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BACKGROUND: The association of hypertension (HTN) and different types of dietary amino acids is not yet clear. The aim of the present study was to investigate the association of branch chain amino acids (BCAAs) and the prevention of HTN. METHODS: This cross-sectional study was conducted on 4184 people aged 35 to 70 using data from the Sabzevar Persian cohort study in Sabzevar, Iran. Data on dietary intake of BCAAs including leucine, isoleucine, and valine were obtained using a validated Food Frequency Questionnaire (FFQ). Multivariable logistic regression analysis assessed the link between HTN and BCAAs. RESULTS: The results showed that participants with HTN had a higher total protein and BCAAs intake than participants with normal BP (P < 0.01). A marginally significant association was found between the risk of HTN with the total intake of BCAAs (OR = 1.018, CI95%: 1.001-1.035, P = 0.04), leucine (OR = 1.040, CI95%:1.002-1.080, P = 0.03), isoleucine (OR = 1.068, CI95%:1.001-1.140, P = 0.04), and valine (OR = 1.060, CI95%:1.003-1.121, P = 0.04). However, the association disappeared after adjusting the total protein and calorie intake. CONCLUSIONS: The results indicated that the dietary intake of BCAAs may be associated with the risk of HTN. Future longitudinal research is warranted.
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Aminoácidos de Cadeia Ramificada , Pressão Sanguínea , Hipertensão , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Irã (Geográfico)/epidemiologia , Hipertensão/epidemiologia , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Estudos Transversais , Idoso , Fatores de Risco , Adulto , Aminoácidos de Cadeia Ramificada/administração & dosagem , Medição de Risco , Proteínas Alimentares/administração & dosagem , Proteínas Alimentares/efeitos adversos , Fatores de ProteçãoRESUMO
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most prevalent cause of ovulatory infertility and endocrine abnormalities in reproductive-age women. Although the MIND diet has been introduced to improve brain function, evidence shows that the MIND diet is rich in beneficial food groups that can have a preventive effect on other metabolic disorders. The present study was conducted to investigate the association between adherence to the MIND diet and PCOS. METHODS: This age and BMI frequency-matched case-control study was conducted on 216 women between January 2018 and March 2019 in Yazd, Iran. PCOS was diagnosed based on Rotterdam criteria. Participants were selected by convenience sampling method. The validated 178-item food frequency questionnaire was used to assess the usual dietary intake. Logistic regression was used to estimate the association between the MIND diet and PCOS. RESULTS: The findings of the present study showed a significant inverse association between adherence to the MIND diet and PCOS in the crude model (OR for T3 vs. T1: 0.12 (95% CI: 0.05-0.25), P-value < 0.001) and multivariable-adjusted model including energy intake, age, BMI, waist circumference, marital status, pregnancy history, drug use history, education and physical activity (OR for T3 vs. T1 = 0.08 (95% CI: 0.03-0.19), P-value < 0.001). Adherence to the MIND diet had a protective effect of 92%. CONCLUSION: Although the results of the present study showed that higher adherence to the MIND diet is associated with a lower risk of PCOS, more studies are needed to confirm these findings in the future.
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Síndrome do Ovário Policístico , Humanos , Feminino , Síndrome do Ovário Policístico/complicações , Estudos de Casos e Controles , Adulto , Irã (Geográfico)/epidemiologia , Dieta/métodos , Dieta/estatística & dados numéricos , Adulto Jovem , Índice de Massa CorporalRESUMO
BACKGROUND: Cardiovascular diseases (CVDs) are one of the main causes of death worldwide. Data on the effect of eggs consumption on the risk of CVDs are still unreliable. Therefore, this study aimed to investigate the association between CVDs and the consumption of eggs. METHODS: In this case-control study, the required data were extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults participated including 1535 patients with CVDs as the case group and 2706 healthy people as controls. Egg consumption was assessed using a valid food frequency questionnaire (FFQ). RESULTS: A significant association was observed between eggs consumption and stroke after adjustment for physical activity, body mass index (BMI), smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), using alcohol, lipid profile, diabetes, and the intake of energy, lipid, protein, carbohydrate, and cholestrol (OR:1.007, 95% CI:1.001-1.013, P = 0.03). No association was found between egg consumption with hypertension, cardiac ischemia, and myocardial infarction. CONCLUSIONS: There was a significant association between the consumption of eggs and stroke. However, more studies are needed to examine the effect of eggs on CVDs.
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Doenças Cardiovasculares , Acidente Vascular Cerebral , Adulto , Humanos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Prospectivos , Fatores de Risco , Estudos de Casos e Controles , Irã (Geográfico)/epidemiologia , Acidente Vascular Cerebral/complicações , Lipídeos , Dieta/efeitos adversosRESUMO
BACKGROUND: Adequate intake of natural antioxidants may improve female fertility. The aim of this study was to examine the link between female infertility and dietary antioxidant index (DAI). METHODS: This case-control study was conducted on 125 women with recently diagnosis of reduced ovarian reserves (AMH < 1.1) as the case group and 125 women with normal ovarian reserve as the control group in Rasht, Iran. The amount of food intake was assessed using the food frequency questionnaire (FFQ) and the DAI was calculated to estimate the antioxidant capacity of the diet. RESULTS: Regarding dietary intake, the infertile women had a lower intake of potassium (2789.25 ± 777 vs. 2593.68 ± 443 mg/d, P = 0.02), magnesium (204.12 ± 66 vs. 189.73 ± 34 mg/d, P = 0.03), copper (0.93 ± 0.40 vs. 0.82 ± 0.20 mg/d, P < 0.01), vitamin C (133.99 ± 46 vs. 122.62 ± 24 mg/d, P = 0.02), and fiber (14.53 ± 3 vs. 13.44 ± 2 g/d, P < 0.05), and a higher intake of cholesterol (205.61 ± 58 vs. 227.02 ± 46 mg/d, P < 0.01) than the control group (All P < 0.05). The DAI was negatively associated with infertility (OR: 0.94, CI 95%: 0.88-0.97, P = 0.03). The association remained significant after adjustments for age, BMI, the underlying diseases, fertility frequency, IVF failure, and calorie intake. CONCLUSION: Following an antioxidant-rich diet may reduce the risk of infertility. More longitudinal studies are warranted to confirm these results and discover the underlying mechanisms.
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Antioxidantes , Infertilidade Feminina , Feminino , Humanos , Estudos de Casos e Controles , Dieta , Ingestão de Alimentos , Reserva OvarianaRESUMO
BACKGROUND: Single Nucleotide Polymorphisms (SNPs) of the Fat mass and obesity-associated (FTO) gene may be associated with obesity by regulating appetite. The present study aimed to investigate the relationship between FTO genotype and resistance to eating in male adolescents. METHODS: The present cross-sectional study included 246 adolescent boys in Tehran, Iran, who were assessed for self-efficacy related to weight control using the Weight Efficacy Lifestyle (WEL), questionnaire, food intake using the Food Frequency Questionnaire (FFQ), physical activity using the International Physical Activity Questionnaire (IPAQ), and anthropometric indices using Bio-Impedance Analyzer (BIA). Moreover, the participants underwent genotyping for the rs9930506 polymorphism of the FTO gene, and the relationship between FTO genotype and resistance to eating was investigated using different models of multiple linear regression. RESULTS: According to our findings, there was a significant reverse relationship between the FTO rs9930506 genotype and resistance to eating (ß: -0.16, P = 0.01). Moreover, the relationship was still significant after adjusting for age, nutritional knowledge, BMI, and mother's BMI, educational level, and occupational status. CONCLUSION: According to our results, the FTO genotype had a significant effect on resistance to eating and food desires. However, there is a need for further studies to evaluate the underlying mechanisms of the effects of the FTO gene on appetite and obesity.
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Obesidade , Polimorfismo de Nucleotídeo Único , Adolescente , Masculino , Humanos , Estudos Transversais , Irã (Geográfico) , Genótipo , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genéticaRESUMO
BACKGROUND: Previous studies examined the effects of obesity on sperm parameters and reported inconsistent results. Thus, the present study aimed to evaluate the association between obesity and the quality of sperm parameters in infertile men. MATERIAL AND METHODS: The present cross-sectional study evaluated 218 infertile men aged 20-50. To this end, the 168-item food frequency questionnaire (FFQ) was utilized to evaluate dietary intake. The anthropometric and biochemical variables were examined using standard methods. Further, the association between obesity and the quality of sperm parameters was evaluated using the controlled linear regression for potential confounders. RESULTS: The normal sperm morphology had a significant inverse association with BMI [adjusted ß - 0.074, CI (- 0.141 to - 0.008), P = 0.029] and WC [adjusted ß - 0.026, CI (- 0.051 to - 0.001), P = 0.038]. Additionally, visceral fat had a marginal inverse association with normal sperm morphology [adjusted ß - 0.065, CI (- 0.138 to 0.008), P = 0.079] and non-progressive sperm motility [adjusted ß - 0.241, CI (- 0.495 to 0.014), P = 0.063]. CONCLUSION: Even though the present results indicated that obesity, abdominal obesity, and visceral fat had inverse associations with normal sperm morphology, more mechanism-based studies should be conducted to confirm these findings.
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Infertilidade , Sêmen , Masculino , Humanos , Estudos Transversais , Motilidade dos Espermatozoides , Obesidade/complicações , EspermatozoidesRESUMO
The pericarp of monogerm sugar beet seed is rubbed off during processing in order to produce uniformly sized seeds ready for pelleting. This process can lead to mechanical damage, which may cause quality deterioration of the processed seeds. Identification of the mechanical damage and classification of the severity of the injury is important and currently time consuming, as visual inspections by trained analysts are used. This study aimed to find alternative seed quality assessment methods by evaluating a machine vision technique for the classification of five damage types in monogerm sugar beet seeds. Multispectral imaging (MSI) was employed using the VideometerLab3 instrument and instrument software. Statistical analysis of MSI-derived data produced a model, which had an average of 82% accuracy in classification of 200 seeds in the five damage classes. The first class contained seeds with the potential to produce good seedlings and the model was designed to put more limitations on seeds to be classified in this group. The classification accuracy of class one to five was 59, 100, 77, 77 and 89%, respectively. Based on the results we conclude that MSI-based classification of mechanical damage in sugar beet seeds is a potential tool for future seed quality assessment.
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Beta vulgaris/química , Sementes/classificação , Gravação de Videoteipe/métodos , Beta vulgaris/crescimento & desenvolvimento , Análise Discriminante , Processamento de Imagem Assistida por Computador , Sementes/química , Gravação de Videoteipe/instrumentaçãoRESUMO
In this experimental study, 30 adult male Wistar rats divided into 5 groups (n=6). Experimental rats were treated with one intraperitoneal injection of 120 mg/kgbw Alloxan monohydrate alone or in combination with 28 days of oral administration with aqueous extract of Rhus coriaria (50, 100 and 250 mg/kgbw) while the control rats received normal saline. At the end of the study, blood glucose, malondialdehyde concentration and catalase activities of kidney and liver tissues were determined. Treatment with Rhus coriaria extract resulted in a significant reduction in blood glucose, and the liver and kidney tissue contents of malondialdehyde in comparison to diabetic group (P<0.05). Furthermore, diabetic group treated with extract showed a significant increase in catalase activities of the liver and kidney (P<0.05). The present study showed that Rhus coriaria could be effective in decreasing diabetic complication and this effect is attributed to the antioxidant activity of the plant.
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Antioxidantes/farmacologia , Diabetes Mellitus Experimental/tratamento farmacológico , Extratos Vegetais/farmacologia , Rhus , Aloxano , Animais , Catalase/metabolismo , Diabetes Mellitus Experimental/metabolismo , Masculino , Ratos , Ratos WistarRESUMO
The current study was designed to examine the role of glutamate NMDA receptors of the mediodorsal thalamus (MD) in scopolamine-induced memory impairment. Adult male rats were bilaterally cannulated into the MD. According to the results, intraperitoneal (i.p.) administration of scopolamine (1.5 mg/kg) immediately after the training phase (post-training) impaired memory consolidation. Bilateral microinjection of the glutamate NMDA receptors agonist, N-Methyl-D-aspartic acid (NMDA; 0.05 µg/rat), into the MD significantly improved scopolamine-induced memory consolidation impairment. Co-administration of D-AP5, a glutamate NMDA receptor antagonist (0.001-0.005 µg/rat, intra-MD) potentiated the response of an ineffective dose of scopolamine (0.5 mg/kg, i.p.) to impair memory consolidation, mimicking the response of a higher dose of scopolamine. Noteworthy, post-training intra-MD microinjections of the same doses of NMDA or D-AP5 alone had no effect on memory consolidation. Moreover, the blockade of the glutamate NMDA receptors by 0.003 ng/rat of D-AP5 prevented the improving effect of NMDA on scopolamine-induced amnesia. Thus, it can be concluded that the MD glutamatergic system may be involved in scopolamine-induced memory impairment via the NMDA receptor signaling pathway.
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N-Metilaspartato , Escopolamina , Ratos , Masculino , Animais , Escopolamina/farmacologia , N-Metilaspartato/farmacologia , Receptores de N-Metil-D-Aspartato/metabolismo , Ácido Glutâmico/metabolismo , Ratos Wistar , Amnésia/induzido quimicamente , Transtornos da Memória/induzido quimicamente , Agonistas de Aminoácidos Excitatórios/farmacologia , Antagonistas de Aminoácidos Excitatórios/farmacologia , Tálamo/metabolismo , Aprendizagem da EsquivaRESUMO
BACKGROUND: The FTO gene polymorphisms may influence the effects of lifestyle interventions on obesity. The present study aimed to assess the influence of the rs9930506 FTO gene polymorphism on the success of a comprehensive weight loss intervention in male adolescents with overweight and obesity. METHODS: This study was carried out on 96 adolescent boys with overweight and obesity who were randomly assigned to the intervention (n = 53) and control (n = 43) groups. The blood samples of the participants were collected, and the FTO gene was genotyped for the rs9930506 polymorphism. A comprehensive lifestyle intervention including changes in diet and physical activity was performed for 8 weeks in the intervention group. RESULTS: Following the lifestyle intervention, BMI and fat mass decreased significantly in the intervention group compared with the control group (both p < 0.05), while no change was found in weight, height or body muscle percentage between the groups. The participants in the intervention group with the AA/AG genotype and not in carriers of the GG genotype had a significantly higher reduction in BMI (-1.21 vs. 1.87 kg/m2, F = 4.07, p < 0.05) compared with the control group. CONCLUSION: The intervention in individuals with the AA/AG genotype has been significantly effective in weight loss compared with the control group. The intervention had no association effect on anthropometric indices in adolescents with the GG genotype of the FTO rs9930506 polymorphism. TRIAL REGISTRATION: Name of the registry: National Nutrition and Food Technology Research Institute; Trial registration number: IRCT2016020925699N2; Date of registration: 24/04/2016; URL of trial registry record: https://www.irct.ir/trial/21447.
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Sobrepeso , Polimorfismo de Nucleotídeo Único , Humanos , Adolescente , Masculino , Sobrepeso/genética , Índice de Massa Corporal , Genótipo , Obesidade/genética , Obesidade/terapia , Redução de Peso/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genéticaRESUMO
Previous studies reported that iron may have an indispensable role in the risk of hypertension (HTN). However, the result of the studies on the relationship between iron and risk of HTN is inconsistent. This study aimed to assess the association between the association of dietary iron intake and HTN in the Iranian population. This case-control study was conducted on 4184 people aged 35 to 70, including 1239 people with HTN and 2945 people with normal blood pressure (BP) in Sabzevar, Iran. Dietary intake was assessed using a food frequency questionnaire (FFQ). The Nutritionist IV software was used in terms of the assessment of dietary intake of iron. An inverse association was found between iron intake and HTN (OR = 0.97, CI 95%: 0.94-0.99, P = 0.04). The association remained significant after adjustment for age, gender, smoking, drinking alcohol, calorie intake, and BMI (OR = 0.94, CI 95%: 0.89-0.98, P = 0.01). As a conclusion, iron intake was inversely associated with HTN. Further longitudinal studies on the effect of iron intake on BP are required to confirm this finding.
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Hipertensão , Humanos , Pressão Sanguínea , Irã (Geográfico)/epidemiologia , Estudos de Casos e Controles , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Ferro , Fatores de RiscoRESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) results in several complications and mortality in intensive care unit (ICU) patients. Limited studies have investigated the effect of enteral nutrition (EN) on the survival of COVID-19 patients in the ICU. The aim of this study was to investigate the association of EN with biochemical and pathological indices associated with mortality in ICU patients with COVID-19. METHODS: This case-control study was conducted on 240 patients with COVID-19 hospitalized in the ICU including 120 eventual nonsurvived as the cases and 120 survived patients as the controls. All of the patients received EN as a high protein high volume or standard formula. Data on general information, anthropometric measurements, and the results of lab tests were collected. RESULTS: The recovered patients received significantly more high protein (60.8% vs. 39.6%, p = .004) and high volume (61.6% vs. 42.3%, p = .005) formula compared to the nonsurvived group. Mortality was inversely associated with high volume (odds ratio [OR]: 0.45 confidence interval [CI]95%, p = .008) and high protein (OR: 0.42 CI95%, p = .003) formula. The results remained significant after adjusting for age and sex. Further adjustment for underlying diseases, smoking, body mass index, and the acute physiology and chronic health evaluation II (APACHE II) score did not change the results. CONCLUSION: The findings of the study showed that there was a significant inverse association between mortality and high volume and high protein formula in patients with COVID-19. Further investigation is warranted.
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COVID-19 , Nutrição Enteral , Unidades de Terapia Intensiva , SARS-CoV-2 , Humanos , COVID-19/mortalidade , COVID-19/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Idoso , Unidades de Terapia Intensiva/estatística & dados numéricos , Estado Terminal/mortalidade , AdultoRESUMO
We discuss the case of a 67-year-old man who presented with a right-sided abdominal pain and on subsequent radiological imaging(s) in the form of an enhanced computed tomography scan of the abdomen and pelvis followed by a delayed excretory phase (computed tomography urogram), found to have a distal 4 mm vesicoureteric junction stone which had caused a pelvicoureteric junction rupture which was evident on extravasation of contrast. This warranted an urgent surgical intervention in the form of ureteric stent insertion. This case clearly depicts that with even a small stone associated with severe flank pain, rupture or pelvicoureteric junction/calyces should be suspected and we should never overlook symptoms and push for medical expulsive therapy in patients who do not appear to be septic or obstructed. This work has been reported in line with the Surgical CAse REport (SCARE) criteria.
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Injury to the underlying bowel is a serious potential complication following inguinal hernia mesh repair. Here the authors describe a rare case of a 69-year-old gentleman who initially presented with a deep collection in the retroperitoneum, which extended into the extraperitoneal space on the anterior abdominal wall 3 weeks following left inguinal hernioplasty. Early sigmoid perforation involving the inguinal hernia mesh repair was diagnosed, and he underwent a successful Hartmann's procedure with mesh removal.
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AIMS: It has been revealed that membrane androgen receptor activation modulates avoidance memory and synaptic plasticity. In a previous study, we showed that Calcineurin, a calcium dependent phosphatase, could be a potential mediator of these AR effects. Also, it is reported that AR activation leads to L-type calcium channel activation. The aim of the current study is to test whether L-type calcium channels are downstream of AR and whether this signal pathway mediates the impairment effect of androgenic steroids on passive avoidance memory and synaptic plasticity. MATERIALS AND METHODS: We measured the effect of Nandrolone Decanoate (AR agonist), AR antagonist (Nilutamide) plus ND or L-type calcium channel inhibitor (Nifedipine) plus ND on passive avoidance performance of adolescent male rats. For extracellular field potential recordings hippocampal slices were perfused with ND, Nilutamide-ND or Nifedipine-ND. KEY FINDINGS: Our results clarified that AR activation by ND could impair avoidance behavior as step through latency decreased in ND-treated group while application of both Nilutamide and Nifedipine reestablished normal avoidance behavior. Also, LTP induction in the CA1 area of hippocampus was diminished by ND perfusion and both AR antagonist and L-type calcium channel inhibitor application lead to normal LTP. These findings support our hypothesis that activation of L-type calcium channels are involved in ARs mechanism effects on both avoidance behavior and hippocampal synaptic plasticity. SIGNIFICANCE: Understanding the biological effects of AR agonists on cognitive processes and its cellular mechanism may be a new/supplementary way to treating fear-related disorders.
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Canais de Cálcio Tipo L , Receptores Androgênicos , Ratos , Masculino , Animais , Canais de Cálcio Tipo L/metabolismo , Receptores Androgênicos/metabolismo , Potenciação de Longa Duração , Nifedipino/farmacologia , Nifedipino/metabolismo , Ratos Wistar , Hipocampo/metabolismo , Plasticidade NeuronalRESUMO
Background and purpose: Neonates of pregnant women with epilepsy may compromise normal neurodevelopment and hippocampal morphology. Memory and learning disorders and a decrease in verbal IQ scores are seen in these children later in life. In the previous study, we suggested that the central muscarinic cholinergic receptors had an important role in learning and memory deficits induced by prenatal pentylenetetrazol-kindling in pups born to kindled mothers. This study aimed to investigate the effects of kindling during pregnancy on long-term potentiation (LTP) induction and the role of M1 muscarinic acetylcholine receptors in the hippocampus of male offspring. Experimental approach: Twenty female Wistar rats were divided into two groups on the 13th day of their gestation (kindled and control; n = 10). Animals in the first group were kindled by i.p. injections of 25 mg/kg body weight pentylenetetrazol every 15 min until seizures occurred and the control group received normal saline. The effect of maternal seizures and perfusion of specific M1 muscarinic receptors antagonist (telenzepine at doses of 0.01, 0.1, and 1 nmol) on the LTP induction of 80 pups were tested at 12 weeks of age by field potential recordings. Findings/Results: The results of the electrophysiological study revealed that recurrent seizures during pregnancy impaired field excitatory postsynaptic potentials (fEPSP)-LTP induction and normal development of M1 muscarinic receptors in the hippocampus of male offspring. Also, the results demonstrated that maternal seizure did not significantly affect the paired-pulse indexes and population spike-LTP in the hippocampus of male offspring. Conclusion and implications: Our study showed that recurrent seizures during pregnancy cause impaired fEPSP-LTP induction and abnormal development of the M1 muscarinic receptor in the hippocampus.
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Active targeting using biological ligands has emerged as a novel strategy for the targeted delivery of diagnostic agents to tumor cells. Conjugating functional targeting moieties with diagnostic probes can increase their accumulation in tumor cells and tissues, enhancing signal detection and, thus, the sensitivity of diagnosis. Due to their small size, ease of chemical synthesis and site-specific modification, high tissue penetration, low immunogenicity, rapid blood clearance, low cost, and biosafety, peptides offer several advantages over antibodies and proteins in diagnostic applications. Epidermal growth factor receptor (EGFR) is one of the most promising cancer biomarkers for actively targeting diagnostic and therapeutic agents to tumor cells due to its active involvement and overexpression in various cancers. Several peptides for EGFR-targeting have been identified in the last decades, which have been obtained by multiple means including derivation from natural proteins, phage display screening, positional scanning synthetic combinatorial library, and in silico screening. Many studies have used these peptides as a targeting moiety for diagnosing different cancers inâ vitro, inâ vivo, and in clinical trials. This review summarizes the progress of EGFR-targeting peptide-based assays in the molecular diagnosis of cancer.
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Neoplasias , Biblioteca de Peptídeos , Humanos , Peptídeos/química , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Receptores ErbB/metabolismo , Ligantes , Linhagem Celular TumoralRESUMO
Introduction: Background: nutritional therapy has an important role in the development of medical care services, and quantitative and qualitative assessments of the status of clinical nutrition in hospitals is crucial. This study aimed to explore the current status of clinical nutrition in hospitals of Guilan province, Iran. Methods: this quantitative-qualitative (mixed method) study was performed on public hospitals in Guilan province, Iran (n = 26). The required information was collected by visiting the hospitals and interviewing with hospital dietitians. The data collection tool had two quantitative and qualitative subscales. The quantitative subscale included a 21-item checklist containing information about the referral system, cooperation of hospital staff in clinical nutrition, clinical nutrition staff status, enteral nutrition, and parenteral nutrition. Results: in more than 55 % of hospitals the patients were not adequately referred to a dietitian. In about 31.2 % of hospitals, cooperation of other departments in the field of clinical nutrition was insufficient. In 37 % of hospitals with intensive care unit (ICU), enteral nutrition was not provided properly. Only 27 % of the hospital properly provided parenteral nutrition for their patients. The most important problems mentioned by hospital dietitians included noncompliance of the food services employers with recommended diets, insufficient number of hospital dietitians, and lack of per case payment method for dietitians. Coverage of diet services by health insurance was the most common suggestion of dietitians to promote diet therapy in public hospitals. Conclusion: the situation of providing nutritional services to patients in public hospitals is not favorable in terms of quantity and quality in Guilan province, Iran. Designing the necessary policies and reorient the clinical nutrition system in hospitals to promote patients' health and accelerate patient recovery is warranted.
Introducción: Antecedentes: la terapia nutricional tiene un papel importante en el desarrollo de los servicios de atención médica, y las evaluaciones cuantitativas y cualitativas del estado de la nutrición clínica en los hospitales son cruciales. Este estudio tuvo como objetivo explorar el estado actual de la nutrición clínica en los hospitales de la provincia de Guilan, Irán. Métodos: este estudio cuantitativo-cualitativo (método mixto) se realizó en hospitales públicos de la provincia de Guilan, Irán (n = 26). La información requerida se recopiló visitando los hospitales y entrevistando a los dietistas de los hospitales. La herramienta de recolección de datos tenía dos subescalas, cuantitativa y cualitativa. La subescala cuantitativa incluía una lista de verificación de 21 ítems que contenía información sobre el sistema de derivación, la cooperación del personal del hospital en nutrición clínica, el estado del personal de nutrición clínica, la nutrición enteral y la nutrición parenteral. Resultados: en más del 40 % de los hospitales, los pacientes no fueron derivados adecuadamente a un dietista. En el 35 % de los hospitales, la cooperación de otros departamentos en el campo de la nutrición clínica fue insuficiente. En el 55 % de los hospitales con unidad de cuidados intensivos (UCI), la nutrición enteral no se brindó adecuadamente. Ninguno de los hospitales proporcionó nutrición parenteral adecuada para los pacientes. Los problemas más importantes mencionados por los dietistas hospitalarios incluyeron el incumplimiento de los programas de alimentos por parte del empleador del sector alimentario, un número insuficiente de dietistas hospitalarios y la falta de pago de honorarios de consulta a los dietistas. La cobertura de los servicios de dietética por parte del seguro de salud fue la sugerencia más común de los dietistas para promover la dietoterapia en los hospitales. Conclusión: la situación de la prestación de servicios nutricionales a pacientes en hospitales públicos no es favorable en términos de cantidad y calidad en la provincia de Guilan, Irán. Se justifica diseñar las políticas necesarias para reorientar el sistema de nutrición clínica en los hospitales y, en definitiva, promover la salud y acelerar la recuperación de los pacientes.
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Serviços de Dietética , Hospitais , Humanos , Irã (Geográfico) , Apoio Nutricional , Nutrição ParenteralRESUMO
Background: Many factors like sedentary lifestyle, metabolic syndrome, and obesity are involved in the increased prevalence of nonalcoholic fatty liver disease (NAFLD). Dietary consumption of carbohydrates may has a role in the risk of NAFLD. This study aimed to investigate the association of NAFLD with the different types of dietary carbohydrates. Methods: This cross-sectional study was carried out on 4200 participants including 660 patients with NAFLD and 3540 helathy individuals without NAFLD ages 35 to 70 in sabzevar, Iran. Data on socio-deomgraphic status, anthropomrtric measurments, blood tests, and dietary intake of different types of dietary carbohydrates was collected. Results: The patients with NAFLD had a significantly higher dietary intake of glucose (29.38 ± 18.29 vs. 27.42 ± 15.96 g/d, P = 0.01) and fructose (33.99 ± 20.19 vs. 31.95 ± 18.34 g/d, P = 0.01) compared to the healthy people. A positive association was observed between NAFLD with the total intake of carbohydrates after adjustment for age, sex, and BMI (OR: 1.001, CI 95%: 1-1.002, P = 0.04) The association remained significant after further adjustments for for education level, marital status, physical activity, smoking, and drinking alcohol (Model 2) and after additional adjustments for calorie intake (Model 3). Conclusions: This study showed a positive association between total dietary carbohydrate and NAFLD. In particular, the amount of dietary of carbohydrates (regardless of the type of carbohydrate) may worsen NAFLD. Further longitudinal studies are warranted.
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BACKGROUND: Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID-19. METHODS: This case-control study was performed on 223 patients with COVID-19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records. RESULTS: The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002-1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors. CONCLUSIONS: Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID-19 outcomes.