As COVID-19 is a new emerging disease, the hematological/immunological changes that develop in the infected patients remain unknown. This study aims to systematically review the hematologic autoimm...

Background and Aims: Previous studies have shown that supplementation of some amino acids such as l‐arginine or its precursors could exert beneficial effects in patients with sickle cell disease (SCD). The objective of this study is to systematically review the literature to assess the effect of arginine administration on the clinical and paraclinical parameters of patients with SCD.Methods: Four online databases of PubMed, Web of Sciences, Scopus, and Embase were selected for systematic search. Eligible studies were clinical trials that evaluated the effect of arginine usage in patients with SCD. Effects sizes were calculated using weighted mean difference (WMD) and Hedge's g and they were pooled using random‐effects modeling with Hartung–Knapp adjustment. Additional analyses were also conducted.Results: Twelve studies containing detail of 399 patients with SCD were found to be eligible. The data synthesis showed that l‐arginine significantly increased the level of NO metabolites (Hedge's g: 1.50, 0.48–1.82, I²: 88%) and hemoglobin F (WMD: 1.69%, 0.86–2.52, I²: 0%) and significantly decreased systolic blood pressure (WMD: −8.46 mmHg, −15.58 to −1.33, I²: 53%) and aspartate transaminase (Hedge's g: −0.49, −0.73 to −0.26, I²: 0%). However, there were no significant effects on hemoglobin, reticulocyte, malondialdehyde and diastolic blood pressure, and alanine transaminase.Conclusion: Our meta‐analysis showed that l‐arginine use for SCD could be beneficial, increase hemoglobin F and exert blood pressure‐lowering and hepatoprotective properties. However, for a firm conclusion and widespread use of l‐arginine for these patients, more studies are needed.

Patient-centered care (PCC) has emerged as a crucial approach in healthcare delivery for older adults, given the aging population and the unique challenges they face. Long-term management and patient involvement are particularly relevant in outpatient settings. This scoping review aimed to provide a comprehensive overview of existing evidence on PCC for older adults in outpatient settings by mapping definitions, core elements, stakeholder perspectives, barriers to implementation, and practical models of PCC adaptation, as well as their outcomes. Additionally, it offers actionable recommendations for integrating PCC into healthcare systems in low- and middle-income countries (LMICs). A systematic search was conducted in PubMed, Web of Science, Scopus, and Google Scholar on 2 August 2024, with no publication year restrictions, to capture the full range of available evidence. We adhered to the JBI methodology for scoping reviews. Data synthesis involved a descriptive approach with findings contextualized to support the integration of PCC into LMIC healthcare systems. From an initial pool of 1474 sources, 76 records were included for data extraction. Most PCC definitions shared key themes, including partnership with patients in decision-making, a holistic approach to patient care, and coordination across multiple disciplines. The review revealed that while patients and providers shared the goal of achieving high-quality, personalized care, their perspectives on PCC differed. Providers emphasized systemic efficiency, teamwork, and care coordination, whereas older patients valued accessibility, emotional connection, trust, and relational aspects of care. Key barriers to implementing PCC included infrastructural challenges, financial and human resource limitations, transportation issues, and time constraints. Successful models of PCC often involved multidisciplinary teams and community-based collaborations, which were particularly effective in managing chronic diseases in older adults. This review highlights the potential of PCC in enhancing the quality of care for older adults in outpatient settings. Building on our findings, a phased approach focusing on older adults with multimorbidity is recommended for LMICs like Iran, with an emphasis on integrating both primary and specialized care. Our proposed seven-dimensional PCC model includes access to care, proactive care, patient empowerment, integration into care pathways, a whole-person approach, coordinated care, and shared decision-making, tailored for LMIC contexts to improve care for older adults.

Background and Aims: Obesity is considered a major growing threat to public health which could negatively affect the quality of life. The current cross‐sectional study was conducted to investigate the population‐based prevalence of metabolically healthy obesity (MHO) and healthy overweight (MHOW) and associated factors in southern Iran. Methods: Baseline data from the Pars Cohort Study was analyzed. Metabolically healthy participants were identified based on the definition of the American Heart Association for the metabolic syndrome. The prevalence of MHOW and MHO and their 95% confidence intervals were estimated. Poisson regression was applied for the calculation of prevalence ratios (PRs). Results: Gender‐ and age‐standardized prevalences of MHOW and MHO were 6.3% (6.0%–6.6%) and 2.3% (2.1%–2.5%), respectively. The following factors were associated with being MHOW compared with those with normal weight: Being younger, female gender (1.31, 1.20–1.43), higher socioeconomic status, being noncurrent cigarette smoker (1.27, 1.11–1.45), low level of physical activity (1.14, 1.03–1.25), having normal overweight during adolescence, and overweight (1.35, 1.24–1.48) or obesity (1.68, 1.53–1.86) during young adulthood. We also found strong associations between MHO and younger age groups, female gender (2.87, 2.40–3.42), being married (1.57, 1.08–2.27), Fars ethnicity (1.25, 1.10–1.43), higher socioeconomic status, ever use of tobacco (1.14, 1.00–1.30), never use of opium (1.85, 1.19–2.86), lower physical activity (1.45, 1.20–1.72), being normal weight in 15‐year body pictogram and being overweight (1.87, 1.59–2.20) or obese (3.20, 2.74–3.72) in 30‐year body pictogram when considering those with normal weight or MHO. Conclusion: Potentially modifiable factors including physical activity should be more emphasized. Furthermore, our study issued that it would be more reasonable that the prevention of unhealthy obesity be initiated before the development of MHO, where there are more protective factors and they could be more effective.

Dysfunction of both the innate and the adaptive immune systems is observed in severe coronavirus disease 2019 which, together with administration of immunosuppressive drugs, could lead to cytomegal...