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RESUMEN Objetivo Caracterizar los determinantes intermedios de la salud en consumidores de sustancias psicoactivas (SPA) reincidentes que están siendo atendidos en un centro de rehabilitación (UNIPSSAM IPS) de la ciudad de Valledupar, Colombia, durante 2021. Métodos Investigación descriptiva de corte transversal. La muestra estuvo constituida por 21 personas reincidentes en el consumo de sustancias psicoactivas que asisten a un centro de rehabilitación de Valledupar, quienes, previo consentimiento informado, diligenciaron el instrumento de recolección de datos. La información fue procesada en SPSS y resumida en tablas uni y bivariadas. Resultados Se evidencian historias de consumo progresivo asociado a determinantes intermedios de salud, en especial circunstancias materiales de vida y comportamentales, mientras que las socioambientales, sobre todo derechos e inclusión social, parecen no afectar la reincidencia. Conclusiones Es necesario realizar intervenciones y programas, orientados a la comunidad, familia e individuo, las cuales tengan un enfoque promocional de la salud y preventivo de la reincidencia en el consumo de psicoactivos, al tiempo que se fortalezca la investigación en este campo.
ABSTRACT Objective To characterize the intermediate determinants of health in recidivist psychoactive substances (PS) users who are being treated at a rehabilitation center (UNIPSSAM IPS) in the city of Valledupar, Colombia, during 2021. Methods Descriptive cross-sectional cohort research. The sample consisted of 21 repeat offenders in the consumption of psychoactive substances who attend a rehabilitation center in Valledupar, who, with prior informed consent, filled out the data collection instrument. The information was processed in SPSS and summarized in uni-and bivariate charts. Results Histories of progressive consumption are evident, associated with intermediate determinants of health, especially material life, and behavioral circumstances, while socio-environmental ones, in particular rights and social inclusion, do not seem to affect recidivism. Conclusions It is necessary to carry out interventions and programs, oriented to the community, family and individual, that have a promotional approach to health and prevent recidivism in the consumption of psychoactive substances, while strengthening research in this field.
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Central chemoreceptors are highly sensitive neurons that respond to changes in pH and CO2 levels. An increase in CO2/H+ typically reflects a rise in the firing rate of these neurons, which stimulates an increase in ventilation. Here, we present an ionic current model that reproduces the basic electrophysiological activity of individual CO2/H+-sensitive neurons from the locus coeruleus (LC). We used this model to explore chemoreceptor discharge patterns in response to electrical and chemical stimuli. The modeled neurons showed both stimulus-evoked activity and spontaneous activity under physiological parameters. Neuronal responses to electrical and chemical stimulation showed specific firing patterns of spike frequency adaptation, postinhibitory rebound, and post-stimulation recovery. Conversely, the response to chemical stimulation alone (based on physiological CO2/H+ changes), in the absence of external depolarizing stimulation, showed no signs of postinhibitory rebound or post-stimulation recovery, and no depolarizing sag. A sensitivity analysis for the firing-rate response to the different stimuli revealed that the contribution of an applied stimulus current exceeded that of the chemical signals. The firing-rate response increased indefinitely with injected depolarizing current, but reached saturation with chemical stimuli. Our computational model reproduced the regular pacemaker-like spiking pattern, action potential shape, and most of the membrane properties that characterize CO2/H+-sensitive neurons from the locus coeruleus. This validates the model and highlights its potential as a tool for studying the cellular mechanisms underlying the altered central chemosensitivity present in a variety of disorders such as sudden infant death syndrome, depression, and anxiety. In addition, the model results suggest that small external electrical signals play a greater role in determining the chemosensitive response to changes in CO2/H+ than previously thought. This highlights the importance of considering electrical synaptic transmission in studies of intrinsic chemosensitivity.