Comparison of clinical presentation and incidence of cardiopulmonary complications between male and female Thai patients with early systemic sclerosis: inception cohort study

Clinical Rheumatology - To determine the prevalence of clinical manifestations and incidence rate of cardiopulmonary complications in a comparison between men and women with early SSc. An inception...     

Human pythiosis, a rare cause of arteritis: case report and literature review

Objective: To present a case of Pythium insidiosum arteritis and review reported cases of human pythiosis.Methods: Search of MEDLINE (PubMed) and the Thai Index Medicus was performed using the words “pythiosis” and “pythium.” Search of abstracts from a scientific meeting also was performed. Only reported cases in the English or Thai language, with enough clinical information for analysis, were included.Results: There were a total of 32 cases of human pythiosis, with 31 identified in the literature. Twenty-five cases were Thai. Twenty of 21 patients with known occupations were farmers. There was ocular infection in 9 cases, subcutaneous infection in 5 cases, arterial infection in 17 cases, and cardiopulmonary infection in 1 case. Thalassemia was a common associated finding. In addition to systemic antifungal therapy, surgery was required in most cases. The highest mortality rate was seen in the arteritic form, particularly in patients with arterial lesions proximal to the superficial femoral artery.Conclusions: Human pythiosis is rare. Physicians should be suspicious of pythiosis in individuals, particularly farmers in Thailand, who develop nonhealing cutaneous ulcers or keratitis, which do not respond to conventional treatment. P insidiosum infections should be listed as a rare cause of infectious arteritis.     

Condom breakage during commercial sex in Chiang Mai, Thailand

Used condoms in 30 female brothels in Chiang Mai, Thailand, during the period from August 1992 to October 1992 were examined for breakage. Data were also collected by interviewing 326 prostitutes who accounted for 65 percent of the total prostitutes providing condoms. The prostitutes had a mean age of 20.6 ± 3.2 years. Sixty-one percent had no formal education. The median duration of prostitution was 13 months. The average number of clients per day in the past 24 hours and in the past 3 months was 4.4 ± 2.5 and 5.5 ± 2.2, respectively. Eighty-eight percent charged between $2 and less than $8 for their sexual service. All refused to practice oral or anal sex during the past 24 hours. Of 5,559 condoms, 298 were used two at a time and 15 were used three at a time. The breakage rate per act of intercourse was 5.9 percent (95% CI = 5.3, 6.5). The breakage per total condoms examined was 5.7 percent (95% CI = 5.1, 6.3). Breakage relating to manufacturing defect, i.e., pinholes, and that relating to use was 0.8 percent (95% CI = 0.6, 1.0) and 5.0 percent (95% CI = 4.4, 5.6), respectively. The probability of breakage when using two condoms at the same time was 3.4 percent (95 % CI = 0.5, 6.3). Most of the breakage occurred at the distal part of the condom. There was no difference between the breakage rates of condoms provided by the brothels and those brought by the client; nor was there any difference between manufacturing defect or use. The breakage rate per client as estimated by prostitutes in the past 24 hours corroborated with that assessed by examination.     

Incidence,predictors, and survival of pulmonary hypertension determined by echocardiography in Thai patients with early systemic sclerosis (SSc): inception cohort study

Clinical Rheumatology - We investigated the incidence, predictors, and survival of pulmonary hypertension (PH) determined by Doppler echocardiography in Thai patients with early SSc (systemic...     

Elevated baseline serum creatine kinase in Thai early systemic sclerosis patients is associated with high incidence of cardiopulmonary complications and poor survival: an inception cohort study

Clinical Rheumatology - Inception cohort data regarding the incidence of cardiopulmonary complications in early systemic sclerosis (SSc) patients comparing those with and without elevated baseline...     

Safety and tolerability of intradermal influenza vaccination in patients with cardiovascular disease

Background It is well-established that influenza vaccination reduces adverse cardiovascular outcomes in patients with cardiovascular diseases （CVD）, however, the vaccine coverage rate in most countries remains low. The concern about the local adverse effects of intramus-cular injection, particularly in CVD patients receiving antithrombotic therapy, is one of the important impediments. This study was con-ducted to assess the safety, side effects and tolerability of intradermal influenza vaccine in CVD patients. Methods This was an observa-tional study in adult CVD patients who had undergone vaccination against seasonal influenza by intradermal vaccination between May 16th and May 30th, 2012 at Maharaj Nakorn Chiang Mai Hospital. The medical history, patients＇ acceptability and adverse effects were collected using a written questionnaire completed by the patient immediately following vaccination and by a telephone survey eight days later. Results Among 169 patients, 52.1%were women and the mean age was 63 ＆#177; 12 years. Coronary artery disease, valvular heart disease and dilated cardiomyopathy were present in 121 （71.6%）, 40 （23.7%） and 8 （4.7%）, respectively. Antithrombotics were used in 89.3%. After vaccination, the pain score was 0, 1 or 2 （out of 10） in 44.4%, 15.1%, and 27.6%of the patients, respectively. Eight days after vaccination, the common adverse reactions were itching 19 （11.9%）, swelling 9 （5.7%） and fatigue （4.7%）. No hematoma or bruising was reported. Conclusions The intradermal influenza vaccination is safe and well tolerates with high rates of satisfaction in CVD patients. This technique should be useful in expanding influenza vaccine coverage.