Changes in the effect of spinal prostaglandin E2 during inflammation: prostaglandin E (EP1-EP4) receptors in spinal nociceptive processing of input from the normal or inflamed knee joint.

Inflammatory pain is caused by sensitization of peripheral and central nociceptive neurons. Prostaglandins substantially contribute to neuronal sensitization at both sites. Prostaglandin E2 (PGE2) applied to the spinal cord causes neuronal hyperexcitability similar to peripheral inflammation. Because PGE2 can act through EP1-EP4 receptors, we addressed the role of these receptors in the spinal cord on the development of spinal hyperexcitability. Recordings were made from nociceptive dorsal horn neurons with main input from the knee joint, and responses of the neurons to noxious and innocuous stimulation of the knee, ankle, and paw were studied after spinal application of recently developed specific EP1-EP4 receptor agonists. Under normal conditions, spinal application of agonists at EP1, EP2, and EP4 receptors induced spinal hyperexcitability similar to PGE2. Interestingly, the effect of spinal EP receptor activation changed during joint inflammation. When the knee joint had been inflamed 7-11 hr before the recordings, only activation of the EP1 receptor caused additional facilitation, whereas spinal application of EP2 and EP4 receptor agonists had no effect. Additionally, an EP3alpha receptor agonist reduced responses to mechanical stimulation. The latter also attenuated spinal hyperexcitability induced by spinal PGE2. In isolated DRG neurons, the EP3alpha agonist reduced the facilitatory effect of PGE2 on TTX-resistant sodium currents. Thus pronociceptive effects of spinal PGE2 can be limited, particularly under inflammatory conditions, through activation of an inhibitory splice variant of the EP3 receptor. The latter might be an interesting target for controlling spinal hyperexcitability in inflammatory pain states.

Los programas sociales que 'alimentan' a medio Perú / Social programs that nourish to a half Peru

Interroga acerca de cómo se lleva a cabo la inversión social; si la desnutrición es uno de los problemas más graves del país, hasta qué punto los programas alimentarios del gobierno están logrando su fin?, ya que en el sector participan las instituciones privadas sin fines de lucro, se pregunta ¿cuáles son las diferencias fundamentales de desempeño en términos de producto, contenido nutricional y población beneficiaria con el sector público y de qué forma se pueden capitalizar sus ventajas competitivas?

Reducción de la desnutrición crónica en el Perú: propuesta para una estrategia nacional / Reduction of chronic desnutrition: proposal for a national strategy

Enfoca la necesidad de cambios institucionales significativos, incluyendo la consolidación de los programas de nutrición dentro de una sola entidad administrativa y la descentralización de la responsabilidad en torno a la implementación del programa. Propone un conjunto integrado de programas que aborden las múltiples causas del enanismo, retardo del crecimiento o desnutrición crónica