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Rerkasem A, Lyons-Reid J, Namwongprom S, Wongsrithep S, Mangklabruks A, Phirom K, Rerkasem K, Derraik JGB. Associations between maternal overweight/obesity during pregnancy and body composition in young adult offspring. Front Public Health 2024; 12:1346900. [PMID: 38544732 PMCID: PMC10968890 DOI: 10.3389/fpubh.2024.1346900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/20/2024] [Indexed: 05/12/2024] Open
Abstract
Background Maternal obesity is associated with an increased risk of large-for-gestational-age births and childhood obesity. However, evidence on its potential associations with long-term offspring body composition remains limited. This prospective cohort study examined associations between maternal body mass index (BMI) during pregnancy and body composition in the young adult offspring. Methods Participants were the offspring from a birth cohort in Chiang Mai (Thailand). Maternal BMI was assessed at the first antenatal clinic visit (≤24 weeks of gestation) in 1989-1990. In 2010-2011, we followed up the offspring at approximately 20 years of age, assessing their body composition using whole-body dual-energy X-ray absorptiometry (DXA) scans. Associations between maternal BMI and offspring body composition were explored using unadjusted and adjusted analyses. Results We assessed 391 young adults (55% were females). Higher maternal BMI was associated with increased offspring fat mass and lean mass. In adjusted analyses, offspring of mothers with overweight/obesity exhibited total body fat percentages 1.5 (95% CI 0.1, 2.9; p = 0.032) and 2.3 (95% CI 0.2, 4.5; p = 0.036) percentage points higher than offspring of normal-weight and underweight mothers, respectively. Fat mass index was similarly higher: 0.9 kg/m2 (95% CI 0.3, 1.5 kg/m2; p = 0.002) and 1.4 kg/m2 (95% CI 0.5, 2.3 kg/m2; p = 0.002), respectively. However, no differences in visceral adiposity were detected. Conclusion Higher maternal BMI during pregnancy was associated with increased adiposity in young adult offspring. Our findings suggest that the cross-generational transmission of maternal obesity-related traits is associated with increased offspring adiposity in the long term.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suthathip Wongsrithep
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kochaphan Phirom
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Clinical Surgical Research Center, Chiang Mai University, Chiang Mai, Thailand
| | - José G. B. Derraik
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Namwongprom S, Dejkhamron P, Unachak K. Success rate of radioactive iodine treatment for children and adolescent with hyperthyroidism. J Endocrinol Invest 2021; 44:541-545. [PMID: 32583373 DOI: 10.1007/s40618-020-01339-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/15/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE To assess the success rate of first dose radioiodine for treatment of hyperthyroidism in children and adolescent. METHODS This is a retrospective data analysis of children and adolescent with hyperthyroidism who received radioiodine (RAI) therapy from January 2013 to December 2017. Age, gender, family history of hyperthyroidism, duration of anti-thyriod drugs (ATDs) treatment, rapid turnover status, 2 h and 24 h I-131 radioiodine uptake (RAIU), thyroid volume, and treatment dose were also analyzed. The goal of RAI therapy was to achieve hypothyroidism within 3-6 months after treatment. Treatment result was evaluated at 6 months after treatment and divided into 2 groups: treatment success (hypothyroid and euthyroid) and treatment failure (hyperthyroid). The same parameters were compared between both groups. RESULTS 32 hyperthyroid patients, 26 female with mean age at treatment of 13.84 ± 1.83 years. All patients had prior treatment with ATDs, with a median treatment duration of 32.5 months (range 2-108). The median estimated thyroid gland size was 24.62 g, range 9.29-72.8. RAI doses ranged from 4.1 to 29.9 mCi (median dose = 7.54 mCi). Significant difference in 24-h I-131 uptake and RI status was demonstrated. Successful treatment rate after single dose of therapeutic I-131 was 65.63%. CONCLUSION With the I-131 dose of 220 μCi/g of thyroid tissue, successful treatment rate after single dose of therapeutic I-131 was 65.63%. RAI therapy with I-131 dose of 250-400 μCi/g of thyroid tissue might be suitable in patients with medical failure from ATDs. Possible role of RI as the predictor for RAI therapy failure are needed to investigate in both adult and children clinical settings.
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Affiliation(s)
- S Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - P Dejkhamron
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - K Unachak
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Chaiwong W, Namwongprom S, Liwsrisakun C, Pothirat C. The roles of impulse oscillometry in detection of poorly controlled asthma in adults with normal spirometry. J Asthma 2021; 59:561-571. [PMID: 33356696 DOI: 10.1080/02770903.2020.1868499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Impulse oscillometry (IOS) has been introduced as a method of assessing asthma control. However, the cutoff IOS values for the detection of asthma control in adults are still unclear. OBJECTIVE To assess the diagnostic ability of IOS for distinguishing between poorly controlled and well controlled adult asthmatic subjects with normal spirometry. METHODS This cross-sectional study was conducted at the Lung Health Center, Chiang Mai, Thailand, between July 2019 and June 2020. IOS and spirometry were performed in all adult asthmatic subjects but only subjects with normal spirometry were enrolled. Poorly controlled asthma was defined in accordance with the Global Initiative for Asthma (GINA) plus an asthma control test (ACT) score ≤19. A Receiver Operating Characteristic (ROC) curve was plotted to detect poorly controlled asthma using the area under the ROC (AuROC) and 95%CI. RESULTS One hundred and forty-two adult asthmatic subjects registering normal spirometry with a mean age of 53.4 ± 15.8 years were enrolled. Eighty-nine (62.7%) subjects were female. IOS parameters including heterogeneity of resistance at 5 Hz and resistance at 20 Hz (R5-R20) and area under reactance (AX) demonstrated excellent detection of poorly controlled asthma with an AuROC of 0.911 and 0.904, respectively. The z-score or absolute value of R5-R20 ≥ 0 and 1 cmH2O/L/s, respectively, represented the highest AuROC of 0.86, with a sensitivity and a specificity of ≥80.0% for the detection of poorly controlled asthma. CONCLUSION IOS is a valuable tool for the detection of poorly controlled asthma in adults with normal spirometry.
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Affiliation(s)
- Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirianong Namwongprom
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Deesomchok A, Chaiwong W, Liwsrisakun C, Namwongprom S, Pothirat C. Reference equations of the impulse oscillatory in healthy Thai adults. J Thorac Dis 2021; 14:1384-1392. [PMID: 35693627 PMCID: PMC9186246 DOI: 10.21037/jtd-21-1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/02/2022] [Indexed: 11/06/2022]
Abstract
Background The ethnicity is significantly under-reported and this may limit the applicability of current impulse oscillometry (IOS) equations to heterogeneous patient populations. Establishing predictive equations for the IOS in the Thai adult population is still required. Therefore, this study aimed to establish reference equations for the IOS in the Thai adult population. Methods This retrospective cross-sectional study of IOS parameters in healthy adults aged greater than 20 years old with normal spirometry and who had no chronic respiratory diseases. Pre-bronchodilator (BD) IOS was performed in all subjects. Reference equations were calculated separately for men and women using multivariable linear regression analysis. Results A total of 127 subjects (87 men and 40 women) with a mean age of 48.7±17.2 (range, 22–92) years were included. The resistance at 5 Hz (R5), resistance at 20 Hz (R20), and area under reactance curve between 5 Hz and resonant frequency (AX) were significantly higher in women compared to men. The reference equations of the IOS parameters were established for men and women. Age, height, and bodyweight were shown to be the influential predictor as they contributed to the most of IOS indices except for the R5–R20 in men equations. Bodyweight was shown to be the influential predictor as it contributed to the most IOS indices except for the X5 in women’s equations. Conclusions We provided the reference equations for the IOS indices in Thai adults. IOS indices including R5, R20, and AX were significantly higher in women compared to men.
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Affiliation(s)
- Athavudh Deesomchok
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Abstract
The diagnosis of chronic obstructive pulmonary disease (COPD) mainly relies on spirometry. Due to the complexity of spirometry, easier-to-do impulse oscillometry (IOS) has been introduced as a complementary approach to conventional pulmonary function testing. Therefore, this study aimed to assess the efficacy of the diagnostic ability of IOS for diagnosing chronic obstructive pulmonary disease (COPD). This cross-sectional study was conducted at the Lung Health Center, Chiang Mai University, Thailand, between June 2019 and January 2020. IOS and spirometry were performed with all subjects suspected of having COPD. A Receiver Operating Characteristic (ROC) curve was plotted, the area under the ROC (AuROC) and 95%CI were compared among COPD and chronic smokers. One hundred and seventeen subjects suspected of having COPD with a mean age of 68.6 ± 8.6 years old were enrolled. Of these 103 (88.0%) were male. Thirty healthy subjects were also enrolled. IOS parameters including resistance at 5 Hz (R5), resonant frequency (Fres), area under reactance (AX), heterogeneity of resistance (R5-R20), and reactance at 5 Hz (X5) demonstrated excellent overall accuracy relative to the diagnosis of COPD with an AuROC ranging from 0.80 - 0.84. The AX ≥ 8.66 cmH2O/L represented an AuROC = 0.79, with a sensitivity of 79.1% and a specificity of 78.0% for the diagnosis of COPD. IOS is a valuable tool for use in the diagnosis of COPD. It may be used in subjects who cannot carry out the spirometric procedure.
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Affiliation(s)
- Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirianong Namwongprom
- Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Aurpibul L, Namwongprom S, Sudjaritruk T, Ounjaijean S. Metabolic syndrome, biochemical markers, and body composition in youth living with perinatal HIV infection on antiretroviral treatment. PLoS One 2020; 15:e0230707. [PMID: 32226033 PMCID: PMC7105120 DOI: 10.1371/journal.pone.0230707] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/06/2020] [Indexed: 12/20/2022] Open
Abstract
People living with HIV who are on antiretroviral treatment are at increased risk of developing premature cardiovascular disease. Children with perinatal HIV infection (PHIV) have survived through their adolescence and are entering adulthood. We determined the prevalence of metabolic syndrome, abnormal biochemical markers, and characterized body composition parameters in youth living with perinatal HIV infection. This cross-sectional study was conducted at the Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand from December 2017 to February 2018. PHIV-youths between 15 <25 years of age who were receiving ART were enrolled. Data collection included ART-related history, blood pressure, and anthropometric measurements. Body composition including android, gynoid fat mass, and total body fat were measured by dual-energy X-ray absorptiometry. Fasting blood was drawn to test for lipid profile, glucose, and high sensitivity c-reactive protein (hsCRP). One hundred and twenty PHIV-youths (48% female) were enrolled. Their mean age and the median duration on ART were 20.3 (SD2.6) and 14.1 (IQR 10.4–14.9) years, respectively; 76 (63%) were on first-line non-nucleoside reverse transcriptase inhibitors-based regimens. Thirty-three (28%), 74 (62%), and 13 (11%) of PHIV-youths were underweight (BMI < 18.5 kg/m2), normal (BMI 18.5–24.9 kg/m2), and overweight (BMI ≥ 25.0 kg/m2), respectively. The prevalence of metabolic syndrome was 10.6% (95%CI 5.0–16.0). Seventy-six of 113 (67.3%) of PHIV-youths had lipid alteration; the most prevalent types being low HDL (46.9%) and increased triglycerides (27.4%). Overall 43 (35.9%) had increased hsCRP (16.7% with immediate and 19.2% with high risk for CVD). Females had significantly higher percentage of android and gynoid fat, but lower Android to gynoid ratio (AGR) compared to males. There were 77%, 31%, and 21% of PHIV-youths in the overweight, normal weight, and underweight group with AGR in tertile 3, respectively. In conclusion, we documented presence of metabolic syndrome in 10.6% of PHIV-youths on ART. Increase AGR representing abdominal obesity was detected even in youths with normal BMI or underweight.
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Affiliation(s)
- Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tavitiya Sudjaritruk
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sakaewan Ounjaijean
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Namwongprom S, Rojanasthien S, Wongboontan C, Mangklabruks A. Contribution of Android and Gynoid Adiposity to Bone Mineral Density in Healthy Postmenopausal Thai Women. J Clin Densitom 2019; 22:346-350. [PMID: 30064814 DOI: 10.1016/j.jocd.2018.05.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 12/31/2022]
Abstract
Dual-energy X-ray absorptiometry (DXA) is one of the major tools for assessing the whole body and regional body composition and body adiposity. Various body composition parameters including android fat mass (AFM), gynoid fat mass (GFM), and android-to-gynoid fat ratio (AG fat ratio) obtained from whole body DXA can be used as a reliable surrogate marker for regional body composition analysis. This study aimed to explore the contribution of android and gynoid adiposity to bone mineral density (BMD) in healthy postmenopausal Thai women. This cross-sectional study enrolled 1448 healthy Thai women, ages 40-90 without medication history or known disease affecting the BMD. Lumbar spine (LS), total femur, and femoral neck BMDs, AFM, GFM, and AG fat ratio were measured by DXA. To evaluate the contribution of android and gynoid adiposity with various measures of BMDs, univariable and multivariable linear regression analyses were used to estimate the regression coefficients. AFM, GFM, and AG fat ratio had a significant positive association with BMD of all measured sites (p < 0.001) in the univariate analysis. The strongest association was found between AG fat ratio and LS BMD (β = 0.156, p ≤ 0.001). In multivariate linear regression analysis, the results continued to show a positive association between AFM and GFM at all skeletal sites after adjusting for age, height, and total body lean mass. Relationship between AG fat ratio and BMD was found only in LS region. GFM had a strongest positive effect with BMD at the LS, total femur, and femoral neck regions. Higher android and gynoid adiposity was associated with higher BMD. GFM rather than AFM shows the strongest positive association with BMDs in postmenopausal Thai women.
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Affiliation(s)
- Sirianong Namwongprom
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Sattaya Rojanasthien
- Department of Orthopaedic, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanpen Wongboontan
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Poonual W, Navacharoen N, Kangsanarak J, Namwongprom S, Saokaew S. Hearing loss screening tool (COBRA score) for newborns in primary care setting. Korean J Pediatr 2017; 60:353-358. [PMID: 29234358 PMCID: PMC5725340 DOI: 10.3345/kjp.2017.60.11.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/08/2017] [Accepted: 03/31/2017] [Indexed: 12/04/2022]
Abstract
Purpose To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69–43.26), 58.52 (95% CI, 36.26–94.44), and 51.56 (95% CI, 33.74–78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59–34.66). Conclusion A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.
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Affiliation(s)
- Watcharapol Poonual
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Thailand
| | - Niramon Navacharoen
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Jaran Kangsanarak
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Sirianong Namwongprom
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Thailand.,Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Surasak Saokaew
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Center of Pharmaceutical Outcomes Research (CPOR), Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
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Poonual W, Navacharoen N, Kangsanarak J, Namwongprom S. Outcome of Early Identification and Intervention on Infants with Hearing Loss Under Universal Hearing Screening Program. J Med Assoc Thai 2017; 100:197-206. [PMID: 29916635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine the outcome of early identification and intervention of hearing loss children. MATERIAL AND METHOD An analytic prospective study. All neonates were screened with TEOAE/ABR. All infants were diagnosed and started early intervention at sixth month and followed for hearing and developmental evaluation until eighteen months of age. RESULTS Three thousand one hundred twenty neonates underwent hearing screening tests. One hundred and three infants had abnormal of 6 months of age and were diagnosed with congenital hearing loss (89 mild hearing loss, 12 moderate hearing loss, 1 moderate-severe hearing loss and 1 profound hearing loss). They received early intervention (8 hearing aid fitting (0.3%), 103 auditory training (3.3%), 103 counseling (3.3%) and 103 combine (3.3%) at 6 months of age). During follow up, eighty nine infants who had abnormal initial hearing tests were found to have normal hearing at eighteen months of age, Only Fourteen infants (0.4%) had permanent hearing loss. There were 7, 5, 1 and 1 infants in the mild, moderate, moderate-severe and profound hearing loss groups. The interventions offered to infants with different levels of hearing impairment were 5 hearing aid fittings (35.7%), 14 auditory training (100%), 14 counseling (100%) and 14 combination of three methods (100%). The development after 12 months follow up in infants with different levels of hearing impairment were 14 auditory improvement (100%), 14 speech improvement (100%) and 5 language improvement (35.7%). The common risk factors ranked in order of frequency are craniofacial anomalies( RR 2.57, 95%CI 1.49-4.43), ototoxic exposure(RR 4.71, 95%CI 1.94-11.46), severe hyperbilirubinemia (RR 2.10, 95%CI 1.08-4.06 ), low APGAR score at 5 minutes (RR 2.42, 95%CI 1.03-5.68) and sepsis (RR 2.02, 95%CI 1.01-4.03). CONCLUSION Continuing evaluation of hearing and development during follow-up is important in children with abnormal hearing tests. Early intervention can prevent acoustic deprivation and improve language development.
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Poonual W, Navacharoen N, Kangsanarak J, Namwongprom S. Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand. J Multidiscip Healthc 2015; 9:1-5. [PMID: 26766912 PMCID: PMC4699512 DOI: 10.2147/jmdh.s92818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program. MATERIALS AND METHODS A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study. RESULTS Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500-2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1-4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6-4.2), sepsis (RR 1.8, 95% CI 1.0-3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9-8.6). CONCLUSION This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people's quality of life.
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Affiliation(s)
| | | | - Jaran Kangsanarak
- Department of Otolaryngology, Chiang Mai University, Chiang Mai, Thailand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Mulligan K, Glidden DV, Anderson PL, Liu A, McMahan V, Gonzales P, Ramirez-Cardich ME, Namwongprom S, Chodacki P, de Mendonca LMC, Wang F, Lama JR, Chariyalertsak S, Guanira JV, Buchbinder S, Bekker LG, Schechter M, Veloso VG, Grant RM. Effects of Emtricitabine/Tenofovir on Bone Mineral Density in HIV-Negative Persons in a Randomized, Double-Blind, Placebo-Controlled Trial. Clin Infect Dis 2015; 61:572-80. [PMID: 25908682 DOI: 10.1093/cid/civ324] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/09/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Daily preexposure prophylaxis (PrEP) with oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) decreases the risk of human immunodeficiency virus (HIV) acquisition. Initiation of TDF decreases bone mineral density (BMD) in HIV-infected people. We report the effect of FTC/TDF on BMD in HIV-seronegative men who have sex with men and in transgender women. METHODS Dual-energy X-ray absorptiometry was performed at baseline and 24-week intervals in a substudy of iPrEx, a randomized, double-blind, placebo-controlled trial of FTC/TDF PrEP. Plasma and intracellular tenofovir concentrations were measured in participants randomized to FTC/TDF. RESULTS In 498 participants (247 FTC/TDF, 251 placebo), BMD in those randomized to FTC/TDF decreased modestly but statistically significantly by 24 weeks in the spine (net difference, -0.91% [95% confidence interval {CI}, -1.44% to -.38%]; P = .001) and hip (-0.61% [95% CI, -.96% to -.27%], P = .001). Changes within each subsequent 24-week interval were not statistically significant. Changes in BMD by week 24 correlated inversely with intracellular tenofovir diphosphate (TFV-DP), which was detected in 53% of those randomized to FTC/TDF. Net BMD loss by week 24 in participants with TFV-DP levels indicative of consistent dosing averaged -1.42% ± 29% and -0.85% ± 19% in the spine and hip, respectively (P < .001 vs placebo). Spine BMD tended to rebound following discontinuation of FTC/TDF. There were no differences in fractures (P = .62) or incidence of low BMD. CONCLUSIONS In HIV-uninfected persons, FTC/TDF PrEP was associated with small but statistically significant decreases in BMD by week 24 that inversely correlated with TFV-DP, with more stable BMD thereafter. CLINICAL TRIALS REGISTRATION NCT00458393.
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Affiliation(s)
| | | | | | - Albert Liu
- University of California, San Francisco Bridge HIV, San Francisco Department of Public Health, California
| | - Vanessa McMahan
- Gladstone Institute of Virology and Immunology, San Francisco, California
| | | | | | | | - Piotr Chodacki
- Desmond Tutu HIV Centre and Department of Medicine, University of Cape Town, South Africa
| | | | | | - Javier R Lama
- Asociacion Civil Impacta Salud y Education, Lima, Peru
| | - Suwat Chariyalertsak
- Chiang Mai University, Thailand Research Institute for Health Sciences, Chiang Mai, Thailand
| | | | - Susan Buchbinder
- University of California, San Francisco Bridge HIV, San Francisco Department of Public Health, California
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre and Department of Medicine, University of Cape Town, South Africa
| | - Mauro Schechter
- Federal University of Rio de Janeiro, Brazil Projeto Praca Onze, Hospital Escola Sao Francisco de Assis
| | - Valdilea G Veloso
- Instituto de Pesquisa Clinica Evandro Chagas-Fundaçao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Robert M Grant
- University of California, San Francisco Gladstone Institute of Virology and Immunology, San Francisco, California
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12
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Pattamapaspong N, Madla C, Mekjaidee K, Namwongprom S. Age estimation of a Thai population based on maturation of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 2015; 246:123.e1-5. [DOI: 10.1016/j.forsciint.2014.10.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/03/2014] [Accepted: 10/30/2014] [Indexed: 10/24/2022]
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13
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Vaseenon T, Chaimuang C, Phanphaisarn A, Namwongprom S, Luevitoonvechkij S, Rojanasthien S. Correlation of proximal femoral bone geometry from plain radiographs and dual energy X-ray absorptiometry in elderly patients. J Med Assoc Thai 2015; 98:39-44. [PMID: 25775730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Fracture prevention in osteoporotic patients is the primary treatment goal in assessing bone mineral density, identification of fracture risk, and determination of who should be treated. The literature shows that parameters of proximal femoral bone geometry such as hip axis length, femoral neck shaft angle (FNA), femoral neck width (FNW) and femoral neck cortical thickness (FNCT) can predict the risk of hip fracture. Those parameters are presented automatically with dual energy X-ray absorptiometry (DXA) scans, which are available in well-equipped hospitals. OBJECTIVE To determine the correlation between proximal femoral bone geometry and the parameters from DXA scans and those from plain radiographs. MATERIAL AND METHOD Forty-eight patients with no previous hip fractures or history of secondary osteoporosis underwent both a DXA scan of the hip area and a plain hip radiograph done in the same position, 25 degrees internal rotation. Bone geometries from both groups were measured to determine the correlation using Pearson correlation coefficient. RESULTS Correlation between the parameters HAL, FNA, FNW andFNCT from the DXA scans and from the measurement of the plain radiograph was significant (p < 0.01) and the level of correlation was moderate to high. The FNCT had least mean difference (0.04). In addition, the parameter FNCT less than 0.29 mm in both DXA scans and plain radiographs, showed a significant correlation with osteoporosis (T-score <-2.5). CONCLUSION The bone geometry parameters from either DXA scans orplain radiographs may be used to predict osteoporotic hip fracture with a moderate to high correlation. Plain radiographs are very helpful when DXA scan results are not available. The FNCT parameter has a strong correlation with osteoporosis.
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Namwongprom S, Rerkasem K, Wongthanee A, Pruenglampoo S, Mangklabruks A. Relationship between body composition parameters and metabolic syndrome in young Thai adults. J Clin Res Pediatr Endocrinol 2014; 6:227-32. [PMID: 25541893 PMCID: PMC4293657 DOI: 10.4274/jcrpe.1576] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between body composition parameters, i.e. waist circumference, android fat mass (AFM), gynoid fat mass (GFM), android to gynoid fat mass ratio (AG ratio) and metabolic syndrome (MS) risk components in young Thai adults. METHODS This was a cross-sectional study conducted among 391 adolescents (174 male, 217 female). The body mass index (BMI), waist circumference, blood pressure, triglyceride, high-density lipoprotein (HDL) cholesterol and glucose levels were determined. AFM, GFM and AG ratio were assessed by dual-energy X-ray absorptiometry (DXA). Linear regression analysis was done to assess the relationship of waist circumference, AFM, GFM and AG ratio with MS risk components' score, separately. RESULTS Among 391 young adults aged 18.5-21.8 years, MS was found in 5.9%. Participants with MS (n=23) had a significantly higher weight, height and BMI than those without MS. There was no statistically significant difference in bone mineral density between the two groups. At univariable linear regression analysis, waist circumferences, AFM, GFM and AG ratio showed significant relationship with MS risk components' score. However, after adjusting for gender, birth weight and BMI, AG ratio demonstrated greater relationship with MS risk components' score (β 1.89, 95%CI 1.096-2.978) than waist circumference (β 0.046, 95%CI 0.033-0.058) and AFM (β 0.979, 95%CI 0.667-1.290). No significant association was observed between GFM and MS risk components' score (β 0.077, 95%CI -0.089-0.243). CONCLUSION The results from this study indicated that AG ratio is a stronger predictor of MS than waist circumference and AFM in young Thai adults. The role of AG ratio for the diagnosis of MS needs to be further investigated.
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Affiliation(s)
- Sirianong Namwongprom
- Chiang Mai University Faculty of Medicine, Department of Radiology, Chiang Mai, Thailand. E-ma-il:
| | - Kittipan Rerkasem
- Chiang Mai University Faculty of Medicine, Department of Surgery, Chiang Mai, Thailand
,
Chiang Mai University The Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Antika Wongthanee
- Chiang Mai University The Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Sakda Pruenglampoo
- Chiang Mai University The Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Chiang Mai University The Research Institute for Health Sciences, Chiang Mai, Thailand
,
Chiang Mai University Faculty of Medicine, Department of Internal Medicine, Chiang Mai, Thailand
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15
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Vasavid P, Chaiwatanarat T, Pusuwan P, Sritara C, Roysri K, Namwongprom S, Kuanrakcharoen P, Premprabha T, Chunlertrith K, Thongsawat S, Sirinthornpunya S, Ovartlarnporn B, Kachintorn U, Leelakusolvong S, Kositchaiwat C, Chakkaphak S, Gonlachanvit S. Normal Solid Gastric Emptying Values Measured by Scintigraphy Using Asian-style Meal:A Multicenter Study in Healthy Volunteers. J Neurogastroenterol Motil 2014; 20:371-8. [PMID: 24948129 PMCID: PMC4102158 DOI: 10.5056/jnm13114] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 05/01/2014] [Accepted: 05/29/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS To report gastric emptying scintigraphy, normal values should be established for a specific protocol. The aim of this study was to provide normal gastric emptying values and determine factors affecting gastric emptying using Asian rice-based meal in healthy volunteers. METHODS One hundred and ninety-two healthy volunteers were included at 7 tertiary care centers across Thailand. Gastric emptying scintigraphy was acquired in 45 degree left anterior oblique view immediately after ingestion of a 267 kcal steamed-rice with technetium-99m labeled-microwaved egg meal with 100 mL water for up to 4 hours. RESULTS One hundred and eighty-nine volunteers (99 females, age 43 ± 14 years) completed the study. The medians (5-95th percentiles) of lag time, gastric emptying half time (GE T1/2) and percent gastric retentions at 2 and 4 hours for all volunteers were 18.6 (0.5-39.1) minutes, 68.7 (45.1-107.8) minutes, 16.3% (2.7-49.8%) and 1.1% (0.2-8.8%), respectively. Female volunteers had significantly slower gastric emptying compared to male (GE T1/2, 74 [48-115] minutes vs. 63 (41-96) minutes; P < 0.05). Female volunteers who were in luteal phase of menstrual cycle had significantly slower gastric emptying compared to those in follicular phase or menopausal status (GE T1/2, 85 [66-102] mintes vs. 69 [50-120] minutes or 72 [47-109] minutes, P < 0.05). All of smoking volunteers were male. Smoker male volunteers had significantly faster gastric emptying compared to non-smoker males (GE T1/2, 56 [44-80] minutes vs. 67 [44-100] minutes, P < 0.05). Age, body mass index and alcohol consumption habits did not affect gastric emptying values. CONCLUSIONS A steamed-rice with microwaved egg meal was well tolerated by healthy volunteers. Gender, menstrual status and smoking status were found to affect solid gastric emptying.
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Affiliation(s)
- Pataramon Vasavid
- Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Pawana Pusuwan
- Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanika Sritara
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Krisana Roysri
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | | | - Teerapon Premprabha
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kitti Chunlertrith
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Satawat Thongsawat
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | | | - Bancha Ovartlarnporn
- Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Udom Kachintorn
- Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somchai Leelakusolvong
- Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chomsri Kositchaiwat
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suriya Chakkaphak
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sutep Gonlachanvit
- GI Motility Research Unit, Division of Gastroenterology, Department of Medicine Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Namwongprom S, Rojanasthien S, Mangklabruks A, Soontrapa S, Taya P, Ongphiphadhanakul B. Erratum to: Discrepancy of left and right hip bone mineral density (BMD) in Thai women: diagnostic agreement and misclassification. Ann Nucl Med 2014. [DOI: 10.1007/s12149-014-0834-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Objective To validate a simple scoring system to classify dengue viral infection severity to patients in different settings. Methods The developed scoring system derived from 777 patients from three tertiary-care hospitals was applied to 400 patients in the validation data obtained from another three tertiary-care hospitals. Percentage of correct classification, underestimation, and overestimation was compared. The score discriminative performance in the two datasets was compared by analysis of areas under the receiver operating characteristic curves. Results Patients in the validation data were different from those in the development data in some aspects. In the validation data, classifying patients into three severity levels (dengue fever, dengue hemorrhagic fever, and dengue shock syndrome) yielded 50.8% correct prediction (versus 60.7% in the development data), with clinically acceptable underestimation (18.6% versus 25.7%) and overestimation (30.8% versus 13.5%). Despite the difference in predictive performances between the validation and the development data, the overall prediction of the scoring system is considered high. Conclusion The developed severity score may be applied to classify patients with dengue viral infection into three severity levels with clinically acceptable under- or overestimation. Its impact when used in routine clinical practice should be a topic for further study.
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Affiliation(s)
- Surangrat Pongpan
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ; Department of Occupational Medicine, Phrae Hospital, Phrae, Thailand
| | - Jayanton Patumanond
- Clinical Epidemiology Program, Faculty of Medicine, Thammasat University, Bangkok, Thailand
| | - Apichart Wisitwong
- Department of Social Medicine, Sawanpracharak Hospital, Nakorn Sawan, Thailand
| | | | - Sirianong Namwongprom
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ; Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sriwongpan P, Patumanond J, Krittigamas P, Tantipong H, Tawichasri C, Namwongprom S. Validation of a clinical risk-scoring algorithm for severe scrub typhus. Risk Manag Healthc Policy 2014; 7:29-34. [PMID: 24600256 PMCID: PMC3933538 DOI: 10.2147/rmhp.s56974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of the study reported here was to validate the risk-scoring algorithm for prognostication of scrub typhus severity. METHODS The risk-scoring algorithm for prognostication of scrub typhus severity developed earlier from two general hospitals in Thailand was validated using an independent dataset of scrub typhus patients in one of the hospitals from a few years later. The predictive performances of the two datasets were compared by analysis of the area under the receiver-operating characteristic curve (AuROC). Classification of patients into non-severe, severe, and fatal cases was also compared. RESULTS The proportions of non-severe, severe, and fatal patients by operational definition were similar between the development and validation datasets. Patient, clinical, and laboratory profiles were also similar. Scores were similar in both datasets, both in terms of discriminating non-severe from severe and fatal patients (AuROC =88.74% versus 91.48%, P=0.324), and in discriminating fatal from severe and non-severe patients (AuROC =88.66% versus 91.22%, P=0.407). Over- and under-estimations were similar and were clinically acceptable. CONCLUSION The previously developed risk-scoring algorithm for prognostication of scrub typhus severity performed similarly with the validation data and the first dataset. The scoring algorithm may help in the prognostication of patients according to their severity in routine clinical practice. Clinicians may use this scoring system to help make decisions about more intensive investigations and appropriate treatments.
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Affiliation(s)
- Pamornsri Sriwongpan
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai ; Department of Social Medicine, Chiangrai Prachanukroh Hospital, Chiang Rai
| | - Jayanton Patumanond
- Clinical Epidemiology Program, Faculty of Medicine, Thammasat University, Bangkok
| | | | | | | | - Sirianong Namwongprom
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai ; Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sriwongpan P, Krittigamas P, Tantipong H, Patumanond J, Tawichasri C, Namwongprom S. Clinical risk-scoring algorithm to forecast scrub typhus severity. Risk Manag Healthc Policy 2013; 6:43-9. [PMID: 24235852 PMCID: PMC3826289 DOI: 10.2147/rmhp.s52470] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The study explored clinical risk characteristics that may be used to forecast scrub typhus
severity under routine clinical practices. Methods Retrospective data were collected from patients registered at two university-affiliated tertiary
care hospitals in the north of Thailand, from 2004 to 2010. Key information was retrieved from
in-patient records, out patient cards, laboratory reports and registers. Patients were classified
into three severity groups: nonsevere, severe (those with at least one organ involvement), and
deceased. Prognostic characteristics for scrub typhus severity were analyzed by a multivariable
ordinal continuation ratio regression. Results A total of 526 patients were classified into nonsevere (n = 357), severe (n = 100), and deceased
(n = 69). The significant multivariable prognostic characteristics for scrub typhus severity were
increased body temperature (odds ratio [OR] = 0.58, 95% confidence interval
[CI] = 0.45–0.74, P < 0.001), increased pulse rate
(OR = 1.03, 95% CI = 1.01–1.05, P < 0.001), presence of crepitation
(OR = 3.25, 95% CI = 1.52–6.96, P = 0.001), increased percentage of
lymphocytes (OR = 0.97, 95% CI = 0.95–0.98, P = 0.001), increased aspartate
aminotransferase (every 10 IU/L) (OR = 1.04, 95% CI = 1.02–1.06, P
< 0.001), increased serum albumin (OR = 0.47, 95% CI = 0.27–0.80, P
= 0.001), increased serum creatinine (OR = 1.83, 95% CI = 1.50–2.24, P
< 0.001), and increased levels of positive urine albumin (OR = 1.43, 95% CI =
1.17–1.75, P < 0.001). Conclusion Patients suspicious of scrub typhus with low body temperature, rapid pulse rate, presence of
crepitation, low percentage of lymphocyte, low serum albumin, elevated aspartate aminotransferase,
elevated serum creatinine, and positive urine albumin should be monitored closely for severity
progression.
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Affiliation(s)
- Pamornsri Sriwongpan
- Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand ; Department of Social Medicine, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | | | | | | | | | - Sirianong Namwongprom
- Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand ; Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
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Sriwongpan P, Krittigamas P, Tantipong H, Patumanond J, Tawichasri C, Namwongprom S. Clinical risk-scoring algorithm to forecast scrub typhus severity. Risk Manag Healthc Policy 2013; 7:11-7. [PMID: 24379733 PMCID: PMC3872011 DOI: 10.2147/rmhp.s55305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To develop a simple risk-scoring system to forecast scrub typhus severity. Patients and methods Seven years’ retrospective data of patients diagnosed with scrub typhus from two university-affiliated hospitals in the north of Thailand were analyzed. Patients were categorized into three severity groups: nonsevere, severe, and dead. Predictors for severity were analyzed under multivariable ordinal continuation ratio logistic regression. Significant coefficients were transformed into item score and summed to total scores. Results Predictors of scrub typhus severity were age >15 years, (odds ratio [OR] =4.09), pulse rate >100/minute (OR 3.19), crepitation (OR 2.97), serum aspartate aminotransferase >160 IU/L (OR 2.89), serum albumin ≤3.0 g/dL (OR 4.69), and serum creatinine >1.4 mg/dL (OR 8.19). The scores which ranged from 0 to 16, classified patients into three risk levels: non-severe (score ≤5, n=278, 52.8%), severe (score 6–9, n=143, 27.2%), and fatal (score ≥10, n=105, 20.0%). Exact severity classification was obtained in 68.3% of cases. Underestimations of 5.9% and overestimations of 25.8% were clinically acceptable. Conclusion The derived scrub typhus severity score classified patients into their severity levels with high levels of prediction, with clinically acceptable under- and overestimations. This classification may assist clinicians in patient prognostication, investigation, and management. The scoring algorithm should be validated by independent data before adoption into routine clinical practice.
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Affiliation(s)
- Pamornsri Sriwongpan
- Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand ; Department of Social Medicine, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | | | | | | | | | - Sirianong Namwongprom
- Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand ; Department of Radiology, Chiang Mai University, Chiang Mai, Thailand
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21
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Namwongprom S, Rerkasem K, Wongthanee A, Pruenglampoo S, Mangklabruks A. Relationship between total body adiposity assessed by dual-energy X-ray absorptiometry, birth weight and metabolic syndrome in young Thai adults. J Clin Res Pediatr Endocrinol 2013; 5:252-7. [PMID: 24379035 PMCID: PMC3889991 DOI: 10.4274/jcrpe.1108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare body fat distribution using dual-energy X-ray absorptiometry (DXA) in young adult subjects with metabolic syndrome (MS) with those without MS and also to determine whether a significant association existed between total body fat mass (FM) and MS along with the effect of birth weight. METHODS This cross-sectional study was conducted on 393 young adult subjects (175 male, 218 female). Body mass index (BMI), waist circumference, blood pressure, triglyceride, high-density lipoprotein cholesterol and glucose levels were determined. Total body FM, lean mass (LM) and percentage of body fat (%BF) were assessed by DXA. Adult Treatment Panel III criteria were used for the diagnosis of MS. RESULTS The prevalence of MS was 5.6% among this group of young adult subjects aged 18.5-21.8 years. Subjects with MS (n=22) had significantly higher values for weight, height, BMI, waist circumference, %BF, total body FM, total body LM, and regional FM and LM. There was no statistically significant difference in bone mineral density between the two groups. There was also no association between birth weight and MS. Multiple logistic regression analysis showed that every 5 kg of total body FM (OR 1.68; 95%CI 1.06-2.66) adjusted for gender, birth weight status, and total body LM were significantly associated with MS. CONCLUSION Total body FM measured by DXA was related to MS in Thai young adults. Thus, body composition analysis might have a role in the identification of subjects with MS status.
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Affiliation(s)
- Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. E-mail:
| | - Kittipan Rerkasem
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
,
The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Antika Wongthanee
- The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sakda Pruenglampoo
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
,
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Pongpan S, Wisitwong A, Tawichasri C, Patumanond J, Namwongprom S. Development of dengue infection severity score. ISRN Pediatr 2013; 2013:845876. [PMID: 24324896 PMCID: PMC3845515 DOI: 10.1155/2013/845876] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 09/12/2013] [Indexed: 06/03/2023]
Abstract
Objectives. To develop a simple scoring system to predict dengue infection severity based on patient characteristics and routine clinical profiles. Methods. Retrospective data of children with dengue infection from 3 general hospitals in Thailand were reviewed. Dengue infection was categorized into 3 severity levels: dengue infection (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Coefficients of significant predictors of disease severity under ordinal regression analysis were transformed into item scores. Total scores were used to classify patients into 3 severity levels. Results. Significant clinical predictors of dengue infection severity were age >6 years, hepatomegaly, hematocrit ≥40%, systolic pressure <90 mmHg, white cell count >5000 / μ L, and platelet ≤50000 / μ L. The derived total scores, which ranged from 0 to 18, classified patients into 3 severity levels: DF (scores <2.5, n = 451, 58.1%), DHF (scores 2.5-11.5, n = 276, 35.5%), and DSS (scores >11.5, n = 50, 6.4%). The derived score correctly classified patients into their original severity levels in 60.7%. An under-estimation of 25.7% and an over-estimation of 13.5% were clinically acceptable. Conclusions. The derived dengue infection severity score classified patients into DF, DHF, or DSS, correctly into their original severity levels. Validation of the score should be reconfirmed before application of routine practice.
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Affiliation(s)
- Surangrat Pongpan
- Program in Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Occupational Medicine, Phrae Hospital, Phrae 54000, Thailand
| | - Apichart Wisitwong
- Department of Social Medicine, Sawanpracharak Hospital, Nakorn Sawan 60000, Thailand
| | | | - Jayanton Patumanond
- Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Namwongprom S, Unachak K, Dejkhamron P, Ua-apisitwong S, Ekmahachai M. Radioactive iodine for thyrotoxicosis in childhood and adolescence: treatment and outcomes. J Clin Res Pediatr Endocrinol 2013; 5:95-7. [PMID: 23748061 PMCID: PMC3701929 DOI: 10.4274/jcrpe.951] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the outcome of radioiodine treatment in thyrotoxicosis in childhood and adolescence. METHODS This was a retrospective study of 27 patients (ages 7.2- 19.8 years) with a diagnosis of thyrotoxicosis who received iodine-131 (I-131) treatment from January 2007 to December 2011 in the Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chiang Mai University. Gender, duration of antithyroid drug (ATD) treatment, 24-hour I-131 uptake, thyroid weight, total dose and number of treatments with I-131, and thyroid status at 6 months after treatment were recorded. RESULTS The outcomes of 27 patients (85.2% female, 14.8% male) treated with radioactive iodine were analyzed to assess the effectiveness of therapy as related to dose and gland size. All children and adolescents received 150 µCi of I-131/g of thyroid tissue (n=27). Six 6 months after treatment, 44.5% of the patients were hyperthyroid, 14.8% were euthyroid, and 40.7% were hypothyroid. Of the 12 cases with hyperthyroidism, 2 cases needed a second dose of I-131 treatment, and they finally reached a hypothyroid state. The patients were classified into 2 groups according to treatment success (euthyroid and hypothyroid) and treatment failure (hyperthyroid). There were no significant differences in age, gender, duration of ATD treatment, 2- and 24-hour I-131 uptake, thyroid weight, and total I-131 dose between these two groups. CONCLUSIONS Radioiodine treatment is safe and effective for thyrotoxicosis in childhood and adolescence. It is suitable as a good second-line therapy for patients with severe complications, those who show poor compliance, and those who fail to respond to ATD treatment.
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Affiliation(s)
- Sirianong Namwongprom
- Chiang Mai University, Faculty of Medicine, Department of Radiology, Chiang Mai, Thailand.
| | - Kevalee Unachak
- Chiang Mai University Faculty of Medicine, Department of Pediatrics, Chiang Mai, Thailand
| | - Prapai Dejkhamron
- Chiang Mai University Faculty of Medicine, Department of Pediatrics, Chiang Mai, Thailand
| | - Supoj Ua-apisitwong
- Chiang Mai University, Faculty of Medicine, Department of Radiology, Chiang Mai, Thailand
| | - Molrudee Ekmahachai
- Chiang Mai University, Faculty of Medicine, Department of Radiology, Chiang Mai, Thailand
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Klaipetch A, Namwongprom S, Ekmahachai M, Lojanapiwat B. Excretory urography and renal scintigraphy for chronic obstructed kidney: does nonopacity mean nonsalvageability? Singapore Med J 2013; 54:267-70. [PMID: 23716152 DOI: 10.11622/smedj.2013106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability. METHODS We retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopacified kidney on one side but normal excretion on the contralateral side. Affected kidneys with split glomerular filtration rate (GFR) < 10 mL/min/1.73 m2 on 99mTc-diethylenetriaminepentaacetic acid diuretic renal scintigraphy were considered nonsalvageable. Non-function was defined based on cutoff points (< 15% and < 20%) to determine the sensitivity and specificity of differential renal function. Differences in IVU and renal scintigraphy findings, with respect to the duration of delayed filming on IVU, were analysed for significance. RESULTS The results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96). CONCLUSION Although most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU.
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Affiliation(s)
- Alisa Klaipetch
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
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Namwongprom S, Rojanasthien S, Mangklabruks A, Soontrapa S, Wongboontan C, Ongphiphadhanakul B. Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women. Int J Womens Health 2013; 5:87-92. [PMID: 23467695 PMCID: PMC3589079 DOI: 10.2147/ijwh.s41884] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD) in postmenopausal and perimenopausal Thai women. METHODS A cross-sectional study was conducted in 1579 healthy Thai women aged 40-90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation. RESULTS Among the study population, 1448 subjects (91.7%) were postmenopausal and 131 (8.3%) were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal women. CONCLUSION Lean mass had a significant beneficial effect on BMD in both postmenopausal and perimenopausal women and can be considered as one of the determinants of bone mass. The effect of the fat mass was related to menopausal status, but only demonstrated a positive impact in perimenopausal women.
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Affiliation(s)
- Sirianong Namwongprom
- Clinical Epidemiology Program and Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai
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Namwongprom S, Rojnastein S, Mangklabruks A, Soontrapa S, Wongboontan C, Ongphiphadhanakul B. Importance of ethnic base standard references for the diagnosis of osteoporosis in Thai women. J Clin Densitom 2012; 15:295-301. [PMID: 22154430 DOI: 10.1016/j.jocd.2011.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 10/28/2011] [Accepted: 10/28/2011] [Indexed: 10/14/2022]
Abstract
Many studies demonstrated the importance of using ethnic-specific normal database in the diagnosis of osteoporosis (OP). Aims of this study were to assess diagnostic agreement, prevalence of OP, and diagnostic misclassification between Caucasian, Japanese, and Thai normal databases. The cross-sectional study of 3181 Thai women who had bone mineral density (BMD) measurement between January 2008 and December 2010 was performed. BMDs at lumbar spine (LS), femoral neck (FN), and total hip (TH) were derived to T-score by using Caucasian, Japanese, and Thai standard references. Kappa statistic was used to assess diagnostic agreement and misclassification. Diagnostic agreements between Caucasian and Thai reference databases were 0.39 for LS and 0.90 for FN. No statistical agreement was found in TH region (0.01, p value=0.264). Applying the Japanese reference, diagnostic agreements were 0.71 for LS, 0.76 for FN, and 0.94 for TH regions. Prevalence of OP in postmenopausal women was 64.1%, 37.7%, and 41.4% using Caucasian, Japanese, and Thai standard references. Percentage of misclassification was varied by menopausal status and reference database from 11.2% to 48.7%. When applying Japanese databases instead of Caucasian normal databases, overall diagnostic misclassification decreased from 35.1% to 16.1%. Choice of reference database has a significant effect on the diagnosis of low bone mass and OP. Japanese reference database has better diagnostic agreement with previously studied Thai reference database in 1999 than Caucasian reference database.
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Affiliation(s)
- Sirianong Namwongprom
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Namwongprom S, Ekmahachai M, Vilasdechanon N, Klaipetch A, Wongboontan C, Boonyaprapa S. Bone mineral density: correlation between the lumbar spine, proximal femur and Radius in northern Thai women. J Med Assoc Thai 2011; 94:725-731. [PMID: 21696083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine the correlation of bone mineral density (BMD) in lumbar spine, proximal femur and 1/3 radius in northern Thai women. MATERIALS AND METHOD The data of this study was collected from the medical records and the BMD results of 885 perimenopausal and postmenopausal women who had the BMD measurement in Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University between January and December 2007. BMD was measured using dual-energy X-ray absorptiometry (Hologic, QDR-4500C). RESULTS Mean age (+/- SD) was 58.7 +/- 9.9 year. The lowest T-score was found 51.6% at lumbar spine (LS), 29.2% at 1/3 radius, 13.8% at femoral neck (FN), 2.9% at total femur (TF) and 2.5% at trochanter region (TR). We found a significant correlation between age, BMI, duration of menopause, and BMD at the LS, TFE FN, TR and 1/3 radius (p < 0.01). The correlation between the BMD measures at LS and TF FN, TR and 1/3 radius were 0.708, 0.667, 0.721 and 0.633, respectively (p < 0 01). Women with perimenopausal status had higher height and BMD values at all five observed sites than postmenopausal women (p < 0.01). CONCLUSION The present found a good correlation of the BMD from various skeletal sites. Interestingly, the correlation was found highest between the LS vs. TR and TF vs. TR region. Clearly, estrogen-deficient plays important role on the low BMD values in all skeletal sites.
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Affiliation(s)
- Sirianong Namwongprom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Namwongprom S, Ekmahachai M, Vilasdechanon N, Chankaew N, Boonyaprapa S, Chitapanarux T. Clinical usefulness of per-rectal portal scintigraphy by Tc-99m pertechnetate in evaluation of the severity of portal hypertension in cirrhotic patients. Singapore Med J 2007; 48:1125-1130. [PMID: 18043841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Variceal haemorrhage is a potentially life-threatening complication in cirrhotic patients. Identification of patients at high risk for bleeding is particularly important. The aim of this study was to determine the clinical usefulness of per-rectal portal scintigraphy (PPS) in the evaluation of the severity of portal hypertension in cirrhotic patients, in terms of correlation between cirrhosis and the parameters of hepatic functional reserve, and identifying the difference of the portal shunt index (PSI) of the bleeding oesophageal variceal (BEV) patients and non-BEV patients. METHODS Portal circulations in 67 patients with cirrhosis and oesophageal varices were evaluated by Tc-99m pertechnetate PPS. Tc-99m pertechnetate (550 MBq) was instilled into the upper rectum, and dynamic images of upper abdomen were taken. Radioactivity curves for the liver and the heart were generated sequentially. Through the analysis of these curves, the PSI was determined. RESULTS The results, expressed as PSI, were: 11.4 +/- 98.4 percent (mean 66.8) in all 67 cirrhotic patients, 56.4 +/- 27.1 percent in cirrhotic patients without history of BEV, and 74.9 +/- 13.6 percent in cirrhotic patients with history of BEV. The PSI was significantly lower in cirrhotic patients without BEV than those with BEV (p-value equals 0.001). The PSI calculated with this method was correlated with the serum albumin, the serum bilirubin, the prothrombin time, and the Child-Turcotte-Pugh score. CONCLUSION Tc-99m pertechnetate PPS has clinical usefulness as a noninvasive method of choice for quantitatively evaluating the severity of portal hypertension in cirrhotic patients.
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Affiliation(s)
- S Namwongprom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
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Namwongprom S, Núñez R, Yeung H, Kim E, Macapinlac H. Unusual Adrenal Metastasis and Abdominal Carcinomatosis Secondary to Hurthle Cell Carcinoma of the Thyroid. Exp Clin Endocrinol Diabetes 2007; 115:694-6. [DOI: 10.1055/s-2007-985361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Won KS, Marom EM, Tateishi U, Namwongprom S, Kim EE. Pulmonary arteriovenous fistula arising in a renal cell carcinoma lung metastasis. Clin Radiol 2007; 62:812-6. [PMID: 17604774 DOI: 10.1016/j.crad.2007.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 02/05/2007] [Accepted: 02/16/2007] [Indexed: 11/26/2022]
Affiliation(s)
- K S Won
- Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Namwongprom S, Núñez R, Kim EE, Macapinlac HA. Tc-99m MDP bone scintigraphy and positron emission tomography/computed tomography (PET/CT) imaging in Erdheim-Chester disease. Clin Nucl Med 2007; 32:35-8. [PMID: 17179801 DOI: 10.1097/01.rlu.0000249758.49841.fa] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sirianong Namwongprom
- Department of Nuclear Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Affiliation(s)
- S Namwongprom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Namwongprom S, Boonyaprapa S, Ekmahachai M, Vilasdechanon N, Somwangprasert A, Sumitsawan S, Taya P. Breast lymphoscintigraphy for sentinel node identification in breast cancers with clinically-negative axillary nodes. Singapore Med J 2005; 46:688-92. [PMID: 16308641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION To analyse and determine the clinical value of lymphoscintigraphy for sentinel lymph node (SLN) localisation in woman undergoing surgery for breast cancer, and evaluate the predictive value of SLN versus axillary lymph node (ALN) status in these patients. METHODS Preoperative breast lymphoscintigraphy was performed in 35 female patients with breast cancer and clinically-negative ALNs. The mean age was 52.8 years (age range 38 to 73 years). The lymphoscintigraphy was performed using 74 MBq of Tc-99m nanocolloid subdermal injection over the tumour. The SLN location was marked on the skin. All patients underwent standard modified radical mastectomy with axillary lymph node dissection (ALND). A comparison of SLN and ALN histopathological results was completed in order to define the means by which the SLN biopsy was able to reflect the final status of ALNs. RESULTS In 20/35 (57.1 percent) cases, SLNs were visualised in 20-minute dynamic imaging. In 12 patients, SLNs were seen after delayed imaging and/or by repositioning the patient. Overall, the estimated SLN identification rate was 91.4 percent. Of 32 patients in whom SLNs were localised by lymphoscintigraphy, nine were positive for metastatic tumours and the rest were negative for tumour involvement. In four of these nine patients, SLN was the only node that contained metastatic tumour cells while in five patients, an additional concomitant ALN metastasis was detected. In four patients, SLN was negative on frozen section, but skip ALN metastases were noted. Of three patients in which SLNs were not localised by lymphoscintigraphy, two had positive ALNs for tumour cells and the remaining one was negative for tumour involvement. CONCLUSION We concluded that SLN localisation using lymphoscintigraphy is an accurate minimally-invasive procedure for staging breast cancer patients with clinically-negative ALNs, and can substantially reduce the morbidity and costs of surgical treatment by avoiding unnecessary ALND in the majority of patients.
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Affiliation(s)
- S Namwongprom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand 50200.
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Muttarak M, Namwongprom S, Sivasomboon C. Clinics in diagnostic imaging (93). Singapore Med J 2004; 45:43-7. [PMID: 14976582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
A 63-year-old woman was found to have pathological fracture of the right lower tibia through a brown tumour, hypercalcemia, and a soft tissue mass at the lower pole of the right lobe of thyroid gland. US scan of the neck showed a well-circumscribed heterogeneously-hypoechoic mass with displacement of the right lobe of thyroid gland. Diagnosis of parathyroid adenoma was confirmed on histopathological examination of the excised specimen. The cause and clinical manifestations of primary hyperparathyroidism are discussed. Imaging methods of parathyroid gland are presented.
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Affiliation(s)
- M Muttarak
- Department of Radiology, Chiang Mai University, Chiang Mai, Thailand.
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