Characteristics of culture-negative subclinical pulmonary tuberculosis: a single-center observation.

Background: Little is known about culture-negative subclinical pulmonary tuberculosis (TB), and its diagnosis remains challenging. Therefore, this study aimed to identify the characteristics and the extent of disease associated with culture-negative subclinical pulmonary TB.

Methods: This retrospective cohort study was conducted on immunocompetent individuals with subclinical pulmonary TB at a university hospital in Thailand from January 2014 to December 2019.

Safety and efficacy of noninvasive ventilation for acute respiratory failure in general medical ward: a prospective cohort study.

Background: Noninvasive ventilation (NIV) is recommended for use in patients with acute respiratory failure of various etiologies. However, we do not know whether the use of NIV in general medical wards is safe and effective. This study aimed to evaluate the safety and efficacy of using NIV and factors associated with NIV failure in general medical wards.

Epidemiology, clinical characteristics, and treatment outcomes of patients with COVID-19 at Thailand's university-based referral hospital.

Background: The epidemiology and outcomes of COVID-19 patients in Thailand are scarce.

Methods: This retrospective cohort study included adult hospitalized patients who were diagnosed with COVID-19 at Siriraj Hospital during February 2020 to April 2020.

Results: The prevalence of COVID-19 was 7.

Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study.

Objective: To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010.

Methods: This retrospective cohort study enrolled adults with severe ARDS (PaO/FiO ratio of <100 with FiO of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure.

The evolution of diaphragm activity and function determined by ultrasound during spontaneous breathing trials.

Purpose: Rapid shallow breathing index (RSBI) is a commonly used index for predicting the outcome of spontaneous breathing trial (SBT). Ultrasound is a non-invasive technique for assessing diaphragm activity and function. This study aimed to investigate changes in diaphragm activity during SBT, and to compare diaphragm function between patients with and without SBT success.

Radiographic Features for Predicting Smear-Negative Pulmonary Tuberculosis.

Background: Diagnosis of smear-negative pulmonary tuberculosis (TB) in some circumstances remains a challenge to physicians especially those working in limited-resource settings.

Objective: To investigate and examine radiographic characters as a predictor of true diagnosis of pulmonary tuberculosis in patients with negative sputum smears.

Material And Method: This retrospective cross-sectional study was conducted in patients with smear-negative pulmonary TB at Siriraj Hospital between January 2013 and June 2014.

Pathological confirmed diagnosis of asbestosis: the first case report in Thailand.

Asbestosis is an occupational lung disease defined as pulmonary fibrosis caused by asbestos. Asbestosis was previously reported in Thailand based on radiologic findings, which demonstrated interstitial lung with calcified pleural plaques, and the patient worked in a fiber cement factory. However there was some doubt about the diagnosis because clinical and radiological findings are nonspecific; there was no data support of asbestos exposure in the patient and no histologic confirmed diagnosis.

Relationship between emphysema quantification and COPD severity.

Objective: To determine the association between emphysema extent from high-resolution computed tomography (HRCT) and the physiological derangement in patients with chronic obstructive pulmonary disease (COPD).

Material And Method: A cross-sectional study was undertaken to quantify the emphysema severity in 23 COPD patients by automated HRCT scoring techniques. Correlation with phenotypic characters in term of exercise capacity [Modified Medical Research Council (mMRC) dyspnea scale, and 6-minute walk distance (6MWD)], pulmonary function testing [spirometry (forced expiratory volume in 1 second, FEV1 and forced vital capacity, FVC), and diffusing capacity (DLCO)], were then assessed.

Learning environment and resident achievement.

Objective: To evaluate the effect of program training atmosphere on the academic performance among internal medicine residents.

Material And Method: Data of satisfaction survey among internal medicine residents in academic year 2012, conducted by the Royal College of Physicians of Thailand, were retrieved. Association between training environment rating scores in three major aspects (program training structure, faculty nurturance, and support system) and board certifying examination scores, were then assessed.

Clinical features and outcomes of isoniazid mono-resistant pulmonary tuberculosis.

Objective: To determine the characteristics of pulmonary tuberculosis (TB) patients harbored organisms with isoniazid mono-resistant drug susceptibility pattern.

Material And Method: A retrospective review of medical records for all culture-proven adult pulmonary TB patients in Siriraj Hospital between July 2009 and July 2011 was conducted. Demographic data, clinical presentations, and radiological characteristics were recorded and compared between isoniazid mono-resistant and other-resistant groups.

Respiratory health effect of persons accidentally expose to high concentration of chlorine gas.

Objective: To evaluate the short term and long term respiratory health effects of subjects who accidentally exposed to high concentration of chlorine gas.

Material And Method: There was an accidental leakage of sodium hypochlorite from an industrial factory in Rayong province in June 2010. Medical records of those who developed severe symptoms after exposed to high concentration of chlorine gas were reviewed.

Are two sputum samples enough for diagnosing pulmonary tuberculosis.

Objective: To determine the optimum number of sputum specimens for smear and culture in the diagnosis of pulmonary tuberculosis.

Material And Method: A retrospective study was conducted in culture-positive pulmonary tuberculosis patients at Siriraj Hospital during April 2009 to October 2010. Number of sputum specimens and microbiological results were retrieved from the microbiologic laboratory.

Contribution of examiner subjectivity and patient heterogeneity on long case examination.

Objective: To evaluate the effect of examiner subjectivity and heterogeneity among the cases on scores from the Royal College of Physicians (RCPT) long case examination.

Material And Method: Data from internal medicine candidates who performed clinical part of RCPT board certifying examination in academic year 2008 were collected. For each candidate, scores from pair of examiners for each of the long case was stratified based on disease category according to the course syllabus into 3 groups; very common, common and uncommon diseases.

Severe obesity is a risk factor for severe obstructive sleep apnea in obese children.

Objective: To determine the association between degree of obesity and severity of OSA in Thai children

Material And Method: The present retrospective study recruited obese children aged 3 to 15 years who had habitual snoring and underwent polysomnography (PSG) between January 2009 and June 2010. Obesity was defined as percentage of ideal weight for height (%W/H) > or = 120 and was classified as mild (%W/H of 120-139), moderate (140-159), severe (160-199) and morbid (> or = 200). OSA was classified as severe (AHI > or = 10) and non-severe (AHI < 10).

Can we predict final outcome of internal medicine residents with in-training evaluation.

Objective: To assess the predictive value of in-training evaluation for determining future success in the internal medicine board certifying examination.

Material And Method: Ninety-seven internal medicine residents from Faculty of Medicine Siriraj Hospital who undertake the Thai Board examination during the academic year 2006-2008 were enrolled. Correlation between the scores during internal medicine rotation and final scores in board examination were then examined.

Population pharmacokinetic modeling of the association between 63396C->T pregnane X receptor polymorphism and unboosted atazanavir clearance.

Atazanavir (ATV) plasma concentrations are influenced by CYP3A4 and ABCB1, which are regulated by the pregnane X receptor (PXR; NR1I2). PXR expression is correlated with CYP3A4 in liver in the absence of enzyme inducers. The PXR single nucleotide polymorphism (SNP) 63396C→T (rs2472677) alters PXR expression and CYP3A4 activity in vitro, and we previously showed an association of this polymorphism with unboosted ATV plasma concentrations.

Reliability and validity of long case and short case in internal medicine board certification examination.

Objective: To be certified for the Thai Board of Internal Medicine, each candidate must pass both written and clinical examinations performed in different academic years. The present study aimed to assess the reliability and validity of the long case and short case which contribute major fractions in the clinical part of board certifying examination.

Material And Method: Data from 585 internal medicine residents entering a first-attempt clinical part in board certifying examination during the academic year 2005-2007 were collected.

Factors determining the severity of pulmonary function impairment in silicotic patients.

Objective: Silicosis is the most common occupational lung disease in Thailand. Determinants of pulmonary function impairment in Thai silicotic patients have not been mentioned before.

Material And Method: The present study was conducted in silicotic patients who attended the Siriraj Occupational Lung Clinic in the year 2006.

Comparison of clinical and polysomnographic characteristics of non-obese and obese patients with obstructive sleep apnea.

Objective: To compare the clinical features, anthropometric indices, and polysomnographic data between different body mass index (BMI) subgroups of obstructive sleep apnea (OSA) patients.

Material And Method: The authors reviewed the data from OSA patients in Siriraj Sleep Clinic from April 2005 to September 2006. Objective measurement for sleepiness (Epworth Sleepiness Scale, ESS), anthropometric measurements [body mass index (BMI), neck circumference, thyromental distance, Mallampati S score, and occlusion pattern] and polysomnographic recordings [apnea/hypopnea index (AHI) during REM and NREM periods, respiratory arousal index, periodic leg movement index, minimal oxygen saturation, total sleep time with oxygen saturation <90%, and desaturation index] were collected.

Recovery of heart rate variability in patients with moderate to severe obstructive sleep apnea after 6-month continuous positive airway pressure treatment.

Objective: To evaluate the effect of long-term treatment with continuous positive airway pressure (CPAP) on the heart rate variability (HRV) of obstructive sleep apnea (OSA) patients.

Material And Method: Patients with moderate to severe OSA who had never used CPAP treatment were enrolled. Short recording HRV analysis was performed at baseline then at one, three, and six months after CPAP treatment.

NRAMP1 and TNF-alpha polymorphisms and susceptibility to tuberculosis in Thais.

Objective And Background: Polymorphisms in the natural resistance-associated macrophage protein gene 1 (NRAMP1) and tumour necrosis factor (TNF)-alpha gene have been found to be associated with susceptibility to tuberculosis in different populations. However, the results are inconsistent. This study aimed to determine whether NRAMP1 and TNF-alpha variants are associated with tuberculosis in Thais.

HRCT of pulmonary tuberculosis mimics malignancy: a preliminary report.

Objective: To evaluate potential predictors of high resolution CT (HRCT) findings of pulmonary mass caused by tuberculosis (Tbc).

Material And Method: A retrospective study of chest HRCT was performed in 10 patients diagnosed as pulmonary Tbc. The size, characteristics of lesions, enhancement and mediastinal lymphadenopathy were interpreted.

Prevalence of bronchial hyperresponsiveness and asthma in the adult population in Thailand.

Objectives: We conducted a nationwide cross-sectional survey of respiratory health in adults aged 20 to 44 years during 2001 to 2002 to determine the prevalence of bronchial hyperresponsiveness (BHR) and asthma in the adult Thai population.

Design: Subjects were selected by a multistage stratified random sampling. The stratification was done on geographic area, age group, and sex.

Tumor necrosis factor-alpha gene promoter polymorphism is not associated with smoking-related COPD in Thailand.

Objective: Susceptibility to COPD is, in part, genetically determined. Tumour necrosis factor (TNF)-alpha gene promoter polymorphisms have been investigated in different populations with inconsistent results. This study aimed to determine the genetic predisposition in Thai smoking-related COPD patients.