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Jeong YJ, Park JS, Kim HW, Min J, Ko Y, Oh JY, Lee EH, Yang B, Ahn JH, Kim JW, Hwang YI, Park KJ, Lee SS, Kim JS, Koo HK. Characteristics of subclinical tuberculosis compared to active symptomatic tuberculosis using nationwide registry cohort in Korea: prospective cohort study. Front Public Health 2023; 11:1275125. [PMID: 38125851 PMCID: PMC10732352 DOI: 10.3389/fpubh.2023.1275125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Objective The clinical manifestations of tuberculosis (TB) range from asymptomatic to disseminated depending on the microbiological and immunological status, making the diagnosis challenging. To improve our understanding of the disease progression mechanism, we aimed to identify the characteristics of subclinical TB and important predictors of symptom development. Methods From July 2018 to June 2019, we systemically collected data from the National Surveillance System of South Korea on patients with pulmonary TB, and compared the characteristics of subclinical and active symptomatic TB patients. Results A total of 4,636 patients with pulmonary TB were included, and the prevalence of subclinical TB was 37.1% (1,720/4,636). In subclinical TB patients, the positivity rates of acid-fast bacilli (AFB) smear and culture were 16.2 and 50.2%, respectively. Subclinical TB patients were younger (55.6 ± 19.2 vs. 60.7 ± 19.5, P < 0.001), had a higher body mass index (21.7 ± 3.1 vs. 21.0 ± 3.5, P < 0.001), less under Medicaid support, and had lower rates of chronic lung disease, AFB smear and culture positivity, and bilateral disease. Regarding the characteristic differences of individual TB-related symptoms, age was positively associated with dyspnoea and general weakness but negatively associated with chest pain, haemoptysis, and weight loss. Male patients were more prone to weight loss. Chronic lung disease was related to symptoms including cough/phlegm, dyspnoea, and haemoptysis, while autoimmune diseases were associated with fever and weight loss. Conclusions The development of TB-related symptoms was associated with microbiological burden and clinical characteristics including underlying comorbidities, which should be evaluated carefully.
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Affiliation(s)
- Yun-Jeong Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Seuk Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Hyung Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jee Youn Oh
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Hye Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Joong Hyun Ahn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Yong Il Hwang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Kwang Joo Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ju Sang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Wong NS, Chan DPC, Chan CP, Poon CM, Lee SS. Community burden of hepatitis A infection and risk of transmission in Hong Kong. Hong Kong Med J 2023; 29 Suppl 7:41-46. [PMID: 38148657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Affiliation(s)
- N S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C P Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C M Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
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Jang BG, Huh KH, Yeom HG, Kang JH, Kim JE, Yoon HJ, Yi WJ, Heo MS, Lee SS. Differentiation between Chondrosarcoma and Synovial Chondromatosis of the Temporomandibular Joint Using CT and MR Imaging. AJNR Am J Neuroradiol 2023; 44:1176-1183. [PMID: 37652584 PMCID: PMC10549951 DOI: 10.3174/ajnr.a7980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND AND PURPOSE Chondrosarcoma and synovial chondromatosis of the temporomandibular joint share overlapping clinical and histopathologic features. We aimed to identify CT and MR imaging features to differentiate chondrosarcoma from synovial chondromatosis of the temporomandibular joint. MATERIALS AND METHODS The CT and MR images of 12 and 35 patients with histopathologically confirmed chondrosarcoma and synovial chondromatosis of the temporomandibular joint, respectively, were retrospectively reviewed. Imaging features including lesion size, center, enhancement, destruction/sclerosis of surrounding bone, infiltration into the tendon of the lateral pterygoid muscle, calcification, periosteal reaction, and osteophyte formation were assessed. A comparison between chondrosarcoma and synovial chondromatosis was performed with a Student t test for quantitative variables and the Fisher exact test or linear-by-linear association test for qualitative variables. Receiver operating characteristic analysis was performed to determine the diagnostic performance for differentiation of chondrosarcoma and synovial chondromatosis based on a composite score obtained by assigning 1 point for each of 9 imaging features. RESULTS High-risk imaging features for chondrosarcoma were the following: lesion centered on the mandibular condyle, destruction of the mandibular condyle, no destruction/sclerosis of the articular eminence/glenoid fossa, infiltration into the tendon of the lateral pterygoid muscle, absent or stippled calcification, periosteal reaction, internal enhancement, and size of ≥30.5 mm. The best cutoff value to discriminate chondrosarcoma from synovial chondromatosis was the presence of any 4 of these high-risk imaging features, with an area under the curve of 0.986 and an accuracy of 95.8%. CONCLUSIONS CT and MR imaging features can distinguish chondrosarcoma from synovial chondromatosis of the temporomandibular joint with improved diagnostic performance when a subcombination of 9 imaging features is used.
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Affiliation(s)
- B G Jang
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - K H Huh
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - H G Yeom
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute (H.G.Y.), School of Dentistry, Wonkwang University, Iksan, Korea
| | - J H Kang
- Department of Oral and Maxillofacial Radiology (J.H.K.), Seoul National University Dental Hospital, Seoul, Korea
| | - J E Kim
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - H J Yoon
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - W J Yi
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - M S Heo
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - S S Lee
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
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Min J, Kim JS, Kim HW, Ko Y, Oh JY, Jeong YJ, Lee EH, Yang B, Lee KM, Ahn JH, Kim JW, Hwang YI, Lee SS, Park JS, Koo HK. Effects of underweight and overweight on mortality in patients with pulmonary tuberculosis. Front Public Health 2023; 11:1236099. [PMID: 37794889 PMCID: PMC10546415 DOI: 10.3389/fpubh.2023.1236099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
Background Poor nutrition increases disease severity and mortality in patients with tuberculosis (TB). There are gaps in our understanding of the effects of being underweight or overweight on TB in relation to sex. Methods We generated a nationwide TB registry database and assessed the effects of body mass index (BMI) on mortality in patients with pulmonary TB. The cause of death was further classified as TB-related or non-TB-related deaths. First, logistic regression analysis was performed to assess the association between BMI (a continuous variable) and mortality, and subgroup analyses of the multivariable logistic regression model were performed separately in male and female patients. Second, we categorized BMI into three groups: underweight, normal weight, and overweight, and assessed the impact of being underweight or overweight on mortality with reference to normal weight. Results Among 9,721 patients with pulmonary TB, the mean BMI was 21.3 ± 3.4; 1,927 (19.8%) were underweight, and 2,829 (29.1%) were overweight. In multivariable logistic regression analysis, mortality was significantly increased with the decrement of BMI (adjusted odds ratio [aOR] = 0.893, 95% confidence interval [CI] = 0.875-0.911). In subgroup analyses, underweight patients had significantly higher odds of mortality, especially TB-related deaths (aOR = 2.057, 95% CI = 1.546-2.735). The association with mortality and male patients was higher (aOR = 2.078, 95% CI = 1.717-2.514), compared with female patients (aOR = 1.724, 95% CI = 1.332-2.231). Being overweight had a significant protective effect against TB-related death only in females (aOR = 0.500, 95% CI = 0.268-0.934), whereas its effect on non-TB-related death was observed only in males (aOR = 0.739, 95% CI = 0.587-0.930). Conclusion Being underweight was linked to high mortality, whereas being overweight had beneficial effects in patients with pulmonary TB.
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Affiliation(s)
- Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ju Sang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jee Youn Oh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yun-Jeong Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Eun Hye Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Ki Man Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Joong Hyun Ahn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Yong Il Hwang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Sung Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Jae Seuk Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Jeong YJ, Park JS, Kim HW, Min J, Ko Y, Oh JY, Lee EH, Yang B, Lee MK, Kim YS, Chang JH, Jegal Y, Lee SS, Kim JS, Koo HK. Deaths from tuberculosis: differences between tuberculosis-related and non-tuberculosis-related deaths. Front Public Health 2023; 11:1207284. [PMID: 37719730 PMCID: PMC10502314 DOI: 10.3389/fpubh.2023.1207284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Objective Tuberculosis (TB) is a major cause of ill health and one of the leading causes of death worldwide. The first step in developing strategies to reduce TB mortality is to identify the direct causes of death in patients with TB and the risk factors for each cause. Methods Data on patients with TB systemically collected from the National Surveillance System of South Korea from January 2019 to December 2020 were included in this study. We analyzed the clinical characteristics associated with TB and non-TB-related deaths, including TB-related symptoms, comorbidities, and radiographic and microbiological findings. Results Of the total of 12,340 patients with TB, 61% were males with a mean age of 61.3 years. During the follow-up period, the overall mortality rate was 10.6%, with TB-related deaths accounting for 21.3% of all TB deaths. The median survival time in the TB-related death group was 22 days. TB-related death was associated with older age, lower body mass index (BMI), dyspnea, fever, general weakness, bilateral radiographic patterns, and acid-fast bacilli (AFB)-positive smears. Non-TB-related deaths were associated with older age, male sex, lower BMI, comorbidities of heart, liver, kidney, and central nervous system (CNS) diseases, CNS TB involvement, the presence of dyspnea, general weakness, and bilateral radiographic patterns. Conclusion Patients with high-risk TB must be identified through cause-specific mortality analysis, and the mortality rate must be reduced through intensive monitoring of patients with a high TB burden and comorbidities.
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Affiliation(s)
- Yun-Jeong Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Seuk Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Hyung Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jee Youn Oh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Hye Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, School of Medicine, Pusan National University Yangsan Hospital, Pusan National University and Research Institute of Convergence Biomedical Science and Technology, Busan, Republic of Korea
| | - Jung Hyun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mokdong Hospital, Ewha Women's University, Seoul, Republic of Korea
| | - Yangjin Jegal
- Division of Pulmonology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Sung Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ju Sang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Jeong YJ, Kang JY, Kim HW, Min J, Ko Y, Oh JY, Kang HH, Lim SC, Hwang HG, Shin KC, Lee HB, Kim JS, Park JS, Lee SS, Koo HK. Association of Underlying Comorbidities and Sites of tuberculosis: an analysis using surveillance data. BMC Pulm Med 2022; 22:417. [DOI: 10.1186/s12890-022-02224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) is a highly heterogeneous disease that can affect any organ. Extrapulmonary TB (EPTB) is more difficult to diagnose due to various clinical presentations. Depending on the characteristics of the patient, the involved site of TB may vary. However, data on clinical characteristics of EPTB are inconsistent and insufficient. This study aimed to identify the characteristics of patients with pulmonary TB (PTB) and EPTB and describe characteristic differences for each involved site.
Methods
We systemically collected data of TB patients included in the national surveillance system in South Korea from July 2018 to June 2019 and compared the characteristics of patients with EPTB with that of PTB.
Results
A total of 7674 patients with a mean age of 60.9 years were included. Among them, 6038 (78.7%) patients were diagnosed with PTB and 1636 (21.3%) with EPTB. In PTB group, the mean age (61.7 ± 18.7 vs. 57.8 ± 19.9) and proportion of male sex (63.3% vs. 50.1%) were higher, but the body mass index was lower (21.2 ± 3.4 vs. 22.7 ± 3.5) than that of the EPTB group. Prevalence of diabetes (20.5% vs. 16.9%) and chronic lung disease (5.1% vs. 2.9%) were higher in PTB group, meanwhile, those of chronic kidney disease (CKD) (2.7% vs. 5.4%) and long-term steroid use (0.4% vs. 1.0%) were higher in EPTB group. Abdominal TB was more prevalent in patients with chronic liver disease (odds ratio [OR]: 2.69, 95% CI: 1.52–4.74), and urogenital TB was more prevalent in patients with CKD (OR: 2.75, 95% CI: 1.08–6.99).
Conclusions
We found that underlying comorbidities were closely associated with the location of TB development, and therefore, the possibility of EPTB should be carefully evaluated while monitoring for underlying disease in TB-endemic areas.
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Petersen E, Zumla A, Hui DS, Blumberg L, Valdoleiros SR, Amao L, Ntoumi F, Asogun D, Simonsen L, Haider N, Traore T, Kapata N, Dar O, Nachega J, Abbara A, Al Balushi A, Kock R, Maeurer M, Lee SS, Lucey DR, Ippolito G, Koopmans M. Vaccination for monkeypox prevention in persons with high-risk sexual behaviours to control on-going outbreak of monkeypox virus clade 3. Int J Infect Dis 2022; 122:569-571. [PMID: 35788415 PMCID: PMC9534076 DOI: 10.1016/j.ijid.2022.06.047] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- E Petersen
- Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark; European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland.
| | - A Zumla
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - D S Hui
- Department of Medicine & Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - L Blumberg
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Veterinary Science, University of Pretoria, South Africa
| | - S R Valdoleiros
- European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland; Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - L Amao
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - F Ntoumi
- Congolese Foundation for Medical Research, Brazzaville, Republic of Congo; Institute of Tropical Medicine, University of Tübingen, Germany
| | - D Asogun
- Irrua Specialized Teaching Hospital, Irrua, Nigeria
| | - L Simonsen
- PandemiX Center, Department of Science and Environment, Roskilde University, Denmark
| | - N Haider
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, United Kingdom
| | - T Traore
- Emergency Preparedness and Response Programme, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - N Kapata
- National Public Health Institute, Ministry of Health, Lusaka, Zambia
| | - O Dar
- Chatham House and UK Public health security agency, London, UK
| | - J Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA; Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - A Abbara
- UK Syria Public Health Network, and Department of Infection, Faculty of Medicine, Imperial College, London, UK
| | - A Al Balushi
- Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - R Kock
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - M Maeurer
- ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Lisbon, Portugal; Medizinische Klinik, Johannes Gutenberg University Mainz, Germany
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, 206 Postgraduate Education Centre, Prince of Wales Hospital, Hong Kong, China
| | - D R Lucey
- Daniel R. Lucey, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - G Ippolito
- Guiseppe Ippolito: Ministry of Health, Rome, Italy.
| | - Mpg Koopmans
- Viroscience Department, Erasmus Medical Center, Rotterdam, Netherlands; Pandemic and Disaster Preparedness Centre, Rotterdam, Netherlands
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Tam G, Wong NS, Lee SS. Serial surveys of Hong Kong medical students regarding attitudes towards HIV/AIDS from 2007 to 2017. Hong Kong Med J 2022; 28:223-229. [PMID: 35765732 DOI: 10.12809/hkmj208838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION With widespread adoption of antiretroviral therapy, human immunodeficiency virus (HIV) epidemiology has changed since the late 2000s. Accordingly, attitudes towards the disease may also have changed. Because medical students are future physicians, their attitudes have important implications in access to care among patients with HIV/acquired immunodeficiency syndrome (AIDS). Here, we performed a survey to compare medical students' attitudes towards HIV/AIDS between the late 2000s (2007-2010) and middle 2010s (2014- 2017). METHODS From 2007 to 2010, we surveyed three cohorts of medical students at the end of clinical training to assess their attitudes towards HIV/AIDS. From 2014 to 2017, we surveyed three additional cohorts of medical students at the end of clinical training to compare changes in attitudes towards HIV/AIDS between the late 2000s and middle 2010s. Each set of three cohorts was grouped together to maximise sample size; comparisons were performed between the 2007-2010 and 2014-2017 cohorts. RESULTS From 2007 to 2010, 546 medical students were surveyed; from 2014 to 2017, 504 students were surveyed. Compared with students in the late 2000s, significantly fewer students in the mid-2010s initially encountered patients with HIV during attachment to an HIV clinic or preferred to avoid work in a field involving HIV/AIDS; significantly more students planned to specialise in HIV medicine. Student willingness to provide HIV care remained similar over time: approximately 78% of students were willing to provide care in each grouped cohort. CONCLUSION Although medical students had more positive attitudes towards HIV/AIDS, their willingness to provide HIV care did not change between the late 2000s and middle 2010s.
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Affiliation(s)
- G Tam
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - N S Wong
- Department of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - S S Lee
- Department of Medicine, The Chinese University of Hong Kong, Hong Kong
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Affiliation(s)
- Greta Tam
- Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - SS Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong
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McNamara PJ, Lee SS, Stanford AH, Bischoff AR, Rios DR, Giesinger RE. Methodological rigor in both targeted neonatal echocardiography training and study design are essential to understanding the impact of ultrasound on neonatal pain. J Neonatal Perinatal Med 2021; 15:7-9. [PMID: 34957953 DOI: 10.3233/npm-210898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P J McNamara
- Department of Pediatrics, University of Iowa, Iowa City, USA.,Department of Internal Medicine, University of Iowa, Iowa City, USA
| | - S S Lee
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - A H Stanford
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - A R Bischoff
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - D R Rios
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - R E Giesinger
- Department of Pediatrics, University of Iowa, Iowa City, USA
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11
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Petersen E, Lee SS, Blumberg L, Kramer LD, Obiero C, Al-Abri S, Abubakar A, Pinto TCA, Yapi BR, Tambyah PA, Holmes AH. International Journal of Infectious Diseases: from the past quarter-century to the next. Int J Infect Dis 2021; 109:36-37. [PMID: 34217873 PMCID: PMC7613580 DOI: 10.1016/j.ijid.2021.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- E Petersen
- International Society for Infectious Diseases, Boston, United States.; Institute for Clinical Medicine, Aarhus University, Denmark..
| | - S S Lee
- International Society for Infectious Diseases, Boston, United States.; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - L Blumberg
- International Society for Infectious Diseases, Boston, United States.; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2195, South Africa
| | - L D Kramer
- International Society for Infectious Diseases, Boston, United States.; School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - C Obiero
- International Society for Infectious Diseases, Boston, United States.; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Global Health, University of Amsterdam, Faculty of Medicine, Amsterdam, Noord-Holland, The Netherlands
| | - S Al-Abri
- International Society for Infectious Diseases, Boston, United States.; Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - A Abubakar
- International Society for Infectious Diseases, Boston, United States.; Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - T C A Pinto
- International Society for Infectious Diseases, Boston, United States.; Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Brazil
| | - B R Yapi
- International Society for Infectious Diseases, Boston, United States.; Centre d'Entomologie Médicale et Vétérinaire, CEMV - Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - P A Tambyah
- International Society for Infectious Diseases, Boston, United States.; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - A H Holmes
- International Society for Infectious Diseases, Boston, United States.; Department of Infectious Disease, Faculty of Medicine, Imperial College London, United Kingdom
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12
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Lau TC, Chong YS, Loo BKG, Ganapathy S, Ho JMD, Lee SS, Yeo J, Samarasekera DD, Goh DLM. Adapting undergraduate paediatric medical education to the challenges of COVID-19 pandemic: perspective of NUS Medicine. Singapore Med J 2021. [DOI: 10.11622/smedj.2021075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
COVID-19 significantly impacted the teaching-learning-assessment activities in many medical schools. In this article, we discuss the impact of COVID-19 on the Yong Loo Lin School of Medicine, National University of Singapore, focusing on paediatric training and the adaptations of the system and the people. The school developed strategies to promptly disseminate information and safety measures to protect all its staff and students. By leveraging on the school’s infrastructure for technology-enabled learning, good-quality medical training and reliable assessments were able to be carried out swiftly. The paediatric curriculum was crafted based on these principles, and it provided distance-based learning with live and interactive sessions to teach core clinical skills. The faculty also tapped on standardised patients to provide consistent and life-like scenarios. Measures were implemented to minimise challenges with technology-enabled learning. Collectively, efforts from the staff, support from the leadership and students’ adaptations tremendously helped to ease the transition.
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13
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Petersen E, Schlagenhauf P, Lee SS, Blumberg L, Kramer L, Obiero C, Al-Abri S, Cunha F, Petrosillo N, Di Caro A, Gautret P, Shafi S, Abubakar A, Pinto TCA, Memish Z, Hui DSC, Zumla A, Grobusch MP. Mandatory immunization against SARS-CoV-2 of athletes, companions and supporters for the Tokyo Olympics. Int J Infect Dis 2021; 108:156-158. [PMID: 34089881 PMCID: PMC8170875 DOI: 10.1016/j.ijid.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- E Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; International Society for Infectious Diseases, Boston, United States; Institute for Clinical Medicine, Aarhus University, Denmark; European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France.
| | - P Schlagenhauf
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Institute for Epidemiology, Biostatistics and Prevention, Zürich, Switzerland
| | - S S Lee
- International Society for Infectious Diseases, Boston, United States; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - L Blumberg
- International Society for Infectious Diseases, Boston, United States; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2195, South Africa
| | - L Kramer
- International Society for Infectious Diseases, Boston, United States; School of Public Health, State University of New York at Albany, Albany, NY, United States
| | - C Obiero
- International Society for Infectious Diseases, Boston, United States; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Global Health, University of Amsterdam, Faculty of Medicine, Amsterdam, Noord-Holland, The Netherlands
| | - S Al-Abri
- International Society for Infectious Diseases, Boston, United States; Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - F Cunha
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; Department of Infectious Diseases, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - N Petrosillo
- European Society for Clinical Microbiology and Infectious Diseases (ESCMID), International Affairs Subcommittee, Basel, Switzerland; Clinical and Research Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani', Rome, Italy
| | - A Di Caro
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; Clinical and Research Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani', Rome, Italy
| | - P Gautret
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; IHU-Méditerranée Infection, Marseille Cedex 05, France
| | - S Shafi
- Mass Gatherings and Global Health Network, London, United Kingdom
| | - A Abubakar
- International Society for Infectious Diseases, Boston, United States; Department of Community Medicine, Ahmadu Bello University Zaria, Nigeria
| | - T C A Pinto
- International Society for Infectious Diseases, Boston, United States; Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Brazil
| | - Z Memish
- Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - D S C Hui
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - A Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - M P Grobusch
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, The Netherlands
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14
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Chan CP, Lee SS, Wong NS. Adherence of nurses to annual seasonal influenza vaccination over a 5-year period. J Hosp Infect 2021; 112:6-15. [PMID: 33640372 DOI: 10.1016/j.jhin.2021.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of influenza infection with associated nosocomial transmission. Sustained adherence to seasonal influenza vaccination uptake each year is important in epidemic control. AIM To assess the adherence of nurses to seasonal influenza vaccination over 5 years and its associated factors. METHODS A cross-sectional study was conducted among nurses after the winter influenza season in Hong Kong in March 2019. Based on influenza vaccine uptake rates in the 2014/15-2018/19 seasons, respondents were stratified into three groups: 'full adherence' (vaccine uptake in five seasons), 'partial adherence' (vaccine uptake in one to four seasons) and 'non-adherence' (no vaccine uptake). Stepwise multi-variable logistic regression was performed to determine the associations between adherence to annual influenza vaccination, respondents' characteristics and considerations for vaccination. FINDINGS Of 1306 nurses recruited, the majority were female (88%) with a median age of 36 years (interquartile range 30-46 years). The influenza vaccination uptake rate increased from 36% in the 2014/15 season to 47% in the 2018/19 season. After stratification, 39%, 40% and 21% of respondents were non-adherers, partial adherers and full adherers, respectively. Full adherence was significantly associated with female gender [adjusted odds ratio (aOR) 0.60], age ≥40 years (aOR 2.92), long-term care facility nurse (aOR 0.56), uptake during studentship (aOR 3.83), local prevalence of seasonal influenza (aOR 0.51) and expert opinion (aOR 4.04). CONCLUSIONS A limited proportion of nurses were fully adherent to seasonal influenza vaccination. Monitoring adherence, improving access to vaccines, and interventions targeting less-adherent HCWs are crucial.
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Affiliation(s)
- C P Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - N S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
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15
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Ghoshani M, Sánchez EH, Lee SS, Singh G, Yaacoub N, Peddis D, Mozaffari M, Binns C, De Toro JA, Normile PS. On the detection of surface spin freezing in iron oxide nanoparticles and its long-term evolution under ambient oxidation. Nanotechnology 2021; 32:065704. [PMID: 33108770 DOI: 10.1088/1361-6528/abc50a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Exchange bias (EB) effects linked to surface spin freezing (SSF) are commonly found in iron oxide nanoparticles, while signatures of SSF in low-field temperature-dependent magnetization curves have been much less frequently reported. Here, we present magnetic properties of dense assemblies of similar-sized (∼8 nm diameter) particles synthesized by a magnetite (sample S1) and a maghemite (sample S2) method, and the influence of long-term (4 year) sample aging under ambient conditions on these properties. The size of the EB field of the different sample (fresh or aged) states is found to correlate with (a) whether a low-temperature hump feature signaling the SSF transition is detected in out-of-phase ac susceptibility or zero-field-cooled (ZFC) dc magnetization recorded at low field and with (b) the prominence of irreversibility between FC and ZFC curves recorded at high field. Sample S1 displays a lower magnetization than S2, and it is in S1 where the largest SSF effects are found. These effects are significantly weakened by aging but remain larger than the SSF effects in S2, where the influence of aging is considerably smaller. A non-saturating component due to spin disorder in S1 also weakens with aging, accompanied by, we infer, an increase in the superspin and the radius of the ordered nanoparticle cores. X-ray diffraction and Mössbauer spectroscopy provide indication of maghemite-like stoichiometry in both aged samples as well as thicker disordered particle shells in aged-S1 relative to aged-S2 (crystallographically-disordered and spin-disordered according to diffraction and Mössbauer, respectively). The pronounced diminution in SSF effects with aging in S1 is attributed to a (long-term) transition, caused by ambient oxidation, from magnetite-like to maghemite-like stoichiometry, and a concomitant softening of the spin-disordered shell anisotropy. We assess the impact of this anisotropy on the nature of the blocking of the nanoparticle superspins.
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Affiliation(s)
- M Ghoshani
- Department of Physics, Faculty of Science, University of Isfahan, Isfahan 81746-73441, Iran
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - E H Sánchez
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - S S Lee
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, Singapore 138669, Singapore
| | - G Singh
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, NSW 2008, Australia
| | - N Yaacoub
- Institut des Molécules et Materiaux du Mans, CNRS UMR-6283, Université du Maine, F-72085 Le Mans, France
| | - D Peddis
- Istituto di Struttura della Materia, CNR, I-00015 Monterotondo Scalo (RM), Italy
- Dipartimento di Chimica e Chimica Industriale (DCCI), Università of Genova, Via Dopdecanes, I-16134, Genova, Italy
| | - M Mozaffari
- Department of Physics, Faculty of Science, University of Isfahan, Isfahan 81746-73441, Iran
| | - C Binns
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - J A De Toro
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - P S Normile
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
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16
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Min J, Kim HW, Koo HK, Ko Y, Oh JY, Kim J, Yang J, Kwon Y, Park YJ, Kang JY, Lee SS, Park JS, Kim JS. Impact of COVID-19 Pandemic on the National PPM Tuberculosis Control Project in Korea: the Korean PPM Monitoring Database between July 2019 and June 2020. J Korean Med Sci 2020; 35:e388. [PMID: 33169559 PMCID: PMC7653169 DOI: 10.3346/jkms.2020.35.e388] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/22/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems and endangered the control and prevention of tuberculosis (TB). We investigated the nationwide effects of COVID-19 on the national Public-Private Mix (PPM) TB control project in Korea, using monitoring indicators from the Korean PPM monitoring database. METHODS The Korean PPM monitoring database includes data from patients registered at PPM hospitals throughout the country. Data of six monitoring indicators for active TB cases updated between July 2019 and June 2020 were collected. The data of each cohort throughout the country and in Daegu-Gyeongbuk, Seoul Metropolitan Area, and Jeonnam-Jeonbuk were collated to provide nationwide data. The data were compared using the χ² test for trend to evaluate quarterly trends of each monitoring indicator at the national level and in the prespecified regions. RESULTS Test coverages of sputum smear (P = 0.622) and culture (P = 0.815), drug susceptibility test (P = 0.750), and adherence rate to initial standard treatment (P = 0.901) at the national level were not significantly different during the study period. The rate of loss to follow-up among TB cases at the national level was not significantly different (P = 0.088); however, the treatment success rate among the smear-positive drug-susceptible pulmonary TB cohort at the national level significantly decreased, from 90.6% to 84.1% (P < 0.001). Treatment success rate in the Seoul metropolitan area also significantly decreased during the study period, from 89.4% to 84.5% (P = 0.006). CONCLUSION Our study showed that initial TB management during the COVID-19 pandemic was properly administered under the PPM project in Korea. However, our study cannot confirm or conclude a decreased treatment success rate after the COVID-19 pandemic due to limited data.
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Affiliation(s)
- Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyung Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jee Youn Oh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jaetae Kim
- Division of Tuberculosis Prevention and Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Jiyeon Yang
- Division of Tuberculosis Prevention and Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Yunhyung Kwon
- Division of Tuberculosis Prevention and Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Young Joon Park
- Director for Epidemiological Investigation Analysis, Director General for Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ji Young Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Seuk Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ju Sang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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To KW, Lee SS. A review of reported cases of HIV pre-exposure prophylaxis failure with resultant breakthrough HIV infections. HIV Med 2020; 22:75-82. [PMID: 33140556 DOI: 10.1111/hiv.12989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Early randomized controlled trials (RCTs) have confirmed high efficacy of pre-exposure prophylaxis (PrEP) for preventing HIV infection in men who have sex with men (MSM) with high HIV exposure risk. Nevertheless, some PrEP failure cases have been reported despite adequate drug adherence. This review aims to summarize the common features of PrEP failure cases and discuss the implications of upscaling PrEP programmes. METHODS A search based on articles and clinical trials was conducted through Medline and OVID, with keywords for accessing publications reporting 'true' PrEP failure in the presence of documented adherence to daily regimen of co-formulated tenofovir disoproxil fumarate/emtricitabone. RESULTS Ten cases of 'true' PrEP failure were identified, all of which were preceded by continued practice of condomless anal sex, despite documented adherence. Dried blood spot and/or hair analyses provided supporting evidence of adherence in eight cases. There was strong association of PrEP failure with recurrent or multiple sexually transmitted diseases and infection with resistant HIV viruses. Seroconversion was usually atypical or delayed because of significantly suppressed viral load, making diagnosis a clinical challenge. DISCUSSION Although it is uncommon, 'true' PrEP failure can occur in a real-world situation, contrary to the outcome of early RCTs. Failure to identify HIV infection while on PrEP can potentially lead to the emergence of drug-resistant virus. To achieve effective HIV prevention, PrEP programmes should emphasize safer sexual practice in addition to drug adherence. Early identification of PrEP failure is crucial, which requires the development of highly sensitive assays and their clinical application.
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Affiliation(s)
- K W To
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
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18
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Ng PCI, Chan JYW, Leung RKK, Li J, Ren Z, Chan AWH, Xu Y, Lee SS, Wang R, Ji X, Zheng J, Chan DPC, Yew WW, Lee SMY. Role of oxidative stress in clofazimine-induced cardiac dysfunction in a zebrafish model. Biomed Pharmacother 2020; 132:110749. [PMID: 33017766 DOI: 10.1016/j.biopha.2020.110749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/19/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Clofazimine (CFZ), a riminophenazine, is now commonly used in the treatment of multidrug-resistant tuberculosis. However, its use may be potentially associated with cardiac dysfunction in some individuals. In this study, the zebrafish heart, by merit of its developmental and genetic characteristics being in homology with that of human, was chosen as an animal model for evaluation of such dysfunction. METHODS Morphological and physiological parameters were used to assess cardiac dysfunction. Transcriptome analysis was performed, followed by validation with real-time quantitative PCR, for delineation of the relevant genomics. RESULTS Exposure of 2 dpf zebrafish to 4 mg/L CFZ for 2 days, adversely affected cardiac functions including significant decreases in HR, SV, CO, and FS, with observable pathophysiological developments of pericardial effusion and blood accumulation in the heart, in comparison with the control group. In addition, genes which respond to xenobiotic stimulus, related to oxygen transport, glutathione metabolism and extracellular matrix -receptor interactions, were significantly enriched among the differentially up-regulated genes. Antioxidant response element motif was enriched in the 5000 base pair upstream regions of the differentially expressed genes. Co-administration of N-acetylcysteine was shown to protect zebrafish against the development of CFZ-induced cardiac dysfunction. CONCLUSIONS This study suggests an important role of oxidative stress as a major pathogenetic mechanism of riminophenazine-induced cardiac dysfunction.
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Affiliation(s)
- Phoebe C I Ng
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Judy Y W Chan
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Ross K K Leung
- School of Public Health, University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - J Li
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Z Ren
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Anthony W H Chan
- Department of Anatomical & Cellular Pathology, Chinese University of Hong Kong, Hong Kong, China
| | - Y Xu
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - R Wang
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Xia Ji
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Jun Zheng
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Denise P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China.
| | - W W Yew
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China.
| | - Simon M Y Lee
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China.
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19
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Chakraborty C, Sharma AR, Sharma G, Bhattacharya M, Lee SS. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options. Eur Rev Med Pharmacol Sci 2020; 24:4016-4026. [PMID: 32329877 DOI: 10.26355/eurrev_202004_20871] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
SARS-CoV-2 is responsible for the outbreak of severe respiratory illness (COVID-19) in Wuhan City, China and is now spreading rapidly throughout the world. The prompt outbreak of COVID-19 and its quick spread without any controllable measure defines the severity of the situation. In this crisis, a collective pool of knowledge about the advancement of clinical diagnostic and management for COVID-19 is a prerequisite. Here, we summarize all the available updates on the multidisciplinary approaches for the advancement of diagnosis and proposed therapeutic strategies for COVID-19. Moreover, the review discusses different aspects of the COVID-19, including its epidemiology; incubation period; the general clinical features of patients; the clinical features of intensive care unit (ICU) patients; SARS-CoV-2 infection in the presence of co-morbid diseases and the clinical features of pediatric patients infected with the SARS-CoV-2. Advances in various diagnostic approaches, such as the use of real-time polymerase chain reaction (RT-PCR), chest radiography, and computed tomography (CT) imaging; and other modern diagnostic methods, for this infection have been highlighted. However, due to the unavailability of adequate evidence, presently there are no officially approved drugs or vaccines available against SARS-CoV-2. Additionally, we have discussed various therapeutic strategies for COVID-19 under different categories, like the possible treatment plans with drug (antiviral drugs and anti-cytokines) therapy for disease prevention. Lastly, potentials candidates for the vaccines against SARS-CoV-2 infection have been described. Collectively, the review provides an overview of the SARS-CoV-2 infection outbreak along with the recent advancements and strategies for diagnosis and therapy of COVID-19.
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Affiliation(s)
- C Chakraborty
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University-Chuncheon Sacred Heart Hospital, Chuncheon-si, Gangwon-do, Korea.
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Kim DH, Kim HJ, Koo HW, Bae W, Park SH, Koo HK, Park HK, Lee SS, Kang HK. The Use of Inappropriate Antibiotics in Patients Admitted to Intensive Care Units with Nursing Home-Acquired Pneumonia at a Korean Teaching Hospital. Tuberc Respir Dis (Seoul) 2020; 83:81-88. [PMID: 31905435 PMCID: PMC6953496 DOI: 10.4046/trd.2019.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/07/2019] [Accepted: 05/23/2019] [Indexed: 11/24/2022] Open
Abstract
Background Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home–acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015–May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics–treated group than in the appropriate antibiotics–treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.
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Affiliation(s)
- Deok Hee Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Ha Jeong Kim
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hae Won Koo
- Department of Neurosurgery, Neuroscience, Radiosurgery and Adaptive Hybrid Neurosurgery Research Center, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Won Bae
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - So Hee Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hyeon Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hye Kyeong Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Sung Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hyung Koo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
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Lee SS, Kwan TH, Wong NS, Lee KCK, Chan DPC, Lam TTN, Lui GCY. Piloting a partially self-financed mode of human immunodeficiency virus pre-exposure prophylaxis delivery for men who have sex with men in Hong Kong. Hong Kong Med J 2019; 25:382-391. [PMID: 31619578 DOI: 10.12809/hkmj198030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg is a proven strategy for preventing human immunodeficiency virus (HIV) transmission in men who have sex with men (MSM). This study aimed to test the feasibility and acceptability of PrEP delivered at a pilot clinic for MSM in Hong Kong, where PrEP service is currently unavailable. METHODS Partially self-financed PrEP was provided to HIV-negative adult MSM with high behavioural risk of HIV transmission after excluding hepatitis B infection and renal insufficiency. Participants received daily TDF/FTC for 30 weeks at 13.3% of the drug cost. Adherence and behaviours were monitored through questionnaires while creatinine and HIV/STI (sexually transmitted infection) incidence were monitored with point-of-care and laboratory tests. Preference for continuing with PrEP was evaluated at the end of the prescription period. RESULTS Seventy-one PrEP-naïve MSM were included in the study, of whom 57 (80%) were retained at the end of 28 weeks. Satisfactory adherence and self-limiting adverse events were reported, while none of the participants contracted HIV. Risk compensation was observed, with an STI incidence of 3.17 per 100 person-years. At the end of the prescription period, a majority (89%) indicated interest in continuing with PrEP. Preference for PrEP was associated with age ≥28 years and peer influence (P=0.04), while stigma was a concern. Price was a deterrent to self-financed PrEP, and only half (51%) considered a monthly cost of ≤HK$500 (US$1=HK$7.8) as reasonable. CONCLUSIONS A partially self-financed mode of PrEP delivery is feasible with good retention in MSM in Hong Kong.
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Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - T H Kwan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - N S Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - T T N Lam
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G C Y Lui
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
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Kwok KO, Li KK, Lee SS, Chng PHY, Wei VWI, Ismail NH, Mosli N, Koh D, Lai A, Lim JW. Multi-centre study on cultural dimensions and perceived attitudes of nurses towards influenza vaccination uptake. J Hosp Infect 2018; 102:337-342. [PMID: 30500386 DOI: 10.1016/j.jhin.2018.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/21/2018] [Indexed: 11/16/2022]
Abstract
This study explored how cultural values affected Health Belief Model (HBM) components and the influenza vaccine uptake among nurses across three Asian populations using a survey conducted in 2017 (N = 3971). The vaccination coverages were 33.5% (Brunei), 35.6% (Hong Kong) and 69.5% (Singapore). Three HBM components (perceived susceptibility, perceived benefits and cues to action) were positively associated with vaccination. A direct negative link and an indirect positive link via HBM were observed between collectivism and vaccination, whereas a negative indirect link via HBM between power distance and vaccination was observed. Cultural values, notably collectivism, advanced HBM to study nurses' vaccination.
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Affiliation(s)
- K O Kwok
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
| | - K K Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - P H Y Chng
- Nursing Administration (Infection Control), Yishun Community Hospital, Singapore
| | - V W I Wei
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - N H Ismail
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam
| | - N Mosli
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam; NUS Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - A Lai
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam; PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | - J W Lim
- NUS Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Health for Life Center, Khoo Teck Puat Hospital (KTPH), Singapore
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Lee NJ, Shin JH, Lee SS, Park DH, Lee SK, Yoon HK. Transcatheter arterial embolization for iatrogenic bleeding after endoscopic ultrasound-guided pancreaticobiliary drainage. Diagn Interv Imaging 2018; 99:717-724. [PMID: 30033142 DOI: 10.1016/j.diii.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to report the incidence of massive bleeding after endoscopic ultrasound-guided transmural pancreaticobiliary drainage (EUS-TPBD) and the clinical outcomes in patients with this condition treated with transcatheter arterial embolization (TAE). PATIENTS AND METHODS We performed a 9-year retrospective analysis of 797 EUS-TPBD procedures (excluding gallbladder or pseudocysts) in 729 patients. Among them, twelve (12/729, 1.65%) patients were referred for TAE to manage active bleeding adjacent to the TPBD sites. There were 8 men and 4 women with a mean age of 66.1 years±13.4 (SD) (range: 45-89 years). The clinical and procedure data of these 12 patients were reviewed. RESULTS Thirteen TAE procedures in 12 patients were performed. The bleeding sites were the left hepatic artery (n=7), the right hepatic artery (n=3), the left gastric artery (n=1), the left accessory gastric artery (n=1) and gastroduodenal artery (n=1). TAE was performed with gelatin sponge particles (n=1), coil (n=1) and n-butyl-2 cyanoacrylate with/without coils (n=11), with technical and clinical success rates of 100% (13/13) and 85% (11/13), respectively. Re-bleeding following embolization with gelatin sponge particles occurred in one patient. Procedure-related ischemic hepatitis was observed in another patient with pancreatic cancer with portal vein involvement. CONCLUSION On the basis of our results, TAE using n-butyl-2 cyanoacrylate seems safe and effective for the treatment of bleeding after EUS-TPBD procedures. When the portal vein is compromised, TAE of the hepatic artery can cause ischemic liver damage.
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Affiliation(s)
- N J Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - J H Shin
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - S S Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D H Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S K Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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Lee SS, Lee CM, Kim TH, Kim JJ, Lee JM, Kim HJ, Ha CY, Kim HJ, Jung WT, Lee OJ, Kim DY. Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2018; 20:800-5. [PMID: 27155184 DOI: 10.5588/ijtld.15.0668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD). SETTING This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013. DESIGN Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group. RESULTS DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment. CONCLUSION DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.
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Affiliation(s)
- S S Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - C M Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - T H Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - J J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - J M Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - H J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - C Y Ha
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - H J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - W T Jung
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - O J Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - D Y Kim
- Department of Thoracic Surgery, Mokpo National Hospital, Mokpo, Republic of Korea
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Wong NS, Lee CK, Ng SC, Wong HK, Chan DPC, Lee SS. Prevalence of hepatitis C infection and its associated factors in healthy adults without identifiable route of transmission. J Viral Hepat 2018; 25:161-170. [PMID: 29032634 DOI: 10.1111/jvh.12804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022]
Abstract
While hepatitis C virus (HCV) infection is long known to be associated with parenteral exposure, the specific route of transmission is not identified in a proportion of infected patients. Taking blood donors as the surrogate of healthy adults in the community in Hong Kong, we identified 91 HCV-infected donors (≤0.02% positive rate) in 2014-2016, of whom 46 were recruited in a mixed-method study to examine their transmission routes. A majority (75%) of the recruited donors were HCV RNA positive, with the predominant subtypes being 1b and 6a. From the results of the structured self-administered questionnaire and in-depth interviews, only 14 (30%) recruited donors could be traced to past history of contaminated blood transfusion (n = 9) or injection drug use (n = 5). Case-control analyses with 3 different control groups were performed to examine factors associated with HCV infection in multivariable analyses. High-risk sexual behaviour, body piercing, intramuscular injection and vaccine inoculation abroad, having lived abroad for >3 months were significantly associated with HCV in donors with otherwise nonidentifiable source of infection. While the specific route of transmission cannot be established for each person, associations with multiple parenteral exposures outside Hong Kong were observed. The World Health Organization has advocated for the global elimination of HCV by 2030. With a high proportion of HCV-infected persons who are unaware of their infections, HCV elimination could be hard to achieve.
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Affiliation(s)
- N S Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - H K Wong
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Shaheen AA, Al-Mattooq M, Yazdanfar S, Burak KW, Swain MG, Congly SE, Borman MA, Lee SS, Myers RP, Coffin CS. Letter: lipid-lowering effect of tenofovir disoproxil fumarate in chronic hepatitis B-more evidence is needed. Authors' reply. Aliment Pharmacol Ther 2017; 46:770-771. [PMID: 28901569 DOI: 10.1111/apt.14282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- A A Shaheen
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Al-Mattooq
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S Yazdanfar
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - K W Burak
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M G Swain
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S E Congly
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M A Borman
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - S S Lee
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - R P Myers
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - C S Coffin
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Shaheen AA, AlMattooq M, Yazdanfar S, Burak KW, Swain MG, Congly SE, Borman MA, Lee SS, Myers RP, Coffin CS. Tenofovir disoproxil fumarate significantly decreases serum lipoprotein levels compared with entecavir nucleos(t)ide analogue therapy in chronic hepatitis B carriers. Aliment Pharmacol Ther 2017; 46:599-604. [PMID: 28707319 DOI: 10.1111/apt.14218] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/25/2017] [Accepted: 06/20/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are first-line treatments for chronic hepatitis B (CHB). Studies suggest lipid lowering effect of TDF in human immunodeficiency virus positive (HIV+) individuals, but the effect on lipids and cardiovascular disease (CVD) risk in CHB is unknown. AIM To compare TDF vs ETV effects on lipid levels in CHB. METHODS In this retrospective cohort study, data on serum lipids and CVD risk factors at baseline and ~1 year on TDF or ETV were collected from CHB carriers. We used propensity score matched models to assess the effect on total cholesterol (TC), LDL-C, HDL and triglycerides (TGL). RESULTS In 348 patients, median age was 57 (IQR: 47-65 years), 63% were male, 77% were Asian, 19% were cirrhotic, 25% were HBeAg positive at baseline, and 72% received TDF vs 28% ETV. ETV-treated patients were older (median age: 60 vs 55, P<.01), had similar smoking and hypertension rates, but diabetes and dyslipidemia were more prevalent (19% vs 9%, P=.01; 14% vs 6%, P=.05, respectively). In propensity score matched models for age, gender, usage of lipid lowering agents, dyslipidemia and diabetes, TDF-treated patients were more likely to show a 20% decrease in TC (95% CI: 3%-25%), LDL-C (95% CI: 1%-25%) and HDL-C (CI: 10%-30%) levels compared with those on ETV. No change in TGL was observed in either group. CONCLUSIONS A greater decline in TC, LDL-C and HDL was observed in CHB carriers receiving TDF compared with ETV. These data may influence anti-viral choice in CHB carriers at risk for CVD.
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Affiliation(s)
- A A Shaheen
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - M AlMattooq
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - S Yazdanfar
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - K W Burak
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - M G Swain
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - S E Congly
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - M A Borman
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - S S Lee
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - R P Myers
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - C S Coffin
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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Cheung EKH, Lee S, Lee SS. Pattern of exposure to information and its impact on seasonal influenza vaccination uptake in nurses. J Hosp Infect 2017; 97:376-383. [PMID: 28807832 DOI: 10.1016/j.jhin.2017.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/06/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Uptake of annual influenza vaccination of healthcare workers (HCWs) varies, and remains at a suboptimal level in many countries. As HCWs are often exposed to a variety of information about vaccination, the pattern of exposure may impact their decision; this deserves further investigation. METHODS Practising nurses in Hong Kong were invited to participate in an anonymous online survey in February 2016, after the winter seasonal peak. The questionnaire covered demographics, work nature and experiences, vaccination uptake history and reasons for vaccination decisions. Two behavioural categories for access to information were defined - passive exposure to information and active information-seeking - differentiated by the source, type and nature of information accessed. Chi-squared test, Mann-Whitney U-test and logistic regression were performed to compare vaccinated and unvaccinated nurses. RESULTS In total, 1177 valid returns were received from nurses. The median age of respondents was 32 years and 86% were female. The overall vaccination rate was 33%. Passive exposure to information from the workplace, professional body and social network was not predictive of vaccination decision, but passive exposure to information from mass media was predictive [odds ratio (OR) 1.78]. Active information-seeking, such as consulting a senior (OR 2.46), organizing promotional activities (OR 2.85) and undertaking an information search (OR 2.43), was significantly associated with increased vaccination uptake. A cumulative effect could be demonstrated for active information-seeking (OR 1.86), but not for passive exposure to information. CONCLUSION The current strategy of promotions and campaigns for seasonal influenza vaccination in HCWs may not be effective in increasing vaccination coverage. Measures targeting information-seeking behaviours may serve as an alternative approach.
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Affiliation(s)
- E K H Cheung
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, 2/F Postgraduate Education Centre, Prince of Wales Hospital, Shatin, Hong Kong
| | - S Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, 2/F Postgraduate Education Centre, Prince of Wales Hospital, Shatin, Hong Kong.
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Chan DP, Lee KC, Lee SS, Tan TY. Community-based molecular epidemiology study of hepatitis C virus infection in injection drug users. Hong Kong Med J 2017; 23 Suppl 5:27-30. [PMID: 28943522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
- D Pc Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - K Ck Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - T Y Tan
- Division of International Epidemiology and Population Studies, John E. Fogarty International Center, National Institutes of Health, USA
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Chan DP, Lee KC, Lee SS. Epidemiology of hepatitis E infection in Hong Kong. Hong Kong Med J 2017; 23 Suppl 5:31-35. [PMID: 28943523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
- D Pc Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - K Ck Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
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Chou CK, Lee SS, Lin TY, Huang YH, Takahashi H, Lai CS, Lin SD, Lin TM. Micro-autologous Fat Transplantation (MAFT) for Forehead Volumizing and Contouring. Aesthetic Plast Surg 2017; 41:845-855. [PMID: 28451799 PMCID: PMC5522520 DOI: 10.1007/s00266-017-0883-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/09/2017] [Indexed: 01/18/2023]
Abstract
Background Frontal fullness in Asians is often considered to indicate one’s public popularity and leadership skills. Numerous materials and techniques have been applied clinically to recontour or volumize the frontal area, with variable results. The micro-autologous fat transplantation (MAFT) technique proposed by Lin et al. (2nd academic congress of Taiwan Cosmetic Association Taipei,
Taiwan) in 2007 has demonstrated its feasibility in facial rejuvenation. In the present study, we used an innovative instrument to apply the MAFT technique to frontal augmentation with fat grafting and reported the results. Methods MAFT was performed on 178 patients (167 female, 11 male) during a 5-year period starting in January 2010. Fat was harvested by liposuction, processed and refined by centrifugation at 1200×g for 3 min. The purified fat was micro-transplanted for frontal contouring with the assistance of an instrument, the MAFT-GUN. The patients were followed up regularly, and photographs were taken for comparison. Results On average, the MAFT procedure took 52 min to complete. The average amount of delivered fat was 10.2 mL. The follow-up period was 34 months on average. No complications, including neurovascular injury, skin necrosis, abscess, nodulation, calcification or irregularity, were noted. A patient-rated satisfaction 5-point Likert scale demonstrated that 83.1% of all patients had favorable results (48.3% were satisfied, and 34.8% were very satisfied). Conclusion The concept and technique of MAFT has changed fat grafting from an operation with unpredictable clinical results to an easy, reliable and consistent procedure. Furthermore, the use of a precisely controlled instrument enabled surgeons to perform highly accurate micro-fat grafting. In comparison with other strategies for volume restoration, the MAFT procedure demonstrated high patient satisfaction with the long-term results. Therefore, the use of MAFT as an alternative approach to forehead contouring and volumizing was addressed. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Electronic supplementary material The online version of this article (doi:10.1007/s00266-017-0883-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C K Chou
- Yuan's General Hospital, No.162, Chenggong 1st Rd., Lingya Dist., Kaohsiung City, 802, Taiwan
| | - S S Lee
- Department of Plastic Surgery, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
| | - T Y Lin
- Division of Traumatology, Department of Emergency, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
| | - Y H Huang
- Department of Plastic Surgery, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
- Charming Institute of Aesthetic and Regenerative Surgery (CIARS), 2F.-1, No.172, Ziqiang 2nd Rd., Qianjin Dist., Kaohsiung City, 801, Taiwan
| | - H Takahashi
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
| | - C S Lai
- Department of Plastic Surgery, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
| | - S D Lin
- Department of Plastic Surgery, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan
| | - T M Lin
- Department of Plastic Surgery, Kaohsiung Medical University, No.100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City, 807, Taiwan.
- Charming Institute of Aesthetic and Regenerative Surgery (CIARS), 2F.-1, No.172, Ziqiang 2nd Rd., Qianjin Dist., Kaohsiung City, 801, Taiwan.
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Mamuad LL, Kim SH, Choi YJ, Soriano AP, Cho KK, Lee K, Bae GS, Lee SS. Increased propionate concentration in Lactobacillus mucosae-fermented wet brewers grains and during in vitro rumen fermentation. J Appl Microbiol 2017; 123:29-40. [PMID: 28425572 DOI: 10.1111/jam.13475] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 04/03/2017] [Accepted: 04/07/2017] [Indexed: 01/15/2023]
Abstract
AIMS This study was conducted to isolate and identify propionate-producing bacteria that can be used as an inoculum in improving wet brewers grains and rumen fermentation via increasing propionate concentration. METHODS AND RESULTS A strain of Lactobacillus that exhibits high levels of propionate production was identified and characterized as Lactobacillus mucosae 521129 by 16S rRNA gene sequencing and phylogenetic analyses. Wet brewers grains were fermented through L. mucosae inoculation and resulted in an increase in propionate concentration. Fermented wet brewers grains were used in in vitro rumen fermentation and revealed that L. mucosae-fermented wet brewers grains produced more gas and had higher accumulations propionate and total volatile fatty acid (VFA) than the control. The fewest methanogen DNA copies were detected in L. mucosae-fermented wet brewers grains. CONCLUSION Identified L. mucosae improved the fermentation of wet brewers grains and the in vitro rumen fermentation via increasing propionate and total VFA concentrations. SIGNIFICANCE AND IMPACT OF THE STUDY The presented research provided the identification of L. mucosae 521129 as a propionate producer and was metabolically profiled. Furthermore, data present the putative application of this organism in improving the fermentation of wet brewers grains and in vitro rumen fermentation.
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Affiliation(s)
- L L Mamuad
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, College of Bio-industry Science, Sunchon National University, Suncheon, Jeonnam, Korea
| | - S H Kim
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, College of Bio-industry Science, Sunchon National University, Suncheon, Jeonnam, Korea
| | - Y J Choi
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, College of Bio-industry Science, Sunchon National University, Suncheon, Jeonnam, Korea
| | - A P Soriano
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, College of Bio-industry Science, Sunchon National University, Suncheon, Jeonnam, Korea.,Small Ruminant Center, Central Luzon State University, Science City of Muñoz, Nueva Ecija, Philippines
| | - K K Cho
- Department of Animal Resources Technology, Gyeongnam National University of Science and Technology, Jinju, Gyeongsang, Korea
| | - K Lee
- Department of Animal Sciences, Ohio State University, Columbus, OH, USA
| | - G S Bae
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Korea
| | - S S Lee
- Ruminant Nutrition and Anaerobe Laboratory, Department of Animal Science and Technology, College of Bio-industry Science, Sunchon National University, Suncheon, Jeonnam, Korea
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Lee SS, Cheung EKH, Leung JNS, Lee CK. Non-compliance to infectious disease deferral criteria among Hong Kong's blood donors. Vox Sang 2017; 112:425-433. [PMID: 28401619 DOI: 10.1111/vox.12520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/20/2017] [Accepted: 03/07/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Donor screening alone cannot eliminate the risk of transfusion-transmitted HIV infection. Donor deferral according to established criteria is a supplemental strategy, which has focused largely on men who have sex with men (MSM). A study was conducted to determine the compliance of non-MSM donors with such criteria and examine its implications on blood safety. MATERIALS AND METHODS Chinese donors who have just donated blood at blood donor centres in Hong Kong were recruited. Based on the contents of the routinely administered predonation Health Screening Questionnaires, participants were requested to complete a survey to assess their practice of deferrable risk behaviours and lifestyle encounters, using tablet computers. RESULTS Over an 8-week period in mid-2016, 1614 donors (male-to-female ratio 1·23) had enrolled in the survey, accounting for 40% of donors giving blood on the survey days. The proportion of respondents who gave blood despite having deferrable HIV risk was 5%: MSM 1·2% (of the male donors); non-MSM risk behaviours 2·6%; risky lifestyle encounters 2·1%. If inconsistent declaration and suspected risk behaviours were included, the total non-compliance rate became 10·8%. Male donors had a higher prevalence of deferrable behavioural risk, even after excluding MSM. Unawareness and non-acceptability were main reasons for non-compliance. CONCLUSION The non-compliance rate of donors to deferral was high, although the ultimate infection risk might be small in the presence of universal screening. Simplification of questionnaires, focus on time-limited deferral and a reduction of deferral items may improve the deferral mechanism without compromising blood safety.
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Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - E K H Cheung
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
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Park DJ, Kang JH, Lee JW, Lee KE, Kim TJ, Park YW, Lee JS, Choi YD, Lee SS. Risk factors to predict the development of chronic kidney disease in patients with lupus nephritis. Lupus 2017; 26:1139-1148. [DOI: 10.1177/0961203317694257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives We analyzed the clinical follow-up results of 88 lupus nephritis patients to find prognostic factors for the development of chronic kidney disease in ethnically homogeneous Korean patients with biopsy-proven lupus nephritis. Methods Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained. Renal biopsy specimens were reclassified according to the International Society of Pathology/Renal Pathology Society classification, separately, by two renal pathologists blinded to the previous classification. Univariate and multivariate analyses were performed using the Cox proportional hazard regression model to identify independent risk factors for chronic kidney disease in lupus nephritis patients. Results Eighteen of 88 patients (20.5%) developed chronic kidney disease during a mean follow-up of 47.6 months (range: 12–96 months). Patients who developed chronic kidney disease were older at onset of lupus nephritis, had less education, and were more likely to have hypertension; they had lower serum albumin levels, lower platelet levels, higher serum creatinine levels, lower estimated glomerular filtration rate, higher chronicity index, and lower frequency of anti-ribosomal P antibodies, and they were less likely to be in complete remission in the first year. In stepwise multivariable analyses, hypertension, lower glomerular filtration rate, and failure to achieve complete remission in the first year of treatment were significant predictors of the development of chronic kidney disease in lupus nephritis patients. Conclusions These findings suggest that patients with hypertension and decreased kidney function at the onset of lupus nephritis and showing a poor response to immunosuppressive drugs in the first year should be monitored carefully and managed aggressively to avoid deterioration of kidney function.
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Affiliation(s)
- D J Park
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J H Kang
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J W Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - K E Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - T J Kim
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Y W Park
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - J S Lee
- Department of Pathology, Chonnam National University Hospital & Medical School, Gwangju, Republic of Korea
| | - Y D Choi
- Department of Pathology, Chonnam National University Hospital & Medical School, Gwangju, Republic of Korea
| | - S S Lee
- Division of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
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Bond DJ, Torres IJ, Lee SS, Kozicky JM, Silveira LE, Dhanoa T, Lam RW, Yatham LN. Lower cognitive functioning as a predictor of weight gain in bipolar disorder: a 12-month study. Acta Psychiatr Scand 2017; 135:239-249. [PMID: 27995622 DOI: 10.1111/acps.12674] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In cross-sectional studies, elevated body mass index (BMI) is associated with cognitive impairment in bipolar disorder (BD). We investigated the direction of this association by prospectively examining changes in BMI and cognition. METHOD We measured BMI and performance in six cognitive domains over 12 months in 80 adolescent and young adult BD patients and 46 healthy comparison subjects (HS). Ninety-three percent of patients received pharmacotherapy and 84% were euthymic. We used repeated-measures ancova and longitudinal mixed models to investigate whether (i) higher BMI and increasing BMI over time predicted lower subsequent cognitive functioning, and (ii) lower cognitive functioning and changes in cognition predicted increasing BMI. RESULTS Neither baseline BMI nor BMI change predicted lower cognitive functioning. Lower baseline scores in attention, verbal memory, working memory, and a composite measure of global cognition predicted increasing BMI in patients and HS. In patients, lower cognitive functioning remained associated with increasing BMI when clinical and treatment variables were adjusted for. Improvement in working memory predicted a smaller subsequent BMI increase in patients. CONCLUSION Lower cognitive functioning in specific domains predicts increasing BMI in patients with BD and healthy young adults. Targeting cognition may be important for minimizing weight gain in BD.
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Affiliation(s)
- D J Bond
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - I J Torres
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - S S Lee
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J-M Kozicky
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - L E Silveira
- Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - T Dhanoa
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - R W Lam
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
| | - L N Yatham
- Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada
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Han SM, Park J, Lee JH, Lee SS, Kim H, Han H, Kim Y, Yi S, Cho JY, Jang IJ, Lee MG. Targeted Next-Generation Sequencing for Comprehensive Genetic Profiling of Pharmacogenes. Clin Pharmacol Ther 2016; 101:396-405. [PMID: 27727443 DOI: 10.1002/cpt.532] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 12/12/2022]
Abstract
Phenotypic differences in drug responses have been associated with known pharmacogenomic loci, but many remain to be characterized. Therefore, we developed next-generation sequencing (NGS) panels to enable broad and unbiased inspection of genes that are involved in pharmacokinetics (PKs) and pharmacodynamics (PDs). These panels feature repetitively optimized probes to capture up to 114 PK/PD-related genes with high coverage (99.6%) and accuracy (99.9%). Sequencing of a Korean cohort (n = 376) with the panels enabled profiling of actionable variants as well as rare variants of unknown functional consequences. Notably, variants that occurred at low frequency were enriched with likely protein-damaging variants and previously unreported variants. Furthermore, in vitro evaluation of four pharmacogenes, including cytochrome P450 2C19 (CYP2C19), confirmed that many of these rare variants have considerable functional impact. The present study suggests that targeted NGS panels are readily applicable platforms to facilitate comprehensive profiling of pharmacogenes, including common but also rare variants that warrant screening for personalized medicine.
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Affiliation(s)
- S M Han
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea
| | - J Park
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea
| | - J H Lee
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, Kyung Hee University, Seoul, Korea
| | - S S Lee
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan, Korea
| | - H Kim
- Celemics Inc, Seoul, Korea
| | - H Han
- Celemics Inc, Seoul, Korea
| | - Y Kim
- Celemics Inc, Seoul, Korea
| | - S Yi
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - J-Y Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - I-J Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - M G Lee
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea
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Lee SS, Ma K, Chu EKY, Wong KH. The phenomenon of missing doses in a cohort of HIV patients with good adherence to highly active antiretroviral therapy. Int J STD AIDS 2016; 18:167-70. [PMID: 17362548 DOI: 10.1258/095646207780132497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A self-administered questionnaire survey was conducted in a specialist HIV clinical service in Hong Kong. A total of 76 male Chinese patients who had been on highly active antiretroviral therapy for over one year were enrolled. All except one had undetectable viral load at the time of the assessment. Though a majority (76%) scored 100% in self-reporting adherence rating, one-third of these had in fact missed at least one dose in the preceding four-week period. Men having sex with men had a lower tendency of missing dose than heterosexuals (13.6% versus 42%, P = 0.019). There was no association between missing doses and clinical staging or the regimens. The study revealed that missing doses may occur despite report of almost complete adherence, which, in the long run, could be a cause for concern.
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Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Sudrajad P, Seo DW, Choi TJ, Park BH, Roh SH, Jung WY, Lee SS, Lee JH, Kim S, Lee SH. Genome-wide linkage disequilibrium and past effective population size in three Korean cattle breeds. Anim Genet 2016; 48:85-89. [PMID: 27642108 DOI: 10.1111/age.12488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 12/01/2022]
Abstract
The routine collection and use of genomic data are useful for effectively managing breeding programs for endangered populations. Linkage disequilibrium (LD) using high-density DNA markers has been widely used to determine population structures and predict the genomic regions that are associated with economic traits in beef cattle. The extent of LD also provides information about historical events, including past effective population size (Ne ), and it allows inferences on the genetic diversity of breeds. The objective of this study was to estimate the LD and Ne in three Korean cattle breeds that are genetically similar but have different coat colors (Brown, Brindle and Jeju Black Hanwoo). Brindle and Jeju Black are endangered breeds with small populations, whereas Brown Hanwoo is the main breeding population in Korea. DNA samples from these cattle breeds were genotyped using the Illumina BovineSNP50 Bead Chip. We examined 13 cattle breeds, including European taurines, African taurines and indicines, and hybrids to compare their LD values. Brown Hanwoo consistently had the lowest mean LD compared to Jeju Black, Brindle and the other 13 cattle breeds (0.13, 0.19, 0.21 and 0.15-0.22 respectively). The high LD values of Brindle and Jeju Black contributed to small Ne values (53 and 60 respectively), which were distinct from that of Brown Hanwoo (531) for 11 generations ago. The differences in LD and Ne for each breed reflect the breeding strategy applied. The Ne for these endangered cattle breeds remain low; thus, effort is needed to bring them back to a sustainable tract.
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Affiliation(s)
- P Sudrajad
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, 305-764, Korea.,Indonesian Agency for Agricultural Research and Development, Ministry of Agriculture, Jakarta, 12540, Indonesia
| | - D W Seo
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, 305-764, Korea
| | - T J Choi
- Animal Breeding and Genetics Division, National Institute of Animal Science, Seonghwan, 31000, Korea
| | - B H Park
- Animal Breeding and Genetics Division, National Institute of Animal Science, Seonghwan, 31000, Korea
| | - S H Roh
- Hanwoo Genetic Improvement Center, National Agricultural Cooperative Federation, Chungnam, 356-831, Korea
| | - W Y Jung
- Hanwoo Genetic Improvement Center, National Agricultural Cooperative Federation, Chungnam, 356-831, Korea
| | - S S Lee
- Hanwoo Genetic Improvement Center, National Agricultural Cooperative Federation, Chungnam, 356-831, Korea
| | - J H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, 305-764, Korea
| | - S Kim
- Animal Breeding and Genetics Division, National Institute of Animal Science, Seonghwan, 31000, Korea
| | - S H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon, 305-764, Korea
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Choi EY, Lee SS, Hyeon JY, Choe SH, Keum BR, Lim JM, Park DC, Choi IS, Cho KK. Effects of β-Glucan on the Release of Nitric Oxide by Macrophages Stimulated with Lipopolysaccharide. Asian-Australas J Anim Sci 2016; 29:1664-1674. [PMID: 27488844 PMCID: PMC5088388 DOI: 10.5713/ajas.16.0418] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 06/20/2016] [Accepted: 07/19/2016] [Indexed: 01/14/2023]
Abstract
This research analyzed the effect of β-glucan that is expected to alleviate the production of the inflammatory mediator in macrophagocytes, which are processed by the lipopolysaccharide (LPS) of Escherichia. The incubated layer was used for a nitric oxide (NO) analysis. The DNA-binding activation of the small unit of nuclear factor-κB was measured using the enzyme-linked immunosorbent assay-based kit. In the RAW264.7 cells that were vitalized by Escherichia coli (E. coli) LPS, the β-glucan inhibited both the combatant and rendering phases of the inducible NO synthase (iNOS)-derived NO. β-Glucan increased the expression of the heme oxygenase-1 (HO-1) in the cells that were stimulated by E. coli LPS, and the HO-1 activation was inhibited by the tin protoporphyrin IX (SnPP). This shows that the NO production induced by LPS is related to the inhibition effect of β-glucan. The phosphorylation of c-Jun N-terminal kinases (JNK) and the p38 induced by the LPS were not influenced by the β-glucan, and the inhibitory κB-α (IκB-α) decomposition was not influenced either. Instead, β-glucan remarkably inhibited the phosphorylation of the signal transducer and activator of transcription-1 (STAT1) that was induced by the E. coli LPS. Overall, the β-glucan inhibited the production of NO in macrophagocytes that was vitalized by the E .coli LPS through the HO-1 induction and the STAT1 pathways inhibition in this research. As the host immune response control by β-glucan weakens the progress of the inflammatory disease, β-glucan can be used as an effective immunomodulator.
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Affiliation(s)
- E Y Choi
- Department of Life Science, Silla University, Busan 617-736, Korea
| | - S S Lee
- Division of Applied Life Science, Graduate School of Gyeongsang National University, IALS, Jinju 660-701, Korea
| | - J Y Hyeon
- Department of Life Science, Silla University, Busan 617-736, Korea
| | - S H Choe
- Department of Life Science, Silla University, Busan 617-736, Korea
| | - B R Keum
- Department of Life Science, Silla University, Busan 617-736, Korea
| | - J M Lim
- Glucan Corporation, Gijang-gun, Busan 46048, Korea
| | - D C Park
- Glucan Corporation, Gijang-gun, Busan 46048, Korea
| | - I S Choi
- Department of Life Science, Silla University, Busan 617-736, Korea
| | - K K Cho
- Department of Animal Resources Technology, Gyeongnam National University of Science and Technology, Jinju 52725, Korea
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To KW, Lai A, Lee KCK, Koh D, Lee SS. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions. J Hosp Infect 2016; 94:133-42. [PMID: 27546456 DOI: 10.1016/j.jhin.2016.07.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from <5% to >90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.
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Affiliation(s)
- K W To
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - A Lai
- Occupational Health Division, Ministry of Health, Negara Brunei Darussalam
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Negara Brunei Darussalam; SSH School of Public Health, National University of Singapore, Singapore
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
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Lee JW, Park DJ, Kang JH, Choi SE, Yim YR, Kim JE, Lee KE, Wen L, Kim TJ, Park YW, Sung YK, Lee SS. The rate of and risk factors for frequent hospitalization in systemic lupus erythematosus: results from the Korean lupus network registry. Lupus 2016; 25:1412-1419. [PMID: 27000153 DOI: 10.1177/0961203316640916] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The survival rate of patients with systemic lupus erythematosus has improved in the last few decades, but the rate of hospitalization and health care costs for these patients remain higher than in the general population. Thus, we evaluated the rate of hospitalization and associated risk factors in an inception cohort of Korean patients with lupus. Methods Of the 507 patients with systemic lupus erythematosus enrolled in the KORean lupus NETwork, we investigated an inception cohort consisting of 196 patients with systemic lupus erythematosus presenting within 6 months of diagnosis based on the American College of Rheumatology classification criteria. We evaluated the causes of hospitalization, demographic characteristics, and laboratory and clinical data at the time of systemic lupus erythematosus diagnosis of hospitalized patients and during a follow-up period. We calculated the hospitalization rate as the number of total hospitalizations divided by the disease duration, and defined "frequent hospitalization" as hospitalization more than once per year. Results Of the 196 patients, 117 (59.6%) were admitted to hospital a total of 257 times during the 8-year follow-up period. Moreover, 22 (11.2%) patients were hospitalized frequently. The most common reasons for hospitalization included disease flares, infection, and pregnancy-related morbidity. In the univariate regression analysis, malar rash, arthritis, pericarditis, renal involvement, fever, systemic lupus erythematosus disease activity index > 12, hemoglobin level < 10 mg/dl, albumin level < 3.5 mg/dl, and anti-Sjögren's syndrome A positivity were associated with frequent hospitalization. Finally, multivariate analysis showed that arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization. Conclusions Our results showed that frequent hospitalization occurred in 11.2% of hospitalized patients and arthritis, pericarditis, and anti-Sjögren's syndrome A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization.
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Affiliation(s)
- J W Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - D J Park
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - J H Kang
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - S E Choi
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y R Yim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - J E Kim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - K E Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - L Wen
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - T J Kim
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y W Park
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Y K Sung
- 2 Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - S S Lee
- 1 Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
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Koh JH, Kwok SK, Lee J, Son CN, Kim JM, Kim HO, Park SH, Sung YK, Choe JY, Lee SS, Park SH. Pain, xerostomia, and younger age are major determinants of fatigue in Korean patients with primary Sjögren’s syndrome: a cohort study. Scand J Rheumatol 2016; 46:49-55. [DOI: 10.3109/03009742.2016.1153142] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- JH Koh
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - SK Kwok
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - J Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - CN Son
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - J-M Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - HO Kim
- Division of Rheumatology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - SH Park
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - YK Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - JY Choe
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - SS Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University School of Medicine, Gwangju, South Korea
| | - SH Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Hui KH, Lee SS, Lam TN. Dose Optimization of Efavirenz Based on Individual CYP2B6 Polymorphisms in Chinese Patients Positive for HIV. CPT Pharmacometrics Syst Pharmacol 2016; 5:182-91. [PMID: 27299708 PMCID: PMC4846779 DOI: 10.1002/psp4.12067] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/29/2016] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to investigate the impact of CYP2B6‐G516T polymorphisms on the pharmacokinetics (PKs) of efavirenz among the Chinese population and to propose doses for different genotypic populations that optimize therapeutic outcomes. Nonlinear mixed‐effect modeling was applied to describe PKs of efavirenz in Chinese patients with human immunodeficiency virus (HIV). Probabilities of successful treatment at different doses were obtained by simulations using the developed model to identify the optimal doses. The model was based on data from 163 individuals. Efavirenz clearance was found to be significantly influenced by CYP2B6‐G516T polymorphisms and body weight. The typical values of oral clearance were 10.2 L/h, 7.33 L/h, and 2.38 L/h and simulation results suggested that the optimal daily oral doses are 550 mg, 350 mg, and 100 mg for the GG, GT, and TT populations, respectively. The effect of CYP2B6‐G516T polymorphisms on efavirenz clearance was successfully quantified. Pharmacogenetics‐based dose individualization of efavirenz may optimize patient outcomes by promoting efficacy while minimizing central nervous system (CNS) side effects.
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Affiliation(s)
- K H Hui
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, Shatin, New Territories, Hong Kong.,Department of Microbiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - T N Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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Cho CI, Alam M, Choi TJ, Choy YH, Choi JG, Lee SS, Cho KH. Models for Estimating Genetic Parameters of Milk Production Traits Using Random Regression Models in Korean Holstein Cattle. Asian-Australas J Anim Sci 2016; 29:607-14. [PMID: 26954184 PMCID: PMC4852220 DOI: 10.5713/ajas.15.0308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/13/2015] [Accepted: 08/07/2015] [Indexed: 11/27/2022]
Abstract
The objectives of the study were to estimate genetic parameters for milk production traits of Holstein cattle using random regression models (RRMs), and to compare the goodness of fit of various RRMs with homogeneous and heterogeneous residual variances. A total of 126,980 test-day milk production records of the first parity Holstein cows between 2007 and 2014 from the Dairy Cattle Improvement Center of National Agricultural Cooperative Federation in South Korea were used. These records included milk yield (MILK), fat yield (FAT), protein yield (PROT), and solids-not-fat yield (SNF). The statistical models included random effects of genetic and permanent environments using Legendre polynomials (LP) of the third to fifth order (L3–L5), fixed effects of herd-test day, year-season at calving, and a fixed regression for the test-day record (third to fifth order). The residual variances in the models were either homogeneous (HOM) or heterogeneous (15 classes, HET15; 60 classes, HET60). A total of nine models (3 orders of polynomials×3 types of residual variance) including L3-HOM, L3-HET15, L3-HET60, L4-HOM, L4-HET15, L4-HET60, L5-HOM, L5-HET15, and L5-HET60 were compared using Akaike information criteria (AIC) and/or Schwarz Bayesian information criteria (BIC) statistics to identify the model(s) of best fit for their respective traits. The lowest BIC value was observed for the models L5-HET15 (MILK; PROT; SNF) and L4-HET15 (FAT), which fit the best. In general, the BIC values of HET15 models for a particular polynomial order was lower than that of the HET60 model in most cases. This implies that the orders of LP and types of residual variances affect the goodness of models. Also, the heterogeneity of residual variances should be considered for the test-day analysis. The heritability estimates of from the best fitted models ranged from 0.08 to 0.15 for MILK, 0.06 to 0.14 for FAT, 0.08 to 0.12 for PROT, and 0.07 to 0.13 for SNF according to days in milk of first lactation. Genetic variances for studied traits tended to decrease during the earlier stages of lactation, which were followed by increases in the middle and decreases further at the end of lactation. With regards to the fitness of the models and the differential genetic parameters across the lactation stages, we could estimate genetic parameters more accurately from RRMs than from lactation models. Therefore, we suggest using RRMs in place of lactation models to make national dairy cattle genetic evaluations for milk production traits in Korea.
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Affiliation(s)
- C I Cho
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - M Alam
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - T J Choi
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - Y H Choy
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - J G Choi
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - S S Lee
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - K H Cho
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
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Park DJ, Kim SH, Nah SS, Lee JH, Kim SK, Lee YA, Hong SJ, Kim HS, Lee HS, Kim HA, Joung CI, Kim SH, Lee SS. Association between catechol-O-methyl transferase gene polymorphisms and fibromyalgia in a Korean population: A case-control study. Eur J Pain 2016; 20:1131-9. [PMID: 26849490 DOI: 10.1002/ejp.837] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although polymorphisms of the catechol-O-methyl transferase (COMT) gene have been implicated in altered pain sensitivity, results concerning the association between COMT gene polymorphisms and fibromyalgia (FM) are equivocal. We assessed the associations between COMT single-nucleotide polymorphisms (SNP) and FM risk and symptom severity. METHODS In total, 409 FM patients and 423 controls were enrolled. Alleles and genotypes at five positions [rs6269 (A>G), rs4633 (C>T), rs4818 (C>G), rs4680 (C>G) and rs165599 (A>G)] in the COMT gene were genotyped from peripheral blood DNA. RESULTS Alleles and genotypes of the rs4818 COMT gene polymorphism were significantly associated with increased susceptibility to FM. The rs4818 GG genotype was more strongly associated with FM compared to the CC genotype (OR = 1.680, 95% CI: 1.057, 2.672, p = 0.027). Although allele and genotype frequencies did not differ among groups, the rs4633 CT genotype was not associated with the presence of FM following adjustment for age and sex (OR = 0.745; 95% CI: 0.558, 0.995; p = 0.046). However, no association was observed between clinical measures and individual COMT SNPs. In haplotype analysis, there was a significant association between ACG haplotype and FM susceptibility sex (OR = 2.960, 95% CI: 1.447, 6.056, p = 0.003) and the number of tender points (p = 0.046). CONCLUSIONS This large-scale study suggests that polymorphisms of the COMT gene may be associated with FM risk and pain sensitivity in Korean FM patients. However, our results differed to those of previous studies, suggesting ethnic variation in COMT gene polymorphisms in FM. WHAT DOES THIS STUDY ADD By contrast to Caucasian and Latin-American populations, the COMT gene polymorphisms are associated with FM risk and pain sensitivity in Korean FM patients, suggesting ethnic variation in COMT gene polymorphisms.
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Affiliation(s)
- D J Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - S H Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - S S Nah
- Department of Internal Medicine, Soonchunhyang University, College of Medicine, Cheonan, Korea
| | - J H Lee
- Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea
| | - S K Kim
- Department of Internal Medicine, Catholic University of Daegu, School of Medicine, Daegu, Korea
| | - Y A Lee
- Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - S J Hong
- Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - H S Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - H S Lee
- Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Seoul, Korea
| | - H A Kim
- Department of Allergy and Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - C I Joung
- Department of Internal Medicine, Konyang University Medical School, Daejeon, Korea
| | - S H Kim
- Departments of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea
| | - S S Lee
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea
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Lee SS. An unusual cause of chest pain in army trainee - spontaneous pneumomediastinum. Med J Malaysia 2016; 71:30-31. [PMID: 27130742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This is a case report of spontaneous pneumomediastinum that occurred in a 19-year-old army trainee during his 2.4km run. Spontaneous pneumomediastinum is a rare disorder. It is usually precipitated by activities related to Valsalva manoeuvres such as strenuous physical activities, retching and vomiting. Treatment is expectant and the disorder usually resolves spontaneously within a few days. However, one must be aware of the disorder so that additional advice such as avoiding activities that involve Valsalva manoeuvres can be given.
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Affiliation(s)
- S S Lee
- Singapore General Hospital Internal Medicine, Department of Internal Medicine, Singapore General Hospital, Academia, Level 4. 20 College Road. 169856 Singapore, Singapore.
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47
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Ou Y, Yau KKW, Poon CM, Hui YV, Lee SS, Lee CK. Donation frequency and its association with demographic characteristics--a 1-year observational study. Transfus Med 2016; 25:366-73. [PMID: 26729059 DOI: 10.1111/tme.12267] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 11/05/2015] [Accepted: 11/28/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study is to enhance the understanding of frequent blood donors' characteristics and devise strategies to achieve an optimal blood inventory. BACKGROUND Apart from donor recruitment and retention, an effective way to increase blood supply is to increase the donation frequency among donors. Understanding the characteristics of frequent donors will be helpful to impact their future donation pattern, which would in turn achieve a stable and adequate blood inventory to meet the changing demands of the society. METHODS AND MATERIALS Demographic information of blood donors for each donation in Hong Kong (HK) was routinely collected and stored in the database of Hong Kong Red Cross Blood Transfusion Service. Logistic regression models (by gender group) with interaction effects were constructed to analyse the differences in the likelihood of being frequent donors and the associations with their demographic characteristics. RESULTS A total of 158,666 blood donors in 2010 gave 227,634 donations during the study. In general, male donors were more likely to be frequent donors. Logistic regression models further identified the characteristics of frequent donors in HK: older, blood type Rh D-ve and repeat donors, although their extent of impact was different for different gender group. CONCLUSION To achieve an optimal blood inventory to meet the challenge of ageing in the society, donors who donate less often should be targeted to increase their donation frequency. More efforts in promotion should be made to recruit those non-donors to join the blood donation pool and motivate 'targeted' existing donors in the population to participate blood donation more regularly.
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Affiliation(s)
- Y Ou
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - K K W Yau
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - C M Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Y V Hui
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong.,Hang Seng Management College, New Territories, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
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Samadi Kochaksaraei G, Castillo E, Osman M, Simmonds K, Scott AN, Oshiomogho JI, Lee SS, Myers RP, Martin SR, Coffin CS. Clinical course of 161 untreated and tenofovir-treated chronic hepatitis B pregnant patients in a low hepatitis B virus endemic region. J Viral Hepat 2016; 23:15-22. [PMID: 26192022 DOI: 10.1111/jvh.12436] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/01/2015] [Indexed: 12/11/2022]
Abstract
Hepatitis B immunoprophylaxis failure is linked to high maternal viraemia. There is limited North American data on hepatitis B outcomes in pregnancy. Pregnant hepatitis B carriers were enrolled January 2011-December 2014 and offered tenofovir in the 3rd trimester if hepatitis B virus (HBV)-DNA was >7-log IU/mL. Outcomes were determined in treated vs untreated patients. In total, 161 women with 169 pregnancies (one twin, 170 infants; median age 32 years), 18% (29/161) HBeAg+ and median HBV-DNA 2.51 log IU/mL (IQR 1.66-3.65; range 0.8-8.1) were studied. 14.3% (23/161) received tenofovir due to high viral load (16/23, median 74 days, IQR 59-110) or due to liver disease (7/23). In 10/16 treated due to high viraemia, with confirmed adherence, follow-up HBV-DNA showed a 5.49 log decline (P = 0.003). In treatment naïve mothers, median alanine aminotransferase (ALT) increased from 17 IU/L (IQR 12-24) to 29 (IQR 18-36) post-partum (P = 1.5e-7). In seven highly viraemic mothers who declined therapy (HBV-DNA >8-log IU/mL); median ALT increased ~3X from baseline (P < 0.01). 26% (44/169) had Caesarean section with no difference in treated vs untreated subjects. No tenofovir-treated mothers had renal dysfunction. Data were available on 167/170 infants; in 50.8% (85/167) who completed immunoprophylaxis, 98.8% (84/85, including 12 exposed to tenofovir in utero) were HBV immune. One infant born to an HBeAg+ mother with HBV-DNA >8-log IU/mL failed immunoprophylaxis. In this prospective Canadian cohort study, most untreated mothers experienced mild HBV flares. Tenofovir in pregnancy is well tolerated and reduces viral load prior to parturition.
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Affiliation(s)
- G Samadi Kochaksaraei
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - E Castillo
- Medical Disorders in Pregnancy, Division of Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - M Osman
- Alberta Health, Government of Alberta, Edmonton, AB, Canada
| | - K Simmonds
- Alberta Health, Government of Alberta, Edmonton, AB, Canada
| | - A N Scott
- Alberta Health, Government of Alberta, Edmonton, AB, Canada
| | - J I Oshiomogho
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S S Lee
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - R P Myers
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S R Martin
- Department of Paediatrics, Alberta Children's Hospital, Calgary, AB, Canada
| | - C S Coffin
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Lin ZX, Che CT, Lee SS, Chan RCY, Ip PSP, Yang JM. Sophora flavescens (Ku-Shen) as a booster for antiretroviral therapy through cytochrome P450 3A4 inhibition. Hong Kong Med J 2015; 21 Suppl 7:S18-S21. [PMID: 26908268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- Z X Lin
- School of Chinese Medicine, School of Biomedical Science, The Chinese University of Hong Kong
| | - C T Che
- School of Chinese Medicine, School of Biomedical Science, The Chinese University of Hong Kong & Department of Medicinal Chemistry and Pharmacognosy, University of Illinois at Chicago, Chicago, USA
| | - S S Lee
- Department of Microbiology & Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong
| | - R C Y Chan
- Department of Microbiology, The Chinese University of Hong Kong
| | - P S P Ip
- School of Chinese Medicine, School of Biomedical Science, The Chinese University of Hong Kong
| | - J M Yang
- School of Chinese Medicine, School of Biomedical Science, The Chinese University of Hong Kong
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50
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Choi JH, Park DJ, Kang JH, Yim YR, Lee KE, Lee JW, Wen L, Kim TJ, Park YW, Lee JK, Lee SS. Comparison of clinical and serological differences among juvenile-, adult-, and late-onset systemic lupus erythematosus in Korean patients. Lupus 2015; 24:1342-9. [PMID: 26085595 DOI: 10.1177/0961203315591024] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 05/12/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We investigated whether systemic lupus erythematosus (SLE) patients could be distinguished based on the time of disease onset and, if so, whether the groups differed in their clinical and laboratory features in ethnically homogeneous Korean patients. METHODS We enrolled 201 SLE patients with available clinical data at the time of onset of SLE from the lupus cohort at Chonnam National University Hospital. Sociodemographic, clinical, and laboratory data, including autoantibodies, and concomitant diseases were found at the time of diagnosis of SLE by reviewing patient charts. We divided SLE patients according to age at SLE diagnosis into three groups: juvenile-onset SLE (JSLE, diagnosed at ≤ 18 years), adult-onset SLE (ASLE, diagnosed at 19-50 years), and late-onset SLE (LSLE, diagnosed at >50 years), and compared baseline demographic, clinical, and relevant laboratory findings. RESULTS Of the 201 patients, 27 (14.4%), 149 (74.1%), and 25 (12.4%) were JSLE, ASLE, and LSLE patients, respectively. Fever, oral ulcers, nephritis, anemia, and thrombocytopenia were more common in JSLE patients than ASLE or LSLE patients (p < 0.05, < 0.05, 0.001, < 0.05, and < 0.05, respectively). However, Sjögren's syndrome was more frequent in LSLE patients than JSLE or ASLE patients (p < 0.05). Disease activity was significantly higher in JSLE patients than in ASLE or LSLE patients (p < 0.001). Anti-dsDNA and anti-nucleosome antibodies were found more frequently in JSLE patients and less frequently in LSLE patients (p < 0.05 and 0.005, respectively) and decreased complement levels were more common in JSLE patients and less common in LSLE patients (p < 0.001, 0.001, and < 0.05, respectively). CONCLUSIONS Our results indicate that SLE patients present with different clinical and serological manifestations according to age at disease onset. JSLE patients have more severe disease activity and more frequent renal involvement and LSLE patients have milder disease activity, more commonly accompanied by Sjögren's syndrome, at disease onset.
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Affiliation(s)
- J H Choi
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - D J Park
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - J H Kang
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Y R Yim
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - K E Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - J W Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - L Wen
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - T J Kim
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Y W Park
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - J K Lee
- Department of Neurosurgery, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - S S Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
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