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Recent Submissions
Outcomes of Vascularized Lymph Node Transfer Treatment in Patients with Lymphedema
(2025-06-01) Kotistienkul B.; Yongsuvimol M.; Poungjantaradej N.; Taweepraditpol S.; Kotistienkul B.; Mahidol University
Objective: This study aimed to evaluate the postoperative outcomes of patients with lymphedema treated with vascularized lymph node transfer (VLNT). Materials and Methods: A retrospective chart review was conducted on 28 patients who underwent VLNT procedures at Siriraj Hospital between 2010 and 2020. Data collected included patient demographics, underlying diseases, previous cancer treatments, duration of lymphedema, etiology of lymphedema, donor and recipient sites, operative time, and limb circumference measurements were taken pre-operatively and at 1, 3, 6, and 12 months postoperatively. Additionally, postoperative complications were documented and analyzed. Results: The review identified various underlying diseases associated with lymphedema, mostly linked to cancer. Noteworthy cancer treatments included node dissection, radiotherapy, and chemotherapy. The etiology of lymphedema varied, with multiple donor and recipient sites used for VLNT procedures. Postoperative limb circumference measurements showed significant percentage reduction in limb circumference, particularly in patients with upper limb lymphedema (p<0.05), while the lower limb showed no statistical significance. Postoperative complications included flap necrosis, flap congestion, flap hematoma, and cellulitis. Conclusion: Our retrospective analysis underscores the effectiveness of VLNT procedures in managing lymphedema at Siriraj Hospital. Despite the diverse etiologies and prior treatments, VLNT demonstrated favorable outcomes in terms of limb circumference reduction, particularly in upper extremities. Further prospective analytic studies are warranted to validate these findings and optimize treatment protocols.
Effects of frugivore species pool and seed size on the diversity and functional composition of frugivores visiting fruiting trees
(2025-10-08) Naniwadekar R.; Gopal A.; Mandal R.; Jayanth A.; Sriprasertsil V.; Ghuman S.; Page N.; Chaplod S.; Lad H.; Gadkari A.; Chandran V.; Desai N.A.; Kadam R.; Strange B.C.; Chimchome V.; Gale G.A.; Joshi J.; Naniwadekar R.; Mahidol University
The relationship between biodiversity and ecosystem functioning in seed dispersal remains understudied despite its critical role in maintaining plant diversity in the tropics. Field studies on this relationship are often confounded by environmental and phylogenetic variations across species richness gradients. We examined how overall avian frugivore species richness at a site influenced the frugivore richness, visitation rates and functional composition of two key effect traits (beak width and hand-wing index) on fruiting trees. Across six sites in tropical Asia, spanning a sevenfold gradient in frugivore species richness but with similar forest types and phylogenetically nested frugivore communities, we recorded 34 014 interactions between 138 avian frugivores and 131 woody plant species. Our results provide some support for the biodiversity-ecosystem functioning relationship, as higher overall frugivore species richness increased the number of frugivore species visiting individual fruiting trees but not the functional composition of frugivores. Seed size had a stronger influence on the frugivore species richness, visitation rates and the beak size of visiting frugivores, highlighting the dominant role of morphological trait matching in influencing plant-frugivore interactions. Our findings suggest functional redundancy in certain aspects of seed dispersal effectiveness due to density compensation and the presence of key seed disperser lineages in species-poor sites.
Erratum: Immunogenicity and safety of the live-attenuated tetravalent dengue vaccine (TAK-003) co-administered with recombinant 9-valent human papillomavirus vaccine (Vaccine (2025) 62, (S0264410X25008552), (10.1016/j.vaccine.2025.127558))
(2025-01-01) El Hindi T.; Anugulruengkitt S.; Lapphra K.; Limkittikul K.; Tangsathapornpong A.; Galindo C.M.; Hellwig M.; Roubinis N.; Schuring R.; Biswal S.; Folschweiller N.; El Hindi T.; Mahidol University
Background: The tetravalent dengue vaccine TAK-003 and the 9-valent human papillomavirus (9vHPV) vaccine regimens are potentially compatible, with overlapping target age groups, facilitating inclusion of TAK-003 into established immunization programs. Methods: This phase 3, open-label, randomized, multicenter trial was conducted in Thailand to investigate the immunogenicity and safety of co-administration of TAK-003 with 9vHPV in healthy participants aged ≥9 to <15 years. Participants were randomized 1:1 to either Group 1 (9vHPV + TAK-003 Month [M]0, TAK-003 M3, 9vHPV M6) or Group 2 (9vHPV M0 and M6) and followed up for 6 months after last vaccination. The primary objective was non-inferiority (NI) (upper bound of the 95 % confidence intervals for the HPV total immunoglobulin G (IgG) level ratio < 1.5) of the immune response to 9vHPV co-administered with TAK-003 versus 9vHPV alone at M7 (1 month after the last 9vHPV dose). Safety was assessed for all participants who received at least one vaccine dose. Results: The trial was completed by 606/614 (98.7 %) participants and 477/614 (77.7 %) participants were included in the per-protocol set (PPS) (Group 1 = 242; Group 2 = 235). Total HPV IgG levels for HPV types ranged from 504 to 7778 mMU/mL in Group 1 and 561 to 7823 mMU/mL in Group 2 at M7 and NI was demonstrated for all HPV types. Seropositivity rates at M4 were ≥99.6 % for all dengue serotypes. No new safety risks were identified from this trial. Conclusions: These findings support the co-administration of the TAK-003 and 9vHPV vaccines. ClinicalTrials.gov registration number: NCT04313244.
Efficacy and safety of curcumin in patients with hand osteoarthritis: a pilot double-blinded randomised controlled trial
(2025-10-06) Tuntiyatorn P.; Lerspongpaibool C.; Kanchanathepsak T.; Watcharananan I.; Tawonsawatruk T.; Tuntiyatorn P.; Mahidol University
BACKGROUND: Curcumin, a substance in Turmeric spices, has been shown to exhibit anti-inflammatory and chondroprotective properties in several preclinical studies. However, there is limited research on the efficacy and side effects of oral curcumin in treating hand osteoarthritis. Thus, the primary aim of this pilot study was to assess the therapeutic effects and potential adverse effects of curcumin in patients with hand osteoarthritis, specifically in terms of pain reduction, improvement in functional outcomes, and relevant blood test parameters. METHOD: This pilot prospective double-blind, randomized controlled trial included patients over 50 years old diagnosed with hand osteoarthritis. Participants received a three-month oral administration of either a turmeric capsule containing curcumin (170 mg/day) or a placebo. The outcomes measures included the Visual Analogue Scale (VAS) for pain, the Disabilities of Arm, Shoulder, and Hand (DASH) score, hand grip and pinch strength, as well as side effects and blood tests at one, two, three, and six months. RESULTS: Twenty-seven patients were enrolled in this study-13 in the curcumin group and 14 in the placebo group. Baseline characteristics were similar between both groups. Although patients in the curcumin group showed reductions in VAS pain scores and improvements in DASH scores after one month, the differences were not statistically significant. However, by the third month, patients in the curcumin group demonstrated significant reductions in VAS pain scores at rest and during activity compared to the baseline scores, with mean differences of 1.37 ± 0.64 (p-value = 0.032) and 1.74 ± 0.73 (p-value = 0.017), respectively. Additionally, their DASH scores improved significantly with a mean difference of 11.84 ± 5.88 (p = 0.044). One patient in the curcumin group experienced gastrointestinal (GI) side effects, leading to withdrawal from the study, but no other adverse effects were reported. CONCLUSION: Based on the results of this pilot study, the authors conclude that a three-month regimen of low-dose oral curcumin may improve pain and functional scores in patients with hand osteoarthritis compared to placebo. However, GI discomfort remains a potential side effect to monitor. Overall, curcumin appears to be a safe and feasible alternative treatment option for hand osteoarthritis, and a larger, definitive randomised controlled trial is warranted. TRIAL REGISTRATION: The trial has been registered in the Thai Clinical Trials Registry(TCTR) database. The identification number is TCTR20210929003.
Mechanical power in patients receiving mechanical ventilation in the surgical intensive care unit and its association with increased mortality: a retrospective cohort study
(2025-10-05) Piriyapatsom A.; Trisukhonth A.; Chintabanyat O.; Thanakiattiwibun C.; Piriyapatsom A.; Mahidol University
INTRODUCTION: A potential correlation between mechanical power (MP) and clinical outcomes in mechanically ventilated patients has been reported. Limited data exist regarding MP among patients admitted to surgical intensive care units (SICUs) who require mechanical ventilation (MV) support. The primary objective of this study was to determine MP in mechanically ventilated patients admitted to the SICU, and the secondary objective was to explore whether MP was associated with clinical outcomes. METHODS: This retrospective cohort study conducted at the SICU of the tertiary university-based hospital included 283 postoperative patients admitted to the SICU who required MV support for ≥12 hours. Ventilator parameters were recorded at MV initiation and 24 hours, and MP was subsequently computed. Cox regression analysis was employed to assess the association between MP and 90-day mortality. RESULTS: MP at MV initiation and 24 hours were median 11.9 (IQR 8.6-17.1) J/min and 11.9 (8.9-16.8) J/min, respectively. MP was significantly higher in non-survivors both at MV initiation and 24 hours (15.4 (12.5-21.2) J/min vs 11 (8.3-15.6) J/min, p<0.001 and 15.9 (10.6-20.2) J/min vs 10.9 (8.5-15.4) J/min, p=0.001, respectively). MP ≥12 J/min at MV initiation was associated with increased 90-day mortality (HR 2.21, 95% CI 1.09 to 4.48), particularly among patients with high acuity, those at a high risk of acute lung injury and those who did not receive lung protective ventilation. In patients with MP ≥12 J/min at MV initiation, a subsequent rise in MP of ≥5 J/min at 24 hours was correlated with accentuated 90-day mortality. CONCLUSION: Among mechanically ventilated patients in the SICU, MP at the initiation and at 24 hours of MV support was approximately 12 J/min. An elevated MP was an independent predictor of elevated 90-day mortality, especially in cases with high illness acuity. Alterations in MP during MV support could impact the 90-day mortality in these individuals.