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PubMed1997

NSAID-induced gastrointestinal damage. Epidemiology, risk and prevention, with an evaluation of the role of misoprostol. An Asia-Pacific perspective and consensus.

The problem of nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal toxicity was reviewed by members of the Asia Pacific League of Associations for Rheumatology (APLAR) in a consensus conference in September 1992. This paper by the participants presents the consensus conclusions incorporating knowledge from recent publications. There had been a high level of concern that much of the toxicity had resulted from extensive and indiscriminate prescribing of NSAIDs. The implementation of evidence-based guidelines was considered likely to be able to effect a substantial reduction in toxicity without significant loss of overall therapeutic benefit. The evidence from which such guidelines could be developed is critically appraised.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2006

Brain aging in very old men with type 2 diabetes: the Honolulu-Asia Aging Study.

OBJECTIVE: Type 2 diabetes leads to cognitive impairment and dementia, which may reflect microvascular and macrovascular complications as well as neurodegenerative processes. There are few studies on the anatomical basis for loss of cognitive function in type 2 diabetes. The objective of this study was to investigate the association between type 2 diabetes and markers of brain aging on magnetic resonance images, including infarcts, lacunes, and white matter hyperintensities as markers of vascular damage and general and hippocampal atrophy as markers of neurodegeneration in Japanese-American men born between 1900 and 1919 and followed since 1965 in the Honolulu-Asia Aging Study. RESEARCH DESIGN AND METHODS: Prevalent and incident dementia was assessed. Associations between magnetic resonance imaging markers and diabetic status were estimated with logistic regression, controlling for sociodemographic and other vascular factors. RESULTS: The prevalence of type 2 diabetes in the cohort is 38%. Subjects with type 2 diabetes had a moderately elevated risk for lacunes (odds ratio [OR] 1.6 [95% CI 1.0-2.6]) and hippocampal atrophy (1.7 [0.9-2.9]). The risk for both hippocampal atrophy and lacunes/infarcts was twice as high in subjects with compared with those without type 2 diabetes. Among the group with type 2 diabetes, those with the longest duration of diabetes, those taking insulin, and those with complications had relatively more pathologic brain changes. CONCLUSIONS: There is evidence that older individuals with type 2 diabetes have an elevated risk for vascular brain damage and neurodegenerative changes. These pathological changes may be the anatomical basis for an increased risk of cognitive impairment or dementia in type 2 diabetes.

Aged, 80 and over↗

PubMed2003

The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia.

OBJECTIVE: The aim of this study was to determine in Thai adults aged >or=35 years the prevalence and management of diabetes and the associations of diabetes with cardiovascular risk factors. RESEARCH DESIGN AND METHODS: The International Collaborative Study of Cardiovascular Disease in Asia was a complex sample survey. Data from a structured questionnaire, brief physical examination, and blood sample were collected from 5,105 individuals aged >or=35 years (response rate 68%). Population estimates were calculated by applying sampling weights derived from the 2000 Thai census. RESULTS: The estimated national prevalence of diabetes in Thai adults was 9.6% (2.4 million people), which included 4.8% previously diagnosed and 4.8% newly diagnosed. The prevalence of impaired fasting glucose was 5.4% (1.4 million people). Diagnosed diabetes, undiagnosed diabetes, and impaired fasting glucose were associated with greater age, BMI, waist-to-hip ratio, systolic blood pressure, total cholesterol, and serum creatinine levels. The majority of individuals with diagnosed diabetes had received dietary or other behavioral advice, and 82% were taking oral hypoglycemic therapy. Blood pressure-lowering therapy was provided to 67% of diagnosed diabetic patients with concomitant hypertension. CONCLUSIONS: Diabetes is common in Thailand, but one-half of all cases are undiagnosed. Because diagnosed diabetes is likely to be treated with proven, low-cost, preventive therapies such as glucose lowering and blood pressure lowering, initiatives that increased diagnosis rates would be expected to produce substantial health benefits in Thailand.

Adult↗

PubMed1977

A heroin "epidemic" in Asia.

Heroin "epidemics" have been reported in North America but not in Asia. Following passage of an anti-opium law in Laos, heroin use suddenly began in one area during 1972. Initially heroin use prevailed among indigenous Asian addicts, mostly older addicts who gradually switched from opium to heroin. In addition, there evolved a new group of indigenous addicts: young, single, unemployed males in urban areas whose first narcotic drug was heroin. After the appearance of heroin in Laos, increasing numbers of younger Americans and Europeans were soon attracted to heroin use in Laos.

Adolescent↗

PubMed1977

"World Traveler" addicts in Asia: II. Comparison with "Stay at home" addicts.

Demographic and clinical characteristics of "world traveler" addicts in Asia have been described in a previous paper. In order to understand more about this group, the 56 American and European addicts seen in Laos were compared to 100 American addicts from Minneapolis matched for age, sex, and year of admission to treatment. "World traveler" addicts tended to be older, better educated, and more apt to be single than this sample of "stay at home" addicts. In comparison to the latter, "travelers" began using narcotic drugs at an older age, became addicted more rapidly, and sought treatment earlier. They were also exposed to more inexpensive, readily available narcotic drugs than the "at home" addicts. These data suggest that exposure to inexpensive, readily available narcotic drugs can result in addiction among a group of people who had previously been refractory to narcotic addiction in their own culture. Loneliness and sociocultural isolation appeared to accelerate the rate at which the average "traveler" moved from nonaddictive use to addiction. Further comparisons to other samples of "at home" addicts will be needed to demonstrate whether these findings are due to "travel" per se or to demographic factors.

Adolescent↗

PubMed2004

Multidrug-resistant tuberculosis in central Asia.

Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major threat to TB control, particularly in the former Soviet Union. To determine levels of drug resistance within a directly observed treatment strategy (DOTS) program supported by Médecins Sans Frontières in two regions in Uzbekistan and Turkmenistan, Central Asia, we conducted a cross-sectional survey of smear-positive TB patients in selected districts of Karakalpakstan (Uzbekistan) and Dashoguz (Turkmenistan). High levels of MDR-TB were found in both regions. In Karakalpakstan, 14 (13%) of 106 new patients were infected with MDR-TB; 43 (40%) of 107 previously treated patients were similarly infected. The proportions for Dashoguz were 4% (4/105 patients) and 18% (18/98 patients), respectively. Overall, 27% of patients with positive smear results whose infections were treated through the DOTS program in Karakalpakstan and 11% of similar patients in Dashoguz were infected with multidrug-resistant strains of TB on admission. These results show the need for concerted action by the international community to contain transmission and reduce the effects of MDR-TB.

Adolescent↗

PubMed2005

Primate-to-human retroviral transmission in Asia.

We describe the first reported transmission to a human of simian foamy virus (SFV) from a free-ranging population of nonhuman primates in Asia. The transmission of an exogenous retrovirus, SFV, from macaques (Macaca fascicularis) to a human at a monkey temple in Bali, Indonesia, was investigated with molecular and serologic techniques. Antibodies to SFV were detected by Western blotting of serum from 1 of 82 humans tested. SFV DNA was detected by nested polymerase chain reaction (PCR) from the blood of the same person. Cloning and sequencing of PCR products confirmed the virus's close phylogenetic relationship to SFV isolated from macaques at the same temple. This study raises concerns that persons who work at or live around monkey temples are at risk for infection with SFV.

Adult↗

PubMed2005

Diabcare Asia 2001--Korea country report on outcome data and analysis.

BACKGROUND: The Diabcare-Asia study was designed for the purpose of describing diabetes control and management, and late complication status in the diabetic population. METHODS: From the 1st of July 2001 to the 1st of September 2001, data from 1170 diabetic patients were collected in 21 centers (one university hospital and 20 clinics located in Seoul and in Gyeonggi, Korea), and blood samples were collected for centralized HbAtc measurements. RESULTS: Only 16.8% of patients at the clinics reported self-monitoring their blood glucose. The mean HbA(1c) was 7.3 +/- 1.4% at the hospital and 7.5 +/- 1.5% at the clinics, and the mean fasting plasma glucose (FPG) levels were 7.0 +/- 3.3 mmol/L at the hospital and 7.9 +/- 2.5 mmol/L at the clinics. About 40% of patients had a HbA(1c) and FPG above the normal upper limits. Screening for microalbuminuria was rarely performed. The available data represents only about 0.9% of the patients at the hospital and 12.3% of the patients at the clinics. Nephropathy (serum creatinine >2 mg/dL) was found in 0.8% of the patients at the hospital and in 3.4% of the patients at the clinics. Retinopathy and neuropathy were commonly reported diabetic complications. The prevalence of other severe late complications was relatively low. CONCLUSION: The data revealed suboptimal glycemic control in about 40% of patients.

Diabetes Complications↗

PubMed1995

Molecular characterization of Vibrio cholerae O139 isolates from Asia.

In 1992, a serologically novel clone of Vibrio cholerae, designated O139, caused large epidemics of diarrhea in India and Bangladesh. To determine the extent of the spread of V. cholerae O139 worldwide, 484 V. cholerae non-O1 strains isolated from different patients with diarrhea in Thailand, Indonesia, the Philippines, and Peru in 1993 were tested for agglutination in O139 antisera. One hundred fifty-one of these 484 isolates were examined for genes encoding cholera toxin, zonula occlulans toxin, the repetitive sequence 1, and the toxin coregulated pilin A (the V. cholerae virulence gene complex). Thirty-three percent (122 of 364) of V. cholerae non-O1 strains isolated from different patients with diarrhea in Thailand agglutinated in O139 antisera. Ninety-eight percent (120 of 122) of V. cholerae O139 contained the V. cholerae virulence gene complex. None of the 104 V. cholerae non-O1 strains isolated from patients with diarrhea in Indonesia or the 14 strains from patients with diarrhea in the Philippines were serotype O139. Four different ribotypes were found in V. cholerae O139 isolated in Asia. Twenty-three (47%) of 49 Thai O139 strains examined were of different ribotypes than isolates from India and Bangladesh; V. cholerae strains that were not O1 or O139 that were isolated from flies and water in Thailand 11 years previously in 1981 contained the same V. cholerae virulence gene complex found in V. cholerae O1 and O139. This suggests that other unidentified virulence determinants are involved in V. cholerae O139 pathogenesis.

Cholera↗

PubMed2002

Risk factors for coronary heart disease in the Japanese--comparison of the background of patients with acute coronary syndrome in the ASPAC study with data obtained from the general population. Asia-Pacific Collaboration on CHD Risk Factor Intervention study.

The relative importance of metabolic risk factors for coronary heart disease (CHD) in the Japanese is assessed by comparing their prevalence in patients with acute coronary syndrome (ACS) enrolled in the Asia-Pacific Collaboration on CHD Risk Factor Intervention (ASPAC) study to that obtained by a serum lipid survey carried out in 1990 and also by comparing them to the ASPAC data from other countries and regions in this area. Hypertension was the most prevalent risk factor among Japanese patients with ACS as in the other countries and regions. The prevalence of obesity with a body mass index (BMI) of 30 or more was several times higher than that in the general population, although the rate was still much lower than in New Zealand and Singapore. In addition to hypercholesterolemia, hypertriglyceridemia and diabetes mellitus were frequently found in Japanese patients with ACS. When the prevalence of metabolic risk factors was compared between people with and without hypertension in the general population, the most remarkable difference was seen in BMI, followed by triglyceride and total cholesterol. These results indicate that hypertriglyceridemia and diabetes mellitus may be more important CHD risk factors in the Japanese population than LDL-cholesterol.

Coronary Disease↗

PubMed1998

[Synthesis and immunogenic properties of peptides--fragments of the immunodominant regions of the VP1 protein of the Asia-1 type of foot- and-mouth disease virus].

Potential immunodominant epitopes were predicted on the basis of a theoretical analysis of the antigenic structure of the VP1 protein of the type Asia-1 foot-and-mouth disease virus. Peptides corresponding to the 140-153, 136-153, 132-153, 143-157, 137-157, and 193-208 fragments of the VP1 protein sequence were synthesized by the solid phase method, and the immunogenic properties of the peptides were studied on guinea pigs. The shortest peptide exhibiting the protective effect was found to correspond to the, 140-153 fragment of the VP1 sequence. The Plm-(Gly)3-(140-153)-(Gly)2-Lys(Plm)-Leu and [Ac-(140-153)-(Gly)3]8-(Lys)7-Gly synthetic constructions in combination with adjuvants provided up to 80% protection of immunized animals against infection with the foot-and-mouth disease virus.

Adjuvants, Immunologic↗

PubMed2000

Diabetic complications and their implications on health care in Asia.

Diabetes mellitus is a growing health problem in the Asia-Pacific region. The acute and chronic complications of diabetes mellitus are major causes of hospital admissions, blindness, renal failure, amputations, stroke, and coronary heart disease in this region. Compared with the general population, the annual per capita health care expenditure is estimated to be four-fold for people with diabetes. Recent prospective studies have provided unequivocal evidence for the crucial role of prolonged hyperglycaemia in the development of chronic diabetic complications. Although the aetiology of hyperglycaemia-induced damage of the kidneys, eyes, nerves, and arteries still remain to be elucidated, observational and interventional studies show that the occurrence and progression of these complications can be prevented by the optimal control of blood glucose, hypertension, and dyslipidaemia. Lifestyle changes such as weight control, increased physical exercise, and smoking cessation are also potentially beneficial in preventing diabetes mellitus and coronary artery disease. Furthermore, the morbidity and mortality caused by diabetes mellitus can be reduced by secondary prevention through regular screening, early detection, and appropriate treatment of chronic complications. Improved diabetes education is needed among health professionals as well as the general and diabetic populations. Government and public health officials should be mindful of the economic impact of this major health problem so that adequate health care resources can be allocated for the primary and secondary prevention of diabetic complications.

Diabetes Complications↗

PubMed2000

[Evaluation of modern antibiotics efficacy at experimental Northern Asia rickettsiosis].

Comparative investigation of antibiotics therapy efficacy at experimental murine Northern Asia rickettsiosis was performed. The efficacy was evaluated by the determination of protective activity in per cent and by the pathogen erradication. The investigated antibiotics may be ranged in the following order (by the diminishing efficacy): ansamycins (azorif, rifapentine, rifampicin), tetracyclines (doxycycline), macrolides (azitromycin, sumamed), carbapenems (imipenem/cilastatin), fluoroquinolones (lomefloxacin, pefloxacin). Rifampicin and its derivatives--azorif, rifapentine, along with doxycycline and azitromycm can be recommended for clinical trials at experimental rickettsiosis profilaxy and treatment in natural infection focus.

Animals↗

PubMed2000

Genotypes and phenotypes for apolipoprotein E and Alzheimer disease in the Honolulu-Asia aging study.

BACKGROUND: The utility of apolipoprotein E (ApoE) type as an indicator of genetic susceptibility to Alzheimer disease (AD) depends on the reliability of typing. Although ApoE protein isoform phenotyping is generally assumed equivalent to genotyping from DNA, phenotype-genotype differences have been reported. METHODS: ApoE genotype and phenotype results were examined for 3564 older (ages 71-93 years) Japanese-American male participants of the Honolulu-Asia Aging Study, an ongoing population-based study of aging and dementia. RESULTS: Both methods demonstrated similar associations of ApoE type with AD: a direct association with ApoE4 and a less dramatic inverse association ApoE2. Advanced age did not appear to influence the ApoE4-AD association. The association with AD among ApoE4 homozygotes [odds ratio (OR) = 14.7] was higher than expected based on an observed OR of 2.0 in heterozygotes. Phenotype-genotype nonconcordance was more frequent for ApoE2 than for ApoE4. The ApoE2 phenotype occurred at a frequency of 7.9% vs a genotype frequency of 4.9%, corresponding to a probability of 56% that an individual with ApoE2 phenotype had the same genotype. CONCLUSIONS: Whereas E4 and E2 phenotypes and genotypes were comparably associated with AD, neither method would be expected to substantially improve the efficiency of case finding in the context of population screening beyond prediction based on age and education. Nonconcordance of phenotype and genotype was substantial for E2 and modest for E4 in this population. The ApoE4-AD association was independent of age.

Aged↗

PubMed2000

Mitochondrial DNA variation in two South Siberian Aboriginal populations: implications for the genetic history of North Asia.

The mtDNAs of 76 individuals representing the aboriginal populations of South Siberia, the Tuvinians and Buryats, were subjected to restriction fragment length polymorphism (RFLP) analysis and control region hypervariable segment I (HVS-I) sequencing, and the resulting data were combined with those available for other Siberian and East Asian populations and subjected to statistical and phylogenetic analysis. This analysis showed that the majority of the Tuvinian and Buryat mtDNAs (94.4% and 92.5%, respectively) belong to haplogroups A, B, C, D, E, F, and M*, which are characteristic of Mongoloid populations. Furthermore, the Tuvinians and Buryats harbor four Asian- and Native American-specific haplogroups (A-D) with frequencies (72.2% and 55%, respectively) exceeding those reported previously for Mongolians, Chinese, and Tibetans. They represent, therefore, the populations that are most closely related to New World indigenous groups. Despite their geographical proximity, the Tuvinians and Buryats shared no HVS-I sequences in common, although individually they shared such sequences with a variety of other Siberian and East Asian populations. In addition, phylogenetic and principal component analyses data of mtDNA sequences show that the Tuvinians clustered more closely with Turkic-speaking Yakuts, whereas the Mongolic-speaking Buryats clustered closer to Korean populations. Furthermore, HVS-I sequences, comprising one-fourth of the Buryat lineages and characterized by the only C-to-T transition at nucleotide position 16223, were identified as different RFLP haplotypes (B, C, D, E, M*, and H). This finding appears to indicate the putative ancestral state of the 16223T HVS-I sequences to Mongoloid macrohaplogroup M, at least. Finally, the results of nucleotide diversity analysis in East Asian and Siberian populations suggest that Central and East Asia were the source areas from which the genetically heterogeneous Tuvinians and Buryats first emerged.

American Indian or Alaska Native↗

PubMed1992

Nucleotide sequence of the cDNA and the derived amino acid sequence for the major antigenic protein of foot and mouth disease virus, type Asia 1 63/72.

A 0.9 kb cDNA for the foot and mouth disease virus (FMDV) type Asia 1 63/72, cloned in the plasmid pUR222 by dC/dG tailing method, was expressed into a protein which was immunogenic in guinea pigs and cattle. The protein purified to homogeneity was found to be basic and of 38 kDa. A sequence of 879 nucleotides of the inserted cDNA was obtained. The nucleotide sequence was 65% GC-rich and was homologous to the gene for VPI of FMDV types A5, OIK and C3 to the extent of 35-40%. From the nucleotide sequence, a sequence of 293 amino acids was derived which contained 43 arginine, 4 lysine, 7 glutamic acid and 18 aspartic acid residues making the protein highly basic. The molecular weight was calculated to be 31.6 kDa. The 38 kDa protein produced by the cloned cDNA is a fused protein composed of the 293 amino acids; 5 and 55 amino acids of the alpha-complementation protein of the beta-galactosidase at the N and C terminal, respectively, and 5 amino acid coded by the dG/dC tails used for cloning the cDNA.

Amino Acid Sequence↗

PubMed1992

Characterization and immune response of a protein produced by a cDNA clone of foot and mouth disease virus, type Asia 1 63/72.

A 0.9 kb double stranded cDNA of foot and mouth disease virus (FMDV) Type Asia 1, 63/72 was cloned in an expression vector, pUR222. A protein of 38 kd was produced by the clone which reacted with the antibodies raised against the virus. A 20 kd protein which may be derived from the 38 kd protein contained the antigenic epitopes of the protein VP1 of the virus. Injection of 10-20 micrograms of the partially purified 38 and 20 kd proteins or a lysate of cells containing 240 micrograms of the proteins elicited high titers of FMDV specific antibodies in guinea pigs and cattle respectively. Also, at these concentrations, the proteins protected 5 of 8 guinea pigs and 3 of 8 cattle when challenged with a virulent virus.

Animals↗

PubMedDate not supplied

[Identification of the yeast species Saccharomyces bayanus in Far East Asia].

The genetic and molecular genetic analyses of nine Far East Asian Saccharomyces isolates allowed us to identify three species (S. cerevisiae, S. paradoxus, and S. bayanus). The occurrence of the last species in Far East Asia was shown for the first time. A new method for the molecular genetic differentiation of Saccharomyces sensu stricto species is described. The ecogeographical distribution of Saccharomyces yeasts is discussed.

DNA, Fungal↗