Factors Influencing Calprotectin Levels

Factors Influencing Calprotectin Levels Several factors have been reported to affect faecal calprotectin levels. Some of these factors have been investigated in this study through the survey. Referring to Figure 3.1, 34% participant are aged between 50-59 years. From this study, a correlation between age and calprotectin level is positive, meaning that, as age of participant increases, calprotectin level increases (p Socioeconomic status is another factor which is thought to impact on calprotectin level. Figure 3.2 shows that 48.86% participants were from medium socioeconomic status. From Table 3.7, the correlation between socioeconomic status and calprotectin level was statistically significant (p The health status of participants was divided in 3 subcategories: healthy, unhealthy, and quite healthy. From Figure 3.3, 66% participants stated that they are healthy while 20% were unhealthy. Referring to Table 3.8, no positive correlation exists between health status and calprotectin level (p>0.05). This implies that health status of the individual does not affect calprotectin level. 47 % participants judged that they were moderately stressed (Figure 3.6). Stress has long been implicated in the pathogenesis of several GI conditions. Stress profile is known to contribute to GI inflammation. From this study, a statistically significant correlation does not exist between calprotectin and stress level (p>0.05) (Table 3.10). This demonstrates that as stress level rises; calprotectin does not increase accordingly, implying that according to the test, GI inflammation is not observed accordingly. This is refuted by findings of another study, reporting that stress is a potent modulator of the inflammatory response in the gut [104]. Among other lifestyle factors which can affect calprotectin level and thus GI inflammation is undoubtedly alcohol consumption. Excessive alcohol consumption often results in intestinal damage, mediated by inflammatory processes [105]. Figure 3.7 shows that only 4.55% participants consumed alcohol regularly. Statistical analysis demonstrates no correlation between alcohol consumption and calprotectin level (p> 0.05; Table 3.11). Another study also reported that faecal calprotectin level in active-drinking alcoholics are not significantly different, compared with controls. These results may suggest the absence of a subclinical intestinal inflammation involving neutrophils in the alcoholics [105]. Cigarette smoking is another factor likely to cause GI inflammation and thus, affecting calprotectin level. With reference to Figure 3.8, 20.45% participants smoke. Table 3.12 shows that the correlation coefficient is 0.073, however, it is not significant (p>0.05). There is no linear relationship between smoking and calprotectin level. However, literature suggests that smoking modifies pro/anti-inflammatory cytokines, which can contribute to inflammation [78]. Cigarette smoke and nicotine can aggravate colon and stomach inflammation [79]. However, this study concludes that no correlation exists between cigarette smoking and calprotectin level. Genetic influences can also alter the probability of suffering from GI inflammation. The study reveals that 40.91% participants (Figure 3.9) have family history of GI inflammation. Using the Mann Whitney test, a statistically significant correlation is seen between calprotectin level and family history of GI inflammation (p Literature suggests that GI surgery may have a protective or detrimental effect on GI inflammation. From Figure 3.11, 12.50% participants had undergone different types of GI surgery. The R2 value for GI surgery and calprotectin level is 0.037 (Table 3.16), implying that no linear relationship exists between calprotectin level and GI surgery. There is only 3.7% chance of having a linear relationship between calprotectin concentration and GI surgery. With reference to Table 3.15, it can be depicted that the correlation between calprotectin concentration and GI surgery is not statistically significant (p>0.05). Consumption of different types of food may have different types of outcome on the GIT. Some food can have a protective role on the GIT while others have detrimental effects. Table 3.2 shows that 62.5% participants consume fruits vegetables daily while 50% consume meat dairy products every day. A correlation between consumption of fruit vegetables and calprotectin level is statistically significant (R=0.236, p Referring to Figure 3.12, it can be seen that 65.91% participants took antibiotics in the last 6 months while 34.09% did not. The Mann Whitney test suggests that there is no correlation between antibiotic intake and calprotectin level (p>0.05) (Table 3.18). 4.2 Central obesity and GI inflammation One aim of this study is to determine whether centrally obese males are more susceptible to GI inflammation or not. 44 participants (50%) were centrally obese while 44 (50%) had a normal waistline (Figure 3.4). The BMI of participants was also assessed. From Figure 3.5, it can be concluded that 56.82% participants had normal BMI (18.5-24.9 kg/m2), 36.36% were overweight (25.0à ¢Ã¢â‚¬ °Ã‚ ¤BMIà ¢Ã¢â‚¬ °Ã‚ ¤29.9) and 6.82% participants were obese (BMIà ¢Ã¢â‚¬ °Ã‚ ¥30.0). It should be noted that an individual with central obesity does not necessarily mean that he is obese. Centrally obese participants can have normal BMI as well. Using the Spearmans correlation, a statistically significant correlation between central obesity and calprotectin level was not found (p> 0.05) (Table 3.9). Moreover, there is no statistically significant correlation between BMI and GI inflammation (Table 3.9). Calprotectin is described as a novel marker of obesity [106]. Literature suggests that central obesity correlates more strongly with disease states compared with total body fat [7]. Another study reported that faecal calprotectin level is normally elevated in individuals with increased BMI [107]. In addition, obesity-relaed systemic changes can create conditions predisposing to gut inflammation [108]. One study reported that though patients have high faecal calprotectin level, which is characteristic of GI inflammation, they may not necessarily have associated symptoms [7]. This provides evidence that there can be increased inflammatory activity in normal subjects associated with obesity. 4.3 Drug use and GI inflammation The main objective of this study is to investigate drug use and GI inflammation. Referring to Table 3.21, a statistically significant correlation was not noted between drug use and calprotectin level (p>0.05). It should be noted that in this study, none of the participants had calprotectin levels higher than 620 pg/ mL, which is the cut off point for this ELISA kit. This implies that no participant suffered from GI inflammation. With reference to Table 3.5, the maximum calprotectin level recorded is 300pg/mL. The mean calprotectin level is 97.3 pg/mL. Referring to Table 3.4, 10.2% participants consume hypoglycaemic drugs while 9.1% use both hypoglycaemic and antihypertensive drugs. Yet, no correlation was found between drug use and GI inflammation (Table 3.21). With reference to Figure 3.19, 39.77% participants use drugs daily. However, no statistically significant correlation was noted between duration of therapy and calprotectin level (p > 0.05) (Table 3.22). This suggests that duration of drug therapy does not influence calprotectin level and hence GI inflammation. Other factors such as frequency of therapy with a given drug or whether the drug is brand or generic also do not affect calprotectin levels (Table 3.22). One study reported that low-dose aspirin treatment does not increase faecal calprotectin levels, although the use of NSAIDs might cause a rise in calprotectin concentrations due to NSAID-induced enteropathy in patients without IBD [39]. This study shows that aspirin does not increase calprotectin level; however, it also demonstrates that NSAIDs do not increase calprotectin level as no participant taking NSAIDs had calprotectin level above the cut off value. 4.4 Signs and symptoms of GI inflammation and calprotectin level With reference to Figure 3.13, 37.50% of the participants stated that they have suffered from GI inflammation in the past. Among those who have suffered from inflammation in the past, 17.05% suffered from gastritis while 11.36% suffered from inflammation of the intestine (Figure 3.14). Some participants have recently suffered from signs and symptoms of GI inflammation such as abdominal pain. Referring to Table 3.3, it can be seen that 27.3% participants suffered from no signs and symptoms of GI inflammation. Another 27.3% stated that they suffered from diarrhoea, abdominal pain and flatulence recently. These are clinical symptoms of GI inflammation. However, despite this fact, no statistically significant correlation was noted between signs symptoms of GI inflammation and calprotectin level (p>0.05) (Table 3.20). Despite this fact that participants clinically suffered from signs and symptoms of GI inflammation, no calprotectin level above the cut-off point of 620 g/mL (Table 3.5) was detected. Although clinical signs symptoms of GI inflammation were present, the calprotectin level might not have risen to a concentration high enough to be detected by the ELISA kit. This may account for calprotectin levels below the cut-off value. In addition, among those suffering from signs and symptoms of GI inflammation, 29.55% of them ultimately took drugs to alleviate these symptoms (Figure 3.15). Furthermore, Figure 3.16 depicts that among those suffering from signs symptoms of GI inflammation, in 57.95% cases, they were acute while in 13.64% cases, these signs and symptoms were chronic. These two factors might have contributed to the fact that no correlation is seen between calprotectin level and signs of GI inflammation as these drugs might have attenuated the inflammation, if ever present, which could have resulted in calprotectin levels below the cut-off point. Moreover, since the inflammation they suffered from was mostly acute, this might imply that the calprotectin level might not have reached a concentration high enough to be detected by the ELISA kit. 4.5 Calprotectin level With reference to Table 3.5, it can be seen that the minimum calprotectin level recorded was 20pg/mL while the maximum level recorded is 300pg/mL. The table also demonstrates that 15.9% of participants had calprotectin level of 80pg/mL. However, we can conclude that none of the participants suffered from GI inflammation because in no case, the calprotectin level exceeded 620pg/mL, which is the cut-off point for this ELISA kit. Only values above 620pg/mL indicate that GI inflammation is detected. Otherwise for all values below 620pg/mL, it suggests that GI inflammation is absent. Another study reported that the normal range for calprotectin is 52.8-352.9 ÃŽÂ ¼g/mL, meaning that levels of calprotectin above 352.9 ÃŽÂ ¼g/ mL should be considered positive for GI inflammation [109]. This shows that there is inter-kit variation for cut-off points for calprotectin level.

Chlamydial Infection :: essays research papers

Chlamydia Chlamydial infection is the most common bacterial sexually transmitted disease in the United States today. The U.S. Centers for Disease Control and Prevention estimates that more than 4 million new cases occur each year. The highest rates of chlamydial infection are in 15 to 19-year old adolescents regardless of demographics or location. Pelvic inflammatory disease (PID), a serious complication of chlamydial infection, has emerged as a major cause of infertility among women of childbearing age. Chlamydial infection is caused by a bacterium, Chlamydial trachomatis, and can be transmitted during vaginal, oral, or anal sexual contact with an infected partner. A pregnant woman may pass the infection to her newborn during delivery, with subsequent neonatal eye infection or pneumonia. The annual cost of chlamydial infection is estimated to exceed $2 billion. SYMPTOMS   Ã‚  Ã‚  Ã‚  Ã‚  Most chlamydial infections are silent, causing no symptoms. However, men and women with Chlamydia may experience abnormal genital discharge or pain during urination. These early symptoms may be mild. If symptoms occur, they usually appear within one or three weeks after exposure. Two of every three infected women and one or two of every four infected men have no symptoms whatsoever. As a result, often the disease may not be diagnosed and treated until complications develop.   Ã‚  Ã‚  Ã‚  Ã‚  Doctors estimate that, in women, one third of the chlamydial infections result in PID (Pelvic Inflammatory Disease). Often these infections are not diagnosed until PID or other complications develop. In men, rarely, chlamydial infections may lead to pain or swelling in the scrotal area, which is a sign of epididymitis, an inflammation of a part of the male reproductive system located in the testicles. Left untreated, this condition, like PID in women, can cause infertility.   Ã‚  Ã‚  Ã‚  Ã‚  Chlamydia can cause proctitis (inflamed rectum) and conjunctivitis (inflammation of the lining of the eye). The bacteria also have been found in the throat as a result of oral sexual contact with an infected partner. In tropical climates, a particular strain of C. trachomatis causes an STD called lymphogranuloma venereum (LGV), which is characterized by prominent swelling and inflammation of the lymph nodes in the groin. Complications may follow if LGV is not treated; this infection is very rare in the United States. DIAGNOSIS:   Ã‚  Ã‚  Ã‚  Ã‚  Chlamydial Infection can easily be confused with gonorrhea because the symptoms of both diseases are similar; in some populations they occur together. The most reliable way to diagnose chlamydial infection is for a clinician to send a sample of secretions from the patient’s genital area to a laboratory that will look for the organism using one of a wide variety of quick and inexpensive laboratory tests.

Expression versus expectations in Chekhov’s The lady with the pet dog

In The lady with the pet dog, Chekhov’s notion of romantic love coincides with his idea of the duplicitous self and society. Central to Chekhov’s discussion of romantic love is the individual and the institutions that define him (in particular, marital and domestic ones) which Chekhov sees as anything but intact. What whole is perceived on the surface is in reality a fragmented clumsily held together by bogus and empty morality tantamount to hypocrisy. In this case, the romantic impulse comes as a liberating and redeeming sensibility. However, Chekhov asserts, the survival, let alone existence of the romantic love is possible only in the dark—in the small, private (and forbidden) enclave away from the persecuting and prying eyes of the collective. Chekhov (2007) writes of Gurov, â€Å"†¦everything that in which he was sincere and did not deceive himself, everything that made the kernel of his life, was hidden from other people; and all that was false in him†¦all that was open† (chap. IV). Indeed what stands out in Chekhov’s work is the clash between individual sentiments and social expectations; defiance versus the norm, liberating passion as opposed to the stifling demands of pseudo-propriety. Such contestation of values is played out in the characters of Anna Sergeyevna and Dmitri Gurov. Both are trapped and paralyzed by their family and marriages, relationships which are more nominal than actual. Both suffer from a breakdown of communication with their partners and more importantly, their selves. Hence, the disruption of self-expression. Their efforts toward self-definition and determination are brutally countered by the conventions of their sexuality and status. As a result, what occurs is an extinction of their personality and consequently, the imperilment of their love. In this climate, masks are the only means of self-preservation. Gurov, for one, is a man of several faces. His faà §ade appears to be in strict compliance with the behavioral codes attendant of his class and gender. His misogynistic gestures belie his genuine nature. He â€Å"always spoke ill of women, and when they are talked about in his presence, used to call them the lower race†¦. yet he could not get on for two days together without the ‘lower race’† (I). Convention, together with his pretensions, reduces Gurov to a flat and passive character. So flat, in fact, that his entire life and personality can be summed up by the following words: â€Å"He was under forty, but he had a daughter already twelve years old, and two sons at school† (I). In this respect, Gurov is a typical family man. He is head (or better yet, cog) of a family the stability and comfortability of which is owed more to economic and social factors than human warmth and understanding. The family stands for the simple reason that Gurov and his wife, no matter how superficially are playing their parts well. Paradoxically and yet, understandably, Gurov’s extra-marital affairs offer no significant threat to the solidity of his domestic sphere. His women are but fleeting muses, objects of a passion that fades just as quickly as it ignites. Such transient and cold encounters inevitably deteriorate: â€Å"†¦every intimacy which at first so agreeably diversifies life and appears a light and charming adventure, inevitably grows into a regular problem of extreme intricacy, and in the long run the situation becomes unbearable† (I). In a sense, Gurov’s relationships with other women are simply extensions of his mechanical family life. Gurov is deader than alive; older than his years. Despite his numerous preoccupations— â€Å"He already felt a longing to go to restaurants, clubs, dinner parties, anniversary celebrations†¦ entertaining distinguished lawyers and artists† (III)—his hunger for life and love remains unsatisfied. His romantic sensibility continues to stagnate. Gurov’s fate is a microscopic version of the spiritual inertia plaguing larger society. As Gurov laments, â€Å"What senseless nights, what uninteresting, uneventful days! The rage for card playing, the gluttony, the drunkenness, the continual talk always about the same thing† (III). Apparently the preoccupied life of the materially comfortable fail to fill the gaping hole within the individual, in this case, a premature organism at most. What intactness is gained through the observance of superficial social rituals is nothing but conformity and monotony. Gurov’s premature self translates to the frustration of his artistic sensibility. Gurov â€Å"had taken a degree in arts, but had a post in the bank; that he had trained as an opera singer, but ad given it up†¦Ã¢â‚¬  (I). Again, passion has given way to practicality and material considerations. Though practically nameless (indeed, one can only name her through Gurov, and partially at that), Gurov’s wife is far from being a peripheral and passive figure. She enters the story (one can even say, intrude) almost simultaneously as Gurov does. The first glimpse of Gurov is intertwined with that of her that one appears to be the foil of another. Chekhov’s description of her evokes strength (and to a degree, death and deadliness) uncommon of her sex: â€Å"†¦his wife seemed half as old again as he†¦. as she said of herself, intellectual. She read a great deal†¦he secretly considered her unintelligent, narrow inelegant, was afraid of her, and did not like to be at home† (I). His wife’s sense of individuality proves corrosive to their relationship. Not that Chekhov despises individuality in women, Anna’s struggle toward self-definition show otherwise. What makes Gurov’s wife’s fatal is that it consumes, by emasculating, Gurov. An individuality such as her hampers union and unity, disadvantageous to love. The juxtaposition of Gurov and his wife’s sensibility lays bare a glaring incongruity, symptomatic of the failure of their marital communication. The marital environment isolates them both. For Gurov â€Å"in his home it was impossible to talk of his love, and he had no one outside†¦Ã¢â‚¬  (III). And when his wife catches on and reacts to   his hints on love: â€Å"†¦no one guessed what it meant; only his wife twitched her black eyebrows, and said: ‘The part of a lady-killer does not suit you at all, Dimitri’† (III). Their marital union is grounded on repulsion and revulsion. In stark contrast to his wife is the character of Anna Sergeyevna, whose individuality, at least in the beginning, is yet to be defined. Which is not to say that she is empty, for like Gurov, Anna is in search of a life above the mundane: â€Å"To live, to live!†¦ I was fired by curiosity†¦I could not control myself; something happened to me, I could not be restrained† (I). The amorphousness of Anna and Gurov serves as a point of connection, a common ground for them. Anna’s gradual progression from anonymity to indiviulaity is paradoxically combined in her identity as â€Å"the lady with the pet dog†. When Gurov’s â€Å"romance with an unknown woman† (I) unexpectedly escalates to full-blown romance – â€Å"that sweet delirium, that madness† (II) — Anna’s personality becomes indelible: â€Å"Anna did not visit him in dreams, but followed him about everywhere and haunted him†¦Ã¢â‚¬  (II). Indeed, what marks Gurov’s love for Anna is its sense of permanence and identity. Anna’s face is not gobbled up by oblivion, nor does it fade in the crowd. To Gurov, she is the only â€Å"lady with the pet dog†. This sense of eternity is not bound to be challenged though. Society looms as a more powerful and sinister force in the lovers’ lives. Their love is taboo, a truth which they can only postpone but never defeat: â€Å"†¦it seemed to them that fate itself had meant them for one another, and they could not understand why he had a wife and she had a husband†¦Ã¢â‚¬  (IV). Chekhov does not negate the potency, even necessity of genuine romantic love. He does not offer false hopes about it either. Gurov and Anna can only dwell in the present; what the future has to offer is far from hopeful: â€Å"†¦and it was clear to both that they still had a long road before them, and that the most complicated and difficult part is only just beginning† (IV). References Chekhov, A. (2007). The lady with the pet dog. Retrieved December 1, 2007, from   http://www.enotes.com/lady-pet-text.

Animal Farm Comparison - 751 Words

Animal Farm by George Orwell is an interesting story that may seem as if it is a story that is meant to be read by a child however, the story withholds much more meaning than what meets the eye. In the book and movie, there is a society that contains many individuals with the beliefs that things should change, but there will be one individual in particular who will end up taking the initiative to follow through with this change while also taking control by telling these individuals what they want to hear, whether it is the truth or not. Power and control are things in which many leaders thrive off of and they will do anything to get their hands on it. Napoleon was a pig on Animal Farm who made it his priority to secretly begin taking†¦show more content†¦In the end of the book, one of the animals on the farm named Clover, witnessed Napoleon sitting at a table playing cards with the humans who were the owners of the farm while discussing with them that the name of â€Å"Animal Farm† should be changed back to its original, â€Å"Manor Farm† (Orwell, 66). Towards the end of the film, Napoleon was seen at the table drinking whiskey with the owner of the farm, Frederick (AF film). Napoleon specifically stated to the animals that they should not engage in the behaviors of man because mankind was evil however, he had lied to them and did exactly what he told them not to do in order to obtain the power he was eager for. To further contribute to obtaining this power and control, in the end of the film, Napoleon decides to use propaganda to finally deceive the animals one last time and to convince them to believe that he is a successful leader and they should believe what he is telling them (AF film). The changes displayed towards the end of both the book and the film are important because they both portray Napoleon’s success of obtaining his power in the same way, but are displayed through events with minor differences. Even though both pieces affect the audience, the film has more of a negative, but powerful effect on the audience because for individuals, visualization plays a big role in how individuals interpret different things. 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