The association between iron deficiency (ID) and hair loss is controversial. Currently, there is no standard oral iron supplementation for patients with female pattern hair loss (FPHL) and ID. We investigated the efficacy of oral iron supplementation for treating FPHL patients with ID. The results of our study revealed that oral iron supplementation combined with topical 3% minoxidil was not superior to topical 3% minoxidil alone in treating FPHL and ID.
{"title":"Efficacy of Oral Iron Supplementation in Treating Patients with Female Pattern Hair Loss and Low Serum Ferritin: A Pilot Study","authors":"Daranporn Triwongwaranat, Kanchalit Thanomkitti, Supisara Wongdama, Nuttagarn Jantanapornchai, Chanika Subchookul, Chayanee Likitwattananurak, Noldtawat Viriyaskultorn, Supenya Varothai, Rattapon Thuangtong","doi":"10.33192/smj.v75i10.264385","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264385","url":null,"abstract":"The association between iron deficiency (ID) and hair loss is controversial. Currently, there is no standard oral iron supplementation for patients with female pattern hair loss (FPHL) and ID. We investigated the efficacy of oral iron supplementation for treating FPHL patients with ID. The results of our study revealed that oral iron supplementation combined with topical 3% minoxidil was not superior to topical 3% minoxidil alone in treating FPHL and ID.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135459481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.33192/smj.v75i10.264256
Pattarawalai Talungchit, Pornpimol Ruangvutilert, Tachjaree Panchalee Boonbowornpong, Buraya Phattanachindakun
Objective: This study aimed to determine the prevalence of urinary tract infection (UTI) among pregnant women with premature uterine contractions. Roles of the current practice of routine simultaneous urinalysis and urine culture in these cases were also evaluated. Materials and Methods: Medical records of pregnant women admitted with premature uterine contractions at Siriraj Hospital between January 2013 and December 2017 were reviewed. Prevalence of UTI in these women was determined. Women were divided into 2 groups based on diagnosis at admission; group 1 included preterm labor/preterm prelabor rupture of membranes (PTL/PPROM), and group 2 was threatened preterm labor (TPL). Evaluations of urinalysis and/or urine culture were performed in these two groups to establish a strategy to reduce unnecessary urine culture. Results: The prevalence of UTI among 2,286 women with premature uterine contractions was 4.9%. Prevalence of UTI were not different between the two groups of women. A positive urine culture was found in 2.4%. The most common organism identified in both groups of women was Escherichia coli. Urinalysis with abnormal cell counts and/or significant presence of bacteria could be used to screen for women in TPL group who should have urine culture with a positive screening rate of 6.5% and 90.9% sensitivity. With this strategy, unnecessary urine culture could be reduced. Conclusion: The prevalence of UTI among pregnant women admitted with premature uterine contractions was 4.9% and was not different between PTL/PPROM group and TPL group. Urinalysis with abnormal cell counts or significant bacteriuria could be a screening tool to reduce number of urine culture in women with TPL.
{"title":"Prevalence of Urinary Tract Infection in Pregnancies with Premature Uterine Contractions","authors":"Pattarawalai Talungchit, Pornpimol Ruangvutilert, Tachjaree Panchalee Boonbowornpong, Buraya Phattanachindakun","doi":"10.33192/smj.v75i10.264256","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264256","url":null,"abstract":"Objective: This study aimed to determine the prevalence of urinary tract infection (UTI) among pregnant women with premature uterine contractions. Roles of the current practice of routine simultaneous urinalysis and urine culture in these cases were also evaluated. Materials and Methods: Medical records of pregnant women admitted with premature uterine contractions at Siriraj Hospital between January 2013 and December 2017 were reviewed. Prevalence of UTI in these women was determined. Women were divided into 2 groups based on diagnosis at admission; group 1 included preterm labor/preterm prelabor rupture of membranes (PTL/PPROM), and group 2 was threatened preterm labor (TPL). Evaluations of urinalysis and/or urine culture were performed in these two groups to establish a strategy to reduce unnecessary urine culture. Results: The prevalence of UTI among 2,286 women with premature uterine contractions was 4.9%. Prevalence of UTI were not different between the two groups of women. A positive urine culture was found in 2.4%. The most common organism identified in both groups of women was Escherichia coli. Urinalysis with abnormal cell counts and/or significant presence of bacteria could be used to screen for women in TPL group who should have urine culture with a positive screening rate of 6.5% and 90.9% sensitivity. With this strategy, unnecessary urine culture could be reduced. Conclusion: The prevalence of UTI among pregnant women admitted with premature uterine contractions was 4.9% and was not different between PTL/PPROM group and TPL group. Urinalysis with abnormal cell counts or significant bacteriuria could be a screening tool to reduce number of urine culture in women with TPL.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135459474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.263934
Nicholas Andrian Singgih, Jacinda Risha Oktaviani, Raden Honggo Pranowo Sampurno Secodiningrat, William Adipurnama, E. Manuputty, Kevin Tandarto
Objective: The incidence of urolithiasis in pediatrics increases to 4-10% annually. One of the methods for treating urolithiasis is ureteroscopy (URS). The small anatomy in pediatrics often makes the initial URS unsuccessful. Alpha blockers, a drug that can relax the ureteral muscles, is a therapy that can be considered before URS is carried out. The objective of this study is to evaluate the efficacy of preoperative tamsulosin for URS access in pediatrics. Materials and Methods: We conducted a search using four databases, including PubMed, EBSCO, Cochrane Library, and ProQuest. This study includes randomized controlled trials (RCTs), retrospective and prospective studies, which compared the efficacy of preoperative alpha blockers and placebo or non-placebo controls in pediatrics undergoing ureteroscopy. The outcome of interest was the success rate of URS access and the duration of surgery. Results: A total of 120 studies were identified from a database search. There were 3 studies included in this review involving 235 patients. The meta-analysis was conducted using a random-effects model. The results of the meta-analysis showed that alpha blockers provided a successful rate of ureteroscopy access in pediatric patients (Odds ratio (OR) 2.73; 95% confidence interval (CI) 1.52 up to 4.91; p=0.0008). Duration of surgery did not show significant results (Mean difference (MD) 3.46; 95% CI -3.59 up to 10.50; p=0.34).
{"title":"The Efficacy of Preoperative Tamsulosin on Ureteroscopy Access in Pediatrics: A Systematic Review and Meta-Analysis","authors":"Nicholas Andrian Singgih, Jacinda Risha Oktaviani, Raden Honggo Pranowo Sampurno Secodiningrat, William Adipurnama, E. Manuputty, Kevin Tandarto","doi":"10.33192/smj.v75i9.263934","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263934","url":null,"abstract":"Objective: The incidence of urolithiasis in pediatrics increases to 4-10% annually. One of the methods for treating urolithiasis is ureteroscopy (URS). The small anatomy in pediatrics often makes the initial URS unsuccessful. Alpha blockers, a drug that can relax the ureteral muscles, is a therapy that can be considered before URS is carried out. The objective of this study is to evaluate the efficacy of preoperative tamsulosin for URS access in pediatrics. Materials and Methods: We conducted a search using four databases, including PubMed, EBSCO, Cochrane Library, and ProQuest. This study includes randomized controlled trials (RCTs), retrospective and prospective studies, which compared the efficacy of preoperative alpha blockers and placebo or non-placebo controls in pediatrics undergoing ureteroscopy. The outcome of interest was the success rate of URS access and the duration of surgery. Results: A total of 120 studies were identified from a database search. There were 3 studies included in this review involving 235 patients. The meta-analysis was conducted using a random-effects model. The results of the meta-analysis showed that alpha blockers provided a successful rate of ureteroscopy access in pediatric patients (Odds ratio (OR) 2.73; 95% confidence interval (CI) 1.52 up to 4.91; p=0.0008). Duration of surgery did not show significant results (Mean difference (MD) 3.46; 95% CI -3.59 up to 10.50; p=0.34).","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The internet and social media enhance communication, education, and social connection among users; however, some adverse effects on health are notable, particularly sexual risk engagement and mood problems. Mobile dating applications (apps)/websites facilitate high sexual-risk access, particularly among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. Recognition of the characteristics of using these platforms and identifying factors related to high sexual risk among LGBTQ youths will facilitate both targeting of those at risk and subsequent intervention. Materials and Methods: Adolescents and youths were invited to voluntarily join this study, scan the QR code, and anonymously complete the questionnaires. These validated questionnaires were launched online via a popular platform among LGBTQs during 2017-2018. Multiple logistic regression was employed to identify factors independently associated with high sexual risk among study subjects. Results: Of 360 participants (mean age: 21±2.8 years, range: 11-25), 60.8% self-reported as homosexual, and the rest were bisexual. Median dating app/website usage was 2 (range 1-10). Two-thirds (62.8%) met partners from those e-platforms, and most (79.6%) developed a sexual relationship. Over half (52.2%) did not use a condom, and one-third (30.6%) abused substances during sex. Poor condom compliance, multiple partners, and substance use were strongly associated with individuals who used >2 apps for longer than 3 years. Depression susceptibility was 32.2%, and was related to condom-use failure (p=0.01). Conclusion: Among LGBTQs, the greater the number and longer time exposed to dating apps/websites, the higher the number of sexual risk behaviors. Moreover, unsafe sex increased among individuals at risk for depression.
{"title":"Influence of Online Dating Apps on Sexual Risk Behaviors among Homosexual and Bisexual Adolescents and Youths in Thailand: An Online Cross-sectional Survey","authors":"Chaloempong Thunyapipat, Supinya In-iw, Boonying Manaboriboon","doi":"10.33192/smj.v75i9.264171","DOIUrl":"https://doi.org/10.33192/smj.v75i9.264171","url":null,"abstract":"Objective: The internet and social media enhance communication, education, and social connection among users; however, some adverse effects on health are notable, particularly sexual risk engagement and mood problems. Mobile dating applications (apps)/websites facilitate high sexual-risk access, particularly among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. Recognition of the characteristics of using these platforms and identifying factors related to high sexual risk among LGBTQ youths will facilitate both targeting of those at risk and subsequent intervention. Materials and Methods: Adolescents and youths were invited to voluntarily join this study, scan the QR code, and anonymously complete the questionnaires. These validated questionnaires were launched online via a popular platform among LGBTQs during 2017-2018. Multiple logistic regression was employed to identify factors independently associated with high sexual risk among study subjects. Results: Of 360 participants (mean age: 21±2.8 years, range: 11-25), 60.8% self-reported as homosexual, and the rest were bisexual. Median dating app/website usage was 2 (range 1-10). Two-thirds (62.8%) met partners from those e-platforms, and most (79.6%) developed a sexual relationship. Over half (52.2%) did not use a condom, and one-third (30.6%) abused substances during sex. Poor condom compliance, multiple partners, and substance use were strongly associated with individuals who used >2 apps for longer than 3 years. Depression susceptibility was 32.2%, and was related to condom-use failure (p=0.01). Conclusion: Among LGBTQs, the greater the number and longer time exposed to dating apps/websites, the higher the number of sexual risk behaviors. Moreover, unsafe sex increased among individuals at risk for depression.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.263011
Reny Nugraheni, Bhisma Murti, M. Irawanto, Endang Sutisna Sulaiman, E. Pamungkasari
Objective: Leprosy is an infectious disease that causes highly complex problems from the medical aspect to social, economic, cultural, security, and national defence issues. This research aimed to develop and analyse the effect of an integrative model on leprosy prevention and control programs to improve the life quality of leprosy survivors. Materials and Methods: This research was conducted in Madura, East Java, Indonesia. The study consists of 360 leprosy survivors. The exposed group in this study was a group of leprosy survivors living within the areas of the Ministry of Health's leprosy program, a total of 180 leprosy survivors. The unexposed groups were leprosy survivors living around the areas with the absence of Ministry of Health leprosy program, a total of 180 leprosy survivors. Results: The quality of life has a direct and positive relationship with health status (b= 0.56 ; 95% CI = 0.14 to 1.00; p=0.010), health status has a direct and positive relationship with healthy behavior (b= 0.55 ; 95% CI = 0.10 to 1.00; p=0.016), healthy behavior has a direct and positive relationship with self-efficacy (b= 0.91 ; 95% CI = 0.38 to 1.44; p=0.001), healthy behavior has a direct and positive relationship with family support (b= 0.54; 95% CI = 0.06 to 1.03; p=0.029), healthy behavior has a direct and positive relationship with attitude (b= 0.56 ; 95% CI = 0.05 to 1.09; p=0.032). Conclusion: Health status, healthy behavior, self-efficacy, family support, attitude and community support related to improving quality of life for leprosy survivors.
目的：麻风病是一种传染性疾病，从医学方面到社会、经济、文化、安全和国防等问题，都会引发极为复杂的问题。本研究旨在开发和分析麻风病预防和控制项目综合模式的效果，以改善麻风病幸存者的生活质量。材料与方法：本研究在印度尼西亚东爪哇的马都拉进行。研究对象包括 360 名麻风病幸存者。本研究中的暴露组是生活在卫生部麻风病项目区域内的麻风病幸存者，共有 180 名麻风病幸存者。未暴露组为生活在卫生部麻风病项目缺失地区周围的麻风病幸存者，共 180 人。研究结果生活质量与健康状况有直接的正相关关系（b= 0.56；95% CI = 0.14 至 1.00；p=0.010），健康状况与健康行为有直接的正相关关系（b= 0.55；95% CI = 0.10 至 1.00；p=0.016），健康行为与自我效能有直接的正相关关系（b= 0.91; 95% CI = 0.38 to 1.44; p=0.001），健康行为与家庭支持有直接的正相关关系（b= 0.54; 95% CI = 0.06 to 1.03; p=0.029），健康行为与态度有直接的正相关关系（b= 0.56; 95% CI = 0.05 to 1.09; p=0.032）。结论健康状况、健康行为、自我效能感、家庭支持、态度和社区支持与麻风病幸存者生活质量的改善有关。
{"title":"Integrative Health Promotion Model in Leprosy Prevention and Control Programs to Improve Quality of Life for Leprosy Survivors","authors":"Reny Nugraheni, Bhisma Murti, M. Irawanto, Endang Sutisna Sulaiman, E. Pamungkasari","doi":"10.33192/smj.v75i9.263011","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263011","url":null,"abstract":"Objective: Leprosy is an infectious disease that causes highly complex problems from the medical aspect to social, economic, cultural, security, and national defence issues. This research aimed to develop and analyse the effect of an integrative model on leprosy prevention and control programs to improve the life quality of leprosy survivors. Materials and Methods: This research was conducted in Madura, East Java, Indonesia. The study consists of 360 leprosy survivors. The exposed group in this study was a group of leprosy survivors living within the areas of the Ministry of Health's leprosy program, a total of 180 leprosy survivors. The unexposed groups were leprosy survivors living around the areas with the absence of Ministry of Health leprosy program, a total of 180 leprosy survivors. Results: The quality of life has a direct and positive relationship with health status (b= 0.56 ; 95% CI = 0.14 to 1.00; p=0.010), health status has a direct and positive relationship with healthy behavior (b= 0.55 ; 95% CI = 0.10 to 1.00; p=0.016), healthy behavior has a direct and positive relationship with self-efficacy (b= 0.91 ; 95% CI = 0.38 to 1.44; p=0.001), healthy behavior has a direct and positive relationship with family support (b= 0.54; 95% CI = 0.06 to 1.03; p=0.029), healthy behavior has a direct and positive relationship with attitude (b= 0.56 ; 95% CI = 0.05 to 1.09; p=0.032). Conclusion: Health status, healthy behavior, self-efficacy, family support, attitude and community support related to improving quality of life for leprosy survivors.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.263372
A. Pramaswari, I. M. O. Adnyana, I. Widyadharma, Ketut Suastika
Objective: Peripheral diabetic neuropathy (PDN) is among the most prevalent diabetes mellitus (DM) sequelae. PDN is a severe health issue that represents a huge social and economic burden worldwide, is associated with long-term morbidity, and diminishes the quality of life of those affected. The neutrophil-lymphocyte ratio (NLR) is a mixture of the two primary components of chronic inflammatory diseases (high neutrophils and low lymphocytes) that contribute to the production of PDN. This study aimed to demonstrate high serum NRL levels enhance the risk of PDN in type 2 DM patients. Materials and Methods: This study employed a case-control design, collecting data from the registers and outpatient medical records of Prof. Dr. IGNG Ngoerah General Hospital type 2 DM patients who satisfied the inclusion and exclusion criteria between January 2018 and December 2019. Based on clinical neuropathy and abnormal electrodiagnostic testing, the PDN diagnosis was established. Serum NLR was collected from laboratory tests recorded by a computer. Results: The Receiver Operating Characteristic (ROC) curve approach determined the NLR cut-off value of 2.18. High NLR substantially increased the incidence of PDN (OR 10.36; 95% CI 3.69-29.07; p<0.001). Other characteristics evaluated, including duration of diabetes, usage of anti-diabetic medications, uncontrolled diabetes, obesity, hypertension, and dyslipidemia, were not significantly associated with the incidence of PDN. High serum NLR was an independent risk factor for PDN in type 2 DM patients (adjusted OR=10.36; 95% CI: 3.57-29.07; p<0.001). Conclusion: Based on the findings of this investigation, it was determined that elevated serum NLR increases the risk of PDN events in patients with type 2 DM.
{"title":"Increased Serum Neutrophil Lymphocyte Ratio Raises the Risk for Peripheral Diabetic Neuropathy in Type 2 Diabetes Mellitus Patients","authors":"A. Pramaswari, I. M. O. Adnyana, I. Widyadharma, Ketut Suastika","doi":"10.33192/smj.v75i9.263372","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263372","url":null,"abstract":"Objective: Peripheral diabetic neuropathy (PDN) is among the most prevalent diabetes mellitus (DM) sequelae. PDN is a severe health issue that represents a huge social and economic burden worldwide, is associated with long-term morbidity, and diminishes the quality of life of those affected. The neutrophil-lymphocyte ratio (NLR) is a mixture of the two primary components of chronic inflammatory diseases (high neutrophils and low lymphocytes) that contribute to the production of PDN. This study aimed to demonstrate high serum NRL levels enhance the risk of PDN in type 2 DM patients. Materials and Methods: This study employed a case-control design, collecting data from the registers and outpatient medical records of Prof. Dr. IGNG Ngoerah General Hospital type 2 DM patients who satisfied the inclusion and exclusion criteria between January 2018 and December 2019. Based on clinical neuropathy and abnormal electrodiagnostic testing, the PDN diagnosis was established. Serum NLR was collected from laboratory tests recorded by a computer. Results: The Receiver Operating Characteristic (ROC) curve approach determined the NLR cut-off value of 2.18. High NLR substantially increased the incidence of PDN (OR 10.36; 95% CI 3.69-29.07; p<0.001). Other characteristics evaluated, including duration of diabetes, usage of anti-diabetic medications, uncontrolled diabetes, obesity, hypertension, and dyslipidemia, were not significantly associated with the incidence of PDN. High serum NLR was an independent risk factor for PDN in type 2 DM patients (adjusted OR=10.36; 95% CI: 3.57-29.07; p<0.001). Conclusion: Based on the findings of this investigation, it was determined that elevated serum NLR increases the risk of PDN events in patients with type 2 DM.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.262021
Wanwarang Teerasamit, Suchanya Hongpinyo, Ranista Tongdee, V. Suvannarerg
Objective: To identify patient characteristics and MR imaging features of hypovascular hypointense nodules in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MR imaging in patients with chronic liver disease associated with progression to hypervascular hepatocellular carcinoma (HCC). Materials and Methods: The institutional review board approved this retrospective review of 40 patients with 60 hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging. Univariate and multivariate Cox regression analyses for hypervascular HCC development were used to define variables, including initial nodule size, cause of cirrhosis, history of locoregional therapy of HCC, fat-containing, signal intensity on T1W, T2W, portal and equilibrium phases of dynamic phase, and DW images. The cumulative percentage incidence of hypervascularity and growth rate were calculated using the receiver operating characteristic (ROC) curve. Results: The prevalence of progression to hypervascular HCC was 45% (27 out of 60). The Multivariable Cox analysis of developing hypervascularization was an initial nodule diameter more than 1 cm. (P=0.027; HR 2.52; 95% CI: 1.11,5.74) The mean growth rate was significantly higher in subsequent hypervascular nodules than in those without hypervascularization (P < 0.001). The cumulative risk incidence of hypervascularization at 3, 6, 12, 24 months was 5%, 20%, 35%, 44 %, respectively. Conclusion: An initial nodule diameter of more than 1 cm and nodules with higher growth rates are significant predictive factors for hypervascular transformation of hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging.
{"title":"Predicting Progression to Hypervascular HCC in Hypovascular Hypointense Nodules in Gadoxetic Acid-enhanced MR Images in Patients with Chronic Liver Disease","authors":"Wanwarang Teerasamit, Suchanya Hongpinyo, Ranista Tongdee, V. Suvannarerg","doi":"10.33192/smj.v75i9.262021","DOIUrl":"https://doi.org/10.33192/smj.v75i9.262021","url":null,"abstract":"Objective: To identify patient characteristics and MR imaging features of hypovascular hypointense nodules in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MR imaging in patients with chronic liver disease associated with progression to hypervascular hepatocellular carcinoma (HCC). Materials and Methods: The institutional review board approved this retrospective review of 40 patients with 60 hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging. Univariate and multivariate Cox regression analyses for hypervascular HCC development were used to define variables, including initial nodule size, cause of cirrhosis, history of locoregional therapy of HCC, fat-containing, signal intensity on T1W, T2W, portal and equilibrium phases of dynamic phase, and DW images. The cumulative percentage incidence of hypervascularity and growth rate were calculated using the receiver operating characteristic (ROC) curve. Results: The prevalence of progression to hypervascular HCC was 45% (27 out of 60). The Multivariable Cox analysis of developing hypervascularization was an initial nodule diameter more than 1 cm. (P=0.027; HR 2.52; 95% CI: 1.11,5.74) The mean growth rate was significantly higher in subsequent hypervascular nodules than in those without hypervascularization (P < 0.001). The cumulative risk incidence of hypervascularization at 3, 6, 12, 24 months was 5%, 20%, 35%, 44 %, respectively. Conclusion: An initial nodule diameter of more than 1 cm and nodules with higher growth rates are significant predictive factors for hypervascular transformation of hypovascular hypointense nodules in the HBP of gadoxetic acid-enhanced MR imaging.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.263161
Tossaporn Siriprapa, T. Thientunyakit, Juri Gelovani
In the past two decades, the research community has focused on defining reliable molecular biomarkers for the early diagnosis of Alzheimer's disease (AD). Several PET radiopharmaceuticals have been developed and gained regulatory approval for the non-invasive detection of Aβ amyloid deposits in the brain. Nowadays, there are several PET imaging tracers available in Thailand for amyloid imaging including [11C]PiB, [18F]Florbetapir, and [18F]Florbetaben. This review provides a summary of commonly used amyloid PET radiopharmaceuticals, focusing on the available radiopharmaceuticals in Thailand and the experiences of using amyloid PET radiopharmaceuticals and imaging for clinical and research applications at Siriraj Hospital.
在过去的二十年里，研究界一直致力于为阿尔茨海默病（AD）的早期诊断确定可靠的分子生物标志物。目前已开发出几种 PET 放射性药物，并获得了监管部门的批准，用于无创检测大脑中的 Aβ 淀粉样蛋白沉积。目前，泰国有几种 PET 成像示踪剂可用于淀粉样蛋白成像，包括 [11C]PiB 、[18F]Florbetapir 和 [18F]Florbetaben 。本综述概述了常用的淀粉样蛋白 PET 放射性药物，重点介绍了泰国现有的放射性药物，以及西丽拉杰医院在临床和研究应用中使用淀粉样蛋白 PET 放射性药物和成像的经验。
{"title":"Amyloid PET Radiopharmaceuticals and Imaging for Clinical and Research Applications in Thailand","authors":"Tossaporn Siriprapa, T. Thientunyakit, Juri Gelovani","doi":"10.33192/smj.v75i9.263161","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263161","url":null,"abstract":"In the past two decades, the research community has focused on defining reliable molecular biomarkers for the early diagnosis of Alzheimer's disease (AD). Several PET radiopharmaceuticals have been developed and gained regulatory approval for the non-invasive detection of Aβ amyloid deposits in the brain. Nowadays, there are several PET imaging tracers available in Thailand for amyloid imaging including [11C]PiB, [18F]Florbetapir, and [18F]Florbetaben. This review provides a summary of commonly used amyloid PET radiopharmaceuticals, focusing on the available radiopharmaceuticals in Thailand and the experiences of using amyloid PET radiopharmaceuticals and imaging for clinical and research applications at Siriraj Hospital.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To study the outcomes and complications of per-oral endoscopic myotomy (POEM) in patients with esophageal achalasia. Materials and Methods: This retrospective observational study reviewed the medical records of esophageal achalasia patients who underwent POEM between March 2013 and September 2022. One hundred and eight cases were included. Results: A total of 108 consecutive patients were included in this study and classified into 4 groups: 30 (27.8%) as type I; 53 (49.1%) as type II; 5 (4.6%) as type III; and 20 (18.5%) as unspecified due to unsuccessful catheter placement across the esophagogastric junction. The mean patient age was 46.10+16.59, 77 (71.3%) patients were female. Ten (9.3%) of the patients had undergone prior treatment, including balloon dilation, POEM, Heller myotomy, and nitroglycerine. Technical success was achieved in 106 (98.1%) cases, clinical success was evaluated only in 88 patients who follow up more than 6 month and the median follow-up time was 20.50 months (range 6-110 months). The clinical success was accomplished in 82 (93.2%), and 26 (24.1%) patients experienced perioperative complications which were significantly associated with anterior myotomy and probably operator learning curve. One patient (1.1%) had recurrent symptoms at 24-month follow up. Gastroesophageal reflux disease (GERD) was found in 19 (21.6%) patients, all of whom responded well to proton pump inhibitors (PPIs). Conclusion: POEM is effective and safe in long-term treatment of achalasia. Although the incidence of symptomatic GERD was slightly high, the cases were not severe and were well controlled with medication.
{"title":"Outcomes of Per-Oral Endoscopic Myotomy in the Treatment of Esophageal Achalasia: Over One Hundred Cases in a Single Tertiary Center","authors":"Kannikar Laohavichitra, Jerasak Wannaprasert, Thawee Raranachu-ek","doi":"10.33192/smj.v75i9.263612","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263612","url":null,"abstract":"Objective: To study the outcomes and complications of per-oral endoscopic myotomy (POEM) in patients with esophageal achalasia. Materials and Methods: This retrospective observational study reviewed the medical records of esophageal achalasia patients who underwent POEM between March 2013 and September 2022. One hundred and eight cases were included. Results: A total of 108 consecutive patients were included in this study and classified into 4 groups: 30 (27.8%) as type I; 53 (49.1%) as type II; 5 (4.6%) as type III; and 20 (18.5%) as unspecified due to unsuccessful catheter placement across the esophagogastric junction. The mean patient age was 46.10+16.59, 77 (71.3%) patients were female. Ten (9.3%) of the patients had undergone prior treatment, including balloon dilation, POEM, Heller myotomy, and nitroglycerine. Technical success was achieved in 106 (98.1%) cases, clinical success was evaluated only in 88 patients who follow up more than 6 month and the median follow-up time was 20.50 months (range 6-110 months). The clinical success was accomplished in 82 (93.2%), and 26 (24.1%) patients experienced perioperative complications which were significantly associated with anterior myotomy and probably operator learning curve. One patient (1.1%) had recurrent symptoms at 24-month follow up. Gastroesophageal reflux disease (GERD) was found in 19 (21.6%) patients, all of whom responded well to proton pump inhibitors (PPIs). Conclusion: POEM is effective and safe in long-term treatment of achalasia. Although the incidence of symptomatic GERD was slightly high, the cases were not severe and were well controlled with medication.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.33192/smj.v75i9.260756
L. Chularojanamontri, C. Wongpraparut, N. Silpa‐archa, Chayada Chaiyabutr, Supisara Wongdama, P. Chiowchanwisawakit
Objective: To evaluated the health-utility values and risk factors for cumulative life course impairment (CLCI) using Patient Acceptable Symptom State (PASS) and European Quality of Life 5 Dimensions (EQ-5D). Materials and Methods: This cross-sectional investigation enrolled patients with psoriasis. Patients were asked PASS questions about their overall self-perceived health state, adaptation, and expectations for current, future, and lifelong conditions. The patients also completed EQ-5D. Results: The mean age of 139 enrolled patients was 45.8 ± 14.4 years, and 57.6% were women. Most cases had chronic plaque psoriasis 121 (87.1%). For current PASS, satisfaction was significantly associated with older age, being married, and lower disease severity. The mean health-utility value and visual analog scale of the 139 patients were 0.89 ± 0.12 and 77.0 ± 17.4, respectively. Patients would not accept their disease if they had moderate to extreme problems in usual activities and depression/anxiety for the future and lifelong. Univariate analysis revealed that depression and usual activities were significantly associated with satisfaction for current PASS, future PASS, and lifelong PASS. Conclusion: Disease severity, age, marital status, problems with usual activities, and depression/anxiety were significantly related to CLCI. These findings may allow physicians to identify psychosocial and psychological aspects of psoriatic patients at high risk for developing CLCI. Early and adequate treatment, good coping strategies, and good social support can prevent a negative impact on CLCI and major life-changing decisions.
{"title":"Evaluating Risk Factors for Cumulative Life Course Impairment in Psoriasis using Patient-Acceptable Symptom State and European Quality of Life 5 Dimensions (EQ-5D)","authors":"L. Chularojanamontri, C. Wongpraparut, N. Silpa‐archa, Chayada Chaiyabutr, Supisara Wongdama, P. Chiowchanwisawakit","doi":"10.33192/smj.v75i9.260756","DOIUrl":"https://doi.org/10.33192/smj.v75i9.260756","url":null,"abstract":"Objective: To evaluated the health-utility values and risk factors for cumulative life course impairment (CLCI) using Patient Acceptable Symptom State (PASS) and European Quality of Life 5 Dimensions (EQ-5D). Materials and Methods: This cross-sectional investigation enrolled patients with psoriasis. Patients were asked PASS questions about their overall self-perceived health state, adaptation, and expectations for current, future, and lifelong conditions. The patients also completed EQ-5D. Results: The mean age of 139 enrolled patients was 45.8 ± 14.4 years, and 57.6% were women. Most cases had chronic plaque psoriasis 121 (87.1%). For current PASS, satisfaction was significantly associated with older age, being married, and lower disease severity. The mean health-utility value and visual analog scale of the 139 patients were 0.89 ± 0.12 and 77.0 ± 17.4, respectively. Patients would not accept their disease if they had moderate to extreme problems in usual activities and depression/anxiety for the future and lifelong. Univariate analysis revealed that depression and usual activities were significantly associated with satisfaction for current PASS, future PASS, and lifelong PASS. Conclusion: Disease severity, age, marital status, problems with usual activities, and depression/anxiety were significantly related to CLCI. These findings may allow physicians to identify psychosocial and psychological aspects of psoriatic patients at high risk for developing CLCI. Early and adequate treatment, good coping strategies, and good social support can prevent a negative impact on CLCI and major life-changing decisions.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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