Route of Infection in Melioidosis

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CLINICAL FEATURES OF TUBERCULOUS SEPTIC ARTHRITIS IN KHON KAEN, THAILAND: A 10-YEAR RETROSPECTIVE STUDY

Abstract. Tuberculous septic arthritis is difficult to diagnose. A retrospective analysis was done on patients over 15 years of age who attended Srinagarind Hospital, Khon Kaen, Thailand, between January 1, 1997 and December 31, 2006, whose synovial fluid culture was positive for Mycobacterium tuberculosis. The medical records of 77 patients were reviewed; one-third were in their sixth decade. Comorbid disease was found in 33 cases (42.9%), with systemic sclerosis being the most common (9 cases) followed by diabetes mellitus (5 cases) and chronic kidney disease (5 cases). Chronic monoarthritis was the most common presentation (34 cases) followed by acute monoarthritis (20 cases). More than half of the polyarticular involvements were disseminated tuberculosis. The knee was the most commonly affected joint (36.4%). Sixty percent had delayed diagnosis due to an incorrect diagnosis. Abnormal chest radiography and blood eosinophilia were found in 40 and 57.3% of cases, respectively. Synovial fluid and synovial tissue staining for acid-fast bacteria were positive in 30 and 40% of cases, respectively. A caseous granuloma was present in 57.5% of cases and non-specific synovitis in 12%. Sixtythree percent had bone erosions. Tuberculous septic arthritis should be considered in patients who present with acute or chronic monoarthritis, and who have an abnormal chest radiograph or eosinophilia. Polyarticular involvement was commonly related to having disseminated tuberculosis and may indicate systemic involvement of tuberculous infection

The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s

Prevalence of erectile dysfunction in Thai scleroderma patients and associated factors

Background Erectile dysfunction (ED) has been reported among patients with systemic sclerosis (SSc) and primarily limited cutaneous SSc in Caucasians. While there is no data on ED among Thais in whom the diffuse cutaneous SSc subset is common. Objectives We aimed to estimate the prevalence of ED among Thais with SSc, evaluate its severity, and determine the associated factors. Methods We did a cross-sectional study among adult Thai male SSc patients. All eligible patients: a) completed the IIEF-15 questionnaire by themselves; b) underwent a genital examination by an experienced urologist to evaluate skin tightness of the penis, scrotum, and phimosis; and, c) were evaluated for Erection Hardness Score. Results A total of 60 male SSc patients were included. The respective mean age and median disease duration was 54.8±7.2 years and 3.1 years (IQR 1.2–7.2). The definition of ED was fulfilled in 53 cases for a prevalence of 88.3% (95%CI 77.4–95.2), while 65% had severe ED, and none had skin tightness of the genitalia. Eight cases had acquired phimosis, and all were in the ED group. The patients with ED vs. those without ED had significantly lower scores for orgasm, sexual desire, and intercourse satisfaction, and trended to be older, have more severe skin tightness and have higher BMI. Conclusion ED is a common problem in men with SSc and is mainly categorized as severe. The severity of SSc might increase the risk of developing ED. We found phimosis was a common genital abnormality co-occurring with ED in SSc

Dynamic Behavior in Hexadecyloctyldimethylammonium Bromide/alkane/water Microemulsions

Self-diffusion coefficients of oil and water (by pulsed-gradient FT-NMR) and steady-state fluorescence anisotropy results for two solubilized probe molecules are reported in microemulsions of hexadecyloctyldimethylammonium bromide (C 8C 16DAB), alkanes, and water. The results show a highly oil-specific effect in microemulsion structure and in the curvature of the surfactant film, leading to the formation of o/w, bicontinuous, and w/o domains depending upon composition and on the nature of the alkane. © 1988 American Chemical Society

Mobility of Toluene in Polystyrene-toluene Solutions

Self-diffusion coefficients and longitudinal (T1) and transverse (T2) NMR relaxation times of toluene in polystyrene-toluene solutions were determined at concentrations up to 50% polymer at room temperature to ca. -70°C. The self-diffusion coefficients were used to calculate the fraction of motionally-altered toluene based on deviations from the Maxwell-Fricke approximation of the obstruction effect. The fraction of motionally-altered toluene was found to be nearly constant with temperature for the lower polymer concentrations but increased with decreasing temperature for the higher polymer concentrations. The relaxation times of the motionally-altered toluene were calculated by using the two-fraction fast-exchange model and used to estimate the mean correlation times from a log-normal distribution of correlation times. The dependence of correlation times on temperature was found to be of the Arrhenius type and the activation energies increased with polymer concentration. The activation energies for translational diffusion ranged from 12 to 22 kJ/mol and those of the motionally-altered solvent\u27s rotational motion from 11 to 42 kJ/mol. © 1992 American Chemical Society

The short-term effect of gloving in combination with Traditional Thai Massage, heat, and stretching exercise to improve hand mobility in scleroderma patients

Background: Systemic sclerosis (SSc) is a chronic, multisystem connective tissue disorder characterized by autoimmune activation, microvascular endothelium damage, and excessive collagen proliferation. The most affected hand presents claw hand deformity and microvascular disease. Deformed hands can cause functional disability and decrease the quality of life. A daily home program can improve mobility of scleroderma patients. Objective: We sought to determine the effect of a daily home exercise program on hand mobility among scleroderma patients. Materials and Methods: This was a randomized control trial. Twenty-eight participants were divided into two groups, both of which received the same daily home treatment: Group 1 with gloves (n = 14) and Group 2 without gloves (n = 14). The 2-week daily home program combined traditional Thai massage (TTM) with stretching exercises and heat. Hand mobility was assessed using hand mobility in scleroderma (HAMIS). The study was conducted in patients who were already on vasodilator drugs. Results: Both groups showed a significant improvement in hand mobility after 2 weeks of daily home exercise program (P < 0.05). Wearing the glove, however, resulted in better thumb mobility. Conclusions: A daily home exercise program improved hand mobility among patients with scleroderma and wearing gloves may improve thumb mobility