INTRODUCTIONMatrix metalloproteinases (MMPs) are a family of zinc-dependent proteinases involved in remodeling the extracellular matrix. Tissue inhibitors of metalloproteinases (TIMPs) are a family ...of four proteins that act to limit the degradative actions of MMPs. Chronic kidney disease (CKD) and acute kidney injury (AKI) are public health problems worldwide, the prevalence of which has been increasing. Recent concept considers MMPs and TIMPs as critical factors before the onset of microalbuminuria, as well as accelerating factors associated with the breakdown of the glomerular basement membrane, renal scarring, and fibrosis during the progression of kidney diseases. Here we reviewed studies of the expression of MMPs and TIMPs in humans, using as clinical samples serum, plasma, and urine, with a focus on their potential role as molecular markers in CKD and AKI, as non-invasive markers. MATERIAL AND METHODSWe used as data sources, studies at Medline database using combinations of the following keywords: CKD, AKI, MMP, TIMP, serum, plasma, and urine. RESULTSEvidence suggests that MMPs/TIMPs could be potential targets for therapeutic intervention in kidney diseases; future studies should attempt to improve the diagnostic or prognostic power of these families. DISCUSSIONConsidering published guides, such as biospecimen reporting for improved study quality (BRISQ), strengthening the reporting of observational studies in epidemiology (STROBE), an updated list of essential items for reporting diagnostic accuracy studies (STARD), transparent reporting of a multivariate prediction model for individual prognosis or diagnosis (TRIPOD), and on the studies reviewed here, we have adapted published recommendations and proposed other news in order to enhance the transparency and quality of MMPs/TIMPs research in CKD and AKI. This review reinforces the complexities of MMPs/TIMPs in the pathobiology of the kidney and the need for well-designed and transparent biomedical studies. HIPPOKRATIA 2018, 22(3): 99-104.
•In laryngeal oncology it is crucial to assess mobility of vocal cord-arytenoid unit.•Current mobility assessment is flawed by weak inter-observer agreement.•Tumor extension assessment by dedicated ...radiologists is recommended.
In clinical practice the assessment of the “vocal cord-arytenoid unit” (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension.
In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated.
Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal.
The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology.
The most frequent mutations associated with rifampin and isoniazid
resistance in Mycobacterium are the substitutions at codons 531 and 315
in the rpoB and katG genes, respectively. Hence, the aim of ...this study
was to characterize these mutations in Mycobacterium isolates from
patients suspected to be infected with drug-resistant (DR) pulmonary
tuberculosis (TB) in Veracruz, Mexico. Drug susceptibility testing of
25 clinical isolates revealed that five were susceptible while 20 (80%)
were DR (15% of the annual prevalence for Veracruz). Of the DR
isolates, 15 (75%) were resistant to rifampin, 17 (85%) to isoniazid
and 15 (75%) were resistant to both drugs (MDR). Sequencing analysis
performed in the isolates showed that 14 (93%) had mutations in the
rpoB gene; seven of these (47%) exhibited a mutation at 531
(S→L). Ten (58%) of the 20 resistant isolates showed mutations in
katG; nine (52%) of these 10 exhibited a mutation at 315 (S→T).
In conclusion, the DR profile of the isolates suggests a significant
number of different DR-TB strains with a low frequency of mutation at
codons 531 and 315 in rpoB and katG, respectively. This result leads us
to consider different regions of the same genes, as well as other genes
for further analysis, which is important if a genetic-based diagnosis
of DR-TB is to be developed for this region.
Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is ...relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.
The fourth Mexican consensus on Helicobacter pylori Bosques-Padilla, F J; Remes-Troche, J M; González-Huezo, M S ...
Revista de Gastroenterología de México (English Edition),
07/2018, Letnik:
83, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Important advances have been made since the last Mexican consensus on the diagnosis and treatment of Helicobacter pylori (H. pylori) infection was published in 2007. Therefore, the Asociación ...Mexicana de Gastroenterología summoned 20 experts to produce "The Fourth Mexican Consensus on Helicobacter pylori". From February to June 2017, 4 working groups were organized, a literature review was performed, and 3 voting rounds were carried out, resulting in the formulation of 32 statements for discussion and consensus. From the ensuing recommendations, it was striking that Mexico is a country with a low-to-intermediate risk for gastric cancer, despite having a high prevalence of H. pylori infection. It was also corroborated that peptic ulcer disease, premalignant lesions, and histories of gastric cancer and mucosa-associated lymphoid tissue lymphoma should be considered clear indications for eradication. The relation of H. pylori to dyspeptic symptoms continues to be controversial. Eradication triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor should no longer be considered first-line treatment, with the following 2 options proposed to take its place: quadruple therapy with bismuth (proton pump inhibitor, bismuth subcitrate, tetracycline, and metronidazole) and quadruple therapy without bismuth (proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole). The need for antimicrobial sensitivity testing when 2 eradication treatments have failed was also established. Finally, the promotion of educational campaigns on the diagnosis and treatment of H. pylori for both primary care physicians and the general population were proposed.
The matrix metalloproteinases (MMP) are a family of 23 enzymes in man. These enzymes were originally described as cleaving extracellular matrix (ECM) substrates with a predominant role in ECM ...homeostasis, but it is now clear that they have much wider functionality. Control over MMP and/or tissue inhibitor of metalloproteinases (TIMP) activity
in vivo occurs at different levels and involves factors such as regulation of gene expression, activation of zymogens and inhibition of active enzymes by specific inhibitors. Whilst these enzymes and inhibitors have clear roles in physiological tissue turnover and homeostasis, if control of their expression or activity is lost, they contribute to a number of pathologies including e.g. cancer, arthritis and cardiovascular disease. The expression of many
MMPs and
TIMPs is regulated at the level of transcription by a variety of growth factors, cytokines and chemokines, though post-transcriptional pathways may contribute to this regulation in specific cases. The contribution of epigenetic modifications has also been uncovered in recent years. The promoter regions of many of these genes have been, at least partly, characterised including the role of identified single nucleotide polymorphisms. This article aims to review current knowledge across these gene families and use a bioinformatic approach to fill the gaps where no functional data are available.
Laryngeal cancer (LC) represents the tumor with the highest male-to-female sex ratio, yet the prognostic significance of sex remains uncertain. This study aimed to assess whether sex serves as an ...independent predictor of tumor control and survival in patients with laryngeal cancer.
A systematic review and a meta-analysis of the literature was performed by querying the PubMed, Scopus, and Google Scholar databases. Outcome measures were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Cumulative hazard ratios (HRs) with 95 % CI are presented for the reported outcomes. QUIPS tool was used for evaluating biases.
Out of a total of 16,592 retrieved articles, a total of 19 articles were included for quantitative analyses. A total of 1195 women affected by LC were analyzed, and compared to 7966 male patients: pooled analysis for survival revealed no significant sex-based differences (OS: HR = 0.786, 95 % CI: 0.590–1.047; DFS: HR = 0.465, 95 % CI 0.150–1.437; DSS: HR = 0.152, 95 % CI 0.01–12.82). All the included studies showed a low to moderate overall risk of bias.
This meta-analysis suggests that sex does not represent a significant independent prognostic factor for patients affected by laryngeal cancer.
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