Parkinson And Age, An Evil That Stalks Public Health In Adults

Parkinson and Age, an evil that stalks public health in adults

Parkinson’s disease is a progressive chronic neurodegenerative pathology (occupying second place within this category), due to the degeneration of dopaminergic neurons in the black substance (locus niger) possessing a high incidence and prevalence, affecting the quality of life of Patients ≥ 65 years, and their socioeconomic status due to their high cost in the acquisition of drugs and characteristic surgical treatments to treat this disease. The manifestations of this pathology in an individual are presented with motor symptoms and not engines, among which we have the tremor at rest, the stiffness and slowdown of the movements, alterations in the posture and in the march, gastrointestinal alterations, of the dream, autonomous and cognitive.

Pharmacological treatment seeks to control motor symptoms and non -engines, which worsen through the natural history of the disease or are accompanied by complications due to therapy, making other interventions such as deep brain stimulation. Although there is still no medication that suspends the development of Parkinson’s disease, the best treatment to improve symptoms is with the restitution of dopamine thanks to its precursor La Levodopa (L-Dopa) and as well as the administration of other substances that increase dopaminergic activity. Being the most economically viable option the administration of drugs to patients who present this pathology with the advantage that our country will not contract an acquisition debt.

Introduction

Parkinson’s disease is the second neuro genetic disease (only being behind Alzheimer Its motor abilities, in a more own language is the neuronal loss in the black substance, which causes striatal dopamine deficiency, and intracellular inclusions that contain aggregates of α-sinuclein that are the neuropathological characteristics of Parkinson’s disease. (1)

Within Ecuador’s indices is a common condition for most elderly, there may be a series of trends within the habits of Ecuadorians who serve to elucidate in a better way the cause of this pathology, This is why it will seek to find the explanation of why Parkinson’s public health is a threat.

There is no concise record on the specific amount of Ecuadorian inhabitants that suffer from it, but it is believed that from 1990 to 2009 there was a duplication between 5.7% to 10.2% conditioning 7.6% of the country’s neurological clinics, taking out all these data only from specialized and mostly belonging to the private health field, located in one of the three main cities, that is, with greater absence of rural areas, this is due to that there is no precise census of the percentage of perishable in non -city areas. (two)

The National MSP (Ministry of Public Health) has been responsible for being aware of the progress of pharmacological treatments of this disease which practically since the beginning of the 1960s, the treatment of Parkinson’s disease has been based on therapy Dopamine pharmacological replacement through the administration of its precursor. Due to the poor penetration that levodop. This combination (levodopa + carbidopa) is still considered pillar of pharmacological treatment, due to the existing evidence of its effectiveness and safety, added to the low cost and time of therapeutic experience worldwide, many of the new therapies are still in phases of Research and development, or its evidence of efficacy and security is insufficient. These include the use of neurotrophic factors, neuroimmunophilin ligands (for neuroprotection and neural regeneration), Coenzyme Q10, adenosine receiver antagonists, glutamate release inhibitors, genetic therapy, stem cells and phytherapy. Until they have demonstrated in controlled clinical studies a favorable efficacy and an adequate security profile, it is meaningless to consider them candidates to integrate the country’s basic drug arsenal. Although at the local-national level, there is still a lot of scientific emptiness that requires being completed through clinical investigations, it is necessary most disturbed spheres in the quality of life, the psycho-social reality of patients and also the characteristics of use of pharmacological treatments during the usual clinical practice. But how a Third World country as ours is can handle or treat Parkinson’s disease, without risking an acquisition debt that would entail even in an indeterminate future and that can put the stability of the MSP at risk?

It is clarifying that unknown of why Parkinson’s is a risk to public health, which is to clarify in this essay.

Method

It is essential Documents, bibliographic reports and articles in relation to this pathology, which served as a guide for the description of each of the variables previously raised in the introduction.

Reference with the use of articles such as support, it was sought to obtain greater knowledge about the most recent information of the disease in various provinces of the country. Then it can be said that for the present study a non -experimental bibliographic review was used as a methodology, since an analysis of various medical articles and books was carried out in portable documents of Parkinson’s disease in older adults, addressing certain topics of Great relevance about the prevalence of this, its causes, pharmacological treatment during habitual clinical practice and how it affects people’s lifestyle.

One of the objectives of this article is the analysis of various documents related to the disease to establish a more effective treatment, because it is still completely unknown what is the main cause of this pathology and that many therapies are still in research phases So its efficacy is still tested, so in the present study a descriptive bibliographic review was also carried out as a support in knowledge about Parkinson’s disease, in addition to knowing how Ecuador being a country in the way of development can treat Parkinson, knowing that its pharmacological treatment has a high cost.

From the historical point of view about this pathology to learn more about it, the following postulate was taken as a reference:

In 1817, Parkinson’s disease was first raised, a name granted by Dr. James Parkinson. It is described as a disease of the nervous system that prevails in more than 1% of the population over 65, which is characterized by the progressive degeneration suffered by dopaminergic neurons located in the Locus Niger (black substance) of the midbrain, and its loss in turn reduces the amount of dopamine that is normally addressed to the striated body. In the black substance the still surviving cells contain Lewy’s bodies, which in turn present the α-sinuclein protein.

This disease from the clinical point of view is characterized by a kinetic condition, with increased muscle tone, bradykinesia, resting tremor and in certain subjects there is a cognitive deterioration that leads to dementia. Based on this information we can better analyze the incidence of this disease in people’s quality of life, how it can affect the social and economic environment of individuals.

Results

It is established that the prevalence of Parkinson’s disease is frequent in a population between 61-71 years and rare in a population under 50 years. As for sex there is no noticeable difference, however, prevalence is a bit greater in male sex compared to the female. 

In Ecuador Parkinson’s disease, frequent pathology in our environment, has not been considered a catastrophic disease despite its high costs in its pharmacological treatment.

A case that was presented in Ecuador is that of Benalcázar, who presented this pathology six months ago, he assures that this disease does not affect his daily life, however, he spends about $ 200 per month on drugs. 

Because our country is still in the process of development, one of the means that this has been adopted is that programs are created for patients presenting this disease. There are factors that can change the natural history of the disease, such as psychological help, swallowing therapy, physical rehabilitation, language therapy among others.

Non -motors are found in Parkinson’s disease which have different treatment options and depend on the severity of the symptomatology that they also present into account the medications they consume to treat motor symptoms and what are the side effects of these.

Among these treatments we find deep brain stimulation, which is used in patients who do not respond to medication and whose quality of life does not improve. Prior to this surgical practice, talamotomy, palemotomy and subtalamotomy were the only options that patients had with advanced Parkinson’s disease, but were replaced by deep brain stimulation by presenting less complications, it also allowed bilateral therapy and an improvement in the motor and non -motor functions equal or greater.

Deep brain stimulation surgery establishes a stimulation in specific areas of the brain that control the movement, making abnormal nerve signals block which are the causes of the tremor and the different symptoms of this pathology.

Unfortunately, this surgical practice is not common in Ecuador, although deep brain stimulation surgery has been using around 30 years in other countries. In the country this operation has only been carried out six times in recent years due to its high cost and previously it had not even reached Ecuador. This is why this surgical practice is not a viable option in the treatment of Parkinson due to its high cost.

For the treatment of motor symptoms of Parkinson’s disease there are no number of pharmacological options. The most used and important drug in the treatment of Parkinson is levadapa, which is a precursor of dopamine that does not suffer the degeneration of this in the gastrointestinal tract, but in the systematic circulation, so it is prescribed together with inhibitors of inhibitors of Discarboxylase.

Dopaminergic antagonistic medications directly stimulate dopamine receptors, among these are the pramipexol and rotigotine ropinirol95. These medications have an efficiency comparable to levadapa, however, in the most advanced phases of the disease their efficiency decreases, for this reason these medications are only used in young patients who do not have cognitive commitment or can also be used in older patients in patients but that they do not have cognitive commitment, and they need to use the levadapa when they no longer achieve a good management of symptoms.

Amantadine is a drug which has an anticholinergic action and in turn increases dopamine 103 contractions. Previously it was used as monotherapy for short periods of time because it reaches dim and momentary effects on Parkinson’s disease, however, currently this drug is associated with the treatment of levadapa when motor oscillations or discinsiae appear. On the other hand, this medicine has adverse effects such as headache, nausea, livid reticular, insomnia, ankle edema, confusion and hallucinations.

Another group of drugs are anticholinergics such as trihexyphenidyl, benztropine and biperidene, these drugs are prescribed to patients whose tremor does not respond to levadopa or dopaminergic agonists, as well as young patients who do not have a cognitive commitment and present bradykinesia and rigidity. The adverse effects of this type of medications are: xerostomy, blurred vision, mydriasis, photophobia, confusion and hallucinations.

Discussion

With what is examined in relation to Parkinson’s disease, it can be confirmed that this generates mismatches in the psychological, family, social and economic sphere, because it requires a lot of collaboration by the State for the family groups of the country’s population, thus As well as relatives, since the treatment of this disease has a high cost and not all families have the appropriate socioeconomic level to acquire the necessary medications and even more being able to perform deep brain surgery.

As for drugs, which are the most accessible path to treating this disease, we have that levodop disease because this is a metabolic precursor of dopamine, which, in turn, is an essential neurotransmitter for muscle control.

In surgical practice, deep cerebral stimulation has been classified as the most effective treatment to control the motor symptoms of Parkinson refractory to medicines, this consists of the implementation of electrodes within areas of the cerebral cortex, which works as a pacemaker of the heart, however, despite its effectiveness it is not very popular in the country due to its high cost and for that reason people are not able to submit to it.

conclusion

As has been observed in the studies analyzed on Parkinson’s disease, we have noticed that the most accessible and economic method used by Ecuador is the administration of drugs, the most effective being Levodopa, supplied by the IESS for a certain affiliated population. These drugs although they do not have a low cost in the market is the most accessible way to treat this pathology, because deep brain surgery even though it has better results in the individual has a high cost and not all people have the purchasing power to be able to perform it, in addition, this is a little treatment