BACKGROUND: Acute coronary syndrome (ACS), a clinical manifestation of chronic coronary artery disease, is often associated with multiple complications, recurrent hospitalizations, and diminished quality of life. Evaluating quality of life is a key outcome for determining the effectiveness of clinical and educational interventions. This study examined the impact of a care program grounded in the Roy Adaptation Model (RAM) on the quality of life of patients with ACS. METHODS: In this randomized controlled trial, 76 patients with ACS were randomly assigned to either the intervention or control group. Data collection took place from July to December 2024. Participants in the intervention arm received a two-week educational care program grounded in the Roy Adaptation Model, delivered through in-person sessions and supplemented with an instructional booklet. Data were gathered using a demographic survey, the SF-36 quality-of-life instrument, and the Roy Adaptation Model assessment form, which were administered at baseline and at one and three months following the intervention. RESULTS: Independent t-tests revealed no significant pre-intervention differences in physical, mental, or overall quality-of-life scores between the groups. Following the intervention, the intervention group demonstrated significant improvements. Repeated-measures ANOVA confirmed significant main effects of time and time-by-group interaction. Subscale analysis demonstrated significant improvements in seven of the eight SF-36 domains in the intervention group. In contrast, the control group exhibited a significant improvement only in general health. CONCLUSION: The Roy Adaptation Model provides an effective framework for fostering adaptation and enhancing quality of life in cardiac patients.
BACKGROUND:The expression of metabolic genes can be changed by the simultaneous effect of endurance exercise and nutrition. The aim of this study was to verify the effects of endurance exercise and whey protein consumption on the expression of Fibronectin type III domain-containing protein 5 (FNDC5), Paraoxonase-1 (PON1), and proliferator-activated receptor alpha (PPARα) genes in muscle. METHODS:A total of twenty BalB/C male mice were accidentally selected and subsequently divided into four groups, with each group consisting of five mice. The groups were as follows: placebo, exercised, whey-supplemented, and exercise plus whey-supplemented. In the groups involving exercise, the animals underwent treadmill exercise three times per week. The expression of FNDC5, PON1, and PPARα genes was analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Finally, GraphPad Prism 9.0 software was used to statistically evaluate changes in gene expression, and one-way analysis of variance (ANOVA) at the p<0.05 level and Tukey's multiple comparison test. RESULTS:FNDC5 gene expression in muscle increased in the groups that were supplemented with whey or exercised, compared to the placebo group. Investigations did not show a significant difference in FNDC5 expression in the liver between the whey-supplemented, exercise plus whey-supplemented, and placebo groups. In both liver and muscle tissue, whey protein increased the expression of PON1 (P = 0.001) regardless of exercise. PPARα expression also increased in muscle tissue. Additionally, the expression of PON1 in muscle was higher in the whey-supplemented group compared to the exercise and placebo groups. CONCLUSION:The consumption of whey protein and its interaction with exercise can significantly contribute to the modification of energy and lipid metabolism, muscle function, and oxidative stress through increased metabolic gene transcription.
BACKGROUND:Coarctation of the aorta (CoA) in infants and young children is typically treated with high-risk open-heart surgery. Endovascular stenting provides a less invasive alternative; however, its safety and efficacy remain underexplored. This study aimed to evaluate procedural success, complications, and four-year outcomes of stenting for CoA. METHODS:A retrospective review included 30 infants and young children (28 days to 3 years of age, weight >2.5 kg) with CoA who underwent endovascular stenting in Kerman and Sistan-Baluchestan, Iran, from 2024 to 2025. Patients with complex heart defects requiring immediate surgery or weighing <2.5 kg were excluded. Diagnostics utilized echocardiography, femoral angiography (for gradient assessment), and CT angiography. Outcomes included reduction in gradient, minor complications (hematoma, transient arrhythmia, localized bleeding, and bruising), major complications (stent thrombosis, vascular rupture, stent migration, vascular injury, sepsis, and mortality), and stent patency. RESULTS:Procedural success was achieved in 27 out of 30 patients (90%, 95% CI: 73.5-97.9%). The mean gradient was reduced by 89% (from 45 ± 10 mmHg to 5 ± 3 mmHg, p<0.001). Minor complications occurred in 3 of 30 patients (10%; 95% CI: 2.1-26.5%), including 2 hematomas and 1 transient arrhythmia; no major complications or mortality were reported. Four-year stent patency was 90% (95% CI: 73.5-97.9%); 3 out of 30 patients (10%) required re-dilation at 2.5 years due to growth. Cox regression analysis found no predictors for re-intervention (p>0.05). CONCLUSION:Endovascular stenting seems to be a safe and effective alternative for CoA in infants and young children. Larger prospective studies are necessary.
BACKGROUND: Diabetic patients face an elevated cardiovascular disease burden, often requiring coronary artery bypass grafting (CABG). However, evidence regarding post-CABG outcomes in diabetic versus non-diabetic patients is inconsistent, and data from the Iranian population are particularly scarce. This study was conducted to clarify this ambiguity by comparing short-term post-CABG complications between these groups.. METHODS: A retrospective cohort study analyzed data from the Yazd Cardiovascular Disease Registry (YCDR) for all CABG patients (2017-2018) at Afshar Hospital. Patients were stratified into diabetic (n=592) and non-diabetic (n=694) groups. We collected standardized data on demographics, comorbidities (including diabetes), and in-hospital major postoperative complications following CABG, such as reoperation, mortality, infections, renal complications, neurological complications (including TIA, stroke, and seizure), and pulmonary complications. RESULTS: The frequency distribution of female sex (36.66% vs. 21.90%), hypertension (65.03% vs. 44.52%), and hyperlipidemia (39.02% vs. 23.20%) in diabetic patients was significantly higher than in non-diabetic patients (p<0.001). No statistically significant differences were observed between diabetic and non-diabetic groups in the incidence of major complications, including reoperation (2.1% vs. 2.3%), mortality (3.2% vs. 2.4%), and other major events (all p>0.05). However, seizure occurred exclusively in the diabetic group (1.1% vs. 0%; p=0.049). Logistic regression analysis demonstrated that diabetes mellitus was not an independent predictor of overall postoperative complications. CONCLUSION: In this cohort, diabetes was not an independent risk factor for most shortterm post-CABG complications. The exception was a higher seizure incidence in diabetic patients, warranting further mechanistic investigation. Larger prospective studies are needed to confirm these findings.
BACKGROUND:Given the importance of diabetes mellitus (DM) and its role in the development of aortic valve stenosis (AVS), as well as its association with adverse outcomes after aortic valve replacement (AVR), the present meta analysis aimed to provide a comprehensive review of previous studies in this field. METHODS:To achieve this objective, a thorough literature search was conducted in PUBMED/MEDLINE, ScienceDirect, CINAHL, EMBASE/SCOPUS, PsycINFO, ClinicalKey, the Cochrane Central Register of Controlled Trials (CENTRAL), ProQuest, Web of Science, and Persian databases such as SID and Magiran. The number of patients, gender ratio, mean age, prevalence of T2DM, AVS, and treatment outcomes after TAVI, TAVR, and SAVR (stroke, early and late mortality) were recorded. RESULTS:This metaanalysis comprised 22 studies involving a total of 760,287 patients with AVS. The pooled prevalence of DM was approximately 31% (95% CI: 26-36%). DM was associated with a significantly higher risk of early mortality, including both inhospital mortality (OR: 2.399) and 30day mortality (OR: 1.45), compared with nonDM patients (p<0.05). However, the increase in late mortality (one year or longer) among DM patients was not statistically significant. Additionally, DM patients showed a significantly elevated risk of stroke compared with nonDM patients (OR: 1.15; 95% CI: 1.03-1.28; p=0.009). CONCLUSION:Overall, DM appears to play a significant role in the development of AVS and is associated with adverse outcomes including mortality and stroke after AVR.
