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 6 (2012): Heft 6 (December 2012)

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

Suche

20 Artikel
Uneingeschränkter Zugang

Editorial. Snakebite, an underreported cause of disabilities and deaths

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 793 - 794

Zusammenfassung

Uneingeschränkter Zugang

Review article. Diagnosis and management of venomous snakebites in Southeast Asia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 795 - 805

Zusammenfassung

Abstract

Background: Globally, snake envenoming is an important medical problem. Various species from different parts of the world require a variety of diagnostic and therapeutic strategies.

Objective: Review clinical manifestations, diagnosis, and management of venomous snakebites in Southeast Asia.

Method: Relevant information was extracted from publications in the PUBMED database (up to June 2012) and the World Health Organization (WHO) website. Expert opinions of the authors were added when clinical trial evidence was lacking.

Results: The clinical findings including local tissue damage, muscular weakness, coagulopathy, and renal injury were summarized. These data can be used to deduce the responsible snake species. The guide for the first aid, initial evaluation, follow-up observation, and antivenin administration was also suggested.

Conclusion: It is critical to transport snakebite victims to hospitals as soon as possible for basic and advance life supports. Appropriate usage of antivenin is life-saving. However, a mode to prevent debilitating tissue necrosis remains to be defined.

Schlüsselwörter

  • Antivenin
  • diagnosis of snakebite
  • management of snakebite
  • Southeast Asia
  • venomous snakebite
Uneingeschränkter Zugang

Original article. The potential risk factors for childhood disabilities in Riyadh rural areas, Saudi Arabia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 807 - 813

Zusammenfassung

Abstract

Background: Childhood disability is a public health con-cern due to their impacts on quality of life and productivity not only for affected children but also for families and populations as a whole. There are at least 650 million people with disabilities worldwide.

Objective: To identify the major biological predictors of disabilities in children, the potential pre-natal, natal, and post-natal risk factors for the disabled children in Riyadh rural areas.

Materials and Methods: A survey of 450 Saudi children, pre-school and school age children, below 20 years was carried out between October 2010 and March 2011 with approval by the Institutional Review Board. The study was conducted from children day care center at Riyadh rural area. Data were collected from the case files by clinical staff.

Results: Children with motor disabilities represented the highest percentage, followed by those having speech, mental, and educational disabilities. The least number of disabilities was the children with auditory deficits. The results of the current study have emphasized certain pre-natal risk factors including extreme ages of marriage, high parity, illiteracy, and consanguineous marriages. Consanguinity, multiparty, and mother childbirth age could be considered as a risk factor for mental (risk ratios (RR) 2.06, 95% CI 1.526-2.7), (RR 1.8, 95% CI 1.2-2.6), (RR 4.7, 95% CI 2.6-8.47) and auditory disabilities (RR 2.6, 95% CI 1.7-3.76), (RR 2, 95% CI 1.25-3.19), (RR 2.6, 95% CI 1.29-5.2). According to our study caesarian labor and prematurity could be considered as a risk factor for motor disability (RR 2.3, 95% CI 1.7-3.1), (RR 2.6, 95% CI 1.46-4.6) while multiparity, very low birth weight, and prematurity were associated with increased risk for speech disabilities (RR 1.14, 95% CI 0.76-1.7), (RR 1.46, 95% CI 0.76-2.76), (RR 7.3, 95% CI 4.9-10.3). In addition, caesarian labor was associated with increased risk for auditory disabilities (RR 1.13, 95% CI 0.59-3.49), while multiparity and mother childbirth age were associated with increased risk for visual disabilities (RR 5.6, 95% CI 4.1-8.27), (RR 7.2, 95% CI 4.19-12.3).

Conclusion: Increasing the knowledge about disabilities’ risk factor could reduce the incidence of future disability.

Schlüsselwörter

  • Childhood disabilities
  • natal and post
  • natal risk factors
  • pre-natal
  • Riyadh rural areas
Uneingeschränkter Zugang

Original article. Influence of +Gz exposure on serum biochemical and hematological parameters

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 815 - 823

Zusammenfassung

Abstract

Background: Exposure to high +Gz provoke a unique physiological stress and various potential harmful effects in humans. Despite the importance of monitoring physical alterations related to +Gz exposure, there have been only a few studies concerning the physical status of human centrifuge trainees.

Objective: We investigated alterations in serum biochemical and complete blood count parameters occurring in subjects exposed to high +Gz.

Methods: One hundred fifty eight flight-naive subjects (group A), who had never experienced flight or centrifuge training, and 80 experienced jet fighter pilots (group B) were exposed to +6Gz and +7.3Gz, respectively. Blood samples were obtained before and immediately after the centrifuge runs.

Results: In group A, creatine phosphokinase (CPK) was increased from a mean of 136.56±17.87 IU/L pre-run to 236.33±23.71 IU/L post-run, a significant 73.1% increase. In 26 of 158 (16.5%) group A subjects, CPK was elevated over 400 IU/L, with a maximum of 1904 IU/L. Δ CPK of group A (99.77±16.94 IU/L) was significantly greater than that of group B (0.53±5.67 IU/L). In addition, Δvalues of total protein, white blood cell count, red blood cell count, hemoglobin, and hematocrit of group A were significantly greater than those of group B.

Conclusion: We demonstrated that the extent of post-centrifuge CPK elevation and hemoconcentration was significantly greater in flight-naive subjects than in experienced jet fight pilots. Our data raise the possibility that the level of experience in flight and centrifuge training can affect the extent of +Gz-induced alterations in blood constituents.

Schlüsselwörter

  • Complete blood count
  • flight experience
  • human centrifuge training
  • serum chemistry
  • +Gz acceleration
Uneingeschränkter Zugang

Original article. Inmunoprotector potential of cellular vaccine formulations developed from Leptospira interrogans Ballum using Mesocricetus auratus as biomodel

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 825 - 832

Zusammenfassung

Abstract

Background: In the last years, Leptospira spp Ballum has increased its representation in human clinical isolations in Cuba. Effective vaccines are needed to control this zoonotic disease.

Objective: With the objective of developing a new vaccine candidate able to generate an effective protection against this serovar, two monovalent formulations developed by two highly virulent strains were evaluated (FoBa and FoBb).

Methods: Clinical isolates of Leptospira serovar Ballum were subjected to serial passages in hamsters and monovalent vaccines were produced by modified methods developed for vax-SPIRAL®. The vaccine efficacy was tested in both experimental and control hamsters.

Results: The Mesocricetus auratus biomodel showed that both formulations generated a protection of 100% against the Ballum lethal infection together to high levels of IgG antibodies and were efficient in the elimination of homologous carrier state but not heterologous carrier states.

Conclusion: Both FoBa and FoBb vaccines were protective against leptospirosis with high IgG titers, absence of clinical signs and dead, and absence of leptospires in kidney of sacrificed animals.

Schlüsselwörter

  • Leptospira
  • leptospirosis
  • Mesocricetus auratus
  • vaccine
Uneingeschränkter Zugang

Original article. Assessment of biochemical changes among Egyptian women with increased body weight

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 833 - 840

Zusammenfassung

Abstract

Background: Obesity is a condition that results from chronic disruption of energy balance where energy intake continuously exceeds energy expenditure and accumulation of body fat results

Objective: We evaluated the relationships between ghrelin and leptin with the metabolic state of normal weight, overweight, and obese Egyptian women.

Methods: We studied 82 subjects with ages from 43 to 65. They were free of endocrine-related disease and divided into three groups according to their body mass index (BMI), group 1 with BMI less than 25 kg/m2, group 2 with BMI between 25 to 30 kg/m2, and group 3 with BMI more than 30 kg/m2. Ghrelin and leptin were determined by ELISA technique. Insulin resistance was measured by homeostasis model assessment. Lipid profile was determined in all groups.

Results: Fasting plasma levels of ghrelin were lower in overweight and obese groups compared to normal weight control group. There was statistically significant negative correlation of ghrelin levels with leptin, BMI and HOMA. Results showed that higher concentrations of fasting leptin were found in overweight and obese groups compared with the normal weight control group. There was statistically significant positive correlation between leptin and other biochemical parameters, insulin, BMI, and HOMA.

Conclusion: Ghrelin and leptin may be associated with obesity. These markers can be of value when assessing management.

Schlüsselwörter

  • Ghrelin
  • HOMA
  • leptin
  • obesity
Uneingeschränkter Zugang

Original article. D-dimer assay not adequate for spontaneous intracranial hemorrhage screening

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 841 - 848

Zusammenfassung

Abstract

Background: Patients with signs/symptoms of spontaneous intracranial hemorrhage (SICH) in the emergency department (ED) generally undergo computed tomography (CT) scanning.

Objective: To assess whether D-dimer assay alone at ED admission can be used for screening non-traumatic patients with suspected ICH who do not have new onset of neurological deficits to reduce the number of CT scans.

Methods: The study included 90 non-traumatic patients who were admitted to the ED and had signs/symptoms suggestive of SICH but did not have new neurological deficits. All patients underwent non-contrast CT within 30 minutes. Three patients also underwent lumbar puncture for a definitive diagnosis. Blood D-dimer levels were measured from venous blood samples obtained in the ED. All patients were followed up for one year. The diagnosis at 3 months follow-up was used to determine whether CT was helpful.

Results: CT was not helpful for 60 patients and was necessary for 30 patients. Multivariate analysis showed that dizziness/vertigo, systolic blood pressure >120 mmHg, and positive D-dimer assay (>500 ng/ml) were significantly related to the need for CT. The results of multivariate analysis were used to perform area under the curve analysis to provide data on sensitivity, specificity, positive predictive value, and negative predictive value for these three independent factors that affect the need for CT examination. Further analysis showed that all seven patients with subarachnoid hemorrhage had a positive D-dimer assay and their median D-dimer level was significantly higher than that of patients with intracerebral hemorrhage or stroke.

Conclusions: D-dimer assay alone is inadequate in the ED for screening non-traumatic patients with suspected SICH who do not have new onset of neurological deficits to reduce the number of CT scans.

Schlüsselwörter

  • Computed tomography
  • D-dimer assay
  • fibrinolysis
  • spontaneous intracranial hemorrhage
  • subarachnoid hemorrhage
Uneingeschränkter Zugang

Original article Outcome of gallbladder polyps in patients with primary sclerosing cholangitis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 849 - 857

Zusammenfassung

Abstract

Background: The American Association for the Study of Liver Disease (AASLD) guideline recommends cholecystectomy for GB polyps of any size in patients with PSC without strong supporting evidence.

Objective: Evaluate the predictors of malignancy and outcomes of PSC patients with GB polyps.

Methods: We identified 86 patients with PSC and GB polyps at the Mayo Clinic, Rochester, MN between January 1, 2000 and August 31, 2009 using a computerized record system. Twenty-six patients were excluded due to indefinite diagnosis or inadequate follow up data.

Results: Of the 2281 patients with PSC, 60 patients (2.6%) were diagnosed as having GB polyps with a median age of 49.8 years; 67% were male. The median follow up from the diagnosis of GB polyps to the last follow-up was 3.5 years. Thirty-one patients (52%) subsequently underwent cholecystectomy and eight of 31 patients (25.8%) developed malignant GB lesions. Low-grade dysplasia of the GB was seen in two (6.4%). Twenty-nine patients without cholecystectomy had a median follow up of 4.8 years and none of them developed a malignant GB lesion during follow-up. By multivariable logistic analysis, the size of GB polyps at baseline was associated with malignant GB lesions or GB dysplasia (OR = 7.0; 95%CI 2.0-25.1).

Conclusions: One third of GB polyps in patients with PSC who underwent cholecystectomy become malignant or developed dysplasia. A GB polyp at first diagnosis of at least 1 cm in size was a good predictor for malignant lesions of GB or GB dysplasia. In PSC patients with comorbidities who had GB polyp size at first diagnosis less than 1 cm, careful monitoring of the progression of GB polyp size over time with periodical assessment by ultrasound may be an option.

Schlüsselwörter

  • Gallbladder polyps
  • outcome
  • primary sclerosing cholangitis
Uneingeschränkter Zugang

Original article. The age of onset of pubertal development in healthy Thai girls in Khon Kaen, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 859 - 865

Zusammenfassung

Abstract

Background: Onset of puberty has shifted toward a younger age in the 21st century. The useful pubertal assessment in the individual child must be based on recent and reliable reference data from the same population. However, currently representative pubertal data for Thai girls are lacking.

Objective: We determined the current prevalence and mean ages at onset of pubertal characteristics in healthy urban Thai girls in Khon Kaen Province, northeast Thailand.

Methods: A cross-sectional study was carried out between January and July 2011. Five hundred and three schoolgirls aged 7 to 16 years were enrolled. All were in good physical health. Stages of breast and pubic hair development were rated on girls by Tanner’s criteria. Assessment was performed by a trained pediatrician. Data on menstruation were collected by the status quo method.

Results: Median (range) ages of the onset of thelarche and pubarche were 9.3 (7.8 to 13.4) and 10.8 (8.9 to 14.5) years, with the mean±SD of 10.1±1.2 and 11.6±1.2 years, respectively. One hundred and eighteen girls had experienced menstruation. The median (range) age of menarche was 11.2 (10.0 to 14.0) years. Mean age was 11.6±0.8 years. The mean ages of pubarche and menarche decreased from the previous study significantly (p <0.001).

Conclusions: The secular trend in decline of the ages of pubarche and menarche were observed in urban Khon Kaen Thai girls. These data can be used as the reference of normal pubertal development in Thai girls in Khon Kaen to determine precocious or delayed puberty.

Schlüsselwörter

  • Menarche
  • pubarche
  • pubertal maturation
  • thelarche
Uneingeschränkter Zugang

Original article. Hazardous atmosphere in the underground pits of rice mills in Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 867 - 874

Zusammenfassung

Abstract

Background: Asphyxiation is the most dangerous hazard in confined spaces. In Thailand, several large rice mills have underground pits in order to transport moist paddy to baking machines. Prolonged unbaked paddy piles can produce several gases that can displace oxygen inside the pits.

Objective: This study describes concentrations of hazardous gases and oxygen content inside the underground pits of rice mills in Thailand.

Methods: At six randomly selected large rice mills in this study, fresh paddy piles were divided into four groups, based on moisture content (<14%, 15-20%, 21-30%, and >30% wet basis (w.b.)). Gas measurement was conducted with direct reading instruments including infrared spectrophotometer (Miran 1BX for CO2, N2O) and toxic gas detector (QRAE plus for CO, NO2, % O2 and flammable gas) at three different depth levels (top, middle, bottom) inside the pits.

Results: The concentrations of CO2, CO, N2O, NO2, and % O2 were in the ranges of 1.7-5438 ppm, 0-61 ppm, 0-4.9 ppm, 0-0.8 ppm, and 19.9-21.6%, respectively whereas concentrations of flammable gas (% lower explosive limit; [%LEL]) were not detected. The highest concentrations of gases were at the middle depth pit level, inside the paddy piles with the highest moisture contents (>30% w.b.). The detected concentrations of gases were higher than limit values based on time-weighted average but below limits immediately dangerous to life.

Conclusion: Although oxygen-deficient atmosphere was not detected under the working conditions of the survey. The findings demonstrated that concentrations of hazardous gases were dependent on both storage time and the moisture content of paddy piles. Measures should be developed to ensure that entry into these pits strictly complies with safety laws

Schlüsselwörter

  • Confined space
  • hazardous atmosphere
  • hazardous gases
  • paddy
  • rice mill
Uneingeschränkter Zugang

Original article. Prevalence of dry eyes in elderly Thai population (the Romklao eye study)

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 875 - 882

Zusammenfassung

Abstract

Background: Dry eye syndrome is a common worldwide problem that can decrease the quality of life and vision among the general population. The prevalence of dry eye varied according to diagnostic criteria, population, and age distribution. Information on the prevalence and risk factors of dry eye can be used to ensure that the appropriate treatment for dry eye patients and the general population are administered correctly.

Objective: Determined the prevalence and risk factors for dry eye syndrome in Thai population.

Methods: Six hundred twenty five subjects between the ages of 50 to 90 were recruited from the Romklao District, Bangkok, Thailand. Subjects were interviewed to assess whether they currently have symptoms of dry eyes, grade the severity, and to determine the risk factors. Associations between dry eyes and risk factors were determined by binary logistic regression.

Results: Out of 625 subjects, 89 subjects (14.2%) had dry eye syndrome. The prevalence of dry eyes was greater in females (16.6%) compared to males (10.6%), p = 0.029. Dry mouth symptoms, allergic history, and previous eye surgery were significantly associated with dry eyes (p = 0.005, 0.013, <0.001, respectively).

Conclusion: Prevalence of dry eyes in the elderly Thai population is 14.2% in our urban study.

Schlüsselwörter

  • Dry eye prevalence
  • population-based survey
  • risk factor
  • Thai population
Uneingeschränkter Zugang

Original article. Correlation of FcγRIIIa polymorphisms and responses to rituximab in Thai population

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 883 - 889

Zusammenfassung

Abstract

Background: Rituximab is a chimeric IgG1 monoclonal antibody against CD20, approved for the treatment of B-cell non-Hodgkin’s lymphoma (NHL). Antibody dependent cellular cytotoxicity (ADCC) has been suggested to be an important mechanism of rituximab via binding to the Fc gamma IIIa receptor (FcγRIIIa) on natural killer (NK) cells. FcγRIIIa has two expressed alleles that differ at amino acid position 158 in the extracellular domain, valine (V158) and phenylalanine (F158). These allelic variants have been demonstrated to differ in IgG1 binding and ADCC. V/V homozygotes and V/F heterozygotes bind to IgG with higher affinity than F/F homozygotes.

Objectives: We identified the frequencies of FcγRIIIa polymorphism and investigate the correlation between FcγRIIIa polymorphism and rituximab responses, both in vitro and in vivo in Thai population.

Methods: The RFLP-Nested PCR and allele specific amplification was used to identify the FcγRIIIa polymorphism in the study. The correlation between FcγRIIIa polymorphism and rituximab responses, both in vitro and in vivo, was also studied.

Results: The distributions of FcγRIIIa-158 polymorphism in these subjects are V/V 40.26%, V/F 16.88%, and F/F 42.86%. Higher rituximab-induced Ramos cell cytotoxicity (mean 33.16%, 36.87%) was observed in the subjects with VV and VF genotypes, respectively. However, the lower cytotoxicity (mean 20.07%) was determined in subjects with FF genotype. As for the in vivo study, the NHL patients with V/V or V/F genotypes had a primary response as complete response; whereas, the NHL patients with F/F genotype had partial response.

Conclusion: FcγRIIIa polymorphism and the primary response in NHL patients tend to correlate. The higher number of patients is necessary for further study. These results provide useful information to understand beneficial response of rituximab as well as other IgG1 therapeutic antibody in Thai patients.

Schlüsselwörter

  • Anti CD20
  • FcγRIIIa polymorphisms
  • NK cell
  • non-Hodgkin’s lymphoma
  • rituximab
Uneingeschränkter Zugang

Brief communication (Original). Optimum duration of perioperative antibiotic therapy in patients with acute non-perforated appendicitis: a prospective randomized trial

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 891 - 894

Zusammenfassung

Abstract

Background: Inappropriate use of antibiotics for perioperative antimicrobial therapy can cause considerable complications including emergence of antibiotic resistance, risk of drug reactions and economic implications.

Objective: We assessed the use of antibiotics in patients with acute non-perforated appendicitis.

Methods: The study was performed on 317 patients aged 15 to 70 years with non-perforated appendicitis who were undergoing open appendectomy. All patients received intravenous ceftriaxone (1 g) and metronidazole (500 mg) immediately after appendectomy. Patients were randomized into one of the following three treatment protocols; A: no further antibiotics, B: three more doses of antibiotics for 1 day (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours), or C: a 3-day course of antibiotics (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours) as the postoperative antibiotic regimen. Postoperative infective complication was the primary endpoint within the 10-day postoperative follow-up period.

Results: A total of 291 patients (female 37.5%), were subjected to final analysis. This included 97 patients in each group. Twenty-six patients failed to return for wound assessment. The groups were comparable in baseline characteristics including age and gender. The Overall frequency of surgical site infection was 6.25%, with 8.2% in group A, 6.25% in group B and 5.2% in group C. The rate of postoperative surgical infection was not significantly different among all groups. There were no perioperative mortalities. No untreated control group could be included for ethical reasons.

Conclusion: A combined preoperative single dose of metronidazole and ceftriaxone appears to be sufficient for the prevention of surgical site infections in patients with uncomplicated appendicitis.

Schlüsselwörter

  • Acute appendicitis
  • ceftriaxone
  • metronidazole
  • prophylactic antibiotic therapy
Uneingeschränkter Zugang

Brief communication (Original). Effect of sacral nerve electrostimulation on sex dysfunction in male rats with spinal cord injury

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 895 - 902

Zusammenfassung

Abstract

Background: Spinal cord injury severely impairs fertility of young men. It can induce erectile dysfunction, ejaculatory dysfunction, and semen abnormalities. However, the precise mechanism is unclear.

Objective: We observed the effects of sacral nerve electrostimulation on sex dysfunction of male rats with spinal cord injury.

Methods: Thirty-six male Sprague-Dawley (SD) rats were randomly divided into three groups (n = 12): sham operated group, spinal cord injury model group, and electrostimulation group. The weight of genitals, related sex hormone index, and sperm motility were examined in each group after operation at two, four, and six weeks, respectively.

Results: Sacral nerve electrostimulation could improve testis and epididymis weight, regulate hormone secretion (including an increase in GnRH, tT, and ABP, but decrease in FSH and LH), and cause an increase in sperm count and motility.

Conclusion: Sacral nerve electrostimulation may be effective in treating sex dysfunction resulting from spinal cord injury.

Schlüsselwörter

  • Hormone
  • sacral nerve electrostimulation
  • sexual dysfunction
  • sperm
  • spinal cord injury
Uneingeschränkter Zugang

Brief communication (Original). Immune injury in rat models of type 2 diabetes mellitus

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 903 - 908

Zusammenfassung

Abstract

Background: Diabetic cardiomyopathy is an important complication of type 2 diabetics. The role of immunoinflammation, immunity, and diet has not been adequately clarified.

Objective: We investigated the relationships between diabetic cardiomyopathy and immuno-inflammation, as well as immunity and diets.

Methods: Sixty Sprague-Dawley (SD) male rats were included in this study, from which 12 were randomly selected as the normal control group (group A) and of which the remaining 48 were considered as the type 2 diabetes mellitus (T2DM) model group. Group A was fed with common diets and the T2DM model group, with high-glucose diets (by adding 20% cane sugar, 10% lard, and 2.5% cholesterol into a 67.5% common diet). After 4-week feeding, the T2DM model group was randomly allocated into three groups according to the diet, highfat diet group (group B), common diet group (group C), and low-fat diet group (group D). All the three groups were then fed for another 10 weeks. At the end of the experiment, body weight, random blood glucose levels, and cardiac weight were measured. Left ventricular tissue was obtained for light microscopy and electron microscopy. Deposits of immunoglobulin G (IgG) in myocardium were identified by immunohistochemistry. Serum levels of high-sensitivity C-reactive protein (hs-CRP) were determined using the enzyme-linked immunosorbent assay (ELISA). All data were statistically analyzed.

Results: The serum level of hs-CRP was significantly higher in groups B, C, and D, than in the control group. Therefore, IgG deposits among cardiac muscle cells were observed in all the model groups, significant deviations were noted in group A (p <0.01) and IgG deposits were less in group D than in groups B and C (p <0.01).

Conclusion: Immuno-inflammation participates in the development of T2DM and diabetic cardimyopathy. Immune injury can be alleviated following dietary interference.

Schlüsselwörter

  • Diabetic cardiomyopathy
  • diet
  • high-sensitivity C-reactive protein
  • immunity
  • type 2 diabetes mellitus
Uneingeschränkter Zugang

Brief communication (Original). Differentially expressed genes of Naegleria fowleri during exposure to human neuroblastma cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 909 - 915

Zusammenfassung

Abstract

Background: Free-living amoeboflagellate, Naegleria fowleri causes acute fulminant primary amoebic meningoencephalitis (PAM). Interaction of N. fowleri with human cells is essential for the cytopathogenic process before phagocytosis and tissue invasion.

Objective: In order to understand the pathogenesis mechanisms of N. fowleri, subtractive cDNA library was used to analyze overall induction in gene expression of N. fowleri during exposure to the human neuroblastoma cells.

Methods: Co-cultivation of N. fowleri and human neuroblastoma SK-N-MC monolayer cultivation was performed. Subtractive cDNA libraries of inoculated N. fowleri at 15, 30, 45, 60, and 120 minutes were constructed. The PCR amplified products were cloned into E. coli. The specific clones were selected and further sequenced. Nucleotide sequences were compared with those deposited in the Genbank using BlastX. Significant probabilities were considered when E-value was less than 10-4. The induction of several gene expressions was validated by real-time RT-PCR.

Results: Extensive changes in gene expression of N. fowleri during the interaction with the human neuroblastoma SK-N-MC in vitro were detected. One hundred twenty clones were obtained. Among these, five clones containing DNA sequence homologue to known genes were identified. These genes included acetyl Co-A synthetase, 18s ribosome RNA, naegleria pore B precursor, isocitrate dehydrogenase, and pyruvate kinase. Real-time quantitative RT-PCR indicated that the expression level of all five genes was up-regulated within 1 hour after exposure. The expression level of acetyl Co-A synthetase increased and reached 7-times significantly greater than that of the control while pyruvate kinase, isocitrate dehydrogenase, naegleria pore B precursor, and 18s ribosome RNA transcripts increased from 2- to 4-fold, respectively.

Conclusions: A defined set of genes in N. fowleri that was differentially transcribed after contacting with the SKN- MC monolayer cells was identified. The transcription profiles unique for amoebic cell may help elucidate the transcriptional framework of N. fowleri pathogenicity and serve as a basis for identifying transcriptional virulence factors.

Keyword

  • cDNA subtraction
  • human neuroblastoma cells
  • Naegleria fowleri
Uneingeschränkter Zugang

Clinical report. Management of rare postoperative ureterocolic fistula

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 917 - 921

Zusammenfassung

Abstract

Background: Ureterocolic fistula after acute colonic diverticulitis and colovesical fistula occurs rarely in patients with colonic diverticula.

Objective: We present our experience with diagnosis and treatment of postoperative ureterocolic fistula.

Methods: A 61-year-old male patient with acute colonic diverticulitis and colovesical fistula developed ureterocolic fistula after resection of sigmoid and descending colon, partial cystectomy and T-loop colostomy.

Results: The identification and subsequent management of this rare postoperative ureterocolic fistula emphasizes the importance of adequate preoperative evaluation, including the preoperative placement of ureteral stents to facilitate identification of the ureters, minimize inadvertent ureteral injury and treat possible coloureteral fistulas.

Conclusion: Our experience suggests that placement of ureteral stents allows successful treatment of postoperative urinary leakage into the peritoneal cavity through the ureterocolonic fistula and precludes major surgical intervention.

Schlüsselwörter

  • Colonic diverticular disease
  • diverticulitis
  • fistulas
  • ureterocolic fistula
Uneingeschränkter Zugang

Clinical report. The Fontan procedure for patients with a single lung

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 923 - 927

Zusammenfassung

Abstract

Background: Single lung Fontan procedure has been performed in patients with a congenital heart disease and a single functional lung. The procedure has not been reported in China.

Objective and Methods: We reported on the case of a 6-year-old child who had a single functional right ventricle, and an atretic left pulmonary artery, who underwent a successful Fontan operation into the single right pulmonary artery. The literature of Fontan procedure in the presence of a single lung is reviewed.

Results: The patient to relate the procedure well and had uneventful recovery. The patient has been followed up for more than two years with reasonable hemodynamics.

Conclusion: The single lung Fontan operation is possible with good outcomes. More patients and longer follow up will be required to standardize the strategies and to document utility of this procedure.

Schlüsselwörter

  • Fontan procedure
  • single lung
Uneingeschränkter Zugang

Clinical report. A decade review of chickenpox among pediatric immunocompromised patients at the King Chulalongkorn Memorial Hospital, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 929 - 935

Zusammenfassung

Abstract

Background: Varicella zoster virus (VZV) infection among immunocompromised patients leads to high morbidity and mortality.

Objective: Describe the natural history and treatment outcomes of chickenpox among immunocompromised children hospitalized in a tertiary care center in the era of acyclovir treatment.

Methods: We conducted a retrospective chart review of immunocompromised children hospitalized with chickenpox at King Chulalongkorn Memorial Hospital between January 1, 2000 and December 31, 2009. Demographic data, clinical manifestations, treatment, and complications were extracted from the patients’ charts. Rate of complications were compared among underlying disease by using chi-square test.

Results: There were 61 admissions. Median interquartile range, (IQR) age was 79 (31 to 123) months. There were 31 (51%) children with hematologic malignancies, 20 (33%) on immununosuppressive drugs, six (10%) neonates, and four (6%) HIV positive. Index cases were from household members (23%), community (15%), and hospital (6%) whereas 56% had no information. Cases peaked during February to March. Median (IQR) duration of fever and active skin lesions were four (3 to 6) and five (4 to 7) days, respectively. All, except one, received acyclovir (50% intravenous, 48% switched from intravenous to oral, 2% oral). Median (IQR) duration of acyclovir treatment and hospitalization were 10 (7 to 14) and nine (7 to 10) days, respectively. Complications included bacterial skin infections (10%), hepatic transaminitis (8%), pneumonia (5%), and disseminated varicella (1%). Rates of complications were 18% among children with malignancies, 3% on immunosuppressive drugs, and none in neonates or HIV positives (p = 0.047). Two children (3%) died due to disseminated varicella and severe pneumonia.

Conclusion: Mortality rate of chickenpox among immunocompromised patients on acyclovir treatment is 3%. Children with hematologic malignancies have the highest rate of complications.

Schlüsselwörter

  • Chicken pox
  • complications
  • immunocompromised host
  • mortality
  • varicella zoster virus
Uneingeschränkter Zugang

Commentary. What is the risk of rabies transmission from patients to health care staff?

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 937 - 939

Zusammenfassung

Abstract

Admission of a human rabies case to hospital often creates great anxiety among staff that fear contamination. The care of a rabies patient requires only standard infectious precautions consisting of basic preventive measure applied in many other common diseases. This should be sufficient to prevent transmission to staff. Therefore, prevention of anxiety among health care workers should be an achievable goals.

Schlüsselwörter

  • Health care workers
  • prevention
  • rabies transmission
20 Artikel
Uneingeschränkter Zugang

Editorial. Snakebite, an underreported cause of disabilities and deaths

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 793 - 794

Zusammenfassung

Uneingeschränkter Zugang

Review article. Diagnosis and management of venomous snakebites in Southeast Asia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 795 - 805

Zusammenfassung

Abstract

Background: Globally, snake envenoming is an important medical problem. Various species from different parts of the world require a variety of diagnostic and therapeutic strategies.

Objective: Review clinical manifestations, diagnosis, and management of venomous snakebites in Southeast Asia.

Method: Relevant information was extracted from publications in the PUBMED database (up to June 2012) and the World Health Organization (WHO) website. Expert opinions of the authors were added when clinical trial evidence was lacking.

Results: The clinical findings including local tissue damage, muscular weakness, coagulopathy, and renal injury were summarized. These data can be used to deduce the responsible snake species. The guide for the first aid, initial evaluation, follow-up observation, and antivenin administration was also suggested.

Conclusion: It is critical to transport snakebite victims to hospitals as soon as possible for basic and advance life supports. Appropriate usage of antivenin is life-saving. However, a mode to prevent debilitating tissue necrosis remains to be defined.

Schlüsselwörter

  • Antivenin
  • diagnosis of snakebite
  • management of snakebite
  • Southeast Asia
  • venomous snakebite
Uneingeschränkter Zugang

Original article. The potential risk factors for childhood disabilities in Riyadh rural areas, Saudi Arabia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 807 - 813

Zusammenfassung

Abstract

Background: Childhood disability is a public health con-cern due to their impacts on quality of life and productivity not only for affected children but also for families and populations as a whole. There are at least 650 million people with disabilities worldwide.

Objective: To identify the major biological predictors of disabilities in children, the potential pre-natal, natal, and post-natal risk factors for the disabled children in Riyadh rural areas.

Materials and Methods: A survey of 450 Saudi children, pre-school and school age children, below 20 years was carried out between October 2010 and March 2011 with approval by the Institutional Review Board. The study was conducted from children day care center at Riyadh rural area. Data were collected from the case files by clinical staff.

Results: Children with motor disabilities represented the highest percentage, followed by those having speech, mental, and educational disabilities. The least number of disabilities was the children with auditory deficits. The results of the current study have emphasized certain pre-natal risk factors including extreme ages of marriage, high parity, illiteracy, and consanguineous marriages. Consanguinity, multiparty, and mother childbirth age could be considered as a risk factor for mental (risk ratios (RR) 2.06, 95% CI 1.526-2.7), (RR 1.8, 95% CI 1.2-2.6), (RR 4.7, 95% CI 2.6-8.47) and auditory disabilities (RR 2.6, 95% CI 1.7-3.76), (RR 2, 95% CI 1.25-3.19), (RR 2.6, 95% CI 1.29-5.2). According to our study caesarian labor and prematurity could be considered as a risk factor for motor disability (RR 2.3, 95% CI 1.7-3.1), (RR 2.6, 95% CI 1.46-4.6) while multiparity, very low birth weight, and prematurity were associated with increased risk for speech disabilities (RR 1.14, 95% CI 0.76-1.7), (RR 1.46, 95% CI 0.76-2.76), (RR 7.3, 95% CI 4.9-10.3). In addition, caesarian labor was associated with increased risk for auditory disabilities (RR 1.13, 95% CI 0.59-3.49), while multiparity and mother childbirth age were associated with increased risk for visual disabilities (RR 5.6, 95% CI 4.1-8.27), (RR 7.2, 95% CI 4.19-12.3).

Conclusion: Increasing the knowledge about disabilities’ risk factor could reduce the incidence of future disability.

Schlüsselwörter

  • Childhood disabilities
  • natal and post
  • natal risk factors
  • pre-natal
  • Riyadh rural areas
Uneingeschränkter Zugang

Original article. Influence of +Gz exposure on serum biochemical and hematological parameters

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 815 - 823

Zusammenfassung

Abstract

Background: Exposure to high +Gz provoke a unique physiological stress and various potential harmful effects in humans. Despite the importance of monitoring physical alterations related to +Gz exposure, there have been only a few studies concerning the physical status of human centrifuge trainees.

Objective: We investigated alterations in serum biochemical and complete blood count parameters occurring in subjects exposed to high +Gz.

Methods: One hundred fifty eight flight-naive subjects (group A), who had never experienced flight or centrifuge training, and 80 experienced jet fighter pilots (group B) were exposed to +6Gz and +7.3Gz, respectively. Blood samples were obtained before and immediately after the centrifuge runs.

Results: In group A, creatine phosphokinase (CPK) was increased from a mean of 136.56±17.87 IU/L pre-run to 236.33±23.71 IU/L post-run, a significant 73.1% increase. In 26 of 158 (16.5%) group A subjects, CPK was elevated over 400 IU/L, with a maximum of 1904 IU/L. Δ CPK of group A (99.77±16.94 IU/L) was significantly greater than that of group B (0.53±5.67 IU/L). In addition, Δvalues of total protein, white blood cell count, red blood cell count, hemoglobin, and hematocrit of group A were significantly greater than those of group B.

Conclusion: We demonstrated that the extent of post-centrifuge CPK elevation and hemoconcentration was significantly greater in flight-naive subjects than in experienced jet fight pilots. Our data raise the possibility that the level of experience in flight and centrifuge training can affect the extent of +Gz-induced alterations in blood constituents.

Schlüsselwörter

  • Complete blood count
  • flight experience
  • human centrifuge training
  • serum chemistry
  • +Gz acceleration
Uneingeschränkter Zugang

Original article. Inmunoprotector potential of cellular vaccine formulations developed from Leptospira interrogans Ballum using Mesocricetus auratus as biomodel

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 825 - 832

Zusammenfassung

Abstract

Background: In the last years, Leptospira spp Ballum has increased its representation in human clinical isolations in Cuba. Effective vaccines are needed to control this zoonotic disease.

Objective: With the objective of developing a new vaccine candidate able to generate an effective protection against this serovar, two monovalent formulations developed by two highly virulent strains were evaluated (FoBa and FoBb).

Methods: Clinical isolates of Leptospira serovar Ballum were subjected to serial passages in hamsters and monovalent vaccines were produced by modified methods developed for vax-SPIRAL®. The vaccine efficacy was tested in both experimental and control hamsters.

Results: The Mesocricetus auratus biomodel showed that both formulations generated a protection of 100% against the Ballum lethal infection together to high levels of IgG antibodies and were efficient in the elimination of homologous carrier state but not heterologous carrier states.

Conclusion: Both FoBa and FoBb vaccines were protective against leptospirosis with high IgG titers, absence of clinical signs and dead, and absence of leptospires in kidney of sacrificed animals.

Schlüsselwörter

  • Leptospira
  • leptospirosis
  • Mesocricetus auratus
  • vaccine
Uneingeschränkter Zugang

Original article. Assessment of biochemical changes among Egyptian women with increased body weight

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 833 - 840

Zusammenfassung

Abstract

Background: Obesity is a condition that results from chronic disruption of energy balance where energy intake continuously exceeds energy expenditure and accumulation of body fat results

Objective: We evaluated the relationships between ghrelin and leptin with the metabolic state of normal weight, overweight, and obese Egyptian women.

Methods: We studied 82 subjects with ages from 43 to 65. They were free of endocrine-related disease and divided into three groups according to their body mass index (BMI), group 1 with BMI less than 25 kg/m2, group 2 with BMI between 25 to 30 kg/m2, and group 3 with BMI more than 30 kg/m2. Ghrelin and leptin were determined by ELISA technique. Insulin resistance was measured by homeostasis model assessment. Lipid profile was determined in all groups.

Results: Fasting plasma levels of ghrelin were lower in overweight and obese groups compared to normal weight control group. There was statistically significant negative correlation of ghrelin levels with leptin, BMI and HOMA. Results showed that higher concentrations of fasting leptin were found in overweight and obese groups compared with the normal weight control group. There was statistically significant positive correlation between leptin and other biochemical parameters, insulin, BMI, and HOMA.

Conclusion: Ghrelin and leptin may be associated with obesity. These markers can be of value when assessing management.

Schlüsselwörter

  • Ghrelin
  • HOMA
  • leptin
  • obesity
Uneingeschränkter Zugang

Original article. D-dimer assay not adequate for spontaneous intracranial hemorrhage screening

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 841 - 848

Zusammenfassung

Abstract

Background: Patients with signs/symptoms of spontaneous intracranial hemorrhage (SICH) in the emergency department (ED) generally undergo computed tomography (CT) scanning.

Objective: To assess whether D-dimer assay alone at ED admission can be used for screening non-traumatic patients with suspected ICH who do not have new onset of neurological deficits to reduce the number of CT scans.

Methods: The study included 90 non-traumatic patients who were admitted to the ED and had signs/symptoms suggestive of SICH but did not have new neurological deficits. All patients underwent non-contrast CT within 30 minutes. Three patients also underwent lumbar puncture for a definitive diagnosis. Blood D-dimer levels were measured from venous blood samples obtained in the ED. All patients were followed up for one year. The diagnosis at 3 months follow-up was used to determine whether CT was helpful.

Results: CT was not helpful for 60 patients and was necessary for 30 patients. Multivariate analysis showed that dizziness/vertigo, systolic blood pressure >120 mmHg, and positive D-dimer assay (>500 ng/ml) were significantly related to the need for CT. The results of multivariate analysis were used to perform area under the curve analysis to provide data on sensitivity, specificity, positive predictive value, and negative predictive value for these three independent factors that affect the need for CT examination. Further analysis showed that all seven patients with subarachnoid hemorrhage had a positive D-dimer assay and their median D-dimer level was significantly higher than that of patients with intracerebral hemorrhage or stroke.

Conclusions: D-dimer assay alone is inadequate in the ED for screening non-traumatic patients with suspected SICH who do not have new onset of neurological deficits to reduce the number of CT scans.

Schlüsselwörter

  • Computed tomography
  • D-dimer assay
  • fibrinolysis
  • spontaneous intracranial hemorrhage
  • subarachnoid hemorrhage
Uneingeschränkter Zugang

Original article Outcome of gallbladder polyps in patients with primary sclerosing cholangitis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 849 - 857

Zusammenfassung

Abstract

Background: The American Association for the Study of Liver Disease (AASLD) guideline recommends cholecystectomy for GB polyps of any size in patients with PSC without strong supporting evidence.

Objective: Evaluate the predictors of malignancy and outcomes of PSC patients with GB polyps.

Methods: We identified 86 patients with PSC and GB polyps at the Mayo Clinic, Rochester, MN between January 1, 2000 and August 31, 2009 using a computerized record system. Twenty-six patients were excluded due to indefinite diagnosis or inadequate follow up data.

Results: Of the 2281 patients with PSC, 60 patients (2.6%) were diagnosed as having GB polyps with a median age of 49.8 years; 67% were male. The median follow up from the diagnosis of GB polyps to the last follow-up was 3.5 years. Thirty-one patients (52%) subsequently underwent cholecystectomy and eight of 31 patients (25.8%) developed malignant GB lesions. Low-grade dysplasia of the GB was seen in two (6.4%). Twenty-nine patients without cholecystectomy had a median follow up of 4.8 years and none of them developed a malignant GB lesion during follow-up. By multivariable logistic analysis, the size of GB polyps at baseline was associated with malignant GB lesions or GB dysplasia (OR = 7.0; 95%CI 2.0-25.1).

Conclusions: One third of GB polyps in patients with PSC who underwent cholecystectomy become malignant or developed dysplasia. A GB polyp at first diagnosis of at least 1 cm in size was a good predictor for malignant lesions of GB or GB dysplasia. In PSC patients with comorbidities who had GB polyp size at first diagnosis less than 1 cm, careful monitoring of the progression of GB polyp size over time with periodical assessment by ultrasound may be an option.

Schlüsselwörter

  • Gallbladder polyps
  • outcome
  • primary sclerosing cholangitis
Uneingeschränkter Zugang

Original article. The age of onset of pubertal development in healthy Thai girls in Khon Kaen, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 859 - 865

Zusammenfassung

Abstract

Background: Onset of puberty has shifted toward a younger age in the 21st century. The useful pubertal assessment in the individual child must be based on recent and reliable reference data from the same population. However, currently representative pubertal data for Thai girls are lacking.

Objective: We determined the current prevalence and mean ages at onset of pubertal characteristics in healthy urban Thai girls in Khon Kaen Province, northeast Thailand.

Methods: A cross-sectional study was carried out between January and July 2011. Five hundred and three schoolgirls aged 7 to 16 years were enrolled. All were in good physical health. Stages of breast and pubic hair development were rated on girls by Tanner’s criteria. Assessment was performed by a trained pediatrician. Data on menstruation were collected by the status quo method.

Results: Median (range) ages of the onset of thelarche and pubarche were 9.3 (7.8 to 13.4) and 10.8 (8.9 to 14.5) years, with the mean±SD of 10.1±1.2 and 11.6±1.2 years, respectively. One hundred and eighteen girls had experienced menstruation. The median (range) age of menarche was 11.2 (10.0 to 14.0) years. Mean age was 11.6±0.8 years. The mean ages of pubarche and menarche decreased from the previous study significantly (p <0.001).

Conclusions: The secular trend in decline of the ages of pubarche and menarche were observed in urban Khon Kaen Thai girls. These data can be used as the reference of normal pubertal development in Thai girls in Khon Kaen to determine precocious or delayed puberty.

Schlüsselwörter

  • Menarche
  • pubarche
  • pubertal maturation
  • thelarche
Uneingeschränkter Zugang

Original article. Hazardous atmosphere in the underground pits of rice mills in Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 867 - 874

Zusammenfassung

Abstract

Background: Asphyxiation is the most dangerous hazard in confined spaces. In Thailand, several large rice mills have underground pits in order to transport moist paddy to baking machines. Prolonged unbaked paddy piles can produce several gases that can displace oxygen inside the pits.

Objective: This study describes concentrations of hazardous gases and oxygen content inside the underground pits of rice mills in Thailand.

Methods: At six randomly selected large rice mills in this study, fresh paddy piles were divided into four groups, based on moisture content (<14%, 15-20%, 21-30%, and >30% wet basis (w.b.)). Gas measurement was conducted with direct reading instruments including infrared spectrophotometer (Miran 1BX for CO2, N2O) and toxic gas detector (QRAE plus for CO, NO2, % O2 and flammable gas) at three different depth levels (top, middle, bottom) inside the pits.

Results: The concentrations of CO2, CO, N2O, NO2, and % O2 were in the ranges of 1.7-5438 ppm, 0-61 ppm, 0-4.9 ppm, 0-0.8 ppm, and 19.9-21.6%, respectively whereas concentrations of flammable gas (% lower explosive limit; [%LEL]) were not detected. The highest concentrations of gases were at the middle depth pit level, inside the paddy piles with the highest moisture contents (>30% w.b.). The detected concentrations of gases were higher than limit values based on time-weighted average but below limits immediately dangerous to life.

Conclusion: Although oxygen-deficient atmosphere was not detected under the working conditions of the survey. The findings demonstrated that concentrations of hazardous gases were dependent on both storage time and the moisture content of paddy piles. Measures should be developed to ensure that entry into these pits strictly complies with safety laws

Schlüsselwörter

  • Confined space
  • hazardous atmosphere
  • hazardous gases
  • paddy
  • rice mill
Uneingeschränkter Zugang

Original article. Prevalence of dry eyes in elderly Thai population (the Romklao eye study)

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 875 - 882

Zusammenfassung

Abstract

Background: Dry eye syndrome is a common worldwide problem that can decrease the quality of life and vision among the general population. The prevalence of dry eye varied according to diagnostic criteria, population, and age distribution. Information on the prevalence and risk factors of dry eye can be used to ensure that the appropriate treatment for dry eye patients and the general population are administered correctly.

Objective: Determined the prevalence and risk factors for dry eye syndrome in Thai population.

Methods: Six hundred twenty five subjects between the ages of 50 to 90 were recruited from the Romklao District, Bangkok, Thailand. Subjects were interviewed to assess whether they currently have symptoms of dry eyes, grade the severity, and to determine the risk factors. Associations between dry eyes and risk factors were determined by binary logistic regression.

Results: Out of 625 subjects, 89 subjects (14.2%) had dry eye syndrome. The prevalence of dry eyes was greater in females (16.6%) compared to males (10.6%), p = 0.029. Dry mouth symptoms, allergic history, and previous eye surgery were significantly associated with dry eyes (p = 0.005, 0.013, <0.001, respectively).

Conclusion: Prevalence of dry eyes in the elderly Thai population is 14.2% in our urban study.

Schlüsselwörter

  • Dry eye prevalence
  • population-based survey
  • risk factor
  • Thai population
Uneingeschränkter Zugang

Original article. Correlation of FcγRIIIa polymorphisms and responses to rituximab in Thai population

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 883 - 889

Zusammenfassung

Abstract

Background: Rituximab is a chimeric IgG1 monoclonal antibody against CD20, approved for the treatment of B-cell non-Hodgkin’s lymphoma (NHL). Antibody dependent cellular cytotoxicity (ADCC) has been suggested to be an important mechanism of rituximab via binding to the Fc gamma IIIa receptor (FcγRIIIa) on natural killer (NK) cells. FcγRIIIa has two expressed alleles that differ at amino acid position 158 in the extracellular domain, valine (V158) and phenylalanine (F158). These allelic variants have been demonstrated to differ in IgG1 binding and ADCC. V/V homozygotes and V/F heterozygotes bind to IgG with higher affinity than F/F homozygotes.

Objectives: We identified the frequencies of FcγRIIIa polymorphism and investigate the correlation between FcγRIIIa polymorphism and rituximab responses, both in vitro and in vivo in Thai population.

Methods: The RFLP-Nested PCR and allele specific amplification was used to identify the FcγRIIIa polymorphism in the study. The correlation between FcγRIIIa polymorphism and rituximab responses, both in vitro and in vivo, was also studied.

Results: The distributions of FcγRIIIa-158 polymorphism in these subjects are V/V 40.26%, V/F 16.88%, and F/F 42.86%. Higher rituximab-induced Ramos cell cytotoxicity (mean 33.16%, 36.87%) was observed in the subjects with VV and VF genotypes, respectively. However, the lower cytotoxicity (mean 20.07%) was determined in subjects with FF genotype. As for the in vivo study, the NHL patients with V/V or V/F genotypes had a primary response as complete response; whereas, the NHL patients with F/F genotype had partial response.

Conclusion: FcγRIIIa polymorphism and the primary response in NHL patients tend to correlate. The higher number of patients is necessary for further study. These results provide useful information to understand beneficial response of rituximab as well as other IgG1 therapeutic antibody in Thai patients.

Schlüsselwörter

  • Anti CD20
  • FcγRIIIa polymorphisms
  • NK cell
  • non-Hodgkin’s lymphoma
  • rituximab
Uneingeschränkter Zugang

Brief communication (Original). Optimum duration of perioperative antibiotic therapy in patients with acute non-perforated appendicitis: a prospective randomized trial

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 891 - 894

Zusammenfassung

Abstract

Background: Inappropriate use of antibiotics for perioperative antimicrobial therapy can cause considerable complications including emergence of antibiotic resistance, risk of drug reactions and economic implications.

Objective: We assessed the use of antibiotics in patients with acute non-perforated appendicitis.

Methods: The study was performed on 317 patients aged 15 to 70 years with non-perforated appendicitis who were undergoing open appendectomy. All patients received intravenous ceftriaxone (1 g) and metronidazole (500 mg) immediately after appendectomy. Patients were randomized into one of the following three treatment protocols; A: no further antibiotics, B: three more doses of antibiotics for 1 day (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours), or C: a 3-day course of antibiotics (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours) as the postoperative antibiotic regimen. Postoperative infective complication was the primary endpoint within the 10-day postoperative follow-up period.

Results: A total of 291 patients (female 37.5%), were subjected to final analysis. This included 97 patients in each group. Twenty-six patients failed to return for wound assessment. The groups were comparable in baseline characteristics including age and gender. The Overall frequency of surgical site infection was 6.25%, with 8.2% in group A, 6.25% in group B and 5.2% in group C. The rate of postoperative surgical infection was not significantly different among all groups. There were no perioperative mortalities. No untreated control group could be included for ethical reasons.

Conclusion: A combined preoperative single dose of metronidazole and ceftriaxone appears to be sufficient for the prevention of surgical site infections in patients with uncomplicated appendicitis.

Schlüsselwörter

  • Acute appendicitis
  • ceftriaxone
  • metronidazole
  • prophylactic antibiotic therapy
Uneingeschränkter Zugang

Brief communication (Original). Effect of sacral nerve electrostimulation on sex dysfunction in male rats with spinal cord injury

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 895 - 902

Zusammenfassung

Abstract

Background: Spinal cord injury severely impairs fertility of young men. It can induce erectile dysfunction, ejaculatory dysfunction, and semen abnormalities. However, the precise mechanism is unclear.

Objective: We observed the effects of sacral nerve electrostimulation on sex dysfunction of male rats with spinal cord injury.

Methods: Thirty-six male Sprague-Dawley (SD) rats were randomly divided into three groups (n = 12): sham operated group, spinal cord injury model group, and electrostimulation group. The weight of genitals, related sex hormone index, and sperm motility were examined in each group after operation at two, four, and six weeks, respectively.

Results: Sacral nerve electrostimulation could improve testis and epididymis weight, regulate hormone secretion (including an increase in GnRH, tT, and ABP, but decrease in FSH and LH), and cause an increase in sperm count and motility.

Conclusion: Sacral nerve electrostimulation may be effective in treating sex dysfunction resulting from spinal cord injury.

Schlüsselwörter

  • Hormone
  • sacral nerve electrostimulation
  • sexual dysfunction
  • sperm
  • spinal cord injury
Uneingeschränkter Zugang

Brief communication (Original). Immune injury in rat models of type 2 diabetes mellitus

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 903 - 908

Zusammenfassung

Abstract

Background: Diabetic cardiomyopathy is an important complication of type 2 diabetics. The role of immunoinflammation, immunity, and diet has not been adequately clarified.

Objective: We investigated the relationships between diabetic cardiomyopathy and immuno-inflammation, as well as immunity and diets.

Methods: Sixty Sprague-Dawley (SD) male rats were included in this study, from which 12 were randomly selected as the normal control group (group A) and of which the remaining 48 were considered as the type 2 diabetes mellitus (T2DM) model group. Group A was fed with common diets and the T2DM model group, with high-glucose diets (by adding 20% cane sugar, 10% lard, and 2.5% cholesterol into a 67.5% common diet). After 4-week feeding, the T2DM model group was randomly allocated into three groups according to the diet, highfat diet group (group B), common diet group (group C), and low-fat diet group (group D). All the three groups were then fed for another 10 weeks. At the end of the experiment, body weight, random blood glucose levels, and cardiac weight were measured. Left ventricular tissue was obtained for light microscopy and electron microscopy. Deposits of immunoglobulin G (IgG) in myocardium were identified by immunohistochemistry. Serum levels of high-sensitivity C-reactive protein (hs-CRP) were determined using the enzyme-linked immunosorbent assay (ELISA). All data were statistically analyzed.

Results: The serum level of hs-CRP was significantly higher in groups B, C, and D, than in the control group. Therefore, IgG deposits among cardiac muscle cells were observed in all the model groups, significant deviations were noted in group A (p <0.01) and IgG deposits were less in group D than in groups B and C (p <0.01).

Conclusion: Immuno-inflammation participates in the development of T2DM and diabetic cardimyopathy. Immune injury can be alleviated following dietary interference.

Schlüsselwörter

  • Diabetic cardiomyopathy
  • diet
  • high-sensitivity C-reactive protein
  • immunity
  • type 2 diabetes mellitus
Uneingeschränkter Zugang

Brief communication (Original). Differentially expressed genes of Naegleria fowleri during exposure to human neuroblastma cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 909 - 915

Zusammenfassung

Abstract

Background: Free-living amoeboflagellate, Naegleria fowleri causes acute fulminant primary amoebic meningoencephalitis (PAM). Interaction of N. fowleri with human cells is essential for the cytopathogenic process before phagocytosis and tissue invasion.

Objective: In order to understand the pathogenesis mechanisms of N. fowleri, subtractive cDNA library was used to analyze overall induction in gene expression of N. fowleri during exposure to the human neuroblastoma cells.

Methods: Co-cultivation of N. fowleri and human neuroblastoma SK-N-MC monolayer cultivation was performed. Subtractive cDNA libraries of inoculated N. fowleri at 15, 30, 45, 60, and 120 minutes were constructed. The PCR amplified products were cloned into E. coli. The specific clones were selected and further sequenced. Nucleotide sequences were compared with those deposited in the Genbank using BlastX. Significant probabilities were considered when E-value was less than 10-4. The induction of several gene expressions was validated by real-time RT-PCR.

Results: Extensive changes in gene expression of N. fowleri during the interaction with the human neuroblastoma SK-N-MC in vitro were detected. One hundred twenty clones were obtained. Among these, five clones containing DNA sequence homologue to known genes were identified. These genes included acetyl Co-A synthetase, 18s ribosome RNA, naegleria pore B precursor, isocitrate dehydrogenase, and pyruvate kinase. Real-time quantitative RT-PCR indicated that the expression level of all five genes was up-regulated within 1 hour after exposure. The expression level of acetyl Co-A synthetase increased and reached 7-times significantly greater than that of the control while pyruvate kinase, isocitrate dehydrogenase, naegleria pore B precursor, and 18s ribosome RNA transcripts increased from 2- to 4-fold, respectively.

Conclusions: A defined set of genes in N. fowleri that was differentially transcribed after contacting with the SKN- MC monolayer cells was identified. The transcription profiles unique for amoebic cell may help elucidate the transcriptional framework of N. fowleri pathogenicity and serve as a basis for identifying transcriptional virulence factors.

Keyword

  • cDNA subtraction
  • human neuroblastoma cells
  • Naegleria fowleri
Uneingeschränkter Zugang

Clinical report. Management of rare postoperative ureterocolic fistula

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 917 - 921

Zusammenfassung

Abstract

Background: Ureterocolic fistula after acute colonic diverticulitis and colovesical fistula occurs rarely in patients with colonic diverticula.

Objective: We present our experience with diagnosis and treatment of postoperative ureterocolic fistula.

Methods: A 61-year-old male patient with acute colonic diverticulitis and colovesical fistula developed ureterocolic fistula after resection of sigmoid and descending colon, partial cystectomy and T-loop colostomy.

Results: The identification and subsequent management of this rare postoperative ureterocolic fistula emphasizes the importance of adequate preoperative evaluation, including the preoperative placement of ureteral stents to facilitate identification of the ureters, minimize inadvertent ureteral injury and treat possible coloureteral fistulas.

Conclusion: Our experience suggests that placement of ureteral stents allows successful treatment of postoperative urinary leakage into the peritoneal cavity through the ureterocolonic fistula and precludes major surgical intervention.

Schlüsselwörter

  • Colonic diverticular disease
  • diverticulitis
  • fistulas
  • ureterocolic fistula
Uneingeschränkter Zugang

Clinical report. The Fontan procedure for patients with a single lung

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 923 - 927

Zusammenfassung

Abstract

Background: Single lung Fontan procedure has been performed in patients with a congenital heart disease and a single functional lung. The procedure has not been reported in China.

Objective and Methods: We reported on the case of a 6-year-old child who had a single functional right ventricle, and an atretic left pulmonary artery, who underwent a successful Fontan operation into the single right pulmonary artery. The literature of Fontan procedure in the presence of a single lung is reviewed.

Results: The patient to relate the procedure well and had uneventful recovery. The patient has been followed up for more than two years with reasonable hemodynamics.

Conclusion: The single lung Fontan operation is possible with good outcomes. More patients and longer follow up will be required to standardize the strategies and to document utility of this procedure.

Schlüsselwörter

  • Fontan procedure
  • single lung
Uneingeschränkter Zugang

Clinical report. A decade review of chickenpox among pediatric immunocompromised patients at the King Chulalongkorn Memorial Hospital, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 929 - 935

Zusammenfassung

Abstract

Background: Varicella zoster virus (VZV) infection among immunocompromised patients leads to high morbidity and mortality.

Objective: Describe the natural history and treatment outcomes of chickenpox among immunocompromised children hospitalized in a tertiary care center in the era of acyclovir treatment.

Methods: We conducted a retrospective chart review of immunocompromised children hospitalized with chickenpox at King Chulalongkorn Memorial Hospital between January 1, 2000 and December 31, 2009. Demographic data, clinical manifestations, treatment, and complications were extracted from the patients’ charts. Rate of complications were compared among underlying disease by using chi-square test.

Results: There were 61 admissions. Median interquartile range, (IQR) age was 79 (31 to 123) months. There were 31 (51%) children with hematologic malignancies, 20 (33%) on immununosuppressive drugs, six (10%) neonates, and four (6%) HIV positive. Index cases were from household members (23%), community (15%), and hospital (6%) whereas 56% had no information. Cases peaked during February to March. Median (IQR) duration of fever and active skin lesions were four (3 to 6) and five (4 to 7) days, respectively. All, except one, received acyclovir (50% intravenous, 48% switched from intravenous to oral, 2% oral). Median (IQR) duration of acyclovir treatment and hospitalization were 10 (7 to 14) and nine (7 to 10) days, respectively. Complications included bacterial skin infections (10%), hepatic transaminitis (8%), pneumonia (5%), and disseminated varicella (1%). Rates of complications were 18% among children with malignancies, 3% on immunosuppressive drugs, and none in neonates or HIV positives (p = 0.047). Two children (3%) died due to disseminated varicella and severe pneumonia.

Conclusion: Mortality rate of chickenpox among immunocompromised patients on acyclovir treatment is 3%. Children with hematologic malignancies have the highest rate of complications.

Schlüsselwörter

  • Chicken pox
  • complications
  • immunocompromised host
  • mortality
  • varicella zoster virus
Uneingeschränkter Zugang

Commentary. What is the risk of rabies transmission from patients to health care staff?

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 937 - 939

Zusammenfassung

Abstract

Admission of a human rabies case to hospital often creates great anxiety among staff that fear contamination. The care of a rabies patient requires only standard infectious precautions consisting of basic preventive measure applied in many other common diseases. This should be sufficient to prevent transmission to staff. Therefore, prevention of anxiety among health care workers should be an achievable goals.

Schlüsselwörter

  • Health care workers
  • prevention
  • rabies transmission

Planen Sie Ihre Fernkonferenz mit Scienceendo