مجله دانشکده پزشکی اصفهان
پیاپی 177 (هفته سوم فروردین 1391)

Stimulatory and/or inhibitory effects of angiotensin II is attributed to angiotensin receptor I. A few studies investigated the role of angiotensin receptor I on cardiovascular system in diabetic subjects. In this study, we evaluated the effects of losartan, an angiotensin II receptor I blocker, on myocardial capillary density in diabetic rats. A total number of 18 male rats were divided into 3 groups of control, diabetic, and diabetic receiving losartan. Diabetes was induced by intraperitoneal injection of streptozotocin (55 mg/kg). A daily dose of 15 mg/kg intraperitoneal losartan was injected to the treatment group. After 21 days, blood samples were taken and myocardial tissue was evaluated by immunohistochemistry. Myocardial capillary density in diabetic animals was lower than the control group (P 0.05). Losartan could not significantly change capillary density in myocardial tissue of the diabetic rats (P 0.05). It seems that losartan administration does not have beneficial effects on myocardial capillary density in diabetic animals.

Changes in lifestyle in recent years have led to increase prevalence of cardiovascular diseases. On the other hand, longer life expectancy has resulted in higher numbers of demented patients including those with vascular dementia (VD). Since VD patients encounter many problems that decrease their quality of life, finding a marker for early detection of the disease is necessary. Measuring plasma levels of brain natriuretic peptide (BNP) might be helpful for early detection of VD. This cross-sectional study was conducted in Alzahra Hospital, Isfahan, Iran during 2011. We selected 2 groups of VD patients and ischemic stroke patients without dementia (ISwD). A group of healthy individuals was also included as the control group. Plasma levels of BNP were measured in all groups. Demographic data was also collected and recorded in a special checklist. Finally, data was analyzed by SPSS. Mean levels of BNP in the control, VD, and ISwD groups were 24.71 ± 13.2, 83.08 ± 9, and 51.57 ± 12.4 pg/ml, respectively. One way analysis of variance (ANOVA) revealed a significant difference between the three groups (P < 0.001). According to the results of this study, plasma level of BNP is a reliable marker for early detection and prediction of VD. This marker can also be used for identifying patients with history of cardiovascular diseases and stroke that are at the risk of VD.

The purpose of this study was to survey the effects an exercise therapy program on joint range of motion (ROM), aerobic fitness, and anxiety of patients with hemophilia A. This study included 20 male hemophilia A patients (age: 22.55 ± 8.07 years; height: 172.17 ± 12.42 cm, weight: 60.88 ± 12.88 kg). After filling consent forms by subjects, pretests were performed during 1 week. The subjects were then randomly allocated into two groups. The experimental group participated in a selected exercise therapy program 3 times a week for 8 weeks. Finally, all tests were repeated as posttests. Descriptive statistics (mean and standard deviation) and inferential statistics including paired sample t-test and analysis of covariance were used to analyze data. The significance level was considered as P < 0.05. There were significant improvements in joints (ankle, knee, hip, shoulder, and elbow) ROM, aerobic fitness, and anxiety of the experimental group after participating in the exercise therapy program (P < 0.05). Moreover, comparisons between groups showed significant differences in joints ROM, aerobic fitness, and anxiety between the experimental and control groups after the intervention (P < 0.05). Correctly designed and performed physical activities can improve levels of physical and psychological factors in hemophilia patients. They should thus be considered seriously as a part of treatment for these patients.

It is necessary to recognize the role and function of immune system in wound healing, control, and treatment of cutaneous leishmaniasis (CL). According to the published papers, immune system factors such of monocyte chemotactic protein-1 (MCP1) and nitric oxide (NO) have an impact on wound healing. In this study, the role of these factors on wound healing and their interaction with glucantime in CL patients were investigated. In a cross-sectional study, 44 (38 males and 6 females) patients who referred to Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, were diagnosed as positive CL using direct microscopy. Before and after treatment with glucantime, 5 ml whole blood samples were obtained from all samples and the sera were incubated at -70°C until use. Serum levels of MCP1 and NO were determined by enzyme-linked immunosorbent assay (ELISA) method and Grise reaction, respectively. Paired t-test was used to compare NO and MCP1 values before and after treatment. Improvements in cutaneous lesions and significant elevations in MCP1 and NO levels (P < 0.05) were observed after treatment. These findings show a significant association between treatment with glucantime and levels of NO and MCP1 (P < 0.05). The interesting results of this investigation revealed that MCP1 and NO play an important role in wound healing of patients with CL.

Mediterranean dietary pattern can have a considerable role in overcoming adverse environmental changes. The purpose of this study was to review the methods that several epidemiologic studies used to evaluate the adherence of different populations to the Mediterranean dietary pattern. In order to perform this literature review, terms related to Mediterranean diet adherence were searched in PubMed. Published studies until 2011 were considered. Reference lists in identified relevant papers were cross-checked manually to ensure that all relevant papers were identified. Finally, among 105 performed investigations that evaluated different outcomes, 35 papers with different scoring patterns were selected. The reviewed evaluation methods could be classified into four categories: 1) those based on a positive or negative scoring of the components; 2) those that added or subtracted standardized components; 3) those based on a ratio between components; and 4) a mixed of two or more mentioned methods. In a useful scoring method, energy intake should be adjusted, so the estimations will be independent of the variations present in energy intake. Based on the objectives of the study, confounding variables must be adjusted as well. The scores constructed by quantiles can discriminate better between the variations of intakes within the study population. Moreover, each Mediterranean diet component should be given an appropriate weight in the final score based on its contribution in outcomes of the study. A combined score based on the recommended intakes in Mediterranean diet pyramid, with a penalty for excess intake and considering a weighting factor for energy from non-Mediterranean foods can reflect Mediterranean diet adherence of the population very well. The content validity of this score can be approved against expected nutritional and biochemical biomarkers. Accompanying serum folate levels can be useful as a complementary tool for evaluating Mediterranean diet adherence. A more precise and quantitative definition of the Mediterranean diet is required if the adherence to such a dietary pattern is intended in order to include all aspects of the Mediterranean diet indices. Therefore, typical Mediterranean foods need to be included and the dietary pattern approach needs to be validated using biomarkers.