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1.
Walsh DS Thavichaigarn P Pattanapanyasat K Siritongtaworn P Kongcharoen P Tongtawe P Yongvanitchit K Jiarakul N Dheeradhada C Pearce FJ Wiesmann WP Webster HK 《The Journal of surgical research》2005,129(2):221-230
BACKGROUND: Severe injury is associated with changes in monocytes that may contribute to poor outcomes. Longitudinal characterization of monocyte response patterns after trauma may provide added insight into these immunological alterations. METHODS: Venous blood obtained seven times during post-injury days 1 through 13 from 61 patients with an injury severity score >20 was assessed by flow cytometry for monocytes (CD14+) expressing HLA-DR or CD71 (transferrin receptor) and for circulating levels of interleukin (IL) 1alpha, IL-1beta, IL-6, soluble CD14 (sCD14), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2) (PGE(2)), thromboxane B(2) (TXB(2)), and endotoxin. Urine neopterin was measured by high-pressure liquid chromatography, expressed as a neopterin-creatinine ratio. RESULTS: Trauma patients had leucocytosis days 1 through 13, monocytosis days 5 through 13, reduced proportions of CD14+HLA-DR+ cells days 2 through 5, and elevated proportions of CD14+CD71+ cells days 1 through 13. Neopterin was elevated all days, peaking on day 10. sCD14 was elevated days 2 through 13, and there were sporadic elevations of IL-1alpha, IL-1beta, IL-6, TNF-alpha, PGE(2), TXB(2), and endotoxin. Sepsis syndrome patients (n = 6) had larger and more prolonged reductions in CD14+HLA-DR+ cells and higher neopterin values, in comparison with uneventful patient outcomes. CONCLUSIONS: Altered proportions of monocytes expressing HLA-DR and CD71 and elevated sCD14 and urine neopterin levels, for up to 2 weeks after severe injury, underscores an extended period of profound immunological effects. Additional studies to more fully assess temporal monocyte response patterns after severe injury, including activation, may be warranted. 相似文献
2.
Varma JK Wiriyakitjar D Nateniyom S Anuwatnonthakate A Monkongdee P Sumnapan S Akksilp S Sattayawuthipong W Charunsuntonsri P Rienthong S Yamada N Akarasewi P Wells CD Tappero JW 《Bulletin of the World Health Organization》2007,85(8):586-592
OBJECTIVE: WHO's new Global Plan to Stop TB 2006-2015 advises countries with a high burden of tuberculosis (TB) to expand case-finding in the private sector as well as services for patients with HIV and multidrug-resistant TB (MDR-TB). The objective of this study was to evaluate these strategies in Thailand using data from the Thailand TB Active Surveillance Network, a demonstration project begun in 2004. METHODS: In October 2004, we began contacting public and private health-care facilities monthly to record data about people diagnosed with TB, assist with patient care, provide HIV counselling and testing, and obtain sputum samples for culture and susceptibility testing. The catchment area included 3.6 million people in four provinces. We compared results from October 2004-September 2005 (referred to as 2005) to baseline data from October 2002-September 2003 (referred to as 2003). FINDINGS: In 2005, we ascertained 5841 TB cases (164/100 000), including 2320 new smear-positive cases (65/100 000). Compared with routine passive surveillance in 2003, active surveillance increased reporting of all TB cases by 19% and of new smear-positive cases by 13%. Private facilities diagnosed 634 (11%) of all TB cases. In 2005, 1392 (24%) cases were known to be HIV positive. The proportion of cases with an unknown HIV status decreased from 66% (3226/4904) in 2003 to 23% (1329/5841) in 2005 (P< 0.01). Of 4656 pulmonary cases, mycobacterial culture was performed in 3024 (65%) and MDR-TB diagnosed in 60 (1%). CONCLUSION: In Thailand, piloting the new WHO strategy increased case-finding and collaboration with the private sector, and improved HIV services for TB patients and the diagnosis of MDR-TB. Further analysis of treatment outcomes and costs is needed to assess this programme's impact and cost effectiveness. 相似文献
3.
Safety and immunogenicity of an HIV subtype B and E prime-boost vaccine combination in HIV-negative Thai adults 总被引:3,自引:0,他引:3
Nitayaphan S Pitisuttithum P Karnasuta C Eamsila C de Souza M Morgan P Polonis V Benenson M VanCott T Ratto-Kim S Kim J Thapinta D Garner R Bussaratid V Singharaj P el-Habib R Gurunathan S Heyward W Birx D McNeil J Brown AE;Thai AIDS Vaccine Evaluation Group 《The Journal of infectious diseases》2004,190(4):702-706
ALVAC-HIV (vCP1521) and AIDSVAX B/E were evaluated in a phase 1/2 trial of human immunodeficiency virus (HIV)-negative Thai adults. Of 133 volunteers enrolled, 122 completed the trial. There were no serious vaccine-related adverse events, nor were there intercurrent HIV infections. Lymphoproliferative responses to glycoprotein 120 E were induced in 63% of the volunteers, and HIV-specific CD8 cytotoxic T lymphocyte responses were induced in 24%. Antibody responses increased in frequency and magnitude in association with the dose level of AIDSVAX B/E. Binding and neutralizing antibodies to the MN strain were induced in 100% and 98%, respectively, of the volunteers receiving 600 microg of AIDSVAX B/E, and such antibodies to E strains were induced in 96% and 71%, respectively, of these volunteers. This vaccine combination was well tolerated and was immunogenic, meeting milestones for advancement to phase 3 evaluation. 相似文献
4.
云南西盟佤族居民患疟求医的现状、费用支付能力和障碍 总被引:5,自引:0,他引:5
目的 评价佤族患疟求医的现状、费用支付能力和障碍。 方法 对社区居民进行问卷调查和参与式行动评估 ,对关键人员进行半结构深度访谈。 结果 自己治疗是村民治疗疟疾的第一行动 ,只有自己治疗无效后才到卫生机构求医 ;5 1% (95 %CI :2 6~ 8 9% )问卷调查回答者从不求医 ,8 8% (95 %CI :5 4~ 13 3 % )仅靠自己治疗 ;3 7 4% (95 % :3 0 9~ 44 3 % )付不起疟疾治疗费 ;村民提出的疟疾治疗费为平均RHB 64 15± 7 0 6(范围 :0~ 5 0 0 )元 ,88 5 % (95 %CI :82 4~ 93 0 % )的人认为不能超过RHBl0 0元。 结论 佤族中的患疟求医行为不当 ,障碍为经济 ,地理 ,知识和技术上的不可及性 ;疟疾病例的家庭管理是改善疟疾治疗现状的方法之一。 相似文献
5.
Genetic variants of HIV-1 in Thailand. 总被引:40,自引:0,他引:40
F E McCutchan P A Hegerich T P Brennan P Phanuphak P Singharaj A Jugsudee P W Berman A M Gray A K Fowler D S Burke 《AIDS research and human retroviruses》1992,8(11):1887-1895
Serosurveys conducted prior to 1988 indicated a very low level of HIV-1 infection in Thailand, even among high-risk groups. The Ministry of Health has reported a dramatic increase in HIV-1 infection during the last three years. The geographic and demographic distribution of the epidemic is broad, involving multiple provinces and risk groups. Foci of higher incidence and prevalence have been noted in the urban center of Bangkok and in the northern provinces of Chiang Mai and Chiang Rai. Here we report the results of genetic characterization of 16 HIV-1 isolates from Thailand using a combination of polymerase chain reaction (PCR) typing and DNA sequencing. The complete sequence of gp160 (env) of five isolates, partial env sequence of six additional isolates, and the gag gene of two isolates were determined. Two highly distinct HIV-1 variants were found. One variant resembled those prevalent in North America and Europe; five of the isolates were of this type. The remaining eleven isolates were very similar to one another and represented a variant unlike any previously described. Phylogenetic tree analysis of complete env and gag genes placed the two variants on widely separated branches. Protein sequence comparisons indicate both general and specific features that distinguish the Northern Thailand variant both from the Bangkok variant and from virtually all previously sequenced HIV-1 isolates. A simple PCR test for distinguishing the two variants has been developed for use in epidemiologic surveys. 相似文献
6.
N Limsomwong L W Pang P Singharaj 《The American journal of tropical medicine and hygiene》1988,38(2):231-236
We studied the effects of daily proguanil compared to weekly chloroquine as malaria prophylaxis in 170 children living in a malaria-endemic area along the Thai-Burmese border. Children aged 5-10 years were matched for age, weight, and presence of splenomegaly then randomly assigned to receive either proguanil (equivalent of 200 mg daily adult dose) or chloroquine (equivalent of 300 mg base weekly). All medications were administered by the investigators and malaria smears were performed on a weekly basis. Among 85 children taking proguanil for 524 human-weeks, there were 17 cases of falciparum malaria and 11 cases of vivax. Of 85 children on chloroquine for 537 human-weeks, there were 24 cases of falciparum and 1 case of vivax. There were no statistically significant differences between the two regimens when analyzed either as suppressive or as causal Plasmodium falciparum prophylactics. The data were suggestive that proguanil may have some causal prophylactic effect against falciparum malaria. There were significantly more vivax prophylactic failures (P less than 0.01) in the proguanil group. Side effects were infrequent, mild, and comparable in both groups. 相似文献
7.
目的开发目标人群喜爱的疟疾防治信息-教育-交流(IEC)材料和指南.方法 采用各类参与式方法,在不同材料制作的各个阶段中让目标人群充分参与.结果开发制作了一套由针对一级目标人群的互动式录像片和两张海报、针对学生的故事画册、教师用"手拉手"活动手册、基层卫生人员实用图表、沟通技巧和上述5种材料使用指南组成的IEC材料.结论通过目标人群的充分参与,开发了一套目标人群喜闻乐见的疟疾防治IEC材料和指南. 相似文献
8.
K Kuvanont A Chitwarakorn C Rochananond M Kreaurat C Ariyarit P Singharaj K Panikabutra D N Taylor 《Sexually transmitted diseases》1989,16(3):137-140
The etiology of urethritis was determined for 303 Thai men with urethral discharge containing 5 or more polymorphonuclear cells (PMN)/high power field (hpf) and 132 men with a discharge containing less than 5 PMN/hpf. Neisseria gonorrhoeae was isolated significantly more often from men with greater than or equal to 5 PMN/hpf than from men with less than 5 PMN/hpf (42% vs 1%, P less than .0001). Chlamydia trachomatis was also isolated more often from patients with greater than or equal to 5 PMN/hpf than from men with less than 5 PMN/hpf (16% vs 8%, P less than .03). Ureaplasma urealyticum was isolated with nearly equal frequency from both groups of patients (45% vs 37%). Among men with a urethral exudate containing greater than or equal to 5 PMN/hpf, N. gonorrhoeae was isolated as the only pathogen from 19% and in combination with C. trachomatis or U. urealyticum in 23% of these men. C. trachomatis or U. urealyticum, but not N. gonorrhoeae, was isolated from 30%, and no pathogen was isolated from 28% of these men. Among men with urethral exudate containing less than 5 PMN/hpf, N. gonorrhoeae was isolated from only 1%, C. trachomatis or U. urealyticum from 41%, and no pathogen from 58%. These findings suggest that all Thai men with urethral discharge containing greater than or equal to 5 PMN/hpf should be treated for non-gonococcal urethritis and for gonococcal urethritis if gram-negative diplococci are demonstrated on gram stain of the urethral discharge. Men with urethritis with less than 5 PMN/hpf should be treated for only non-gonococcal urethritis. 相似文献
9.
采用社区参与式制作疟疾健康教育互动式录像片(In English) 总被引:4,自引:0,他引:4
目的制作一部通俗易懂和适应佤族文化特点的互动式翘首健康教育录像片。方法直接从目标人群中悼念背景材料及故事素材,邀请社区代表参与创作故事提纲,预测试脚本,充当演员和观测试录像片。结果制作出了六节传递六则疟疾信息的录像片。结论目标人群的参与可确保所制作的IEC村落通俗易懂和文化习俗上易于接受,在西盟制作的这一录像片不仅被认为适用千佤族,而且也适用于其它民族,现已经被从中文翻译成了佤、哈尼和傣等少数民族语言。 相似文献
10.