Rivista e Edizione

Volume 16 (2022): Edizione 3 (June 2022)

Volume 16 (2022): Edizione 2 (April 2022)

Volume 16 (2022): Edizione 1 (February 2022)

Volume 15 (2021): Edizione 6 (December 2021)

Volume 15 (2021): Edizione 5 (October 2021)

Volume 15 (2021): Edizione 4 (August 2021)

Volume 15 (2021): Edizione 3 (June 2021)

Volume 15 (2021): Edizione 2 (April 2021)

Volume 15 (2021): Edizione 1 (February 2021)

Volume 14 (2020): Edizione 6 (December 2020)

Volume 14 (2020): Edizione 5 (October 2020)

Volume 14 (2020): Edizione 4 (August 2020)

Volume 14 (2020): Edizione 3 (June 2020)

Volume 14 (2020): Edizione 2 (April 2020)

Volume 14 (2020): Edizione 1 (February 2020)

Volume 13 (2019): Edizione 6 (December 2019)

Volume 13 (2019): Edizione 5 (October 2019)

Volume 13 (2019): Edizione 4 (August 2019)

Volume 13 (2019): Edizione 3 (June 2019)

Volume 13 (2019): Edizione 2 (April 2019)

Volume 13 (2019): Edizione 1 (February 2019)

Volume 12 (2018): Edizione 6 (December 2018)

Volume 12 (2018): Edizione 5 (October 2018)

Volume 12 (2018): Edizione 4 (August 2018)

Volume 12 (2018): Edizione 3 (June 2018)

Volume 12 (2018): Edizione 2 (April 2018)

Volume 12 (2018): Edizione 1 (February 2018)

Volume 11 (2017): Edizione 6 (December 2017)

Volume 11 (2017): Edizione 5 (October 2017)

Volume 11 (2017): Edizione 4 (August 2017)

Volume 11 (2017): Edizione 3 (June 2017)

Volume 11 (2017): Edizione 2 (April 2017)

Volume 11 (2017): Edizione 1 (February 2017)

Volume 10 (2016): Edizione 6 (December 2016)

Volume 10 (2016): Edizione 5 (October 2016)

Volume 10 (2016): Edizione 4 (August 2016)

Volume 10 (2016): Edizione 3 (June 2016)

Volume 10 (2016): Edizione 2 (April 2016)

Volume 10 (2016): Edizione s1 (December 2016)

Volume 10 (2016): Edizione 1 (February 2016)

Volume 9 (2015): Edizione 6 (December 2015)

Volume 9 (2015): Edizione 5 (October 2015)

Volume 9 (2015): Edizione 4 (August 2015)

Volume 9 (2015): Edizione 3 (June 2015)

Volume 9 (2015): Edizione 2 (April 2015)

Volume 9 (2015): Edizione 1 (February 2015)

Volume 8 (2014): Edizione 6 (December 2014)

Volume 8 (2014): Edizione 5 (October 2014)

Volume 8 (2014): Edizione 4 (August 2014)

Volume 8 (2014): Edizione 3 (June 2014)

Volume 8 (2014): Edizione 2 (April 2014)

Volume 8 (2014): Edizione 1 (February 2014)

Volume 7 (2013): Edizione 6 (December 2013)

Volume 7 (2013): Edizione 5 (October 2013)

Volume 7 (2013): Edizione 4 (August 2013)

Volume 7 (2013): Edizione 3 (June 2013)

Volume 7 (2013): Edizione 2 (April 2013)

Volume 7 (2013): Edizione 1 (February 2013)

Volume 6 (2012): Edizione 6 (December 2012)

Volume 6 (2012): Edizione 5 (October 2012)

Volume 6 (2012): Edizione 4 (August 2012)

Volume 6 (2012): Edizione 3 (June 2012)

Volume 6 (2012): Edizione 2 (April 2012)

Volume 6 (2012): Edizione 1 (February 2012)

Volume 5 (2011): Edizione 6 (December 2011)

Volume 5 (2011): Edizione 5 (October 2011)

Volume 5 (2011): Edizione 4 (August 2011)

Volume 5 (2011): Edizione 3 (June 2011)

Volume 5 (2011): Edizione 2 (April 2011)

Volume 5 (2011): Edizione 1 (February 2011)

Volume 4 (2010): Edizione 6 (December 2010)

Volume 4 (2010): Edizione 5 (October 2010)

Volume 4 (2010): Edizione 4 (August 2010)

Volume 4 (2010): Edizione 3 (June 2010)

Volume 4 (2010): Edizione 2 (April 2010)

Volume 4 (2010): Edizione 1 (February 2010)

Dettagli della rivista
Formato
Rivista
eISSN
1875-855X
Pubblicato per la prima volta
01 Jun 2007
Periodo di pubblicazione
6 volte all'anno
Lingue
Inglese

Cerca

Volume 4 (2010): Edizione 5 (October 2010)

Dettagli della rivista
Formato
Rivista
eISSN
1875-855X
Pubblicato per la prima volta
01 Jun 2007
Periodo di pubblicazione
6 volte all'anno
Lingue
Inglese

Cerca

22 Articoli
Accesso libero

Second line antiretroviral therapy for treatment of HIV in Asia

Pubblicato online: 13 Apr 2018
Pagine: 673 - 677

Astratto

Abstract

Limited access to virological monitoring has led to a high prevalence of resistance to nucleoside reverse transcriptase inhibitors (NRTIs) at the time of first line failure in most studies from low- and middle-income countries (LMIC). Nevertheless, the current standard of care is to include NRTIs in second line regimens. The activity of tenofovir/emtricitabine following failure of stavudine/lamivudine or zidovudine/lamivudine is dependent on the sensitivity of the monitoring strategy used during first line therapy and the threshold for switching, whereas these factors are less important if the opposite sequencing strategy is used. Boosted protease inhibitors (PIs) are the foundation of effective second-line therapy with demonstrated efficacy in early salvage regimens and high barrier to resistance. Lopinavir/ritonavir and ritonavir-boosted atazanavir have recently been described by the World Health Organization as preferred boosted PIs for use in LMIC. Alternative approaches currently under investigation include boosted PI monotherapy, dual boosted PIs, and the combination of raltegravir (an HIV integrase inhibitor) and a boosted PI.

Parole chiave

  • Antiretroviral therapy
  • HIV
  • protease inhibitor
  • second line
  • treatment failure
Accesso libero

Biomedical prevention: what is the current status?

Pubblicato online: 13 Apr 2018
Pagine: 679 - 682

Astratto

Abstract

Biomedical HIV prevention strategies for primary or secondary prevention of HIV transmission can be seen as an adjunct to behavioral prevention approaches. These interventions include vaccination, female controlled vaginal microbicides, male circumcision, treatment of sexually transmitted infections that cause genital ulceration, Pre-Exposure Prophylaxis (PREP) and Post-Exposure Prophylaxis (PEP). This article reviews results from recent randomized controlled trials of novel biomedical prevention approaches and discusses interpretation of the results. The only intervention consistently demonstrating reductions in HIV transmission was adult male circumcision in Sub-Saharan Africa. Results of PREP trials will be available in the next several years.

Parole chiave

  • Biomedical prevention
  • HIV
Accesso libero

HIV-vaccines: lessons learned and the way forward

Pubblicato online: 13 Apr 2018
Pagine: 683 - 690

Astratto

Abstract

A safe and efficacious preventive HIV vaccine, as part of a comprehensive prevention program, remains among the highest public health priorities. It would be the best tool that could reduce the spread of HIV significantly in the long run. Current AIDS vaccine candidates are unable to induce neutralizing antibodies against primary HIV isolates or only to a very limited and narrow extent, representing a major obstacle in the development of an efficacious HIV vaccine. Clinical efforts have mainly focused on T-cell vaccines such as DNA and various recombinant vectors alone or in prime-boost regimens. The Merck Ad5 vaccine not only failed to show efficacy but also was associated with increased risk of HIV acquisition in vaccinees in a Phase IIb trial. While gp120 alone was not efficacious, the ALVAC prime and gp120 boost regimen showed 31% efficacy in a Phase III trial in Thailand. These contrasting results illustrate the limitations of available laboratory assays to assess the vaccine-induced immune responses and the lack of understanding of immune correlates of protection. Efforts should therefore focus on developing vaccine candidates inducing broadly neutralizing antibodies. Similarly, new vector strategies such as replicating vectors should be explored to induce strong and broad T-cell responses in the systemic and mucosal compartments. Innovation in immune assay development and testing algorithms is critically needed. The standardization of more relevant and predictive non-human primate models for immunogenicity and efficacy studies will contribute to better and faster vaccine assessment. HIV vaccine development requires innovative ideas and a sustained long-term commitment of the scientific community, civil society, politicians, and donors and participants for clinical research.

Parole chiave

  • Clinical trial
  • efficacy
  • HIV
  • Thailand
  • vaccine
Accesso libero

Sexual life and contraception in people living with HIV

Pubblicato online: 13 Apr 2018
Pagine: 691 - 701

Astratto

Abstract

As people living with HIV (PLH) are living longer and healthier lives in the era of highly active antiretroviral therapy, common reproductive health issues are becoming more important. According to WHO, PLH should be offered routine counselling on sexual and reproductive health, so that they can implement informed, healthy, and appropriate decisions. PLH need special attention with regard to the use of contraceptive methods that provide dual protection against HIV/sexually transmitted infection transmission and unintended pregnancies. This article includes literature review on sexual life and contraception in the context of HIV infection including barrier methods, natural methods, sterilization, hormonal contraception, intrauterine device, spermicides/ microbicides and emergency contraception. To date, there is no perfect method that provides both protection against HIV transmission and unintended pregnancy. Although male condom remains the principal contraceptive method, its male-controlled usage is its most important obstacle. This article describes the pros and cons of each method for PLH as well as the interaction between hormonal contraceptives and antiretroviral drugs. Many questions remain to be answered. It is therefore important that studies of different methods of contraception in PLH continue.

Parole chiave

  • Contraception
  • family planning
  • HIV
  • prevention
  • sexual life
Accesso libero

Elevated urinary total sialic acid and increased oxidative stress in patients with bladder cancer

Pubblicato online: 13 Apr 2018
Pagine: 703 - 710

Astratto

Abstract

Background: Increased production and release of sialic acid have been reported in many malignant conditions including bladder cancer. 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) have been widely used as oxidative stress biomarkers. Objective: Determine urinary levels of total sialic acid (TSA), 8-OHdG, and MDA in patients with urinary bladder cancer, and evaluate their clinical relevance. Patients and methods: Forty-five patients with histologically proven bladder cancer and 41 healthy subjects were recruited for the study. Morning urine samples were collected from all participants for measurements of TSA, 8-OHdG and MDA using thiobarbituric assay, competitive ELISA and spectrophotometry methods, respectively. Histological examination was performed for all patients. Results: Bladder cancer patients excreted urinary TSA, 8-OHdG, and MDA significantly higher than healthy controls. Based on receiver operating characteristic curve analysis, urinary TSA had adequate diagnostic potential to distinguish patients from healthy populations, and its cutoff value was chosen at 95.26 μg/g creatinine. Sensitivity, specificity, and accuracy of urinary TSA determination were 75.6%, 75.6%, and 75.6%, respectively. Both in patient and healthy groups, urinary TSA was linearly correlated with urinary 8-OHdG. Patients with highseverity grade (n=27) excreted urinary TSA significantly greater than those with low-severity grade (n=18). Conclusion: Urinary TSA, 8-OHdG, and MDA increased in patients with bladder cancer. The elevated urinary TSA was associated with enhanced oxidative stress. In addition, urinary TSA increased with progressiveness of the tumor.

Parole chiave

  • Bladder cancer
  • 8-OHdG
  • oxidative stress
  • transitional cell carcinoma
  • urinary sialic acid
Accesso libero

Anti-apoptotic function of T-KTS+, T-KTS-, WT1+/+ and WT1+/- isoforms in breast cancer

Pubblicato online: 13 Apr 2018
Pagine: 711 - 720

Astratto

Abstract

Background: WT1 was originally identified in Wilms tumor, a childhood kidney cancer. This gene was expressed in wide variety of solid cancers. Alternative splicing of WT1 transcript generates four major protein isoforms and thirty-six minor protein isoforms, each having different functional properties. WT1 gene has been considered as a tumor suppressor gene and anti-apoptotic protein. However, the mechanism of WT1 in breast cancer remains unclear. Objective: Evaluate the role of truncated WT1 isoforms (T-KTS+ and T-KTS-) and two major WT1 isoforms (+/+ and +/-) in apoptosis in breast cancer cell line, MCF-7. Materials and methods: RNA interference (RNAi) was employed in an attempt to define the role of WT1 in a breast cancer cell line (MCF-7). Furthermore, MCF-7 overe-xpressing cells that stably expressed two truncated WT1 isoforms (T-KTS+ and T-KTS-) or two major WT1 isoforms (+/+ and +/-) were generated and exposed to Doxorubicin. The mortality of cells was determined as a percentage of trypan blue-stained cells in total cells. The apoptotic molecules in apoptosis pathway were detected using RT-PCR, caspase-7 activity assay and Western blot analysis techniques. Results: Transfection of siRNAWT1 into MCF-7 cells resulted in decreasing of WT1 protein and related to the increasing in number of cell death and caspase-7 activity. Over-expression of T-KTS+, T-KTS-, WT1+/+ and WT1+/- isoforms protected cells from cell death induced by apoptosis-inducing agent, doxorubicin. Moreover, the expression of apoptotic p53, Bak and caspase-7 were decreased by the expression of all four WT1 isoforms, especially T-KTS- and T-KTS+ isoforms. Conclusion: T-KTS+ and T-KTS- isoforms as well as WT1+/+ and WT1+/- isoforms could function as an antiapoptotic protein in breast cancer cell line, MCF-7.

Parole chiave

  • Anti-apoptosis
  • MCF-7
  • truncated WT1
  • WT1
Accesso libero

Adenosine pretreatment attenuates angiotensin II-mediated p38 MAPK activation in a protein kinase A dependent manner

Pubblicato online: 13 Apr 2018
Pagine: 721 - 729

Astratto

Abstract

Background: Adenosine is known as a protective and anti-inflammatory nucleoside. Angiotensin II is the main hormone of the renin-angiotensin system. It is associated with endothelial permeability, recruitment, and activation of the immune cells through induction of inflammatory mediators. Matrix metalloproteinase-9 (MMP-9) plays an important role in inflammatory processes mediated by macrophages. Objectives: Investigate whether adenosine pretreatment modulates angiotensin II-induced MMP-9 expression and activation of signaling molecules. Methods: Human monocytic U-937 cells were treated with either adenosine or angiotensin II alone or angiotensin II following a pretreatment with adenosine. Supernatants were analyzed for MMP-9 activity by zymography method. MMP-9 gene expression was analyzed using real-time PCR. Activation of inflammatory mediators IκB-α, NF-κB, JNK, p38 MAPK, and STAT3 were analyzed by a multi-target ELISA kit. Association of Protein kinase A (PKA) in adenosine effects was studied by pre-incubation with H89, a selective PKA inhibitor. Results: Treatment of the cells with angiotensin II significantly increased MMP-9 production (p <0.05). Adenosine pretreatment did not attenuate this angiotensin II effect. Angiotensin II treatment induced NF-κB, JNK and p38 activation. Pretreatment with adenosine prior to angiotensin II stimulation showed a 40% inhibitory effect on p38 induction (p <0.05). This effect was reversed by PKA inhibition. Conclusion: The present data confirmed that monocytic MMP-9 was a target gene for angiotensin II. Adenosine pretreatment did not inhibit MMP-9 increase in response to angiotensin II. However, it showed a potential inhibitory effect on angiotensin II inflammatory signaling.

Parole chiave

  • Adenosine
  • angiotensin II
  • matrix metalloproteinase-9
  • p38 MAPK
  • signaling
Accesso libero

Effect of serotonin depletion on cortical spreading depression evoked cerebrovascular changes

Pubblicato online: 13 Apr 2018
Pagine: 731 - 738

Astratto

Parole chiave

  • Cerebral blood flow
  • cortical spreading depression
  • endothelial cell
  • low serotonin
  • ultrastructural changes
Accesso libero

Effects of aquatic exercise and land-based exercise on postural sway in elderly with knee osteoarthritis

Pubblicato online: 13 Apr 2018
Pagine: 739 - 745

Astratto

Abstract

Background: Knee Osteoarthritis (knee OA) is the most common joint disease in the elderly. It is a major cause of walking disability and balance impairment. The balance impairment or increase postural sway may result in increased risk of fall. Objectives: Compare effects of aquatic exercise and land-based exercise on postural sway and physical performance (pain, quality of life, leg muscle strength and leg muscle flexibility) in the elderly with knee OA. Subjects and methods: Fifty elderly women with knee OA were recruited for this study. They were randomized into aquatic exercise (n=25) and land-based exercise group (n=25). Postural sway views by anterior-posterior amplitude, medio-lateral amplitude, and total area were measured in subjects with eye opened or closed during double and single leg stance after six-week training, using the Force platform. Functional outcome was tested by the modified WOMAC. Knee injury and Osteoarthritis Outcome Score (KOOS), and pain scale were tested by Visual Analog Scale (VAS). Leg muscle strength was measured by chair stand, and leg muscle flexibility was measured by sit-andreach test. Aquatic group exercised at King Chulalongkorn Memorial Hospital therapeutic pool, while landbased group exercised at home. Results: In comparing postural sway before and after exercise, reduction in postural sway and pain, and increase in strength, the aquatic group were significantly better than those for land-based group (p <0.05). WOMAC, KOOS scores, and sit-and-reach test after six-weeks training were improved after exercise, but these were not significantly different between groups (p >0.05). Conclusion: Elderly patients with knee OA need exercise to improve balance and reduce sway. Six-week aquatic exercise was better than land-based exercise in sway reduction.

Parole chiave

  • Aquatic exercise
  • elderly
  • knee osteoarthritis
  • land-based exercise
  • postural sway
Accesso libero

Sutureless elastic ring silo for the gastroschisis

Pubblicato online: 13 Apr 2018
Pagine: 747 - 755

Astratto

Abstract

Background: The definitive surgical management of gastroschisis is the return of the eviscerated abdominal content into the abdomen as soon as possible. Objectives: Assess the efficacy of using a sutureless elastic ring silo (SERS) for the management of gastroschisis. Methods: Neonates with gastroschisis were enrolled at Songklanagarind Hospital between January 2006 and December 2008. A primary repair (PR) was attempted in all cases. If this was not possible due to concerns about abdominal compartment syndrome, a stage abdominal closure with a silo pouch was fashioned: a traditional silo (TS) or SERS. When the bowel was completely reduced, a second-stage closure was performed in the operating room. Data collected included general demographic data, size of defect, associated anomalies, hospital course, mode of gastroschisis closure, duration of parenteral nutrition (PN) and ventilator, first feeding age, complications, and length of hospital stay (LOS). Results: Twenty-nine children with gastroschisis were treated (PR: 9, TS: 9, and SERS: 11). There were no differences (p >0.05) concerning gender, mode of delivery, APGAR scores, gestational age, birth weight, or defect size. A preformed silo was employed in 20 of 29 cases, TS in nine (31%), and SERS in 11 (38%) cases in an average operative time of 80.6 and 40 minutes, respectively, a significantly shorter operative time in the SERS (p =0.007). Overall, there were no differences (p >0.05) concerning duration of ventilator support (10.2 days), duration of PN (21.3 days), first feeding age (15 days), LOS (26.5 days), and complication. Conclusion: The use of a sutureless elastic ring silo with readily available inexpensive materials is simple, safe and efficacious in our setting.

Parole chiave

  • Abdominal wall defects
  • gastroschisis
  • preformed silo
  • staged closure
  • sutureless silo
  • umbilical cord preservation
Accesso libero

Hepatocyte steatosis increases the expression of adhesion molecules in endothelial cells

Pubblicato online: 13 Apr 2018
Pagine: 757 - 763

Astratto

Abstract

Background: Non-alcoholic fatty liver disease is considered a hepatic manifestation of the metabolic syndrome. It is associated with endothelial dysfunction as an early event of generalized atherosclerosis. However, it is unclear whether steatotic hepatocytes influence endothelial function directly. Objective: Explore the influence of hepatocyte steatosis on the function of endothelial cells. Methods: Oleic and palmitic acid (2:1 mixture, final concentration: 1 mM for 24 hours) was used to induce a normal adult hepatocyte strain (L-02) for transformation into steatosis cells. This was followed by oil red O staining and transmission electron microscopy (TEM) for verification. The culture solution of steatotic L-02 cells was filtered and collected, and added into the culture substrate of human umbilical vein endothelial cells (HUVECs). The expression of vascular cellular adhesion molecule -1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin in HUVECs was detected by real-time polymerase chain reaction and Western blot assays. The apoptosis and proliferation of HUVECs was determined using flow cytometry. The experimental results were compared with the controls. Results: Oil red O staining and microscopic observation showed that the cytoplasm of induced L-02 cells contained a large amount of red lipid droplets. TEM results showed that the cytoplasm had lipid accumulation, swelling mitochondria, fewer cristae, and reduced number of rough endoplasmic reticula accompanied with degranulation. However, these changes were not observed in normal L-02 cells. As to the group of HUVECs treated by the filtrate of steatosis L-02 cells, the mRNA and protein expression of VCAM-1, ICAM-1, and E-selectin was higher than that in the control group. The difference was statistically significant (p <0.01). No significant difference was found when HUVECs apoptosis and proliferation were assessed by flow cytometry. Conclusion: Secretion from steatotic hepatocytes could boost the expression of VCAM-1, ICAM-1, and E-selectin in endothelial cells, indicating that hepatocyte steatosis could induce endothelial cell dysfunction. The proliferation and apoptosis of endothelial cells did not change, suggesting that hepatocyte steatosis had no influence on the viability of endothelial cells under this condition.

Parole chiave

  • Adhesion molecules
  • dysfunction
  • endothelial cell
  • hepatocyte
  • steatosis
Accesso libero

Effectiveness of endotracheal-tube size by age-based formula for Thai pediatric cardiac patients: a retrospective study

Pubblicato online: 13 Apr 2018
Pagine: 765 - 771

Astratto

Abstract

Background: Pediatric patients with congenital heart diseases may have pathological airway abnormality and delayed development. To predict the appropriate size of endotracheal tube (ETT), a formula between diameter and age has been widely used for Western normal children. However, it is unclear whether this age-based (AB) formula is applicable to Thai pediatric cardiac patients. Objective: Evaluate the effectiveness of uncuffed ETT size by AB formula for pediatric cardiac patients. Methods: A retrospective study was conducted using 320 cases of non-cardiac and cardiac patients aged 2-7 years old who were orally intubated with a regular uncuffed ETT at Siriraj Hospital, Thailand. The exclusion criteria were history of tracheostomy, upper airway obstruction, and expected difficult intubation. Demographic data and final ETT used were recorded. Results: The tube- size predicted by the AB formula could be applied to 54.4% of non-cardiac and 48.1% of cardiac patients (p= 0.314), whereas three sizes of tubes (one above and one below the predicted size) covered 96.9% and 94.4% of non-cardiac and cardiac patients, respectively (p = 0.413). The ETT with 0.5 mm in ID larger than the predicted size were more often used in 35.0% of cardiac patients compared with 22.5% of non-cardiac patients (p= 0.019). There were no significant differences between methods using age (actual, round-up, and truncated) to calculate the AB formula. The Pearson’s correlation between the ID of the ETT with height in non-cardiac and cardiac patients were 0.430 and 0.683, respectively (p <0.001), whereas correlations with weight were 0.622 and 0.561 (p <0.001), respectively. Conclusion: The AB formula was applicable to non-cardiac and cardiac children aged 2-7 years old. For Thai pediatric cardiac patients, we recommend to use a one-size larger ETT than non-cardiac patients.

Parole chiave

  • Age-based formula
  • anesthesia
  • cardiac patients
  • endotracheal tube
  • pediatric
Accesso libero

Thai parental perception of the etiology of autism spectrum disorders with an emphasis on genetics

Pubblicato online: 13 Apr 2018
Pagine: 773 - 779

Astratto

Abstract

Background: More than 90% of cases of autism spectrum disorders (ASDs) are idiopathic and are multi-factorial inheritant in etiology. Although parental perceptions of ASDs etiologies including genetics have been investigated well in western countries, there is no study regarding Asian parental perspectives on the genetic etiology of ASDs. Objectives: Examine what Thai parents perceived to be the etiology of ASDs with particular focus on the role of genetics, and analyze the correlation between demographics of parents and the perception of genetics as an etiology of ASDs. Methods: Children diagnosed with an ASD at Ramathibodi Hospital were recruited, and 328 questionnaires were mailed to their parents between February 1 and March 31, 2008. Based on 252 answers received, the perception of genetics as an etiology of ASDs was evaluated using univariate and multivariate analysis. Results: Among 252 parents, 44.0% cited genetics, 52% cited other prenatal and perinatal factors such as stress and chemical exposure during pregnancy, 33% cited postnatal factors such as child rearing, child’s viewing of television, and playing computer game as etiologies of ASDs. Parents’ education, positive family history of ASDs, and positive family history of speech delay were all significantly associated with the perception of genetics as an etiology of ASDs. Conclusions: Less than half of Thai parents cited genetics as an etiology of ASDs. This finding alerts medical professionals to spend more time and effort to educate and counsel parents.

Parole chiave

  • Autism spectrum disorders
  • etiology
  • genetics
  • multi-factorial
  • parental perception
  • Thai
Accesso libero

Cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy

Pubblicato online: 13 Apr 2018
Pagine: 781 - 786

Astratto

Abstract

Background: Cerebellar hemorrhage is a rare but serious perinatal condition with various etiologies leading to fetal and neonatal death and adverse neurological complications. Complete autopsy and placental examination are essential for identification of a cause of the bleeding. Objective: Present a case of cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy (FTV). Method: Autopsy of a stillborn female fetus, 26 weeks gestation, with intrauterine growth restriction, delivered by a 37-year-old woman. Results: The fetus showed multiple recent peticheal hemorrhages along the cerebellar cortex. The placenta revealed a large thrombosed chorionic blood vessel. Microscopic findings showed multiple vascular thrombosis and massive FTV throughout the placental villi. These were recognized as two histologic patterns, ‘early’ stromal karryorhxis, and ‘late’ villous stromal involution. Conclusion: Massive FTV was a leading cause of fetal stress due to increased resistant of downstream placental villi. This longstanding stressful environment induced auto-regulation impairment of fetal cerebral blood flow resulting in cerebellar parenchymal bleeding. Careful placental examination is beneficial for understating the mode and mechanism of fetal death.

Parole chiave

  • Cerebellar hemorrhage
  • fetal stroke
  • fetal thrombotic vasculopathy
Accesso libero

Diagnostic tests for tuberculous lymphadenitis: fine needle aspirations using tissue culture in mycobacteria growth indicator tube and tissue PCR

Pubblicato online: 13 Apr 2018
Pagine: 787 - 792

Astratto

Abstract

Background: The diagnosis of tuberculous lymphadenitis (TBLN) ranges from therapeutic diagnosis to open biopsy with tissue culture. The open biopsies are accepted as the gold standard to diagnose TBLN, but it requires skin incision that leaves unwanted scars. Objective: Test the sensitivity and specificity of fine needle aspiration (FNA) using tissue culture in mycobacteria growth indicator tube (MGIT) and tissue polymerase chain reaction (PCR) for comparison with open biopsy using tissue culture. Subject and methods: Forty patients with clinically suspected cervical tuberculous lymphadenitis were recruited at King Chulalongkorn Memorial Hospital. The patients underwent FNA followed by open biopsies either excisional or incisional. Specimens from FNA were collected for tissue culture in MGIT and for tissue PCR. The specimens from open biopsies were divided into two portions for tissue culture in MGIT (the gold standard) and for hispathology. Results: FNA for tissue culture in MGIT had a moderate sensitivity (65%) but high specificity (83%) (73% positive and 76% negative predictive value). FNA for tissue PCR had a moderate sensitivity (53%) but very high specificity (96%) (90% positive and 73% negative predictive values). Combination of either FNA for tissue culture or FNA tissue PCR revealed an increase in sensitivity and specificity to 83.6% and 80.0%, respectively. However, a combination of both FNA for tissue culture and FNA tissue PCR revealed a decrease in sensitivity (34.5%) but a highly increase in specificity (99.0%). Conclusion: Either the FNA using tissue culture in MGIT or tissue PCR had a moderate sensitivity but high specificity. FNA using tissue culture or FNA tissue PCR may be used as an alternative test for diagnosis TBLN. The techniques may replace the open biopsies because of its effectiveness and low complication rate.

Parole chiave

  • FNA
  • MGIT
  • PCR
  • tuberculosis
  • lymphadenitis
Accesso libero

Pubertal growth in normal Thai children: a longitudinal study

Pubblicato online: 13 Apr 2018
Pagine: 793 - 795

Astratto

Abstract

Background: Pubertal growth data in Thai children has been reported as cross-sectional studies. There is no longitudinal study in Thai children. Objective: Investigate the longitudinal growth data in normal Thai children including the relationship between age at pubertal onset and other growth parameters. Material and method: Eighty-eight normal children (44 boys, 44 girls) were longitudinally assessed for the growth and puberty until they reached their final adult height. Pubertal staging was assessed by the Tanner method. Results: Mean age of pubertal onset was 10.2 ± 1.2 years for girls and 12.2 ± 1.0 years for boys. Total pubertal height gain was 18.3 ± 4.0 cm for girls and 22.3 ± 4.4 cm for boys. Total pubertal height gain had a negative correlation with age at pubertal onset for girls, but not for boys. Conclusion: The onset of puberty was not much changed from previous studies. Girls with early puberty had a higher pubertal height gain. This might be due to a compensatory mechanism. These longitudinal growth data can be used as a reference in clinical practices for Thai children.

Parole chiave

  • Pubertal onset
  • pubertal height gain
  • Thai children
Accesso libero

Role of vascular endothelial growth factor receptor in the pro-proliferation activity of CD40-CD40L in AGS gastric cancer cells

Pubblicato online: 13 Apr 2018
Pagine: 797 - 802

Astratto

Abstract

Background: CD40 is a type α-membrane protein of the tumor necrosis factor receptor super-family, and CD40- induced responses may mediate growth and angiogenesis in carcinoma cells. Objectives: Define the effect of CD40 ligation on AGS gastric cancer cell line and the role of vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR) signals in this process. Methods: We treated AGS cells with 1 μg/mL soluble CD40 ligand (sCD40L) with or without pre-incubation of either anti-VEGF mAb (MAB293) or VEGFR tyrosine kinase inhibitor (SU5416). We determined the growth effects by cell counts or [3H]-thymidine incorporation assay and VEGF levels in cell-free supernatant using enzymelinked immunosorbent assays. Results: The engagement of CD40-induced AGS cells proliferation accompanied by a significant increase autocrine VEGF through PI3K activation (p <0.05), and exogenous VEGF alone had no effect on spontaneous cell growth. SU5416 with a concentration of 8 μM lead to a dramatic decrease in cell survival induced by sCD40L (p <0.05), whereas MAB293 did not have the similar effect (p >0.05). Conclusion: CD40-CD40L interaction promoted AGS cancer cell line proliferation through a VEGFR-dependent signal pathway in the presence of an internal autocrine loop.

Parole chiave

  • CD40
  • gastric cancer
  • sCD40L
  • VEGF
  • VEGFR
Accesso libero

Efficacy of sanitation and sanitary factors against the German cockroach (Blattella germanica) infestation and effectiveness of educational programs on sanitation in Iran

Pubblicato online: 13 Apr 2018
Pagine: 803 - 810

Astratto

Abstract

Background: Sanitation and educational programmes as tactics of the biorational control programme to affect bait performance against German cockroaches have been reported, but these are limited to discussion on the effect of these factors alone. Objective: Investigate the effectiveness of sanitation and related factors on German cockroaches (Blattella germanica) in Iran. Methods: Sticky traps were used to monitor cockroach infestations at three residential buildings comprising of 150 apartment units in the southwest part of Iran. Educational programmes using pamphlets, posters, and lectures to describe the importance of sanitation, exclusion, and low toxic control in biorational control approach was performed in the intervention groups of the surveyed residential buildings. The cockroach index and sanitation rate tables were tools to evaluate the infestation and sanitation. A questionnaire was distributed to collect information on unsanitary factors and occupants’ attitudes towards sanitation. Results: There was a significant correlation between infestation and poor sanitation. Furthermore, there was significant correlation between infestation and sanitation in a biorational system. The effectiveness of a comprehensive educational program on the improvement of unsanitary factors such as “dirty and cluttered”, “unwashed dishes left at night” and “leftover foods exposed at places” or “food debris” was significant as it reduced upon cockroach infestation. Other relevant effects were also taken into consideration. Conclusion: Sanitation has positive impact in reduction of German cockroach infestation.

Parole chiave

  • Biorational control
  • education
  • German cockroach
  • infestation rate
  • sanitation rate
  • unsanitary factors
Accesso libero

Does history-taking help predict rabies diagnosis in dogs?

Pubblicato online: 13 Apr 2018
Pagine: 811 - 815

Astratto

Abstract

Background: Rabies is a fatal disease. However, dogs are the principal vehicle for rabies transmission of human. A little information about pre-morbid behavior in rabid dogs could be found in the literature. Objective: Assess the value of history taking in predicting rabies diagnosis in dogs, and identify the percentage of rabies positives by history taking in a prospective study. Materials and methods: Studies were conducted at the Rabies Diagnostic Unit, Queen Saovabha Memorial Institute, Thai Red Cross Society between 2002 and 2008. Historical data were collected prospectively from 153 live rabies suspected dogs on admission to the diagnostic facility. Results: Rabies was found in 14% to 80% of dogs with completed questionnaires except for dogs less than one month old, not sick or sick for more than 10 days. Conclusion: History taking does not help in decision-making for rabies post-exposure prophylaxis of humans.

Parole chiave

  • Clinical diagnosis
  • history-taking
  • observation
  • rabid dog
Accesso libero

Increasing the remnant liver volume using portal vein embolization

Pubblicato online: 13 Apr 2018
Pagine: 817 - 820

Astratto

Abstract

Background: Portal vein embolization (PVE) is a common procedure to induce hypertrophy of the remnant liver (RL) before major hepatectomy. Objective: Evaluate increased RL volume after PVE based on CT volumetric measurement. Methods: Multi-detector computed tomography (MDCT) was used to measure hepatic volumetric measurement, including total liver volume and RL volumes of pre- and post-PVE. Complications were recorded from PVE and from three-month after post-extended hepatectomy liver dysfunction. Result and conclusion: There was a 10% increase in RL volume. Mean days between CT and PVE were 20 days. No major complications from PVE were observed.

Parole chiave

  • Portal vein embolization
  • volume of remnant liver
  • extended hepatectomy
  • multidetector CT
  • CT volumetric measurement
Accesso libero

Post-antibiotic and post-antibiotic sub-MIC effects of gentamicin, sophoraflavanone G, and their combination against a clinical isolate of Staphylococcus aureus

Pubblicato online: 13 Apr 2018
Pagine: 821 - 826

Astratto

Abstract

Background: Post-antibiotic effect (PAE) defines the potential of a drug to delay re-growth of a bacterial population after short-term exposure and removal of a drug. Determination of the PAE is recommended in preclinical evaluation of all new antimicrobial agents, because it influences optimal antimicrobial dosing intervals. Objective: Evaluate the PAE and PA-SME of gentamicin and sophoraflavanone G against Staphylococcus aureus (S. aureus) itself and in combination. Methods: A spectrophotometric method was used to determine the PAE and PA-SME. Results: Sophoraflavanone G and gentamicin, showed considerable PAE and PA-SME at the tested concentrations against S. aureus. The increased duration of PAE caused by sophoraflavanone G and gentamicin was dosedependent. In addition, sophoraflavanone G at sub-MIC concentrations enhanced the PAE and PA-SME of gentamicin in a dose-dependent manner. The highest enhancing effect was observed for gentamicin at the synergistic MIC and 1/2 the synergistic MIC levels against S. aureus 0.03 μg/mL (30 ng/mL) of sophoraflavanone G (with PAE=55 minutes). It enhanced the post-antibiotic sub-MIC effect (PA-SME) duration of gentamicin at concentrations of 4 μg/mL from 15 minutes to 80 minutes (a six-fold increase). Conclusion: Sophoraflavanone G is promising for the preparation of an effective therapeutic formulation against gentamicin-resistant S. aureus.

Parole chiave

  • Gentamicin
  • post-antibiotic effect
  • sophoraflavanone G
  • Staphylococcus aureus
Accesso libero

Vascular repair is vulnerable to renal regeneration in early stage of diabetic nephropathy

Pubblicato online: 13 Apr 2018
Pagine: 827 - 828

Astratto

22 Articoli
Accesso libero

Second line antiretroviral therapy for treatment of HIV in Asia

Pubblicato online: 13 Apr 2018
Pagine: 673 - 677

Astratto

Abstract

Limited access to virological monitoring has led to a high prevalence of resistance to nucleoside reverse transcriptase inhibitors (NRTIs) at the time of first line failure in most studies from low- and middle-income countries (LMIC). Nevertheless, the current standard of care is to include NRTIs in second line regimens. The activity of tenofovir/emtricitabine following failure of stavudine/lamivudine or zidovudine/lamivudine is dependent on the sensitivity of the monitoring strategy used during first line therapy and the threshold for switching, whereas these factors are less important if the opposite sequencing strategy is used. Boosted protease inhibitors (PIs) are the foundation of effective second-line therapy with demonstrated efficacy in early salvage regimens and high barrier to resistance. Lopinavir/ritonavir and ritonavir-boosted atazanavir have recently been described by the World Health Organization as preferred boosted PIs for use in LMIC. Alternative approaches currently under investigation include boosted PI monotherapy, dual boosted PIs, and the combination of raltegravir (an HIV integrase inhibitor) and a boosted PI.

Parole chiave

  • Antiretroviral therapy
  • HIV
  • protease inhibitor
  • second line
  • treatment failure
Accesso libero

Biomedical prevention: what is the current status?

Pubblicato online: 13 Apr 2018
Pagine: 679 - 682

Astratto

Abstract

Biomedical HIV prevention strategies for primary or secondary prevention of HIV transmission can be seen as an adjunct to behavioral prevention approaches. These interventions include vaccination, female controlled vaginal microbicides, male circumcision, treatment of sexually transmitted infections that cause genital ulceration, Pre-Exposure Prophylaxis (PREP) and Post-Exposure Prophylaxis (PEP). This article reviews results from recent randomized controlled trials of novel biomedical prevention approaches and discusses interpretation of the results. The only intervention consistently demonstrating reductions in HIV transmission was adult male circumcision in Sub-Saharan Africa. Results of PREP trials will be available in the next several years.

Parole chiave

  • Biomedical prevention
  • HIV
Accesso libero

HIV-vaccines: lessons learned and the way forward

Pubblicato online: 13 Apr 2018
Pagine: 683 - 690

Astratto

Abstract

A safe and efficacious preventive HIV vaccine, as part of a comprehensive prevention program, remains among the highest public health priorities. It would be the best tool that could reduce the spread of HIV significantly in the long run. Current AIDS vaccine candidates are unable to induce neutralizing antibodies against primary HIV isolates or only to a very limited and narrow extent, representing a major obstacle in the development of an efficacious HIV vaccine. Clinical efforts have mainly focused on T-cell vaccines such as DNA and various recombinant vectors alone or in prime-boost regimens. The Merck Ad5 vaccine not only failed to show efficacy but also was associated with increased risk of HIV acquisition in vaccinees in a Phase IIb trial. While gp120 alone was not efficacious, the ALVAC prime and gp120 boost regimen showed 31% efficacy in a Phase III trial in Thailand. These contrasting results illustrate the limitations of available laboratory assays to assess the vaccine-induced immune responses and the lack of understanding of immune correlates of protection. Efforts should therefore focus on developing vaccine candidates inducing broadly neutralizing antibodies. Similarly, new vector strategies such as replicating vectors should be explored to induce strong and broad T-cell responses in the systemic and mucosal compartments. Innovation in immune assay development and testing algorithms is critically needed. The standardization of more relevant and predictive non-human primate models for immunogenicity and efficacy studies will contribute to better and faster vaccine assessment. HIV vaccine development requires innovative ideas and a sustained long-term commitment of the scientific community, civil society, politicians, and donors and participants for clinical research.

Parole chiave

  • Clinical trial
  • efficacy
  • HIV
  • Thailand
  • vaccine
Accesso libero

Sexual life and contraception in people living with HIV

Pubblicato online: 13 Apr 2018
Pagine: 691 - 701

Astratto

Abstract

As people living with HIV (PLH) are living longer and healthier lives in the era of highly active antiretroviral therapy, common reproductive health issues are becoming more important. According to WHO, PLH should be offered routine counselling on sexual and reproductive health, so that they can implement informed, healthy, and appropriate decisions. PLH need special attention with regard to the use of contraceptive methods that provide dual protection against HIV/sexually transmitted infection transmission and unintended pregnancies. This article includes literature review on sexual life and contraception in the context of HIV infection including barrier methods, natural methods, sterilization, hormonal contraception, intrauterine device, spermicides/ microbicides and emergency contraception. To date, there is no perfect method that provides both protection against HIV transmission and unintended pregnancy. Although male condom remains the principal contraceptive method, its male-controlled usage is its most important obstacle. This article describes the pros and cons of each method for PLH as well as the interaction between hormonal contraceptives and antiretroviral drugs. Many questions remain to be answered. It is therefore important that studies of different methods of contraception in PLH continue.

Parole chiave

  • Contraception
  • family planning
  • HIV
  • prevention
  • sexual life
Accesso libero

Elevated urinary total sialic acid and increased oxidative stress in patients with bladder cancer

Pubblicato online: 13 Apr 2018
Pagine: 703 - 710

Astratto

Abstract

Background: Increased production and release of sialic acid have been reported in many malignant conditions including bladder cancer. 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) have been widely used as oxidative stress biomarkers. Objective: Determine urinary levels of total sialic acid (TSA), 8-OHdG, and MDA in patients with urinary bladder cancer, and evaluate their clinical relevance. Patients and methods: Forty-five patients with histologically proven bladder cancer and 41 healthy subjects were recruited for the study. Morning urine samples were collected from all participants for measurements of TSA, 8-OHdG and MDA using thiobarbituric assay, competitive ELISA and spectrophotometry methods, respectively. Histological examination was performed for all patients. Results: Bladder cancer patients excreted urinary TSA, 8-OHdG, and MDA significantly higher than healthy controls. Based on receiver operating characteristic curve analysis, urinary TSA had adequate diagnostic potential to distinguish patients from healthy populations, and its cutoff value was chosen at 95.26 μg/g creatinine. Sensitivity, specificity, and accuracy of urinary TSA determination were 75.6%, 75.6%, and 75.6%, respectively. Both in patient and healthy groups, urinary TSA was linearly correlated with urinary 8-OHdG. Patients with highseverity grade (n=27) excreted urinary TSA significantly greater than those with low-severity grade (n=18). Conclusion: Urinary TSA, 8-OHdG, and MDA increased in patients with bladder cancer. The elevated urinary TSA was associated with enhanced oxidative stress. In addition, urinary TSA increased with progressiveness of the tumor.

Parole chiave

  • Bladder cancer
  • 8-OHdG
  • oxidative stress
  • transitional cell carcinoma
  • urinary sialic acid
Accesso libero

Anti-apoptotic function of T-KTS+, T-KTS-, WT1+/+ and WT1+/- isoforms in breast cancer

Pubblicato online: 13 Apr 2018
Pagine: 711 - 720

Astratto

Abstract

Background: WT1 was originally identified in Wilms tumor, a childhood kidney cancer. This gene was expressed in wide variety of solid cancers. Alternative splicing of WT1 transcript generates four major protein isoforms and thirty-six minor protein isoforms, each having different functional properties. WT1 gene has been considered as a tumor suppressor gene and anti-apoptotic protein. However, the mechanism of WT1 in breast cancer remains unclear. Objective: Evaluate the role of truncated WT1 isoforms (T-KTS+ and T-KTS-) and two major WT1 isoforms (+/+ and +/-) in apoptosis in breast cancer cell line, MCF-7. Materials and methods: RNA interference (RNAi) was employed in an attempt to define the role of WT1 in a breast cancer cell line (MCF-7). Furthermore, MCF-7 overe-xpressing cells that stably expressed two truncated WT1 isoforms (T-KTS+ and T-KTS-) or two major WT1 isoforms (+/+ and +/-) were generated and exposed to Doxorubicin. The mortality of cells was determined as a percentage of trypan blue-stained cells in total cells. The apoptotic molecules in apoptosis pathway were detected using RT-PCR, caspase-7 activity assay and Western blot analysis techniques. Results: Transfection of siRNAWT1 into MCF-7 cells resulted in decreasing of WT1 protein and related to the increasing in number of cell death and caspase-7 activity. Over-expression of T-KTS+, T-KTS-, WT1+/+ and WT1+/- isoforms protected cells from cell death induced by apoptosis-inducing agent, doxorubicin. Moreover, the expression of apoptotic p53, Bak and caspase-7 were decreased by the expression of all four WT1 isoforms, especially T-KTS- and T-KTS+ isoforms. Conclusion: T-KTS+ and T-KTS- isoforms as well as WT1+/+ and WT1+/- isoforms could function as an antiapoptotic protein in breast cancer cell line, MCF-7.

Parole chiave

  • Anti-apoptosis
  • MCF-7
  • truncated WT1
  • WT1
Accesso libero

Adenosine pretreatment attenuates angiotensin II-mediated p38 MAPK activation in a protein kinase A dependent manner

Pubblicato online: 13 Apr 2018
Pagine: 721 - 729

Astratto

Abstract

Background: Adenosine is known as a protective and anti-inflammatory nucleoside. Angiotensin II is the main hormone of the renin-angiotensin system. It is associated with endothelial permeability, recruitment, and activation of the immune cells through induction of inflammatory mediators. Matrix metalloproteinase-9 (MMP-9) plays an important role in inflammatory processes mediated by macrophages. Objectives: Investigate whether adenosine pretreatment modulates angiotensin II-induced MMP-9 expression and activation of signaling molecules. Methods: Human monocytic U-937 cells were treated with either adenosine or angiotensin II alone or angiotensin II following a pretreatment with adenosine. Supernatants were analyzed for MMP-9 activity by zymography method. MMP-9 gene expression was analyzed using real-time PCR. Activation of inflammatory mediators IκB-α, NF-κB, JNK, p38 MAPK, and STAT3 were analyzed by a multi-target ELISA kit. Association of Protein kinase A (PKA) in adenosine effects was studied by pre-incubation with H89, a selective PKA inhibitor. Results: Treatment of the cells with angiotensin II significantly increased MMP-9 production (p <0.05). Adenosine pretreatment did not attenuate this angiotensin II effect. Angiotensin II treatment induced NF-κB, JNK and p38 activation. Pretreatment with adenosine prior to angiotensin II stimulation showed a 40% inhibitory effect on p38 induction (p <0.05). This effect was reversed by PKA inhibition. Conclusion: The present data confirmed that monocytic MMP-9 was a target gene for angiotensin II. Adenosine pretreatment did not inhibit MMP-9 increase in response to angiotensin II. However, it showed a potential inhibitory effect on angiotensin II inflammatory signaling.

Parole chiave

  • Adenosine
  • angiotensin II
  • matrix metalloproteinase-9
  • p38 MAPK
  • signaling
Accesso libero

Effect of serotonin depletion on cortical spreading depression evoked cerebrovascular changes

Pubblicato online: 13 Apr 2018
Pagine: 731 - 738

Astratto

Parole chiave

  • Cerebral blood flow
  • cortical spreading depression
  • endothelial cell
  • low serotonin
  • ultrastructural changes
Accesso libero

Effects of aquatic exercise and land-based exercise on postural sway in elderly with knee osteoarthritis

Pubblicato online: 13 Apr 2018
Pagine: 739 - 745

Astratto

Abstract

Background: Knee Osteoarthritis (knee OA) is the most common joint disease in the elderly. It is a major cause of walking disability and balance impairment. The balance impairment or increase postural sway may result in increased risk of fall. Objectives: Compare effects of aquatic exercise and land-based exercise on postural sway and physical performance (pain, quality of life, leg muscle strength and leg muscle flexibility) in the elderly with knee OA. Subjects and methods: Fifty elderly women with knee OA were recruited for this study. They were randomized into aquatic exercise (n=25) and land-based exercise group (n=25). Postural sway views by anterior-posterior amplitude, medio-lateral amplitude, and total area were measured in subjects with eye opened or closed during double and single leg stance after six-week training, using the Force platform. Functional outcome was tested by the modified WOMAC. Knee injury and Osteoarthritis Outcome Score (KOOS), and pain scale were tested by Visual Analog Scale (VAS). Leg muscle strength was measured by chair stand, and leg muscle flexibility was measured by sit-andreach test. Aquatic group exercised at King Chulalongkorn Memorial Hospital therapeutic pool, while landbased group exercised at home. Results: In comparing postural sway before and after exercise, reduction in postural sway and pain, and increase in strength, the aquatic group were significantly better than those for land-based group (p <0.05). WOMAC, KOOS scores, and sit-and-reach test after six-weeks training were improved after exercise, but these were not significantly different between groups (p >0.05). Conclusion: Elderly patients with knee OA need exercise to improve balance and reduce sway. Six-week aquatic exercise was better than land-based exercise in sway reduction.

Parole chiave

  • Aquatic exercise
  • elderly
  • knee osteoarthritis
  • land-based exercise
  • postural sway
Accesso libero

Sutureless elastic ring silo for the gastroschisis

Pubblicato online: 13 Apr 2018
Pagine: 747 - 755

Astratto

Abstract

Background: The definitive surgical management of gastroschisis is the return of the eviscerated abdominal content into the abdomen as soon as possible. Objectives: Assess the efficacy of using a sutureless elastic ring silo (SERS) for the management of gastroschisis. Methods: Neonates with gastroschisis were enrolled at Songklanagarind Hospital between January 2006 and December 2008. A primary repair (PR) was attempted in all cases. If this was not possible due to concerns about abdominal compartment syndrome, a stage abdominal closure with a silo pouch was fashioned: a traditional silo (TS) or SERS. When the bowel was completely reduced, a second-stage closure was performed in the operating room. Data collected included general demographic data, size of defect, associated anomalies, hospital course, mode of gastroschisis closure, duration of parenteral nutrition (PN) and ventilator, first feeding age, complications, and length of hospital stay (LOS). Results: Twenty-nine children with gastroschisis were treated (PR: 9, TS: 9, and SERS: 11). There were no differences (p >0.05) concerning gender, mode of delivery, APGAR scores, gestational age, birth weight, or defect size. A preformed silo was employed in 20 of 29 cases, TS in nine (31%), and SERS in 11 (38%) cases in an average operative time of 80.6 and 40 minutes, respectively, a significantly shorter operative time in the SERS (p =0.007). Overall, there were no differences (p >0.05) concerning duration of ventilator support (10.2 days), duration of PN (21.3 days), first feeding age (15 days), LOS (26.5 days), and complication. Conclusion: The use of a sutureless elastic ring silo with readily available inexpensive materials is simple, safe and efficacious in our setting.

Parole chiave

  • Abdominal wall defects
  • gastroschisis
  • preformed silo
  • staged closure
  • sutureless silo
  • umbilical cord preservation
Accesso libero

Hepatocyte steatosis increases the expression of adhesion molecules in endothelial cells

Pubblicato online: 13 Apr 2018
Pagine: 757 - 763

Astratto

Abstract

Background: Non-alcoholic fatty liver disease is considered a hepatic manifestation of the metabolic syndrome. It is associated with endothelial dysfunction as an early event of generalized atherosclerosis. However, it is unclear whether steatotic hepatocytes influence endothelial function directly. Objective: Explore the influence of hepatocyte steatosis on the function of endothelial cells. Methods: Oleic and palmitic acid (2:1 mixture, final concentration: 1 mM for 24 hours) was used to induce a normal adult hepatocyte strain (L-02) for transformation into steatosis cells. This was followed by oil red O staining and transmission electron microscopy (TEM) for verification. The culture solution of steatotic L-02 cells was filtered and collected, and added into the culture substrate of human umbilical vein endothelial cells (HUVECs). The expression of vascular cellular adhesion molecule -1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin in HUVECs was detected by real-time polymerase chain reaction and Western blot assays. The apoptosis and proliferation of HUVECs was determined using flow cytometry. The experimental results were compared with the controls. Results: Oil red O staining and microscopic observation showed that the cytoplasm of induced L-02 cells contained a large amount of red lipid droplets. TEM results showed that the cytoplasm had lipid accumulation, swelling mitochondria, fewer cristae, and reduced number of rough endoplasmic reticula accompanied with degranulation. However, these changes were not observed in normal L-02 cells. As to the group of HUVECs treated by the filtrate of steatosis L-02 cells, the mRNA and protein expression of VCAM-1, ICAM-1, and E-selectin was higher than that in the control group. The difference was statistically significant (p <0.01). No significant difference was found when HUVECs apoptosis and proliferation were assessed by flow cytometry. Conclusion: Secretion from steatotic hepatocytes could boost the expression of VCAM-1, ICAM-1, and E-selectin in endothelial cells, indicating that hepatocyte steatosis could induce endothelial cell dysfunction. The proliferation and apoptosis of endothelial cells did not change, suggesting that hepatocyte steatosis had no influence on the viability of endothelial cells under this condition.

Parole chiave

  • Adhesion molecules
  • dysfunction
  • endothelial cell
  • hepatocyte
  • steatosis
Accesso libero

Effectiveness of endotracheal-tube size by age-based formula for Thai pediatric cardiac patients: a retrospective study

Pubblicato online: 13 Apr 2018
Pagine: 765 - 771

Astratto

Abstract

Background: Pediatric patients with congenital heart diseases may have pathological airway abnormality and delayed development. To predict the appropriate size of endotracheal tube (ETT), a formula between diameter and age has been widely used for Western normal children. However, it is unclear whether this age-based (AB) formula is applicable to Thai pediatric cardiac patients. Objective: Evaluate the effectiveness of uncuffed ETT size by AB formula for pediatric cardiac patients. Methods: A retrospective study was conducted using 320 cases of non-cardiac and cardiac patients aged 2-7 years old who were orally intubated with a regular uncuffed ETT at Siriraj Hospital, Thailand. The exclusion criteria were history of tracheostomy, upper airway obstruction, and expected difficult intubation. Demographic data and final ETT used were recorded. Results: The tube- size predicted by the AB formula could be applied to 54.4% of non-cardiac and 48.1% of cardiac patients (p= 0.314), whereas three sizes of tubes (one above and one below the predicted size) covered 96.9% and 94.4% of non-cardiac and cardiac patients, respectively (p = 0.413). The ETT with 0.5 mm in ID larger than the predicted size were more often used in 35.0% of cardiac patients compared with 22.5% of non-cardiac patients (p= 0.019). There were no significant differences between methods using age (actual, round-up, and truncated) to calculate the AB formula. The Pearson’s correlation between the ID of the ETT with height in non-cardiac and cardiac patients were 0.430 and 0.683, respectively (p <0.001), whereas correlations with weight were 0.622 and 0.561 (p <0.001), respectively. Conclusion: The AB formula was applicable to non-cardiac and cardiac children aged 2-7 years old. For Thai pediatric cardiac patients, we recommend to use a one-size larger ETT than non-cardiac patients.

Parole chiave

  • Age-based formula
  • anesthesia
  • cardiac patients
  • endotracheal tube
  • pediatric
Accesso libero

Thai parental perception of the etiology of autism spectrum disorders with an emphasis on genetics

Pubblicato online: 13 Apr 2018
Pagine: 773 - 779

Astratto

Abstract

Background: More than 90% of cases of autism spectrum disorders (ASDs) are idiopathic and are multi-factorial inheritant in etiology. Although parental perceptions of ASDs etiologies including genetics have been investigated well in western countries, there is no study regarding Asian parental perspectives on the genetic etiology of ASDs. Objectives: Examine what Thai parents perceived to be the etiology of ASDs with particular focus on the role of genetics, and analyze the correlation between demographics of parents and the perception of genetics as an etiology of ASDs. Methods: Children diagnosed with an ASD at Ramathibodi Hospital were recruited, and 328 questionnaires were mailed to their parents between February 1 and March 31, 2008. Based on 252 answers received, the perception of genetics as an etiology of ASDs was evaluated using univariate and multivariate analysis. Results: Among 252 parents, 44.0% cited genetics, 52% cited other prenatal and perinatal factors such as stress and chemical exposure during pregnancy, 33% cited postnatal factors such as child rearing, child’s viewing of television, and playing computer game as etiologies of ASDs. Parents’ education, positive family history of ASDs, and positive family history of speech delay were all significantly associated with the perception of genetics as an etiology of ASDs. Conclusions: Less than half of Thai parents cited genetics as an etiology of ASDs. This finding alerts medical professionals to spend more time and effort to educate and counsel parents.

Parole chiave

  • Autism spectrum disorders
  • etiology
  • genetics
  • multi-factorial
  • parental perception
  • Thai
Accesso libero

Cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy

Pubblicato online: 13 Apr 2018
Pagine: 781 - 786

Astratto

Abstract

Background: Cerebellar hemorrhage is a rare but serious perinatal condition with various etiologies leading to fetal and neonatal death and adverse neurological complications. Complete autopsy and placental examination are essential for identification of a cause of the bleeding. Objective: Present a case of cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy (FTV). Method: Autopsy of a stillborn female fetus, 26 weeks gestation, with intrauterine growth restriction, delivered by a 37-year-old woman. Results: The fetus showed multiple recent peticheal hemorrhages along the cerebellar cortex. The placenta revealed a large thrombosed chorionic blood vessel. Microscopic findings showed multiple vascular thrombosis and massive FTV throughout the placental villi. These were recognized as two histologic patterns, ‘early’ stromal karryorhxis, and ‘late’ villous stromal involution. Conclusion: Massive FTV was a leading cause of fetal stress due to increased resistant of downstream placental villi. This longstanding stressful environment induced auto-regulation impairment of fetal cerebral blood flow resulting in cerebellar parenchymal bleeding. Careful placental examination is beneficial for understating the mode and mechanism of fetal death.

Parole chiave

  • Cerebellar hemorrhage
  • fetal stroke
  • fetal thrombotic vasculopathy
Accesso libero

Diagnostic tests for tuberculous lymphadenitis: fine needle aspirations using tissue culture in mycobacteria growth indicator tube and tissue PCR

Pubblicato online: 13 Apr 2018
Pagine: 787 - 792

Astratto

Abstract

Background: The diagnosis of tuberculous lymphadenitis (TBLN) ranges from therapeutic diagnosis to open biopsy with tissue culture. The open biopsies are accepted as the gold standard to diagnose TBLN, but it requires skin incision that leaves unwanted scars. Objective: Test the sensitivity and specificity of fine needle aspiration (FNA) using tissue culture in mycobacteria growth indicator tube (MGIT) and tissue polymerase chain reaction (PCR) for comparison with open biopsy using tissue culture. Subject and methods: Forty patients with clinically suspected cervical tuberculous lymphadenitis were recruited at King Chulalongkorn Memorial Hospital. The patients underwent FNA followed by open biopsies either excisional or incisional. Specimens from FNA were collected for tissue culture in MGIT and for tissue PCR. The specimens from open biopsies were divided into two portions for tissue culture in MGIT (the gold standard) and for hispathology. Results: FNA for tissue culture in MGIT had a moderate sensitivity (65%) but high specificity (83%) (73% positive and 76% negative predictive value). FNA for tissue PCR had a moderate sensitivity (53%) but very high specificity (96%) (90% positive and 73% negative predictive values). Combination of either FNA for tissue culture or FNA tissue PCR revealed an increase in sensitivity and specificity to 83.6% and 80.0%, respectively. However, a combination of both FNA for tissue culture and FNA tissue PCR revealed a decrease in sensitivity (34.5%) but a highly increase in specificity (99.0%). Conclusion: Either the FNA using tissue culture in MGIT or tissue PCR had a moderate sensitivity but high specificity. FNA using tissue culture or FNA tissue PCR may be used as an alternative test for diagnosis TBLN. The techniques may replace the open biopsies because of its effectiveness and low complication rate.

Parole chiave

  • FNA
  • MGIT
  • PCR
  • tuberculosis
  • lymphadenitis
Accesso libero

Pubertal growth in normal Thai children: a longitudinal study

Pubblicato online: 13 Apr 2018
Pagine: 793 - 795

Astratto

Abstract

Background: Pubertal growth data in Thai children has been reported as cross-sectional studies. There is no longitudinal study in Thai children. Objective: Investigate the longitudinal growth data in normal Thai children including the relationship between age at pubertal onset and other growth parameters. Material and method: Eighty-eight normal children (44 boys, 44 girls) were longitudinally assessed for the growth and puberty until they reached their final adult height. Pubertal staging was assessed by the Tanner method. Results: Mean age of pubertal onset was 10.2 ± 1.2 years for girls and 12.2 ± 1.0 years for boys. Total pubertal height gain was 18.3 ± 4.0 cm for girls and 22.3 ± 4.4 cm for boys. Total pubertal height gain had a negative correlation with age at pubertal onset for girls, but not for boys. Conclusion: The onset of puberty was not much changed from previous studies. Girls with early puberty had a higher pubertal height gain. This might be due to a compensatory mechanism. These longitudinal growth data can be used as a reference in clinical practices for Thai children.

Parole chiave

  • Pubertal onset
  • pubertal height gain
  • Thai children
Accesso libero

Role of vascular endothelial growth factor receptor in the pro-proliferation activity of CD40-CD40L in AGS gastric cancer cells

Pubblicato online: 13 Apr 2018
Pagine: 797 - 802

Astratto

Abstract

Background: CD40 is a type α-membrane protein of the tumor necrosis factor receptor super-family, and CD40- induced responses may mediate growth and angiogenesis in carcinoma cells. Objectives: Define the effect of CD40 ligation on AGS gastric cancer cell line and the role of vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR) signals in this process. Methods: We treated AGS cells with 1 μg/mL soluble CD40 ligand (sCD40L) with or without pre-incubation of either anti-VEGF mAb (MAB293) or VEGFR tyrosine kinase inhibitor (SU5416). We determined the growth effects by cell counts or [3H]-thymidine incorporation assay and VEGF levels in cell-free supernatant using enzymelinked immunosorbent assays. Results: The engagement of CD40-induced AGS cells proliferation accompanied by a significant increase autocrine VEGF through PI3K activation (p <0.05), and exogenous VEGF alone had no effect on spontaneous cell growth. SU5416 with a concentration of 8 μM lead to a dramatic decrease in cell survival induced by sCD40L (p <0.05), whereas MAB293 did not have the similar effect (p >0.05). Conclusion: CD40-CD40L interaction promoted AGS cancer cell line proliferation through a VEGFR-dependent signal pathway in the presence of an internal autocrine loop.

Parole chiave

  • CD40
  • gastric cancer
  • sCD40L
  • VEGF
  • VEGFR
Accesso libero

Efficacy of sanitation and sanitary factors against the German cockroach (Blattella germanica) infestation and effectiveness of educational programs on sanitation in Iran

Pubblicato online: 13 Apr 2018
Pagine: 803 - 810

Astratto

Abstract

Background: Sanitation and educational programmes as tactics of the biorational control programme to affect bait performance against German cockroaches have been reported, but these are limited to discussion on the effect of these factors alone. Objective: Investigate the effectiveness of sanitation and related factors on German cockroaches (Blattella germanica) in Iran. Methods: Sticky traps were used to monitor cockroach infestations at three residential buildings comprising of 150 apartment units in the southwest part of Iran. Educational programmes using pamphlets, posters, and lectures to describe the importance of sanitation, exclusion, and low toxic control in biorational control approach was performed in the intervention groups of the surveyed residential buildings. The cockroach index and sanitation rate tables were tools to evaluate the infestation and sanitation. A questionnaire was distributed to collect information on unsanitary factors and occupants’ attitudes towards sanitation. Results: There was a significant correlation between infestation and poor sanitation. Furthermore, there was significant correlation between infestation and sanitation in a biorational system. The effectiveness of a comprehensive educational program on the improvement of unsanitary factors such as “dirty and cluttered”, “unwashed dishes left at night” and “leftover foods exposed at places” or “food debris” was significant as it reduced upon cockroach infestation. Other relevant effects were also taken into consideration. Conclusion: Sanitation has positive impact in reduction of German cockroach infestation.

Parole chiave

  • Biorational control
  • education
  • German cockroach
  • infestation rate
  • sanitation rate
  • unsanitary factors
Accesso libero

Does history-taking help predict rabies diagnosis in dogs?

Pubblicato online: 13 Apr 2018
Pagine: 811 - 815

Astratto

Abstract

Background: Rabies is a fatal disease. However, dogs are the principal vehicle for rabies transmission of human. A little information about pre-morbid behavior in rabid dogs could be found in the literature. Objective: Assess the value of history taking in predicting rabies diagnosis in dogs, and identify the percentage of rabies positives by history taking in a prospective study. Materials and methods: Studies were conducted at the Rabies Diagnostic Unit, Queen Saovabha Memorial Institute, Thai Red Cross Society between 2002 and 2008. Historical data were collected prospectively from 153 live rabies suspected dogs on admission to the diagnostic facility. Results: Rabies was found in 14% to 80% of dogs with completed questionnaires except for dogs less than one month old, not sick or sick for more than 10 days. Conclusion: History taking does not help in decision-making for rabies post-exposure prophylaxis of humans.

Parole chiave

  • Clinical diagnosis
  • history-taking
  • observation
  • rabid dog
Accesso libero

Increasing the remnant liver volume using portal vein embolization

Pubblicato online: 13 Apr 2018
Pagine: 817 - 820

Astratto

Abstract

Background: Portal vein embolization (PVE) is a common procedure to induce hypertrophy of the remnant liver (RL) before major hepatectomy. Objective: Evaluate increased RL volume after PVE based on CT volumetric measurement. Methods: Multi-detector computed tomography (MDCT) was used to measure hepatic volumetric measurement, including total liver volume and RL volumes of pre- and post-PVE. Complications were recorded from PVE and from three-month after post-extended hepatectomy liver dysfunction. Result and conclusion: There was a 10% increase in RL volume. Mean days between CT and PVE were 20 days. No major complications from PVE were observed.

Parole chiave

  • Portal vein embolization
  • volume of remnant liver
  • extended hepatectomy
  • multidetector CT
  • CT volumetric measurement
Accesso libero

Post-antibiotic and post-antibiotic sub-MIC effects of gentamicin, sophoraflavanone G, and their combination against a clinical isolate of Staphylococcus aureus

Pubblicato online: 13 Apr 2018
Pagine: 821 - 826

Astratto

Abstract

Background: Post-antibiotic effect (PAE) defines the potential of a drug to delay re-growth of a bacterial population after short-term exposure and removal of a drug. Determination of the PAE is recommended in preclinical evaluation of all new antimicrobial agents, because it influences optimal antimicrobial dosing intervals. Objective: Evaluate the PAE and PA-SME of gentamicin and sophoraflavanone G against Staphylococcus aureus (S. aureus) itself and in combination. Methods: A spectrophotometric method was used to determine the PAE and PA-SME. Results: Sophoraflavanone G and gentamicin, showed considerable PAE and PA-SME at the tested concentrations against S. aureus. The increased duration of PAE caused by sophoraflavanone G and gentamicin was dosedependent. In addition, sophoraflavanone G at sub-MIC concentrations enhanced the PAE and PA-SME of gentamicin in a dose-dependent manner. The highest enhancing effect was observed for gentamicin at the synergistic MIC and 1/2 the synergistic MIC levels against S. aureus 0.03 μg/mL (30 ng/mL) of sophoraflavanone G (with PAE=55 minutes). It enhanced the post-antibiotic sub-MIC effect (PA-SME) duration of gentamicin at concentrations of 4 μg/mL from 15 minutes to 80 minutes (a six-fold increase). Conclusion: Sophoraflavanone G is promising for the preparation of an effective therapeutic formulation against gentamicin-resistant S. aureus.

Parole chiave

  • Gentamicin
  • post-antibiotic effect
  • sophoraflavanone G
  • Staphylococcus aureus
Accesso libero

Vascular repair is vulnerable to renal regeneration in early stage of diabetic nephropathy

Pubblicato online: 13 Apr 2018
Pagine: 827 - 828

Astratto

Pianifica la tua conferenza remota con Sciendo