Hormozgan Medical Journal
Volume:27 Issue: 4, Oct 2023

Over a year has passed since the diagnosis of the first coronavirus disease 2019 (COVID-19) case in Wuhan, China. After that, this disease spread worldwide and infected people with a spectrum of symptoms, the most important and fatal of which are respiratory symptoms. Kinins, particularly bradykinin, are responsible for many respiratory functions, including vasodilation, vasoconstriction, and regulating permeability in vessels and lung tissue. The present study aims to review the bradykinin synthesis and degradation process, its mechanism of action, and its contribution to pulmonary function. Also, we investigate the role of bradykinin in treating and reducing the severity of COVID-19 symptoms. Results indicate that engagement of angiotensin-converting enzyme 2 (ACE2), a factor contributing to vasomotion and vascular permeability, as a result of virus entrance and its failure to inactivate des-Arg9-bradykinin (DABK) along with infiltration of proinflammatory cytokines, leads to increased vascular permeability and pulmonary edema. Consequently, inhibition of DABK synthesis or activity through blockade of the type 2 bradykinin receptors can help manage pulmonary edema.

Context: 

Clonal hematopoiesis (CH), characterized by the clonal proliferation of mutant hematopoietic cells, is frequently observed in older individuals. It is widely recognized that ageing leads to somatic mutations in hematopoietic stem cells, increasing the risk of developing various diseases later in life. However, the impact of these clonal hematopoiesis-related mutations on the activation and regulation of the immune response remains uncertain.

Evidence acquisition: 

To address this knowledge gap, a thorough review of the existing literature on clonal hematopoiesis and immune dysregulation was conducted. Relevant studies were systematically searched and their key findings were carefully analyzed to provide a comprehensive overview.

The review shows that mutations associated with clonal hematopoiesis have a significant impact on the modulation of immune responses in the body. These mutations are found to contribute to immune dysregulation, which has important implications for disease progression in the elderly. 

This review highlights the importance of studying immune dysregulation in the context of clonal hematopoiesis. By unravelling the relationship between CH-related mutations and immune responses, we can improve our understanding of disease progression in the elderly and identify promising therapeutic targets. This knowledge can inform the development of innovative interventions for improved disease management.

Varicocelectomy is a surgical intervention to treat varicocele. It may recover fertility in men by improving semen parameters and sex hormones. This research studied the role of varicocelectomy, focusing on semen properties and sex hormones. 

In this cross-sectional study, the data were collected from 45 patients with different varicocele grades who underwent varicocelectomy. The data were collected and compared before and after clinical examination. 

After varicocelectomy, a significant improvement was observed in certain semen parameters, such as motility and concentration. However, among sex hormones, only testosterone increased after the surgical intervention (P=0.007). 

To our knowledge, varicocele treatment may almost improve male fertility. Accordingly, varicocelectomy positively affects parameters such as testosterone and serum FSH levels and sperm count and motility. As such, varicocelectomy emerges as a practical approach to improve male fertility and sex disorders.

Anabolism has a major contribution in increasing proteolysis and muscle mass of athletes. This study was done to investigate the impact of the acute use of different doses of glutamine supplementation following exhaustive physical activity on cortisol and testosterone levels in young male athletes. 

Following a semi-experimental design, 24 male athletes with a mean age of 22.35±1.79 years were randomly selected and divided into two intervention groups (glutamine; 0.1 and 0.6 gr/kg body weight (BW) and a placebo group (10 g of dextrin dissolved in 500 mL water), each with eight subjects. Serum levels of cortisol and testosterone were measured immediately, 90 minutes, and 24 hours following the test. Data analysis was done using paired t-test and repeated measures analysis of variance at P<0.05.

Bruce protocol significantly increased cortisol levels immediately after physical activity (P<0.05). Cortisol levels significantly decreased in subjects receiving glutamine at 0.6 g/kg Bw (P=0.03) and 0.1 g/kg BW (P=0.02) 90 minutes and 24 hours following the protocol. Meanwhile, testosterone levels only increased in cases who received glutamine at 0.6 g/kg BW 24 hours following the protocol (P=0.02).

According to the results of this study, taking a glutamine supplement at a dose of 0.6 g/kg body weight after exhausting activities is probably effective in maintaining an anabolic profile.

The present study aimed to assess and compare the effects of high-intensity interval training and moderate-intensity continuous training on oxidative stress-related markers in the left ventricular tissue of the heart muscle in healthy male rats.

Fifteen male Wistar rats, aged 50-70 days, were randomly divided into 3 groups: Control group (CON), high-intensity interval training (HIIT), and moderate-intensity continuous training (MICT). After determining the maximum speed of VO2max, the training program of HIIT (six 2-min periods with 85%-90% VO2max and five 2-min with 50%-60% VO2max intensity) and MICT (same distance of running as HIIT with 70% VO2max intensity) groups were performed for 8 weeks, 5 days per week. Forty-eight hours after the last intervention session, the animals were anesthetized, and their heart tissue was removed and stored at -80°C. Then, the expression rates of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), AMP-activated protein kinase (AMPK), and superoxide dismutase (SOD) genes were measured by real-time PCR, and the concentration of malondialdehyde (MDA) in left ventricular tissue of heart was measured by colorimetry method. One-way analysis of variance and Tukey post hoc test were used for data analysis at the significance level of P<0.05.

There were significant differences between the groups’ expression rates of AMPK, PGC-1α, and SOD (P<0.05). The expression rates of AMPK and PGC-1α were higher in the MICT group than in the CON group (P<0.05). No significant difference was observed between HIIT and MICT groups regarding AMPK and PGC-1α (P>0.05). SOD expression was significantly higher in the HIIT group than CON and MICT groups (P<0.05). SOD expression was also higher in the MICT group compared to the CON group (P<0.05). MDA concentration was not significantly different between the studied groups (P>0.05).

HIIT and MICT induce positive adaptations in the expression of AMPK, PGC-1α, and SOD in the heart tissue of healthy male rats. However, HIIT stimulates SOD gene expression more than MICT.

During the novel coronavirus disease 2019 (COVID-19) pandemic, the incidence of cardiovascular diseases increased. In this context, diagnosing ST-elevation myocardial infarction (STEMI) in COVID-19 cases has become complex and challenging. 

This study explored the characteristics and compared clinical outcomes between COVID-19 and non-COVID-19 patients with STEMI.

This prospective observational study was conducted on adult patients admitted with the diagnosis of STEMI in the first 6 months of the pandemic. Patients were evaluated for COVID-19 diagnosis and divided into two groups: COVID-19-positive and COVID-19-negative. Then, they were monitored during hospitalization and 6 months after discharge. 

Of 131 patients admitted with STEMI, 22.13% had COVID-19 infection. Most patients were men, and the COVID-19-positive patients were older than non-infected patients (63.97±12.54 vs 58.19±10.97 years; P=0.039). The COVID-19-infected patients had a higher prevalence of diabetes (P=0.003) and heart failure (P=0.008). They had higher levels of erythrocyte sedimentation rate (ESR) (P=0.003) and neutrophil count (P=0.018), whereas lymphocyte count declined considerably in these patients (P=0.012). In addition, hospital length of stay was higher in the infected patients (6.64±4.30 vs 4.93±3.59 days; P=0.023). During the study period, the overall mortality rate in our setting was 8.82% and 17.24% in COVID-19-negative and -positive patients, respectively. However, this difference was not statistically significant (P=0.195). 

Although the current study employed a small sample, the findings suggest notable differences between the STEMI patients with and without COVID-19 infection regarding some parameters, especially underlying comorbidities. However, the difference in mortality was not significant.

The high incidence of lung cancer and its poor prognosis have led to significant health problems in recent decades. This research aimed to study the prevalence of histopathological types of primary lung malignancies, focusing on treatment plans and their effective causes. 

This descriptive cross-sectional study employed a census method over 5 years (2016-2021). A total of 567 diagnosed cases of primary malignant tumors of the lung were extracted from the department’s records. Then, their slides were reviewed according to WHO 2004 histological classification of lung tumors and entered into the checklist. 

In this study, there were 567 lung malignancies, of which 434(77.1%) affected male patients and 130(22.9%) female patients, with a mean age of 66.1±12.3 years. The most common tumors among men and women were adenocarcinoma and squamous cell carcinoma (25.6% and 9.3%, respectively). Among the clinical symptoms, shortness of breath was the most common (24.7%). Cough with shortness of breath (24.2%), hemoptysis (10.9%), and weight loss (6.5%) were other clinically common manifestations. Chemotherapy had the highest treatment frequency (63.3%). Moreover, 432 patients (79.2%) had a history of smoking, 143(25.2%) reported a history of drug use, and 30.7% died of the cancer, resulting in a survival rate of 69.3%.

The results of the present study showed that the most common tumors were adenocarcinoma and squamous cell carcinoma, and their prevalence was higher in men than women during the study period. Furthermore, lung cancer treatment is usually not associated with the desired results, and the prognosis of lung cancer is still poor.

In middle-aged women, the postmenopausal period is associated with increased oxidative, inflammatory, and psychological stress. We intend to investigate the effect of home-based aerobic exercise (HAE) on serum levels of 8-hydroxy-2’-deoxyguanosine (8-C) and the expression of telomerase reverse transcriptase (TERT) in leukocytes of postmenopausal women.

A total of 20 sedentary postmenopausal women who had at least 12 months passed since their last menstruation participated in the study voluntarily. Their Mean±SD age, height, weight, and body mass index (BMI) were respectively 52.4±3.8 years, 161.4±3.7 cm, 74.4±6.8 kg, and 28.6±3.4 kg/m2. They were randomly divided into two groups: Home-based aerobic exercise (HAE, n=10) and inactive control (CON, n=10). HAE group undertook 4 weeks of home-based aerobic exercise (4 d/wk, intensity: 70%-80% maximal heart rate) with online supervision. Participants’ weight and fasting blood samples (12-h fasting state) were measured and taken before and 48 hours after the intervention. TERT expression in blood leukocytes and serum levels of 8-OHDG were assessed by real-time PCR and ELISA methods, respectively. The collected data were analyzed using mixed (2×2) repeated measure ANOVA and independent samples t-test in SPSS software. A significance level of P<0.05 was considered for all tests.

The findings showed that 4 weeks of HAE increased TERT expression significantly compared to the CON (ES=0.40, P<0.05). Although 8-OHDG serum level in the HAE group increased following training compared to pre-training (P<0.05), no significant difference was observed between the CON and HAE groups (P>0.05). Also, the interaction effect on 8-OHDG was not significant (ES=0.11, P>0.05). In addition, after 4 weeks of HAE, body weight and BMI significantly decreased in the training group compared to the control (P<0.05).

According to these findings, HEA effectively reduces telomere erosion and improves weight control in postmenopausal women.