Plasma Vascular Endothelial Growth Factor Dysregulation in Defining Aggressiveness of Head and Neck Squamous Cell Carcinoma

Background. High circulating vascular endothelial growth factor (VEGF) levels tend to reflect tumor aggressiveness for being associated with tumor progression and prognosis. Measurement of soluble VEGF receptor-1 (sVEGFR-1) may improve diagnostic power of VEGF assay. Methods. This study investigated regulation of plasma VEGF by sVEGFR-1 in 82 patients with head and neck squamous cell carcinoma compared with 32 healthy subjects to obtain information for assay characterization. Results. Normality or abnormality of VEGF/sVEGFR-1secretion patterns was rated into five diagnostic levels from definitely abnormal (likelihood ratios) (LRs = 4–∞) to definitely normal (LRs = 0–0.17). Because of ineffective VEGF regulation, high grade tumor had a greater chance (62.5%) than low grade tumor (20%) in expressing a definitely abnormal pattern and a lower chance to express the normal pattern (P = 0.007). VEGF alone had much lower diagnostic power in differentiating between normal (LRs = 0.3–0.9) and abnormal secretion patterns (LRs = 2.2–2.4). Conclusions. VEGF dysregulation is suggestive of tumor aggressiveness for causing persistent plasma VEGF elevation. sVEGFR-1 improves diagnostic power of VEGF assay particularly in identifying subset of low grade tumor with underlying aggressive disease and ruling out aggressiveness in subset of high grade tumor

Work- and Travel-related Physical Activity and Alcohol Consumption: Relationship With Bone Mineral Density and Calcaneal Quantitative Ultrasonometry

AbstractA number of healthy workers rarely exercise because of a lack of time or resources. Physical activity related to work and everyday travel may be more feasible, but evidence of its beneficial effect on bone health is scarce. We assessed if this form of physical activity was associated with higher bone mineral density (BMD) and stiffness index (SI) when adjusted for recreational physical activity, age, body mass index, smoking, alcohol consumption, education, and serum level of 25-hydroxyvitamin D. Healthy workers, aged 25–54 yr, of the Electricity Generating Authority of Thailand were surveyed. The outcomes were BMD (lumbar spine, femoral neck, and total hip) and calcaneal SI. Physical activity was estimated using the global physical activity questionnaire and considered active when >600 metabolic equivalent tasks (min). Of 2268 subjects, 74% were men. Active male subjects had significantly higher BMD at the femoral neck and total hip (p < 0.005). However, the association was not significant with male lumbar spine BMD, male SI, or any bone parameters in women (p > 0.05). In men, work and travel physical activity seems beneficial to male bone health; hence, it should be encouraged. Furthermore, smoking appeared harmful while moderate alcohol consumption was beneficial

Genetic Polymorphisms of Endothelial Nitric Oxide Synthase Associated with Hypertension and Blood Homocysteine Levels

Charinya Chaichanabut,1 Piyamitr Sritara,2 Jintana Sirivarasai3 1Master of Science Program in Nutrition, Faculty of Medicine Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 3Nutrition Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Jintana Sirivarasai, Nutrition Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand, Tel +662-201-1483, Fax +662-201-2625, Email [email protected]: Endothelial dysfunction is a key mechanism in the development of hypertension and is closely linked to impairment of endothelial nitric oxide synthase (eNOS) and hyperhomocysteinemia. Genetic polymorphisms of eNOS (rs1799983 and rs2070744) are strongly associated with the risk of hypertension in individuals of Asian ethnicities. This study aimed to investigate the relationship between these polymorphisms and the risk of hypertension associated with homocysteine levels.Participants and Methods: For this cross-sectional study, we enrolled 370 Thai men aged 40– 60 years from the Electricity Generating Authority of Thailand cohort study for both variants genotyping by TaqMan allelic discrimination analysis. Clinical, anthropometric, and biochemical parameters were also analyzed.Results: In the high blood pressure group (n = 267), systolic and diastolic blood pressure and triglyceride levels were higher in those with homocysteine levels ≥ 15 μmol/L than in those with homocysteine levels < 15 μmol/L (p < 0.05). Significant risk of hypertension was found in GG and GT of rs1799983 (G894T), and in TT and TC of rs2070744 (T-786C), with higher ORs in heterozygous genotypes (all p values < 0.05). Further evaluation of the interactions between SNPs and HCY revealed that individuals with the GT or TC genotype, together with hyperhomocysteinemia, had an increased risk of hypertension (all p< 0.05).Conclusion: eNOS variants rs1799983 and rs2070744 may be risk factors for hypertension linked to hyperhomocysteinemia. These findings provide potentially useful healthcare strategies for the management of hypertension.Keywords: endothelial nitric oxide synthase, polymorphisms, hypertension, hyperhomocysteinemi

Nurse preparedness for the non‐communicable disease escalation in Thailand: A cross‐sectional survey of nurses

Chronic diseases are now the largest cause of mortality in Thailand, and form an increasingly large portion of the healthcare landscape. In the Thai health system, many patients with chronic conditions receive care and disease management services from nurses, yet specialized training in chronic diseases is not currently part of standard nursing degree programs. Given the evolving epidemiology of the Thailand population, we questioned whether practicing nurses remain confident in their knowledge and skills in chronic disease management. We conducted a cross‐sectional, self‐efficacy survey of nurses in eight randomly‐selected provinces in Thailand, receiving 468 responses. Nurse self‐efficacy was analyzed in prominent chronic disease types, including cancer, hypertension, diabetes, heart disease, cerebrovascular diseases, and pulmonary diseases. Factors, such as geographic location, education level, continuing education experience, and hospital size, were found to significantly affect nurse self‐efficacy levels; nurses highly prioritized additional training in heart diseases and cerebrovascular diseases, followed by hypertension, cancer, and diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90274/1/j.1442-2018.2011.00657.x.pd

Prevalence of Dyslipidemia and Goal Attainment with Lipid-Lowering Therapy: Insights from Thai Multicenter Study and Overview of the Major Guidelines

Background Since the release in Thailand in 2001 of the Third Guidelines by the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults or the Adult Treatment Panel (ATP III), there have been no nationwide studies on the proportion of dyslipidaemic patients who have achieved the low-density lipoprotein cholesterol (LDL-C) goals. The authors therefore aimed to estimate the percentage achievement of LDL-C goals based on the modified NCEP ATP III guidelines in intermediate- to high-risk patients. Methods The authors conducted a hospital-based, cross-sectional, epidemiological survey. Patients (1240) were selected consecutively from 50 hospitals across Thailand. Patients were included if they had been treated with statins for at least 3 months. Results Two-thirds were female, and the mean age was 61.7+69.5 years. The median duration of statin treatment was 21 months. Half (633/1240) of the patients achieved the LDL-C goal levels as defined by the NCEP guidelines (51.1%, 95% CI 48.3% to 53.8%). The very high-risk group had the lowest percentage achievement (11.6%; 95% CI 1.6% to 21.6%), compared with 54.2% (95% CI 50.9% to 57.4%) for the high-risk group and 47.0% (95% CI 41.1% to 52.8%) for the moderate-risk group. More males achieved the LDL-C goals than females (55.6% vs. 48.9%; P = 0.029). Conclusions Overall, 51.1% of the patients with cardiovascular risk, on statins treatment, achieved the NCEP ATP III LDL-C goal levels

An Alkoxide Free Sol-Gel Synthesis of Nanosized TiO 2

ABSTRACT Nanosized TiO 2 with anatase structure has been prepared by a non-alkoxide sol-gel route from an aqueous solution of titanyl sulfate. This paper investigated the influence of stirrer speed on anatase precipitation carried out in batch mode. Stirrer speed was varied between 400 and 1000 rpm. The intensity of stirring determined the final particle size of anatase aggregates in suspension. Changes to primary agglomerate and crystal population due to varying stirrer speed were reported. In our study, the smallest aggregates (mean size of 6-8 nm) were obtained at a stirrer speed of 1000 rpm. It was also found that the anatase to rutile phase transformation began at 800°C of calcination. A calcination treatment, from 400 to 1000°C, was applied. The degree of crystallinity and purity of the synthesized materials were reported. The crystalline anatase particles had an average particle size of 10-20 nm between the calcination temperature 400-600°C. The powders were characterized by powder X-ray diffraction (XRD), the morphology and grain size of the titania particles were examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). XRD patterns indicated that the samples were crystalline titania which had very broad and small peaks of anatase phase. The TEM observations showed the vast majority of particles were quasispherical; the average size distribution of particle was about 20 nm. The TEM results supported the conclusions derived from the XRD data. Finally, the amorphous hydrous and crystalline titania particles were characterized by thermogravimetric (TGA) and differential thermal analysis (DTA)

The Efficacy of Low-Iodine Diet Instructional Media for the Preparation of Radioactive Iodine Therapy in Thyroid Patients

Objective: To develop and evaluate a low-iodine diet (LID) instructional media for preparing radioactive iodine (RAI) therapy on LID practices, and knowledge in thyroid patients.  Material and Methods: This study was a randomized control trial (RCT), consisting of 120 thyroid participants; divided into 2 groups: a control group (original leaflet) and an intervention group (video and booklets). The efficacy of LID media was determined by measuring iodine intake, urine I/Cr ratio, knowledge tests, satisfaction surveys, and facilitators and barriers during the LID period.  Results: This study was conducted with 96 individuals. The energy and biggest nutrient intake changes were significantly lower than the baseline. The iodine intake levels of the intervention group were significantly lower than those of the control group. Conversely, the urine I/Cr ratio and proportion of participants that achieved the criteria of both groups showed no significant difference via inter-group. Participants evaluated “agreed” and “strongly agreed” for satisfaction assessment. Furthermore, both groups suggested the importance of social support and encouragement to attain their goal.  Conclusion: The results of the efficacy of LID instructional media were evidence-based for developing and evaluating LID multimedia for preparing RAI therapy in thyroid patients in Thailand. There are also good instruments for advice to thyroid patients in the hospital