Browsing by Author "San Lazaro Hospital"

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    Erratum: Procalcitonin (PCT)guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting. (Clin Chem Lab Med (2020) 58:12 (1983–91) Doi:10.1515/cclm-2019-1122)
    (2021-02-01) Chien Chang Lee; Andrea Lay Hoon Kwa; Anucha Apisarnthanarak; Jia Yih Feng; Eric Howard Gluck; Akihiro Ito; Anis Karuniawati; Petrick Periyasamy; Busadee Pratumvinit; Jeetendra Sharma; Rontgene Solante; Subramanian Swaminathan; Niraj Tyagi; Dien Minh Vu; Kapil Zirpe; Philipp Schuetz; Duke-NUS Medical School; Artemis Health Sciences; San Lazaro Hospital; Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo; Thammasat University Hospital; Hospital Canselor Tuanku Muhriz UKM; Sir Ganga Ram Hospital; Universitat Basel; Kantonsspital Aarau; Singapore General Hospital; Swedish Covenant Hospital; Veterans General Hospital-Taipei; Faculty of Medicine Siriraj Hospital, Mahidol University; Kurashiki Central Hospital; BGS Gleneagles Global Hospital; National Hospital of Tropical Diseases; Grant Medical Foundation
    There is typo in Figure 1 and Figure 2 of this article. Instead of “… repeated testing or monitoring for discontinuation …” it should read “… repeated testing for monitoring and discontinuation …” (see corrected Figures).
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    Multi-country evaluation of the sensitivity and specificity of two commercially-available NS1 ELISA assays for dengue diagnosis
    (2010-08-01) Maria G. Guzman; Thomas Jaenisch; Roger Gaczkowski; Vo Thi Ty Hang; Shamala Devi Sekaran; Axel Kroeger; Susana Vazquez; Didye Ruiz; Eric Martinez; Juan C. Mercado; Angel Balmaseda; Eva Harris; Efren Dimano; Prisca Susan A. Leano; Sutee Yoksan; Elci Villegas; Herminia Benduzu; Iris Villalobos; Jeremy Farrar; Cameron P. Simmons; Instituto de Medicina Tropical Pedro Kouri; Universitatsklinikum Heidelberg; University of Oxford; University of Malaya; Organisation Mondiale de la Sante; CNDR; University of California, Berkeley; San Lazaro Hospital; Mahidol University; Universidad De Los Andes, Merida; Hospital Central de Maracay
    Background:Early diagnosis of dengue can assist patient triage and management and prevent unnecessary treatments and interventions. Commercially available assays that detect the dengue virus protein NS1 in the plasma/serum of patients offers the possibility of early and rapid diagnosis. Methodology/Principal Findings:The sensitivity and specificity of the Pan-E Dengue Early ELISA and the PlateliaTMDengue NS1 Ag assays were compared against a reference diagnosis in 1385 patients in 6 countries in Asia and the Americas. Platelia was more sensitive (66%) than Pan-E (52%) in confirmed dengue cases. Sensitivity varied by geographic region, with both assays generally being more sensitive in patients from SE Asia than the Americas. Both kits were more sensitive for specimens collected within the first few days of illness onset relative to later time points. Pan-E and Platelia were both 100% specific in febrile patients without evidence of acute dengue. In patients with other confirmed diagnoses and healthy blood donors, Platelia was more specific (100%) than Pan-E (90%). For Platelia, when either the NS1 test or the IgM test on the acute sample was positive, the sensitivity versus the reference result was 82% in samples collected in the first four days of fever. NS1 sensitivity was not associated to disease severity (DF or DHF) in the Platelia test, whereas a trend for higher sensitivity in DHF cases was seen in the Pan-E test (however combined with lower overall sensitivity). Conclusions/Significance:Collectively, this multi-country study suggests that the best performing NS1 assay (Platelia) had moderate sensitivity (median 64%, range 34-76%) and high specificity (100%) for the diagnosis of dengue. The poor sensitivity of the evaluated assays in some geographical regions suggests further assessments are needed. The combination of NS1 and IgM detection in samples collected in the first few days of fever increased the overall dengue diagnostic sensitivity. © 2010 Guzman et al.
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    Mycobacterium Tuberculosis infection among HIV/AIDS patients in Thailand: Clinical manifestations and outcomes
    (2002-12-01) Nimfa M. Putong; Punnee Pitisuttithum; Wichai Supanaranond; Benjaluck Phonrat; Somsit Tansuphasawadikul; Udomsak Silachamroon; Huot Chan Yuda; Valai Bussaratid; Nalinee Aswapokee; Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University; San Lazaro Hospital
    A one year retrospective study, was conducted at Bamrasnaradura Hospital, Nonthaburi Province, Bangkok, Thailand, of 271 subjects with both TB and HIV/AIDS. Single males (median age group 31 to 40 years) were most likely to develop co-infection. The commonest clinical manifestations on initial presentation included a low grade fever, cough, weight loss, lymphadenopathy with pancytopenia, and lung infiltrates. Multi-drug resistant TB (MDR-TB) was found in 26.6% of the subjects which was significantly associated with a past history of anti-TB treatment (p = 0.005; OR=2.5); it was also significantly associated with disseminated TB (p = 0.022; OR=1.9) and mortality (p= 0.013; OR=2.8). Analysis of clinical outcomes showed that 46.7% were lost to follow-up and 13.3% had died by the time of follow-up. Among those who survived, only 11.4% had been successfully treated; the rest had not improved due to relapse (2.9%), therapeutic failure (8.8%), treatment in progress (5.9%), and failure to complete treatment (10.7%).
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    Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting
    (2020-01-01) Chien Chang Lee; Andrea Lay Hoon Kwa; Anucha Apisarnthanarak; Jia Yih Feng; Eric Howard Gluck; Akihiro Ito; Anis Karuniawati; Petrick Periyasamy; Busadee Pratumvinit; Jeetendra Sharma; Rontgene Solante; Subramanian Swaminathan; Niraj Tyagi; Dien Minh Vu; Kapil Zirpe; Philipp Schuetz; Duke-NUS Medical School Singapore; Artemis Health Sciences; National Taiwan University Hospital; San Lazaro Hospital; University of Indonesia, RSUPN Dr. Cipto Mangunkusumo; Thammasat University Hospital; Sir Ganga Ram Hospital; Universitat Basel; Kantonsspital Aarau; Singapore General Hospital; Swedish Covenant Hospital; Veterans General Hospital-Taipei; Faculty of Medicine, Siriraj Hospital, Mahidol University; Kurashiki Central Hospital; Universiti Kebangsaan Malaysia; B.G.S Gleneagles Global Hospital; National Hospital of Tropical Diseases; Grant Medical Foundation
    © 2020 ©2020 Philipp Schuetz et al., published by De Gruyter, Berlin/Boston. Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations. The group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely. Use of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.