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Biomedical subjects

Chitsanu Pancharoen

Publications and source records attributed to Chitsanu Pancharoen.

At least 19 recordsLinked to original sources
PubMed2006

Use of taste-masking product, FLAVORx, to assist Thai children to ingest generic antiretrovirals.

We evaluated whether FLAVORx helped thirty Thai children take opened capsule, crushed tablets and liquid generic ARVs with more ease. All children had excellent adherence, evaluated by PACTG Standard International Questionnaire and interviewing, before and after one month of FLAVORx. Eighty percent took ARV with more ease and wish to continue FLAVORx. Strawberry was the most popular flavor.

Journal Article↗
PubMed2006

Effects of highly active antiretroviral therapy (HAART) on psychomotor performance in children with HIV disease.

OBJECTIVE: This study assesses the effects of HAART on psychomotor performance of symptomatic HIV-infected children. It is one of the first studies to look at neurobehavioral functioning in children infected with HIV in resource-limited countries. DESIGN: A longitudinal pilot study of vertically HIV-infected children at the HIV Netherlands Australia Thailand Research Collaboration Center in Bangkok, Thailand. METHODS: A total of 34 children participated in the study of whom 16 had never received antiretroviral (ARV) therapy and were about to start HAART (Newly treated children), 7 did not receive antiretroviral therapy (Untreated children) and 11 had been treated with HAART for more than one year (HAART experienced children). All children were administered 4 psychomotor tasks at baseline and after 4 months. The Newly treated and the Untreated children were also evaluated after 12 months. RESULTS: In general, the children performed similarly on all psychomotor tasks at baseline. After 12 months of HAART, there was a significant increase in CD4% in the Newly treated group. Overall, psychomotor performance did not change at the 4-month evaluation in all groups. At the 12-month evaluation psychomotor performance had deteriorated substantially on all tasks in both the Newly treated and the Untreated children. CONCLUSIONS: There was no significant difference in psychomotor functioning between children newly treated, previously treated and untreated with HAART over the course of one year. Psychomotor performance deteriorated after 12 months of HAART, which provides important indications concerning the lack of benefits of HAART on psychomotor functions in children despite immunologic reconstitution. Further research with larger sample sizes is needed to confirm these findings.

Analysis of Variance↗
PubMed2005

Reduced-dose intradermal vaccination against hepatitis A with an aluminum-free vaccine is immunogenic and can lower costs.

A reduced dose (0.1 mL) of intradermal hepatitis A virus (HAV) vaccine could facilitate the control of hepatitis A in countries of endemicity. All study subjects receiving an aluminum-free HAV vaccine intradermally were seroprotected 28 days after vaccination (anti-HAV titer, > or =10 mIU/mL). Seroprotection rates decreased to 80.8% at 12 months but returned to 100%, with titers increasing 28-fold, after receipt of a booster vaccination.

Adolescent↗
PubMed2005

Pharmacokinetics and 24-week efficacy/safety of dual boosted saquinavir/lopinavir/ritonavir in nucleoside-pretreated children.

OBJECTIVE: To assess the pharmacokinetics and 24-week efficacy and safety of dual boosted saquinavir/lopinavir/ritonavir combination in children. DESIGN: Twenty reverse transcription inhibitor-pretreated children at 2 centers in Thailand were treated with saquinavir/lopinavir/ritonavir in an open label, single arm, 6-month prospective study. The dosage was 50 mg/kg twice daily (bid) for saquinavir and 230/57.5 mg/m bid for lopinavir/ritonavir. Ten children also received lamivudine. METHODS: Samples were collected for a 12-hour pharmacokinetic profile in all children. Plasma concentrations of saquinavir, lopinavir and ritonavir were determined using a validated high performance liquid chromatography technique. RESULTS: At baseline, the median age was 8.5 years, with human immunodeficiency virus (HIV) RNA 4.9 log10 copies/mL, CD4 count 129 cells/microL and CD4%, 6.5%. Median area under the concentration curve at 0-12 hours and Cmin were 39.4 mg/L.h and 1.4 mg/L for saquinavir and 118 mg/L.hr and 5.9 mg/L for lopinavir. After 24 weeks of treatment, HIV RNA was suppressed below 400 copies/mL for 16 of 20 (80%) children (intent-to-treat analysis) and below 50 copies/mL for 12 of 20 children (60%), and CD4% (count) rose by a median of 6% (216 cells/microL). Median changes of triglyceride and total cholesterol were 56 and 36.5 mg/dL, respectively (P = 0.01). Lopinavir Cmin <1 and saquinavir Cmin <0.28 mg/L correlated with HIV RNA >400 copies/mL, and lopinavir Cmax >15 mg/L correlated with rises in cholesterol (P < 0.05). CONCLUSION: Plasma drug concentrations of saquinavir, lopinavir and ritonavir were at the higher limits of expected ranges for adult treatment at approved dosages (1000/100 mg bid for saquinavir, 400/100 mg bid for lopinavir/ritonavir). The regimen was well-tolerated and had good efficacy at 24 weeks. This dual boosted protease inhibitor combination should be assessed in larger trials of reverse transcription inhibitor-experienced children.

Anti-HIV Agents↗
PubMed2005

Hospital-based epidemiologic survey of malignancies in children infected with human immunodeficiency virus in Thailand.

To determine the incidence and spectrum of malignancies in human immunodeficiency virus-infected children, we surveyed 48 hospitals in Thailand between 1996 and 2000. There were 23 children (14 boys and 9 girls; average age at diagnosis of malignancy, 4.2 years), and the incidence rate was 0.6 per 1000 person-years. The most common malignancy was lymphoma (87.0%). The prognosis was poor.

AIDS-Related Opportunistic Infections↗
PubMed2005

Serum and urine sodium levels in dengue patients.

We evaluated serum and urine sodium levels in children with dengue infections. Children with acute febrile illness admitted to Bhumibol Adulyadej Hospital in Bangkok from January 1999 to January 2000 were enrolled. Serum and urine sodium levels were measured before initiating intravenous fluid therapy. Two milliliters of blood were obtained on admission and before discharge to test for anti-dengue virus antibody using the enzyme-linked immunosorbent assay technique. Hyponatremia was defined as a serum sodium level <130 mEq/l and depletion of circulatory volume was defined as a urine sodium level < 20 mEq/l. Out of 93 enrolled patients, 49 were categorized as dengue patients and 44 were as non-dengue patients. Six dengue patients developed shock whereas 43 patients did not. The mean serum sodium level was significantly lower in dengue patients compared to non-dengue patients (p-value < 0.0001). Hyponatremia was 9.7 times more common in dengue patients. Among dengue patients, the mean serum sodium level was significantly lower in shock patients compared to non-shock patients (p-value = 0.003). However, the prevalence of hyponatremia was not different between the two groups. The mean urine sodium level was significantly lower in dengue patients compared to non-dengue patients (p-value < 0.0001). A urine sodium level < or = 20 mEq/l was 8.1 times more common in dengue patients. Among dengue patients, the mean urine sodium level was not significantly different between shock and non-shock patients. In shock patients, a urine sodium level < or = 20 mEq/l was 7.6 times more common.

Acute Disease↗
PubMed2005

Concomitant dengue infection and Kawasaki disease in an infant: a case report and literature review.

A previously healthy 11-month-old girl presented with fever and rash for 6 days. Physical examination revealed an irritable infant with a high fever, injected conjunctivae, red cracked lips, posterior auricular lymphadenopathy, hepatomegaly, generalized erythematous maculopapular rash and petechial hemorrhage on trunk, face and extremities. Complete blood count showed atypical lymphocytosis and thrombocytopenia. Dengue infection was initially diagnosed. The persistent fever and clinical manifestations of Kawasaki disease (KD) were observed on day 8 with high erythrocyte sedimentation rate (56 mm/hr). Treatment of KD included intravenous immunoglobulin on day 9 of the illness. Desquamation of the fingers was found on day 15 of the illness. Ectasia of left coronary artery with small aneurysmal dilatation was detected by echocardiography on day 15 of the illness. Hemagglutination-inhibition test and enzyme-linked immunosorbent assay for dengue virus eventually showed a four-fold rising. According to the literature review, this is the second reported case of dengue infection concomitant with KD. The natural course of each disease may be modified and causes some difficulties in diagnosis and management.

Dengue↗
PubMed2005

Childhood shigellosis at King Chulalongkorn Memorial Hospital, Bangkok, Thailand: a 5-year review (1996-2000).

The objective of this study was to evaluate the demographic data and clinical presentation of childhood shigellosis, and to study the microbiological data and antimicrobial susceptibilities of Shigella spp. Nine thousand nine hundred fourteen stool culture specimens from children aged 0-15 years who were treated at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 1996 and 2000 were retrospectively reviewed. Data were collected from microbiological records and medical charts of childhood shigellosis in terms of demographic data, symptoms, signs, and complications of the patients, and the species and antimicrobial susceptibilities of the organisms. The data were analyzed in terms of means, ranges, and percentages. Of 1,523 children whose stool cultures were positive for pathogenic bacteria, 80 (5.3%) were infected with Shigella spp; 34 females and 46 males. The age distribution ranged from 1 day to 13 years with a mean age of 3.6 years. Common clinical presentations included diarrhea (96.6%), fever (77.6%) and vomiting (44.8%); seizures were the most common complication found (27.6%). Watery and mucous were the most common characteristics of stools. The major Shigella spp found was S. sonnei (62.8%), which was susceptible to co-trimoxazole, ampicillin, cefazolin and ciprofloxacin in 2.3, 84.1, 100 and 100%, respectively. A short course of quinolones or oral cephalosporins should be recommended for the treatment of childhood shigellosis in areas with low susceptibility rates to co-trimoxazole and ampicillin.

Adolescent↗
PubMed2005

The prevalence of varicella-zoster virus infection in normal healthy individuals aged above 6 months.

The prevalence of varicella-zoster virus (VZV) infection was studied by determining the presence of IgG antibody to VZV (anti-VZV IgG) using ELISA method. Three hundred and fifty sera collected from Thai healthy individuals aged above 6 months (mean age +/- standard deviation = 14.9 +/- 11.4) were tested, the prevalence of VZV infection was 64.6% (225/350). All samples were randomly sampling from healthy children and blood donors who visited the hospital and clssified into 7 groups, 50 samples each, according to their age, i.e., group 1; 6 months-3 years, group 2; 4-6 years, group 3; 7-9 years, group 4; 10-14 years, group 5; 15-19 years, group 6; 20-24 years and group 7; above 25 years. The prevalence of VZV infection were 12%, 42%, 64%, 70%, 78%, 84% and 100% respectively. The mean amount of anti-VZV IgG among groups of positive VZV infection (225 samples) was 86.8 +/- 29.7 unit/ml. The mean amount of anti-VZV IgG was highest in 6 months-3 years age group (113.6 +/- 39.2 unit/ml). Significant difference of the mean amount of anti- VZV IgG was found between group 1, 3, 6 and other groups (p-value < 0.05). There was a correlation between history of varicella and the presence of anti-VZV IgG in the serum. 95.3% of individuals with positive history has already had the antibody. The important associated factors that might involve VZV infection were age, number of members in family and place of exposure to VZV infection. Other factors, such as sex and income did not show any association to VZV infection.

Adolescent↗
PubMed2004

Resistance to dual nucleoside reverse-transcriptase inhibitors in children infected with HIV clade A/E.

The prevalence of nucleoside reverse-transcriptase inhibitor (NRTI) mutations was determined among 95 human immunodeficiency virus-infected Thai children who were treated with dual nucleoside reverse-transcriptase inhibitors. Almost all children had resistance to at least 1 NRTI, and approximately half of the children had resistance to multiple NRTIs. Cross-resistance to stavudine and azidothymidine was universal.

Child↗
PubMed2004

Post-operative meningitis caused by drug-resistant Streptococcus pneumoniae: two case reports.

We report 2 patients with post-operative meningitis caused by drug-resistant Streptococcus pneumoniae (DRSP), following correction of frontoethmoidal encephalomeningocele in 1 patient and adenotonsillectomy in the other. Both patients responded well to vancomycin plus cefotaxime. DRSP may be colonized in the upper respiratory tract and causes serious infections after surgical operation.

Anti-Bacterial Agents↗
PubMed2004

Immunization for persons infected with human immunodeficiency virus.

Immunization is an important measure to protect HIV-infected children and adults against certain vaccine preventable diseases. However, the antibody response, which is associated with the level of CD4+ T cell count, is frequently impaired in this group of patients. Certain vaccines enhance virus replication and transiently increase HIV viral load. Theoretically, vaccination should be given before the immune status of the patients is suppressed. Inactivated vaccines are generally safe and are beneficial for HIV-infected patients. These vaccines should be administered at appropriate age recommended for immunocompetent individuals. Live vaccines should be used with caution since some of the vaccines may be harmful to patients with severe immunologic suppression. Recommendations for immunization in HIV-infected patients may differ from country to country, depending on the availability and affordability of each vaccine, and the prevalence of each preventable disease. Vaccine trial in HIV-infected patients is needed in order to establish the most appropriate vaccine recommendation for this group of patients.

Adult↗
PubMed2004

A phase IV open label study to assess the safety, tolerability and immunogenicity of a Haemophilus influenzae type B (Hib) CRM197 conjugated vaccine administered to healthy infants at 2, 4, and 6 months of age.

The objective of this prospective clinical study was to evaluate the safety, tolerability and immunogenicity of Chiron Hib vaccine (Vaxem Hib) in Thai infants. This trial was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand from June to November 1999. Three intramuscular injections of the vaccine were given to 119 infants at 2, 4 and 6 months of age. Reactions and adverse events after the vaccination were recorded. Blood samples for anti-PRP antibody were collected before the first immunization, and after the second and third immunizations. After the second dose, 91% and 58% of the subjects had anti-PRP antibody titers of > or =0.15 microg/ml and > or =1.0 microg/ml, respectively. After the third dose, 99% and 90% of the subjects had anti-PRP antibody titer > or =0.15 mcirog/ ml and > or =1.0 microg/ml, respectively. Local and systemic reactions were mild and transient. The study indicates that Vaxem Hib vaccine is safe and well tolerated. Three doses of the vaccine are necessary to achieve adequate protection in infants.

Antibodies, Bacterial↗
PubMed2004

Hospital-based epidemiology of childhood cholera: a 6-year review in a university hospital in Bangkok, Thailand.

BACKGROUND: Cholera is the cause of severe acute watery diarrhea. Without proper fluid therapy, severe cholera kills half of the affected patients. In terms of epidemiology and surveillance, up-to-date information of this disease in each country is essential. OBJECTIVES: To evaluate 1) prevalence, serogroups, serotypes and antimicrobial susceptibility pattern of V cholerae, and 2) demographic data and clinical manifestation of pediatric patients with cholera. MATERIAL AND METHOD: Microbiogical records of children aged 0-15 years with cholera, who were treated at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between January 1995 and December 2000 were retrospectively reviewed Serogroups, serotypes, and antimicrobial susceptibility of V. cholerae were studied Medical records of children with positive stool cultures for V. cholerae were reviewed in terms of demographic data, clinical manifestation of the patients. RESULTS: Of 11,709 stool culture specimens, pathogenic bacteria were found in 1,745 specimens and 95 specimens (5.4%) were positive for V. cholerae. V. cholerae O1 and non-O1/non-O139 were found in 52.6% and 47.4%, respectively. Common serotypes of V. cholorae O1 were Ogawa. Antimicrobial susceptibility of the pathogens to co-trimoxazole, ampicillin, ceftriaxone, ciprofloxacin and gentamicin were 55.0%, 56.4%, 91.4%, 92.5% and 94.9%, respectively. Age distribution of the patients ranged from 2 months to 15 years with an average age of 2.92 years. Clinical manifestations included acute watery diarrhea (92.8%), vomiting (56.4%), fever (37.5%), hypotension (19.6%) and abdominal pain (3.8%). Stool leukocytes were microscopically detected in 20% of the patients. No patients died in the present study. CONCLUSION: Childhood cholera in Thailand still exists. Most patients presented with acute watery diarrhea. Regarding antimicrobial susceptibility pattern, ceftriaxone and quinolones are appropriate drugs of choice.

Adolescent↗
PubMed2003

Hemodynamic profiles of patients with dengue hemorrhagic fever during toxic stage: an echocardiographic study.

OBJECTIVE: To study left ventricular performance and hemodynamic abnormalities during different stages of dengue hemorrhagic fever (DHF). DESIGN AND SETTING: Observational study in a tertiary medical school hospital. PATIENTS: Twenty-four patients with serologically confirmed diagnosis of dengue virus infection and DHF according to the WHO criteria. METHODS: Echocardiography was performed during toxic, convalescent stages and at least 2 weeks after discharge (recovery). Left ventricular ejection fraction, rate-corrected velocity of circumferential fiber shortening adjusted for end-systolic meridional wall stress (VCFC/ESS) Z score, end-diastolic volume Z score, cardiac index, heart rate, mean arterial pressure, and total systemic vascular resistance (SVR) were compared between different stages of DHF. RESULTS: Ejection fraction and VCFC/ESS were significantly lower during the toxic stage than after recovery. End-diastolic volume was low during toxic stage and returned to normal during convalescence and recovery. Cardiac index was low during the toxic stage due to decreased preload (low end-diastolic volume) and depressed left ventricular ejection fraction. Cardiac index remained subnormal during convalescence due to sinus bradycardia. Wide variation in heart rate during toxic stage resulted in a small, nonsignificant increase compared to recovery. With treatment, heightened SVR resulted in relatively normal mean arterial pressure throughout the course of the illness. CONCLUSIONS: The mechanism of decreased cardiac output during toxic stage of DHF is complex. Decreased preload is accompanied by decreased left ventricular performance, and possibly a subnormal heart rate response in some patients.

Analysis of Variance↗
PubMed2003

Preventive strategies of perinatal HIV-1 transmission: an experience from Thailand.

There are at least 6 million people in the Asia-Pacific region living with HIV/AIDS. The number of HIV-1 infected women and children is increasing. Important components in order to prevent perinatal HIV-1 transmission include counselling, HIV testing, family planning, obstetric care, antiretroviral agents and avoidance of breast feeding. Zidovudine or nevirapine used as monotherapy or in combination with other antiretroviral agents are recommended as a standard of care in the prevention of perinatal HIV-1 transmission. Each country needs to have its own data concerning HIV/AIDS epidemiology, and the infrastructure and resources to select appropriate strategies in reducing the perinatal HIV-1 transmission rate.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Efficacy and safety of meropenem as an empirical treatment for febrile neutropenia in children with cancer.

Meropenem is a promising carbapenem antibiotic as an empirical monotherapy in patients with febrile neutropenia (FN). With the limited data of the therapy in pediatric patients, the authors conducted this study to evaluate the efficacy and safety of meropenem as empirical antibiotic therapy in 30 pediatric cancer patients with FN (mean age = 7.5 years), who were admitted to King Chulalongkorn Memorial Hospital from May 2000 to December 2001. Meropenem 60 mg/kg/day was given intravenously every 8 hours. The efficacy of meropenem was assessed as successful, inconclusive and failure on days 3 and 5 of the therapy and compared to that of other empirical antibiotics used from January 1997 to April 2000. The study showed that six blood culture specimens (20%) grew organisms, half of which were considered to be contaminants, and six urine culture specimens (20%) grew gram negative rod bacteria. On day 3 and 5 of the therapy, the success rate of meropenem was higher than that of comparatives (30.0% vs 17.6% on day 3, 50.0% vs 39.3% on day 5). The use of meropenem appeared safe, with minimal side effects. In conclusion, the present study showed that meropenem was safe and tolerable in children. The efficacy as an empirical monotherapy in pediatric cancer patients with FN was satisfactory, with a failure rate of 23.3 per cent on day 5 of treatment.

Adolescent↗