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Bradley B, Kamalanathan M, Shah AJ, Read N, Hall J, Belton M, Baker L. P116 Multidrug-resistant tuberculosis (MDR-TB) monitoring in southeast london using current recommendations; does it prevent complications? Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mandal S, Suh ES, Boleat E, Asher W, Kamalanathan M, Lee K, Douiri A, Murphy PB, Steier J, Hart N. A cohort study to identify simple clinical tests for chronic respiratory failure in obese patients with sleep-disordered breathing. BMJ Open Respir Res 2014; 1:e000022. [PMID: 25478174 PMCID: PMC4212713 DOI: 10.1136/bmjresp-2014-000022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/07/2014] [Accepted: 03/12/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chronic respiratory failure complicating sleep-disordered breathing in obese patients has important adverse clinical implications in terms of morbidity, mortality and healthcare utilisation. Screening strategies are essential to identify obese patients with chronic respiratory failure. METHOD Prospective data were collected from patients with obesity-related sleep-disordered breathing admitted for respiratory assessment at a UK national sleep and ventilation centre. Hypercapnia was defined as an arterial partial pressure of carbon dioxide of >6kPa. RESULTS 245 obese patients (56±13 years) with a body mass index of 48±12 kg/m(2), forced vital capacity (FVC) of 2.1±1.1 L, daytime oximetry (SpO2) of 91±6% and abnormal overnight oximetry were included in the analysis. Receiver operator curve analysis for the whole group showed that an FVC ≤3 L had a sensitivity of 90% and a specificity of 41% in predicting hypercapnia, and an SpO2 ≤95% had a sensitivity of 83% and a specificity of 63% in predicting hypercapnia. Gender differences were observed and receiver operator curve analysis demonstrated 'cut-offs' for (1) SpO2 of ≤95% for men and ≤93% for women and (2) FVC of ≤3.5 L for men and ≤2.3 L for women, in predicting hypercapnia. CONCLUSIONS The measurement of FVC and clinic SpO2 in obese patients with abnormal overnight limited respiratory studies predicted hypercapnia. This may have clinical utility in stratifying patients attending sleep clinics.
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Affiliation(s)
- S Mandal
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK ; Division of Asthma Allergy and Lung Biology , King's College London , London , UK
| | - E S Suh
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK ; Division of Asthma Allergy and Lung Biology , King's College London , London , UK
| | - E Boleat
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - W Asher
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - M Kamalanathan
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - K Lee
- Division of Asthma Allergy and Lung Biology , King's College London , London , UK ; Lane Fox Respiratory Unit , Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - A Douiri
- Division of Health and Social Care Research , King's College London , London , UK ; Guy's and St Thomas' NHS Foundation Trust and King's College London, National Institute Health Research Biomedical Research Centre , London , UK
| | - P B Murphy
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK ; Division of Asthma Allergy and Lung Biology , King's College London , London , UK
| | - J Steier
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK ; Division of Asthma Allergy and Lung Biology , King's College London , London , UK ; Lane Fox Respiratory Unit , Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - N Hart
- Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust , London , UK ; Division of Asthma Allergy and Lung Biology , King's College London , London , UK ; Lane Fox Respiratory Unit , Guy's and St Thomas' NHS Foundation Trust , London , UK ; Guy's and St Thomas' NHS Foundation Trust and King's College London, National Institute Health Research Biomedical Research Centre , London , UK
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Mandal S, Suh E, Kamalanathan M, Ramsay M, Harding R, Moxham J, Hart N. P178 Nocturnal oximetry monitoring to predict hypercapnia in obese patients. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tay ST, Kamalanathan M, Rohani MY. Antibody prevalence of Orientia tsutsugamushi, Rickettsia typhi and TT118 spotted fever group rickettsiae among Malaysian blood donors and febrile patients in the urban areas. Southeast Asian J Trop Med Public Health 2003; 34:165-70. [PMID: 12971530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The seroprevalence of Orientia tsutsugamushi (OT), Rickettsia typhi (RT) and TT118 spotted fever group rickettsiae (SFGR) among blood donors and febrile Malaysian patients in the urban areas was determined. Of the 240 blood donors, 5.4%, 9.2% and 1.7% had either present or previous exposure to OT, RT and SFG rickettsiae, respectively. Patients admitted to an urban hospital had high seroprevalences of OT (43.5%) and RT (22.9%), as compared to SFGR (11.6%). Antibody levels suggestive of recent infections of scrub typhus, murine typhus and tick typhus were detected in 16.8%, 12.7% and 8.2% of patients respectively. No significant difference was noted in the distribution of rickettsial antibodies among urban patients from 2 geographical locations. However, the serologic patterns of rickettsial infection in the urban areas were different form those of rural areas.
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Affiliation(s)
- S T Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
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Tay ST, Kamalanathan M, Rohani MY. Borrelia burgdorferi (strain B. afzelii) antibodies among Malaysian blood donors and patients. Southeast Asian J Trop Med Public Health 2002; 33:787-93. [PMID: 12757227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
In this study, the presence of IgG and IgM antibodies against Borrelia burgdorferi (strain B. afzelii) among Malaysian blood donors and patients admitted to hospital with various infectious diseases was determined. Sera were screened using enzyme-linked immunosorbent assay (ELISA); positive sera were then subjected to Western blot testing. All but one of the blood donors were negative for borrelial antibodies. Of 121 patients' sera, IgM antibodies were detected in 24 (19.8%) and IgG antibodies were detected in 5 (4.1%) sera. Only one of two patients with skin manifestations suggestive of Lyme disease had IgM antibody against B. afzelii. Of 30 patients with exposure to tick typhus, 4 (13.3%) were IgM positive and 1 (3.3%) was IgG positive. Based on the detection of antigenic bands by Western blot, 6 patients' sera showed positive reactions. Antigenic bands of p39, p41 and p59/62 kDa were the commonest findings of Western blotting. This study provides serological evidence of B. afzelii infections in Malaysia; further investigation is needed to correlate serological and clinical findings.
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Affiliation(s)
- S T Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
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Tee TS, Kamalanathan M, Suan KA, Chun SS, Ming HT, Yasin RM, Devi S. Seroepidemiologic survey of Orientia tsutsugamushi, Rickettsia typhi, and TT118 spotted fever group rickettsiae in rubber estate workers in Malaysia. Am J Trop Med Hyg 1999; 61:73-7. [PMID: 10432060 DOI: 10.4269/ajtmh.1999.61.73] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The seroprevalence of Orientia tsutsugamushi, Rickettsia typhi, and TT118 spotted fever group (SFG) rickettsiae in 300 rubber estate workers in Slim River, Malaysia was determined in December 1996 and March 1997. In December, which was the wet season, 23.3%, 3.0%, and 57.3% of the population had antibodies detected against the three rickettsiae, respectively. The highest seropositive rate of 40% was detected for single infection with SFG rickettsiae, followed by a rate of 15.3% for both O. tsutsugamushi and SFG rickettsiae among the rubber estate workers. Subjects less than 21 years old had a lower seroprevalence of SFG rickettsiae compared with the other age groups. Indians had a higher seroprevalence of O. tsutsugamushi compared with other ethnic groups. Rubber tappers had a higher seroprevalence of SFG rickettsiae compared with other occupational groups. During the dry season in March 1997, there was a significant increase in the seroprevalence of R. typhi. The seroconversion rates for IgM against O. tsutsugamushi, R. typhi, and SFG rickettsiae were 5.7%, 12.3%, and 15.1%, respectively, during the four-month period. Significant variations of antibody titers towards the three rickettsiae was noted among subjects who were bled twice. This suggests a significant and continual exposure of rubber estate workers to the three rickettsiae.
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Affiliation(s)
- T S Tee
- Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
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