Oxidative stress-related genetic variation and antioxidant vitamin intake in intact and ruptured abdominal aortic aneurysm: a Swedish population-based retrospective cohort study.

AIMS: The aim of this study is to investigate how genetic variations in genes related to oxidative stress, intake of antioxidant vitamins, and any potential interactions between these factors affect the incidence of intact abdominal aortic aneurysm (AAA) and its rupture (rAAA), accounting for sex differences where possible. METHODS AND RESULTS: The present retrospective cohort study (n = 25 252) uses baseline single-nucleotide polymorphisms (SNPs) and total antioxidant vitamin intake data from the large population-based, Malmö Diet and Cancer Study. Cumulative incidence of intact AAA was 1.6% and of rAAA 0.3% after a median follow-up of 24.3 years. A variant in NOX3 (rs3749930) was associated with higher rAAA risk in males [adjusted hazard ratio (aHR): 2.49; 95% confidence interval (CI): 1.36-4.35] and the overall population (aHR: 1.88; 95% CI: 1.05-3.37). Higher intakes of antioxidant vitamins, riboflavin, and folate were associated with 20% and 19% reduced intact AAA incidence, respectively. Interestingly, the inverse associations between riboflavin and vitamin D intake with intact AAA incidence were stronger in the individuals carrying the NOX3 variant as compared with the wild-type recessive genotype, i.e. by 60% and 66%, respectively (P for interaction < 0.05). Higher riboflavin intake was associated with a 33% male-specific intact AAA risk reduction, while higher intake of vitamin B12 intake was associated with 55% female-specific intact AAA risk increase; both these associations were significantly modified by sex (P for interaction < 0.05). CONCLUSIONS: Our findings highlight the role of oxidative stress genetic variations and antioxidant vitamin intake in AAA. Although a low AAA/rAAA sample size limited some analyses, especially in females, our findings highlight the need for future randomized controlled trials and mechanistic studies, to explore the potential benefits of antioxidant vitamins while accounting for genetic and sex differences.

Abdominal aortic aneurysm (AAA) is an old age-related disease with lethal complication in the form of rupture (rAAA). Present study aimed to understand how genetic variations in oxidative stress­related genes and the intake of antioxidant vitamins influence the risk of AAA and rAAA. The study identified specific genetic differences associated with an increased risk of rAAA. Interestingly, higher intakes of riboflavin and folate were linked to a reduced risk of AAA. Interestingly, we observe that both genetics and sex modify the effect of vitamin intake on intact AAA risk, providing new insight into the individual differences in the benefits of vitamins. Although the low sample for rAAA and females limits some conclusions, the findings emphasize the need for future randomized controlled trials to explore the potential benefits of antioxidant vitamins while accounting for genetic and sex differences.

Role of Yoga in Minimizing Stress and Anxiety in Women Experiencing Dysmenorrhea.

Primary dysmenorrhea is characterized by recurring, crampy lower abdominal pain occurring during menstruation in the absence of pelvic pathology. It is the most common gynaecological complaint among adolescents. According to the literature, young females with primary dysmenorrhea experience stress, anxiety, lower-back pain, and depression. Yoga is widely practiced to improve health and promote relaxation. It includes breath regulation, simple meditation, and practicing particular body postures. Regular Yoga practice can serve as an adjunct to the primary treatment of dysmenorrhea symptoms. This study focuses on the impacts and benefits of yoga in young females with dysmenorrhea and associated physiological changes.

Dietary and Physical Exercise Facilitation for Cardiovascular Health in Indian Subcontinent.

The advent of industrialization and outburst of urbanization significantly influences the lifestyle of people. Further, the incidence of noncommunicable diseases, such as chronic lung conditions, cancer, cardiovascular diseases (including conditions affecting the heart and blood vessels), diabetes, hypertension, and obesity, has increased. The prevalence of cardiovascular diseases in India in 2016 was reported to be 54.5 million. One out of four deaths was associated with cardiovascular diseases. With time, the prevalence of cardiovascular diseases is exerting more impact on the younger Indian population aged 20-29 years. The foremost risk factors for disability-adjusted life-years include poor dietary habits, tobacco use, and low physical activity. A healthy diet and an optimum physical activity level should be projected as primary interventions for noncommunicable diseases in the Indian subcontinent. Government health organizations and associations should concentrate and prioritize the current situation and scale up cost-effective policies and innovative techniques with interventional research and funding, especially on diet and exercise facilitation, as comprehensive management toward minimizing cardiovascular diseases to safeguard Indian economy's future.

Mitochondrial heteroplasmic shifts reveal a positive selection of breast cancer.

BACKGROUND: Breast cancer is, despite screening, not always detected early enough and is together with other tumor types known to shed genetic information in circulation. Unlike single-copy nuclear DNA, mitochondrial DNA (mtDNA) copies range from 100s to 10,000s per cell, thus providing a potentially alternative to identify potential missing cancer information in circulation at an early stage. METHODS: To characterize mitochondrial mutation landscapes in breast cancer, whole mtDNA sequencing and bioinformatics analyses were performed on 86 breast cancer biopsies and 50 available matched baseline cancer-free whole blood samples from the same individuals, selected from a cohort of middle-aged women in Sweden. To determine whether the mutations can be detected in blood plasma prior to cancer diagnosis, we further designed a nested case-control study (n = 663) and validated the shortlisted mutations using droplet digital PCR. RESULTS: We detected different mutation landscapes between biopsies and matched whole blood samples. Compared to whole blood samples, mtDNA from biopsies had higher heteroplasmic mutations in the D-loop region (P = 0.02), RNR2 (P = 0.005), COX1 (P = 0.037) and CYTB (P = 0.006). Furthermore, the germline mtDNA mutations had higher heteroplasmy level than the lost (P = 0.002) and de novo mutations (P = 0.04). The nonsynonymous to synonymous substitution ratio (dN/dS) was higher for the heteroplasmic mutations (P = 7.25 × 10-12) than that for the homoplasmic mutations, but the de novo (P = 0.06) and lost mutations (P = 0.03) had lower dN/dS than the germline mutations. Interestingly, we found that the critical regions for mitochondrial transcription: MT-HSP1 (odds ratio [OR]: 21.41), MT-TFH (OR: 7.70) and MT-TAS2 (OR: 3.62), had significantly higher heteroplasmic mutations than the rest of the D-loop sub-regions. Finally, we found that the presence of mt.16093T > C mutation increases 67% risk of developing breast cancer. CONCLUSIONS: Our findings show that mitochondrial genetic landscape changes during cancer pathogenesis and positive selection of mtDNA heteroplasmic mutations in breast cancer. Most importantly, the mitochondrial mutations identified in biopsies can be traced back in matched plasma samples and could potentially be used as early breast cancer diagnostic biomarkers.

The Parental Stress Scale: Validity and Reliability of Gujarati Translated Version in Parents of Children with Cerebral Palsy.

Background: The parental Stress Scale (PSS) is an 18 item self-report scale that indicates positive (e.g., emotional benefits, personal development) and negative (demands on resources, restrictions) themes of parenthood. This study was aimed to study the reliability and validity of the Gujarati version of PSS (PSS-G) by a study performed among parents of children with Cerebral Palsy (CP). Methods: In total, 152 parents of children with CP were assessed for evaluation of stress using the Gujarati version of PSS and the English version of the Parenting Stress Index- Short form. Concurrent validity was evaluated using Pearson's correlations, internal consistency was evaluated using Cronbach's alpha, and test-retest reliability was evaluated using the intraclass correlation coefficient value. Results: The scales of the PSS-G revealed high internal consistency (i.e., Cronbach's α = 0.923) and the intraclass correlation coefficient value for test-retest reliability of 0.987. Moreover, Pearson's correlation coefficient also supports the concurrent validity of PSS-G for parents of children with CP. Conclusion: The PSS-G is a valid and reliable outcome measure to evaluate parental stress in parents of children with CP. As the robust psychometric properties of PSS-G is already established, research can be performed to extend its utility and routine use in clinical and public health settings.

Evaluation of Mental Health and Quality of Life among Indian Professionals Embarked as COVID-19 Survivors.

Background: Government guidelines for lockdown and quarantine measures impacted the daily lives and health of individuals amid the coronavirus disease 2019 (COVID-19) pandemic. The pandemic caused significant changes in the daily routine and lifestyles of individuals worldwide with the simultaneous emergence of mental health disorders. Stress caused by COVID-19 pandemic outbreaks and consequent social isolation significantly influenced the mental health and quality of life of professionals among Indian population. This study aimed to evaluate the mental health and quality of life among Indian professionals embarked as COVID-19 survivors. Methods: A 20-item self-administered questionnaire was developed and circulated among the participants with the following domains: helplessness, apprehension, mood swing, physical activity, restlessness, insomnia, irritation, mental stress, and emotional instability to assess their mental health and quality of life. Results: Of the total 322 participants, 73.6% of individuals experienced helplessness, 56.2% felt the need for counseling, 65.5% reported feeling irritated even over minor issues, 62.1% experienced negative thoughts during isolation, 76.5% experienced difficulty in falling asleep, and 71.9% felt restless during their course of illness. Conclusion: The study concludes that mental health and quality of life among COVID-19 survivors was affected by sleep, physical activities, emotional instability, and job profile, as well as support from others, mood swings, and the need for counseling.

Characterization of the Mitochondrial Genetic Landscape in Abdominal Aortic Aneurysm.

Background Abdominal aortic aneurysm (AAA) is a vascular disease with a mortality rate of >80% if ruptured. Mitochondrial dysfunction has been previously implicated in AAA pathogenesis. In this study, we aimed to characterize the mitochondrial genetic landscape in AAA. Methods and Results Whole mitochondrial genome sequencing and bioinformatics analysis were performed in comorbidity matched 48 cases without AAA and 48 cases with AAA, objectively diagnosed, and selected from a cohort of 65-year-old men recruited for a screening program. We identified differential mutational landscapes in men with and without AAA, with errors in mitochondrial DNA replication or repair as potential sources. Heteroplasmic insertions and overall heteroplasmy of structural rearrangements were significantly elevated in AAA cases. Three heteroplasmic variants were associated with risk factors of AAA: leukocyte concentration, plasma glucose, and cholesterol levels, respectively. Interestingly, mutations were more prevalent in regulatory part of the mitochondria, the displacement loop region, in AAA as compared with controls (P value <0.05), especially in the conserved and critical mitochondrial extended termination-associated sequence region. Moreover, we report a novel 24 bp mitochondrial DNA duplication present exclusively in cases with AAA (4%) and 75% of the unmatched AAA biopsies. Finally, the haplogroup cluster JTU was overrepresented in AAA and significantly associated with a positive family history of AAA (odds ratio, 2.9 [95% CI, 1.1-8.1]). Conclusions This is the first study investigating the mitochondrial genome in AAA, where important genetic alterations and haplogroups associated with AAA and clinical risk factors were identified. Our findings have the potential to fill in gaps in the missing genetic information on AAA.

Recent Advances in Chest Rehabilitation during COVID-19 Outbreak: A Systematic Review.

Background: The current COVID-19 pandemic has brought the entire world to a halt, resulting in illness, death, and changes in individual roles. Physical therapy and chest rehabilitation play a critical role following aftermath of pandemics. Methods: PubMed, Google Scholar, PEDro, MEDLINE were searched for randomized controlled trials. Methodological quality was assessed independently by two authors using PEDro scale. Data for disability, chest physical functions and adverse effects were analyzed. Results: A meta-analysis was not possible due to the heterogeneity of the studies included for review. After applying the studies' inclusion and exclusion criteria, a total of eight articles with 420 patients were included in the study for their detailed analysis. Two independent authors verified and screened the data, with the third author double-checked and searched for additional articles. Conclusion: Findings revealed that chest rehabilitation approaches influence the clinical condition of people during COVID-19 outbreak resulting in improved condition stabilization and recovery, the consequent reduction in hospitalization period and improved health-related quality of life.

Mitochondrial DNA Copy Number: Linking Diabetes and Cancer.

Recent Advances: Various studies have suggested that mitochondrial DNA copy number (mtDNA-CN), a surrogate biomarker of mitochondrial dysfunction, is an easily quantifiable biomarker for chronic diseases, including diabetes and cancer. However, current knowledge is limited, and the results are controversial. This has been attributed mainly to methodology and study design. Critical Issues: The incidence of diabetes and cancer has increased significantly in recent years. Moreover, type 2 diabetes (T2D) has been shown to be a risk factor for cancer. mtDNA-CN has been associated with both T2D and cancer. However, it is not known whether mtDNA-CN plays any role in the association between T2D and cancer. Significance: In this review, we have discussed mtDNA-CN in diabetes and cancer, and reviewed the literature and methodology used in published studies so far. Based on the literature review, we have speculated how mtDNA-CN may act as a link between diabetes and cancer. Furthermore, we have provided some recommendations for reliable translation of mtDNA-CN as a biomarker. Future Directions: Further research is required to elucidate the role of mtDNA-CN in the association between T2D and cancer. If established, early lifestyle interventions, such as physical activity and diet control that improve mitochondrial function, may help preventing cancer in patients with T2D. Antioxid. Redox Signal. 37, 1168-1190.

Physical Exercises in Combination with Botulinum Toxin in Treating Children with Cerebral Palsy: A Literature Review.

Background: Botulinum Toxin type-A (BoNT-A) is a safe and effective treatment for reducing spasticity in children with cerebral palsy (CP). BoNT-A injection into the muscles alleviate spasticity by interrupting neurotransmission at motor endplate (MEP). Physical activities combined with botulinum injections can help children with CP to become physically independent and improve their health-related quality of life. Methods: 'Botulinum toxin' and 'Physical exercises' for children and adolescents, were searched in three major online databases (PubMed, Science Direct, and Scopus). Through the inclusion and exclusion processes from total 1,233, nine articles were selected for review. Results: All studies included were experimental trials including various interventions. Botulinum toxins when paired with physical exercises to treat hypertonia, a condition in which a little change in tone can affect a child's balance, strength and motor function, as well as secondary concerns such as malalignment and repair contractures. Conclusion: BoNT and physical exercises are two promising therapeutic techniques for treating children with CP that enable them for enhancing use and function of their afflicted limb.

Effect of Resistance Training on Body Composition, Hemodynamic Parameters and Exercise Tolerance among Patients with Coronary Artery Disease: A Systematic Review.

BACKGROUND: Effectiveness and safety of Resistance Training in treating various Cerebrovascular Disease diagnoses have drawn attention in recent years. Patients suffering with coronary artery disease should be offered individually tailored Resistance Training in their exercise regimen. Resistance Training was developed to help individuals with their functional status, mobility, physical performance, and muscle strength. OBJECTIVE: The objective of this review was to collect, summarize and present information on the state of science focusing on usefulness, viability, safety and efficacy of Resistance Training in treating coronary artery disease and enhancing the aerobic capacity and improving overall health-related quality of life. METHODS: The review is prepared in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Searches were conducted in Cochrane Library, PubMed/MEDLINE, PEDro and Scopus database. PEDro scale was used for methodological quality assessment of included studies. Two independent reviewers determined the inclusion criteria of studies by classifying interventions based on core components, outcome measures, diagnostic population and rated the quality of evidence and strength of recommendations using GRADE criteria. RESULTS: Total 13 studies with 1025 patients were included for the detailed analysis. Findings emphasize the importance of assessing effectiveness and safety of Resistance Training in individuals with coronary artery disease. Patient specific designed exercise programs as Resistance Training targets at enhancing patients' exercise tolerance, improves hemodynamic response and muscular strength with reduction in body fat composition. CONCLUSION: Resistance Training is an effective exercise that should be incorporated to counteract the loss of muscle strength, muscle mass, and physiological vulnerability, as well as to combat the associated debilitating effects on physical functioning, mobility and overall independence and Quality of Life during rehabilitation of patients with coronary artery disease.

Eficácia da liberação do músculo iliopsoas sobre os parâmetros respiratórios em pacientes com dor lombar crônica: um protocolo de ensaio clínico controlado randomizado único cego, dois grupos, pré-teste/pós-teste / Efficacy of iliopsoas muscle release on respiratory parameters in patients with chronic low back pain: a single blinded, two- groups, pre-test/post-test randomized controlled trial protocol

OBJETIVO: Iliopsoas e o músculodiafragma compartilham fixação comum nas vértebras L2, a contração do iliopsoas pode levar à redução da excursão do diafragma levando à dificuldade respiratória. Portanto, o presente estudo controlado fornecerá evidências sobre o efeito da liberação do músculo iliopsoas na melhoria da eficiência respiratória em pacientes com dor lombar crônica. MÉTODO / DESENHO: Um total de trinta e quatro participantes com lombalgia crônica mecânica lombar crônica devido à rigidez dos flexores do quadril, dor lombar crônica e dificuldade respiratória serão recrutados com base nos critérios de seleção e serão alocados aleatoriamente em dois grupos, Grupo A (tratamento conservador + liberação miofascial iliopsoas), Grupo B (tratamento conservador + tratamento simulado). Ambos os grupos receberão a intervenção três vezes por semana durante 3 semanas. As medidas de resultado serão o Questionário de Incapacidade de Roland Morris, a Escala Numérica de Avaliação da Dor e a Capacidade de Difusão do Pulmão, pois o monóxido de carbono será usado como medidas de resultado. DISCUSSÃO: Este estudo ajudará a identificar a eficácia da liberação de iliopsoas na dor lombar e seu efeito nos parâmetros respiratórios. REGISTRO DO ENSAIO: Este ensaio foi registrado prospectivamente em cliniclatrials.gov (CTRI / 2020/04/024661), em 16 de abril de 2020.

BACKGROUND AND PURPOSE: Iliopsoas and diaphragm muscle share common attachment at L2 vertebrae, iliopsoas tightness may lead to reduce diaphragm excursion leading to breathing difficulty. Therefore, the present controlled trial will provide evidence on the effect of the iliopsoas muscle release in upgrading respiratory efficiency in patients with chronic low back pain. METHOD/DESIGN: A total of thirty-four participants with mechanical chronic low back pain due to hip flexor tightness and having breathing difficulty will be recruited based on selection criteria. It will be randomly allocated into Group A (conservative treatment + iliopsoas myofascial release), Group B (conservative treatment + sham treatment). Both the group will receive the intervention three times a week for three weeks. The outcome measures will be the Roland Morris Disability Questionnaire, Numeric Pain Rating Scale, and diffuse capacity of Lung for Carbon monoxide as outcome measures. DISCUSSION: This trial will help identify the effectiveness of iliopsoas release in low back pain and its effect on respiratory parameters. TRIAL REGISTRATION: This trial has been prospectively registered at cliniclatrials.gov (CTRI/2020/04/024661) on 16 April 2020.

Associations of global DNA methylation and homocysteine levels with abdominal aortic aneurysm: A cohort study from a population-based screening program in Sweden.

Abdominal aortic aneurysm (AAA) is a life-threatening condition with a mortality rate of over 80%. Persistent smoking, which is a risk factor for AAA, has lasting effects on DNA methylation. Moreover, a plasma-amino acid, homocysteine, previously implicated in vascular diseases, including aneurysms, has well-established biological association with methylation. In the present study, we aimed to determine the global DNA methylation, homocysteine levels and their association with AAA and its growth. Enzyme-linked immunosorbent assay (ELISA) was used to quantify global DNA methylation in whole blood-DNA samples and diagnostic enzymatic assay quantified plasma homocysteine, from 65-year old men with (n = 116) and without AAA (n = 230) diagnosed at ultrasound screening. We found significantly higher global DNA methylation (p < .001) and homocysteine levels (p < .001) in men with AAA compared to those without AAA, and direct linear associations with baseline aortic diameter. On multivariable regression analysis, global DNA methylation (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.1-2.9) and homocysteine levels (OR: 1.1; 95% CI:1.0-1.1) were positively associated with AAA, independent of smoking, medication use, and major co-morbidities. However, we did not find any significant association between DNA methylation or homocysteine levels with AAA growth during follow-up. We found that global DNA methylation and homocysteine levels are higher in men with AAA but are not associated with AAA growth. This indicates that different pathways and mechanisms may be involved in initiation and progression of AAA. More studies are needed to understand the precise role of DNA methylation, homocysteine and their interplay in AAA pathophysiology.