Zeitschriften und Ausgaben

Volumen 16 (2022): Heft 3 (June 2022)

Volumen 16 (2022): Heft 2 (April 2022)

Volumen 16 (2022): Heft 1 (February 2022)

Volumen 15 (2021): Heft 6 (December 2021)

Volumen 15 (2021): Heft 5 (October 2021)

Volumen 15 (2021): Heft 4 (August 2021)

Volumen 15 (2021): Heft 3 (June 2021)

Volumen 15 (2021): Heft 2 (April 2021)

Volumen 15 (2021): Heft 1 (February 2021)

Volumen 14 (2020): Heft 6 (December 2020)

Volumen 14 (2020): Heft 5 (October 2020)

Volumen 14 (2020): Heft 4 (August 2020)

Volumen 14 (2020): Heft 3 (June 2020)

Volumen 14 (2020): Heft 2 (April 2020)

Volumen 14 (2020): Heft 1 (February 2020)

Volumen 13 (2019): Heft 6 (December 2019)

Volumen 13 (2019): Heft 5 (October 2019)

Volumen 13 (2019): Heft 4 (August 2019)

Volumen 13 (2019): Heft 3 (June 2019)

Volumen 13 (2019): Heft 2 (April 2019)

Volumen 13 (2019): Heft 1 (February 2019)

Volumen 12 (2018): Heft 6 (December 2018)

Volumen 12 (2018): Heft 5 (October 2018)

Volumen 12 (2018): Heft 4 (August 2018)

Volumen 12 (2018): Heft 3 (June 2018)

Volumen 12 (2018): Heft 2 (April 2018)

Volumen 12 (2018): Heft 1 (February 2018)

Volumen 11 (2017): Heft 6 (December 2017)

Volumen 11 (2017): Heft 5 (October 2017)

Volumen 11 (2017): Heft 4 (August 2017)

Volumen 11 (2017): Heft 3 (June 2017)

Volumen 11 (2017): Heft 2 (April 2017)

Volumen 11 (2017): Heft 1 (February 2017)

Volumen 10 (2016): Heft 6 (December 2016)

Volumen 10 (2016): Heft 5 (October 2016)

Volumen 10 (2016): Heft 4 (August 2016)

Volumen 10 (2016): Heft 3 (June 2016)

Volumen 10 (2016): Heft 2 (April 2016)

Volumen 10 (2016): Heft s1 (December 2016)

Volumen 10 (2016): Heft 1 (February 2016)

Volumen 9 (2015): Heft 6 (December 2015)

Volumen 9 (2015): Heft 5 (October 2015)

Volumen 9 (2015): Heft 4 (August 2015)

Volumen 9 (2015): Heft 3 (June 2015)

Volumen 9 (2015): Heft 2 (April 2015)

Volumen 9 (2015): Heft 1 (February 2015)

Volumen 8 (2014): Heft 6 (December 2014)

Volumen 8 (2014): Heft 5 (October 2014)

Volumen 8 (2014): Heft 4 (August 2014)

Volumen 8 (2014): Heft 3 (June 2014)

Volumen 8 (2014): Heft 2 (April 2014)

Volumen 8 (2014): Heft 1 (February 2014)

Volumen 7 (2013): Heft 6 (December 2013)

Volumen 7 (2013): Heft 5 (October 2013)

Volumen 7 (2013): Heft 4 (August 2013)

Volumen 7 (2013): Heft 3 (June 2013)

Volumen 7 (2013): Heft 2 (April 2013)

Volumen 7 (2013): Heft 1 (February 2013)

Volumen 6 (2012): Heft 6 (December 2012)

Volumen 6 (2012): Heft 5 (October 2012)

Volumen 6 (2012): Heft 4 (August 2012)

Volumen 6 (2012): Heft 3 (June 2012)

Volumen 6 (2012): Heft 2 (April 2012)

Volumen 6 (2012): Heft 1 (February 2012)

Volumen 5 (2011): Heft 6 (December 2011)

Volumen 5 (2011): Heft 5 (October 2011)

Volumen 5 (2011): Heft 4 (August 2011)

Volumen 5 (2011): Heft 3 (June 2011)

Volumen 5 (2011): Heft 2 (April 2011)

Volumen 5 (2011): Heft 1 (February 2011)

Volumen 4 (2010): Heft 6 (December 2010)

Volumen 4 (2010): Heft 5 (October 2010)

Volumen 4 (2010): Heft 4 (August 2010)

Volumen 4 (2010): Heft 3 (June 2010)

Volumen 4 (2010): Heft 2 (April 2010)

Volumen 4 (2010): Heft 1 (February 2010)

Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

Volumen 10 (2016): Heft 1 (February 2016)

Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

12 Artikel

Editorial

Uneingeschränkter Zugang

Key approaches to nosocomial infection control

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 1 - 2

Zusammenfassung

Mini review article

Uneingeschränkter Zugang

Current trends in the risk prediction for hepatitis B virus-related hepatocellular carcinoma

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 3 - 13

Zusammenfassung

Abstract

Chronic hepatitis B related hepatocellular carcinoma (HCC) is a leading cause of cancer death in hepatitis B virus endemic areas including the Asia-Pacific region. The risk of HCC development can be reduced by antiviral therapy and surveillance programs. However, this would place a heavy fiscal burden on low- and middle-income countries, which are in these endemic areas. Therefore, there is a need for accurate prediction of HCC risk to prioritize patient care. Based on well-established host and viral risk factors, several HCC risk scores have been derived and validated: GAG-HCC, CU-HCC, and REACH-B for Asians and PAGE-B for white people of European ancestry. Each score has been shown to be accurate in predicting HCC up to 10 years into the future when applied to the appropriate patient group, especially with regards to their ethnicity and antiviral therapy status. Recently noninvasive tests of liver fibrosis have been integrated into existing HCC risk scores with encouraging results. As HCC risk prediction continues to evolve, the future promises a more individualized approach to HCC surveillance, ultimately leading to improved patient care and resource allocation.

Schlüsselwörter

  • Albumin
  • antiviral therapy
  • cirrhosis
  • entecavir
  • transient elastography

Original article

Uneingeschränkter Zugang

Factors associated with mortality and high treatment expense of adult patients hospitalized with chronic kidney disease in Thailand

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 15 - 24

Zusammenfassung

Abstract Background

Chronic kidney disease (CKD) is a global public health problem with a high risk of hospitalization and death. Few nationwide data have been reported regarding the outcomes of patients hospitalized with CKD in developing countries.

Objectives

To study the risk factors associated with mortality and high treatment costs of adult patients hospitalized with CKD in Thailand.

Methods

The medical data forms for adult inpatients with CKD collected in fiscal year 2010 were analyzed to determine the number of CKD admissions, associated comorbidities and complications, mortality rates, and hospital charges. Factors influencing mortality rates were evaluated by multiple logistic regression.

Results

The total number of CKD patients was 128,338. After adjustment, the major factors associated with high hospital charges were (a) comorbidities (e.g. pneumonia OR 3.18, 95% CI 3.03–3.34; sepsis OR 2.87, 95% CI 2.74–3.00; acute kidney injury (AKI) on preexisting CKD OR 2.83, 95% CI 2.69–2.98) and (b) dialysis treatment (i.e., hemodialysis OR 5.16, 95% CI 4.94–5.39; peritoneal dialysis OR 3.40, 95% CI 3.14–3.69). The risk factors for high mortality were: being male, elderly, having comorbidity (viz., sepsis, respiratory failure, stroke, pneumonia, ischemic heart disease, AKI in addition to CKD, heart failure, and diabetes), and CKD complications (viz., metabolic acidosis, hyperkalemia, volume overload, and anemia requiring blood transfusion).

Conclusions

Prevention and early treatment of any comorbidity and complications of CKD might reduce mortality and treatment costs of patients hospitalized with CKD.

Schlüsselwörter

  • Chronic kidney disease
  • mortality
  • risk factors
  • predictors
  • high cost
Uneingeschränkter Zugang

Skilled birth attendance in Balochistan, Pakistan

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 25 - 34

Zusammenfassung

Abstract Background

Pakistan faces high maternal and neonatal mortality despite interventions from government, national, and international organizations.

Objective

To assess factors associated with the use of skilled birth attendance in Balochistan.

Methods

A logistic regression model was used to identify factors influencing use of skilled birth attendance from data obtained from the Balochistan Multiple Indicator Cluster Survey 2010, together with social and economic determinants..

Results

Only 25.7% of the expectant mothers in Balochistan Province used skilled birth attendance. Women from rural areas were less likely to use skilled attendance compared with compared with those from urban areas (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.51–0.95). Poverty was negatively associated with use (OR = 0.26, 95% CI = 0.02–0.51). Lack of education was negatively associated with skilled birth attendance (OR = 0.38, 95% CI = 0.09–0.67). Women from 25 to 34 years old were more likely to use skilled birth attendance than younger women (OR = 1.51, 95% CI = 1.03 –2.81). Women who justified being beaten by their husbands were less likely to use skilled attendance (OR = 0.64; 95% CI = 0.39–0.89).

Conclusions

There are gaps in use of skilled birth attendance between women in urban and rural settings, rich and poor, the educated and those with no schooling. Their age, age at first marriage, number of children ever born, attitude toward being beaten by their husband, and source of skilled antenatal care significantly influenced the expectant mothers to use skilled birth attendance.

Schlüsselwörter

  • Balochistan
  • determinants
  • multiple indicator cluster survey
  • skilled birth attendant
  • utilization

Brief communication (Original)

Uneingeschränkter Zugang

Colistin susceptibility of gram-negative clinical isolates from Tamil Nadu, India

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 35 - 39

Zusammenfassung

Abstract Background

Colistin is one of the oldest antibiotics in the polymyxin group, and is used mostly against gramnegative bacteria. Because of developing resistance among clinical isolates colistin has become an alternative drug for multidrug resistant bacteria.

Objectives

To determine colistin resistance among isolates from Tamil Nadu, India.

Methods

We included 94 gram-negative isolates from two centers in Tamil Nadu in the present study. Isolates were identified by 16S rRNA sequencing. Minimal inhibitory concentrations (MICs) were determined by agar dilution.

Results

The isolates identified at species level included 48 Escherichia coli, 9 Klebsiella pneumoniae, 10 Pseudomonas aeruginosa, 5 Proteus mirabilis, 4 Salmonella enterica, 3 Enterobacter hormaechei, 3 Enterobacter cloacae, 2 Achromobacter xylosoxidans, 2 Acinetobacter baumannii, 1 Providencia vermicola, 1 Acinetobacter towneri, 1 Enterobacter gergoviae, 2 Providencia rettgeri, 1 Enterobacter asburiae, 1 Pseudomonas stutzeri, and 1 Salmonella typhi. The MIC of colistin ranged from 0.12 μg/ml to 128 μg/ml. The MIC50 was 1 μg/mL and MIC90 was >128 μg/ml. The MIC ≥ 8 μg/mL was resistant breakpoint for all the species. A total of 27 isolates were resistant to colistin. Colistin resistant isolates included E. coli (9/48), K. pneumoniae (6/9), P. aeruginosa (3/10), A. baumannii (1/2), P. mirabilis (4/5), E. cloacae (1/3), P. rettgeri (2/2), and S. enterica (1/4). Carbapenem susceptibility of colistin resistant isolates was tested and 14 were found to be resistant to meropenem.

Conclusions

Our study indicates the emergence of colistin resistant isolates from clinical samples among different groups of gram-negative organisms. Resistance to both carbapenem and colistin occurs. Developing new antibiotics and programs to reduce nosocomial infections is necessary especially for multidrug resistant isolates.

Schlüsselwörter

  • Antimicrobial agents
  • gram negative
  • multi-drug resistant
  • pathogenesis
  • polymyxin
Uneingeschränkter Zugang

Antibiotic resistance, multidrug resistance and enterobacterial repetitive intergenic consensus polymerase chain reaction profiles of clinically important Klebsiella species

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 41 - 47

Zusammenfassung

Abstract Background

Klebsiella species are important opportunistic pathogens causing a variety of infections, especially in hospitalized and immunocompromised patients.

Objectives

To investigate the clinical prevalence of five different Klebsiella species (K. pneumoniae, K. ornithinolytica, K. oxytoca, K. terrigena, and K. rhinoscleromatis) including antibiotic resistance profiles using six different antibiotics and combinations (trimethoprim-sulfamethoxazole, ampicillin-sulbactam, imipenem, piperacillin-tazobactam, ciprofloxacin, ceftizoxime).

Methods

Resistance of Klebsiella spp. including multidrug resistant (MDR) strains was determined by using a Kirby–Bauer disk diffusion method and genotypical analysis was performed by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR).

Results

Urine samples and the urology service unit were the most common sources of K. ornithinolytica, K. pneumoniae, and K. terrigena strains. The greatest drug resistance was observed against trimethoprim-sulfamethoxazole (88%), the least resistance was observed against imipenem (12%). Apart from these, 11 different antibiotypes were generated and antibiotype AI (resistant only to trimethoprim-sulfamethoxazole) was the most frequently observed (40%). MDR profiles of Klebsiella spp. were also investigated and 25% of all Klebsiella spp. strains were found to be MDR; and 65% of these were isolated from urine samples. MDR strains were mostly found to be K. ornithinolytica (35%) followed by K. pneumoniae (29%). Genotyping was performed by using ERIC PCR and Klebsiella spp. strains were grouped in 23 genotypes with a similarity coefficient of 70%.

Conclusions

Antibiotyping and antibiotype profiles may provide valuable information for hospitalized patients that could identify problem spots and allow evidence-based provision of preventive measures against nosocomial emergence of infections with new MDR strains.

Schlüsselwörter

  • Antibiotic resistance
  • ERIC PCR
  • spp
  • multidrug resistance
Uneingeschränkter Zugang

Genotypic characterization of Enterococcus species isolated from the oral cavity and their pattern of antibiotic susceptibility

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 49 - 53

Zusammenfassung

Abstract Background

Enterococci comprise a small share of oral flora and occur as contaminants in food such as meat and cheese. They are commonly encountered in patients with infections of oral tissues such as necrotic pulp, root canals and periodontitis.

Objective

To characterize the genotypes of Enterococcus isolated from patients with oral infection and to determine their antibiotic susceptibility.

Method

We genotypically characterized a number of isolates of Enterococcus species derived from patients with various oral infections. All the isolates were tested for the presence of putative virulence genes; efaA (gene for endocarditis), gelE (gene for gelatinase), ace (gene for collagen binding antigen), asa (gene for aggregation substance), cylA (gene for cytolysin activator), and esp (gene for surface adhesin) of E. faecalis and E. faecium as described in previous studies.

Result

E. faecalis dominated in oral infections compared with E. faecium. Isolates were susceptible to most antibiotics (only four were resistant to vancomycin). To our knowledge, the first report from this region.

Conclusion

Treatment of enterococcal infections of the oral mucosal and deep oral areas necessitate microbiological diagnosis and identification of resistance strains.

Schlüsselwörter

  • Antibiotic susceptibility pattern
  • Enterococcus species
  • genotypic characterization
  • oral infections
Uneingeschränkter Zugang

Comparison of slow and fast action gel baits for pest management of Blattella germanica (German cockroach) infestation in housing

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 55 - 59

Zusammenfassung

Abstract Background

Gel baits are important for integrated pest management (IPM). The relative efficacy of various baits is unknown.

Objective

To evaluate the efficacy of different gel belts (hydramethylnon 2%, fipronil 0.05%, and imidacloprid 2.15%) for control of Blattella germanica (German cockroach) infestation.

Method

All the tested (field) strains were collected from housing in Yasuj city, Iran. Ten German cockroaches for each developmental stage were placed in separate labeled glass rearing jars of the same size. Mortality was observed at 12 h intervals after exposure to baits. Each study was conducted in triplicate.

Result

All gel baits produced 100% mortality of cockroaches within 1 to 5 days. However, imidacloprid killed cockroaches more rapidly (LT50 = 13.3 h) than fipronil (LT50 = 32.5 h) or hydramethylnon (LT50 = 61.6 h). The results showed rapid, quick, and slow action for the three baits respectively. Comparison between the baits showed that the slow action bait is more compatible with IPM, being the most effective in 3 or more days; increased potential for secondary mortality through horizontal transmission of lethal dose and also via residue; decreased risk of food contamination by dead cockroaches; will decrease the chance of behavioral resistance, and it had higher feeding stimulation potential than the others.

Conclusion

Hydramethylnon is preferred for IPM. Fipronil is a plausible alternative.

Schlüsselwörter

  • Cockroach infestation
  • fast action bait
  • IPM
  • slow action bait
Uneingeschränkter Zugang

The prevalence of some gastrointestinal nematodes and cestodes in Iraqis

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 61 - 66

Zusammenfassung

Abstract Background

Infections with helminths are associated with deficient sanitary facilities, unsafe human waste disposal, inadequate and lack of safe drinking water, and low socioeconomic status.

Objective

To determine the prevalence of some gastrointestinal helminths among Iraqi people, and association of infections with age, sex, and region in Iraq.

Method

This study is retrospective, including reported cases of infections using an available surveillance database from January 2013 to December 2013 of all provinces of Iraq by the Ministry of Health.

Result

The overall prevalence of gastrointestinal helminthiasis was 1.39%. Enterobius vermicularis found to be the predominant helminth parasite. No significant (P < 0.05) relationship was found between sex and infection, although male individuals tended to show greater helminthiasis, while a significant relationship was found between age and infection. The common infections were more frequent among the 5-14 year age group. We found a lower prevalence of helminth infections in the northern (Ninevah, Suleimaniyah, Ta’mim, Erbil, and Dohuk) and middle Euphrates (Babil, Karbala, Najaf, Qadisiyah, and Muthanna) region provinces, compared with the middle (Baghdad, Anbar, Diyala, and Salahuddin) and southern (Wasit, Dhi-qar, Misan, and Basrah) region provinces where the prevalence was higher.

Conclusion

In this study, we found lower prevalence of infections in Iraq than similar studies conducted in other parts of Asia, which may be a consequence of the sample size, seasonal diversity, general personal hygiene, and public health services.

Schlüsselwörter

  • Helminths
  • human
  • infectious
  • Iraq
  • prevalence
Uneingeschränkter Zugang

Prevalence of impaired lower airway function in Thai patients with allergic rhinitis

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 67 - 74

Zusammenfassung

Abstract Background

Allergy is a chronic inflammatory disease, which may affect the upper and lower airway in reversible airflow obstruction or asthma. Spirometry is a noninvasive way to assess lower airway function routinely and to detect reversible airflow obstruction.

Objective

To determine the prevalence of abnormal spirometry in Thai patients with allergic rhinitis (AR) who did not have lower airway symptoms.

Method

Spirometry and bronchodilation testing were performed in AR patients.

Result

We included 153 patients aged from 20 to 60 years who had AR (diagnosed by clinical data and positive skin prick test) and who fulfilled the study criteria. Twenty-three patients with AR (15%) showed decreased forced expiratory volume in 1 s (FEV1) compared with normal values (FEV1 <80% of predicted value). Four patients with AR (3%) showed reversible airflow obstruction. Thirty-seven patients with AR (24%) showed decreased forced expiratory flow during 25-75 s (FEF25-75) compared with the reference value (FEF25-75 <80% of predicted value). The sensitization to both indoor and outdoor allergens was statistically and significantly associated with the decreased FEV1 (odds ratio (OR) = 7.79, 95% confidence interval (CI) 1.08-55.91, P = 0.03). The duration of AR was more than 10 years significantly affected FEF25-75 (adjusted OR = 2.6; 95%CI = 1.01-6.72, P = 0.04).

Conclusion

Impaired lower airway function and reversible airflow obstruction in patients with AR are not uncommon. Spirometry should be performed to detect lower airway impairment early in patients with AR, especially those sensitized to indoor and outdoor allergens.

Schlüsselwörter

  • Allergic rhinitis
  • asthma
  • FEV
  • reversible airflow obstruction
  • spirometry
Uneingeschränkter Zugang

Correlation between broth microdilution, E-test and disk diffusion methods for testing antifungal susceptibility of Candida species isolated from Thai blood samples

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 75 - 80

Zusammenfassung

Abstract Background

Broth microdilution (BMD) is a standard assay for susceptibility of Candida to antifungals, but complexity limits its routine application. E-test (ET) and disk diffusion (DD) assays are attractive alternatives because of their simplicity and reproducibility.

Objectives

To determine the correlation between BMD, and ET and DD assay results for Candida isolates.

Methods

We tested 63 Candida isolates for their susceptibility to fluconazole and voriconazole using BMD, ET, and DD, and recorded minimum inhibitory concentrations (MIC) and inhibitory zone diameters (ZD). Spearman correlations were determined and the Clinical and Laboratory Standards Institute recommendations were used to assess major and minor errors in test results.

Results

The isolates included 32 (51%) C. albicans, 14 (22%) C. tropicalis, 12 (19%) C. parapsilosis, 4 (6%) C. glabrata, and 1 (2%) C. guilliermondii. The BMD-MIC and ET-MIC had good correlation for fluconazole (r = 0.94; P < 0.001) and voriconazole (r = 0.95; P < 0.001). The BMD-MIC for both antifungals were significantly correlated with the ZD of the DD assays (r = −0.47; P < 0.001; r = −0.75; P < 0.001, respectively). Agreement between the BMD and the ET and DD results exceeded 90%. No major errors were identified in any comparisons.

Conclusions

C. albicans were predominant among the isolates and were susceptible to fluconazole and voriconazole. The BMD results were well correlated with ET and DD assay results, and therefore ET and DD assays can be recommended as initial screening tools in resource-limited hospitals because of their relatively low cost.

Schlüsselwörter

  • Broth microdilution
  • candidiasis
  • disk diffusion
  • E-test

Clinical vignette

Uneingeschränkter Zugang

Prednisolone-induced immune hemolysis: a case report

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 81 - 85

Zusammenfassung

Abstract Background

Drug induced immune hemolysis is potentially serious. Most commonly antibiotics are responsible, while immunosuppressive drugs have been reported rarely.

Objectives

To report a rare case of suspected prednisolone-induced immune hemolysis.

Methods

A 59-year-old male patient with hemoglobin H disease and lymphoma developed hemagglutination and immune hemolytic anemia 20 days after receiving prednisolone.

Results

A direct antiglobulin test was positive for C3d. A test indicated prednisolone-dependent red blood cell antibody of the “immune complex” type. Tests with all other medications administered to the patient were negative. Dexamethasone was given to the patient without any reaction, as consistent with in vitro test results.

Conclusions

Physicians should be aware of possible prednisolone-induced complement-mediated immune hemolysis by an immune complex mechanism and request appropriate diagnostic tests as indicated.

Schlüsselwörter

  • Drug-induced immune hemolysis
  • prednisolone
12 Artikel

Editorial

Uneingeschränkter Zugang

Key approaches to nosocomial infection control

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 1 - 2

Zusammenfassung

Mini review article

Uneingeschränkter Zugang

Current trends in the risk prediction for hepatitis B virus-related hepatocellular carcinoma

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 3 - 13

Zusammenfassung

Abstract

Chronic hepatitis B related hepatocellular carcinoma (HCC) is a leading cause of cancer death in hepatitis B virus endemic areas including the Asia-Pacific region. The risk of HCC development can be reduced by antiviral therapy and surveillance programs. However, this would place a heavy fiscal burden on low- and middle-income countries, which are in these endemic areas. Therefore, there is a need for accurate prediction of HCC risk to prioritize patient care. Based on well-established host and viral risk factors, several HCC risk scores have been derived and validated: GAG-HCC, CU-HCC, and REACH-B for Asians and PAGE-B for white people of European ancestry. Each score has been shown to be accurate in predicting HCC up to 10 years into the future when applied to the appropriate patient group, especially with regards to their ethnicity and antiviral therapy status. Recently noninvasive tests of liver fibrosis have been integrated into existing HCC risk scores with encouraging results. As HCC risk prediction continues to evolve, the future promises a more individualized approach to HCC surveillance, ultimately leading to improved patient care and resource allocation.

Schlüsselwörter

  • Albumin
  • antiviral therapy
  • cirrhosis
  • entecavir
  • transient elastography

Original article

Uneingeschränkter Zugang

Factors associated with mortality and high treatment expense of adult patients hospitalized with chronic kidney disease in Thailand

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 15 - 24

Zusammenfassung

Abstract Background

Chronic kidney disease (CKD) is a global public health problem with a high risk of hospitalization and death. Few nationwide data have been reported regarding the outcomes of patients hospitalized with CKD in developing countries.

Objectives

To study the risk factors associated with mortality and high treatment costs of adult patients hospitalized with CKD in Thailand.

Methods

The medical data forms for adult inpatients with CKD collected in fiscal year 2010 were analyzed to determine the number of CKD admissions, associated comorbidities and complications, mortality rates, and hospital charges. Factors influencing mortality rates were evaluated by multiple logistic regression.

Results

The total number of CKD patients was 128,338. After adjustment, the major factors associated with high hospital charges were (a) comorbidities (e.g. pneumonia OR 3.18, 95% CI 3.03–3.34; sepsis OR 2.87, 95% CI 2.74–3.00; acute kidney injury (AKI) on preexisting CKD OR 2.83, 95% CI 2.69–2.98) and (b) dialysis treatment (i.e., hemodialysis OR 5.16, 95% CI 4.94–5.39; peritoneal dialysis OR 3.40, 95% CI 3.14–3.69). The risk factors for high mortality were: being male, elderly, having comorbidity (viz., sepsis, respiratory failure, stroke, pneumonia, ischemic heart disease, AKI in addition to CKD, heart failure, and diabetes), and CKD complications (viz., metabolic acidosis, hyperkalemia, volume overload, and anemia requiring blood transfusion).

Conclusions

Prevention and early treatment of any comorbidity and complications of CKD might reduce mortality and treatment costs of patients hospitalized with CKD.

Schlüsselwörter

  • Chronic kidney disease
  • mortality
  • risk factors
  • predictors
  • high cost
Uneingeschränkter Zugang

Skilled birth attendance in Balochistan, Pakistan

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 25 - 34

Zusammenfassung

Abstract Background

Pakistan faces high maternal and neonatal mortality despite interventions from government, national, and international organizations.

Objective

To assess factors associated with the use of skilled birth attendance in Balochistan.

Methods

A logistic regression model was used to identify factors influencing use of skilled birth attendance from data obtained from the Balochistan Multiple Indicator Cluster Survey 2010, together with social and economic determinants..

Results

Only 25.7% of the expectant mothers in Balochistan Province used skilled birth attendance. Women from rural areas were less likely to use skilled attendance compared with compared with those from urban areas (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.51–0.95). Poverty was negatively associated with use (OR = 0.26, 95% CI = 0.02–0.51). Lack of education was negatively associated with skilled birth attendance (OR = 0.38, 95% CI = 0.09–0.67). Women from 25 to 34 years old were more likely to use skilled birth attendance than younger women (OR = 1.51, 95% CI = 1.03 –2.81). Women who justified being beaten by their husbands were less likely to use skilled attendance (OR = 0.64; 95% CI = 0.39–0.89).

Conclusions

There are gaps in use of skilled birth attendance between women in urban and rural settings, rich and poor, the educated and those with no schooling. Their age, age at first marriage, number of children ever born, attitude toward being beaten by their husband, and source of skilled antenatal care significantly influenced the expectant mothers to use skilled birth attendance.

Schlüsselwörter

  • Balochistan
  • determinants
  • multiple indicator cluster survey
  • skilled birth attendant
  • utilization

Brief communication (Original)

Uneingeschränkter Zugang

Colistin susceptibility of gram-negative clinical isolates from Tamil Nadu, India

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 35 - 39

Zusammenfassung

Abstract Background

Colistin is one of the oldest antibiotics in the polymyxin group, and is used mostly against gramnegative bacteria. Because of developing resistance among clinical isolates colistin has become an alternative drug for multidrug resistant bacteria.

Objectives

To determine colistin resistance among isolates from Tamil Nadu, India.

Methods

We included 94 gram-negative isolates from two centers in Tamil Nadu in the present study. Isolates were identified by 16S rRNA sequencing. Minimal inhibitory concentrations (MICs) were determined by agar dilution.

Results

The isolates identified at species level included 48 Escherichia coli, 9 Klebsiella pneumoniae, 10 Pseudomonas aeruginosa, 5 Proteus mirabilis, 4 Salmonella enterica, 3 Enterobacter hormaechei, 3 Enterobacter cloacae, 2 Achromobacter xylosoxidans, 2 Acinetobacter baumannii, 1 Providencia vermicola, 1 Acinetobacter towneri, 1 Enterobacter gergoviae, 2 Providencia rettgeri, 1 Enterobacter asburiae, 1 Pseudomonas stutzeri, and 1 Salmonella typhi. The MIC of colistin ranged from 0.12 μg/ml to 128 μg/ml. The MIC50 was 1 μg/mL and MIC90 was >128 μg/ml. The MIC ≥ 8 μg/mL was resistant breakpoint for all the species. A total of 27 isolates were resistant to colistin. Colistin resistant isolates included E. coli (9/48), K. pneumoniae (6/9), P. aeruginosa (3/10), A. baumannii (1/2), P. mirabilis (4/5), E. cloacae (1/3), P. rettgeri (2/2), and S. enterica (1/4). Carbapenem susceptibility of colistin resistant isolates was tested and 14 were found to be resistant to meropenem.

Conclusions

Our study indicates the emergence of colistin resistant isolates from clinical samples among different groups of gram-negative organisms. Resistance to both carbapenem and colistin occurs. Developing new antibiotics and programs to reduce nosocomial infections is necessary especially for multidrug resistant isolates.

Schlüsselwörter

  • Antimicrobial agents
  • gram negative
  • multi-drug resistant
  • pathogenesis
  • polymyxin
Uneingeschränkter Zugang

Antibiotic resistance, multidrug resistance and enterobacterial repetitive intergenic consensus polymerase chain reaction profiles of clinically important Klebsiella species

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 41 - 47

Zusammenfassung

Abstract Background

Klebsiella species are important opportunistic pathogens causing a variety of infections, especially in hospitalized and immunocompromised patients.

Objectives

To investigate the clinical prevalence of five different Klebsiella species (K. pneumoniae, K. ornithinolytica, K. oxytoca, K. terrigena, and K. rhinoscleromatis) including antibiotic resistance profiles using six different antibiotics and combinations (trimethoprim-sulfamethoxazole, ampicillin-sulbactam, imipenem, piperacillin-tazobactam, ciprofloxacin, ceftizoxime).

Methods

Resistance of Klebsiella spp. including multidrug resistant (MDR) strains was determined by using a Kirby–Bauer disk diffusion method and genotypical analysis was performed by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR).

Results

Urine samples and the urology service unit were the most common sources of K. ornithinolytica, K. pneumoniae, and K. terrigena strains. The greatest drug resistance was observed against trimethoprim-sulfamethoxazole (88%), the least resistance was observed against imipenem (12%). Apart from these, 11 different antibiotypes were generated and antibiotype AI (resistant only to trimethoprim-sulfamethoxazole) was the most frequently observed (40%). MDR profiles of Klebsiella spp. were also investigated and 25% of all Klebsiella spp. strains were found to be MDR; and 65% of these were isolated from urine samples. MDR strains were mostly found to be K. ornithinolytica (35%) followed by K. pneumoniae (29%). Genotyping was performed by using ERIC PCR and Klebsiella spp. strains were grouped in 23 genotypes with a similarity coefficient of 70%.

Conclusions

Antibiotyping and antibiotype profiles may provide valuable information for hospitalized patients that could identify problem spots and allow evidence-based provision of preventive measures against nosocomial emergence of infections with new MDR strains.

Schlüsselwörter

  • Antibiotic resistance
  • ERIC PCR
  • spp
  • multidrug resistance
Uneingeschränkter Zugang

Genotypic characterization of Enterococcus species isolated from the oral cavity and their pattern of antibiotic susceptibility

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 49 - 53

Zusammenfassung

Abstract Background

Enterococci comprise a small share of oral flora and occur as contaminants in food such as meat and cheese. They are commonly encountered in patients with infections of oral tissues such as necrotic pulp, root canals and periodontitis.

Objective

To characterize the genotypes of Enterococcus isolated from patients with oral infection and to determine their antibiotic susceptibility.

Method

We genotypically characterized a number of isolates of Enterococcus species derived from patients with various oral infections. All the isolates were tested for the presence of putative virulence genes; efaA (gene for endocarditis), gelE (gene for gelatinase), ace (gene for collagen binding antigen), asa (gene for aggregation substance), cylA (gene for cytolysin activator), and esp (gene for surface adhesin) of E. faecalis and E. faecium as described in previous studies.

Result

E. faecalis dominated in oral infections compared with E. faecium. Isolates were susceptible to most antibiotics (only four were resistant to vancomycin). To our knowledge, the first report from this region.

Conclusion

Treatment of enterococcal infections of the oral mucosal and deep oral areas necessitate microbiological diagnosis and identification of resistance strains.

Schlüsselwörter

  • Antibiotic susceptibility pattern
  • Enterococcus species
  • genotypic characterization
  • oral infections
Uneingeschränkter Zugang

Comparison of slow and fast action gel baits for pest management of Blattella germanica (German cockroach) infestation in housing

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 55 - 59

Zusammenfassung

Abstract Background

Gel baits are important for integrated pest management (IPM). The relative efficacy of various baits is unknown.

Objective

To evaluate the efficacy of different gel belts (hydramethylnon 2%, fipronil 0.05%, and imidacloprid 2.15%) for control of Blattella germanica (German cockroach) infestation.

Method

All the tested (field) strains were collected from housing in Yasuj city, Iran. Ten German cockroaches for each developmental stage were placed in separate labeled glass rearing jars of the same size. Mortality was observed at 12 h intervals after exposure to baits. Each study was conducted in triplicate.

Result

All gel baits produced 100% mortality of cockroaches within 1 to 5 days. However, imidacloprid killed cockroaches more rapidly (LT50 = 13.3 h) than fipronil (LT50 = 32.5 h) or hydramethylnon (LT50 = 61.6 h). The results showed rapid, quick, and slow action for the three baits respectively. Comparison between the baits showed that the slow action bait is more compatible with IPM, being the most effective in 3 or more days; increased potential for secondary mortality through horizontal transmission of lethal dose and also via residue; decreased risk of food contamination by dead cockroaches; will decrease the chance of behavioral resistance, and it had higher feeding stimulation potential than the others.

Conclusion

Hydramethylnon is preferred for IPM. Fipronil is a plausible alternative.

Schlüsselwörter

  • Cockroach infestation
  • fast action bait
  • IPM
  • slow action bait
Uneingeschränkter Zugang

The prevalence of some gastrointestinal nematodes and cestodes in Iraqis

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 61 - 66

Zusammenfassung

Abstract Background

Infections with helminths are associated with deficient sanitary facilities, unsafe human waste disposal, inadequate and lack of safe drinking water, and low socioeconomic status.

Objective

To determine the prevalence of some gastrointestinal helminths among Iraqi people, and association of infections with age, sex, and region in Iraq.

Method

This study is retrospective, including reported cases of infections using an available surveillance database from January 2013 to December 2013 of all provinces of Iraq by the Ministry of Health.

Result

The overall prevalence of gastrointestinal helminthiasis was 1.39%. Enterobius vermicularis found to be the predominant helminth parasite. No significant (P < 0.05) relationship was found between sex and infection, although male individuals tended to show greater helminthiasis, while a significant relationship was found between age and infection. The common infections were more frequent among the 5-14 year age group. We found a lower prevalence of helminth infections in the northern (Ninevah, Suleimaniyah, Ta’mim, Erbil, and Dohuk) and middle Euphrates (Babil, Karbala, Najaf, Qadisiyah, and Muthanna) region provinces, compared with the middle (Baghdad, Anbar, Diyala, and Salahuddin) and southern (Wasit, Dhi-qar, Misan, and Basrah) region provinces where the prevalence was higher.

Conclusion

In this study, we found lower prevalence of infections in Iraq than similar studies conducted in other parts of Asia, which may be a consequence of the sample size, seasonal diversity, general personal hygiene, and public health services.

Schlüsselwörter

  • Helminths
  • human
  • infectious
  • Iraq
  • prevalence
Uneingeschränkter Zugang

Prevalence of impaired lower airway function in Thai patients with allergic rhinitis

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 67 - 74

Zusammenfassung

Abstract Background

Allergy is a chronic inflammatory disease, which may affect the upper and lower airway in reversible airflow obstruction or asthma. Spirometry is a noninvasive way to assess lower airway function routinely and to detect reversible airflow obstruction.

Objective

To determine the prevalence of abnormal spirometry in Thai patients with allergic rhinitis (AR) who did not have lower airway symptoms.

Method

Spirometry and bronchodilation testing were performed in AR patients.

Result

We included 153 patients aged from 20 to 60 years who had AR (diagnosed by clinical data and positive skin prick test) and who fulfilled the study criteria. Twenty-three patients with AR (15%) showed decreased forced expiratory volume in 1 s (FEV1) compared with normal values (FEV1 <80% of predicted value). Four patients with AR (3%) showed reversible airflow obstruction. Thirty-seven patients with AR (24%) showed decreased forced expiratory flow during 25-75 s (FEF25-75) compared with the reference value (FEF25-75 <80% of predicted value). The sensitization to both indoor and outdoor allergens was statistically and significantly associated with the decreased FEV1 (odds ratio (OR) = 7.79, 95% confidence interval (CI) 1.08-55.91, P = 0.03). The duration of AR was more than 10 years significantly affected FEF25-75 (adjusted OR = 2.6; 95%CI = 1.01-6.72, P = 0.04).

Conclusion

Impaired lower airway function and reversible airflow obstruction in patients with AR are not uncommon. Spirometry should be performed to detect lower airway impairment early in patients with AR, especially those sensitized to indoor and outdoor allergens.

Schlüsselwörter

  • Allergic rhinitis
  • asthma
  • FEV
  • reversible airflow obstruction
  • spirometry
Uneingeschränkter Zugang

Correlation between broth microdilution, E-test and disk diffusion methods for testing antifungal susceptibility of Candida species isolated from Thai blood samples

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 75 - 80

Zusammenfassung

Abstract Background

Broth microdilution (BMD) is a standard assay for susceptibility of Candida to antifungals, but complexity limits its routine application. E-test (ET) and disk diffusion (DD) assays are attractive alternatives because of their simplicity and reproducibility.

Objectives

To determine the correlation between BMD, and ET and DD assay results for Candida isolates.

Methods

We tested 63 Candida isolates for their susceptibility to fluconazole and voriconazole using BMD, ET, and DD, and recorded minimum inhibitory concentrations (MIC) and inhibitory zone diameters (ZD). Spearman correlations were determined and the Clinical and Laboratory Standards Institute recommendations were used to assess major and minor errors in test results.

Results

The isolates included 32 (51%) C. albicans, 14 (22%) C. tropicalis, 12 (19%) C. parapsilosis, 4 (6%) C. glabrata, and 1 (2%) C. guilliermondii. The BMD-MIC and ET-MIC had good correlation for fluconazole (r = 0.94; P < 0.001) and voriconazole (r = 0.95; P < 0.001). The BMD-MIC for both antifungals were significantly correlated with the ZD of the DD assays (r = −0.47; P < 0.001; r = −0.75; P < 0.001, respectively). Agreement between the BMD and the ET and DD results exceeded 90%. No major errors were identified in any comparisons.

Conclusions

C. albicans were predominant among the isolates and were susceptible to fluconazole and voriconazole. The BMD results were well correlated with ET and DD assay results, and therefore ET and DD assays can be recommended as initial screening tools in resource-limited hospitals because of their relatively low cost.

Schlüsselwörter

  • Broth microdilution
  • candidiasis
  • disk diffusion
  • E-test

Clinical vignette

Uneingeschränkter Zugang

Prednisolone-induced immune hemolysis: a case report

Online veröffentlicht: 31 Jan 2017
Seitenbereich: 81 - 85

Zusammenfassung

Abstract Background

Drug induced immune hemolysis is potentially serious. Most commonly antibiotics are responsible, while immunosuppressive drugs have been reported rarely.

Objectives

To report a rare case of suspected prednisolone-induced immune hemolysis.

Methods

A 59-year-old male patient with hemoglobin H disease and lymphoma developed hemagglutination and immune hemolytic anemia 20 days after receiving prednisolone.

Results

A direct antiglobulin test was positive for C3d. A test indicated prednisolone-dependent red blood cell antibody of the “immune complex” type. Tests with all other medications administered to the patient were negative. Dexamethasone was given to the patient without any reaction, as consistent with in vitro test results.

Conclusions

Physicians should be aware of possible prednisolone-induced complement-mediated immune hemolysis by an immune complex mechanism and request appropriate diagnostic tests as indicated.

Schlüsselwörter

  • Drug-induced immune hemolysis
  • prednisolone

Planen Sie Ihre Fernkonferenz mit Scienceendo