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The possible role of oxidants and antioxdant imbalance in pathophysiology of schizophrenia.
Ghodake SR, Suryakar AN, Padalkar RK, Kulhalli PM, Abdul Kayyum shaikh
International Journal of Medical Research and Health Sciences , 2012,
Abstract: There are large growing data demonstrating that reactive oxygen species are involved in initiation and development of many different neuropsychiatric disorders including schizophrenia. Oxidative stress is a state of disequilibrium between oxidant process and the antioxidant defense system as a consequence of increased production of free radicals or when the antioxidant system is inefficient or a combination of both events. In order to examine lipid peroxidation and antioxidant status in study subjects (40 schizophrenic patients and 40 healthy controls), the levels of malondialdehyde (MDA) as an index of lipid peroxidation and free radical scavenging antioxidants like erythrocyte superoxide dismutase, glutathione, vitamin E, vitamin C and TAC have been evaluated. The objective of this study is to investigate the oxidant/ antioxidant imbalance leading to oxidative stress. Significantly lower levels of the antioxidant were found in patients as compared to normal controls with an increased oxidative stress as indicated by high plasma malondialdehyde levels and nitric oxide metabolites. This study shows that the dysregulation of oxidant and antioxidant defense system might be important mediator for development and progression of clinical conditions in schizophrenia. So, the findings also provide the theoretical basis to develop the new therapeutic approach towards antioxidant supplementation.
Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis
Pereira Jr., Jose Carlos;Pradella-Hallinan, Marcia;Pessoa, Hugo de Lins;
Clinics , 2010, DOI: 10.1590/S1807-59322010000500013
Abstract: data collected from medical literature indicate that dopaminergic agonists alleviate restless legs syndrome symptoms while dopaminergic agonists antagonists aggravate them. dopaminergic agonists is a physiological regulator of thyroid-stimulating hormone. dopaminergic agonists infusion diminishes the levels of thyroid hormones, which have the ability to provoke restlessness, hyperkinetic states, tremors, and insomnia. conditions associated with higher levels of thyroid hormones, such as pregnancy or hyperthyroidism, have a higher prevalence of restless legs syndrome symptoms. low iron levels can cause secondary restless legs syndrome or aggravate symptoms of primary disease as well as diminish enzymatic activities that are involved in dopaminergic agonists production and the degradation of thyroid hormones. moreover, as a result of low iron levels, dopaminergic agonists diminishes and thyroid hormones increase. iron therapy improves restless legs syndrome symptoms in iron deprived patients. medical hypothesis. to discuss the theory that thyroid hormones, when not counterbalanced by dopaminergic agonists, may precipitate the signs and symptoms underpinning restless legs syndrome. the main cause of restless legs syndrome might be an imbalance between the dopaminergic agonists system and thyroid hormones.
Issues in contemporary fluid management
Jean-Louis Vincent
Critical Care , 2000, DOI: 10.1186/cc964
Abstract: Most critically ill patients will require volume expansion at some juncture during their stay in the intensive care unit (ICU). Common indications for fluid administration in the ICU include trauma, haemorrhage, dehydration and sepsis. Surgical patients also typically require fluids both perioperatively and postoperatively. An array of additional clinical situations may also prompt fluid administration; for instance, in burn victims, hypoproteinaemic patients, cirrhotic patients with ascites undergoing therapeutic paracentesis, and so on.The pathophysiologic mechanisms of fluid imbalance and the optimal approaches to fluid management continue to be actively investigated in both clinical and preclinical studies. Further light is also being shed on fluid management issues by recent meta-analyses. The meta-analytic findings are provocative; however, many questions have been raised regarding their implications for clinical practice. One such question is the appropriateness of relying on mortality as the primary outcome measure, since choice of fluid may exert a relatively minor impact on this particular endpoint. Also, the manner in which the skilled clinician implements a fluid management strategy may have a greater bearing on outcome than the type of fluid administered.The appropriate basis for adopting a particular fluid management strategy is an understanding of the underlying pathophysiology of fluid imbalance. Hypovolaemia can lead to reduced circulating blood volume, diminished venous return and, in severe cases, arterial hypotension. The aims of fluid management are to preserve intravascular fluid volume, adequate blood pressure and tissue oxygenation. In the hypovolaemic patient with normal pulmonary function, the use of colloids to maintain colloid osmotic pressure can limit the development of pulmonary oedema under conditions of elevated hydrostatic pressure. This approach may be of more limited value during states of increased lung capillary permeability; ho
Pathophysiology of Hypertrophic Pyloric Stenosis Revisited: The Use of Isotonic Fluid for Preoperative Infusion Therapy Is Supported  [PDF]
Ralf-Bodo Troebs
Open Journal of Pediatrics (OJPed) , 2014, DOI: 10.4236/ojped.2014.43027
Abstract: Background: The aim of this study was to elucidate the preoperative clinical and biochemical profile of infants with IHPS to optimize infusion therapy. Patients and Method: We retrospectively analyzed data from 56 infants who were operated for IHPS. Our study includes growth and laboratory data prior to the initiation of therapy. Results: Median duration of propulsive vomiting was 4 d; the median age was 37 d (18 - 108), and the median body weight was 3840 g (2760 -5900). Metabolic alkalosis (MAlk) with a pH of 7.45 ± 0.06 and an stHCO3- of 28.7 ± 4.5 mmol/l was found. In a subgroup of the infants, negative base excess (BE) was observed. The sodium concentration was normal or reduced (mean/median of 137 mmol/l). There was a strong negative correlation between stHCO3- and K+. The carbon dioxide partial pressure tended to increase (5.72 ± 0.84 kPa). Calculations of osmolality revealed a normal osmolarity. Hypoglycemia did not occur. The creatinine clearance according to the Schwartz formula remained at a normal level (85.3 ± 24.3 ml/min/1.73 m2). Discussion: The presented case series is characterized by a short duration of preoperative vomiting. MAlk can be classified as a chloride deficiency syndrome. It is accompanied by normo- or hyponatremic dehydration with normal osmolality. Partial respiratory compensation occurred. A normal creatinine clearance indicated good glomerular renal function. Conclusion: The presented study supports the use of an isotonic infusion fluid with a low glucose concentration for preoperative infusion therapy.
Vertigo and Imbalance  [cached]
Michael G. HALMAGYI,Gulden AKDAL
Journal of Neurological Sciences , 2005,
Abstract: Vertigo, dizzeness and imbalance are common complaints of patients seen in pratice. Both of the terms are used interchangable by the patients. Most of the patients seen in a balance clinic have recurrent vertigo. Recurrent vertigo is almost never due to a serious neurological problem. It is almost always due to; benign positional vertigo, Meniere’s disease or migraine. The rest of the patients have an imbalance not vertigo. The clinicians should distinguish vertigo from imbalance, and do the proper tests for evaluating patient with vertigo. In this review, conditions causing vertigo and imbalance and evaluating patients are discussed in detail.
Vertigo and Imbalance  [cached]
Michael G. HALMAGYI,Gulden AKDAL
Journal of Neurological Sciences , 2005,
Abstract: --------------------------------------------------------------------------------Vertigo, dizzeness and imbalance are common complaints of patients seen in pratice. Both of the terms are used interchangeable by the patients. Most of the patients seen in a balance clinic have recurrent vertigo. Recurrent vertigo is almost never due to a serious neurological problem. It is almost always due to; benign positional vertigo, Meniere’s disease or migraine. The rest of the patients have an imbalance not vertigo. The clinicians should distinguish vertigo from imbalance, and do the proper tests for evaluating patient with vertigo. In this review, evaluating patients and conditions causing vertigo or imbalance are discussed in detail.
Pathophysiology of nephrolithiasis  [cached]
Christos Paliouras,Eirini Tsampikaki,Polichronis Alivanis,Georgios Aperis
Nephrology Reviews , 2012, DOI: 10.4081/nr.2012.e14
Abstract: The incidence of nephrolithiasis has risen over the last twenty years and continues to rise. Although it is often referred to as a disease, recent advances in the understanding of the pathophysiology suggest that it is a systemic disorder. We conducted a PubMed based literature review on the recent advances in the pathophysiology of kidney stone formation. There is a link between diabetes, metabolic syndrome, obesity, insulin resistance and nephrolithiasis. Along with the aging population and a Western diet, these are the main reasons for the rising incidence and prevalence of nephrolithiasis. Different theories as to the pathophysiological mechanisms of lithogenesis have been proposed, including the free and fixed particle theories, and Randal’s plaque hypothesis. Among the different types of kidney stones, those containing calcium are the most common, followed by those containing uric acid, struvite and cystine. Supersaturated urine, acidic urine pH and reductions in kidney stone inhibitors in the urine are the main recognized causes that contribute to the formation of all these stonetypes. Nephrolithiasis is considered a systemic pathology that may lead to end-stage renal disease. Although much progress has been made, the underlying pathophysiological mechanisms of kidney stone formation are still not fully understood.
The pathophysiology of bronchiectasis  [cached]
Paul T King
International Journal of COPD , 2009,
Abstract: Paul T KingDepartment of Medicine, Department of Respiratory and Sleep Medicine, Monash University, Monash Medical Centre, Melbourne, Victoria, AustraliaAbstract: Bronchiectasis is defined by permanent and abnormal widening of the bronchi. This process occurs in the context of chronic airway infection and inflammation. It is usually diagnosed using computed tomography scanning to visualize the larger bronchi. Bronchiectasis is also characterized by mild to moderate airflow obstruction. This review will describe the pathophysiology of noncystic fibrosis bronchiectasis. Studies have demonstrated that the small airways in bronchiectasis are obstructed from an inflammatory infiltrate in the wall. As most of the bronchial tree is composed of small airways, the net effect is obstruction. The bronchial wall is typically thickened by an inflammatory infiltrate of lymphocytes and macrophages which may form lymphoid follicles. It has recently been demonstrated that patients with bronchiectasis have a progressive decline in lung function. There are a large number of etiologic risk factors associated with bronchiectasis. As there is generally a long-term retrospective history, it may be difficult to determine the exact role of such factors in the pathogenesis. Extremes of age and smoking/chronic obstructive pulmonary disease may be important considerations. There are a variety of different pathogens involved in bronchiectasis, but a common finding despite the presence of purulent sputum is failure to identify any pathogenic microorganisms. The bacterial flora appears to change with progression of disease. Keywords: bronchiectasis, inflammation, obstructive lung disease, pathophysiology, pathology
El desbalance glomérulo-tubular en la fisiopatología de la hipertensión arterial asociada al bajo peso al nacer Glomerular-tubular imbalance in the pathophysiology of the arterial hypertension associated with low birth weight
Adina Pérez Mejías,María Ofelia Barber Fox,Aydelín Pérez Ramos
Revista Habanera de Ciencias M??dicas , 2011,
Abstract: La hipertensión arterial constituye un problema de salud mundial. Quedan sin esclarecer mecanismos fisiopatogénicos en su aparición. Se ha asociado el bajo peso al nacer por crecimiento intrauterino retardado con la hipertensión en la edad adulta, relacionado con nefrogénesis incompleta. El desarrollo de hipertensión en ratas, provocando hipertrofia tubular proximal, indica que el desbalance entre las funciones glomerular y tubular genera incapacidad excretora del ri ón y esta podría existir en el da o renal del bajo peso. Con el objetivo de valorar la posible implicación del desbalance glomérulo-tubular a preponderancia tubular en los mecanismos fisiopatológicos renales descritos en la hipertensión asociada al crecimiento intrauterino retardado, se utilizaron métodos teóricos. El cuerpo teórico elaborado se fundamentó en datos consultados en revistas científicas. Se concluye que el estado de desbalance glomérulo-tubular con preponderancia tubular, ha sido poco estudiado en relación con el desarrollo de la hipertensión en estos sujetos. Este fenómeno no se reconoce, hasta el momento, como una anormalidad renal, que puede constituir un mecanismo hipertensógeno primario. High blood pressure (hypertension) is a global health problem. Pathophysiologic mechanisms are unclear in their appearance. Reports have linked low birth weight and intrauterine growth retardation with hypertension in adulthood, related to incomplete nephrogenesis. The development of hypertension in rats leading to proximal tubular hypertrophy indicates that the imbalance between glomerular and tubular functions generates excretory kidney failure and it could be in renal damage of the low weight. In order to assess the possible involvement of glomerular-tubular imbalance with tubular preponderance, within pathophysiological renal mechanisms described in hypertension associated with intrauterine growth retardation, theoretical methods were used. The theoretical framework developed was based on data accessed in scientific journals. We conclude that the state of glomerular-tubular imbalance with tubular preponderance has been little studied in relation to the development of hypertension in these subjects. This phenomenon is not recognized, so far as abnormal renal, which may be a primary hypertensogenous mechanism.
The pathophysiology of bronchiectasis
Paul T King
International Journal of Chronic Obstructive Pulmonary Disease , 2009, DOI: http://dx.doi.org/10.2147/COPD.S6133
Abstract: thophysiology of bronchiectasis Review (22949) Total Article Views Authors: Paul T King Published Date October 2009 Volume 2009:4 Pages 411 - 419 DOI: http://dx.doi.org/10.2147/COPD.S6133 Paul T King Department of Medicine, Department of Respiratory and Sleep Medicine, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia Abstract: Bronchiectasis is defined by permanent and abnormal widening of the bronchi. This process occurs in the context of chronic airway infection and inflammation. It is usually diagnosed using computed tomography scanning to visualize the larger bronchi. Bronchiectasis is also characterized by mild to moderate airflow obstruction. This review will describe the pathophysiology of noncystic fibrosis bronchiectasis. Studies have demonstrated that the small airways in bronchiectasis are obstructed from an inflammatory infiltrate in the wall. As most of the bronchial tree is composed of small airways, the net effect is obstruction. The bronchial wall is typically thickened by an inflammatory infiltrate of lymphocytes and macrophages which may form lymphoid follicles. It has recently been demonstrated that patients with bronchiectasis have a progressive decline in lung function. There are a large number of etiologic risk factors associated with bronchiectasis. As there is generally a long-term retrospective history, it may be difficult to determine the exact role of such factors in the pathogenesis. Extremes of age and smoking/chronic obstructive pulmonary disease may be important considerations. There are a variety of different pathogens involved in bronchiectasis, but a common finding despite the presence of purulent sputum is failure to identify any pathogenic microorganisms. The bacterial flora appears to change with progression of disease.
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