Panminerva medica
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Review Meta Analysis
Angiotensin receptor blockers and breast cancer risk: a meta-analysis.
Some studies reported that angiotensin receptor blockers (ARBs) reduced the risk of breast cancer. However, other studies did not show similar results. ⋯ This study provided evidence that ARBs was associated with decreased breast cancer in Asians and increased risk of breast cancer in Caucasians.
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The myocardial extracellular matrix (ECM) is the dynamic environment that is fundamental for the structural and physiological homeostasis of the heart. Alterations in ECM homeostasis may lead to diastolic or systolic dysfunction and consequent development of heart failure (HF). For degradation of ECM, matrix metalloproteinases (MMPs) are responsible. ⋯ Majority of studies enrolling the higher count of participants suggested that the state of active myocardial remodeling is accompanied by enhanced activation of MMP-2 and MMP-9 and may be also represented by changes in their circulating concentrations. Their levels may be a useful marker for the identification of patients at risk for HF development and poor outcome by themselves, or at the very least as a components of multimarker approach. At the same time MMP-2 and MMP-9 circulating levels can serve as indicators of efficiency of the therapy provided to HF patients, as well as for identification of patients who could profit from particular therapeutic intervention via modification of MMP pathway.
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Catastrophic antiphospholipid syndrome (CAPS) is a rare variant that accounts for 1% of patients with APS. Despite its low frequency, the mortality-related is very high ranging from 50% of patients in the first series to 37% in the most recent data. The current knowledge of this potential devastating entity comes from the International Registry of patients with CAPS, named CAPS Registry. ⋯ Therefore, treatment strategy is based on the combination of anticoagulation, glucocorticoids, plasma exchange and/or intravenous immunoglobulins, the so-called triple therapy. In refractory cases or in those with initial life-threatening situation, rituximab may be an effective option. Recently, some cases of CAPS have been effectively treated with the addition of eculizumab to the triple therapy.
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Editorial Comment
HOTAIR and gastric cancer: a lesson from two meta-analyses.