Hippokratia
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Matrix 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. ⋯ Considering 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.
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Rehabilitation provided to patients after stroke mainly aims at improvement in gait function. The most common gait training strategies include treadmill exercise and traditional overground gait training. The study was designed to assess the effectiveness of two models of gait re-education in post-stroke patients, namely conventional physical therapy and treadmill training. ⋯ Treadmill training seems to be a valuable and effective method of gait re-education, which can be used at various periods following a stroke, and mainly leads to improvement in walking speed and walking capacity. However, no standard has been defined so far with regard to treadmill-supported recovery of gait function in patients after stroke. We still do not know the optimum duration and frequency of exercise. Further study should investigate long-term effects and the way treadmill training impacts on patients' daily activities. HIPPOKRATIA 2018, 22(2): 51-59.
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The recent advent of high-throughput sequencing methods enabled the study of the composition of the upper respiratory tract (URT) microbial ecosystem and its relationship with health and disease in immense detail. The aim of the present study was the characterization of the human pharyngeal microbiome of healthy individuals in Greece. ⋯ The URT is colonized by a variety of protective and potentially pathogenic bacteria. This microbiome system is highly diverse and varies significantly between individuals. Geographic location and ethnicity are considered to be a strong determinants and factors affecting the diversity and abundance of the URT microbiome. Although some of the most abundant families are common irrespective of these factors, the dominance patterns are usually different between the study subjects and between the studies from other geographic locations. Unique differentially abundant families, genera and species were identified, and further studies are needed to elucidate their role. Further studies should focus on the investigation of the URT microbiome dynamics and the interaction with the host in health and disease. HIPPOKRATIA 2018, 22(1): 29-36.
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Gram-negative bacteria as emerging pathogens affecting mortality in skin and soft tissue infections.
Skin and soft tissue infections (SSTIs) are commonly encountered in clinical practice and mainly caused by gram-positive cocci such as S.aureus and β-hemolytic streptococci. Complicated SSTIs involving deeper tissues often necessitate surgical intervention and occur in patients with significant comorbidities such as diabetes or immunocompromising conditions. ⋯ This study denotes the role of gram-negative bacteria in SSTI epidemiology. Therapeutic protocols regarding the empiric treatment of SSTIs should necessarily take into account the local epidemiology of isolated pathogens and antimicrobial resistance. HIPPOKRATIA 2018, 22(1): 23-28.