Abstract
Aim. This study reviews the role of vitamin E in cardiovascular diseases.
Background. Cardiovascular diseases are among the most common health-related problems, and the number of the patients with cardiovascular diseases increases each year. Long-term manifestations of cardiovascular disease bears a lot of cost to the family and society.
Method. This review study was conducted by searching out the related literature in the databases Google Scholar, PubMed, PMC, Springer, and Elsevier, for papers published from 2014 to 2018. Initially, a total of 72 articles were found and the number of articles was reduced to 42 by removing duplicates and articles that were only accessible as abstract. Finally, a review by 21 articles was carried out.
Findings. α-Tocopherol is the most common form of vitamin E in human tissues. Increased oxidative stress is an important mediator of endothelial injury in hypertension pathology, associated with increased oxidant protein production, such as hydrogen peroxide super oxidation, decreased nitric oxide synthesis, and decreased biological capacity of antioxidants. Oxidative stress may lead to endothelial dysfunction, inflammation, hypertrophy, fibrosis, and angiogenesis associated with hypertensive vascular changes. Vitamin E deficiency can provide a constraint for micro ribonucleic acids (miRNAs) networks, and this may lead to the progression of atherosclerosis. Vitamin E deficiency causes adverse effects in cardiovascular systems. However, the effect of its use in the treatment of diseases is still not fully understood.
Discussion. A good amount of Vitamin E should be provided and it should be replaced before the complications occur.

Abstract
Aim. This review study aims to investigate the impact of reducing Door-to-ECG (DTE) time on on morbidity and mortality of patients with chest pain referred to emergency department.
Background. Chest pain is the second most common reason for referral to an emergency unit. According to American Heart Association, all patients with chest pain presenting to the emergency ward should be approached with an ECG within 10 minutes of entrance to the emergency department. This is considered as the first line of diagnostic tests for myocardial infarction.
Method. In this narrative review study, several databases and search engines including SID, Pub Med, Google Scholar, Web of Science and Scopus were used to find the articles published between 2000 and 2018. The keywords used to search articles were “Door to ECG”, “chest pain”, “emergency unit” and “triage”. The articles selected for review were interventional or descriptive in terms of design, in Persian or English, with available full text. The criterion for selecting articles was the similarity of the their subject with the search keywords including Door to ECG (DTE) time and triage and their value in the early diagnosis and treatment of coronary disorders.
Findings. A total of 20 articles were found. After removing the articles that didn’t meet the inclusion criteria, 11 articles related to the subject of the study remained in review. The significant outcomes of timely triage, appropriate time to perform ECG, barriers to access and suggestions for faster treatment by the system especially the role of nurses, were investigated.
Conclusion. The reduction of triage time and Door to ECG (DTE) time as well as the role of the nurse in those cases are associated with a reduction in the morbidity and mortality of cardiac patients.

Abstract
Aim. The aim of this review was to investigate the role of Catecholamines in the pathogenesis of Takotsubo cardiomyopathy and related nursing care.
Background. Takotsubo cardiomyopathy is an acute syndrome characterized by acute reversible systolic dysfunction of the apical and middle segments of the left ventricle in the absence of significant coronary artery occlusion. It is believed that emotional and physical stressors are the main drivers for the disease. Despite many years of efforts to better understand this disorder, current knowledge is limited, but several authors have agreed on the relationship between Catecholamines and the development of this syndrome.
Method. This study was carried out by searching the databases and search engines (PubMed, Google Scholar, and Web of Science) to find full text articles published between 2014-2018 using the keywords "Broken heart syndrome", "Apical ballooning syndrome", "Takotsubo cardiomyopathy", "Stress-induced cardiomyopathy", “Catecholamines”, “Nursing” and “Nursing care”. Of 392 articles, 21 were included in the study.
Findings. Among the various hypotheses, Catecholamine-induced microvascular dysfunction is currently the most accepted hypothesis. Stressful stimuli can increase the activity of the Hypothalamus-Pituitary- Adrenal axis and release Catecholamine. If Catecholamines are the leading cause of Takotsubo cardiomyopathy, it is quite possible that prescribing exogenous Catecholamines cause this condition.
Conclusion. Although many studies have attributed some of the Catecholamine toxicity to the pathophysiology of Takotsubo cardiomyopathy, due to the potential impact on current treatment strategies, further study is required. Due to cardiovascular side effects, the use of Catecholamines for therapeutic purposes requires more evidence. Regarding the similarity of the symptoms of this syndrome with myocardial ischemia, nursing care in this type of cardiomyopathy is very important.

Abstract
Aim. This review study aimed to investigate the role of thirst in the development of delirium in patients admitted to intensive care units.
Background. Delirium is a common clinical syndrome in patients admitted to intensive care units, affecting approximately one-third of these patients. Delirium is a multidimensional phenomenon. One of the most important and controversial factors in the occurrence of delirium is the phenomenon of thirst.
Method. This study was conducted by searching out Persian and English databases of Magiran, SID, Web of Science, Science Direct, PubMed, Scopus, without publication year consideration and using the keywords "thirst", "dehydration", "hyperosmolarity" and "delirium". Of 55 articles retrieved, 17 articles were reviewed by the research team among, and finally, after complying with the inclusion criteria and evaluating the quality of articles, 6 articles were included in the study.
Findings. The findings of the present study showed that tolerating the thirst for more than 24 hours is a risk factor for delirium. The role of fluid deficiency in the pathogenesis of delirium is not fully understood, but factors such as tissue hypoperfusion (especially in the brain and kidneys), increased concentrations of drugs or their metabolites in reduced intravascular volumes, and decreased renal function in excretion and/or drug metabolism are possible causes for development of delirium.
Conclusion. There is a lack of studies in this area and due to the importance of delirium and thirst in patients in the intensive care units or the elderly patients, more studies should be conducted in this area. All these factors calls for more attention and studies in this area.