ABSTRACT
Parkinson's disease (PD) is a degenerative condition resulting from the loss of dopaminergic neurons. This neuronal loss leads to motor and non-motor neurological symptoms. Most PD cases are idiopathic, and no cure is available. Recently, it has been proposed that insulin resistance (IR) could be a central factor in PD development. IR has been associated with PD neuropathological features like α-synuclein aggregation, dopaminergic neuronal loss, neuroinflammation, mitochondrial dysfunction, and autophagy. These features are related to impaired neurological metabolism, neuronal death, and the aggravation of PD symptoms. Moreover, pharmacological options that involve insulin signaling improvement and dopaminergic and non-dopaminergic strategies have been under development. These drugs could prevent the metabolic pathways involved in neuronal damage. All these approaches could improve PD outcomes. Also, new biomarker identification may allow for an earlier PD diagnosis in high-risk individuals. This review describes the main pathways implicated in PD development involving IR. Also, it presents several therapeutic options that are directed at insulin signaling improvement and could be used in PD treatment. The understanding of IR molecular mechanisms involved in neurodegenerative development could enhance PD therapeutic options and diagnosis.
Subject(s)
Insulin Resistance , Insulins , Parkinson Disease , Humans , Autophagy , Cell Death , DopamineABSTRACT
INTRODUCCIÓN: El paciente estandarizado (PE) o simulado es una herramienta globalmente aceptada dentro de la enseñanza médica. Se trata de un actor altamente entrenado que simula una o más enfermedades, desempeñándose como una herramienta integradora de conocimientos. METODOLOGÍA: Se evaluó la percepción del estudiante de Medicina sobre el manejo integral de pacientes, utilizando PE como estrategia, a través de una encuesta de satisfacción. El análisis incluyó el uso de medidas de frecuencia como medias y proporciones para todas las preguntas del cuestionario. RESULTADOS: La gran mayoría de los estudiantes de la carrera de Medicina (95,8%; 45 de 47) manifestaron estar de acuerdo en que la práctica con PE les permitió integrar conocimientos. El 95,8% (45 de 47) percibió esta estrategia como útil para el desarrollo de habilidades de comunicación con pacientes. CONCLUSIONES: Al utilizar la estrategia del PE en simulación clínica, las habilidades de comunicación fueron percibidas como las más desarrolladas dentro del aprendizaje del manejo integral clínico
INTRODUCTION: The standardized patient (SP) or simulated patient is a globally accepted tool within the medical education. Usually, a highly-trained actor simulates one or more diseases performing as an integrative tool in the learning process. METHODOLOGY: We evaluated the perception of knowledge gaining after using the SP strategy in a group of medical students through a satisfaction survey. The analysis included the use of frequency measures as means and proportions for all questions in the questionnaire. RESULTS: Most medical students (95.8%; 45 from 47) expressed agreement that the SP practice allowed them to integrate knowledge. Also, 95,8% (45 from 47) agreed that this strategy was useful for the development of communication skills with patients. CONCLUSIONS: When using the SP strategy in clinical simulation, communication skills were perceived as the most developed within the learning of clinical integral management
