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Ischemic stroke has remained a principal cause of mortality and neurological disabilities worldwide. Blood flow resumption, reperfusion, in the cerebral ischemia prompts a cascade in the brain characterized by various cellular mechanisms like mitochondrial dysfunction, oxidative stresses, endoplasmic reticulum (ER) stress, and excitotoxicity, finally resulting in programmed cell death. Any changes in the ER-mitochondria axis are probably responsible for both the onset and progression of central nervous system diseases. Melatonin, a neurohormone secreted by the pineal gland, has antioxidative, anti-inflammatory, and anti-apoptotic properties. Most studies have shown that it exerts neuroprotective effects against ischemic stroke. It was observed that melatonin therapy after the stroke not only leads to reduce mitochondrial dysfunction but also cause to alleviate ER stress and inflammation. This review discusses the impact of melatonin on mitochondrial, ER function, and on the crosstalk between two organelles as a therapeutic target for stroke. Given that the influences of melatonin on each organelle separately, its effects on mechanisms of crosstalk between ER and mitochondria are discussed.

Sleep deprivation (SD) induces learning and memory deficits via inflammatory responses and oxidative stress. On the other hand, sericin (Ser) possesses potent antioxidant and neuroprotective effects. We investigated the effect of different doses of Ser on the SD-induced cognitive impairment. Ser (100, 200, and 300 mg/kg) was administered to animals via oral gavage for 8 days, 5 days before to SD, and during SD. SD was induced in mice using a modified multiple platform model, starting on the 6th day for 72 h. Spatial learning and memory were assessed using the Lashley III maze. Serum corticosterone level, and hippocampal malondialdehyde (MDA), total antioxidant capacity (TAC), and the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) enzymes were evaluated. The expression of growth-associated protein 43 (GAP-43), post-synaptic density-95 (PSD-95), synapsin 1 (SYN-1), and synaptophysin (SYP), and inflammation markers were detected by western blotting. SD caused cognitive impairment, while Ser pretreatment prevented such an effect. Serum corticosterone also increased with SD, but its levels were suppressed in SD mice receiving Ser. Furthermore, Ser normalized SD-induced reduction in the hippocampus activity of SOD and GPx, increased TAC, and decreased MDA levels. Besides, Ser pretreatment increased GAP-34, SYP, SYN-I, and PSD-95 and reduced IL1-β and TNF-α in the hippocampus. SD induced memory impairment and pretreatment with Ser improved memory via its antioxidant, anti-inflammation, and up-regulation of synaptic proteins in the hippocampus.

Iron-overload cardiomyopathy is the principal cause of mortality in thalassemia. Via feature-tracking cardiac magnetic resonance (FT-CMR), we investigated alterations in cardiac deformation with the progression in myocardial iron overload (MIO). We enrolled 154 patients with thalassemia (50.64% male, mean age = 32.19 ± 9.79 years) referred for MIO assessment and 28 controls (50% male, mean age = 31.07 ± 4.35 years). Functional, strain, and T2* values were assessed in 4 study groups: no MIO (T2*20), mild-to-moderate MIO (T2* = 10-20), severe MIO (T2*10), and healthy controls. The recorded strain values were compared between the groups. The study groups were statistically significantly different vis-à-vis left ventricular (LV) global longitudinal strain (GLS) (F [3, 178] = 20.30), LV global radial strain (GRS) (F [3, 178] = 11.61), right ventricular (RV) GLS (F [3, 178]) = 5.32), RV global circumferential strain (GCS) (F [3, 178] = 26.02), and RVGRS (F [3, 178] = 16.86) (Ps 0.005). The post hoc test revealed that LVGLS, RVGCS, and RVGRS were different between patients with thalassemia but without MIO and the control group (Ps 0.001). A significant difference in LVGLS and LVGRS was detected between the T2*20 and 10 ≤ T2* ≤ 20 groups (Ps 0.05). The multivariate logistic regression analysis depicted LVGRS as the most robust predictor of MIO (T2* ≤ 20) (odds ratio = 0.920, 95% CI 0.886 to 0.955), which predicted MIO with a cutoff point of 31.16% or less (sensitivity = 62% and specificity = 80.77%). Biventricular FT-CMR values are impaired in patients with thalassemia even without MIO. With MIO progression, LV strain values are the first ones to be undermined. Notably, functional CMR indices are jeopardized late, only after severe iron deposition.

A subgroup of COVID‐19 patients with cardiac magnetic resonance imaging evidence of myocardial inflammation may exhibit subendocardial fibrosis, compatible with myocardial infarction, while epicardial coronary arteries are normal.

It has been documented that aging increases the risk of cardiovascular disease including myocardial ischemia/reperfusion (IR) injury and acute myocardial infarction. In this study, we aimed to investigate the individual or combined effects of nicotinamide mononucleotide (NMN) and melatonin (Mel) treatment on apoptotic markers, expression of SIRT3, and FOXO1, and infarct size of the aged myocardium subjected to IR injury. Sixty aged Wistar rats (22–24 months) were assigned to five groups including sham, IR, NMN+IR, Mel+IR, and NMN+Mel+IR (combination therapy). Isolated hearts were exposed to 30-min regional ischemia followed by 60-min reperfusion. NMN (100 mg/kg/day/i.p.) was injected every second day starting on day 28 before IR injury. Melatonin was added to the perfusion solution five minutes prior to and until 15 min after the start of reperfusion. The infarct size was assessed by computerized planimetry. The mRNA levels of SIRT3, FOXO1, and apoptotic genes Bax, Bcl-2, and Caspase-3 were estimated by real-time PCR. All treatments reduced infarct size as compared with the IR group. Melatonin and NMN upregulated the gene expression of Bcl‐2, SIRT3, and FOXO1 and downregulated the gene expression of Bax, and Caspase‐3, in comparison to the IR group. Also, the protein levels of SIRT3, quantified by Western blotting, were upregulated by the interventions. The effects of combination therapy were significantly greater than those of melatonin or NMN alone. These findings indicate that the combined administration of NMN and melatonin can protect the aged heart against IR injury by decreasing apoptosis and activating the SIRT3/FOXO1 pathway.

Unilateral absence of pulmonary artery is a rare congenital disorder that can remain asymptomatic until adulthood. Absence of left pulmonary artery (ALPA) has been reported in one‐third of these patients. We are the first to introduce an adult case of ALPA associated with partial anomalous pulmonary venous connection.

COVID‐19 affects the heart through various pathways. It can increase thrombotic complications that ultimately lead to myocardial infarction even in patients without a history of underlying heart disease.

The use of chemotherapy medicines for breast cancer (BC) has been associated with an increased risk of cardiotoxicity. In recent years, there have been growing interests regarding the application of cardiovascular magnetic resonance (CMR) imaging, a safe and noninvasive modality, with the potential to identify subtle morphological and functional changes in the myocardium. In this investigation, we aimed to review the performance of various CMR methods in diagnosing cardiotoxicity in BC, induced by chemotherapy or radiotherapy. For this purpose, we reviewed the literature available in PubMed, MEDLINE, Cochrane, Google Scholar, and Scopus databases. Our literature review showed that CMR is a valuable modality for identifying and predicting subclinical cardiotoxicity induced by chemotherapy. The novel T1, T2, and extracellular volume mapping techniques may provide critical information about cardiotoxicity, in addition to other CMR features such as functional and structural changes. However, further research is needed to verify the exact role of these methods in identifying cardiotoxicity and patient management. Since multiple studies have reported the improvement of left ventricular performance following the termination of chemotherapy regimens, CMR remains an essential imaging tool for the prediction of cardiotoxicity and, consequently, decreases the mortality rate of BC due to heart failure.

Objectives To achieve sustainable health development, health systems need to constantly enhance their efficiency, through for instance reducing waste of resources. This study aimed to measure the efficiency in producing health in Upper Middle-Income Countries (UMICs) with a focus on Iran. Method A modified data envelopment analysis (DEA)-based Malmquist Productivity Index (MPI) was used to assess the changes in health productivity. Panel data was extracted from databases of the World Health Organization and the World Bank for the period of 2009–2015. Results The efficiency score of 13% of countries was higher than 0.8, while the score of all countries was above 0.5. The average score of Iran performance was 0.791 during the period. On average, performance improved in 15 countries, while it declined in 20 countries during the study period. Conclusion Different countries have implemented various health reforms to improve efficiency. We envisage, policy makers in the UMICs locate their health system performance and plan to improve it in line with the local specifications, along with the global pathway towards universal health coverage and sustainable health development ultimately.

PURPOSE: Vildagliptin has been shown to prevent microvascular complications during diabetes. The aim of this research was to evaluate the antioxidant effects of vildagliptin in diabetic nephropathy. METHODS: The diabetes was induced in the animals by high-fat diet and intraperitoneal injection of 35 mg/kg streptozotocin. After diagnosis of diabetes, the vildagliptin (6 mg/kg/day) was orally administered for one month. The biochemical parameters of blood urea nitrogen, creatinine, insulin, and serum albumin were measured. The levels of stress oxidative markers were detected using spectrophotometry. RESULTS: Treatment with vildagliptin significantly diminished blood glucose, oxidative stress, and reduced creatinine as well as increased insulin secretion. In addition, the vildagliptin improved renal glomerular and tubule interstitial damages and reduced vascular lesions. CONCLUSIONS: The treatment with vildagliptin can be useful in controlling the renal complications of type 2 diabetes mellitus through inhibiting lipid peroxidation and increasing the antioxidant enzymes.

Given the fact that both melatonin and nicotinamide mononucleotide (NMN) act as pleiotropic agents in various age-related cognitive disorders, we aimed to investigate the effect of these compounds separately and together on the cognitive outcomes, mitochondrial function, and apoptosis in aged rats. Forty old and ten young (24 and 3 months old, respectively) male Wistar rats were randomly allocated into five groups: Young+Normal saline (NS), Aged+NS, Aged+Melatonin, Aged+NMN, and Aged+melatonin+NMN. Melatonin (10 mg/kg) and NMN (100 mg/kg) were administered, separately or in combination for 28 every other day in aged animals. The Barnes maze and novel object recognition test were used to assess spatial and episodic-like memories, respectively. Also, apoptosis and alterations in mitochondrial function including reactive oxygen species (ROS) and ATP levels as well as mitochondrial membrane potential were assessed in both prefrontal cortex (PFC) and hippocampus (HIP) regions. Behavioral results revealed that NMN and melatonin separately or in combination, alleviate aging-induced memory impairment. Moreover, agents’ co-administration declined mitochondrial dysfunction and apoptotic cell count both in PFC and HIP regions. The agents separately or in combination (more potent) could induce neuroprotective effect and improve learning and memory in aged animals.

Background: For many patients with neurological complaints, a non-enhanced brain computed tomography (CT) scan is the first workup. In some of these patients, there is no pathological finding. Anemia is a condition that can present with neurological symptoms without any imaging findings. The correlation of dural venous sinus density with hemoglobin (Hb) level has been shown in some recent studies. Objectives: This study aimed to propose a strategy to predict the level of Hb and investigate the possibility of underlying anemia based on dural venous sinus density to facilitate treatment. Patients and Methods: The CT scans of selected patients, who were referred to Faghihi Hospital in Shiraz, Iran, from October 2018 until February 2019, were reviewed in this study; the complete blood count (CBC) was measured for cases without any findings. The data of 78 patients, including CBC parameters and the mean Hounsfield unit (HU) in the superior sagittal sinus (SSS), torcula herophili (TH), and transverse sinuses (TS), were also analyzed. Results: A relatively strong direct linear correlation was found between the Hb level and HU. The Hb level was calculated based on the following formula: Hb level = 0.2 × SSS HU + 1.2 × sex factor - 0.01 × age (where sex factor is zero for females and one for males). Besides, measurement of the cutoff point for the mean HU of SSS, based on the ROC curve to predict anemia, showed that with SSS HU ≤ 50, anemia could be predicted with 84.62% sensitivity, 75.38% specificity, and 75.64% accuracy in the general population. Conclusion: A significant positive correlation was found between the Hb level and the mean HU of dural venous sinuses. Therefore, the level of Hb is predictable based on HU, and differential diagnoses are limited.

Objective. In hypertrophic cardiomyopathy (HCM), myocardial fibrosis is routinely shown by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging. We evaluated the efficacy of 2 novel contrast-free CMR methods, namely, diffusion-weighted imaging (DWI) and feature-tracking (FT) method, in detecting myocardial fibrosis. Methods. This cross-sectional study was conducted on 26 patients with HCM. Visual and quantitative comparisons were made between DWI and LGE images. Regional longitudinal, circumferential, and radial strains were compared between LGE-positive and LGE-negative segments. Moreover, global strains were compared between LGE-positive and LGE-negative patients as well as between patients with mild and marked LGE. Results. All 3 strains showed significant differences between LGE-positive and LGE-negative segments ( P < 0.001 ). The regional longitudinal and circumferential strain parameters showed significant associations with LGE ( P < 0.001 ), while regional circumferential strain was the only independent predictor of LGE in logistic regression models (OR: 1.140, 95% CI: 1.073 to 1.207, P < 0.001 ). A comparison of global strains between patients with LGE percentages of below 15% and above 15% demonstrated that global circumferential strain was the only parameter to show impairment in the group with marked myocardial fibrosis, with borderline significance ( P = 0.09 ). A review of 212 segments demonstrated a qualitative visual agreement between DWI and LGE in 193 segments (91%). The mean apparent diffusion coefficient was comparable between LGE-positive and LGE-negative segments ( P = 0.51 ). Conclusions. FT-CMR, especially regional circumferential strain, can reliably show fibrosis-containing segments in HCM. Further, DWI can function as an efficient qualitative method for the estimation of the fibrosis extent in HCM.

Introduction: North Khorasan province has one of the highest rates of hypertension. One of the main causes of hypertension is obesity. Obesity is one of the most important public health problems around the world as a risk factor for non-communicable diseases. Since a similar study was not conducted in Bojnurd, we examined the relationship between waist to hip ratio with hypertension. Methods: The present cross-sectional study was conducted on women referring to Bojnurd health centers. To analyze the data, we used t-test, chi-square, multiple logistic regression and Pearson correlation in Stata 12 software. Results: In this cross-sectional study, the prevalence of systolic blood pressure was 14.78% and diastolic blood pressure was 15.65%. So waist to the hips showed the highest correlation with the changes in hypertension. Conclusion: There are significant relationships between the age and the number of pregnancies with the risk of hypertension. Since a significant percentage of people are unaware of the existence of hypertension, changing diet and having regular physical activity along with social support is an important strategy.

The colon is partly controlled by myenteric and submucosal plexuses, which respond to stress and lead to some gastrointestinal disorders. These plexuses play roles in irritable bowel syndrome. Patients suffering from this syndrome can be treated with some antidepressants, including sertraline and nortriptyline. The primary aim of study was to compare the effect of a sertraline and a nortriptyline on the structural changes of the enteric neurons after stress exposure in both sexes. The secondary objectives were to evaluate the effects of stress on the submucosal and myenteric plexuses. Male and female Sprague-Dawley rats were assigned to four subgroups. The first subgroup received no stress. The other three subgroups received chronic variable stress (CVS) and were given phosphate buffer, sertraline (10 mg/kg/day), or nortriptyline (10 mg/kg/day). After 45 days, the neuron number in their colon plexuses was estimated using the stereologic method. The number of neurons increased by 40–51% in the submucosal plexus and by 57–69% in the myenteric plexus in the CVS group compared with the control group (p

Nicotinamide adenine dinucleotide (NAD + ) has been described as central coenzyme of redox reactions and is a key regulator of stress resistance and longevity. Aging is a multifactorial and irreversible process that is characterized by a gradual diminution in physiological functions in an organism over time, leading to development of age-associated pathologies and eventually increasing the probability of death. Ischemia is the lack of nutritive blood flow that causes damage and mortality that mostly occurs in various organs during aging. During the process of aging and related ischemic conditions, NAD + levels decline and lead to nuclear and mitochondrial dysfunctions, resulting in age-related pathologies. The majority of studies have shown that restoring of NAD + using supplementation with intermediates such as nicotinamide mononucleotide and nicotinamide riboside can be a valuable strategy for recovery of ischemic injury and age-associated defects. This review summarizes the molecular mechanisms responsible for the reduction in NAD + levels during ischemic disorders and aging, as well as a particular focus is given to the recent progress in the understanding of NAD + precursor’s effects on aging and ischemia.

Chronic Sleep Restriction (CSR) is known as a risk factor for cardiovascular diseases. However, the structural changes of Sinoatrial (SA) node cells have received less attention. This study aimed to evaluate the effects of CSR on SA node in an animal model using stereological methods. Adult male Sprague-Dawley rats were randomly divided into CSR, grid-floor, and control groups. The CSR procedure was designed such a way that the animals had a full cycle of sleep (6 hours) per day, while they were unable to have a Rapid Eye Movement (REM) sleep during the remaining 18 hours. This was induced by a multiplatform box containing water. The grid-floor animals were placed in the same multiplatform box with a grid-floor covering to prevent falling in water. After 21 days, the right atria were dissected out. Then, the location of the SA node was determined and evaluated by stereological techniques. The total volume of the SA node, the total volume of the main node cells, the volume of the connective tissue, and mean volume of the node cells were respectively enlarged by 60%, 47%, 68%, and 51% in the CSR animals compared to the grid-floor rats (p < 0.05). However, no significant changes were detected in these parameters in the control and grid-floor animals. The population of the main node cells remained constant in all animal groups. In addition, the three-dimensional reconstruction of the SA node in the CSR group showed a hypertrophied appearance. In conclusion, CSR induced hypertrophic changes in the rats' SA node structures without alteration in the number of main node cells.

Exposure to heat stress (HS) has adverse effects on brain function, leading to anxiety-like behavior and memory impairment. Sericin is a silk derived protein with various neurobiological activities. The present study has investigated the effects of sericin on anxiety and cognitive impairments, in HS-received mice. The adult male mice were exposed to HS (43 oC, 15 min once a day for 14 days) and simultaneously treated with 100, 150, and 200 mg/kg/day of sericin through oral gavage. Elevated plus-maze and Lashley III Maze tests were used to evaluate anxiety and learning and memory, respectively. The hippocampal BAX, BCL-2, caspase3, caspase9 and heat-shock protein-70 (HSP-70) were evaluated by western blotting and oxidative stress markers including malondialdehyde (MDA), total antioxidant capacity (TAC), super oxide dismutase (SOD) as well as glutathione peroxidase (GPx) were evaluated by spectroscopy method. The serum was collected for the analysis of the corticosterone levels. Treatment with sericin in higher doses reversed anxiety-like behavior and cognitive deficit induced by HS. Moreover, heat exposure increased serum corticosterone, hippocampal MDA, apoptotic proteins and HSP-70 levels. Sericin administration decreased serum corticosterone and enhanced hippocampal antioxidant defense and attenuated apoptosis and HSP-70 levels. The results show that the protective effects of sericin against HS-mediated cognitive dysfunction and anxiety-like behavior is possibly through suppressing HSP-70, oxidative stress and apoptosis.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is known as a primary genetic heart disease that leading to the myocardial deposition of fibrofatty tissue in right ventricular (RV) wall. Sometimes, it occurs in the left ventricular (LV) subepicardial wall. This study introduces a child referred to our hospital with influenza-like symptoms and ventricular tachyarrhythmia, followed by cardiac failure. However, in our subsequent evaluation, there was evidence of severe LV and RV dysfunction based on the echocardiography. Moreover, cardiac magnetic resonance showed not only the major criteria of ARVC but also those of Lake Luise seen in myocarditis. Regarding the deteriorating condition during the hospital course, he was later scheduled for heart transplantation. Finally, the histopathological study of explanted heart revealed RV myocyte atrophy with the infiltration of fibrofatty tissue in myocardium diagnostic of ARVC, resolving dilemma between ARVC and myocarditis.

Objectives: Many patients with breast cancer (BC) require cardiotoxic anthracycline-based chemotherapy. We intended to assess the early cardiotoxic effects of doxorubicin utilizing cardiac magnetic resonance (CMR) imaging. Material and Methods: Forty-nine patients including 21 otherwise healthy females with BC at a mean age (±SD) of 47.62 ± 9.07 years and 28 normal controls at a mean age (±SD) of 45.18 ± 4.29 years were recruited. They underwent CMR and transthoracic echocardiography at baseline and 7 days after four biweekly cycles of doxorubicin and cyclophosphamide. Biventricular functional, volumetric, global strain, and tissue characterization findings were analyzed and compared with those of 28 controls. Results: In post-chemotherapy CMR, 4 patients (19.04%), three symptomatic and one asymptomatic, exhibited evidence of doxorubicin cardiotoxicity. Significant differences in biventricular ejection fraction, left ventricular end-systolic volume index, and all 3D global strain values were noted after chemotherapy in comparison with the baseline (all P < 0.05). More than half of the study population showed a significant change in all right ventricular global strain values. One patient (4.76%) exhibited evidence of diffuse myocardial edema in post-chemotherapy CMR, and 3 patients (14.28%) showed myocardial fibrosis. The study participants were clinically followed up for 4–10 months (mean = 7 months). Overall, 8 patients (38.09%) complained of dyspnea on exertion and fatigue on follow-up. None of the CMR markers was associated with the development of symptoms. Conclusion: Our investigation revealed striking changes in CMR parameters in the follow-up of BC patients treated with cardiotoxic chemotherapy. These exclusive CMR features assist in the early initiation of preventive cardiac strategies.

A 24-year-old woman referred to our radiology department with the diagnosis of new positive blood culture brucellosis and severe aortic regurgitation for evaluation of periaortic thickening. Cardiac magnetic resonance imaging elegantly revealed the presence of active aortitis, most probably caused by brucellosis.

Ischemic heart diseases are the major reasons for disability and mortality in elderly individuals. In this study, we tried to examine the combined effects of nicotinamide mononucleotide (NMN) preconditioning and melatonin postconditioning on cardioprotection and mitochondrial function in ischemia/reperfusion (I/R) injury of aged male rats. Sixty aged Wistar rats were randomly allocated to 5 groups, including sham, control, NMN-receiving, melatonin-receiving, and combined therapy (NMN+melatonin). Isolated hearts were mounted on Langendorff apparatus and then underwent 30-minue ligation of left anterior descending coronary artery to induce regional ischemic insult, followed by 60 minutes of reperfusion. Nicotinamide mononucleotide (100 mg/kg/d intraperitoneally) was administered for every other day for 28 days before I/R. Melatonin added to perfusion solution, 5 minutes prior to the reperfusion up to 15 minutes early reperfusion. Myocardial hemodynamic and infarct size (IS) were measured, and the left ventricles samples were obtained to evaluate cardiac mitochondrial function and oxidative stress markers. Melatonin postconditioning and NMN had significant cardioprotective effects in aged rats; they could improve hemodynamic parameters and reduce IS and lactate dehydrogenase release compared to those of control group. Moreover, pretreatment with NMN increased the cardioprotection by melatonin. All treatments reduced oxidative stress and mitochondrial reactive oxygen species (ROS) levels and improved mitochondrial membrane potential and restored NAD+/NADH ratio. The effects of combined therapy on reduction of mitochondrial ROS and oxidative status and improvement of mitochondrial membrane potential were greater than those of alone treatments. Combination of melatonin and NMN can be a promising strategy to attenuate myocardial I/R damages in aged hearts. Restoration of mitochondrial function may substantially contribute to this cardioprotection.

Introduction: Limited data exist regarding the presence and importance of diastolic parameters in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We sought to evaluate RV diastolic parameters and echo-based diastolic predictors of major adverse cardiovascular events (MACE). Method: 48 patients with a definitive diagnosis of ARVC were included and followed for 6-18 months. A comprehensive standard two-dimensional (2D) transthoracic echocardiography (TTE) with precise evaluation of systolic and diastolic indices of both ventricles was done. RV isovolumetric relaxation time (IVRT), RV myocardial performance index (MPI), and right atrial (RA) volume were evaluated. Results: 48 patients (mean age = 38.5 ± 14 years; 79.2% male) were enrolled. 27.3% had grade I, 68.2% had grade II, and 4.5% had grade III RV diastolic dysfunction. In 12-month follow-up, 12 patients (25%, with mean RV3DEF = 24.8 ± 9%) experienced MACE and required hospitalization: ventricular tachyarrhythmia in 7 patients (14.6%), RV clot in 2 subjects (4.2%), and right-sided failure in 3 cases (6.3%). In logistic regression analysis, tissue Doppler velocity of tricuspid annulus (e' TV) (P = .02, OR = 0.581, CI = 0.368-0.917), peak E mitral valve (P = .043, OR = 0.95, CI = 0.913- 0.999), tissue Doppler velocity of septal e' (P = .052, OR = 0.733, CI = 0.536-1.003), and MPI (P = .009, OR = 95, CI = 3.083-2942) were powerful predictors of MACE. Conclusion: In our study, RV diastolic function parameters including e' TV and e′ MV, RA volume and area, and RV MPI were powerful predictors of MACE and may be considered during the baseline and follow-up of the ARVC patients.

Aspartame is an artificial sweetener used in about 6000 sugar-free products. Aspartame consumption could be associated with various neurological disorders. This study aimed to evaluate the effect of aspartame onmedial Prefrontal Cortex (mPFC) as well as neuroprotective effects of vitamin E. The rats were divided into seven groups, including distilled water, corn oil, vitamin E (100 mg/kg/day), and low (acceptable daily dose) and high doses of aspartame (40 and 200 mg/kg/day) respectively, with or without vitamin E consumption, for 8 weeks. Behavioral tests were recorded and the brain was prepared for stereological assessments. Novel objects test and eight-arm radial maze showed impairmentoflong- and short-termmemoriesin aspartame groups. Besides, mPFC volume, infralimbic volume, neurons number, glial cells number, dendrites length per neuron,and number of spines per dendrite length were decreased by 7–61% in the rats treated with aspartame. However, neurons’ number, glial cells number, and rats’ performance in eight-arm radial mazes were improved by concomitant consumption of vitamin E and aspartame. Yet, the mPFC volume and infralimbic cortex were protected only in the rats receiving the low dose of aspartame + vitamin E. On the other hand, dendrites length, spines number,and novel object recognition were not protected by treatment with vitamin E + aspartame. The acceptable daily dose or higher doses of aspartame could induce memory impairments and cortical cells loss in mPFC. However, vitamin E could ameliorate some of these changes.

There is limited quantitative microscopic information concerning the three-dimensional arrangement of cardiomyocytes and microvessels in cardiotoxic condition. The aim of this study was to evaluate the cardiac tissue of rats under different experimental conditions using modern second-order stereology and Voronoi tessellation techniques to show the spatial arrangement of the cardiomyocytes and microvessels. Sprague-Dawley rats were randomly divided into two groups (n = 6). The control group received PBS and the doxorubicin (DOX) group received 4 mg/kg DOX on days 1, 8, 15, and 22. On the 24th day, the left ventricle was sectioned and prepared according to the “orientator” method for microscopically evaluations. The “covariance functions” were plotted using “linear dipole probes”. Polygonal tessellation of the ventricles was also diagrammed using ImageJ software. The plotting the covariance curves of the cardiomyocytes and microvessels forming the “gaps” by slopped down, crossing the reference line and rose again. In the control group, the gaps were placed at 35–40 μm and 14–16 μm for the cardiomyocytes and microvessels, respectively. In the cardiotoxic group, the curves demonstrated larger gaps in comparison with the normal hearts, indicating repulsion of these structures. The curves of the cross-correlation function of the cardiomyocytes-microvessels also demonstrated the cardiomyocytes and microvessels were not normally correlated after the toxicity. Evaluation of Voronoi tessellations for the cardiomyocytes nuclei and microvessels in the normal and cardiotoxic groups showed that the areas of polygons in the normal heart were placed in the smaller range, while the areas fell in a larger range in the cases of cardiotoxicity. Stereological and Voronoi Tessellation methods showed that ventricular tissue lost its normal spatial arrangement in doxorubicin-induced cardiotoxicity in rats.

One of the important factors in the occurrence of acute kidney injury (AKI) among renal transplant patients (RTPs) is ischemia reperfusion injury (IRI). The current study aimed at determining the anti-inflammatory and anti-oxidative effects of melatonin on the complications of IRI and the level of Klotho expression in these patients.A total of 40 renal transplant candidates were randomly assigned into placebo or melatonin group receiving the same dose of 3 mg/day. In order to measure serum melatonin levels, inflammatory and oxidative stress factors, renal function biomarkers, and Klotho gene/protein expression, venous blood samples were taken from patients over two different time points, i e, 24 h before the transplantation and at discharge from hospital.Melatonin was associated with improvement in renal transplantation, since the serum level of neutrophil gelatinase-associated lipocalin, as a renal functional marker, significantly decreased (P .001). The effect of melatonin as a suppressor of inflammation and oxidative stress was also evident in the melatonin group due to a significant reduction in the serum levels of MDA, CP, 8-OHdG, and TNF-α markers (P .001).Reduction in serum levels of renal function and oxidative stress/inflammatory markers in the melatonin group indicates that melatonin can inhibit IRI outcomes in RTPs through its anti-oxidant and anti-inflammatory properties. However, these properties do not appear as a result of influence on the level of Klotho gene/protein expression.

Methadone is a drug associated with the development of prolonged Correcred QT (QTc) interval, as QT interval prolongation can occur in up to 15% of methadone-maintenance patients. In recent years, methadone found to be associated with an increased risk of sudden death in a community-based study (1, 2). ‘‘Torsades de Pointes’’ is a quick and dangerous rhythm that quickly becomes ventricular fibrillation. If this rhythm is rapid or prolonged, it can lead to ventricular fibrillation or sudden cardiac death. The usual clinical manifestations of TdP are palpitations, dizziness, and syncope. It is certain that no cardiac drugs are recognized to increase the propensity for TdP. The most common risk factors of methadone-associated QT prolongation and TdP include a high dose of methadone or chronic use, old age, accompaniment with enhancing drugs methadone levels, infections such as AIDS, old age, low potassium, kidney failure, heart disease, female gender, and cirrhosis of the liver (3). Despite the availability of methadone for over 60 years, only in the past 10 years has this medication received attention for its potential to cause QTc prolongation leading to Torsades de Pointes (4-6). We report 4 cases of methadone-induced Torsades de pointes. Through rapid taper of methadone, the patient’s ECG normalized.

Introduction: Castor bean seed is used to control some medical conditions including diabetes mellitus due to popular belief in its effectiveness. However it may cause severe poisoning in humans and animals and its components (ricin) might be used as a biological weapon. In the present case, a rare intra-ventricular hemorrhage followed by unconsciousness had occurred after poisoning with caster bean. Because there is no direct antidote or reversal agent for this condition, fresh frozen plasma (FFP) was prescribed to control the hemorrhage and good results were achieved. Case Presentation: A 63-year-old female taking castor bean seed as a treatment for her diabetes was admitted to the emergency ward for a comatose state. A computed tomography image of her head demonstrated an intraventricular hemorrhage. Symptomatic and supporting care was prescribed. After two weeks without significant improvement, the patient was administered five units of FFP. However, the patient’s neurological status dramatically improved and remained stable. Conclusions: Intraventricular hemorrhage followed by comatose state is a rare finding of the castor bean seed ingestion. The patient’s condition improved dramatically after FFP transfusion.