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 8 (2014): Heft 1 (February 2014)

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

Suche

18 Artikel

Editorial

access type Uneingeschränkter Zugang

Stem cells and medical tourism

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 3

Zusammenfassung

Review article

access type Uneingeschränkter Zugang

Human therapeutic cloning, pitfalls and lack luster because of rapid developments in induced pluripotent stem cell technology

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 5 - 10

Zusammenfassung

Abstract

Background: Therapeutic cloning is the combination of somatic cell nuclear transfer (SCNT) and embryonic stem cell (ES) techniques to create specific ES cells that match those of a patient. Because ES cells derived by nuclear transfer (SCNT ES cells) are genetically identical to the donor, it will not generate rejection by the host’s immune system and thus therapeutically may be more acceptable. Induced pluripotent stem cells (iPS) are a type of pluripotent stem cell artificially derived from an adult somatic cell by inducing a forced expression of a set of specific pluripotent genes. In the past few years, rapid progress in reprogramming and iPS technology has been made, and it seems to shadow any progress made in SCNT programs.

Objective: This review compares the application perspective of SCNT with that of iPS in regenerative medicine.

Methods:We conducted a literature search using the MEDLINE (PubMed), Wiley InterScience, Springer, EBSCO, and Annual Reviews databases using the keywords “iPS”, “ES”, “SCNT” “induced pluripotent stem cells”, “embryonic stem cells”, “therapeutic cloning”, “regenerative medicine”, and “somatic cell nuclear transfer”. Only articles published in English were included in this review.

Results: These two methods both have advantages and disadvantages. Nevertheless, by using SCNT to generate patient-specific cell lines, it eliminates complications by avoiding the use of viral vectors during iPS generation. Success in in vitro matured eggs from aged women and even differentiation of oocytes from germ stem cells will further enhance the application of SCNT in regenerative medicine.

Conclusion: Human SCNT may be an appropriate mean of generating patient stem cell lines for clinical therapy in the near future.

Schlüsselwörter

  • iPS
  • review
  • SCNT
  • therapeutic cloning

Original article

access type Uneingeschränkter Zugang

A comparison of mammography, ultrasonography, and far-infrared thermography with pathological results in screening and early diagnosis of breast cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 11 - 19

Zusammenfassung

Abstract

Background: Many breast-imaging techniques have been developed as primary clinical methods for identifying early-stage breast cancers and differentiating them from benign breast tumors. For the large population of China, any screening method that is rapid, economical, and accurate is worthy of evaluation.

Objective: To compare the effectiveness of mammography, color Doppler ultrasonography, and far-infrared thermography in the screening and early diagnosis of breast cancer.

Methods: Data from 2036 women with breast disease between January 2007 and May 2011 were included in this study. All patients underwent mammography, ultrasonography, and far-infrared thermography imaging. The diagnostic accuracy of the three methods was determined using postoperative pathological results as the diagnostic criterion standard.

Results: There were 480 patients found to have breast malignancies on pathological examination. The lesion diameter was <2 cm in 853 cases. Among them, breast cancer was found in 73 patients and carcinoma in situ in 22 patients. There was no difference in the accuracy of mammography and ultrasonography (96.1% versus 95.8%). However, there were significant differences between the accuracy of far-infrared thermography (97.1%) and ultrasonography and mammography. The sensitivity and specificity of far-infrared thermography was superior to that of mammography and ultrasonography in lesions <2 cm in diameter.

Conclusion: Far-infrared thermography is more accurate for breast cancer screening than ultrasonography and mammography for lesions <2 cm. It has comparable diagnostic accuracy to ultrasound and better diagnostic accuracy than mammography for lesions >2 cm in diameter.

Schlüsselwörter

  • Breast cancer
  • color Doppler ultrasonography
  • far-infrared thermography
  • mammography
access type Uneingeschränkter Zugang

BMP-2 can promote the osteogenic differentiation of human endometrial stem cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 21 - 29

Zusammenfassung

Abstract

Background: Human endometrial-derived stem cells (hEnSCs) as multipotent accessible source of cells are known as useful cell candidates in the field of bone tissue engineering. However, the effect of bone morphogenic protein-2 (BMP-2) as an osteoinductive growth factor has not been clearly ascertained.

Objective: To evaluate the effect of the remarkable osteoinductive growth factor BMP-2, on promotion of osteogenic differentiation in hEnSCs.

Methods: Endometrial biopsies were obtained from healthy women referred to the hospital for infertility treatment. After tissue digestion in collagenase, the isolated endometrial cells were expanded in Dulbecco’s modified Eagle medium (DMEM) supplemented with 10% FBS. The propagated cells were characterized based on the expression of endometrial (CD90, CD105), endothelial (CD31), and hematopoietic (CD34, CD133) stem cell markers. Cells were differentiated in osteogenic medium containing DMEM supplemented with 10% FBS, 10 nM dexamethasone, 50 μg/ml Ascorbic acid, and 10 mM β-glycerophosphate in the presence or absence of BMP-2 for 21 days. Alizarin red staining was performed to verify the matrix mineralization. Immunocytochemical staining was conducted to detect the expression of OCT-4, CD133, and osteopontin as well as osteocalcin. The expression of osteoblast transcripts, including osteopontin, osteonectin, and alkaline phosphatase (ALP) were analyzed by semi quantitative PCR.

Results: The expanded EnSCs were spindle shaped. They were positive for the expression of Oct-4, CD90, and CD105, while they were negative for endothelial and hematopoietic markers. The matrix mineralization was confirmed by Alizarin red in both groups at day 21. Although the expression of osteopontin and osteocalcin was detected in both groups by immunological staining, the expression of osteocalcin was more intense in the presence of BMP-2. ALP, Osteonectin and osteopontin transcripts were expressed in all groups; however, the expression of ALP and osteopontin was upregulated in the presence of BMP-2.

Conclusion: BMP-2 as an osteoinductive growth factor, could promote the osteogenic differentiation of EnSCs in vitro.

Schlüsselwörter

  • Bone morphogenetic protein-2
  • endometrial stem cells
  • osteogenic differentiation
access type Uneingeschränkter Zugang

Factors predicting quality of life for coronary artery disease patients after percutaneous coronary intervention

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 31 - 42

Zusammenfassung

Abstract

Background: A clear understanding of factors affecting patients’ perception of quality of life (QOL) would be useful for improving continuous care in coronary artery disease (CAD) patients.

Objective: To examine the causal relationships between cardiac self-efficacy, social support, left-ventricular ejection fraction (LVEF), angina, dyspnea, depression, vital exhaustion, functional performance, and QOL in CAD patients experiencing postpercutaneous coronary intervention (post-PCI).

Methods: We used a research survey for causal analysis design to explore the theoretical linkage, guided by the revised Wilson and Cleary model, between QOL interest variables and patient QOL. The 303 subjects were all post-PCI CAD patients. All participants completed the following surveys: (1) a demographic data questionnaire, (2) a QOL Index (Cardiac version IV), (3) the Center for Epidemiologic Studies Depression Scale, (4) the Cardiac Self-efficacy Scale, (5) the Social Support Questionnaire, (6) the Rose Questionnaire for angina, (7) the Rose Dyspnea Scale, (8) the SF-36: vitality subscale, and (9) the Functional Performance Inventory Short-Form, with reliability ranging from 0.72 to 0.98. Data were analyzed using a linear structural relationship analysis.

Results: The postulated model was found to fit the empirical data and explained 54% of the variance in quality of life (χ2 = 1.90, df = 3, p = 0.59, χ2/df = 0.63, root mean square error of approximation = 0.00, Goodness of Fit Index = 0.99, Adjusted Goodness of Fit Index = 0.98). Social support, depression, and vital exhaustion were found to significantly and directly affect the QOL of post-PCI CAD patients. Cardiac self-efficacy was the only variable that had an indirect effect on quality of life (β = 0.21, p < 0.001).

Conclusion: Health care providers should be aware of the significant effects of social support, depression, vital exhaustion, and self-efficacy on QOL, and develop appropriate nursing interventions to improve quality of life in post-PCI CAD patients.

Schlüsselwörter

  • Cardiac self-efficacy
  • coronary artery disease
  • depression
  • quality of life
  • social support
  • vital exhaustion

Brief communication (Original)

access type Uneingeschränkter Zugang

Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 43 - 52

Zusammenfassung

Abstract

Background: The use of embryos in embryonic stem cell research (ESCR) has elicited ethical controversies as it entails the destruction of 5-day old human embryos to harvest stem cells.

Objective: To explore the ethical positions of Islam, Buddhism, Hinduism, and Catholicism concerning the use of (1) left-over embryos from in vitro fertilization (IVF) also known as ‘surplus’ embryos and (2) ‘research embryos’ which are created by scientists to conduct research using embryonic stem cells.

Methods: The opinions of religious leaders of Buddhist, Hindu, and Catholic faiths in Malaysia pertaining to ESCR were examined via in-depth, semi-structured interviews while Islamic responses are collected from local writings related to the derivation of fatwa on this issue. Participants’ responses on the ethics of human stem cell research are presented as a reflection of various scriptural texts of these four religions. These are presented and supported with the help of international bioethics literature and focus on the use of ‘surplus’ embryos and ‘research’ embryos.

Results: Islamic ethics deviate from Hindu and Buddhist teachings regarding saving of research embryos that have been created specifically for research and are considered as human lives only after 120 days fertilization. Hindu and Buddhists also underscore the sanctity of human life, but give priority to the alleviation of suffering in living adult humans. They generally encourage ESCR. Research is a knowledge-seeking endeavor considered noble by Islam. This is also a concept within Hindu and Buddhist philosophy; in particular, when potentially beneficial research goals are the basis. Catholicism also emphasizes sanctity of human life, but stresses also the inviolability of embryos from the moment of conception.

Conclusion: Embryonic stem cell research is permissible and encouraged according to Hindu and Buddhist perspectives in view of the potential benefits of such research to society, with some reservations. This is similar to Islamic views on the ethics of ESCR. However, Catholicism differs from all the other three religions; it appears to discourage research in this field because of the likely violation of a sacred principle in Catholic teachings.

Schlüsselwörter

  • Bioethics
  • embryo
  • ethics
  • religion
  • sanctity of life
  • stem cell research
access type Uneingeschränkter Zugang

Early decompressing craniectomy in patients with traumatic brain injury and cerebral edema

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 53 - 59

Zusammenfassung

Abstract

Background: Decompressing craniectomy (DC) is an important method for the management of severe traumatic brain injury (TBI).

Objective: To analyze the effect of prophylactic DC within 24 hours after head trauma TBI.

Methods: Seventy-two patients undergoing prophylactic DC for severe TBI were included in this retrospective study. Both of the early and late outcomes were studied and the prognostic factors were analyzed.

Results: In this series, cumulative death in the first 30 days after DC was 26%, and 28 (53%) of 53 survivors in the first month had a good outcomes. The factors including Glasgow Coma Score (GCS) score at admission, whether the patient had an abnormal pupil response and whether the midline shift was greater than 5 mm were most important prognostic factors for the prediction of death in the first 30 days and the final outcome at 6 months after DC.

Conclusion: Prophylactic DC plays an important role in the management of highly elevated ICP, especially when other methods of reduction of ICP are unavailable.

Schlüsselwörter

  • Decompressing craniectomy
  • outcome
  • traumatic brain injury
access type Uneingeschränkter Zugang

Use of rabies immune globulin in seven urban emergency rooms in Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 61 - 65

Zusammenfassung

Abstract

Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immune globulin (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; 35% 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 use of RIG, this life saving biological is grossly underused because of poor availability in Emergency Rooms (ERs) even though stocked by local dealers. Animal bite centers must make RIG available for severe exposures.

Schlüsselwörter

  • Animal bites
  • medical officers’ practices
  • rabies immune globulin
  • rabies prophylaxis
access type Uneingeschränkter Zugang

Long-term clinical effects of treatment by daytime ambulatory peritoneal dialysis with an individualized dialysis dose mode are comparable to traditional dialysis methods (hemodialysis or continuous ambulatory peritoneal dialysis) for end-stage renal failure

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 67 - 73

Zusammenfassung

Abstract

Background: At present, patients with end-stage renal failure (ESRD) face the question of how to achieve adequate dialysis to maintain their survival with the best quality of life as long as possible. Therefore, the choice of suitable dialysis methods and dialysis dose is important.

Objective: To find suitable dialysis methods and an appropriate dialysis dose for patients with ESRD.

Methods: Our research compares the long-term clinical effects between the patients undergoing continuous ambulatory peritoneal dialysis (CAPD), daytime ambulatory peritoneal dialysis (DAPD), and hemodialysis (HD). Thirty-two patients subjected to peritoneal dialysis were selected and divided into group A (n = 16) and group B (n = 16), group A was treated by using the traditional CAPD pattern; group B was treated by using DAPD. Forty-six patients of renal failure at final stage were divided into group A (n = 23) and group B (n = 23), group A was treated by using a HD method, group B was treated by using a DAPD method.

Results: When the same dialysis dose was applied, the patients with long-term DAPD treatment can obtain satisfactory clinical therapeutic efficacy for the period of maintenance dialysis, thoroughness of dialysis, maintenance of nutritional status, blood pressure regulation, reduction in incidence rate of peritoneal infection, maintenance of relatively high activity in daily life and alleviation in depression, comparable to patients treated with traditional CAPD or HD methods.

Conclusion: The long-term clinical effects of DAPD are comparable to CAPD or HD.

Schlüsselwörter

  • CAPD
  • continuous ambulatory peritoneal dialysis
  • DAPD
  • daytime ambulatory peritoneal dialysis
  • end-stage renal failure
  • hemodialysis
access type Uneingeschränkter Zugang

Assessment of 5-year system-wide type 2 diabetes control measures in a Southeast Asian metropolis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 75 - 82

Zusammenfassung

Abstract

Background: Sparse information exists regarding the progress of the chronic care model (CCM) implementation for type 2 diabetes, at system-wide level for developing countries including Thailand.

Objective: We assessed the extent to which type 2 diabetes patients in Bangkok, Thailand report having received CCM-based services by using the Patient Assessment of Chronic Illness Care (PACIC).

Methods: One thousand type 2 diabetes patients from 64 healthcare facilities throughout Bangkok were randomly selected, data about the extent they have received CCM-based services, their dietary, physical activity, medication-taking behaviors, body mass index (BMI), and blood sugar control status were collected by a set of structured questionnaires and medical record abstraction.

Results: PACIC and self-management scores for patients receiving care from public hospitals and health centers were significantly higher than those from private hospitals. Being the primary care unit (PCU)-where the CCM implementation has been enforced since 2008 was significantly associated with higher PACIC scores for public hospitals. This was not the case for private hospitals. PCU status was significantly associated with better selfmanagement scores for patients in both public and private hospitals. However, variations in PACIC and selfmanagement scores did not reflect to BMI or glycemic control outcomes of the patients.

Conclusion: There is encouraging evidence of progress of CCM implementation for type 2 diabetes patients in Bangkok, Thailand. This had also resulted in improved self-management, but not physiological or metabolic outcomes.

Schlüsselwörter

  • Patient assessment of chronic illness care
  • quality of care
  • type 2 diabetes
access type Uneingeschränkter Zugang

Anatomical and functional outcome after bilateral scrotal flap in penile reconstruction

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 83 - 86

Zusammenfassung

Abstract

Background: Injection of alloplastic material underneath the penile skin for penile augmentation causes many complications such as inflammation, infection, ulceration, and pain during sexual activity. One of the treatments for complications after these penile augmentation procedures is surgical excision of the foreign body granuloma followed by penile skin coverage with bilateral scrotal flaps. There are no prior prospective studies published about anatomical and functional outcomes.

Objective: To study the anatomical and functional outcome of one-stage bilateral scrotal flap reconstruction in patients after surgical removal of paraffinoma from penile shafts.

Methods: Patients who suffered from complications of penile foreign body granuloma were treated by surgical excision and reconstruction with bilateral scrotal flaps. The penile lengths and circumferences when flaccid and erect were recorded preoperatively and postoperatively. The patients were interviewed using questionnaires and satisfaction scored to determine their sexual experiences were recorded before and after surgery.

Results: Thirteen patients were enrolled in this study. The mean follow-up time was 23.5 (11.5-40.5) weeks. The mean erectile length and the maximal circumference were 11.8 (9-15) cm, 14.5 (11.5-17) cm preoperatively, and 11.7 (10-14) cm, 11.8 (10-13) cm postoperatively. Satisfaction scores of sexual activity is 6.84 (0-9) preoperatively, and 8.38 (5-10) postoperatively.

Conclusion: One-stage bilateral scrotal flap coverage is a good option for penile skin reconstruction. This technique can achieve satisfactory results both anatomically and functionally.

Schlüsselwörter

  • Foreign body granuloma
  • paraffinoma
  • penile reconstruction
  • scrotal flap
access type Uneingeschränkter Zugang

Early interdisciplinary intensive rehabilitation significantly improves the quality of life of stroke survivors: a multi-center study

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 87 - 95

Zusammenfassung

Abstract

Background: Interdisciplinary and intensive stroke rehabilitation programs have been shown to be positively correlated with improved functional outcomes. However, data regarding their combined use on the quality of life (QOL) of stroke survivors appears scant.

Objective: To evaluate whether interdisciplinary intensive rehabilitation programs for stroke survivors can improve their health-related QOL (HRQOL) scores and whether the timing of the interdisciplinary intensive rehabilitation has a significant effect on HRQOL scores.

Materials and Methods: This was a multi-center, prospective study. Patients were retrospectively selected from the Thai Stroke Rehabilitation Registry database. Three hundred seventy-six stroke patients from nine main tertiary hospitals in Thailand who had received acute stroke rehabilitation were screened between March and December 2006. Two hundred seven patients completed World Health Organization Quality of Life scale abbreviated Thai version (WHOQOL-BREF-Thai) questionnaires and were divided into two groups based on the time after onset of stroke to start interdisciplinary intensive rehabilitation: sub-acute (<1 month) and chronic (≥1 month). WHOQOL-BREF-Thai questionnaires were composed of four domains (physical health, psychological well being, social relationships and environment satisfaction), which were administered to the patients before and after interdisciplinary intensive rehabilitation to assess QOL.

Results: After interdisciplinary intensive rehabilitation, patients from both groups showed significant improvement in their quality of life in all domains, sex life and family relationships. However, patients from the sub-acute group had more significant improvement in their environment domain, family relationships and overall WHOQOL scores than those in the chronic group.

Conclusion: Early interdisciplinary intensive stroke rehabilitation can significantly improve environment domain, family relationships and overall WHOQOL of stroke patients.

Schlüsselwörter

  • Interdisciplinary intensive rehabilitation
  • quality of life
  • stroke
access type Uneingeschränkter Zugang

Unusual clinical manifestations of dengue infection in children in a tertiary care hospital in northeast Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 97 - 103

Zusammenfassung

Abstract

Background: Dengue virus infection has been a public health concern in Thailand. In the past decades, there has been recent interest concerning unusual clinical manifestations in both dengue fever (DF) and dengue hemorrhagic fever (DHF).

Objective: We described the unusual clinical manifestations and outcomes of children with dengue admitted to a tertiary care hospital in northeast Thailand.

Materials and Methods: A study was conducted on the 73 patients with serologically confirmed dengue infection admitted to Srinagarind Hospital, a tertiary care facility in northeast Thailand between January 2007 and August 2011.

Results: Of the 73 children examined, 42 (57%) were boys and 31 were girls. Their age ranged from 8 months to 14 years (median 11 years). Nine patients developed neurological symptoms, 6 patients had altered consciousness, and 3 patients convulsion. Among 9 patients with neurological symptoms, 1 patient had acute kidney injury, 1 had hepatic failure, and 1 had kidney and liver involvement, mostly associated with fluid resuscitation or prolonged shock. Apart from neurological symptoms, one patient developed infection associated hemophagocytic syndrome and was treated with intravenous immunoglobulin. Two patients died from multiple organ failure, and 1 patient was brought back home in a moribund condition. The other patients recovered completely.

Conclusion: Altered consciousness was the most commonly observed unusual neurological manifestation. Patients who did not develop acute kidney injury or liver failure had mild clinical courses and recovered from neurological symptoms without sequelae. Acute kidney injury was associated with fluid overload and/or prolonged shock. Careful fluid management and close monitoring for complications resulted in favorable outcomes.

Schlüsselwörter

  • Dengue fever
  • dengue hemorrhagic fever
  • dengue shock syndrome
  • dengue virus infection
  • unusual manifestation
access type Uneingeschränkter Zugang

Using a 360-degree assessment of pediatric residency training: experience at Prince of Songkla University, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 110

Zusammenfassung

Abstract

Background: The Department of Pediatrics, Prince of Songkla University (PSU) with 7-10 pediatric residents per year has implied a 360-degree evaluating instrument for residency training since 2007.

Objective: We determined the competency ratings of pediatric residents during their training.

Methods: During 2007-2011, 23 pediatric residents finished the pediatric residency program. At each ward rotation, each pediatric resident was rated for competency skills by four different categories of raters: attending staff, nurses, medical students, and the patients’ parents. The average score of each competency given by each category of raters was calculated, and was compared to scores of multiple-choice questions (MCQ) and constructed response questions (CRQ) of Thai Board of Pediatric Examination.

Results: The mean overall scores of each resident rated by the attending staff, nurses, medical students, and patients’ parents increased with year of residency training. The mean overall scores of each resident rated by attending physicians were positively correlated with the MCQ (r = 0.42, p = 0.04) and CRQ (r = 0.71, p < 0.001) scores of the Thai Board of Pediatrics Examination.

Conclusion: The 360-degree assessments with ratings by attending physicians during the pediatric training are reliable for assessment the medical knowledge of the residents.

Schlüsselwörter

  • Pediatric residency training
  • postgraduate training
  • 360-degree assessment
  • 360-degree evaluating instrument

Clinical report

access type Uneingeschränkter Zugang

Delayed presentation of congenital tibial pseudarthrosis and neurofibromatosis: a difficult union

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 111 - 118

Zusammenfassung

Abstract

Background: A new case of congenital pseudarthrosis of the tibia (CPT) presents yearly to CSC, but treatment is prolonged, and not always successful.

Objective: To study the outcomes of treatment, and to determine whether a relationship with neurofibromatosis (NF) was of significance.

Methods: A review of the medical records at our centre revealed 11 cases of CPT, 5 of which were associated with neurofibromatosis.

Results: Most patients had multiple operations for their case of CPT, which did finally lead to union in 6 out of 6 cases with no NF, but in only 1 case out of 5 when NF was present.

Conclusion: Late presentation and severe deformity can be overcome, and union can be achieved, but NF has a deleterious effect on obtaining union.

Schlüsselwörter

  • Cambodia
  • congenital pseudarthrosis of tibia
  • Ilizarov
  • neurofibromatosis
  • non-union
access type Uneingeschränkter Zugang

Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 119 - 122

Zusammenfassung

Abstract

Background: Isolated right atrial rupture is a very rare catastrophic complication of cardiopulmonary resuscitation.

Objective: We described a rare case of right atrial rupture after external cardiac massage.

Methods: We reported the case of a 62-year-old male patient who developed excessive bleeding following external cardiac massage for sudden cardiac arrest in the intensive care unit after coronary artery bypass grafting.

Results: This man underwent successful emergency repair of the tear of the right atrium without using cardiopulmonary bypass.

Conclusion: Right atrial rupture can occur after external cardiac massage. An emergency repair is needed.

Schlüsselwörter

  • Cardiac massage
  • complication
  • coronary artery bypass grafting
  • excessive bleeding
  • right atrial rupture
access type Uneingeschränkter Zugang

Acquired factor VII deficiency associated with synovial sarcoma

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 123 - 126

Zusammenfassung

Abstract

Background: Acquired factor VII (FVII) deficiency mostly results from liver disease or vitamin K antagonists. Isolated acquired FVII deficiency is a rare event, and only a few cases have been reported. To our knowledge, this is the first reported case of synovial sarcoma associated with FVII deficiency.

Objective: To describe our findings in a 20-year-old man, who presented with hemoptysis, weight loss, and later developed a suprascapular mass.

Methods: A review of the medical record of the patient plus a comparison with the literature was conducted.

Results: A biopsy from a suprascapular mass was made and the histopathological diagnosis of the tumor was confirmed as synovial sarcoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The FVII level was 31%. No evidence of a FVII inhibitor or inactivator was demonstrated. Prothrombin time normalized during tumor regression and FVII level was elevated to 103%.

Conclusion: Clinicians should be alert to the possible association of acquired FVII deficiency in cancer patients.

Schlüsselwörter

  • Bleeding
  • factor VII deficiency
  • soft tissue sarcoma
access type Uneingeschränkter Zugang

Movement of the tympanic membrane causing pulsatile tinnitus

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 127 - 129

Zusammenfassung

Abstract

Background: Movement of the tympanic membrane can be a cause of pulsatile tinnitus. There are many etiologies that cause movement of the tympanic membrane, including otogenic pneumocephalus. This is an uncommon presentation after head injury that may be missed as the diagnosis of the primary cause of the symptoms.

Objective: To report a rare case of pulsatile tinnitus because of otogenic pneumocephalus.

Methods: Case report from chart review with relevant investigations and treatment.

Results: We describe the very interesting case of a patient who presented with pulsatile tinnitus because of otogenic pneumocephalus. On examination, we found a moving tympanic membrane. A CT scan revealed pneumocephalus in the right temporoparietal region that was continuous with the adjacent mastoid air cells. There was a transverse fracture through the mastoid process. A meticulous mastoidectomy with unroofing of the epitympanum was performed with widening of the aditus ad antrum. The mastoid cavity was closed without fat obliteration. After the operation, the pulsatile tinnitus ceased completely.

Conclusion: Mastoidectomy and unroofing the epitympanum without fat obliteration is a very simple and effective option for the treatment of pulsatile tinnitus because of pneumocephalus.

Schlüsselwörter

  • Moving tympanic membrane
  • pneumocephalus
  • pulsatile tinnitus
18 Artikel

Editorial

access type Uneingeschränkter Zugang

Stem cells and medical tourism

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 3

Zusammenfassung

Review article

access type Uneingeschränkter Zugang

Human therapeutic cloning, pitfalls and lack luster because of rapid developments in induced pluripotent stem cell technology

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 5 - 10

Zusammenfassung

Abstract

Background: Therapeutic cloning is the combination of somatic cell nuclear transfer (SCNT) and embryonic stem cell (ES) techniques to create specific ES cells that match those of a patient. Because ES cells derived by nuclear transfer (SCNT ES cells) are genetically identical to the donor, it will not generate rejection by the host’s immune system and thus therapeutically may be more acceptable. Induced pluripotent stem cells (iPS) are a type of pluripotent stem cell artificially derived from an adult somatic cell by inducing a forced expression of a set of specific pluripotent genes. In the past few years, rapid progress in reprogramming and iPS technology has been made, and it seems to shadow any progress made in SCNT programs.

Objective: This review compares the application perspective of SCNT with that of iPS in regenerative medicine.

Methods:We conducted a literature search using the MEDLINE (PubMed), Wiley InterScience, Springer, EBSCO, and Annual Reviews databases using the keywords “iPS”, “ES”, “SCNT” “induced pluripotent stem cells”, “embryonic stem cells”, “therapeutic cloning”, “regenerative medicine”, and “somatic cell nuclear transfer”. Only articles published in English were included in this review.

Results: These two methods both have advantages and disadvantages. Nevertheless, by using SCNT to generate patient-specific cell lines, it eliminates complications by avoiding the use of viral vectors during iPS generation. Success in in vitro matured eggs from aged women and even differentiation of oocytes from germ stem cells will further enhance the application of SCNT in regenerative medicine.

Conclusion: Human SCNT may be an appropriate mean of generating patient stem cell lines for clinical therapy in the near future.

Schlüsselwörter

  • iPS
  • review
  • SCNT
  • therapeutic cloning

Original article

access type Uneingeschränkter Zugang

A comparison of mammography, ultrasonography, and far-infrared thermography with pathological results in screening and early diagnosis of breast cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 11 - 19

Zusammenfassung

Abstract

Background: Many breast-imaging techniques have been developed as primary clinical methods for identifying early-stage breast cancers and differentiating them from benign breast tumors. For the large population of China, any screening method that is rapid, economical, and accurate is worthy of evaluation.

Objective: To compare the effectiveness of mammography, color Doppler ultrasonography, and far-infrared thermography in the screening and early diagnosis of breast cancer.

Methods: Data from 2036 women with breast disease between January 2007 and May 2011 were included in this study. All patients underwent mammography, ultrasonography, and far-infrared thermography imaging. The diagnostic accuracy of the three methods was determined using postoperative pathological results as the diagnostic criterion standard.

Results: There were 480 patients found to have breast malignancies on pathological examination. The lesion diameter was <2 cm in 853 cases. Among them, breast cancer was found in 73 patients and carcinoma in situ in 22 patients. There was no difference in the accuracy of mammography and ultrasonography (96.1% versus 95.8%). However, there were significant differences between the accuracy of far-infrared thermography (97.1%) and ultrasonography and mammography. The sensitivity and specificity of far-infrared thermography was superior to that of mammography and ultrasonography in lesions <2 cm in diameter.

Conclusion: Far-infrared thermography is more accurate for breast cancer screening than ultrasonography and mammography for lesions <2 cm. It has comparable diagnostic accuracy to ultrasound and better diagnostic accuracy than mammography for lesions >2 cm in diameter.

Schlüsselwörter

  • Breast cancer
  • color Doppler ultrasonography
  • far-infrared thermography
  • mammography
access type Uneingeschränkter Zugang

BMP-2 can promote the osteogenic differentiation of human endometrial stem cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 21 - 29

Zusammenfassung

Abstract

Background: Human endometrial-derived stem cells (hEnSCs) as multipotent accessible source of cells are known as useful cell candidates in the field of bone tissue engineering. However, the effect of bone morphogenic protein-2 (BMP-2) as an osteoinductive growth factor has not been clearly ascertained.

Objective: To evaluate the effect of the remarkable osteoinductive growth factor BMP-2, on promotion of osteogenic differentiation in hEnSCs.

Methods: Endometrial biopsies were obtained from healthy women referred to the hospital for infertility treatment. After tissue digestion in collagenase, the isolated endometrial cells were expanded in Dulbecco’s modified Eagle medium (DMEM) supplemented with 10% FBS. The propagated cells were characterized based on the expression of endometrial (CD90, CD105), endothelial (CD31), and hematopoietic (CD34, CD133) stem cell markers. Cells were differentiated in osteogenic medium containing DMEM supplemented with 10% FBS, 10 nM dexamethasone, 50 μg/ml Ascorbic acid, and 10 mM β-glycerophosphate in the presence or absence of BMP-2 for 21 days. Alizarin red staining was performed to verify the matrix mineralization. Immunocytochemical staining was conducted to detect the expression of OCT-4, CD133, and osteopontin as well as osteocalcin. The expression of osteoblast transcripts, including osteopontin, osteonectin, and alkaline phosphatase (ALP) were analyzed by semi quantitative PCR.

Results: The expanded EnSCs were spindle shaped. They were positive for the expression of Oct-4, CD90, and CD105, while they were negative for endothelial and hematopoietic markers. The matrix mineralization was confirmed by Alizarin red in both groups at day 21. Although the expression of osteopontin and osteocalcin was detected in both groups by immunological staining, the expression of osteocalcin was more intense in the presence of BMP-2. ALP, Osteonectin and osteopontin transcripts were expressed in all groups; however, the expression of ALP and osteopontin was upregulated in the presence of BMP-2.

Conclusion: BMP-2 as an osteoinductive growth factor, could promote the osteogenic differentiation of EnSCs in vitro.

Schlüsselwörter

  • Bone morphogenetic protein-2
  • endometrial stem cells
  • osteogenic differentiation
access type Uneingeschränkter Zugang

Factors predicting quality of life for coronary artery disease patients after percutaneous coronary intervention

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 31 - 42

Zusammenfassung

Abstract

Background: A clear understanding of factors affecting patients’ perception of quality of life (QOL) would be useful for improving continuous care in coronary artery disease (CAD) patients.

Objective: To examine the causal relationships between cardiac self-efficacy, social support, left-ventricular ejection fraction (LVEF), angina, dyspnea, depression, vital exhaustion, functional performance, and QOL in CAD patients experiencing postpercutaneous coronary intervention (post-PCI).

Methods: We used a research survey for causal analysis design to explore the theoretical linkage, guided by the revised Wilson and Cleary model, between QOL interest variables and patient QOL. The 303 subjects were all post-PCI CAD patients. All participants completed the following surveys: (1) a demographic data questionnaire, (2) a QOL Index (Cardiac version IV), (3) the Center for Epidemiologic Studies Depression Scale, (4) the Cardiac Self-efficacy Scale, (5) the Social Support Questionnaire, (6) the Rose Questionnaire for angina, (7) the Rose Dyspnea Scale, (8) the SF-36: vitality subscale, and (9) the Functional Performance Inventory Short-Form, with reliability ranging from 0.72 to 0.98. Data were analyzed using a linear structural relationship analysis.

Results: The postulated model was found to fit the empirical data and explained 54% of the variance in quality of life (χ2 = 1.90, df = 3, p = 0.59, χ2/df = 0.63, root mean square error of approximation = 0.00, Goodness of Fit Index = 0.99, Adjusted Goodness of Fit Index = 0.98). Social support, depression, and vital exhaustion were found to significantly and directly affect the QOL of post-PCI CAD patients. Cardiac self-efficacy was the only variable that had an indirect effect on quality of life (β = 0.21, p < 0.001).

Conclusion: Health care providers should be aware of the significant effects of social support, depression, vital exhaustion, and self-efficacy on QOL, and develop appropriate nursing interventions to improve quality of life in post-PCI CAD patients.

Schlüsselwörter

  • Cardiac self-efficacy
  • coronary artery disease
  • depression
  • quality of life
  • social support
  • vital exhaustion

Brief communication (Original)

access type Uneingeschränkter Zugang

Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 43 - 52

Zusammenfassung

Abstract

Background: The use of embryos in embryonic stem cell research (ESCR) has elicited ethical controversies as it entails the destruction of 5-day old human embryos to harvest stem cells.

Objective: To explore the ethical positions of Islam, Buddhism, Hinduism, and Catholicism concerning the use of (1) left-over embryos from in vitro fertilization (IVF) also known as ‘surplus’ embryos and (2) ‘research embryos’ which are created by scientists to conduct research using embryonic stem cells.

Methods: The opinions of religious leaders of Buddhist, Hindu, and Catholic faiths in Malaysia pertaining to ESCR were examined via in-depth, semi-structured interviews while Islamic responses are collected from local writings related to the derivation of fatwa on this issue. Participants’ responses on the ethics of human stem cell research are presented as a reflection of various scriptural texts of these four religions. These are presented and supported with the help of international bioethics literature and focus on the use of ‘surplus’ embryos and ‘research’ embryos.

Results: Islamic ethics deviate from Hindu and Buddhist teachings regarding saving of research embryos that have been created specifically for research and are considered as human lives only after 120 days fertilization. Hindu and Buddhists also underscore the sanctity of human life, but give priority to the alleviation of suffering in living adult humans. They generally encourage ESCR. Research is a knowledge-seeking endeavor considered noble by Islam. This is also a concept within Hindu and Buddhist philosophy; in particular, when potentially beneficial research goals are the basis. Catholicism also emphasizes sanctity of human life, but stresses also the inviolability of embryos from the moment of conception.

Conclusion: Embryonic stem cell research is permissible and encouraged according to Hindu and Buddhist perspectives in view of the potential benefits of such research to society, with some reservations. This is similar to Islamic views on the ethics of ESCR. However, Catholicism differs from all the other three religions; it appears to discourage research in this field because of the likely violation of a sacred principle in Catholic teachings.

Schlüsselwörter

  • Bioethics
  • embryo
  • ethics
  • religion
  • sanctity of life
  • stem cell research
access type Uneingeschränkter Zugang

Early decompressing craniectomy in patients with traumatic brain injury and cerebral edema

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 53 - 59

Zusammenfassung

Abstract

Background: Decompressing craniectomy (DC) is an important method for the management of severe traumatic brain injury (TBI).

Objective: To analyze the effect of prophylactic DC within 24 hours after head trauma TBI.

Methods: Seventy-two patients undergoing prophylactic DC for severe TBI were included in this retrospective study. Both of the early and late outcomes were studied and the prognostic factors were analyzed.

Results: In this series, cumulative death in the first 30 days after DC was 26%, and 28 (53%) of 53 survivors in the first month had a good outcomes. The factors including Glasgow Coma Score (GCS) score at admission, whether the patient had an abnormal pupil response and whether the midline shift was greater than 5 mm were most important prognostic factors for the prediction of death in the first 30 days and the final outcome at 6 months after DC.

Conclusion: Prophylactic DC plays an important role in the management of highly elevated ICP, especially when other methods of reduction of ICP are unavailable.

Schlüsselwörter

  • Decompressing craniectomy
  • outcome
  • traumatic brain injury
access type Uneingeschränkter Zugang

Use of rabies immune globulin in seven urban emergency rooms in Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 61 - 65

Zusammenfassung

Abstract

Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immune globulin (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; 35% 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 use of RIG, this life saving biological is grossly underused because of poor availability in Emergency Rooms (ERs) even though stocked by local dealers. Animal bite centers must make RIG available for severe exposures.

Schlüsselwörter

  • Animal bites
  • medical officers’ practices
  • rabies immune globulin
  • rabies prophylaxis
access type Uneingeschränkter Zugang

Long-term clinical effects of treatment by daytime ambulatory peritoneal dialysis with an individualized dialysis dose mode are comparable to traditional dialysis methods (hemodialysis or continuous ambulatory peritoneal dialysis) for end-stage renal failure

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 67 - 73

Zusammenfassung

Abstract

Background: At present, patients with end-stage renal failure (ESRD) face the question of how to achieve adequate dialysis to maintain their survival with the best quality of life as long as possible. Therefore, the choice of suitable dialysis methods and dialysis dose is important.

Objective: To find suitable dialysis methods and an appropriate dialysis dose for patients with ESRD.

Methods: Our research compares the long-term clinical effects between the patients undergoing continuous ambulatory peritoneal dialysis (CAPD), daytime ambulatory peritoneal dialysis (DAPD), and hemodialysis (HD). Thirty-two patients subjected to peritoneal dialysis were selected and divided into group A (n = 16) and group B (n = 16), group A was treated by using the traditional CAPD pattern; group B was treated by using DAPD. Forty-six patients of renal failure at final stage were divided into group A (n = 23) and group B (n = 23), group A was treated by using a HD method, group B was treated by using a DAPD method.

Results: When the same dialysis dose was applied, the patients with long-term DAPD treatment can obtain satisfactory clinical therapeutic efficacy for the period of maintenance dialysis, thoroughness of dialysis, maintenance of nutritional status, blood pressure regulation, reduction in incidence rate of peritoneal infection, maintenance of relatively high activity in daily life and alleviation in depression, comparable to patients treated with traditional CAPD or HD methods.

Conclusion: The long-term clinical effects of DAPD are comparable to CAPD or HD.

Schlüsselwörter

  • CAPD
  • continuous ambulatory peritoneal dialysis
  • DAPD
  • daytime ambulatory peritoneal dialysis
  • end-stage renal failure
  • hemodialysis
access type Uneingeschränkter Zugang

Assessment of 5-year system-wide type 2 diabetes control measures in a Southeast Asian metropolis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 75 - 82

Zusammenfassung

Abstract

Background: Sparse information exists regarding the progress of the chronic care model (CCM) implementation for type 2 diabetes, at system-wide level for developing countries including Thailand.

Objective: We assessed the extent to which type 2 diabetes patients in Bangkok, Thailand report having received CCM-based services by using the Patient Assessment of Chronic Illness Care (PACIC).

Methods: One thousand type 2 diabetes patients from 64 healthcare facilities throughout Bangkok were randomly selected, data about the extent they have received CCM-based services, their dietary, physical activity, medication-taking behaviors, body mass index (BMI), and blood sugar control status were collected by a set of structured questionnaires and medical record abstraction.

Results: PACIC and self-management scores for patients receiving care from public hospitals and health centers were significantly higher than those from private hospitals. Being the primary care unit (PCU)-where the CCM implementation has been enforced since 2008 was significantly associated with higher PACIC scores for public hospitals. This was not the case for private hospitals. PCU status was significantly associated with better selfmanagement scores for patients in both public and private hospitals. However, variations in PACIC and selfmanagement scores did not reflect to BMI or glycemic control outcomes of the patients.

Conclusion: There is encouraging evidence of progress of CCM implementation for type 2 diabetes patients in Bangkok, Thailand. This had also resulted in improved self-management, but not physiological or metabolic outcomes.

Schlüsselwörter

  • Patient assessment of chronic illness care
  • quality of care
  • type 2 diabetes
access type Uneingeschränkter Zugang

Anatomical and functional outcome after bilateral scrotal flap in penile reconstruction

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 83 - 86

Zusammenfassung

Abstract

Background: Injection of alloplastic material underneath the penile skin for penile augmentation causes many complications such as inflammation, infection, ulceration, and pain during sexual activity. One of the treatments for complications after these penile augmentation procedures is surgical excision of the foreign body granuloma followed by penile skin coverage with bilateral scrotal flaps. There are no prior prospective studies published about anatomical and functional outcomes.

Objective: To study the anatomical and functional outcome of one-stage bilateral scrotal flap reconstruction in patients after surgical removal of paraffinoma from penile shafts.

Methods: Patients who suffered from complications of penile foreign body granuloma were treated by surgical excision and reconstruction with bilateral scrotal flaps. The penile lengths and circumferences when flaccid and erect were recorded preoperatively and postoperatively. The patients were interviewed using questionnaires and satisfaction scored to determine their sexual experiences were recorded before and after surgery.

Results: Thirteen patients were enrolled in this study. The mean follow-up time was 23.5 (11.5-40.5) weeks. The mean erectile length and the maximal circumference were 11.8 (9-15) cm, 14.5 (11.5-17) cm preoperatively, and 11.7 (10-14) cm, 11.8 (10-13) cm postoperatively. Satisfaction scores of sexual activity is 6.84 (0-9) preoperatively, and 8.38 (5-10) postoperatively.

Conclusion: One-stage bilateral scrotal flap coverage is a good option for penile skin reconstruction. This technique can achieve satisfactory results both anatomically and functionally.

Schlüsselwörter

  • Foreign body granuloma
  • paraffinoma
  • penile reconstruction
  • scrotal flap
access type Uneingeschränkter Zugang

Early interdisciplinary intensive rehabilitation significantly improves the quality of life of stroke survivors: a multi-center study

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 87 - 95

Zusammenfassung

Abstract

Background: Interdisciplinary and intensive stroke rehabilitation programs have been shown to be positively correlated with improved functional outcomes. However, data regarding their combined use on the quality of life (QOL) of stroke survivors appears scant.

Objective: To evaluate whether interdisciplinary intensive rehabilitation programs for stroke survivors can improve their health-related QOL (HRQOL) scores and whether the timing of the interdisciplinary intensive rehabilitation has a significant effect on HRQOL scores.

Materials and Methods: This was a multi-center, prospective study. Patients were retrospectively selected from the Thai Stroke Rehabilitation Registry database. Three hundred seventy-six stroke patients from nine main tertiary hospitals in Thailand who had received acute stroke rehabilitation were screened between March and December 2006. Two hundred seven patients completed World Health Organization Quality of Life scale abbreviated Thai version (WHOQOL-BREF-Thai) questionnaires and were divided into two groups based on the time after onset of stroke to start interdisciplinary intensive rehabilitation: sub-acute (<1 month) and chronic (≥1 month). WHOQOL-BREF-Thai questionnaires were composed of four domains (physical health, psychological well being, social relationships and environment satisfaction), which were administered to the patients before and after interdisciplinary intensive rehabilitation to assess QOL.

Results: After interdisciplinary intensive rehabilitation, patients from both groups showed significant improvement in their quality of life in all domains, sex life and family relationships. However, patients from the sub-acute group had more significant improvement in their environment domain, family relationships and overall WHOQOL scores than those in the chronic group.

Conclusion: Early interdisciplinary intensive stroke rehabilitation can significantly improve environment domain, family relationships and overall WHOQOL of stroke patients.

Schlüsselwörter

  • Interdisciplinary intensive rehabilitation
  • quality of life
  • stroke
access type Uneingeschränkter Zugang

Unusual clinical manifestations of dengue infection in children in a tertiary care hospital in northeast Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 97 - 103

Zusammenfassung

Abstract

Background: Dengue virus infection has been a public health concern in Thailand. In the past decades, there has been recent interest concerning unusual clinical manifestations in both dengue fever (DF) and dengue hemorrhagic fever (DHF).

Objective: We described the unusual clinical manifestations and outcomes of children with dengue admitted to a tertiary care hospital in northeast Thailand.

Materials and Methods: A study was conducted on the 73 patients with serologically confirmed dengue infection admitted to Srinagarind Hospital, a tertiary care facility in northeast Thailand between January 2007 and August 2011.

Results: Of the 73 children examined, 42 (57%) were boys and 31 were girls. Their age ranged from 8 months to 14 years (median 11 years). Nine patients developed neurological symptoms, 6 patients had altered consciousness, and 3 patients convulsion. Among 9 patients with neurological symptoms, 1 patient had acute kidney injury, 1 had hepatic failure, and 1 had kidney and liver involvement, mostly associated with fluid resuscitation or prolonged shock. Apart from neurological symptoms, one patient developed infection associated hemophagocytic syndrome and was treated with intravenous immunoglobulin. Two patients died from multiple organ failure, and 1 patient was brought back home in a moribund condition. The other patients recovered completely.

Conclusion: Altered consciousness was the most commonly observed unusual neurological manifestation. Patients who did not develop acute kidney injury or liver failure had mild clinical courses and recovered from neurological symptoms without sequelae. Acute kidney injury was associated with fluid overload and/or prolonged shock. Careful fluid management and close monitoring for complications resulted in favorable outcomes.

Schlüsselwörter

  • Dengue fever
  • dengue hemorrhagic fever
  • dengue shock syndrome
  • dengue virus infection
  • unusual manifestation
access type Uneingeschränkter Zugang

Using a 360-degree assessment of pediatric residency training: experience at Prince of Songkla University, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 110

Zusammenfassung

Abstract

Background: The Department of Pediatrics, Prince of Songkla University (PSU) with 7-10 pediatric residents per year has implied a 360-degree evaluating instrument for residency training since 2007.

Objective: We determined the competency ratings of pediatric residents during their training.

Methods: During 2007-2011, 23 pediatric residents finished the pediatric residency program. At each ward rotation, each pediatric resident was rated for competency skills by four different categories of raters: attending staff, nurses, medical students, and the patients’ parents. The average score of each competency given by each category of raters was calculated, and was compared to scores of multiple-choice questions (MCQ) and constructed response questions (CRQ) of Thai Board of Pediatric Examination.

Results: The mean overall scores of each resident rated by the attending staff, nurses, medical students, and patients’ parents increased with year of residency training. The mean overall scores of each resident rated by attending physicians were positively correlated with the MCQ (r = 0.42, p = 0.04) and CRQ (r = 0.71, p < 0.001) scores of the Thai Board of Pediatrics Examination.

Conclusion: The 360-degree assessments with ratings by attending physicians during the pediatric training are reliable for assessment the medical knowledge of the residents.

Schlüsselwörter

  • Pediatric residency training
  • postgraduate training
  • 360-degree assessment
  • 360-degree evaluating instrument

Clinical report

access type Uneingeschränkter Zugang

Delayed presentation of congenital tibial pseudarthrosis and neurofibromatosis: a difficult union

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 111 - 118

Zusammenfassung

Abstract

Background: A new case of congenital pseudarthrosis of the tibia (CPT) presents yearly to CSC, but treatment is prolonged, and not always successful.

Objective: To study the outcomes of treatment, and to determine whether a relationship with neurofibromatosis (NF) was of significance.

Methods: A review of the medical records at our centre revealed 11 cases of CPT, 5 of which were associated with neurofibromatosis.

Results: Most patients had multiple operations for their case of CPT, which did finally lead to union in 6 out of 6 cases with no NF, but in only 1 case out of 5 when NF was present.

Conclusion: Late presentation and severe deformity can be overcome, and union can be achieved, but NF has a deleterious effect on obtaining union.

Schlüsselwörter

  • Cambodia
  • congenital pseudarthrosis of tibia
  • Ilizarov
  • neurofibromatosis
  • non-union
access type Uneingeschränkter Zugang

Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 119 - 122

Zusammenfassung

Abstract

Background: Isolated right atrial rupture is a very rare catastrophic complication of cardiopulmonary resuscitation.

Objective: We described a rare case of right atrial rupture after external cardiac massage.

Methods: We reported the case of a 62-year-old male patient who developed excessive bleeding following external cardiac massage for sudden cardiac arrest in the intensive care unit after coronary artery bypass grafting.

Results: This man underwent successful emergency repair of the tear of the right atrium without using cardiopulmonary bypass.

Conclusion: Right atrial rupture can occur after external cardiac massage. An emergency repair is needed.

Schlüsselwörter

  • Cardiac massage
  • complication
  • coronary artery bypass grafting
  • excessive bleeding
  • right atrial rupture
access type Uneingeschränkter Zugang

Acquired factor VII deficiency associated with synovial sarcoma

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 123 - 126

Zusammenfassung

Abstract

Background: Acquired factor VII (FVII) deficiency mostly results from liver disease or vitamin K antagonists. Isolated acquired FVII deficiency is a rare event, and only a few cases have been reported. To our knowledge, this is the first reported case of synovial sarcoma associated with FVII deficiency.

Objective: To describe our findings in a 20-year-old man, who presented with hemoptysis, weight loss, and later developed a suprascapular mass.

Methods: A review of the medical record of the patient plus a comparison with the literature was conducted.

Results: A biopsy from a suprascapular mass was made and the histopathological diagnosis of the tumor was confirmed as synovial sarcoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The FVII level was 31%. No evidence of a FVII inhibitor or inactivator was demonstrated. Prothrombin time normalized during tumor regression and FVII level was elevated to 103%.

Conclusion: Clinicians should be alert to the possible association of acquired FVII deficiency in cancer patients.

Schlüsselwörter

  • Bleeding
  • factor VII deficiency
  • soft tissue sarcoma
access type Uneingeschränkter Zugang

Movement of the tympanic membrane causing pulsatile tinnitus

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 127 - 129

Zusammenfassung

Abstract

Background: Movement of the tympanic membrane can be a cause of pulsatile tinnitus. There are many etiologies that cause movement of the tympanic membrane, including otogenic pneumocephalus. This is an uncommon presentation after head injury that may be missed as the diagnosis of the primary cause of the symptoms.

Objective: To report a rare case of pulsatile tinnitus because of otogenic pneumocephalus.

Methods: Case report from chart review with relevant investigations and treatment.

Results: We describe the very interesting case of a patient who presented with pulsatile tinnitus because of otogenic pneumocephalus. On examination, we found a moving tympanic membrane. A CT scan revealed pneumocephalus in the right temporoparietal region that was continuous with the adjacent mastoid air cells. There was a transverse fracture through the mastoid process. A meticulous mastoidectomy with unroofing of the epitympanum was performed with widening of the aditus ad antrum. The mastoid cavity was closed without fat obliteration. After the operation, the pulsatile tinnitus ceased completely.

Conclusion: Mastoidectomy and unroofing the epitympanum without fat obliteration is a very simple and effective option for the treatment of pulsatile tinnitus because of pneumocephalus.

Schlüsselwörter

  • Moving tympanic membrane
  • pneumocephalus
  • pulsatile tinnitus

Planen Sie Ihre Fernkonferenz mit Scienceendo