Evaluating Plasma Galectin-3 Levels in Patients With an Increased Risk of Atherosclerotic Cardiovascular Disease Who Underwent Coronary Artery Revascularization.

Coronary artery disease (CAD) is a common atherosclerotic cardiovascular disease (ASCVD) associated with significant mortality. Galectin-3 is a novel inflammatory factor implicated in the initiation and progression of atherosclerosis. We aimed to evaluate the association of plasma galectin-3 with the risk of ASCVD and the need for coronary artery revascularization. Patients with angina who underwent coronary angiography were divided into groups per their risk of ASCVD. Patients (n = 385) were stratified into having low (n = 21), moderate (n = 40), high (n = 41), and very high risk (n = 283) for ASCVD. The mean age ± standard error of the mean was 53.9 ± 0.5 years and 73% of patients were men. Plasma galectin-3 levels were higher in patients with CAD than non-CAD primarily in patients with stable and unstable angina. Patients with stable CAD had higher levels of galectin-3 relative to acute coronary syndrome patients. Increased plasma galectin-3 level was associated with increased risk of ASCVD and degree of coronary stenosis. By multivariate analysis, the plasma galectin-3 level was independently associated with increased ASCVD risk and body mass index. Plasma galectin-3 levels were independently higher in patients who underwent percutaneous coronary intervention (PCI) than medically treated patients. In addition, age, male gender, smoking, and diabetes mellitus were associated with PCI. In conclusion, plasma galectin-3 levels are elevated in patients with CAD and associated with increased risk of ASCVD and the need for PCI. Plasma galectin-3 could be used as a potential improving predictor of ASCVD risk and when making therapeutic guidance or selecting patients who underwent PCI when the decision is difficult.

Predictors of intensive care unit length of stay and mortality among unvaccinated COVID-19 patients in Jordan.

Background: Factors associated with mortality and intensive care unit (ICU) admission due to Coronavirus Disease 2019 (COVID-19) in Jordanian patients are not known particularly among unvaccinated patients. Aim: To examine predictors of mortality and ICU stay in unvaccinated COVID-19 patients in the north of Jordan. Methods: Patients admitted with COVID-19 between October-December 2020 were included. Data on baseline clinical and biochemical characteristics, length of ICU stay, COVID-19 complications and mortality were collected retrospectively. Findings: 567 COVID-19 patients were included. The mean age was 64.64±0.59 years. 59.9% of patients were males. The mortality rate was 32.3%. Underlying cardiovascular disease or diabetes mellitus was not associated with mortality. The mortality increased with the number of underlying diseases. Independent predictors of ICU stay were neutrophil/lymphocyte ratio, invasive ventilation, the development of failure, myocardial infarction, stroke and venous thromboembolism. The use of multivitamins was observed to be negatively associated with ICU stay. Independent predictors of mortality were age, underlying cancer, severe COVID-19, neutrophil/lymphocyte ratio, C-reactive protein (CRP), creatinine level, pre-use of antibiotics, ventilation during hospitalisation, and length of ICU stay. Conclusion: COVID-19 was associated with an increased length of ICU stay and mortality among unvaccinated COVID-19 patients. The prior use of antibiotics was also associated with mortality. The study highlights the need for close monitoring of respiratory and vital signs, inflammatory biomarkers such as WBC and CRP, and prompt ICU care in COVID-19 patients.

Atrial Fibrillation after Rheumatic Heart Valve Surgery: Incidence, Predictors, and Outcomes.

BACKGROUND: Atrial fibrillation after cardiac surgery (AFACS) impacts 10 to 65% of patients. AFACS is associated with stroke and other systemic embolic manifestations. METHODS: Patients at our hospital who underwent rheumatic valve surgery procedures including aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG were included in this study in the period from 2002 to 2017. RESULTS: In total, 346 patients were included in the current analysis, with a mean age of 51.6 ± 16.1 years, and 51% were males. AFACS was documented in 102 patients (29.9%) .: Univariate predictors of AFACS included age, gender, body mass index (BMI), operation type, left ventricular ejection fraction (EF), left atrial (LA) diameter, previous history of AF, use of aldosterone antagonists more than a month before surgery, use of diuretics more than a month before surgery, length of ICU stay, total length of stay, cross-clamp time more than 90 minutes, pump time more than 120 minutes, postoperative acute kidney injury, left ventricular dimensions.By multivariate analysis, only age (p = 0.028, AOR = 10.6), male gender (p = 0.021, AOR = 3.4), type of surgery (p = 0.034, AOR = 7.12), history of AF (p = 0.018, AOR = : 2.32), BMI (p < 0.001, AOR = 3.91), EF before surgery (p ≤ 0.001, AOR = 3.91), and LA diameter (p = 0.0051, AOR = 18.23) were independent predictors of AFACS. CONCLUSION: This study identifies risk factors associated with the development of atrial fibrillation after rheumatic valve heart surgery. Older patients, male gender, type of surgery, preoperative AF, BMI, EF before surgery, and LA diameter are independent predictors of AF after cardiac valve surgery.

Impact of atorvastatin on plasma and cardiac biomarkers of inflammation, oxidative stress, and fibrosis in a rat model of streptozotocin-induced diabetes.

Oxidative stress and fibrosis foster the development of cardiovascular disease (CVD) in diabetes. Atorvastatin protects against cardiovascular diseases in diabetes patients. However, the mechanisms are not completely known. This study evaluated the impact of atorvastatin on vascular and myocardial oxidative stress, inflammation, and fibrosis in a model of diabetes. Male Wistar rats were assigned into four groups; control rats, atorvastatin-treated rats (Ator, 40 mg/kg given by oral gavage for 6 weeks), diabetes rats (DM, single IP 40 mg/kg streptozotocin), and diabetes rats treated with atorvastatin (DM + Ator). Serum and cardiac inflammatory, oxidant, and fibrotic markers were measured. Cardiac fibrosis was evaluated by Masson trichrome stain. Streptozotocin-induced diabetes as documented by the marked elevation in blood glucose. Levels of oxidant biomarkers of serum and cardiac nitrite, cardiac nitrate, and cardiac thiobarbituric acid reactive substances (TBARS) were increased in the DM group. The use of atorvastatin reduced nitrite and TBARS levels. Serum and cardiac inflammatory factors of endothelin-1 (ET-1) were elevated in the DM group, and the use of atorvastatin reduced these increases. Cardiac C-reactive protein tended to increase in the DM group and the use of atorvastatin reduced its level. Cardiac interstitial fibrosis was increased in the DM group with a parallel increase in the platelet-derived growth factor level. The use of atorvastatin reduced cardiac fibrosis. Diabetes was associated with an increase in serum and/or myocardial markers of oxidative stress, inflammation, and fibrosis. The use of atorvastatin reduced cardiac interstitial fibrosis and decreased cardiac oxidant and inflammatory biomarkers.

Awareness and knowledge of manuscript writing and research integrity: A cross sectional survey among graduate students.

Graduate students face a variety of barriers when writing manuscripts. The major barrier is inadequate writing experience and training. We aimed to evaluate the awareness and the knowledge of the basic principles in manuscript writing and research integrity among graduate students, and to assess the usefulness of workshops to improve their knowledge about manuscript writing process. A cross sectional survey was developed to evaluate the awareness and the knowledge about the manuscript writing steps and the research integrity among graduate students in Jordan. A one-day workshop about manuscript writing and research integrity was conducted. Students (n = 285) completed the questionnaire. Most participants were female masters'; students. Although 83.8% of the students were aware of the general manuscript structure, most of them were not aware of the basic concepts to write most manuscript sections. Only 22.5% of the students were aware of the authorship criteria. Data showed a lack of knowledge of different practices of scientific misconduct. Barriers in manuscript writing included the lack of focused research methodology courses and the lack of professional workshops and the absence constructive mentorship support. The workshop was useful in introducing the key concepts in manuscript writing. The present study revealed a lack of knowledge among graduate students about manuscript writing and scientific misconduct. Professional workshops are useful in improving students' knowledge.

Plasma lipoprotein (a) and tissue plasminogen activator are associated with increased risk of atherosclerotic cardiovascular disease.

Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of mortality. Lipoprotein a (Lp(a)) is a low-density lipoprotein (LDL)-like particle with a similar structure to tissue plasminogen activator (t-PA) and it competes with plasminogen for its binding site leading to reduced fibrinolysis. The aim of this study was to assess association of Lp(a) and t-PA levels with risk of ASCVD and whether they are dependent on LDL levels. Patients who presented to the catheterization lab for assessment of coronary artery disease were included and stratified by their risk of ASCVD into low, moderate, high, and very high risk. Plasma levels of Lp(a) and t-PA levels were measured before catheterization. Consecutive patients (n = 362) were included. The mean age±sem was 52.28 ± 0.60 years. Plasma Lp(a) and t-PA levels were higher in very-high and high-risk patients relative to low-risk patients. Serum levels of triglyceride and high-density lipoprotein but not LDL were correlated with risk of ASCVD. Plasma Lp(a) and t-PA were not correlated or modified with LDL level. Plasma Lp(a) and t-PA levels were higher in patients undergoing coronary revascularization relative to patients having no intervention. Plasma t-PA level was higher in patients presented with myocardial infarction compared to those with angina. Multivariate analysis documented independent association of Lp(a) and t-PA with ASCVD risk. Plasma Lp(a) and t-PA levels are associated with increased ASCVDASCVD risk independent of LDL and could be used as predictors of atherosclerosis risk and in selecting patients who may benefit from coronary revascularization.

Predictors of mortality among patients with type 2 diabetes in Jordan.

BACKGROUND: Diabetes Mellitus (DM) is a common metabolic disease associated with increased risk of mortality. OBJECTIVE: The aim of this study was to examine predictors of mortality among patients with type 2 diabetes in the north of Jordan. METHODS: Electronic data files for diabetes patients admitted between the period of 2014-2018 at a tertiary center in the north of Jordan were reviewed. Patient's characteristics, clinical and laboratory data, use of medications and mortality rate were collected. RESULTS: Mean age of patients (n = 957) was 60.99 ± 0.37 (mean ± sem). Most of patients had multiple risk factors and underlying cardiovascular diseases (CVDs). Mortality rate was 10.1%. Univariate predictors of mortality included age, chronic kidney disease (CKD), acute kidney injury, hypertension, heart failure (HF), coronary artery disease, venous thromboembolism (VTE), stroke, atrial fibrillation (AF), and chronic obstructive pulmonary disease (COPD). As the number of CVDs increases, mortality rate also increases (Odd ratio 2.0, p < 0.0001). Use of insulin, aspirin, ACEi/ARBS, beta blockers, and diuretics were also associated with mortality. Fasting glucose and percentage of glycated hemoglobin were not associated with mortality. By multivariable logistic regression analysis adjusting for confounders and collinearity; age, HF, AF, COPD, VTE, and CKD were associated with mortality. CONCLUSION: Key risk factors of mortality are CVDs and CKD indicating that the primary step of management should focus on optimizing risk factors to prevent diabetes complications and death.

Predictors of short-term mortality after rheumatic heart valve surgery: A single-center retrospective study.

BACKGROUND: Valve replacement surgeries holds risks of morbidity and mortality. MATERIALS AND METHODS: The study cohort included 346 patients who underwent different types of valve surgery, excluding redo and Bentall operations. All operations were performed through a median sternotomy using cardiopulmonary bypass. RESULTS: Mean patient age was 51.6 ± 16.1 years, and 51% were male. Approximately 21% had diabetes, and 44.6% were hypertensive. Aortic valve replacement (AVR) was performed in 125 patients (37%), mitral valve replacement (MVR) in 95 (28%), combined AVR and MVR in 42 (13%), AVR plus coronary artery bypass grafting (CABG) in 19 (6%), and MVR plus CABG in 32 (10%). Operative mortality was 5.8% (n = 20). In the bivariate-level analysis, older age, operation type, hypertension, emergency surgery, use of a biological valve in the aortic or mitral position, pump time greater than 120 min, and aortic clamp time greater than 60 min were significant predictors of 30-day mortality. Use of medications stratified by duration (less than or more than a month) was also shown to be a predictor of mortality. Use of angiotensin-converting enzyme inhibitors, digoxin, beta-blockers, statins, and loop diuretics was associated with mortality. Older age, emergency/salvage surgery, use of beta-blockers for less than 1 month preoperatively, and use of a biological valve in the aortic position were significant and independent predictors of 30-day mortality. CONCLUSION: Age, emergency valve surgery, use of a biological valve, use of beta-blockers for less than 1 month before surgery, type of surgery, EF<35%, pump time, and cross clamp time were all found to be independent predictors of mortality in patients undergoing valve surgery. Further prospective multicenter studies may be needed to provide a comprehensive assessment of mortality in patients undergoing valve surgery in Jordan.

Predictors of Acute Kidney Injury Following Surgical Valve Replacement.

BACKGROUND: Acute kidney injury is a serious complication after surgical valve replacement and holds increased mortality rates. OBJECTIVES: To study predictors of acute kidney injury after surgical valve replacement. MATERIALS AND METHODS: Patients who underwent valve surgery procedures at our center were included. Procedures included aortic valve replacement (AVR), mitral valve replacement (MVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with/without CABG. RESULTS: A total of 346 patients were included. The mean age was 51.56 (16.1). Males (n = 178) comprised 51%.At the univariate level analysis, predictors of acute kidney injury were found including age, ejection fraction, hypertension, history of CAD, emergency surgery, recent myocardial infarction, diabetes, atrial fibrillation, history of heart failure, mitral regurgitation (MR), pump time >120 minutes, aortic cross clamp >90 minutes, perioperative blood transfusion, re-exploration for bleeding, use of mechanical and biologic valve in aortic position, use of biologic valve in mitral position, prolonged inotropic support, postoperative stroke, and use of angiotensin converting enzyme inhibitors (ACEi) < a month, (all p < 0.05).By Logistic regression analysis, Age (p < 0.0001, odds ratio[AOR] = 1.076), hypertension (p = 0.039, AOR = 1.829), heart failure (p = 0.019, AOR = 2.448), MR (p = 0.0001, AOR = 3.110), use of ACEi 120 minutes (p = 0.022, AOR = 1.797), perioperative blood transfusion (p = 0.008, AOR = 2.532), and prolonged inotropic support (p = 0.012, AOR = 2.591) were significant and independent predictors of AKI. CONCLUSION: Independent predictors of acute kidney injury following valve surgeries include age, hypertension, heart failure, MR, use of ACEi

Comparison of the cardiac effects of electronic cigarette aerosol exposure with waterpipe and combustible cigarette smoke exposure in rats.

AIMS: Electronic cigarette (ECIG) has been used as an alternative to tobacco smoking as it lacks the majority of toxicants found in tobacco smoke. However, the effect of ECIG aerosol inhalation on cardiac health are not well studied. The present study aimed to compare the effects of ECIGs with that of combustible tobacco cigarette (T-Cigs) and waterpipe (WP) smoke on cardiac biomarkers of oxidative stress, inflammation, and fibrosis. MAIN METHODS: Rats were randomized into control (fresh air, n = 12), ECIG aerosol (n = 12), T-Cig smoke (n = 15), or WP (n = 13) smoke conditions in which they were exposed 1 h/daily, 6 day/week for 4 weeks. Cardiac biomarkers of oxidative stress, inflammation, and remodeling were assessed. KEY FINDINGS: Relative to control, significant increase in heart to body weight ratio was observed in all exposed groups. Cardiac endothelin-1 and myeloperoxidase were increased for ECIG and T-Cig. Cardiac nitrite and TBARS were increased in all exposed groups, but activity of superoxide dismutase was increased for ECIG and T-Cig only while glutathione levels increased for ECIG only. No changes were observed for cardiac C-reactive protein and catalase activity. Cardiac fibrosis was observed in all exposed groups coupled with an increase in the transforming growth factor beta protein that was significant for ECIG only. SIGNIFICANCE: ECIG aerosol may promote cardiac alterations in similar manner to tobacco smoke by promoting myocardial oxidative stress and inflammation leading to fibrosis. With regard to cardiac health, exposure to ECIG aerosol and combustible T-Cig smoke may lead to similar adverse outcomes.

Edaravone protects from memory impairment induced by chronic L-methionine administration.

Hyperhomocysteinemia is a well-known cause of cognitive impairment and neurodegeneration. Increased oxidative stress in the brain has a major possible role in hyperhomocysteinemia-induced pathogenesis. Edaravone is a potent free radical scavenger that has a neuroprotective effect against memory impairment in several experimental models. The current study investigated the possible protective effect of edaravone in L-methionine-induced vascular dementia in a rat model. L-methionine was given (1.7 mg/kg/day) through oral gavage, while edaravone was given (6 mg/kg/day) intraperitoneally. The administration of methionine and edaravone started concomitantly and continued for a total of 9 weeks. Spatial learning and memory were assessed using the radial arm water maze (RAWM). Changes in the oxidative stress-related biomarkers in the hippocampus were assessed using enzymatic assays. Chronic L-methionine administration resulted in short-term and long-term memory impairment, whereas edaravone prevented such effect. Furthermore, edaravone ameliorated L-methionine induced decrease in the activity of the antioxidant enzymes catalase and glutathione peroxidase as well as the ratio of reduced glutathione to oxidized glutathione (GSH/GSSG ratio). Edaravone also prevented increase in the oxidized glutathione (GSSG) secondary to chronic L-methionine administration. In conclusion, the current study suggests that memory impairment and oxidative stress secondary to chronic L-methionine administration can be prevented by edaravone, probably via enhancing antioxidant mechanisms in the hippocampus.

The CHRNA5 Polymorphism (rs16969968) and its Association with Waterpipe Smoking Addiction among Jordanians.

Waterpipe smoking is a form of tobacco use that causes nicotine/tobacco dependence and has become a global health problem. In the current study, the association of rs16969968 SNP in the CHRNA5 gene with waterpipe dependence was investigated. A total of 386 men and women who used a waterpipe to smoke tobacco were recruited and divided into less dependent and more dependent smokers based on their score on the Lebanon Waterpipe Dependence Scale (LWDS). Results showed a significant difference in the distribution of GG, GA, and AA genotypes by waterpipe dependence status (P<0.001). The more dependent group showed a higher frequency of the AA genotype than the less dependent smokers' group (38% versus 23% respectively). In addition, the more dependent smokers exhibited more A allele than less dependent smokers (53% versus 37% respectively, P<0.001). In conclusion, there is an association between the rs16969968 SNP and waterpipe dependence as assessed by the LWDS.

The Impact of Spironolactone on Markers of Myocardial Oxidative Status, Inflammation and Remodeling in Hyperthyroid Rats.

BACKGROUND: Hyperthyroidism promotes the development and progression of cardiovascular diseases (CVD). Aldosterone, a key mediator of myocardial inflammation, oxidative stress and fibrosis, may be activated in hyperthyroidism. OBJECTIVE: To assess the impact of hyperthyroidism on aldosterone levels and myocardial oxidative status, inflammatory and fibrotic markers in hyperthyroid rats, and to test if the use of spironolactone (an aldosterone antagonist) attenuates these changes. METHODS: Adult Wistar rats were randomly distributed into 4 groups; controls, spironolactone treated rats (Spir, 50mg/kg/day), hyperthyroid rats (Hyper, daily intraperitoneal levothyroxine 0.3mg/kg/day), and spironolactone treated hyperthyroid rats (Hyper+Spir) for 4 weeks. Blood pressure (Bp), and levels of serum and myocardial aldosterone, oxidants/antioxidants, inflammatory and fibrotic markers were measured. RESULTS: Levothyroxine increased serum thyroid hormones and increased Bp, heart rate and heart to bodyweight ratio. Relative to control, serum aldosterone levels were increased in Hyper and Hyper+ Spir groups. In parallel, cardiac lipid peroxides and serum endothelin-1 were increased whereas cardiac superoxide dismutase, catalase, glutathione, and matrix metalloproteinase -2 were reduced in the Hyper group. Spironolactone decreased serum thyroid hormones and improved cardiac lipid peroxides and metalloproteinase -2 levels. The use of spironolactone decreased serum nitrite levels and increased cardiac SOD and glutathione. Cardiac levels of aldosterone, endothelin-1, transforming growth factor-beta and nitrite were similar among all groups. CONCLUSION: Hyperthyroid status was associated with an increase in aldosterone and oxidant/ inflammatory biomarkers. The use of spironolactone enhanced antioxidant defenses. Aldosterone antagonists may serve as potential drugs to attenuate the development of cardiac disease in hyperthyroidism.

Impact of cigarette smoking on kidney inflammation and fibrosis in diabetic rats.

Background: Cigarette smoking is a very common habit worldwide contributing to risk of kidney dysfunction and diabetes (DM). However, the mechanisms are unclear. Aim: The goal of the present study was to assess the effects of cigarette smoking on kidney oxidative stress, inflammation, and remodeling in streptozotocin (STZ) rat model of diabetes. Methods: Rats were randomized into control (intraperitoneal (i.p.) citrate buffer injection and exposure to fresh air), cigarette smoking (1 h daily for 6 d/week, citrate buffer), DM (single dose STZ 35 mg/kg i.p. and exposure to fresh air), and DM + smoking groups for a period of 4 weeks. Kidney biomarkers of inflammation, oxidative stress, and remodeling were measured. Results: A significant increase in kidney to body weight ratio was observed in diabetic groups. Diabetes but not smoking increased blood urea nitrogen levels without changes in creatinine levels. Kidney levels of thiobarbituric acid substances, nitrite, endothelin-1, and C-reactive protein were increased significantly in the DM + smoking groups. Smoking induced GSH expression and activity of superoxide dismutase. A significant increase in kidney fibrosis was observed in the DM + smoking group coupled with a similar increase in transforming growth factor beta. Protein levels of matrix metalloproteinase-2, (MMP-2), mitogen-activated protein kinases, and c-Jun N terminal kinase were elevated in Smoking and DM + smoking groups. Conclusion: Cigarette smoke might promote risk of kidney dysfunction in DM by augmentation of renal inflammation, oxidant radicals and fibrosis. The kidney promotes compensatory increase in MMP-2 in response to smoking probably to prevent pro-fibrotic factors induced-fibrosis.

Omega-3 fatty acids protects against chronic sleep-deprivation induced memory impairment.

AIMS: The current study aims to evaluate the possible protective effect of omega-3 fatty acids on memory impairment induced by sleep-deprivation in rats. MATERIALS AND METHODS: Animals were chronically sleep deprived using the modified multiple platform model (8 h/day for 8 weeks). Omega-3 fatty acids were administered as fish oil via oral gavage at a daily dose of 100 mg omega-3 PUFA/100 g BWT. The spatial learning and memory were evaluated using the radial arm water maze (RAWM). Additionally, the following oxidative stress biomarkers were measured in the hippocampus: glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG, glutathione peroxidase (GPx), catalase, superoxide dismutase (SOD), and thiobarbituric acid reactive substance (TBARS). KEY FINDINGS: Animals in the SD group committed significantly more errors in both short- and long- term memory tests of the RAWM compared to other groups. On the other hand, animals that were sleep deprived and treated with omega-3 fatty acids committed similar number of errors compared to the control group. This indicates that SD impaired both short- and long- term memories, and that chronic omega-3 fatty acids administration prevented these effects. Omega-3 fatty acids also prevented the decreases in hippocampal GPx, catalase and GSH/GSSG ratio and normalized the increases in GSSG levels, which were impaired by SD model. No changes were observed on hippocampal TBARS levels, or activity of SOD among experimental groups. SIGNIFICANCE: In conclusion, a protective effect of omega-3 fatty acids administration has been observed against chronic SD-induced memory impairment probably via improving hippocampus antioxidant effects.

Vitamin E modifies high-fat diet-induced reduction of seizure threshold in rats: Role of oxidative stress.

There is increasing evidence that oxidative stress is a causal factor in different neurodegenerative disorders such as Alzheimer's disease and epilepsy. High-fat diet (HFD) has been shown to induce oxidative stress and neuronal damage that may increase susceptibility to seizures. The present study was undertaken to investigate the relationships between vitamin E, a potent antioxidant, HFD, and chemically induced seizures, using the PTZ seizure model in rats. Animals were randomly assigned into four groups: control, HFD, vitamin E (Vit E), and high-fat diet with vitamin E (HFD + Vit E) group. Vitamin E and/or HFD were administered to animals for 6 weeks. Thereafter, PTZ seizure threshold was measured in control and treated rats, and different brain regions were analyzed for levels of oxidative stress biomarkers. Current results revealed a significant reduction in PTZ seizure threshold in rats consuming HFD, which could be prevented by vitamin E supplement. Alongside, vitamin E supplement prevented HFD induced changes in oxidative stress biomarkers and capacity enzymes. Therefore, current results suggest that prolonged consumption of HFD increases susceptibility to PTZ induced seizures, which may be related to HFD induced oxidative stress. This increase in the PTZ susceptibility could be prevented by the administration of vitamin E, probably through its antioxidant effect, particularly at the brain hippocampal region.

Omega-3 Fatty Acids Prevent Post-Traumatic Stress Disorder-Induced Memory Impairment.

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can happen after exposure to a traumatic event. Post-traumatic stress disorder is common among mental health disorders that include mood and anxiety disorders. Omega-3 fatty acids (OMGs) are essential for the maintenance of brain function and prevention of cognition dysfunctions. However, the possible effect of OMG on memory impairment induced by PTSD has not been studied. In here, such an effect was explored using a rat model of PTSD. The PTSD-like behavior was induced in animals using a single-prolonged stress (SPS) rat model of PTSD (2 h restraint, 20 min forced swimming, 15 min rest, 1⁻2 min diethyl ether exposure). The OMG was administered orally at a dose of 100 mg omega-3 polyunsaturated fatty acid (PUFA)/100 g body weight/day. Spatial learning and memory were assessed using the radial arm water maze (RAWM) method. Changes in oxidative stress biomarkers, thiobarbituric acid reactive substances (TBARS), and brain derived neuroptrophic factor (BDNF) in the hippocampus following treatments were measured. The results revealed that SPS impaired both short- and long-term memory (p < 0.05). Use of OMG prevented memory impairment induced by SPS. Furthermore, OMG normalized SPS induced changes in the hippocampus that reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG ratios, the activity of catalase, glutathione peroxidase (GPx), and TBARSs levels. In conclusion, the SPS model of PTSD-like behavior generated memory impairment, whereas OMG prevented this impairment, possibly through normalizing antioxidant mechanisms in the hippocampus.

Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes.

BACKGROUND: The limited implementation of clinical pharmacy service programs and the lack of studies identifying barriers to achieve blood glucose control have all attributed to the increased proportion of type 2 diabetes patients who have poor glycemic control in Jordan. OBJECTIVE: To explore factors associated with higher HbA1c in patients with type 2 diabetes in Jordan. METHODS: Variables including socio-demographics, disease and treatment factors were collected from171 patients with type2 diabetes at an outpatient diabetes clinic in Amman. Validated questionnaires were used to assess medication adherence, self-care activities, diabetes knowledge and healthrelated quality of life in addition to data collected from medical records. After the single-predictor analysis, stepwise linear regression was performed to develop a model with variables that best predicted hemoglobin A1c. RESULTS: Medication adherence was inversely associated with HbA1c values (ß = -0.275; t = 2.666; P < 0.01), indicating better glycemic control. Receiving insulin therapy was also associated with less HbA1c values and better glycemic control (ß = - 0.184; t = 2.080; P < 0.05). Patients who had one or more comorbid conditions (ß = 0.215; t = 2.264; P < 0.05) and those with longer diabetes duration (ß = 0.092; t = 1.339; P < 0.05) were found to have significantly higher HbA1c values. CONCLUSION: Emphasizing medication adherence, particularly for patients with longer duration of diabetes and those with multiple comorbid diseases should be strongly considered in future diabetes management programs implemented to improve glycemic control in patients with type 2 diabetes.

Plasma endothelin-1 levels are increased in atrial fibrillation patients with hyperthyroidism.

BACKGROUND: Endothelin-1 (ET-1) is a potent vasoconstrictor, mitogen and inflammatory factor that may contribute to development of atrial fibrillation (AF). Plasma ET-1 levels are increased in hyperthyroid patients, but studies evaluating its relation to AF development in hyperthyroid patients are lacking. OBJECTIVE: The present study seeks to evaluate the relation of plasma ET-1 to AF development as a function of thyroid status. METHODS: Blood samples from euthyroid patients (n = 41), hypothyroid (n = 61), hyperthyroid (n = 41), AF with hyperthyroidism (n = 9), and euthyroid AF (n = 10) patients were collected. Plasma ET-1, CRP, and thyroid hormone levels were measured and compared between groups. RESULTS: Plasma ET-1 levels were higher in hyperthyroid and euthyroid AF patients> hyperthyroid-non-AF > hypo and euthyroid non-AF patients. Plasma ET-1 levels positively correlated with free T3 and T4 levels, and negatively with TSH levels. By multivariate analysis, plasma ET-1 was positively associated with AF, hyperthyroidism, and age. Plasma CRP did not vary by study group in either univariate or multivariate analyses. CONCLUSION: Plasma ET-1 is associated with AF, elevated in hyperthyroid patients and positively correlated with thyroid hormone levels, suggesting that hyperthyroidism may increase ET-1 expression and release. This study may guide development of novel predictors of AF associated with hyperthyroidism, and may help to personalize therapy in hyperthyroid patients.

Vitamin D as potential antidepressant in outpatients with musculoskeletal pain
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OBJECTIVE: To determine the incidence of vitamin D deficiency, anxiety, and depression disorders in an outpatient population with musculoskeletal pain (MSP), and to evaluate the effects of correcting a vitamin D deficiency on MSP and psychological symptoms. MATERIALS AND METHODS: A total of 261 outpatients with MSP and 100 controls were involved. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological symptoms. Serum vitamin D was measured. Outpatients with vitamin D insufficiency and deficiency received oral vitamin D supplementation. Pain severity and psychological symptoms were evaluated before and after vitamin D supplementation plus dairy products. RESULTS: Vitamin D deficiency was found in 88.7% of participants in the MSP group and 69% of controls. Clinical anxiety was reported by 38.3% of participants in the MSP group and 9% of controls, while clinical depression was reported by 31.8% of participants in the MSP group and 2% of controls. Multisite pain was significantly and positively associated with anxiety, depression, and pain severity, and was inversely associated with daily calcium intake. Anxiety was inversely associated with vitamin D level, daily calcium intake, and age. A similar pattern was observed for depression. MSP was the most significant independent predictor of anxiety (OR = 7.84) and depression (OR = 5.89). Relative to baseline, all measured outcome parameters significantly improved after vitamin D supplementation plus increased intake of dairy products. CONCLUSION: Low serum vitamin D is associated with MSP along with low calcium intake, depression, and anxiety. Supplementation with vitamin D improved MSP and associated disorders.
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