Surgical outcome of coronary artery fistulas repair in children

Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction, or coronary aneurysms. This article reviews the clinical characteristics and surgical outcome of 10 patients with CAF in Rajae Heart Center. From 1990 to 2000, 10 patients (age, 6 months to 15 years; mean age, 8.5 years) were diagnosed with CAF by echocardiography and cardiac catheterization. Six were female and 4 were male. All patients with isolated CAF (9) were asymptomatic. One patient with associated anomaly (mitral valve prolapse with severe mitral regurgitation) had dyspnea on exertion and palpitation. Five fistulas originated from the right coronary artery-three from the left and two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2), and pulmonary artery (1). The ratio of pulmonary to systemic flow ranged between I and 1.6. All patients had surgical ligation. In the symptomatic patient, in addition to ligation, mitral valve replacement was performed. There was no operative or late death. Follow-up evaluation (range, 1-6 years-, mean, 4.2 years) showed no evidence of recurrent or residual CAF. Surgical management of CAF is a safe and effective treatment resulting in 100% survival and clousure rate

Predicting dietary behavior of type 2 diabetics: Application of the theory of planned behavior and perceived risk of diabetes complications construct

BACKGROUND: Diabetes mellitus (DM) is considered a major health problem due to its complications. However, it could be prevented or delayed by modifications in the patients’ behavior and diets. The objective of this study was to explore the utility of the theory of planned behavior (TPB) and complications of diabetes perceived risk to find modifiable diabetes-related beliefs in order to make behavioral changes feasible. METHODS: The present descriptive-analytical cross-sectional study was conducted in diabetes clinics in Semirom, Iran, based on TPB and complications of diabetes perceived risk using a self-administered questionnaire. A total of 154 patients with diabetes without complications of diabetes participated in the study. Measured variables were patients’ attitude, subjective norm, perceived behavioral control, complications of diabetes perceived risk, intention to maintain a healthful diet and nutritional style. Structural equation modeling was used to analyze data. RESULTS: The results revealed that the TPB and perceived risk of diabetes complications fitted the data acceptably well among patients with type 2 diabetes and within dietary behavior. Perceived behavioral control, subjective norm, perceived risk of diabetes complications, and intention to maintain a healthy diet were related to healthy diet behavior. No relation was found between attitude and intention to follow a healthy diet. CONCLUSION: The TPB and perceived risk of diabetes complications is a useful theory in determining intentions of patients with diabetes and their adherence to a healthy diet

Predicting dietary behavior of type 2 diabetics: Application of the theory of planned behavior and perceived risk of diabetes complications construct

BACKGROUND: Diabetes mellitus (DM) is considered a major health problem due to its complications. However, it could be prevented or delayed by modifications in the patients’ behavior and diets. The objective of this study was to explore the utility of the theory of planned behavior (TPB) and complications of diabetes perceived risk to find modifiable diabetes-related beliefs in order to make behavioral changes feasible. METHODS: The present descriptive-analytical cross-sectional study was conducted in diabetes clinics in Semirom, Iran, based on TPB and complications of diabetes perceived risk using a self-administered questionnaire. A total of 154 patients with diabetes without complications of diabetes participated in the study. Measured variables were patients’ attitude, subjective norm, perceived behavioral control, complications of diabetes perceived risk, intention to maintain a healthful diet and nutritional style. Structural equation modeling was used to analyze data. RESULTS: The results revealed that the TPB and perceived risk of diabetes complications fitted the data acceptably well among patients with type 2 diabetes and within dietary behavior. Perceived behavioral control, subjective norm, perceived risk of diabetes complications, and intention to maintain a healthy diet were related to healthy diet behavior. No relation was found between attitude and intention to follow a healthy diet. CONCLUSION: The TPB and perceived risk of diabetes complications is a useful theory in determining intentions of patients with diabetes and their adherence to a healthy diet

Circulating levels of adropin and diabetes: a systematic review and meta-analysis of observational studies

Abstract Objective Adropin, a newly identified regulatory protein has garnered attention given its potential role in metabolism regulation, especially glucose metabolism and insulin resistance. However, studies on the association between adropin and type 2 diabetes mellitus (T2DM) are equivocal. The aim of this study is to assess the association between serum adropin levels and T2DM using a systematic review and meta-analysis of observational studies. Methods PubMed, Scopus, ISI Web of science, and Google Scholar were searched, up to August 2022, for studies that reported the association between serum levels of adropin in adults with T2DM compared to a control group without diabetes. A random-effect model was used to compute the pooled weighted mean difference (WMD) with 95% confidence intervals (CI). Results Meta-analysis of 15 studies (n = 2813 participants) revealed that the serum adropin concentrations were significantly lower in patients with T2DM compared with the control group (WMD= -0.60 ng/mL, 95% CI: -0.70 to -0.49; I2 = 99.5%). Subgroup analysis also found lower concentration of adropin in patients with T2DM who were otherwise healthy compared to a control group (n = 9; WMD=-0.04 ng/ml, 95% CI= -0.06 to -0.01, p = 0.002; I2 = 96.4). Conclusions Our study showed adropin levels are lower in patients with diabetes compared to a control group without diabetes. However, the limitations of observational studies challenge the validity of the results, and further investigations are needed to confirm the veracity of these findings and additionally explore possible mechanisms

Renal capsule for augmentation cystoplasty in canine model: a favorable biomaterial?

ABSTRACT Purpose: To evaluate effectiveness of canine renal capsule for augmentation cystoplasty. Materials and Methods: Ten adult dogs participated in this study. After induction of anesthesia each animal underwent bed side urodynamic study, bladder capacity and bladder pressure was recorded. Then via mid line incision abdominal cavity was entered, right kidney was identified and its capsule was dissected. Bladder augmentation was done by anastomosing the renal capsule to the bladder. After 6 months bed side urodynamic study was performed again and changes in bladder volume and pressure were recorded. Then the animals were sacrificed and the augmented bladders were sent for histopathology evaluation. Results: Mean maximum anatomic bladder capacity before cystoplasty was 334.00±11.40cc which increased to 488.00±14.83cc post-operatively (p=0.039). Mean anatomic bladder pressure before cystoplasty was 19.00±1.58cmH2O which decreased to 12.60±1.14cmH2O post-operatively (p=0.039). Histopathology evaluation revealed epithelialization of the renal capsule with urothelium without evidence of fibrosis, collagen deposits or contracture. Conclusions: Our data shows that renal capsule is a favorable biomaterial for bladder augmentation in a canine model

Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: a randomized clinical trial protocol

Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods: This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients.&nbsp