Mitochondrial dysfunction and oxidative stress are increasingly implicated in the pathophysiology of schizophrenia. The brain is the body's highest energy consumer, and the glutathione system is the brain's dominant free radical scavenger. In the current paper, we review the evidence of central and peripheral nervous system anomalies in the oxidative defences of individuals with schizophrenia, principally involving the glutathione system. This is reflected by evidence of the manifold consequences of oxidative stress that include lipid peroxidation, protein carboxylation, DNA damage and apoptosis - all potentially part of the process of neuroprogression in the disorder. Importantly, oxidative stress is amenable to intervention. We consider the clinical potential of some possible interventions that help reduce oxidative stress, via augmentation of the glutathione system, particularly N-acetyl cysteine. We argue that a better understanding of the mechanisms and pathways underlying oxidative stress will assist in developing the therapeutic potential of this area.
Acetylcysteine ; Glutathione ; Humans ; Magnetic Resonance Imaging ; Mitochondrial Diseases ; Nervous System ; physiopathology ; Oxidative Stress ; Schizophrenia ; physiopathology

BACKGROUND: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. METHODS: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. RESULTS: The mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%. CONCLUSION: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.
Aged ; Aortic Valve* ; Bioprosthesis ; Cardiopulmonary Bypass ; Chest Tubes ; Drainage ; Female ; Follow-Up Studies ; Heart ; Heart Valve Prosthesis Implantation ; Hemodynamics ; Hospital Mortality ; Humans ; Intensive Care Units ; Intubation ; Length of Stay ; Minimally Invasive Surgical Procedures ; Prostheses and Implants ; Prosthesis Design ; Stroke Volume ; Surgical Instruments ; Survival Rate

Purpose: Perineal electromyography (EMG) is a crucial part of urodynamic studies. Many researchers focused on the standardization of techniques in urodynamics, but no study has yet evaluated the differences with various reference electrode placements. The aim of this study was to determine the optimal placement of the reference electrode for recording pelvic floor activity in urodynamic studies. Methods: Children over 6 years of age without anatomic or neurological abnormalities were invited to participate in the study. Four reference electrodes were placed on the right kneecap, the inner surface of the right inner thigh, the right anterior iliac spine (AIS), and the skin over the left gluteal muscles for simultaneous recording. The EMG signal formed by pelvic contraction during forceful straining was recorded both in the supine and sitting positions. The root mean square (RMS) value of each muscle contraction signal was calculated. Results: Twenty-one participants (10 boys and 11 girls) were included. The mean age was 10.19±3.20 years. The highest RMS values were obtained with the reference electrode on the thigh in the supine position and the AIS in the sitting position. Significant differences were found between the mean RMS values of the knee and other locations of reference electrodes in the supine position, as well as between mean RMS values in all regions except the thigh and gluteus in the sitting position. The minimum mean RMS values in both positions were obtained with the reference electrode on the knee. Conclusions During urodynamic studies, reference electrodes shall be placed on AIS in the sitting and on the inner thigh in the supine position. The knee is not a suitable option for reference electrode placement. This information may help improve EMG recordings in the evaluation of pelvic floor muscles.