was satisfactory. This experience adds arguments to the discussion about the need to implement programs like this one in health institutions and to include laughter therapy in the curricula of health educational programs.