Effect of Combined Application of Hydrofluoric and Phosphoric Acids and Active Irrigation with a Microbrush on Shear Bond Strength of Lithium Disilicate Ceramics to Enamel.

Background: This study assessed the effect of combined application of hydrofluoric (HF) acid and phosphoric acid (PA) and active irrigation (AI) with a microbrush on shear bond strength (SBS) of lithium disilicate (LDS) ceramics to enamel. Materials and Methods: This in vitro study was conducted on 40 extracted teeth that received enamel preparation with a #12 cylindrical bur. Forty IPS e.max LT rods (3mm diameter, 6mm height) were fabricated and randomly assigned to four groups (n = 10) for surface treatment with 5% HF (group 1), 5% HF and AI with a microbrush for 20 seconds (group 2), 5% HF and 32% PA (group 3), and 5% HF and 32% PA plus AI with a microbrush for 20 seconds (group 4). Silane and Choice 2 cement were used for bonding rods to enamel. The SBS was measured by a universal testing machine. Data were analyzed by two-way analysis of variance (ANOVA), Bonferroni, and Chi-square tests (alpha = 0.05). Results: Group 4 had the highest SBS, and group 1 had the lowest SBS (P < 0.05). Group 2 had a significantly higher SBS than group 1, and group 4 had a significantly higher SBS than group 3. AI with a microbrush significantly increased the SBS (P < 0.05), but the application of PA caused no significant change in SBS (P > 0.05). The interaction effect of PA and AI on SBS was not significant (P > 0.05). Conclusion: The application of PA in addition to 5% HF acid caused no significant change in the SBS of LDS ceramic to enamel. However, AI with a microbrush significantly increased the SBS.

Animal and plant-based proteins have different postprandial effects on energy expenditure, glycemia, insulinemia, and lipemia: A review of controlled clinical trials.

Dietary proteins have been shown to stimulate thermogenesis, increase satiety, and improve insulin sensitivity in the short and long term. Animal-based proteins (AP) and plant-based proteins (PP) have different amino acid profiles, bioavailability, and digestibility, so it seems to have various short- and long-term effects on metabolic responses. This review aimed to compare the findings of controlled clinical trials on postprandial effects of dietary Aps versus PPs on energy expenditure (EE), lipemia, glycemia, and insulinemia. Data are inconclusive regarding the postprandial effects of APs and PPs. However, there is some evidence indicating that APs increase postprandial EE, DIT, and SO more than PPs. With lipemia and glycemia, most studies showed that APs reduce or delay postprandial glycemia and lipemia and increase insulinemia more than PPs. The difference in amino acid composition, digestion and absorption rate, and gastric emptying rate between APs and PPs explains this difference.

The effect of propolis supplementation on cardiovascular risk factors in women with rheumatoid arthritis: A double-blind, placebo, controlled randomized clinical trial.

Propolis has gained popularity in recent years because of its beneficial properties, which make it a possible preventative and therapeutic agent as well as a valuable food and cosmetic ingredient. The objective of this study was to evaluate the effects of propolis supplementation on cardiovascular risk factors in women with rheumatoid arthritis. This randomized, double-blind, placebo-controlled clinical trial was performed among 48 patients diagnosed with rheumatoid arthritis. Subjects were randomly assigned to placebo and intervention groups, supplemented with 1000 mg/day of propolis for 12 weeks. Cardiovascular risk factors including, high-sensitivity C-reactive protein (hs-CRP), monocyte chemoattractant protein (MCP-1), Nitric oxide, blood pressure, and lipid profile were assessed pre-and post-intervention. The atherogenic index of plasma value, as well as total cholesterol/high-density lipoprotein cholesterol (HDL-C), triglyceride/HDL-C, and non-HDL-C/HDL-C ratios, were significantly reduced in the intervention group, compared with the placebo group post-intervention (p < 0.05). Moreover, there was a significant reduction in the serum level of hs-CRP in the intervention group when compared with the placebo group (p = 0.001). Furthermore, propolis supplementation could marginally reduce MCP-1 (p = 0.051). These data indicate that propolis supplementation may be a promising treatment strategy for cardiovascular complications among rheumatoid arthritis patients.

Applying artificial intelligence to detect and analyse oral and maxillofacial bone loss-A scoping review.

Radiographic evaluation of bone changes is one of the main tools in the diagnosis of many oral and maxillofacial diseases. However, this approach to assessment has limitations in accuracy, inconsistency and comparatively low diagnostic efficiency. Recently, artificial intelligence (AI)-based algorithms like deep learning networks have been introduced as a solution to overcome these challenges. Based on recent studies, AI can improve the detection accuracy of an expert clinician for periapical pathology, periodontal diseases and their prognostication, as well as peri-implant bone loss. Also, AI has been successfully used to detect and diagnose oral and maxillofacial lesions with a high predictive value. This study aims to review the current evidence on artificial intelligence applications in the detection and analysis of bone loss in the oral and maxillofacial regions.

Postprandial effects of dietary protein source on metabolic responses, appetite, and arterial stiffness indices in overweight and obese men: the study protocol for a randomized crossover clinical trial.

BACKGROUND: Different dietary protein sources are supposed to have various effects on metabolic responses and arterial stiffness in the postprandial period. This study aims to assess the postprandial effects of dietary protein sources, including animal-based protein (AP) and plant-based protein (PP), as part of a high-protein breakfast on appetite response, energy metabolism, and arterial stiffness in overweight and obese men. METHODS: This acute randomized crossover clinical trial will be conducted at the Persian study research center at Imam Reza Hospital, affiliated with the Mashhad University of Medical Sciences, located in the northeast of Iran. Forty-six healthy overweight, and obese men aged 18-60 years will be enrolled based on the eligibility criteria. The subjects will complete two interventions (high-protein AP and PP meals) with 1 week washout period. The primary outcome will be the acute effect of the two test meals on appetite response, energy metabolism parameters, including resting metabolism rate (RMR), diet-induced thermogenesis (DIT), and substrate oxidation (SO), and arterial stiffness indices, including pulse wave velocity (PWV) and pulse wave analysis (PWA). The secondary outcomes include changes in lipemia, glycemia, and insulinemia. DISCUSSION: The findings of this study will provide novel insight regarding the acute effects of different protein sources on energy metabolism, appetite, and arterial stiffness as a significant cardiovascular disease (CVD) risk factor. It will help dieticians develop effective and efficient meal plans to improve weight reduction and maintenance in overweight/obese individuals. TRIAL REGISTRATION: Iranian Registry of Clinical Trials; code: IRCT20211230053570N1; registered on February 10, 2022.

The effect of low dietary inflammatory index score formula on inflammatory, metabolic, and clinical outcomes in critically ill traumatic brain injury patients: A single-blind randomized controlled pilot study.

In traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses are frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DII®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. This single-blind randomized controlled pilot study was conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low-DII score or standard formula at the intensive care unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. The trial groups did not differ significantly in baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in the GCS score in the low-DII score formula group compared to the standard formula group. Over 2 weeks, high sensitivity C-reactive protein (hs-CRP) values of -2.73 (95% CI: -3.67, -1.79) mg/dL in the low-DII score formula group versus 0.65 (95% CI: -0.29, 1.58) mg/dL in controls were obtained. Moreover, the length of hospital stay was longer for the standard formula group than for the low-DII score formula group. The low-DII score formula improves inflammatory factors (serum hs-CRP) and metabolic biomarkers (LDL-c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity, appear to be enhanced.

The effects of adjunctive treatment with L-carnitine on monitoring laboratory variables in ICU patients: a double-blinded randomized controlled clinical trial.

BACKGROUND: Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of L-carnitine adjunctive therapy on monitoring variables in critical illness. METHOD: A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g L-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. RESULT: Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (<0.001), creatinine (Cr) (0.005), and international normalized ratio (INR) (0.049) decreased meaningfully in the intervention vs. control group. CONCLUSION: L-Carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, lactate, Ca, Alb, and total protein. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT 20151108024938N2. This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) (available at https://en.irct.ir/trial/30748 , May 2018).

Prevalence and Risk Factors of Anemia in the MASHAD Cohort Study.

BACKGROUND: Anemia is a serious public health problem which may be associated with cardiovascular diseases (CVDs) and brain damage. This survey aims to determine the prevalence of anemia and its association with demographic and biochemical factors and metabolic syndrome in a human sample derived from the MASHAD cohort study. METHODS: This survey was conducted on a sub-sample of 9847 individuals aged 35 to 65 as part of the MASHAD cohort study. Demographic characteristics and biochemical and anthropometrics indices were recorded. Data were analyzed using SPSS version 20. RESULTS: Anemia was seen in 11.5% of the population. Anemia was significantly more prevalent in younger subject (P<0.001), females (P<0.001) and those with elevated body mass index (BMI) (P<0.001). Mean high-density lipoprotein (HDL) was higher in anemic participant (P=0.032). The incidence of anemia was significantly lower in smokers (P<0.001) and also participant with hypertension (HTN) (P<0.001), diabetes mellitus (DM) (P<0.001) and metabolic syndrome (MetS) (P<0.001). Mean FBG (P<0.001), TG (P<0.001), total cholesterol (P<0.001), LDL (P<0.001) and uric acid (P<0.001) were significantly lower in anemic subjects. Cholesterol, MetS, low-density lipoprotein (LDL), BMI, uric acid, diabetes mellitus and also TG remained significantly different after multivariate analysis between anemic and healthy participants. CONCLUSION: The studied population had a lower prevalence of anemia compared to the previous WHO report for Iranians. Iron deficiency is recognized as the most important cause of anemia in Iran; however, further investigations will be need to confirm this pattern. We demonstrated that anemia is adversely associated with MetS and DM.

Is Habitual Dietary Intake of Fats Associated with Apelin Gene Expression in Visceral and Subcutaneous Adipose Tissues and Its Serum Levels in Obese Adults?

INTRODUCTION: Apelin could be one of the last protective defenses before developing obesity-related disorders, including insulin resistance, type 2 diabetes, and hypertension, which can be modified by dietary intake. The present study investigated the association of habitual intake of total fatty acids (TFAs), saturated-, monounsaturated-, polyunsaturated FAs, n-3, and n-6 FAs with Apelin expression in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). METHODS: We obtained VAT and SAT from 168 participants (64 nonobese and 104 obese) who had undergone open abdominal surgery. Dietary intake information was gathered with a valid and reliable food frequency questionnaire. The mRNA expression of the Apelin gene was analyzed by real-time PCR. RESULTS: Apelin serum levels were increased in the obese subjects compared to the nonobese group (p = 0.016). The SAT and VAT Apelin mRNA levels were significantly elevated in the obese participants compared to the nonobese ones (p < 0.05). Based on BMI status, only obese subjects indicated a positive association between SAT and VAT Apelin expression and TFA intake (p < 0.001). However, this association was observed between SAT and VAT Apelin gene expression and polyunsaturated fatty acid (PUFA) and n-3 FA intakes in both obese and nonobese groups (p < 0.05). CONCLUSION: High Apelin gene expression was associated with TFA intake in obese subjects in both fat tissues. However, habitual intake of PUFA and n-3 FA was associated with Apelin gene expression in obese and nonobese individuals. Our results indicate a determinative role of the quality and quantity of FA intake on adipose tissue.

The effects of synbiotic supplementation on enteral feeding tolerance, protein homeostasis, and muscle wasting of critically ill adult patients: a randomized controlled trial.

BACKGROUND: Enteral feeding intolerance, energy-protein malnutrition, and muscle wasting are common conditions in the critical care setting. The primary aim of this study was to investigate the effect of synbiotic supplementation on enteral feed volume, energy and protein homeostasis, and muscle mass maintenance in critically ill adult patients. METHODS: A consecutive of 42 patients admitted to the Edalatian Medical ICU, requiring enteral nutrition (EN), were prospectively randomized to receive the synbiotic capsule (containing a combination of Lactobacillus, Bifidobacterium, Streptococcus, and fructooligosaccharides) or placebo (21 patients in each group) for a maximum of 14 days. Enteral intolerance and energy homeostasis were evaluated on a daily basis. Nitrogen balance and 24-h urine creatinine excretion were recorded on days 1 and 14. Mid-arm circumference was recorded every 3 days. RESULTS: Mean EN volume, energy, and protein intake per day were 962.5 ± 533.82 ml, 770 ± 427.05 kcal, and 38.5 ± 21.35 g (fourth day) vs. 590 ± 321.1 ml, 472 ± 256.81 kcal, and 23.6 ± 12.84 g (first day) in the synbiotic group (p < 0.05). Changes in the placebo group were not statistically significant. On day 1, nitrogen balance (NB) was - 19.84 ± 8.03 in the synbiotic vs. - 10.99 ± 9.12 in the placebo group (p = 0.003). On day 14, NB was - 14.18 ± 13.05 in the synbiotic and - 9.59 ± 7.71 in the placebo group (p = 0.41). Mid-arm circumference (MAC), 24-h urine creatinine, and creatinine-height index were almost steady in the synbiotic group, while they decreased in the placebo group. CONCLUSION: Overall, it can be concluded that enteral nutrition supplemented with synbiotics has no statistically significant effect on energy and protein homeostasis and muscle mass maintenance of critically ill patients on day 14, but it can increase enteral feed volume and energy and protein intake during the first 4 days of ICU admission. TRIAL REGISTRATION: The trial protocol has been approved in Iranian Registry of Clinical Trials on March 17, 2019. The registration reference is IRCT20190227042857N1.

Study protocol for a pilot randomised controlled trial evaluating the effectiveness of oral trehalose on inflammatory factors, oxidative stress, nutritional and clinical status in traumatic head injury patients receiving enteral nutrition.

INTRODUCTION: In traumatic brain injury (TBI) patients, inflammatory processes and oxidative stress have been linked to the development of neurodegenerative diseases, disability, increased rate of muscle catabolism, malnutrition, hospital stay and mortality. Previous in vitro and in vivo studies have shown that trehalose can decrease inflammatory and oxidative factors. Therefore, the present study was designed to evaluate the effect of oral trehalose consumption on this marker in critically ill TBI patients at intensive care unit (ICU). METHODS AND ANALYSIS: This study is a pilot randomised, prospective and double-blind clinical trial. The study sample size is of 20 (10 patients in each group) TBI patients aged 18-65 years at ICU. Randomisation is performed by permuted block randomisation method. The allocation ratio is 1:1. An intervention group will receive 30 g of trehalose instead, as a part of the carbohydrate of daily bolus enteral feeding and the control group will receive standard isocaloric hospital bolus enteral feeding for 12 days. The inflammatory factors (C reactive protein, interleukin 6) and oxidative stress markers (glutathione, malondialdehyde, superoxide dismutase, pro-oxidant-antioxidant balance, total antioxidant capacity) will be measured at the baseline, at the 6th day, and at the end of the study (12th day). Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, Nutrition Risk in the Critically ill scores, 28-day mortality, anthropometric assessments and the clinical and nutritional status will be measured. Each patient's nutritional needs will be calculated individually. The statistical analysis would be based on the intention to treat. ETHICS AND DISSEMINATION: The vice-chancellor of the research centre of Mashhad University of Medical Sciences is sponsoring this study. IR.MUMS.MEDICAL.REC.1400.113. TRIAL REGISTRATION NUMBER: Iranian Registry of Clinical Trials (IRCT) Id: IRCT20210508051223N1, Registration date: 26 July 2021.

The effects of l-Carnitine supplementation on inflammatory markers, clinical status, and 28 days mortality in critically ill patients: A double-blind, randomized, placebo-controlled trial.

AIM: Critical ill patients experience catabolic stress, which results in a systemic inflammatory response. The inflammatory response is associated with increased complications, including infection, multi-organ dysfunction, increased length of ICU stays, and mortality. l-Carnitine supplementation may play an important role in these patients by regulating inflammatory cell function. The purpose of the present study was to investigate the effect of l-Carnitine supplementation on clinical status, inflammatory markers, and mortality rate in critically ill patients admitted to the intensive care unit (ICU). METHODS: This randomized, double-blind, placebo-controlled trial was performed on critically ill patients. Subjects were randomly assigned into placebo (n = 27) and l-Carnitine (n = 27) groups. l-Carnitine (3000 mg/day) was administered via nasogastric tube for the intervention group for 7 days, while the other group received a placebo for the same duration. Serum levels of inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6) were measured. Nutritional status and the acute physiology and chronic health evaluation (APACHE) score, sequential organ failure assessment (SOFA) score, and 28-day mortality were also recorded. RESULTS: Fifty-one critically ill patients completed the study. l-Carnitine supplementation significantly reduced the levels of CRP (mean change ± SE: -34.9 ± 6.5) and IL-6 (mean change ± SE: -10.64 ± 2.16) compared to the baseline, which is both statistically significant compared with the control group (p < 0.05). The SOFA and APACHE scores were significantly reduced in the l-Carnitine group compared with the placebo group (p = 0.02 and p < 0.001, respectively). CONCLUSIONS: l-Carnitine supplementation showed beneficial effects on inflammatory and clinical outcomes of critically ill patients. TRIAL REGISTRATION DETAILS: Trial registration: IRCT, Registered 30 May 2018, https://www.irct.ir/trial/30748.

Effects of Melatonin and Propolis Supplementation on Inflammation, Oxidative Stress, and Clinical Outcomes in Patients with Primary Pneumosepsis: A Randomized Controlled Clinical Trial.

BACKGROUND AND OBJECTIVE: The present study aimed to investigate the effects of propolis and melatonin supplementation on inflammation, clinical outcomes, and oxidative stress markers in patients with primary pneumosepsis. MATERIALS AND METHODS: This pilot randomized controlled trial was conducted on 55 patients with primary pneumosepsis who were randomly assigned to the intervention and control groups. In the three intervention groups, the patients received propolis alone (1,000 mg/day), propolis (1,000 mg/day) plus melatonin (20 mg/day), and melatonin alone (20 mg/day). The control group received placebo. The inflammatory and oxidative stress markers as well as clinical outcomes were evaluated before and after the intervention, and the 28-day survival rate was also recorded. RESULTS: After the intervention, the combination of propolis and melatonin significantly reduced interleukin-6 (-55.282 pg/mL) and C-reactive protein (-21.656 mg/L) levels, while increasing gavage intake (326.680 mL/day) and improving some clinical outcomes (APACHE II, SOFA, and NUTRIC scores) compared to the control group. However, no significant difference was observed between the groups in terms of oxidative stress and hematological indices. In addition, there was no significant difference in the 28-day survival rate between the groups (p = 0.07). CONCLUSION: Supplementation with propolis and melatonin may improve clinical outcomes by reducing inflammation. Further investigations are required to confirm these findings.

Effects of synbiotic supplementation on the serum endotoxin level, inflammatory status, and clinical outcomes of adult patients with critical illness: A randomized controlled trial.

BACKGROUND:  Gutmicrobiota dysbiosis, endotoxemia, and systemic inflammation are major factors contributing to disease pathophysiology in patients with critical illness. The present study aimed to assess the effects of synbiotic supplementation on serum endotoxin and inflammationof adult patients with critical illness. METHODS:  This double-anonymized, randomized controlled trial was conducted at the intensive care unit (ICU) of Imam Reza Hospital in Mashhad, Iran. In the intervention group, 20 patients received synbiotic capsules (containing a combination of Lactobacillus, Bifidobacterium, Streptococcus, and fructooligosaccharides) twice per day for a maximum of 14 days. In the control group, 18 patients received placebo capsules. The serum levels of endotoxin and C-reactive protein and the neutrophil to lymphocyte ratio (NLR) were measured before and after the intervention. In addition, clinical outcomes and Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores were recorded. RESULTS:  Basic characteristics were similar in the intervention and control groups. The NLR and serum endotoxin levels (median [IQR]) significantly declined in the synbiotic group (7.83 [4.58-12.57] to 6.01 [4.25-9.38]; P = .04; and 11.98 [10.64-12.65] to 10.58 [9.41-12.34]; P = .03, respectively). However, no significant changes were observed in the mentioned parameters in the placebo group. The clinical outcomes were also similar in the study groups, such as the length of hospital/ICU stay and hospital/28-day mortality rate. CONCLUSION:  Although synbiotic supplementation (500 mg twice daily for 14 days) could reduce serum endotoxin and inflammatory markers, it had no effects on the clinical outcomes of the patients.

Dietary patterns and health-related quality of life among Iranian adolescents.

PURPOSE: Examining the associations of a-posteriori-defined dietary patterns and health-related quality of life (HRQOL) among Iranian adolescents. METHODS: This cross-sectional study was conducted among 900 apparently healthy students (mean age 15.33 years; 53.0% female) during 2020-21. The validated Persian version of self-report Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL) for healthy adolescents was used in an online survey to assess HRQOL. Total, physical health, psychosocial health, emotional functioning, social functioning, and school functioning PedsQL scores were calculated, and impaired HRQOL was defined as > 1 standard deviation below the total population sample mean PedsQL scores. A validated food frequency questionnaire was used to assess dietary intakes during telephone interviews. Daily intakes of 20 predefined food groups were calculated and submitted to the principal component factor analysis to identify a-posteriori-defined dietary patterns. RESULTS: Three major dietary patterns labeled as Mediterranean, mixed, and unhealthy were identified, of which only the Mediterranean pattern characterized by high intakes of vegetables, fruits, olives, potatoes, eggs, nuts and legumes, pickles, low-fat dairy, fish, poultry, and vegetable oils was consistently associated with HRQOL. Controlling for covariates in the multivariable-adjusted binary logistic regression analysis, participants in the top tertile of Mediterranean pattern score were less likely to have impaired HRQOL than those in the bottom tertile (total: OR 0.25; physical health: OR 0.35; psychosocial health: OR 0.15; emotional functioning: OR 0.17; social functioning: OR 0.15; and school functioning: OR 0.18; all P < 0.010). CONCLUSION: Current findings indicate that an a-posteriori-defined Mediterranean-style dietary pattern is associated with better HRQOL among healthy Iranian adolescents.

The effect of early enteral nutrition supplemented with synbiotics on lipid and glucose homeostasis in critically ill patients: A randomized controlled trial.

BACKGROUND AND AIMS: The aim of the present study was to investigate the effects of gut microbiota modulation through synbiotic supplementation on lipid and glucose homeostasis in tube-fed critically-ill adult patients. METHODS: This study is placebo-controlled, parallel, single-center, double-blind clinical trial. 42 patients were randomly distributed in placebo and synbiotic groups to receive intervention for a maximum of 14 days. Serum levels of fasting glucose, total cholesterol, and triglycerides, insulin, and free fatty acids were obtained from blood sampling at baseline and the end of the study. Also, insulin resistance was determined by homeostasis model assessment of insulin resistance (HOMA-IR). RESULT: Fasting glucose level (Day0 = 87.84 ±â€¯15.51, Day14 = 83.76 ±â€¯8.71 mg/dl, P = 0.51), fasting insulin level (Day0 = 9.46 ±â€¯7.31, Day14 = 7.97 ±â€¯5.19 mIU/L, P = 1.00), and HOMA index (Day0 = 1.89 ±â€¯1.48, Day14 = 1.72 ±â€¯1.17, P = 0.75) during the study were decreasing in both groups, but the decreases were not significant. Serum levels of total cholesterol, triglyceride, and free fatty acidsat the beginning of the study were 114.18 ±â€¯43.43 mg/dl, 146.59 ±â€¯53.99 mg/dl, 0.83 ±â€¯0.57 mmol/L, and at the end of the study were 129.10 ±â€¯39.05 mg/dl, 127.40 ±â€¯91.88 mg/dl, 0.88 ±â€¯0.77 mmol/L, respectively. None of these changes were significant either (P = 0.99, P = 0.38, P = 0.90, respectively). CONCLUSIONS: According to our findings, synbiotics supplementation in critically ill patients has no significant effect on lipid and glucose profile.

The antiviral immune defense may be adversely influenced by weight loss through a calorie restriction program in obese women.

BACKGROUND: Obesity and weight loss are reported to be associated with immune function. This study aimed to investigate the changes in counts of lymphocytes involved in microbial defense during weight loss in obese women. METHODS: This clinical trial involved 29 women with a body mass index (BMI) ≥ 30 kg/m2. The intervention group was prescribed a low-calorie diet (600 kcal lower than caloric requirement per day) plus Orlistat (120 mg three times daily). The control group received ad libitum diet. Anthropometric indices, obesity-related traits, and blood pressure were assessed every three weeks. Metabolic indices and plasma count of lymphocyte subpopulations (CD3, CD4, CD8, CD19, and CD16/56, as well as the ratio of CD4:CD8) were measured at baseline and after the intervention (after 10% weight loss). RESULTS: After the weight loss, natural killer cells (CD16/56) decreased in the intervention group (P=0.014) even after adapting for all confounders. No significant changes were observed in other immune markers compared to the control group. CONCLUSIONS: Caloric restriction-induced weight loss might independently weaken the antiviral immune defense. Further clinical trials are warranted to better clarify the association between weight loss, calorie restriction, and immunity.

A multi-centre survey on hospital malnutrition: result of PNSI study.

BACKGROUND: Disease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university f. METHODS: Persian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA). RESULTS: In total, 2109 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.68 ± 14.65 years and 25.44 ± 6.25 kg/m2, respectively. Malnutrition (SGA-B & C) was identified in 23.92% of the patients, 26.23 and 21% of whom were among the admitted and discharged patients, respectively. The highest prevalence of malnutrition was in burns (77.70%) and heart surgery (57.84%) patients. Multivariate analysis presented male gender (OR = 1.02, P < 0.00), malignant disease (OR = 1.40, P < 0.00), length of hospital stay (OR = 1.20, P < 0.00), and polypharmacy (OR = 1.06, P < 0.00) as independent risk factors for malnutrition. Malnutrition was not associated with age (P = 0.10). CONCLUSION: This study provides an overall and comprehensive illustration of hospital malnutrition in Iran university hospitals, finding that one out of four patients were malnourished; thus, appropriate consideration and measures should be taken to this issue.

The effect of propolis supplementation on inflammatory factors and oxidative status in women with rheumatoid arthritis: Design and research protocol of a double-blind, randomized controlled.

BACKGROUNDS AND AIMS: Rheumatoid arthritis (RA), is immune-inflammatory disease which is associated with great pain and disability. Overproduction of pro-inflammatory cytokines and oxidative stress play an important role in RA pathogenesis and related outcomes. The aim of this study was to evaluate the effects of propolis on inflammatory biomarkers and oxidative stress status in RA patients. METHODS/DESIGN: Randomized, placebo-controlled, and double-blind clinical trial aiming to recruit 48 patients with RA. Block randomization will be used. An intervention group will receive 500 mg/twice a day propolis capsules for 3 months and control group will receive the placebo for the same dose and duration. The oxidative stress status (malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx)), and inflammatory biomarkers (interleukin-17 (IL-17), Tumor necrosis factor alpha (TNF-α), High-sensitivity C-reactive protein (hs-CRP)), lipid profile (total cholesterol (TC), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), and triglyceride (TG)) and also physical activity, anthropometric indices, clinical and nutritional status will be measured at beginning and end of this study. The primary analysis will be based on theintention-to-treat principle. DISCUSSION: If this randomized clinical trial shows the reduction in inflammatory cytokines and oxidative stress and improves clinical outcome, it would provide evidence for other clinical trials to evaluate the efficacy of propolis supplementation in RA patients.

Expression of toll like receptors before and after coronary angiography with isomolar contrast among those with and without coronary atherosclerosis.

Angiography is a safe technique for the detection of and treatment of cardiovascular diseases. However, the effects of the technique on the molecular response of the immune system are yet to be clarified. Toll like receptors (TLRs) are the important molecule participate in the innate immunity responses and induction of inflammation. This project was designed to explore the effects of angiography on the expression of TLR1, TLR2, TLR3 and TLR4. Fifty-five participants, including three separate groups (without artery stenosis, with one artery stenosis and more than one artery stenosis), were assessed in this project. TLR1, TLR2, TLR3 and TLR4 expression levels were evaluated in peripheral blood immune cells by measuring mRNA before and after angiography using Real-Time PCR techniques. mRNA levels of TLR1, TLR2 and TLR3 were significantly increased following angiography. Expression of TLR4 did not change after angiography. Other criteria also showed no correlation on TLR expression after angiography. TLR4 mRNA levels had a positive correlation with age in the participants without artery stenosis. Angiography may induce inflammation in subjects without artery stenosis via up-regulation of TLR1, 2 and 3 which may lead to cardiovascular diseases related complications.