Romanian Journal of Military Medicine Issue No.2 / 2023, Vol. CXXVI, May

Edition number: 2 | Volume: CXXVI | Month: May | Year: 2023

Prognostic Value of Serum Biomarkers in Secondary Peritonitis – A Literature Review

Background: Infection and sepsis represent major complications after abdominal surgery for secondary peritonitis. Finding new tools that can help identify patients at risk for developing postoperative complications is of the utmost importance for clinicians. We tried to evaluate the use of different biomarkers in evaluating the postoperative prognosis of patients with secondary peritonitis. Methods: We searched the available literature on the usefulness of serum biomarkers in evaluating prognosis in patients with secondary peritonitis. Results: Elevated postoperative lactate levels and high procalcitonin (PCT) levels were associated with negative outcomes. C-reactive protein values increase rapidly in response to the surgical insult but have no value in assessing the overall prognosis. Conclusion: Procalcitonin (PCT) is superior to other biomarkers in predicting severe septic complications and overall mortality in patients with secondary peritonitis.

Vascular Changes in Hypertension: Is There Cell Death Involved? – A Narrative Review

Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained.

Concise Review on Modulation Mechanism of Matrix Metalloproteinase via Oncoviruses in Aggressiveness of Malignancies

Matrix metalloproteinases (MMPs) are a member of the protein family intimately associated with zinc-containing endopeptidases, which are the main proteases implicated in extracellular matrix (ECM) degradation. The high ability of MMPs in the degradation of extracellular proteins is an important event in many normal biological as well as pathologic processes, including tumor progression, tissue repair, wound healing, developmental morphogenesis, and inflammatory diseases. This review is focused on the description of the modulation mechanism of MMPs via oncoviruses. Up to now, a large number of oncogenic viruses have been detected and recognized as etiologic factors of multiple human cancers. Actually, by expression of several viral oncoproteins of tumorigenic viruses with the simple genetic system, we are able to deregulate or modulate the pathways of cell transformation procedure in malignancy. In brief, upregulated expression of MMPs genes by direct (through DNA binding) , as well as indirect interactions (by activating PI-3K/AKT, ERK/MAPK, IFN/JAK/STAT, JNK, NF-κB signaling pathways and/or immune response) with tumorigenic viruses, have a noticeable role in the proliferation of cells, as well as angiogenesis, mobility, EMT, invasiveness, and metastatic features. In fact, the growth of tumor-related researchers offers a future perspective for the efficiency of targeted, molecular-based therapies and its anticancer effects via diverse mechanisms such as the suppression of viral oncoproteins.