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Biomedical subjects

S Sirinavin

Publications and source records attributed to S Sirinavin.

33 records · Page 2Linked to original sources
PubMed1991

Antibodies against dengue viral proteins in primary and secondary dengue hemorrhagic fever.

Antibodies against dengue viral proteins were demonstrated in sera from dengue-infected patients by polyacrylamide gel electrophoresis, Western blotting, and enzyme immunoassay. Primary dengue cases showed low titers of IgG class antibodies to envelope (E) proteins and two non-structural proteins, NS3 and NS5, in sera collected during the convalescent phase. Secondary dengue- infected patients always demonstrated IgG antibodies to E proteins in sera collected during the acute phase, and high titers of IgG antibodies to many other proteins, including NS1, NS3, NS5, and C proteins in sera collected during the convalescent phase. Appearance of antibodies to E, NS3, and NS5 could be detected within five days after the onset of fever. These three dengue viral proteins and their corresponding antibodies may be involved in the immunopathologic mechanism underlying this disease. For diagnostic purposes, identifying the non-structural proteins such as NS3 and NS5 may be the best means for early confirmation of the disease.

Acute Disease↗
PubMed1991

Intradermal hepatitis B virus immunization: immunogenicity and reactogenicity.

Mass immunization of hepatitis B virus (HBV) vaccine in adults is frequently demanded. However the high cost of conventional immunization is an obstacle to the provision of this vaccine. We investigated the serological response and adverse reactions following administration of a low-dose (1 or 2 micrograms of yeast-derived HBV vaccine (HB-VAX II, Merck, Sharp and Dohme) intradermally in young adults. Each 1 ml dose of the vaccine contained 10 micrograms of HBsAg protein. The study population included 58 female volunteers, aged 20-33 years, who were serologically-negative for HBV. They were alternately allocated to 1 microgram or 2 micrograms intradermal dose given by 2 experienced nurses as one or two 0.1 ml injections. Doses were given at 0, 1, and 6 months. Anti-HBs concentration was tested by enzyme-immunoassay on their sera obtained at 1, 6, and 7 months after the first dose. Positive seroconversion (anti-HBs greater than 10 IU/1) at 7 months was found in 90% (95% CL 79%, 100%) of the 1 microgram group and 96% (95% CL 89%, 100%) of the 2 micrograms group. Local reaction, a transient pigmented macule with an underlying nodule, was found in most volunteers but did not bother them. Intradermal HBV immunization could be an alternative strategy for mass immunization in young adults.

Adult↗
PubMed1990

Plasma prostacyclin (PGI2) in dengue hemorrhagic fever.

Dengue hemorrhagic fever (DHF) is an epidemic viral disease. The exact mechanism attributable to platelet and vascular dysfunctions is still obscure. Plasma 6-keto-PGF1a (6KPGF1), the stable metabolite of PGI2 was determined in 60 DHF patients and in 11 non-DHF (NDHF) patients with fever of over 38.5 degrees C to compare with that of 33 normal children (NC) in the same age group (2-15 years). Among 60 DHF patients, 32 had blood obtained during impending shock, whereas blood samples of the remainder were taken during normotension. Their plasma 6 KPGF1 values (mean +/- SE) were 201.06 +/- 12.42 and 132.87 +/- 13.08 pg/ml respectively. All patients had serology positive for acute dengue viral infection. The plasma 6 KPGF1 (mean +/- SE) of 33 NC and 11 - NDHF subjects were 149.82 +/- 4.93 and 108.69 +/- 14.53 respectively. The plasma 6KPGF1 levels of 32 DHF patients with impending shock were significantly higher than those of 28 normotensive DHF patients (p less than 0.005), 33 NC (p less than 0.005) and 11 - NDHF patients (p less than 0.005). However the levels in 28 normotensive DHF patients are not statistically different from the values of 33 NC and 11 - NDHF patients. It is concluded that there is a tendency of excessive PGI2 production in DHF patients during hypotensive crisis.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Primary amoebic meningoencephalitis in Thailand: report of a case and review literatures.

Primary amoebic meningoencephalitis (PAM) which is caused by free-living amoeba, Naegleria fowleri, is a rare disease. We report the fifth case in Thailand in order to add more information. The patient was a previously healthy 4 1/2-year-old girl from Nakhon Pathom province. For several weeks before this illness she had swum in a water supply canal. She developed high fever with change in consciousness. Her cerebrospinal fluid contained numerous Naegleria fowleri which grew in culture media and mice inoculation. She did not respond to treatment with intravenous and intraventricular amphotericin B, and oral rifampicin. She died on the fifth day of illness. Water sample from the canal also grew N. fowleri. All five reported cases in Thailand were reviewed. It was found that none of them had been exposed to a common source. Four of the five cases were male, and four cases occurred during the summer months, March to May. These findings agree with worldwide information.

Adolescent↗
PubMed1989

Failure of norfloxacin to eradicate intestinal colonization of non-typhoidal salmonella in infants.

Infant colonization with non-typhoidal Salmonella (NTS) is common and eradication is problematic. Oral norfloxacin has promising properties for solving this problem, though it has potential toxicity to infants. The drug has been available in Thailand since 1987. Since then, some infants who had diarrhea or NTS colonization were treated with oral norfloxacin 15-20 mg/kg/day for 3-5 days on individual physician's judgement. This observational study was performed in infants and children who had NTS in stool, seen at Ramathibodi hospital from September 1987 to February 1988, in order to give preliminary information. Sixteen of 48 infants received oral norfloxacin treatment. Nine infants had established failure of NTS eradication from follow-up rectal swab cultures. Five infants did not have follow-up rectal swab culture, and two had negative culture once on day 7 after treatment. Considering that 7 infants who did not have evidence of bacteriologic failure were free from colonization, the excretion rate during the first two weeks could be estimated as 56 per cent which is not less than the natural history of this disease. This observation suggests failure of oral norfloxacin, 15 mg/kg/day given in 2 divided doses for 3 days, in eradication NTS colonization in infants.

Humans↗
PubMed1988

Predictors for extraintestinal infection in Salmonella enteritis in Thailand.

To identify the risks and predictors for extraintestinal Salmonella infection (ETI) in infants and children with nontyphoidal Salmonella enteritis, we performed a retrospective review of 326 infants and children with diarrhea and rectal swab cultures positive for nontyphoidal Salmonella enteritis seen at Ramathibodi Hospital between 1981 and 1983. Nineteen patients had bacteremia. The overall rate of bacteremia was 5.8% which was 24.3% of those having blood cultures taken. Salmonella typhimurium was the most common cause of ETI and the most invasive among the common serotypes causing enteritis. The clinical characteristics of the patients with high probabilities of having ETI were: younger than 6 months of age; high body temperature; and immunocompromising conditions. The observed frequency of ETI in these patients was 21.9 to 26.3% compared with 0 to 0.7% in patients without those risk factors.

Adolescent↗
PubMed1985

Diphtheritic septicaemia and probable endocarditis: a case report and review of the literature.

Corynebacterium diphtheriae usually produces an infection limited to the respiratory tract and the organisms rarely invade the blood stream. We report the case of a 6-year-old girl who, 2 months after an unsuccessful repair of a ventricular septal defect, developed septicaemia with non-toxigenic C. diphtheriae. The organism appeared resistant to penicillin in vitro and failed to respond to a course of trimethoprim-sulfamethoxazole to which it was susceptible in the laboratory. A cure was finally achieved using cephalothin and gentamicin, followed by an additional course of ampicillin and amoxicillin. Twelve previously recorded cases of diphtheritic sepsis and endocarditis are reviewed.

Amoxicillin↗
PubMed1984

Cefuroxime treatment of bacterial meningitis in infants and children.

Recently, ampicillin- and chloramphenicol-resistant strains of Haemophilus influenzae type b and multiply-resistant Salmonella strains have appeared in some areas of the world. Therefore, alternative drug therapy for infections caused by these organisms is being sought. We used cefuroxime to successfully treat five children with H. influenzae type b meningitis and two children with Salmonella meningitis. Four H. influenzae type b isolates and one Salmonella isolate were resistant to ampicillin, chloramphenicol, and cotrimoxazole. Each of the patients received 200 to 250 mg of cefuroxime per kg per day in four divided doses for 14 to 21 days. The concentrations of cefuroxime in cerebrospinal fluid at 2 h after intravenous 50-mg/kg doses were 6.4 +/- 1.7 (mean +/- standard deviation) and 3.6 +/- 2.2 micrograms/ml on days 2 and 14 of treatment, respectively. The level of drug in cerebrospinal fluid was 1.34 +/- 1.3 micrograms/ml in children without meningitis. The mean cefuroxime concentration in subdural fluid samples from each of three patients was 12.6, 15, and 25.2 micrograms/ml. Cefuroxime is recommended as an alternative drug for the treatment of H. influenzae type b meningitis, but additional information is necessary before cefuroxime can be recommended for therapy of Salmonella meningitis.

Body Fluids↗
PubMed1980

Determining gentamicin dosage in infants and children with renal failure.

Gentamicin half-life values based on pharmacologic calculations were determined in 23 infants and children with diminished renal function. The half-life times correlated significantly with serum creatinine concentrations in patients who had steady-state creatinine levels (Y = 0.379 + 3.841 X, R = 0.951, P less than 0.001). This relationship provides a basis for formulating gentamicin dosage in pediatric patients with renal failure. The half-life of gentamicin is estimated by multiplying the serum creatinine concentration by four; three-quarters of the loading dose is administered every two half-lives. When renal function is unstable and changing daily, gentamicin half-life cannot be reliably predicted from the serum creatinine value.

Bacterial Infections↗
PubMed1979

Primary suppurative myositis in children.

Primary suppurative myositis is rare in the United States when compared with the incidence of disease in the tropics. Clinically, it may mimic many of the more common diseases, such as hematoma, osteomyelitis, arthritis, or appendiceal abscess. It usually has a benign course, with complete recovery after appropriate treatment. Prolonged morbidity and an increased mortality may result from unfamiliarity with this entity. Six children had primary suppurative myositis; one died as a result of perforation of a psoas abscess into the dural sac causing staphylococcal meningitis.

Child↗
PubMed1979

Pitfalls in collecting blood specimens for antibiotic assay.

Obtaining blood samples for antibiotic analysis from intravenous lines through which the antibiotic had been administered was critically evaluated. Flushing volumes required to remove contaminating antibiotic varied with the type of antibiotic and with different plastics. Obtaining blood specimens from the intravenous lines is not practical in infants and not advised in adults.

Adult↗
PubMedDate not supplied

Internal carotid artery occlusion associated with Mycoplasma pneumoniae infection.

A 12-year-old girl with serologically-proved Mycoplasma pneumoniae infection developed right-sided hemiparalysis 10 days after the onset of the disease. Cerebral infarction was documented by cranial computed tomography; cerebral angiography revealed left carotid artery occlusion. Cerebrospinal fluid examination was normal. Cerebral infarction is a rare central nervous system complication of M. pneumoniae infection; however, occlusion of the internal carotid artery near the bifurcation has never been demonstrated; therefore, this patient with central nervous system complication of M. pneumoniae infection is unique.

Carotid Artery, Internal↗
PubMedDate not supplied

A study of nonbacterial agents of acute lower respiratory tract infection in Thai children.

From January 1986 to December 1987, 596 children less than 5 years of age with lower respiratory tract infection (LRI)--manifested as laryngitis, croup, bronchitis, bronchiolitis, and pneumonia--were studied for evidence of infection with respiratory tract viruses Mycoplasma pneumoniae, and Chlamydia trachomatis. Of the 596 children in the study, 315 were ambulatory and 281 were hospitalized. Virologic studies included isolation and rapid diagnosis of virus from specimens of nasopharyngeal aspirate (NPA) and serologic studies of blood samples. Cultures of NPA for C. trachomatis were performed for children less than 6 months of age who had pneumonia. Of the LRI cases, 45% were associated with viral infections of the respiratory tract and 12.1% were associated with C. trachomatis. Respiratory syncytial virus (RSV) accounted for 45.2% of infections with viral agents and was associated with acute bronchitis, acute bronchiolitis, and pneumonia. Parainfluenza type 3 virus was the most common virus found in conjunction with laryngitis and croup. The incidence of infections due to RSV peaked in July and August, while that of infections due to parainfluenza viruses peaked in February and March; influenza viruses and adenoviruses were isolated throughout the year.

Acute Disease↗
PubMedDate not supplied

Aeromonas septicemia in infants and children.

Our experience at the Ramathibodi Hospital with 20 infants and children who had Aeromonas septicemia is reviewed. Their ages were from 1 day to 14 years. Eighteen patients had underlying diseases: leukemia, 5; aplastic anemia, 4; cirrhosis, 2; thalassemia/hemoglobinopathy, 3; renal failure, 1; ileal perforation, 1; marasmus, 1; and cavernous hemangioma with thrombocytopenia, 1. Blood cultures yielded Aeromonas hydrophila in all patients, and four patients had polymicrobial bacteremia. Fifteen episodes of septicemia were community-acquired and five were hospital-acquired. The clinical manifestations of these patients were similar to septicemia due to other Gram-negative enteric bacilli. Two patients each had ecthyma gangrenosum, necrotizing fasciitis and meningitis. Antibiotic treatment included penicillins, cephalosporins, aminoglycosides and sulfamethoxazole-trimethoprim. The overall case fatality rate was 50%; eight of the nine patients with acute leukemia or aplastic anemia died. With the exception of one child the blood cultures were sterile in all patients before death. Aeromonas septicemia is an uncommon but severe infection which occurs predominantly in compromised hosts.

Acute Disease↗