RESUMEN
Polycyclic aromatic hydrocarbon (PAHs) are part of particulate matter (PM), which is produced from incomplete combustion of organic matter. Biomarkers mean biological indicators, molecules that indicate a normal or abnormal process in the body and may be a sign of a condition or disease. Studies show that PAHs increase the risk of cardiovascular diseases through processes such as oxidative stress, inflammation and atherosclerosis. The present study focused on the evaluation of health effects PAHs biomarkers on cardiovascular diseases (CVD). In this narrative study, data were collected from databases such as Scopus, PubMed, Web of science and Google Scholar in the period 1975-2023. After screening, duplicate and irrelevant articles were removed. Finally, 68 articles related to the effect of PAHs on CVD were included in the study. In addition to the articles found through the search in databases, another 18 articles from the references of the selected articles were included. According to the finding in during the biotransformation of PAH, a number of metabolites are made, such as phenols, diols, quinones, and epoxides. Phenolic isomers have the highest percentage and biomarkers used for their detection include 2-OHNAP used to trace naphthalene from heating processed food, 3-OHPHEN used to trace phenanthrene from diesel, 2-OHFLU used to trace fluorene and 1-OHPYR used to trace pyrene from cigarette and hookah smoke. According to the result, increasing blood pressure and heart rate and causing atherosclerosis are the main complications due to exposure to PAH metabolite on cardiovascular system. The most important agents that causes this affects including increased homocysteine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), serum biomarkers of C-reactive protein, and triglycerides. Result this study showed that cardiovascular diseases risk is increased by exposure to PAH biomarkers from smoking, car emissions, occupational exposure, and incinerators. Therefore, strict controls should be implemented for sources of PAH production and exposure.
RESUMEN
BACKGROUND: In this double-blinded randomized clinical trial, we aimed to compare the safety and efficacy of a combination of Dexmedetomidine and Ketamine (DK) with Propofol and Fentanyl (PF) for sedation in colonoscopy patients. METHODS: In this study, 64 patients who underwent colonoscopy were randomized into two groups: 1) A, which received PF, and 2) B, which received DK for sedation. Among 64 patients, 31 patients were included in PF, and 33 patients were included in the DK group. Both groups were similar in terms of demographics. Patients' sedation score (based on Ramsay sedation scale) and vital signs were recorded at 2, 5, 10, and 15 minutes. Complications including apnea, hypotension, hypoxia, nausea, and vomiting, along with gastroenterologist satisfaction and patients' pain score (based on Wong-Baker faces pain assessment scale), were recorded by a checklist. Data were analyzed by SPSS v.18 software, using chi-square, independent t-tests, and repeated measures analysis with p<0.05 as the criterion for significant differences. RESULTS: The mean score of sedation was 4.82±0.49 in the DK group and 5.22±0.45 in the PF group (p value=0.001). Serious complications, including hypotension (p value=0.005) and apnea (p value=0.10) were significantly higher in the PF group. Satisfaction of gastroenterologist (p value= 0.400) and patients' pain score (p value = 0.900) were similar among groups. CONCLUSION: Combination of DK provides sufficient sedation with fewer complications in comparison with PF in colonoscopy patients.
