Pilot randomized clinical trial of the Teachable Moment Brief Intervention for hospitalized suicide attempt survivors.

OBJECTIVE: The aim of this study was to further evaluate the acceptability and feasibility of the Teachable Moment Brief Intervention (TMBI). METHOD: A single blind, pilot randomized controlled trial of the TMBI + care as usual (CAU) compared to CAU was conducted for patients who survived a recent suicide attempt that required medical inpatient hospitalization. The intervention was delivered on medical/surgical and inpatient psychiatry units in the medical center. Interviews were completed at baseline, 1, 3, and 12 months. RESULTS: Patients reported high ratings of satisfaction with the TMBI. Interventionists representing fields of Psychiatry, Social Work, and Counseling were able to deliver the intervention with fidelity to the treatment manual with equal adherence ratings. The TMBI patients were more likely to maintain a positive recovery trajectory on motivation and engagement in mental health services at 3 months. CONCLUSION: The TMBI provides an option for targeted intervention to health care providers as they engage patients admitted to an acute medical setting after a serious suicide attempt. This is the second pilot study demonstrating enhanced motivation in the post-hospitalization period.

Effects of ozone oxidative preconditioning on different hepatic biomarkers of oxidative stress in endotoxic shock in mice.

In endotoxic shock, variations are known to occur in different biochemical parameters of oxidative stress. Ozone oxidative preconditioning (OOP) is a good candidate to restore the redox balance on different tissue. This investigation examined the effect of OOP on different biomarkers of oxidative stress in hepatic tissue of mice treated with lipopolysaccharide (LPS). LPS doses of 30 mg/kg were administered intraperitoneally (i.p.) and pretreatment with ozone/oxygen mixture (OOM) was applied i.p. at 0.2, 0.4, and 1.2 mg/kg once daily during 5 days before LPS injection. The mice were euthanized under ether atmosphere at different times, 1 and 24 h after LPS injection. Hepatic tissue from all animals was taken for biochemical determinations of oxidative stress parameters such as thiobarbituric acid reactive substances (TBARS) content and activity of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione S-transferase (GST). The results demonstrated that OOP reduces levels of TBARS content and increases the activity of GPx in hepatic tissue. In conclusion, OOP was able to recover the redox balance and in this way to protect the animals against the oxidative damage induced by endotoxemia.

Comparing the accuracy of ES-BC, EIS-GS, and ES Oxi on body composition, autonomic nervous system activity, and cardiac output to standardized assessments.

BACKGROUND AND PURPOSE: THE ELECTRO SENSOR COMPLEX (ESC) IS SOFTWARE THAT COMBINES THREE DEVICES USING BIOELECTRICAL IMPEDANCE, GALVANIC SKIN RESPONSE, AND SPECTROPHOTOMETRY: (1) ES-BC (Electro Sensor-Body Composition; LD Technology, Miami, FL) to assess body composition, (2) EIS-GS (Electro Interstitial Scan-Galvanic Skin; LD Technology) to predict autonomic nervous system activity, and (3) ES Oxi (Electro Sensor Oxi; LD Technology) to assess cardiac output. The objective of this study was to compare each to a standardized assessment: ES-BC to dual-energy X-ray absorptiometry (DXA), EIS-GS to heart rate variability, and ES Oxi to BioZ Dx Diagnostic System (BioZ Dx; SonoSite Inc, Bothell, WA). PATIENTS AND METHODS: The study was conducted in two waves. Fifty subjects were assessed for body composition and autonomic nervous system activity. Fifty-one subjects were assessed for cardiac output. RESULTS: We found adequate relative and absolute agreement between ES-BC and DXA for fat mass (r = 0.97, P < 0.001) with ES-BC overestimating fat mass by 0.1 kg and for body fat percentage (r = 0.92, P < 0.001) with overestimation of fat percentage by 0.4%. For autonomic nervous system activity, we found marginal relative agreement between EIS-GS and heart rate variability by using EIS-GS as the predictor in a linear regression equation (adjusted R(2) = 0.56, P = 0.03). For cardiac output, adequate relative and absolute agreement was found between ES Oxi and BioZ Dx at baseline (r = 0.60, P < 0.001), after the first exercise stage (r = 0.79, P < 0.001), and after the second exercise stage (r = 0.86, P < 0.001). Absolute agreement was found at baseline and after both bouts of exercise; ES Oxi overestimated baseline and stage 1 exercise cardiac output by 0.3 L/minute and 0.1 L/minute, respectively, but exactly estimated stage 2 exercise cardiac output. CONCLUSION: ES-BC and ES Oxi accurately assessed body composition and cardiac output compared to standardized instruments, whereas EIS-GS showed marginal predictive ability for autonomic nervous system activity. The ESC software managing the three devices would be useful to help detect complications related to metabolic syndrome, diabetes, and cardiovascular disease and to noninvasively and rapidly manage treatment follow-up.

Effect of ozone pre-conditioning on redox activity in a rat model of septic shock.

The confirmed advantageous effects of oxygen/ozone therapy in several clinical conditions stimulated experimental studies on effects of the therapy in induced septic shock. This study researches the influence of Ozone Oxidative Pre-conditioning (OOP) in unbalance between pro-oxidant and antioxidant activity generated in liver and lung during a process of sepsis. The study was conducted on male rats. Sepsis was induced by intraperitoneal injection of fecal material and pre-treatment with ozone/oxygen mixture was administered before fecal material injection. Activities of catalase, glutathione peroxide, and superoxide dismutase were measured, as well as conjugated dienes (CD) and thiobarbituric acid reactive substances (TBARS) were estimated. The results demonstrated that OOP not cause oxidative damage. It reduced levels of pro-oxidant biomarkers in lung and liver, with decreased total pro-oxidant activity and elevated total antioxidant activity from a system for diagnosis of oxidative stress in both tissues. These results suggest that OOP protected liver and lung for oxidative stress in septic shock.

Effect of ozone/oxygen mixture on systemic oxidative stress and organic damage.

Ozone is a molecule of high energetic content. Its great oxidative power has been used in medicine for the treatment of several illnesses with a wide spectrum. The rectal insufflation with a mixture of ozone/oxygen is considered as a simple therapy, not painful, of low cost and practically free from adverse effects. Given its potential oxidation and lack of side-effects, the objective has been to know the state of different indexes of redox state in blood which may contribute to understanding the mechanism by which mixtures of ozone/oxygen administered by intrarectal route are able to exert actions on other organs. With this purpose female rabbits were used, distributed into four groups, and three doses of ozone/oxygen mixture were tested. When treatment was finished, the determination of pro-oxidant and antioxidant markers was carried out. Also indexes of organic damage were determined. Ozone doses administered to rabbits did not cause adverse effects and mortality did not show significant changes relative to tissue damages and they increased enzymes activities belonging to the first line antioxidant defences. The results demonstrate that ozone/oxygen mixture administered by rectal insufflations is innocuous and it is able to increase the antioxidant defense of the organism.

Ozone oxidative preconditioning reduces nitrite levels in blood serum in LPS: induced endotoxic shock in mice.

OBJECTIVE AND DESIGN: Reactive oxygen species, and also reactive species of nitrogen such as nitric oxide, play an important role in the pathogenesis of peritonitis and septic shock. Ozone oxidative preconditioning (OOP) has shown protective effects in various experimental models of peritonitis in rats and endotoxic shock in mice. Currently, strong evidence is available that this protective effect of OOP is due to its action on the balance between endogenous antioxidants and pro-oxidants, which is favorable for anti-oxidant defense. The aim of this research was to elucidate whether or not OOP is able to reduce nitrite levels in blood serum of mice treated with lipopolysaccharide (LPS). We used an experimental model of endotoxic shock induced by LPS in mice in which the animals were pre-treated with ozone/oxygen mixture for 5 days (once daily), with injection of LPS 24 h thereafter to induce endotoxic shock. RESULTS: Mice pretreated with OOP showed a significant decrease in nitrite levels with all three doses tested [0.2 mg/kg (50.91%), 0.4 mg/kg (47.3%) and 1.2 mg/kg (34.6%)]. CONCLUSIONS: Ozone oxidative preconditioning significantly reduced nitrite levels in blood serum of mice with endotoxic shock induced by LPS. We propose that OOP merits further testing in studies as a potential alternative treatment to reduce nitrite levels in patients with sepsis syndrome and septic shock.

Preconditioning with ozone/oxygen mixture induces reversion of some indicators of oxidative stress and prevents organic damage in rats with fecal peritonitis.

OBJECTIVE AND DESIGN: Reactive oxygen and nitrogen species are involved in the pathogenesis of sepsis syndrome with peritonitis and the septic shock. The aim of this study was to determine whether ozone oxidative preconditioning (OOP) may exert beneficial effects in the prevention and treatment of sepsis syndrome in rats inoculated by the intraperitoneal route (i.p.) with fecal material and also to determine if antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPx) may exert protective effects against this systemic inflammatory disorder. MATERIALS AND METHODS: Male Wistar rats were used. SOD and GPx activities were determined in erythrocytes. Thiobarbituric acid reactive substances (TBARS) content as biomarkers of oxidative stress, alanine amino transferase (ALT), aspartate amino transferase (AST) and creatinine (CRE) were measured in blood serum and myeloperoxidase (MPO) in lung tissue as markers of organs damage. RESULTS: In rats submitted to OOP, SOD and GPx activities were significantly increased and it was accompanied by significant decrease of TBARS content in blood serum. OOP also significantly reduced levels of ALT, AST and CRE in blood serum as well as MPO in rat lung. CONCLUSION: The results support the important role of SOD and GPx in the protective effects of OOP against organ damage induced by fecal peritonitis in rats.

Ozone oxidative post-conditioning in acute renal failure.

OBJECTIVES: The ischaemia-reperfusion process is largely mediated by reactive oxygen species. Taking into account that a transient and controlled administration of ozone is able to upregulate cellular antioxidant enzymes, a morphological, biochemical and functional renal study was performed in rats undergoing warm renal ischaemia. METHODS: Rats were divided into four groups. All except the negative controls underwent 60 min' bilateral renal ischaemia followed by 10 days' reperfusion. The positive control group received no further treatment. The ozone group received an ozone/oxygen mixture (ozone dose 0.5 mg/kg) immediately after the ischaemia and daily for the 10 days' reperfusion; the oxygen group were given the same concentration of oxygen alone (13 mg/kg). Biochemical parameters fructosamine, phospholipase A2, catalase, superoxide dismutase and thiobarbituric acid reactive substances were measured, as well as renal plasma flow and glomerular filtration rate. KEY FINDINGS: Renal plasma flow and glomerular filtration rate decreased significantly in the positive controls and the oxygen group whereas values in the ozone group were similar to those in the negative control group. With respect to the biochemical parameters, ozone maintained a homeostasis redox, with significant increases in catalase and superoxide dismutase activities and similar values for phospholipase A2 and fructosamine compared with the negative control group. Fewer morphological alterations were seen in kidneys from the ozone group. No advantages were obtained in the positive control and oxygen groups. CONCLUSIONS: The protective effect of ozone may be explained by upregulation of the antioxidant defence system and beneficial effects on blood circulation and in oxygen metabolism. Ozone treatment may represent a therapeutic approach for minimising renal damage after transplantation.

Citocinas inflamatorias, sus acciones y efectos en la sepsis y el choque séptico / Inflammatory cytokines and their actions and effects in the sepsis and septic shock

Se expusieron las acciones y los efectos biológicos que ejercen las citocinas pro-inflamatorias, así como el papel que desempeñan en el desarrollo de la sepsis y de su complicación más severa, el choque séptico, tanto en el humano como en los modelos experimentales en animales, desarrollados con el objetivo de esclarecer los complejos mecanismos patogénicos que intervienen; esto hace factible el desarrollo de nuevos fármacos y otros procederes terapéuticos efectivos y seguros para el tratamiento de una enfermedad grave, causante de una morbilidad y mortalidad elevada al nivel mundial. También se destacan las interacciones complejas que se desarrollan entre las diversas citocinas proinflamatorias y las de estas con otros mediadores de la denominada respuesta inflamatoria sistémica. Se señaló el comportamiento dual de las acciones de algunas citocinas en ocasiones portadoras de efectos opuestos, así como la dependencia de sus acciones del período de tiempo en que se administran. Otra característica no menos importante es que con frecuencia difieren entre sí y no hay correspondencia entre los resultados de los efectos de las citocinas en los humanos con los obtenidos en los modelos experimentales en animales con choque séptico y endotóxico.

The actions and biological effects that the pro-inflammatory cytokines exert, as well as the role they play in the evolution of sepsis and of its most severe complication, the septic shock, both in humans and in experimental animal models, developed in order to clarify the complex pathogenic mechanisms taking place, were exposed. This makes possible the development of new drugs and other effective and safe therapeutical procedures for the treatment of a severe disease causing a high morbidity and mortality at the world level. The complex interactions occurring among the diverse pro-inflammatory cytokines were stressed, as well as their interactions with other mediators of the so-called systemic inflammatory response. The dual behaviour of the actions of some cytokines occasionally carriers of opposed effects, as well as their actions depending on the period of time in which they were administered, were emphasized. Another significant characteristic was that they frequently varied, and that there was no correspondence between the results of the effects of the cytokines in humans and those obtained in the experimental animal models with septic and endotoxic shock.