The global, prevalence, and risk factors of postoperative fever after percutaneous nephrolithotomy: A systematic review and meta-analysis.

Objective: This study aimed to explore the global, prevalence, and risk factors of fever after percutaneous nephrolithotomy (PCNL) by conducting a systematic review and meta-analysis. Methods: The high-sensitivity searching was conducted without time limitation until December 30, 2020 in Web of Sciences, Scopus, and PubMed based on inclusion and exclusion criteria. Results: The prevalence rates of fever and sepsis among patient undergoing PCNL were estimated 9.5% (95% confidence interval [CI]: 9.3%-9.7%), and 4.5% (95% CI: 4.2%-4.8%), respectively. Nephrostomy tube was used in 9.96% (95% CI: 9.94%-9.97%) of patients. The mean preoperative white blood cells of patients were 6.401×109/L; 18.3% and 4.55% of patients were considered as the positive urinary culture and pyuria, respectively. About 20.4% of patients suffered from residual stones. The odds ratios (ORs) of fever in patients who suffering from diabetes mellitus, hydronephrosis, staghorn stones, and blood transfusion were 4.62 (95% CI: 2.95-7.26), 1.04 (95% CI: 0.81-1.34), 2.57 (95% CI: 0.93-7.11), and 2.65 (95% CI: 1.62-4.35), respectively. Patients who underwent PCNL in prone position were more likely to develop fever (OR: 1.23; 95% CI: 0.75-2.00) than patients in supine position. Conclusion: The current study showed that patients who suffer from diabetes mellitus, hydronephrosis, staghorn stones, nephrostomy tube or double-J stent, blood transfusion, and also patients who underwent PCNL in prone position surgery are more likely to develop a postoperative fever after PCNL.

Nutrients in prevention, treatment, and management of viral infections; special focus on Coronavirus.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a pandemic caused by coronavirus with mild to severe respiratory symptoms. This paper aimed to investigate the effect of nutrients on the immune system and their possible roles in the prevention, treatment, and management of COVID-19 in adults. METHODS: This Systematic review was designed based on the guideline of the Preferred Reporting for Systematic Reviews (PRISMA). The articles that focussed on nutrition, immune system, viral infection, and coronaviruses were collected by searching databases for both published papers and accepted manuscripts from 1990 to 2020. Irrelevant papers and articles without English abstract were excluded from the review process. RESULTS: Some nutrients are actively involved in the proper functioning and strengthening of the human immune system against viral infections including dietary protein, omega-3 fatty acids, vitamin A, vitamin D, vitamin E, vitamin B1, vitamin B6, vitamin B12, vitamin C, iron, zinc, and selenium. Few studies were done on the effect of dietary components on prevention of COVID-19, but supplementation with these nutrients may be effective in improving the health status of patients with viral infections. CONCLUSION: Following a balanced diet and supplementation with proper nutrients may play a vital role in prevention, treatment, and management of COVID-19. However, further clinical trials are needed to confirm these findings and presenting the strong recommendations against this pandemic.

The status of clinical nutrition in hospitals of Guilan province, Iran - A mixed-method study.

Introduction: Background: nutritional therapy has an important role in the development of medical care services, and quantitative and qualitative assessments of the status of clinical nutrition in hospitals is crucial. This study aimed to explore the current status of clinical nutrition in hospitals of Guilan province, Iran. Methods: this quantitative-qualitative (mixed method) study was performed on public hospitals in Guilan province, Iran (n = 26). The required information was collected by visiting the hospitals and interviewing with hospital dietitians. The data collection tool had two quantitative and qualitative subscales. The quantitative subscale included a 21-item checklist containing information about the referral system, cooperation of hospital staff in clinical nutrition, clinical nutrition staff status, enteral nutrition, and parenteral nutrition. Results: in more than 55 % of hospitals the patients were not adequately referred to a dietitian. In about 31.2 % of hospitals, cooperation of other departments in the field of clinical nutrition was insufficient. In 37 % of hospitals with intensive care unit (ICU), enteral nutrition was not provided properly. Only 27 % of the hospital properly provided parenteral nutrition for their patients. The most important problems mentioned by hospital dietitians included noncompliance of the food services employers with recommended diets, insufficient number of hospital dietitians, and lack of per case payment method for dietitians. Coverage of diet services by health insurance was the most common suggestion of dietitians to promote diet therapy in public hospitals. Conclusion: the situation of providing nutritional services to patients in public hospitals is not favorable in terms of quantity and quality in Guilan province, Iran. Designing the necessary policies and reorient the clinical nutrition system in hospitals to promote patients' health and accelerate patient recovery is warranted.

Introducción: Antecedentes: la terapia nutricional tiene un papel importante en el desarrollo de los servicios de atención médica, y las evaluaciones cuantitativas y cualitativas del estado de la nutrición clínica en los hospitales son cruciales. Este estudio tuvo como objetivo explorar el estado actual de la nutrición clínica en los hospitales de la provincia de Guilan, Irán. Métodos: este estudio cuantitativo-cualitativo (método mixto) se realizó en hospitales públicos de la provincia de Guilan, Irán (n = 26). La información requerida se recopiló visitando los hospitales y entrevistando a los dietistas de los hospitales. La herramienta de recolección de datos tenía dos subescalas, cuantitativa y cualitativa. La subescala cuantitativa incluía una lista de verificación de 21 ítems que contenía información sobre el sistema de derivación, la cooperación del personal del hospital en nutrición clínica, el estado del personal de nutrición clínica, la nutrición enteral y la nutrición parenteral. Resultados: en más del 40 % de los hospitales, los pacientes no fueron derivados adecuadamente a un dietista. En el 35 % de los hospitales, la cooperación de otros departamentos en el campo de la nutrición clínica fue insuficiente. En el 55 % de los hospitales con unidad de cuidados intensivos (UCI), la nutrición enteral no se brindó adecuadamente. Ninguno de los hospitales proporcionó nutrición parenteral adecuada para los pacientes. Los problemas más importantes mencionados por los dietistas hospitalarios incluyeron el incumplimiento de los programas de alimentos por parte del empleador del sector alimentario, un número insuficiente de dietistas hospitalarios y la falta de pago de honorarios de consulta a los dietistas. La cobertura de los servicios de dietética por parte del seguro de salud fue la sugerencia más común de los dietistas para promover la dietoterapia en los hospitales. Conclusión: la situación de la prestación de servicios nutricionales a pacientes en hospitales públicos no es favorable en términos de cantidad y calidad en la provincia de Guilan, Irán. Se justifica diseñar las políticas necesarias para reorientar el sistema de nutrición clínica en los hospitales y, en definitiva, promover la salud y acelerar la recuperación de los pacientes.

Impact of Curcumin Supplementation on Radiation Dermatitis Severity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Radiation dermatitis (RD) is a common side effect of radiotherapy in most breast cancer patients. Curcumin has recently attracted more attention for managing the side effects of breast cancer treatments. This review study aimed to investigate the effect of curcumin on the severity of radiation dermatitis in patients with breast cancer.   Methods: All eligible randomized controlled trials (RCTs) were collected by searching PubMed, Scopus, Cochrane, and Web of Science. The effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Study heterogeneity was assessed through Q statistics and I-squared. RESULTS: Four RCTs with 882 patients were included in the final analysis. The results of the meta-analysis indicated that curcumin supplementation significantly reduced radiation dermatitis severity (RDS) score in the intervention group compared to the control group (WMD=-0.50; 95% CI -0.72 to -0.27, P <0.001). A significant heterogeneity was observed between the studies (I2 = 95.7%, P < 0.001). CONCLUSION: Based on the results of the present study, curcumin has significant effects in reducing the severity of radiation dermatitis in breast cancer patients receiving radiotherapy. Further well-designed longitudinal studies are recommended to confirm these results and to discover the underlying mechanisms of the effects of curcumin on the severity of radiation dermatitis in patients with cancer.

The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID-19: A case-control study.

BACKGROUND: The coronavirus disease-2019 (COVID-19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID-19. METHODS: This case-control study was conducted on critically ill COVID-19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. RESULTS: Compared to the group of COVID-19 patients who died in <30 day, the survived patients had a lower eosinophile level (2.2 ± 0.5 vs. 6 ± 0.0, p < .001) and higher vitamin D supplementation duration (9 ± 4.4 vs. 3.3 ± 1.9 day, p = .001). Vitamin D supplementation had a positive association with survival in COVID-19 patients (OR: 1.98, 95% CI: 1.15-3.40, p < .05). The association remained significant after adjustments fot age, sex, underlying diseases, and smoking. CONCLUSION: Vitamin D supplementation in critically ill patients with COVID-19 has the potential to increase survivability within the first 30 days of hospitalization.

Mental Health and Resilience among Nurses in the COVID-19 Pandemic: A Web-Based Cross-Sectional Study.

Objective: Nurses exposed to COVID-19 could be psychologically stressed. The present study investigated the mental health and the resilience level in the nurses' population. Method: This cross-sectional study was performed on 432 nurses in 27 hospitals working in Guilan province, north of Iran, between April 29, to May 14, 2020. Mental health and resilience were measured using the 12-item General Health Questionnaire-12 (GHQ-12) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Hierarchical multiple linear regression model was used to identify factors associated with mental health. Results: The mean GHQ-12 and CD-RISC-10 scores were 15.72 (SD, 5.67) and 25.97 (SD, 6.88), respectively. Probable psychological distress (GHQ-12 score ≥ 15) was present in 57.2% of nurses. Among demographic and COVID-19-related variables, only educational level was significantly and negatively correlated with mental health. After controlling the variables, hierarchical regression analyses results showed that lower resilience was associated with poor mental health (ß = -0.49; P < 0.001). Conclusion: Regarding the nurses' mental health, appropriate psychological/psychiatric intervention is necessary, and resilience can play a role as a mental health promoter.

Does the rs9939609 FTO gene polymorphism affect fat percentage? A meta-analysis.

This meta-analysis aimed to investigate the association of the rs9939609 FTO gene polymorphism and body fat percentage (BF%). To the best of our knowledge, this study is the first meta-analysis to evaluate the relationship between FTO rs9939609 polymorphism and BF%. We searched PubMed, Web of science, Scopus and Embase to identify studies investigating the relations between the rs9939609 FTO gene polymorphism and BF%. Studies that meet inclusion criteria were collected for the final analysis. There was significant differences in the level of BF% between different genotypes of FTO rs9939609 polymorphism, and the carriers of the A allele of FTO rs9939609 polymorphism had higher BF%. The association was significant between carriers of TT genotype compared to carriers of AA (p = .007) and AT genotypes (p = .04), but not between AT and AA genotypes. This study identified that the carriers of the A allele of FTO rs9939609 polymorphism have higher BF%.

The Role of Tumor Necrosis Factor-α (TNF-α) Polymorphisms in Gastric Cancer: a Meta-Analysis.

PURPOSE: Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine which may play a role in the development of gastric cancer (GC). This study aimed to investigate the association of five TNF-α polymorphisms including TNF-α-857, TNF-α-1031, TNF-α-863, TNF-α-308, and TNF-α-238 polymorphisms with GC risk. METHODS: All eligible case-control studies were collected by searching PubMed, Scopus, and Web of Science. The association of the risk of GC with TNF-α polymorphisms was estimated using odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed via Cochrane's Q and I2 analyses. RESULTS: A total of 46 publications involving 16, 715 cases with GC and 27, 998 controls were recruited. The study revealed a significant association for TNF-α 308 (recessive model: OR = 0.646, P = 0.035), TNF-α-1031 (homozygote model: OR = 1.584, P = 0.027), and TNF-α-857 (homozygote model: OR = 1.760, P = 0.001) polymorphisms with the GC risk. The results of subgroup analysis based ethnicity found a significant association between GC risk and TNF-α-857 polymorphism in Caucasian subgroup (P = 0.005) and TNF-α-1031 polymorphism and GC risk in Asians (P = 0.018). CONCLUSIONS: This study suggested that TNF-α-857 and TNF-α-1031 polymorphisms may be associated with the increased gastric cancer risk.

Intake of food groups and cervical cancer in women at risk for cervical cancer: A nested case-control study.

Background: The risk of cervical cancer was reported to be influenced by dietary components. This study aimed to illustrate the association between cervical cancer with the intake of food groups in women with a history of cervical neoplasia. Methods: This nested case-control study was conducted in 558 people with a history of cervical intraepithelial neoplasia (CIN), including 279 women with cervical cancers and 279 controls with low-grade squamous intraepithelial lesions (LSIL). A validated food frequency questionnaire (FFQ) was used to assess the intake of food groups. Results: The intake of fruits and vegetables in the case group was significantly lower than the control group (P=0.001). Low intake of dairy products, vegetables, and fruits was associated with cervical cancer risk (OR=4.67; 95% CI 1.2-9.49, P=0.001; OR=9.75, 95% CI 1.36-19. 51, P=0.001; and OR=4.82, 95% CI 1.09-7.25, P=0.001, respectively). After adjusting for age, family history, age at first menstruation, number of children, history of vaginal infection, and age at first sexual intercourse, the results were still significant. Additional adjustments to BMI did not change the results. Conclusion: The results indicate that the risk of cervical cancer can be affected by the intake of certain food groups. Further longitudinal studies are needed to confirm these findings and determine the underlying mechanism of the influence of dietary components on cervical cancer risk.

Interactions of Colorectal Cancer, Dietary Fats, and Polymorphisms of Arachidonate Lipoxygenase and Cyclooxygenase Genes: A Literature Review.

Objective: Genetics and dietary factors play important roles in the development of colorectal cancer (CRC). However, the underlying mechanisms of the interactions between CRC, gene polymorphisms, and dietary fat are unclear. This review study investigated the effects of polymorphisms of arachidonate lipoxygenase (ALOX) and cyclooxygenase (COX) genes in the association between CRC and dietary fat. Methods: All the related papers published from 2000 to 2022 were collected from different databases such as PubMed, Science Direct, Scopus, and Cochran using related keywords such as colorectal cancer, ALOX, COX, polymorphism, and dietary fat. Non-English and unrelated documents were excluded. Results: Some single-nucleotide polymorphisms (SNPs) in the ALOX and COX genes, such as rs2228065, rs6413416, and rs4986832 in the ALOX gene, and rs689465 in the COX gene may play significant roles in the association between the risk of CRC and dietary fats. SNPs of ALOX and COX genes may influence the effects of dietary fatty acids on the risk of CRC. Conclusion: Some polymorphisms of the ALOX and COX genes may have important roles in the effects of dietary fat on the risk of CRC. If future studies confirm these results, dietary recommendations for preventing colorectal cancer may be personalized based on the genotype of the ALOX and COX genes.

Comparison of Biochemical and Pathological Parameters and Parenteral Nutrition of ICU Patients Under Supervision of Dietitians and Surgeons.

Background: Nutrient imbalance can frequently occur in patients with indications for parenteral nutrition (PN) after gastrointestinal surgery. This study aimed to compare the recommendations of a surgeon to those of a dietitian in the field of parenteral nutrition. Methods: This study was performed on 256 patients undergoing gastrointestinal surgery who received PN, which included 120 patients who received PN based on recommendations of the surgeons and 136 patients who were referred to receive PN under the supervision of a dietitian in Razi Hospital in Rasht, Iran. Data on PN and clinical outcomes of the patients were collected. Results: Patients under the supervision of dietitians received higher vitamin B complex and lipids and lower vitamin A and vitamin E than the surgeon-supervised patients (all P < 0.001). In the group receiving PN under the supervision of a surgeon, the level of blood glucose (207 vs. 182, P < 0.01), sodium (138 vs. 136, P = 0.01), potassium (3.97 vs. 3.53, P < 0.01), and white blood cell count (9.83 vs. 9.28, P < 0.01) increased significantly at the end of the PN compared to baseline. In the group receiving PN under the supervision of a dietician, the level of serum Cr (1.23 vs. 1.32, P = 0.04), Mg (2.07 vs. 1.84, P < 0.01), and pH (7.45 vs. 7.5, P = 0.03) significantly improved after receiving parenteral nutrition compared to baseline. Conclusion: The amounts of nutrients recommended for PN by the surgeon and dietitian were different. Implementation of dietitian recommendations in critically ill patients under PN can improve patients' clinical parameters.

A pro-inflammatory diet increases the likelihood of obesity and overweight in adolescent boys: a case-control study.

BACKGROUND: Obesity and Overweight at an early age can contribute with many chronic diseases such as cancers, diabetes and cardiovascular diseases. Diet-related inflammation is one of the most important underlying mechanisms that may has a key role in obesity and overweight. This paper aimed to compare the dietary inflammatory index (DII®) in normal weight and overweight adolescent boys. METHODS: A total of 535 adolescent boys (214 cases were overweight and obese and 321 controls with normal weight) participated in this study from two schools in Tehran, Iran. The student's weight and body composition were measured using a Bio-Impedance Analyzer (BIA) scale. A validated semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess dietary inflammatory index. RESULTS: Results obtained from modeling DII® as a continuous variable identified a positive association between DII® and obesity (OR = 1.08, CI 1.01-1.16). After multivariable adjustment, subjects with DII® > 0.02 had at 1.5 times higher odds of obesity and overweight compared to subjects with DII® ≤ 0.02 (OR = 1.52; CI 1.04-2.22). CONCLUSION: Our study indicated the importance of dietary-induced inflammation in the obesity and overweight during adolescence. Therefore, advising adolescent to consume diet with lower DII® with more fruits and vegetables, rich sources of fiber, flavonoids, zinc, magnesium and selenium and avoiding the consumption of saturated fatty acids (SFA), trans-fatty acids, and cholesterol may support a healthy weight.