Associations of variability in body mass index with cardiovascular outcomes in the general population: A systematic review.

In today's world, high variability of body mass index (BMI) is known as a significant global health problem that can lead to many negative impacts on the cardiovascular system, including atrial fibrillation (AF) and coronary heart disease. The current systematic review aims to elucidate the effect of variability in BMI on the risk of cardiovascular outcomes. Four databases, including PubMed, Scopus, MEDLINE, and CENTRAL, were searched. All related articles up to 10 June 2022, were obtained. Titles, abstracts, and full texts were reviewed. After screening abstracts and full texts, four articles were included in our study. In these four cohort studies, 7,038,873 participants from the USA and South Korea were involved. These articles generally considered the BMI and outcomes including cardiovascular disease, AF, and coronary heart disease. All these articles reported an association between the variability of BMI and increased risk of cardiovascular outcomes. Due to the negative impact of the high variability of BMI on the risk of cardiovascular outcomes, health policymakers and practitioners should pay more attention to the significant role of BMI in health problems and physicians might better check the variability of BMI visits to visit.

Evaluation of elevated serum apelin-13 and D-dimer concentrations in individuals diagnosed with pulmonary embolism.

BACKGROUND: Given the limited specificity of D-dimer, there is a perceived need to discover a more precise marker for diagnosing individuals who are suspected of having pulmonary embolism (PE). In this study, by evaluating the increase in the serum level of Apelin-13 and D-dimer, we found valuable findings about Apelin-13, which can be suggested as an auxiliary and non-invasive diagnostic biomarker in individuals with suspected PE, based on the obtained results. METHODS: In this case-control study, 52 Iranian individuals were included, all of whom were suspected to have PE. These individuals were then divided into two groups based on the results of CT angiography, which is considered the gold standard imaging method for diagnosing PE. The two groups were patients with PE and patients without PE. Finally, the levels of certain markers in the serum were compared between the two groups. RESULTS: The mean serum D-dimer levels in patients with PE were significantly elevated (p < 0.001) in comparison to those without PE (1102.47 to 456.2 ng/ml). Furthermore, the mean level of Apelin-13 was significantly higher in patients with PE (49.8 to 73.11 ng/L) (p < 0.001). The cutoff point of Apelin-13 has been calculated at 58.50 ng/ml, with 90.9% sensitivity and 90% specificity. The D-dimer cutoff point was 500 ng/ml, with 95.5% sensitivity and 43.3% specificity. CONCLUSIONS: Based on the results of this study, the serum level of Apelin-13 can be used as a novel diagnostic and screening biomarker in patients with pulmonary thromboembolism.

Lipid variability and risk of microvascular complications in patients with diabetes: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The current systematic review aimed to elucidate the effects of lipid variability on microvascular complication risk in diabetic patients. The lipid components studied were as follows: High-density lipoprotein (HDL), High-density lipoprotein (LDL), Triglyceride (TG), Total Cholesterol (TC), and Remnant Cholesterol (RC). METHOD: We carried out a systematic search in multiple databases, including PubMed, Web of Science, and SCOPUS, up to October 2nd, 2023. After omitting the duplicates, we screened the title and abstract of the studies. Next, we retrieved and reviewed the full text of the remaining articles and included the ones that met our inclusion criteria in the study. RESULT: In this research, we examined seven studies, comprising six cohort studies and one cross-sectional study. This research was conducted in Hong Kong, China, Japan, Taiwan, Finland, and Italy. The publication years of these articles ranged from 2012 to 2022, and the duration of each study ranged from 5 to 14.3 years. The study group consisted of patients with type 2 diabetes aged between 45 and 84 years, with a diabetes history of 7 to 12 years. These studies have demonstrated that higher levels of LDL, HDL, and TG variability can have adverse effects on microvascular complications, especially nephropathy and neuropathic complications. TG and LDL variability were associated with the development of albuminuria and GFR decline. Additionally, reducing HDL levels showed a protective effect against microalbuminuria. However, other studies did not reveal an apparent relationship between lipid variations and microvascular complications, such as retinopathy. Current research lacks geographic and demographic diversity. Increased HDL, TG, and RC variability have been associated with several microvascular difficulties. Still, the pathogenic mechanism is not entirely known, and understanding how lipid variability affects microvascular disorders may lead to novel treatments. Furthermore, the current body of this research is restricted in its coverage. This field's lack of thorough investigations required a more extensive study and comprehensive effort. CONCLUSION: The relationship between lipid variation (LDL, HDL, and TG) (adverse effects) on microvascular complications, especially nephropathy and neuropathic (and maybe not retinopathy), is proven. Physicians and health policymakers should be highly vigilant to lipid variation in a general population.

Lipoprotein (a) as a predictor of diabetic retinopathy in patients with type 2 diabetes: A systematic review.

BACKGROUND: Lipoprotein a (LP(a)), an LDL-like lipoprotein, known as a risk factor for cardiovascular diseases, has a controversial association with diabetic retinopathy in patients with type 2 diabetes-the current systematic review aimed to critically assess the association between LP(a) and diabetic retinopathy. METHODS: A systematic review of relevant studies was conducted after a thorough search in PubMed, Scopus, and Google Scholar electronic databases. We used English observational, case-control, and prospective cohort studies published up to August 2022, including type 2 diabetic patients as the population, diabetic retinopathy as the outcome, and LP(a) as the intervention. RESULT: 17 relevant studies, including 4688 patients with diabetes, were included in this systematic review. While in 13 studies, Lipoprotein(a) was recognized as a risk factor for diabetic retinopathy, only three studies reported no evidence of a relationship between the two. Also, another study showed a mixed outcome of the relationship between LP(a) and diabetic retinopathy. CONCLUSION: High serum lipoprotein(a) in patients with type 2 diabetes is considered a risk factor for diabetic retinopathy. However, further large-scaled cohort studies are still required to validate this finding.

The association of subacute thyroiditis with viral diseases: a comprehensive review of literature

Introduction: Subacute thyroiditis (SAT), also known as de Quatrain's thyroiditis or granulomatous thyroiditis, is an inflammatory disease of the thyroid. Most of the time, it manifests in the thirties to fifties and is more common in women. SAT can have either viral or post-viral origin. Some viruses, like influenza, COVID-19, Epstein-Barr virus, cytomegalovirus, hepatitis, coxsackievirus 16, and mumps virus, have been linked to SAT development. The COVID-19 pandemic has affected people's lives all around the world and has changed our attitude toward the treatment of many diseases. It has also made us look deeper into the subject in a way that we would be able to treat this sort of disease with a newer insight. Objective: Regarding the importance of this issue, we decided to summarize our extensive searches from online databases, including PubMed, Google Scholar, Medline, Web of Science, and Scopus until February 2023, which we found effective in elucidating the association of subacute thyroiditis and viral diseases. Method: Different online databases were searched for narrative review articles, systemic review articles, and original articles, which were published until February 2023. Result: According to the included studies, we found that there is a correlation between SAT and several viruses such as Epstein-Barr virus, influenza virus, human immunodeficiency virus, cytomegalovirus, oral and cervical virus, hepatitis, dengue virus, and SARS-COV-2. The effect of each of the viral diseases mentioned in the SAT is given in the text. Conclusions: According to the results mentioned in the text, because SAT may be challenging for early diagnosis, due to the potential of classic symptoms as well as the interference of similar clinical symptoms between thyrotoxicosis and viral reactions, the correlation between SAT and viral diseases should be considered so that we can avoid misdiagnosis and lateness.

Prognostic value of fragmented QRS in acute pulmonary embolism: a cross-sectional-analytic study of the Iranian population.

BACKGROUND: Acute Pulmonary embolism (APE) is considered one of the deadliest cardiovascular diseases. Electrocardiographic (ECG) abnormalities in pulmonary embolism (PE) are increasingly reported. A growing number of studies have recommended that ECG plays a crucial role in the prognostic assessment of PE patients. However, there is scarce data on the prognostic importance of fragmented QRS (fQRS) on outcomes in patients with APE. This study aims to investigate the prognostic value of fQRS in APE patients. MATERIALS AND METHODS: This is a cross-sectional-analytic study. This study included 280 patients diagnosed with APE admitted to Shahid Madani hospital, Tabriz, Iran. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. A checklist was prepared for all patients, demographic, clinical characteristics, and Major Adverse Cardiopulmonary events (MACPE), including in-hospital mortality, need for thrombolysis, mechanical ventilation, and surgical embolectomy, were recorded. Patients were divided into two groups: patients who manifested fQRS on their ECG and patients who did not; Then, demographic, clinical characteristics, and MACPE were compared in the two groups, as mentioned earlier. Furthermore, all statistical analyses were carried out using SPSS software. RESULTS: 48 patients (17.14%) had fQRS(+) on their ECG, and 232 patients (82.86%) did not have it on their ECG. In data analysis, 22 patients (8.7%) had in-hospital mortality, 35 patients (13.9%) needed thrombolysis, nine patients (3.9%) required mechanical ventilation, and 13 patients (5.1%) needed surgical embolectomy. fQRS was not significantly associated with in-hospital mortality (P = 0.225), need for thrombolysis (P = 0.684), mechanical ventilation (P = 1.000), and surgical embolectomy (P = 1.000). Demographic and clinical characteristics were also similar in both groups. CONCLUSIONS: This study does not support the idea that fQRS on ECG is a valuable predictor of in-hospital mortality, the need for thrombolysis, mechanical ventilation, and surgical embolectomy.

Pharmacotherapeutic potential of walnut (Juglans spp.) in age-related neurological disorders.

Global and regional trends of population aging spotlight major public health concerns. As one of the most common adverse prognostic factors, advanced age is associated with a remarkable incidence risk of many non-communicable diseases, affecting major organ systems of the human body. Age-dependent factors and molecular processes can change the nervous system's normal function and lead to neurodegenerative disorders. Oxidative stress results from of a shift toward reactive oxygen species (ROS) production in the equilibrium between ROS generation and the antioxidant defense system. Oxidative stress and neuroinflammation caused by Amyloid-ß protein deposition in the human brain are the most likely pathogenesis of Alzheimer's disease (AD). Walnut extracts could reduce Amyloid-ß fibrillation and aggregation, indicating their beneficial effects on memory and cognition. Walnut can also improve movement disabilities in Parkinson's disease due to their antioxidant and neuroprotective effect by reducing ROS and nitric oxide (NO) generation and suppressing oxidative stress. It is noteworthy that Walnut compounds have potential antiproliferative effects on Glioblastoma (the most aggressive primary cerebral neoplasm). This effective therapeutic agent can stimulate apoptosis of glioma cells in response to oxidative stress, concurrent with preventing angiogenesis and migration of tumor cells, improving the quality of life and life expectancy of patients with glioblastoma. Antioxidant Phenolic compounds of the Walnut kernel could explain the significant anti-convulsion ability of Walnut to provide good prevention and treatment for epileptic seizures. Moreover, the anti-inflammatory effect of Walnut oil could be beneficial in treating multiple sclerosis. In this study, we review the pharmaceutical properties of Walnut in age-related neurological disorders.

Selective serotonin reuptake inhibitors: New hope in the fight against COVID-19.

The emerging COVID-19 pandemic led to a dramatic increase in global mortality and morbidity rates. As in most infections, fatal complications of coronavirus affliction are triggered by an untrammeled host inflammatory response. Cytokine storms created by high levels of interleukin and other cytokines elucidate the pathology of severe COVID-19. In this respect, repurposing drugs that are already available and might exhibit anti-inflammatory effects have received significant attention. With the in vitro and clinical investigation of several studies on the effect of antidepressants on COVID-19 prognosis, previous data suggest that selective serotonin reuptake inhibitors (SSRIs) might be the new hope for the early treatment of severely afflicted patients. SSRIs' low cost and availability make them potentially eligible for COVID-19 repurposing. This review summarizes current achievements and literature about the connection between SSRIs administration and COVID-19 prognosis.

Effects of different adhesion promoters and deproteinizing agents on the shear bond strength of orthodontic brackets: An in vitro study.

OBJECTIVE: To evaluate the effects of different adhesion promoters, namely, Enhance LC, Ortho Solo, Assure Universal Bonding Resin and deproteinizing agents such as 5.25% NaOCl, 10% papain gel on the shear bond strength of orthodontic brackets. MATERIALS AND METHOD: The present study was approved by the Ethics Committee of Teerthanker Mahaveer Dental College and Research Centre, affiliated to Teerthanker Mahaveer University, Moradabad, India. Around 150 extracted sound human upper bicuspids were taken and divided into six groups. Group 1 control (37% H3PO4), Group 2 (37% H3PO4 + Ortho Solo), Group 3 (37% H3PO4 + Assure Universal Bonding Resin), Group 4 (37% H3PO4 + Enhance LC), Group 5 (5.25% NaOCl + 37% H3PO4), and Group 6 (10% papain gel + 37% H3PO4). In all the groups (n = 150) orthodontic metal brackets were bonded with TransbondTM XT and all the samples were subjected for evaluation of shear bond strength using Instron universal testing machine at a cross speed of 0.5 mm/min. The bracket failure mode was examined using Adhesive Remnant Index (ARI). The Kruskal-Wallis test and the Mann-Whitney test were used to compare the shear bond strength. The Chi-square test was used to determine significant differences in the ARI scores among the groups. The significance for all statistical tests was P < 0.05. RESULTS: Mean values of shear bond strength showed statistically significant differences between the evaluated groups (P < 0.005). The lowest and highest shear bond strength was attributed to Group 1 (control) and Group 2 (Ortho Solo), respectively. No statistically significant difference was noted for the mean ARI scores between control, adhesion promoters, and deproteinized group (P < 0.05). CONCLUSION: It was concluded that adhesion promoters and deproteinizing agents can be used to enhance the shear bond strength of orthodontic brackets. Among all the groups Ortho Solo showed the highest bond strength when used with TransbondTM XT.

Effects of different deproteinizing agents on topographic features of enamel and shear bond strength - An in vitro study.

OBJECTIVES: To evaluate and compare the effect of different enamel deproteinizing agents on topographic features of enamel and shear bond strength before acid etching. MATERIALS AND METHOD: In total, 120 sound human maxillary premolars were taken and divided into three groups: Group 1 control (37% phosphoric acid (H3PO4), Group 2, (5.25% Sodium Hypochlorite (NaOCl)+ 37% H3PO4, and Group 3, (10% Papain gel + 37% H3PO4). These groups were further divided into A and B subgroups. In subgroups 1A, 2A, and 3A (n30) topographic features were evaluated using Scanning electron microscope (SEM) at different magnifications. Insub-groups 1B, 2B, and 3B (n90) metal brackets were bonded with Transbond™ XT, and all the samples were subjected for Shear Bond Strength (SBS) evaluation using universal testing machineat a cross speed of 0.5 mm2/min. The failure mode was analyzed using adhesive remnant index (ARI). Statistical analysis was done using one-way ANOVA for the shear bond strength, and Kruskal-Wallis test followed by Mann-Whitneywas performed for ARI scores. RESULTS: SEM showed predominance of type 3 etching pattern in control Group (1A) and type 1 and type 2 in deproteinizedGroups (2A and 3A). Mean values of shear bond strength showed statistically significant differences between evaluated groups (P < 0.005). The lowest and highest shear bond strength was attributed to Group 1B (Control) and 3B (10% papain gel), respectively. Statisticallysignificant differences were noted for the mean ARI scores between control and deproteinized group (P < 0.05). CONCLUSION: 10% papain geland 5.25% NaOCl can be used as deproteinizing agents on enamel surface before acid etchingto enhance the shear bond strength of orthodontic brackets.

Retratamento ortodôntico de um caso com dentição mutilada e periodontalmente comprometida / Orthodontic re-treatment of a case with multilated and periodontally compromised dentition

Introdução / Atualmente, na Odontologia, vem ocorrendo um aumento no número de pacientes adultos, com dentição mutilada ou periodontalmente comprometida, que estão à procura de tratamento ortodôntico. Uma adequada combinação entre o tratamento periodontal e o ortodôntico permite que uma dentição saudável e com função adequada seja restabelecida. / Objetivo / Apresentar o tratamento, combinando o retratamento ortodôntico e o tratamento periodontal, de uma paciente de 27 anos de idade, com: incisivos superiores e inferiores vestibularizados; ausência do primeiro e do terceiro molares superiores esquerdos, primeiro e terceiro molares inferiores direitos, e primeiro molar inferior esquerdo; presença de mobilidade dentária grau III nos incisivos centrais inferiores, em decorrência de doença periodontal; e perda óssea horizontal moderada e generalizada. / Resultados / A saúde periodontal foi restabelecida por meio de raspagem e alisamento radicular, realizados antes do tratamento ortodôntico. O tratamento ortodôntico ativo com sistema MBT foi finalizado em um período de 18 meses. / Conclusão / Com esse estudo, demonstramos que a combinação do tratamento ortodôntico e do tratamento periodontal, por meio de uma abordagem interdisciplinar, pode melhorar a função mastigatória do paciente, assim como sua estética, oclusão e a condição periodontal.

Intensive care nurses' opinions and practice for oral care of mechanically ventilated patients.

CONTEXT: Oral care is an essential aspect of critical care nursing. However, no study has been published on oral care practice of Iranian and Asian nurses. The majority of published studies were conducted in western and European countries. AIMS: This study aimed to evaluate the nurses' opinions and practice about oral care in patients under mechanical ventilation. SETTINGS AND DESIGN: A cross-sectional study was conducted on 130 intensive care nurses from 6 intensive care units in the university hospitals of Iran. MATERIALS AND METHODS: A questionnaire was used to gather the data and charts of 45 patients were evaluated. STATISTICAL ANALYSIS: Descriptive statistical analysis are presented. RESULTS: Oral care obtained the 7(th) rank in prority and a mean score of 5.7 on a scale of 1-10. More than 21% of subjects did not perform oral care in their usual duties. High load of writing tasks and personnel shortages were the major barriers to oral care. Only 20% of the patients' charts contained a report on oral care. CONCLUSIONS: Nurses did not consider oral care in intensive care patients as a high priority. This result highlights the need to continue education programs on oral care for improving the knowledge and attitude of intensive care nurses with respect to oral care.