Type 2 diabetes patients requiring empagliflozin in Southeast of Iran: Frequency and guideline adherence (2022–2023) / Pacientes con diabetes tipo 2 que requieren empagliflozina en el sureste de Irán: frecuencia y cumplimiento de las directrices (2022-2023)

Introduction: Empagliflozin plays a beneficial role in individuals with type 2 diabetes at high risk of cardiovascular complications. This study aimed to assess the prevalence of individuals with type 2 diabetes who required empagliflozin based on clinical guidelines between the years 2022 and 2023. Material and methods: This study was a descriptive-analytical cross-sectional study conducted on a target population of patients with type 2 diabetes. Patient data, including demographic characteristics, smoking status, hypertension, hyperlipidemia, renal insufficiency, retinopathy, and proteinuria, were collected. The indication for prescribing empagliflozin was determined based on the risk of cardiovascular complications. Results: A total of 398 individuals with type 2 diabetes with a mean age of 58.4 years were examined. Overall, 87.4% of the patients had an indication for empagliflozin prescription. The indication for empagliflozin prescription was significantly higher in men, individuals with hyperlipidemia, those over 55 years of age, obese individuals, and smokers. The mean age, body mass index, and triglyceride levels were higher in candidates for empagliflozin prescription. Male candidates for empagliflozin had significantly higher rates of smoking and systolic blood pressure compared to females. Conclusions: The findings of this study demonstrated that a significant percentage of individuals with type 2 diabetes had an indication for empagliflozin prescription based on clinical and laboratory criteria. (AU)

Introducción: La empagliflozina tiene un papel beneficioso en las personas con diabetes tipo 2 con alto riesgo de complicaciones cardiovasculares. Este estudio tuvo como objetivo evaluar la prevalencia de pacientes con este padecimiento que requerían empagliflozina según las guías clínicas entre los años 2022 y 2023. Material y métodos: Se trata de un estudio transversal descriptivo-analítico realizado en una población objetivo de personas con diabetes tipo 2. Se recogieron los datos de los pacientes, incluyendo las características demográficas, el hábito tabáquico, la hipertensión, la hiperlipidemia, la insuficiencia renal, la retinopatía y la proteinuria. La indicación para prescribir empagliflozina se determinó en función del riesgo de complicaciones cardiovasculares. Resultados: Se examinaron un total de 398 individuos con diabetes tipo 2 con una edad media de 58,4 años. En general, 87,4% de estos tenía una indicación para la prescripción de empagliflozina, la cual fue significativamente mayor en los hombres, aquellos con hiperlipidemia, obesidad, los mayores de 55 años y los fumadores. La edad media, el índice de masa corporal y los niveles de triglicéridos fueron mayores en los candidatos a la prescripción de este medicamento. Los candidatos masculinos a este fármaco tenían tasas significativamente más altas de tabaquismo y presión arterial sistólica, en comparación con las mujeres. Conclusiones: Los resultados de este estudio demostraron que un porcentaje significativo de personas con diabetes tipo 2 tenía una indicación para la prescripción de empagliflozina según los criterios clínicos y de laboratorio. (AU)

Type 2 diabetes patients requiring empagliflozin in Southeast of Iran: Frequency and guideline adherence (2022-2023).

INTRODUCTION: Empagliflozin plays a beneficial role in individuals with type 2 diabetes at high risk of cardiovascular complications. This study aimed to assess the prevalence of individuals with type 2 diabetes who required empagliflozin based on clinical guidelines between the years 2022 and 2023. MATERIAL AND METHODS: This study was a descriptive-analytical cross-sectional study conducted on a target population of patients with type 2 diabetes. Patient data, including demographic characteristics, smoking status, hypertension, hyperlipidemia, renal insufficiency, retinopathy, and proteinuria, were collected. The indication for prescribing empagliflozin was determined based on the risk of cardiovascular complications. RESULTS: A total of 398 individuals with type 2 diabetes with a mean age of 58.4 years were examined. Overall, 87.4% of the patients had an indication for empagliflozin prescription. The indication for empagliflozin prescription was significantly higher in men, individuals with hyperlipidemia, those over 55 years of age, obese individuals, and smokers. The mean age, body mass index, and triglyceride levels were higher in candidates for empagliflozin prescription. Male candidates for empagliflozin had significantly higher rates of smoking and systolic blood pressure compared to females. CONCLUSIONS: The findings of this study demonstrated that a significant percentage of individuals with type 2 diabetes had an indication for empagliflozin prescription based on clinical and laboratory criteria.

The effect of PRP and hyperosmolarity simultaneous use on expression profile alteration of miRNAs associated with cartilage differentiation in human adipose tissue-derived mesenchymal stem cells.

BACKGROUND: Mesenchymal stem cells (MSC) are a type of multipotent stem cell whose differentiation into cartilage cells has been considered in recent years. Platelet-rich plasma (PRP) may impair cartilage differentiation due to its richness in growth factors and hyperosmolarity due to its proximity to the required cartilage environment. OBJECTIVES: The main purpose of this study was to treat human adipose tissue-derived MSCs concurrently with PRP and hyperosmolarity to investigate the expression profile of micro-RNA (miRNA) involved in the cartilage process differentiation. We examined the effect of PRP and the increase in osmolarity on the expression of miR-27, miR-101, miR-140, miR-145, miR-146, and miR-199. METHODS: Mesenchymal stem cells were extracted from human adipose tissue and differentiated into chondrocytes and the effect of baseline cultures (diff), PRP (prp), hyperosmolarity (os), base plus hyperosmolarity (diff + os), PRP plus hyperosmolarity (prp + os) next to the control group were studied in cartilage differentiation using specific stains such as Alcian blue, hematoxylin and eosin, and collagen type 2 and 10 immunohistochemistry. In addition, the expression of miR-27, miR-140, miR-199, miR-146, miR-101, and miR-145 was evaluated using real-time PCR. CONCLUSION: Human adipose tissue-derived MSCs with the ability to differentiate into adipocytes and osteocytes showed the properties of chondrocytes in all differentiation groups. Alkaline phosphatase (ALP) enzyme activity and calcium deposition were lower in the diff + os group than in other groups. Therefore, the diff + os group may be a more suitable environment for cartilage differentiation. Furthermore, 5% PRP concentration and hyperosmolarity showed a positive effect on miR-140, miR-199, miR-27, and, miR-146 and a negative effect on miR-101 and miR-145 on cartilage differentiation.

Immunomodulation in leukemia: cellular aspects of anti-leukemic properties.

Immunomodulation is a mechanism that stimulates or inhibits immune responses under the influence of secretory mediators. This study will review the role of cytokines and chemotherapy in the modulation of immune responses in leukemia. We searched the PubMed database and Google scholar search engine of English-language papers (1995-2018) using the "Immunomodulation", "Leukemia", "Tregs", "Natural killer cells", "Mesenchymal stem cells", "Macrophages" and "chemotherapy" as keywords. In leukemias, T regulatory cells (Tregs), natural killer cells (NK), macrophages (MQs) and mesenchymal stem cells (MSCs) alter their functional and secretion patterns. Some of the changes in NK cells and classic MQ (M1) potentiate the immune responses against leukemia, but some Tregs changes will compromise the immune system. The effect of a cell on immunomodulation is in contrast to another cell, in which the cells are engaged in a competition so that a cell that having a higher effect on immunomodulation will be the contest winner. The outcome of immunomodulation in response to leukemia is determined by the ratio of stimulatory activity of NK cells and M1 to the inhibitory effect of Tregs, while the dual role of MSCs through immunomodulators and cytokines can be effective in weakening/enhancing the immune response.

Soil oxidation-reduction in wetlands and its impact on plant functioning.

Soil flooding in wetlands is accompanied by changes in soil physical and chemical characteristics. These changes include the lowering of soil redox potential (Eh) leading to increasing demand for oxygen within the soil profile as well as production of soil phytotoxins that are by-products of soil reduction and thus, imposing potentially severe stress on plant roots. Various methods are utilized for quantifying plant responses to reducing soil conditions that include measurement of radial oxygen transport, plant enzymatic responses, and assessment of anatomical/morphological changes. However, the chemical properties and reducing nature of soil environment in which plant roots are grown, including oxygen demand, and other associated processes that occur in wetland soils, pose a challenge to evaluation and comparison of plant responses that are reported in the literature. This review emphasizes soil-plant interactions in wetlands, drawing attention to the importance of quantifying the intensity and capacity of soil reduction for proper evaluation of wetland plant responses, particularly at the process and whole-plant levels. Furthermore, while root oxygen-deficiency may partially account for plant stress responses, the importance of soil phytotoxins, produced as by-products of low soil Eh conditions, is discussed and the need for development of methods to allow differentiation of plant responses to reduced or anaerobic soil conditions vs. soil phytotoxins is emphasized.

Threshhold for recovery in the marsh halophyte Spartina alterniflora grown under the combined effects of salinity and soil drying.

A study quantifying the physiological threshhold at which Spartina alterniflora plants are able to tolerate the interactive effects of salinity and soil drying was conducted in a climate controlled greenhouse. The experiment consisted of two levels of salinity (3-5 ppt, L and 35-38 ppt, H) as well as four dynamic water levels: flooding (water level maintained 3-5 cm above the soil surface at high tide and 10 cm below the soil surface at low tide for entire study duration, F), 8-day drought (water level maintained at least 20 cm below the soil surface at high tide for 8 days then flooded, 8 days), 16-day drought (water level maintained at least 20 cm below the soil surface at high tide for 16 days then flooded, 16 days), and 24-day drought (water level maintained at least 20 cm below the soil surface at high tide for 24 days then flooded, 24 days). Plant gas exchange and growth responses were measured along with soil conditions of redox potential and water potential. Significant decreases were seen in plant gas exchange and growth in response to increases in salinity and soil drying. Survival was 100% for all flooded treatments while increased salinity combined with soil drying decreased survival to 86% in both low salt/24-day drought plants (LD24) and high salt/16-day drought plants (HD16). The lowest survival rate was seen in the high salt/24-day drought treatment (HD24) at 29%. Therefore, it appears that the critical time for recovery from the combined effects of increased salinity and soil drying may greatly diminish after two weeks from the onset of stress conditions. Consequently, if salinity continues to increase along the MRDP, marshes dominated by S. alterniflora may be more susceptible to short-term drought and likewise large-scale marsh browning.

Partial flooding enhances aeration in adventitious roots of black willow (Salix nigra) cuttings.

Black willow (Salix nigra) cuttings are used for streambank stabilization where they are subjected to a range of soil moisture conditions including flooding. Flooding has been shown to adversely impact cutting performance, and improved understanding of natural adaptations to flooding might suggest handling and planting techniques to enhance success. However, data assessing the root aeration in adventitious roots that are developed on cuttings of woody species are scant. In addition, it appears that no data are available regarding aeration of the root system under partially flooded conditions. This experiment was designed to examine the effects of continuous flooding (CF) and partial flooding (PF) on aerenchyma formation and radial oxygen loss (ROL) in black willow cuttings. Photosynthetic and growth responses to these conditions were also investigated. Under laboratory condition, replicated potted cuttings were subjected to three treatments: no flooding (control, C), CF, and PF. Water was maintained above the soil surface in CF and at 10 cm depth in PF. Results indicated that after the 28-d treatments, root porosity ranged between 28.6% and 33.0% for the CF and C plants but was greater for the PF plants (39.2% for the drained and 37.2% for the flooded portions). A similar response pattern was found for ROL. In addition, CF treatment led to decreases in final root biomass and root/shoot ratio. Neither CF nor PF had any detectable adverse effects on plant gas exchange or photosystem II functioning. Our results indicated that S. nigra cuttings exhibited avoidance mechanisms in response to flooding, especially the partially flooded condition which is the most common occurrence in riparian systems.

High oxygen level in a soaking treatment improves early root and shoot development of black willow cuttings.

Black willow (Salix nigra) stem cuttings are commonly used to stabilize eroded streambanks with survival dependent on rapid development of adventitious roots to maintain plant water balance, absorb nutrients, and provide anchorage and support especially during flood and drought events. Soaking cuttings in water prior to planting increases survival and growth rates, but it is not known whether oxygen content in the soaking water affects the rate of early root and shoot initiation and growth. A laboratory experiment tested the hypothesis that cuttings treated with high oxygen (>95% saturation, 8.62 mg O2 l(-1)) soaking exhibit more rapid initiation and growth of roots and shoots than cuttings treated with low oxygen (<15% saturation, 1.24 mg O2 l(-1)) soaking and control (unsoaked). Root initiation was enhanced in both high and low O2 soaking treatments compared to control (100, 93, and 41%, respectively, n = 27). High O2 soaking led to greater root length than low O2 soaking during the fourth week after planting (26.5 and 12.3 cm on day 22; 27.7 and 19.1 cm on day 27, respectively). Shoot growth was greater in high O2 compared to low O2 soaking on days 36 and 56 after planting (9.3 and 6.3 cm on day 36, 10.7 and 7.2 cm on day 56, respectively). Shoot and root biomass production was stimulated in both soaking treatments, with 200% more biomass production by day 59 compared to control. Results of this study demonstrated that a high oxygen soaking treatment has potential for improving early root and shoot growth, and survival in willow cuttings planted at riparian restoration sites.

Effects of soil conditions on survival and growth of black willow cuttings.

Current streambank restoration efforts focus on providing bank stability, enhancing water quality, and improving woody habitat using native vegetation rather than traditional engineering techniques. However, in most cases harsh site conditions limit restoration success. A two-year field study was conducted at Twentymile Creek, in northern Mississippi, investigating edaphic factors governing the survival of black willow (Salix nigra) cuttings used for streambank restoration. Low height growth, above-ground biomass production, and average leaf area were observed in willow cuttings grown in plots subjected to moisture deficits. However, sediment texture emerged as the dominant factor determining willow post growth, health, and survival. Shoot biomass, leaf biomass, and total above-ground biomass were 15-, 10-, and 14-fold greater for large willow cuttings (posts) grown in plots with sandy sediments relative to those grown in plots with similar moisture and soil redox potential but with silt and clay sediments. Average leaf size, average leaf mass and specific leaf area were all lower in fine textured plots. Under moisture conditions present at our sites, coarse-grained sediment (sand) was more conducive to willow growth, biomass production, and survival than were fine-grained sediments (silt/clay). Our results strongly suggest that soil texture and moisture conditions can determine restoration success. Therefore, it is critical that site conditions are factored into the selection of project locations prior to the initiation of willow planting restoration projects.

The effects of crude oil and the effectiveness of cleaner application following oiling on US Gulf of Mexico coastal marsh plants.

Field studies were conducted in two different marsh habitats in Louisiana coastal wetlands to evaluate the effects of oiling (using South Louisiana Crude oil, SLC) and the effectiveness of a shoreline cleaner (COREXIT 9580) in removing oil from plant canopies. The study sites represented two major marsh habitats; the brackish marsh site was covered by Spartina patens and the freshwater marsh was covered by Sagittaria lancifolia. Field studies were conducted in each habitat using replicated 5.8 m2 plots that were subjected to three treatments; oiled only, oiled + cleaner (cleaner was used 2 days after oiling), and a control. Plant gas exchange responses, survival, growth, and biomass accumulation were measured. Results indicated that oiling led to rapid reductions in leaf gas exchange rates in both species. However, both species in 'oiled + cleaned' plots displayed improved leaf conductance and CO2 fixation rates. Twelve weeks after treatment initiation, photosynthetic carbon fixation in both species had recovered to normal levels. Over the short-term, S. patens showed more sensitivity to oiling with SLC than S. lancifolia as was evident from the data of the number of live shoots and above-ground biomass. Above-ground biomass remained significantly lower than control in S. patens under 'oiled' and 'oiled + cleaned' treatments while it was comparable to controls in S. lancifolia. These studies indicated that the cleaner removed oil from marsh grasses and alleviated the short-term impact of oil on gas exchange function of the study plants. However, use of cleaner had no detectable effects on above-ground biomass production or regeneration at the end of the first growing season in S. patens. Similarly, no beneficial effects of cleaner on carbon fixation and number of live shoots were apparent beyond 12 weeks in S. lancifolia.

Plant functions in wetland and aquatic systems: influence of intensity and capacity of soil reduction.

Wetland or hydric soils, in addition to excess water and limited air-filled porosity, are characterized by anaerobic or reducing conditions. Wetland plants have developed physiological and morphological adaptations for growing under these conditions. Various methods exist for measuring plant responses to reducing conditions in wetland and aquatic environments, including assessment of radial oxygen transport, cellular enzymatic transformations, changes in root structure, and nutrient uptake. However, a gap exists in quantifying the chemical properties and reducing nature of soil environment in which plant roots are grown. The variation in reducing conditions, oxygen demand, and other associated processes that occur in wetland soils makes it difficult to truly compare the plant responses reported in the literature. This review emphasizes soil-plant interactions in wetlands, drawing attention to the importance of quantifying the intensity and capacity of reduction and/or oxygen demand in wetland soils to allow proper evaluation of wetland plant responses to such conditions.

The effects of oil spill and clean-up on dominant US Gulf coast marsh macrophytes: a review.

The objective of this review was to synthesize existing information regarding the effects of petroleum hydrocarbons on marsh macrophytes in a manner that will help guide research and improve spill-response efficiency. Petroleum hydrocarbons affect plants chemically and physically. Although plants sometime survive fouling by producing new leaves, even relatively non-toxic oils can stress or kill plants if oil physically prevents plant gas-exchange. Plant sensitivity to fouling varies among species and among populations within a species, age of the plant, and season of spill. Physical disturbance and compaction of vegetation and soil associated with clean-up activities following an oil spill appear to have detrimental effects on the US Gulf coast marshes. Other techniques, including the use of chemicals such as cleaners or bioremediation, may be necessary to address the problem. Clean-up may also be beneficial when timely removal prevents oil from migrating to more sensitive habitats.

Leaf gas exchange and growth of flood-tolerant and flood-sensitive tree species under low soil redox conditions.

Seedlings of Taxodium distichum L., Quercus lyrata Walt. and Q. falcata var. pagodaefolia Ell. were grown for 22 days in a rhizotron system providing two soil redox potential regimes, +170 mV (low Eh) and +560 mV (high Eh). Leaf chlorophyll concentration and gas exchange, root alcohol dehydrogenase (ADH) activity, root and leaf ethylene production, and growth and biomass partitioning were measured. In response to the low Eh soil treatment, stomatal conductance was reduced in Q. falcata and Q. lyrata but not in T. distichum, whereas net photosynthesis was reduced significantly in all species; however, net photosynthesis in T. distichum began to recover within 2 weeks of treatment initiation. Within each treatment, mean stomatal conductance and net photosynthesis were significantly greater in T. distichum than in the oak species. Leaf chlorophyll concentration was not affected by the soil treatments. All species showed significant reductions in root and leaf dry weights in response to the low Eh soil condition. The low Eh soil treatment resulted in increased root ADH activity and ethylene production in T. distichum, but had no effect on root ADH activity and ethylene production in the oak species.

Interaction of flooding and salinity stress on baldcypress (Taxodium distichum).

Coastal wetlands of the southeastern United States are threatened by increases in flooding and salinity as a result of both natural processes and man-induced hydrologic alterations. Furthermore, global climate change scenarios suggest that, as a consequence of rising sea levels, much larger areas of coastal wetlands may be affected by flooding and salinity in the next 50 to 100 years. In this paper, we review studies designed to improve our ability to predict and ameliorate the impacts of increased flooding and salinity stress on baldcypress (Taxodium distichum (L.) Rich.), which is a dominant species of many coastal forested wetlands. Specifically, we review studies on species-level responses to flooding and salinity stress, alone and in combination, we summarize two studies on intraspecific variation in response to flooding and salinity stress, we analyze the physiological mechanisms thought to be responsible for the interaction between flooding and salinity stress, and we discuss the implications for coastal wetland loss and the prospects for developing salt-tolerant lines of baldcypress.

Effect of fluctuating rhizosphere redox potential on carbon assimilation ofSpartina alterniflora.

Spartina alterniflora Lois. plants from a Louisiana salt marsh were subjected to fluctuating levels of soil redox potential under controlled environmental conditions. The experiment was designed to examine the changes in carbon assimilation rates in response to the change in rhizosphere sediment redox condition representing a broad range of reduction normally associated with oxygen deficient environments. Variation in sediment redox potential is frequently encountered by this species in its natural environment in Louisiana's Gulf Coast marshes as a result of tidal patterns. Results indicated some adverse effects of extreme anoxic conditions on carbon assimilation ofS. alterniflora, a possible reflection of this species limited ability for maintaining root oxygenation under rapid, intense reduction in soil redox potential. It was also demonstrated that gas exchange limitations may be temporary and apparently may follow by some recovery. Carbon assimilation rates declined 15 to 21% when soil redox level decreased rapidly to below-200 mV which was followed by substantial recovery. A system for accurate control and measurement of rhizosphere redox potential and simultaneous measurement of plant photosynthetic activity is described.