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Effect of L-arginine on cardiac reverse remodeling and quality of life in patients with heart failure
No full textBackground & aims: Heart failure (HF), as a major cardiac disease, is associated with considerable mortality, morbidities and poor quality of life. The aim of this study was to investigate the effect of L-arginine supplementation on cardiac outcomes and quality of life in patients with ischemic HF. Methods: This double-blind randomized controlled clinical trial was conducted in 50 patients with ischemic HF. Patients were randomly assigned to receive either 3 gr/d L-arginine or placebo, for 10 weeks. Cardiac function (based on echocardiography and six-minute walk test), blood pressure, and quality of life (based on the Minnesota living with heart failure questionnaire) were assessed. Results: The results showed significant improvements in ejection fraction (�6.5 ± 8.7 vs. �0.7 ± 7.8, P = 0.037), left ventricular function (P = 0.043), diastolic dysfunction (P = 0.01) and marginally improvement in changes of left ventricular dimension during diastole (LVDd) (4 ± 6 vs. 0.3 ± 6.9 mm, P = 0.065) in the L-arginine compared to the placebo group. At the end of the study, physical aspect (5.7 ± 3.3 vs. 1.2 ± 6.1, P = 0.002) and total score (10 ± 6.7 vs. 4.1 ± 9.4, P = 0.011) of quality of life improved significantly in the L-arginine compared with the placebo group. Additionally, pre-to post-values of diastolic blood pressure, mean arterial pressure, LVDd, LV ejection fraction, left ventricular function, diastolic dysfunction as well as physical and total scores of quality of life improved significantly within the intervention, but not the placebo, group (all P < 0.05). Conclusion: This study showed that 3 gr/d L-arginine supplementation for 10 weeks could improve cardiac recovery and function, and quality of life in patients with HF. This study was registered at the Iranian Clinical Trial Registration Center (www.irct.ir) with IRCT20170202032367N4 code. © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolis
Induced dysregulation of ACE2 by SARS-CoV-2 plays a key role in COVID-19 severity
Get PDFSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of COVID-19, is reported to increase the rate of mortality worldwide. COVID-19 is associated with acute respiratory symptoms as well as blood coagulation in the vessels (thrombosis), heart attack and stroke. Given the requirement of angiotensin converting enzyme 2 (ACE2) receptor for SARS-CoV-2 entry into host cells, here we discuss how the downregulation of ACE2 in the COVID-19 patients and virus-induced shift in ACE2 catalytic equilibrium, change the concentrations of substrates such as angiotensin II, apelin-13, dynorphin-13, and products such as angiotensin (1�7), angiotensin (1�9), apelin-12, dynorphin-12 in the human body. Substrates accumulation ultimately induces inflammation, angiogenesis, thrombosis, neuronal and tissue damage while diminished products lead to the loss of the anti-inflammatory, anti-thrombotic and anti-angiogenic responses. In this review, we focus on the viral-induced imbalance between ACE2 substrates and products which exacerbates the severity of COVID-19. Considering the roadmap, we propose multiple therapeutic strategies aiming to rebalance the products of ACE2 and to ameliorate the symptoms of the disease. © 202
Resveratrol supplementation and acute pancreatitis: A comprehensive review
Get PDFResveratrol, a natural polyphenolic ingredient extracted from herbs, suppresses oxidative stress and inflammation. We performed a comprehensive review to find any evidence about the effects of Resveratrol on acute pancreatitis (AP). Resveratrol has been found to directly impact cytokine generation. As these factors play a crucial role in the pathophysiology of AP, resveratrol might attenuate AP and its complications. Mechanistically, resveratrol exerts its pharmacological effects through anti-inflammatory and antioxidant mechanisms via interaction with different signaling molecules and transcription factors. Indeed, resveratrol might prove to be an effective therapeutic component for AP treatment in the future. In this review, we shed light on potential most recent pathways through which resveratrol might impact the management and control of AP. © 202
To Adjust or Not to Adjust: The Role of Different Covariates in Cardiovascular Observational Studies
No full textCovariate adjustment is integral to the validity of observational studies assessing causal effects. It is common practice to adjust for as many variables as possible in observational studies in the hopes of reducing confounding by other variables. However, indiscriminate adjustment for variables using standard regression models may actually lead to biased estimates. In this paper, we differentiate between confounders, mediators, colliders, and effect modifiers. We will discuss that while confounders should be adjusted for in the analysis, one should be wary of adjusting for colliders. Mediators should not be adjusted for when examining the total effect of an exposure on an outcome. Automated statistical programs should not be used to decide which variables to include in causal models. Using a case scenario in cardiology, we will demonstrate how to identify confounders, colliders, mediators and effect modifiers and the implications of adjustment or non-adjustment for each of them. © 2021 Elsevier Inc
Elderberry diet ameliorates motor function and prevents oxidative stress-induced cell death in rat models of Huntington disease
No full textHuntington's disease (HD) is an inherited neurodegenerative disorder which begins in the striatum and then spreads to other neural areas. Known as a progressive movement cognitive disorder, HD has no efficient therapy. Although the exact mechanism of HD is still unknown, several different etiological processes such as oxidative stress have been shown to play critical roles. Also, the current evidence indicates a strong correlation between immune activation and neural damage induced by neuroinflammatory and apoptotic agents in neurodegenerative disorders. Thus, natural products like Elderberry (EB) could be considered as a novel and potential therapeutic candidate for the treatment of this disease. In this study EB was added to the daily ration of ordinary rats for two months in order to ameliorate inflammatory and oxidative responses in rats injected with 3-nitropropionic acid (3-NP) in an experimental model of HD. Using Rotarod and electromyography setups, we showed that EB diet significantly recovered motor failure and muscle incoordination in 3-NP injected rats compared to the control group. Also, the molecular findings implied that EB diet led to a significant drop in 3-NP induced growth in caspase-3 and TNF-α concentration. The treatment also improved striatal antioxidative capacity by a significant reduction in ROS and a remarkable rise in GSH, which might be correlated with motor recovery in the tests. In sum, the findings demonstrate the advantages of EB treatment in the HD rat model with a score of beneficial anti-oxidative and anti-inflammatory effects. © 2021 Elsevier B.V
Nursing physical workload and mental workload in intensive care units: Are they related?
Get PDFAim: In order to ensure patient safety and quality of care, it is important to consider factors which may impact on nursing workloads. This study aimed to investigate the simultaneous physical and mental workload and any relationships between these concepts on nurses working in intensive care units. Design: A cross-sectional design was undertaken. Method: Participants were nurses (N = 105) recruited from six adult intensive care units which met the inclusion criteria. Nursing Activities Score (NAS) to measure physical workload and NASA Task Load Index (NASA-TLX) to measure mental workload were used. Data were collected for each participating nurse in three shifts (morning, evening and night). Data were analysed using bivariate correlation and multivariable linear regression analysis. Results: The mean (SD) of nurses' physical and mental workload was 72.84 (22.07) and 70.21 (12.36), respectively. A significant relationship between physical and mental workload (p <.001) was identified. © 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd
Male Factors: the Role of Sperm in Preimplantation Embryo Quality
No full textFew studies have been conducted on the paternal effects on embryogenesis as compared with studies on maternal effects. The fertility potential of sperm decreases with genomic material abnormalities. Damaged DNA of sperm has been correlated with poor fertilization, reduced implantation and pregnancy rates, and increased production of aneuploid embryos. Evidence suggests that the role of sperm in embryogenesis goes beyond genomic material transfer, and centrosomes, sperm-derived cytoplasmic factors, paternal mRNA, and small RNAs are essential for early embryonic development. Epigenetic factors like histone modification and DNA methylation participate in the regulation of gene expression in sperm. The etiology of sperm chromatin abnormalities is important in male fertility and may affect reproductive outcomes. Success in implantation depends on the quality of the fertilized sperm and oocyte as well as the type of assisted reproductive techniques. Therefore, male factors affecting development of embryo can play a role in the failure of assisted reproductive techniques. Further studies are needed to evaluate clinical aspects and the risks of transmitting genetic or epigenetic disorders to provide safe therapies for infertility. © 2020, Society for Reproductive Investigation
Psychoanalytic explanation of key personality traits of instagram micro-celebrities: A qualitative study
Get PDFBackground: With the growing use of social networks, a large number of studies have investigated their psychological effects. Previous research has demonstrated that virtual networks, especially Instagram, negatively affect users' mental health and make them vulnerable to mental disorders. However, the studies have been descriptive and provide descriptive statements; hence, they do not contribute to in-depth understanding of such vulnerability. Accordingly, qualitative studies should be conducted to delve into this phenomenon. Objectives: This article aimed to understand the key personality traits of popular Iranian Instagram users, assuming that the networks make individuals psychoanalytically vulnerable to clinical outcomes. Methods: Regarding the research method, the deductive content analysis was adopted for the data extracted from semi-structured in-depth interviews with users having > 10,000 followers. Psychodynamic diagnostic manual, PDM-2 second edition, and the structured analysis matrix were considered to make sense of the collected data. Results: The results demonstrated that the dominant key personality traits in popular Instagram users were narcissism with three subcategories (namely narcissistic central tension, pathogenic belief about oneself, and pathogenic belief about others) and depression with two subcategories (namely depressive pathogenic belief about oneself and pathogenic belief about others). Conclusions: According to the findings, the structures and categories underpinning our experiences by Instagram are inherently narcissistic. Rather than changing individuals' dynamics, Instagram promotes this intellectual and communicative style inversely by normalizing it and reinforcing the narcissistic personality disorder established by the family and cultural structure of society. Copyright © 2021, Author(s)
The cardiomyopathy of Friedreich's ataxia common in a family: A case report
Get PDFIntroduction and importance: Friedreich's Ataxia is an autosomal recessive disease and is usually associated with arterial dysfunction, muscle weakness, spasm in the lower extremities, scoliosis, bladder dysfunction, lack of reflexes in the lower extremities, and imbalance. Approximately 2.3 people have cardiomyopathy. In this article, we have reviewed a case of Friedreich's Ataxia with hypertrophic cardiomyopathy. Case presentation: A 19-year-old woman with Friedreich's Ataxia has been protesting since she was 11 years old and complained of chest pains, dyspnea, and heart palpitations without a medical history. In ECG, Asymmetrical invert T wave diffuse, diffuse ST-segment depression, and left ventricular hypertrophy were observed. In echocardiography, the left ventricle was reported as hyperimmobile with increased EF (70�75). Clinical discussion: In the present study, a patient with Friedrich Ataxia was diagnosed with chest pain, dyspnea, and palpitations without any medical history, and was discharged from the hospital after treatment. In the patients introduced and our patient, there was significant fibro-myocardial hypertrophy, in which the ventricular septal hypertrophy was marked by hypertrophic cardiomyopathy. Conclusion: Because early diagnosis of the disease is difficult, clinical signs and the patient's current profile at the time of referral will be very helpful. © 202
Vibrio cholerae toxin coregulated pilus provokes inflammatory responses in Coculture model of Caco-2 and peripheral blood mononuclear cells (PBMC) leading to increased colonization
No full textThe aim of this study was to assess the modulatory effect of TcpA in the expression of CEACAM1 adhesin molecule and IL-1, IL-8, and TNF-α pro-inflammatory cytokines in the Coculture model of Caco-2/PBMC (peripheral blood mononuclear cell) that can mimic the intestinal milieu. The TcpA gene from Vibrio cholerae ATCC14035 was cloned in pET-28a and transformed into Escherichia coli Bl-21. The recombinant TcpA-His6 protein was expressed and purified using Ni-column chromatography. The sequencing of transformed plasmid and Western blot analysis of purified protein confirmed the identity of rTcp. The cytotoxicity of different concentrations of recombinant protein for human colon carcinoma cell line (human colorectal adenocarcinoma cell Caco-2 cell) was assessed by MTT assay and showed viability of 92%, 82%, and 70%, for 10 µg/mL of TcpA after 24, 48, and 72 h, respectively. Co-cultures of Caco-2 and PBMCs were used to mimic the intestinal milieu and treated with different concentrations of rTcpA (1, 5, 10, and 50 µg/mL). Our data showed about 2.04-, 3.37-, 3.68-, and 42.7-fold increase in CEACAM1 gene expression, respectively, compared with the nontreated Caco-2/PBMC Coculture. Moreover, the expression of IL-1, IL-8, and TNF-α genes was significantly increased up to 15.75-, 7.04-, and 80.95-folds, respectively. In conclusion, V. cholerae TcpA induces statistically significant dose-dependent stimulatory effect on TNF-α, IL-,1, and IL-8 pro-inflammatory cytokines expression. Of these, TNF-α was much more affected which, consequently, elevated the CEACAM1 expression level in IECs. This suggests that TcpA protein is a critical effector as an inducer of increased adhesion potential of V. cholera as well as inflammatory responses of host intestinal tissue. © 2021 The Societies and John Wiley & Sons Australia, Lt