High-sensitivity cardiac troponin I for cardiovascular risk stratification in apparently healthy individuals.

Troponin I and T as cardiac-specific biomarkers are highly useful tools not only in the diagnosis of acute coronary syndromes but also as independent predictors of several other clinical conditions. High-sensitivity cardiac troponin (hs-cTn) assays allow the detection of considerably low concentrations of cardiac troponin in apparently healthy and asymptomatic individuals, being a candidate tool for cardiovascular risk stratification in the general population. A group of Greek experts summarized the bulk of evidence regarding the use of hs-cTnI as a predictor of cardiovascular events and mortality in apparently healthy individuals and its additive value on top of existing risk stratification methods. This document could serve as a guide for the incorporation of hs-cTnI as an additional risk stratification tool in cardiovascular prevention strategies in apparently healthy individuals.

The Impact of the Patras Carnival on the Course of the COVID-19 Pandemic and the Outbreak of Influenza A: A Multicenter Cross-Sectional Study.

Background: We investigated the impact of the indoor mass gathering of young people during the Patras Carnival in Greece on the course of the COVID-19 pandemic and the influenza A epidemic. Materials and Methods: For influenza A, we tested 331 subjects with high fever (>38 °C), who arrived at five separate private laboratories over a two-week period after the carnival, via rapid test. One hundred and eighty-eight of them were young adults (17−35 years old), all unvaccinated against influenza A but all immunized against SARS-CoV-2, either through vaccination or previous infection. For the SARS-CoV-2 pandemic, we tested 2062 subjects at two time periods, two weeks before and two weeks after the carnival, also via rapid test. Additionally, we examined 42 samples positive for influenza A and 51 samples positive for SARS-CoV-2 for the possibility of co-infection via molecular testing (i.e., RT-PCR). Results: 177/331 (53.5%) subjects tested positive for influenza A, and 109/177 (61.6%) of the positive subjects were young adults, and 93/109 (85.3%) of these subjects were tested in the first week after the carnival. Additionally, 42 samples of those subjects were molecularly tested, and 5 were found negative for influenza A but positive for SARS-CoV-2. Regarding the SARS-CoV-2 pandemic, the increase in the positivity index for young adults between the pre-carnival and post-carnival periods was moderate. Conclusions: Our study indicates that the indoor mass gathering of young people during the carnival contributed to the outbreak of an influenza A epidemic and had a moderate but not statistically significant impact on the course of the SARS-CoV-2 pandemic, corroborating the crucial role of vaccination against the epidemic's waves. It also showed the need for the use of high-quality rapid tests for their management.

Changes of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in the serum of patients with autoimmune diseases: association with age and disease activity.

Matrix metalloproteinases participate in the degradation of the extracellular matrix proteins and are regulated mainly by their respective tissue inhibitors. In a variety of inflammatory connective tissue diseases, variations in the tissue content of both metalloproteinases and tissue inhibitors have been reported. The purpose of this study was to determine the serum levels of metalloproteinases and tissue inhibitors in patients with autoimmune diseases and compare with those of healthy individuals of similar age. The metalloproteinase content was analyzed by zymography and it was found that the serum levels of metalloproteinase-2 and metalloproteinase-9 of all autoimmune disease samples were decreased, in all diseases examined and independently of clinical activity, while those of active metalloproteinase-9 were significantly elevated. Both tissue inhibitors were quantitated by direct enzyme-linked immunosorbent assay and were also found decreased in autoimmune disease samples, confirming the balance that should exist in the secretion of metalloproteinases and tissue inhibitors. These results suggested that the increased active form of metalloproteinase-9, together with the decreased concentration of tissue inhibitor-2, could be used for diagnostic purposes and for the follow-up of patients with autoimmune diseases.