Outcomes of Treatment,Survival Rates,and Factors related to Survival of Stage III Lung Cancer Patients Treated at Srinagarind Hospital,Faculty of Medicine,Khon Kaen University,Thailand

Background: Lung cancer (LC) is the leading cause of death worldwide. Stage III lung cancer (Stage III-LC) is characterized by local metastasis. The treatments for LC differ at each stage, while for stage IIIA and IIIB treatment various approaches have been tried with uncertain results. We determined the survival time of Stage III-LC patient and compared survival among multiple factors. Methods: Data were collected from the Srinagarind Hospital-Based Cancer Registry (2014 - 2019). 324 patients from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, were followed up until December 31, 2021. The survival rate was estimated using Kaplan-Meier and the Log-rank test. In addition, hazard ratios (HR) and the 95% CI were estimated using Cox regression. Results: Of the 324 Stage III-LC patients, the total follow-up time was 447.3 person-years, and 288 cases died during the study, for a mortality rate of 64.4 per 100 person-years (95% CI: 57.40-72.27). The respective 1-, 3-, and 5-year survival rate was 44.1% (95% CI: 38.67-49.45), 16.2 (95% CI: 12.34-20.51), and 9.3 (95% CI: 6.14-13.31). The median survival time was 0.84 years (10.1 months) (95% CI: 0.73-1.00). After adjusting for sex and stage of disease, sequential chemoradiotherapy (SC) represented the most independent predictor of the risk of death (adjusted HR= 1.58; 95% CI: 1.41-2.18). Females had a mortality risk of 0.74-fold compared to males (adjusted HR = 0.74, 95% CI: 0.57-0.95). Stage of disease and stages IIIB and III (unknown and undefined) had a respective 1.33-fold (adjusted HR = 1.33, 95% CI: 1.00-1.84) and 1.48-fold (adjusted HR = 1.48, 95% CI: 1.09-2.00) risk of death compared to stage IIIA. Conclusion: Sex, stage of disease, and SC were related to stage III-LC survival, so physicians should emphasize combination therapy. Further research should focus on combination therapy and survival among Stage III-LC patients.     

Interferon-gamma release assays in tuberculous uveitis: a comprehensive review

Tuberculous uveitis (TBU) comprises a broad clinical spectrum of ocular manifestations, making its diagnosis challenging. Ophthalmologists usually require evidence from investigations to confirm or support a clinical diagnosis of TBU. Since direct isolation of the causative organism from ocular specimens has limitations owing to the small volume of the ocular specimens, resultant test positivities are low in yield. Immunodiagnostic tests, including the tuberculin skin test and interferon-gamma release assays (IGRAs), can help support a clinical diagnosis of TBU. Unlike the tuberculin skin test, IGRAs are in vitro tests that require a single visit and are not affected by prior Bacillus Calmette-Guerin vaccination. Currently, available IGRAs consist of different techniques and interpretation methods. Moreover, newer generations have been developed to improve the sensitivity and ability to detect active tuberculosis. This narrative review collates salient practice points as a reference for general ophthalmologists, such as evidence for the utilization of IGRAs in patients with suspected TBU, and summarizes basic knowledge and details of clinical applications of these tests in a clinical setting.     

Cardiovascular effects of 14-deoxy-11,12-didehydroandrographolide and Andrographis paniculata extracts

Andrographis paniculata has been widely used as a traditional medicine for the treatment of common cold, diarrhea and hypertension. The three major active diterpenoids are andrographolide (AP1), 14-deoxy-11,12-didehydroandrographolide (AP3) and neoandrographolide (AP4). It has been reported that AP3 has hypotensive and vasorelaxation effects. However, there is only limited information on the cardiovascular effects of the other diterpenoids and crude extracts containing different levels of AP3. Therefore, the present study investigated the effects of these diterpenoids, AP1, AP3, and AP4, isolated from A. paniculata, and different aqueous plant extracts on blood pressure, vascular and chronotropic responses by using conscious rats and their isolated aortas and right atria as the test models. Among the three major diterpenoids, AP3 was the most potent compound for inducing vasorelaxation and decreasing heart rate. In addition, Extract B (high level of AP3) had greater hypotensive effect in conscious rats than Extract A (low level of AP3). Verapamil, a Ca2+ channel blocker, also had a hypotensive effect less than that of Extract C containing a high level of AP3. At the doses and durations of Extract A and B which produced hypotension, the responses of the Extract A-treated aorta to norepinephrine, and the vascular muscarinic responses to acetylcholine of both extracts were decreased. However, repeated doses of both extracts did not alter cardiac beta-adrenoceptor and muscarinic responses of extract-treated rats to NE and ACh, respectively. The results of this study suggest that vascular smooth muscle is the major site of these hypotensive effects of both AP3 and A. paniculata extracts. Furthermore, the consumption of A. paniculata products containing high levels of AP3 may be responsible for causing hypotension in some patients taking this herbal drug.     

Delayed light activation of resin composite affects the bond strength of adhesives under dynamic simulated pulpal pressure

Clinical Oral Investigations - To evaluate the effect of a time delay before the light activation of resin composite on the microtensile bond strength (µTBS) of self-etch adhesives under...     

Microbiology in toothbrush samples from children exposed to lead in southern Thailand

Objective. The purpose of this study was to evaluate the prevalence and level of selected oral bacterial species in association with dental caries in low versus high blood lead (PbB) children. Material and methods. With an observational cross-sectional design, a sample of 292 children aged 6–11 years from two primary schools around a shipyard, known to be an area contaminated with lead, were examined. The number of decayed and filled surfaces on deciduous teeth (dfs) and the number of decayed, missing, and filled surfaces on permanent teeth (DMFS) were recorded. Microbiological plaque samples were taken from each child with a toothbrush. Enumeration of 17 bacterial species was carried out using the checkerboard DNA-DNA hybridization technique. Results. Overall means (SD) of dfs and DMFS were 13.2 (9.5) and 1.3 (2.3), respectively. Prevalence of excessive count (≥10⁶ cells/sample) was 100% for 4 known cariogenic bacteria and over 95% in another 2 species. With Bonferroni correction for type I error adjustment, there was no significant association between the count of each bacterial species and PbB and caries experience. The checkerboard method is sensitive in bacteria detection, but may not be suitable for differentiating caries risk in the endemic population.     

Momordica charantia L. Extract Protects Hippocampal Neuronal Cells against PAHs-Induced Neurotoxicity: Possible Active Constituents Include Stigmasterol and Vitamin E

Polycyclic aromatic hydrocarbons (PAHs) have been recognized to cause neurobehavioral dysfunctions and disorder of cognition and behavioral patterns in childhood. Momordica charantia L. (MC) has been widely known for its nutraceutical and health-promoting properties. To date, the effect of MC for the prevention and handling of PAHs-induced neurotoxicity has not been reported. In the current study, the neuroprotective effects of MC and its underlying mechanisms were investigated in mouse hippocampal neuronal cell line (HT22); moreover, in silico analysis was performed with the phytochemicals MC to decipher their potential function as neuroprotectants. MC was demonstrated to possess neuroprotective effect by reducing reactive oxygen species’ (ROS’) production and down-regulating cyclin D1, p53, and p38 mitogen-activated protein kinase (MAPK) protein expressions, resulting in the inhibition of cell apoptosis and the normalization of cell cycle progression. Additionally, 28 phytochemicals of MC and their competence on inhibiting cytochrome P450 (CYP: CYP1A1, CYP1A2, and CYP1B1) functions were resolved. In silico analysis of vitamin E and stigmasterol revealed that their binding to either CYP1A1 or CYP1A2 was more efficient than the binding of each positive control (alizarin or purpurin). Together, MC is potentially an interesting neuroprotectant including vitamin E and stigmasterol as probable active components for the prevention for PAHs-induced neurotoxicity.