La salud y los cuidados: un análisis interseccional de género y vejeces a partir del trabajo realizado en CEPRAM (2022) / Health and care: an intersectional analysis of gender and old age from the work done at CEPRAM (2022)

INTRODUCCION: Nuestra región, y Argentina, se encuentra atravesando un momento de rápido envejecimiento demográfico. Se trata de un proceso contextualizado social e históricamente de representaciones, estereotipos y significados particulares. El presente trabajo tiene por objetivo describir y analizar las posibles articulaciones entre la perspectiva de salud integral, redes en salud y los cuidados a y entre personas adultas mayores a partir de la experiencia de trabajo en el CEPRAM (Centro de Promoción del Adulto Mayor) en el que las mujeres ocupan un rol central. MÉTODOS: Investigación cualitativa interaccionista con entrevistas sobre experiencias y significados. RESULTADOS: Refieren mejoras en su autoestima, flexibilidad, apertura y escucha como reconocimiento del otro/a. La cantidad y la calidad de cobertura en servicios de cuidados recae mayoritariamente sobre las familias y especialmente, sobre las mujeres y disidencias, perpetuando la desigualdad de género en la distribución de tareas, las condiciones en que se llega y transita la vejez. Ellas vieron este espacio como uno de cuidados, dando sustento a formas más integrales de entenderlos como eje de la salud. CONCLUSIONES: CEPRAM logró captar y solucionar necesidades ­socioafectivas­ de mujeres mayores, insatisfechas y no atendidas por el Estado. Promueve la autonomía relacional donde la participación y la construcción de redes basadas en los vínculos, fundamentales para su salud integral. Los entornos extrahospitalarios como oportunidad de acercamiento al sistema de salud, deben resolver necesidades de cuidado con perspectiva de envejecimiento saludable, fomentando la habilidad funcional, así como los atributos relacionados con el proceso diferenciado por género y salud que permiten a la persona ser y hacer (AU)

INTRODUCTION: Our region, and Argentina, is going through a period of rapid demographic aging. It is a socially and historically contextualized process of representations, stereotypes and particular meanings. The aim of this paper is to describe and analyze the possible articulations between the integral health perspective, health networks and care for and among older adults based on the experience of working in the CEPRAM (Center for the Promotion of Older Adults) in which women play a central role. METHODS: Qualitative interactionist research with interviews on experiences and meanings. RESULTS: They report improvements in their self-esteem, flexibility, openness and listening as recognition of the other. The quantity and quality of coverage in care services falls mostly on families and especially on women and dissidents, perpetuating gender inequality in the distribution of tasks, the conditions in which old age arrives and passes. Women saw this space as one of care, giving support to more comprehensive ways of understanding it as the axis of health. CONCLUSIONS: CEPRAM was able to capture and solve the social and emotional needs of older women, unsatisfied and unmet by the State. It promotes relational autonomy where participation and the construction of networks based on bonds are fundamental for their integral health. The out-of-hospital environments as an opportunity to approach the health system, should solve care needs with a healthy aging perspective, promoting functional ability, as well as the attributes related to the process differentiated by gender and health that allow the person to be and to do (AU)

Transient Global Amnesia Recurrence: Prevalence and Risk Factor Meta-analysis.

Background and Objectives: Transient global amnesia (TGA) is an acute amnestic disorder with unclear pathophysiology. Although considered a benign phenomenon, the possibility of a recurrence is a major concern for the patient. Our objective is to identify the prevalence and risk factors of relapse to help clinicians counsel patients about it. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidance, we screened 1,658 studies from MEDLINE, Lilacs, and Embase databases, published from 1985 to April 2021, in English or Spanish. We included 36 observational case-control and cohort studies that included patients with TGA according to the Caplan or Hodges and Warlow diagnostic criteria. We performed a meta-analysis with a random effect model for proportions and calculation of odds ratio (OR) for identified risk factors. Methodological quality was assessed according to the Newcastle-Ottawa scale. Results: We identified 4,514 TGA cases and 544 recurrence events (12.73%). A follow-up had no effect on its variance. We identified a statistically significant association between recurrence and sexual activity as a trigger, a personal history or current state of migraine and depression (OR 1,481 95% CI [1.0341-2.1222] p = 0.04; OR = 2.0795 95% CI [1.3892-3.1128] p = 0.003; and OR = 4.4871 95% CI [1.890-10.651] p = 0.0288, respectively). Discussion: The analysis showed that approximately 1 of 8 participants may experience recurrence, with an increased risk in the case of a history or current state of migraine, depression, or sexual intercourse before the event. A personal history of migraine and depression was associated with 2 and 4 times risk, respectively.

Dopamine Neurotransmission in the Ventral Tegmental Area Promotes Active Forgetting of Cocaine-Associated Memory.

Dopamine (DA) neurons in the ventral tegmental area (VTA) are well-known components of the brain involved in reward-related behaviors and participate in the generation of new memories. Much attention has been focused to understand how DA neurons integrate a diversity of afferent signals with local excitatory and inhibitory influences regulated by somatodendritic release of dopamine. However, the mechanisms that actively forget rewarding information are still terra incognita. Using rodents in the conditioned place preference (CPP) behavioral task, we show that during acquisition D1-type DA receptors (D1R) in the VTA are crucial components of a neural circuit involving the hippocampus that induces active forgetting of cocaine-associated long-term memory, while VTA and nucleus accumbens (NAc) D1R are required for its formation. Inhibition of VTA D1R results in increased activation of VTA ERK1/2 and in prolonging memory storage of cocaine-place association in an ERK-dependent manner. Moreover, intra-VTA infusion of a specific D1 agonist induces forgetting of cocaine-associated consolidated memory. In contrast, D1R in the NAc shell, medial prefrontal cortex, or amygdala appear not to participate in the maintenance of cocaine-associated memory. Our present results suggest that at the moment of learning D1R-mediated neurotransmission in the VTA actively participates in at least two processes affecting the fate of appetitive memory: its consolidation involving NAc shell DA neurotransmission and its forgetting via DA activation of the hippocampus.

Activation of D1/5 Dopamine Receptors in the Dorsal Medial Prefrontal Cortex Promotes Incubated-Like Aversive Responses.

It is well established that neurons of the mammalian medial prefrontal cortex (mPFC) modulate different behavioral outputs, including several memory types. This behavioral modulation is, at least in part, under the control of the D1-like Dopamine (DA) receptor (D1/5R) which comprises D1 and D5-specific subtypes (D1R and D5R, respectively). Here, combining a set of behavioral assays with pharmacology, we determined whether the activation of D1/5R in the mPFC during almost neutral or weak negative-valence experiences induces aversive behaviors. The intra mPFC bilateral infusion of the D1/5R agonist SKF 38393 (6.25 µg/side) immediately after exposing rats to the white compartment of a place conditioning apparatus promotes a incubated-like aversive memory when tested 7 days thereafter, but it was not seen 24 h after conditioning. No signs of fear or changes in the anxiety state were observed after the exposure to the white compartment. This aversive response is observed only when the experience paired with the mPFC D1/5R activation has a context component involved. By using specific agonists for D1R or D5R subtypes we suggest that D5R mediate the induction of the aversive behavior. No aversive effects were observed when the D1/5R agonist was infused into the dorsal hippocampus (HP), the nucleus accumbens (NAcc) or the basolateral amygdala (BLA) of rats exposed to the white compartment. Taken together, our present findings endorse the idea that activation of mPFC D1/5R is sufficient to induce incubated-like aversive memories after exposing rats to an apparent neutral or weak negative-valence environment and that mPFC might be considered a key brain region involved in providing adaptive emotional behaviors in response to an ever-changing environment.