Glutamate-N-methyl-D-aspartate receptor modulation and minocycline for the treatment of patients with schizophrenia: an update

Growing consistent evidence indicates that hypofunction of N-methyl-D-aspartate (NMDA) transmission plays a pivotal role in the neuropathophysiology of schizophrenia. Hence, drugs which modulate NMDA neurotransmission are promising approaches to the treatment of schizophrenia. The aim of this article is to review clinical trials with novel compounds acting on the NMDA receptor (NMDA-R). This review also includes a discussion and translation of neuroscience into schizophrenia therapeutics. Although the precise mechanism of action of minocycline in the brain remains unclear, there is evidence that it blocks the neurotoxicity of NMDA antagonists and may exert a differential effect on NMDA signaling pathways. We, therefore, hypothesize that the effects of minocycline on the brain may be partially modulated by the NMDA-R or related mechanisms. Thus, we have included a review of minocycline neuroscience. The search was performed in the PubMed, Web of Science, SciELO, and Lilacs databases. The results of glycine and D-cycloserine trials were conflicting regarding effectiveness on the negative and cognitive symptoms of schizophrenia. D-serine and D-alanine showed a potential effect on negative symptoms and on cognitive deficits. Sarcosine data indicated a considerable improvement as adjunctive therapy. Finally, minocycline add-on treatment appears to be effective on a broad range of psychopathology in patients with schizophrenia. The differential modulation of NMDA-R neurosystems, in particular synaptic versus extrasynaptic NMDA-R activation and specific subtypes of NMDA-R, may be the key mediators of neurogenesis and neuroprotection. Thus, psychotropics modulating NMDA-R neurotransmission may represent future monotherapy or add-on treatment strategies in the treatment of schizophrenia

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Myocardial ischemia caused by a coronary anomaly left anterior descending coronary artery arising from right sinus of Valsalva

We present the case of a patient in anomalous origin of the left anterior descending coronary artery that caused myocardial ischemia and led to positive myocardial scintigraphic results. Coronary angiography showed that the left anterior descending coronary artery arose from the right coronary ostium-an anomaly that has been associated with chest discomfort-without atherosclerotic lesions. Left circumflex artery and the diagonal branches were arising from the left main coronary artery and the whole coronary tree were free of atherosclerosis. © 2006 Elsevier Ireland Ltd. All rights reserved

Hypertrophic cardiomyopathy with midventricular obstruction in association with ostium secundum-type atrial septal defect

This paper reports a 74 year-old-man with a hypertrophic cardiomyopathy associated with mid-ventricular obstruction and a secundum type atrial septal defect. He had been suffering from shortness of breath and occasional attacks of dizziness. Doppler echocardiography revealed the gradient in the mid-left ventricular area. A transesophageal echocardiogram confirmed the findings of transthoracic study and an ostium secundum-type atrial septal defect was documented. The present case represents a rare combination of hypertrophic cardiomyopathy associated with midventricular obstruction, and an ostium secundum type atrial septal defect in an elderly man

N-terminal probrain natriuretic peptide predicts altered circadian variation in essential hypertension

Diminished nocturnal blood pressure fall in nondipper hypertensive patients are closely associated with poor prognosis. N-terminal probrain natriuretic peptide can also identify poor prognosis in miscellaneous heart diseases. In this study, we aimed to clarify the association between probrain natriuretic peptide levels and diminished nocturnal blood pressure fall in patients with essential hypertension. Twenty-six consecutive nondipper (age: 53±8 years, 14 men) (group 1), and 26 dipper hypertensive patients (age: 52±9 years, 16 men) (group 2), based on ambulatory blood pressure monitoring, and age and sex-matched 28 normotensive participants (age: 50±11 years, 16 men) (group 3) were compared with each other. Although systolic and diastolic ambulatory blood pressure values were similar in hypertensives during the day, those at night were higher in group 1 (P0.05), there were great differences between plasma probrain natriuretic peptide levels (88±20, 58±22 and 47±20 pg/ml, respectively, P0.05). © 2007 Lippincott Williams & Wilkins, Inc

Early detection of cardiac function by tissue Doppler imaging in patients with mitral stenosis and sinus rhythm

Objectives: We evaluated the changes in left ventricular function by means of tissue Doppler imaging (TDI) in patients with mitral stenosis (MS). Study design: Standard echocardiographic and TDI studies were performed in 26 patients (18 females, mean age 38±7 years) with severe MS [mitral valve area (MVA) <1.2 cm2], in 32 patients (24 females, mean age 35±9 years) with mild to moderate MS (MVA ?1.2 cm2), and in 25 age-matched healthy volunteers (17 females, mean age 39±6 years). All the patients were in sinus rhythm and none had hypertension or coronary artery disease. Systolic myocardial velocity, early and late diastolic velocities were measured in the basal lateral segment and basal interventricular septum from the apical four-chamber views. Results: Left ventricular dimensions, ejection fraction, end-diastolic and end-systolic diameters, and fractional shortening of the left ventricle were similar in all the groups. Patients with MS had significantly decreased peak systolic myocardial velocities in both the lateral wall and interventricular septum of the left ventricle. In addition, early diastolic velocity and the ratio of early/late diastolic velocities were significantly lower. E-wave deceleration time and late diastolic myocardial velocities were similar in three groups. Peak systolic myocardial velocities were significantly correlated with mitral valve areas measured at the septum (r=0.57, p<0.01) and the lateral wall (r=0.48, p<0.01) of the left ventricle. Conclusion: Our results show that, despite the presence of seemingly normal findings on standard echocardiography, TDI may provide evidence for left ventricular systolic dysfunction in patients with MS, representing early signs of myocardial abnormality

Isolated noncompaction of left ventricular myocardium in an elderly man

[No abstract available