Asian Biomedicine最新文献

Background: Hypertension remains a prominent public health concern in Saudi Arabia, contributing to cardiovascular morbidity and mortality. With widespread smartphone use and the national push toward digital transformation under Saudi Vision 2030, mobile health (mHealth) applications are a promising option for increasing self-management among hypertension patients.

Objective: This study aims to analyze the acceptance, preferences, and perceived barriers toward utilizing mHealth applications for hypertension self-management among patients in Saudi Arabia.

Methods: A cross-sectional survey was conducted from January to March 2025 utilizing an online, self-administered questionnaire disseminated across the 5 administrative regions of Saudi Arabia. The study investigated demographics, clinical factors, technology utilization, preferred app features, attitudes, and readiness to adopt mHealth solutions. Descriptive statistics and Pearson correlation analysis were employed.

Results: Among the 1098 respondents, 55.3% were female, and the mean age was 45.0 ± 11.8 years. A majority (95.2%) owned cellphones, although only 22.1% had used a health-related app, and 11.8% had used one for hypertension. Most participants reported great interest in app features like medication reminders (78.4%) and blood pressure tracking (71.9%). Willingness to utilize mHealth was high (85.6%), and substantially linked with education level (P = 0.008) and number of drugs (P = 0.03).

Conclusion: The study reveals considerable support for mHealth integration into hypertension care in Saudi Arabia. Tailoring app design to user demands and aligning deployment with Vision 2030's digital health agenda can boost chronic illness management and patient empowerment nationally.

Background: The Thai Cardiac Electrophysiology Club, part of the Heart Association of Thailand under the Royal Patronage of His Majesty the King, published a Clinical Practice Guideline for the Management of Patients with Atrial Fibrillation (AF) in 2012. The availability of new evidence indicates a significant need for the updating of the existing clinical practice guideline.

Objective: To serve as guidelines on the diagnosis and management of Thai patients with AF.

Methods: Meetings were conducted from September 2024 to March 2025, including a public hearing that engaged various stakeholders. The final Thai version received approval in February 2025, while the English translation was completed in April 2025.

Results: AF is highly prevalent. The diagnosis is crucial to detect those who need treatment for the prevention of complication. Holistic management focused on stroke prevention, symptom management, and management of cardiovascular risk factors; and comorbidity is the key success factor to maintain a good quality of life. Emerging evidence regarding newer classes of anticoagulant indicates that these treatments are effective and safe for stroke prevention. Newer catheter ablation technology has been developed and provides a better success rate and lower rate of complication. The newer stroke risk prediction CHA₂DS₂-VA Score is recommended for the Thai population due to its simplicity.

Conclusion: The 2025 updated AF clinical practice guidelines establish a framework, provide recommendations, and serve as a comprehensive resource for the contemporary diagnosis and management of AF in the Thai population, with the goal of preventing complications.

Background: The burden of gastrointestinal (GI) and liver diseases in Southeast Asian (SEA) nations is substantial and evolving. Understanding contemporary trends is crucial for targeted public health interventions in this heterogeneous region.

Objective: To analyze disability-adjusted life years (DALYs) for major GI and liver diseases across 11 SEA nations from 1990 to 2021.

Methods: Age-standardized DALY rates per 100,000 were extracted from the Global Burden of Disease (GBD) 2021 study. We analyzed overall trends, causes with the highest relative DALY rate increases per country (1990-2021), and countries with the highest DALY rates per cause (2021).

Results: Although infectious GI DALYs such as diarrheal diseases declined, non-communicable disease, particularly GI cancers and chronic liver diseases, showed increasing prominence. Pancreatic cancer DALYs exhibited major relative increases in Indonesia (+61.7%) and Vietnam (+51.6%). Non-alcoholic fatty liver disease (NAFLD)-related DALYs (including cirrhosis) surged in Malaysia (+65.3%) and Thailand (+59.7%). In 2021, Cambodia, Myanmar, and Indonesia faced the highest DALY burdens from chronic hepatitis B and C. Brunei Darussalam, Malaysia, and Thailand led in colorectal cancer DALYs, while Brunei Darussalam also had high pancreatic cancer rates.

Conclusion: SEA nations confront a complex and evolving burden of transitioning GI and liver diseases. The persistent high impact of viral hepatitis, coupled with the alarming rise of NAFLD and GI cancers such as pancreatic cancer, underscores the urgent need for tailored national strategies focused on prevention, early detection, and enhanced treatment access.

Background: Children of patients with nephrolithiasis (NL) are highly susceptible to stone development. Abnormal urinary mineral excretion and elevated protein/albumin excretion rates have been reported in disease-free children of patients with NL. Increased protein excretion in these children could be associated with the risk of stone formation.

Objective: Explore the urinary proteomic profiles in children with NL who are highly susceptible to stone development. The suspected urinary proteins were further validated in the urine of children with and without a family history of stone formation.

Methods: Twenty-eight patients with NL (N), 40 volunteers (V), 46 children of patients with NL (NC) and 33 children of volunteer subjects (VC) were enrolled. The 24-hour urine of the participants was collected. Thirty urine samples were randomly selected from each children's group (NC and VC) to investigate proteins with abnormal excretion. Quantitative proteomic analysis was conducted using tandem mass spectrometry. The levels of bikunin (AMBP), alpha-1-antitrypsin (AAT), transferrin (TF), alpha-2-HS-glycoprotein (fetuin-A), and adiponectin levels were measured in all samples using enzyme-linked immunosorbent assay.

Results: Total urinary protein excretion was increased in both N and NC. Urinary excretion rates for 26 proteins increased and 2 proteins decreased in the NC group compared to the VC group. The urinary excretion rates of AMBP, AAT, and TF in patients with NL and their children were higher than those of control and normal children while fetuin-A was increased only in the NC group. Elevation of urinary AAT and TF was dependent on urinary supersaturation.

Conclusion: Children of patients with calcium oxalate had increased urinary protein excretion, including AAT, TF, AMBP, and fetuin-A, considering the consequences of abnormal urine compositions. Increased excretion of these proteins may impact stone formation in these high-risk childhood members by regulation of renal inflammation, oxidation, crystallization, and crystal growth. We propose that AAT and TF excretion rates are potentially used as indicators for urinary supersaturation in high-risk populations.

Background: DNA methylation markers are emerging as promising diagnostic tools for the early detection of colorectal cancer (CRC) that can significantly improve survival rates.

Objective: To compare the capabilities of blood plasma and tissue biopsy for detecting these markers in early CRC stages by diagnostic measures.

Methods: Nine studies published from 2020 to 2024 were analyzed, and the study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.

Results: This review reaffirms tissue-based samples as the gold standard based on the superior sensitivity and specificity with markers such as SFMBT2 being over 90% in the 2 parameters. However, due to its invasive nature, it challenges applicability for asymptomatic patients or routine screening. Plasma-based markers (SEPT9 and HAND1) offer a noninvasive alternative, with moderate sensitivity (40%-75.8%) and high specificity (69%-94.7%), while combining multiple markers improves overall diagnostic performance. However, most plasma-based assays evaluated in this review do not yet meet the 2021 Centers for Medicare and Medicaid Services approval benchmarks of ≥74% sensitivity and ≥90% specificity compared with colonoscopy, which shows the need for further optimization before its clinical implementation. QUADAS-2 illustrated a potential high risk of bias in patient selection and flow/timing domains, which underscores the need for more standardized diagnostic workflows and assay protocols.

Conclusions: Future research should focus on multi-marker panels, adherence to regulatory thresholds, cost-effectiveness analyses, and clear clinical management pathways to facilitate the widespread implementation of plasma-based CRC screening.

Background: Esophageal and gastric subepithelial lesions (SELs) are increasingly identified in routine endoscopic evaluations, necessitating optimal resection strategies. Minimally invasive techniques, including endoscopic resection (ER), laparoscopic resection (LR), and laparoscopic-endoscopic cooperative surgery (LECS), have distinct advantages. The present study compares the outcomes of these techniques.

Objective: To compare the clinical outcomes of ER, LR, and LECS in the management of esophageal or gastric SELs at King Chulalongkorn Memorial Hospital.

Methods: A retrospective review was conducted on patients undergoing ER, LR, or LECS for esophageal and gastric SELs from January 2012 to August 2022. The primary outcome was the complete resection rate. Secondary outcomes included success rates, complications, and length of hospital stay. Statistical significance was set at P < 0.05.

Results: Among 42 patients, 11 (26.2%) underwent ER, 12 (28.6%) underwent LR, and 19 (45.2%) underwent LECS. Complete resection was significantly higher in LR (100%) and LECS (84.2%) than ER (45.5%) (P = 0.033). Delayed bleeding occurred in 18.2% of ER cases (P = 0.052). Hospital stay was shortest in ER (3.9 d) and longest in LR (9.3 d) (P = 0.877).

Conclusion: While all techniques had high success rates, ER had the lowest complete resection rate and the highest bleeding risk. LR ensured complete resection but required longer hospitalization. LECS provided a balance between oncologic efficacy and safety. Surgical planning should be tailored based on tumor characteristics and surgical expertise.

Background: The growing role of pharmacists in cancer care highlights the need to understand research trends linking pharmaceutical education and oncology.

Objective: To quantitatively investigate the bibliometric status of the entanglement between pharmacy/pharmaceutical education and cancer-related issues, providing feasible information and suggestions for the developmental basis and research hotspots.

Methods: Bibliometric analysis was performed using the Web of Science Core Collection. Boolean operations (BO) were used to set up the literature query set. The literature published between 1985 and 2022 was screened for the types of "article" and "review." The citation analysis and research hotspot extraction were performed using the "analyze results" and "citation report" functions of Clarivate Analytics.

Results: The bibliometric analysis of 722 relevant papers showed that the global interest in the topic is increasing and the collaboration between countries is quite active. The extraction results showed that guidelines for cancer therapy, palliative care and pain management, pharmacy staff's attitudes and knowledge, and adherence to chemotherapy were the main research hotspots and that these have been long-term discussed.

Conclusion: Conducting a bibliometric study to analyze the overall publication status, developmental basis, and research hotspots will reveal the logical entanglement of the existing academic research between pharmacy/pharmaceutical education and cancer, and will provide a reference for academic development in the educational and oncological community.

Background: Transcutaneous bilirubinometers provide a non-invasive method to estimate total serum bilirubin (TSB) using multiwavelength reflectance. However, their accuracy during phototherapy (PT) remains controversial due to decreased dermal bilirubin.

Objective: To assess the correlation between TSB and transcutaneous bilirubin (TcB) measured from covered and exposed skin areas before, during, and after PT.

Methods: In this prospective study, 70 neonates undergoing PT were assessed. TcB measurements were obtained from the exposed sternum and the forehead, which were covered with an aluminum-coated radiopaque patch. TSB and TcB values were measured before PT, at 24 h during treatment, and 8 h post-treatment. The agreement between TSB and TcB values was evaluated using the intraclass correlation coefficient (ICC).

Results: TcB values of covered skin showed significant correlation with TSB at all-time points (ICC = 0.665 for pre-PT, ICC = 0.520 at 24 h, and ICC = 0.537 for post-treatment). TcB values of exposed skin showed poor correlation during and after PT. Mean differences between covered TcB and TSB remained within acceptable limits (<1 mg/dL).

Conclusion: TcB measurements from covered skin offer a reliable, non-invasive alternative to serum bilirubin levels in neonates receiving PT, reducing the need for repeated blood draws.

Background: Primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) in diffuse large B-cell lymphoma (DLBCL) patients undergoing rituximab-cyclophosphamide-doxorubicin-vincristine-prednisolone every 21 d (R-CHOP-21) chemotherapy varies based on physician discretion.

Objectives: The present study aims to investigate the impact of primary G-CSF prophylaxis on febrile neutropenia (FN) and other outcomes in DLBCL patients receiving R-CHOP-21 in real-world practice.

Methods: Medical records of 103 newly diagnosed DLBCL patients, aged 18-80 years, were retrospectively analyzed. Seventy-four patients received primary G-CSF prophylaxis (prophylaxis group), while 29 patients did not receive prophylaxis (non-prophylaxis group). The occurrence of FN and other outcomes was compared between the two groups.

Results: The prophylaxis group had older patients (median ± interquartile ranges [IQR], 63 ± 12 years vs. 50 ± 15 years, P < 0.001). The incidence of FN after the first R-CHOP was not statistically significant between groups (8.3% vs. 17.2%, P = 0.177). However, FN events were significantly higher in non-prophylaxis cycles (7.40%) compared with prophylaxis cycles (2.70%) (P = 0.027). Cumulative FN events were lower in the prophylaxis group (14.9%) than in the non-prophylaxis group (27.6%) (P = 0.134). FN-free survival was not significantly different between prophylaxis and non-prophylaxis groups (hazard ratio [HR], 0.48; 95% confidence interval [95%CI], 0.17-1.35), while primary G-CSF prophylaxis significantly improved event-free survival (HR, 0.36; 95%CI, 0.16-0.84).

Conclusions: Primary G-CSF prophylaxis may reduce the risk of FN in DLBCL patients undergoing R-CHOP-21 treatment. The present study highlights the importance of primary G-CSF prophylaxis, especially for those at high risk of FN.