فهرست مطالب

  • پیاپی 215 (اردیبهشت 1401)
  • تاریخ انتشار: 1401/05/18
  • تعداد عناوین: 12
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  • بنین آذرنوش، زینت نیک آئین*، فریده اشرف گنجویی، زهرا حاجی انزهایی صفحات 1-9
    زمینه و هدف

    گذران اوقات فراغت نقش مهمی در تربیت و تعلیم جامعه دارد؛ لذا هدف از انجام این تحقیق بررسی اثر تاثیر گذران اوقات فراغت مبتنی بر رفتار برنامه ریزی شده بر گرایش به فعالیت جسمانی در دانش آموزان می باشد.

    روش کار

    در این مطالعه نیمه تجربی، جامعه آماری شامل دانش آموزان پسر مقطع دوم متوسطه شهرستان چالوس بود که تعداد نمونه آماری از طریق نمونه گیری تصادفی تعداد 40 نفر انتخاب گردید و این افراد به دو گروه 20 نفره مداخله و کنترل تقسیم شدند. ابزار تحقیق شامل بسته آموزشی طراحی شده (که ده جلسه به طول انجامید) و پرسشنامه گرایش به فعالیت جسمانی جندقی (1396) با 18 سوال و 5 مولفه نگرش به گرایش به فعالیت جسمانی، آگاهی، هنجارهای انتزاعی، کنترل رفتاری درک شده، قصد رفتاری بود. برای تجزیه و تحلیل داده های از آزمون های t مستقل و t همبسته استفاده شد.

    یافته ها: 

    نتایج نشان داد که بین نمره گرایش به فعالیت جسمانی دانش آموزان قبل و بعد از مداخله درون گروه مداخله اختلاف معناداری مشاهده شد (001/0=p). همچنین نتایج آزمون t مستقل نشان داد در گروه مداخله با توجه به آموزش گذران اوقات فراغت مبتنی بر مدل رفتار برنامه ریزی شده بر گرایش به فعالیت جسمانی در دانش آموزان افزایش مشاهده شده است که تفاضل بین قبل و بعد از مداخله برابر 1/8 می باشد که میانیگن از 2/42 به 3/53 افزایش یافت.

    نتیجه گیری: 

    به طور کلی می توان اینگونه بیان کرد که اجرای برنامه آموزشی مبتنی بر نظریه رفتار برنامه ریزی شده می تواند در ارتقاء و گرایش دانش آموزان به فعالیت جسمانی تاثیر داشته باشد.

    کلیدواژگان: رفتار برنامه ریزی شده، گرایش به فعالیت جسمانی، دانش آموزان
  • هادی ملک، راحله هدایتی*، سینا رحیمی زاده صفحات 10-14
    زمینه و هدف

    بیماری کرونا ویروس COVID-19  که ناشی از عفونت با ویروس کرونا از نوع SARS-COV2 می باشد عمدتا موجب درگیری راه های هوایی و سیستم ایمنی می شود اما می تواند سایر ارگان ها مانند کلیه، سیستم قلبی عروقی، ریه و سیستم عصبی را نیز درگیر کرده و موجب افزایش مرگ و میر گردد (1، 2). مطالعات مختلف نشان دهنده افزایش تعداد بیمارانی است که عوارض طولانی مدت ناشی ازCOVID-19  را دارند. اینها بیمارانی هستند که علایم مزمن بیماری را هفته ها یا حتی ماه ها پس از شروع بیماری از خود نشان می دهند. گزارش ها حاکی از آن است که 66% - 87% از بیماران COVID-19 حداقل یک علامت ادامه دار و مزمن ناشی از بیماری را از خود نشان می دهند که شایع ترین آنها عبارتند از: خستگی، سرفه، اختلال بویایی، سردرد، درد استخوانی و درد قفسه سینه. این علامت ها در همه شدت هایCOVID-19  و در بیماران بستری و سرپایی دیده می شود (3).دپارتمان های تصویر برداری در سراسر دنیادر جستجوی راه های مختلف برای کمک به کنترل عوارض دراز مدت COVID-19  هستند (4). یکی از عوارض مهم با مرگ و میر بالا عوارض کلیوی است مطالعات نشان داده است که 5% تا 23% بیمارانCOVID-19  علایم آسیب حاد کلیه را دارند که شامل وجود پروتیین در ادرار، افزایش اوره و کراتینین خون، هماچوری و آسیب های هیستوپاتولوژیک است (5). تهاجم ارگان های مختلف در کووید 19 ناشی از انتشار وسیع گیرنده های آنزیم مبدل آنژیوتانسین 2 (ACE2) در این اندام ها است، کلیه بالاترین میزان گیرنده های ACE2 در بدن را دارا می باشد، سلول های مزانژیال، پدوسیت ها، اپیتلیوم جداری کپسول بومن و مجاری جمع کننده بیشترین میزان از گیرنده هایACE2  را نمایش می دهند. مکانیزم های مختلف برای تظاهرات کلیوی کووید 19 پیشنهاد شده اند که شامل تهاجم مستقیم ویروس به کلیه و همینطور اختلال در سیستم رنین آنژیوتانسین آلدوسترون است (6). این ویروس به گیرنده های ACE2 می چسبد و باعث التهاب سیستمیک و اختلال در سیستم ایمنی اندام های مختلف می شود (7،8). این تهاجم و همچنین استفاده از داروهای نفروتوکسیک و ایسکمی و هایپوکسی ناشی از بیماری منجر به عوارض کلیوی کووید 19 می شود که شامل آسیب حاد کلیوی و همچنین پیشرفت آسیب کلیه در بیماران دچار بیماری مزمن کلیوی (Chronic Kidney Disease) می باشد (9).در حقیقت تعداد زیادی از بیماران پس از آسیب حاد کلیه ناشی از کووید 19 عوارض کلیوی دراز مدت را در پیگیری (Follow up) از خود نشان می دهند (5). مطالعات اخیر نشان می دهد که ایجاد آسیب حاد کلیه در این بیماران باعث پروگنوز ضعیف بیماری می شود، آسیب کلیوی باعث افزایش موربیدیتی و مورتالیتی می شود، بنابرین بیمارانی که مشکلات کلیوی دارند باید به صورت دقیق تر پیگیری شوند تا در صورت هرگونه کاهش در عملکرد کلیه مورد درمان قرار گیرند (10). پروتیینوری فاکتور خطر مستقل برای افزایش دوره بستری و پذیرش در ICU در بیماران کووید 19 می باشد (11). پزشکی هسته ای به عنوان یک تصویر برداری عملکردی، آناتومیکال و مولکولی می تواند در تشخیص عوارض مزمن کلیوی، پیگیری بیماران و پاسخ به درمان مفید باشد (4).هدف از این مقاله معرفی اسکن کلیوی99m Tc DMSA  به عنوان یک تصویر برداری پزشکی هسته ای است که ثابت شده که برای ارزیابی شروع، پیشرفت و درمان اختلالات عملکردی کورتکس کلیه در بیماران کووید 19 یک روش حساس و دقیق است (12).اسکنDMSA  یک اسکن رادیونوکلیید با استفاده از دیمرکاپتو سوکسینیک اسید است که در ارزیابی شکل کلیه و عملکرد کورتکس به کار می رود. رادیواکتیویته تکنسیم باDMSA  ترکیب می شود و به بیمار تزریق می شود، سپس تصویر برداری بیمار با استفاده ازدوربین گاما 2 الی 3 ساعت بعد انجام می شود (13). زمان تصویر برداری برای هر نما 5 الی 10 دقیقه است که بر اساس شمارگان رادیوداروی جمع آوری شده می باشد. اصولا نما های خلفی و مایل خلفی بهترین نما ها برای تفسیر اسکن می باشند. بیمار باید قبل و بعد از تصویر برداری مایعات فراوان بنوشد و ناشتایی برای این اسکن لازم نیست (14). اسکنDMSA  یک روش ایمن، در دسترس و با اشعه کم می باشدکه اطلاعات دقیق راجع به مورفولوژی و عملکرد کورتکس کلیه به ما می دهد این روش همچنین می تواند برای اندازه گیری فانکشن نسبی دو کلیه به کار رود . همچنین اختلالات آناتومیک که باعث آسیب عملکرد عروقی کلیه و یا مجاری ادرار می شوند نیز با این روش قابل تشخیص می باشند (13).آسترمن و همکاران نشان دادندکه نارسایی حاد کلیوی در بیماران کووید 19 با افزایش ریسک مرگ و میر همراه است ولی مشخص نشده که اثرات طولانی مدت این آسیب حاد در عملکرد کلیوی و خطر دیالیز مزمن و میزان مرگ و میر چقدر است (6).گانسوورت و همکاران خاطر نشان کردند که بیماران مزمن کلیوی و کسانی که دیالیز می شوند یا پیوند کلیه انجام داده اند ممکن است در معرض خطر بیشتری برای مرگ ومیر ناشی از این بیماری باشند و نشان دادند که می بایست از روش های دیگر برای بررسی دوره بیماری در این افراد استفاده گردد (9).همیلتون و همکاران پس از مطالعه گسترده در جمعیت زیادی از مبتلایان به کووید در انگلستان نشان دادند که نارسایی حاد کلیه که در اثر کووید ایجاد شود صرف نظر از شدت آن می تواند با عوارض و مرگ و میر بیشتری در بیماران همراه باشد و بنابراین نیاز به مطالعات تصویر برداری بیشتر برای بررسی درمان های مختلف و بررسی دوره بیماری است (10). اسکن DMSA می تواند هم در فاز حاد و هم در فاز مزمن اختلال عملکرد کورتکس را نشان دهد، این اسکن همچنین می تواند اختلالات کانونی پارانشیم کلیه و سکل های کلیوی 6 ماه پس از عفونت حاد، تشخیص افتراقی اسکار از اختلالات کورتکس قابل برگشت کلیه داپلکس، کلیه کوچک، بافت دیسپلاستیک و کلیه نعل اسبی به کار رود (13).تعداد، اندازه و محل آسیب های کورتکس نیز با این اسکن قابل نمایش است (4). برای تشخیص سکل های کلیویمی بایست اسکنDMSA  حداقل 6 ماه پس از عفونت حاد انجام شود (15).

    نتیجه گیری:

     مرور مقالات درحال حاضر نشان می دهد که اسکن کورتیکال کلیوی99m Tc DMSA  می تواند درفازحاد کووید 19 برای تشخیص به موقع اختلال عملکرد کورتکس کلیه، تشخیص پیلو نفریت حاد، ارزیابی فانکشن نسبی دوکلیه و سایز آنها به کار رود. در فاز مزمن کووید 19 این اسکن برای تشخیص اسکار کلیوی، ارزیابی کنترل پیشرفت آسیب کلیوی، و ارزیابی پاسخ به درمان به مفید است. هرچند با توجه به اهمیت مطلب نیازمند مطالعات بیشتری در این زمینه می باشیم.

    کلیدواژگان: COVID-19، عوارض کلیوی، اسکن کلیوی 99m Tc DMSA، آسیب حاد کلیه
  • محمدامین عباسی، محمد مومنی، علیرضا الماسی نوکیانی، آتوسا نجم الدین* صفحات 15-22
    زمینه و هدف

    دیابت یکی از بیماری های شایع در ایران و جهان می باشد. این  بیماری به عنوان یک عامل خطر در بیماران مبتلا به 19-COVID می باشد. ریسک علایم شدید و مرگ میر در بیماران دیابتی مبتلا به 19-COVID بیشتر از سایرین می باشد. این مطالعه با هدف بررسی تفاوت شدت درگیری ریه در سی تی اسکن قفسه سینه بیماران دیابتی  و غیردیابتی مبتلا به کووید-19 انجام شد.

    روش کار

    مطالعه حاضر یک مطالعه توصیفی تحلیلی است که به صورت مقطعی بر روی  148 بیمار مبتلا به کووید  شامل 74 بیمار دیابتی و 74 بیمار غیر دیابتی در در سال 1399 انجام شد. ابتدا مشخصات دموگرافیک و اولیه بیماران ثبت شد. سپس اولین سی تی اسکن آنها توسط یک نفر رادیولوژیست ماهر و با تجربه بررسی و نمره دهی شد.

    یافته ها:

      تفاوت آماری معناداری بین سن بیماران مبتلا به کرونا در دو گروه  بیماران دیابتی و غیر دیابتی مشاهده شد (002/0=P).  ولی بین جنسیت بیماران مبتلا به کرونا در دو گروه بیماران دیابتی و غیر دیابتی تفاوتی مشاهده نشد. میانگین معیار نمره سی تی اسکن قفسه سینه در بیماران دیابتی و غیر دیابتی مبتلا به کووید19 به ترتیب برابر 2/21 و .04/20 بوده است. تفاوت آماری معناداری بین نمره سی تی اسکن قفسه سینه در دو گروه بیماران دیابتی و غیر دیابتی مشاهده نشد.هم چنین تفاوت آماری معناداری بین نمره سی تی اسکن قفسه سینه بیماران مبتلا به کووید 19 به تفکیک جنس و سن در دو گروه دیابتی و غیر دیابتی مشاهده نشد. 

    نتیجه گیری

    اگر چه درگیری ریوی بیماران دیابتی مبتلا به کووید 19 بیشتر از بیماران غیردیابتی میباشد ،ولی این تفاوت از نظر آماری معنی دار نیست.

    کلیدواژگان: دیابت، کووید 19، سی تی اسکن
  • عارفه ابراهیمیان، عماد بهبودی* صفحات 23-27

    در سال اخیر، سارس کروناویروس 2 در سطح جهان گسترش یافته و جمعیتی را که فاقد ایمنی برای این ویروس بوده اند را آلوده کرده و مسبب بیماری و مرگ و میر قابل توجهی گردیده است (1، 2). ایمنی به سارس کروناویروس 2 چه از طریق عفونت طبیعی و چه از طریق واکسیناسیون، تا حدی سبب حفاظت و کاهش خطر پیامدهای بالینی مهم آن می گردد. برای مثال، تخمین زده شده که افراد بهبود یافته سروپازیتیو، می توانند تا 89% حفاظت در برابر عفونت مجدد  داشته باشند (3) و اثربخشی واکسن نیز 50 تا 95% گزارش شده است (4). با این وجود طول دوره ایمنی ایجاد شده مشخص نیست و با گذشت زمان این ایمنی، تضعیف می شود (5، 6). به علاوه نگرانی فرار واریانت های جدید از سیستم ایمنی نیز وجود دارد (7). یک سوال مهم که در اینجا مطرح می شود شناسایی ارتباط ایمنی با حفاظت علیه سارس کروناویروس 2 و بنابراین پیش بینی این که چطور این تغییرات، بر نتایج بالینی بیماری اثرگذار است می باشد. تیتر آنتی بادی خنثی کننده یک پیشگوی مهم کارایی واکسن های در حال تولید و آینده می باشد. مطالعات نشان می دهند که سطح آنتی بادی خنثی کننده به مرور زمان کاهش می یابد و ممکن است در یک سال، نیاز به بوستر هم وجود داشته باشد. با این حال حفاظت علیه فرم شدید بیماری ممکن است بطور قابل ملاحظه ای دوام بیشتری داشته باشد. می توان گفت که ایجاد پاسخ همورال قوی یا ضعیف، بستگی به اینتراکشن ویروس و میزبان و التهابی که ایجاد می شود، دارد. اگر این چالش در سطح پایین باشد، آنتی بادی ایجاد شده، عملکرد ضعیف تری دارد اما اگر این چالش در سطح بالا باشد، آنتی بادی تولید شده فانکشنال تر و در برابر مواجهه مجدد با پاتوژن، پاسخ تهاجمی تر را نشان می دهد. به علاوه، در این زمینه  پاسخ های ایمنی سلولی می توانند نقش برجسته ای را ایفا کنند (8). بنابراین اگر واکسن های موجود، مثل عفونت طبیعی قادر باشند علاوه بر تولید آنتی بادی های خنثی کننده، پاسخ ایمنی سلولی را هم برانگیزند، ماندگاری ایمنی ناشی از واکسن نیز افزایش می یابد. سوال دیگر که مطرح می شود این است که آیا تعیین تیتر آنتی بادی، پس از عفونت طبیعی یا واکسیناسیون می تواند مارکر درستی از وضعیت حفاظت در برابر عفونت باشد؟ آنتی بادی ها به عنوان مارکرهای عفونت می باشند و اگر تداوم داشته باشند می توانند سبب ایمنی طولانی مدت شوند. در بیشتر واکسن های تایید شده از نظر بالینی، تیتر آنتی بادی  متصل شونده را اندازه گیری می کنند، در حالیکه این تیتر آنتی بادی خنثی کننده است که نشان می دهد که یک واکسن چه میزان ایمنی زایی دارد. یک آنتی بادی، علاوه بر اینکه باید به آنتی ژن مورد نظر متصل شود باید قادر به خنثی کردن آن آنتی ژن هم باشد که این کار را یا به وسیله مسدود کردن عفونت با جلوگیری از اتصال پاتوژن به گیرنده یا جذب سلول های ایمنی برای پاک سازی  و کنترل بیماری انجام می دهد که این موضوع در مطالعات واکسن نیز باید مدنظر قرار بگیرد.  علاوه بر تیتر و عملکرد آنتی بادی، دانستن اینکه چطور عملکرد آنتی بادی با ایمنی سلولی ارتباط دارد و ماهیت ایمنی سلول T و B، برای پی بردن به حفاظت طولانی مدت علیه عفونت مجدد الزامی است (9). اینکه چطور برخی افراد با وجود داشتن تیتر آنتی بادی، دچار عفونت مجدد می شوند هنوز معلوم نیست. آیا وجود آنتی بادی های اختصاصی علیه سایر آنتی ژن های ویروسی قادرند تیتر پایین آنتی بادی عملکردی اختصاصی RBD را جبران کنند؟ جواب منفی است. آزمایشات نشان می دهد که زمانی که تست های Ab-mediated complement deposition(ADCD) و  Ab- dependent neutrophil phagocytosis(ADNP) انجام گرفت مشخص شد که خنثی سازی ویروس تنها در افرادی که تیتر بالای آنتی بادی IgG علیه ناحیه RBD را داشتند دیده شد. بنابراین نتیجه گرفته شد که تنها، آنتی بادی علیه RBD خنثی کننده است (10). با این وجود نمیتوان گفت که تیتر بالای آنتی بادی ضد RBD به معنای ایمنی بالا می باشد به این دلیل که تمام آنتی بادی های علیه RBD  نیز خنثی کننده نمی باشند. آیا اگر آنتی بادی ها فاقد اتصال خوب یا عملکرد موثر باشند به این معنی است که حفاظتی در برابر عفونت مجدد وجود ندارد؟ ما نمی توانیم به قطع این را بگوییم چون نمی توان نقش سلول T که بعنوان یک ارتباط دهنده ایمنی قوی به کووید19 عمل می کند را  نادیده گرفت. فرض کنید که تیتر آنتی بادی را در تعدادی افراد داوطلب در زمان T0 (زمان شروع آزمایش) بسنجیم. آیا تنها افراد علامت دار از نظر آنتی بادی خنثی کننده مثبت هستند؟ طبق آزمایشی که YC Bartsch و همکاران انجام دادند (9) افرادی که بدون علامت بودند نیز دارای آنتی بادی اختصاصی علیه RBD با اختصاصیت بالای 5/99% بوسیله تست الایزا بودند. یعنی این آنتی بادی هم در افراد علامت دار و هم بدون علامت وجود داشته اما در افراد علامت دار تیتر آن بیشتر بوده است.  بعد از پیگیری افراد برای سنجش تیتر آنتی بادی بعد از مدت زمان معین، تعداد کمی از شرکت کنندگان پاسخ آنتی بادی را بطور کامل از دست دادند و در افراد باقی مانده تقریبا نیمی از افراد کاهش تیتر آنتی بادی و نیمی دیگر به طرز عجیبی افزایش در تیتر آنتی بادی داشتند. این مشاهده را به دو طریق میتوان توجیه کرد، اول اینکه از نظر طول دوره ای که از عفونت میگذشت این افراد متفاوت بودند و دوم اینکه افرادی که افزایش تیتر آنتی بادی داشته اند ممکن است دوباره در معرض عفونت قرار گرفته باشند. با دانستن این مطالب میتوان نتیجه گرفت که اندازه گیری تیتر آنتی بادی پس از عفونت یا واکسیناسیون، اطلاعات دقیقی در مورد سطح حفاظت در برابر عفونت سارس کروناویروس 2 را به ما نخواهد داد. روش های روتین آزمایشگاهی بالینی نظیر تست الایزا هرگز قادر نخواهد بود که به شما اطمینان بدهد که آنتی بادی های تولید شده در بدن شما خنثی کننده هستند یا خیر، چون این امر نیاز به تست های خنثی سازی تخصصی دارد. بعلاوه با دانستن تیتر آنتی بادی اولیه نمیتوان به راحتی تخمین زد که سرعت کاهش آنتی بادی سریع تر یا آهسته تر خواهد بود. بنابراین به مدل هایی که پاسخ های ایمنی به عفونت را پیش بینی می کنند نیاز است تا  ارتباط ایمنی با حفاظتی که به وسیله واکسن های در حال گسترش ایجاد می شود را تعیین کنند. از آنجا که در مطالعات مختلف، جهت سنجش تیتر آنتی بادی خنثی کننده از یک روش واحد استفاده نشده است، نیاز به روش های نرمالایز کردن اطلاعات برای مقایسه بهتر نتایج وجود دارد. به علاوه پیشنهاد می کنیم که علاوه بر سنجش تیتر آنتی بادی خنثی کننده، پاسخ سلول های T و B خاطره، که با حفاظت بالا علیه سارس کروناویروس 2 مرتبطند، نیز اندازه گیری شود تا بتوانیم پیش بینی بهتری نسبت به خنثی سازی داشته باشیم.

    کلیدواژگان: سارس کوروناویروس 2، آنتی بادی، حفاظت، الایزا
  • سودابه بساک نژاد، قدرت الله شاکری نژاد، کیهان فتحی*، بنفشه مرادی، سارا شیرمردی صفحات 28-38
    زمینه و هدف

    زندگی با سرطان پستان، چالش های قابل توجهی را برای زنان ایجاد کرده است. به نظر می رسد مولفه های روان شناختی بسیاری در مواجهه با چالش های همراه با درمان بیماری نقش دارد. هدف پژوهش حاضر نیز تعیین نقش ادراک از بیماری، حمایت اجتماعی ادراک شده و شیوه های مقابله با استرس در امید به زندگی زنان مبتلا به سرطان پستان بود.

    روش کار

    جامعه ی مورد نظر زنان مبتلا به سرطان پستان در شهر اهواز بودند که از بین آن ها 60 زن داوطلب شرکت در پژوهش شدند. ابزار مورد استفاده در این پژوهش شامل فرم مختصر شده ی ادراک از بیماری (بردبنت، 2006)، حمایت اجتماعی ادراک شده چند بعدی (زیمت و همکاران، 1998)، سبک های مقابله ای در موقعیت های ویژه (بیلینگز و موس، 1981) و امید به زندگی (اشنایدر، 1991) بود. در این پژوهش به منظور تحلیل داده ها از رگرسیون چند متغیری استفاده شد.

    یافته ها: 

    یافته ها نشان داد که بین حمایت اجتماعی و سبک مقابله ای مسیله مدار با امید به زندگی بیماران مبتلا به سرطان پستان رابطه مثبت معنی داری وجود دارد (001/0=P) . همچنین، بین ادراک بیماری و سبک مقابله ای هیجان مدار با امید به زندگی بیماران مبتلا به سرطان پستان رابطه منفی معنی داری وجود دارد (001/0=P) .

    نتیجه گیری:

     با توجه به اهمیت امید، در زندگی و درمان مبتلایان به سرطان، پیشنهاد می شود که کادر درمان و روان شناسان در مداخلات و پروتکل درمانی خود به نقش امید به زندگی به ویژه در مبتلایان به سرطان پستان توجه کنند.

    کلیدواژگان: ادراک از بیماری، حمایت اجتماعی ادراک شده، شیوه های مقابله با استرس، امید به زندگی، سرطان پستان
  • احمد مزارعی ستوده، ابوالفضل بخشی پور*، محمود جاجرمی صفحات 39-50
    زمینه و هدف

    توقع مهم از الگوی ازدواج در جهان امروز این است که زوج ها به نیازهای یکدیگر به عشق، صمیمیت و عاطفه توجه کنند، بنابراین هدف از انجام این پژوهش تعیین اثربخشی گروه درمانی وجودی بر صمیمیت و رضایت زناشویی زنان افسرده متاهل بود.

    روش کار

    روش پژوهش نیمه آزمایشی با گروه آزمایش و گروه گواه، طرح پیش آزمون، پس آزمون و پیگیری دو ماهه و جامعه آماری پژوشه را 56 زن افسرده مراجعه کننده به دو مرکز مشاوره و روانشناسی در مشهد در سال 1398 تشکیل دادند. از این جامعه 30 زن افسرده متاهل به شیوه هدفمند انتخاب و به شکل تصادفی 15 زن در هر یک از دو گروه آزمایش و گواه تقسیم شدند. ابزار پژوهش پرسشنامه صمیمیت زناشویی والکر و تامپسون (1983) و پرسشنامه رضایت زناشویی انریچ، 1989؛ و همچنین برنامه مداخله بسته آموزشی-درمانی نظریه وجودی مدل فرانکل و یالوم در 8 جلسه 90 دقیقه ای گروهی به گروه آزمایش آموزش داده شد. داده ها با استفاده از آزمون تحلیل واریانس مختلط با اندازه گیری مکرر تحلیل شد.

    یافته ها: 

    نتایج حاکی از تاثیر درمان وجودی بر صمیمیت زناشویی و رضایت زناشویی بود و صمیمیت زناشویی و رضایت زناشویی در گروه آزمایش در مرحله پس آزمون افزایش داشته و این افزایش در مرحله پیگیری نیز پایدار نشان می دهد (05/0> p)؛ ولی در گروه گواه تغییری مشاهده نمی شود (05/0 <p).

    نتیجه گیری:

     با توجه به یافته های پژوهش می توان از درمان وجودی به شیوه گروهی در جهت بهبود صمیمیت و رضایت زناشویی استفاده نمود و این مطالعه، کارایی و اثربخشی گروه درمانی وجودی بر سطح سلامت روان افراد شرکت کننده را افزایش داد که گامی مثبت در بهبود سلامت روان است.

    کلیدواژگان: صمیمیت، رضایت، زناشویی، درمان وجودی
  • اطلسی صفایی، محمد شیبانی، یاسر عزیزی* صفحات 51-64

    شیوع بالای سرطان در سراسر دنیا، این بیماری را به یک معضل بهداشت جهانی تبدیل کرده است. راهکارهای درمانی متعددی از جمله شیمی درمانی برای سرطان وجود دارد. داروهای آنتی نیوپلاستیک معمولا به صورت ترکیبی می توانند در روند شیمی درمانی به کار روند. این داروها علاوه بر آسیب رساندن و از بین بردن سلول های سرطانی به سلول های سالم نیز آسیب می رسانند و عوارض جانبی فراوانی مانند تهوع، سرکوب مغز استخوان، و عوارض قلبی و کلیوی ایجاد می کنند. از جمله داروهای پرکاربرد در شیمی درمانی آنتراسایکلین ها هستند. دوکسوروبیسین به عنوان پرکاربردترین عضو این خانواده مکانیسم های آسیب سلولی متعددی داشته و سمیت قلبی ناشی از آن بسیار شایع است. اتصالات شکاف دار از مهم ترین ساختارها در سلول های عضله ی قلبی هستند. وجود اتصالات شکاف دار در سلول های قلبی برای حفظ یکپارچگی انقباضات عضله ی قلبی، گسترش منظم موج تحریکی و تحریک الکتریکی قلب لازم است. اتصالات بین سلولی (اتصالات شکاف دار) از مهم ترین ساختارها در سلول های عضله ی قلبی یا کاردیومیوسیت ها هستند. ضرورت حضور اتصالات شکاف دار برای حفظ یکپارچگی انقباضات عضله ی قلبی، گسترش منظم موج تحریکی و تحریک الکتریکی غیر قابل انکار است. اتصالات شکاف دار ارتباط بین سلول های مجاور را تشکیل می دهند که از زیرواحدهای پروتیین کانکسین تشکیل شده اند و امکان ارتباط مستقیم بین سلولی را فراهم می کنند. در یک قلب طبیعی 3 ایزوفرم اصلی پروتیین کانکسین CX40، CX43 و CX45 وجود دارد که شایع ترین ایزوفرم آن در قلب کانکسین 43 است. CX43 در میوکارد دهلیزها و بطن ها بیشترین بیان را دارند. سیرتویین ها یک رده ی پروتیینی هستند که تقریبا در تمامی گونه ها از باکتری تا پستانداران وجود دارند. فعالیت سیرتویین با کنترل متابولیک، آپوپتوز، بقای سلول، پیشرفت التهاب و پیری مرتبط است. سیرتویین 3 به طور اختصاصی در ماتریکس میتوکندری موجود است و در هسته نیز دیده شده است، این پروتیین نقش مهمی در متابولیسم انرژی سلولی یا تنظیم ردوکس بازی می کند. موش های دارای نقص سیرتویین 3 علایم هیپرتروفی قلبی، افزایش در بیان مارکرهای استرس قلبی، فیبروز و همچنین توانایی تحمل استرس اکسیداتیو کمتری در مقایسه با موش های طبیعی دارند. تا به حال مکانیسم های پرشماری در توجیه علت ایجاد سمیت قلبی توسط دوکسوروبیسین بیان شده اند ولی با توجه به اهمیت پروتیین های مذکور در قلب، هدف از این مطالعه بررسی نقش کانکسین ها و سیرتویین ها در سمیت قلبی ناشی از دوکسوروبیسین بود.

    کلیدواژگان: سمیت قلبی، دوکسوروبیسین، کانکسین 43، سیرتوئین 3
  • الهام مددی زاده، محسن امینایی، کیوان خرمی پور* صفحات 65-76
    زمینه و هدف

    بیماری های متابولیک از جمله چاقی و دیابت علاوه بر تاثیرات محیطی می توانند باعث آلزایمر و اختلالات شناختی شوند. دلیل اصلی ایجاد آلزایمر و اختلالات شناختی رسوب خارج سلولی پلاک های بتا آمیلویید و ظاهر شدن تجمعات پروتیین فسفریله تاو است که در نهایت موجب تخریب نورون های هیپوکمپ می شود. این آسیب ها حتی می تواند یک قدم فراتر گذاشته و تهدید کننده زندگی افراد باشد. یکی از روش های پیشگیری و درمان این عوارض تمرینات تناوبی با شدت زیاد است که به علت صرفه جویی در زمان بسیار و تاثیر گذاری بیشتری نسبت به انواع دیگر تمرینات مورد توجه قرار گرفته اند. هدف از این مطالعه، مرور اثر تمرینات تناوبی با شدت زیاد بر اختلالات شناختی و... ناشی از چاقی و دیابت می باشد.

    روش کار

    بدین منظور پایگاه های Google Scholar، PubMed، Scopus، SID، نور و مگیران مورد بررسی قرار گرفتند. در این مطالعه مروری، علاوه بر تمرین تناوبی با شدت زیاد حداقل یکی از کلید واژه های اختلالات شناختی، هیپوکمپ و آلزایمر باید در عنوان یا کلمات کلیدی مطالعات وجود می داشت و مطالعات چاپ شده بین سال های 2000 تا 30 جولای 2021 تجزیه و تحلیل شدند.

    یافته ها:

     در جست و جوی اولیه 152 مطالعه براساس عنوان و کلید واژه های مورد نظر یافت شد و بعد از بررسی های اولیه، 84 مطالعه به علت مرتبط نبودن چکیده با مفاهیم مورد نظر حذف شد. از بین مطالعات باقی مانده 38 مورد به علت دارا نبودن حداقل یک ترکیب از سه کلید واژه مورد نظر حذف شد. در مرحله سوم متن کامل 30 مطالعه، بررسی شد و 15 مطالعه به علت مرتبط نبودن متن کامل با مفاهیم مورد نظر حذف شدند و در نهایت اطلاعات 15 مطالعه حیوانی و انسانی به دو زبان فارسی و انگلیسی مورد بررسی قرار گرفت.

    نتیجه گیری:

     مرور این مطالعات نشان می دهد که تمرینات تناوبی با شدت زیاد باعث بهبود اختلالات شناختی و افزایش یادگیری و حافظه می شوند. با این حال جهت انتخاب تاثیرگذار ترین پروتکل تمرین بر اساس نقش متغیرهای تمرینی مانند نوع، شدت و حجم تمرین به پژوهش های مقایسه ای بیشتری نیاز است.

    کلیدواژگان: تمرینات تناوبی با شدت زیاد، اختلالات شناختی، آلزایمر، هیپوکمپ
  • نازیلا پاینده، مقصود پیری*، محمدعلی آذربایجانی، سید علی حسینی صفحات 77-90
    زمینه و هدف

    استخوان جز بافت هایی است که برای داشتن عملکرد طبیعی نیازمند دریافت بار مکانیکی می باشد. تاثیر تمرین مقاومتی و عصاره گرده لقاح خرما بر تراکم بافت استخوان و تکثیر سلول های استیوبلاست در رت های نر جوان بود.

    روش کار

    برای انجام تحقیق تجربی حاضر 36 سر رت نر 8 هفته ای و دامنه وزنی 20±220 گرم از انستیتو پاستور ایران خریداری شده و به طور تصادفی به 6 گروه 1) شم، 2) تمرین، 3) گرده نخل، 4) تستوسترون، 5) تمرین+گرده نخل و 6) تمرین+ تستوسترون تقسیم شدند. پس از یک هفته سازگاری رت های گروه های 2، 4 و 6 به مدت چهار هفته و پنج جلسه در هفته تمرینات مقاومتی را انجام دادند، گروه های 3 و 5 پنج روز در هفته mg/kg 100 گرده لقاح خرما به صورت گاواژ دریافت کردند همچنین گروه های 4 و 6 پنج جلسه در هفته mg/kg 2 تستوسترون پروپیونات به صورت صفاقی دریافت نمودند.

    یافته ها: 

    نتایج نشان داد تمرین مقاومتی، عصاره خرما و تستوسترون پروپیونات بیان ژن استیوکلسین، ALP ، استیوپنتین و استیووژنز پروتیین ALP را افزایش داد.

    نتیجه گیری:

     با توجه به نتایج استفاده همزمان از تمرین مقاومتی و عصاره گرده لقاح خرما جهت روند استخوان زایی با مشورت توصیه می شود.

    کلیدواژگان: گرده خرما، تمرین مقاومتی، استئوژنز، استخوان، استئوبلاست
  • محسن اکبرپور*، محدثه گنجی، گیتی تپه رشی، رضا هاشمی ماد، محمد حسنی صفحات 91-101
    زمینه و هدف

    فعالیت بدنی با وجود فواید گوناگونی که برای سلامتی عمومی دارد، می تواند به دلیل افزایش فشار اکسایشی از طریق افزایش تولید گونه های واکنش پذیر، موجب آسیب احتمالی بافت های مختلف بدن شود و هدف از این مطالعه مقایسه تاثیر هشت هفته تمرین مقاومتی سنتی و TRX روی شاخص های آسیب عضلانی دانشجویان زنان غیر فعال می باشد.

    روش کار

    در این مطالعه نیمه تجربی، تعداد (28) دختر غیرفعال سالم  با میانگین سن 38/1±00/21 سال به طور تصادفی به سه گروه: تمرین مقاومتی سنتی (9)، تمرین  TRX(9) و کنترل (10) تقسیم  شدند. گروه های تجربی پروتکل تمرینی را سه جلسه در هفته به مدت 8 هفته با شدت 65 الی 80 درصد  اجرا کردند. نمونه های خونی قبل از شروع تمرین و 48 ساعت پس از آخرین جلسه ی تمرین اخذ و میزان کراتین کیناز و لاکتات دهیدروژناز اندازه گیری شد. داده ها با استفاده از آزمون های شاپیرو ویلک، تی وابسته و تحلیل واریانس یک سویه مورد تجزیه و تحلیل آماری قرار گرفت.

    یافته ها: 

    نتایج نشان داد که تفاوت معناداری در سطح کراتین کیناز خون در سه گروه وجود نداشت ولی در میزان فعالیت آنزیم لاکتات دهیدروژناز در گروه تمرین مقاومتی سنتی و در گروه TRX از مرحله پیش آزمون به پس آزمون کاهش معنی داری مشاهده شد. همچنین نتایج تحلیل واریانس یک طرفه تفاوت معنی داری در سطح لاکتات دهیدروژناز در هر دو گروه تجربی با گروه کنترل و بین گروه های تجربی نشان داد (05/0 <p).

    نتیجه گیری:

     با توجه به یافته های پژوهش حاضر می توان بیان کرد که تمرین بدنی منظم TRX و مقاومتی سنتی با شدت متوسط هر دو نه تنها منجر به تشدید شاخص های آسیب عضلانی نشده اند بلکه  آثار سودمندی روی متغیر های آسیب عضلانی از جمله لاکتات دهیدروژناز داشتند که نشان دهنده سودمند بودن این گونه تمرینات در زندگی افراد غیر فعال است.

    کلیدواژگان: تمرین مقاومتی سنتی، TRX، کراتین کیناز، لاکتات دهیدروژناز، دختران غیرفعال
  • مازیار عزیزی سعادتلو، احمد عبدی*، جواد مهربانی، آسیه عباسی دلویی صفحات 102-116
    زمینه و هدف

    بررسی ویژگی های فیزیولوژیکی و شناخت عوامل پاتولوژیکی قلبی هنگام فعالیت های ورزشی استقامتی می تواند زمینه مناسبی را در شناسایی ورزشکارانی که در معرض خطر هستند، فراهم کند. هدف این پژوهش بررسی تاثیر مکمل کافیین-نیترات بر NTproBNP و IL-6 به دنبال یک دوره فعالیت هوازی در دوندگان حرفه ای استقامتی بود.

    روش کار:

     این مطالعه از نوع نیمه تجربی- میدانی آزمایشگاهی بود، 15دونده نخبه مرد با میانگین سنی 8/3±5/27، میانگین قد 7±7/176، میانگین وزن 8/7±9/69 و شاخص توده بدنی 5/1±3/22 و حداکثر اکسیژن مصرفی (ml/kg/min) 6/4±2/52 انتخاب و به صورت سه سوکور و تصادفی، به سه گروه: 1) دوز بالا (9.6میلی مول نیترات و 400میلی گرم کافیین)، 2) دوز پایین (4.8 و 200) و 3) دارونما تقسیم شدند. آزمودنی ها از هفت روز قبل از آزمون، روزانه دو بارمکمل را به همراه 250سی سی  آب مصرف کردند. فعالیت ورزشی هوازی شامل دویدن روی تردمیل به مسافت 5 کیلومتر بود.

    یافته ها:

     نتایج نشان داد که مصرف مکمل تاثیر معناداری بر میزان NTproBNP (821/0=p) نداشته، ولی باعث کاهش IL-6 (001/0=p) شد. همچنین یک جلسه فعالیت ورزشی سبب افزایش معنی داری در سطح NTproBNP (05/0<p) و IL-6 (05/0<p) شده و مصرف مکمل بعد از هفت روز سبب کاهش سطح NTproBNP (071/0=p) و IL-6 (092/0=p)  به دنبال فعالیت ورزشی شد.

    نتیجه گیری:

     افزایش معنی دار مقادیر NTproBNP و IL-6 بلافاصله بعد از فعالیت و کاهش معنی دار آن ها بعد از هفت روز همراه با مصرف مکمل کافیین-نیترات، نشان دهنده این بود که استفاده از مکمل کافیین-نیترات  باعث بهبود اختلال قلبی ناشی از فعالیت ورزشی شدید می شود.

    کلیدواژگان: کافئین-آب چغندر، فعالیت ورزشی، قلبی عروق، دوندگان استقامتی
  • خدیجه فریدونفرا، امیرعباس منظمی*، زهره رحیمی، مهرعلی رحیمی صفحات 117-129
    زمینه و هدف

    پژوهش حاضر با هدف تعیین آثار هشت هفته تمرین مقاومتی بر شاخص های ترکیب بدنی، نیمرخ چربی و کبد چرب در زنان دیابتی مبتلا به کبد چرب غیر الکلی اجرا شد.

    روش کار

    در این مطالعه 30 زن دیابتی (سن 8 ± 48 سال، قد 2 ± 158سانتی متر، وزن 8 ±76 کیلوگرم) دارای کبد چرب غیر الکلی (درجه دو و سه) شرکت کردند و به صورت تصادفی به دو گروه کنترل (15=n) و تمرین (15=n) تقسیم شدند. گروه تمرین، تمرینات مقاومتی عضلات بالاتنه و  پایین تنه را  به صورت سه ست (70-50 درصد یک تکرار بیشینه، 16-10 تکرار) در هر جلسه و سه جلسه در هر هفته و طی هشت هفته اجرا کردند. از آزمون یک تکرار بیشینه و تکنیک الایزا به ترتیب جهت اندازه گیری قدرت حداکثر عضلات پا و سینه و شاخص های نیمرخ چربی و کبد چرب استفاده شد. از روش آماری آنووای دو راهه با  اندازه گیری مکرر جهت تعیین تفاوت ها استفاده شد.

    یافته ها:

     نتایج تحقیق نشان داد که متغیرهای HDL، ALT و AST  تفاوت معنادارای در گروه کنترل در مقایسه درون گروهی داشتند (05/0 <p). همچنین در مقایسه بین گروهی نتایج نشان داد که  تفاوت معناداری در گروه های کنترل و تمرین در متغیرهای ترکیب بدن ،نیمرخ چربی و کبد چرب وجود دارد (05/0 <p).

    نتیجه گیری: 

    این نتایج پیشنهاد می کنند که تمرین مقاومتی می تواند از طریق جبران اثرات تخریبی دیابت نوع دو و کبد چرب غیر الکلی در متغیرهای HDL، ALT و AST  سطوح متغیرهای نیمرخ چربی و آنزیم های کبدی را به شرایط نرمال نزدیک کند.

    کلیدواژگان: تمرین مقاومتی، ترکیب بدن، نیمرخ چربی، کبد چرب غیرالکلی، دیابت نوع دو
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  • Banin Azarnoush, Zinat Nikaeen*, Farideh Ashraf Ganjouei, Zahra Haji Anzahaei Pages 1-9
    Background & Aims

    Nowadays, engaging in sports activities has become widespread in all societies and the number of people who engage in all kinds of sports as a competitive sport or as a recreational sport (leisure) is increasing every day. Optimal leisure time plays an important role in educating the community and prevents individual, social, economic, and cultural problems. Leisure is an activity through which members of society, regardless of the constraints of the environment and the requirements of life, develop their talents and develop their personalities. How to spend leisure time is a reflection of the social, economic, and cultural conditions of any society that the optimal use of this time can have a significant impact on improving the quality of social and economic life of society. Physical activity in leisure time is one of the things that make leisure time enjoyable and useful and has a tremendous effect on the physical and mental health of human beings and can have a great contribution in filling leisure time and positive social, economic and Have someone with you. Sport has a special place in the division of leisure time and is in the line of recreation and includes the active production of leisure experience in which the participants have some control over the work process. Leisure physical activities are sports and recreational activities that are performed for the purpose of pleasure, competition, building social relationships, and gaining physical fitness in leisure. Low participation in physical activity causes physical problems such as for overweight and obesity among children, adolescents, and young people, which is a major concern. Studies have shown that with age, physical activity decreases. Since attitude affects behavior and has a cause-and-effect relationship with behavior, the study of attitude to motor and sports activities is the source of conscious behavior to achieve well-being and well-being goals and is very important. Undoubtedly, building a healthy and vibrant society depends on the mental and physical health of the members of the society and owes to the efforts of healthy, efficient, and thoughtful human resources. The results of various researches indicate that people with different perspectives and attitudes engage in sports activities. At the same time, the theory of planned behavior is one of the well-known models of behavior change and In fact, it can be said that the planned behavior model can change the behavior and attitude of people, especially students, towards sports activities. The main purpose of programs and sports activities at the level of schools and educational institutions, while filling part of students' leisure time, helping to grow and develop their moral, psychological, physical, championship and cultural aspects of education in parallel It is another science and technology, so that the future creators of the country can make their progress and excellence and that of society possible. Undoubtedly, research on such a subject can be effective in many leisure programs and is of great importance. Especially in Iran and in schools, even the sports bell is often considered a time of recreation, and as it should be, a careful scientific view of adolescents' physical activities during these hours as well as in leisure time should not be considered, so it is necessary to Codified training to create interest and change the attitude and tendency of as many students as possible and increase the hours spent on sports and the continuation of their interests should be taken seriously. In this regard, in this study, an attempt has been made to apply the theory of planned behavior as a theoretical framework for research and education based on exercise, predictors of behavior tend to physical activity among adolescents and students.

    Methods

    In this quasi-experimental study, the statistical population consisted of male high school students in Chalous city. The number of statistical samples was 40 through random sampling and these people were divided into two groups of 20 intervention and control. Research tools include a designed educational package (which lasted ten sessions) and Jandaghi Physical Activity Trend Questionnaire (2017) with 18 questions and 5 components of Physical Activity Attitude Questionnaire (6 questions), Awareness (3 questions), Abstract norms (3 questions), perceived behavioral control (4 questions), behavioral intention (2 questions). Independent t-test and sample pairs were used to analyze the data.

    Results

    The results showed that there was a significant difference between the scores of students' tendency to physical activity before and after the intervention within the intervention group (p = 0.001). Also, the results of the independent t-test showed that in the intervention group, due to leisure training based on the model of planned behavior on the tendency to physical activity in students, an increase was observed that the difference between before and after the intervention was 8.1. The mean increased from 42.2 to 53.3.

    Conclusion

    According to the research findings, the difference between before and after the intervention is 8.1, which the average has increased from 42.2 to 53.3. In planned behaviors, a range of individual attitudes changes as his or her awareness increases, cognition of and abstraction of abstract norms improves, and perceptions of behavior and control increase. A person's behavioral intent eventually develops. On the other hand, rapid industrial changes and transformations are associated with many social and economic consequences and have important effects on how people spend their leisure time, which results in turning to cyberspace in their leisure time, which causes many physical and mental problems. Individuals can take a big step in improving the health status of society by changing the mental approach of individuals and the tendency to do physical activity in their spare time. The findings of this study showed that the attitude to exercise improves the tendency to physical activity and exercise. Attitude towards behavior means to what extent the desired behavior is desirable, pleasant, useful, and enjoyable for the person, which depends on the person's judgment about the effects and consequences of the behavior. In fact, attitude is based on the consequences of individual experience, behavior, or surrogate experiences through learning to observe others. Because of the direct experience of a behavior, positive beliefs about the consequences of the behavior are reinforced and then act as a motivation to continue. Attitude also refers to the emotions caused by the behavior, the experience of these pleasant emotions can affect its promotion and continuity. In fact, using the rain of thoughts and discussing the consequences of behavior and physical activity by the target group, and experiencing the positive physical and psychological benefits resulting from it affects the tendency of students to physical activity. On the other hand, one of the important obstacles in engaging in physical activity is the lack of awareness about the benefits of physical activity and also the lack of sufficient information about the levels and scope of physical activity and exercise. In general, it can be said that the implementation of an educational program based on the theory of planned behavior can affect the promotion and inclination of students to physical activity.

    Keywords: Planned Behavior, Tendency to Physical Activity, Students
  • Hadi Malek, Raheleh Hedayati*, Sina Rahimizadeh Pages 10-14

    COVID-19 mainly affects respiratory and immune systems, but other organs like renal, cardiovascular, lung and nervous systems could also be involved in both acute and chronic settings (1, 2). There is a lot of studies that demonstrate an increasing number of long COVID-19 who continue to experience persistent symptoms weeks or even months after the initial disease. Reports suggested that 66-87% of COVID-19 patients have at least one persistent chronic symptom related to the disease, the most common symptoms are fatigue, cough, anosmia, headaches, arthralgia, and chest pain that affect those with all grades of COVID-19 as well as inpatients and outpatients (3). Nowadays, imaging departments worldwide are exploring the different ways to may help for the management of chronic long covid-19 (4). One of the important complications with high morbidity and mortality is renal involvement. Studies show that 5–23% of people with COVID-19 have the symptoms of acute kidney injury (AKI) including proteinuria, elevated blood urea and creatinine, hematuria,  and histopathological damages (5). The multiorgan invasion of SARS-CoV-2 is a result of the wide distribution of angiotensin-converting enzyme 2 (ACE2) receptors in the organs; kidneys have the highest expression of ACE2 receptors in the body. Mesangial cells, podocytes, parietal epithelium of the Bowman’s Capsule, and the collecting ducts in the kidney show ACE2 receptors. Several mechanisms have been proposed for the renal manifestations of COVID-19 including direct viral invasion to the kidneys as well as a disturbance in renin-angiotensin-aldosterone system (RAAS) homeostasis (6). This virus binds to ACE2 receptors and leads to systemic inflammation and immune dysregulation in different organs (7, 8). This invasion leads to renal complications of COVID-19 which are acute renal injury and also deterioration and progression of previous renal disease in chronic kidney disease (CKD) patients (9). A large number of patients after acute renal injury of COVID‐19 have typically experienced long-term renal consequences during follow‐up (5). Recent studies showed that the development of AKI is associated with a poor prognosis. Renal injury increases morbidity and mortality, therefore subjects with evidence of renal involvement should be closely monitored and appropriately managed to avoid any decline in renal function (10). Renal injury is common in moderate to severe SARS-CoV-2 patients. Baseline proteinuria is an independent risk factor for increased hospitalization duration and ICU admission in subjects with COVID-19 (11). Nuclear medicine as functional, anatomical, and molecular imaging could be useful in diagnosing chronic renal complications, follow up and evaluation of response to treatment (4). The purpose of this study is to introduce 99m Tc DMSA renal scintigraphy as a nuclear medicine imaging that proved to be accurate and sensitive in assessing the onset, progression, and response to treatment of cortical renal dysfunction of COVID-19 patients (12). 99m Tc-DMSA scintigraphy is a radionuclide scan that uses dimercaptosuccinic acid (DMSA) in assessing renal morphology, structure, and function. Radioactive technetium-99m is combined with DMSA and injected into a patient, followed by imaging with a gamma camera after 3 hours (13). Imaging time is approximately 5 - 10 minutes depending on the counts collected per view take. Usually, posterior and posterior oblique views are the best images for interpretation of the scan. The patient is asked to maintain good hydration before and after the radiotracer injection. Usually, fasting is not required for scans (14). 99m Tc-DMSA scintigraphy is a safe, widely available with a low radiation dose that provides information about the morphology and function of the cortex of kidneys utilizing radiopharmaceuticals with high renal clearance. It can also use for measuring relative renal function. Anatomical abnormalities causing renal vascular or urinary tract malfunction can be diagnosed as well (13). 99m Tc-DMSA scintigraphy could help in the evaluation of cortical dysfunction and relative function of kidneys. It can also be used for detection of focal renal parenchymal abnormalities, differential diagnosis of scar from recoverable cortical dysfunction 6 months after acute infection, detection of acute pyelonephritis, evaluation of response to therapy by comparing baseline and fallow up scans, and discovery of associated abnormalities: abnormal duplex kidney, small kidney, dysplastic tissue and horseshoe kidney (13). The number, size, and location of areas of cortical loss can be assessed as well (4). A large polar hypoactive area, without deformity of the outlines and with indistinct margins will generally heal; marked localized deformity of the outlines or deformed outlines (volume loss) generally correspond to permanent sequelae. Renal sequelae should anyway best be estimated on a DMSA scintigraphy performed at least 6 months after acute infection (15). In conclusion, review of articles show that 99m Tc DMSA cortical renal scintigraphy can use in renal complications of covid-19 by demonstrating acute cortical dysfunction, acute pyelonephritis, size of kidneys, and relative function of kidneys. In a chronic setting, we can use a DMSA scan for detection of cortical scars, progression of renal cortical dysfunction, and response to therapy. Further research is needed to help improve effectiveness of this imaging.

    Keywords: COVID-19, Renal complications, 99m Tc-DMSA scintigraphy, Acute kidney injury
  • MohammadAmin Abbasi, Mohammad Momeni, Alireza Almasi Nokiani, Atousa Najmaldin* Pages 15-22
    Background & Aims

    The new coronavirus, known as severe coronavirus syndrome (SARS-CoV2), is a viral pneumonia caused by an emerging virus that causes Coronavirus Disease 2019 (COVID-19) (1). The etiology and pathology of the disease are not known exactly, but it has been reported to enter host cells by the angiotensin-converting enzyme (ACE2). (2) The range of clinical symptoms of the disease varies from asymptomatic to respiratory failure, which requires mechanical ventilation. These symptoms have been more severe in patients with diabetes and hypertension (1). Detection of COVID-19 is based on RT-PCR (real-time reverse transcription polymerase chain reaction) test of the pharyngeal sample. It has been found that chest CT scans can be useful in diagnosing interstitial pneumonia in patients with suspected COVID-19 (7, 8). Bilateral peripheral GGO involvement is the most common finding on chest CT scan in COVID-19 patients. The appearance of GGO alone or with consolidative opacities was also a common finding in chest CT. Chest CT scan and pathological changes are more severe in patients with diabetes. Diabetes is one of the most common diseases in Iran and the world. This disease is considered as a risk factor in patients with 19-COVID. The risk of severe symptoms and death in diabetic patients with COVID-19 is higher than others. This study aimed to evaluate the differences in the severity of lung involvement in chest CT scan of diabetic and non-diabetic patients with Covid-19.

    Methods

    The present study is a retrospective cross-sectional study that was performed on 148 patients with Covid-19 including 74 diabetic patients and 74 non-diabetic patients admitted to Kosar Hospital in Semnan and Firoozabadi Hospital in Tehran in 2016. Inclusion criteria were confirmation of coronary heart disease, confirmation of diagnosis of diabetes from 5 years ago and use of diabetic drugs in the case group. Demographic information, signs and symptoms, chest CT scan findings and RT-PCR were extracted from patients' medical records. Statistical analysis was performed using SPSS software and the significance level of P was less than 0.05.

    Results

    There was a statistically significant difference between the age of patients with COVID-19 in the two groups of diabetic and non-diabetic patients (p = 0.002). Chest CT scan in diabetic and non-diabetic patients with COVID-19 was 21.44 and 20.04, respectively. There was no statistically significant difference between the chest CT scores of patients with diabetic and non-diabetic groups by sex and age.

    Conclusion

    In the present study, the rate of lung involvement by chest CT scan in 74 diabetic patients with Covid-19 was compared with 74 non-diabetic patients. There was a statistically significant difference between the ages of patients with COVID-19 in both diabetic and non-diabetic patients, so that the mean age of diabetic patients was higher than non-diabetic patients. There was no statistically significant difference between the sex and chest CT scan score of patients with COVID-19 in the two groups of diabetic and non-diabetic patients. The results of the present study showed that the mean age of diabetic patients was higher than non-diabetic patients. The rate of pulmonary involvement in diabetic and non-diabetic patients with COVID-19 was not different and the score of lung CT scan was similar in both groups; In addition, age and gender had no effect on CT scan score. This finding is the most important result of the present study. Pulmonary infiltration may be due to the body's immune response to the virus, and overproduction of inflammatory cytokines, known as cytokine storms, can cause lung damage (15). People with diabetes are affected by low-grade chronic inflammation that may facilitate the cytokine storm, which in turn appears to be the cause of severe cases of COVID-19 (19). IL-6 is the most common marker of inflammation in diabetes mellitus with COVID-19. (20). From these cases, it can be concluded that in diabetic patients, due to the higher level of inflammatory cytokines, lung damage is also expected to increase. Another cause of severe COVID-19 9 and more lung involvement in diabetic patients can be a disorder in the innate immune system of these patients, which increases the risk of infection. Another mechanism in the disorder of the immune system in diabetic patients is the increased adhesion of microorganisms to the cells of diabetic patients; In addition, some Firoozabadi hospital clinical research development unit(FHCRDU),patients with COVID-19 is higher than non-diabetic patients, this difference is not statistically significant.

    Keywords: Diabetes, COVID 19, CT scan
  • Arefeh Ebrahimian, Emad Behboudi* Pages 23-27

    Dear Editor The current epidemic of the novel Coronavirus disease 2019 (COVID-19) risen from Wuhan, China, turned to a worldwide concern because of its incubation period (2-14 days) and its high transmission rate. The first cases of the infection were reported in December 2019 in Wuhan with symptoms like pneumonia with an unknown reason. Very soon it was known as a novel kind of Coronavirus on 31 December 2019. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the main viral agent of this disease, is belonging to betacoronavirus genera, Coronaviridae family, an enveloped positive sense RNA virus. Like SARS-CoV, SARS-CoV-2 attacks the organism by binding to the angiotensin-converting enzyme 2 (ACE2). Recently, some reports of SARS-CoV-2 infection have been shown that the virus is found not only in the respiratory tract but also in the gastrointestinal tract. In recent year, SARS-CoV-2 is still infecting populations that lack immunity to the virus, causing significant disease and mortality (1, 2). Immunity to SARS-CoV-2, either through natural infection or through vaccination, to some extent protects and reduces the risk of significant clinical consequences. For example, it has been estimated that improved seropositive individuals can have up to 89% protection against re-infection (3) and that vaccine efficacy has been reported to be 50 to 95% (4). However, the duration of the created immunity period is not known and over time, this immunity weakens (5, 6), in addition, there is concern about the escape of new variants from the immune system (7). An important question here is to identify the immune link with protection against SARS-CoV-2 and thus predict how these changes will affect the clinical outcome of the disease. Neutralizing antibody titer is an important predictor of the effectiveness of vaccines in development. Studies show that the level of neutralizing antibodies decreases over time and a booster may be needed within a year. However, protection against the severe form of the disease may be significantly longer. It can be said that the development of a strong or weak humoral response depends on the interaction of the virus and the host and the inflammation that occurs. If the challenge is low, the antibody produced has poor performance, but if the challenge is high, the antibody produced is more functional and responds more aggressively to re-exposure to the pathogen. In addition, cellular immune responses can play a prominent role in this regard (8). Therefore, if existing vaccines, such as natural infections, are able to stimulate the cellular immune response in addition to producing neutralizing antibodies, the immunity persistence of the vaccine will also increase. Another question that arises is whether determining the antibody titer after a natural infection or vaccination can be a correct marker of the state of protection against infection? Antibodies act as markers of infection and, if persisted, can lead to long-term immunity. In most clinically approved vaccines we measure the binding antibody titer, while this is a neutralizing antibody titer that indicates how immunogenic is a vaccine. An antibody, in addition to binding to the desired antigen, must also be able to neutralize that antigen, either by blocking the infection by preventing the pathogen from binding to the receptor or by stimulate immune cells for clearance and disease control, which should also be considered in vaccine studies. In addition to antibody titer and function, knowing how antibody function is related to cellular immunity and the nature of T and B cell immunity is essential to realizing long-term protection against re-infection (9). It is not yet known how some people get re-infected despite having antibody titers. Can the presence of specific antibodies against other viral antigens compensate for the low titer of functional RBD specific antibodies? The answer is no. Experiments show that when the Ab-mediated complement deposition (ADCD) and Ab-dependent neutrophil phagocytosis (ADNP) tests were performed, virus neutralization was seen only in individuals with high IgG antibody titers against the RBD region. Therefore, it was concluded that only antibodies against RBD are neutralizing (10). However, it cannot be said that a high titer of anti-RBD antibody means high immunity because not all antibodies against RBD are neutralizing. Does it mean that there is no protection against re-infection if the antibodies lack good binding or function? We cannot say for sure because the role of the T cell, which acts as a strong immune responder to coronavirus disease 2019 (COVID-19), cannot be ignored. Suppose we measure the antibody titer in a number of volunteers at time T0 (test start time). Are only symptomatic people positive for neutralizing antibodies? According to an experiment conducted by YC Bartsch et al. (9) asymptomatic individuals also had specific antibodies against RBD with a specificity of over 99.5% by enzyme-linked immunosorbent assay (ELISA). This means that this antibody was present in both symptomatic and asymptomatic individuals, but its titer was higher in symptomatic individuals. After tracking subjects for antibody titers after a certain period of time, a small number of participants completely lost their antibody response, and in the remaining individuals, almost half of the subjects had decreased antibody titers and the other half had a dramatically increased antibody titers. This observation can be justified in two ways, first, that these people differed in the length of time they spent with the infection, and second, that people with elevated antibody titers may be re-exposed to the infection. Knowing this, it can be concluded that measuring the antibody titer after infection or vaccination will not give us accurate information about the level of protection against SARS-CoV-2 infection. Routine clinical laboratory methods such as ELISA will never be able to make sure that the antibodies produced in your body are neutralizing or not, because this requires specialized neutralizing tests. In addition, knowing the initial antibody titer, it is not easy to estimate that the rate of antibody reduction will be faster or slower. Therefore, models that predict immune responses to infection need to determine the link between the protection provided by expanding vaccines. Because in different studies, a single method has not been used to measure the neutralizing antibody titer, there is a need for data normalization methods to better compare the results. In addition, we suggest that in addition to measuring the neutralizing antibody titer, the responses of memory T and B cells, which are associated with high protection against SARS-CoV-2, be measured so that we can have a better prognosis for neutralization.

    Keywords: SARS-CoV-2, Antibody, Protection, ELISA
  • Soudabeh Bassak Nejad, Ghodratollah Shakeri Nejad, Keyhan Fathi*, Banafsheh Moradi, Sara Shirmardi Pages 28-38
    Background & Aims

    Today, cancer is a growing phenomenon that is recognized as one of the major problems for contemporary human health. Breast cancer is still the most common cancer among women in the world. Living with breast cancer presents women with significant challenges that interfere with their physical, social, psychological, economic and spiritual life of patients. These challenges are major factors that reduce the quality of life of women with breast cancer. One of the psychological components that plays a key role in the lives of these patients and their families is hope. Hope is a vital factor in predicting the adaptation of cancer patients to the nature of the disease and its treatment, especially when faced with the prospect of chronic pain. Low or no hope can threaten the patient's physical and mental health. Another important psychological component in coping with the disease is the perception of the disease. Perception of disease means the belief or image that patients have of their disease, which affects their adaptation to the disease and their psychological state. Understanding the causes of breast cancer can affect patients' ability to seek medical treatment; Because misconceptions may lead to search for alternative health care from unapproved sources. Another psychological factor related to life expectancy in patients is the availability and perception of social support. The availability of social support is considered a important source of coping that can help the patient to cope with life with cancer. Evidence from the research literature shows that social support from family, friends, and other important individuals is associated with reduced mental health problems such as depression, anxiety, and suicidal behaviors, and improved quality of life in women with breast cancer. Another important psychological component that people use when facing problems is coping styles. These styles that developed to reduce stress are important both in acute periods of stress (such as natural disasters) and in patients suffering from chronic illnesses such as depression, breast cancer, and HIV / AIDS. One of the most common styles for managing a challenging situation is trying to deal with and change the stressful stimulus; This strategy is called problem-oriented coping. Most research shows that people who use this style are more adaptable. On the other hand, research shows that people who use emotion-oriented and avoidance strategies experience higher stress and lower quality of life. Thus, the aim of this study was to determine the role of perception of disease, perceived social support and coping style in the life expectancy in women with breast cancer.

    Methods

    The method of the present study is descriptive-correlational. The statistical population is all patients with breast cancer in Ahvaz in 1398 that 60 patients volunteered to participate in the study by available sampling method. Inclusion criteria include 1- ability to read and write, 2- being between 31 to 70 years old, 3- having 2 to 3 years of illness, 4- undergoing chemotherapy without or before mastectomy, 5- Not having a history of psychiatric illness and being hospitalized in psychiatric wards and 6- Willingness to participate in research. In order to conduct the research, after obtaining the necessary permits and coordination with the relevant authorities from the two public hospitals of Baqaei and Golestan in an available method, 70 patients who met the research criteria were asked to complete the research tools. Due to the decrease in patients staying in the hospital during corona disease and the lack of cooperation of patients, the sample of this study was reduced from 70 volunteers to 60 patients. The tools used in this study included questionnaires of disease perception (Bradbent, 2006), multidimensional perceived social support (Zimt et al., 1998), coping styles in special situations (Billings & Moss, 1981) and  life expectancy (Schneider, 1991). In this study, multivariate regression was used to analyze the data.

    Results

    The results showed that there is a negative and significant relationship between perception of disease and life expectancy (-0.78). Also, there is a significant relationship between predictor variables including social support, problem-oriented coping styles and emotion-oriented coping style with participants' life expectancy (0.80, 0.47 and -0.52, respectively). On the other hand, the relationship between avoidant coping style and participants' life expectancy was not significant (0.06 and 0.06, respectively). Also, the results of stepwise regression analysis indicate that the variables of social support and disease perception are the best predictors of life expectancy in patients with breast cancer, respectively.

    Conclusion

    The findings of this study showed that there is a positive and significant relationship between social support and life expectancy of breast cancer patients. Sun et al. Also found in their research that people who benefit from the social support of their relatives when faced with problems are more satisfied with life. Perceived social support affects patients' life expectancy in two ways. First, it can vaccinate a person before experiencing stress, thus reducing the harmful effects of stress. Second, it acts as a shield against the stress of the disease and makes the patient more satisfied with his life and hopes for positive consequences such as health and reducing the risk of disease. Also, this study showed that there is a significant positive relationship between problem-oriented coping style and life expectancy of breast cancer patients. When people believe that they have the ability to cope with stressful events such as illness, their anxiety is reduced and they can choose more effective coping strategies. Also, this study showed that the perception of the disease has a negative and significant relationship with life expectancy of women with breast cancer. Therefore, when patients have negative beliefs and perceptions of their disease and its various aspects, they experience physical and mental problems that can increase the burden of the disease for them and reduce their quality of life. Considering the importance of hope in the life and treatment of cancer patients, it is recommended that medical staff and psychologists pay attention to the role of life expectancy in their interventions and treatment protocol, especially in breast cancer patients.

    Keywords: Perception of disease, Perceived social support, Coping styles, Life expectancy, Breast cancer
  • Ahmad Mazarei Sotoodeh, Abolfazl Bakhshipour*, Mahmoud Jajarmi Pages 39-50
    Background & Aims

    Depression is a common mental illness that causes mental, occupational, and physical dysfunction. Most empirical studies on the causes of depression adopt a predisposition-depression model in which vulnerable individuals become depressed when external stressors outweigh the individual's personal resources to overcome the illness. In addition to examining genetic predispositions, research on depression has paid much attention to the study of personality vulnerabilities. Therefore, achieving a healthy society obviously depends on the health of the family and the realization of a healthy family is conditional on the mental health of its members and having a favorable relationship with each other. Therefore, improving the health of family members in their relationships will undoubtedly have positive effects on society. When the family center includes a healthy environment and warm relationships and intimate interpersonal interaction, it can lead to the growth and development of family members. The existence of a satisfactory marriage is a place of intersection and exchange of positive feelings and emotions between couples, and the formation of a normal family plays an important role in the health, quality, and satisfaction of married life and the well-being of the whole society. An important expectation from the pattern of marriage in today's world is that couples pay attention to each other's needs for love, intimacy, and affection. Also, people consider marriage to be the most intimate relationship of adulthood, a relationship for which the main source of affection, support, and satisfaction. The ability to cultivate intimacy is an interpersonal factor, the importance of which is often highlighted because of its essential role in the development of close relationships and its relationship with marital satisfaction. Thus, intimacy creates both personal and communication satisfaction and is the main factor in providing health, adjustment, happiness, and a sense of meaning in couples; Besides, intimacy seems to improve commitment in relationships and increase communication compatibility, so this study aimed to determine the effectiveness of existential group therapy on intimacy and marital satisfaction of depressed married women.

    Methods

    The present study with the code IR.IAU.BOJNOURD.REC.1399.009 was approved by the ethics committee of Islamic Azad University Bojnourd branch. Quasi-experimental research method with pre-test, post-test with a control group and two-month follow-up and the statistical population of married female clients applied for counseling from two counseling and psychology centers in Mashhad in the period of October to November 1398. Beck Depression Inventory, 56 women who scored higher in this questionnaire according to the inclusion criteria, which were: having at least a diploma, more than 3 years of married life, and no mental or physical illness available 30 women were selected. For these people, the research plan including the number of sessions, the duration of each session, and the issues raised in the sessions, were fully explained, and after obtaining their full consent and desire in the research company, written consent was obtained and their names were included in the research list. Became; Then 30 women were randomly selected into two experimental groups (15 women) and a control (15 women). Research tools: Walker and Thompson Marital Intimacy Questionnaire (1983) and Enrich Marital Satisfaction Questionnaire, 1989; Also, the intervention program of the educational-therapeutic package of the existential theory of Frankel and Yalom models were taught to the experimental group in 8 90-minute group sessions. Data were analyzed using repeated measures mixed analysis of variance.

    Results

    The results show that group existential therapy was effective on the score of marital intimacy (P = 0.020) with an effect size of 0.18 and also on the score of marital satisfaction (P = 0.017) with an effect size of 0.18. Also, the comparison of the three stages in the experimental group and the control group shows that the difference between marital intimacy and marital satisfaction in the post-test and follow-up stages in comparison with the pre-test is significant and this effect remains stable until the follow-up stage; While in the control group, these differences are not significant.

    Conclusion

    The aim of this study was the effectiveness of group existential therapy on intimacy and marital satisfaction of depressed married women. The results of this study show that the mean of marital intimacy in both experimental groups in the post-test stage has increased compared to the pre-test. Also, repeated measures analysis of variance confirms that this intervention has been able to affect marital intimacy in the post-test and follow-up stages, and this effect has remained stable until two months after the end of the training, according to the results of the Bephroni post hoc test. According to the research literature, each of these approaches is one of the most effective and successful interventions in the field of psychotherapy. A look at the extent of the impact of each of these approaches on marital intimacy in explaining the findings of this study will be enlightening. The basis of all human relationships is the need to belong, to love, to acknowledge, and to respect. Hence, a healthy relationship is characterized by interdependence, calculation, and an existential relationship based on generosity and mutual love. As a result, existential psychotherapy helped married women in the experimental group to get to know each other better during a dynamic relationship with their husbands and family members; Get acquainted with their inner and fundamental needs, meanings and values, and explore them in the depths of their being. They were also trained to identify challenges in their relationships, to approach the issue from their own perspective, and then to try to address the issue from the perspective of the other person as well as the perspective of a third person to address all aspects of a Get acquainted with the problem and challenge and then take action to reduce the challenges in the heart of their relationship by accepting their role and responsibility. According to the research findings, group existential therapy can be used to improve intimacy and marital satisfaction.

    Keywords: Intimacy, Satisfaction, Marriage, Existential Therapy
  • Atlasi Safaei, Mohammad Sheibani, Yaser Azizi* Pages 51-64

    Cancer has become a major health problem worldwide. The reported incidence of new cancer cases is estimated at 19.3 million, with a mortality rate of 10 million in the world in 2020. There are some approaches for cancer treatment such as chemotherapy, neoadjuant surgery, hormone therapy, and radiotherapy. Chemotherapy is an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body. It’s usually used to treat cancer, as cancer cells grow and divide faster than other cells. On the other hand, chemotherapy means consuming anti-neoplastic drugs, alone or in combination. However, these drugs can cause damages to the normal cells and have many side effects. The most common side effects are allergic reactions, hair loss, urination disturbances, heart damages, bone marrow suppression, vomiting, and kidney injury. Anthracyclines are commonly used in chemotherapy; especially doxorubicin is the most widely used drug of this family. Doxorubicin, the anthracycline antibiotic, was first produced from Streptomyces peucetius var. caesius in 1960. Doxorubicin is represented as one of the most effective broad-spectrum anti-cancer agent. It is determined widely efficient against various types of cancers, including solid malignancies (bladder, breast, lung, etc.) and hematologic tumors (Hodgkin’s disease and non-Hodgkin’s lymphomas, pediatric leukemia). The primary mechanism of action of doxorubicin involves the drug’s ability to intercalate within DNA base pairs, causing breakage of DNA strands and inhibition of both DNA and RNA synthesis. Also, it inhibits the enzyme topoisomerase II, causing DNA damage and induction of apoptosis. Doxorubicin stabilizes the topoisomerase II complex after it has broken the DNA chain for replication, preventing the DNA double helix from being resealed and thereby stopping the process of replication. When combined with iron, doxorubicin also causes free radical-mediated oxidative damage to DNA, further limiting DNA synthesis. Iron chelators, such as dexrazoxane, may prevent free radical formation by limiting binding of doxorubicin with iron. The most dangerous side effect of doxorubicin is cardiomyopathy, leading to congestive heart failure. Doxorubicin-induced cardiotoxicity starts from myocardial cell injury; and is followed by left ventricular damage. It is assumed that this drug has many cytotoxic mechanisms. The cardiac side effects of doxorubicin during a chemotherapy regimen can be acute, chronic, or even gradually progressive and persistent after termination of doxorubicin therapy. The incidence of doxorubicin-induced cardiotoxicity rises with the escalation in total cumulative dose of doxorubicin during a day or a treatment cycle. Cardiotoxicity induced by doxorubicin is very common and there is no reliable and absolute treatment for this problem. Unfortunately, there are currently a few medications for the treatment of doxorubicin-induced cardiotoxicity in clinical setting. Extensive basic and clinical researches have been done to discover preventive treatments. Various studies sought to explain the underlying cellular mechanism that participates in the manifestation of this medication’s undesirable effects. Disruption of normal mitochondrial function, decreased amount of antioxidant defense (catalase, superoxide dismutase, and peroxidase), production of reactive oxygen species (ROS), iron free radical formation, oxidative stress pathways, activation of inflammatory cascade and inflammatory factors including nuclear factor-κB (NF-κB), tumor necrosis factor-alpha (TNF-α), and imbalance of intracellular ions homeostasis are involved in phathophysiology of doxorubicin-induced cardiotoxicity. Gap junctions are the most important structures in cardiomyocytes. The presences of gap junctions in the cardiomyocytes are necessary for conduction of impulses and maintenance of the integrity of cardiac cells contractions and excitation. Gap junctions are aggregates of intercellular channels that facilitate direct cell–cell interactions and intercellular transmission of molecules and ions. Electrical connection between cardiomyocytes and maintenance of the normal cardiac rhythm are mediated by gap junctions, and these junctions consist of groups of membrane channels that directly link the cytoplasmic parts of nearby cells. Each gap‐junctional channel is constructed from connexins. The most abundant isoform of connexin in the mammalian cardiac cells is connexin43 (Cx43), while other types of connexins are also expressed. Cx43 generally localizes in gap junctions, but has also been detected in mitochondria, and it is considered vital for cardioprotection. Mitochondrial-Cx43 has a crucial role in mitochondrial permeability under conditions of calcium overload and oxidative stress. Additionally, Cx43 also participates in other cellular functions such as cell growth, differentiation and death/survival signaling, but the involvement of Cx43 in these functions may be partially or fully independent of its role in intercellular communication. Administration of doxorubicin induces alterations in Cx43 expression and distribution. Therefore, electrical signal conduction between cardiomyocytes, intracellular calcium homeostasis, and mitochondrial function are disturbed. As a result, a part of the cardiotoxic effects of doxorubicin is exerted by affecting function of Cx43. Elevation in the level of Cx43 in the intercalated discs could reduce doxorubicin cardiotoxic effects such as cardiomyocytes calcium overload and ECG abnormities. Sirtuins are a well-known family of proteins found in most classes of the organisms, including mammals. Sirtuins have many vital roles in mammalian physiology, and they may provide new targets for treating diseases associated with aging and perhaps increasing lifespan. Seven mammalian sirtuins, SIRT1–7, have been identified. Sirtuin 1 (SIRT1) and sirtuin 3 (SIRT3) are essential for the regulation of metabolic processes in mammalian. Various metabolic disorders are related to SIRT1 and SIRT3 deficiencies. The kidney, brain, and heart have highest tissue levels of SIRT3. It is localized in the mitochondrial matrix, and it is necessary for enzymatic activity and expression of many mitochondrial proteins. Moreover, mitochondrial sirtuins reduce degree of myocardial ischemia-reperfusion injury, expansion of cardiac hypertrophy, and heart failure. Therefore, elevation in cardiac tissue levels of sirtuins for improvement of myocardial mitochondrial energetics is a novel approach in several cardiac disorders. Sirtuins are activated by low energy levels and stimulate energy production through their activation of transcription factors and enzymatic regulators of cardiac energy metabolism. Mitochondrial sirtuins preserve mitochondrial function by increasing mitochondrial metabolism, inhibiting ROS generation, decreasing apoptosis, controlling the quality of mitochondria, and increasing autophagy. Moreover, doxorubicin interferes with myocardial energetics; thus, a hopeful approach to reduce cardiotoxic effects of doxorubicin may be to target mitochondria and improve metabolic function. Because of the importance of sirtuin and CX43 in the cardiac function, the aim of this study was to investigate the role of connexins and sirtuins in doxorubicin-induced cardiotoxicity.

    Keywords: Cardiotoxicity, Doxorubicin, Connexin 43, Sirtuin 3
  • Elham Madadizadeh, Mohsen Aminaei, Keyvan Khorami Pour* Pages 65-76
    Background & Aims

    Nowadays, industrialization has reduced physical activity and lifestyle changes, resulting in the spread of lifestyle-related diseases. A common feature in most diseases associated with the new lifestyle is obesity. Obesity as a multifactorial disease is often associated with other diseases such as hypertension and cardiovascular disease, osteoarthritis and some kinds of cancers. Considering as a global problem, obesity is on the rise in adults, adolescents, and children. In many societies, the prevalence of overweight and obesity has increased over the past two decades. In the United States, the risk of developing overweight and obesity during a person's lifetime is 4% and 6%, respectively. Obesity is associate with many secondary diseases such as diabetes. Diabetes is a group of metabolic diseases that have in common high blood glucose levels. Symptoms often include frequent urination, increased thirst and increased appetite. If left untreated, diabetes can cause many health complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes and cognitive impairment.Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. The most common form of diabetes is type 2 diabetes. High blood glucose causes damage to various organs as well as disturbances in their function. The average life expectancy of diabetic patients is 10 years less than their non-diabetic peers. Diabetes is the most common metabolic disease in humans. Along with peripheral insulin resistance, which is present in 90% of patients with type 2 diabetes, research has also shown central insulin resistance, especially in the hippocampus, which causes impaired glucose metabolism, memory and cognitive problems, and eventually Alzheimer's. The hippocampus is part of the limbic system, and plays important roles in the consolidation of information from short-term memory to long-term memory, and in spatial memory that enables navigation. In Alzheimer's disease, the hippocampus is one of the first regions of the brain to suffer damage short-term memory loss and disorientation are included among the early symptoms. As a result, metabolic diseases such as obesity and diabetes, in addition to environmental effects, can cause Alzheimer's and cognitive disorders. Alzheimer's disease (AD) is one of the main and most common diseases of the nervous system. While 10-15% of AD patients have a genetic background, 85-90% have non genetic causes.The main cause of AD and cognitive disorders is extracellular accumulation of beta amyloid. These plaques cause inflammation and oxidative stress, which eventually leads to the destruction of cortical and hippocampal neurons. The presence of tau protein clots in brain tissue is another feature of AD. Since the hippocampus is the main site of memory and learning, the accumulation of tau and beta amyloid plaques in the hippocampus causes memory and learning disorders. Symptoms of AD include memory loss, anxiety, depression, and cognitive impairment. Cognitive impairment is a major problem in AD patients. Cognitive function refers to a set of mental processes that contribute to perception, memory, and reason. Cognitive function begins with the initial processing of data and ends with executive function. Early data processing requires few stimuli and thus shows a limited level of cognitive function. In contrast, executive functions represent more advanced cognitive processes that contribute to purposeful behavior. Disruption of these cognitive processes can go a step further and cause premature or delayed complications of various diseases by disrupting function of most body systems which eventually could lead to death.Exercise has always been considered as a useful intervention in preventing metabolic disorders. Since the most important reason for not exercising is lack of time, high intensity interval training (HIIT) because of less time needed and being more beneficial have replaced traditional training with high volume. HIIT consists of intervals (from 45 seconds to 4 minutes) of high-intensity activity (more than 85% of maximal heart rate) and low-intensity activity (approximately 50% of maximal heart rate). Many studies have shown the therapeutic and even preventive role of HIIT in memory and learning disorders induced by obesity and diabetes. However, some other reported no positive effects. Therefore, the aim of this study was to review the effect of HIIT on memory and learning impairments induced by obesity and diabetes. Hereby, we tried to find out if HIIT could improve memory and learning impairments induced by obesity and diabetes and in this case which HIT protocol would be the most effective.

    Methods

    The protocol of the present study is as follows: a search was conducted on Google Scholar, PubMed, Scopus, SID, Noor and Mgiran databases. Studies between 2000 and July 2021 which meet inclusion criteria (the manuscript considered as valid by http://impactfactor.ir) were included.  In the initial search, 152 studies were found based on the title and keywords. Then, 84 studies were deleted due to the lack of abstract relevance to the field. Of the remaining studies (68 studies), 38 were removed due to not having at least one combination of our keywords (in addition to HIIT, at least one of the words cognitive impairment, hippocampus, and AD should be included in the title or keywords of the study). In the third stage, the full text of 30 studies was reviewed and 15 studies were excluded due to the lack of relevance of the full text to the field. Finally, the full text of 15 studies was thoroughly reviewed, and at the end, due to the relevance of the full text of these articles and their subject matter to the authors of the present study, they were regularly categorized based on the sample used (human, animal) And entered the research.

    Results

    8 studies (30%) were conducted between 2000-2010 and 19 studies (70%) were conducted between 2021-2011. 18 studies (66%) were long-term (studies with training protocol lasted more than a week) and 9 studies (33%) were short-term (studies with training protocol lasted less than a week). 8 studies (30%) used human participants and 19 studies (70%) used animal.

    Conclusion

    HIIT shows opposite effects to promote cognitive function by promoting mitochondrial functions and reduce neuronal apoptosis in the hippocampus. Preliminary evidence suggests that HIIT can induce structural and functional brain changes in patients with mild cognitive impairment (MCI) and AD, but results are still inconclusive. It also has been suggested that, HIIT could exerts anti-inflammatory effects and improves the brain redox status, thereby ameliorating the pathophysiological hallmarks of AD (e.g., beta amyloid deposition).Also There is evidence suggesting that incorporating HIIT into the school day is not associated with improvements in the executive function skill of inhibition, but rather, HIIT is better related to attention–concentration in the classroom. Studies showed that only four minutes of HIIT between classes can improve selective attention in children.Notably, HIIT is useful in combating a wide range of neurocognitive and neuropsychiatric symptoms in obese and diabetic rodents, including improving learning and memory disorders, reducing depression-like behaviors, and improving uncontrolled appetitive behaviors.Restored neurogenesis, improved synaptic plasticity, and reduced neuroinflammation may altogether contribute to cognitive improvements in obese and diabetic rodents. Furthermore, accumulating evidence has suggested the indisputable role of adipose tissues on cognitive function, metabolic function, and neural plasticity. HIIT can effectively attenuate metabolic syndromes in obesity and diabetes by improving lipid profile, adipose tissue inflammation, and insulin resistance.In sum, this review of these studies shows that performing any type of HIIT can increase improve cognitive function and learning. HIIT could also stimulates neurogenesis in the hippocampus, and prevents hippocampal neurodegeneration induced by diabetes. As a result, HIIT can improve cognitive impairment, increase learning and memory, and ultimately improve AD symptoms.  Also The authors show that HIIT is beneficial to cognitive control and working memory capacity when compared against "a blend of board games, computer games, and trivia quizzes" and that this effect is mediated by the Adipokines polymorphism. That  study "suggests a promising alternative to enhance cognition, via short and potent exercise regimens". A meta-analysis studies showed that HIIT can elicit short term brain improvements.Future studies should examine the effect of HIIT on the molecular basis of AD (e.g., beta-amyloid protein accumulation and tau) in addition to behavioral tests to measure short- and long-term memory in mice and measure their learning. In addition, measuring the stress and anxiety of mice can help us determine an effective training protocol. In addition, to complete the results of the present study, it is better to examine different training protocols. In this regard, the effect of different types of exercise (running, optional exercise, etc.) on cognitive functions and improvement of learning and memory disorders has been investigated. Therefore, the effect of intense swimming on cognitive function has not been studied yet and it is suggested that it be the focus of suture studies.

    Keywords: HIIT, Cognitive Impairments, Alzheimer Diseases, Hippocampus
  • Nazila Payandeh, Maghsoud Peeri*, MohammadAli Azarbayjani, Seyed Ali Hosseini Pages 77-90
    Background & Aims

    One of the tissues that is affected by physical activity is bone. Bone is one of the tissues that needs to receive mechanical load to have normal function as a key factor in strengthening bone mass (2). Evidence shows that the mechanical load resulting from physical activity activates a set of proteins involved in the process of osteoblast activation and inhibits osteoclasts. One of these proteins is osteonectin. It is commonly used as a serum marker of osteoblastic bone formation and is believed to regulate minerals in the bone matrix, but now new genetic and pharmacological evidence also points to the hormonal role of this protein (5).Osteopointin, on the other hand, accounts for about 2% of non-collagenous bone proteins and is synthesized mainly by osteoblasts as well as bone-forming cells, bone cells and other hematopoietic cells in the bone marrow (7). Another important factor in the ossification process is ALP, a membrane-bound tetrameric enzyme found in the plasma membrane of osteoblasts. This substance plays an important role in the formation of osteoids and mineralization by degrading enzymes inhibiting minerals, pyrophosphate at alkaline pH (8).Also, due to their active phytochemical compounds, medicinal plants can affect the formation and destruction of bone tissue through various mechanisms. One of the plants used in traditional medicine for various therapeutic purposes is palm tree pollen. This plant is used to improve infertility and impotence in men and women. Phytochemical compounds such as estrone, α-amirin, triterpenoidal, saponins, flavonoids, estrone, estradiol and estriol are abundant in this plant (15). Therefore, the researcher seeks to answer the question whether resistance training and date pollen extract affect bone tissue density and osteoblast cell proliferation in young males?

    Methods

    For the present experimental study, 36 8-week-old male rats with a weight range of 220 20 20 g were purchased from the Pasteur Institute of Iran and randomly divided into 6 groups: 1) sham, 2) exercise, 3) palm pollen, 4) testosterone. 5) Exercise + palm pollen and 6) Exercise + Testosterone were divided. After one week of adaptation, groups 2, 4 and 6 performed resistance training for four weeks and five sessions per week. Groups 3 and 5 performed 100 mg / kg of date fertilization pollen five days a week. Gavage was also given. Groups 4 and 6 also received 2 mg / kg of testosterone propionate per week peritoneally. Finally, descriptive statistics, Shapiro-Wilk test, two-way analysis of variance and Benferroni post hoc using SPSS software at a significance level of p <0.05 were used for statistical analysis of data.

    Results

    The results showed that resistance training and drug administration significantly increased osteocalcin gene expression, ALP concentration, ALP gene expression and osteopontin and osteogenesis of femoral bone tissue. Although the highest expression of osteocalcin gene was observed in the group of resistance training and date palm pollen or testosterone enanthate, but the interaction of these two interventions was not statistically significant. It was also found that resistance training (palm pollen and testosterone enanthate) significantly reduced serum ALP. The interaction of these two interventions on serum ALP concentration was significant. Simultaneous resistance training and medication enhanced the reducing effect of each intervention.

    Conclusion

    In this study, due to resistance training, osteocalcin, osteopontin, ALP, RUNX2 gene expression, ALP protein expression and osteogenesis were significantly increased. While serum ALP showed a significant decrease.The expression of bone matrix proteins, alkaline phosphatase, and osteocalcin appears to increase with the differentiation of osteoblasts, which may lead to bone mineralization and formation. Another reason for the increased expression of acetocalcin gene in this study can be explained by the change in cytokine changes caused by resistance training, especially interleukin-6. Much of IL-6 has been reported to be secreted into the bloodstream from muscle during physical activity, an increase that is essential for increasing physical function capacity. IL-6, on the other hand, triggers signals in osteoblasts to stimulate osteoclast differentiation and the secretion of the bioactive form of osteocalcin into the bloodstream. In general, an increase in interleukin-6 is necessary to increase circulating osteocalcin levels during physical activity (28).Another mechanism of increased expression of osteocalcin gene induced by resistance training in this study can be explained based on the effect of resistance training on oxidative stress. Evidence suggests that regular resistance training can increase antioxidant capacity and reduce oxidative stress (29). On the other hand, increasing oxidative pressure can reduce the process of osteoblast differentiation by activating apoptotic processes in bone (30).In the present study, resistance training increased the expression of osteopontin gene. Along with osteocalcin, acetaminophen is involved in the organization of the extracellular matrix, the coordination of bone cell interactions with the extracellular matrix, and the matrix minerals. Both proteins also play a structural role in bone and determine the tendency of bone to break. As a result, these proteins may regulate the structure and morphology of the entire bone and affect the mechanical properties of bone (36, 37). Like osteocalcin, the mechanical load resulting from resistance training appears to stimulate the expression of the osteopontin gene. It has been shown that the application of mechanical load on bone increases the periosteal of bone by increasing the activation of bone formation processes. In these conditions, mechanical load can stimulate both gene expression and ALP protein expression by activating adult osteoblasts and increase They become (26).On the other hand, date palm extract could increase the expression of the studied genes and the process of osteogenesis. The effect of date palm extract on increasing gene expression of osteocalcin, osteopontin, alkaline phosphatase and osteogenesis can be examined from two perspectives. The first view is the effect of this extract on the motility of LH followed by stimulation of testicular Leydig cells to produce and secrete circulating testosterone. Numerous studies have reported stimulation of testosterone secretion after induction of date palm pollen (45, 46).The view on the effect of date pollen extract on the process of outcomes measured in this study is the antioxidant and anti-inflammatory role of the compounds in this plant material (47, 48). As mentioned about the antioxidant and anti-inflammatory effect of physical exercise and its role on acetoblasts, increasing oxidative stress and inflammation has an inhibitory effect on the differentiation and proliferation of osteoblasts (30). Induction of date palm pollen extract in this way can develop the process of bone formation.

    Keywords: Date Pollen, Resistance Training, Osteogenesis, Bone, Osteoblast
  • Mohsen Akbarpour*, Mohadese Ghanji, Giti Taperashi, Reza Hashemi Mad, Mohamad Hasani Pages 91-101
    Background & Aims

    Intense physical activity, despite its various benefits for general health, can cause possible damage to various tissues of the body due to increasing oxidative stress through increasing production of reactive species. Muscle bruising and pain is a common experience that occurs after performing unusual and intense activities, especially after resistance and extroverted activities. Delayed muscle spasm is associated with the release of creatine kinase, lactate dehydrogenase, and aspartate aminotransferase, and can be measured by the release of these enzymes into the blood. Numerous studies have examined the effect of resistance trainings on muscle injury indices that creatine kinase and lactate dehydrogenase, spartate aminotransferase, alanine aminotransferase and myoglobin indices increased significantly after exercise. In another study, they did not see any significant changes in CK and LDH muscle injury indices after 3 hours of cycling. Therefore, due to the injuries, researchers have drawn attention to the effects of resistance exercise on muscle injury indices. Although resistance training improves performance, it does not prevent the release of inflammatory and traumatic factors, so these factors can cause acute sports injuries, which will be especially important at a young age. Nowadays, special attention is paid to the use of various methods of resistance training, the most prominent of which is TRX or the same resistance training exercises suspended by body weight. Therefore, considering the different effects of sports activities, especially strength training on different parts of the body and the possibility of injury in these exercises, and considering the differences in the type of resistance training programs such as TRX and circular resistance, it is important to pay attention to the effects of this type of training and muscle injury indices. Also due to the contradictory results about the effect of exercise, especially the effect of resistance activity on muscle injury indices and also the lack of sufficient research on the long-term effect of TRX training on muscle injury indices and especially insufficient research on the comparison of resistance training and TRX, the researcher decided to compare 8 weeks of traditional resistance training and TRX on the indicators of muscle injury in inactive women.

    Methods

    In this semi-experimental study, (28) healthy inactive girls with a mean age of 21.00 38 1.38 years were randomly divided into three groups: traditional resistance training (9), TRX training (9) and control (10). The experimental groups performed the training protocol three times a week for 8 weeks with an intensity of 65 to 80%. Blood samples were taken before training and 48 hours after the last training session and creatine kinase and lactate dehydrogenase levels were measured. Data were statistically analyzed using Shapiro-Wilk, dependent t-test and one-way analysis of variance.

    Results

    The results showed that traditional resistance training and TRX both cause significant changes in LDH levels, while there was no significant difference in CPK variable from pre-test to post-test in all three groups. Also, in examining the differences between groups, no significant difference was observed between the three study groups at CPK levels. While there was a significant difference in the amount of lactate dehydrogenase between the three groups (p <0.05). According to the results of Table 3, there was a significant difference in the levels of lactate dehydrogenase between the resistance group and the TRX group (p = 0.0001), the control group with the TRX group (p = 0.0001) and the control group with the resistance group (p = 0.012) was observed.

    Conclusion

    The presence of CK and LDH in the blood is an indirect sign of muscle damage as well as the diagnosis of medical conditions such as heart attack, muscular dystrophy and brain diseases. Cellular disorders, especially muscle cells, can cause CK and LDH to leak from cells into the blood serum. The findings of the present study showed that although there was a difference in the means of the three groups in both variables of creatine kinase and LDH, but this difference was significant only for LDH (P <0.05). The results of this study also showed that there is no significant difference in creatine kinase index between the two types of traditional resistance training and TRX after eight weeks. These factors affect the amount of response and the time period of secretion along with the injury. In general, the researchers state that intense resistance activities due to increased mechanical-metabolic pressure on the fibers lead to rupture of fibers, fluidization of z-plates, rupture of sarcolemma, displacement of intracellular organs, instability of plasma membranes and increasing secretion of intracellular proteins, after performing the resistant and intense activity. In fact, fatigue of muscle fibers following exhaustive activities can lead to increasing permeability of cell membranes to intracellular free calcium ions and dysfunction of sodium-potassium pumps, causing instability of cell membranes and activation of proteases and intracellular lipases. There is a close relationship between the release of phospholipases and creatine kinase due to the activity of intracellular proteolytic enzymes stimulated by calcium in the isolated muscle of mammals. The results of this study on LDH showed that the LDH of the experimental groups was significantly lower than the control group. Lactate dehydrogenase is one of the enzymes involved in the anaerobic pathway of ATP production. The secretion of lactate from the training muscle and the activity of the muscle pump indicate the role of continuous exercise training on the rate of cell damages. It has also been shown that trained people have less enzymatic release into the bloodstream than people who did not, which may be due to the adaptation of trained people to the physical activity and exercise; because the skeletal muscles of athletes and trained people have the highest amount of ATP, which is used during exercise and physical activity to maintain the integrity of the cell membrane, and as a result, reduces the leakage of enzymes into the blood. In any case, it seems that as a result of running consecutive weeks of regular exercise programs, intramuscular adaptation may be established, and the nature of resistance training programs causes adaptation to occur at all levels, including intramuscular and better blood supply, which reduces the activity level of CK and LDH enzymes as indicators of muscle and cell damage; therefore, it seems that the use of appropriate methods of training reduces the disruption of biochemical changes. Therefore, according to the findings of the present study, it can be stated that the implementation of TRX training program and traditional resistance both can significantly reduce the rate of LDH cell damage index and no change in CK, and there is no difference between this type of training on the indicators muscle damage in young women, so both types of exercise can have beneficial effects on muscle injury indices.

    Keywords: Traditional resistance training, TRX, Creatine kinase, Lactate dehydrogenase, Inactive females
  • Maziyar Azizi, Ahmad Abdi*, Javad Mehrebani, Asiyeh Abbasi Deloyi Pages 102-116
    Background & Aims

    The study of physiological characteristics and recognition of cardiac pathological factors during exercise and endurance activities can provide a good background in identifying athletes who are at risk. NTproBNP has been reported as a biological marker for the diagnosis of heart failure and disease progression in response to increased stress on the heart wall, increased volume, ventricular and atrial pressure, and other conditions such as ischemia or myocardial infarction and in response to various signals Increased myocardial infarction On the other hand, several studies have shown that elevated cytokines, particularly IL-6, severely modulate cardiac function and can lead to myocyte damage. Increased plasma IL-6 levels during exercise are associated with left ventricular dysfunction and are an important factor in the development of heart failure. It was a professional profession.

    Methods

    The method of this research is laboratory, cross-sectional, laboratory, cross-sectional, and three-blind, by randomly selecting professional runners with the aim of investigating the effect of caffeine and beet juice supplementation on nitrate on NTproBNP and IL-6 followed by a The course of aerobic activity was performed in professional endurance runners. 15 elite male runners with a mean age of 27.5 3 3.8, mean height of 176.7 7 7.7, mean weight of 69.9 7 7.8 and body mass index of 22.3 1 1.5 and maximum oxygen consumption (ml / kg / min) Select 5.2 4 4.6 and randomly, into three groups: 1) High dose (9.6 mmol nitrate and 400 mg caffeine), 2) Low dose (4.8 and 200) and 3) Placebos were divided. Subjects consumed the supplement twice daily with 250 cc of water for seven days before the test. Aerobic exercise included running on a treadmill for 5 km. Plasma concentration of NTproBNP was measured in picograms per ml (pg / ml) and by electrochemiluminescence immunoassay (Elecsys NTproBNP 2010) with a sensitivity of 125 pg / ml. Plasma IL-6 was measured by BMS213HS kit with a sensitivity of 0.02 pg / ml and the results were shown in picograms per ml. Beet powder in powder form Beet powder Sun Say extract completely herbal and organic without sugar, gluten and other preservatives and synthetic chemicals and license made 10645/14 and caffeine in powder form made by Karen company and natural beet juice placebo It was examined by a food quality control laboratory and determined as a placebo with a little basic nitrate. The supplements were combined in three forms by the researcher's colleague in water and provided to the researcher as a solution for consumption. Random help supplement: 1) 9.6 mmol beet extract and 400 mg caffeine for high dose group, 2) 4.8 mmol beet extract and 200 mg caffeine for low dose group and 3) placebo water Natural beets were obtained for the placebo group.

    Results

    The results showed that supplementation had no significant effect on NTproBNP (p = 0.821), but decreased IL-6 (p = 0.001). Also, one session of exercise significantly increased the levels of NTproBNP (p <0.05) and IL-6 (p <0.05) and supplementation after seven days decreased the levels of NTproBNP (p = 0.071) and IL-6 (p = 0.092) followed by sports activities.

    Conclusion

    Considering the increase in plasma levels of NTproBNP and IL-6 immediately after exercise intervention and their significant decrease seven days after intervention, it can be said that due to doubts about the increase in these parameters after exercise, an activity with such a temporal and intense nature does not seem to lead to harm. However, the greater intensity in competitions and the effect of repetition of this training pattern in the long run cannot be ignored and it is suggested that in addition to interpreting the study results of plasma levels of NTproBNP and IL-6 in athletes, comprehensive cardiological studies and physiological factors affect Examine the secretion of these markers in other endurance sports activities for more accurate information on the physiological function of athletes' hearts during endurance sports activities. Also, due to the lack of significant effect of caffeine nitrate supplement on NTproBNP and significant reduction of this supplement on IL-6 after intense and short anaerobic exercise, it is not possible to be confident about taking caffeine-nitrate supplement to control inflammatory factors after intense anaerobic exercise. Commented; However, taking this supplement, due to its anti-oxidant properties and findings based on previous studies, will probably be somewhat beneficial for athletes who train hard. It may need to be used for a longer period of time to be more effective, and more studies are needed to find out more about the anti-inflammatory effects of caffeine-nitrate supplementation in humans. The limitations of this study were low number of samples, duration of sports intervention, lack of control over mental states and motivation of the subjects. Also, although the subjects were given a 24-hour reminder form, it was not possible to precisely control their feeding. In general, according to the findings of the present study and regardless of its limitations and considering the precautionary aspects, it can be recommended to young athletes that they can use caffeine-nitrate supplement to modulate cardiovascular risk factors.

    Keywords: Caffeine-Beet Supplementation, Aerobic Activity, Cardiovascular, Endurance Runners
  • Khadijeh Freidoonfara, Amirabbas Monazzami*, Zohreh Rahimi, Mehrali Rahimi Pages 117-129
    Background & Aims

    Increased prevalence of obesity is known as the main reason for the spread of metabolic diseases including nonalcoholic fatty liver disease (NAFLD). On the other hand, research on the effect of resistance training on diabetic people simultaneously with NAFLD is limited. Therefore, the present study was conducted with the aim of determining the effects of 8 weeks of resistance training on body composition indices, fat profiles and fatty liver in diabetic women with non-alcoholic fatty liver.

    Methods

    This experimental study was performed with two groups including training group (15) and control (15). 30 diabetic women in the age range of 45 to 65 years were randomly selected (48 ± 8 years old age, 158 ± 2, weight of 76 ± 8 kg) and were divided into two groups of control and training. The criteria for entering the research included at least 6 years of history of diabetes, BMI between 25 and 36 (kg / m2), a glycemic index between 120 and 150 (mg / dl), glycosylated hemoglobin (HA1C) between 6.5 to 9 and having a fatty liver of grid 2 and 3 (via sonography). Exclusion criteria included known genetic disease, endocrine disease and advanced complications of diabetes, hepatitis C and B and autoimmunity, hemochromatosis, or liver-related diseases, cardiac-pulmonary disease and drug and alcohol consumption. Weight and BMI were measured by using  body  composition device model (Inbody570). Body fat percentage (BFP) was measured by a three-point method (arms, thighs and supraspinatus) using a Harpanden metal caliper (with an accuracy of 0.05 mm) and calculated by Jackson and Pollack formulas. Serum levels of fasting blood sugar, LDL, HDL, AST and ALT were analyzed using a bionic diagnostic kit (made in Iran) with a mindray analyzer BS-480 and insulin using a monobind kit (made in the USA). On the other hand, the training group performed resistance exercises for upper and lower torso muscles in three sets (70-50% of one maximum repetition, 10-16 repetitions) in each session and three sessions per week for eight weeks. Participants performed eight different strength training, including large muscle groups, on the machines. These movements include: Bench press, Barbell curl, Lying triceps press, lat pull down, leg press, leg extension, Lying leg curl and Standing calf raise. Each training session includes warm-up phase using stretching movements for 5 minutes, resistance movement phase in the form of three sets (50-70% of one maximum repetition, 10-16 repetitions) for 35 to 50 minutes and Finally, the cooling-down step was for 5 minutes. A maximum repetition test was used to measure the maximum strength of the leg and chest muscles. A 90-second break was also allowed between sets. The training duration gradually increased from 45 in the first week to 60 minutes in the eighth week. During these two months, individuals were asked to refrain from engaging in physical activity outside of the program. The subjects in the control group were also asked not to do any sports activities during the program and to do only their normal daily activities. Two-way ANOVA with repeated measures was used to determine the differences and independent t-test was used to compare the changes of the two groups in pre-test and post-test (∆) and interval confidence of 95% was considered at all stages of the test.

    Results

    The results of two-way ANOVA with repeated measurements showed that there was a significant difference between the groups in the interaction (group × time) in weight, WHR, body fat percentage and a maximum repetition (leg press and chest press) (P <0.05) but this result in BMI changes was not significant (p>0.05). In addition, the results of two-way ANOVA with repeated measures showed that there was a significant difference between the groups in the interaction (group × time) and in the variables of glucose and insulin (P <0.05). Also, comparing the interaction (group × time) using two-way ANOVA test with repeated measures showed that there were a significant difference between the control and training groups in HDL, LDL, TG, TC variables (P <0.05). Also, the results of the two-way ANOVA test with repeated measures showed that in the within group comparison (difference between pre-test and post-test) and in ALT and AST variables, a significant difference were observed in both control and exercise groups (P <0.05). Also, comparing delta changes (pre-test and post-test changes) using independent t-test, the results showed that there were a significant difference between ALT and AST variables between control and training groups (P <0.05).

    Conclusion

    According to the results of this study, it can be said that performing eight weeks of moderate-intensity resistance training can improve metabolic parameters such as glycemic index, insulin resistance, 1RM and body composition index (weight, BMI, WHR) and body fat percentage) in women with T2DM and NAFLD. These results suggest that resistance training can modulate the levels of lipid profile variables and liver enzymes closer to normal by compensating for the destructive effects of type 2 diabetes and non-alcoholic fatty liver in HDL, ALT and AST variables.

    Keywords: Resistance Training, Body composition, Lipid Profile Indices, Non-Alcoholic Fatty Liver, Type 2 Diabetes