Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)

Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of massive blood transfusion in the surgical intensive care units (SICUs). Methods: This is an analysis of the THAI-SICU study which was a prospective cohort that was done in the 9-university-based SICUs in Thailand. The study included only patients admitted due to trauma mechanisms. Massive transfusion was defined as received 10 units of packed red blood cells on the first day of admission. Patient characteristics and physiologic data were analyzed to identify the potential factors. A multivariable regression was then performed to identify the significant model. Results: Three hundred and seventy patients were enrolled. Sixteen patients (5%) received massive transfusion in the SICUs. The factors that significantly predicted massive transfusion were an initial sequential organ failure assessment (SOFA) ≥9 (risk difference (RD) 0.13, 95% confidence interval (CI): 0.03-0.22, p = 0.01); intra-operative blood loss ≥4900 mL (RD 0.33, 95% CI: 0.04-0.62, p = 0.02) and intra-operative blood transfusion ≥10 units (RD 0.45, 95% CI: 0.06 to 0.84, p = 0.02). The probability to have massive transfusion was 0.976 in patients who had these 3 factors. Conclusion: Massive blood transfusion in the SICUs occurred in 5%. An initial SOFA ≥9, intra-operative blood loss ≥4900 mL, and intra-operative blood transfusion 10 units were the significant factors to predict massive transfusion in the SICUs.     

Quantitative differences in intervertebral disc–matrix composition with age-related degeneration

This study was carried out to determine the effect of age on the intervertebral disc, using a rabbit model. Anulus fibrosus and nucleus pulposus tissue from New Zealand white rabbits aged 3 years old (old rabbits) and 6 months old (young rabbits) were used. The water content, the proteoglycan, the DNA content, and the mRNA levels of aggrecan, type I collagen, and type II collagen were all measured for each sample. Water, proteoglycan, DNA, and the mRNA levels of aggrecan and type II collagen were all greater in the nucleus pulposus of the young rabbits as compared to the old. For the anulus fibrosus, the difference between young and old is less marked with only proteoglycan and DNA being greater in the young disc as compared to the old. Clearly, according to our results, it is the nucleus pulposus that suffers the brunt of the changes with age.     

Salmonella lamphun: first isolation of a new Salmonella serovar in Thailand

Two isolates of a new Salmonella serovar, Salmonella Lamphun were discovered from animal feeds in Thailand, in 2003, which belongs to group C, with antigenic formula 6,8:y: 1,2. Both isolates were susceptible to all antimicrobials tested. The pulsed field gel electrophoresis pattern of both isolates comprises 11 DNA fractions sized 48, 65, 77, 105, 110, 170, 244, 330, 337,453 and 1,135 kbp. Up to April 2005, no human or animal infection by this new Salmonella serovar was reported.     

No effect of interleukin-2 on IgE levels given in addition to antiretroviral therapy in HIV-infected adults with CD4 >300 cells/mm3

HIV-infected patients may have frequent atopy caused by an imbalance of Th1 and Th2 cytokines. The objective of the present study was to investigate whether IL-2 given in addition to antiretrovirals (ARV) would result in lower IgE levels and less allergic symptoms. Patients naive to IL-2 (n=28) began IL-2 plus ARV and were followed for 12 months. IgE, eosinophil and CD4 counts, HIV RNA, symptom scoring, PFT and skin prick test (SPT) were performed. It was found that the baseline median CD4 and IgE were 386.5 cells/mm3 and 63.5 IU/ml, respectively. Four patients had allergic rhinitis (AR) and 61% had a positive SPT to at least 1 antigen. At month 12, patients had higher CD4 counts (p < 0.001) compared to the baseline; however, there were no differences in IgE levels, allergic symptom scores or HIV RNA. The eosinophil count was higher after IL-2 administration. It was concluded that IL-2 plus ARV resulted in higher CD4 counts but had no effect on atopy.     

Accuracy of Moyers' probability chart in a group of Thai subjects

The objective of this study is to investigate the accuracy of Moyers' probability chart in predicting canine and premolar sizes from the sum of lower incisors in a group of Thai subjects. The fifty models of orthodontic patient, Faculty of dentistry, Mahidol University with no loss of tooth material mesio-distally, fully erupted permanent teeth, no mesial or distal restoration and normal tooth morphology were selected. The results of this study show that the under-estimation less than or equal to 2 mm. is 32 casts on upper (64%) and 28 casts on lower (56%) and the over estimation greater than 2 mm. is 16 casts on upper (32%) and 18 casts on lower (36%). In comparison of 14 models which have the same value of sum of lower incisors, there is a significant (alpha = 0.05) difference between the combined canine and premolar size of this study and Moyers' probability chart.     

Congenital absence and loss of teeth in an orthodontic patient group

Panoramic radiographs of 1,160 orthodontic patients, 655 females and 505 males, 6-15 years of age were selected for study in congenital absence, loss of permanent teeth and premature loss of deciduous teeth. The result from this investigation showed congenital absence for 100 subjects (8.6%, not including third molars) and 185 subjects (16%, third molars included). The permanent upper lateral incisors are most frequently missing (22.4%, third molars excluded), followed by upper second premolar, 17.8%, lower second premolar, 15.1%, and then lower lateral incisor, 12.5%. The study also showed loss of permanent teeth of 105 subjects (9.1%). The lower first molars are most frequently lost (52.8%), followed by the upper first molar (18.2%). There is no statistical significance (alpha = 0.01) between females and males in both congenital absence and loss of permanent teeth. The premature loss of deciduous teeth was found in 467 subjects (40.3%). The most frequently loss happened to second deciduous molars, followed by first deciduous molars and then deciduous canines. There is more statistical significance (alpha = 0.01) in females than in males.     

Antimicrobial resistance and molecular epidemiology of Salmonella Rissen from animals, food products, and patients in Thailand and Denmark

Recently we reported increases in both the number of Salmonella infections due to Salmonella Rissen in Thailand and the isolation of this serovar from pork products in Thailand. The objectives of the present study were to determine the genetic diversity and antimicrobial resistance of Salmonella Rissen isolates recovered from humans, food products, and animals in Denmark and Thailand. Additionally, risk factors due to travel and consumption of specific food products were analyzed and evaluated. A total of 112 Salmonella Rissen isolates were included in this study from Thailand and Denmark. Thai isolates were recovered from humans, uncooked food, and ready-to-eat food. Danish isolates were obtained from humans (with and without a history of travel to Thailand prior to the infection), Danish pig or pork products, imported pig or pork products, turkeys, and animal feed. A total of 63 unique XbaI PFGE patterns were observed. The predominant pattern was shared by 22 strains. Limited antimicrobial resistance was observed in the Danish strains, and a higher degree of resistance was observed in strains originating from Thailand. Virtually all isolates were resistant to tetracycline. The tet A gene was detected in tetracycline-resistant isolates. Statistical analysis and molecular subtyping identified the combination of travel to Thailand and consumption of imported pig or pork products as well consumption of as pig or pork products produced in Denmark as risk factors for Salmonella Rissen infection among the Danish patients. The outcome of this study might be used as a supplement for future Salmonella Rissen investigations and outbreak detection.     

Comparison of chemical profiles,antioxidation, inhibition of skin extracellular matrix degradation,and anti-tyrosinase activity between mycelium and fruiting body of Cordyceps militaris and Isaria tenuipes

ContextCordyceps militaris and Isaria tenuipes (Cordycipitaceae) are high-value fungi that are used for health-promoting food supplements. Since laboratory cultivation has begun for these fungi, increased output has been achieved.ObjectiveThis study compared the chemical profiles, antioxidant, anti-tyrosinase, and skin extracellular matrix degradation inhibition between mycelium and fruiting body of C. militaris and I. tenuipes.Materials and methodsThe antioxidative potential of 10% v/v aqueous infused extract from each fungus was separately investigated using 2,2-azinobis(3-ethylbenzo-thiazoline-6-sulphonic acid) (ABTS), 1,1-diphenyl-2-picrylhydrazyl (DPPH), ferric reducing antioxidant ability, and ferric thiocyanate methods. The inhibition against MMP-1, elastase, and hyaluronidase were determined to reveal their anti-wrinkle potential. Anti-tyrosinase activities were determined.ResultsC. militaris and I. tenuipes extracts were found to contain a wide range of bioactive compounds, including phenolics, flavonoids, and adenosine. A correlation was discovered between the chemical compositions and their biological activities. The extract from I. tenuipes fruiting body (IF) was highlighted as an extraordinary elastase inhibitor (IC₅₀ = 0.006 ± 0.004 mg/mL), hyaluronidase inhibitor (IC₅₀: 30.3 ± 3.2 mg/mL), and antioxidant via radical scavenging (ABTS IC₅₀: 0.22 ± 0.02 mg/mL; DPPH IC₅₀: 0.05 ± 0.02 mg/mL), thereby reducing ability (EC₁: 95.3 ± 4.8 mM FeSO₄/g extract) and lipid peroxidation prevention (IC₅₀: 0.40 ± 0.11 mg/mL). IF had a three-times higher EC₁ value than ascorbic acid and significantly higher elastase inhibition than epigallocatechin gallate.Discussion and conclusionsIF is proposed as a powerful natural extract with antioxidant and anti-wrinkle properties; therefore, it is suggested for further use in pharmaceutical, cosmeceutical, and nutraceutical industries.