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

Suche

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

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

Suche

18 Artikel
Uneingeschränkter Zugang

Editorial. Administering equine rabies immunoglobulin to rabies exposed patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 143 - 144

Zusammenfassung

Uneingeschränkter Zugang

Original article. Cinnamic aldehyde inhibits proliferation and invasion in a well-defined 3-dimensional culture of human cutaneous melanoma cells in tissue engineered-skin

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 145 - 153

Zusammenfassung

Abstract

Background: Tissue-engineered skin can be used not only to cover and repair skin damage, but also as a model to test the efficacy of drugs and cosmetics.

Objective: To establish a 3-dimensional (3D) culture model of skin melanoma invasion using A375 melanoma cells in vitro for studying melanoma and with which to conduct preliminary evaluation of therapeutic drugs. Here we evaluated the efficacy of cinnamic aldehyde to inhibit tumor cell growth in our 3D model of malignant melanoma.

Methods: Melanoma cells A375 were inoculated onto the surface of tissue-engineered skin and cultured at the air-liquid interface. On day 5, cinnamic aldehyde (20 μ☐) was added to the culture medium. Skin samples cultured for different days were stained with hematoxylin and eosin and observed using transmission electron microscopy. Immunohistochemical staining of E-cadherin, proliferating cell nuclear antigen (PCNA), and matrix metalloproteinase (MMP)-9 was conducted separately.

Results: A large number of A375 cell clumps had invaded the deep dermis by day 15. The tumor cells formed clumps through the desmosomes and connected with the surrounding fibroblasts through cell junctions. While the expression of E-cadherin was lost in the tumor cells, expression of MMP-9 and PCNA increased with increasing depth of invasion. Cinnamic aldehyde inhibited the proliferation and invasion of melanoma cells in the 3D culture model. Expression of MMP-9 and PCNA significantly decreased in melanoma cells in the model treated with cinnamic aldehyde.

Conclusion: The 3D culture model successfully retains the biological proliferation and invasion characteristics of the malignant melanoma cells and can be used as a system to study further the biological characteristics of malignant melanoma and to evaluate the efficacy of drug treatment. Cinnamic aldehyde and compounds of its class may prove useful treatments for patients with advanced melanomas.

Schlüsselwörter

  • Cinnamic aldehyde
  • invasion
  • melanoma
  • proliferation
  • tissue-engineered skin
  • 3-dimensional culture
Uneingeschränkter Zugang

Original article. Electron micrographs of human and avian influenza viruses with high and low pathogenicity

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 155 - 167

Zusammenfassung

Abstract

Background: An outbreak of highly pathogenic avian influenza (HPAI) H5N1 virus in Thailand was first reported in 2004. To date, electron micrographs demonstrating the morphology of HPAI H5N1 virus particle are quite limited.

Objective: To demonstrate the morphology of HPAI H5N1 virus particles, avian influenza viruses with low pathogenicity, seasonal influenza viruses, and H5N1 structural components in infected cells. The M amino acid residues that might affect the viral morphology were also analyzed.

Methods: Electron micrographs of negatively-stained virus particles and positively-stained thin sections of the HPAI H5N1 virus infected cells were visualized under a transmission electron microscope. M amino acid sequences of the study viruses were retrieved from the GenBank database and aligned with those of reference strains with known morphology and residues that are unique for the morphological type of the virus particles.

Results: Morphologically, three forms of influenza virus particles, spherical, regular, and irregular rods, and long filamentous particles, were demonstrated. However, the spherical form was the most predominant morphological type and accounted for more than 80% of the virus populations examined. In addition, the viral entry and exit steps including incomplete particles in infected Madin-Darby canine kidney cells were visualized. Our analyses did not find any M amino acid residues that might influence the viral morphology.

Conclusion: Of all virus isolates studied, we demonstrated that the spherical particles were the major population observed regardless of virus subtype, host of origin, virus virulence, or passage history. Our study suggested that the morphology of influenza virus particles released, might not be strongly influenced by M gene polymorphism.

Schlüsselwörter

  • Electron micrographs
  • highly pathogenic avian influenza H5N1 virus
  • influenza virus
  • low pathogenic avian influenza virus
  • M amino acid sequence
  • virus morphology
Uneingeschränkter Zugang

Heat stress-induced PPAR-β enhances HUVEC resistance to oxidant injury

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 169 - 184

Zusammenfassung

Abstract

Background: Mild heat stress provides protection to cells, which is known as thermal tolerance. Various kinds of heat shock proteins have been proven to play important roles in this process. Another antiapoptotic factor induced by mild heat stress, peroxisome proliferator activated receptor beta (PPAR-β), provides a protective effect to cells against subsequent oxidant injury.

Objective: To understand the expression of PPAR-β and other proteins in human umbilical vein endothelial cells (HUVECs) during mild heat stress. H2O2-induced apoptosis of cells with mild heat pretreatment were also investigated to elucidate cell resistance to oxidant injury.

Methods: HUVECs were chosen in the current study because vascular endothelial cells in burn wounds, especially in the zone of stasis, suffer sequentially from heat stimulus and oxidant injury.

Results: The cells were subjected to 43 ☐C for 25 minutes and allowed to recover for different times (from 1 to 72 hours). The PPAR-β expression was found to be upregulated in the later recovery stage. BCL-2 also showed a similar trend, but P53 showed otherwise. Heat pretreated HUVECs were exposed to 400 μmol/L of H2O2 for 12 hours, and apoptosis rate was assessed. H2O2-induced apoptosis was attenuated by heat pretreatment and by the PPAR-β agonist GW0742 (p < 0.01 and p < 0.05 versus control group); HUVECs transfected with PPAR-β shRNA seemed much more susceptible to oxidation damage (p < 0.05 versus the control group). Mild heat stress also upregulated the BCL-2 expression relative to PPAR-β.

Conclusion: Heat-induced PPAR-β may be partly responsible for this process, which may also be one of the possible explanations of the antiapoptotic function of PPAR-β, although the specific mechanism needs further examination.

Schlüsselwörter

  • Heat stress
  • PPAR-β
  • HUVEC
  • oxidant injury
Uneingeschränkter Zugang

p53-associated differential response to platinumgemcitabine and platinum-paclitaxel in advanced nonsmall cell lung cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 185 - 192

Zusammenfassung

Abstract

Background: Platinum-paclitaxel and platinum-gemcitabine are commonly used first-line chemotherapies for advanced non-small-cell lung cancer (NSCLC). Currently, there is no established biomarker predicting the treatment outcomes of these two regimens. Previous studies have suggested that p53 expression might determine the response to platinum compounds and gemcitabine, but not paclitaxel. We hypothesized that p53 overexpression would predict a worse response to platinum-gemcitabine than to platinum-paclitaxel in patients with advanced NCSLC.

Objective: To investigate whether tumor p53 expression would be able to predict the treatment outcome of these two chemotherapy regimens in advanced NSCLC patients.

Methods: We identified patients with advanced NSCLC who had been treated with either platinum-gemcitabine or platinum-paclitaxel as first-line chemotherapy at King Chulalongkorn Memorial Hospital. We obtained the corresponding archived tissue samples and performed immunohistochemical staining to determine the p53 expression in tumor tissues. We then compared the response rates and time to progression (TTP) between two regimens and p53 expression statuses.

Results: Of the 76 advanced NSCLC patients, we identified 40 (52.6%) patients with p53 overexpression, in which we showed better treatment outcomes with platinum-paclitaxel than with platinum-gemcitabine: the response rates were 42.1% vs 14.3% (p = 0.053) and TTPs were 5.3 [95%CI, 4.3-6.3] months vs 3.3 [95%CI, 1.3-5.2] months (p = 0.067). In the platinum-gemcitabine group, the response rate and TTP were better in normal expression of p53 subgroup compared to p53-overexpression subgroup (response rate 47.4% vs 14.3%, p = 0.026 and TTP 5.0 [95%CI, 4.4-5.5] months vs 3.3 [95%CI, 1.3-5.2] months, p = 0.062). These differences were not found in the platinum-paclitaxel group.

Conclusion: Our findings suggest that p53 expression is a potential predictive marker for the response to platinum-gemcitabine in advanced NSCLC. Consequently, platinum-paclitaxel would be favored over platinumgemcitabine in patients with p53 overexpression.

Schlüsselwörter

  • Advanced NSCLC
  • gemcitabine
  • paclitaxel
  • platinum
  • p53 expression
Uneingeschränkter Zugang

Original article. Effects of two carboxymethylcellulose-containing saliva substitutes on post-radiation xerostomia in head and neck cancer patients related to quality of life

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 193 - 202

Zusammenfassung

Abstract

Background: Post-radiotherapy xerostomia affects a patients’ quality of life (QoL). Carboxymethylcellulose (CCMC)-based saliva substitute products have been widely used to relieve symptoms of xerostomia.

Objective: We compared subjective short-term clinical effectiveness between commercially available CCMCbased saliva substitutes (GC Dry Mouth Gel) and King Chulalongkorn Memorial Hospital (KCMH) saliva substitutes on post-radiation xerostomia related QoL.

Methods: Fifty head and neck cancer patients with post-radiation xerostomia were randomly assigned (1:1) to receive either CCMC-based saliva substitutes (CCMC group) or KCMH saliva substitutes (KCMH group) in a blinded manner. Patients returned to our clinic 14 days after treatment for follow-up assessment. Comprehensive xerostomia questionnaires were used to evaluate the clinical effectiveness of the two CCMC-based saliva substitutes. Xerostomia severity level and four major domains of xerostomia-related quality of life, before and after treatments were assessed. Primary outcomes of QoL were analyzed using an ANCOVA, adjusting for baseline differences and chi-square statistics.

Results: After the completion of 14 days treatment, mean self-rated VAS scores of xerostomia severity in the CCMC group and KCMH group were 50.1 and 59.0 mm., respectively (p = 0.04). Mean scores of the CCMC group were significantly different from the KCMH group in three continuous outcome variables, namely speech difficulty, taste alteration, and frequency of sipping water. Additionally, there was one dichotomous outcome variable, taste alteration (p < 0.05). No other significant difference was found between the groups. The proportion of patients reporting a “response” or “major improvement” from baseline in xerostomia severity and speech difficulty were significantly different between groups (p = 0.03 and 0.04, respectively).

Conclusion: Commercially available CMC-based saliva substitute showed better outcomes in improving severity of xerostomia, speech difficulty, taste alteration, and frequency of sipping water compared with KCMH saliva substitute.

Schlüsselwörter

  • Carboxymethylcellulose
  • head and neck cancer
  • quality of life
  • radiation
  • saliva substitute
  • xerostomia
Uneingeschränkter Zugang

Original article. Incidence and severity of acute adverse reactions to intravenous iodinated contrast media: 8-year experience in King Chulalongkorn Memorial Hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 203 - 209

Zusammenfassung

Abstract

Background: Increasing numbers of acute adverse reactions to contrast media are being seen. Institutional information about incidence and severity of acute adverse reactions to contrast media is essential to inform radiologists of the both common and life-threatening acute adverse reactions encountered.

Objectives: We determined the overall, type-specific and severity of acute adverse reactions to intravenous iodinated contrast media at King Chulalongkorn Memorial hospital between January 2002 and December 2009.

Methods: This retrospective study reviewed 663 report forms for acute adverse reactions to contrast media among 74,010 intravenous iodinated contrast injections using five types of contrast media including meglumine/sodium ioxitalamate, iohexol, iopamidol, iopromide, and iobitridol.

Results: The overall incidence of acute adverse reactions to iodinated contrast media was about 0.9%. Of these 0.8% were minor, and 0.1% were major reactions. The majority of minor reactions were urticaria and the majority of major reactions were facial edema. One contrast-related death was reported. Incidence of acute adverse reactions to nonionic contrast media was 0.58%, and was 4.29 % in the ionic group. The type-specific incidence of acute adverse reactions was 4.29% for meglumine/sodium ioxitalamate, 0.82% for iohexol, 0.29% for iopamidol, 0.65% for iopromide, and 0.25% for iobitridol.

Conclusion: Acute adverse reactions to intravenous iodinated contrast media account for less than one percent of injections. The incidence is higher in the ionic contrast media group. The majority of reactions are mild. However, severe reactions can still be encountered and death related to contrast media exist.

Schlüsselwörter

  • Acute adverse reactions
  • contrast media
  • intravenous
  • iodinated
  • incidence
  • severity
Uneingeschränkter Zugang

Original article. Expression profile of human neuroblastoma cells after exposure to Naegleria fowleri

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 211 - 218

Zusammenfassung

Abstract

Background: Naegleria fowleri, a free-living amoeboflagellate, is the causative agent of life threatening primary amoebic meningoencephalitis with up to a 98% mortality rate. The pathogenesis involves neuronal dysfunction and damages the host central nervous system. Understanding the interactions of the target cells and the protozoa may facilitate an integrated approach to address important biological questions.

Objective: We investigated changes in protein expression of the host cells post Naegleria fowleri infection.

Methods: The analysis was based on two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) of the proteins extracted from human neuroblastoma SK-N-MC after exposure to N. fowleri trophozoites over a period of six hours. We observed differences in protein expression as early as 15 minutes after the exposure, and the differences remained throughout the six hours study.

Results: The identified protein spots corresponded to 53 proteins unique to human and 24 of these proteins were identified as involved in signal transduction, translation, immune response, cytoskeleton, and stress response. We also observed changes in the abundance of these proteins after cocultivating SK-N-MC with N. fowleri, especially those involved in angiogenesis, fatty acid metabolism, signal transduction, translation, stress response, signal pathway, and respiration.

Conclusions: The proteomics analysis from this report suggested how and by which means the SK-N-MC responded after N. fowleri infection.

Schlüsselwörter

  • Host response trophozoites
  • human neuroblastoma SK-N-MC
  • Naegleria fowleri infection proteomics
Uneingeschränkter Zugang

Original article. A novel reverse transcription polymerase chain reaction reveals a high prevalence of Plasmodium vivax gametocyte carriage in an endemic area of Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 219 - 226

Zusammenfassung

Abstract

Background: Gametocytes are precursors of malaria sexual stages that are infective to mosquito vectors and play crucial roles in maintaining cycle of infection. Microscopy cannot determine the status of gametocyte carriage in those who had submicroscopic gametocytemia that may serve as infectious reservoirs in endemic areas. Meanwhile, gametocytes possess stage-specific mRNA that can be detected by molecular methods.

Objective: To develop a sensitive method for detection of Plasmodium vivax gametocytes using reverse transcription polymerase chain reaction (RT-PCR) and determine its diagnostic performance in clinical samples.

Materials and Methods: A nested RT-PCR was devised using primers targeting Pvs25, a mature gametocytespecific mRNA transcript of P. vivax (nested Pvs25 RT-PCR). Performance of the assay was evaluated using mRNA extracted from blood samples of 180 febrile patients attending a malaria clinic in Tak Province. Total RNA was extracted from blood samples that were preserved in RNAlater and from dried blood on filter papers. Malaria species was determined by microscopy from Giemsa stained blood smears and reaffirmed by nested PCR targeting mitochondrial cytochrome b (nested mtCytb PCR).

Results: Of 180 blood samples, malaria was diagnosed in 120 patients (69 P. vivax and 51 P. falciparum) by microscopy and 125 patients by nested mtCytb PCR (69 P. vivax, 51 P. falciparum and 5 coinfections with both these species). Microscopy detected gametocytes in 30 of all 74 (40.5%) P. vivax positives by nested mtCytb PCR. Meanwhile, 67 of 74 (90.5%) P. vivax-positive isolates that were preserved in RNAlater gave positive results by nested Pvs25 RT-PCR. Therefore, nested Pvs25 RT-PCR identified mature P. vivax gametocytes more than twice as frequently as microscopy. The minimum detection threshold for nested Pvs25 RT-PCR was 10 copies of template DNA whereas no cross-reactivity with other human malaria species was observed. Dried blood collected on filter papers offered comparable results for Pvs25 mRNA detection with blood stored in RNA preservative with only 2.7% difference in positive rates.

Conclusion: The nested RT-PCR targeting Pvs25 developed in this study is sensitive and specific for diagnosing mature P. vivax gametocytes and can be efficiently applied to both blood samples kept in RNA preservative and dried blood on filter paper.

Schlüsselwörter

  • Plasmodium vivax
  • Gametocyte
  • Pvs25
  • reverse transcription polymerase chain reaction
  • Thailand
Uneingeschränkter Zugang

Original article. Prevalence of vitamin D deficiency and association of serum vitamin D level with anthropometric and metabolic factors in metabolic syndrome patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 227 - 235

Zusammenfassung

Abstract

Background: Accumulating evidence suggests that vitamin D deficiency may contribute to an increased risk of glucose intolerance, diabetes, insulin resistance, and metabolic syndrome. Vitamin D levels vary between different populations and their association with metabolic syndrome in non-western populations remains equivocal.

Objective: We examined the prevalence of vitamin D deficiency and association of vitamin D levels with anthropometric and metabolic factors in metabolic syndrome patients.

Methods: A cross-sectional study was conducted in 300 patients with metabolic syndrome. Patients were prospectively recruited, physically examined, and assessed for vitamin D levels and other laboratory data.

Results: The prevalence of vitamin D deficiency [25(OH)D ≤20 ng/mL] was 40.7% [95% CI = 35% to 46%]. In multivariate analysis, after adjustment for all variables, we found that increased waist circumference (WC) (adjusted odds ratio [AOR] = 1.058; 95% CI = 1.016-1.103), decreased hand skin color darkness (AOR = 0.757; 95% CI = 0.597-0.959), increased total cholesterol (AOR = 1.019; 95% CI = 1.005-1.032), and increased systolic blood pressure (SBP) (AOR = 1.029; 95% CI = 1.003-1.055) were significantly associated with an increased risk of vitamin D deficiency.

Conclusion: High prevalence of vitamin D deficiency has been observed in metabolic syndrome patients. After multivariate adjustment for all variables, high WC, light skin color, high total cholesterol levels, and high SBP were significantly associated with an increased risk of vitamin D deficiency.

Schlüsselwörter

  • Anthropometric
  • association
  • metabolic syndrome
  • prevalence
  • vitamin D deficiency
Uneingeschränkter Zugang

Brief Communication (Original). Knowledge, attitude, and practice of rabies prophylaxis among physicians at Indian animal bite clinics

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 237 - 242

Zusammenfassung

Abstract

Background: Animal bites in humans are an important public health problem. Timely and correct postexposure prophylaxis for victims is necessary to prevent deaths.

Objectives: We studied the knowledge, attitude, and actual practice of rabies prophylaxis among physicians at animal bite clinics and the relationship between their knowledge and actual practice.

Methods: A cross sectional study was conducted among 109 physicians working in eight Indian cities. The data collected were analyzed using SPSS version16.0. The descriptive statistics computed. Spearman’s rank correlation was computed to measure the relationship between knowledge, attitude and practice.

Results: The knowledge, attitude and practice of these anti rabies clinic physicians were inadequate with respect to different parameters. The appropriate life-saving use of immunoglobulins was one of these. The present study also showed that there was a significant difference between knowledge, attitude, and practice.

Conclusions: Knowledge, attitude, and practice needs to be improved through properly designed awareness programmes for all physicians dealing with rabies exposures. Emphasis should be on following current WHO guidelines for post exposure prophylaxis of rabies.

Schlüsselwörter

  • Animal bites
  • animal bite clinics
  • medical officers knowledge and practices
  • rabies prophylaxis
  • use of immunoglobulins
  • wound care
Uneingeschränkter Zugang

Brief Communication (Original). Utilization of rabies immunoglobulin in seven urban Pakistan emergency rooms

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 243 - 247

Zusammenfassung

Abstract

Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immunoglobulin (RIG) administration, a life-saving biological, is often avoided by emergency room health care providers (HCPs)

Objective: To understand the practices of HCPs for administration of RIG in severe dog-bite exposures, which are common causes of emergency room visits in Pakistan.

Methods: A cross-sectional study was conducted among 103 HCPs working in seven hospitals in three cities of Pakistan.

Results: Of 103 HCPs who responded to the questionnaires, 97.1% had administered rabies vaccine and 31.1% had administered ERIG in the past three years of their practice; three quarters said they would prefer to use HRIG if available. Thirty-five percent said they would not inject wounds at all, 24.3% would only vaccinate a patient with severe dog bites, but not administer RIG. More than 55% were concerned about the cost of human and equine RIG.

Conclusion: Although there is awareness about the use of RIG, this life saving biological is grossly underused because of poor availability in clinics and emergency rooms (ERs) even though stocked by local suppliers. Hospitals and animal bite centers must make RIG available for severe exposures.

Schlüsselwörter

  • Animal bites
  • rabies immunoglobulin
  • medical officers’ practices
  • rabies prophylaxis
Uneingeschränkter Zugang

Brief communication (Original). Melioidosis: an underdiagnosed disease in India (epidemiology, clinical features, and outcomes)

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 249 - 256

Zusammenfassung

Abstract

Background: Melioidosis is an emerging infectious disease in Southeast Asia. It is an under diagnosed and under reported disease in India mostly because of lack of awareness.

Objective: We studied the clinical profile and outcome of melioidosis.

Methods: A prospective observational study conducted at Kasturba Hospital, Manipal University from May 2007 to July 2009.

Results: There were 31 diagnosed patients in all. Diabetes mellitus was the most common risk factor (68%). Eighty-one percent of cases were detected in the rainy season. Male to female ratio was 3:1. The median age was 48 years. Fifty-two percent of patients were in the age group 41 to 60 years. Thirty-two of patients were agriculturists. Respiratory symptoms were the predominant presentations. The majority (87%) of patients had fever. The bacteria were sensitive to ceftazidime, cotrimoxazole, carbapenems, piperacillin, doxycycline, and chloramphenicol, and resistant to aminoglycosides. Forty-eight percent of patients had bacteremia. Forty-five percent of cases were cured. Twenty-percent of patients had septicemia and septic shock. Sixteen percent of patients died because of septic shock.

Conclusion: Melioidosis is very difficult disease to diagnose clinically and to treat; mostly because of varied presentations. Awareness of the existence of this disease in an endemic region with various underlying risk factors is essential for successful treatment. The early use of appropriate antibiotics and the efficient care of patients with sepsis improves outcomes dramatically. Patients with septicemia and septic shock still result in high mortality rates in spite of efficient critical care.

Schlüsselwörter

  • Burkholderia pseudomallei
  • melioidosis
  • pneumonia
  • septicemia
  • septic shock
  • splenic abscess
Uneingeschränkter Zugang

Brief communication (Original). Risk factors for tooth loss among adults aged 18 to 64 years in Taiwan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 257 - 265

Zusammenfassung

Abstract

Background: In Taiwan, tooth loss increases with aging. However, little is known about the oral health of adults between ages 18 to 64 years and associated factors for tooth loss.

Objective: To identify associated independent factors for tooth loss among Taiwanese adults aged 18 to 64 years.

Methods: This cross-sectional study evaluated oral health and tooth loss among adults aged 18 to 64 years. Demographics, tooth loss data, and oral health-related variables were collected from a secondary database and were analyzed to determine risk factors for tooth loss.

Results: In adults aged 18 to 64, older age, unmarried status, lower income, higher BMI, and chronic disease were associated with tooth loss. Adults with disease histories (i.e., hypertension, diabetes, asthma, heart disease) or who smoked or chewed betel nut were more likely to have missing teeth. Adults who had regular dental hygiene practices such as using dental floss, mouthwash, and having regular professional scaling were less likely to have missing teeth.

Conclusions: Knowledge of associated risk factors for tooth loss in adults aged 18 to 64 years may help develop national programs and policies for dental care in Taiwan specific for younger and middle-aged adults and help to promote long-term oral health throughout adulthood.

Schlüsselwörter

  • Adults
  • epidemiology
  • health survey
  • oral health
  • tooth loss
Uneingeschränkter Zugang

Brief communication (Original). Certain risk factors associated with positive SCCIT test for tuberculosis in cattle at two cities in Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 267 - 274

Zusammenfassung

Abstract

Background: Bovine tuberculosis is a significant disease in animals and monitoring is important in preventing spread and transmission to man.

Objective: We identified risk factors for a positive tuberculin test (SCCIT) in cattle at Faisalabad and Okara, Pakistan.

Methods: Fifty-nine herds (230 cattle) at Faisalabad and 38 (291 cattle) at Okara were included in the study. The risk factors studied included area, farm, nature of villages, location, total cattle, presence of other animals, other species (buffalo, small ruminants, equines or pets), age, sex, live weight, calving number, lactation length, lactation status, total milk produced, and per day milk.

Results: Our results showed an association between age, live weight, calving number, lactation length, and total number of cattle at the farm with positive tuberculin test. The analysis of variance technique also showed association of all of these factors except lactation length with positive skin test. The results of logistic regression analysis also suggested an association of age, live weight, calving number, total animals at the farm, and total cattle at the farm with positive SCCIT test in cattle.

Conclusions: The prevalence of tuberculosis in cattle is around 9% at herd level and 2% at animal level with stronger risk factors being live weight, total animals, and total cattle at the farm.

Schlüsselwörter

  • Cattle
  • Pakistan
  • risk factors
  • tuberculosis
Uneingeschränkter Zugang

Brief communication (Original). Validation of a high-performance liquid chromatography method for the determination of pyridostigmine in plasma

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 275 - 279

Zusammenfassung

Abstract

Background: Pyridostigmine is a reversible acetylcholinesterase inhibitor that is used in military medicine as a prophylactic agent against intoxication by nerve agents and in the treatment of myasthenia.

Objective: We developed and validated a high-performance liquid chromatography (HPLC) method for the quantification of pyridostigmine in plasma samples.

Methods: Pyridostigmine was isolated from plasma using one-step protein precipitation by chloroform. The separation was performed on an analytical C18 column (250 × 4.6 mm; 4 μm particle size). The detector wavelength was set at 270 nm. The mobile phase was a mixture of acetonitrile and aqueous solution (15:85 v/v) of sodium-1-hepatene sulfonate and triethylamine, adjusted to pH 3.0 at a flow rate of 1.5 ml min-1. Hydrochlorothiazide was used as internal standard.

Results: The recovery of drug from plasma samples was above 90%. Using the current method, pyridostigmine (rt = 7.3) and hydrochlorothiazide (rt = 6.4) peaks were well resolved. The calibration curve was linear over the concentration range of 15-60 ng ml-1. The inter- and intraday assay coefficients of variation were found to be less than 8%.

Conclusion: The currently described procedure could be used as a simple, rapid and sensitive tool in bioavailability and bioequivalency investigations for the quantification of pyridostigmine in human plasma samples.

Schlüsselwörter

  • Drug
  • high-performance liquid chromatography
  • Mestinon
  • method validation
Uneingeschränkter Zugang

Brief communication (Original). Controlling head lice in Iranian primary schools for girls

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 281 - 285

Zusammenfassung

Abstract

Background: In spite of large budgets for procurement and distribution of pediculicide shampoos, prevalence of pediculosis in girls’ primary schools continues.

Objective: To study the efficacy of the pediculicide shampoos lindane 1% and permethrin 1%, for pediculosis control among students.

Methods: One thousand forty two louse-infested schoolgirls in 31 girls’ primary schools were randomly treated with the shampoos (520 students with lindane 1% and 722 students with permethrin 1%). One hundred twenty five contaminated schoolgirls were treated with placebo shampoos. Efficacy of shampoos was studied after using twice with a one week interval. At the start, an educational pamphlet was distributed among all students discussing methods of prevention and directions for use of shampoos.

Results: We found that shampoo treatment resulted in only 52.9% overall recovery. With lindane, it was 50.96% and with permethrin 54.29%. The highest level of recovery was observed among primary school girls in grade five. Recovery in the central zone of the city and in private schools was better. Furthermore, the efficacy level of the shampoos was influenced by different factors such as parasite load, type of school, school location, level of education, level of awareness, and sociocultural factors.

Conclusion: Pediculicide shampoos are effective, but education and modification of sociocultural factors are also important.

Schlüsselwörter

  • Lindane shampoo
  • pediculicide
  • pediculosis
  • permethrin shampoo
Uneingeschränkter Zugang

Brief communication (Original). Congenital heart disease in elementary school children in rural Thailand: the role of the trained noncardiologist

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 287 - 291

Zusammenfassung

Abstract

Background: Congenital heart diseases (CHD) comprise about one-third of all major birth defects. Children with delayed diagnosis and improper treatment are at a high risk of morbidity and mortality.

Objective: To determine the prevalence of unrecognized congenital heart disease among elementary school students and study the types and frequency of congenital heart disease in Phitsanulok, Pichit, and Kampangpetch provinces of Thailand using trained nurses and other health care personnel.

Methods: Between September 2008 and September 2010, 138,529 students from 1,243 elementary schools were screened for abnormal heart conditions by trained nurses or health care workers. The students who were suspected to have CHD were referred to a pediatric cardiologist for complete evaluation and identification of the lesions.

Results: Five hundred forty eight students were suspected to have heart diseases and 102 students were diagnosed as CHD. The average prevalence of unrecognized CHD in Phitsanulok, Pichit, and Kampangpetch was 0.74 per 1,000. Simple acyanotic lesions (ventricular septal defect, atrial septal defect, and pulmonary stenosis) were common in this study (32.35%, 16.67%, and 11.76%, respectively).

Conclusion: Qualified nurses or health care workers can be useful for identifying patients with CHD. The role of these personnel in the national heart screening program should be further clarified.

Schlüsselwörter

  • Congenital heart disease screening in children
  • prevalence
  • Thailand
18 Artikel
Uneingeschränkter Zugang

Editorial. Administering equine rabies immunoglobulin to rabies exposed patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 143 - 144

Zusammenfassung

Uneingeschränkter Zugang

Original article. Cinnamic aldehyde inhibits proliferation and invasion in a well-defined 3-dimensional culture of human cutaneous melanoma cells in tissue engineered-skin

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 145 - 153

Zusammenfassung

Abstract

Background: Tissue-engineered skin can be used not only to cover and repair skin damage, but also as a model to test the efficacy of drugs and cosmetics.

Objective: To establish a 3-dimensional (3D) culture model of skin melanoma invasion using A375 melanoma cells in vitro for studying melanoma and with which to conduct preliminary evaluation of therapeutic drugs. Here we evaluated the efficacy of cinnamic aldehyde to inhibit tumor cell growth in our 3D model of malignant melanoma.

Methods: Melanoma cells A375 were inoculated onto the surface of tissue-engineered skin and cultured at the air-liquid interface. On day 5, cinnamic aldehyde (20 μ☐) was added to the culture medium. Skin samples cultured for different days were stained with hematoxylin and eosin and observed using transmission electron microscopy. Immunohistochemical staining of E-cadherin, proliferating cell nuclear antigen (PCNA), and matrix metalloproteinase (MMP)-9 was conducted separately.

Results: A large number of A375 cell clumps had invaded the deep dermis by day 15. The tumor cells formed clumps through the desmosomes and connected with the surrounding fibroblasts through cell junctions. While the expression of E-cadherin was lost in the tumor cells, expression of MMP-9 and PCNA increased with increasing depth of invasion. Cinnamic aldehyde inhibited the proliferation and invasion of melanoma cells in the 3D culture model. Expression of MMP-9 and PCNA significantly decreased in melanoma cells in the model treated with cinnamic aldehyde.

Conclusion: The 3D culture model successfully retains the biological proliferation and invasion characteristics of the malignant melanoma cells and can be used as a system to study further the biological characteristics of malignant melanoma and to evaluate the efficacy of drug treatment. Cinnamic aldehyde and compounds of its class may prove useful treatments for patients with advanced melanomas.

Schlüsselwörter

  • Cinnamic aldehyde
  • invasion
  • melanoma
  • proliferation
  • tissue-engineered skin
  • 3-dimensional culture
Uneingeschränkter Zugang

Original article. Electron micrographs of human and avian influenza viruses with high and low pathogenicity

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 155 - 167

Zusammenfassung

Abstract

Background: An outbreak of highly pathogenic avian influenza (HPAI) H5N1 virus in Thailand was first reported in 2004. To date, electron micrographs demonstrating the morphology of HPAI H5N1 virus particle are quite limited.

Objective: To demonstrate the morphology of HPAI H5N1 virus particles, avian influenza viruses with low pathogenicity, seasonal influenza viruses, and H5N1 structural components in infected cells. The M amino acid residues that might affect the viral morphology were also analyzed.

Methods: Electron micrographs of negatively-stained virus particles and positively-stained thin sections of the HPAI H5N1 virus infected cells were visualized under a transmission electron microscope. M amino acid sequences of the study viruses were retrieved from the GenBank database and aligned with those of reference strains with known morphology and residues that are unique for the morphological type of the virus particles.

Results: Morphologically, three forms of influenza virus particles, spherical, regular, and irregular rods, and long filamentous particles, were demonstrated. However, the spherical form was the most predominant morphological type and accounted for more than 80% of the virus populations examined. In addition, the viral entry and exit steps including incomplete particles in infected Madin-Darby canine kidney cells were visualized. Our analyses did not find any M amino acid residues that might influence the viral morphology.

Conclusion: Of all virus isolates studied, we demonstrated that the spherical particles were the major population observed regardless of virus subtype, host of origin, virus virulence, or passage history. Our study suggested that the morphology of influenza virus particles released, might not be strongly influenced by M gene polymorphism.

Schlüsselwörter

  • Electron micrographs
  • highly pathogenic avian influenza H5N1 virus
  • influenza virus
  • low pathogenic avian influenza virus
  • M amino acid sequence
  • virus morphology
Uneingeschränkter Zugang

Heat stress-induced PPAR-β enhances HUVEC resistance to oxidant injury

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 169 - 184

Zusammenfassung

Abstract

Background: Mild heat stress provides protection to cells, which is known as thermal tolerance. Various kinds of heat shock proteins have been proven to play important roles in this process. Another antiapoptotic factor induced by mild heat stress, peroxisome proliferator activated receptor beta (PPAR-β), provides a protective effect to cells against subsequent oxidant injury.

Objective: To understand the expression of PPAR-β and other proteins in human umbilical vein endothelial cells (HUVECs) during mild heat stress. H2O2-induced apoptosis of cells with mild heat pretreatment were also investigated to elucidate cell resistance to oxidant injury.

Methods: HUVECs were chosen in the current study because vascular endothelial cells in burn wounds, especially in the zone of stasis, suffer sequentially from heat stimulus and oxidant injury.

Results: The cells were subjected to 43 ☐C for 25 minutes and allowed to recover for different times (from 1 to 72 hours). The PPAR-β expression was found to be upregulated in the later recovery stage. BCL-2 also showed a similar trend, but P53 showed otherwise. Heat pretreated HUVECs were exposed to 400 μmol/L of H2O2 for 12 hours, and apoptosis rate was assessed. H2O2-induced apoptosis was attenuated by heat pretreatment and by the PPAR-β agonist GW0742 (p < 0.01 and p < 0.05 versus control group); HUVECs transfected with PPAR-β shRNA seemed much more susceptible to oxidation damage (p < 0.05 versus the control group). Mild heat stress also upregulated the BCL-2 expression relative to PPAR-β.

Conclusion: Heat-induced PPAR-β may be partly responsible for this process, which may also be one of the possible explanations of the antiapoptotic function of PPAR-β, although the specific mechanism needs further examination.

Schlüsselwörter

  • Heat stress
  • PPAR-β
  • HUVEC
  • oxidant injury
Uneingeschränkter Zugang

p53-associated differential response to platinumgemcitabine and platinum-paclitaxel in advanced nonsmall cell lung cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 185 - 192

Zusammenfassung

Abstract

Background: Platinum-paclitaxel and platinum-gemcitabine are commonly used first-line chemotherapies for advanced non-small-cell lung cancer (NSCLC). Currently, there is no established biomarker predicting the treatment outcomes of these two regimens. Previous studies have suggested that p53 expression might determine the response to platinum compounds and gemcitabine, but not paclitaxel. We hypothesized that p53 overexpression would predict a worse response to platinum-gemcitabine than to platinum-paclitaxel in patients with advanced NCSLC.

Objective: To investigate whether tumor p53 expression would be able to predict the treatment outcome of these two chemotherapy regimens in advanced NSCLC patients.

Methods: We identified patients with advanced NSCLC who had been treated with either platinum-gemcitabine or platinum-paclitaxel as first-line chemotherapy at King Chulalongkorn Memorial Hospital. We obtained the corresponding archived tissue samples and performed immunohistochemical staining to determine the p53 expression in tumor tissues. We then compared the response rates and time to progression (TTP) between two regimens and p53 expression statuses.

Results: Of the 76 advanced NSCLC patients, we identified 40 (52.6%) patients with p53 overexpression, in which we showed better treatment outcomes with platinum-paclitaxel than with platinum-gemcitabine: the response rates were 42.1% vs 14.3% (p = 0.053) and TTPs were 5.3 [95%CI, 4.3-6.3] months vs 3.3 [95%CI, 1.3-5.2] months (p = 0.067). In the platinum-gemcitabine group, the response rate and TTP were better in normal expression of p53 subgroup compared to p53-overexpression subgroup (response rate 47.4% vs 14.3%, p = 0.026 and TTP 5.0 [95%CI, 4.4-5.5] months vs 3.3 [95%CI, 1.3-5.2] months, p = 0.062). These differences were not found in the platinum-paclitaxel group.

Conclusion: Our findings suggest that p53 expression is a potential predictive marker for the response to platinum-gemcitabine in advanced NSCLC. Consequently, platinum-paclitaxel would be favored over platinumgemcitabine in patients with p53 overexpression.

Schlüsselwörter

  • Advanced NSCLC
  • gemcitabine
  • paclitaxel
  • platinum
  • p53 expression
Uneingeschränkter Zugang

Original article. Effects of two carboxymethylcellulose-containing saliva substitutes on post-radiation xerostomia in head and neck cancer patients related to quality of life

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 193 - 202

Zusammenfassung

Abstract

Background: Post-radiotherapy xerostomia affects a patients’ quality of life (QoL). Carboxymethylcellulose (CCMC)-based saliva substitute products have been widely used to relieve symptoms of xerostomia.

Objective: We compared subjective short-term clinical effectiveness between commercially available CCMCbased saliva substitutes (GC Dry Mouth Gel) and King Chulalongkorn Memorial Hospital (KCMH) saliva substitutes on post-radiation xerostomia related QoL.

Methods: Fifty head and neck cancer patients with post-radiation xerostomia were randomly assigned (1:1) to receive either CCMC-based saliva substitutes (CCMC group) or KCMH saliva substitutes (KCMH group) in a blinded manner. Patients returned to our clinic 14 days after treatment for follow-up assessment. Comprehensive xerostomia questionnaires were used to evaluate the clinical effectiveness of the two CCMC-based saliva substitutes. Xerostomia severity level and four major domains of xerostomia-related quality of life, before and after treatments were assessed. Primary outcomes of QoL were analyzed using an ANCOVA, adjusting for baseline differences and chi-square statistics.

Results: After the completion of 14 days treatment, mean self-rated VAS scores of xerostomia severity in the CCMC group and KCMH group were 50.1 and 59.0 mm., respectively (p = 0.04). Mean scores of the CCMC group were significantly different from the KCMH group in three continuous outcome variables, namely speech difficulty, taste alteration, and frequency of sipping water. Additionally, there was one dichotomous outcome variable, taste alteration (p < 0.05). No other significant difference was found between the groups. The proportion of patients reporting a “response” or “major improvement” from baseline in xerostomia severity and speech difficulty were significantly different between groups (p = 0.03 and 0.04, respectively).

Conclusion: Commercially available CMC-based saliva substitute showed better outcomes in improving severity of xerostomia, speech difficulty, taste alteration, and frequency of sipping water compared with KCMH saliva substitute.

Schlüsselwörter

  • Carboxymethylcellulose
  • head and neck cancer
  • quality of life
  • radiation
  • saliva substitute
  • xerostomia
Uneingeschränkter Zugang

Original article. Incidence and severity of acute adverse reactions to intravenous iodinated contrast media: 8-year experience in King Chulalongkorn Memorial Hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 203 - 209

Zusammenfassung

Abstract

Background: Increasing numbers of acute adverse reactions to contrast media are being seen. Institutional information about incidence and severity of acute adverse reactions to contrast media is essential to inform radiologists of the both common and life-threatening acute adverse reactions encountered.

Objectives: We determined the overall, type-specific and severity of acute adverse reactions to intravenous iodinated contrast media at King Chulalongkorn Memorial hospital between January 2002 and December 2009.

Methods: This retrospective study reviewed 663 report forms for acute adverse reactions to contrast media among 74,010 intravenous iodinated contrast injections using five types of contrast media including meglumine/sodium ioxitalamate, iohexol, iopamidol, iopromide, and iobitridol.

Results: The overall incidence of acute adverse reactions to iodinated contrast media was about 0.9%. Of these 0.8% were minor, and 0.1% were major reactions. The majority of minor reactions were urticaria and the majority of major reactions were facial edema. One contrast-related death was reported. Incidence of acute adverse reactions to nonionic contrast media was 0.58%, and was 4.29 % in the ionic group. The type-specific incidence of acute adverse reactions was 4.29% for meglumine/sodium ioxitalamate, 0.82% for iohexol, 0.29% for iopamidol, 0.65% for iopromide, and 0.25% for iobitridol.

Conclusion: Acute adverse reactions to intravenous iodinated contrast media account for less than one percent of injections. The incidence is higher in the ionic contrast media group. The majority of reactions are mild. However, severe reactions can still be encountered and death related to contrast media exist.

Schlüsselwörter

  • Acute adverse reactions
  • contrast media
  • intravenous
  • iodinated
  • incidence
  • severity
Uneingeschränkter Zugang

Original article. Expression profile of human neuroblastoma cells after exposure to Naegleria fowleri

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 211 - 218

Zusammenfassung

Abstract

Background: Naegleria fowleri, a free-living amoeboflagellate, is the causative agent of life threatening primary amoebic meningoencephalitis with up to a 98% mortality rate. The pathogenesis involves neuronal dysfunction and damages the host central nervous system. Understanding the interactions of the target cells and the protozoa may facilitate an integrated approach to address important biological questions.

Objective: We investigated changes in protein expression of the host cells post Naegleria fowleri infection.

Methods: The analysis was based on two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) of the proteins extracted from human neuroblastoma SK-N-MC after exposure to N. fowleri trophozoites over a period of six hours. We observed differences in protein expression as early as 15 minutes after the exposure, and the differences remained throughout the six hours study.

Results: The identified protein spots corresponded to 53 proteins unique to human and 24 of these proteins were identified as involved in signal transduction, translation, immune response, cytoskeleton, and stress response. We also observed changes in the abundance of these proteins after cocultivating SK-N-MC with N. fowleri, especially those involved in angiogenesis, fatty acid metabolism, signal transduction, translation, stress response, signal pathway, and respiration.

Conclusions: The proteomics analysis from this report suggested how and by which means the SK-N-MC responded after N. fowleri infection.

Schlüsselwörter

  • Host response trophozoites
  • human neuroblastoma SK-N-MC
  • Naegleria fowleri infection proteomics
Uneingeschränkter Zugang

Original article. A novel reverse transcription polymerase chain reaction reveals a high prevalence of Plasmodium vivax gametocyte carriage in an endemic area of Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 219 - 226

Zusammenfassung

Abstract

Background: Gametocytes are precursors of malaria sexual stages that are infective to mosquito vectors and play crucial roles in maintaining cycle of infection. Microscopy cannot determine the status of gametocyte carriage in those who had submicroscopic gametocytemia that may serve as infectious reservoirs in endemic areas. Meanwhile, gametocytes possess stage-specific mRNA that can be detected by molecular methods.

Objective: To develop a sensitive method for detection of Plasmodium vivax gametocytes using reverse transcription polymerase chain reaction (RT-PCR) and determine its diagnostic performance in clinical samples.

Materials and Methods: A nested RT-PCR was devised using primers targeting Pvs25, a mature gametocytespecific mRNA transcript of P. vivax (nested Pvs25 RT-PCR). Performance of the assay was evaluated using mRNA extracted from blood samples of 180 febrile patients attending a malaria clinic in Tak Province. Total RNA was extracted from blood samples that were preserved in RNAlater and from dried blood on filter papers. Malaria species was determined by microscopy from Giemsa stained blood smears and reaffirmed by nested PCR targeting mitochondrial cytochrome b (nested mtCytb PCR).

Results: Of 180 blood samples, malaria was diagnosed in 120 patients (69 P. vivax and 51 P. falciparum) by microscopy and 125 patients by nested mtCytb PCR (69 P. vivax, 51 P. falciparum and 5 coinfections with both these species). Microscopy detected gametocytes in 30 of all 74 (40.5%) P. vivax positives by nested mtCytb PCR. Meanwhile, 67 of 74 (90.5%) P. vivax-positive isolates that were preserved in RNAlater gave positive results by nested Pvs25 RT-PCR. Therefore, nested Pvs25 RT-PCR identified mature P. vivax gametocytes more than twice as frequently as microscopy. The minimum detection threshold for nested Pvs25 RT-PCR was 10 copies of template DNA whereas no cross-reactivity with other human malaria species was observed. Dried blood collected on filter papers offered comparable results for Pvs25 mRNA detection with blood stored in RNA preservative with only 2.7% difference in positive rates.

Conclusion: The nested RT-PCR targeting Pvs25 developed in this study is sensitive and specific for diagnosing mature P. vivax gametocytes and can be efficiently applied to both blood samples kept in RNA preservative and dried blood on filter paper.

Schlüsselwörter

  • Plasmodium vivax
  • Gametocyte
  • Pvs25
  • reverse transcription polymerase chain reaction
  • Thailand
Uneingeschränkter Zugang

Original article. Prevalence of vitamin D deficiency and association of serum vitamin D level with anthropometric and metabolic factors in metabolic syndrome patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 227 - 235

Zusammenfassung

Abstract

Background: Accumulating evidence suggests that vitamin D deficiency may contribute to an increased risk of glucose intolerance, diabetes, insulin resistance, and metabolic syndrome. Vitamin D levels vary between different populations and their association with metabolic syndrome in non-western populations remains equivocal.

Objective: We examined the prevalence of vitamin D deficiency and association of vitamin D levels with anthropometric and metabolic factors in metabolic syndrome patients.

Methods: A cross-sectional study was conducted in 300 patients with metabolic syndrome. Patients were prospectively recruited, physically examined, and assessed for vitamin D levels and other laboratory data.

Results: The prevalence of vitamin D deficiency [25(OH)D ≤20 ng/mL] was 40.7% [95% CI = 35% to 46%]. In multivariate analysis, after adjustment for all variables, we found that increased waist circumference (WC) (adjusted odds ratio [AOR] = 1.058; 95% CI = 1.016-1.103), decreased hand skin color darkness (AOR = 0.757; 95% CI = 0.597-0.959), increased total cholesterol (AOR = 1.019; 95% CI = 1.005-1.032), and increased systolic blood pressure (SBP) (AOR = 1.029; 95% CI = 1.003-1.055) were significantly associated with an increased risk of vitamin D deficiency.

Conclusion: High prevalence of vitamin D deficiency has been observed in metabolic syndrome patients. After multivariate adjustment for all variables, high WC, light skin color, high total cholesterol levels, and high SBP were significantly associated with an increased risk of vitamin D deficiency.

Schlüsselwörter

  • Anthropometric
  • association
  • metabolic syndrome
  • prevalence
  • vitamin D deficiency
Uneingeschränkter Zugang

Brief Communication (Original). Knowledge, attitude, and practice of rabies prophylaxis among physicians at Indian animal bite clinics

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 237 - 242

Zusammenfassung

Abstract

Background: Animal bites in humans are an important public health problem. Timely and correct postexposure prophylaxis for victims is necessary to prevent deaths.

Objectives: We studied the knowledge, attitude, and actual practice of rabies prophylaxis among physicians at animal bite clinics and the relationship between their knowledge and actual practice.

Methods: A cross sectional study was conducted among 109 physicians working in eight Indian cities. The data collected were analyzed using SPSS version16.0. The descriptive statistics computed. Spearman’s rank correlation was computed to measure the relationship between knowledge, attitude and practice.

Results: The knowledge, attitude and practice of these anti rabies clinic physicians were inadequate with respect to different parameters. The appropriate life-saving use of immunoglobulins was one of these. The present study also showed that there was a significant difference between knowledge, attitude, and practice.

Conclusions: Knowledge, attitude, and practice needs to be improved through properly designed awareness programmes for all physicians dealing with rabies exposures. Emphasis should be on following current WHO guidelines for post exposure prophylaxis of rabies.

Schlüsselwörter

  • Animal bites
  • animal bite clinics
  • medical officers knowledge and practices
  • rabies prophylaxis
  • use of immunoglobulins
  • wound care
Uneingeschränkter Zugang

Brief Communication (Original). Utilization of rabies immunoglobulin in seven urban Pakistan emergency rooms

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 243 - 247

Zusammenfassung

Abstract

Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immunoglobulin (RIG) administration, a life-saving biological, is often avoided by emergency room health care providers (HCPs)

Objective: To understand the practices of HCPs for administration of RIG in severe dog-bite exposures, which are common causes of emergency room visits in Pakistan.

Methods: A cross-sectional study was conducted among 103 HCPs working in seven hospitals in three cities of Pakistan.

Results: Of 103 HCPs who responded to the questionnaires, 97.1% had administered rabies vaccine and 31.1% had administered ERIG in the past three years of their practice; three quarters said they would prefer to use HRIG if available. Thirty-five percent said they would not inject wounds at all, 24.3% would only vaccinate a patient with severe dog bites, but not administer RIG. More than 55% were concerned about the cost of human and equine RIG.

Conclusion: Although there is awareness about the use of RIG, this life saving biological is grossly underused because of poor availability in clinics and emergency rooms (ERs) even though stocked by local suppliers. Hospitals and animal bite centers must make RIG available for severe exposures.

Schlüsselwörter

  • Animal bites
  • rabies immunoglobulin
  • medical officers’ practices
  • rabies prophylaxis
Uneingeschränkter Zugang

Brief communication (Original). Melioidosis: an underdiagnosed disease in India (epidemiology, clinical features, and outcomes)

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 249 - 256

Zusammenfassung

Abstract

Background: Melioidosis is an emerging infectious disease in Southeast Asia. It is an under diagnosed and under reported disease in India mostly because of lack of awareness.

Objective: We studied the clinical profile and outcome of melioidosis.

Methods: A prospective observational study conducted at Kasturba Hospital, Manipal University from May 2007 to July 2009.

Results: There were 31 diagnosed patients in all. Diabetes mellitus was the most common risk factor (68%). Eighty-one percent of cases were detected in the rainy season. Male to female ratio was 3:1. The median age was 48 years. Fifty-two percent of patients were in the age group 41 to 60 years. Thirty-two of patients were agriculturists. Respiratory symptoms were the predominant presentations. The majority (87%) of patients had fever. The bacteria were sensitive to ceftazidime, cotrimoxazole, carbapenems, piperacillin, doxycycline, and chloramphenicol, and resistant to aminoglycosides. Forty-eight percent of patients had bacteremia. Forty-five percent of cases were cured. Twenty-percent of patients had septicemia and septic shock. Sixteen percent of patients died because of septic shock.

Conclusion: Melioidosis is very difficult disease to diagnose clinically and to treat; mostly because of varied presentations. Awareness of the existence of this disease in an endemic region with various underlying risk factors is essential for successful treatment. The early use of appropriate antibiotics and the efficient care of patients with sepsis improves outcomes dramatically. Patients with septicemia and septic shock still result in high mortality rates in spite of efficient critical care.

Schlüsselwörter

  • Burkholderia pseudomallei
  • melioidosis
  • pneumonia
  • septicemia
  • septic shock
  • splenic abscess
Uneingeschränkter Zugang

Brief communication (Original). Risk factors for tooth loss among adults aged 18 to 64 years in Taiwan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 257 - 265

Zusammenfassung

Abstract

Background: In Taiwan, tooth loss increases with aging. However, little is known about the oral health of adults between ages 18 to 64 years and associated factors for tooth loss.

Objective: To identify associated independent factors for tooth loss among Taiwanese adults aged 18 to 64 years.

Methods: This cross-sectional study evaluated oral health and tooth loss among adults aged 18 to 64 years. Demographics, tooth loss data, and oral health-related variables were collected from a secondary database and were analyzed to determine risk factors for tooth loss.

Results: In adults aged 18 to 64, older age, unmarried status, lower income, higher BMI, and chronic disease were associated with tooth loss. Adults with disease histories (i.e., hypertension, diabetes, asthma, heart disease) or who smoked or chewed betel nut were more likely to have missing teeth. Adults who had regular dental hygiene practices such as using dental floss, mouthwash, and having regular professional scaling were less likely to have missing teeth.

Conclusions: Knowledge of associated risk factors for tooth loss in adults aged 18 to 64 years may help develop national programs and policies for dental care in Taiwan specific for younger and middle-aged adults and help to promote long-term oral health throughout adulthood.

Schlüsselwörter

  • Adults
  • epidemiology
  • health survey
  • oral health
  • tooth loss
Uneingeschränkter Zugang

Brief communication (Original). Certain risk factors associated with positive SCCIT test for tuberculosis in cattle at two cities in Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 267 - 274

Zusammenfassung

Abstract

Background: Bovine tuberculosis is a significant disease in animals and monitoring is important in preventing spread and transmission to man.

Objective: We identified risk factors for a positive tuberculin test (SCCIT) in cattle at Faisalabad and Okara, Pakistan.

Methods: Fifty-nine herds (230 cattle) at Faisalabad and 38 (291 cattle) at Okara were included in the study. The risk factors studied included area, farm, nature of villages, location, total cattle, presence of other animals, other species (buffalo, small ruminants, equines or pets), age, sex, live weight, calving number, lactation length, lactation status, total milk produced, and per day milk.

Results: Our results showed an association between age, live weight, calving number, lactation length, and total number of cattle at the farm with positive tuberculin test. The analysis of variance technique also showed association of all of these factors except lactation length with positive skin test. The results of logistic regression analysis also suggested an association of age, live weight, calving number, total animals at the farm, and total cattle at the farm with positive SCCIT test in cattle.

Conclusions: The prevalence of tuberculosis in cattle is around 9% at herd level and 2% at animal level with stronger risk factors being live weight, total animals, and total cattle at the farm.

Schlüsselwörter

  • Cattle
  • Pakistan
  • risk factors
  • tuberculosis
Uneingeschränkter Zugang

Brief communication (Original). Validation of a high-performance liquid chromatography method for the determination of pyridostigmine in plasma

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 275 - 279

Zusammenfassung

Abstract

Background: Pyridostigmine is a reversible acetylcholinesterase inhibitor that is used in military medicine as a prophylactic agent against intoxication by nerve agents and in the treatment of myasthenia.

Objective: We developed and validated a high-performance liquid chromatography (HPLC) method for the quantification of pyridostigmine in plasma samples.

Methods: Pyridostigmine was isolated from plasma using one-step protein precipitation by chloroform. The separation was performed on an analytical C18 column (250 × 4.6 mm; 4 μm particle size). The detector wavelength was set at 270 nm. The mobile phase was a mixture of acetonitrile and aqueous solution (15:85 v/v) of sodium-1-hepatene sulfonate and triethylamine, adjusted to pH 3.0 at a flow rate of 1.5 ml min-1. Hydrochlorothiazide was used as internal standard.

Results: The recovery of drug from plasma samples was above 90%. Using the current method, pyridostigmine (rt = 7.3) and hydrochlorothiazide (rt = 6.4) peaks were well resolved. The calibration curve was linear over the concentration range of 15-60 ng ml-1. The inter- and intraday assay coefficients of variation were found to be less than 8%.

Conclusion: The currently described procedure could be used as a simple, rapid and sensitive tool in bioavailability and bioequivalency investigations for the quantification of pyridostigmine in human plasma samples.

Schlüsselwörter

  • Drug
  • high-performance liquid chromatography
  • Mestinon
  • method validation
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Brief communication (Original). Controlling head lice in Iranian primary schools for girls

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 281 - 285

Zusammenfassung

Abstract

Background: In spite of large budgets for procurement and distribution of pediculicide shampoos, prevalence of pediculosis in girls’ primary schools continues.

Objective: To study the efficacy of the pediculicide shampoos lindane 1% and permethrin 1%, for pediculosis control among students.

Methods: One thousand forty two louse-infested schoolgirls in 31 girls’ primary schools were randomly treated with the shampoos (520 students with lindane 1% and 722 students with permethrin 1%). One hundred twenty five contaminated schoolgirls were treated with placebo shampoos. Efficacy of shampoos was studied after using twice with a one week interval. At the start, an educational pamphlet was distributed among all students discussing methods of prevention and directions for use of shampoos.

Results: We found that shampoo treatment resulted in only 52.9% overall recovery. With lindane, it was 50.96% and with permethrin 54.29%. The highest level of recovery was observed among primary school girls in grade five. Recovery in the central zone of the city and in private schools was better. Furthermore, the efficacy level of the shampoos was influenced by different factors such as parasite load, type of school, school location, level of education, level of awareness, and sociocultural factors.

Conclusion: Pediculicide shampoos are effective, but education and modification of sociocultural factors are also important.

Schlüsselwörter

  • Lindane shampoo
  • pediculicide
  • pediculosis
  • permethrin shampoo
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Brief communication (Original). Congenital heart disease in elementary school children in rural Thailand: the role of the trained noncardiologist

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 287 - 291

Zusammenfassung

Abstract

Background: Congenital heart diseases (CHD) comprise about one-third of all major birth defects. Children with delayed diagnosis and improper treatment are at a high risk of morbidity and mortality.

Objective: To determine the prevalence of unrecognized congenital heart disease among elementary school students and study the types and frequency of congenital heart disease in Phitsanulok, Pichit, and Kampangpetch provinces of Thailand using trained nurses and other health care personnel.

Methods: Between September 2008 and September 2010, 138,529 students from 1,243 elementary schools were screened for abnormal heart conditions by trained nurses or health care workers. The students who were suspected to have CHD were referred to a pediatric cardiologist for complete evaluation and identification of the lesions.

Results: Five hundred forty eight students were suspected to have heart diseases and 102 students were diagnosed as CHD. The average prevalence of unrecognized CHD in Phitsanulok, Pichit, and Kampangpetch was 0.74 per 1,000. Simple acyanotic lesions (ventricular septal defect, atrial septal defect, and pulmonary stenosis) were common in this study (32.35%, 16.67%, and 11.76%, respectively).

Conclusion: Qualified nurses or health care workers can be useful for identifying patients with CHD. The role of these personnel in the national heart screening program should be further clarified.

Schlüsselwörter

  • Congenital heart disease screening in children
  • prevalence
  • Thailand

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