Publications by authors named "Apichat Kaewdech"
Article Synopsis
- Cholangiocarcinoma (CCA) patients in Southern Thailand exhibit late-stage diagnoses, with 59.4% diagnosed at TMN stage IV, and the overall median survival is only 5-6 months.
- The study reviewed 223 CCA patients between 2018 and 2021, identifying that intrahepatic CCA (iCCA) was the most common subtype (49.3%), and only 15.1% of patients were considered resectable.
- Key factors affecting survival included TMN stage, with a higher risk of mortality linked to late-stage diagnosis, while systemic chemotherapy and palliative biliary drainage improved outcomes for unresectable patients.
Article Synopsis
- Hepatocellular carcinoma (HCC) is a major cause of cancer deaths, often linked to chronic liver disease, but extrahepatic factors also play a significant role in its development.
- * A review of literature up to October 2024 finds that prevention strategies include hepatitis vaccinations, antiviral treatments, lifestyle changes (like diet and exercise), environmental controls, and regular screenings for high-risk groups.
- * A holistic approach that integrates medical, lifestyle, and environmental strategies is crucial for effectively reducing HCC incidence worldwide.
Background/aims: Dengue-associated acute liver failure (ALF) poses a significant risk for mortality, especially in regions lacking access to liver transplantation. Although Plasma Exchange (PLEX) is recognized as a potential therapeutic intervention for dengue-associated ALF, data on its efficacy remain limited. This systematic review aimed to comprehensively examine the literature on PLEX and other combination therapies for dengue-associated ALF.
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- The study examines the newly defined categories of steatotic liver disease (SLD), classifying them into metabolic dysfunction-associated (MASLD), alcohol-related (ALD), and a combination of both (MetALD).
- A large sample of nearly 10,000 adults was analyzed, revealing that most had MASLD, with higher rates of diabetes in this group and worse overall survival for those with ALD.
- The findings suggest that the SAFE score can effectively assess long-term health outcomes for these liver disease subgroups, highlighting significant differences in survival rates among them.
Article Synopsis
- * From 2010 to 2019, an estimated 364,700 new cases and 324,100 deaths from primary liver cancer were reported in this region, representing 68% and 67% of global totals, respectively.
- * Noteworthy trends include rising incidence rates linked to metabolic dysfunction and alcohol-related liver issues, while viral hepatitis remains the top cause, emphasizing the urgent need for targeted healthcare strategies.
Article Synopsis
- - The study assessed the effectiveness of a mouthwash with poly l-Lysine and glycerol monolaurate in reducing harmful microbes linked to oral infections and periodontitis by evaluating its impact on growth, biofilm formation, and cell toxicity.
- - Results showed that this mouthwash could reduce biofilm by up to 19.9% in just 5 minutes and maintained high cell viability across different cell types (77.2%-100%).
- - The mouthwash also successfully down-regulated specific mRNA expression and reduced adhesion and inflammation in gastric and oral cells, indicating potential benefits in managing oral and gastric health.
Article Synopsis
- - This study evaluated the aMAP score's effectiveness in predicting hepatocellular carcinoma (HCC) in Thai patients with chronic hepatitis B (CHB) by analyzing data from 2008 to 2019, focusing on factors like age, sex, and blood levels.
- - Out of 1,060 patients, 789 were eligible for analysis, and 51 developed HCC, with significant differences in HCC incidence based on risk group classifications over 3, 5, and 10 years.
- - The aMAP score showed promising predictive ability with AUROCs of 0.748, 0.777, and 0.784 over time, but the CU-HCC score outperformed it with
Article Synopsis
- - CDI is a widespread healthcare-associated infection that significantly affects the elderly, posing serious health and economic issues, yet detailed data on its impact are scarce.
- - Using data from the Global Burden of Disease Study 2019, the analysis from 2000 to 2019 showed CDI resulted in about 18,181 deaths and 252,709 disability-adjusted life years (DALYs) among older adults, with the Americas facing the highest burden.
- - The findings highlight the urgent need for specialized public health strategies to address the rising CDI rates, particularly in high-sociodemographic index (SDI) regions and the Americas.
Article Synopsis
- Proton pump inhibitors (PPI) are commonly used to prevent re-bleeding in high-risk peptic ulcer patients after endoscopic treatment, and this study compares their effectiveness to vonoprazan (VPZ), which can achieve similar gastric pH levels.
- The study involved 44 patients with high-risk peptic ulcers, randomly assigned to receive either PPI or VPZ, and key outcomes measured included re-bleeding rates at different time intervals, blood transfusions needed, hospital stay duration, and ulcer healing rates.
- Results showed a 9.1% re-bleeding rate in the PPI group within 72 hours compared to 0% in the VPZ group, but no significant differences were found
Article Synopsis
- - Metabolic dysfunction-associated steatotic liver disease (MASLD) is becoming a global health issue, and the primary treatment involves lifestyle interventions (LSI) to manage the disease.
- - A study conducted in Thailand involved 122 noncirrhotic MASLD patients, who were divided into a control group receiving standard care and an intervention group receiving regular updates and info via the LINE app about LSI and MASLD.
- - After 24 weeks, while both groups improved in various health metrics, the intervention group showed a significant enhancement in liver stiffness compared to the control group, indicating that social media can be effective in managing MASLD.
Article Synopsis
- Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is a significant global health concern, especially as advanced fibrosis (F≥2) increases mortality risks.
- It’s crucial for primary care providers to refer patients with significant fibrosis to specialists, highlighting the need for effective noninvasive risk assessment tools.
- The study evaluates the Steatosis-associated fibrosis estimator (SAFE) against other tools, like FIB-4 and NAFLD fibrosis score (NFS), suggesting that using SAFE earlier could reduce the misclassification of patients at risk for serious liver issues.
Article Synopsis
- Helicobacter pylori is a major gastrointestinal pathogen that poses health risks due to antibiotic resistance, highlighting the need for alternative treatments.
- This study investigates the effects of Limosilactobacillus fermentum T0701 cell-free supernatants (LCFS) against H. pylori, finding that it has significant antimicrobial activity and can inhibit the bacteria effectively.
- LCFS demonstrates safety, as it shows no toxicity to human gastric cells and possesses no virulence or resistance genes, making it a promising non-toxic option for preventing H. pylori infections.
Article Synopsis
- This study investigates the risk of developing hepatocellular carcinoma (HCC) in patients with Type 2 diabetes being treated with either sodium-glucose cotransporter-2 inhibitors (SGLT2i) or dipeptidyl peptidase-4 inhibitors (DPP4i).
- In a retrospective analysis involving over 62,000 patients in Hong Kong, it found that SGLT2i users had a significantly lower risk of developing HCC compared to those using DPP4i.
- The findings indicate SGLT2i is associated with reduced HCC risk, even among patients with complicating factors like cirrhosis and viral infections.
Comparative effectiveness of sodium-glucose cotransporter-2 inhibitors for new-onset gastric cancer and gastric diseases in patients with type 2 diabetes mellitus: a population-based cohort study.
Oscar Hou In Chou Vinod Kumar Chauhan Cheuk To Skylar Chung Lei Lu Teddy Tai Loy Lee Apichat Kaewdech
Gastric Cancer
September 2024
Objective: To compare the risks of gastric cancer and other gastric diseases in patients with type-2 diabetes mellitus (T2DM) exposed to sodium-glucose cotransporter 2 inhibitors (SGLT2I), dipeptidyl peptidase-4 inhibitors (DPP4I) or glucagon-like peptide-1 receptor agonists (GLP1a).
Design: This was a population-based cohort study of prospectively collected data on patients with T2DM prescribed SGLT2I, DPP4I or GLP1a between January 1st 2015 and December 31st 2020 from Hong Kong. The outcomes were new-onset gastric cancer, peptic ulcer (PU), acute gastritis, non-acute gastritis, and gastroesophageal reflux disease (GERD).
Article Synopsis
- * Data from the Global Burden of Disease study revealed that in 2019 there were significant increases in ALD prevalence and incidence, particularly among the older age group (25-29), with varying trends across different regions.
- * The findings suggest a growing public health concern regarding ALD in younger populations, highlighting the need for policies to reduce alcohol consumption and prevent disease.
Article Synopsis
- Colonoscopy is crucial for cancer screening, but effective bowel preparation is essential for accurate diagnosis and safety during the procedure.
- A study evaluated the effectiveness of a smartphone app providing bowel preparation instructions compared to standard methods among first-time colonoscopy patients, focusing on preparation quality and detection rates.
- Results showed that patients using the app had significantly better bowel preparation scores, indicating that the app could enhance the colonoscopy experience and improve colorectal cancer screening outcomes.
Article Synopsis
- The study investigates whether tracking changes in liver stiffness measurements (LSM) over time can better predict liver-related events (LRE) in patients with compensated advanced chronic liver disease (cACLD) compared to just looking at the most recent LSM.
- Analyzing data from 480 patients across five countries, researchers found that while a higher current LSM was linked to a higher risk of LRE, changes in LSM over time were not significantly predictive.
- The conclusion is that once the latest LSM value is available, previous LSM measurements do not provide any additional predictive benefit for LRE in cACLD patients.
Background/purpose: The oral cavity is considered a reservoir of associated with gastric infection. It aimed to examine the prevalence of strains from the oral cavity and gastric tissue of patients with different stage of gastric-diseases. Strains were further characterized for virulence genes, adhesion ability, and inflammation responses.
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- - This study investigated the impact of chronic hepatitis B (CHB) on health-related quality of life (HRQoL) across five stages in Thai patients, highlighting differences in health state utilities (HSU) and EuroQol-visual analogue scale (EQ-VAS) scores.
- - Data was collected from 422 patients at a super-tertiary care center, with findings showing that HRQoL decreased significantly as the disease progressed, especially in patients with advanced-/terminal-stage hepatocellular carcinoma (HCC).
- - A strong correlation between HSU and EQ-VAS scores was found, indicating that as patients moved to more severe stages, their quality of life and overall health perceptions declined markedly, with the most affected
Article Synopsis
- Liver transplantation (LT) is the second most common solid organ transplant and is crucial for treating conditions like decompensated chronic liver disease (CLD), hepatocellular carcinoma (HCC), and acute liver failure (ALF).
- The causes of CLD vary by region, with viral hepatitis predominating in the east and alcohol-related liver disease (ALD) in the west, while non-alcoholic fatty liver disease (NAFLD) is rising globally.
- Early detection and management of acute-on-chronic liver failure (ACLF) are essential, as LT remains the most viable treatment for high-risk patients, emphasizing the need for timely evaluations and tailored treatment strategies.
Non-Invasive Serum Biomarkers for the Diagnosis of Cirrhosis in Patients with Autoimmune Hepatitis (AIH) and AIH-Primary Biliary Cholangitis Overlap Syndrome (AIH-PBC): Red Cell Distribution Width to Platelet Ratio (RPR) Yielded the Most Promising Result.
Siwanon Nawalerspanya Jarukit Tantipisit Suraphon Assawasuwannakit Apichat Kaewdech Naichaya Chamroonkul
Diagnostics (Basel)
January 2024
Article Synopsis
- Researchers assessed the accuracy of six non-invasive serum biomarkers for diagnosing cirrhosis in patients with autoimmune hepatitis (AIH) or overlap with primary biliary cholangitis (PBC).
- A retrospective study included 139 adult patients who had liver biopsies, revealing a cirrhosis prevalence of 35.3%.
- The red cell distribution width to platelet ratio (RPR) was found to be the most effective biomarker, with a high diagnostic accuracy, particularly in AIH-PBC overlap patients.
Article Synopsis
- Primary liver cancer can originate from two cell types, leading to different types of tumors: hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICCA), with combined tumors (cHCC-CCA) displaying mixed characteristics.
- Researchers utilized deep learning to categorize tumors in a study involving 405 cHCC-CCA patients, successfully distinguishing between HCC and ICCA types.
- This deep learning method showed potential for enhancing treatment strategies and improving patient outcomes for those with complex liver cancers.
Background/aims: Proton pump inhibitors (PPIs) are frequently prescribed to cirrhotic patients, but there is limited longitudinal evidence regarding their effects. This study aimed to assess the impact of PPIs on adverse events in cirrhotic patients.
Methods: A comprehensive search was conducted using the Medline and Embase databases to identify relevant articles.
Article Synopsis
- The study investigates the long-term risks associated with metabolic dysfunction-associated steatotic liver disease (MASLD) by analyzing data from 129 original studies comparing MASLD patients to those without the condition.* -
- Results indicate that individuals with MASLD have a higher risk of various complications, including cardiovascular issues, metabolic disorders (like diabetes and hypertension), chronic kidney disease, and certain cancers, with those having advanced liver disease at an even greater risk.* -
- The findings highlight the need for comprehensive treatment approaches for MASLD due to its serious multisystem effects on health.*
Article Synopsis
- Patients who stop nucleos(t)ide analogue therapy for chronic hepatitis B risk viral rebound and severe liver flare-ups, requiring close monitoring.
- A study of 475 HBeAg-negative patients found that higher levels of both hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) DNA 24 weeks after stopping treatment are linked to a greater risk of clinical relapse and lower chances of HBsAg loss.
- The study suggests that low levels of HBsAg and HBV DNA at follow-up can predict better outcomes, indicating potential criteria for determining the suitability of patients for finite therapy in hepatitis B treatment.