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Physical Stress from Colonoscopy and Polypectomy in Elderly Individuals: Evaluation Using Damage Biomarkers in Blood
Hiroaki Igarashi,
Hiroko Yamashita,
Kiyoshi Tsuchiya,
Yuki Hanaoka,
Dai Sugimoto,
Itsuro Ogata
Issue:
Volume 6, Issue 2, March 2018
Pages:
33-39
Received:
3 February 2018
Accepted:
25 February 2018
Published:
21 March 2018
Abstract: Colonoscopy is routinely performed worldwide, but it is still a physically stressful screening method for colorectal cancer, particularly in elderly individuals. No previous study has evaluated physical stress from colonoscopy itself and polypectomy using blood-derived biomarkers. This study aimed to evaluate physical stress from colonoscopy and polypectomy in elderly individuals using white blood cell counts (WBCs) and C-reactive protein (CRP) levels, which are widely used blood-based biomarkers that respond quickly to tissue damage. In this single-center, retrospective observational study, 109 consecutive patients, aged ≥ 80 years, were enrolled. In all patients, WBCs and CRP levels were measured before and half-a-day after colonoscopy. The changes were subsequently compared. Patients were divided into two groups: those with polypectomy (P+) and those without polypectomy (P-). The changes in WBCs and CRP levels were determined and compared between the two groups. In the P + group, correlations between the number of resected polyps and changes in WBCs and CRP levels were also evaluated. Of the 109 patients, there were 48 men and 61 women with a mean age of 83.9 ± 3.1 years (range, 80-91 years); 58 patients received polypectomy. In all patients, the mean WBC after colonoscopy showed no significant change from that before colonoscopy (before: 5400/μL, after: 5200/μL, P = 0.092), and the mean CRP level showed a slight elevation after colonoscopy (before: 0.05 mg/dL, after: 0.08 mg/dL, P < 0.001). Compared to before colonoscopy, the mean WBC after colonoscopy decreased slightly in the P- group (before 5400/μL, after 4900/μL, P = 0.002), but showed no significant difference in the P+ group (5400/μL, 5400/μL, P = 0.48). Conversely, the mean CRP level increased very slightly in both the P- and P+ groups (from 0.06 mg/dL to 0.07 mg/dL, P = 0.003; from 0.04 mg/dL to 0.08 mg/dL, P < 0.001, respectively), but it was not significantly different between the groups. The elevation of both WBCs and CRP levels showed only minor correlations with the number of resected polyps. In conclusion, colonoscopy can be well tolerated even by elderly individuals because physical stress from colonoscopy, with respect to WBCs and CRP levels, was minimal even if polypectomy was performed.
Abstract: Colonoscopy is routinely performed worldwide, but it is still a physically stressful screening method for colorectal cancer, particularly in elderly individuals. No previous study has evaluated physical stress from colonoscopy itself and polypectomy using blood-derived biomarkers. This study aimed to evaluate physical stress from colonoscopy and po...
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Revitalization Teeth: A Prospective Case Series
Christian Holscher,
Kerstin Galler
Issue:
Volume 6, Issue 2, March 2018
Pages:
40-45
Received:
3 March 2018
Accepted:
19 March 2018
Published:
10 April 2018
Abstract: In addition to caries, dental trauma is one of the most common causes of damage to permanent teeth and pulp. Pulp necrosis or damage to Hertwig’s epithelial root sheath (HERS) leads to arrested tooth root development in immature teeth. Pulp necrosis can be treated by revitalization, a biology-based treatment alternative to apexification. Induction of a blood clot inside the root canal can lead to healing of periapical lesions and increased root length and thickness. Traumatic impact as the cause of pulp necrosis may affect the treatment outcome negatively, depending on the severity of damage to HERS. Revitalization procedures in four teeth with pulp necrosis following dental trauma were performed using a standardized treatment protocol. Three teeth were dislocated, the fourth tooth was avulsed. Each patient exhibited at least two clinical signs of pulp necrosis as well as radiographic evidence of apical periodontitis. X-rays were taken using individualized film holders (IFH) to reliably assess the treatment outcome. Revitalization treatment was performed without instrumentation of the canal walls, but disinfection with sodium hypochlorite and intracanal dressing with triple antibiotic paste (TAP) for three weeks. Provocation of bleeding was induced in a second visit, the blood clot was covered with collagen followed by calcium silicate cement, and teeth were sealed with resin composite. Clinical and radiographic follow-ups were performed after 1, 3, 6 and 12 months. An increase of root length and thickness was evident in the three teeth with dislocation injuries. In one case, formation of mineralized tissue below the calcium silicate cement was observed. The tooth which had been avulsed and replanted showed resorption of the apical root area. The observations made in this study support the assumption that a separation of HERS and the cells that form pulp and dentin during tooth root development may negatively affect the outcome after a standardized revitalization procedure. The consistent implementation of standardized treatment protocols and the use of IFH are helpful receiving a reliable treatment outcome.
Abstract: In addition to caries, dental trauma is one of the most common causes of damage to permanent teeth and pulp. Pulp necrosis or damage to Hertwig’s epithelial root sheath (HERS) leads to arrested tooth root development in immature teeth. Pulp necrosis can be treated by revitalization, a biology-based treatment alternative to apexification. Induction ...
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Transcriptome Analysis Reveals Multiple Pathways of Lobelia chinensis in Inhibiting Streptococcus pyogenes
Xiaoying Lin,
Xiangyu Kong,
Chengping Wen,
Zhixing He
Issue:
Volume 6, Issue 2, March 2018
Pages:
46-57
Received:
27 March 2018
Accepted:
15 April 2018
Published:
19 May 2018
Abstract: Clinically, Lobelia chinensis has the potential to treat Streptococcus pyogenes (GAS) infections. This study demonstrated that Lobelia chinensis and penicillin have comparative inhibitory effects when their concentration was 12 mg/mL. To uncover the possible pathways of inhibition of GAS by Lobelia chinensis, transcriptome analysis was used to explore significantly changed genes when GAS was cultured under Lobelia chinensi. Lobelia chinensis could induce alterations of 366 genes in expression level, mainly involving biosynthesis process, translation, cytoplasm, and lipid, carbohydrate metabolic process. In addition, penicillin only induced 17 genes alteration and no GO/KEGG pathway enrichment. Therefore, Lobelia chinensis showed more modes of regulating GAS than penicillin. The regulatory modes of Lobelia chinensis may be the inhibition of cell replication and growth of GAS. This study indicated that Lobelia chinens is a potential drug for the treatment of GAS infection due to its considerable inhibition effects and multiple inhibition modes.
Abstract: Clinically, Lobelia chinensis has the potential to treat Streptococcus pyogenes (GAS) infections. This study demonstrated that Lobelia chinensis and penicillin have comparative inhibitory effects when their concentration was 12 mg/mL. To uncover the possible pathways of inhibition of GAS by Lobelia chinensis, transcriptome analysis was used to expl...
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Canine Rabies Outbreaks, Vaccination Coverage, and Transmission in Humans: Greater Accra Region, Ghana- A Retrospective Study-2006-2011
Perdita Hilary Lopes,
Patricia Akweongo,
Fred Wurapa,
Edwin Afari,
Samuel Oko Sackey,
Edward Mark Hansen,
Kofi Mensah Nyarko
Issue:
Volume 6, Issue 2, March 2018
Pages:
58-63
Received:
10 April 2018
Accepted:
26 April 2018
Published:
21 May 2018
Abstract: Rabies is a highly fatal, viral, zoonotic disease caused by a Lyssa virus. It is acquired through the bite of an infected animal, mostly dogs. Estimated annual global human mortalities from rabies is 61,000, over 99% of which are from developing countries where about US$583.5 million is spent on its control. Rabies is enzootic in Ghana. Vaccinating about 70% of the dog population leads to a reduction in rabies transmission to humans; however, percentage dog anti-rabies vaccination coverage in Ghana is unknown. This study therefore investigated the magnitude of rabies in dogs and humans in the Greater-Accra region, and assessed annual percentage dog anti-rabies vaccination coverage from 2007-2011. Secondary data on rabies vaccination, post mortem and dog quarantine records for all ten districts in the region, and human rabies records were analysed. Means and percentages were calculated, graphs drawn and trends analysed. The number of animal samples which tested positive out of 309, was 283. Predictive value positive was 91.6%. Of the positive cases, 97.5% (276/283) had no previous vaccination history, and 96.1% (272/283) were from dogs. Fifty-five out of 174 (31.6%) samples were from dogs which bit more than one person. Human exposures to dog and other animal bites are not differentiated. Average annual number of outbreaks was 31, whereas percentage dog vaccination ranged from 10.26-17.56. Current annual percentage dog anti-rabies vaccination coverage is very low, whereas the incidence of dog rabies in the region is high. The number of humans affected may be underestimated. Government should immediately facilitate annual mass vaccination of pets.
Abstract: Rabies is a highly fatal, viral, zoonotic disease caused by a Lyssa virus. It is acquired through the bite of an infected animal, mostly dogs. Estimated annual global human mortalities from rabies is 61,000, over 99% of which are from developing countries where about US$583.5 million is spent on its control. Rabies is enzootic in Ghana. Vaccinating...
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