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Saetan N.,Chulalongkorn University | Honsawek S.,Chulalongkorn University | Tanavalee A.,Chulalongkorn University | Yuktanandana P.,Chulalongkorn University | And 4 more authors.
International Orthopaedics | Year: 2014

Purpose: Recent evidence suggests that angiogenesis and inflammation contribute to the development and progression of osteoarthritis (OA). The purpose of this study was to investigate vascular endothelial growth factor (VEGF) levels in plasma and synovial fluid of patients with knee OA and to determine the relationship of VEGF levels with disease severity in knee OA. Methods: A total of 100 subjects were enrolled in this study (80 knee OA patients and 20 healthy controls). Plasma and synovial fluid VEGF levels were analysed using enzyme-linked immunosorbent assay. VEGF expressions in synovial membrane and articular cartilage samples were assessed using immunohistochemistry. Results: VEGF level in synovial fluid of knee OA patients was tenfold higher than that in paired plasma (P<0.001). Both plasma and synovial fluid VEGF exhibited a positive correlation with radiographic severity (r=0.454 and r=0.727, P<0.001, respectively). VEGF expression was highly detectable in synovial lining cells and articular chondrocytes of knee OA patients. Conclusions: VEGF levels in both plasma and synovial fluid were positively correlated with the severity of knee OA. Therefore, VEGF may be useful for monitoring OA severity and could play a substantial role in the development and progression of knee OA. © 2013 Springer-Verlag.

Phimda K.,Diabetes and Hypertension Clinic | Chotnoparatpat P.,Bangkok Metropolitan Administration Medical College
International Journal of Collaborative Research on Internal Medicine and Public Health | Year: 2012

Introduction: The national health examination survey in Thailand determined that T2DM and dyslipidemia were probable risk factors resulting in higher rate of uncontrolled hypertension. This had been reported with controlled rate as low as 15%. The authors investigated if the choice of antihypertensive agents render better blood pressure control in Thai hypertensive patients. Objective: To assess the blood pressure (BP) lowering efficacy of Perindopril/indapamide Fixed Dose Combination (P/I FDC), as an antihypertensive of choice in Thai hypertensive patients with multiple co-morbidities and risk factors. Method: A prospective consecutive open-blind evaluation short-term follow-up was initiated with Perindopril 4 mg/Indapamide 1.25 mg Fixed Dose Combination (P/I FDC) among 1,364 Thai hypertensive patients, as newly diagnosed monotherapy, or switched from either inhibitors of angiotensin converting enzyme or angiotensin receptor blocking agents, with addition of either calcium channel blockers of beta-blockers allowed in a multi-center trial hypertensive patients with safety monitoring program demanded by Thai health authority. Result: After 3 months of treatment, the SBP/DBP of patients receiving P/I FDC-based treatment (mean ± SD), [95% CI] was 131.6±9.6 [131.0-132.1] /78.7 ±7.1 [78.3-79.0] mmHg resulting from SBP/DBP reduction of 26.6/11.8 mmHg respectively. In the overall cohort, only 9.7% of patients required additional antihypertensive agents. The authors founded that in newly diagnosed stage 2 hypertensive patients, hypertensive patients with diagnosed dyslipidemia, and with diagnosed T2DM, P/I FDC mono-therapy or in combination effectively reduced SBP/DBP by 33.9/16.0 mmHg, 30.7/12.8 mmHg and 23.5/11.0 mmHg respectively. Overall blood pressure normalization with P/I FDC with SBP/DBP<130/80 mmHg and <140/90 mmHg were 48.2% and 91.4% respectively which were above earlier reported in Thai hypertensive patients. P/I FDC was well tolerated by patients, with a reported cough incidence of 5.1 %. Conclusion: The choice of antihypertensive agents is a critical factor for the control of hypertension. P/I FDC is an effective antihypertensive agent in Thai hypertensive patients for uncontrolled hypertension. It is effective in both newly diagnosed stage I, stage II hypertension and among patients with diagnosed Type 2 Diabetes and dyslipidemia. In daily clinical practice, P/I FDC should be recommended as the first choice antihypertensive among uncontrolled Thai hypertensive patients.

Wichaidit W.,Mahidol University | Kaewkungwal J.,Mahidol University | Sirivichayakul C.,Mahidol University | Taechaboonsermsak P.,Mahidol University | Suvithayasiri V.,Bangkok Metropolitan Administration Medical College
Southeast Asian Journal of Tropical Medicine and Public Health | Year: 2011

The objective of this study was to conduct a cross-sectional evaluation of pregnancy indicators, child growth failure, and the effect of antenatal care on birth outcomes in a marginalized community under the care of a health center in Suan Phung District, Ratchaburi Province. Health and socioeconomic data about children born in 2007 and their parents were obtained from the sub-district health center and district hospital were collected and analyzed by univariate and multivariate methods. Most of the residents in the study were Karen ethnic origin. Data was available for 152 children, of which 136 met study inclusion criteria. Health outcomes of the study population significantly different from the general Thai population included higher average parity (2.53 ± 1.99 vs 1.735; p<0.001), lower average birth weight (2,876.05 ± 399.48 grams vs 3,200 grams, p<0.001), and lower average height-for-age and weight-for-age (p<0.001). The prevalences of stunting, underweight and wasting were higher than the general Thai population (p<0.001). Having fewer than 4 antenatal care (ANC) visits was associated with low birth weight (unadjusted OR 4.88, 95% CI 1.13-21.05; adjusted OR 5.77, 95% CI 1.27- 26.30).

Kasetsermwiriya W.,Kyushu University | Kasetsermwiriya W.,Bangkok Metropolitan Administration Medical College | Nagai E.,Kyushu University | Nakata K.,Kyushu University | And 3 more authors.
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2014

Purpose: To compare the outcomes of laparoscopic surgery and open surgery for gastric gastrointestinal stromal tumors (GISTs) by size-matched analysis and evaluate whether laparoscopic surgery for lesions of >5 cm is feasible. Patients and Methods: Data of 44 consecutive patients with gastric GIST who underwent surgery from 1988 to 2011 were reviewed. Twenty-three patients who underwent successful laparoscopic surgery were compared with 10 patients with similar tumor sizes who underwent open surgery. Among the 23 patients in the laparoscopic group, we compared postoperative results between GISTs of ≤5 cm and >5 cm. Results: There were no differences in clinicopathological characteristics between the laparoscopic surgery group (LG) and the open surgery group (OG). The operation time was not different, but the blood loss (5.5 mL [range, 0-425 mL] in LG and 125 mL [range, 0-676 mL] in OG) (P=.008) and postoperative hospital stay (21 days in OG and 8 days in LG) (P<.001) were significantly less in the LG. Postoperative complications and recurrence were not different. Comparison between patients with lesions of >5 cm and patients with smaller lesions in the LG found that smaller lesions were associated with a shorter postoperative hospital stay (7.5 days versus 11 days) (P=.037). Conclusions: Laparoscopic resection of primary gastric GISTs is feasible even for tumors of >5 cm. © 2014, Mary Ann Liebert, Inc.

Phumeetham S.,Mahidol University | Chat-uthai N.,Mahidol University | Manavathongchai M.,Bangkok Metropolitan Administration Medical College | Viprakasit V.,Mahidol University
Jornal de Pediatria | Year: 2012

Objectives: To evaluate the association between the genetic polymorphism of the tumor necrosis factor-alpha (TNF-α) gene and the development of sepsis and septic shock in Thai pediatric patients and to investigate the clinical impacts of TNF-α polymorphisms in this population. Methods: To perform this genetic association study, a prospective analysis of pediatric patients (age < 18 years) with clinical sepsis/septic shock was conducted. All clinical data were collected by pediatric intensive care experts, and genetic analyses were performed at a central laboratory. A single nucleotide polymorphism (SNP) located in the 5′-promoter region at position -308 was genotyped and the results were associated with clinical phenotypes. Results: A total of 167 Thai individuals were investigated, 66 of which were pediatric patients with sepsis/septic shock and 101 were healthy controls. Interestingly, we could not identify an association between sepsis and -308 (G/A) polymorphism, which have previously been demonstrated to be a major SNP associated with sepsis in several Caucasian populations, since there was no frequency difference between cases and controls. Conclusions: In this report, the major TNF-α polymorphism (-308) was not associated with clinical sepsis/septic shock in Thais. This information will be important for future analyses to identify the role of TNF-α as a genetic risk for the development of immunopathology underlying several diseases in Asia. Copyright © by Sociedade Brasileira de Pediatria.

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