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Prins TJ, Min AM, Gilder ME, Tun NW, Schepens J, McGregor K, Carrara VI, Wiladphaingern J, Paw MK, Moo E, Simpson JA, Angkurawaranon C, Rijken MJ, van Vugt M, Nosten F, McGready R. Comparison of perinatal outcome and mode of birth of twin and singleton pregnancies in migrant and refugee populations on the Thai Myanmar border: A population cohort. PLoS One 2024; 19:e0301222. [PMID: 38635671 PMCID: PMC11025774 DOI: 10.1371/journal.pone.0301222] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 03/12/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND In low- and middle-income countries twin births have a high risk of complications partly due to barriers to accessing hospital care. This study compares pregnancy outcomes, maternal and neonatal morbidity and mortality of twin to singleton pregnancy in refugee and migrant clinics on the Thai Myanmar border. METHODS A retrospective review of medical records of all singleton and twin pregnancies delivered or followed at antenatal clinics of the Shoklo Malaria Research Unit from 1986 to 2020, with a known outcome and estimated gestational age. Logistic regression was done to compare the odds of maternal and neonatal outcomes between twin and singleton pregnancies. RESULTS Between 1986 and 2020 this unstable and migratory population had a recorded outcome of pregnancy of 28 weeks or more for 597 twin births and 59,005 singleton births. Twinning rate was low and stable (<9 per 1,000) over 30 years. Three-quarters (446/597) of the twin pregnancies and 96% (56,626/59,005) of singletons birthed vaginally. During pregnancy, a significantly higher proportion of twin pregnancies compared to singleton had pre-eclampsia (7.0% versus 1.7%), gestational hypertension (9.9% versus 3.9%) and eclampsia (1.0% versus 0.2%). The stillbirth rate of twin 1 and twin 2 was higher compared to singletons: twin 1 25 per 1,000 (15/595), twin 2 64 per 1,000 (38/595) and singletons 12 per 1,000 (680/58,781). The estimated odds ratio (95% confidence interval (CI)) for stillbirth of twin 1 and twin 2 compared to singletons was 2.2 (95% CI 1.3-3.6) and 5.8 (95% CI 4.1-8.1); and maternal death 2.0 (0.95-11.4), respectively, As expected most perinatal deaths were 28 to <32 week gestation. CONCLUSION In this fragile setting where access to hospital care is difficult, three in four twins birthed vaginally. Twin pregnancies have a higher maternal morbidity and perinatal mortality, especially the second twin, compared to singleton pregnancies.
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Affiliation(s)
- Taco J. Prins
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
- Amsterdam University Medical Centres, Department of Internal Medicine & Infectious diseases, and Research groups: APH, GH and AII&I, Amsterdam UMC, Amsterdam, The Netherlands
| | - Aung Myat Min
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Mary E. Gilder
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Nay Win Tun
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Janneke Schepens
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Kathryn McGregor
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Verena I. Carrara
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jacher Wiladphaingern
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Mu Koh Paw
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Eh Moo
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Marcus J. Rijken
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Michele van Vugt
- Amsterdam University Medical Centres, Department of Internal Medicine & Infectious diseases, and Research groups: APH, GH and AII&I, Amsterdam UMC, Amsterdam, The Netherlands
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Gumpangseth T, Komutrattananont P, Palee P, Lekawanvijit S, Kanchai C, Prasitwattanaseree S, Mahakkanukrauh P. Collagen and elastic fibers assessment of the human heart valves for age estimation in Thais using image analysis. Forensic Sci Med Pathol 2024:10.1007/s12024-023-00775-3. [PMID: 38634992 DOI: 10.1007/s12024-023-00775-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 04/19/2024]
Abstract
The study investigated the relationship between the histological compositions of the tricuspid, pulmonary, mitral, and aortic valves, and age. All 85 fresh human hearts were obtained with an age range between 20 and 90 years. The central area of the valves was conducted to analyze the density of collagen and elastic fibers by using an image analysis program. Neural network function in MATLAB was used for classification data and accuracy test of the age predictive model. Overall, a gradual increase in the density of collagen and elastic fibers was demonstrated with age in all valve types. The pulmonary valve cusps had the least density of collagen and elastic contents, whereas the most dense of collagen was found in the mitral leaflets. A similarity was noted for the elastic fibers in the tricuspid, mitral, and aortic valves. The highest correlation between the collagen (r = 0.629) and elastic fibers (r = 0.713) and age was found in the noncoronary cusp of the aortic valve. The established predictive equations using collagen and elastic fibers in the noncoronary cusp provided the standard error of ± 14.0 and 12.5 years, respectively. A 60.9% of accuracy was found in all age groups using collagen, while accuracy in elastic fibers showed 70.0% in the classification process using the neural networks. The current study provided additional data regarding age-associated changes of collagen and elastic fibers in the human heart valves in Thais and the benefits and application in age forensic identification.
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Affiliation(s)
- Treerat Gumpangseth
- Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Excellence Center in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | - Patison Palee
- College of Arts Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Suree Lekawanvijit
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaturong Kanchai
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sukon Prasitwattanaseree
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pasuk Mahakkanukrauh
- Excellence Center in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, 50200, Thailand.
- Department of Anatomy, Faculty of Medicine and Research Cluster in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, 50200, Thailand.
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Khin Moe Myint, DeMaranville J, Wongpakaran T, Peisah C, Arunrasameesopa S, Wongpakaran N. Meditation Moderates the Relationship between Insecure Attachment and Loneliness: A Study of Long-Term Care Residents in Thailand. Medicina (Kaunas) 2024; 60:622. [PMID: 38674268 DOI: 10.3390/medicina60040622] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Loneliness is prevalent among residents of long-term care settings, posing significant challenges to their mental wellbeing. Insecure attachment has been identified as a contributing factor to loneliness in this population. Previous research has suggested that meditation may have beneficial effects on mental health outcomes. This study aimed to examine the relationship between meditation, insecure attachment, and loneliness among residents of long-term care facilities in Thailand. Specifically, the study sought to investigate the moderating effect of meditation on the association between insecure attachment (both avoidance and anxiety) and loneliness. Materials and Methods: A cross-sectional study was conducted involving 236 residents living in long-term care homes in Thailand. Participants completed self-report measures including the 18-item Revised Experience of Close Relationship questionnaire (to assess attachment anxiety and avoidance), the Inner Strength-Based Inventory (to measure meditation practice), and the 6-item Revised Version of the University of California Los Angeles Loneliness Scale. Moderation analyses were performed to explore the role of meditation in the relationship between insecure attachment and loneliness. Results: The mean age of participants was 73.52 years, with females accounting for 57.6% of the sample. Among the participants, 58.4% reported engaging in meditation, with practice frequency ranging from often to daily. The mean meditation score was 2.92 out of 5, indicating regular but not daily practice. Meditation was found to moderate the relationship between insecure attachment (both avoidance and anxiety) and loneliness. Specifically, the moderation effect between attachment anxiety and loneliness was significant (B = 0.44, SE = 0.21, 95% CI [0.30, 0.86]), as was the interaction effect between attachment anxiety and loneliness (B = -0.34, SE = 0.17, 95% CI [-0.67, -0.02]). Conclusions: The findings suggest that the impact of meditation practice on loneliness is influenced by an individual's attachment dimension. Meditation demonstrates a moderating effect on attachment avoidance, anxiety, and loneliness, with variations observed in the direction of these effects. The clinical implications of these findings and recommendations for further research are discussed.
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Affiliation(s)
- Khin Moe Myint
- Master of Science Program (Mental Health), Multidisciplinary Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Justin DeMaranville
- Master of Science Program (Mental Health), Multidisciplinary Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Tinakon Wongpakaran
- Master of Science Program (Mental Health), Multidisciplinary Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Carmelle Peisah
- Master of Science Program (Mental Health), Multidisciplinary Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
- Discipline of Psychiatry and Mental, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Suthikarn Arunrasameesopa
- Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi 11120, Thailand
| | - Nahathai Wongpakaran
- Master of Science Program (Mental Health), Multidisciplinary Interdisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Likhitweerawong N, Boonchooduang N, Khorana J, Phinyo P, Patumanond J, Louthrenoo O. Executive dysfunction as a possible mediator for the association between excessive screen time and problematic behaviors in preschoolers. PLoS One 2024; 19:e0298189. [PMID: 38574024 PMCID: PMC10994291 DOI: 10.1371/journal.pone.0298189] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 01/20/2024] [Indexed: 04/06/2024] Open
Abstract
Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13-0.44], which was more than half of the total effect (54.9%, 95% CI [37.4-100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time.
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Affiliation(s)
- Narueporn Likhitweerawong
- Department of Pediatrics, Division of Growth and Development, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nonglak Boonchooduang
- Department of Pediatrics, Division of Growth and Development, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jiraporn Khorana
- Department of Surgery, Division of Pediatric Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jayanton Patumanond
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Orawan Louthrenoo
- Department of Pediatrics, Division of Growth and Development, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sapbamrer R, Sittitoon N, Thongtip S, Chaipin E, Sutalangka C, La-up A, Thirarattanasunthon P, Thammachai A, Suwannakul B, Sangkarit N, Kitro A, Panumasvivat J, Srisookkum T. Socio-demographic, agricultural, and personal protective factors in relation to health literacy among farmers from all regions of Thailand. Front Public Health 2024; 12:1364296. [PMID: 38590809 PMCID: PMC10999635 DOI: 10.3389/fpubh.2024.1364296] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Farmers are vulnerable to adverse health effects from pesticide exposure due to their health literacy (HL). Therefore, this study aims to investigate HL among farmers in four main regions of Thailand, investigating socio-demographics, agricultural, and personal protective factors to their HL. Methods This cross-sectional design study was conducted on 4,035 farmers from January to July 2023. The European Health Literacy Survey Questionnaire-47 items were used to measure HL. Results Thai farmers had a mean HL score of 34.7 ± 8.7, and the farmers in the North region of Thailand had the highest frequency of limited HL (75.8%). Socio-demographic factors that were associated with HL included gender, region of living, marital status, education level, co-morbidity, and number of family members. Agricultural factors associated with HL included planting status, working hours on farm, spraying pesticides, harvesting crops, pesticide use of >1 type, access information from government officers, access information from posters/brochures, information from online multimedia, and access information from neighbors. Personal protective factors that were associated with HL included wearing a hat, goggles, a rubber apron, and a long-sleeved shirt. Discussion Our study recommends that strategies and interventions to enhance the HL of farmers should be focused on the target populations, which include men, widows, or divorced, those with low levels of education, those who have co-morbidities, and those who applied pesticides of more than 1 type and improper personal protective equipment (PPE) use. The primary emphasis needs to be on the North region of Thailand, making that the target area to improve health equity in Thailand. These efforts would enhance the HL of farmers and sustainably improve pesticide safety behavior. Additionally, there is an urgent need for supportive measures aimed at altering on-farm practices and promoting education on alternative pest management strategies, particularly non-chemical crop protection, to ensure sustainable agriculture.
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Affiliation(s)
- Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nalin Sittitoon
- School of Environmental Health, Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Sakesun Thongtip
- Department of Environmental Health, School of Public Health, University of Phayao, Phayao, Thailand
| | - Eakasit Chaipin
- Department of Public Health, Faculty of Science, Rajabhat Lampang University, Lampang, Thailand
| | - Chatchada Sutalangka
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Aroon La-up
- Nakhonsawan Campus, Mahidol University, Nakhonsawan, Thailand
| | | | - Ajchamon Thammachai
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jinjuta Panumasvivat
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Taweewun Srisookkum
- Department of Community Health, School of Public Health, University of Phayao, Phayao, Thailand
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Nan SN, Wittayachamnankul B, Wongtanasarasin W, Tangsuwanaruk T, Sutham K, Thinnukool O. An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand. BMC Med Inform Decis Mak 2024; 24:83. [PMID: 38515130 PMCID: PMC10956271 DOI: 10.1186/s12911-024-02456-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Emergency Department (ED) overcrowding is a global concern, with tools like NEDOCS, READI, and Work Score used as predictors. These tools aid healthcare professionals in identifying overcrowding and preventing negative patient outcomes. However, there's no agreed-upon method to define ED overcrowding. Most studies on this topic are U.S.-based, limiting their applicability in EDs without waiting rooms or ambulance diversion roles. Additionally, the intricate calculations required for these scores, with multiple variables, make them impractical for use in developing nations. OBJECTIVE This study sought to examine the relationship between prevalent ED overcrowding scores such as EDWIN, occupancy rate, and Work Score, and a modified version of EDWIN newly introduced by the authors, in comparison to the real-time perspectives of emergency physicians. Additionally, the study explored the links between these overcrowding scores and adverse events related to ED code activations as secondary outcomes. METHOD The method described in the provided text is a correlational study. The study aims to examine the relationship between various Emergency Department (ED) overcrowding scores and the real-time perceptions of emergency physicians in every two-hour period. Additionally, it seeks to explore the associations between these scores and adverse events related to ED code activations. RESULTS The study analyzed 459 periods, with 5.2% having Likert scores of 5-6. EDOR had the highest correlation coefficient (0.69, p < 0.001) and an AUC of 0.864. Only EDOR significantly correlated with adverse events (p = 0.033). CONCLUSION EDOR shows the most robust link with 'emergency physicians' views on overcrowding. Additionally, elevated EDOR scores correlate with a rise in adverse events. Emergency physicians' perceptionof overcrowding could hint at possible adverse events. Notably, all overcrowding scores have high negative predictive values, efficiently negating the likelihood of adverse incidents.
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Affiliation(s)
- Sukumpat Na Nan
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Borwon Wittayachamnankul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Wachira Wongtanasarasin
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Theerapon Tangsuwanaruk
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Krongkarn Sutham
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Orawit Thinnukool
- Embedded System and Computational Science Lab, Chiang Mai University, 50200, Chiang Mai, Thailand.
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Gilder ME, Pateekhum C, Wai NS, Misa P, Sanguanwai P, Sappayabanphot J, Tho NE, Wiwattanacharoen W, Nantsupawat N, Hashmi A, Angkurawaranon C, McGready R. Determinants of health care worker breastfeeding experience and practices and their association with provision of care for breastfeeding mothers: a mixed-methods study from Northern Thailand. Int Breastfeed J 2024; 19:8. [PMID: 38273372 PMCID: PMC10809554 DOI: 10.1186/s13006-024-00613-4] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Improving breastfeeding rates is one of the most cost-effective ways to prevent infant deaths, but most of the world falls far below WHO recommended breastfeeding practices. Confident, informed healthcare workers are an important resource to promote breastfeeding, but healthcare workers are at risk of early breastfeeding cessation themselves. Culture, ethnicity and socio-economic status impact breastfeeding rates with some of the highest and lowest rates in Southeast Asia reported from Thailand. This study explores the relationship between workplace determinants of breastfeeding, personal breastfeeding outcomes for healthcare workers, and the breastfeeding care healthcare workers provide their patients. METHODS This study used a sequential exploratory design guided by a conceptual framework based on social ecological/ecological psychology models. Participants came from four clinical sites in Northern Thailand, from ethnically Burman or Karen communities with high breastfeeding rates, and Thai communities with low breastfeeding rates. In-depth interviews (July 2020-November 2020) were followed by a quantitative survey (November 2020-July 2021) derived from validated questionnaires (Australian Breastfeeding Knowledge and Attitudes Questionnaire and the Workplace Breastfeeding Support Scale) with minor local adaptations. RESULTS Interviews highlighted the beneficial effects of supportive workplace policies, the importance of physical spaces to facilitate proximity between mothers and infants, and the problem of low milk production. Meeting the WHO recommended practices of exclusive breastfeeding to 6 months or total breastfeeding to 2 years or more was more common in sites with higher levels of breastfeeding support (aOR 7.3, 95%CI 1.8, 29.1 for exclusive breastfeeding). Exclusive breastfeeding was also higher when staff set breastfeeding goals (aOR 4.4, 95%CI 1.7, 11.5). Staff who were able to see their infants during the work day were less likely to terminate breastfeeding because of work (aOR 0.3, 95%CI 0.1, 0.8). Staff who met both WHO recommendations themselves were more likely to report high levels of confidence caring for breastfeeding patients (aOR 2.6, 95%CI 1.1, 6.4). CONCLUSIONS Workplace protections including supportive maternity leave policies and child-friendly spaces can improve breastfeeding outcomes for healthcare workers. These improved outcomes are then passed on to patients who benefit from healthcare workers who are more confident and attentive to breastfeeding problems.
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Affiliation(s)
- Mary Ellen Gilder
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Chanapat Pateekhum
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Nan San Wai
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Prapatsorn Misa
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Phimthip Sanguanwai
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
- Mae Ramat Hospital, Mae Ramat, Tak, Thailand
| | - Jarntrah Sappayabanphot
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | | | | | - Nopakoon Nantsupawat
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Ahmar Hashmi
- Institute for Implementation Science, University of Texas Health Sciences Center (UTHealth), Houston, TX, USA
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Sciences Center (UTHealth), Houston, TX, USA
| | - Chaisiri Angkurawaranon
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand.
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Mano C, Kongkaew A, Tippawangkosol P, Junkum A, Siriyasatien P, Jariyapan N. In vitro susceptibility to miltefosine of amphotericin B-resistant Leishmania (Mundinia) martiniquensis. Parasitol Res 2023; 122:3027-3035. [PMID: 37796293 DOI: 10.1007/s00436-023-07992-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
Leishmania (Mundinia) martiniquensis is a newly described species that causes human visceral, disseminated, and mucocutaneous leishmaniases. Amphotericin B deoxycholate (AmpB) is the first-line drug for the treatment of leishmaniasis in Thailand; however, several relapse cases of leishmaniasis caused by L. martiniquensis have been documented. In this study, in vitro susceptibility to AmpB and miltefosine (MIL) of wild-type (before treatment, LSCM1) and two AmpB-resistant L. martiniquensis strains (an in vitro-induced AmpB-resistant strain, AmpBRP2i, and a relapse strain, LSCM1-6) were determined. Results reveal that the IC50 value and resistance index against both drugs of promastigotes and intracellular amastigotes of the AmpBRP2i and LSCM1-6 strains were statistically significantly higher than those of the LSCM1 strain suggesting that cross-resistance with MIL occurred in both AmpB-resistant strains. The results of this study advocate further investigation into mechanisms that involve the complex nature of AmpB/MIL resistance in L. martiniquensis and development of effective methods for the identification of the AmpB-resistant parasites to help delivery of appropriate treatments for patients and for epidemiological surveys to survey the potential spread of drug-resistant strains.
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Affiliation(s)
- Chonlada Mano
- Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Aphisek Kongkaew
- Animal House Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pongsri Tippawangkosol
- Center of Insect Vector Study, Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Anuluck Junkum
- Center of Insect Vector Study, Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Padet Siriyasatien
- Center of Excellence in Vector Biology and Vector-Borne Disease, Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Narissara Jariyapan
- Center of Excellence in Vector Biology and Vector-Borne Disease, Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
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9
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Limmahakhun S, Adulkasem N, Rungsiyakull C, Jingjit W, Rojanasthien S. Micromotion and stress shielding between taper fluted and cylindrical femoral stems for Paprosky bone deficiency type IIIB. Musculoskelet Surg 2023; 107:391-396. [PMID: 36944751 DOI: 10.1007/s12306-023-00781-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Taper fluted and cylindrical femoral stems have been commonly used for revision surgery with femoral bone loss. Shape and material differences between taper fluted and cylindrical confused surgeons whether superiority and inferiority in comparisons especially for type IIIB Paprosky bone deficiency. This study aims to investigate the micromotion between implant and bone interface and stress distribution around the implant in human cadaveric experiments. METHODS Paired comparisons of 7 cadavers between taper fluted stem and cylindrical stem were tested under dynamic cyclic loading. RESULTS The results showed appropriate bone-implant micromotions for bone osteointegration could be observed between both taper fluted and cylindrical stems (85 ± 10 μm and 113 ± 80 μm respectively, p = 0.59). Taper fluted stem attained the load distribution from the proximal to distal surrounding bone (from 4.92 ± 2.87 MPa to 2.14 ± 1.43 MPa, p = 0.43), while the cylindrical stem type showed the proximal bone stress shielding (from 2.56 ± 0.76 MPa to 5.23 ± 0.77 MPa, p = 0.03). CONCLUSION Both taper fluted and cylindrical femoral stems provided an adequate initial stability with a proper micromotions for bone-implant osteointegration for type IIIB Paprosky femoral bone loss. The taper fluted femoral stem had better biomechanical advantage in terms of greater stress transfer to periprosthetic bone.
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Affiliation(s)
- S Limmahakhun
- Department of Orthopaedic Surgery, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Suthep, Muang District, Chiang Mai, 50200, Thailand.
| | - N Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Suthep, Muang District, Chiang Mai, 50200, Thailand
| | - C Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineer, Chiang Mai University, Chiang Mai, Thailand
| | - W Jingjit
- Department of Orthopaedic Surgery, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Suthep, Muang District, Chiang Mai, 50200, Thailand
| | - S Rojanasthien
- Department of Orthopaedic Surgery, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Suthep, Muang District, Chiang Mai, 50200, Thailand
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10
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Shinawatra P, Kasirawat C, Khunanon P, Boonchan S, Sangla S, Maneeton B, Maneeton N, Kawilapat S. Exploring Factors Affecting Impostor Syndrome among Undergraduate Clinical Medical Students at Chiang Mai University, Thailand: A Cross-Sectional Study. Behav Sci (Basel) 2023; 13:976. [PMID: 38131833 PMCID: PMC10740738 DOI: 10.3390/bs13120976] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
Impostor syndrome is a psychological condition that inhibits individuals' ability to recognize their achievements such that they fear being exposed as forgers. It is common in medical students, particularly in the early stages of clerkship training while transitioning from preclinical to clinical training. This cross-sectional study assessed the prevalence and associated factors of the imposter phenomenon among medical clinical students using the Clance Impostor Phenomenon Scale (CIPS), focusing on sociodemographic characteristics, mental health status, and occurrence of the impostor phenomenon. Out of 228 undergraduate clinical-year medical students, 108 (47.4%) reported experiencing the impostor phenomenon. The results from the multivariable analysis showed that high levels of stress (adjusted odds ratio = 2.315; 95% confidence interval = 1.105-4.853), anxiety (6.462; 1.374-30.392), and depression (4.219; 1.448-12.290) were significantly associated with an increased risk of experiencing the impostor phenomenon. We found no difference between participants in the early or later years of clerkship training. The study highlights the prevalence of impostor syndrome among medical students and its link to mental health issues. Addressing this issue through education, mentorship, systemic problem solving, normalizing failure, and monitoring and treating mental health issues could help students reach and realize their full educational and professional potential.
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Affiliation(s)
- Purichaya Shinawatra
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (C.K.); (P.K.); (S.B.); (S.S.)
| | - Chayada Kasirawat
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (C.K.); (P.K.); (S.B.); (S.S.)
| | - Phichittra Khunanon
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (C.K.); (P.K.); (S.B.); (S.S.)
| | - Sorrathorn Boonchan
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (C.K.); (P.K.); (S.B.); (S.S.)
| | - Siripit Sangla
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (C.K.); (P.K.); (S.B.); (S.S.)
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.M.); (S.K.)
| | - Narong Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.M.); (S.K.)
| | - Suttipong Kawilapat
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.M.); (S.K.)
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11
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Ruangchaisiwawet A, Bankhum N, Tanasombatkul K, Phinyo P, Yingchankul N. Prevalence and the association between clinical factors and Diabetes-Related Distress (DRD) with poor glycemic control in patients with type 2 diabetes: A Northern Thai cross-sectional study. PLoS One 2023; 18:e0294810. [PMID: 38011152 PMCID: PMC10681199 DOI: 10.1371/journal.pone.0294810] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Glycemic control is important to prevent diabetic complications. However, evidence linking factors such as diabetes-related distress (DRD) to poor glycemic outcomes is lacking in Thailand. Therefore, this study aimed to investigate the prevalence and associated factors of poor glycemic control type 2 diabetes. METHODS A cross-sectional study was conducted on 127 type 2 diabetic patients between December 2021 and March 2022 at Maharaj Nakorn Chiang Mai Hospital, Thailand. Data collection included demographic data, clinical data (duration of being type 2 diabetes, diabetic treatment modalities, weight, height, blood pressure, FBS, and HbA1c), behavioral data (self-care behavior, physical activity, dietary assessment, smoking, alcohol consumption, and sleep quality), and psycho-social data (depression and DRD). Poor glycemic control was defined as not achieving the target HbA1c based on the 2021 American Diabetes Association (ADA) Guideline. Multivariable logistic regression was used to explore the associations between potential factors including DRD, and poor glycemic control. RESULTS The prevalence of poor glycemic control in patients with type 2 diabetes was 29.1%. Our analysis revealed that age under 65 years old (OR 6.40, 95% CI 2.07-19.77, p = 0.001), obesity (BMI ≥ 25 kg/m2) (OR 2.96, 95% CI 1.05-8.39, p = 0.041), and DRD (OR 14.20, 95% CI 3.76-53.64, p<0.001) were significantly associated with poor glycemic control. Three dimensions of DRD were associated with poor glycemic control, including emotional distress (OR 4.23, 95% CI 1.51-11.85, p = 0.006), regimen-related distress (OR 6.00, 95% CI 1.88-19.18, p = 0.003), and interpersonal distress (OR 5.25, 95% CI 1.39-20.02, p = 0.015). CONCLUSION AND RECOMMENDATION Age, obesity, and DRD are associated with poor glycemic control. A holistic approach that includes addressing DRD is crucial for improving glycemic outcomes in patients with type 2 diabetes. Further studies in broader populations using a cohort design are recommended.
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Affiliation(s)
| | - Narumit Bankhum
- Nutrition and Dietary service section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krittai Tanasombatkul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Nalinee Yingchankul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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12
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Surit P, Wongtanasarasin W, Boonnag C, Wittayachamnankul B. Association between air quality index and effects on emergency department visits for acute respiratory and cardiovascular diseases. PLoS One 2023; 18:e0294107. [PMID: 37972204 PMCID: PMC10653395 DOI: 10.1371/journal.pone.0294107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Several studies suggest that air pollution, particularly PM2.5, increases morbidity and mortality, Emergency Department (ED) visits, and hospitalizations for acute respiratory and cardiovascular diseases. However, no prior study in Southeastern Asia (SEA) has examined the effects of air pollutants on ED visits and health outcomes. This study focused on the association of the Air Quality Index (AQI) of PM2.5 and other pollutants' effects on ED visits, hospitalization, and unexpected deaths due to acute respiratory disease, acute coronary syndrome (ACS), acute heart failure (AHF), and stroke. METHODS We conducted a retrospective study with daily data from ED visits between 2018 and 2019 at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. The AQI of air pollution data was collected from outdoor air quality from the Smoke Haze Integrated Research Unit and the Air Quality Index Visual Map. A distributed lag, non-linear and quasi-Poisson models were used to explore the relationship between air quality parameters and ED visits for each disease. RESULTS 3,540 ED visits were recorded during the study period. The mean daily AQI of PM2.5 was 89.0 ± 40.2. We observed associations between AQI of PM2.5 and the ED visits due to ACS on the following day (RR = 1.023, 95% confidence interval [CI]: 1.002-1.044) and two days after exposure (RR = 1.026, 95% CI: 1.005-1.047). Also, subgroup analysis revealed the association between AQI of PM2.5 and the ED visits due to pneumonia on the current day (RR = 1.071, 95% CI: 1.025-1.118) and on the following day after exposure (RR = 1.024, 95% CI: 1.003-1.046). AQI of PM2.5 associated with increased mortality resulted from ACS on lag day 3 (OR = 1.36, 95% CI: 1.08-1.73). The AQI of PM10 is also associated with increased ED visits due to COPD/asthma and increased hospitalization in AHF. In addition, the AQI of O3 and AQI of NO2 is associated with increased ICU admissions and mortality in AHF. CONCLUSION Short-term PM2.5 exposure escalates ED visits for ACS and pneumonia. PM10's AQI associates with COPD/asthma ED visits and AHF hospitalizations. AQI of O3 and NO2's link to increased ICU admissions and AHF mortality. Urgent action against air pollution is vital to safeguard public health.
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Affiliation(s)
- Panumas Surit
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wachira Wongtanasarasin
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chiraphat Boonnag
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Biomedical Informatics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Borwon Wittayachamnankul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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13
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Wivatvongvana P, Soonthornthum C, Kitisak K. Intermittent tetraburst stimulation combined with transcranial direct current stimulation once weekly for treatment-resistant depression: a case report. J Med Case Rep 2023; 17:415. [PMID: 37779185 PMCID: PMC10544463 DOI: 10.1186/s13256-023-04152-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Single-time non-invasive brain stimulation was carried out using the two-technique approach on a patient suffering from treatment-resistant depression. Five treatment sessions given at weekly intervals resulted in a significant improvement in the Patient Health Questionnaire-9 score for up to 6 weeks. The findings of this study could pave the way for a more efficient less resource-intensive time- and budget-saving technique of employing non-invasive brain stimulation for patients with treatment-resistant depression by minimizing the number of stimulation sessions. CASE PRESENTATION A 67-year-old married non-Latino white American woman suffering from treatment-resistant depression received intermittent tetraburst stimulation in combination with transcranial direct current stimulation weekly for 5 consecutive weeks. Diagnostic transcranial magnetic stimulation showed an observable electrophysiological change. The patient reported a drastic improvement in Patient Health Questionnaire-9 score up until 6-week follow-up and expressed satisfaction with the treatment. CONCLUSIONS This case study suggests that a streamlined protocol for using non-invasive brain stimulation could prove more effective for patients and healthcare providers in terms of safety in comparison to the present guidelines.
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Affiliation(s)
- Pakorn Wivatvongvana
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Chutimon Soonthornthum
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kittipong Kitisak
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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Inchai C, Vaseenon T, Tanaka Y, Mahakkanukrauh P. The Specific Anatomical Morphology of Lateral Ankle Ligament: Qualitative and Quantitative Cadaveric based Study. Orthop Surg 2023; 15:2683-2688. [PMID: 37620949 PMCID: PMC10549863 DOI: 10.1111/os.13872] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE The accurate understanding in morphological features of the lateral ankle ligaments is necessary for the diagnosis and management of ankle instability and other ankle problems. The purpose of this study was to evaluate the anatomical morphology and the attachment areas of lateral ligament complex of ankle joint based on the cadaveric study. METHODS Fifty-four fresh frozen cadaveric ankles were dissected to evaluate the lateral ankle ligaments. Each ligament was separated into two or three small bundles. In the investigated footprint areas, acrylic colors were used as a marker point to locate specific areas of ligament bundle attached to the bone. The Image J software was used to measure and analyze the sizes of the specific footprint areas to achieve descriptive statistical analysis. RESULTS The double bands of anterior talofibular ligament (ATFL) were found as a major type in the present study with 57.41% (31 of 54 ankles) while the single band of ATFL was observed in 42.59% (23 of 54 ankles). The attachment sizes of the ATFL, posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL) were evaluated into two areas; proximal and distal attachments. The average of proximal or fibular part of ATFL, PTFL and CFL were 85.06, 134.27, 93.91 mm2 respectively. The average of distal part of ATFL, PTFL and CFL were 100.07, 277.61, 249.39 mm2 respectively. CONCLUSION Considering the lateral ankle ligament repaired or reconstruction especially using arthroscopy, the precise understanding in specific detail of the lateral ankle ligament may help both diagnose and select the appropriate treatment for solving the ankle problems. These observations may help the surgeon to perform the surgical procedure for determining the appropriate techniques and avoid complication to patients.
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Affiliation(s)
- Chirapat Inchai
- Department of Anatomy, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Tanawat Vaseenon
- Department of Orthopedics, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Yasuhito Tanaka
- Department of Orthopaedic SurgeryNara Medical UniversityKashiharaJapan
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
- Excellence in Osteology Research and Training Center (ORTC), Chiang Mai UniversityChiang MaiThailand
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Charoenvicha C, Wongkawinwoot K, Sirikul W, Khwanngern K, Sirimaharaj W. Predisposing factors of non-syndromic cleft lip and cleft palate in the northern Thai population: A 10-year retrospective case-control study. Congenit Anom (Kyoto) 2023; 63:147-153. [PMID: 37515453 DOI: 10.1111/cga.12529] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/01/2023] [Accepted: 06/04/2023] [Indexed: 07/30/2023]
Abstract
The most common congenital anomaly is orofacial cleft, which is categorized into two main types: cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). One of the most accepted etiologies is multifactorial (gene-environment). This study aimed to identify the amendable risk factors of an orofacial cleft in Northern Thailand. A retrospective case-control study in Maharaj Nakorn Chiang Mai Hospital was conducted from 2011 to 2020. One hundred and seventeen cases of CL/P and CPO were included. Forty-nine normal children were enrolled in a time-matched control group. Exploratory survey data on maternal exposures were collected. Multivariate logistic regression was used to estimate the adjusted association between maternal exposures and CL/P, and CPO occurrence. Multivariate analysis identified three predisposing factors that increased the risk of CL/P and CPO. The first factor was caffeine consumption with a total amount of 560 mg/week (adjusted OR: 7.59; 95% CI: 2.48-23.23; p < 0.001). The second factor was any smoker or passive smoking (adjusted OR: 8.47; 95% CI: 1.63-43.92; p = 0.011). The third factor was a low socioeconomic status (income of lower than 270 USD/month; adjusted OR: 4.05; 95% CI: 1.07-15.27; p = 0.039). From the 10-year study in Northern Thailand: caffeine consumption, exposure to cigarette smoke, and low socioeconomic status were identified as associated negative factors for orofacial clefts. We propose that preconceptional counseling for risk reduction should be emphasized in reducing the mother's exposure to these factors. Future investigations in large multicenter populations are suggested.
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Affiliation(s)
- Chirakan Charoenvicha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
| | - Karn Wongkawinwoot
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
| | - Wachiranun Sirikul
- Faculty of Medicine, Department of Community Medicine, Chiangmai University, Chiang Mai, Thailand
| | - Krit Khwanngern
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
| | - Wimon Sirimaharaj
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
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Kövi Z, Wongpakaran T, Wongpakaran N, Zábó V, Birkás B, Mirnics Z. Comparison of typical Thai and Hungarian personality profiles using the Zuckerman-Kuhlman-Aluja Personality Questionnaire. Sci Rep 2023; 13:13508. [PMID: 37598240 PMCID: PMC10439948 DOI: 10.1038/s41598-023-40654-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023] Open
Abstract
The aim of our study was to compare typical Thai and Hungarian personality profiles of the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). 672 Thai and 647 Hungarian were included in our study. The distribution of age, gender and education level were matched. The ZKA-PQ was administered that measures Aggression, Extraversion, Activity, Sensation Seeking and Neuroticism. We tested reliability, the structural invariance and analyzed aggregated mean profiles for cultures as well as typical profiles by cluster analyses. Reliability of factors were acceptable in both cultures, but some facets (especially AC3 Restlessness) showed low reliability. The global Tucker's coefficient of congruence (TCC) for cross-cultural factorial invariance was 95. We have also run a Multigroup Confirmatory Factor Analysis, but fit indices were not adequate. Cross-cultural neural network invariance was not met either. Hungarians scored significantly higher on Extraversion, Sensation Seeking, Aggression and Activity. Cluster-analyses revealed six typical profiles: Introverted impulsive, Reserved, Resilients, Overcontrolled, Aggressive impulsive and Positive sensation seeker. Majority of first two clusters were Thai respondents, majority for last two clusters were Hungarians. In sum, there were some cross-cultural congruence in factor structure, but strict invariance was not fulfilled. Comparison of mean profiles remain tentative, but cluster analysis revealed cross-cultural differences in typical profiles.
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Affiliation(s)
- Zsuzsanna Kövi
- Centre of Specialist Postgraduate Programmes in Psychology, Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest, 1037, Hungary
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd., T. Sriphoom, A. Meung Chiang Mai, Chiang Mai, 50200, Thailand.
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd., T. Sriphoom, A. Meung Chiang Mai, Chiang Mai, 50200, Thailand
| | - Virág Zábó
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, 1075, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, 1075, Hungary
| | - Béla Birkás
- Institute of Behavioural Sciences, Medical School, University of Pécs, Pécs, 7624, Hungary
| | - Zsuzsanna Mirnics
- Department of Personality and Health Psychology, Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest, 1037, Hungary
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Saengsin K, Gauvreau K, Prakash A. Comparison of aortic stiffness and hypertension in repaired coarctation patients with a bicuspid versus a tricuspid aortic valve. J Cardiovasc Magn Reson 2023; 25:31. [PMID: 37316842 PMCID: PMC10268521 DOI: 10.1186/s12968-023-00941-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Coarctation of the aorta (COA) is associated with reduced aortic distensibility and systemic hypertension (HTN). 60-85% of COA patients have a bicuspid aortic valve (BAV). It is not known if the presence of a BAV accentuates the aortopathy and HTN in CoA patients. We examined whether patients with COA and a BAV had lower aortic distensibility by CMR, and a higher prevalence of systemic HTN compared with COA patients with a tricuspid aortic valve (TAV). METHODS In successfully repaired COA patients excluding those with residual COA, ascending aorta (AAO) and descending aorta (DAO) distensibility was calculated by CMR. HTN was assessed using standard pediatric and adult criteria. RESULTS Among 215 COA patients (median age 25.3 years), 67% had a BAV, and 33% had a TAV. Median AAO distensibility z-score was lower in the BAV group (- 1.2 versus - 0.7; p = 0.014) but DAO distensibility was similar in BAV and TAV patients. HTN prevalence was similar in BAV (32%) and TAV groups (36%, p = 0.56). On multivariable analysis controlling for confounders, HTN was not associated with BAV but was associated with male gender (p = 0.003) and older age at follow-up (p = 0.004). CONCLUSIONS In young adults with treated COA, those with a BAV had stiffer AAO compared to those with a TAV, but DAO stiffness was similar. HTN was not related to BAV. These results suggest that although the presence of a BAV in COA exacerbates the AAO aortopathy, it does not exacerbate the more generalized vascular dysfunction and associated HTN.
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Affiliation(s)
- Kwannapas Saengsin
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kimberlee Gauvreau
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ashwin Prakash
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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18
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Dukaew N, Thongkumkoon P, Sirikaew N, Dissook S, Sakuludomkan W, Tongjai S, Thiennimitr P, Na Takuathung M, Benjanuwattra J, Kongthaweelert P, Koonrungsesomboon N. Gut Microbiota-Mediated Pharmacokinetic Drug-Drug Interactions between Mycophenolic Acid and Trimethoprim-Sulfamethoxazole in Humans. Pharmaceutics 2023; 15:1734. [PMID: 37376182 DOI: 10.3390/pharmaceutics15061734] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Mycophenolic acid (MPA) and trimethoprim-sulfamethoxazole (TMP-SMX) are commonly prescribed together in certain groups of patients, including solid organ transplant recipients. However, little is known about the pharmacokinetic drug-drug interactions (DDIs) between these two medications. Therefore, the present study aimed to determine the effects of TMP-SMX on MPA pharmacokinetics in humans and to find out the relationship between MPA pharmacokinetics and gut microbiota alteration. This study enrolled 16 healthy volunteers to take a single oral dose of 1000 mg mycophenolate mofetil (MMF), a prodrug of MPA, administered without and with concurrent use of TMP-SMX (320/1600 mg/day) for five days. The pharmacokinetic parameters of MPA and its glucuronide (MPAG) were measured using high-performance liquid chromatography. The composition of gut microbiota in stool samples was profiled using a 16S rRNA metagenomic sequencing technique during pre- and post-TMP-SMX treatment. Relative abundance, bacterial co-occurrence networks, and correlations between bacterial abundance and pharmacokinetic parameters were investigated. The results showed a significant decrease in systemic MPA exposure when TMP-SMX was coadministered with MMF. Analysis of the gut microbiome revealed altered relative abundance of two enriched genera, namely the genus Bacteroides and Faecalibacterium, following TMP-SMX treatment. The relative abundance of the genera Bacteroides, [Eubacterium] coprostanoligenes group, [Eubacterium] eligens group, and Ruminococcus appeared to be significantly correlated with systemic MPA exposure. Coadministration of TMP-SMX with MMF resulted in a reduction in systemic MPA exposure. The pharmacokinetic DDIs between these two drugs were attributed to the effect of TMP-SMX, a broad-spectrum antibiotic, on gut microbiota-mediated MPA metabolism.
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Affiliation(s)
- Nahathai Dukaew
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphoom, Muang, Chiang Mai 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Patcharawadee Thongkumkoon
- Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nutnicha Sirikaew
- Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sivamoke Dissook
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wannachai Sakuludomkan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphoom, Muang, Chiang Mai 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siripong Tongjai
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Parameth Thiennimitr
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Mingkwan Na Takuathung
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphoom, Muang, Chiang Mai 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juthipong Benjanuwattra
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Prachya Kongthaweelert
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphoom, Muang, Chiang Mai 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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19
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Intui K, Nuchniyom P, Laoung-On J, Jaikang C, Quiggins R, Sudwan P. Neuroprotective Effect of White Nelumbo nucifera Gaertn. Petal Tea in Rats Poisoned with Mancozeb. Foods 2023; 12:foods12112175. [PMID: 37297420 DOI: 10.3390/foods12112175] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Nelumbo nucifera Gaertn. (N. nucifera) tea is used as food and folk medicine to reduce toxicity in Southeast Asia. Mancozeb (Mz) is used for controlling fungi in agriculture and contains heavy metals. This study aimed to examine the effect of white N. nucifera petal tea on cognitive behavior, hippocampus histology, oxidative stress, and amino acid metabolism in rats poisoned with mancozeb. Seventy-two male Wistar rats were divided into nine groups (n = 8 in each). Y-maze spontaneous alternation test was used to assess cognitive behavior, and amino acid metabolism was investigated by nuclear magnetic resonance spectroscopy (1H-NMR) from blood. There was a significant increase in relative brain weight in the Mz co-administered with the highest dose (2.20 mg/kg bw) of white N. nucifera group. The levels of tryptophan, kynurenine, picolinic acid, and serotonin in blood showed a significant decrease in the Mz group and a significant increase in the Mz co-administered with low dose (0.55 mg/kg bw) of white N. nucifera group. However, there was no significant difference in cognitive behavior, hippocampus histology, oxidative stress, and corticosterone. This study demonstrated that a low dose of white N. nucifera petal tea has a neuroprotective effect against mancozeb.
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Affiliation(s)
- Ketsarin Intui
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pimchanok Nuchniyom
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Jiraporn Laoung-On
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Churdsak Jaikang
- Toxicology Section, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ranida Quiggins
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Paiwan Sudwan
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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20
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Wanchaitanawong W, Kanjanavanit R, Srisuwan T, Wongcharoen W, Phrommintikul A. Diagnostic role of aortic valve calcium scoring in various etiologies of aortic stenosis. Sci Rep 2023; 13:8019. [PMID: 37198243 DOI: 10.1038/s41598-023-34118-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/25/2023] [Indexed: 05/19/2023] Open
Abstract
Most of the studies about aortic valve calcium (AVC) score in aortic stenosis (AS) were based on degenerative or bicuspid AS but not rheumatic AS. We aimed to study the diagnostic accuracy of AVC score to determine severe AS in various etiologies. Adult patients diagnosed with mild to severe AS were enrolled. AVC score were identified from multi-detector computed tomography (MDCT) scan. The AVC score was highest in bicuspid AS (3211.9 (IQR (1100.0-4562.4) AU) compared to degenerative AS (1803.7 (IQR (1073.6-2550.6) AU)), and rheumatic AS (875.6 (IQR 453.3-1594.0) AU), p < 0.001. For the ROC curve to identify severe AS, the AVC score performed well in degenerative and bicuspid AS with the area under the ROC curve (AuROC) 0.834 (95% CI, 0.730, 0.938) in degenerative group; and 0.820 (95% CI, 0.687, 0.953) in bicuspid AS. Whereas AVC score had non-significant diagnostic accuracy with AuROC 0.667 (95% CI, 0.357, 0.976) for male and 0.60(95% CI, 0.243, 0.957) for female in rheumatic AS. The cut-off AVC score values to identify severe AS were AVCS > 2028.9AU (male) and > 1082.5AU (female) for degenerative AS, and > 2431.8AU (male) and > 1293.5AU (female) for bicuspid AS. In conclusions, AVC score is the accurate test for assessing severity in patients with degenerative and bicuspid AS but performs poorly in rheumatic AS group.
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Affiliation(s)
- Wisarut Wanchaitanawong
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Rungsrit Kanjanavanit
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tanop Srisuwan
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanwarang Wongcharoen
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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21
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Chitapanarux T, Gumrai P, Kongkarnka S, Wannasai K, Lertprasertsuke N. Programmed death-ligand 1 expression and overall survival in Thai patients with gastric cancer. Sci Rep 2023; 13:7241. [PMID: 37142693 PMCID: PMC10160126 DOI: 10.1038/s41598-023-34434-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/29/2023] [Indexed: 05/06/2023] Open
Abstract
Programmed death-ligand 1 (PD-L1) expression has now been implicated in gastric cancer (GC). This study was conducted to determine the impact of clinicopathological characteristics on PD-L1 expression and its association with survival in GC patients receiving standard-of-care. In total, 268 GC patients receiving upfront surgery were enrolled at Chiang Mai University Hospital. PD-L1 expression was assayed by immunohistochemistry staining using the Dako 22C3 pharmDx. The rates of PD-L1 positivity by combined positive score (CPS) at a cutoff value of 1 and 5 were 22% and 7%. PD-L1 positivity was significantly higher in patients younger than 55 than those older than 55 (32.6% vs. 16.5%, p = 0.003; 11.6% vs. 4.4%, p = 0.027). PD-L1 positivity was observed more frequently in GC with metastases than without (25.2% vs. 17.1%, p = 0.112; 7.2% vs. 6.7%, p = 0.673). Patients with PD-L1 positive had a significantly shorter median overall survival than those with PD-L1 negative (32.7 vs. 41.6 months, p = 0.042, 27.6 vs. 40.8 months, p = 0.038). In conclusion, PD-L1 expression has been associated with young age, short survival, and metastases, although unrelated to the tumor stage. For GC patients, PD-L1 testing is recommended, especially among young patients with metastases.
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Affiliation(s)
- Taned Chitapanarux
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Pawut Gumrai
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sarawut Kongkarnka
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Komson Wannasai
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nirush Lertprasertsuke
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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22
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Chaiut W, Sapbamrer R, Dacha S, Sudjaritruk T, Parwati I, Sumarpo A, Malasao R. Characteristics of Respiratory Syncytial Virus Infection in Hospitalized Children Before and During the COVID-19 Pandemic in Thailand. J Prev Med Public Health 2023; 56:212-220. [PMID: 37287198 DOI: 10.3961/jpmph.23.019] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES This study compared the epidemiological and clinical manifestations of patients hospitalized with respiratory syncytial virus (RSV) infection before and during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care hospital in Chiang Mai Province, Thailand. METHODS This retrospective observational study utilized data from all cases of laboratory-confirmed RSV infection at Maharaj Nakorn Chiang Mai Hospital from January 2016 to December 2021. Differences in the clinical presentation of RSV infection before (2016 to 2019) and during (2020 to 2021) the COVID-19 pandemic were analyzed and compared. RESULTS In total, 358 patients hospitalized with RSV infections were reported from January 2016 to December 2021. During the COVID-19 pandemic, only 74 cases of hospitalized RSV infection were reported. Compared to pre-pandemic levels, the clinical presentations of RSV infection showed statistically significant decreases in fever on admission (p=0.004), productive cough (p=0.004), sputum (p=0.003), nausea (p=0.03), cyanosis (p=0.004), pallor (p<0.001), diarrhea (p<0.001), and chest pain (p<0.001). Furthermore, vigilant measures to prevent the spread of COVID-19, including lockdowns, also interrupted the RSV season in Thailand from 2020 to 2021. CONCLUSIONS The incidence of RSV infection was affected by the COVID-19 pandemic in Chiang Mai Province, Thailand, which also changed the clinical presentation and seasonal pattern of RSV infection in children.
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Affiliation(s)
- Wilawan Chaiut
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sauwaluk Dacha
- Department of Physical Therapy, Faculty of Associated Medical Science, Chiang Mai University, Chiang Mai, Thailand
| | - Tavitiya Sudjaritruk
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ida Parwati
- Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Anton Sumarpo
- Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
- Department of Clinical Pathology, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia
| | - Rungnapa Malasao
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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23
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Arjsri P, Mapoung S, Semmarath W, Srisawad K, Tuntiwechapikul W, Yodkeeree S, Dejkriengkraikul P. Pyrogallol from Spirogyra neglecta Inhibits Proliferation and Promotes Apoptosis in Castration-Resistant Prostate Cancer Cells via Modulating Akt/GSK-3 β/ β-catenin Signaling Pathway. Int J Mol Sci 2023; 24:ijms24076452. [PMID: 37047425 PMCID: PMC10094533 DOI: 10.3390/ijms24076452] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
Castration-resistant prostate cancer (CRPC) is an advanced form of prostate cancer associated with poor survival rates. The high proliferation and metastasis rates have made CRPC one of the most challenging types of cancer for medical practitioners and researchers. In this study, the anti-cancer properties and inhibition of CRPC progression by S. neglecta extract and its active constituents were determined using two CRPC cell lines, DU145 and PC3. The ethyl acetate fraction of S. neglecta (SnEA) was obtained using a solvent-partitioned extraction technique. The active constituents of SnEA were then determined using the HPLC technique, which showed that SnEA mainly contained syringic acid, pyrogallol, and p-coumaric acid phenolic compounds. After the determination of cytotoxic properties using the SRB assay, it was found that pyrogallol, but not the other two major compounds of SnEA, displayed promising anti-cancer properties in both CRPC cell lines. SnEA and pyrogallol were then further investigated for their anti-proliferation and apoptotic induction properties using propidium iodide and Annexin V staining. The results showed that SnEA and pyrogallol inhibited both DU145 and PC3 cell proliferation by inducing cell cycle arrest in the G0/G1 phase and significantly decreased the expression of cell cycle regulator proteins (cyclin D1, cyclin E1, CDK-2, and CDK-4, p < 0.001). SnEA and pyrogallol treatments also promoted apoptosis in both types of CRPC cells through significantly downregulating anti-apoptotic proteins (survivin, Bcl-2, and Bcl-xl, p < 0.001) and upregulating apoptotic proteins (cleaved-caspase-9, cleaved-caspase-3 and cleaved-PARP-1, p < 0.001). Mechanistic study demonstrated that SnEA and pyrogallol inactivated the Akt signaling pathway leading to enhancement of the active form of GSK-3β in CRPC cell lines. Therefore, the phosphorylation of β-catenin was increased, which caused degradation of the protein, resulting in a downregulation of β-catenin (unphosphorylated form) transcriptional factor activity. The current results reflect the potential impact of S. neglecta extract and pyrogallol on the management of castration-resistant prostate cancer.
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Affiliation(s)
- Punnida Arjsri
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Anticarcinogenesis and Apoptosis Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sariya Mapoung
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Warathit Semmarath
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
- Akkraratchkumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Kamonwan Srisawad
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Anticarcinogenesis and Apoptosis Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wirote Tuntiwechapikul
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Anticarcinogenesis and Apoptosis Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Supachai Yodkeeree
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Anticarcinogenesis and Apoptosis Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pornngarm Dejkriengkraikul
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Anticarcinogenesis and Apoptosis Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai 50200, Thailand
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24
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Thongnak L, Pengrattanachot N, Promsan S, Phengpol N, Sutthasupha P, Jaikumkao K, Lungkaphin A. Metformin mitigates renal dysfunction in obese insulin-resistant rats via activation of the AMPK/PPARα pathway. Arch Pharm Res 2023; 46:408-422. [PMID: 36966452 DOI: 10.1007/s12272-023-01439-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/28/2023] [Indexed: 03/27/2023]
Abstract
Insulin signaling and lipid metabolism are disrupted by long-term consumption of a high-fat diet (HFD). This disruption can lead to insulin resistance, dyslipidemia and subsequently renal dysfunction as a consequence of the inactivation of the AMP-activated protein kinase (AMPK) and peroxisome proliferator-activated receptor-α (PPARα) or AMPK/PPARα pathways. We investigated the impact of metformin on the prevention of renal dysfunction through the modulation of AMPK-regulated PPARα-dependent pathways in insulin-resistant rats induced by a HFD. Male Wistar rats were fed a HFD for 16 weeks to induce insulin resistance. After insulin resistance had been confirmed, metformin (30 mg/kg) or gemfibrozil (50 mg/kg) was given orally for 8 weeks. Evidence of insulin resistance, dyslipidemia, lipid accumulation and kidney injury were observed in HF rats. Impairment of lipid oxidation, energy metabolism and renal organic anion transporter 3 (Oat3) expression and function were demonstrated in HF rats. Metformin can stimulate the AMPK/PPARα pathways and suppress sterol regulatory element-binding transcription factor 1 (SREBP1) and fatty acid synthase (FAS) signaling (SREBP1/FAS) to enable the regulation of lipid metabolism. Renal inflammatory markers and renal fibrosis expression induced by a HFD were more effectively reduced after metformin treatment than after gemfibrozil treatment. Interestingly, renal Oat3 function and expression and kidney injury were improved following metformin and gemfibrozil treatment. Renal cluster of differentiation 36 (CD36) or sodium glucose cotransporter type 2 (SGLT2) expression did not differ after treatment with metformin or gemfibrozil. Metformin and gemfibrozil could reduce the impairment of renal injury in obese conditions induced by a HFD through the AMPK/PPARα-dependent pathway. Interestingly, metformin demonstrated greater efficacy than gemfibrozil in attenuating renal lipotoxicity through the AMPK-regulated SREBP1/FAS signaling pathway.
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Affiliation(s)
- Laongdao Thongnak
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Nattavadee Pengrattanachot
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sasivimon Promsan
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nichakorn Phengpol
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prempree Sutthasupha
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krit Jaikumkao
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Anusorn Lungkaphin
- Renal Transporter and Molecular Signaling Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Functional Foods for Health and Disease, Department of Physiology, Faculty of Medicine, Chiang Mai University, Intravaroros Road, 50200, Chiang Mai, Thailand.
- Functional Food Research Center for Well-Being, Chiang Mai University, Chiang Mai, Thailand.
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25
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Kansuttiviwat C, Niprapan P, Tantiworawit A, Norasetthada L, Rattarittamrong E, Rattanathammethee T, Hantrakool S, Piriyakhuntorn P, Punnachet T, Hantrakun N, Chai-adisaksopha C. Impact of antiphospholipid antibodies on thrombotic events in ambulatory cancer patients. PLoS One 2023; 18:e0279450. [PMID: 36662720 PMCID: PMC9858372 DOI: 10.1371/journal.pone.0279450] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/07/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite the conflicting data, the positivity of antiphospholipid antibodies (aPL) in cancer patients may be associated with an increased risk of thrombosis. OBJECTIVE To identify the prevalence and impact of aPL on venous thromboembolic events (VTE) and arterial thrombosis (ATE) in ambulatory cancer patients. METHODS In this single-center, prospective cohort study, we enrolled newly diagnosed ambulatory cancer patients receiving chemotherapy. Non-cancer controls were age- and sex-matched. Participants were evaluated for aPL. Primary outcomes were the composite outcome of VTE or ATE and the prevalence of aPL positivity in cancer patients. Secondary outcomes included the risk of VTE and ATE in cancer patients and all-cause mortality at six-month follow-up duration. RESULTS There were 137 cases and 137 controls with mean age of 56.0±12.3 and 55.5±12.1 years, respectively. Cancer patients were more likely to have positive aPL compared to controls, with the risk difference of 9.4% (95%CI 1.5 to 17.5). Composite of ATE or VTE occurred in 9 (6.6%) in cancer patients and 2 (1.5%) in controls. Cancer patients with aPL positivity were associated with higher risk of ATE or VTE (risk ratio [RR] 3.6, 95% CI 1.04-12.4). Positive LA in cancer patients were associated with higher risk of composites of ATE or VTE (RR 5.3 95%CI 1.3-21.0), whereas the anti-β2-GPI positivity were associated with increased risk of VTE (RR 4.7, 95%CI 1.1-19.2). CONCLUSION aPL was more prevalent in active cancer patients and positive aPL in cancer patients was associated with arterial or venous thrombosis.
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Affiliation(s)
| | - Piangrawee Niprapan
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lalita Norasetthada
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekarat Rattarittamrong
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanawat Rattanathammethee
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sasinee Hantrakool
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pokpong Piriyakhuntorn
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Teerachat Punnachet
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nonthakorn Hantrakun
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chatree Chai-adisaksopha
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Wongpakaran N, Pooriwarangkakul P, Suwannachot N, Mirnics Z, Kövi Z, Wongpakaran T. Moderating role of observing the five precepts of Buddhism on neuroticism, perceived stress, and depressive symptoms. PLoS One 2022; 17:e0277351. [PMID: 36449445 PMCID: PMC9710746 DOI: 10.1371/journal.pone.0277351] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 10/25/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Evidence has shown that the Five precepts significantly affect the relationship between attachment and resilience; however, little is known whether observing the Five Precepts would help reduce depressive symptoms among those who experience risks. The aim of this study was to examine the moderating role of the Five Precepts in the mediation model relationship among neuroticism, perceived stress, and depression. PATIENTS AND METHODS The study employed a cross-sectional survey design and data were collected from the end of 2019 to September 2022 in Thailand. In all, 644 general participants completed questionnaires on the Neuroticism Inventory (NI), the 10-item Perceived Stress Scale (PSS), Depression Subscale, and the Five-Precept Subscale of the Inner Strength-based Inventory (SBI-PP). Mediation and moderation analyses with 5000 bootstrapping methods were used. RESULTS Among all, 74.2% were female, and the mean age totalled 28.28 years (SD = 10.6). SBI-PP was shown to have a moderation effect on the relationship between NI, PSS and depressive symptoms. The moderating effect between SBI-PP and PSS was significant, whereas SBI-PP and NI was not. The index of moderated mediation from the Five Precepts was significant (b = -0.019 (95%CI -0.029, -0.009)). The moderated mediation model increased the percent variance explaining depressive symptoms to 47.6%, compared with 32.6% from the mediation model alone. CONCLUSION Observing the Five Precepts offers evidence that it buffers the effect of perceived stress on depression. People with high levels of observing the Five Precepts are less likely to develop depressive symptoms. Implications as well as possible future research are discussed.
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Affiliation(s)
- Nahathai Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | - Zsuzsanna Kövi
- Károli Gáspár University of the Reformed Church, Budapest, Hungary
- * E-mail: (TW); (ZK)
| | - Tinakon Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
- * E-mail: (TW); (ZK)
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Tananuvat N, Tansanguan S, Wongpakaran N, Wongpakaran T. Reliability, validity, and responsiveness of the Thai version of the Dry Eye-Related Quality-of-Life Score questionnaire. PLoS One 2022; 17:e0271228. [PMID: 35852996 PMCID: PMC9295941 DOI: 10.1371/journal.pone.0271228] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/25/2022] [Indexed: 11/29/2022] Open
Abstract
Dry eye disease (DED) is a common and growing eye problem worldwide. Chronic DED symptoms can, subsequently, affect the patients’ quality of life (QOL). This prospective cross-sectional study aimed to assess the reliability, validity, and responsiveness of the Thai version of the Dry Eye-Related Quality-of-Life Score (DEQS-Th) questionnaire and to evaluate its accuracy in DED screening. Psychometric validation was conducted on DED participants. All participants completed the DEQS-Th and other measurements including the Ocular Surface Disease Index (OSDI) and the 5-level EQ-5D (EQ-5D-5L). Internal consistency, concurrent validity, convergent, and discriminant validity were evaluated. The standardized response mean (SRM) was used to evaluate the responsiveness of the DEQS-Th. The optimal cut-off score of DEQS-Th for DED screening was assessed. Among 100 participants with a mean age of 50.9 ± 14.4 years, and 89.0% female, the internal consistency of the DEQS-Th was excellent (Cronbach’s alpha: 0.80–0.92). The test-retest intraclass correlation was 0.82–0.92. It showed concurrent validity with the OSDI (r = 0.694, p < .001) and EQ-5D-5L index scores (r = -0.578, p < .001). DED is suspected if the DEQS-Th score ≥ 18.33 (AUC = 0.897, sensitivity 90.0%, specificity 76.7%) or its Short Form score ≥ 3 (AUC 0.857, sensitivity 93.0%, specificity 63.3%). The SRM of the symptom subscale of DEQS-Th was 0.82, indicating relatively large responsiveness, whereas the impact on daily life subscale and the summary score was small. In conclusion, the DEQS-Th is valid and reliable for evaluating the multifaceted effects of DED on a patient’s QOL. It can be useful for primary assessment and monitoring of DED in routine clinical practice.
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Affiliation(s)
- Napaporn Tananuvat
- Faculty of Medicine, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
| | - Sasiwimon Tansanguan
- Faculty of Medicine, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
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Tangmonkongvoragul C, Chokesuwattanaskul S, Khankaeo C, Punyasevee R, Nakkara L, Moolsan S, Unruan O. Prevalence of symptomatic dry eye disease with associated risk factors among medical students at Chiang Mai University due to increased screen time and stress during COVID-19 pandemic. PLoS One 2022; 17:e0265733. [PMID: 35320310 PMCID: PMC8942203 DOI: 10.1371/journal.pone.0265733] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/07/2022] [Indexed: 12/31/2022] Open
Abstract
Dry eye disease (DED) is one of the most common ophthalmological disorders, resulting from several systemic and ocular etiologies including meibomian gland dysfunction (MGD). During the COVID-19 pandemic, medical students are among the high-risk group for DED, mainly due to the increasing use of a visual display terminal (VDT) for online lectures and psychological stress from encountering several changes. Our study aimed to explore the prevalence of DED using the symptom-based definition and potential risk factors in medical students. This is a prospective cross-sectional study that included medical students at Chiang Mai University between November 2020 and January 2021. All participants were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, the Thai version of the 10-Item Perceived Stress Scale-10 (T-PSS-10), the LipiView® II interferometer, and an interview for other possible risk factors. Overall, 528 participants were included in the study; half of the participants were female. The prevalence of DED was 70.8%. In the univariate analysis, female sex, contact lens wear, and T-PSS-10 stress scores were significantly higher in the DED group (P = 0.002, 0.002, and <0.001, respectively). Moreover, participants with severe DED were likely to have higher meibomian gland tortuosity but not statistically significant. In the multivariate analysis, contact lens use and T-PSS-10 score were significant risk factors associated with the severity of DED. In conclusions, the prevalence of DED in medical students was as high as 70.8%. Contact lens use and psychological stress evaluated using the T-PSS-10 questionnaire had a significant correlation with a risk of DED. Female gender and duration of VDT use were also associated. Most of the risk factors were modifiable and may be used as initial management in patients with DED.
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Affiliation(s)
| | | | | | | | - Lapat Nakkara
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suttipat Moolsan
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Onpreeya Unruan
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Wikan N, Hankittichai P, Thaklaewphan P, Potikanond S, Nimlamool W. Oxyresveratrol Inhibits TNF-α-Stimulated Cell Proliferation in Human Immortalized Keratinocytes (HaCaT) by Suppressing AKT Activation. Pharmaceutics 2021; 14:63. [PMID: 35056961 PMCID: PMC8781909 DOI: 10.3390/pharmaceutics14010063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022] Open
Abstract
Psoriasis is a complex inflammatory disease characterized by hyperproliferative keratinocyte caused by active PI3K/AKT signaling. TNF-α concentrated in the psoriatic lesions stimulates AKT activation. We previously discovered that oxyresveratrol inhibited inflammation via suppressing AKT phosphorylation, therefore oxyresveratrol may possess a conserved property to block AKT activation and proliferation in keratinocyte in response to TNF-α. Our current study proved that oxyresveratrol exhibited potent anti-proliferative effects against TNF-α. These effects are explained by the findings that oxyresveratrol could potentially inhibit TNF-α-stimulated AKT and GSK3-β activation in a dose-dependent manner, and its inhibitory pattern was comparable to that of a specific PI3K inhibitor. Results from immunofluorescence supported that oxyresveratrol effectively inhibited AKT and GSK3-β activation in individual cells upon TNF-α stimulation. Furthermore, functional assay confirmed that oxyresveratrol repressed the expansion of the HaCaT colony over 3 days, and this was caused by the ability of oxyresveratrol to induce cell cycle arrest at S and G2/M phases and the reduction in the expression of a proliferative marker (Ki-67) and a survival marker (MCL-1). Given the importance of TNF-α and the PI3K/AKT pathway in the psoriatic phenotype, we anticipate that oxyresveratrol, which targets the TNF-α-stimulated PI3K/AKT pathway, would represent a promising psoriasis therapy in the near future.
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Affiliation(s)
- Nitwara Wikan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.W.); (P.H.); (P.T.); (S.P.)
| | - Phateep Hankittichai
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.W.); (P.H.); (P.T.); (S.P.)
| | - Phatarawat Thaklaewphan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.W.); (P.H.); (P.T.); (S.P.)
| | - Saranyapin Potikanond
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.W.); (P.H.); (P.T.); (S.P.)
- Research Center for Development of Local Lanna Rice and Rice Products, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wutigri Nimlamool
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (N.W.); (P.H.); (P.T.); (S.P.)
- Research Center for Development of Local Lanna Rice and Rice Products, Chiang Mai University, Chiang Mai 50200, Thailand
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Pojanapotha P, Boonnag C, Siritikul S, Chalanunt S, Kuntawong P, Wongpakaran N, Wongpakaran T. Helpful family climate moderates the relationship between perceived family support of ADHD symptoms and depression: a conditional process model. BMC Psychol 2021; 9:112. [PMID: 34321085 PMCID: PMC8317368 DOI: 10.1186/s40359-021-00615-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Symptoms of attention deficit hyperactivity disorder (ADHD) are commonly comorbid with depression This study aimed to examine the relationship between ADHD symptoms and depression through perceived family support and to explore whether the magnitude of the relationship depended on the type of family climate of medical students. METHODS This cross-sectional study was conducted among 124 first year medical students in Thailand. Participants completed questionnaires on ADHD symptoms, depression, perceived family support, and 9 types of family climate. The questionnaires included the Adult ADHD Self-Report Scale Screener, Patient Health Questionnaire-9, and revised Thai Multidimensional Scale of Perceived Social Support. Mediational analysis was adopted to examine the mediating role of perceived family support in the relationship between ADHD symptoms and depression, while moderation analysis was applied to examine the extent of the relationship depending on family climate. RESULTS The relationship between ADHD symptoms and depression was moderate. Perceived family support partially mediated this relationship after controlling for age and sex. Among the types of family climate, only helpful family climate was a significant moderator of perceived family support and depression. The moderated mediation model increased the variance in depression from 17% by the mediation model to 21%. However, follow-up conditional mediational analysis showed that the indirect effect of ADHD symptoms on depression via perceived family support was not significant and that this effect did not vary linearly as a function of helpful family climate. CONCLUSION The findings of the study revealed that poor family support might be one risk of developing depression in the context of ADHD symptoms. Further study on providing intervention concerning family support among those with ADHD symptoms should be warranted. In addition, a study on helpful family climate in a larger sample size, in other populations, and in a longitudinal fashion for a more robust conclusion is encouraged.
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Affiliation(s)
- Pichaya Pojanapotha
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | | | | | | | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand.
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Kobroob A, Peerapanyasut W, Kumfu S, Chattipakorn N, Wongmekiat O. Effectiveness of N-Acetylcysteine in the Treatment of Renal Deterioration Caused by Long-Term Exposure to Bisphenol A. Biomolecules 2021; 11:655. [PMID: 33946939 PMCID: PMC8145636 DOI: 10.3390/biom11050655] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Human health hazards caused by bisphenol A (BPA), a precursor for epoxy resins and polycarbonate-based plastics, are well documented and are closely associated with mitochondrial impairment and oxidative imbalance. This study aimed to assess the therapeutic efficacy of N-acetylcysteine (NAC) on renal deterioration caused by long-term BPA exposure and examine the signaling transduction pathway involved. Male Wistar rats were given vehicle or BPA orally for 12 weeks then the BPA-treated group was subdivided to receive vehicle or NAC concurrently with BPA for a further 4 weeks, while the vehicle-treated normal control group continued to receive vehicle through to the end of experiment. Proteinuria, azotemia, glomerular filtration reduction and histopathological abnormalities caused by chronic BPA exposure were significantly reduced following NAC therapy. NAC also diminished nitric oxide and lipid peroxidation but enhanced renal glutathione levels, and counteracted BPA-induced mitochondrial swelling, increased mitochondrial reactive oxygen species production, and the loss of mitochondrial membrane potential. The benefit of NAC was related to the modulation of signaling proteins in the AMPK-SIRT3-SOD2 axis. The present study shows the potential of NAC to restore mitochondrial integrity and oxidative balance after long-term BPA exposure, and suggests that NAC therapy is an effective approach to tackle renal deterioration in this condition.
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Affiliation(s)
- Anongporn Kobroob
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand;
| | - Wachirasek Peerapanyasut
- Renal Physiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sirinart Kumfu
- Cardiac Electrophysiology Research and Training Center, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (N.C.)
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (N.C.)
| | - Orawan Wongmekiat
- Renal Physiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
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Jearjaroen P, Pakdeepak K, Tocharus C, Chaichompoo W, Suksamrarn A, Tocharus J. Inhibitory Effect of Hexahydrocurcumin on Memory Impairment and Amyloidogenesis in Dexamethasone-Treated Mice. Neurotox Res 2021; 39:266-276. [PMID: 32852718 DOI: 10.1007/s12640-020-00269-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/16/2022]
Abstract
A high dose of dexamethasone induces neurodegeneration by initiating the inflammatory processes that lead to neural apoptosis. A dexamethasone administration model induces overproduction of amyloid-β (Aβ) and tau protein hyperphosphorylation and shows abnormalities of cholinergic function similar to Alzheimer's disease (AD). This study aimed to investigate the protective effect of hexahydrocurcumin on the brain of dexamethasone-induced mice. The results showed that hexahydrocurcumin and donepezil attenuated the levels of amyloid precursor protein and β-secretase mRNA by reverse transcription polymerase chain reaction, decreased the expression of hyperphosphorylated tau, and improved synaptic function. Moreover, we found that hexahydrocurcumin treatment could decrease interleukin-6 levels by attenuating p65 of nuclear factor kappa-light-chain-enhancer (NF-κB) of activated beta cells. In addition, hexahydrocurcumin also decreased oxidative stress, as demonstrated by the expression of 4-hydroxynonenal and thereby prevented apoptosis. Therefore, our finding suggests that hexahydrocurcumin prevents dexamethasone-induced AD-like pathology and improves memory impairment.
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Affiliation(s)
- Pranglada Jearjaroen
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanet Pakdeepak
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chainarong Tocharus
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Waraluck Chaichompoo
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Ramkhamhaeng University, Bangkok, Thailand
| | - Apichart Suksamrarn
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Ramkhamhaeng University, Bangkok, Thailand
| | - Jiraporn Tocharus
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Center for Research and Development of Natural Products for Health, Chiang Mai University, Chiang Mai, Thailand.
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Phinyo P, Boonyanaruthee C, Paholpak P, Pruksakorn D, Phanphaisarn A, Sangsin A. Natural disease progression and novel survival prediction model for hepatocellular carcinoma with spinal metastases: a 10-year single-center study. World J Surg Oncol 2020; 18:135. [PMID: 32563268 PMCID: PMC7306143 DOI: 10.1186/s12957-020-01913-9] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Individual prediction of life expectancy in patients with spinal metastases from hepatocellular carcinoma (HCC) is key for optimal treatment selection, especially when identifying potential candidates for surgery. Most reported prognostic tools provide categorical predictions, and only a few include HCC-related factors. This study aimed to investigate the natural progression of the disease and develop a prognostic tool that is capable of providing individualized predictions. METHODS Patients with HCC-derived metastatic spinal disease were identified from a retrospective cohort of patients with spinal metastases who were diagnosed at Chiang Mai University Hospital between 2006 and 2015. Kaplain-Meier methods and log-rank tests were used to statistically evaluate potential factors. Significant predictors from the univariable analysis were included in the flexible parametric survival regression for the development of a prognostic prediction model. RESULTS Of the 1143 patients diagnosed with HCC, 69 (6%) had spinal metastases. The median survival time of patients with HCC after spinal metastases was 79 days. In the multivariable analysis, a total of 11 potential clinical predictors were included. After backward elimination, four final predictors remained: patients aged > 60 years, Karnofsky Performance Status, total bilirubin level, and multifocality of HCC. The model showed an acceptable discrimination at C-statistics 0.73 (95% confidence interval 0.68-0.79) and fair calibration. CONCLUSION Four clinical parameters were used in the development of the individual survival prediction model for patients with HCC-derived spinal metastases of Chiang Mai University or HCC-SM CMU model. Prospective external validation studies in a larger population are required prior to the clinical implication of the model.
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Affiliation(s)
- Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Permsak Paholpak
- Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Dumneoensun Pruksakorn
- Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research, Chiang Mai University, Chiang Mai, Thailand
| | - Areerak Phanphaisarn
- Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research, Chiang Mai University, Chiang Mai, Thailand
| | - Apiruk Sangsin
- Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research, Chiang Mai University, Chiang Mai, Thailand
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Tschirhart N, Jiraporncharoen W, Angkurawaranon C, Hashmi A, Nosten S, McGready R, Ottersen T. Choosing where to give birth: Factors influencing migrant women's decision making in two regions of Thailand. PLoS One 2020; 15:e0230407. [PMID: 32240176 PMCID: PMC7117675 DOI: 10.1371/journal.pone.0230407] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/01/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Choosing where to give birth can be a matter of life and death for both mother and child. Migrants, registered or unregistered, may face different choices and challenges than non-migrants. Despite this, previous research on the factors migrant women consider when deciding where to give birth is very limited. This paper addresses this gap by examining women's decision making in a respective border and urban locale in Thailand. METHODS We held focus group discussions [13] with 72 non-Thai pregnant migrant women at non-government clinics in a rural border area and at two hospitals in Chiang Mai, a large city in Northern Thailand in 2018. We asked women where they will go to give birth and to explain the factors that influenced their decision. RESULTS Women identified getting the relevant documentation necessary to register their child's birth, safe birth and medical advice/quality care, as the top three factors that influenced their care seeking decision making. Language of service, free or low cost care, language of services, proximity to home, and limited alternate options for care were also identified as important considerations. CONCLUSION Understanding factors that migrant women value when choosing where to deliver can help health care providers to create services that are responsive to migrants' preferences and encourage provision of relevant information which may influence patient decision making. The desire to obtain birth documentation for their child appears to be important for migrants who understand the importance of personal documentation for the lives of their children. Healthcare institutions may wish to introduce processes to facilitate obtaining documentation for pregnant migrant women and their newborns.
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Affiliation(s)
- Naomi Tschirhart
- Department of Community Medicine and Global Health and Centre for Global Health, Oslo Group on Global Health Policy, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Ahmar Hashmi
- Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Rose McGready
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Trygve Ottersen
- Department of Community Medicine and Global Health and Centre for Global Health, Oslo Group on Global Health Policy, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Santisukwongchote K, Amornlertwatana Y, Sastraruji T, Jaikang C. Possible Use of Blood Tryptophan Metabolites as Biomarkers for Coronary Heart Disease in Sudden Unexpected Death. Metabolites 2019; 10:E6. [PMID: 31861670 PMCID: PMC7022541 DOI: 10.3390/metabo10010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/22/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022] Open
Abstract
Coronary heart disease (CHD) is the major cause of death in sudden unexpected death (SUD) cases. Tryptophan (TRP) and its metabolites are correlated with the CHD patient but less studies in the SUD. The aim of this study was to evaluate the relationship of TRP and its metabolites with the CHD in the SUD cases. Blood samples and heart tissues were collected from CHD subjects (n = 31) and the control group (n = 72). Levels of kynurenine (KYN), kynurenic acid (KYA), xanthurenic acid (XAN), 3-hydroxyanthranillic acid (HAA), quinolinic acid (QA), picolinic acid (PA) and 5-hydroxyindoleacetic acid (HIAA) were determined by HPLC-DAD. A severity of heart occlusion was categorized into four groups, and the relationship was measured with the TRP metabolites. The HIAA and The KYN levels significantly differed (p < 0.01) between the CHD group and the control group. Lower levels of QA/XAN, PA/KA, HAA/XAN, KYN/XAN and KYN/TRP were found in the CHD group. However, PA/HAA, PA/HIAA, PA/KYN and XAN/KA values in the CHD group were higher than the control group (p < 0.05). This study revealed that the values of PA/KA and PA/HAA provided better choices for a CHD biomarker in postmortem bodies.
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Affiliation(s)
- Kobchai Santisukwongchote
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Yutti Amornlertwatana
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Thanapat Sastraruji
- Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Churdsak Jaikang
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
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