IntroductionMatrix metalloproteinases and tissue inhibitors of metalloproteinases could be promising biomarkers for establishing prognosis during the development of sepsis. It is necessary to clarify the relationship between matrix metalloproteinases and their tissue inhibitors. We conducted a cohort study with 563 septic patients, in order to elucidate the biological role and significance of these inflammatory biomarkers and their relationship to the severity and mortality of patients with sepsis.Materials and methodsA multicentric prospective cohort was performed. The sample was composed of patients who had sepsis as defined by the International Conference 2001. Serum procalcitonin, creatinine, urea nitrogen, C-Reactive protein, TIMP1, TIMP2, MMP2 and MMP9 were quantified; each patient was followed until death or up to 30 days. A descriptive analysis was performed by calculating the mean and the 95% confidence interval for continuous variables and proportions for categorical variables. A multivariate logistic regression model was constructed by the method of intentional selection of covariates with mortality at 30 days as dependent variable and all the other variables as predictors.ResultsOf the 563 patients, 68 patients (12.1%) died within the first 30 days of hospitalization in the ICU. The mean values for TIMP1, TIMP2 and MMP2 were lower in survivors, MMP9 was higher in survivors. Multivariate logistic regression showed that age, SOFA and Charlson scores, along with TIMP1 concentration, were statistically associated with mortality at 30 days of septic patients; serum MMP9 was not statistically associated with mortality of patients, but was a confounder of the TIMP1 variable.ConclusionIt could be argued that plasma levels of TIMP1 should be considered as a promising prognostic biomarker in the setting of sepsis. Additionally, this study, like other studies with large numbers of septic patients does not support the predictive value of TIMP1 / MMP9.

Objetivo: Establecer la frecuencia de las características histopatológicas de los pacientes llevados a tiroidectomía con diagnóstico definitivo de tumor maligno de tiroides.Materiales y métodos: Estudio observacional, descriptivo, de corte transversal, retrospectivo, realizado en un laboratorio de patología de la clínica Carlos Ardila Lülle (FOSCAL) en Bucaramanga, Colombia, donde se recopilaron los reportes de patología de los pacientes intervenidos por el servicio de cirugía, con diagnóstico de carcinoma de tiroides en el periodo comprendido entre 2001 y 2013.Resultados: Del total de 268 piezas quirúrgicas evaluadas, se encontraron 247 casos de carcinoma papilar, seguido de 16 registros de carcinoma folicular, 5 de carcinoma medular, 5 de carcinoma anaplásico y un solo caso de linfoma de tiroides. Los pacientes mayores de 45 años presentaron mayor compromiso de la cápsula y del tejido peritiroideo. De acuerdo con la guía latinoamericana para el manejo del cáncer de tiroides, 79,4% de los pacientes tenían al menos una característica de alto riesgo de recurrencia.Conclusión: La proporción del cáncer de tiroides en relación con el tipo de tumor, la variante histológica y la frecuencia de aparición por sexo en la población estudiada mantiene un comportamiento similar a la descrita en la literatura internacional. Sin embargo, es llamativo que la gran mayoría de los casos estudiados tienen riesgo alto de recurrencia luego de la terapia inicial. Abstract Objective: To establish the frequency of the histopathological characteristics in patients undergoing thyroidectomy with a final diagnosis of malignant thyroid tumor. Materials and methods: This was a retrospective, cross sectional, descriptive and observational study conducted at Clínica Carlos Ardila Lülle (FOSCAL) in Bucaramanga, Colombia where pathology reports were collected from patients diagnosed with thyroid carcinoma between 2001 and 2013. Results: Of the total 268 surgical specimens examined, 247 corresponded to papillary carcinoma, followed by 16 specimens of follicular carcinoma, 5 of medullary carcinoma, 5 of anaplastic carcinoma and only one thyroid lymphoma. Patients over 45 years of age showed a greater involvement of the thyroid capsule and perithyroid tissue. According to the Latin American guidelines for the management of thyroid cancer, 79.4% of patients had at least one feature for high risk of recurrence. Conclusions: The incidence of thyroid cancer per type of tumor, histologic variant, and gender distribution in the studied population is consistent with the international literature. Nevertheless, the observation that the vast majority of the cases studied present with a high risk of recurrence after initial treatment is intriguing.