Calprotectin and cross-linked N-terminal telopeptides in peri-implant and gingival crevicular fluid

In a previous study on guided bone augmentation, a new collagen membrane was compared with an e-PTFE one on 28 partially edentulous patients who received 50 dental implants at stage 2 surgery. After implant integration and subsequent loading, we were able to recruit 22 patients with 22 implants and their contra-lateral corresponding teeth for longitudinal observation. Clinical parameters probing depth (PD), bleeding on probing (BoP), plaque index (PI), assessment of gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PCF) volumes and periapical radiographs were performed at 2- and 3-year control appointments. Calprotectin (MRP 8/14) and cross-linked N-terminal telopeptide (NTx) levels in both crevicular fluids were determined by ELISA. PD was significantly reduced from years 2 to 3 appointments at implant sites as at teeth sites. At the 3-year appointment in both compartments, fluid volumes were significantly increased, which corresponded well with ascending NTx levels. The total amount of calprotectin decreased non-significantly in both GCF and PCF samples. Periapical radiographs revealed stable bone conditions around implants without significant changes from years 2 to 3 examinations. Clinical peri-implant parameters were considered as stable as the periodontal parameters of their corresponding teeth. A parallel increase in NTx levels in both GCF and PCF at 3-year appointment is not clearly understood; it may reflect an upregulation in the overall bone turnover rate.     

MR imaging of the colon: "technique, indications, results and limitations"

In the last few years virtual colonography using MR imaging has shown a proceeding development regarding detection and quantification of colorectal pathologies. Dark-lumen MR colonography (MRC) has been a leading tool for the diagnosis of the entire colon and their pathologies. This review article describes some of the underlying techniques of MRC concerning data acquisition, the need for intravenously applied paramagnetic contrast agent, as well as indications, results and limitations of MRC for the detection of colorectal pathologies. In addition, new techniques to improve patient acceptance are discussed.     

The corner of the coloproctologist: what to ask to radiologist

Defecation disorders, fecal incontinence, often associated to urinary and genital dysfunction, represent symptoms of a large number of functional and structural alterations of pelvic floor. They can be evaluated by functional and morphologic tests. A perfect anatomic and functional knowledge of the anorectum and pelvic floor is indispensable for a correct diagnostic and therapeutic path. Incontinence due to sphincter lesions can be diagnosed only by imaging techniques. In defecation disorders the issue is complex because functional and anatomic alterations can coexist. The radiological diagnosis of dyssynergic defecation is a diagnosis of confidence that enhances its value when manometric and electromyographic evidence of pelvic dyssynergia are detected. When anatomical alterations are detected the aim is to understand their physiopathology, to make a more precise diagnosis and treatment, and to minimize the errors of an inappropriate therapy. Our attention is focused on the information provided by imaging techniques about anorectum and pelvic floor abnormalities for optimal therapeutic planning.     

The ProTect device in the treatment of severe fecal incontinence: preliminary results of a multicenter trial

Background Patients suffering from severe fecal incontinence (FI) in whom surgical treatment has either failed or is inappropriate due to high operative risks and those who refuse to undergo surgery are condemned to living with their embarrassing symptoms, often responsible for progressive social isolation. ProTect is a new, relatively simple, medical device intended for selected patients suffering from severe FI. It consists of a pliable, silicone catheter with an inflatable balloon that seals the rectum at the anorectal junction, acting like an anal plug. The proximal part of the catheter incorporates two contacts that monitor the rectum for the presence of feces. The patient is alerted to an imminent bowel movement and, hence, a potential fecal accident, through a beeper. Methods A multicenter trial has been set up to assess the reliability of the device in preventing episodes of FI and to evaluate its impact on quality of life. Patients with significant FI (CCF>10) were prospectively entered into this 14-day study. Two quality of life questionnaires and a daily log of bowel activity and incontinent episodes were completed before and during the study. Results Currently, the study enrolled 17 patients and 11 patients (9 women, 2 men) with a mean age of 66 years (range, 46–85) completed the trial. In these 11 subjects, there was an overall significant improvement in the quality of life (p<0.05) and a significant reduction in incontinence scores (p<0.001) while using ProTect compared to baseline. Conclusions The ProTect is a safe non-surgical device that is able to prevent episodes of FI. It is unique because it can be used according to a patient’s needs without interfering with activities of daily living.     

Motivation for hay: Effects of a pelleted diet on behavior and physiology of horses

The natural diet of free-ranging horses is grass, which is typically high in fiber and calorically dilute, however diets for high performance domestic horses are often low in fiber and calorically dense. The aim of the study was to determine the motivation of horses for hay when fed a low roughage diet. Their motivation could be used to determine if low roughage diets compromise the welfare of horses. Eight mares were fed two different diets in counterbalanced order: ad libitum orchard grass hay; a complete pelleted feed (pellets). Each trial lasted three weeks, with a one-week transition period between diets. To determine the motivation of horses for fiber they were taught to press a panel to obtain a food reward. The fixed ratio (FR) was increased using a progressive ratio ((1,2,4,7,11…) technique. When fed pellets, the horses worked for a median FR of 1 (Range = 1-497) to attain pellets, and when fed hay, they worked for a median FR of 25.5 (4-497) to attain pellets. When fed hay, the horses worked for a median FR of 0 (0-0) to attain hay, and when fed pellets, they worked for a FR of 13 (2-79) to attain hay. These results indicate a greater motivation for hay, a high fiber diet, when fed a low fiber diet. The horses spent 10 (5-19.4)% of their time during a 24-hour period eating pellets compared to 61.5 (29-76) % of their time eating hay. Horses spent 58% of their time standing when fed the pellets and only 37% of their time standing when fed hay. Searching behavior (i.e. sifting through wood shaving bedding for food particles) took up 11.5 (1.4-32) % of the horse's day when fed pellets, but only 1.2 (0-3.5) % of the daily time budget when fed hay. Horses chew more times when eating a hay diet (43,476 chews/day) than when eating a pellet diet (10,036 chews/day). Fecal pH was lower in horses fed the pelleted diet.     

广西壮族自治区陆川县农村集中式供水水质检测结果

目的调查农村集中式供水水质卫生情况,为监督管理提供科学依据。方法按照生活饮用水卫生规范要求及国家标准检验方法进行样品采集和检测。结果共检测水样402份,合格率33.83%。不合格项目以微生物指标为主,总大肠菌群、耐热大肠菌群污染严重。结论陆川县农村生活饮用水集中式供水水质卫生合格率较低,检测结果表明质量监管机构需要采取适当的措施,保障公众健康。     

Noninvasive methods in evaluation of inflammatory bowel disease: where do we stand now? An update

The inflammatory bowel diseases, consisting of Crohn’s disease, ulcerative colitis and indeterminate colitis, are distinguished by idiopathic and chronic inflammation of the digestive tract. The distinction between inflammatory bowel diseases and functional bowel disorders, such as irritable bowel syndrome, can be complex because they often present with similar symptoms. Rapid and inexpensive noninvasive tests that are sensitive, specific and simple are needed to prevent patient discomfort, delay in diagnosis, and unnecessary costs. None of the current commercially available serological biomarker tests can be used as a stand-alone diagnostic in clinics. Instead, these are used as an adjunct to endoscopy in diagnosis and prognosis of the disease. Along these lines,, fecal lactoferrin and calprotectin tests seem to be one step further from other tests with larger number of studies, higher sensitivity and specificity and wider availability.     

The appendix as a conduit for antegrade continence enemas in patients with anorectal malformations: lessons learned from 163 cases treated over 18 years

Introduction

The antegrade continence enema (ACE) has been shown to be a safe and effective method for managing fecal incontinence in the pediatric population. The purpose of this study was to examine our experience with the ACE procedure using the appendix as a catheterizable conduit in children with anorectal malformations (ARMs).

Methods

We reviewed the charts of all patients who underwent an ACE procedure using the appendix as a catheterizable conduit between January 1992 and January 2010. Preoperative diagnosis (ARM type), operative details, functional outcomes, and postoperative complications were assessed. Technical modifications over time included selective cecoplication, implementation of the umbilical V-V appendicoplasty technique, and laparoscopy for cecal mobilization.

Results

Mean age was 9.9 ± 0.6 years, and 67% were male. The most common preoperative diagnosis was rectourethral fistula in boys (39%) and persistent cloaca in girls (61%). Forty-five complications occurred in 41 patients with an overall incidence of 25.6% (stricture, 18%; leakage, 6%; prolapse, 4%; intestinal obstruction, 0.6%). The incidence of stomal leakage was lower in patients when a cecoplication was performed (2.9% [4/138] vs 29.4% [5/17]; P < .01), and the incidence of stricture was lower in patients when the umbilical anastomosis was created using the V-V appendicoplasty technique (11% [11/100] vs 30% [18/60]; P < .01). Successful management of incontinence was reported by 96% of all patients.

Conclusions

The ACE procedure using the umbilical V-V appendicoplasty provides an effective and cosmetically superior means for bowel management in children with ARMs. The rate of late complications is not insignificant however, and preventative strategies should focus on careful operative technique and ensuring compliance with catheterization protocols well past the initial postoperative period.     

探讨低菌鼠认知功能的改变及粪菌移植的改善作用

目的 研究抗生素干预SD大鼠肠道菌群后,认知功能的改变及粪菌移植的改善作用。方法 随机选取30只SD雄鼠,分为对照组(NC)和低菌组(LB),低菌组给予广谱抗生素喂养5周,收集粪便16S rDNA测序,Morris水迷宫及旷场实验评估大鼠认知功能。低菌鼠构建后,低菌组给与正常粪菌移植12周,16S测序及行为学检测,HE观察海马形态,Western Blot法检测海马中凋亡相关蛋白表达,TUNEL染色观察神经元凋亡情况。结果 低菌鼠水迷宫逃避潜伏期增加、穿越次数减少,旷场实验显示低菌鼠自主运动减少(P<0.05)。粪菌移植处理后,低菌鼠学习记忆能力得到改善。16S rDNA测序结果表明,低菌鼠的物种数明显减少,在门水平变形菌门明显增多、厚壁菌门及拟杆菌门明显减少(P<0.05);在纲水平变形菌纲明显增多。粪菌移植后,低菌鼠粪菌移植组物种数恢复,厚壁菌门及拟杆菌门占比提高。HE染色显示粪菌移植组海马神经元排列较整齐,但海马组织神经元凋亡细胞增多,Bax、Caspase-3蛋白表达增加,Bcl-2表达水平减少。结论 低菌鼠学习记忆下降,粪菌移植后可以改善大鼠行为学改变,恢复菌群结...