Effective food hygiene principles and dietary intakes to reinforce the immune system for prevention of COVID-19: a systematic review.

BACKGROUND: This study aimed at reviewing effective food hygiene principles and dietary intakes to reinforce the immune system for prevention of corona virus disease 2019 (COVID-19). METHODS: The systematic literature search was performed in three databases from Jan. 2020 up to 10th July 2020. English articles that focused on nutrition, food, immunity and corona virus were searched. Systematic and narrative reviews were included. RESULTS: After evaluation of search papers, 27 relevant articles were used in this review. The importance of nutrients, phytochemicals, probiotics and some spices were highlighted for enhancing immunity during the COVID-19 pandemic. A healthy dietary pattern with proper energy intake provides sufficient nutrients. The unhealthy dietary pattern is linked with inflammation and risk factors related to high mortality in patients with severe COVID-19 infection. Different thermal procedures have been used for the inactivation of viruses. It is recommended not to consume raw or undercooked animal products. CONCLUSIONS: It is critical to ensure that the nutritional needs of the population are met and sustained based on standards during a COVID-19 pandemic. Clear advice on adequate calorie intake and an optimal healthy diet to support the immune function should be provided. Good hygiene practices must be performed by everyone and done in the food industry.

Relationship between body mass index, risk of venous thromboembolism and pulmonary embolism: A systematic review and dose-response meta-analysis of cohort studies among four million participants.

BACKGROUND: The relationship between body mass index (BMI) and risk of venous thromboembolism (VTE) and pulmonary embolism (PE) is a controversial issue. This dose-response meta-analysis was performed to investigate the association between BMI and risk of VTE and PE incidence based on cohort studies. METHOD: A comprehensive systematic search was conducted up to August 2019 in MEDLINE/PubMed, SCOPUS, and Cochrane. DerSimonian and Laird random-effects models were run to estimate combined hazard ratios (HRs) with 95% confidence intervals (CIs). Dose-response analysis was also carried out based on BMI values. RESULTS: Eleven articles with 16 arms and 3,910,747 participants were eligible for inclusion in this systematic review and meta-analysis. Pooled results showed a positive association between BMI and risk of VTE in the obese participants compared to participants classified in the normal BMI category (HR: 1.62, 95% CI: 1.29-2.04, I2 = 95%). Furthermore, results showed a significant association between lower BMI (underweight versus normal BMI category) and reduced risk of PE (HR: 0.80, 95% CI: 0.70-0.92, I2 = 9%) and higher risk of PE in obese versus normal BMI participants (HR: 2.24, 95% CI: 1.93-2.60, I2 = 0%). There was a significant linear relationship between BMI and risk of VTE (p < 0.001) and PE (p < 0.001). CONCLUSIONS: This systematic review and dose-response meta-analysis with 3,910,747 participants highlights obesity as a significant risk factor related to the incidence of VTE and PE.

The efficacy of probiotics in prevention of urinary tract infection in children: A systematic review and meta-analysis.

BACKGROUND: A consensus has not been reached yet about the efficacy of probiotics in reducing the incidence of urinary tract infections (UTIs) in children. This systematic review and meta-analysis was designed to assess the efficacy of probiotics in prevention UTI in children. METHODS: The present study was designed based on guidelines for systematic reviews of clinical trials. Two independent reviewers performed an extensive search in the Medline, Embase, Web of Science and Scopus electronic databases up to the end of 2016. The summery of eligible studies was assessed independently by two reviewers and recorded in the data extraction form. Finally, a pooled relative risk (RR) was reported with a 95% confidence interval (95% CI). RESULTS: Data from 10 studies were entered in the present meta-analysis. Probiotic therapy did not have any beneficial effect on the incidence of UTI (RR = 0.94; 95% CI 0.85-1.03; p = 0.19) and its recurrence (RR = 0.93; 95% CI 0.85-1.02; p = 0.14). Subgroup analyses showed that probiotics as monotherapy do not have any beneficial effects on prevention of UTI (RR = 0.96; 95% CI 0.89-1.04; p = 0.31). However, the incidence of UTI is reduced if probiotics are used as adjuvant therapy to antibiotics (RR = 0.92; 95% CI 0.85-0.99; p = 0.02). CONCLUSION: The present meta-analysis showed that probiotics did not have a beneficial effect in reducing the incidence or recurrence of UTI. Only a moderate efficacy was seen when a probiotic was used as adjuvant therapy to antibiotics.

Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study.

INTRODUCTION: Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED). METHODS: In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016. The discriminatory power and calibration of the models were calculated and compared using STATA 11. RESULTS: 2148 patients with the mean age of 39.50±17.27 years were studied (75.56% males). The area under the curve of REMS and RAPS in predicting in-hospital mortality were calculated to be 0.93 (95% CI: 0.92-0.95) and 0.899 (95% CI: 0.86-0.93), respectively (p=0.02). These measures were 0.92 (95% CI: 0.90-0.94) and 0.86 (95% CI: 0.83-0.90), respectively, regarding poor outcome (p=0.001). The optimum cut-off point in predicting outcome was found to be 3 for REMS model and 2 for RAPS model. The sensitivity and specificity of REMS and RAPS in the mentioned cut offs were 95.93 vs. 85.37 and 77.63 vs. 83.51, respectively, in predicting mortality. Calibration and overall performance of the two models were acceptable. CONCLUSION: The present study showed that adding age and level of arterial oxygen saturation to the variables included in RAPS model can increase its predictive value. Therefore, it seems that REMS could be used for predicting mortality and poor outcome of trauma patients in emergency settings.

Worthing Physiological Score vs Revised Trauma Score in Outcome Prediction of Trauma patients; a Comparative Study.

INTRODUCTION: Awareness about the outcome of trauma patients in the emergency department (ED) has become a topic of interest. Accordingly, the present study aimed to compare the rapid trauma score (RTS) and worthing physiological scoring system (WPSS) in predicting in-hospital mortality and poor outcome of trauma patients. METHODS: In this comparative study trauma patients brought to five EDs in different cities of Iran during the year 2016 were included. After data collection, discriminatory power and calibration of the models were assessed and compared using STATA 11. RESULTS: 2148 patients with the mean age of 39.50±17.27 years were included (75.56% males). The AUC of RTS and WPSS models for prediction of mortality were 0.86 (95% CI: 0.82-0.90) and 0.91 (95% CI: 0.87-0.94), respectively (p=0.006). RTS had a sensitivity of 71.54 (95% CI: 62.59-79.13) and a specificity of 97.38 (95% CI: 96.56-98.01) in prediction of mortality. These measures for the WPSS were 87.80 (95% CI: 80.38-92.78) and 83.45 (95% CI: 81.75-85.04), respectively. The AUC of RTS and WPSS in predicting poor outcome were 0.81 (95% CI: 0.77-0.85) and 0.89 (95% CI: 0.85-0.92), respectively (p<0.0001). CONCLUSION: The findings showed a higher prognostic value for the WPSS model in predicting mortality and severe disabilities in trauma patients compared to the RTS model. Both models had good overall performance in prediction of mortality and poor outcome.

Vitamin D-Fortified Bread Is as Effective as Supplement in Improving Vitamin D Status: A Randomized Clinical Trial.

CONTEXT: Bread can potentially be a suitable vehicle for fortification with vitamin D. OBJECTIVE: This study was undertaken to evaluate the following: 1) the bioavailability of vitamin D from the fortified Iranian bread and 2) the possible effects of daily consumption of the fortified bread on certain health aspects. DESIGN, SETTING, AND PARTICIPANTS: This was a randomized, double-blind, placebo-controlled trial conducted over 8 weeks in 90 healthy subjects aged 20-60 years. INTERVENTION: Subjects were randomly allocated to one of three groups: 1) fortified bread (FP; 50 g bread fortified with 25 µg vitamin D3 plus placebo daily; n = 30); 2) supplement (SP; 50 g plain bread plus 25 µg vitamin D supplement daily; n = 30); and 3) control (CP; 50 g plain bread plus placebo daily; n = 30). OUTCOME MEASURES: Initial and final anthropometric and biochemical assessments were performed. RESULTS: The within-group changes of serum 25-hydroxyvitamin D concentrations were 39.0 ± 22.6 (P < .001), 28.9 ± 31.2 (P < .001), and -9.2 ± 12.3 nmol/L in the FP, SP, and CP groups, respectively. Only in FP and SP groups, serum intact PTH concentrations decreased approximately 13.5% and 14.5%, respectively. Visceral fat also showed a significant decrement in FP (-1.05% ± 1.4%; P ≤ .001) and SP (-0.96% ± 1.7%; P = .006). Serum low-density lipoprotein cholesterol concentration showed a within-group reduction in FP (-10.4 ± 11.2 mg/dL; P < .001) and an insignificant decrement in SP (-6.6 ± 20.2 mg/dL; P = .083). Serum high-density lipoprotein increased in both vitamin D-supplemented groups (FP: 9.7 ± 7.6 vs SP: 5.7 ± 6.7 mg/dL; P < .001). CONCLUSION: Vitamin D-fortified bread could be potentially effective in raising circulating 25-hydroxyvitamin D levels of the population to nearly adequate levels.

Nitric Oxide is Necessary for Diazoxide Protection Against Ischemic Injury in Skeletal Muscle.

Ischemia reperfusion injury (IR injury) is a common problem in clinical conditions. Researches have frequently revealed that ATP- sensitive potassium (KATP) channels and nitric oxide plays a role in protection against ischemic injury in skeletal muscle. The present study aimed at evaluating the possible link between this two pathways. Sixty-eight male wistar rats, were pretreated with saline, diazoxide (KATP opener; 45 mg/Kg, IP), glibenclamide (KATP inhibitor; 5 mg/Kg), or L-NAME (iNOS inhibitor; 20 mg/Kg, IP) before 3 h ischemia and 2 h reperfusion. Activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and the level of malondialdehyde (MDA) and expression of iNOS were measured in muscle tissue. Tissue MDA content was significantly increased by IR (p < 0.001). Diazoxide significantly decreased the IR-induced elevation of tissue MDA level (p < 0.05) and Glibenclamide increased MDA (p < 0.05 vs. IR group). L-NAME inhibited the effect of diazoxide on decreasing MDA (p < 0.01 vs., diazoxide+IR group) and IR decreased the activity of SOD and CAT (p < 0.01), while pretreatment with diazoxide increased activity of SOD and CAT (p < 0.01). Glibenclamide decreased SOD and CAT activity after IR (p < 0.05). L-NAME pretreatment in diazoxide-treated rats abolished the effect of diazoxide on increasing the activity of SOD and CAT (p < 0.05 vs. Diaz+IR). Expression of iNOS was increased by IR (p < 0.01 vs. Sham group). Diazoxide significantly decreased iNOS expression after IR (p < 0.05 vs. IR). L-NAME significantly decreased iNOS expression after IR (p < 0.01) in diazoxide-treated rats (p < 0.01 vs. Diaz+IR). In conclusion, the results of present study suggested a NO dependent protective effect for diazoxide against muscle IR injury.

Effect of short and long-term treatment with omega-3 Fatty acids on scopolamine-induced amnesia.

Two omega-3 fatty acids including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are essential for the physiologic function of neuronal cell membrane. Normal function of neuronal cell membrane requires appropriate composition of fatty in its structure. Present study was designed to compare the effect of short-term and long-term pretreatment with omega-3 fatty acids on scopolamine-induced amnesia and possible involvement of apoptotic or oxidative pathways. Male Wistar rats were gavaged by omega-3 fatty acids [60 mg/Kg (DHA + EPA)] or saline for 2 weeks (short-term model) or 8 weeks (Long-term model), then received intra-CA1 scopolamine (2 µg/rat). Finally, the avoidance response was examined and hippocampus tissue was prepared. Intra-CA1 injection of scopolamine abolished the memory performance in rats. Short-term or long-term pretreatment with omega-3 fatty acids improved memory (p < 0.01 and p < 0.001, respectively). Pretreatment for 2 weeks had no effect on the tissue Malondialdehyde (MDA) contents or SOD and CAT activity. In addition, pretreatment for 2 weeks with omega-3 fatty acids had no effects on tissue Bax and Bcl-2 expression. Conversely, long-term pretreatment with omega-3 fatty acids decreased tissue MDA contents (p < 0.01), SOD activity (p < 0.05) and increased CAT activity (p < 0.01). Long-term pretreatment with omega-3 fatty acids also decreased Bax protein expression (p < 0.05) with no effect on the expression of Bcl-2 protein. In conclusion, long-term exposure to omega-3 fatty acids inhibited the scopolamine-induced oxidative stress, apoptosis and amnesia while the effect of short-term treatment was restricted to the improved memory without significant effect on apoptosis or oxidative stress. Therefore, long-term treatment with low doses of omega-3 fatty acids suggested a suitable treatment for amnesia.