Antioxidants and their role in the prevention and treatment of chronic kidney disease (CKD), perspective of complementary nursing and medicine: a review

BACKGROUND: Chronic kidney disease (CKD) is a progressive and irreversible disease that leads to end-stage renal disease. Many factors such as increased oxidative stress play a role in the occurrence of this complication. Due to the effective role of the antioxidant defense system in controlling many of the complications in which oxidative stress is involved, the present study was conducted to evaluate the role of antioxidants in the prevention and treatment of chronic kidney disease. METHODS: In this review study, studies using standard keywords in internal and external databases including: SID, Magiran, IranDoc, Medlib, Science Direct, PubMed, Scopus, Embase, Web of Science, Medline and Google Scholar search engine, were retrieved and selected without time limit. RESULTS: Among the selected articles, 14 articles were eligible for inclusion in the study, which was performed on more than 20,000 people and several animal models of rats from 2005 onwards. The results showed that there is an inverse relationship between the concentration of antioxidant enzymes in the body and the intensity and progression of CKD. In severe cases, a significant decrease in the concentration of antioxidant enzymes in the body, as well as cofactors such as selenium, iron and zinc in the progressive and severe course of CKD has been observed. CONCLUSIONS: The positive and significant effect of antioxidant compounds in chronic kidney disease is evident. The use of these compounds in the diet in the form of fruits, vegetables and grains, as well as the supply of iron and zinc and other minerals elements as cofactors for the action of enzymatic antioxidants has an effective role in the prevention and treatment of diseases by controlling free radicals

High Gain Magnetically Coupled Single Switch Quadratic Modified SEPIC DC-DC Converter

This article proposes, analyzes, and tests an improved high voltage gain dc-dc converter based on a single-ended primary-inductor converter (SEPIC). The proposed magnetically coupled quadratic modified SEPIC converter (MCQ-MSC) employs a coupled transformer with an optimized design to obtain a high voltage boost factor by controlling the transformer's turn ratio along with the switching duty cycle. Thanks to the unique structure of the coupled transformer, high voltage gain is obtained at low turns ratio, which is highly desirable for high voltage applications and the compact size of the converter. In addition to the coupled transformer, a voltage-boosting module is utilized to achieve a very high output voltage for a low switching duty cycle. The proposed inverter has a single switch with a wide control range of duty cycle (0<D<1), causing low conducting losses and high efficiency. Furthermore, a clamping circuit is successfully designed to remove the leakage inductance effects of the coupled transformer on the power switch. The proposed MCQ-MSC drains a continuous current from the input dc source, which makes it a suitable choice for renewable energy sources (RES). The hardware prototype of the proposed converter is tested to verify the mathematical expressions and theoretical results.acceptedVersionPeer reviewe

Conditioned medium from amniotic fluid mesenchymal stem cells could modulate Alzheimer's disease-like changes in human neuroblastoma cell line SY-SY5Y in a paracrine manner

Background: Alzheimer's disease is usually diagnosed by significant extracellular deposition of beta-amyloid and intracellular neurofibrillary tangle formation. Here, we investigated the paracrine effect of amniotic fluid-derived mesenchymal stem cells on AD changes in human SH-SY5Y cells. Methods: SH-SY5Y cells were divided into five groups: Control, 0.1 mu g/ml LPS, 10 mu g/ml LPS, 0.1 mu g/ml LPS + conditioned medium, and 10 mu g/ml LPS + conditioned medium. Cells were incubated with 0.1% and 10 mu g/ml LPS for 48 h, followed by incubation with the conditioned medium of amniotic fluid-derived mesenchymal stem cells for the next 24 h. Beta-amyloid plaques were monitored by Congo-red staining. Survival and apoptosis were assessed by the MTT assay and flow cytometric analysis of Annexin-V. ELISA was used to measure the levels of neprilysin, angiotensin-converting enzyme, and Matrix Metallopmteinase-9. A PCR array was used to measure the expression of genes involved in neurogenesis. Results: Bright-field imaging showed beta-amyloid plaques in the group treated with 10 mu g/ml LPS. We found minimal effects in groups receiving 0.1 mu g/ml LPS. The data showed that the reduction in the levels of neprilysin, angiotensin-converting enzyme, and Matrix Metalloproteinase-9 in the LPS-treated cells was attenuated after incubation with the stem cell secretome (p < 0.05). Amniotic fluid stem cell secretome increased the viability of LPS-treated SH-SY5Y cells (p 0.05) and was associated with a decrease in apoptotic changes (p < 0.05). We found the modulation of several genes involved in neurogenesis in the 10 mu g/ml LPS + conditioned medium group compared to cells treated with 10 mu g/ml LPS alone. Conclusion: Amniotic fluid stem cell secretion reduces AD-like pathologies in the human neuronal lineage.Tabriz University of Medical Sciences [IR.TBZMED.REC.1396.639]This study was supported by a grant from Tabriz University of Medical Sciences (IR.TBZMED.REC.1396.639) Grant holder: Dr. Alireza Nourazarian

Physical and biological properties of blend‐electrospun polycaprolactone/chitosan‐based wound dressings loaded with N‐decyl‐N , N ‐dimethyl‐1‐decanaminium chloride: An in vitro and in vivo study

Dual-pump electrospinning of antibacterial N-decyl-N, N-dimethyl-1-decanaminium-chloride (DDAC)-loaded polycaprolactone (PCL) nanofibers, and chitosan (CS)/polyethylene-oxide (PEO)-based wound dressings with hydrophilic and hydrophobic properties to eliminate and absorb pathogenic bacteria from wound surface besides antibacterial action and to support wound healing and accelerate its process. Physicochemical properties of the prepared nanofibrous mat as well as antibacterial, cytotoxicity, and cell compatibility were studied. The full-thickness excisional wound healing properties up to 3 weeks using hematoxylin and eosin and Masson-trichrome staining were investigated. Addition of DDAC to CS/PEO-PCL mats decreased the diameter of the nanofibers, which is a crucial property for wound healing as large surface area per volume ratio of nanofibers, in addition to proper cell adhesion, increases loading of DDAC in mats and leads to increased cell viability and eliminating Gram-positive bacteria at in vitro studies. In vivo studies showed DDAC-loaded CS/PEO-PCL mats increased epithelialization and angiogenesis and decreased the inflammation according to histological results. We demonstrated that hydrophobic PCL/DDAC mats, besides antibacterial properties of DDAC, absorbed and eliminated the hydrophobic pathological microorganisms, whereas the hydrophilic nanofibers consisted of CS/PEO, increased the cell adhesion and proliferation due to positive charge of CS. Finally, we were able to increase the wound healing quality by using multifunctional wound dressing. CS/PEO-PCL containing 8 wt % of DDAC nanofibrous mats is promising as a wound dressing for wound management due to the favorable interactions between the pathogenic bacteria and PCL/CS-based wound dressing. Keywords:chitosan; hydrophobic; Nanofiber; N-decyl-N; N-dimethyl-1-decanaminium chloride; polycaprolactone; wound dressin

Lawsone-encapsulated chitosan/polyethylene oxide nanofibrous mat as a potential antibacterial biobased wound dressing

Biodegradable and absorptive wound dresses with antibacterial activity are in demand to accelerate wound healing along with eliminating bacterial infection. Plant-derived naphthoquinones compounds such as lawsone have shown sustained antibacterial functions to avoid development of bacterial resistance by reducing pH or attaching to bacterial proteins. Here the nanofibrous mats based on chitosan/polyethylene oxide (PEO) fibers containing various concentrations of lawsone (0, 1, 3, 7, 10% wt.) were fabricated by electrospinning for potential applications as wound dressing materials. The results exhibited that the chitosan/PEO/Lawsone nanofibers possess antibacterial activity toward Gram-negative and -positive bacteria. Surprisingly, the addition of lawsone in the proper amount into chitosan/PEO nanofibers not only introduced an antithetical property but also reduced the platform's cytotoxicity, promoting cell viability of normal human fibroblast cells. Accordingly, the achieved data suggest the potential application of biocompatible nanofibrous mats as an antibacterial wound dressing material

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Safiri S, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY &amp; HEPATOLOGY. 2019;4(12):913-933.Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd