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Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units.

Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered.

Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05).

Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit.

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Background and Objective: The comorbidity of type 2 diabetes mellitus (T2DM) and hypertension may exacerbate chronic inflammation and regular exercise training considered as an important therapeutic approach for such patients. This study was done to evaluate the eight weeks effects of regular exercise training on apelin and tumor necrosis factor alpha (TNF-a) plasma levels in hypertensive postmenopausal women with T2DM.
Methods: This quasi-experimental study was conducted on 20 postmenopausal women with hypertension and T2DM. Subjects non-randomlly allocated into intervention and control groups. Training program consisted of 25-40 minutes of aerobic exercise at 50-70 percent of maximal heart rate, 3 sessions per week for 8 weeks. The plasma level of apelin, TNF-a and glucose was measured, subsequently.
Results: 8 weeks exercise training was significantly reduced apelin, TNF-a, and glucose levels in the intervention group compared to the control group (P<0.05).
Conclusion: Aerobic exercise can mediate some of its favorable effects on hypertension pathological conditions associated with type 2 diabetes mellitus by reducing plasma apelin and TNF-a levels.

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Background and Objective: Age is the greatest risk factor for cardiovascular disease that is associated with shortens telomere. TRF2 and TERT genes expression in heart tissue   reduce in elderly. These geness are associated with shortens telomere. Exercise can play a useful role in maintaining the length of telomeres. This study was carry out to determine the effect of high intensity interval training (HIIT) and continuous endurance training on TRF2 and TERT gene expression in heart tissue of aged male rats.

Methods: In this experimental study 24 adult aged male rats (88-96 weeks, 363±12 g) allocated into three groups including control, endurance training (5 sessions per week: with 60-70 of maximum speed of group) and HIIT (5 sessions per week: 80 percent in the first and second week, 90% maximum speed of the third week, 100 % until the end of the exercise for 6 weeks). Gene expression of TRF2 and TERT were assessment by Real-time - PCR and the quantification of gene expression levels using the Pfaffl formula.

Results: TRF2 gene significantly increased in HIIT and CET groups in compared to control group (P<0.05). TERT gene non- significantly increased in HIIT and CET groups in compared to the control group.

Conclusion: It seems, 6 weeks of high-intensity interval training and continuous endurance training to be able regulate the growth and longevity of the heart cells by maintaining the length telomere by increasing TRF2 gene expression.

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Background and Objective: Researches has shown that exercise and nutrition exercises can have a different effect on serum Brain Derived Neurotrophic Factor (BDNF( levels and resting blood pressure in young people. This study was done to determine the effect of a period of High Intensity Interval Training (HIIT) with omega-3 supplementation on the serum levels of BDNF and resting blood pressure in inactive male students.
Methods: In this clinical trail study, 32 non-athlete male students were randomly divided into control, supplements, training and training + supplement. Subjects in supplementary group were received daily (2000 mg) of omega-3 capsules. The training groups were also subjected to HIIT training for 6 weeks. The training + Supplemental group also included a combination of the same training program were associated with omega-3 supplementation. BDNF levels were measured by ELISA method 24 and 48 hours perior the exercise protocol and after the last training session. Blood pressure disturbances were also evaluated at the same time and before blood sampling according to the recommendations of the British Heart Association.
Results: The serum levels of BDNF in the group after 6 weeks in the training + supplementation group and the training group increased significantly compared to the pre-test values (P˂0.05). Also, a significant difference between-group training + supplementation group and training, supplementation and control groups were observed (P˂0.05). Systolic and diastolic blood pressures were significantly reduced in training + supplementary, training and supplementation groups compared to pretest values (P˂0.05). A significant reduction in systolic blood pressure in the training + supplementation group was observed compared to supplemental and control groups (P˂0.05).
Conclusion: HIIT combined with supplementation with omega-3 supplementation improved the BDNF serum level and reducing resting blood pressure in inactive male students.

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Background and Objective: Writing about emotions and emotional disturbances, improve the performance of an autonomous system, immune system and physical and mental health. The aim of this study was to determine the effect of narrative writing on stress intensity of attendants’ patients hospitalized in intensive care units (ICUs).
Methods: This single blind clinical study was done on 106 attendants’ of adult patients hospitalized in ICUs of Babol city in northern Iran. The patients' attendants were divided into two groups of 53 controls and intervention. Data were collected using stress (DASS21) questionnaire. Intervention was writing narration about feelings, thoughts and experiences related to the hospitalized patient and ICU in a notebook as daily for seven days in the intervention group.
Results: The mean and standard deviation of overall stress intensity following intervention were significantly reduced in the intervention group in comparison with controls (P<0.05) (22.64±7.89 versus 17.15± 8.2). There was significant relationship between intervention and control groups in three areas of stress, anxiety and depression (P<0.05).
Conclusion: Narrative writing reduces the severity of stress in attendants’ patients in ICUs.

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Background and Objective: Hypertension is associated with changes in the structure and function of the vessels. This study was done to evaluate the effect of aerobic training with Garlic consumption on matrix metalloproteinase-3, 9 (MMP-3, MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in obese postmenopausal women with hypertension.
Methods: This double-blind clinical trial study was done on 36 obese postmenopausal women with hypertension. Participants were randomly divided into 4 groups including control group, Garlic consumption, aerobic training and training with Garlic consumption. Subjects in training groups participated in a progressive aerobic training for eight weeks, three sessions a week (55% to 65% of the reserved heart rate and for 30 to 55 min). Garlic and training with Garlic groups consumed 1000 mg of garlic supplement for eight weeks (after breakfast and dinner). Two days before and after the protocol, blood samples were taken in fasting state.
Results: The level of MMP-3 and MMP-9 were significantly decreased in Garlic, aerobic training and training with Garlic groups in compared to the control group (P<0.05). Also, the level of MMP-3 in the training with Garlic was significantly reduced in compared to the training and the Garlic groups (P<0.05). MMP-9 in the training with Garlic was significantly reduced in compared to the Garlic group (P<0.05). However, TIMP-1 level were significantly increased in the Garlic, training and training with Garlic in comparison with control group (P<0.05).
Conclusion: Aerobic training alone and in combination with Garlic affect on extracellular matrix thorough reduction of MMP-3, MMP-9 and increasing TIMP-1, improves systolic blood pressure in obese postmenopausal women with hypertension.

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Background and Objective: Physical activity and the use of herbal supplements can affect liver enzymes. Nano-curcumin is an effective ingredient (deferulovl methane) in turmeric with antioxidant, antibacterial, antifungal, antiviral, anti-inflammatory and anti-proliferative properties and can play an important role in preventing liver fibrosis. This study was performed to determine the effect of 6 weeks of high intensity interval training (HIIT) with Nano-curcumin supplementation on liver enzyme levels in overweight female students.
Methods: This clinical trial study was performed on 48 overweight female students of Shahid Chamran University of Ahvaz, Iran with an average age of 21.7±1.32 years and a BMI equals 27.8±2.46kg/m² during 2018. Participants were randomly divided into 4 groups: control, Nano-curcumin supplementation (One 80 mg capsule daily), training and training combined with nano-curcumin supplementation (one 80 mg capsule daily). Training groups performed an exercise protocol of HIIT training with maximum heart rate for 6 weeks (three sessions per week). Blood samples were obtained to liver enzymes measurement (ALT, AST and ALP) before and after the intervention period.
Results: Performing six weeks of high intensity interval training along with taking nano-curcumin supplemen led to a significant reduction in serum level of AST and ALT compared to control group (P<0.05). In the supplement-training group, a significant decrease was observed in serum levels of ALT and AST compared to pre-test (P<0.05). But no statistically significant changes were observed in ALP serum level.
Conclusion: It seems taking nano-curcumin supplement along with high intensity interval training have a favorable effects on improving some of the liver characteristics of overweight female students.

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Background and Objective: Eotaxin is a pre-inflammatory adipokinin secreted from adipose tissue that plays an important role in function regulating of adipose tissue. This study was done to determine the effect of high-intensity interval training on the gene expression of eotaxin in visceral adipose tissue and insulin resistance following metabolic syndrome in rats.
Methods: In this experimental study, 40 male Wistar rats (weight 180±20 gr) were selected and after 12 weeks of high-fat diet and the creation of the metabolic syndrome model were randomly divided into four groups including  control, metabolic syndrome, High-Intensity Interval Training (HIIT) and metabolic syndrome with HIIT. Rats in the high-fat diet were subjected to a special diet (30 to 40% fat) for 12 weeks to develop a model of metabolic syndrome. HIIT consisted of 5 to 10 interval 1-minute intensive running on treadmill at 80 to 95% of maximum speed and in slow alternations at 55% of maximum speed for 8 weeks. Insulin resistance using HOMA-IR mode is considered as a basic factor for determining metabolic syndrome.
Results: The gene expression of eotaxin and insulin resistance in the metabolic syndrome group were significantly higher than the control group (P<0.05). Gene expression of eotaxin and insulin resistance was significantly lower in HIIT and metabolic syndrome with HIIT groups than the metabolic syndrome group (P<0.05). Also, the gene expression of eotaxin and insulin resistance was significantly lower in HIIT group than the metabolic syndrome with HIIT group.
Conclusion: It seems that HIIT may be an important factor in down-regulating eotaxin and insulin resistance in metabolic syndrome.

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Background and Objective: Understanding the cellular signaling mechanisms involved in muscle hypertrophy is considered a scientific challenge. Mammalian target of rapamycin (mTOR) is one of the regulatory factors in this process that increases protein synthesis in skeletal muscle through phosphorylation. This study aimed to determine the effect of six weeks of high-intensity interval training (HIIT) on phosphorylated mTOR protein in the quadriceps muscles of adult male Wistar rats.
Methods: In this experimental study, 16 adult male Wistar rats (six weeks old and weighing an average of 190.93±4.97g) were used. The animals were randomly divided into two groups of control and training (n=8). The training group underwent six weeks of HIIT on a treadmill, with five sessions per week. The load was increased during the six weeks from repeating the interval of 30 meters per minute for 30 seconds in the first sessions to eleven repetitions of the interval of 35 meters per minute for 30 seconds at the end of the sixth week, with rest intervals between the intervals at a speed of 13 meters per minute for 60 seconds. The control group did not undergo any training. The mice were anesthetized, and the Vastus lateralis of the quadriceps muscle was extracted. The level of phosphorylated mTOR protein in the quadriceps muscle was measured using the immunohistochemical method.
Results: HIIT significantly increased the levels of mTOR phosphorylation protein in male Wistar quadriceps femoris muscle compared to the control group (P<0.05).
Conclusion: Interval activity can have a positive effect on muscle hypertrophy through mTOR.
 

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Background and Objective: Considering hypertension as the most prevalent comorbidity among patients diagnosed with COVID-19, this study intended to investigate clinical characteristics and in-hospital mortality risk factors among COVID-19 patients with hypertension history.
Methods: This descriptive-analytical study was conducted on 527 hypertensive patients (277 male and 250 female) a mean age of 64.73±13.13 years infected with COVID-19 and hospitalized at Sayyad Shirazi Hospital, Gorgan Iran from February to September 2020. The patients’ data were extracted from the hospital information system and completed by patients’ medical records and telephone calls. The association between the risk factors and in-hospital mortality was identified by employing the logistic regression analysis in three various models, including model 1 (demographic data and patients’ history), model 2 (model 1 plus vital signs and pulse oximetry measurement at hospital admission) model 3 (model 2 plus laboratory findings at hospital admission). Each model individually described the odds ratios (ORs) with 95% confidence intervals (95% CIs) for every risk factor. Furthermore, a corrected area under the receiver-operating characteristics curve (AUC) was estimated to evaluate the model’s discriminatory power.
Results: Among 527 hospitalized patients, 88 patients (16.6 %) died during 6.48 days of hospitalization, of which 47 patients were men. In model 1, opium consumption (CI95%=1.16-3.85, OR=2.11) and cognitive impairment at admission (CI95%=0.98-5.40, OR=2.30) were significantly associated with higher mortality (AUC=0.65). In model 2, after adding vital signs and oxygen saturation, cognitive impairment association lost its association, and only opium consumption (CI95%=1.09-3.19, OR=1.87) and oxygen saturation (CI95%=0.90-0.95, OR=0.93) were associated with in-hospital mortality. (AUC=0.73). In model 3, after incorporating laboratory findings, with an AUC of 0.79 (CI95%=0.70-0.90), each percent higher oxygen saturation at admission was associated with a 7% decrease in in-hospital mortality (CI95%=0.88-1.00, OR=0.93). Although opium consumption and higher creatinine level lead to higher mortality, the associations were not significant.
Conclusion: Regarding the association of oxygen saturation at admission with in-hospital mortality among hypertensive patients diagnosed with COVID-19, the pulse oximetry measurement data upon admission would be crucial in evaluating these patients.

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Background and Objective: Vitamin D deficiency is highly prevalent among obese individuals, with multiple underlying mechanisms contributing to this condition. This study aimed to determine the combined effects of high-intensity interval training (HIIT) and vitamin D supplementation on the levels of inflammatory markers, transforming growth factor beta 1 (TGF-β1) and tumor necrosis factor alpha (TNF-α), in young women with vitamin D deficiency.
Methods: In this clinical trial, 39 sedentary women with vitamin D deficiency were randomly assigned to three groups: A control group, a HIIT-based running group, and a combined group (training + vitamin D). The training program included 12 one-minute repetitions of running at 80% to 90% of maximum heart rate (HRmax) and one minute of active rest at 50% HRmax, performed three sessions per week. Vitamin D supplementation was used weekly at a dose of 50,000 IU. TGF-β1 and TNF-α levels were measured and compared before and after the intervention.
Results: After 8 weeks of HIIT-based running, with and without vitamin D supplementation, the levels of inflammatory markers, TGF-β1 and TNF-α, showed a statistically significant decrease compared to the control group (P<0.05). The mean percentage change in TGF-β1 and TNF-α was also significantly greater in the combined group than in the training group without vitamin D supplementation (P<0.05).
Conclusion: Following 8 weeks of HIIT-based running, both inflammatory markers, TGF-β1 and TNF-α decreased in the study subjects, and this reduction was more pronounced in the vitamin D-receiving group.