Clinical Characteristics and Survival of Pemphigoid and Pemphigus Patients in a Thai Population

Objective: Pemphigoid and pemphigus are skin diseases with high morbidity and mortality. The research aims to study the clinical presentations, comorbidities, and medications used prior to diagnosis, as well as the survival rates and prognostic factors for pemphigoid and pemphigus patients. Materials and Methods: The cohort study was conducted on retrospective data of patients who were treated at Naresuan University Hospital between 1 October 2012 and 30 September 2022. Results: There were 30 pemphigoid patients and 44 pemphigus patients. Pemphigoid patients were on average older than pemphigus patients (76 years vs 52 years), have more skin blisters, and less oral cavity lesions. Neurological disease increases risk of being diagnosed as a bullous pemphigoid (odds ratio=4.6, p-value =0.051). After adjustment by neurologic disease and age at diagnosis, pemphigoid was not significantly associated with the use of any medications. The survival rate of pemphigus was 91.1% at 1 year and 82.2% at 5 years, while the survival rate of pemphigoid was 69.9% at 1 year, and 47.7% at 5 years. In multivariable Cox regression analysis, there was worse prognosis among pemphigoid and pemphigus patients that have comorbidity disease (adjusted HR= 3.13, p-value=0.057) and were older than 70 years (adj HR= 6.93, p-value=0.015). Conclusion: Clinical characteristics of bullous pemphigoid and pemphigus were different such as age of onset, presence of blister and oral lesion. Neurological disease was a risk factor for developing bullous pemphigoid than pemphigus. Survival of pemphigoid patients was worse than pemphigus patients. However, this finding could be confounded by older age of pemphigoid patients

The Environmental Implications of Asia's 1997 Financial Crisis

Summary This article assesses the environmental implications of the Asian financial crisis in South?East Asia and Melanesia, covering the period from mid?1997 until early 1999. It examines the implications for agricultural development, natural resource management, industrial pollution, corporate activities, and state environment budgets and implementation. It shows that the crisis has contributed to extensive environmental changes. There are, however, considerable variations across sectors, areas, and time. For some environmental issues, such as water quality and conservation, the crisis has (in some instances) aggravated environmental mismanagement in the immediate term. In others, such as agriculture, plantations, and fisheries, it has created powerful incentives to expand export?oriented production to earn foreign exchange. And in still others, most notably commercial timber and urban air pollution, it has created temporary respites and windows of opportunity for environmental reformers, although if reforms are unsuccessful, environmental management is likely to worsen in the long term. Finally, the article points to the need for further research to help the countries of the Asia?Pacific address the immediate and future implications of the present crisis, as well as build a set of analytical tools for policymakers, donors, and development specialists to analyse the environmental implications of globalisation as well as future financial crises

The calming effect of roasted coffee aroma in patients undergoing dental procedures

AbstractCoffee beverage consumption is well-known to exert various health benefits; however, the effects of coffee aroma are rarely explored. This study aimed to investigate the calming effect of inhaling coffee aroma while the patients underwent dental procedures (probing and scaling). Salivary α-amylase (sAA) and cortisol (sCort) levels were measured as proxies of sympathetic nervous system and hypothalamic–pituitary–adrenal axis responses to stress respectively. Blood pressures and pulse rates were recorded. The results showed that undergoing dental procedures could increase sAA and sCort levels of the patients inhaling sham aroma while those inhaling coffee aroma had significantly decreased sAA and sCort levels (40% and 25% differences, respectively). The pulse rates of those inhaling coffee aroma were also lower. Subjective assessment using visual analog scale was in line with objective measures as well. The preference for coffee aroma or the frequency of coffee drinking had no effect on the sAA and sCort responses. This is the first study to provide evidence on the effect of coffee aroma on sAA and sCort levels in patients undergoing dental procedures.</jats:p

Key Points and Best Practices for Successful Municipal Solid Waste Incineration

Abstract With the ever-growing volume of waste around the world, the tackling methods have also expanded. Among these, currently the most prevailing technology is the municipal solid waste (MSW) incineration. If used right, the advantages of the said technology are incredible. In this paper, we will discuss some key points and best practices for a successful MSW incineration and will look into the noteworthy case of Japan in this area.</jats:p