Sleep profile status based on substance use, lipids and demographic variables in Tabari cohort study

BACKGROUND

This study aims to investigate the situation of sleep profile and its related factors in the Tabari Cohort Tabari (TCS) population.

METHODS

The information of 10255 of the Tabari cohort population in the enrolment phase was used in this study. The sleep profile data was collected and recorded by trained questioners. The sleep duration in day & night, the time interval between going bed and falling asleep, continuous use of sedatives, involuntary nap, limb hypermobility during sleep and shift working were determined for each person. Data analysis was performed by independent T test and Pearson correlation coefficient.

RESULTS

Mean, standard deviation, median, minimum and maximum of sleep duration in this population were 7.6, 1.6, 7.5, 0.5 and 17 h. Frequency of sleeping less than 6 h, 6-10 h and more than 10 h were 1168(11.4%), 8463(82.5%) and 624(6.1%) respectively. Prevalence of sleeping more than 10 h among men and women were 5% and 6.8% respectively (P < 0.001). Prevalence of sedative routine use among men and women were 4.7% and 9.6% respectively (P < 0.001). There were significant relationships between sleep duration and area residence, age group (P < 0.001), education level (P < 0.001), socioeconomic level (P < 0.001), triglyceride (P = 0.002), HDL-cholesterol (P = 0.013) and Cholesterol total (P = 0.021). There was a negative correlation between age and sleep duration (r = -0.062, P < 0.001).

CONCLUSION

The results showed the association of the quality and quantity of sleep with personal, social, environmental and biological factors such as gender, age, economic status, educational status, and lipid profile. Therefore without proper intervention, the incidence of outcomes associated with these risk factors can be predicted in TCS In later years.

Association between liver enzymes and metabolic syndrome: results of the enrollment phase of Tabari cohort

BACKGROUND

The association between liver enzymes and metabolic syndrome (MetS) has been evaluated in several studies with different results. The purpose of this study is to determine the association between the serum levels of these liver enzymes and MetS in Tabari cohort population.

METHOD

In this case-control study, data collected from the enrolment phase of the Tabari cohort population have been used. MetS was defined based on IDF (international diabetes federation) standards. Then, 476 patients with MetS (case group) and 476 age-sex matched controls were selected randomly.

RESULTS

Mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in case group than control group (20.59 vs. 19.99 respectively, p = 0.339 and 24.64 vs. 20.16 respectively, p < 0.001). The chance of having MetS, high triglyceride, and fasting blood glucose (FBG) was significantly higher in people with ALT ≥ 40 (1.63, 2.35, and 2.02, respectively). The chance of having MetS in people with AST ≥ 40 was 1.45 times higher than that among those with normal AST level (p > 0.05).

CONCLUSION

This study showed that there is an association between liver enzymes and MetS as well as some of its components. Liver enzymes, especially ALT, can be used as an early indicator of MetS in the at risk population.

Immune-related adverse events (irAEs) in ankylosing spondylitis (AS) patients treated with interleukin (IL)-17 inhibitors: a systematic review and meta-analysis

BACKGROUND

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by immune system dysregulation and inflammation in the joints. Interleukin (IL)-17 inhibitors are new biological drugs used to treat AS. In this study, we aimed to assess the risk of immune system-related AEs due to targeting IL-17 or IL-17R.

METHODS

The CENTRAL, PubMed, Scopus, Google Scholar, Clinical Trials Registry, and ICTRP were searched for randomized clinical trials (RCTs) and non-RCTs until February 2021. The risk of irAEs in patients treated with IL-17 inhibitors compared to the placebo or a drug-free control was evaluated. In studies that reported AEs of the IL-17 inhibitors at several different time points, we compared the number of cases/100 patient-year in which irAEs were reported. Subgroup analyses were also performed based on the dose and type of drugs.

RESULTS

Thirteen studies of 1848 AS patients treated by IL-17 inhibitors (secukinumab, ixekizumab, bimekizumab, and netakimab) and 764 participants who received a placebo were included. The risk of some AEs related to immune function in patients under IL-17 inhibitors treatment was significantly higher than that of the placebo group, including infection and infestation (risk difference RD = 0.09, P = 0.02), nasopharyngitis (RD = 0.04, P < 0.001), opportunistic infections (RD = 0.01, P = 0.04), and neutropenia (RD = 0.04, P = 0.03). Besides, the results of the Cochran Q test showed that there were significant differences between the occurrence of some AEs over time, including infection and infestations (p < 0.001, RCTs), upper respiratory tract infections (p < 0.001, non-RCTs), urinary tract infections (p < 0.001, non-RCTs), and diarrhea (p < 0.01, RCTs).

CONCLUSIONS

The most common immune system-related AEs in patients treated with IL-17 inhibitors are mucosal and opportunistic infections.

Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study

In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35-70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.

Treatment by PI3K/mTOR Inhibitor BEZ235 Combined with TLR-7/8 Agonist Interfere with Immune Evasion Mechanisms of WEHI-3 Mouse Leukemia Cells

BACKGROUND

Several PI3K/Akt/mTOR pathway inhibitors and TLR agonists induce tumor cell death. However, the mechanisms of these therapeutic approaches in acute myeloid leukemia (AML) cells are still unknown.

OBJECTIVES

To investigate the effects of BEZ235, as a dual inhibitor of PI3K and mTOR pathways, and TLR7/8 agonist R848 on the expression and regulation of the immune inhibitory molecules in myeloid leukemia cells.

METHODS

WEHI-3 leukemia cells were incubated with dual PI3K and mTOR inhibitor BEZ235 and TLR7/8 agonist R848 for 48 hrs. Firstly, cell viability was assessed by MTT method. The semi-quantitative relative mRNA expression of Galectin-9 (Gal-9), PD-L1, PVR, and STAT3 was assessed according to HPRT as a housekeeping gene. Finally, the protein expression of phosphorylated STAT3 was evaluated by western blotting analysis.

RESULTS

WEHI-3 cells showed growth inhibition following treatment with BEZ235 and R848 whose combination exerted more proliferation arrest. The mRNA expression of Gal-9, PD-L1 and PVR immune checkpoint molecules significantly reduced in treated cells with BEZ235 and R848. Combined treatment indicated more reduction compared with the single treatment. Finally, the expression and phosphorylation of STAT3 were down-regulated after a single or dual treatment with BEZ235 and R848.

CONCLUSION

Our results conclude that treatment with the combination of BEZ235 and R848 interferes with immune evasion mechanisms through STAT3-signaling pathway in WEHI-3 leukemia cells.

Helicobacter pylori Infection and Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Since numerous studies have stated that there may be a relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease, and because of the high prevalence of both conditions worldwide, this study investigated the risk of non-alcoholic fatty liver disease in patients infected with H. pylori. Following a systematic review of PubMed, Scopus, Web of Science and Embase, and a search in Google Scholar using MeSH terms such as H. pylori and non-alcoholic fatty liver disease, the relevant papers up to November 2020 were reviewed. All cohort, case-control, and cross-sectional studies that examined the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori entered this study. A meta-analysis was conducted in STATA 11. This systematic review examined 22 papers with 117 117 participants (33 711 patients infected with H. pylori and 83 406 participants as control) and 20 studies were subjected to meta-analysis The results indicated a 22% to 27% increase in the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori (crude odds ratio: 1.27, 95% CI: 1.17-1.33; and adjusted odds ratio: 1.22, 95% CI: 1.09-1.35). According to the subgroup analysis, the study region, sample size, and the method of diagnosing H. pylori were the factors contributing to the high heterogeneity. The meta-analysis revealed the increased risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori. This indicates that H. pylori is a serious risk factor in patients susceptible to NAFLD.

Efficacy of compound topical anesthesia combined with photobiomodulation therapy in pain control for placement of orthodontic miniscrew: a double-blind, randomized clinical trial

This study aims to investigate the effect of compound topical anesthetic (CTA) application combined with photobiomodulation therapy (PBMT) on the level of pain perceived during placement of miniscrews and 24 h post the procedure in the buccal side of the maxillary bone. This randomized, prospective, single-center, split-mouth, double-blinded study included 25 subjects (12 males and 13 females, aged 16 to 35). Two anesthetic techniques before implantation were performed including Profound gel +PBM with 980 nm diode laser and local anesthesia with 2% lidocaine hydrochloride. Then, the miniscrews with the size of 1.6 mm in diameter and 8 mm in length were placed with a hand driver in the buccal side of the maxillary bone. The pain immediately after miniscrew placement (T1), also 12 h (T2), and 24 h (T3) post the procedure were collected by visual analog scale (VAS). Data were analyzed by SPSS version 22. There were no statistically significant differences in mean VAS scores within or between CTA combined with PBMT or injection applications, immediately after miniscrew placement (P = 0.75), 12 h after miniscrew placement (P = 0.4), and 24 h after miniscrew placement (P = 1.0). Compound topical anesthetic combined with PBMT provided adequate local anesthesia for the placement of miniscrews in the buccal side of the maxillary bone.

Effects of Vitamin E on Doxorubicin Cytotoxicity in Human Breast Cancer Cells in Vitro

OBJECTIVE

This study aimed to evaluate in vitro synergistic anticancer effect of doxorubicin combined with Vitamin E.

METHODS

The MTT assay was utilized to assess the cytotoxicity of Vitamin E and vitamin E combined with doxorubicin and vital activities of SKBR3, MDA-MB-231, and HFF cells over a 24-hour incubation period. In addition, the antioxidant properties of these interventions and the decrease of reactive oxygen species (ROS) content caused by the treatment were evaluated.

RESULTS

The antiproliferative effect of doxorubicin increased significantly in combination with vitamin E (Doxcorobicin 2µM vs. Vitamin E 120µM, P=0.000). Despite reducing cell ROS content due to vitamin E treatment, the combination of vitamin E and doxorubicin showed no significant synergistic effect (Doxcorobicin 2µM vs. Vitamin E 120µM, P=0.998).

CONCLUSION

This study indicated that the doxorubicin-vitamin E treatment reduced the viability of breast cancer cells with the minimum side effects on normal cells. In addition, the high dosage of vitamin E intensified the cytotoxicity of doxorubicin.

Melatonin effects on sleep quality and outcomes of COVID-19 patients: An open-label, randomized, controlled trial

This trial aims to evaluate the effectiveness of adding melatonin to the treatment protocol of hospitalized coronavirus disease 2019 (COVID-19) patients. This was an open-label, randomized controlled clinical trial in hospitalized COVID-19 patients. Patients were randomized into a treatment arm receiving melatonin plus standard care or a control arm receiving standard care alone. The trial's primary endpoint was sleep quality examined by the Leeds Sleep Evaluation Questionnaire (LSEQ). The trial's secondary endpoints were symptoms alleviation by Day 7, intensive care unit admission, 10-day mortality, white blood cell count, lymphocyte count, C-reactive protein status, and peripheral capillary oxygen saturation. Ninety-six patients were recruited and allocated to either the melatonin arm (n = 48) or control arm (n = 48). Baseline characteristics were similar across treatment arms. There was no significant difference in symptoms on Day 7. The mean of the LSEQ scores was significantly higher in the melatonin group (p < 0.001). There was no significant difference in laboratory data, except for blood oxygen saturation, which has improved significantly in the melatonin group compared with the control group (95.81% vs. 93.65% respectively, p = 0.003). This clinical trial study showed that the combination of oral melatonin tablets and standard treatment could substantially improve sleep quality and blood oxygen saturation in hospitalized COVID-19 patients.