rss_2.0Asian Biomedicine FeedSciendo RSS Feed for Asian Biomedicine Biomedicine 's Cover accuracy of complete blood cell count and neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios for neonatal infection<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Complete blood cell (CBC) counts and neutrophil-to-lymphocyte (NLR), lymphocyte-to-monocyte (LMR), and platelet-to-lymphocyte ratios (PLR) are simple measurements that are conducted as part of routine diagnostic procedures.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To determine the diagnostic importance, specificity, and sensitivity of these measurements for the diagnosis of neonatal infections and in discriminating between neonatal sepsis and various other infections.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective study of data from a consecutive series of 232 neonatal patients admitted to Yildirim Beyazit University Yenimahalle Training and Research Hospital in Ankara for 2 years from 2016 to 2018. We included patients with a diagnosis of or clinically suspected infection, and healthy neonates were included as controls. Data included CBC counts, and bacterial culture results, considered the criterion standard for the diagnosis of neonatal sepsis. NLR, LMR, and PLR were calculated. We compared data using independent Student <italic>t</italic> and Mann–Whitney <italic>U</italic> tests and determined the sensitivity, specificity, and likelihood ratio (LHOR) of the characteristics for neonatal sepsis using receiver operating characteristic curve analyses.</p> </sec> <sec><title style='display:none'>Results</title> <p>We included data from 155 neonatal patients with a diagnosis or suspicion of infection and 77 healthy neonates. NLR was significantly higher in neonates with sepsis or fever due to dehydration (<italic>P</italic> &lt; 0.001) than in neonates with other infections or healthy neonates. LMR was significantly higher in neonates with sepsis or viral infection than in those with other infections or healthy controls (<italic>P</italic> = 0.003). In neonates with early-onset sepsis (EOS), we found cut-off values of ≥4.79 [area under curve (AUC) 0.845, 95% confidence interval (CI) 0.76–0.93, LHOR 11.6, specificity 98.7%, sensitivity 15%] for NLR, ≥1.24 (AUC 0.295; CI 0.18–0.41, LHOR 1.02, specificity 2.6%, sensitivity 100%) for LMR, and ≥37.72 (AUC 0.268; CI 0.15–0.39, LHOR 0.86, specificity 7.8%, sensitivity 80%) for PLR. We found cut-off values of ≥4.94 (AUC 0.667; CI 0.56–0.77, LHOR 4.16, specificity 98.7%, sensitivity 5.4%) for NLR and ≥10.92 (AUC 0.384; CI 0.26–0.51, LHOR 6.24, specificity 98.7%, sensitivity 8.1%) for LMR in those with late-onset sepsis (LOS).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>CBCs, NLR, LMR, and PLR may be useful for the differential diagnosis of EOS and LOS, and neonates with sepsis from those with other infection. NLR may be a useful diagnostic test to identify neonatal patients with septicemia more quickly than other commonly used diagnostic tests such as blood cultures. NLR has high specificity and LHOR, but low sensitivity.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00PIWI-interacting RNA (piRNA): a narrative review of its biogenesis, function, and emerging role in lung cancer<abstract> <title style='display:none'>Abstract</title> <p>Cancer remains elusive in many aspects, especially in its causes and control. After protein profiling, genetic screening, and mutation studies, scientists now have turned their attention to epigenetic modulation. This new arena has brought to light the world of noncoding RNA (ncRNA). Although very complicated and often confusing, ncRNA domains are now among the most attractive molecular markers for epigenetic control of cancer. Long ncRNA and microRNA (miRNA) have been studied best among the noncoding genome and huge data have accumulated regarding their inhibitory and promoting effects in cancer. Another sector of ncRNAs is the world of PIWI-interacting RNAs (piRNAs). Initially discovered with the asymmetric division of germline stem cells in the <italic>Drosophila</italic> ovary, piRNAs have a unique capability to associate with mammalian proteins analogous to P-element induced wimpy testis (PIWI) in <italic>Drosophila</italic> and are capable of silencing transposons. After a brief introduction to its discovery timelines, the present narrative review covers the biogenesis, function, and role of piRNAs in lung cancer. The effects on lung cancer are highlighted under sections of cell proliferation, stemness maintenance, metastasis, and overall survival, and the review concludes with a discussion of recent discoveries of another class of small ncRNAs, the piRNA-like RNAs (piR-Ls).</p> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Multivariable analysis of clinical and laboratory data manifestations predicting severity and mortality risk in patients with Coronavirus disease 2019 in the mountainous west of Iran: a retrospective single-center study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory test findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality.</p> </sec> <sec><title style='display:none'>Results</title> <p>After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01–1.04, <italic>P</italic> = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01–3.45, <italic>P</italic> = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03–1.13, <italic>P</italic> = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02–1.36, <italic>P</italic> = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00–1.07, <italic>P</italic> = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09–0.58, <italic>P</italic> = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26–1.02, <italic>P</italic> = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00–1.15, <italic>P</italic> = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW – standard deviation (RDW-SD) 0.624.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Optimal diagnosis and management of non-alcoholic fatty liver disease manifestations and etiological risk factors in patients hospitalized with COVID-19 in Turkey<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Coronavirus disease 2019 (COVID-19) can affect the neurological as well as the respiratory system. Neurological manifestations may involve the central or peripheral nervous systems, or musculoskeletal system. Findings can range from mild presentations, such as headache and anosmia, to severe complications, such as stroke and seizure.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To evaluate the neurological findings and to determine etiological risk factors for mortality in patients hospitalized for COVID-19.</p> </sec> <sec><title style='display:none'>Methods</title> <p>Medical records of patients with COVID-19 who were hospitalized and sought neurological consultation between March 2020 and March 2021 at a reference pandemic hospital in Turkey were reviewed retrospectively in a cross-sectional study design.</p> </sec> <sec><title style='display:none'>Result</title> <p>We included data from 150 (94 male) patients. Their mean age ± standard deviation was 68.56 ± 16.02 (range 21–97) years. The patients were categorized into 2 groups according to any acute neurological event or progression of neurological disease. Ischemic cerebrovascular events, seizures, and encephalopathy were the most common acute neurological events, while deterioration in consciousness, epileptic seizures, and Parkinson disease were observed in those with progression of neurological disease. Abnormal neurological findings were found at a mean of 7.8 ± 9.7 days following COVID-19 diagnosis and 50 (a third of) patients died. A logistic regression model found that advanced age, increased Modified Charlson Comorbidity Index (MCCI) score, and prolonged duration of hospitalization were factors significantly associated with increased mortality; however, sex and day of abnormal neurological findings after COVID-19 diagnosis were not. Common conditions accompanying neurological events were hypertension, coronary artery disease–heart failure, and diabetes mellitus.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>COVID-19 may present with neurological symptoms in our Turkish patients and comorbidities are often present.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Association between serum uric acid level and non-alcoholic fatty liver disease in Koreans<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The association between serum uric acid (SUA) levels and non-alcoholic fatty liver disease (NAFLD) is controversial.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>We compared the association of SUA levels with NAFLD, abnormal alanine transferase (ALT), and the degree of liver fibrosis to clarify the association of SUA levels with NAFLD.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective cross-sectional study. Adult patients who underwent a health check-up (N = 1,343) were included for analysis. Fatty liver was diagnosed by abdominal ultrasonography. The degree of liver fibrosis was determined using the NAFLD fibrosis score (NFS). Pearson correlation analysis showed a stronger correlation of SUA level with the fatty liver index (<italic>r</italic> = 0.40, <italic>P</italic> &lt; 0.001) than the correlation with serum ALT level (<italic>r</italic> = 0.28, <italic>P</italic> &lt; 0.001), or NFS (<italic>r</italic> = 0.018, <italic>P</italic> = 0.51). SUA levels in patients with NAFLD and an abnormal liver function test (LFT) result were significantly higher than levels in patients without NAFLD and abnormal LFT results. By contrast, there was no significant association of SUA level with NFS grade. When age, male sex, body mass index, the presence of hypertension, diabetic mellitus, and NAFLD, abnormality of ALT level, and SUA level were included in binary logistic regression to evaluate risk factors for elevated NFS grade, hyperuricemia was not significantly associated with NFS grade (OR = 0.94, <italic>P</italic> = 0.75).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Pearson correlation and logistic regression together indicated SUA level is more closely associated with hepatic steatosis than abnormal liver function test or hepatic fibrosis.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Injectable calcium phosphate and styrene–butadiene polymer-based root canal filling material<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>Background</title><p>Three-dimensional obturation of the root canal system is mandatory for a successful root canal treatment. Using a filling material with optimal properties may enable the root canal to be sealed well and therefore obtain the desired obturation.</p></sec><sec><title style='display:none'>Objective</title><p>To develop a new injectable paste endodontic filling material using calcium phosphate powder and a styrene–butadiene emulsion polymer.</p></sec><sec><title style='display:none'>Methods</title><p>The powder phase comprised an equivalent molar ratio of tetracalcium phosphate, anhydrous dicalcium phosphate, bismuth oxide, and calcium chloride. The liquid phase comprised a styrene–butadiene rubber emulsion in distilled water. The powder and the liquid were mixed to achieve a paste consistency. The paste was subjected to various tests including flow, setting time, dimensional change, solubility, and radiopacity to indicate its suitability as a root canal filling material. All these tests were conducted according to the American National Standards Institute–American Dental Association for endodontic sealing materials. After passing these tests, the paste was submitted to an injectability test.</p></sec><sec><title style='display:none'>Results</title><p>The material showed acceptable flowability with 19.1 ± 1.3 min setting time and 0.61 ± 0.16% shrinkage after 30 days of storage. We found the highest solubility at 24 h (6.62 ± 0.58%), then the solubility decreased to 1.09 ± 0.08% within 3 days. The material was more radiopaque than a 3 mm step on an aluminum wedge. Furthermore, the material showed good injectability of 93.67 ± 1.80%.</p></sec><sec><title style='display:none'>Conclusions</title><p>The calcium phosphate powder in styrene–butadiene emulsion met basic requirements for a root canal filling material with promising properties.</p></sec></abstract>ARTICLE2021-02-21T00:00:00.000+00:00Atypical complication in an adult patient with dengue and autoimmune hemolytic anemia: a case report<abstract><title style='display:none'>Abstract</title><p>Severe dengue infection is associated with life-threatening complications, including severe bleeding. The bleeding tendency is typically associated with the shock phase of infection, for which blood replacement may be needed. However, repetitive blood transfusion can lead to volume overload. Administration of recombinant activated factor VII (rFVIIa) might be used to counteract bleeding without inducing volume overload. We describe the case of a patient with severe dengue infection who presented with intractable bleeding; he was initially treated with massive blood transfusions, which resulted in volume overload. He was then treated with rFVIIa to reverse the bleeding. During the second week of his hospitalization, his hematocrit dropped precipitously, and autoimmune hemolytic anemia was diagnosed. Supportive treatment was provided until recovery. Autoimmune hemolytic anemia is a rare complication in adult patients with dengue. Supportive care was effective for this atypical complication.</p></abstract>ARTICLE2021-02-21T00:00:00.000+00:00Gene polymorphisms and diseases in Asians features of normal lung change in asymptomatic elderly patients<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.431_s_001_w2aab3b7b3b1b6b1aab1c17b1Aa"><title style='display:none' id="d574916e16891_w2aab3b7b3b1b6b1aab1c17b1aAa">Background</title><p>Not all morphological lung changes in the elderly contribute to respiratory disease and may be a consequence of normal aging.</p></sec><sec id="j_1905-7415.0905.431_s_002_w2aab3b7b3b1b6b1aab1c17b2Aa"><title style='display:none' id="d574916e16900_w2aab3b7b3b1b6b1aab1c17b2aAa">Objectives</title><p>To describe the changes in asymptomatic elderly patients compared with those in younger patients in a Thai population.</p></sec><sec id="j_1905-7415.0905.431_s_003_w2aab3b7b3b1b6b1aab1c17b3Aa"><title style='display:none' id="d574916e16909_w2aab3b7b3b1b6b1aab1c17b3aAa">Methods</title><p>The study cohort comprised 60 participants without respiratory symptoms in three groups of 20 by age: 20-40 years, 41-60 years, and &gt;60 years. Participants were prospectively selected from patients referred for computed tomography (CT) of the abdomen, or head and neck, and underwent sequential CT during deep breathing at four lung levels. Two observers scored images by consensus. We compared groups using Pearson chi-square and Fisher exact tests, and used receiver operating characteristic curves to categorize bronchiectasis and bronchial wall thickening by age.</p></sec><sec id="j_1905-7415.0905.431_s_004_w2aab3b7b3b1b6b1aab1c17b4Aa"><title style='display:none' id="d574916e16918_w2aab3b7b3b1b6b1aab1c17b4aAa">Results</title><p>Air trapping was related to age (5/20 group 1, 7/20 group 2, and 18/20 group 3 (<italic>P</italic> &lt;0.01)) and was most prevalent in lower lobes (78%, <italic>P</italic> &lt; 0.01). Reticulation was found in only one middle aged patient (<italic>P</italic> = 0.36). Bronchiectasis was more common in patients &lt;56 years (7/23) than &lt;56 years (3/37), <italic>P</italic> = 0.035. Bronchial wall thickening (7/23 in patients &gt;56 years and 2/37 in patients &lt;56 years, <italic>P</italic> = 0.02) and extensive air trapping were related to age (0/6 group 1, 1/6 group 2, and 5/6 group 3, <italic>P</italic> = 0.02). Findings were independent of smoking history.</p></sec><sec id="j_1905-7415.0905.431_s_005_w2aab3b7b3b1b6b1aab1c17b5Aa"><title style='display:none' id="d574916e16947_w2aab3b7b3b1b6b1aab1c17b5aAa">Conclusions</title><p>Asymptomatic older patients had higher prevalence of bronchiectasis, bronchial wall thickening, and air trapping, independent of smoking history.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Multidrug resistance gene 1 polymorphisms in pediatric patients with leukemia at a national referral hospital in Indonesia<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.432_s_001_w2aab3b7b4b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e7487_w2aab3b7b4b1b6b1aab1c16b1aAa">Background</title><p>Acute lymphoblastic leukemia (ALL) is the most prevalent cancer in the pediatric population. From 25% to 30% of patients with ALL will have a relapse that leads to death when they are teenagers. At Cipto Mangunkusumo Hospital, 40% of 126 pediatric patients with ALL relapsed from 2005 to 2011. A multiple variant of multidrug resistance gene 1 (<italic>MDR1</italic>) is C3435T, which can be used to understand the genetic basis of susceptibility to relapse.</p></sec><sec id="j_1905-7415.0905.432_s_002_w2aab3b7b4b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e7499_w2aab3b7b4b1b6b1aab1c16b2aAa">Objectives</title><p>To identify the profile of <italic>MDR1</italic> polymorphism in pediatric Indonesian patients with ALL.</p></sec><sec id="j_1905-7415.0905.432_s_003_w2aab3b7b4b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e7511_w2aab3b7b4b1b6b1aab1c16b3aAa">Methods</title><p>We collected data from 44 patients with ALL who attended Cipto Mangunkusumo Hospital between January and June 2014. We investigated a silent C3435T polymorphism in <italic>MDR1</italic> exon 26 with polymerase chain reaction- restriction fragment length polymorphism using <italic>Mbo</italic>I.</p></sec><sec id="j_1905-7415.0905.432_s_004_w2aab3b7b4b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e7526_w2aab3b7b4b1b6b1aab1c16b4aAa">Results</title><p>There were 32 male and 12 female patient participants in this study. Eighteen patients were 1–3 years old and 26 were over 3 years. The mean age at 1–3 years was 2.4 ± 0.86, and over 3 years it was 6.3 ± 2.67 years. There were 27 patients with ALL in the standard risk group and 17 in the high risk group. We determined that the 25 samples from patients with ALL in the standard risk group were not digestible (allele T) and the 6 samples from patients with ALL in the high risk group were digestible (allele C).</p></sec><sec id="j_1905-7415.0905.432_s_005_w2aab3b7b4b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e7536_w2aab3b7b4b1b6b1aab1c16b5aAa">Conclusions</title><p>The prevalence of the T allele was higher than that of the C allele in pediatric Indonesian patients with ALL.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Comparing goniometric and radiographic measurement of Q angle of the knee<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.433_s_001_w2aab3b7b5b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e3933_w2aab3b7b5b1b6b1aab1c16b1aAa">Background</title><p>The Q angle is a relevant clinical diagnostic measurement to detect various disorders of the knee. The common method used to measure the Q angle in the routine clinical practice is by radiography. An alternative to radiographic measurement is goniometry, by which exposure to x-rays can be avoided.</p></sec><sec id="j_1905-7415.0905.433_s_002_w2aab3b7b5b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e3942_w2aab3b7b5b1b6b1aab1c16b2aAa">Objectives</title><p>To compare and correlate the goniometric measurement of Q angle with radiographic measurement of the Q angle in patients with acute knee pain.</p></sec><sec id="j_1905-7415.0905.433_s_003_w2aab3b7b5b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e3951_w2aab3b7b5b1b6b1aab1c16b3aAa">Methods</title><p>We selected 45 patient participants with a mean age of 32.5 years who satisfied the inclusion criteria for this study. All the patients underwent goniometric measurement of the Q angle followed by x-ray imaging of the entire lower limb. Later the bony prominences were marked on the x-ray image and the Q angle formed was measured using a protractor. The Pearson correlation coefficient between the goniometric and radiographic measurements was determined.</p></sec><sec id="j_1905-7415.0905.433_s_004_w2aab3b7b5b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e3960_w2aab3b7b5b1b6b1aab1c16b4aAa">Results</title><p>We found a significant relationship between Q angles obtained using a goniometer and x-ray imaging in the supine position (r = 0.91, P = 0.001). The mean difference between the goniometric measurement of Q angle and the radiographic measurement was 0.1°, which is not significant.</p></sec><sec id="j_1905-7415.0905.433_s_005_w2aab3b7b5b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e3970_w2aab3b7b5b1b6b1aab1c16b5aAa">Conclusions</title><p>Goniometry can be used to measure Q angle as accurately as radiography, and can be used as an inexpensive and radiation free alternative.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Soluble lectin-like oxidized low density lipoprotein receptor-1 in metabolic syndrome<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.439_s_001_w2aab3b7c11b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e236_w2aab3b7c11b1b6b1aab1c16b1aAa">Background</title><p>Serum levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) reflect increases in LOX-1 receptor expression associated with inflammation and metabolic disorders.</p></sec><sec id="j_1905-7415.0905.439_s_002_w2aab3b7c11b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e245_w2aab3b7c11b1b6b1aab1c16b2aAa">Objectives</title><p>To examine sLOX-1 levels in metabolic syndrome and association of sLOX-1 with classical risk factors, and with metabolic syndrome, a clustering of metabolic disorders associated with cardiovascular risk factors.</p></sec><sec id="j_1905-7415.0905.439_s_003_w2aab3b7c11b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e254_w2aab3b7c11b1b6b1aab1c16b3aAa">Methods</title><p>We selected 148 serum samples from patient participants with metabolic syndrome and 206 samples from patients with non-metabolic syndrome as controls, using the modified National Cholesterol Educational Program Adult Treatment Panel III (NCEP-ATP III) criteria.</p></sec><sec id="j_1905-7415.0905.439_s_004_w2aab3b7c11b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e263_w2aab3b7c11b1b6b1aab1c16b4aAa">Results</title><p>Levels of sLOX-1 were increased significantly in participants with metabolic syndrome (P &lt; 0.001). Serum sLOX-1 was positively associated with body mass index (BMI), blood pressure, fasting plasma glucose, triglyceride, and total cholesterol, but negatively associated with high-density lipoprotein cholesterol. Analysis of serum sLOX-1 for metabolic syndrome showed 99.03% specificity and 100% sensitivity. The area under the receiver operating characteristic curve was 0.998 (95%CI 0.996-1.001, P &lt; 0.001). A univariate analysis showed sLOX-1 was significantly correlated with metabolic syndrome, but was not after adjustment for sex, age, blood pressure, and BMI. Multivariate regression analysis found that being overweight (82.3; 95%CI 10.7–631.9), hyperglycemia (1.1; 95%CI 1.1–1.2), and hypertriglyceridemia (1.1; 95%CI 1.0–1.1) were significantly correlated with metabolic syndrome. HDL cholesterol was a protective factor (0.96; 95%CI: 0.93–0.99).</p></sec><sec id="j_1905-7415.0905.439_s_005_w2aab3b7c11b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e273_w2aab3b7c11b1b6b1aab1c16b5aAa">Conclusions</title><p>Serum sLOX-1 is a suitable biomarker for diagnosis of metabolic syndrome. However, univariate and multivariate analysis suggested that sLOX-1 may be a modulating factor, and not an independent risk factor.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Coinheritance of Southeast Asian ovalocytosis and the β-thalassemia trait in a Malay family<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.442_s_001_w2aab3b7c13b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e9282_w2aab3b7c13b1b6b1aab1c16b1aAa">Background</title><p>Southeast Asian ovalocytosis (SAO) is a red blood cell membrane disorder caused by a 27 base pair (bp) deletion in the <italic>SLC4A1</italic> that transcribes to a truncated variant of band-3 glycoprotein. β-Thalassemia is another red blood cell disorder, caused by mutant alleles in the β-globin gene that lead to globin chain impairment. Both conditions occur in Southeast Asian countries, including Malaysia.</p></sec><sec id="j_1905-7415.0905.442_s_002_w2aab3b7c13b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e9294_w2aab3b7c13b1b6b1aab1c16b2aAa">Objectives</title><p>This report describes hematological and molecular features of a patient with both SAO and β-thalassemia and her children.</p></sec><sec id="j_1905-7415.0905.442_s_003_w2aab3b7c13b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e9303_w2aab3b7c13b1b6b1aab1c16b3aAa">Methods</title><p>A 58-year-old Malay woman presented to our clinic with dizziness, tiredness, and easy fatigability. She was mildly anaemic. Analysis of her complete blood counts and her peripheral blood smear revealed microcytic hypochromic anaemia with large numbers of macro-ovalocytes and stomatocytes.</p></sec><sec id="j_1905-7415.0905.442_s_004_w2aab3b7c13b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e9312_w2aab3b7c13b1b6b1aab1c16b4aAa">Results</title><p>Hemoglobin and globin gene studies revealed heterozygous β-thalassemia, and further analysis demonstrated a heterozygous 27 bp deletion on the <italic>SLC4A1</italic> gene consistent with SAO. Analysis of the patient’s offspring showed co-inheritance of β-thalassemia and SAO in her elder daughter and son, and SAO alone in another daughter.</p></sec><sec id="j_1905-7415.0905.442_s_005_w2aab3b7c13b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e9325_w2aab3b7c13b1b6b1aab1c16b5aAa">Conclusions</title><p>High frequencies of SAO and different β-thalassemia mutations are present in the Malaysian population, thus coinheritance of SAO and β-thalassemia is not uncommon. However, this coinheritance is rarely reported, possibly because the red blood cell indices are overlooked and peripheral smear examinations are not routine.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Incidence and risk factors for adverse events during anesthesiologist-led sedation or anesthesia for diagnostic imaging in children: a prospective, observational cohort study<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.436_s_001_w2aab3b7b8b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e34092_w2aab3b7b8b1b6b1aab1c16b1aAa">Background</title><p>Pediatric sedation for diagnostic radiological procedures remains the mainstay for adequate imaging quality.</p></sec><sec id="j_1905-7415.0905.436_s_002_w2aab3b7b8b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e34101_w2aab3b7b8b1b6b1aab1c16b2aAa">Objectives</title><p>To clarify the risk of adverse events during anesthesiologist-led sedation or anesthesia for diagnostic radiological procedures in children in order to improve quality of care.</p></sec><sec id="j_1905-7415.0905.436_s_003_w2aab3b7b8b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e34110_w2aab3b7b8b1b6b1aab1c16b3aAa">Methods</title><p>We enrolled children aged &lt;15 years given sedation or anesthesia by an anesthesiologist and scheduled for computed tomography, magnetic resonance imaging, or nuclear medicine imaging November 2010-September 2014. We recorded adverse events occurring in the first 24 h.</p></sec><sec id="j_1905-7415.0905.436_s_004_w2aab3b7b8b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e34119_w2aab3b7b8b1b6b1aab1c16b4aAa">Results</title><p>Of 1,042 patients enrolled, adverse events were recorded in 254 (24.4%, 95% confidence interval [CI] 21.9 to 27.1). Adverse respiratory events occurred in 31 (3.0%), cardiovascular events in 7 (0.7%), sedation was prolonged in 165 (15.8%), there was one case of contrast allergy (0.01%), and there were 50 other minor complications (4.9%). Of the respiratory complications, there were 14 of airway obstruction (1.3%), 2 of apnea (0.2%), 14 of oxygen desaturation (1.3%), and one of laryngospasm (0.01%). There were no life threatening complications or consequences. Age &lt;1 year (adjusted odds ratio [adjusted OR] 2.5, 95% CI 1.2 to 5.3) and American Society of Anesthesiologists (ASA) physical status classification 2 and 3 (adjusted OR 4.6, 95% CI 1.1 to 19.8, and adjusted OR 6.3, 95% CI 1.3 to 30.9, respectively) were risk factors for respiratory complications.</p></sec><sec id="j_1905-7415.0905.436_s_005_w2aab3b7b8b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e34129_w2aab3b7b8b1b6b1aab1c16b5aAa">Conclusions</title><p>Adverse events were common during sedation or anesthesia, but no life threatening or sentinel events occurred under experienced supervision. Caution should be exercised in children &lt;1 year or with an ASA classification &gt;1.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Role of and polymorphisms in oxidative stress derived cancer in Thais with and without dyslipidemia<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0904.430_s_001_w2aab3b7ab1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e20368_w2aab3b7ab1b6b1aab1c16b1aAa">Background</title><p>Hyperlipidemia can induce the endogenous production of reactive oxygen species (ROS), which may cause carcinogenesis. Cytochrome P450 (CYP) 2E1 activity, induced by various factors including polyunsaturated fatty acids, effects the incidence of cancers, whereas NQO1, a flavoprotein, may protect against ROS.</p></sec><sec id="j_1905-7415.0904.430_s_002_w2aab3b7ab1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e20377_w2aab3b7ab1b6b1aab1c16b2aAa">Objectives</title><p>To investigate the effect of <italic>CYP2E1</italic> and <italic>NQO1</italic> polymorphism on oxidative stress status in Thais with and without dyslipidemia.</p></sec><sec id="j_1905-7415.0904.430_s_003_w2aab3b7ab1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e20392_w2aab3b7ab1b6b1aab1c16b3aAa">Methods</title><p>We included 1380 apparently healthy employees of the Electricity Generating Authority of Thailand in this study. We determined their <italic>CYP2E1</italic> and <italic>NQO1</italic> genotypes and related these to blood lipid profiles, and circulating levels of antioxidant enzymes, malondialdehyde (MDA), and reduced glutathione (GSH). Lifestyle-related factors were determined from questionnaires.</p></sec><sec id="j_1905-7415.0904.430_s_004_w2aab3b7ab1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e20407_w2aab3b7ab1b6b1aab1c16b4aAa">Results</title><p>All tested genotype frequencies were in Hardy-Weinberg equilibrium. The heterozygous and variant genotype distribution and allele frequency of <italic>CYP2E1 *5B</italic> were less common than <italic>CYP2E1 *6</italic>. Heterozygous <italic>NQO1</italic> was the most prevalent form. The frequency of the mutated allele <italic>CYP2E1 *5B</italic> was 0.16, <italic>CYP2E1 *6</italic> was 0.22, and <italic>NQO1 *2</italic> was 0.43. Significant differences were observed for blood cholesterol, triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol between normolipidemic participants, and those with hypercholesterolemia, hypertriglyceridemia, and combined hyperlipidemia. Participants in the hyperlipidemic subgroup who bore any variant alleles of genes had higher plasma MDA and GSH levels, and superoxide dismutase and glutathione peroxidase activity, but lower catalase activity when compared with normolipidemic participants bearing wild-type alleles.</p></sec><sec id="j_1905-7415.0904.430_s_005_w2aab3b7ab1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e20436_w2aab3b7ab1b6b1aab1c16b5aAa">Conclusions</title><p>Variations in genetic disposition and dyslipidemia can modify oxidative stress status. Relatively more free radicals may be generated in individuals in subgroups with hyperlipidemia bearing any variant alleles.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00The effects of modified ultrafiltration on clinical outcomes of adult and pediatric cardiac surgery<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.429_s_001_w2aab3b7b2b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e24948_w2aab3b7b2b1b6b1aab1c16b1aAa">Background</title><p>Cardiopulmonary bypass (CPB) can contribute to the development of an inflammatory response and postsurgical morbidity. Conventional ultrafiltration and modified ultrafiltration (MUF) can mitigate the adverse effects of CPB by removing free water and inflammatory mediators, at least in part.</p></sec><sec id="j_1905-7415.0905.429_s_002_w2aab3b7b2b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e24957_w2aab3b7b2b1b6b1aab1c16b2aAa">Objectives</title><p>To evaluate evidence for the effects of MUF on clinical outcomes of cardiac surgery in pediatric and adult patients.</p></sec><sec id="j_1905-7415.0905.429_s_003_w2aab3b7b2b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e24966_w2aab3b7b2b1b6b1aab1c16b3aAa">Methods</title><p>A literature review of MEDLINE-indexed articles published between 1990 and June 2014 was conducted on PubMed. A search on the website and the Cochrane Central Register of Controlled Trials was also performed with relevant keywords. The search was limited to English language articles and human studies.</p></sec><sec id="j_1905-7415.0905.429_s_004_w2aab3b7b2b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e24975_w2aab3b7b2b1b6b1aab1c16b4aAa">Results</title><p>Our primary search identified 84 potential articles, of which 55 articles were relevant to conventional ultrafiltration, modified ultrafiltration, ultrafiltration, cardiopulmonary bypass, extracorporeal circulation, pediatric and adult cardiac surgery. There were 3 meta-analyses, 7 review literatures, 21 randomized controlled trials. The remainder consisted of 18 controlled and 6 observational studies. MUF has been beneficial effects on postoperative bleeding, chest drainage, transfusion requirement, and improvement cardiac function, but effects in adult cardiac surgery inconclusive because data was relatively limited.</p></sec><sec id="j_1905-7415.0905.429_s_005_w2aab3b7b2b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e24985_w2aab3b7b2b1b6b1aab1c16b5aAa">Conclusions</title><p>MUF may improve post-CPB hemodynamic activity and cardiac function in pediatric cardiac surgery. By contrast, the clinical trials in adults are limited mostly by small sample sizes that preclude an adequately powered assessment of clinically relevant outcomes. The available data are conflicting and several studies show no differential outcomes. Further studies are required to identify patients who will most likely benefit from ultrafiltration and to establish standard protocols.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Socioeconomic and lifestyle determinants of blood glucose screening in Malaysia<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.440_s_001_w2aab3b7c12b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e13835_w2aab3b7c12b1b6b1aab1c16b1aAa">Background</title><p>The increase in prevalence of diabetes is a serious public health issue. It is well-documented that use of blood glucose screening can help to reduce the risk of developing diabetes.</p></sec><sec id="j_1905-7415.0905.440_s_002_w2aab3b7c12b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e13844_w2aab3b7c12b1b6b1aab1c16b2aAa">Objectives</title><p>To examine the socioeconomic and lifestyle factors associated with use of blood glucose screening among Malaysian adults.</p></sec><sec id="j_1905-7415.0905.440_s_003_w2aab3b7c12b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e13853_w2aab3b7c12b1b6b1aab1c16b3aAa">Methods</title><p>Nationally representative data from 2,415 survey respondents was used. The survey was a cross-sectional population-based study previously conducted by the Ministry of Health Malaysia. A logistic regression model was developed to estimate the likelihood of using blood glucose screening.</p></sec><sec id="j_1905-7415.0905.440_s_004_w2aab3b7c12b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e13862_w2aab3b7c12b1b6b1aab1c16b4aAa">Results</title><p>Age, marital status, ethnicity, income, smoking, and body mass index were significantly associated with use of blood glucose screening. In particular, older individuals, married individuals, Malays, higher income earners, non-smokers, and being obese, overweight or of normal weight were correlated with a higher likelihood of using blood glucose screening.</p></sec><sec id="j_1905-7415.0905.440_s_005_w2aab3b7c12b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e13872_w2aab3b7c12b1b6b1aab1c16b5aAa">Conclusions</title><p>It is important to acquire a better knowledge of the factors that can influence the decision of people to adopt preventive measures. Having better information regarding which groups of individuals use or do not use blood glucose screening can assist governments in developing appropriate intervention programs.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Severe blunt eye trauma causes a decrease in central macular thickness within first 48 hours of trauma<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.435_s_001_w2aab3b7b7b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e5671_w2aab3b7b7b1b6b1aab1c16b1aAa">Background</title><p>Blunt eye trauma is an important emergency in ophthalmology practice, and may alter the structure of the macula.</p></sec><sec id="j_1905-7415.0905.435_s_002_w2aab3b7b7b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e5680_w2aab3b7b7b1b6b1aab1c16b2aAa">Objectives</title><p>To evaluate the optic coherence tomography (OCT) measurements of central macular thickness (CMT) among patients admitted to the hospital within 48 hours of blunt eye trauma.</p></sec><sec id="j_1905-7415.0905.435_s_003_w2aab3b7b7b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e5689_w2aab3b7b7b1b6b1aab1c16b3aAa">Methods</title><p>Prospective cross-sectional study to evaluate patients who were admitted to hospital with blunt eye trauma within 48 hours trauma. Spectral domain OCT was used to measure macular thickness. CMT measurements of 24 healthy and 26 traumatized eyes of same patients were analyzed as control and case groups, respectively.</p></sec><sec id="j_1905-7415.0905.435_s_0044_w2aab3b7b7b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e5698_w2aab3b7b7b1b6b1aab1c16b4aAa">Results</title><p>The mean CMT measurements were 230.04 ± 18.64 μm in control and 226.50 ± 18.89 μm in traumatized groups. The difference between two groups was not statistically significant (<italic>P</italic> = 0.412). However, when the patients were classified according to the severity of trauma, CMT measurements of severely injured patients were found significantly lower than both healthy and mildly traumatized eyes (<italic>P</italic> = 0.008, <italic>P</italic> = 0.004, respectively).</p></sec><sec id="j_1905-7415.0905.435_s_005_w2aab3b7b7b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e5717_w2aab3b7b7b1b6b1aab1c16b5aAa">Conclusions</title><p>Early stage macular OCT findings at blunt eye trauma may change with the severity of trauma. We have determined an insignificant increase in the mildly traumatized group in CMT compared with the healthy group within the first 48 hours of blunt trauma as a sign of macular trauma. However, in the severely traumatized group in CMT values significantly decreased, which may be a sign of cellular loss. Further prospective studies with long follow-up periods are warranted to elucidate the effects of this decrease in thickness.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Prevalence and risk factors for inappropriate birth weight for gestational age<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.434_s_001_w2aab3b7b6b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e31640_w2aab3b7b6b1b6b1aab1c16b1aAa">Background</title><p>Infants with an inappropriate birth weight for their gestational age are more likely to develop complications during pregnancy and postpartum, and have increased long-term health risks.</p></sec><sec id="j_1905-7415.0905.434_s_002_w2aab3b7b6b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e31649_w2aab3b7b6b1b6b1aab1c16b2aAa">Objectives</title><p>To determine the prevalence and risk factors for infants with inappropriate birth weight for their gestational age.</p></sec><sec id="j_1905-7415.0905.434_s_003_w2aab3b7b6b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e31658_w2aab3b7b6b1b6b1aab1c16b3aAa">Methods</title><p>We enrolled 820 women with uncomplicated, singleton pregnancies who gave birth to a live born infant at term. Prepregnancy baseline and obstetric information were extracted from medical records, including body mass index (BMI), gestational weight gain, and infant birth weight. Prevalence of small-for-gestational age (SGA) and large-for-gestational age (LGA) infants was determined. We compared variables between groups to identify associated factors.</p></sec><sec id="j_1905-7415.0905.434_s_004_w2aab3b7b6b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e31667_w2aab3b7b6b1b6b1aab1c16b4aAa">Results</title><p>Prevalence of SGA was 2.6% and LGA was 10.5%. Prepregnancy BMI and gestational weight gain were significantly higher in the LGA than in the SGA group (<italic>P</italic> = 0.041 and &lt; 0.001, respectively). The birth weight and gestational weight gain, but not the prepregnancy BMI, were significantly different (<italic>P</italic> &lt; 0.001). Logistic regression analysis determined that inadequate gestational weight gain significantly increased the risk of SGA (adjusted OR 3.20, 95%CI 1.06 to 9.64, <italic>P</italic> = 0.039), and significantly reduced the risk of LGA (adjusted OR 0.43, 95% CI 0.20 to 0.91, <italic>P</italic> = 0.028). Excessive gestational weight gain significantly increased the risk of LGA (adjusted OR 2.00, 95% CI 1.21 to 3.30, <italic>P</italic> = 0.006). There was no significant association with prepregnancy BMI.</p></sec><sec id="j_1905-7415.0905.434_s_005_w2aab3b7b6b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e31692_w2aab3b7b6b1b6b1aab1c16b5aAa">Conclusions</title><p>Controlling gestational weight gain may improve maternal and neonatal outcomes.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00en-us-1