Three-year durability of dual-nucleoside versus triple-nucleoside therapy in a Thai population with HIV infection

We compared the long-term immunologic and virologic efficacy of the dual- and triple-nucleoside therapy for HIV infection. This was a retrospective analysis of 2 randomized clinical trials in antiretroviral-naive patients. In the dual-nucleoside group, 15 started with didanosine (ddI) monotherapy and then added stavudine (d4T) after 24 weeks, 63 started with various doses of d4T and ddI, and 53 started with zidovudine (ZDV) and lamivudine (3TC). In the triple-nucleoside group, 53 started with ZDV, 3TC, and ddI. After 48 weeks, patients who were not failing were randomized to immediate (before treatment failure) versus delayed (at the time of virologic failure) switching from ddI and d4T to ZDV and 3TC or vice versa and from ZDV, 3TC, and ddI to d4T, 3TC, and abacavir (ABC). Failure was defined as a plasma HIV-1 RNA level>or=1 log10 above nadir or >or=10,000 copies/mL when nadir was <500 copies/mL. Patients failing therapy before week 48 received the new treatment as in the immediate switching group. Hydroxyurea was added to the last treatment regimen if patients failed after week 96. CD4 count and plasma HIV-1 RNA level (branched DNA assay with a cutoff point of 50 copies/mL) at week 144 were analyzed by intention to treat. Compared with the dual-nucleoside group, the triple-nucleoside group had a higher proportion of patients with <50 copies/mL at 144 weeks (60% vs. 18%; P<0.001), higher median CD4 count (388 cells/microL vs. 346 cells/microL; P=0.018), and longer duration of response, defined as the time from onset of viral suppression (<500 copies/mL) to the time of treatment failure (the first of 2 consecutive HIV-1 RNA measurements >500 copies/mL never followed by 2 consecutive visits showing suppressible viremia to <500 copies/mL) or discontinuation from the study (144 weeks vs. 104 weeks; P=0.002). Multivariate regression analyses showed that significant predictors for treatment success, defined as a plasma viral load <50 copies/mL at week 144, were asymptomatic clinical status at enrollment, a baseline plasma viral load 相似文献   

Association between the levels of prostaglandin E2 in tears and severity of dry eye

AIM: To investigate the relationship between the levels of prostaglandin E2 (PGE2) in tears and dry eye disease severity based on both clinical symptoms and signs. METHODS: Tear samples were collected from 36 non-Sjögren syndrome dry eye patients (10 males and 26 females, mean age 50.11±11.17y). All participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent a detailed ophthalmic examination including, tear film breakup time (TBUT), ocular surface fluorescein staining, Schirmer I test, and meibomian gland assessment. The level of PGE2 in tears was measured using enzyme-linked immunosorbent assay (ELISA). The independent associations between tear PGE2 levels and other variables including demographics, OSDI scores, TBUT, Schirmer scores, ocular surface staining scores, and stage of meibomian gland dysfunction (MGD) were evaluated using linear regression analysis. RESULTS: The mean PGE2 level in tears of dry eye patients was 537.85±234.02 pg/mL. The tear PGE2 levels significantly positively correlated with OSDI scores (R=0.608, P<0.001), however, they did not significantly associate with TBUT (R=0.153, P=0.373), Schirmer scores (R=-0.098, P=0.570), ocular surface staining scores (R=0.282, P=0.095), and stage of MGD (R=-0.107, P=0.535). Male sex was significantly negatively correlated with tear PGE2 levels. CONCLUSION: The levels of PGE2 in tears are positively correlated with dry eye symptoms. However, no significant association was found between tear PGE2 levels and the results of other common dry eye diagnostic tests.     

Effect of a pH-controlled co-precipitation process on rhodamine B adsorption of MnFe2O4 nanoparticles

We investigated the effect of a pH-controlled co-precipitation process on the adsorption behavior of manganese ferrite (MnFe₂O₄) nanoparticles as well as their structural and magnetic properties. The pH of prepared MnFe₂O₄ nanoparticles is typically an important factor affecting the adsorption capacity of an adsorbent. In this study, MnFe₂O₄ nanoparticles were prepared using a co-precipitation method at four different pH values of 9.0, 9.5, 10.0, and 10.5. The adsorption behaviors on rhodamine B (RhB) by MnFe₂O₄ nanoparticles prepared at different pH values were investigated. It was found that, via a pH-controlled process, MnFe₂O₄ nanoparticles prepared at pH 10.5 showed the highest RhB removal efficiency. The results indicated that the large pore size and surface charge of MnFe₂O₄ nanoparticles improved the adsorption capacities for RhB. Kinetic data were fitted to a pseudo-second order kinetic model and revealed that equilibrium was reached within 60 min. The isotherm data showed that the Langmuir maximum adsorption capacity of the MnFe₂O₄ nanoparticles prepared at pH 10.5 for RhB was 9.30 mg g⁻¹.

The MnFe₂O₄-pH 10.5 sample exhibited high adsorption capacity towards rhodamine B (RhB) solution. The high adsorption capacity towards RhB can be attributed to the large pore size and negative surface charge of MnFe₂O₄ nanoparticles.     

Understanding the Complexities of Eliminating Trans Fatty Acids: The Case of the Trans Fatty Acid Ban in Thailand

Trans fatty acids (TFAs) have no known health benefits and are linked to an increased risk of noncommunicable diseases (NCDs). To eliminate TFAs from the food supply, the government of Thailand imposed a ban on partially hydrogenated oils (PHOs) in 2018. This study was aimed at analyzing the government policies and actions to eliminate TFAs in Thailand, focusing on policy content, context, process, and actors. This single-case qualitative study used a documentary review and interviews with 20 key policy actors. The data analysis was guided by thematic analysis based on the policy triangle framework. The results reveal that policy actors—government organizations, academics, civil society organizations, and the food industry—have different roles, interests, and influences with regard to eliminating TFAs in Thailand. Both formal and informal communication among policy actors aided in the policymaking process and the actions that followed. Changing perceptions of TFAs, the low intake of PHOs in Thailand, hype around trans fats, and trade dynamics shaped the government’s decision to impose the ban. As a result, the ban was selected to avoid the technical components of TFA elimination. This study suggests that eliminating TFAs in Thailand could be further enhanced by strengthening government actions in terms of enforcement and creating consumer awareness.     

The effect of estradiol vaginal tablet and conjugated estrogen cream on urogenital symptoms in postmenopausal women: a comparative study.

OBJECTIVES: To compare the effects of estradiol vaginal tablet with conjugated estrogen cream on urogenital symptoms, vaginal health index, vaginal cytology, endometrial thickness, and plasma estradiol level in postmenopausal women. METHODS: Fifty-three women with urogenital symptoms were randomized to local vaginal treatment of 25 microg estradiol tablet or 1 g of conjugated estrogen cream for 12 weeks. They were assessed for urogenital symptoms, vaginal health index, vaginal cytology, endometrial thickness and estradiol level. RESULTS: Forty-eight women completed the treatment. Both groups showed improvement of urogenital symptoms, vaginal health index, and vaginal cytology after the first 4 weeks of treatment. Conjugated estrogen cream showed superior efficacy in alleviating vaginal dryness and dyspareunia. Two cases of endometrial proliferation were noted. CONCLUSIONS: Estradiol vaginal tablet and conjugated estrogen cream were effective in treating urogenital symptoms, the restoration of normal vaginal epithelium and reduction of vaginal pH in postmenopausal women. However, 2 cases of endometrial proliferation were noted.     

Female urinary incontinence: a cross-sectional study from a Thai rural area

The aims of this study were to investigate the prevalence and associated factors of female urinary incontinence in a Thai rural area and to investigate the impact of female urinary incontinence on quality of life. A population-based cross-sectional survey was performed from September 2003 to February 2004. A total of 1,126 women completed the questionnaires. The overall prevalence of urinary incontinence was 36.50%, i.e. stress urinary incontinence (33.60%), urge urinary incontinence (11.00%) and mixed urinary incontinence (8.07%). Urinary incontinence adversely affected quality of life; the mixed urinary incontinence group reported significantly greater impairment than the stress and urge urinary incontinence groups. Advancing age, labouring occupation, postmenopausal status, years since menopause, medical diseases, childbirth and vaginal delivery were associated with this problem.     

Baseline and kinetics of serum hepatitis B virus RNA predict response to pegylated interferon‐based therapy in patients with hepatitis B e antigen‐negative chronic hepatitis B

Serum hepatitis B virus (HBV) RNA has emerged as a novel biomarker of treatment response. This study aimed to investigate the role of this marker in predicting long‐term outcome of patients with hepatitis B e antigen (HBeAg)‐negative chronic hepatitis B (CHB) receiving pegylated interferon (PEG‐IFN)‐based therapy. Serial serum samples from 91 patients with HBeAg‐negative CHB previously treated with PEG‐IFN alone or combined with entecavir in a randomized trial were retrospectively analysed. HBV RNA quantification was examined by droplet digital PCR. At the end of 3 years post‐treatment follow‐up, maintained virological response (MVR, HBV DNA < 2000 IU/mL), and hepatitis B surface antigen (HBsAg) clearance were achieved in 37.4% (34/91) and 7.7% (7/91), respectively. Baseline serum HBV RNA concentrations correlated with HBV DNA and covalently closed circular DNA but did not correlate with HBsAg levels. Multiple regression analysis showed that pre‐treatment HBV RNA and HBsAg were independently associated with MVR and HBsAg clearance. Baseline HBV RNA (cut‐off 2.0 log₁₀ copies/mL) had a positive predictive value (PPV) and a negative predictive value in predicting MVR of 80.8% and 80.0%, respectively. At the same cut‐off value, PPV and NPV for predicting HBsAg clearance were 30.8% and 95.4%, respectively. At week 12 during therapy, HBV RNA level ≥ 2 log₁₀ copies/mL displayed high NPVs of achieving MVR and HBsAg clearance (95% and 100%, respectively). In conclusion, the measurement of HBV RNA prior to PEG‐IFN‐based therapy could identify patients with high probability of MVR. In addition, HBV RNA kinetics may serve as a promising “stopping rule” in patients infected with HBV genotypes B or C.     

Pericardial effusion in primary systemic carnitine deficiency

Summary A patient with pericardial effusion and a complicated presentation of primary systemic carnitine deficiency (PSCD) is described. This is the first case of PSCD reported to have pericardial effusion. Compound heterozygosity for two mutations in the SLC22A5 gene, T440M and F23del, and four SLC22A5 polymorphisms (c.IVS3+6A>G, c.−77G>A, c.−78C>T, and p.S95S) were identified in the patient. Electronic supplementary material Supplementary material is available for this article at     

A reduced curcuminoid analog as a novel inducer of fetal hemoglobin

Thalassemia is an inherited disorder of hemoglobin molecules that is characterized by an imbalance of α- and β-globin chain synthesis. Accumulation of unbound α-globin chains in erythroid cells is the major cause of pathology in β-thalassemia. Stimulation of γ-globin production can ameliorate disease severity as it combines with the α-globin to form fetal hemoglobin. We examined γ-globin-inducing effect of curcuminoids extracted from Curcuma longa L. and their metabolite reduced forms in erythroid leukemia K562 and human primary erythroid precursor cells. The results showed that curcuminoid compounds, especially bisdemethoxycurcumin are potential γ-globin enhancers. We also demonstrated that its reduced analog, hexahydrobisdemethoxycurcumin (HHBDMC), is most effective and leads to induction of γ-globin mRNA and HbF in primary erythroid precursor cells for 3.6?±?0.4- and 2.0?±?0.4-folds, respectively. This suggested that HHBDMC is the potential agent to be developed as a new therapeutic drug for β-thalassemia and related β-hemoglobinopathies.