Oxidative Stress in Schizophrenia

Increasing evidence indicates that oxidative damage exists in schizophrenia. Available literature about possible mechanisms of oxidative stress induction was reviewed. Furthermore, possibilities of measuring biomarkers of schizophrenia outside the central nervous system compartment, their specificity for different types of schizophrenia and potential therapeutic strategies to prevent oxidative injuries in schizophrenia were discussed. Data were extracted from published literature found in Medline, Embase, Biosis, Cochrane and Web of Science, together with hand search of references. Search terms were: schizophrenia, oxidative stress, antipsychotics, antioxidants and fatty acids. Finding a sensitive, specific and non invasive biomarker of schizophrenia, which could be measured in peripheral tissue, still stays an important task. Antioxidant enzymes, markers of lipid peroxidation, oxidatively modified proteins and DNA are most commonly used. As it considers the supplemental therapy, according to our meta-analysis vitamin E could potentially improve tardive dyskinesia, while for the effect of therapy with polyunsaturated fatty acids there is no clear evidence. Oxidative stress is a part of the pathology in schizophrenia and appears as a promising field to develop new therapeutic strategies. There is a need for well designed, placebo controlled trials with supplementation therapy in schizophrenia

Dried Volumetric Microsampling Approaches for the Therapeutic Drug Monitoring of Psychiatric Patients Undergoing Clozapine Treatment

Clozapine is one of the most widely used second-generation antipsychotic drugs (SGAs) for the treatment of schizophrenia. Despite advantages over first-generation drugs, clozapine still shows significant side effects and interindividual variations in efficacy. In order to ensure frequent therapeutic drug monitoring (TDM) and improve the compliance of psychiatric patients undergoing clozapine treatment, two novel dried microsampling approaches based on whole blood and plasma volumetric absorptive microsampling (b-VAMS and p-VAMS) and microfluidic generated-dried blood spot technology (mfDBS) were developed and coupled to HPLC with electrochemical detection (ED). The proposed miniaturized strategies by means of VAMS and microfluidic channel-based devices provide several advantages in terms of collection, storage, and handling compared to classical blood and plasma processing. Satisfactory validation results were obtained for all microsampling platforms, with mean extraction yields >85.1%, precision as relative standard deviation (RSD) < 5.1%, and stability < 4.5% analyte loss after 30 days for p-VAMS; mean extraction yields > 83.4%, precision RSD < 5.4%, and stability < 4.6% analyte loss after 30 days for b-VAMS, and mean extraction yields > 74.0%, precision RSD < 5.6%, and stability < 4.9% analyte loss after 30 days for mfDBS. The original microsampling methodologies have been successfully applied to the blood and plasma collected from five psychiatric patients for the monitoring of the levels of clozapine and its main metabolites, providing robust and reliable quali-quantitative results. Comparisons between results of the two dried microsampling technologies with those obtained by classic fluid plasma analysis were in good agreement and have demonstrated that the proposed miniaturized approaches could be suitable for TDM purposes

Evaluation of antioxidant status and lipid peroxidation in dogs with myxomatous mitral valve degeneration stage B1

Myxomatous mitral valve degeneration (MMVD) is the most common naturally occurring heart disease in dogs. There is a lack of data on antioxidant status and oxidative damage in dogs with MMVD stage B1 according to the American College of Veterinary Internal Medicine (ACVIM B1). The aim of this study was to investigate antioxidant status (plasma vitamin E, lipid-standardized vitamin E (LS-VitE), antioxidant capacity of lipid-(ACL) and water-soluble antioxidants, whole blood glutathione peroxidase and erythrocyte superoxide dismutase), and lipid peroxidation [malondialdehyde (MDA)] in dogs with MMVD ACVIM B1. Serum cholesterol and triglyceride concentrations were measured to calculate LS-VitE. Fourteen dogs with MMVD ACVIM B1 and 12 control dogs were included in the study. Dogs with MMVD had significantly higher vitamin E, ACL, MDA, and cholesterol concentrations and significantly higher LS-VitE values than control dogs. No significant correlations between MDA and antioxidant parameters were determined in either group. In conclusion, oxidative damage to lipids is already present and the antioxidant status is altered but not depleted in dogs with MMVD ACVIM B1. The antioxidant response to increased oxidative damage consists mainly of the activation of fat-soluble antioxidants. Further research is needed to evaluate the efficacy and targets of early antioxidant supplementation to prevent or ameliorate oxidative stress and mitigate disease progression in dogs with early-stage MMVD

Effects of different positions of defecation on human health and the role of health care in defecation in bed

Uvod: Na odvajanje blata vplivajo psiho-vedenjski dejavniki, peristaltika, volumen in konsistenca blata, prehrana, starost, spol, položaj odvajanja, in drugi vplivi. V zdravstveni negi se priporočajo različni koti dvignjenega vzglavja za odvajanje v postelji po namestitvi nočne posode. Namen: Raziskati vpliv različnih položajev odvajanja na zdravje in počutje ljudi ter opredeliti vlogo zdravstvene nege pri odvajanju v postelji. Metode dela: Uporabljena je deskriptivna metoda dela s pregledom znanstvene in strokovne literature. Pregled literature je bil opravljen med julijem 2015 in majem 2016. V analizo je bilo vključenih 24 člankov. Rezultati: Sedeči položaj odvajanja je dejavnik tveganja za nastanek hemoroidov, obstipacije, raka, prolapsa medeničnih organov, urinske inkontinence, vnetne črevesne bolezni, divertikuloze, hiatusne hernije, gastro-ezofagealne refluksne bolezeni, kardio-vaskularnih dogodkov in akutne pulmonalne tromboembolije. Čepeči položaj odvajanja je dejavnik tveganja za možgansko kap in globoko venozno trombozo pri ogroženih osebah. Pri pacientih z že motenim pretokom krvi zaradi periferne arterijske bolezni čepenje povzroči nadaljnje ishemične poškodbe perifernega tkiva. Vsaka epizoda čepenja pri teh bolnikih pospeši potek bolezni. Čepenje je najbolj naraven in fiziološki položaj odvajanja. Pacienti navajajo neprijetne značilnosti klasičnih nočnih posod, kot so trdota, hladnost in pritisk robu na zadnjico. Pacienti, ki morajo odvajati v postelji, se pogosto izogibajo uporabi nočne posode, tako da zmanjšajo vnos tekočine v telo ali tako, da na skrivaj vstajajo in sami odidejo na stranišče. To vedenje je nevarno in ima lahko negativne posledice na zdravje. Pri ležečem levem bočnem položaju se pri nekaterih pojavijo disinergični vzorci odvajanja. Razprava in zaključek: Pri sedečem položaju odvajanja je potreben veliko večji napor za odvajanje, ki je vzročni dejavnik za številne zdravstvene težave. Z informiranjem javnosti o tveganjih, povezanih z modernimi stranišči, lahko preprečimo veliko nepotrebnega trpljenja. Zaradi nefleksibilnosti bi imelo mnogo ljudi težave pri prilagajanju na čepeča stranišča. V 40 letih lahko dosežemo, da bo 90% populacije sposobna odvajati v čepečem položaju. Optimalen položaj pri odvajanju v postelji je položaj s čim bolj dvignjenim vzglavjem in podprtim ledvenim delom. Nekatere medicinske sestre težko zagotavljajo čustveno oskrbo, kar se kaže z negativnim odnosom do pacientov. Sistem je potrebno preoblikovati tako, da bo zaznal te odklone in se ustrezno odzval na to. Percepcija pacientov o kakovosti zdravstvene nege je v veliki meri odvisna od sposobnosti medicinske sestre, da prepozna potrebe pacienta. Najbolj vidna vloga medicinske sestre pri odvajanju v postelji je namestitev pacienta v optimalen položaj in nega, nekoliko manj vidna pa še nudenje čustvene podpore, zmanjševanje zadrege ter ostalih neprijetnih občutij v povezavi z aktivnostjo odvajanja.Introduction: Defecation is influenced by: psycho-behavioral factors, peristalsis, volume and consistency of the stool, diet, age, gender, position of defecation and other influences. In health care different bed reclining angles are recommended for defecation in bed after installing bedpans. Purpose: To investigate the effect of different positions of defecation on human health and well-being and to define the role of nursing in defecation in bed. Methods: We used the descriptive method with a review of the scientific and technical literature. A literature review was made between July 2015 and May 2016. In the analysis it included 24 articles. Results: The sitting position of defecation is a risk factor for hemorrhoids, constipation, cancer, pelvic organ prolapse, urinary incontinence, inflammatory bowel disease, diverticulosis, hiatal hernia, gastroesophageal reflux disease, cardio-vascular events, acute pulmonary thromboembolism. The squatting position of defecation is a risk factor for stroke and deep venous thrombosis in persons at risk. In patients with an already disturbed blood flow due to peripheral arterial disease squatting can cause further damage to ischemic peripheral tissues. Each episode of squatting in these patients accelerates the course of the disease. Squatting is the most natural and physiological status of defecation. Patients indicate the unpleasant characteristics of traditional bedpans, such as hardness, coldness and pressure within the buttocks. Patients who must defecate in bed often avoid the use of bedpans by reducing the intake of fluids, or secretly getting up and going to the toilet by themselves. This behavior is dangerous and can have negative effects on their health. In the left lateral lying position a dyssynergic pattern of defecation appears in some people. Discussion and conclusion: The sitting position requires much more effort for defecation, which is the causative factor in many health problems. By informing the public about the risks associated with modern toilets we can prevent a lot of unnecessary suffering. Due to inflexibility many people would have difficulties in adapting to squatting toilets. In 40 years we can achieve that 90% of the population are capable of defecation in a squatting position. The optimal position for defecation in bed is the position with the headboard most elevated and a supported lumbar part. Some nurses find it difficult to provide emotional care, which is reflected by the negative attitude towards patients. The system must be restructured in a way that will detect these deviations and adequately respond to it. The perception of patients about the quality of care is largely dependent on the ability of nurses to recognize the needs of the patient. The most visible role of the nurse in defecation in bed is the installation of the patient in the optimal position and care for the patients, a little less visible one is providing emotional support, reducing embarrassment and other unpleasant feelings in connection with the activity of defecation

Evaluation of oxidative stress parameters in dogs with brachycephalic obstructive airway syndrome before and after surgery

Abstract Introduction: Canine brachycephalic obstructive airway syndrome (BOAS) is a conformation-related respiratory disorder of dog breeds having congenitally flattened facial and skull anatomy. The aim of the study was to determine oxidative stress parameters, the lipid peroxidation product malondialdehyde, and antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase in BOAS patients before and after surgical treatment and in healthy brachycephalic dogs. Material and Methods: Nine healthy brachycephalic dogs that had not undergone surgery and 39 BOAS patients were included in the study. The BOAS patients were classified as grade 1 (5/34), grade 2 (16/34), and grade 3 (13/34) based on the decrease in the radius of the airway in the larynx. In BOAS patients, oxidative stress parameters were determined before and two weeks after surgery, while in control dogs, blood samples were collected only on inclusion to the study. Results: All BOAS patients showed various degrees of improvement in clinical signs after surgery. Significantly lower (P < 0.05) SOD activity was found in grade 2 and 3 BOAS patients than in grade 1 patients. Two weeks after surgery, a significant (P < 0.05) increase in SOD activity in grade 2 and 3 patients was observed. Conclusion: Antioxidant enzyme SOD may play an important role in BOAS and can be used as a biomarker of antioxidant status assessment in BOAS patients

The effect of two acute bouts of exercise on oxidative stress, hematological, and biochemical parameters, and rectal temperature in trained canicross dogs

Canicross is a sport discipline that connects human and canine athletes in running. Changes in physiological, hematological, and biochemical parameters, and exercise-induced oxidative stress have not been thoroughly characterized in canicross dogs. The aim of our study was the assessment of the health status of trained canicross dogs that were subjected to two acute bouts of exercise with their owners during the training season. Health status was assessed by measuring the rectal temperature, hematological and biochemical parameters, as well as blood oxidative stress parameters (plasma malondialdehyde, lipid peroxidation markerwhole blood glutathione peroxidase and erythrocyte superoxide dismutase1, antioxidant enzymes) before and during a two-day canicross training session and after a 24-h rest period. Seven trained canicross dogs (three females/four males) aged 12–120 months were included in the study. Blood samples were collected before and immediately after the first acute bout of exercise (day 1), after the second acute bout of exercise (day 2), and after 24 h of rest (day 3). Rectal temperature was measured at the same time as blood sample collection. The majority of hematological and biochemical parameters remained within reference ranges at all sampling times. Rectal temperature was significantly higher after training on days 1 and 2 compared to resting temperature on day 3. Hematological parameters did not change significantlyhowever, there were significant differences in urea, creatinine, creatine kinase, and triglycerides between specific sampling times. Despite significant changes, these biochemical parameters remained within reference ranges. Significant changes in biochemical parameters seem to reflect the dogs\u27 physiological response to each acute bout of exercise, considering all biochemical parameters and rectal temperature returned to pre-exercise values after a 24-h rest period (day 3). No significant differences in oxidative stress parameters were found between any sampling times. Relatively high erythrocyte superoxide dismutase1 activity at all sampling times may indicate that the canicross dogs are adapted to training by an increased expression of antioxidant enzymes. Based on our results, we can conclude that the trained canicross dogs included in our study were healthy, in good physical condition, and fit for the two acute bouts of field exercise

Effects of vitamin E and coenzyme Q10 supplementation on oxidative stress parameters in untrained leisure horses subjected to acute moderate exercise

Abstract The effects of antioxidant supplements on exercise-induced oxidative stress have not been investigated in untrained leisure horses. We investigated the effects of 14-day supplementation with vitamin E (1.8 IU/kg/day), coenzyme Q10 (CoQ10ubiquinone800 mg/day), and a combination of both (the same doses as in mono-supplementation) on the blood levels of CoQ10, vitamin E, and oxidative stress parameters in untrained leisure horses subjected to acute moderate exercise. Correlations between lipid peroxidation and muscle enzyme leakage were also determined. Forty client-owned horses were included in the study, with 10 horses in each of the antioxidant and placebo (paraffin oil) groups. Blood parameters were measured before supplementation, before and immediately after exercise, and after 24 h of rest. The differences in individual parameters between blood collection times and groups were analysed with linear mixed models (p ˂ 0.05). None of the supplemented antioxidants affected vitamin E and CoQ10 concentrations, oxidative stress parameters, or serum muscle enzymes. Lipid peroxidation occurred in horses supplemented with placebo and CoQ10 but not in horses supplemented with vitamin E or the combination of both antioxidants. These results suggest that vitamin E alone or in combination with CoQ10 prevented lipid peroxidation in untrained leisure horses subjected to acute moderate exercise

The evolving role of microsampling in therapeutic drug monitoring of monoclonal antibodies in inflammatory diseases

Monoclonal antibodies (mAbs) have been extensively developed over the past few years, for the treatment of various inflammatory diseases. They are large molecules characterized by complex pharmacokinetic and pharmacodynamic properties. Therapeutic drug monitoring (TDM) is routinely implemented in the therapy with mAbs, to monitor patients’ treatment response and to further guide dose adjustments. Serum has been the matrix of choice in the TDM of mAbs and its sampling requires the visit of the patients to laboratories that are not always easily accessible. Therefore, dried blood spots (DBS) and various microsampling techniques have been suggested as an alternative. DBS is a sampling technique in which capillary blood is deposited on a special filter paper. It is a relatively simple procedure, and the patients can perform the home-sampling. The convenience it offers has enabled its use in the quantification of small-molecule drugs, whilst in the recent years, studies aimed to develop microsampling methods that will facilitate the TDM of mAbs. Nevertheless, hematocrit still remains an obstacle that hinders a more widespread implementation of DBS in clinical practice. The introduction of novel analytical techniques and contemporary microsampling devices can be considered the steppingstone to the attempts made addressing this issue