Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran.

Background: Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined. Objective: To investigate the association between CAC score and in-hospital mortality of COVID-19 patients. Method: This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes. Results: The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70-10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13-1.53, P value < 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47-2.77, P value < 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79-18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18-40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value < 0.001). Conclusion: Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.

Challenging the angiosome concept: Delineating peripheral arterial disease patterns in diabetic foot ulcers.

OBJECTIVES: The angiosome concept has significantly impacted diabetic foot ulcer management by highlighting the vascular anatomy's role in wound healing. However, its clinical applicability and validity remain debated due to complexities in foot blood supply and ulcer location determination. METHODS: A cross-sectional study was conducted on 84 individuals with diabetic foot ulcers undergoing lower limb angiography. Demographics, ulcer characteristics, and angiographic data were collected and analyzed using descriptive statistics and relevant tests. RESULTS: Digital subtraction angiography assessed 89 limbs with diabetic foot ulcers; males comprised 54.8%, primarily type 2 diabetes (96.4%), averaging 64.36 ± 10.09 years. Of 129 angiosomes, angiosome 2 (40.3%) had the highest ulcer incidence. Posterior tibial artery (PTA) involvement was predominant (72.9%), while external iliac artery (EIA) and profunda femoris artery (PFA) were least affected (2.4% each). Posterior tibial artery showed 46.5% complete occlusion. Angiosome 2 correlated notably with anterior tibial artery (ATA), peroneal artery (CPA), and PTA, but categorizing angiosomes by supply patterns showed no significant artery correlation (p > .05). CONCLUSIONS: The research indicates inconsistent support for below-the-knee artery involvement correlating with foot ulcer locations in angiosomes. While aiding vascular comprehension, the angiosome concept may not fully elucidate lower limb vascular complexities and ulcer genesis. Factors like collateral circulation should be noticed to understanding ulcer localization and severity, extending beyond angiosomal arterial supply.

Peppermint as a promising treatment agent in inflammatory conditions: A comprehensive systematic review of literature.

Inflammation, a type of the body's defense against injury or infection, causes many chronic disorders including diabetes, cardiovascular disease, and cancer. Therefore, discovering natural compounds with numerous biological activities for the management of inflammation is highly recommended. Out of natural compounds, peppermint and its main component, menthol, has been suggested to possess antiinflammatory potential. Four databases including Web of Sciences, PubMed, Scopus, and Embase were searched to identify articles about peppermint and its antiinflammatory effects up to March 2023. Out of 3805 records screened, 14 articles met the study criteria. The evidence reviewed here proposed peppermint as an antiinflammatory agent. Peppermint may suppress inflammation by activating the AMP-activated protein kinase/unc-51 like kinase 1/nuclear factor-E2 associated factor 2 autophagy pathway, downregulating extracellular signal-regulated kinase-nuclear factor kappa B and mitogen activated protein kinases pathways, attenuating oxidative stress, suppressing the production of pro-inflammatory mediators and nitric oxide, and inducing the production of antiinflammatory prostaglandins. Due to the promising antiinflammatory effects of peppermint and the lack of human studies in this regard, future randomized clinical trials examining the effects of peppermint on inflammation and its related maladies are warranted.

Does the Grape Products Intake has an Effect on Body Weight in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

INTRODUCTION: There is a growing interest in the considerable benefits of grape products intake, as some studies have indicated that they may improve cardiometabolic risk factors. However, the widespread impact of grape products on the anthropometric indices is not fully resolved. METHOD: The purpose of this systematic review and meta-analysis was to examine the effects of grape products intake on anthropometric indices in adults. Randomized controlled trials (RCT) examining the effects of grape products intake on anthropometric indices, published up to December 2021, were identified through PubMed, SCOPUS, and ISI Web of Science databases. 30 studies with 35 effect sizes, including 1284 participants (708 cases and 576 controls), were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence interval (CI). RESULT: The outcomes have revealed grape products intake to significantly decrease body weight (p = 0.001) and body mass index (p = 0.004) in obese participants, and also, a greater effect was observed when grape seed extract was used. CONCLUSION: Our study suggests that grape products intake may help to decrease body weight in obese participants. Future large RCTs with longer duration and obese populations are needed to expand our findings.

The effects of purslane consumption on lipid profile and C-reactive protein: A systematic review and dose-response meta-analysis.

Earlier investigations into the impact of purslane, Portulaca oleracea, on lipid profile and C-reactive protein (CRP) produced contradictory findings. The effect of purslane consumption on lipid profiles and CRP was assessed in this comprehensive review and meta-analysis. We conducted a thorough literature search in online databases, including PubMed, Scopus, the Cochrane library, and ISI Web of Science to find relevant randomized controlled trials up to June 2023. By incorporating 14 effect sizes from 13 RCTs, we were able to show that purslane consumption significantly decreases serum triglyceride (TG) (WMD: -16.72, 95% CI: -22.49, -10.96 mg/dL, p < .001), total cholesterol (TC) (WMD: -9.97, 95% CI: -19.86, -0.07 mg/dL, p = .048), and CRP (WMD: -1.22, 95% CI: -1.63, -0.80 mg/L, p < .001) levels in patients compared to the control group. In addition, purslane consumption significantly increases high-density lipoprotein (HDL-C) (WMD: 4.09, 95% CI: 1.77, 6.41 mg/dL, p = .001) levels. However, purslane consumption did not affect low-density lipoprotein (LDL-C) levels. According to a suggested optimal dosage, purslane consumption is considered to be safe up to 30 g/day. Purslane consumption can significantly improve cardiovascular health by improving lipid profile and inflammation status.

Response: Impact of implantable cardioverter defibrillator on survival in patients with nonischemic dilated cardiomyopathy.

Our previous study aimed to investigate overall survival (OS) and sudden cardiac death (SCD) variables in nonischemic dilated cardiomyopathy (DCM) patients treated only with standard medical treatments versus those who received implantable cardioverter defibrillator (ICD) in addition to routine medical treatments. Our findings revealed no significant difference in OS between the two groups (p = .25), but a significant decrease in SCD rate due to ICD insertion (p = .02). Furthermore, we found no significant difference between the two groups concerning baseline characteristics and type of medical treatments received. We attempted to answer and clarify the concerning points regarding the survival benefits of ICD insertion in nonischemic DCM patients that were mentioned.

Spatial organization and function of RNA molecules within phase-separated condensates are controlled by Dnd1.

Germ granules, condensates of phase-separated RNA and protein, are organelles essential for germline development in different organisms The patterning of the granules and its relevance for germ cell fate are not fully understood. Combining three-dimensional in vivo structural and functional analyses, we study the dynamic spatial organization of molecules within zebrafish germ granules. We find that localization of RNA molecules to the periphery of the granules, where ribosomes are localized depends on translational activity at this location. In addition, we find that the vertebrate-specific Dead end (Dnd1) protein is essential for nanos3 RNA localization at the condensates' periphery. Accordingly, in the absence of Dnd1, or when translation is inhibited, nanos3 RNA translocates into the granule interior, away from the ribosomes, a process that is correlated with loss of germ cell fate. These findings highlight the relevance of sub-granule compartmentalization for posttranscriptional control, and its importance for preserving germ cell totipotency.

Spatial organization and function of RNA molecules within phase-separated condensates in zebrafish are controlled by Dnd1.

Germ granules, condensates of phase-separated RNA and protein, are organelles that are essential for germline development in different organisms. The patterning of the granules and their relevance for germ cell fate are not fully understood. Combining three-dimensional in vivo structural and functional analyses, we study the dynamic spatial organization of molecules within zebrafish germ granules. We find that the localization of RNA molecules to the periphery of the granules, where ribosomes are localized, depends on translational activity at this location. In addition, we find that the vertebrate-specific Dead end (Dnd1) protein is essential for nanos3 RNA localization at the condensates' periphery. Accordingly, in the absence of Dnd1, or when translation is inhibited, nanos3 RNA translocates into the granule interior, away from the ribosomes, a process that is correlated with the loss of germ cell fate. These findings highlight the relevance of sub-granule compartmentalization for post-transcriptional control and its importance for preserving germ cell totipotency.

Clinical results of everolimus-eluting stents and sirolimus-eluting stents in patients undergoing percutaneous coronary intervention.

Background: It has been pronounced that everolimus-eluting stent (EES) had lower charge of goal-lesion revascularization and stent thrombosis as compared with sirolimus-eluting stents (SES).The goal of this observation was to compare the efficacy and protection of EES with SES in primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods: In this retrospective study, a total of 404 patients with coronary artery stenosis who underwent angioplasty of one or more coronary arteries were included in the study. Of these, 202 were treated with SES and the others with EES. The data were collected by a questionnaire through which the annual incidence of coronary stent complications including the occurrence of stent thrombosis (confirmed by re-angiography), the occurrence of acute coronary syndrome leading to hospitalization, the occurrence of vascular myocardial infarction related to the stenting vessel, the need for re-angiography and angioplasty and finally the incidence of cardiac mortality were evaluated. Results: This study showed that the odds ratio of EES thrombosis to SES stent in the unadjusted model is 1.01 (0.06-16.34) and in the adjusted model for confounding variables was equal to 0.80 (0.04-13.35) which in both models, these values were not statistically significant. Conclusion: The findings of the present study indicate that there is no statistically significant difference between the outcomes in the two groups treated with SES and EES release stents.

The effects of purslane consumption on glycemic control and oxidative stress: A systematic review and dose-response meta-analysis.

Purslane (Portulaca oleracea L.) is a herbal remedy with wide range of pharmaceutic properties. Although the beneficial effect of purslane on the treatment of Type 2 Diabetes Mellitus (T2DM) has been shown, there is an inconsistency among the results of previous studies. Therefore, this study is aimed at conducting a systematic review and meta-analysis on the effect of purslane on glycemic profile and oxidative stress markers. A systematic search was performed in the Scopus, Web of science, PubMed and the Cochrane Library to find articles related to the effect of the purslane on Malondialdehyde (MDA) and Total Antioxidant Capacity (TAC), Fasting Blood Sugar (FBS), Hemoglobin A1c (HbA1c), insulin resistance, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) up to September 2022. Among the 611 initial studies that were identified from searching electronic databases, 16 Randomized Clinical Trials (RCTs) involving 1122 participants (557 cases and 565 controls) were included for data analysis. The results of random-effects modeling demonstrated that purslane consumption significantly reduced FBS (p < .001), MDA (p < .001) and increased TAC (p < .001). However, purslane consumption did not affect HbA1c (p < .109), fasting insulin (p = .298) and HOMA-IR (p = .382). Meta-analyses were performed using both the random- and fixed-effects model where appropriate, and I 2 index was used to evaluate the heterogeneity. This meta-analysis study suggests that purslane has beneficial effects on oxidative stress markers and glycemic parameter. Therefore, it may be a promising adjuvant therapy in T2DM because of its benefits and negligible adverse effects.

The impact of implantable cardioverter defibrillator on the prognosis of nonischemic dilated cardiomyopathy patients compared with standard medical treatments.

BACKGROUND: Patients with nonischemic dilated cardiomyopathy (DCM) are susceptible to arrhythmias and implantable cardioverter defibrillator (ICD) in addition to medical treatments may help prevent sudden cardiac death (SCD) and improve survival in this population. HYPOTHESIS: We aim to investigate the impact of ICD insertion on survival and prognosis of patients with nonischemic DCM. METHODS: We retrospectively analyzed data from patients with nonischemic DCM treated with medical therapy with or without ICD who referred to our hospital from January 2020 to November 2021. Patients were divided based on the treatment that they had received into two equal groups. Different variables including demographic features, comorbidities, medical treatments, hospitalization rate, function class, and left ventricular ejection fraction before and after treatments were investigated in this study. In addition, variables in survival including overall survival (OS) and SCD were compared between the two groups. RESULTS: A total of 120 patients were investigated in this study. Mean ± SD of age and follow-up time of patients were 64.0 ± 12.7 years old and 61.2 ± 15.9 months, respectively. Ten (16.7%) patients with medical therapy, and seven (11.7%) patients with ICD and medical therapy died during the follow-up period (p = 0.25). However, the two groups had a significant difference regarding SCD (11.7% vs. 1.7%, p = 0.02). CONCLUSION: In patients with nonischemic DCM who had undergone ICD insertion in addition to standard medical treatments, SCD was significantly reduced compared with patients receiving just medical treatments. OS had no significant difference between our two studied groups.

A Multiple-Center, Retrospective Study of Characteristics and Outcomes of Hospitalized COVID-19 Patients with Cardiovascular Disease in North Iran.

Background: In this retrospective study, we investigated the outcomes and demographic characteristics of COVID-19 patients with and without a history of CVD. Methods: This large retrospective, multicenter study was performed on inpatients with suspected COVID-19 pneumonia who were admitted across four hospitals in Babol, Northern Iran.Demographic data, clinical data, and cycle threshold value (Ct) results of Real Time PCR were obtained. Then, participants were divided into two groups: (1) cases with CVDs, (2) cases without CVDs. Results: A total of 11097 suspected COVID-19 cases with a mean ± SD age of 53 ±25.3 (range: 0 to 99) years were involved in the present study. Out of whom 4599 (41.4%) had a positive RT-PCR result. Of those, 1558 (33.9%) had underlying CVD. Patients with CVD had significantly more co-morbidities such as hypertension, kidney disease, and diabetes. Moreover, 187 (12%) and 281 (9.2%) of patients with and without CVD died, respectively. Also, mortality rate was significantly high among the three groups of Ct value in patients with CVD, with the highest mortality in those with Ct between 10 and 20 (Group A = 19.9%). Conclusions: In summary, our results highlight that CVD is a major risk factor for hospitalization and the severe consequences of COVID-19. Death in CVD group is significantly higher compared to non-CVD. In addition, the results show that age-related diseases can be a serious risk factor for the severe consequences of COVID-19.

Complications of Implantable Cardioverter Defibrillator and Their Potential Risk Factors in Patients with Hypertrophic Cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. Methods: This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. Results: In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications (P = 0.01). Conclusion: We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.

Echocardiographic and electrocardiographic assessments in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory disease affecting many organs. Recent studies have demonstrated that psoriasis is associated with cardiovascular disorders. We investigated the echocardiographic and conduction system changes in psoriasis patients. METHODS: In this case-control study, 36 psoriatic patients and 36 healthy controls were enrolled. Demographic and clinical data, echocardiographic and P wave dispersion (PWD) in 12-lead electrocardiogram were evaluated in both groups. We recruited patients with confirmed diagnosis via biopsy and have not been under recent systemic treatment. Patients with underlying cardiovascular disease were excluded from the study. RESULTS: Mean age was 41.56±16.20 and 39.67±13.85 year in case and control groups, respectively. There was no significant difference in the baseline characteristics of the two groups. PWD was significantly higher in the case group (p<0.05). High pulmonary artery pressure was observed in 14 psoriatic patients and 1 individual in the control group (p<0.001). Left ventricular diastolic dysfunction was significantly higher among individuals who were above 60 years of age (p<0.01) but not significantly different between the two groups. CONCLUSION: Psoriatic patients are more susceptible to future development of atrial fibrillation because of higher PWD. There is no significant difference between the diastolic function in these patients.

Effect of long-term exposure to PM2.5 on years of life lost in a populated Middle Eastern city.

From a public health point of view, years of life lost (YLL) is a more important index than the number of deaths to evaluate the effect of risk factors. The objective of the present study was to estimate the burden of disease including years of life lost (YLL) and expected life remaining (ELR) attributed to long-term exposure to PM2.5 in Ahvaz, one of the most polluted cities of the world, during March 2014 through March 2017. AirQ + software was used for the estimation of YLL and ELR due to all natural causes of death. Hourly concentrations of PM2.5 were acquired from the Department of Environment (DoE) of Ahvaz. Several steps were performed to validate the raw air quality data. Only the monitors were included that had minimum data completeness of 75%. Two age groups were selected for this study, including 0-64 and 65 < years. The life table approach was used to estimate YLL and ELR. Annual averages of PM2.5 were 5.2-8 times higher than the air quality guideline (10 µg/m3) set by WHO for long-term exposure to PM2.5. In total, PM2.5 has caused 234,041 years of life lost due to mortality. About 84% of YLLs were attributed to people older than 65 years old. The YLLs of men were higher than those for women. The YLLs in the third year were greater than the first two years. PM2.5 has caused the average age of total population, people aged 0-64 years old, and people > 65 years old decreased by 2.5, 3, and 1.6 years, respectively. These studies indicated that people in a city that the air quality is highly affected by dust storms, industrial emissions, and urban air pollution are significantly at risk. Air pollution control strategies and actions should be designed and executed to improve the quality of ambient air.

Cellular Blebs and Membrane Invaginations Are Coupled through Membrane Tension Buffering.

Bleb-type cellular protrusions play key roles in a range of biological processes. It was recently found that bleb growth is facilitated by a local supply of membrane from tubular invaginations, but the interplay between the expanding bleb and the membrane tubes remains poorly understood. On the one hand, the membrane area stored in tubes may serve as a reservoir for bleb expansion. On the other hand, the sequestering of excess membrane in stabilized invaginations may effectively increase the cell membrane tension, which suppresses spontaneous protrusions. Here, we investigate this duality through physical modeling and in vivo experiments. In agreement with observations, our model describes the transition into a tube-flattening mode of bleb expansion while also predicting that the blebbing rate is impaired by elevating the concentration of the curved membrane proteins that form the tubes. We show both theoretically and experimentally that the stabilizing effect of tubes could be counterbalanced by the cortical myosin contractility. Our results largely suggest that proteins able to induce membrane tubulation, such as those containing N-BAR domains, can buffer the effective membrane tension-a master regulator of all cell deformations.

Fluid dynamics during bleb formation in migrating cells in vivo.

Blebs are cellular protrusions observed in migrating cells and in cells undergoing spreading, cytokinesis, and apoptosis. Here we investigate the flow of cytoplasm during bleb formation and the concurrent changes in cell volume using zebrafish primordial germ cells (PGCs) as an in vivo model. We show that bleb inflation occurs concomitantly with cytoplasmic inflow into it and that during this process the total cell volume does not change. We thus show that bleb formation in primordial germ cells results primarily from redistribution of material within the cell rather than being driven by flow of water from an external source.

Bleb Expansion in Migrating Cells Depends on Supply of Membrane from Cell Surface Invaginations.

Cell migration is essential for morphogenesis, organ formation, and homeostasis, with relevance for clinical conditions. The migration of primordial germ cells (PGCs) is a useful model for studying this process in the context of the developing embryo. Zebrafish PGC migration depends on the formation of cellular protrusions in form of blebs, a type of protrusion found in various cell types. Here we report on the mechanisms allowing the inflation of the membrane during bleb formation. We show that the rapid expansion of the protrusion depends on membrane invaginations that are localized preferentially at the cell front. The formation of these invaginations requires the function of Cdc42, and their unfolding allows bleb inflation and dynamic cell-shape changes performed by migrating cells. Inhibiting the formation and release of the invaginations strongly interfered with bleb formation, cell motility, and the ability of the cells to reach their target.